17439	----	Skin, Inflammation of the 62 Skin, Inflammation of the (Herb Remedies) 412 Skinner's Dandruff Cure 485 Sleep 603 Sleeplessness 299 Sleeplessness (Herb Remedies} 426, 430, 439 Smallpox, Diagnosis of 4 Smallpox 201 Causes 201 Symptoms 201 Eruptions 201 Confluent Form 201 Varioloid 201 Treatment 202 Diet 202 Nursing 202 General Rule for Disinfection 203 Hands, Body, etc 203 Vaccination and Re-vaccination and its Prevention of Smallpox 203 A Good Time to be Vaccinated 203 Why Vaccinate? 203 Smallpox entirely prevented by re-vaccination 204 Who Should Be Vaccinated 204 Who Should Not Be Vaccinated 205 When Should a Person be Vaccinated? 205 Vaccination after Exposure to Smallpox 205 With what should one be vaccinated? 206 Where Vaccination Should Be Performed? 206 After Vaccination 206 Common Appearances after Vaccination 206 What to do during and after Vaccination? 207 Make a Record of your Vaccination? 207 Lives Saved from Smallpox in Michigan 207 Smith's Electric Oil 470 Smooth Tonsilitis, Diagnosis of 5 Snake Bites 377 Symptoms of a Snake Bite 378 Treatment 378 First thing to do 378 Mothers' Remedies (Unclassified) 680 1. Simple Poultice for 680 2. Onions and Salt for 681 Snake Bite (Herb Remedies) 434 Soda (Medical Use) 669 Salt Water Bath, Tonic Action 630 Softening of the Brain 298 Soft Diet 644 Soothing Syrup, Overdose of 622 Sore Eyes (Rare Prescription) 470, 549 Mothers' Remedies (Unclassified) 681 1. Camphor and Breast Milk for 681 Sore Mouth, Canker 97 Sore Mouth, Canker (Herb Remedies) 410, 420, 442, 444 Sore Throat 21 Symptoms 21 Chronic 21 Prevention of the Chronic Kind 21 Prevention of the Acute Kind 21 Mothers' Remedies 21 1. Used for Years Successfully 21 2. Splendid Liniment for 22 3. Simple Gargle for 22 4. Home Made Salve for 22 5. Cold Packs Sure Cure for 22 6. Ointment for 22 7. Remedy from a Mother in Johnson City, Tenn 22 8. Gargle and Application for 23 9. Vinegar Gargle for 23 10. Alum and Vinegar for 23 11. Kerosene for 23 12. Remedy always at hand 23 13. Simple Remedy for 23 Physicians' Treatment for Sore Throat 23 1. Inhalation of Steam 23 2. Sulphur and Cream for 23 3. Good Old Mothers' Remedies 23 1. Physicians' Local Treatment 24 2. When the Attack is Mild 24 3. I like the following at the beginning 24 4. For Chronic Catarrh 24 5. Other Gargles 24 6. Snuff 24 Mothers' Remedies (Unclassified) 681 1. Mustard Plaster for 681 Sore Throat (Herb Remedies) 418, 420, 431, 434, 442 Sore Throat (Rare Prescription) 475 Sores or Ulcers 72 Sores or Ulcers (Herb Remedies) 410, 412, 413, 416, 431, 434, 447 Southern Cholera Cure 483 Spasms 542, 616 Spasms (Herb Remedies) 420, 432 Spasmodic Asthma 37 Spasm of the Glottis 26 Special Diseases 265 Spice Plaster 635 Spice Poultice 634 Spice Poultice from a Stanlyton, Va., Mother 634 [938 MOTHERS' REMEDIES] Spinal Cord, Injuries of 303 Causes 303 Symptoms 303 Treatment 303 Traumatism of the Cord 303 Symptoms 303 Recovery 304 Treatment, Immediate 304 Spinal Cord, Organic Diseases of 304 Spine, Concussion of the 303 Splinters 621 Splinter, to Extract 682 Splints 381 Spoiled Foods, Poison by 407 Sponge Bath 630 Spots, Liver 61 Spotted Fever, Diagnosis of 4 Sprains 383 Sprains (Herb Remedies) 410 Squint 356 Internal or Convergent Squint 356 External or Divergent Squint 356 Causes of Convergent (Internal) Squint 356 Treatment 356 External (Divergent Squint) 356 Squint, Operation for 664 Stab Wounds 303 Stammering 301 Mothers' Remedies 301 1. Easy Cure for 301 Mothers' Remedies (Unclassified) 681 1. Canadian Mother's Treatment for 681 Physicians' Treatment 301 Starch Bath 630 Starch and Laudanum 641 Starch Poultice 632 Steatoma 85 Sterilization 624 Sterilized Milk 593 Sterilizing, A Simple Method of 593 Stiff Neck 324 Stimulant (Herb Remedies) 433 Stings 379 Mothers' Remedies 379 1. Leaves of Geranium Good for Bee or Wasp 379 2. Simple Remedy for 379 Mothers' Remedies (Unclassified) 681 1. Old Tried Canadian Remedy for 681 2. From Nettles 681 Stings (Herb Remedies) 412, 443 Stomach, Bleeding from 107 Stomach, Cancer of the 106, 334 Stomach Headache 270 Stomach, Neuralgia of the 107 Stomach, Operation for 665 Stomach, Acute Inflammation of the 111 Stomach Trouble 103 Stomach Trouble (Herb Remedies) 439, 442, 443 Stomach, Diagnosis of Ulcer of the 5 Stomatitis Aphthous 97 Stomatitis, Gangrenous 99 Strabismus 356 Strychnine, Poison by 407 Stye 348 Causes 348 Symptoms 348 Course 348 Mothers' Remedies 348 1. Home Method to Kill 348 Mothers' Remedies (Unclassified) 681 1. Common Tea Leaves for 681 Treatment 349 Suffocated, Treatment of 397 Sugar, Kind to Use 578 Sulphuric Acid, Poison by 407 Sulphur (Medical Use) 670 Summer Complaint, Prepared Flour for 648 Sunburn 90 Mothers' Remedies 91 1. Lemon Juice and Vinegar for 91 2. Ammonia Water for 91 3. Relief from Pain and Smarting of 91 4. Preparation for 91 Physicians' Treatment 91 1. For Sunburn 91 2. For Sunburn 91 3. The following is a good combination 91 Sunstrokes 375 Symptoms 375 Prognosis 376 Mothers' Remedies 376 1. Quick Method to Relieve 376 Treatment 376 For Severe Cases 376 Medicine 376 Sunstrokes and Intoxicants (Chapter) 371 Superficial Felons 70 Suppurative Tonsilitis 190 Sweating, to Cause (Herb Remedies) 441, 443, 444 Mothers' Remedies (Unclassified) 681 1. Sweating, to Cause 681 2. Another 682 Sweating, Excessive 75 Symptoms 75 Causes 75 Treatment 75 Application for the Local Treatment 75 White Oak Bark for 75 Sweating, Excessive (Herb Remedies) 426, 432, 434 Sweating, Foul 57 Symptoms 57 Mothers' Remedies 57 1. Alum Water for 57 2. Borax and Alcohol for 57 3. Simple Home Remedy for 57 Physicians' Treatment 57 1. Dressing Powders 57 2. Boric Acid, powdered, may also be used 57 3. Dusting Powder 57 4. One per cent Solution 58 Sweat, Lessened Secretion of 57 Sweats, Night 44 Swellings (Herb Remedies) 429, 443 Swelling of the Glottis 26 Symptoms 26 Sympathetic Inflammation of the Eye 334 Sympathetic Ophthalmia 354 Syphilis 415 Syphilis (Herb Remedies) 415, 429, 434, 435, 436, 438, 440 Syrup of Figs 485 Table 636 Taenia Saginata 48 Taenia Solium 48 Talipes 370 Tape Worm 48 Tape Worm (Rare Prescription) 483 Tapioca Jelly 652 Tartar Emetic, Poison by 407 Taste 307 Taste Buds 307 Taste Buds, Plate of 308 Teeth 563 Teething 560, 618 Tegumentary (Skin) Leprosy 238 Temperature (Fever) Under the Tongue, Arm-pit 642 Temperature of the Room 624 Tetanus 231 Tetter, Dry 63 [MEDICAL INDEX 939] Tetter, Humid 63 Things in the Ear 395 Things in the Nose 396 Thomas's Electric Oil 486 Thread Worm 46 Throat, Sore 21 Throat, Sore (Herb Remedies) 418, 420, 425, 431, 434, 437, 442, 444 Thrush 551 Thumb, Dislocation 380 Thyroid Gland, Diseases of 258 Symptoms 258 Treatment 258 Thyroiditis 258 Tic Doloureux 265 Tickling in Throat 25 Tinea Trichophytina 86 Tobacco, Poison by 407 Toe-Nail, Ingrowing 395 Tongue, The 642 Ulcers 643 High Fever 643 Dark Brown or Blackish Coating 643 Strawberry Tongue 643 Cankered Tongue 643 Cholera Infantum 643 Constipation 643 Biliousness 643 Tonic (Herb Remedies) 424, 425, 428, 432, 444, 445 Tonic, General (Rare Prescription) 475 Tonsilitis, Diagnosis of 5 Tonsilitis, Acute 187 Follicular, Inflammation of 187 Causes 187 Symptoms 187 Diagnosis Between Acute Tonsilitis and Diphtheria 188 Mothers' Remedies 188 1. Raw Onion for 188 2. Peppermint Oil good for 188 3. Borax Water for 188 4. Salt and Pepper with relieve 188 5. Peroxide of Hydrogen will cure 188 6. A Remedy Effective for 188 Physicians' Treatment for Tonsilitis 189 1. Home Treatment 189 2. Smartweed 189 3. Salt Pork for 189 4. Liniment 189 5. Internally 189 6. Hot Water 189 7. Thyme 189 8. Steaming with Compound Tincture of Benzoin 189 9. For the Pain 189 10. Medicines, Parke, Davis & Co., Anti-Tonsilitis Tablet No. 645 is very good 190 11. Aspirin 190 12. Dr. Hare of Philadelphia 190 Tonsilitis, Suppurative 190 Tonsils, Operation for 665 Tonsil, Pharyngeal 8 Toothache 119 Mothers' Remedies 119 1. Dry Salt and Alum for 119 2. Oil of Cloves quick relief for 119 3. Home Made Poultice for 119 4. Clove Oil and Chloroform 119 5. Sure Cure for 119 6. Salt and Alum Water for 119 7. Oil of Cinnamon for 119 8. Reliable Remedy for 119 9. From Decoyed Teeth 120 Mothers' Remedies (Unclassified) 682 1. Benzoin for 82 2. Oil of Cinnamon for 682 Physicians' Treatment 121 Toothache (Herb Remedies) 418 Toothache (Rare Prescription) 483 Tooth Powders 120 Mothers' Tooth Powders 120 1. The Ashes of Burnt Grape Vine 120 2. Tooth Powder 120 3. Tooth Powder 120 4. Tooth Powder 120 5. Tooth Wash 120 6. Commonly Used 120 Torticollis 323 Tracheotomy and Intubation, Operation for 664 Traumatism of the Cord 303 Symptoms 303 Recovery 304 Treatment, Immediate 304 Tremens, Delirium 372 Trichiniasis 50 Modes of Infection 51 Symptoms 51 Physicians' Treatment 52 Tricuspid Stenosis (narrowing) 344 Recovery 344 Treatment: (a) While Compensated 344 (b) The Stage of Broken Compensation 344 Tricuspid (Valve) Insufficiency 344 Cause 344 Trifacial Neuralgia 265 Tub Bath (common) 631 Tuberculosis of the Lungs, Diagnosis of 5 Tuberculosis 211 Forms-The Lungs 211 Ordinary Consumption 211 1. Acute Miliary Tuberculosis 211 (a) Acute General Miliary Tuberculosis 211 (b) Pulmonary (Lung) Type 211 (c) Tubercular Meningitis 211 2. Tuberculosis of the lymph nodes (glands) 212 3. Tuberculous Pleurisy 212 4. Tuberculous Pericarditis 212 5. Tuberculous Peritonitis 212 6. Tuberculosis of the Larynx 212 7. Acute Pneumonia (Pulmonary Tuberculosis) or Galloping Consumption 212 8. Chronic Ulcerative Pulmonary Tuberculosis 212 9. Chronic Miliary Tuberculosis 212 10. Tuberculosis of the Alimentary Canal 212 11. Tuberculosis of the Brain 212 12. Tuberculosis of the Liver, Kidneys, Bladder, etc 212 13. Tuberculosis of Joints 212 Mesenteric Kind 212 Mothers' Remedies 212 1. Simple Home Method to Break Up 212 2. Physicians' Treatment 212 Physicians' Treatment for Consumption 213 Sanitary 213 Prevention of Tuberculosis 213 Second 213 Individual Prevention 213 General Measures 214 At Home 214 Diet-Treatment 214 Diet in Tuberculosis Furnished by a Hospital 214 May Take 214 Must Not Take 214 What every person should know about Tuberculosis, whether he has had the disease or not 214 Tuberculosis (Herb Remedies) 437 Tuberculosis Patients, How to Treat the Sputum from 627 Tuberculosis, Cervical 212 [940 MOTHERS' REMEDIES] Tuberculated Leprosy 238 Tubercular Meningitis 210 Tubercular Peritonitis 134 Tuberculous Tumors 297 Tumors 336 A Benign Tumor 336 A Malignant Tumor 336 Some Varieties 336 Malignant Sarcoma (Sarcomata) 336 Diagnosis 337 Treatment 337 Tumors (Herb Remedies) 412, 434, 447 Tumors of the Brain 296 Causes-Predisposing 296 Gumma 296 Tuberculous Tumors 297 Glioma 297 Sarcoma and Cancer 297 Symptoms 297 Treatment 297 For Headache 297 For Vomiting 297 Tumor of the Nose 19 Turpentine (Medical Use) 670 Turpentine and Mustard Stupes 635 Turpentine Stupes 634 Typhoid Fever, Diagnosis of 5 Typhoid Fever 195 Cause 195 Symptoms 196 Time 196 Incubation 196 First Week 196 Second Week 196 Third Week 196 Fourth Week 197 Special Symptoms and Variations 197 Walking Type 197 Digestive Symptoms 197 Diarrhea 107 Perforation of the Bowel 197 Treatment 197 Prevention 197 Sanitary Care 197 Sanitary Care of the Household Articles 198 Diet and Nursing in Typhoid Fever 198 Cold Sponging 199 The Bath 199 Medical Treatment 199 Management of the Convalescent 199 Typhus Fever 200 Symptoms 200 Eruptions 200 Fever 201 Treatment like Typhoid 200 Ulcers 72 Causes 72 Treatment 72 Chronic Ulcer 72 Mothers' Remedies 72 1. The Potato Lotion for 72 2. Chickweed Ointment for 72 3. Healing Ointment for 72 4. Excellent Salve for 72 5. An Old German Remedy for 72 6. An Antiseptic Wash for 72 7. Chickweed and Wood Sage Poultice for 73 8. Blood Root and Sweet Nitre for 73 9. A Good Combination for 73 10. A Four Ingredient Remedy for 73 11. Carrots will heal 73 12. A Remedy that Cures 73 13. Bread and Indian Meal for 13 Physicians' Treatment for Ulcers 73 Balsam of Peru is good for 74 A Salve 74 Poultice 74 Indolent Sluggish Ulcer 74 Poultice for 74 Ulcers (Herb Remedies) 410, 412, 413, 416, 431, 434, 447 Ulcer of the Cornea, Diagnosis of 5 Ulcer of the Cornea 351 Ulcer of the Stomach, Diagnosis of 5 Ulcer of the Stomach and Duodenum 106 Symptoms 106 Physicians' Treatment 106 1. Rest 106 2. Feed by the Rectum 106 Uraemia, Acute 156 Uraemia, Acute (Herb Remedies) 435 Uraemia, Chronic 156 Uraemia, Toxaemia 166 Urethritis 235 Urethritis (Herb Remedies) 415 Urinary Passage 164 Mothers' Remedies 164 1. Dandelion Root win clean 164 Urinary Passage (Herb Remedies) 411, 415, 432, 436, 443 Urine, Blood in the 156 Urine, Scalding (Herb Remedies) 440 Urticaria 89 Uterus, Cancer of the 334 Vaccination 208 Symptoms 208 Vagina, The 491 Vaginal Douche, for Cleansing the 641 Vagina, Inflammation of 496 Vaginismus 497 Vaginitis 496 Van Buskirk's Fragrant Sozodont 485 Vanilla Snow 648 Varicella 179 Varicose Veins 345 Predisposing Causes 346 Exciting Causes 346 Physicians' Treatment 346 Palliative 346 Varicose Veins (Herb Remedies) 410 Variola 201 Varix 345 Vaselin (Medical Use) 670 Venereal Diseases 494 Ventilation 623 Verucca 80 Vestibule, The 491 Vinegar (Medical Use) 673 Vomiting 115 Mothers' Remedies 115 1. Spice Poultice to Stop 115 2. Mustard Plaster to Stop 115 3. Parched Corn, Drink to Stop 115 4. Peppermint Application for 115 5. Mustard and Water for 115 6. Warm Water for 115 Physicians' Treatment 115 1. For Vomiting 115 2. For Nervous Vomiting 115 3. A Little Brandy 116 4. Oil of Cloves 116 5. Lime Water 116 6. Vinegar Fumes 116 7. Seidlitz Powder 116 8. Mustard Plaster 116 9. One-tenth drop of Ipecac 116 10. One-half drop of Fowler's Solution 116 Vomiting (Herb Remedies) 423, 433, 440 Vulva, Cysts of 406 Vulva, Inflammation of 491 Vulva, Itching of 495 Vulvitis 494 [MEDICAL INDEX 941] Warm Baths (90 to 100 F.) 630 Wart 89 Mothers' Remedies 89 1. An Application for 89 2. Match and Turpentine for 89 3. Muriate of Ammonia for 89 4. Turpentine for 89 5. Warts, to Remove 89 6. Milkweed Removes 89 7. For Warts 89 Warts (Herb Remedies) 413, 416 Watt's Anti-Rheumatic Pills 487 Weak Back 682 Mothers' Remedies (Unclassified) 682 1. Liniment for 682 2. Turpentine, and Sweet Oil for 682 Weaning 569 Wen 85 Treatment 85 Wet Cupping 635 Whites, The 510 White's Cough Syrup 487 White Swelling 236 Whitlow 69 Whole Wheat Bread 653 Whooping Cough, Diagnosis of 5 Whooping Cough 180 Symptoms 181 The First Stage 181 Spasmodic or Second Stage 181 Stage of the Decline 182 Complications 182 Diagnosis 182 Mortality 182 Mothers' Remedies 182 1. Chestnut Leaves for 182 2. Chestnut Leaves and Cream for 182 3. Mrs. Warren's 182 4. Raspberry Tincture for 182 Physicians' Treatment for Whooping Cough 183 Medical Treatment 183 1. Good Powder 183 2. Tincture of Aconite 183 3. The Best Treatment 183 Diet 183 Whooping Cough (Herb Remedies) 437, 439 Whooping Cough (Rare Prescription) 484 Wine of Antimony (Poison by) 407 Wind-pipe, Bleeding from 38 WOMAN'S DEPARTMENT 489 Abortion (Accidents of Pregnancy) 524 Causes 525 Causes--Due to the Father--Paternal 525 Foetal Causes 525 Symptoms 525 Threatened Abortion 526 Inevitable Abortion 526 Treatment--Preventive 526 Treatment of Threatened Abortion 526 Treatment of the Inevitable Abortion 527 Placenta Praevia 527 Treatment 527 Amenorrhea 505 Causes 505 Symptoms 505 Treatment 505 Bleeding after Delivery 540 Breast Broken, Abscess 538 Breasts, Care of 538 Breasts, Inflammation of 538 Abscess, Broken Breast 538 Treatment-Preventive 538 Mothers' Remedies for Sore Breasts 539 1. A Never Failing Remedy for 539 2. An Herb Treatment for 539 3. A Hot Poultice for 539 4. Fresh Hops for 539 5. A Poultice of Peach Leaves for 539 Mothers' Remedies for Sore Nipples 539 1. A Good Wash for 539 2. A Good Family Ointment for 539 Cervix, Diseases of 497 Tear of the Cervix (Laceration) 497 Causes 497 Symptoms, Immediate and Remote 497 Remote Symptoms 497 Treatment 498 Cervix, Inflammation of the 498 Cause 498 Symptoms 498 Treatment 498 Cervix, Tear of 497 Childbirth 494 Clitoris, The 491 Convulsions (Eclampsia) 542 Treatment 542 Criminal Abortion 494 Cystocele 514 Causes 514 Symptoms 514 Treatment 514 Diseases of Women, Causes of 493 Menstruation 494 Dress 494 Prevention of Conception 494 Criminal Abortion 494 Childbirth 494 Venereal Diseases 494 Dress 494 Dysmenorrhea 507 Eclampsia 542 Endometritis 498 Endometritis, Putrid 500 Symptoms 500 Treatment 500 Diet 500 Endometritis, Septic, Puerperal 499 Symptoms 499 Treatment 499 Fallopian Tubes, Diseases of 502 Fallopian Tubes, Inflammation of 502 Fibromata 501 Genital Organs, Female, Anatomy of 490 Glands of Bartholin, The 401 Hemorrhage, Post-Partum (Bleeding After Delivery) 540 Causes 540 Symptoms 540 Treatment 540 Pulse and Temperature 541 Treatment 541 Diet 542 Hymen, The 491 Labia Majora, The 490 Labia Minora, The 490 Labor 528 Premonitory Signs of Labor 528 Stages of Labor 529 The First Stage 529 Second Stage 529 Third Stage 530 Management of Labor 530 Preparation of the Bed 530 Preparation of the Patient 530 Examination of the Patient 531 Management of the Second Stage 532 Dr. Manton, of Detroit, Says: 532 Management of the Third Stage 534 The Child 534 Another Method 535 The Mother 535 Rest 537 After-Pains 537 [942 MOTHERS' REMEDIES] The Bladder 537 The Bowels 533 Leucorrhea (The Whites) 510 Causes 510 From a Torn Cervix 510 In Inflammation of the Canal of the Cervix 510 Inflammation of the Body of the Womb 510 If the Inflammation Is Caused by Gonorrhea 510 Symptoms 510 Mothers' Remedies 510 1. Slippery Elm for 510 2. Glycerin for 511 3. Common Tea for 511 4. Witch-Hazel for 511 5. White Oak Bark for 511 6. A Good Herb Remedy for 511 7. Common Vinegar for 511 8. An Easily Prepared Remedy for 511 9. Home-Made Suppositories for 511 10. A Good Home Remedy for 512 11. A New York Doctor's Remedy for 512 Physicians' Treatment 512 Local 512 1. One Ounce of White Oak Bark 512 2. Tannic Acid and Glycerin 512 3. Lloyd's Golden Seal 512 4. This Combination Gives Good Service 512 5. Witch-Hazel in Warm Water 512 6. Many other Simple Remedies 512 Lochia, The 540 Diet 540 Menorrhagia 505 Causes 505 Local Causes 505 Symptoms 506 Physicians' Treatment for Profuse Menstruation 506 1. An Easily Prepared Remedy for 506 2. In Young Girls 506 3. Blaud's Pills Will Do Well 506 4. If the Appetite Is Poor 506 5. Tincture of Nux Vomica 506 6. Golden Seal Root 506 7. Oil of Erigeron or Flea-bane 506 8. Oil of Cinnamon 506 9. Cranesbill (Geranium Maculatum) 507 Menopause (Change of Life) 513 Symptoms 513 Mothers' Remedies 513 1. A Useful Herb Remedy for 513 2. An Old Tried Remedy for 513 3. Good Advice From an Experienced Mother 513 Physicians' Treatment 513 Menstruation 494 Menstruation, Delayed 504 Causes 505 Mothers' Remedies, Obstruction of Monthly Flow 503 1. An Herb Remedy for 505 2. Smartweed for 505 Menstruation, Difficult 507 Causes 507 Symptoms 507 Mothers' Remedies for Painful Menstruation 507 1. A Good Tonic for 507 2. A Home Remedy for 507 Physicians' Treatment 507 1. For the Attack 507 2. If the Patient's Nervous System Is Run Down 508 3. Fluid Extract of Blue Cohosh 508 4. Tincture of Pulsatilla 503 5. Tincture of Cocculus 508 Menstruation, Premature 504 Treatment 504 Menstruation, Vicarious (In Place of) 505 Midwifery, or Obstetrics 515 Milk Leg 542 Symptoms 542 Treatment 543 Diet 543 Miscarriage 524 Mons Veneris 490 Obstetrics, or Midwifery 515 Small Bodies 515 The Embryo or Impregnated Egg 515 Development of the Different Months 515 First Month 515 Second Month 515 Third Month 515 Fourth Month 516 Fifth Month 516 Sixth Month 516 Seventh Month 516 Eighth Month 516 Ninth Month 516 Nausea and Vomiting 517 Breasts 517 Bladder 517 Abdominal Changes 518 Pigmentation 518 Quickening 518 The Blood 518 Nervous System 518 Constipation Is the Rule 518 The Foetal Heart-beat 518 Pelvic Signs 519 Duration of Pregnancy 519 How to Determine Date of Confinement 519 Position of the Womb 519 Twins 519 Sex 519 Diagnosis 519 Hygiene of Pregnancy 519 Clothing 520 Food 520 Bathing 520 The Bowels and Bladder 520 Exercise, Rest and Sleep 521 The Vagina 521 The Breasts and Nipples 521 Nervous System 521 Disorders of Pregnancy 521 Mothers' Remedies 522 1. A Great Aid for 522 2. Nausea of Pregnancy, Menthol and Sweet Oil for 522 3. Bouillon or Broth for 522 4. Indigestion and Heartburn 522 Teeth 523 Constipation 523 Difficult Breathing 523 Varicose Veins and Piles 523 Piles 523 Albumin in the Urine (Albuminuria) 524 Treatment 524 Organs of Generation, The Internal 491 Ovaries, The 493 Ovary, Diseases of 503 Ovaries, Inflammation of the 503 Causes 503 Symptoms 503 Treatment 503 Physicians' Treatment 503 Ovaries, Tumors of the 504 Symptoms 504 Treatment 504 Ovaritis 503 Pelvis, The 400 Placenta Praevia 527 Pregnancy, Accidents of 524 Premature Labor (Accidents of Pregnancy) 524 [MEDICAL INDEX 943] Prevention of Conception 494 Pruritis 495 Rectocele 514 Causes 514 Symptoms 514 Treatment 514 Salpingitis 502 Causes 502 Symptoms 502 The Symptoms of the Chronic Variety 502 Treatment of the Acute Kind 503 For the Chronic Variety 503 Vagina, The 491 Vagina, Inflammation of 496 Varieties 496 1. Catarrhal or Simple Form 496 2. Granular 496 3. Gonorrheal Form 496 4. Diphtheritic 497 5. Senile Type 497 Symptoms 497 Treatment (In Acute Cases) 497 In Chronic Cases 497 Vaginismus 497 Treatment 497 Vaginitis 496 Venereal Diseases 494 Vestibule, The 491 Vulva, Cyst of 496 Cause 496 Symptoms 496 Condition 496 Treatment 496 Vulva, Inflammation of the 494 Causes 494 Other Causes 494 In Infants 495 Symptoms and Condition of the Parts 495 Treatment 495 1. If There Is Much Pain 495 2. For Chronic Form 495 Vulva, Itching of the 495 Causes 495 Parts Irritable 495 Symptoms 495 Treatment 496 Local 496 Vulvitis 494 Whites, The 510 Womb, Cancer of the Body of 500 Treatment 500 Womb, Displacements 508 Causes 508 Symptoms 508 Treatment 509 Operations 509 Womb, Falling or Prolapse of 509 For the Incomplete Falling 509 For the Complete Falling 509 Mothers' Remedies 509 1. Unicorn Root for 509 2. A Fine Herb Combination for 509 3. A Physician's Treatment for 509 4. A Never-Failing Remedy for 510 5. White Oak Bark for 510 Womb, Fibroid Tumors of 501 1. Interstitial 501 2. Sub-Mucus (Under the Mucous Membrane) 501 3. Sub-Peritoneal 501 Causes 501 Symptoms 501 Mothers' Remedy 501 1. Common Wood Cactus for 501 Treatment 501 Symptoms Calling for an Operation 501 Womb, Inflammation of the Lining of the 498 Causes 498 Acute Variety 498 Gonorrheal Variety, Symptoms 498 Mothers' Remedy 499 1. A Good Tonic for 499 Physicians' Treatment 499 Womb, Malignant Diseases of 500 Causes 500 Symptoms 500 Treatment 500 Womb, Subinvolution 501 Causes 501 Symptoms 501 Results 502 Treatment 502 Womb, Bleeding from the (Herb Remedies) 412, 413, 423 Womb, Cancer of the Body of 500 Womb, Displacements of 508 Womb, Falling or Prolapse 509 Womb, Fibroid Tumors of 501 Womb Headache 271 Womb, Inflammation of the Lining of 498 Womb, Malignant Disease of 500 Womb, Subinvolution 501 Wool Sorters' Disease 230 Worms, Flesh 61 Worms, Pin 46 Worm, Round 44 Symptoms 45 Mothers' Remedies 45 1. Sage Tea for 45 2. Tansy Remedy for 45 3. Peach Leaf Tea for 45 Physicians' Treatment 45 1. Dr. Osler of Oxford, England, recommends as follows 45 2. Dr. Ritter's Santonin Remedy 45 3. Dr. Douglas, of Detroit, Michigan 46 4. The Following Is from Professor Stille 46 Worm, Round (Herb Remedies) 414, 432, 446 Worm, Tape 48 Symptoms 48 Treatment, Preventive 49 Mothers' Remedies 49 1. Pumpkin Seed Tea for 49 2. Another Good Remedy for 49 3. Ontario Mothers' Remedy for 49 4. Successful Remedy for Children or Adults 49 Physicians' Treatment 49 Preparing the Patient 49 Giving the Remedy and Receiving the Worm 49 1. Light Diet 50 2. Pelletierine Remedy for 50 3. Infusion and Emulsion for 50 4. An Old-Time Remedy for 50 Worm, Thread 46 Mothers' Remedies 46 1. Aloes Treatment for 46 2. Pink Root for 46 3. Quassia Chips for 47 4. Lime Water Injection for 47 5. Salt Water Remedy for 47 Physicians' Treatment 47 1. Santonin in Small Doses and Mild Purgative Like Rhubarb 47 2. Santonin for 47 3. Dr. Tooker of Chicago, Illinois 47 4. Dr. Tooker Gives Another Method 47 5. Another Remedy for 47 6. Spearmint Treatment for 47 7. Internal Treatment for 48 8. Tincture of Cina, to Accompany Injection 48 [944 MOTHERS' REMEDIES] Worm, Thread (Herb Remedies) 423, 432, 446 Wounds 621 Wounds, Punctured 393 Wounds, Rusty Nail 393 Wounds, Stab 392 Wounds, Torn 393 Wounds, Torn (Herb Remedies) 430, 434, 443 Writer's Cramp 292 Causes 292 Symptoms 292 Recovery 292 Physicians' Treatment 292 Wry Neck 324 Yeast Poultice 633 Yellow Fever 224 INDEX TO MANNERS AND SOCIAL CUSTOMS INCLUDING PAGES 683 TO 790 MANNERS' AND SOCIAL CUSTOMS 683 Afternoon Wear 768 Incongruity in Dress 768 Appropriate Dress for Women 768 Bachelor Hospitality 704 Bachelor and the Chaperon, The 764 Cheaper Ways of Entertaining 765 Bachelor's Chafing Dish, The 765 Village Society, In 766 Should He Offer His Arm? 766 The Outside of the Walk 766 Minor Matters of Men's Etiquette 766 Cards and Calls 766 Bad Habits 767 Car Fare Question, The 767 Balls, the Etiquette of 722 Calls, the Etiquette of 690 Time and Manner 690 Men's Demeanor 690 "Pour Prendre Conge" 691 Girls' Manners 691 First Calls 691 Calls After Wedding 740 Card, Calling, Etiquette 688 For Women 688 A General Rule 688 After Social Functions 688 After Absence 688 For Men 689 Letters of Introduction 689 At a Hotel 689 Styles in Cards 689 Uses of Names 689 Carriage Etiquette 777 Minor Items 778 Children's Parties 727 Games 727 Supper 727 Games for Older Children 727 Christening Ceremonies 747 Ceremony, The 747 Sponsors 748 Church Christenings 748 Church Etiquette 776 Friendly Advances 776 Demeanor 776 Civility in Public 778 Rude Tourists 778 Telephone Etiquette 779 Concerning Introductions 685 Women and Introductions 685 When Calling 685 General Introductions 686 Men and Introductions 686 A Few Things Not to Do 686 In Company 687 School Girls' Etiquette 687 Cook's Work, The 781 Should Understand Duties 781 Nurse, The 782 Debutante, The 721 A Grave Mistake 721 Her Dress 721 If Not a Belle 722 Decollette Gowns Are Worn When? 769 Wearing the Hat 769 Ornaments 769 Debutante's Dress, The 769 Dressing on Modest Allowance 770 Dinner, The Informal 700 Family Dinners 701 Requirements 701 Setting the Table 702 Dinners and Luncheons 698 Formal Dinners 698 Serving the Dinner 698 The Help Required 699 Precedence 700 Be Prompt 700 Dress for Elderly Women 770 Suitable, The 770 Duties of a Chaperon 771 Mothers as Chaperons 771 Chaperon's Lot Not Easy 771 Chaperon a Social Help 771 Chaperon of the Motherless Girl, The 772 Avoid Espionage 772 Girls and the Chaperon, The 772 Chaperon in Middle Class Society, The 772 Duties and Dress of Servants 779 Maid, The One 779 Instructing the Maid 780 Maid's Serving, the 780 Duties of Waitress and Cook 781 Engagements, Announcement of 729 How Disclosed 729 After the Announcement 730 Girl's Behavior, The 730 Length of Engagement 730 Breaking Off 731 Wedding Trousseau, The 731 Engagements, Concerning 728 Parental Wishes 728 Entertainments, At Small 723 Card Parties 724 At the Party 724 Etiquette for Children 726 First Lessons 726 Etiquette of Correspondence, The 755 Essentials, The 756 Letter Forms 756 Abbreviations 757 What Not to Do 757 Placing the Stamps 758 [ MANNERS AND SOCIAL CUSTOMS 945] When to Write 758 Care in Writing 758 Keeping Letters 759 Letters of Congratulation and Condolence 759 Etiquette of Dress, The 767 Garden Parties 723 Refreshments 723 Guests, What is Expected of the 712 Dress at Week-End Visits 712 Men's Wear 712 Guests, The Obligations of 715 About Being Thoughtful 715 Outside Acquaintance 716 Other Points to Observe 716 Concerning Departure 716 At Home Again 717 Hat, The Etiquette of the 761 Coachman's Salute, The 762 Hat, When to Raise the 762 At Other Times 762 Hat and Coat When Calling 763 Home Wedding, The 740 Correct Attire 740 After the Wedding 742 Wedding Gifts 742 What to Give 742 Acknowledgments 743 Wedding Decorations 743 Hospitality in the Home 708 Real Hospitality 703 Short Visits 709 The Unexpected Visit 709 The Inopportune Arrival 709 Visits that Save Expense 710 Hostess, The Duties of 713 The Visitors' Comfort 713 Preparing for Company 713 The Hostess's Invitations 714 The Visitor's Entertainments 714 Invitations 692 Invitations, Formulas for 692 Replies 693 Must Not Ask Invitations 694 Other Particulars 694 Informal Invitations 694 Afternoon Tea 695 The Verbal Invitation 695 Luncheons 703 Formal Luncheons 703 Minor Particulars 703 Large Luncheons 704 Manners for Men 760 Value of Courtesy 760 Manners of the Gentleman, The 760 Training, A Matter of 761 Politeness an Armor 761 Manners and Social Customs 683 Importance of Knowledge 684 A Matter of Habit 634 Men's Dress 767 Mourning Garments 751 Expense of Mourning, The 752 Mourning Wear 752 Period of Mourning, The 753 French Mourning 753 Mourning for Men 754 Duties of Friends, The 754 Mourning Etiquette 749 Funerals, Conduct of 749 Undertaker, The 749 Duties of the Next Friend, The 750 House Funeral, The 750 Church Funerals 751 Flowers 751 Neighborhood Etiquette 777 Borrowing 777 Receptions 707 Receiving 707 Decorations 707 Rules for Precedence 763 Smoking, About 763 Smoke, Where not to 764 Expectoration, About 764 Social Affairs, The Young Girl's 718 Girl and the Chaperon 719 Girl and the Young Men, The 719 About Gifts 720 Telephone, The 720 Speech, Good Form in 773 Use of Slang and Colloquialisms 773 Form of Address 774 Courtesy of Conversation 774 "Stag" Dinners 725 Subjects of Conversation 775 Discourtesies 778 Some Things to Avoid 775 The Speaking Voice 776 Summary 782 Table Etiquette 704 At the Table 705 Using the Fork 705 Vegetables, Fruits, etc 705 The Spoon 706 Finger Bowls 707 Tea, the Musical and Informal 725 Visiting Etiquette for Girls 717 Deference to Age 718 Wedding-Anniversaries 745 Wedding, The 745 Silver Wedding, The 745 Golden Weddings, The 746 Courtesies of the Occasion, The 746 Gifts 747 Wedding Festivities 732 Engagement "Showers" 732 How Presented 732 Refreshments 733 Wedding Invitations and Announcements 696 Correct Form 696 The Bridegroom's Family 697 Other Items 697 Wedding Preparations 738 The Expense of the Wedding 733 Bride's Privileges, The 734 Who Pays? 735 Wedding Gown, The, 735 Later Wear of the Wedding Gown 735 Bridal Flowers 736 Widow's Bridal Attire 786 Man's Wedding Garments, The 736 Bride's Mother, The 737 Church Wedding, The Formal 737 Bride's Father, The 738 Another Form 738 Best Man's Duties, The 738 Duties of the Ushers 739 Wedding Reception, The 739 Refreshments 739 Going Away 739 Weddings, The Simplest of 744 Week-End Visits 710 Invitation, The 710 Amusements 711 Hostess's Arrangements 711 Young Girls' Parties 724 Birthday Party 725 [946 MOTHERS' REMEDIES] MISCELLANEOUS INDEX PAGES 790 TO 908 Including Chapters on "Beauty and the Toilet," "Nursery Hints and Fireside Gems," "Domestic Science," "Canning and Pickling," "Candy" "General Miscellaneous" and "Glossary" Acid or Lye, Burns from 858 Account Book, Kitchen 867 "Affection" (Quotation) 808 "After the Burial," from Lowell 809 "All Girls and Boys" (Quotation) 808 Almonds, Salted 830 Ants, Troubled With 886 Apples, The Quickest Way to Core 877 Awkwardness Due to Eyes 811 Baby, Amusing 814 "Baby-Class Tree, The" (Poem) 805 Baby's Fine Dresses 803 Baby's Kimona 802 Baby's Layette 801 Baby's Meals 807 Baby's Nerves 803 Baby's Nose 814 Baby's Outing 802 Baby's Petticoats 811 Baby, Pretty Things for 802 "Baby's Purpose" (Quotation) 808 Baby (Quotations) 801, 802 Baby, Rather Hard On 810 Baby's Sleeves 813 Baby's Veil 814 Baking, Apples Cored for 874 Baking Dishes, Discolored China 877 Baking Help 868 "Barefoot Boy" (Quotation) 804 Barefoot, Going 803 Basting Thread, To Save 885 Bathing the Baby, Hints for 866 Bathrobe, A 812 Bathtub, Folding 816 BEAUTY AND THE TOILET 790 "Be Discreet" (Quotation) 813 Bed Sheeting 872 Bed Time 815 Beef, Creamed 829 Beef-Tea, Preparing, A Way of 866 Bindings, Book With Delicate 890 Black Ants, How to Kill 861 Blacking, Soap With Stove 857 Blackheads 790 Blankets, To Remove Stains from 858 Blankets, To Wash White Woolen 889 Bowl, Finger 883 Boy's Garments 802 "Boys" (Quotation) 802 Bread, To Freshen 865 Breakfast Food, Cooking 884 Breakfast Food, To Open Packages 871 Broom Bags 864 Broom, How to Preserve the Household 880 Bruise or Cut, For 858 Brush, To Sweep Stairs With Paint 859 Bunions 799 Bureau Drawers That Stick 891 Buttons for Future Use 885 Buttonhole, To Make a Neat 876 Buttons, Sewing on 888 Cake Tins, Greasing 873 Cake Tins, Non-Sticking 860 Cake Tins, To Prevent Sticking 865 Canary Seed, To Keep Mice Away from 879 Candle Grease, To Remove 863 Candle Grease, To Take Out of Linen 881 Candles, To Keep in Warm Weather 879 CANDY MAKING 848 Candy Making at Home 848 Chocolate Candy, Plain 851 Chocolate Candies 850, 851 Chocolate Caramels 851 Chocolate Fudge 851 Chocolate Nut Caramels 851 Chocolate Peppermint Wafers 852 Chocolate Creams 850 Chocolate Creams, No. 2 851 Cocoanut Caramels 852 Cocoanut Cream Bars 851 Cocoanut Snow Balls 852 Confectioners' and Common Candy 848 Cream Dates 854 Crystallized Fruits 854 Bonbons, Making the 850 Butter Scotch 853 Flavor and Color 849 Fondant, French or Boiled 849 Fondant, Making the 849 Hints, A Few 855 Hoarhound Candy 854 Maple Balls 852 Maple Candies 852 Maple Creams, No. 2 852 Maple Creams 852 Marron Glaces 854 Marshmallows 854 Molasses Candies 852 Molasses Taffy 852 Molasses Taffy No. 2 853 Nougat 853 Nut Bars 853 Nut Loaf 853 Other Candies 854 Peanut Candy 853 Popcorn Baskets 853 Popcorn Candy 853 Sour Drops 853 School Girl's Delight 854 Stick Candy 854 Sugar, Boiling the 848 Wafers 852 CANNING 831 Apples 832 Apples and Quinces 831 Apple Sauce 832 Butter, Apple 832 Canning Fruits, Table for 833 Corn 833 Grapes 833 Peaches 832 Peaches, Brandy 832 [948 MOTHERS' REMEDIES] Flowers, Wild 814 Fly Paper Stains, To Remove 866 Fondue, Cheese 829 Food, Scorched 875 Forbearance (Quotation) 807 Forming Habits 815 Foulard Dress, Have You been Hoarding? 876 Four Things (Quotation) 815 Freckles 791 Freshen Nuts, How to 868 Friendship (Quotation) 813 Friends, Making (Quotation) 814 Fruit After Cutting, To Keep Grape 868 Fruit Cans, When the Top Cannot Be Removed 873 Fruit Stains, To Remove from the Hands 867 Furniture Brush, A Serviceable 890 Furniture, Clean Gilt 801 Furniture, Paint Wicker 801 Furniture Polish, A Good 880 Furniture, To Remove White Marks On 881 Furniture, To Wash 890 Gas, How to Economize on 886 Gas, Save the 865 Gilded Surfaces, To Clean 891 Gilt Frames, Cleaning 888 Gingham Apron for the Housewife 887 Glass, Paint That Sticks to 890 Gloss, To Give Starch a 874 Glass Stopper, How to Remove 866 Gloves, To Clean Kid 888 Gnawing Holes, If the Mice Are 872 Gowns, Afternoon 810 Gravies, Making 875 Gray Hair 795 Grease from Silk, To Remove 870 Grease, To Take Out Wagon 889 Greatness of Love, The (Quotation) 806 Hair, The 793 Hair, Care of the 794 Hair, Clipping the 794 Hair, Color of the 795 Hair, Dyed 795 Hair Brushes, Washing 859 Hair, Gray 795 Hair and Health 796 Hair Tonic, A 796 Hair, Washing the 795 Hands, The 797 Hand Churn, Small 878 Handkerchiefs, Uses for Men's Old Silk 889 Hands and Nose, Red 792 Hangers, Hat 864 Harsh Commands 813 Health as an Aid to Beauty 790 Hem, Putting in a Temporary 885 Hemstitching 871 Hems of Table Linen, To Turn Easily and Accurately 889 Hints, House-Cleaning 888 Homes, Summer 881 Honesty (Quotation) 814 Hot Water Bottle, To Preserve 859 House Account, Keeping a 874 House, A Spotless 879 Household, A Convenience for 889 Household, A Handy Disinfectant for the 892 House Key, How to Carry 862 Housekeeping, Systematic 868 Housewife, Hints for the 892 Housewife, Systematic, A 879 Human Face, The (Quotation) 806 Ice Box, Borax as a Purifier for 891 Idleness (Quotation) 804 Indulgence 807 Intemperance (Quotation) 803 Ironing Day, Conveniences for 877 Ironing Board, Conveniences for 861 Iron Holders Made from Asbestos 884 Iron Rust, To Remove 877 Iron Sink, To Keep in Good Condition 886 JAMS AND JELLIES 845 Apple 845 Blackberry Jam 846 Blackberry 845 Crab Apple 845 Cranberry 845 Gooseberry Jam 847 Grape 846 Orange Marmalade 846 Peach 847 Plum and Apple Jam 846 Raspberry Jams 847 Rhubarb 846 Rhubarb and Apple 846 Spiced Grape 846 Strawberry and Red Currant Jam 847 Tomato Marmalade 846 JAMS AND JELLIES (DOMESTIC SCIENCE METHOD) 822 Glasses for Jelly, To Prepare 822 Jelly Glasses, To Cover 823 Jelly Bag, To Make 823 Good Fruits for Making Jelly 823 General Directions for Making Jelly 823 Apple Jelly 823 Barberry Jelly 824 Crab Apple Jelly 823 Currant Jelly 824 Grape Jam 824 Grape Jelly 824 Quince Jelly 824 Raspberry Jam 824 Raspberry Jelly 824 Strawberry Jam 824 Keep Dainties Away from the Beginning 809 Kerosene Lamps, Paint Smoked from 857 Kettles, Burned 867 Kitchen Apron 877 Kitchen Apron, How to Attach Holder to 863 Kitchen Apron, Making a 875 Kitchen, Convenient Addition to 862 Kitchen, Drop Table for 877 Kitchen, A Useful Article in 886 Lace, Sewing 876 Laces, To Wash 858 Lamp Burners, To Clean 858 Lamps, Kerosene 868 Lap-Board, When Using 876 Last Step, The 868 Laugh, The Value of (Quotation) 812 Learning to Sew 804 Learning Wisdom (Quotation) 810 Leather Furniture, Clean 861 Lemons, How to Obtain More Juice 858 Lemons, Washing 872 Life (Quotation) 816 Linen Collars, Use of Old 859 Linen, To Make Easier to Write on 878 Linoleum, Clean 862 Linoleum or Oilcloth That Is Cracked 891 Little Minds 815 Liquid Whiteners 793 Living Room, Attractive 882 Long Seams, Basting 885 Love (Quotation) 805 Love, The Two Symptoms of 813 Lunches, Putting Up 891 Maidenhood (Quotation) 813 [MISCELLANEOUS INDEX 949] Machine Grease, To Remove 879 Market, Going to 890 MARMALADES AND BUTTERS (DOMESTIC SCIENCE METHOD) 825 Apple 825 Crab Apple 825 Peach 825 Pineapple 825 Rhubarb 825 Marred, If Tour Paint Has Been 881 Massage 792 Matrimony, Cares of (Quotation) 811 Meals, Airing House After 888 Meals, Cheerfulness at 871, 883 Meat, Broiling 870 Meat, The Color Should Be 873 Meat, Larding a Piece of 878 Medicine Cupboard 865 MEDICAL DICTIONARY 893 Medicine (Quotation) 811 Method 807 Methods of Cooking Eggs 813 Mildew, To Remove 874 Milk Vessels, Never Pour Scalding Water Into 872 Mittens, Kitchen 875 Moulding by Circumstances (Quotation) 815 Moulding, To Prevent Fruits from 891 Mop Handles, Uses of 884 Money to Children 812 Mother (Quotation) 801 Motherhood 801 Moths 871 Moths in Carpet 890 Mould, To Keep Free From 859 Mouth Breathing 812 Mouth and Teeth 797 Muddy Skirt, To Make Wash Easily 871 Mud Stains, To Remove 876 Music, To Pack 863 Mutton Chops, To Make Tender 875 Mysterious Future, The (Quotation) 808 Nails, Care of the 797 Finger Nail Powder 797 Implements 797 The Process 797 Nails, Ingrowing 799 Nail Powder, Finger 797 Needles, For Broken 862 Needle Holder, A 857 Needle Sharpener 867 Needles, Threading 885 Nicknames (Quotation) 803 Night Petticoats 812 Night Lamp, A New 864 Noon of Life, The (Quotation) 812 Now or Never (Quotation) 811 Nursery 810 NURSERY HINTS' AND FIRESIDE GEMS 800 Obedience 812 Oil Cloth, Buying a New 874 Old Velvet, Uses for 858 Oranges as Medicine 806 Oven, After Cake is Removed from 873 Oysters, Creamed 829 Oysters, Raw 883 Paint and Varnish, Cleaning 860 Pancakes, Sour Milk 869 Pantry, Closed Cupboards in the 874 Peaches, Left Over 870 Pea-Pods, Uses for 878 Peas Cooking 886 Petticoats, Children 867 Petticoat, making over a Heatherbloom 887 Petticoats, Making Children's 873 Piano Keys, To Clean 881 PICKLES 835 Beet 835 Blackberries, Mothers' 836 Brocoli 836 Cabbage 836 Cantelope, Sweet 836 Catsup, Aunt Mary's 838 Catsup, Grape 839 Catsup, Gooseberry 838 Catsup, Pepper 839 Catsup, Tomato 838 Cauliflower 835 Celery Sauce, Mother Used to Make 837 Cherries 839 Chili Sauce 837, 840 Cucumber, Ripe 837 Cucumber, Sliced 838 Currants, Spiced 840 Dill Pickles, Grandmother's 838 Grapes, Spiced 840 Green Beans 841 Green Tomato 839 Mustard 836, 838 Oyster Catsup 839 Peaches, Sweet 836 Pears, Ginger 840 Pickles, Bottled 838 Pickles, Mustard 839 Pickles, Mixed 836 Pickles, Spanish 840 Pickles, Sweet Mixed 839 Prunes, Sweet 836 Relish, Corn 839 Relish, Tomato 837 Sauce, Green Tomato, for Meats or Fish 837 Soye Tomato 840 Spiced Vinegar for Pickles 838 Tomato 837 Tomato, Green 837, 840 Tomato Relish 837 PICKLES (Domestic Science Method) 826 Chili Sauce 826 Cucumber, Sweet 827 Olive Oil Pickles 826 Pickled Pears or Peaches, Sweet 826 Tomato, Green 827 Picnic Supplies 808 Pie Crust, How to Make 863 Pillows, to Air 878 Pillow Slips, Changing 859 Pillows, Separate Night and Day 886 Pimples 791 Pinafore, The 810 Pineapple, To Preserve 884 Pincushion, A Brick 867 Pitchers, To Prevent Dripping 865 Plaster-of-Paris, To Clean 881 Playground for Boys 808 Plaited Skirt, Pressing a 873 Poison Bottle, To Mark 865 Poison, Let the Bottle Tinkle 863 Politics and Veracity (Quotation) 813 Pomades, Use of 794 Potatoes, To Improve Baked 875 Potatoes, Boiled 869 Potatoes, Browning 872 Powder, To Use 793 Praying of a Child (Poem) 800 PRESERVES 841 Apple 841 Apricot 842 Brandied Peaches 844 Cherries 841 Citron 842 [950 MOTHERS' REMEDIES] Citron and Quince 842 Fig and Rhubarb 841 Grape 844 Lemon Butter 841 Peaches 844 Pear 841, 842, 843 Pear Chip 845 Pineapple 842 Purple Plums 844 Quinces 844 Raspberry and Currant 822 Rhubarb 841 Spiced Currant 843 Spiced Gooseberries 843 Spiced Grapes 844 Spiced Peaches 845 Strawberry 822, 841, 843 Tomato 843 Princess Skirt 813 Progress (Quotation) 809 Prominent Ear 814 Pudding, Steaming or Boiling 886 Purses, Old Suitcases and 891 Putty, To Remove 871 Quilts, Hanging Out 890 Quilts, Washing 884 Rarebit, Welsh 830 Ravelings, A Use for 866 Reading (Quotation) 813 Reasoning Versus Punishment 802 Red Ant, To Destroy 867 Rice, Boiling 870 Roaches, To Exterminate 886 Rock Me to Sleep (Quotation) 809 Romper, The 807 Rouge 793 Rubber, To Mend 877 Ruffle Easily, To 873 Rugs, To Clean Light 880 Rugs, Cleaning 861 Rule, A Good (Quotation) 804 Rust, Charcoal to Prevent 857 Sacks, A Use for 857 Salad, Delicious 880 Salted Almonds 830 Sanitary Care of Baby' Bottles 815 Sanitary Drinking Cups 812 Saw, Toy 874 Scallops, To Mark 876 Schooling, Early (Quotation) 803 Screens, Putting A way 882 Scrub Bucket, Convenient 880 Scrub Bucket Leaks, When the 869 Scrubbing Brush, The Care of 857 Scrubbing Tender Faces 805 Seam, Stitching down 873 Securing Covering at Night 814 Selfishness (Quotation) 807 Sewing Machine, After Cleaning the 887 Sewing Machine, Conveniences 873 Sewing Room, A Hint 862 Sewing, To Save Time by 858 Sewing, Time Saved in 864 Sheets, to Hold in Place 866 Shelves for Cupboard 883 Shoes, Children's, To Save 879 Shoe Cover, A 863 Shoe Polisher, A Satisfactory 866 Shortcake, Meat 875 Sickness, in Case of 857 Sieve, To Clean 860 Silence (Quotation) 811 Silk Gloves, To Preserve 867 Silk, Grease Stains on 883 Silk, Using on the Machine 863 Silverware, Cleaning 890 Silver, To Clean 859 Skins of Tomatoes, To Remove Quickly 878 Skirts, To Press 863 Soap Shaker, Home-Made 861 Soft Soap, To Make 886 Song of Long Ago, A (Quotation) 810 Songs and Story-Telling 813 Souring, To Keep Bread from 872 Spoon, Uses of a Wooden 890 Sprinkling Clothes, New Method 671 Stains, Old Perspiration 889 Stains, Removing 859 Stained Water Bottles, To Make Clean 871 Stale Bread, Uses for 872 Starch, To Prevent from Boiling Over 866 Stews and Hash, How to Make 864 Stilletto, Convenient Place for 860 Stocking Tops, For Convenient Holders 864 Stockings from Wearing Out, To Prevent 867 Stoves, Cleaning 870 Stove, The Easiest Way to Blacken 875 Suits, Wash 872 Sunburn 791 Sweaters 814 Sweeping as a Beautifier 882 Sweeping Brush, Cleaning the 881 System (Quotation) 807 Tablecloths, to Prevent from blowing off 865 Table Linen, Mending 869, 885 Table Linen, A Neat Way to Hem 883 Table Linen, Fruit Stains on 880 Table, Preparing Oranges for the 871 Table, To Prevent Marks on the 888 Tomato, Hollowing out a 875 Tangled Threads, To Remove 887 Tarnished Brass, To Wash 876 Tea and Coffee 815 Tears, Banish 816 Tears (Quotation) 803 Teeth, Children's 798 Teeth, Cleansing the 798 Teeth Second 803 Temperature of the Nursery 809 Tinware Rusting, To Prevent 878 Tireless Talkers (Quotation) 806 Toast, Curried 829 Toaster, A Good Substitute for a 883 Tomato, Curry of 830 Tooth Powder 811 Tough Meat, to Make Tender 884 Towels, Loops on 859 Towels, Tea 879 Toy, Children's 869 Toys, Discarded 859 Training (Quotation) 803 Tub, Galvanized 874 Tub for the Playroom 811 Tufted Furniture, For 862 Underclothing, Hemstitching 885 Undergarments (Infants) 803 Unique Table Protector 815 Unselfishness 806 Vegetables, Boiling 890 Vegetable, Chestnuts as 874 Vegetables, To Make Tender 878 Vegetables, To Restore Freshness to 887 Veils, Washing 881 "Village Blacksmith," from Longfellow's 806 Vinegar, For Clearing 858 Vinegar, To Give a Nice Flavor 872 Wall Paper, Light Colored 879 Water Pipes in the Kitchen 872 Wedding Celebrations 810 [MISCELLANEOUS INDEX 951] Welsh Rarebit 830 Whisks, Worn Brooms or 887 White Dress, if turned yellow 874 White Fabric, To Remove Dust from 887 White Spots Caused by Dishes, to Remove 866 Wholesome Pleasures 805 Wild Flowers 802 Windows, Cleaning in Winter 861 Windows, For Closing 892 Window, Sanitary Screen 871 Windows, Washing 861 Wood Berries, Bright, May Be Preserved 881 Wood Floors, Soft to Paint 889 Wood Work, Old, to Keep Clean 881 Wood Work, To Wash Grained 888 Woolen Clothing, Cleaning Black 877 Woolens, Washing Fine 888 Wringer Rollers, Renewing 865 Wrinkles 792 Wrinkled Hands 792 Zweiback Noodles 808 
15019	----	A QUEENS Delight; OR, The Art of Preserving, Conserving and Candying. As also A right Knowledge of making Perfumes, and Distilling the most Excellent Waters. Never before Published. LONDON. Printed by _E. Tyler_, and _R. Holt_, for _Nath._ _Brooke_, at the Angel in _Corn-Hill_, near the Royal Exchange. 1671. A QUEENS DELIGHT OF Conserves, and Preserves, Candying and Distilling Waters. _To preserve white Pear Plums, or green._ Take the Plums, and cut the stalk off, and wipe them then take the just weight of them in Sugar, then put them in a skillet of water, and let them stand in and scald, being close covered till they be tender, they must not seeth, when they be soft lay them in a Dish, and cover them with a cloth, and stew some of the the Sugar in the glass bottom, and put in the Plums, strewing the sugar over till all be in, then let them stand all night, the next day put them in a pan, and let them boil a pace, keeping them clean scummed, & when your Plums look clear, your syrup will gelly, and they are enough. If your Plums be ripe, peel off the skins before you put them in the glass; they will be the better and clearer a great deal to dry, if you will take the Plums white; if green, do them with the rinds on. _To preserve Grapes_ Take Grapes when they be almost through ripe, and cut the stalks off, and stone them in the side, and as fast as you can stone them strew Sugar on them; you must take to every pound of Grapes three quarters of a pound of Sugar, then take some of the sower Grapes; and wring the juyce of them, and put to every pound of Grapes two spoonfuls of juyce, then set them on the fire, and still lift up the pan and shake it round, for fear of burning to, then set them on again, & when the Sugar is melted, boil them as fast as you can possible, and when they look very clear, and the syrup is somewhat thick, they are enough. _To preserve Quinces white._ Take a pair and coar them, and to every pound of your equal weights in Sugar and Quince, take a wine pint of water; put them together, and boil them as fast as you can uncovered; and this way you may also preserve Pippins white as you do Quinces. _To preserve Respass._ Take a pound of Respass, a pound of fine Sugar, a quarter of a pint of the juyce of Respass, strew the Sugar under and above the Respass, sprinkle the juyce all on them, set them on a clear fire, let them boil as soft as is possible, till the syrup will gelly, then take them off, let them stand till they be cold, then put them in a glass. After this manner is the best way. _To preserve Pippins._ Take fair Pippins, and boil them in fair water till they be somewhat tender, then take them out, and peel off the skins and put them into a fair earthen pot, and cover them till they be cold, then make the syrup with fair water and Sugar, seeth it, and scum it very clean, then being almost cold, put in your Pippins, so boil them softly together, put in as much rind of Oranges as you think will tast them, if you have no Oranges take whole Cinamon and Cloves, so boil them high enough to keep them all the year. _To preserve fruits green._ Take Pippins, Apricocks, Pear-Plums, or Peaches when they be green, scald them in hot water, and peel them or scrape them, put them into another water not so hot as the first, then boil them very tender, take the weight of them in Sugar, put to it as much water as will make a syrup to cover them; then boil them something leisurely, and take them up, then boil the syrup till it be somewhat thick, that it will batten on a dish side, and when they are cold, put them together. _To preserve Oranges and Lemons the best way._ Take and boil them as for paste, then take as much sugar as they weigh, and put to it as much water as will cover them by making a syrrup, then boil them very leisurely till they be clear, then take them up and boil the syrup till it batten on the dish side, and when they are cold put them up, &c. _An approved Conserve for a Cough or Consumption of the Lungs._ Take a pound of Elecampane Roots, draw out the pith, and boil them in two waters till they be soft, when it is cold put to it the like quantity of the pap of roasted Pippins, and three times their weight of brown sugar-candy beaten to powder, stamp these in a Mortar to a Conserve, whereof take every morning fasting as much as a Walnut for a week or fortnight together, and afterwards but three times a week. _Approved_. _To make conserve of Any of these Fruits._ When you have boiled your paste as followeth ready to fashion on the Pie-plate, put it up into Gallipots, and never dry it, and this is all the difference between Conserves. And so you may make Conserves of any Fruits, this is for all hard Fruits, as Quinces, Pippins, Oranges and Lemons. _To dry any Fruits after they are preserved, to or Candy them._ Take Pippins, Pears or Plums, and wash them out in warm water from the syrup they are preserved in, strew them over with searsed Sugar, as you would do flower upon fish to fry them; set them in a broad earthen Pan, that they may lie one by one; then set them in a warm Oven or Stove to dry. If you will candy them withall, you must strew on Sugar three or four times in the drying. _To preserve Artichokes young, green Walnuts and Lemons, and the Elecampane-Roots, or any bitter thing._ Take any of these, and boil them tender, and shift them in their boyling six or seven times to take away their bitterness out of one hot water into another, then put a quart of Salt unto them, then take them up and dry them with a fair cloth, then put them into as much clarified Sugar as will cover them, then let them boil a walm or two, and so let them stand soaking in the Sugar till the next morning, then take them up and boil the Sugar a little higher by it self, and when they are cold put them up. Let your green Walnuts be prickt full of holes with a great pin, and let them not be long in one water, for that will make them look black; being boiled tender, stick two or three Cloves in each of them. Set your Elecampane-Roots, being clean scraped, and shifted in their boilings a dozen times, then dry them in a fair cloth, and so boil them as is above written, take half so much more than it doth weigh, because it is bitter, &c. _To preserve Quinces white or red._ Take the Quinces, and coar them, and pare them, those that you will have white, put them into a pail of water two or three hours, then take as much Sugar as they weigh, put to it as much water as will make a Syrup to cover them, then boil your Syrup a little while, then put your Quinces in, and boil them as fast as you can, till they be tender and clear, then take them up, and boil the Syrup a little higher by it self, and being cold put them up. And if you will have them red, put them raw into Sugar, and boil them leisurely close covered till they be red and put them not into cold water. _To preserve Grapes._ Take the Clusters, and stone them as you do Barberries, then take a little more Sugar than they weigh, put to it as much Apple water as will make a Syrup to cover them, then boil them as you do Cherries as fast as you can, till the Syrup be thick and being cold pot it, thus may you preserve Barberries or English Currans, or any kind of Berries. _To preserve Pippins, Apricoks, Pear-Plums and Peaches when they are ripe._ Take Pippins and pare them, bore a hole through them, & put them into a Pail of water, then take as much Sugar as they do weigh, and put to it as much water as will make a Syrup to cover them, and boil them as fast as you can, so that you keep them from breaking, until they be tender, that you may prick a Rush through them: let them be a soaking till they be almost cold, then put them up. Your Apricoks and Peaches must be stoned & pared, but the Pear-Plums must not be stoned nor pared. Then take a little more Sugar than they weigh, then take as much Apple water and Sugar as will make a Syrup for them, then boil them as you do your Pippins, and Pot them as you do the Pippins likewise, &c. _To preserve Pippins, Apricocks, Pear-Plums, or Peaches green._ Take your Pippins green and quoddle them in fair water, but let the water boil first before you put them in, & you must shift them in two hot waters before they will be tender, then pull off the skin from them, and so case them in so much clarified Sugar as will cover them, and so boil them as fast as you can, keeping them from breaking, then take them up, and boil the syrup until it be as thick as for Quiddony; then pot them, and pour the syrup into them before they be cold. Take your Apricocks and Pear-Plums and boil them tender, then take as much Sugar as they do weigh, and take as much water as will make the syrup, take your green Peaches before they be stoned and thrust a pin through them, and then make a strong water of ashes, and cast them into the hot standing lye to take off the fur from them, then wash them in three or four waters warm, so then put them into so much clarified Sugar as will candy them; so boil them, and put them up, &c. _To dry Pippins, or Pears without Sugar._ Take Pippins or Pears and prick them full of holes with a bodkin, & lay them in sweet wort three or four dayes, then lay them on a sieves bottom, till they be dry in an Oven, but a drying heat. This you may do to any tender Plum. _To make Syrup of Clove-gilly flowers._ Take a quart of water, half a bushel of Flowers, cut off the whites, and with a sieve sift away the seeds, bruise them a little; let your water be boiled, and a little cold again, then put in your Flowers, and let them stand close covered twenty four hours; you may put in but half the flowers at a time, the strength will come out the better; to that liquor put in four pound of Sugar, let it lye in all night, next day boil it in a Gallipot, set it in a pot of water, and there let it boil till all the Sugar be melted and the syrup be pretty thick, then take it out, and let it stand in that till it be through cold, then glass it. _To make Syrup of Hysop for Colds._ Take a handful of Hysop, of Figs, Raisins, Dates, of each an ounce, of Collipint half an handful, French Barley one ounce, boil therein three pints of fair water to a quart, strain it and clarifie it with two whites of Eggs, then put in two pound of fine sugar, and boil it to a syrup. _To make Orange Water._ Take a pottle of the best Maligo Sack, and put in as many of the peels of Oranges as will go in, cut the white clean off, let them steep twenty four hours; still them in a glass still, and let the water run into the Receiver upon fine Sugar-candy; you may still it in an ordinary Still. _To dry Cherries._ Take a pound of sugar, dissolve it in thin fair water, when it is boiled a little while, put in your Cherries after they are stoned, four pound to one pound of Sugar, let them lye in the Sugar three dayes, then take them out of the syrup and lay them on sieves one by one, and set them before the Sun upon stools, turn them every day, else they will mould; when they look of a dark red colour, and are dry then put them up. And so you may do any manner of Fruit. In the Sun is the best drying of them, put into the syrup some juyce of Rasps. _To make juyce of Liquorish._ Take English Liquorish, and stamp it very clean, bruise it with a hammer, and cut it in peices; to a pound of Liquorish thus bruised, put a quart of Hysop water, let them soak together in an earthen pot a day and a night, then pull the Liquorish into small pieces, and lay it in soak again two dayes more; then strain out the Liquorish, and boil the liquor a good while. Stir it often; then put in half a pound of Sugar-candy, or Loaf-sugar finely beaten, four grains of Musk, as much Ambergreece, bruise them small with a little Sugar; then boil them together till it be good & thick, still have care you burn it not; then put it out in glass plates, and make it into round rolls, and set it in a drying place till it be stiff, that you may work it into rolls to be cut as big as Barley corns, and so lay them on a place again: If it be needful strew on the place again a little Sugar to prevent thickning; so dry them still if there be need and if they should be too dry, the heat of the fire will soften them again. _A Perfume for Cloths, Gloves._ Take of Linet two grains, of Musk three, of Ambergreece four, and the oyl of Bems a pretty quantity; grinde them all upon a Marble stone fit for that purpose; then with a brush or sponge rake them over, and it will sweeten them very well; your Gloves or Jerkins must first be washed in red Rose-water, and when they are almost dry, stretch them forth smooth, and lay on the Perfumes. _To make Almond Bisket._ Take the whites of four new laid Eggs, and two yolks, then beat it well for an hour together, then have in readiness a quarter of a pound of the best Almonds blanched in cold water, & beat them very small with Bose-wart, for fear of Oyling; then, have a pound of the best Loaf-sugar finely beaten, beat that in the Eggs a while, then put in your Almonds, and five or six spoonfuls of the finest flower, and so bake them together upon Paper plates, you may have a little fine Sugar in a piece of tiffany to dust them over as they be in the Oven, so bake them as you do Bisket. _To dry Apricocks._ First stone them, then weigh them, take the weight of them in double refined Sugar, make the syrup with so much water as will wet them, and boil it up so high, that a drop being droped on a Plate it will slip clean off, when it is cold, put in your Apricocks being pared, whilst your Syrup is hot, but it must not be taken off the fire before you put them in, then turn them in the syrup often, then let them stand 3 quarters of an hour, then take them out of the syrup, and tie them up in Tiffanies, one in a tiffany or more, as they be in bigness, and whilst you are tying them up, set the syrup on the fire to heat, but not to boil, then put your Apricocks into the syrup, and set them on a quick fire, and let them boil, as fast as you can, skim them clean, and when they look clear take them from the fire, and let them lie in the syrup till the next day, then set them on the fire to heat, but not to boil; then set them by till the next day, and lay them upon a clean Sieve to drain, and when they are well drained, take them out of the Tiffanies, and so dry them in a Stove, or better in the Sun with Glasses over them, to keep them from the dust. _To make Quinces for Pies._ Wipe the Quinces, and put them into a little vessel of swall Beer when it hath done working; stop them close that no air can get in, and this will keep them fair all the year and good. _The best way to break sweet Powder._ Take of Orrice one pound, Calamus a quarter of a pound, Benjamin one half pound, Storax half a pound, Civet a quarter of an ounce, Cloves a quarter of a pound, Musk one half ounce, Oyl of Orange flowers one ounce, Lignum Aloes one ounce, Rosewood a quarter of a pound, Ambergreece a quarter of an ounces. To every pound of Roses put a pound of powder; the bag must be of Taffity, or else the powder will run through. _To make excellent Perfumes._ Take a quarter of a pound of Damask Rose-buds cut clean from the Whites, stamp them very small, put to them a good spoonful of Damask Rose-water, so let them stand close stoopped all night, then take one ounce and a quarter of Benjamin finely beaten, and also searsed, (if you will) twenty grains of Civit, and ten grains of Musk; mingle them well together, then make it up in little Cakes between Rose leaves, and dry them between sheets of Paper. _To make Conserve of Roses boiled._ Take a quart of red Rose-water, a quart of fair water, boil in the Water a pound of red Rose-leaves, the whites cut off, the leaves must be boiled very tender; then take three pound of Sugar, and put to it a pound at a time, and let it boil a little between every pound, so put it up in your pots. _To make Conserves of Roses unboiled._ Take a pound of red Rose leaves, the whites cut off, stamp them very fine, take a pound of Sugar, and beat in with the Roses, and put it in a pot, and cover it with leather, and set it in a cool place. _To make a very good Pomatum._ Take the Fat of a young Dog one pound, it must be killed well that the blood settle not into the fat, then let the outer skin be taken off before it be opened, lest any of the hair come to the fat, then take all the fat from the inside, and as soon as you take it off fling it into Conduit water, and if you see the second skin be clear, peel it and water it with the other: be sure it cools not out of the water: you must not let any of the flesh remain on it, for then the Pomatum will not keep. To one pound of this fat take two pound of Lambs caule, and put it to the other in the water and when you see it is cold, drain it from the water in a Napkin, and break it in little peices with your fingers, and take out all the little veins; then take eight ounces of Oyl of Tartar, and put in that first, stiring it well together, then put it into a Gallon of Conduit water, and let it stand till night; shift this with so much Oyl and Water, morning and evening seven dayes together, and be sure you shift it constantly; and the day before you mean to melt it wring it hard by a little at a time, and be sure the Oyl and water be all out of it, wring the water well out of it with a Napkin every time you shift it; then put in three pints of Rose-water; let it stand close covered twelve hours, then wring out that, and put it in a pint of fresh Rose-water into a high Gallipot with the _Fæces_; then tie it close up, and set it in a pot of water, and let it boil two hours then take it out, and strain it into an earthen Pan, let it stand till it be cold; then cut a hole in it, and let out the water, then scrape away the bottom, and dry it with a cloth, and dry the pan, melt it in a Chafing-dish of Coales, or in the Gallipots; beat it so long till it look very white and shining; then with your hand fling it in fine Cakes upon white paper, and let it lye till it be cold, then put it into Gallipots. This will be very good for two or three years. _To make Raisin Wine._ Take two pound of Raisins of the Sun shred, a pound of good powdered Sugar, the juice of two Lemons, one pill, put these into an earthen Pot with a top, then take two gallons of water, let it boil half an hour, then take it hot from the fire, and put it into the pot, and cover it close for three or four dayes, stirring it twice a day, being strained put it into bottles, and stop it more close, in a fortnight or three weeks it may be drunk; you may put in Clove Gilly flowers, or Cowslips, as the time of the year is when you make it; and when you have drawn this from the Raisins, and bottled it up, heat two quarts of water more, put it to the ingredients, and let it stand as aforesaid. This will be good, but smaller than the other, the water must be boiled as the other. _To make Rasberry Wine._ Take a Gallon of good Rhenish Wine, put into it as much Rasberries very ripe as will make it strong, put it in an earthen pot, and let it stand two dayes, then pour your Wine from your Rasberries, and put into every bottle two ounces of Sugar, stop it up and keep it by you. _The best way to preserve Cherries._ Take the best Cherries you can get, and cut the stalks something short, then for every pound of these Cherries take two pound of other Cherries, and put them of their stalks and stones, put to them ten spoonfuls of fair water, and then set them on the fire to boil very fast till you see that the colour of the syrup be like pale Claret wine, then take it off the fire, and drain them from the Cherries into a Pan to preserve in. Take to every pound of Cherries a quarter of Sugar, of which take half, and dissolve it with the Cherry water drained from the Cherries, and keep them boiling very fast till they will gelly in a spoon, and as you see the syrup thin, take off the Sugar that you kept finely beaten, and put it to the Cherries in the boiling, the faster they boil, the better they will be preserved, and let them stand in a Pan till they be almost cold. _A Tincture of Ambergreece._ Take Ambergreece one ounce, Musk two drams, spirit of Wine half a pint, or as much as will cover the ingredients two or three fingers breadth, put all into a glass, stop it close with a Cork and Bladder; set it in Horse dung ten or twelve days, then pour off gently the Spirit of Wine, and keep it in a Glass close stopt, then put more spirit of Wine on the Ambergreece, and do as before, then pour it off, after all this the Ambergreece will serve for ordinary uses. A drop of this will perfume any thing, and in Cordials it is very good. _To make Usquebath the best way._ Take two quarts of the best _Aqua vitæ_, four ounces of scraped liquorish, and half a pound of sliced Raisins of the Sun, Anniseeds four ounces, Dates and Figs, of each half a pound, sliced Nutmeg, Cinnamon, Ginger, of each half an ounce, put these to the _Aqua vitæ_, stop it very close, and set it in a cold place ten dayes, stirring it twice a day with a stick, then strain and sweeten it with Sugar-candy; after it is strained, let it stand till it be clear, then put into the glass Musk and Ambergreece; two grains is sufficient for this quantity. _To preserve Cherries with a quarter of their weights in Sugar._ Take four pound of Cherries, one pound of Sugar, beat your Sugar and strew a little in the bottom of your skillet, then pull off the stalk and stones of your Cherries, and cut them cross the bottom with a knife; let the juyce of the Cherries run upon the Sugar; for there must be no other liquor but the juyce of the Cherries; cover your Cherries over with one half of your Sugar, boil them very quick, when they are half boiled, put in the remainder of your sugar, when they are almost enough, put in the rest of the sugar; you must let them boil till they part in sunder like Marmalade, stirring them continually; so put them up hot into your Marmalade glasses. _To make Gelly of Pippins._ Take Pippins, and pare them, and quarter them, and put as much water to them as will cover them, and let them boil till all the vertue of the Pippins are out; then strain them, and take to a pint of that liquor a pound of Sugar, and cut long threads of Orange peels, and boil in it, then take a Lemon, and pare and slice it very thin, and boil it in your liquor a little thin, take them out, and lay them in the bottom of your glass, and when it is boiled to a gelly, pour it on the Lemons in the glass. You must boil the Oranges in two or three waters before you boil it in the gelly. _To make Apricock Cakes._ Take the fairest Apricocks you can get, and parboil them very tender, then take off the Pulp and their weight of Sugar, and boil the Sugar and Apricocks together very fast, stir them ever lest they burn to, and when you can see the bottom of the Skillet it is enough; then put then into Cards sowed round, and dust them with fine Sugar, and when they are cold stone them, then turn them, and fill them up with some more of the same stuff; but you must let them stand for three or four dayes before you turn them off the first place; and when you find they begin to candy, take them out of the Cards, dust them with Sugar again; so do ever when you turn them. _To preserve Barberries the best way._ First stone them and weigh them, half a pound of sugar to half a pound of them, then pair them and slice them into that liquor, take the weight of it in sugar; then take as many Rasberries as will colour it, and strain them into the liquor, then put in the sugar, boil it as fast as you can, then skim it till it be very clear, then put in your Barberries, and that sugar you weighed, and so let them boil till the skin be fully risen up, then take them off, and skin them very clean, and put them up. _To make Lozenges of Red Roses._ Boil your sugar to sugar again, then put in your Red Roses being finely beaten and made moist with the juyce of a Lemmon, let it not boil after the Roses are in but pour it upon a Pye-plate, and cut it into what form you please. _To make Chips of Quinces._ First scald them very well, then slice them into a Dish, and pour a Candy Syrup to them scalding hot, and let them stand all night, then lay them on plates, and searse sugar on them, and turn them every day, and scrape more sugar on them till they be dry. If you would have them look clear, heat them in syrup, but not to boil. _To make Sugar of Wormwood, Mint, Anniseed, or any other of that kinde._ Take double refined Sugar, and do but wet it in fair water, or Rose-water and boil it to a Candy, when it is almost boiled take it off, and stir it till it be cold; then drop in three or four drops of the Oyls of whatsoever you will make, and stir it well; then drop it on a board, being before fitted with Sugar. _To make Syrup of Lemons or Citrons._ Pare off all the rindes, then slice your Lemmons very thin, and lay a lare of Sugar finely beaten, and a lare of Lemons in a silver Bason till you have filled it, or as much as you mean to make, & so let it stand all night; the next day pour off the liquor that runs from it into a glass through a Tiffany strainer. Be sure you put sugar enough to them at the first, and it will keep a year good, if it be set up well. _To make Jambals of Apricocks or Quinces._ Take Apricocks or Quinces, and quoddle them tender, then take their Pulp and dry it in a dish over a Chafing-dish of coals, and set it in a Stove for a day or two; then beat it in a stone Mortar, putting in as much Sugar as will make a stiff paste; then colour it with Saunders, Cochinele or blew Starch, and make it up in what colour you please, rowl them with battle doors into long pieces, and tye them up in knots, and so dry them. _To make Cherry-water._ Take nine pound of Cherries, pull out the stones and stalks, break them with you hand, and put them into nine pints of Claret Wine, take nine ounces of Cinamon, and three Nutmegs, bruise them, and put them into this, then take of Rosemary and Balm, of each half a handful, of sweet Marjoram a quarter of a handful; put all these with the aforenamed into an earthen pot well leaded; so let them stand to infuse twenty four hours; so distil it in a Limbeck, keeping the strongest water by it self, put some sugar finely beaten into your glasses. If your first water be too strong, put some of the second to it as you use it. If you please you may tye some Musk and Ambergreese, in a rag, and hang it by a thread in your glass. _To make Orange Cakes._ Take Oranges and pare them as thin as you can, then take out the meats clean, and put them in water; let them lye about an hour, shift the water, and boil them very tender in three or four waters, then put them up, and dry them on a cloath: mince them as small as you can, then put them into a dish, and squeeze all the juyce of the meat into them, and let them stand till the next day, take to every pound of these a pound and a quarter of double refined Sugar. Boil it with a spoonful of water at the bottom to keep it from burning till it be Sugar again; then put in your Oranges and let them stand and dry on the fire, but not boil; then put them on glass plates, and put them in a stove, the next day make them into Cakes, and so fry them as fast as you can. _To preserve Oranges the French way._ Take twelve of the fairest Oranges and best coloured, and if you can get them with smooth skins they are the better, and lay them in Conduit water, six dayes and nights, shifting them into fresh water morning and evening; then boil them very tender, and with a knife pare them very thin, rub them with salt, when you have so done, core them with a coring Iron, taking out the meat and seeds; then rub them with a dry cloth till they be clean, add to every pound of Oranges a pound and half of Sugar, and to a pound of sugar a pint of water; then mingle your, sugar and water well together in a large skillet or pan; beat the whites of three Eggs and put that into it, then set it on the fire, and let it boil till it rises, and strain it through a Napkin; then set it on the fire again, and let it boil till the syrup be thick, then put in your Oranges, and make them seethe as fast as you can, now and then putting in a piece of fine loaf Sugar the bigness of a Walnut, when they have boiled near an hour, put into them a pint of Apple water; then boil them apace, and add half a pint of white Wine, this should be put in before the Apple-water, when your Oranges are very clear, & your Syrup is so thick that it will gelly, (which you may know by setting some to cool in a spoon) when they are ready to be taken off from the fire; then put in the juyce of eight Lemons warm into them, then put them into an earthen pan, and so let them stand till they be cold, then put every Orange in a several glass or pot; if you do but six Oranges at a time it is the better. _To preserve green Plums._ The greatest Wheaten Plum is the best, which will be ripe in the midst of _July_, gather them about that time, or later, as they grow in bigness, but you must not suffer them to turn yellow, for then they never be of good colour; being gathered, lay them in water for the space of twelve hours, and when you gather them, wipe them with a clean linnen cloth, and cut off a little of the stalks of every one, then set two skillets of water on the fire, and when one is scalding hot put in your Plums, and take them from the fire, and cover them, and let them rest for the space of a quarter of an hour; then take them up, and when your other skillet of water doth boil, put them into it; let them but stay in it a very little while, and so let the other skillet of water, wherein they were first boiled, be set to the fire again, and make it to boil, and put in your Plums as before, and then you shall see them rivet over, and yet your Plums very whole; then while they be hot, you must with your knife scrape away the riveting; then take to every pound of Plums a pound and two ounces of Sugar finely beaten, then set a pan with a little fair water on the fire, and when it boils, put in your Plums, and let them settle half a quarter of an hour till you see the colour wax green, then set them off the fire a quarter of an hour, and take a handful of Sugar that is weighed, and strow it in the bottom of the pan wherein you will preserve, and so put in your Plums one by one, drawing the liquor from them, and cast the rest of your Sugar on them; then set the pan on a moderate fire, letting them boil continually but very softly, and in three quarters of an hour they will be ready, as you may perceive by the greenness of your Plums, and thickness of your syrup, which if they be boiled enough, will gelly when it is cold; then take up your Plums, and put them into a Gallipot, but boil your Syrup a little longer, then strain it into some vessel, and being blood-warm, pour it upon your plums, but stop not the pot before they be cold. Note also you must preserve them in such a pan, as they may lye one by another, and turn of themselves; and when they have been five or six days in the syrup, that the syrup grow thin, you may boil it again with a little Sugar, but put it not to your Plums till they be cold. They must have three scaldings, and one boiling. _To dry Plums._ Take three quarters of a pound of Sugar to a pound of black Pear-plums, or Damsins, slit the Plums in the crest, lay a lay of Sugar with a lay of Plums, and let them stand all night; if you stone the Plums, fill up the place with sugar, then boil them gently till they be very tender, without breaking the skins, take them into an earthen or silver dish, and boil your syrup afterwards for a gelly, then pour it on your Plums scalding hot, and let them stand two or three dayes, then let them be put to the Oven after you draw your bread, so often untill your syrup be dryed up, and when you think they are almost dry, lay them in a sieve, and pour some scalding water on them, which will run through the sieve, and set them in an Oven afterwards to dry. _To preserve Cherries the best way, bigger than they grow naturally, &c._ Take a pound of the smallest Cherries, and boil them tender in a pint of fair water, then strain the liquor from the substance, then take two pound of good Cherries, and put them into a preserving-pan with a lay of Cherries, and a lay of sugar: then pour the syrup of the other Cherries about them, and so let them boil as fast as you can with a quick fire, that the syrup may boil over them, and when your syrup is thick and of good colour, then take them up, and let them stand a cooling by partitions one from another, and being cold you may pot them up. _To preserve Damsins, red Plums or black._ Take your Plums newly gathered, and take a little more sugar than they do weigh, then put to it as much water as will cover them; then boil your syrup a little while, and so let it cool, then put in your Damsins or Plums, then boil them leasurely in a pot of seething water till they be tender, then being almost cold pot them up. _To dry Pippins or Pears._ Take your Pippins, Pears, Apricocks, pare them, and lay them in a broad earthen pan one by one, and so rowl them in searsed Sugar as you flower fried fish; put them in an Oven as hot as for manchet, and so take them out, and turn them as long as the Oven is hot; when the Oven is of a drying heat, lay them upon a Paper, and dry them on the bottom of a Sieve; so you may do the least Plum that is. _To dry Pippins or Pears another way._ Take Pippins or Pears, and lay them in an earthen Pan one by one, and when they be baked plump and not broken, then take them out, and lay them upon a Paper, then lay them on a Sieves bottom, and dry them as you did before. _To dry Apricocks tender._ Take the ripest of the Apricoks, pare them, put them into a silver or earthen skillet, and to a pound of Apricocks put three quarters of a pound of Sugar, set your Apricocks over your fire; stirring them till they come to a pulp, and set the Sugar in another skillet by boiling it up to a good height, then take all the Apricocks, and stir them round till they be well mingled, then let it stand till it be something cold and thick, then put it into cards, being cut of the fashion of an Apricock, and laid upon glass plates; fill the Cards half full, then set them in your stove, but when you find they are so dry that they are ready to turn, then provide as much of your pulp as you had before, and so put to every one a stove, when they are turned, (which you must have laid before) & pour the rest of the Pulp upon them, so set them into your stove, turning them till they be dry. _To dry Plums._ Take a pound of Sugar to a pound of Plums, pare them, scald your Plums, then lay your Plums upon a sieve till the water be drained from them, boil your Sugar to a Candy height, and then put your Plums in whilst your syrup is hot, so warm them every morning for a week, then take them out, and put them into your stove and dry them. _To dry Apricocks._ Take your Apricocks, pare and stone them, then weigh half a pound of sugar to a pound of Apricocks, then take half that sugar, and make a thin syrup, and when it boileth, put in the Apricocks; then scald them in that syrup; then take them off the fire, and let them stand all night in that syrup, in the morning take them out of that syrup, and make another syrup with the other half of the sugar, then put them in, and preserve them till they look clear; but be sure you do not do them so much as those you keep preserved without drying; then take them out of that syrup, and lay them on a piece of Plate till they be cold; then take a skillet of fair water, and when the water boils take your Apricocks one after another in a spoon, and dip them in the water first on one side, and then on the other; not letting them go out of the spoon: you must do it very quick, then put them on a piece of plate, and dry them in a Stove, turning them every day; you must be sure that your Stove or Cupboard where you dry them, the heat of it be renewed three times a day with a temperate drying heat untill they be something dry, then afterwards turn once as you see cause. _Conserves of Violets the Italian manner._ Take the leaves of blue Violets separated from their stalks and greens, beat them very well in a stone Mortar, with twice their weight of Sugar, and reserve them for your use in a glass vessel. _The Vertue._ The heat of Choller it doth mitigate extinguisheth thirst, asswageth the belly, and helpeth the Throat of hot hurts, sharp droppings and driness, and procureth rest: It will keep one year. _Conserves of red Roses the Italian manner._ Take fresh red Roses not quite ripe, beat them in a stone Mortar, mix them with double their weight of Sugar, and put them in a glass close stopped, being not full, let them remain before you use them three months, stirring of them once a day. _The Vertues._ The Stomach, Heart, and Bowels it cooleth, and hindreth vapours, the spitting of blood and corruption for the most part (being cold) it helpeth. It will keep many years. _Conserve of Borage Flowers after the Italian manner._ Take fresh Borage flowers cleansed well from their heads four ounces, fine sugar twelve ounces, beat them well together in a stone Mortar, and keep them in a vessel well placed. The vertues are the same with Bugloss flowers. _Conserve of Rosemary flowers after the Italian manner._ Take new Rosemary Flowers one pound, of white sugar one pound; so beat them together in a Marble Mortar with a wooden Pestle, keep it in a gallipot, or vessel of earth well glassed, or in one of hard stone. It may be preserved for one year or two. _The Vertues._ It comforteth the heart, the stomach, the brain, and all the nervous part of the Body. _Conserve of Betony after the Italian way._ Betony new and tender one pound, the best sugar three pound, beat them very small in a stone Mortar, let the sugar be boiled with two pound of Betony-water to the consistance of a syrup, at length mix them together by little and little over a small fire, and make a Conserve, which keep in a glass. _The Vertues._ It helpeth the cold pains of the head, purgeth the stomach and womb: it helpeth stoniness of the Reins, and furthereth Conception. _Conserve of Sage._ Take new flowers of Sage one pound, sugar one pound; so beat them together very small in a Marble Mortar, put them in a vessel well glassed and steeped, set them in the Sun, stir them daily; it will last one year. _The Vertues._ It is good in all cold hurts of the brain, it refresheth the Stomach, it openeth obstructions and takes away superfluous and hurtfull humours from the stomach. _Conserve of flowers of Lavender._ Take the flowers being new, so many as you please, and beat them with three times their weight of white Sugar, after the same manner as Rosemary flowers; they will keep one year. _The Vertues._ The Brain, the Stomach, Liver, Spleen, and Womb it maketh warm, and is good in the Suffocation of the Womb, hardness of the spleen and for the Apoplexy. _Conserve of Marjoram._ The Conserve is prepared as Betony, it keepeth a year. _The Vertues._ It is good against the coldness, moistness of the Brain, and Stomach, and it strengthneth the Vital spirits. _Conserve of Peony after the Italian way._ In the Spring take of the Flowers fresh half a pound, Sugar one pound, beat them together in a good stone Mortar, then put them in a glass, and set them in the sun for three months, stirring them daily with a wooden Spathula. _The Vertues._ It is good against the Falling-sickness, and giddiness in the head, it cleanseth the Reins and Bladder. Touching Candies, as followeth. _To Candy Rosemary-flowers in the Sun._ Take Gum-Dragon, and steep it in Rose-water, then take the Rosemary flowers, good coloured, and well pickt, and wet them in the water that your Gum dragon is steeped in, then take them out, and lay them upon a paper, and strew fine Sugar over them; this do in the hot sun, turning them, and strewing Sugar on them, till they are candied, and so keep them for your use. _To Make Sugar of Roses._ Take the deepest coloured red Roses, pick them, cut off the white bottoms, and dry your red leaves in an Oven, till they be as dry as possible, then beat them to powder and searse them, then take half a pound of Sugar beaten fine, put it into your pan with as much fair water as will wet it; then set it in a chaffing-dish of coals, and let it boil till it be sugar again, then put as much powder of Roses as will make it look very red stir them well together, and when it is almost cold, put it into pailes, and when it is throughly cold, take them off, and put them in boxes. _To Candy Pippins, Pears, Apricocks or Plums._ Take of these fruits being pared, and strew sugar upon them, as you do flower upon frying fish; then lay them on a board in a Pewter dish, so put them into an Oven as hot as for Manchet; as the liquor comes from them, pour forth, turn them, and strew more Sugar on them, and sprinkle Rose-water on them, thus turning and sugaring of them three or four times, till they be almost dry, then lay them on a Lettice Wire, or on the bottom of a sieve in a warm Oven, after the bread is drawn out, till they be full dry: so you may keep them all the year. _To Candy or clear Rockcandy flowers._ Take spices, and boil them in a syrup of Sugar, then put in the flowers, boil them till they be stiff, when you spread them on a Paper, lay them on round Wires in an earthen pan, then take as much hard Sugar as will fill your pan, and as much water as will melt the sugar, that is half a pint to every pound; then beat a dozen spoonfuls of fair water, and the white of an Egg in a bason, with a birchen rod till it come to a Froth, when your sugar is melted and boiled, put the froth of the Egg in the hot syrup, and as it riseth, drop in a little cold water; so let it boil a little while, then scum it, then boil it to a Candy height, that is, when you may draw it in small threads between your finger and your thumb: then pour forth all your syrup that will run from it in your pan, then set it a drying one hour or two, which done pick up the wiers, and take off the flowers, and lay them on papers, and so dry them. _To Candy Spanish Flowers._ Take the Blossoms of divers sorts of flowers, and make a syrup of water and sugar, and boil it very thick, then put in your Blossoms, and stir them in their boiling, till it turn to sugar again, then stir them with the back of a spoon, till the Sugar fall from it; so may you keep them for Sallets all the year. _To Candy Grapes, Cherries or Barberries._ Take of these fruits, and strew fine sifted sugar on them, as you do flower on frying fish, lay them on a lattice of wier in a deep earthen pan, and put them into an Oven as hot as for Manchet; then take them out, and turn them and sugar them again, and sprinkle a little Rose-water on them, pour the syrup forth as it comes from them, thus turning and sugaring them till they be almost dry, then take them out of the earthen pan, and lay them on a lattice of wire, upon two billets of wood in a warm Oven, after the bread is drawn, till they be dry and well candied. _To Candy Suckets of Oranges, Lemons, Citrons, and Angelica._ Take, and boil them in fair water tender, and shift them in three boilings, six or seven times, to take away their bitterness, then put them into as much Sugar as will cover them, and so let them boil a walm or two, then take them out, and dry them in a warm Oven as hot as Manchet, and being dry boil the Sugar to a Candy height, and so cast your Oranges into the hot Sugar, and take them out again suddenly, and then lay them upon a lattice of Wyer or the bottom of a Sieve in a warm Oven after the bread is drawn, still warming the Oven till it be dry, and they will be well candied. _To Candy the Orange Roots._ Take the Orange Roots being well and tenderly boiled, petch them and peel them, and wash them out of two or three waters; then dry them well with a fair cloth; then pot them together two or three in a knot, then put them into as much clarified Sugar as will cover them, and so let them boil leisurely, turning them well until you see the Sugar drunk up into the Root; then shake them in the Bason to sunder the knits; and when they wax dry, take them up suddenly, and lay them on sheets of white Paper, and so dry them before the fire an hour or two, and they will be candied. _Candy Orange Peels after the Italian way._ Take Orange Peels so often steeped in cold water, as you think convenient for their bitterness, then dry them gently, and candy them with some convenient syrup made with Sugar, some that are more grown, take away that spongious white under the yellow peels, others do both together. _The Vertues._ They corroborate the Stomach and Heart. _To Candy Citrons after the Spanish way._ Take Citron Peels so large as you please the inner part being taken away, let them be steeped in a clear lye of water and ashes for nine dayes, and shift them the fifth day, afterward wash them in fair water, till the bitterness be taken away, and that they grow sweet, then let them be boiled in fair water till they grow soft, the watry part being taken away, let them be steeped in a vessel of stone twenty four hours, with a Julip, made of white Sugar and three parts water; after let them be boiled upon a gentle fire, to candiness of Penidies or Paste; being taken out of that, let them be put into a glass vessel, one by one, with the julip of Roses made somewhat hard or with sugar; some do add Amber and Musk to them. _The Vertues._ It comforteth the Stomach and Heart, it helpeth concoction. _Candied Cherries, the Italian way._ Take Cherries before they are full ripe, the stones taken out, put clarified sugar boiled to a height, then pour it on them. _Chicory Roots candied the Italian way._ Take Chicory new and green, the outward Bark being taken away, then before they be candied, let them be cut in several parts, and gently boiled, that no bitterness may remain, then set them in the air placed severally, and put sugar to them boiled to a height. Touching Marmalets, and Quiddony, as followeth. _To make Marmalet of Damsins._ Take two quarts of Damsins that be through ripe, and pare off the skin of three pints of them, then put them into an earthen Pipkin, those with the skins undermost then set the Pipkin into a pot of seething water, and let the water seethe apace untill the Damsins be tender. Cover the Pipkin close, that no water gets into them, and when they are tender, put them out into an earthen pan, and take out all the stones and skins, and weigh them, and take the weight with hard sugar, then break the sugar fine, and put it into the Damsins, then set it on the fire, and make it boil apace till it will come from the bottome of the skillet, then take it up, and put it into a glass but scum it clear in the boiling. _To make white Marmalet of Quinces._ Take unpared Quinces, and boil them whole in fair water, peel them and take all the pap from the core, to every pound thereof add three quarters of a pound of Sugar, boil it well till it comes well from the pans bottom, then put it into boxes. _To make Marmalet of any tender Plum._ Take your Plums, & boil them between two dishes on a Chafing dish of coals, then strain it, and take as much Sugar as the Pulp doth weigh, and put to it as much Rose-water, and fair water as will melt it, that is, half a pint of water to a pound of Sugar, and so boil it to a Candy height, then put the pulp into hot sugar, with the pap of a roasted apple. In like manner you must put roasted apples to make Past Royal of it, or else it will be tough in the drying. _To make Orange Marmalet._ Take Oranges, pare them as thin as you can; boil them in four several waters, let them be very soft before you take them out, then take two quarts of Spring-water, put thereto twenty Pippins pared, quartered, and coared, let them boil till all the vertue be out, take heed they do not lose the colour; then strain them, put to every pint of water a pound of sugar, boil it almost to a Candy-height, then take out all the meat out of the Oranges, slice the peel in long slits as thin as you can, then put in your peel with the juyce of two Lemmons, and one half Orange, then boil it to a Candy. _To make Quiddony of Pippins of Ruby or any Amber colour._ Take Pippins, and cut them in quarters, and pare them, and boil them with as much fair water as will cover them, till they be tender, and sunk into the water, then strain all the liquor from the Pulp, then take a pint of that liquor, and half a pound of Sugar, and boil it till it be a quaking gelly on the back of a spoon; so then pour it on your moulds, being taken out of fair water; then being cold turn them on a wet trencher, and so slide them into the boxes, and if you would have it ruddy colour, then boil it leasurely close covered, till it be as red as Claret Wine, so may you conceive, the difference is in the boiling of it; remember to boil your Quinces in Apple-water as you do your Plums. _To make Quiddony of all kind of Plums._ Take your Apple-water, and boil the Plums in it till it be red as Claret Wine, and when you have made it strong of the Plums, put to every pint half a pound of Sugar, and so boil it till a drop of it hang on the back of a spoon like a quaking gelly. If you will have it of an Amber colour, then boil it with a quick fire, that is all the difference of the colouring of it. _To make Marmalet of Oranges, or Orange Cakes, &c._ Take the yellowest and fairest Oranges, and water them three days, shifting the water twice a day, pare them as thin as you possible can, boil them in a water changed five or six times, until the bitterness of the Orange be boiled out, those that you preserve must be cut in halves, but those for Marmalet must be boiled whole, let them be very tender, and slice them very thin on a Trencher, taking out the seeds and long strings, and with a Knife make it as fine as the Pap of an Apple; then weigh your Pap of Oranges, and to a pound of it, take a pound and a half of sugar; then you must have Pippins boiled ready in a skillet of fair water, and take the pap of them made fine on a Trencher, and the strings taken out, (but take not half so much Pippins as Oranges) then take the weight of it in sugar, and mix it both together in a Silver or Earthen Dish; and set it on the coals to dry the water out of it, (as you do with Quince Marmalet) when your sugar is Candy height, put in your stuff, and boil it till you think it stiff enough, stirring it continually: if you please you may put a little Musk in it. Touching Pastrey and Pasties. _To make Sugar Cakes._ Take three pound of the finest Wheat Flower, one pound of fine Sugar, Cloves, and Mace of each one ounce finely searsed, two pound of butter, a little Rose-water, knead and mould this very well together, melt your butter as you put it in; then mould it with your hand forth upon a board, cut them round with a glass, then lay them on papers, and set them in an Oven, be sure your Oven be not too hot, so let them stand till they be coloured enough. _To make clear Cakes of Plums._ Take Plums of any sorts, Raspiss are the best, put them in a stone Jug, into a pot of seething water, and when they are dissolved, strain them together through a fair cloth, and take to a pint of that a pound of sugar, put to as much color as will melt it, and boil to a Candy height; boil the liquor likewise in another Posnet, then put them seething hot together, and so boil a little while stirring them together, then put them into glasses, and set them in an Oven or Stove in a drying heat, let them stand so two or three weeks, and never be cold, removing them from one warm place to another, they will turn in a week; beware you set them not too hot, for they will be tough; so every day turn them till they be dry; they will be very clear. _To make Paste of Oranges and Lemons._ Take your Oranges well coloured, boil them tender in water, changing them six or seven times in the boiling, put into the first water one handful of Salt, and then beat them in a wooden bowl with a wooden Pestle, and then strain them through a piece of Cushion Canvas, then take somewhat more than the weight of them in Sugar, then boil it, dry and fashion it as you please. _To make Rasberry Cakes._ Take Rasberries, and put them into a Gallipot, cover them close, and set them into a skillet of water, and let them boil till they are all to mash, then rub them through a strainer of Cushion Canvas, put the liquor into a silver bason, and set it upon a very quick fire; and put into it one handful or two of whole Rasberries, according to the quantity of your liquor; and as you shall like to have seeds in your paste: Thus let it boyl very fast till it be thick; and continually stir, lest it burn; then take two silver dishes that are of a weight, and put them into your scales, in the one put the Raspiss stuffe, and in the other double refined Sugar finely beaten, as much as the weight of Raspiss stuff; then put as much water to the sugar as will melt it, set it upon the fire, and let it boil till it be very high candied, then take it from the fire, and put your Raspiss stuff into it; and when your Sugar and Rasberries are very well mixt together, and the sugar well melted from about the dish, (which if it will not do from the fire, set it on again) but let it not boil in any case; when it is pretty cool, lay it by spoonfuls in places, and put it into your stuff, keeping temperate fire to it twice a day till it be candied that will turn them, joyn two of the pieces together, to make the cakes the thicker. _To make Paste of Genoa Citrons._ Take Citrons, & boil them in their skins, then scrape all the pulp from the core, strain it through a piece of Cushion Canvas, take twice the weight of the pulp in Sugar, put to it twice as much water as will melt it that is half a pint to every pound of Sugar, boil it to a Candy height; dry the Pulp upon a Chafing-dish of Coales, then put the syrup and the Pulp hot together, boil it with stirring until it will lye upon a Pye-plate, set it in a warm stone Oven upon two billets of wood, from the heat of the Oven, all one night, in the morning turn it, and set it in the like heat again, so turn it every day till it be dry. _To make a French Tart._ Take a quarter of Almonds or thereabouts, and peel them, then beat them in a mortar, take the white of the breast of a cold Capon, and take so much Lard as twice the quantity of the Capon, and so much Butter, or rather more, and half a Marrow-bone, and if the bone be little then all the Marrow, with the juyce of one Lemon; beat them all together in a Mortar very well, then put in one half pound of loaf sugar grated, then take a good piece of Citron, cut it in small pieces, and half a quarter of Pistanius, mingle all these together, take some flour, and the yolks of two or three Eggs, and some sweet Butter, and work it with cold water. _To make Cakes of Pear Plums._ Take a pound of the clear, or the Pulp, a pound of Sugar, and boil it to a Sugar again, then break it as small as you can, and put in the clear, when your Sugar is melted in it, and almost cold, put it in glass plates, and set them into your stove as fast as you can, with coals under them, and so twice a day whilst they be dry enough to cut; if you make them of the clear, you must make paste of Apples to lay upon them, you must scald them, and beat them very well, and so use them as you do your Plums, and then you may put them into what fashion you please. _To make Cakes, viz._ Take a pound of Sugar finely beaten, four yolks of Eggs, two whites, one half pound of Butter washt in Rose-water, six spoonfuls of sweet Cream warmed, one pound of Currans well pickt, as much flower as will make it up, mingle them well together, make them into Cakes, bake them in an Oven; almost as hot as for Manchet, half an hour will bake them. _To make a Cake the way of the Royal Princess, the Lady_ Elizabeth, _daughter to King_ Charles _the first._ Take half a peck of Flower, half a pint of Rose-water, a pint of Ale-yeast, a pint of Cream, boil it, a pound and an half of Butter, six Eggs, (leave out the whites) four pound of Currans, one half pound of Sugar, one Nutmeg, and a little Salt, work it very well, and let it stand half an hour by the fire, and then work it again, and then make it up, and let it stand an hour and a half, in the Oven; let not your Oven be too hot. _To make Paste of Apricocks._ Take your Apricock, & pare them, and stone them, then boil them tender betwixt two dishes on a Chafing-dish of coals; then being cold, lay it forth on a white sheet of paper; then take as much sugar as it doth weigh, & boil it to a candy height, with as much Rose-water and fair water as will melt the sugar; then put the pulp into the Sugar, and so let it boil till it be as thick as for Marmalet, now and then stirring of it; then fashion it upon a Pye-plate like to half Apricocks, and the next day close the half Apricocks to the other, and when they are dry, they will be as cleer as Amber, and eat much better than Apricocks itself. _To make Paste of Pippins like leaves, and some like Plums, with their stones, and Stalks in them._ Take Pippins pared and coared, and cut in pieces, and boiled tender, so strain them, and take as much Sugar as the Pulp doth weigh, and boil it to a Candy height with as much Rose-water and fair water as will melt it, then put the pulp into the hot sugar, and let it boil until it be as thick as Marmalet; then fashion it on a Pye-plate, like Oaken leaves, and some like half Plums, the next day close the half Plums together; and if you please you may put the stones and stalks in them, and dry them in an Oven, and if you will have them look green, make the paste when Pippins are green; and if you would have them look red, put a little Conserves of Barberries in the Paste, and if you will keep any of it all the year, you must make it as thin as Tart stuff, and put it into Gallipots. _To make Paste of Elecampane roots, an excellent remedy for the Cough of the Lungs._ Take the youngest Elecampane roots, and boil them reasonably tender; then pith them and peel them; and so beat it in a Mortar, then take twice as much sugar as the Pulp doth weigh, and so boil it to a Candy height, with as much Rose-water as will melt it; then put the pulp into the Sugar with the pap of a roasted-apple, then let it boil till it be thick, then drop it on a Pye-plate, and so dry it in an Oven till it be dry. _To make Paste of flowers of the colour of Marble, tasting of natural flowers._ Take every sort of pleasing Flowers, as Violets, Cowslips, Gilly-flowers, Roses or Marigolds, and beat them in a Mortar, each flower by it self with sugar, till the sugar become the colour of the flower, then put a little Gum Dragon steept in water into it, and beat it into a perfect paste; and when you have half a dozen colours, every flower will take of his nature, then rowl the paste therein, and lay one piece upon another, in mingling sort, so rowl your Paste in small rowls, as big and as long as your finger, then cut it off the bigness of a small Nut, overthwart, and so rowl them thin, that you may see a knife through them, so dry them before the fire till they be dry. _To make Paste of Rasberries or English Currans._ Take any of the Frails, and boil them tender on a Chafing-dish of coals betwixt two dishes and strain them, with the pap of a rosted Apple; then take as much sugar as the Pulp doth weigh, and boil to a Candy height with as much Rose-water as will melt it; then put the Pulp into the hot Sugar, and let it boil leisurely till you see it is as thick as Marmalet, then fashion it on a Pie-plate, and put it into the Oven with two billets of wood, that the place touch not the bottom, and so let them dry leasurely till they be dry. _To make Naples Bisket._ Take of the same stuff the Mackaroons are made of, and put to it an ounce of pine-apple-seeds in a quarter of a pound of stuff, for that is all the difference between the Mackaroons and the Naples Bisket. _To make Italian Biskets._ Take a quarter of a pound of searsed sugar, and beat it in an Alablaster mortar with the white of an Egg, and a little Gum Dragon steept in Rose-water, to bring it to a perfect paste, then mould it up with a little Anniseed and a grain of Musk; then make it up like Dutch-bread, and bake it on a Pie-plate in a warm Oven till they rise somewhat high and white, take them out, but handle them not till they be throughly dry and cold. _To make Prince Biskets_ Take a pound of searsed sugar, and a pound of fine flower, eight Eggs with two of the reddest yolks taken out, and so beat together one whole hour, then take you Coffins, and indoice them over with Butter very thin, then put an ounce of Anniseeds finely dusted, and when you are ready to fill your Coffins, put in the Anniseeds and so bake it in an Oven as hot as for Manchet. _To make Marchpane to Ice and Gild, and garnish it according to Art._ Take Almonds, and blanch them out of seething water, and beat them till they come to a fine paste in a stone Mortar, then take fine searsed sugar, and so beat it altogether till it come to a prefect paste, putting in now and then a spoonful of Rose-water, to keep it from oyling; then cover your Marchpane with a sheet of paper as big as a Charger, then cut it round by that Charger, and set an edge about it as about a Tart, then bottom it with Wafers, then bake it in an Oven, or in a Baking-pan, and when it is hard and dry, take it out of the Oven, and ice it with Rose-water and Sugar, and the white of an Egg, being as thick as butter, and spread it over thin with two or three feathers; and then put it into the Oven again, and when you see it rise high and white, take it out again and garnish it with some pretty conceit, and stick some long Comfits upright in it, so gild it, then strow Biskets and Carrawayes on it. If your Marchpane be Oyly in beating, then put to it as much Rose-water as will make it almost as thin as to ice. _Lozenges_ Take Blossoms of Flowers, and beat them in a bowl-dish, and put them in as much clarified Sugar as may come to the colour of the cover, then boile them with stirring, till it is come to Sugar again; then beat it fine, and searse it, and so work it up to paste with a little Gum Dragon, steep it in Rose-water, then print it with your mould, and being dry, keep it up. _To make Walnuts artificial._ Take searsed Sugar, and Cinnamon, of quantity a like, work it up with a little Gum Dragon, steep it in Rose-water, and print it in a mould made like a Walnut-shell, then take white Sugar Plates, print it in a mold made like a Walnut kernel, so when they are both dry, close them up together with a little Gum Dragon betwixt, and they will dry as they lie. _To make Collops like Bacon of Marchpane._ Take some of your Marchpane Paste, and work it in red Saunders till it be red; then rowl a broad sheet of white Paste, and a sheet of red Paste, three of the white, and four of the red, and so one upon another in mingled sorts, every red between, then cut it overthwart, till it look like Collops of Bacon, then dry it. _To make artificial Fruits._ Take a Mould made of Alablaster, three yolks, and tye two pieces together, and lay them in water an hour, and take as much sugar as will fill up your mold, and boil it in a _Manus Christi_, then pour it into your mould suddenly, and clap on the lid, round it about with your hand, and it will be whole and yellow, then colour it with what colour you please, half red, or half yellow, and you may yellow it with a little Saffron steept in water. Touching Preserves and Pomanders. _To make an excellent perfume to burn between two Rose leaves._ Take an ounce of Juniper, an ounce of Storax, half a dozen drops of the water of Cloves, six grains of Musk, a little Gum Dragon steept in water, and beat all this to paste, then roll it in little pieces as big as you please, then put them betwixt two Rose-leaves, and so dry them in a dish in an Oven, and being so dried, they will will burn with a most pleasant smell. _To make Pomander._ Take an ounce of Benjamin, an ounce of Storax, and an ounce of Laudanum, heat a Mortar very hot, and beat all these Gums to a perfect paste; in beating of it, put in six grains of Musk, four grains of Civet; when you have beaten all this to a fine paste with you hands with Rose-water, rowl it round betwixt your hands, and make holes in the heads, and so string them while they be hot. _To make an Ipswich Water._ Take a pound of fine white Castle-soap shave it thin in a pint of Rose-water, and let it stand two or three days; then pour all the water from it, and put to it half a pint of freshwater; and so let it stand one whole day, then pour out that, and put half a pint more, and let it stand a night more then put to it half an ounce of powder called sweet Marjoram, a quarter of an ounce of the powder of Winter-Savory, two or three drops of the Oyl of Spike, and the Oyl of Cloves, three grains of Musk, and as much Ambergreese; work all these together in a fair Mortar, with the powder of an Almond Cake dryed, and beaten as small as fine flour, so rowl it round in your hands in Rose-water. _To make a sweet Smell._ Take the Maste of a sweet Apple-tree, being gathered betwixt the two Lady-dayes, and put to it a quarter of Damask Rose-water, & dry it in a dish in an Oven; wet in drying two or three times with Rose-water, then put to it an ounce of Benjamin, an ounce of Storax Calamintæ: these Gums being beaten to powder, with a few leaves of Roses, then you may put what cost of Smells you will bestow, as much Civet or Ambergreese, and beat it altogether in a Pomander or a Bracelet. Touching Wine. _To make Hypocras._ Take four Gallons of Claret Wine, eight ounces of Cinnamon, three Oranges, of Ginger, Cloves, and Nutmegs a small quantity, Sugar six pound, three sprigs of Rosemary, bruise all the spices somewhat small, and so put them into the Wine, and keep them close stopped, and often shaked together a day or two, then let it run through a gelly bag twice or thrice with a quart of new Milk. _The Lady_ Thornburghs _Syrup of Elders._ Take Elder-berries when they be red, bruise them in a stone Mortar, strain the juyce, and boil it to a consumption of almost half, scum it very clear, take it off the fire whilest it is hot, put in sugar to the thickness of a syrup; put it no more on the fire, when it is cold, put it into Glasses, not filling them to the top, for it will work like Beer. This cleanseth the stomach and spleen, and taketh away all obstructions of the Liver, by taking the quantity of a spoonful in a morning, and fasting a short time after it. _To make gelly of Raspis the best way._ Take the Raspis, and set them over the fire in a Posnet, and gather out the thin juyce, the bottom of the skillet being cooled with fair water, and strain it with a fine strainer, and when you have as much as you will, then weigh it with Sugar, and boil them till they come to a Gelly, which you may perceive by drawing your finger on the back of the spoon. _To dry Fox Skins._ Take your shee Fox Skins, nail them upon a board as strait as you can, then brush them as clean as you can, then take Aqua Fortis, and put into it a six pence, and still put in more as long as it will dissolve it, then wash your skin over with this water, and set it to dry in the sun; and when it is dry, wash it over with the spirits of wine; this must be done in hottest time of Summer. Choice Secrets made known. _To make true Magistery of Pearl._ Dissolve two or three ounces of fine seed Pearl in distilled Vinegar, & when it is perfectly dissolved, and all taken up, pour the Vinegar into a clean glass Bason; then drop some few drops of Oyl of Tartar upon it, & it will cast down the Pearl into fine Powder, then pour the Vinegar clean off softly, then put to the Pearl clear Conduit or Spring water; pour that off, and do so often untill the taste of the Vinegar and Tartar be clean gone, then dry the powder of Pearl upon warm embers, and keep it for your use. _How to make Hair grow._ Take half a pound of Aqua Mellis in the Spring time of the year, warm a little of it every Morning when you rise in a Sawcer, and tie a little spunge to a fine box comb, and dip it in the water, and therewith moisten the roots of the Hair in combing it, and it will grow long, thick, and curled in a very short time. _To write Letters of Secret, that they cannot be read without the directions following._ Take fine Allum, beat it small, and put a reasonable quantity of it into water, then write with the said water. The work cannot be read, but by steeping your paper in fair running water. You may likewise write with Vinegar, or the juyce of Lemon or Onion; if you would read the same, you must hold it before the fire. _How to keep Wine from Sowring._ Tye a piece of very salt Bacon on the inside of your barrel, so as it touch not the Wine, which will preserve Wine from sowring. _To take out Spots of Grease or Oyl._ Take bones of sheeps feet, burn them almost to ashes, then bruise them to powder, and put of it on the spot, and lay it in the sun when it shineth hottest, when the powder becomes black, lay on fresh in the place till it fetch out the spots, which will be done in a very short time. _To make hair grow black, though any colour._ Take a little Aqua Fortis, put therein a groat or sixpence, as to the quantity of the aforesaid water, then set both to dissolve before the fire, then dip a small spunge in the said water, and wet your beard or hair therewith; but touch not the skin. _King_ Edwards _perfume._ Take twelve spoonfuls of right red Rose-water, the weight of six pence in fine powder of Sugar, and boil it on hot Embers and Coles softly, and the house will smell as though it were full of Roses; but you must burn the sweet Cypress wood before, to take away the gross air. _Queen_ Elizabeths _Perfume._ Take eight spoonfuls of Compound water, the weight of two pence in fine powder of Sugar, and boil it on hot Embers and Coals, softly, and half an ounce of sweet Marjoram dried in the Sun, the weight of two pence of the powder of Benjamin. This Perfume is very sweet, and good for the time. _Mr._ Ferene _of the_ New Exchange, _Perfumer to the Queen, his rare Dentifrice, so much approved of at Court._ First take eight ounces of Ireos roots, also four ounces of Pomistone, and eight ounces of Cutle-bone, also eight ounces of Corral, and a pound of Brick if you desire to make them red; but he did oftener make them white, and then instead of the Brick did take a pound of fine Alabaster; all this being throughly beaten, and sifted through a fine searse, the powder is then ready prepared to make up in a paste, which must be done as follows. _To make the said Powder into Paste._ Take a little Gum Dragant, and lay it in steep twelve hours, in Orange flower water, or Damask Rose-water, and when it is dissolved, take the sweet Gum, and grind it on a Marble stone with the aforesaid powder, and mixing some crums of white bread, it will come into a Paste, the which you may make Dentifrices, of what shape or fashion you please, but rolls is the most commodious for your use. _The Receipt of the Lady_ Kents _powder, presented by her Ladyship to the Queen._ Take white Amber, Crabs eyes, red Corral, Harts-horn and Pearl, all prepared several, of each a like proportion, tear and mingle them, then take Harts-horn gelly, that hath some Saffron put into a bag, dissolve into it while the gelly is warm, then let the gelly cool, and therewith make a paste of the powders, which being made up into little balls, you must dry gently by the fire side. Pearl is prepared by dissolving it with the juyce of Lemons, Amber prepared by beating it to powder; so also Crabs-eyes and Coral, Harts-horn prepared by burning it in the fire, and taking the shires of it especially, the pith wholly rejected. _A Cordial Water of Sir_ Walter Raleigh. Take a gallon of Strawberries, and put them into a pint of _Aqua vitæ_, let them stand for four or five days, strain them gently out, and sweeten the water as you please with fine Sugar; or else with perfume. _The Lady_ Malets _Cordial Water._ Take a pound of fine Sugar beaten and put to it a quart of running water, pour it three or four times through a bag; then put a pint of Damask Rose-water, which you must always pour still through the bag, then four penniworth of Angelica water, four pence in Clove-water, four pence of Rosa Solis, one pint of Cinnamon-water, or three pints and a half _Aqua vitæ_, as you find it in taste; put all these together three or four times through the bag or strainer, and then take half an ounce of good Muskallis and cut them grosly, & put them into a glass, and fill them with the water, &c. * * * * * _A Sovereign Water of Dr._ Stephens, _which he long times used, wherewith he did many Cures; he kept secretly till a little before his death, and then he gave it to the Lord Arch-bishop of_ Canterbury _in writing, being as followeth_, viz. * * * * * Take a Gallon of good Gascoine Wine, and take Ginger, Gallingale, Cinamon, Nutmegs, Cloves, Grains, Anniseeds, Fennil-seed, of every of them a dram, then take Caraway-seed, of red Mints, Roses, Thime, Pellitory of the Wall, Rosemary, wild Thime, Camomil, the leaves if you cannot get the flowers, of small Lavander, of each a handful, then bray the Spices small, and bray the Herbs, and put all into the Wine, and let it stand for twelve hours, stirring divers times, then still it in a Limbeck, and keep the first water, for it is best, then put the second water by it self, for it is good, but not of such vertues, &c. _The Vertues of this water._ It comforts the Spirits Vital, and helps all inward Diseases that come of cold, it is good against the shaking of the Palsie; it cures the contraction of the Sinews, helps the conception of Women if they be Barren, it kills the Worms in the Belly and Stomach; it cures the cold Dropsie, and helps the Stone in the Bladder, and in the Reins of the back; it helps shortly the stinking breath, and whosoever useth this Water morning and evening, (and not too often) it preserveth him in good liking, and will make him seem young very long, and Comforteth nature marvellously; with this water did Dr. _Stephens_ preserve his life, till extream age would not let him go or stand and he continued five years, when all the Physicians judged he would not live a year longer, nor did he use any other Medicine but this, &c. _A Plague Water to be taken one spoonful every four hours with one sweat every time._ Take Scabious; Betony, Pimpernel, and Turmentine-roots, of each a pound, steep these all night in three gallons of strong Beer, and distil them all in a Limbeck, and when you use it, take a spoonful thereof every four hours, and sweat well after it, draw two quarts of water, if your Beer be strong, and mingle them both together. _Poppy water._ Take four pound of the flower of Poppies well pickt and sifted, steep them all night in three Gallons of Ale that is strong, and still it in a Limbeck; you may draw two quarts, the one will be strong and the other will be small, &c. _A Water for a Consumption, or for a Brain that is weak._ Take Cream (or new milk) and Claret-wine, of each three pints of Violet-flowers, Bugloss and Borage-flowers, of each a spoonful, Comfrey, Knot-grass, and Plantane of these half a handful, three or four Pome-waters sliced, a stick of Liquorish, some Pompion seeds and strings; put to this a Cock that hath been chased and beaten before he was killed, dress it as to boil, and parboil it until there be no blood in it; then put them in a pot, and set them over your Limbeck, and the soft fire; draw out a pottle of water, then put your water in a Pipkin over a Charcoal fire, and boil it a while, dissolve therein six ounces of white Sugar-candy, & two penny weight of Saffron: when it is cold strain it into a glass, & let the Patient drink three or four spoonfuls three or four times a day blood-warm; your Cock must be cut into small pieces, & the bones broken, and in case the flowers and herbs are hard to come by, a spoonful of their stilled waters are to be used. _Another of the same._ Take a pottle of good Milk, one pint of Muscadine, half a pint of red Rose-water, a penny manchet sliced thin, two handfuls of Raisins of the sun stoned, a quarter of a pound of fine sugar, sixteen Eggs beaten; mix all these together, then distill them in a common still with a soft fire, then let the Patient drink three or four spoonfuls at a time blood warm, being sweetned with _Manus Christi_ made with Corral and Pearl; when your things are all in the still, strew four ounces of Cinamon beaten; this water is good to put into broath, &c. _A good Stomach Water._ Take a quart of _Aqua Composita_, or _Aqua vitæ_, (the smaller) and put into it one handful of Cowslip flowers, a good handful of Rosemary flowers, sweet Marjoram, a little Pellitory of the Wall, a little Betony and Balm, of each a little handful, Cinnamon half an ounce, Nutmegs a dram, Anniseeds, Coriander seeds, Caroway seeds, Gromel seeds, Juniper berries, of each a dram, bruise the spice and seed, and put them into _Aqua Composita_, or _Aqua vitæ_, with your Herbs together, and put into them a pound of very fine sugar, stir them well together, and put them into a glass and let it stand in the sun nine days, and stir it every day; two or three Dates, and a little race of Ginger sliced into it will make it the better, especially against wind, &c. _A Bag of purging Ale._ Take of Agrimony, Speedwell, Liverwort, Scurvy-grass, Water-cresses, of each a handful, of Monks Rhubarb, and red Madder, of each half a pound, of Horseradishes three ounces, Liquorish two ounces, Sassafrage four ounces, Sena seven ounces, sweet Fennil-seeds two drams, Nutmegs four; pick and wash your Herbs and Roots, and bruise them in a Mortar, and put them in a bag made of a Bolter, & so hang them in three gallons of middle Ale, and let it work in the Ale, and after three days you may drink it as you see occasion, &c. _The Ale of Health and Strength, by Viscount St._ Albans. Take Sassafras wood half an ounce, Sarsaparilla three ounces, white Saunders one ounce, Chamapition an ounce, China-root half an ounce, Mace a quarter of an ounce, cut the wood as thin as may be with a knife into small peices, and bruise them in a Mortar; put to them these sorts of Herbs, (viz.) Cowslip flowers, Roman-wormwood, of each a handful, of Sage, Rosemary, Betony, Mugwort, Balm and Sweet-marjoram, of each half a handful, of Hops; boil all these in six gallons of Ale till it come to four; then put the wood and hearbs into six gallons of Ale of the second wort, and boil it till it come to four, let it run from the dregs, and put your Ale together, and tun it as you do other purging Ale, &c. _A Water excellent good against the Plague._ Take three pints of Malmsey, or Muscadine, of Sage and Rue, of each one handful, boil them together gently to one pint, then strain it and set it on the fire again, and put to it one penniworth of Long Pepper, Ginger four drams, Nutmegs two drams, all beaten together, then let it boil a little, take it off the fire, and while it is very hot, dissolve therein six penniworth of Mithridate, and three penniworth of Venice Treacle, and when it is almost cold put to it a pint of strong Angelica water, or so much _Aqua vitæ_, and so keep it in a glass close stopped. _A Cordial Cherry-water._ Take a pottle of _Aqua vitæ_, two ounces of ripe Cherries stoned, Sugar one pound, twenty four Cloves, one stick of Cinamon, three spoonfuls of aniseeds bruised, let these stand in the _Aqua vitæ_ fifteen days, and when the water hath fully drawn out the tincture, pour it off into another glass for your use, which keep close stopped, the Spice and the Cherries you may keep, for they are very good for winde in the Stomach. _The Lord_ Spencers _Cherry-water._ Take a pottle of new Sack, four pound of through ripe Cherries stoned, put them into an earthen pot, to which put an ounce of Cinnamon, Saffron unbruised one dram, tops of Balm, Rosemary or their flowers, of each one handful, let them stand close covered twenty four hours, now and then stirring them; then put them into a cold Still, to which put of beaten Amber two drams, Corianderseed one ounce, Alkerms one dram, and distill it leisurely, and when it is fully distilled, put to it twenty grains of Musk. This is an excellent Cordial, good for Faintings and Swoundings, for the Crudities of the Stomach, Winde and Swelling of the Bowels, and divers other evil Symptomes in the Body of Men and Women. _The Herbs to be distilled for Usquebath._ Take Agrimony, Fumitory, Betony, Bugloss, Wormwood, Harts-tongue, Carduus Benedictus, Rosemary, Angelica, Tormentil, of each of these for every gallon of Ale one handful, Anniseed, and Liquorish well bruised half a pound, still these together, and when it is stilled, you must infuse Cinamon, Nutmeg, Mace, Liquorish, Dates, and Raisins of the Sun, and sugar what quantity you please. The infusion must be till the colour please you. _Dr._ Kings _way to make Mead._ Take five quarts and a pint of water, and warm it, then put one quart of Honey to every gallon of Liquor, one Lemon, and a quarter of an ounce of Nutmegs; it must boil till the scum rise black, that you will have it quickly ready to drink, squeeze into it a Lemon when you tun it. It must be cold before you tun it up. _To make Syrup of Rasberries._ Take nine quarts of Rasberries, clean pickt, and gathered in a dry day, and put to them four quarts of good Sack, into an earthen pot, then paste it up very close, and set it in a Cellar for ten days, then distill it in a Glass or Rosestill, then take more Sack and put in Rasberries to it, then when it hath taken out all the colour of the Raspis, strain it out and put in some fine Sugar to your taste, and set it on the fire, keeping it continually stirring till the scum doth rise; then take it off the fire, let it not boil, skim it very clean, and when it is cold put it to your distilled Raspis; colour it no more than to make it a pale Claret Wine. This put into bottles or Glasses stopt very close. _To make Lemon Water._ Take twelve of the fairest Lemons, slice them, and put them into two pints of White wine, and put to them Cinamon two drams, Gallingale two drams, of Rose-leaves, Borage and Bugloss flowers, of each one handful, of yellow Saunders one dram; steep all these together twelve hours; then distill them gently in a Glass still untill you have distilled one pint and an half of the Water, and then adde to it three ounces of Sugar; one grain of Ambergreese, and you will have a most pleasing cleansing Cordial water for many uses. _To make Gilly-flower Wine._ Take two ounces of dryed Gilly-flowers, and put them into a pottle of Sack, and beat three ounces of Sugar-candy, or fine Sugar and grind some Ambergreese, and put it in the bottle and shake it oft, then run it through a gelly bag, and give it for a great Cordial after a weeks standing or more. You may make Lavander as you do this. _The Lady_ Spotswood _Stomach Water._ Take white Wine one pottle, Rosemary and Cowslip flowers, of each one handful, as much Betony leaves, Cinamon and Cloves grosly beaten, of both one ounce; steep all these three dayes, stirring it often; then put to it Mithridate four ounces, and stir it together, and distil it in an ordinary still. _Water of Time for the Passion of the Heart._ Take a quart of white Wine, and a pint of Sack, steep in it as much broad Thime as it will wet, put to it of Galingale and Calamus Aromaticus, of each one ounce, Cloves, Mace, Ginger, and grains of Paradise two drams, steep these all night, the next morning distil it in an ordinary still, drink it warm with Sugar. _A Receipt to make damnable Hum._ Take Species de Gemmis, Aromaticum Rosatum, Diarrhodon Abbatis, Lætificans Galeni, of each four drams, Loaf-sugar beaten to powder half a pound, small _Aqua Vitæ_ three Pints, strong Angelica water one pint; mix all these together, and when you have drunk it to the Dregs, you may fill it up again with the same quantity of water. The same powders will serve twice, and after twice using it, it must be made new again. _An admirable Water for sore Eyes._ Take _Lapis Tutiæ_; Aloes Hepatica, fine hard sugar, of each three drams, beat them very small, and put them into a Glass of three pints, to which put red Rose-water and white Wine, of each one pint; set the Glass in the Sun, in the Month of _July_, for the whole Month, shaking it twice in a day for all that while; then use it as followeth, put one drop thereof into the Eye in the evening, when the party is in bed, and one drop in the morning an hour before the Patient riseth: Continue the use of it till the Eyes be well. The older the Water, the better it is. Most approved. _A Snail Water for weak Children, and old People._ Take a pottle of Snails, and wash them well in two or three waters, and then in small Beer, bruise them shells and all, then put them into a gallon of red Cows Milk, red Rose leaves dried, the whites cut off, Rosemary, sweet Marjoram, of each one handful, and so distil them in a cold still, and let it drop upon powder of white Sugar candy in the receiver; drink of it first and last, and at four a clock in the afternoon, a wine-glass full at a time. _Clary Water for the Back, Stomach, &c._ Take three gallons of midling Beer, put in a great brass Pot of four gallons, and put to it ten handfuls of Clary gathered in a dry day, Raisins of the Sun stoned three pounds, Anniseeds, and Liquorish, of each four ounces, the whites and shells of twenty four eggs, or half so many, if there be not so much need, beat the shells small, and mix them with the whites; put to the bottoms of three white loaves, put into the Receiver one pound of white sugar-candy, or so much fine loaf sugar beaten small, and distill it through a Limbeck, keep it close, and be seldom without it; for it reviveth very much the stomach and heart, strengtheneth the back, procureth appetite and digestion, driveth away Melancholly, sadness and heaviness of the heart, &c. _Dr._ Montfords _Cordial Water._ Take Angelica leaves twelve handfuls, six leaves of Carduus Benedictus, Balm & Sage, of each five handfuls, the seeds of Angelica and sweet Fennil, of each five ounces bruised, scraped and bruised Liquorish twelve ounces, Aromaticum Rosatum, Diamoscus dulcis, of each six drams; the Herbs being cut small, the seeds and Liquorish bruised, infuse them into two gallons of Canary Sack for twenty four hours, then distill it with a gentle fire, and draw off onely five pints of the spirits, which mix with one pound of the best Sugar dissolved into a Syrup in half a pint of pure red Rose-water. _Aqua Mirabilis, Sir_ Kenelm Digby's _way._ Take Cubebs, Gallingale, Cardamus, Melliot flowers, Cloves, Mace, Ginger, Cinamon, of each one dram bruised small, juyce of Celandine one pint, juyce of Spearmint half a pint, juyce of Balm half a pint, sugar one pound, flower of Cowslips, Rosemary, Borage, Bugloss, Marigolds, of each two drams, the best Sack three pints, strong Angelica water one pint, red Rose-water half a pint, bruise the Spices and flowers, & steep them in the Sack & Juyces one night, the next morning distill it in an ordinary Limbeck or glass still, and first lay Hearts-tongue leaves in the bottom of the Still. _The Vertues of the precedent Water._ This Water preserveth the Lungs without grievances, and helpeth them; being wounded, it suffereth the blood not to putrifie, but multiplieth the same; this water suffereth not the heart to burn, nor melancholly, nor the Spleen to be lifted up above nature; it expelleth the Rheum, preserveth the Stomach, conserveth Youth, and procureth a good colour, it preserveth Memory, it destroyeth the palsie; if this be given to one a dying, a spoonful of it reviveth him; in the summer use one spoonful a week fasting, in the winter two spoonfuls. _A Water for fainting of the Heart._ Take Bugloss and red Rose-water of each one pint, Milk half a pint, Anniseeds and Cinamon grosly bruised, of each half an ounce, Maiden-hair two handfuls, Harts-tongue one handful, both shred, mix all together, and distill it in an ordinary still, drink of it morning and evening With a little sugar. _A Surfeit Water._ Take half a bushel of red Corn Poppy, put it into a large dish, cover it with brown Paper, and lay another dish upon it, set it in an Oven after brown bread is baked divers times till it be dry, which put into a pottle of good _Aqua vitæ_, to which put Raisins of the sun stoned half a pound, six figs sliced, three Nutmegs sliced, two flakes of Mace bruised, two races of Ginger sliced, one stick of Cinnamon bruised, Liquorish sliced one ounce, Aniseed, Fennil-seed, and Cardamums bruised, of each one dram; put all these into a broad glass body, and lay first some Poppy in the bottom, then some of the other ingredients, then Poppy again, and so untill the Glass be full; then put in the _Aqua vitæ_, and let it infuse till it be strong of the spices, and very red with the Poppy, close covered, of which take two or three spoonfuls upon a surfeit, and when all the liquor is spent, put more _Aqua vitæ_ to it, and it will have the same effect the second time, but no more after. _Dr._ Butlers _Cordial Water against Melancholly, &c. most approved._ Take the flowers of Cowslips, Marigolds, Pinks, Clove-gilly-flowers, single stock gilly-flowers, of each four handfuls, the flowers of Rosemary, and Damask Roses, of each three handfuls, Borage and Bugloss flowers, and Balm leaves, of each two handfuls; put them in a quart of Canary Wine into a great Bottle or Jug close stopped, with a Cork, sometimes stirring the flowers and wine together, adding to them Anniseeds bruised one dram, two Nutmegs sliced, _English_ Saffron two pennyworth; after some time of infusion, distill them in a cold Still with a hot fire, hanging at the Nose of the Still Ambergreece and Musk, of each one grain; then to the distilled water put White Sugar-candy finely beaten six ounces, and put the glass wherein they are into hot water for one hour. Take of this water at one time three spoonfuls thrice a week, or when you are ill, it cureth all melancholly fumes, and infinitely comforts the spirits. _The admirable and most famous Snail Water._ Take a peck of garden shell snails, wash them well in small beer, and put them in a hot Oven till they have done making a noise, then take them out, and wipe them well from the green froth that is upon them, and bruise them shells and all in a stone Mortar, then take a quart of earth worms, scower them with salt, slit them & wash them well with water from their filth, and in a stone Mortar beat them to pieces, then lay in the bottom of your distilled pot Angelica two handfuls, and two handfuls of Celandine upon them, to which put two quarts of Rosemary flowers, Bears foot, Agrimony, red Dock Roots, Bark of Barberries, Betony, Wood sorrel, of each two handfuls, Rue one handful; then lay the Snails and worms on the top of the Herbs and Flowers, then pour on three Gallons of the strongest Ale, and let it stand all night, in the morning put in three ounces of Cloves beaten, six penniworth of beaten Saffron and on the top of them six ounces of shaved Harts-horn, then set on the Limbeck, and close it with paste, and so receive the water by pints, which will be nine in all, the first is the strongest, whereof take in the morning two spoonfuls in four spoonfuls of small Beer, and the like in the afternoon; you must keep a good Diet and use moderate exercise to warm the blood. This Water is good against all Obstructions whatsoever. It cureth a Consumption and Dropsie, the stopping of the Stomach and Liver. It may be distilled with milk for weak people and children, with Harts-tongue and Elecampance. _A singular Mint water._ Take a still full of Mints, put Balm, and Penniroyal, of each one good handful, steep them in Sack, or Lees of Sack twenty four hours, stop it close, and stir it now and then: Distill it in an ordinary Still with a very quick fire, and keep the Still with wet cloaths, put into the receiver as much sugar as will sweeten it, and so double distill it. Distillings. _A most Excellent_ Aqua Coelestis _taught by Mr._ Philips Apothecary. Take of Cinamon one dram, Ginger half a dram, the three sorts of Saunders, of each of them three quarters of an ounce, Mace and cubebs, of each of them one dram, Cardamom the bigger and lesser, of each three drams, Setwall-roots half an ounce, Anniseed, Fennil-seed Basil-seed, of each two drams, Angelica roots, Gilly-flowers, Thyme, Calamint, Liquorish, Calamus, Masterwort, Pennyroyal, Mint, Mother of Thyme, Marjoram, of each two drams, red Rose-seed, the flowers of Sage and Betony, of each a dram and a half, Cloves, Galingal, Nutmegs, of each two drams, the flowers of Stechados, Rosemary, Borage and Bugloss flowers, of each a dram and half, Citron Rindes three drams; bruise them all, and put in these Cordial Powders, Diamber Aromaticum, Diamascum, Diachoden, the Spices made with Pearl, of each three drams; infuse all these in twelve pints of _Aqua Vitæ_; in a glass, close stopped for fifteen dayes, often shaking it, then let it be put into a Limbeck close stopped, and let it be distilled gently; when you have done, hang in a cloth, two drams of Musk, half a dram of Ambergreese, and ten or twelve grains of gold, and so receive it to your use. _Hypocras taught by Dr._ Twine _for Wind in the Stomach._ Take Pepper, Grains, Ginger, of each half an ounce, Cinnamon, Cloves, Nutmegs, Mace, of each one ounce grosly beaten, Rosemary, Agrimony, both shred of each a few crops, red Rose leaves a pretty quantity, as an indifferent gripe, a pound of Sugar beaten; lay these to steep in a gallon of good Rhenish or white-Wine in a close vessel, stirring it two or three times a day the space of three or four dayes together, then strain it through an Hypocras strainer, and drink a draught of it before meat half an hour, and sometimes after to help digestion. _Marigold flowers distilled, good for the pain of the Head._ Take Marigold flowers, and distill them, then take a fine cloth and wet in the aforesaid distilled water, and so lay it to the forehead of the Patient, and being so applied, let him sleep if he can; this with Gods help will cease the pain. _A Water good for Sun burning._ Take Water drawn off the Vine dropping, the flowers of white Thorn, Bean-flowers, Water Lilly-flowers, Garden Lilly-flowers, Elder-flowers, and Tansie-flowers, Althea-flowers, the whites of Eggs, French Barley. _The Lady_ Giffords _cordial Water._ Take four quarts of _Aqua vitæ_, Borrage and Poppy-water, of each a pint, two pounds of Sugar-candy, one pound of figs sliced, one pound of Raisins of the Sun stoned, two handfuls of red Roses clipped and dried, one handful of red Mint, half a handful of Rosemary, as much of Hysop, a few Cloves; put all these in a great double Glass close stopped, and set it in the sun three months, and so use it. _A water for one pensive and very sick, to comfort the Heart very excellent._ Take a good spoonful of _Manus Christi_, beaten very small into powder, then take a quarter of a pound of very fine sugar, and beat it small, and six spoonfuls of Cinamon water, and put to it, and ten spoonfuls of red Rose-water; mingle all these together, and put them in a dish, and set them over a soft fire five or six walms, and so let it be put into a glass, and let the party drink thereof a spoonful or two, as he shall see cause. _To perfume Water._ Take Malmsey or any kind of sweet water; then take Lavender, Spike, sweet Marjoram, Balm, Orange peels, Thyme, Basil, Cloves, Bay leaves, Woodbine flowers, red and white Roses, and still them all together. FINIS. The Table. _Ale of health and strength._ _Almond Bisket._ _Apricock cakes how to make._ _Aqua mirabilis, Sir_ Kenelm Digby's _way._ _Aqua Coelestis._ _Cake the Lady_ Elizabeths _way._ _Cakes how to make_, &c. _Cakes of Pear-plums._ _Clear cakes of Plums._ _Collops like bacon of Marchpane._ _Cherry water._ _Cordial Cherry water._ _Cherry water by the Lord_ Spencer. _Chips of Quinces._ _Cordial water by Sir_ Walter Raleigh. _by the Lady_ Malet. _by Doctor_ Muntford. _by Doctor_ Butler. _by the Lady_ Gifford. _Conserve for a cough or consumption of the Lungs._ Conserve _of Borage flowers._ _Betony._ _Lavender flower._ _Lemons._ _Oranges._ _Piony._ _Pippins._ _Quinces._ _Roses boyl'd._ _unboild._ _Roses._ _Sage._ _Violets._ _Marjoram._ Candy, _or clear Rockcandy flowers._ Candy _Apricocks._ _Barberries._ _Chicory roots._ _Cherries._ _Citrons._ _Grapes._ _Orange roots._ _Orange pills._ _Pippins, Pears, Plums._ _Rosemary-flowers in the sun._ _Spanish flowers._ _Suckets of Oranges, Lemons_, &c. Dry _Fox-skins how._ Dry _Apricoks._ _Cherries._ _Plums._ _Pippins or Pears._ _Pippins or Pear-Plums without sugar._ Dentifrices _the best and paste of the same._ Damnable Hum. French _Tart to make._ Fruits _to dry or Candy after preserved._ Fruit _artificial to make._ Gelly _of Pippins._ _Of Raspiss._ Gilly-_flower Wine._ Hair _to make grow._ _To grow black._ Hypocras. _Doctor_ Twines _way._ Jumbals _of Apricocks or Quinces._ Ipswich _water._ Italian _Bisquet._ Juyce _of Liquorish._ Letters _to write secretly._ Lozenges _Of red Roses._ Lemon _water._ Magistery _of Pearl._ Marchpane _to ice and gild._ Marmalet _of Damsins._ _Oranges._ _Plums._ _Quinces._ Mead, _Doctor_ Kings _way._ Mint-_Water._ Marigold-_flowers distild good for the head._ Naples-_Bisquet._ Orange-_Water._ Orange-_Cakes._ Preserves. _To preserve Artichokes young._ _Apricocks._ _Barberries._ _Cherries._ _Damsins._ _Elecampane-root._ _Fruit green._ _Grapes._ _Green plums._ _Lemons._ _Oranges._ _Pear-plums white or green._ _Pippins, or Peaches._ _Plums red or black._ _Quinces white._ _White or red._ _Respass._ Paste _of Apricocks._ _Citrons._ _Elecampane-roots._ _Flowers with its natural taste._ _Oranges and Lemons._ _Pippins like leaves, and some like plums, with their stones and stalks in them._ _Rasberries or English Currans._ Perfumes, _for Cloathes, Gloves._ _Perfumes excellent._ _K._ Edwards. _Q._ Elizabeths. _Perfume water._ Purging-_bag for Ale._ Plague-_water._ Poppy-_water._ Pomander. Pomatum _good._ Prince-_Bisquet._ Powder _the Lady_ Kents. Quinces _for pies._ Quiddony _of Pippins._ _Of all kinds of plums._ Raisin _Wine._ Rasberry _Wine._ _Shrubbery cakes._ Sweet _smell._ _Sweet powder to break._ Syrup _of Clove-gillyflowers._ _Of Hysop for colds._ _Lemons or Citrons._ _Elders._ _Rasberries._ Spots _of grease or Oyle to take out._ Dr. Stephens _sovereign Water._ Stomach _water the Lady_ Spotswoods. Snail-water _most excellent._ Sugar _of Wormwood, Mint, Aniseed &c._ _Of Roses._ Surfeit water. Tincture _of Ambergreese._ Usquebath _distilled with herbs._ Walnuts _artificial._ Wine _to keep from souring._ Water _for a Consumption._ _For the stomach._ _The Plague._ _Of Time for passion of the heart._ _For sore eyes._ _Of Snails for children and old people._ _Of Clary for the back and stomach._ _For fainting of the heart._ _Sunburning._ _One pensive to comfort the heart._ FINIS. 
14377	----	Proofreading Team, from Scans from Biblioteca de la Universitat de Barcelona THE QUEENE-LIKE CLOSET Or RICH CABINET [Illustration] Printed for Rich: Lownes White Lion in Duck Layne neare West Smithfield The Queen-like Closet OR RICH CABINET: Stored with all manner of RARE RECEIPTS For _Preserving, Candying and Cookery_. Very Pleasant and Beneficial to all Ingenious Persons of the FEMALE SEX. BY HANNAH WOLLEY. The Second EDITION. LONDON Printed for _Richard Lowndes_ at the _White Lion_ in _Duck-Lane_, near _West-Smithfield_, 1672. TO THE TRULY VERTUOUS AND My much Honoured Friend Mrs. _GRACE BUZBY_, Daughter to the Late _Sr. HENRY CARY_, Knight Banneret; And WIFE to Mr. _ROBERT BUZBY_, Gentleman, and Wollen Draper of LONDON _Madam_, Your Kind and Good Acceptance of my Endeavours in Work for You, and that Esteem You have for what else I can do, make me bold to present this Book to You; which by that time You have perused, I doubt not but You will deem it worthy of the Title it bears; and indeed it was never opened before: If it may yield You any Delight or Benefit, I shall be glad; for as You have a true Love and Esteem for me, so I have a very great Love and Honourable Esteem for You; and shall always be _Your most Observant servant_, _HANNAH WOLLEY._ To all Ladies, Gentlewomen, and to all other of the Female Sex who do delight in, or be desirous of good Accomplishments. Ladies and Gentlewomen, _I Presume those Bookes which have passed from me formerly, have got me some little credit and esteem amongst you. But there being so much time past since they were Printed, that methinks, I hear some of you say_ I wish Mrs. _Wolley_ would put forth some New Experiments _and to say the Truth, I have been importun'd by divers of my Friends and Acquaintance to do so._ _I shall not give an Apish Example every Day or Week to follow ridiculous and foolish Fancies, nor could I be too like the_ Spaniard, _always to keep in one Dress: I am not ashamed, nor do I disown what I have already Printed, but some of you being so perfect in your practises, and I very desirous still to serve you, do now present you with this_ Queen-like Closet: _I do assure you it is worthy of the Title it bears, for the very precious things you will find in it._ _Thus beseeching your kind Acceptance of this Book, and of my earnest Desires to you, I take my Leave, but shall always be to all who have esteem for me,_ Their Faithful and Humble Servant, HANNAH WOLLEY. _Ladies, I do here present you (yet) That which sure will well content A Queen-like Closet rich and brave (Such) not many Ladies have: Or Cabinet, in which doth set Jems richer than in Karkanet; (They) only Eies and Fancies please, These keep your Bodies in good ease; They please the Taste, also the Eye; Would I might be a stander by: Yet rather I would wish to eat, Since 'bout them I my Brains do beat: And 'tis but reason you may say, If that I come within your way; I sit here sad while you are merry, Eating Dainties, drinking Perry; But I'm content you should so feed, So I may have to serve my deed._ _Hannah Wolley._ These things following are sold by _Richard Lowndes_ Book-seller, at the _White-Lion_ in _Duck-Lane_ near _West-Smithfield_. A Cordial Powder, which doth infallibly Cure the _Rickets_ in Children, and causeth an easie production of Teeth. Dr. _Lionel Lockyer_'s Universal Pill, curing any Disease curable by Physick; it operates gently and safely, it being very amicable to Nature in purifying the whole Body throughout, and then subduing all Diseases, whether internal or external, as hath been experimented by persons of all sorts and sexes, both young and old, with admirable success. Mr. _Matthew_ his Diaphoretick and Diuretick Pill, purging by Sweat and Urine: This Pill being composed of Simples of a very powerful operation, purged from their churlish and malignant quality by an excellent Balsam of long preparation, is by it made so amicable to Nature, that it hath upon ample experience been found effectual for curing all common Diseases. Mr. _Edmund Buckworth's_ famous Lozenges, for the Cure of Consumptions, Catarrhs, Asthma's, Phtisick, and all other Diseases incident to the Lungs, Colds new and old, Hoarsness, Shortness of Breath, and Stuffings of the Stomach; also a sovereign Antidote against the Plague, and all other contagious Diseases. The famous Spirit of Salt of the World, well known for a sovereign Remedy against most Diseases; Truly and only prepared by _Constantine Rhodocanaces_, Grecian, one of His Majesties Chymists. THE Queen-like CLOSET, OR Rich Cabinet. 1. _To make_ Aqua Mirabilis _a very delicate way._ Take three Pints of Sack, three Pints of White Wine, one quart of the Spirit of Wine, one quart of the juice of Celandine leaves, of Melilot-flowers, Cardamum-seeds, Cubebs, Galingale, Nutmegs, Cloves, Mace, Ginger, two Drams of each; bruise them, and mix them with the Wine and Spirits, let it stand all night in the Still, not an Alembeck, but a common Still, close stopped with Rye Paste; the next morning make a slow fire in the Still, and all the while it is stilling, keep a wet Cloth about the neck of the Still, and put so much white Sugar Candy as you think fit into the Glass where it drops. 2. _The Plague-Water which was most esteemed of in the late great Visitation._ Take three Pints of Muskadine, boil therein one handful of Sage, and one handful of Rue until a Pint be wasted, then strain it out, and set it over the Fire again. Put thereto a Penniworth of Long Pepper, half an Ounce of Ginger, and a quarter of an Ounce of Nutmegs, all beaten together, boil them together a little while close covered, then put to it one penniworth of Mithridate, two penniworth of Venice Treacle, one quarter of a Pint of hot Angelica Water. Take one Spoonful at a time, morning and evening always warm, if you be already diseased; if not, once a day is sufficient all the Plague time. It is most excellent Medicine, and never faileth, if taken before the heart be utterly mortified with the Disease, it is also good for the Small Pox, Measles, or Surfets. 3. _A very Soveraign Water._ Take one Gallon of good Claret Wine, then take Ginger, Galingale, Cinnamon, Nutmegs, Grains, Cloves, Anniseeds, Fennel-seeds, Caraway-seeds, of each one dram; then take Sage, Mint, Red-Rose leaves, Thyme, Pellitory of the Wall, Rosemary, Wild Thyme, Camomile, Lavander, of each one handful, bruise the Spices small and beat the Herbs, and put them into the Wine, and so let stand twelve hours close covered, stirring it divers times, then still it in an Alembeck, and keep the best Water by it self, and so keep every Water by it self; the first you may use for aged People, the other for younger. This most excellent Water was from Dr. _Chambers_, which he kept secret till he had done many Cures therewith; it comforteth the Vital Spirits; it helpeth the inward Diseases that come of Cold; the shaking of the Palsie; it helpeth the Conception of Women that are barren; it killeth the Worms within the Body, helpeth the Stone within the Bladder; it cureth the Cold, Cough, and Tooth-ach, and comforteth the Stomach; it cureth the Dropsie, and cleanseth the Reins; it helpeth speedily the stinking Breath; whosoever useth this Water, it preserveth them in good health, and maketh seem young very long; for it comforteth Nature very much; with this water Dr. _Chambers_ preserved his own life till extreme Age would suffer him neither to go nor stand one whit, and he continued five years after all Physicians judged he could not live; and he confessed that when he was sick at any time, he never used any other Remedy but this Water, and wished his Friends when he lay upon his Deth-Bed to make use of it for the preservation of their Health. 4. _To Make Spirit of Mints._ Take three Pints of the best white Wine, three handfuls of right Spear mint picked clean from the stalks, let it steep in the wine one night covered, in the morning, put it into a Copper Alembeck, and draw it with a pretty quick fire; and when you have drawn it all, take all your Water and add as much Wine as before, and put to the Water, and the same quantity of Mint as before; let it steep two or three hours, then put all into your Still, and draw it with a soft fire, put into your Receiver a quantity of Loaf Sugar, and you will find it very excellent; you may distil it in an ordinary Still if you please; but then it will not be so strong nor effectual. Thus you may do with any other Herbs whatsoever. 5. _To make the Cordial Orange-Water._ Take one dozen and a half of the highest coloured and thick rin'd Oranges, slice them thin, and put them into two Pints of Malago Sack, and one Pint of the best Brandy, of Cinamon, Nutmegs, Ginger, Cloves, and Mace, of each one quarter of an Ounce bruised, of Spear-mint and Balm one handful of each, put them into an ordinary Still all night, pasted up with Rye Paste; the next day draw them with a slow fire, and keep a wet Cloth upon the Neck of the Still; put in some Loaf Sugar into the Glass where it dropeth. 6. _To make Spirit of Oranges or of Limons._ Take of the thickest rin'd Oranges or Limons, and chip off the Rinds very thin, put these Chips into a Glass-bottle, and put in as many as the Glass will hold, then put in as much Malago Sack as the Glass will hold besides; stop the bottle close that no Air get in, and when you use it, take about half a spoonful in a Glass of Sack; it is very good for the Wind in the Stomach. 7. _To make Limon Water._ Take twelve of the fairest Limons, slice them, and put them into two Pints of white Wine, and put to them of Cinamon and Galingale, of each, one quarter of an Ounce, of Red Rose Leaves, Burrage and Bugloss Flowers, of each one handful, of yellow Sanders one Dram, steep all these together 12 hours, then distil them gently in a Glass Still, put into the Glass where it droppeth, three Ounces of Sugar, and one Grain of Amber-Greece. 8. _A Water for fainting of the Heart._ Take of Bugloss water and Red Rose Water, of each one Pint, of Red Cows milk half a Pint, Anni-seed and Cinamon of each half an Ounce bruised, Maiden hair two handfuls, Harts-tongue one handful, bruise them, and mix all these together, and distil them in an ordinary Still, drink of it Morning and Evening with a little Sugar. 9. _To make Rosemary Water._ Take a Quart of Sack or white Wine with as many Rosemary Flowers as will make it very thick, two Nutmegs, and two Races of Ginger sliced thin into it; let it infuse all night, then distil it in an ordinary Still as your other waters. 10. _To make a most precious Water._ Take two Quarts of Brandy, of Balm, of Wood-Betony, of Pellitory of the Wall, of sweet Marjoram, of Cowslip-Flowers, Rosemary-Flowers, Sage-Flowers, Marigold-Flowers, of each of these one handful bruised together; then take one Ounce of Gromwell seeds, one Ounce of sweet Fennel seeds, one Ounce of Coriander seeds bruised, also half an Ounce of Aniseeds and half an Ounce of Caraway-seeds, half an Ounce of Juniper Berries, half an Ounce of Bay Berries, One Ounce of green Licoras, three Nutmegs, one quarter of an Ounce of large Mace, one quarter of an Ounce of Cinamon, one quarter of an Ounce of Cloves, half an Ounce of Ginger, bruise all these well together, then add to them half a pound of Raisons in the Sun stoned, let all these steep together in the Brandy nine days close stopped, then strain it out, and two Grains of Musk, two of Amber-Greece, one pound of refined Sugar; stop the Glass that no Air get in, and keep it in a warm place. 11. _Doctor_ Butler's _Treacle Water._ Take the roots of Polipody of the Oak bruised, _Lignum Vitæ_ thin sliced, the inward part thereof, Saxifrage roots thin sliced, of the shavings of Harts-horn, of each half a pound, of the outward part of yellow Citron not preserved; one Ounce and half bruised, mix these together; Then take {Fumitory water} {Carduus-water } Of each one of {Camomile-water} Ounce. {Succory-water } of Cedar wood one Ounce, of Cinamon three drams, of Cloves three drams, bruise all your forenamed things; Then take of Epithimum two ounces and a half, of Cerratch six ounces, of Carduus and Balm, of each two handfuls, of Burrage Flowers, Bugloss Flowers, Gillyflowers, of each four ounces, of Angelica root, Elecampane root beaten to a Pap, of each four ounces, of Andronichus Treacle and Mithridate, of each four ounces; mix all these together, and incorporate them well, and grind them in a Stone Mortar, with part of the former Liquor, and at last, mix all together, and let them stand warm 24 hours close stopped, then put them all into a Glass Still, and sprinkle on the top of _Species Aromatica rosata_ and _Diambre_, of the Species of _Diarodon abbatis_, _Diatrion Santalon_, of each six drams; then cover the Still close, and lute it well, and distill the water with a soft fire, and keep it close. This will yield five Pints of the best water, the rest will be smaller. 12. _The Cordial Cherry Water._ Take nine pounds of red Cherries, nine pints of Claret Wine, eight ounces of Cinamon, three ounces of Nutmegs; bruise your Spice, stone your Cherries, and steep them in the Wine, then add to them half a handful of Rosemary, half a handful of Balm, one quarter of a handful of sweet Marjoram, let them steep in an earthen Pot twenty four hours, and as you put them into the Alembeck, to distil them, bruise them with your hands, and make a soft fire under them, and distil by degrees; you may mix the waters at your pleasure when you have drawn them all; when you have thus done, sweeten it with Loaf-Sugar, then strain it into another Glass, and stop it close that no Spirits go out; you may (if you please) hang a Bag with Musk and Amber-greece in it, when you use it, mix it with Syrrup of Gilly-flowers or of Violets, as you best like it; it is an excellent Cordial for Fainting fits, or a Woman in travel, or for any one who is not well. 13. _A most excellent Water for the Stone, or for the Wind-Cholick._ Take two handfuls of Mead-Parsly, otherwise called Saxifrage, one handful of Mother-Thyme, two handfuls of Perstons, two handfuls of Philipendula, and as much Pellitory of the Wall, two ounces of sweet Fennel seeds, the roots of ten Radishes sliced, steep all these in a Gallon of Milk warm from the Cow, then distil it in an ordinary Still, and four hours after, slice half an ounce of the wood called Saxifrage, and put into the Bottle to the water, keep it close stopped, and take three spoonfuls at a time, and fast both from eating and drinking one hour after; you must make this water about Midsummer; it is a very precious water, and ought to be prized. 14. _The Cock water, most delicate and precious for restoring out of deep Consumptions, and for preventing them, and for curing of Agues, proved by my self and many others._ Take a Red Cock, pluck him alive, then slit him down the back, and take out his Intrals, cut him in quarters, and bruise him in a Mortar, with his Head, Legs, Heart, Liver and Gizard; put him into an ordinary Still with a Pottle of Sack, and one quart of Milk new from a red Cow, one pound of blew Currants beaten, one pound of Raisins in the Sun stoned and beaten, four Ounces of Dates stoned and beaten, two handfuls of Peniroyal, two handfuls of Pimpernel, or any other cooling Herb, one handful of Mother-thyme, one handful of Rosemary one handful of Burrage, one quart of Red Rose water, two ounces of Harts-horn, two ounces of China root sliced, two ounces of Ivory shaving, four ounces of the flower of French Barley; put all these into your Still and paste it up very well, and still it with a soft fire, put into the Glass where it droppeth one pound of white Sugar Candy beaten very small, twelve peniworth of Leaf-Gold, seven grains of Musk, eleven grains of Amber-greece, seven grains of Bezoar stone; when it is all distilled, mix all the waters together, and every morning fasting, and every evening when you go to bed, take four or five Spoonfuls of it warm, for about a Month together, this hath cured many when the Doctors have given them over. 15. _Walnut water, or the Water of Life._ Take green Walnuts in the beginning of _June_, beat them in a Mortar, and distil them in an ordinary Still, keep that Water by it self, then about Midsummer gather some more, and distil them as you did before, keep that also by it self, then take a quart of each and mix them together, and distil them in a Glass Still, and keep it for your use; the Virtues are as followeth; It will help all manner of Dropsies and Palsies, drank with Wine fasting; it is good for the eyes, if you put one drop therein; it helpeth Conception in Women if they drink thereof one spoonful at a time in a Glass of Wine once a day, and it will make your skin fair if you wash therewith; it is good for all infirmities of the Body, and driveth out all Corruption, and inward Bruises; if it be drunk with Wine moderately, it killeth Worms in the Body; whosoever drinketh much of it, shall live so long as Nature shall continue in him. Finally, if you have any Wine that is turned, put in a little Viol or Glass full of it, and keep it close stopped, and within four days it will come to it self again. 16. _To make Wormwood Water._ Take four ounces of Aniseeds, four ounces of Licoras scraped, bruise them well with two ounces of Nutmegs, add to them one good handful of Wormwood, one root of Angelica, steep them in three Gallons of Sack Lees and strong Ale together twelve hours; then distill them in an Alembeck, and keep it for your use. 17. _A very rare Cordial Water._ Take one Gallon of white Wine, two ounces of Mithridate, two ounces of Cinamon, one handful of Balm, a large handful of Cowslips, two handfuls of Rosemary Flowers, half an ounce of Mace, half an ounce of Cloves, half an ounce of Nutmegs, all bruised, steep these together four days in an earthen Pot, and covered very close, distil them in an ordinary Still well pasted, and do it with a very slow fire; save the first water by it self, and the small by it self, to give to Children; when you have occasion to use it, take a spoonful thereof, sweetned with Loaf-Sugar; this Water is good to drive out any Infection from the heart, and to comfort the Spirits. 18. _Another most excellent Cordial._ Take Celandine, Sage, Costmary, Rue, Wormwood, Mugwort, Scordium, Pimpernel, Scabious, Egrimony, Betony, Balm, Carduus, Centory, Peniroyal, Elecampane roots, Tormentil with the roots, Horehound, Rosa Solis, Marigold Flowers, Angelica, Dragon, Marjoram, Thyme, Camomile, of each two good handfuls; Licoras, Zedoary, of each one ounce; slice the Roots, shred the Herbs, and steep them in four quarts of white Wine, and let it stand close covered 2 days, then distil it in an ordinary Still pasted up; when you use it, sweeten it with fine Sugar, and warm it. 19. _To make_ Rosa Solis. Take a Pottle of _Aqua Composita_, and put it into a Glass, then a good handful of _Rosa Solis_ clean picked, but not washed, put it to the _Aqua Composita_, then take a pound of Dates stoned and beaten small, half a peniworth of Long Pepper, as much of Grains, and of round Pepper, bruise them small, take also a pound of Loaf-Sugar well beaten, a quarter of a pound of Powder of Pearl, and six leaves of Book Gold; put all to the rest, and stir them well together in the Glass, then cover it very close, and let it stand in the Sun fourteen days, ever taking it in at night; then strain it, and put it into a close Bottle; you must not put in the Pearl, Gold or Sugar till it hath been sunned and strained, neither must you touch the Leaves of the _Rosa Solis_ with your hands when you pick it; keep it very close. 20. _The Heart Water._ Take five handfuls of Rosemary Flowers, two drams of red Coral, two drams of Powder of Pearl, two drams of white Amber, two drams of Cinamon, two pound of the best Prunes stoned, six Pints of Damask Rose water, two Pints of Sack; put all these into a Pipkin never used, stop it up with Paste, let them stand upon a soft fire a little while, then distil it in an ordinary Still pasted up. 21. _The Plague Water._ Take Rosemary, Red Balm, Burrage, Angelica, Carduus, Celandine, Dragon, Featherfew, Wormwood, Penyroyal, Elecampane roots, Mugwort, Bural, Tormentil, Egrimony, Sage, Sorrel, of each of these one handful, weighed weight for weight; put all these in an earthen Pot, with four quarts of white Wine, cover them close, and let them stand eight or nine days in a cool Cellar, then distil it in a Glass Still. 22. _The Treacle Water._ Take one pound of old Venice Treacle, of the Roots of Elecampane, Gentian, Cyprus, Tormentil, of each one ounce, of Carduus and Angelica, half an ounce, of Burrage, Bugloss, and of Rosemary Flowers one ounce of each; infuse these in three Pints of white Wine, one Pint of Spring Water, two Pints of Red Rose water; then distil them in an ordinary Still pasted up. This is excellent for Swounding Fits or Convulsions, and expelleth any venomous Disease; it also cureth any sort of Agues. 23. _The Snail water excellent for Consumptions._ Take a Peck of Snails with the Shells on their Backs, have in a readiness a good fire of Charcoal well kindled, make a hole in the midst of the fire, and cast your Snails into the fire, renew your fire till the Snails are well rosted, then rub them with a clean Cloth, till you have rubbed off all the green which will come off. Then bruise them in a Mortar, shells and all, then take Clary, Celandine, Burrage, Scabious, Bugloss, five leav'd Grass, and if you find your self hot, put in some Wood-Sorrel, of every one of these one handful, with five tops of Angelica. These Herbs being all bruised in a Mortar, put them in a sweet earthen Pot with five quarts of white Wine, and two quarts of Ale, steep them all night; then put them into an Alembeck, let the herbs be in the bottom of the Pot, and the Snails upon the Herbs, and upon the Snails put a Pint of Earth-worms slit and clean washed in white Wine, and put upon them four ounces of Anniseeds or Fennel-seeds well bruised, and five great handfuls of Rosemary Flowers well picked, two or three Races of Turmerick thin sliced, Harts-horn and Ivory, of each four ounces, well steeped in a quart of white Wine till it be like a Jelly, then draw it forth with care. 24. _To make a rare sweet Water._ Take sweet Marjoram, Lavender, Rosemary, Muscovy, Maudlin, Balm, Thyme, Walnut Leaves, Damask Roses, Pinks, of all a like quantity, enough to fill your Still, then take of the best Orrice Powder, Damask Rose Powder, and Storax, of each two ounces; strew one handful or two of your Powders upon the Herbs, then distil them with a soft fire; tie a little Musk in a piece of Lawn, and hang it in the Glass wherein it drops, and when it is all drawn out, take your sweet Cakes and mix them with the Powders which are left, and lay among your Clothes, or with sweet Oyles, and burn them for perfume. 25. _A very good Surfet water._ Take what quantity of Brandy you please, steep a good quantity of the Flowers of Red Poppies therein, which grow amongst the Wheat, having the black bottoms cut off, when they have been steeped long enough, strain them out, and put in new, and so do till the Brandy be very red with them, and let it stand in the Sun all the while they infuse, then put in Nutmegs, Cloves, Ginger and Cinamon, with some fine Sugar, so much as you think fit, and keep it close stopped; this is very good for Surfets, Wind in the Stomach, or any Illness whatever. 26. _An excellent Water for the Stomach, or against Infection._ Take Carduus, Mint and Wormwood, of each a like quantity, shred them small and put them into new Milk, distil them in an ordinary Still with a temperate fire; when you take any of it, sweeten it with Sugar, or with any Syrrup, what pleases you best; it is a very good water, though the Ingredients are but mean. 27. _The Melancholy Water._ Take of the Flowers of Gilliflowers, four handfuls, Rosemary flowers three handfuls, Damask Rose leaves, Burrage and Bugloss flowers of each one handful, of Balm leaves six handfuls, of Marigold flowers one handful, of Pinks six handfuls, of Cinamon grosly beaten, half an ounce, two Nutmegs beaten, Anniseeds beaten one ounce, three peniworth of Saffron; put them all into a Pottle of Sack, and let them stand two days, stirring them sometimes well together; then distil them in an ordinary Still, and let it drop into a Glass wherein there is two grains of Musk, and eight ounces of white Sugar Candy, and some Leaf-Gold; take of this Water three times a week fasting, two spoonfuls at a time, and ofter if you find need; distil with soft fire; this is good for Women in Child-bed if they are faint. 28. _To make the Elder water, or spirit of_ Sambucus. Take some Rye Leaven, and break it small into some warm Water, let it be a sowre one, for that is best; about two Ounces or more: then take a Bushel of Elder Berries beaten small, and put them into an earthen Pot and mix them very well with the Leaven, and let it stand one day near the Fire; then put in a little Yest, and stir it well together to make it rise, so let it stand ten days covered, and sometimes stir it; then distil it in an Alembeck; keep the first Water by it self, and so the second, and the third will be good Vinegar, if afterward you colour it with some of the Berries. Distil it with a slow fire, and do not fill the Still too full. This Water is excellent for the Stomach. 29. _To make the Balm water Green._ Take any Wine or Lees of Wine, or good Strong Beer or Ale with the Grounds, and stir them all together very well, lest the Wine Lees be too thick, and burn the bottom of the Pot; put them into an Alembeck with good store of Balm unwashed, therein still these till you leave no other tast but fair water, and draw also some of that, draw two Alembecks full more as you draw the first, until you have so much as will fill your Alembeck, then put this distilled water into your Alembeck again, and some more Balm, if you draw a Wine Gallon, put to it half a pound of Coriander seeds bruised, two Ounces of Cloves, one quarter of an Ounce of Nutmegs, and one quarter of an Ounce of Mace bruised all of them, then set a Receiver of a Gallon under it, and fill it with fresh and green Balm unwashed, and your Water will be as green as Grass; put still more and more of the Herbs fresh, and let it stand a week to make it the more green. Take this Green Water, and put to it one quart of the best Damask Rosewater, and before you mix your Balm-water and Rose-water together, you must dissolve two pounds of fine Sugar in the first distilled water, then take Ambergreece and Musk, of each eight Grains, being ground fine, and put it into the Glass in a piece of Lawn; put also a little Orange or Limon Pill to it, and keep it cool and from the Air. 30. _To make the very best Surfet-water._ Take one Gallon of the best French Spirits, and a Pint of Damask-Rose-water, half a Pint of Poppy water, one pound of white Sugar Candy bruised, then take one pound and half of Raisins in the Sun stoned, half a pound of Dates stoned and sliced, then take one Ounce of Mace, one Ounce of Cloves, one Ounce of Cinamon, one Ounce of Aniseeds rubbed clean from the dust, then take a quarter of an Ounce of Licoras clean scraped and sliced, and all the Spices grosly beaten, let all these steep in the Spirits four days; then take a quarter of a peck of Red Poppy Leaves fresh gathered, and the black part cut off, and put them in, and when it hath stood four or five days, strain it, and put it into your Glass, then put in your Sugar-Candy finely beaten, twelve peniworth of Ambergreece, six peniworth of Musk, keep it close, and shake it now and then, and when you use it, you may put some kind of Syrrup to it, what you please. 31. _To make the true Palsie-water, as it was given by that once very famous Physician Doctor_ Matthias. Take Lavender Flowers stripped from the stalks, and fill a Gallon-Glass with them, and pour on them good Spirit of Sack, or perfect _Aqua vitæ_ distilled from all Flegm, let the quantity be five quarts, then circulate them for six weeks, very close with a Bladder, that nothing may breath out; let them stand in a warm place, then distil them in an Alembeck with his Cooler, then put into the said water, of Sage, Rosemary, and Wood-Betony Flowers; of each half a handful, of Lilly of the Valley, and Burrage, Bugloss, and Cowslip Flowers, one handful of each; steep these in Spirit of Wine, Malmsie, or _Aqua vitæ_, every one in their Season, till all may be had; then put also to them of Balm, Motherwort, Spike-flowers, Bay leaves, the leaves of Orange trees, with the Flowers, if they may be had, of each one ounce, put them into the aforesaid distilled Wine all together, and distil it as before, having first been steeped six weeks; when you have distilled it, put into it Citron Pill, dried Piony seeds hull'd, of each five Drams, of Cinamon half an Ounce, of Nutmegs, Cardamum seeds, Cubebs, and yellow Saunders, of each half an ounce, of lignum Aloes one dram; make all these into Powder, and put them into the distilled Wine abovesaid, and put to them of Cubebs anew, a good half pound of Dates, the stones taken out, and cut them in small pieces, put all these in, and close your Vessel well with a double Bladder; let them digest six weeks, then strain it hard with a Press, and filtrate the Liquor, then put into it of prepared Pearl, Smaragdus, Musk and Saffron, of each half a Scruple; and of Ambergreece one Scruple, red Roses dried well, Red and Yellow Saunders, of each one ounce, hang these in a Sarsenet Bag in the water, being well sewed that nothing go out. _The virtues of this Water._ This Water is of exceeding virtue in all Swoundings and Weaknesses of the heart, and decaying of Spirits in all Apoplexies and Palsies, also in all pains of the Joints coming of Cold, for all Bruises outwardly bathed and dipped Clothes laid to; it strengtheneth and comforteth all animal, natural and viral Spirits, and cheareth the external Senses, strengtheneth the Memory, restoreth lost Speech, and lost Appetite, all weakness of the Stomach, being both taken inwardly, and bathed outwardly; it taketh away the Giddiness of the Head, helpeth lost Hearing, it maketh a pleasant Breath, helpeth all cold disposition of the Liver, and a beginning Dropsie; it helpeth all cold Diseases of the Mother; indeed none can express sufficiently; it is to be taken morning and evening, about half a Spoonful with Crums of Bread and Sugar. 32. _For a Cough of the Lungs, or any Cough coming of Cold, approved by many._ Take a good handful of French Barley, boil it in several waters till you see the water be clear, then take a quart of the last water, and boil in it sliced Licoras, Aniseeds bruised, of each as much as you can take up with your four Fingers and your Thumb, Violet Leaves, Strawberry Leaves, five fingered Grass, Maidenhair, of each half a handful, a few Raisins in the Sun stoned; boil these together till it come to a Pint, then strain it, and take twelve or fourteen Jordan Almonds blanched and beaten, and when your water is almost cold, put in your Almonds, and stir it together, and strain it; then sweeten it with white Sugar Candy; drink this at four times, in the morning fasting, and at four of the Clock in the Afternoon a little warmed; do this nine or ten days together; if you please, you may take a third draught when you go to Bed; if you be bound in your body, put in a little Syrrup of Violets, the best way to take it, is to suck it through a straw, for that conveys it to the Lungs the better. 33. _To make the best Bisket-Cakes._ Take four new laid Eggs, leave out two of the Whites, beat them very well, then put in two spoonfuls of Rose-water, and, beat them very well together, then put in a pound of double refin'd Sugar beaten and searced, and beat them together one hour, then put to them one pound of fine Flower, and still beat them together a good while; then put them upon Plates rubbed over with Butter, and set them into the Oven as fast as you can, and have care you do not bake them too much. 34. _Perfumed Roses._ Take Damask Rose Buds, and cut off the Whites, then take Rose-water or Orange-Flower water wherein hath been steeped _Benjamin_, _Storax_, _Lignum Rhodium_, Civet or Musk, dip some Cloves therein and stick into every Bud one, you must stick them in where you cut away the Whites; dry them between white Papers, they will then fall asunder; this Perfume will last seven years. Or do thus. Take your Rose Leaves cut from the Whites, and sprinkle them with the aforesaid water, and put a little powder of Cloves among them. 35. _To make Tincture of Caraways._ Take one quart of the Spirits of French Wine, put into it one pound of Caraway Comfits which are purled, and the Pills of two Citron Limons; let it stand in a warm place to infuse, in a Glass close stopped for a Month, stirring it every day once. Then strain it from the seeds, and add to it as much Rosewater as will make it of a pleasant taste, then hang in your Bottle a little Ambergreece, and put in some Leaf-Gold; this is a very fine Cordial. 36. _To get away the Signs of the Small Pox._ Quench some Lime in white Rosewater, then shake it very well, and use it at your pleasure; when you at any time have washed with it, anoint your face with Pomatum, made with Spermaceti and oyl of sweet Almonds. 37. _To make clouted Cream._ Take Milk that was milked in the morning, and scald it at noon; it must have a reasonable fire under it, but not too rash, and when it is scalding hot, that you see little Pimples begin to rise, take away the greatest part of the Fire, then let it stand and harden a little while, then take it off, and let it stand until the next day, covered, then take it off with a Skimmer. 38. _To make a_ Devonshire-_White-pot._ Take two quarts of new Milk, a peny white Loaf sliced very thin, then make the Milk scalding hot, then put to it the Bread, and break it, and strain it through a Cullender, then put in four Eggs, a little Spice, Sugar, Raisins, and Currans, and a little Salt, and so bake it, but not too much, for then it will whey. 39. _To make the_ Portugal _Eggs._ Take a very large Dish with a broad brim, lay in it some _Naples_ Bisket in the Form of a Star, then put so much Sack into the Dish as you do think the Biskets will drink up; then stick them full with thin little pieces of preserved Orange, and green Citron Pill, and strew store of French Comfits over them, of divers colours, then butter some Eggs, and lay them here and there upon the Biskets, then fill up the hollow places in the Dish, with several coloured Jellies, and round about the Brim thereof lay Lawrel Leaves guilded with Leaf-Gold; lay them flaunting, and between the Leaves several coloured Jellies. 40. _To Candy Flowers the best way._ Takes Roses, Violets, Cowslips, or Gilly-flowers, and pick them from the white bottoms, then have boiled to a Candy height Sugar, and put in so many Flowers as the Sugar will receive, and continually stir them with the back of a Spoon, and when you see the Sugar harden on the sides of the Skillet, and on the Spoon, take them off the Fire, and keep them with stirring in the warm Skillet, till you see them part, and the Sugar as it were sifted upon them, then put them upon a paper while they are warm and rub them gently with your hands; till all the Lumps be broken, then put them into a Cullender, and sift them as clean as may be, then pour them upon a clean Cloth, and shake them up and down till there be hardly any Sugar hanging about them; then if you would have them look as though they were new gathered, have some help, and open them with your fingers before they be quite cold, and if any Sugar hang about them, you may wipe it off with a fine Cloth; to candy Rosemary Flowers, or Archangel, you must pull out the string that stands up in the middle of the Blossom, and take them which are not at all faded, and they will look as though they were new gathered, without opening. 41. _To pickle Cucumbers._ Take the least you can get, and lay a layer of Cucumbers, and then a layer of beaten Spices, Dill, and Bay Leaves, and so do till you have filled your Pot, and let the Spices, Dill, and Bay Leaves cover them, then fill up your Pot with the best Wine Vinegar, and a little Salt, and so keep them. Sliced Turneps also very thin, in some Vinegar, Pepper and a little Salt, do make a very good Sallad, but they will keep but six Weeks. 42. _To make Sugar Cakes._ Take a pound of fine Sugar beaten and searced, with four Ounces of the finest Flower, put to it one pound of Butter well washed with Rose-water, and work them well together, then take the Yolks of four Eggs, and beat them with four Spoonfuls of Rosewater, in which hath been steeped two or three days before Nutmeg and Cinamon, then put thereto so much Cream as will make it knead to a stiff Paste, rowl it into thin Cakes, and prick them, and lay them on Plates, and bake them; you shall not need to butter your Plates, for they will slip off of themselves, when they are cold. 43. _To make a very fine Cream._ Take a quart of Cream, and put to it some Rosewater and Sugar, some large Mace, Cinamon and Cloves; boil it together for a quarter of an hour, then take the yolks of eight Eggs, beat them together with some of your Cream, then put them into the Cream which is boiling, keep it stirring lest it curdle, take it from the fire, and keep it stirring till it be a little cold, then run it through a Strainer, dish it up, and let it stand one night, the next day it will be as stiff as a Custard, then stick it with blanched Almonds, Citron Pill and Eringo roots, and so serve it in. 44. _To make Syrup of Turneps for a Consumption._ Take half a peck of Turneps washed and pared clean, cut them thin, put to them one pound of Raisins of the Sun stoned, one quarter of a pound of Figs cut small, one Ounce of Anniseeds bruised, half an Ounce of Licoras sliced, one Ounce of Cloves bruised, two handfuls of Burrage Flowers, and so much water as will cover all, and two fingers breadth above them, then boil it on a great fire in an earthen Vessel covered, untill the roots be soft and tender, then strain out the Liquor, and to every Pint of it put a pound of fine Sugar, the whites of two Eggs beaten, boil it to a Syrrop, and use it often, two or three spoonfuls at a time. 45. _For a Consumption._ Take a Pint of Red Cows milk, then take the Yolk of a new laid Egg potched very rare, then stir it into the Milk over a soft fire, but do not let it boil, sweeten it with a little Sugar Candy, and drink it in the morning fasting, and when you go to bed. 46. _To make Bottle Ale for a Consumption._ Take a quart of Ale, and a Pint of strong _Aqua vitæ_, Mace and Cinamon, of each one quarter of an Ounce, two Spoonfuls of the powder Elecampane root, one quarter of a pound of Loaf Sugar, one quarter of a pound of Raisins of the Sun stoned, four spoonfuls of Aniseeds beaten to Powder, then put all together into a Bottle and stop it close. Take three spoonfuls of this in a morning fasting, and again one hour before Supper and shake the Bottle when you pour it out. 47. _To make Cakes of Quinces._ Take the best you can get, and pare them, and slice them thin from the Core, then put them into a Gallipot close stopped, and tie it down with a Cloth, and put it into a Kettle of boiling water, so that it may stand steddy about five hours, and as your water boils away in the Kettle, fill it up with more warm water, then pour your Quinces into a fine hair sieve, and let it drain all the Liquor into a Bason, then take this Liquor and weigh it, and to every pound take a pound of double refin'd Sugar, boil this Sugar to a Candy height, then put in your Liquor, and set them over a slow fire, and stir them continually till you see it will Jelly, but do not let it boil; then put it into Glasses, and set them in a Stove till you see them with a Candy on the top, then turn them out with a wet Knife on the other side upon a white Paper, sleeked over with a sleek-stone, and set them in the Stove again till the other side be dry, and then keep them in a dry place. 48. _To make Marmalade of Apricocks._ Take Apricocks, pare them and cut them in quarters, and to every pound of Apricocks put a pound of fine Sugar, then put your Apricocks into a Skillet with half of the Sugar, and let them boil very tender and gently, and bruise them with the back of a Spoon, till they be like Pap, then take the other part of the Sugar, and boil it to a Candy height, then put your Apricocks into that Sugar, and keep it stirring over the fire, till all the Sugar be melted, but do not let it boil, then take it from the fire, and stir it till it be almost cold; then put it in Glasses, and let it have the Air of the fire to dry it. 49. _To make Limon Cakes._ Take half a pound of refin'd sugar, put to it two spoonfuls of Rosewater, as much Orange Flower water, and as much of fair water, boil it to a Candy height, then put in the Rind of a Limon grated, and a little Juice, stir it well on the fire, and drop it on Plates or sleeked Paper. 50. _To make Wafers._ Take a quart of Flower heaped and put to it the yolks of four Eggs, and two or three spoonfuls of Rosewater, mingle this well together, then make it like Batter with Cream and a little Sugar, and bake it on Irons very thin poured on. 51. _To make Marmalade of Cherries with Currans._ Take four pounds of Cherries when they are stoned, and boil them alone in their Liquor for half an hour very fast, then pour away the Liquor from them, and put to them half a Pint and little more of the juice of Currans, then boil a pound of double refin'd Sugar to a Candy height, and put your Cherries and Juice of Currans in that, and boil them again very fast till you find it to jelly very well. 52. _To preserve Rasberries._ Take the weight of your Rasberries in fine Sugar, and take some Rasberries and bruise them a little; then take the clearest of the bruised Rasberries, I mean the Juice and the weight of it in Sugar, and your other Sugar named before, and boil it, and scum it, then put in your whole Rasberries, and boil them up once, then let them stand over the fire without boiling till you see it will Jelly, and that it look clear, then take up your Rasberries one by one, and put them into Glasses, then boil your Syrrop, and put it over them. 53. _To make Syrrop of Ale, good for weak People to take inwardly, or to heal old Sores, applied thereto._ Take two Gallons of Ale Wort, the strongest you can get, so soon as it is run from the Grounds, set it on the fire in a Pipkin, and let it boil gently and that you do perceive it to be as though it were full of Rags; run it through a strainer, and set it on the fire again, and let it boil until it be thick, and scum it clean, and when it is much wasted, put it into a lesser Pan to boil, or else it will burn; when it is thick enough, take it off, and when it is cold, put it into Gallipots, take as much as a Walnut fasting; and as much when you go to bed. 54. _To make whipt Sillibub._ Take half a Pint of Rhenish Wine or white Wine, put it into a Pint of Cream, with the Whites of three Eggs, season it with Sugar, and beat it as you do Snow-Cream, with Birchen Rods, and take off the Froth as it ariseth, and put it into your Pot, so do till it be beaten to a Froth, let it stand two or three hours till it do settle, and then it will eat finely. 55. _To make Raisin Wine or Stepony._ Take four Gallons of Spring-water, four pounds of Raisins of the Sun stoned, the juice of four good Limons, and the Rind of two cut thin, boil the Raisins, and Pill in the Water for half an hour or more, then put in the juice of Limon, and a little Spice, Sugar and Rosewater, and let it stand but a little more over the fire; then put it into an earthen pot, and beat it together till it be cold, then bottle it up, it will keep but a few days. _Memorandum_, Two pounds of Sugar to one pound of Cowslips is enough for Conserve. 56. _To boil Samphire._ Take Water and Salt so strong as will bear an Egg, boil it, and when it boils, put in your Samphire unwashed, and let it scald a little, then take it off, and cover it so close that no Air can get in, and set the Pot upon a cold Wisp of Hay, and so let it stand all night, and it will be very green, then put it up for your use. 57. _To make Cabbage Cream._ Take twenty five Quarts of new Milk, set it on the fire till it be ready to boil, stir it all the while that it creams not, then pour it into twenty several Platters so fast as you can, when it is cold, take off the Cream with a Skimmer, and lay it on a Pie Plate in the fashion of a Cabbage, crumpled one upon another, do thus three times, and between every Layer you must mingle Rosewater and Sugar mingled thick, and laid on with a Feather; some use to take a little Cream and boil it with Ginger, then take it from the fire and season it with Rosewater and Sugar, and the Juice of Jordan Almonds blanched and beaten, then stir it till it be cold, that it cream not; then take Toasts of Manchet cut thin, not too hard, nor brown, lay them in the bottom of the Dish, and pour the Cream upon them, and lay the Cabbage over. 58. _To make a Trifle._ Take sweet Cream, season it with Rosewater and Sugar, and a little whole Mace, let it boil a while, then take it off, and let it cool, and when it is lukewarm put it into such little Dishes or Bowls as you mean to serve it in; then put in a little Runnet, and stir it together; when you serve it in, strew on some French Comfits. 59. _To make thick Cream._ Take sweet Cream, a little Flower finely searced, large Mace, a stick of Cinamon, Sugar and Rosewater, let all these boil together till it be thick, then put into it thick Cream, the yolks of Eggs beaten, then let it seeth but a little while for fear of turning, then pour it out, and when it is cold serve it in. 60. _To pickle Purslan to keep all the Year._ Take the Leaves from the stalks, then take the Pot you mean to keep them in, and strew Salt over the bottom, then lay in a good row of the Leaves, and strew on more Salt, then lay in a row of the stalks, and put in more Salt, then a row of the Leaves, so keep it close covered. 61. _To Stretch Sheeps Guts._ After they are clean scowred, lay them in water nine days, shifting them once a day, and they will be very easie to fill, and when they are filled, they will come to their wonted bigness. 62. _To make Cream of Pastes and Jellies._ Put Eggs into the Cream as you do for Fool, and slice your Sweet-meats very thin and boil with them, then sweeten it, and put it into a Dish. 63. _To make a rare Medicine for the Chine-Cough._ Make a Syrrop of Hysop-water and white Sugar Candy, then take the Powder of Gum Dragon, and as much of white Sugar Candy mixed together, and eat of it several times of the day, or take the above-named Syrrop, either of them will do the Cure. 64. _For a Consumption._ Take of Syrrop of Violets, Syrrop of Horehound, Syrrop of Maidenhair and Conserve of Fox Lungs, of each one ounce, mix them well together, and take it often upon a Liquoras stick in the day time, and at night. 65. _To make very rare Ale._ When your Ale is tunned into a Vessel that will hold eight or nine Gallons, and that hath done working, ready to be stopped up, then take a Pound and half of Raisins of the Sun stoned and cut in pieces, and two great Oranges, Meat and Rind, and sliced thin, with the Rind of one Limon, and a few Cloves, one Ounce of Coriander seeds bruised, put all these in a Bag, and hang them in the Vessel, and stop it up close; when it hath stood four days, bottle it up, fill the Bottles but a little above the Neck, and put into every one a Lump of fine Sugar, and stop them close, and let it be three Weeks or a month before you drink it. 66. _To make Ale to drink within a Week._ Tun it into a Vessel which will hold eight Gallons, and when it hath done working, ready to bottle, put in some Ginger sliced, and an Orange stuck with Cloves, and cut here and there with a Knife, and a pound and half of Sugar, and with a stick stir it well together, and it will work afresh; when it hath done working, stop it close, and let it stand till it be clear, then bottle it up and put a Lump of Sugar into every Bottle, and then stop it close, and knock down the Corks, and turn the Bottles the Bottoms upwards, and it will be fit to drink in a Weeks time. 67. _For the Griping in the Guts._ Take a peniworth of Brandy, and a peniworth of Mithridate mixed together, and drink it three nights together when you go to rest, or take a little Oil of Aniseeds in a Glass of Sack three times. 68. _To make a Sack Posset._ Take twelve Eggs beaten very well, and put to them a Pint of Sack, stir them well that they curd not, then put to them three Pints of Cream, half a Pound of white Sugar, stirring them well together, when they are hot over the fire, put them into a Bason, and set the Bason over a boiling pot of water, until the Posset be like a Custard, then take it off, and when it is cool enough to eat, serve it in with beaten Spice strewed over it very thick. 69. _To make Pennado._ Take Oatmeal clean picked and well beaten, steep it in water all night, then strain it and boil it in a Pipkin with some Currans, and a Blade or two of Mace, and a little Salt; when it is well boiled, take it off, and put in the Yolks of two or three new laid Eggs beaten with Rosewater, then set it on a soft fire, and stir it that it curd not, then sweeten it with Sugar, and put in a little Nutmeg. 70. _To make Cakes without Fruit._ Take four pounds of fine Flower, rub into it one pound of Butter very well, then take warmed Cream, and temper it with Ale yest, so mix them together, and make them into a Paste, put in a little Rosewater, and several Spices well beaten, let it lie by the fire till the Oven heat, and when you make it up, knead into it half a pound of Caraway Comfits, and three quarters of a pound of Bisket-Comfits, make it up as fast as you can, not too thick, nor cut it too deep, put it into a hoop well butter'd, and wash it over with the White of an Egg, Rosewater, and Sugar, and strew it with some Comfits; do not bake it too much. 71. _A Sack Posset without Milk._ Take thirteen Eggs and beat them very well, and while they are beating, take a quart of Sack, half a pound of fine Sugar, and a Pint of Ale, and let them boil a very little while, then put these Eggs to them, and stir them till they be hot, then take it from the fire, and keep it stirring a while, then put it into a fit Bason, and cover it close with a Dish, then set it over the fire again till it arise to a Curd; then serve it in with some beaten spice. 72. _A very fine Cordial._ One Ounce of Syrrop of Gilly-flowers, one dram of Confection of Alkermes, one Ounce and a half of Burrage-water, the like of Mint-water, one Ounce of Dr. _Mountsford's_ water, as much of Cinamon water mixed together. 73. _The best way to preserve Goosberries green and whole._ Pick them clean and put them into water as warm as milk, so let them stand close covered half an hour, then put them into another warm water and let them stand as long, and so the third time, till you find them very green; then take their weight in fine Sugar, and make a Syrrop, then put them in, and let them boil softly one hour; then set them by till the next day, then heat them again, so do twice, then take them from that Syrrop and make a new Syrrop and boil them therein, till you find they be enough. 74. _To make the Orange Pudding._ Take the rind of a small one pared very thin, and boiled in several waters, and beaten very fine in a Mortar, then put to it four Ounces of fine Sugar, and four Ounces of fresh Butter, and the Yolks of six Eggs, and a little Salt, beat it together in the Mortar till the Oven heats, and so butter a dish and bake it, but not too much; strew Sugar on it and serve it to the Table, Bake it in Puff-past. 75. _To make French Bread._ Take half a Bushel of fine Flower, ten Eggs, one pound and a half of fresh Butter, then put in as much Yest as you do into Manchet, temper it with new milk pretty hot, and let it lie half an hour to rise, then make it into Loaves or Rolls, and wash it over with an Egg beaten with Milk; let not your Oven be too hot. 76. _To make a made dish._ Take four Ounces of sweet Almonds blanched, and beaten with Rosewater, strain them into some Cream, then take Artichoke bottoms boiled tender, and some boiled Marrow, then boil a quart of Cream with some Rosewater and Sugar to some thickness, then take it off, and lay your Artichokes into a Dish, and lay the Marrow on them, then mix your Almond Cream, and the other together, and poure it over them, and set it on Coals till you serve it in. 77. _To make a Cake with Almonds._ Take one pound and half of fine Flower, of Sugar twelve Ounces beaten very fine, mingle them well together, then take half a pound of Almonds blanched, and beaten with Rosewater, mingle all these with as much Sack as will work it into a Paste, put in some Spice, some Yest, and some plumped Currans with some Butter, and a little salt, to make it into a Cake and bake it. 78. _To make a Sillibub._ Take a Limon pared and sliced very thin, then cover the bottom of your Sillibub Pot with it, then strew it thick with fine Sugar, then take Sack or white Wine, and make a Curd with some Milk or Cream, and lay it on the Limon with a Spoon, then whip some Cream and Whites of Eggs together, sweetened a little, and cast the Froth thereof upon your Sillibub, when you lay in your Curd, you must lay Sugar between every Lay. 79. _To make fine Water-Gruel._ Take the best Oatmeal beaten, and steep it in water all night, the next day strain it, and boil it with a Blade of Mace, and when it is enough, put in some Raisins and Currans which have been infused in a Pot (in a Pot of seething Water) and a little Wine, a little Salt, a little Sugar, and so eat it. 80. _To make Limon Cream._ Take a quart of Cream, keep it stirring on the fire until it be blood warm, then take the Meat of three Limons sweetened well with Sugar, and a little Orange Flower water, sweeten them so well that they may not turn the Cream, then stir them into the Cream, on the fire with some yolks of Eggs, and serve it cold; Limon Posset thickned with yolks of Eggs, makes a fine Cawdle for a sick body. 81. _To make rare Cakes with Almonds._ Take two Pounds and an half of blanched Almonds beaten fine with Rosewater, mix them with a Pound and three quarters of fine Sugar and some Musk, and Ambergreece, six Whites of Eggs beaten to a Froth, let them stand a little, then set them on a Chafing-dish of Coals, and dry them a little, stirring them all the while, then take half a Peck of Flower, put into it a little salt, three Pints of Ale-Yest, have in readiness your Cream lukewarm, strain your Yest, and put into it six spoonfuls of Sack, put in Spice into your Flower, and make all these into a stiff Paste with the Cream, work it well and lay it by the fire to rise one hour, then work into your Paste two pounds and a quarter of fresh Butter; pull your Paste in pieces three times, then strew in a pound of Caraway Comfits, and make this Paste into five Cakes, lay them upon buttered Plates or double Papers, then strew Caraway Comfits on the top and double refined Sugar; one hour will bake them sufficiently. 82. _To make_ Shrewsbury _Cakes._ Take four pounds of Flower, two pounds of Butter, one pound and an half of fine Sugar, four Eggs, a little beaten Cinamon, a little Rosewater, make a hole in the Flower, and put the Eggs into it when they are beaten, then mix the Butter, Sugar, Cinamon, and Rosewater together, and then mix them with the Eggs and Flower, then make them into thin round Cakes, and put them into an Oven after the Houshold Bread is drawn; this quantity will make three dozen of Cakes. 83. _To make Goosberry Wine._ Bruise ripe Goosberries with an Apple-Beater, but do not beat them too small, then strain them through a hair strainer, and put your Juice into an earthen Pot, keep it covered four or five days till it be clear, then draw it out into another Vessel, letting it run into a hair sieve, stop it close, and let it stand one fortnight, then draw it out into quart Bottles, putting one Pound of Sugar into eight Bottles, stop them up close, and in a week or fortnights time you may drink them. 84. _To make Damson Wine._ Take four Gallons of Water and put to every Gallon of Water four Pounds of Malaga Raisins, and half a Peck of Damsons. Put the Raisins and Damsons into a Vessel without a head, cover the Vessel and let them steep six days, stirring them twice every day; then let them stand as long without stirring, then draw the Wine out of the Vessel, and colour it with the infused juice of Damsons sweetened with Sugar, till it be like Claret Wine, then put it into a Wine-vessel for a fortnight, and then bottle it up. 85. _To pickle Cucumbers the very best way._ Take those you mean to pickle, and lay them in water and salt three or four days, then take a good many great Cucumbers, and cut the outsides of them into water, for the insides will be too pappy, boil them in that Water, with Dill seeds and Fennel seeds, and when it is cold, put to it some salt, and as much of Vinegar as will make it a strong Pickle, then take them out of the Water and Salt, and pour this Liquor over them, so let them stand close covered for a fortnight or three weeks. Then pour the Pickle from them and boil it, and when it is cold add to it some more Vinegar, and put it to them again, so let them stand one Month longer, and now and then when you see occasion, boil it again, and when it is cold, put it to them, and every time you boil it, put some Vinegar thereto, and lay the seeds and pieces of Cucumbers on the top, and after the first fortnight when you boil it, put in some whole Pepper and some whole Cloves and Mace, and always put the Liquor cold over them. 86. _To make the best Orange Marmalade._ Take the Rinds of the deepest coloured Oranges, boil them in several Waters till they are very tender, then mince them small, and to one pound of Oranges, take a Pound of Pippins cut small, one Pound of the finest Sugar, and one Pint of Spring-water, melt your Sugar in the Water over the fire, and scum it, then put in your Pippins, and boil them till they are very clear, then put in the Orange Rind, and boil them together, till you find by cooling a little of it, that it will jelly very well, then put in the Juice of two Oranges, and one Limmon, and boil it a little longer; and then put it up in Gally-pots. 87. _To preserve White Quinces._ Take the fairest you can get, and coddle them very tender, so that a straw may go through to the Core, then core them with a scoop or small knife, then pare them neatly, and weigh them, to every pound of Quinces, take one pound of double refined Sugar, and a Pint of the Water wherein thin slices of Pippins have been boiled; for that is of a Jellying quality, put your Sugar to the Pippin water, and make a Sirrup, and scum it, then put in your Quinces, and boil them very quick, and that will keep them whole and white, take them from the fire sometimes and shake them gently, keep them clean scummed, when you perceive them to be very clear, put them into Gally-pots or Glasses, then warm the Jelly and put it to them. 88. _To make Conserve of Red Roses._ Take their Buds and clip off the Whites, then take three times their weight in Sugar double refin'd; beat the Roses well in a Mortar, then put in the Sugar by little and little, and when you find it well incorporated, put it into Gally-pots, and cover it with Sugar, and so it will keep seven years. 89. _To make plain Bisket-Cakes._ Take a Pottle of Flower, and put to it half a pound of fine Sugar, half an Ounce of Caraway seeds, half an Ounce of Anniseeds, six spoonfuls of Yest, then boil a Pint of Water or little more, put into it a quarter of a Pound of Butter or a little more, let it stand till it be cold, then temper them together till it be as thick as Manchet, then let it lie a while to rise, so roul them out very thin, and prick them, and bake them in an Oven not too hot. 90. _To make Green Paste of Pippins._ Take your Pippins while they be green, and coddle them tender, then peel them, and put them into a fresh warm Water, and cover them close, till they are as green as you desire. Then take the Pulp from the Core, and beat it very fine in a Mortar, then take the weight in Sugar, and wet it with Water, and boil it to a Candy height, then put in your Pulp, and boil them together till it will come from the bottom of the Skillet, then make it into what form you please, and keep them in a stove. 91. _To make Paste of any Plumbs._ Take your Plumbs, and put them into a Pot, cover them close, and set them into a Pot of seething Water, and so let them be till they be tender, then pour forth their Liquor, and strain the Pulp through a Canvas strainer, then take to half a Pound of the Pulp of Plumbs half a Pound of the Pulp of Pippins, beat them together, and take their weight in fine Sugar, with as much Water as will wet it, and boil it to a Candy height; then put in your Pulp, and boil them together till it will come from the bottom of the Posnet, then dust your Plates with searced Sugar, and so keep them in a Stove to dry. 92. _To make Almond Ginger-Bread._ Take a little Gum-Dragon and lay it in steep in Rosewater all night, then take half a Pound of Jordan Almonds blanched and beaten with some of that Rosewater, then take half a pound of fine Sugar beaten and searced, of Ginger and Cinamon finely searced, so much as by your taste you may judge to be fit; beat all these together into a Paste, and dry it in a warm Oven or Stove. 93. _To make Snow Cream._ Take a Pint of Cream, and the Whites of three Eggs, one spoonful or two of Rosewater, whip it to a Froth with a Birchen Rod, then cast it off the Rod into a Dish, in the which you have first fastened half a Manchet with some Butter on the bottom, and a long Rosemary sprig in the middle; when you have all cast the Snow on the dish, then garnish it with several sorts of sweet-meats. 94. _To preserve Oranges and Limons that they shall have a Rock Candy on them in the Syrrup._ Take the fairest and cut them in halves, or if you will do them whole, then cut a little hole in the bottom, so that you may take out all the meat, lay them in water nine days, shifting them twice every day, then boil them in several Waters, till a straw will run through them, then take to every Pound of Orange or Limon one Pound of fine Sugar, and one quart of Water, make your Syrrup, and let your Oranges or Limons boil a while in it, then let them stand five or six days in that Syrrup, then to every Pound, put one Pound more of Sugar into your Syrrup, and boil your Oranges till they be very clear, then take your Oranges out, and boil your Syrrup almost to Candy, and put to them. 95. _To make Sugar Plate._ Take a little Gum-Dragon laid in steep in Rosewater till it be like Starch, then beat it in a Mortar with some searced Sugar till it come to a perfect Paste, then mould it with Sugar, and make it into what form you please, and colour some of them, lay them in a warm place, and they will dry of themselves. 96. _To make Artificial Walnuts._ Take some of your Sugar Plate, print it in a Mould fit for a Walnut Kernel, yellow it over with a little Saffron, then take searced Cinamon and Sugar, as much of the one as the other, work it in Paste with some Rosewater, wherein Gum Dragon hath been steeped, and print it in a Mould for a Walnut shell, and when they are dry, close them together over the shell with a little of the Gum water. 97. _To make short Cakes._ Take a Pint of Ale Yest, and a Pound and half of fresh Butter, melt your Butter, and let it cool a little, then take as much fine Flower as you think will serve, mingle it with the Butter and Yest, and as much Rosewater and Sugar as you think fit, and if you please, some Caraway Comfits, so bake it in little Cakes; they will last good half a year. 98. _To preserve red Roses, which is as good and effectual as any Conserve, and made with less trouble._ Take Red Rose Buds clipped clean from their Whites one pound, put them into a Skillet with four Quarts of Water, Wine measure, then let them boil very fast till three Quarts be boiled away, then put in three pounds of fine Sugar, and let it boil till it begins to be thick, then put in the Juice of a Limon, and boil it a little longer, and when it is almost cold, put it into Gally-Pots, and strew them over with searced Sugar, and so keep them so long as you please, the longer the better. 99. _A fine Cordial Infusion._ Take the flesh of a Cock Chick cut in small pieces, and put into a Glass with a wide Mouth, put to it one Ounce of Harts-horn, half an Ounce of Red Coral prepared, with a little large Mace, and a slice or two of Limon, and two Ounces of White Sugar-Candy, stop the Glass close with a Cork, and set it into a Vessel of seething Water, and stuff it round with Hay that it jog not; when you find it to be enough, give the sick Party two spoonfuls at a time. 100. _For a Cough of the Lungs._ Take two Ounces of Oil of sweet Almonds newly drawn, three spoonfuls of Colts-foot Water, two spoonfuls of Red Rose-Water, two Ounces of white Sugar-Candy finely beaten; mingle all these together, and beat it one hour with a spoon, till it be very white; then take it often upon a Licoras stick. This is very good. 101. _To preserve Grapes._ Take your fairest white Grapes and pick them from the stalks, then stone them carefully, and save the Juice, then take a pound of Grapes, a pound of fine Sugar, and a pint of water wherein sliced Pippins have been boiled, strain that water, and with your Sugar and that make a Syrup, when it is well scummed put in your Grapes, and boil them very fast, and when you see they are as clear as glass, and that the Syrup will jelly, put them into Glasses. 102. _To make Collops of Bacon in Sweet-meats._ Take some Marchpane Paste, and the weight thereof in fine Sugar beaten and searsed, boil them on the fire, and keep them stirring for fear they burn, so do till you find it will come from the bottom of the Posnet, then mould it with fine Sugar like a Paste, and colour some of it with beaten Cinnamon, and put in a little Ginger, then roll it broad and thin, and lay one upon another till you think it be of a fit thickness and cut it in Collops and dry it in an Oven. 103. _To make Violet Cakes._ Take them clipped clean from the whites and their weight in fine Sugar, wet your Sugar in fair water, and boil it to a Candy height, then put in your Violets, and stir them well together, with a few drops of a Limon, then pour them upon a wet Pye-Plate, or on a slicked paper, and cut them in what form you please; do not let them boil, for that will spoil the colour: Thus you may do with any Herb or Flower, or with any Orange or Limon Pill, and, if you like it, put in a little Musk or Ambergreece. 104. _To preserve white Damsons._ Take to every pound one pound of fine Sugar and a quarter of a pint of fair water, make your Syrup and scum it well, then take it from the fire, and when it is almost cold put in your Damsons, and let them scald a little, then take them off a while, and then set them on again; when you perceive them to be very clear, put them into Pots or Glasses. 105. _To make a very good Cake._ Take a peck of Flower, four pound of Currans well washed, dryed and picked, four pounds of Butter, one pound of Sugar, one ounce of Cinnamon, one ounce of Nutmegs, beat the Spice and lay it all night in Rosewater, the next day strain it out, then take one pint and an half of good Ale-Yest the Yolks of 4 Eggs, a pint of Cream, put a pound of the butter into the warmed Cream, put the rest into the Flower in pieces, then wet your Flower with your Cream, and put in your Currans, and a little Salt, and four or five spoonfuls of Caraway-Comfits and your Spice, mix them all and the Yest well together, and let it lie one hour to rise, then make it up and Bake it in a Pan buttered: It may stand two hours. 106. _To make Paste Royal._ Take Quince Marmalade almost cold, and mould it up with searced Sugar to a Paste, them make it into what form you please and dry them in a Stove. 107. _To make Paste of Pippins coloured with Barberries._ Take the Pulp of Codled Pippins, and as much of the Juice of Barberries as will colour it, then take the weight of it in fine Sugar, boil it to a Candy height, with a little water, then put in your Pulp beaten very well in a mortar, boil it till it come from the bottom of the Posnet, then dust your Plate with Sugar, and drop them thereon, and dry them in a Stove or warm Oven. 108. _To preserve Barberries._ Take one Pound of stoned Barberries and twice their weight in fine Sugar, then strip two or three handfuls of Barberries from their stalks, and put them into a Dish with as much Sugar as Barberries, over a Chafing dish of Coals, when you see they are well plumped, strain them, then wet your other Sugar with this, and no Water, boil it and scum it, and then put in your stoned Barberries, and boil them till they are very clear. 109. _To make Jelly of Currans or of any other Fruit._ Take your Fruit clean picked from the stalks, and put them into a long Gally-pot, and set it into a Kettle of Water close covered; keep the Water boiling till you find the Fruit be well infused, then pour out the clearest, and take the weight of it in fine Sugar, wet your Sugar with Water, and boil it to a Candy height, then put in your clear Liquor, and keep it stirring over a slow fire till you see it will jelly, but do not let it boil; the Pulp which is left of the Liquor, you may make Paste of if you please, as you do the Pippin Paste before named. 110. _To make a Goosberry Fool._ Take a Pint and an half of Goosberries clean picked from the stalks, put them into a Skillet with a Pint and half of fair Water, scald them till they be very tender, then bruise them well in the Water, and boil them with a Pound and half of fine Sugar till it be of a good thickness, then put to it the Yolks of six Eggs and a Pint of Cream, with a Nutmeg quartered, stir these well together till you think they be enough, over a slow fire, and put it into a Dish, and when it is cold, eat it. 111. _To make perfumed Lozenges._ Take twelve Grains of Ambergreece, and six grains of Musk, and beat it with some Sugar plate spoken of before, then roule it out in thin Cakes, and make them into what form you please, you may make them round like a Sugar Plumb, and put a Coriander seed in each of them, and so they will be fine Comfits, and you may make them into Lozenges to perfume Wine with. 112. _To Candy Eryngo Roots._ Take the Roots new gathered, without Knots or Joints, wash them clean, and boil them in several Waters till they are very tender, then wash them well, and dry them in a Cloth, slit them, and take out the Pith, and braid them in Braids as you would a Womans Hair, or else twist them, then take twice their weight in fine Sugar, take half that Sugar, and to every Pound of Sugar, one quarter of a pint of Rosewater and as much fair water, make a syrup of it, and put in your roots and boil them, and when they are very clear, wet the rest of the Sugar with Rosewater, and boil it to a Candy height, then put in the Roots and boil them, and shake them, and when they be enough, take them off, and shake them till they are cold and dry, then lay them upon Dishes or Plates till they are throughly dry, and then put them up; thus you may do Orange or Limon, or Citron Pill, or Potato Roots. 113. _To preserve Goosberries._ Take your Gooseberries, and stone them, then take a little more than their weight in fine Sugar, then with as much Water as will melt the Sugar, boil it and scum it, then put in your Goosberries, and boil them apace till they be clear, then take up your Goosberries, and put them into Glasses, and boil the Syrup a little more, and put over them. 114. _To make Leach and to colour it._ Take one Ounce of Isinglass and lay it in Water four and twenty hours, changing the Water three or four times, then take a quart of new Milk, boiled with a little sliced Ginger and a stick of Cinamon, one spoonful of Rosewater, and a quarter of a Pound of Sugar, when it hath boiled a while, put in the Isinglass, and boil it till it be thick, keeping it always stirring, then strain it, and keep it stirring, and when it is cold, you may slice it out, and serve it upon Plates; you may colour it with Saffron, and some with Turnsole, and lay the White and that one upon another, and cut it, and it will look like Bacon; it is good for weak people, and Children that have the Rickets. 115. _To take away the Signs of the Small Pox._ Take some Spercma-ceti, and twice so much Virgins Wax, melt them together and spread it upon Kids Leather, in the shape of Mask, then lay it upon the Face, and keep it on night and day, it is a very fine Remedy. 116. _For Morphew, or Freckles, and to clear the Skin._ Take the Blood of any Fowl or Beast, and wipe your Face all over with it every night when you go to bed for a fortnight together, and the next day wash it all off with White Wine, and white Sugar Candy, and sometimes hold your face over the smoke of Brimstone for a while, and shut your eyes, if you add the Juice of a Limon to the white Wine, it will be the better. 117. _To make Almond Butter to look white._ Take about two Quarts of Water, the bottom of a Manchet, and a Blade of large Mace, boil it half an hour, and let it stand till it be cold, then take a Pound of sweet Almonds blanched, and beaten with Rosewater very fine, so strain them with this Water many times, till you think the virtue is out of them, and that it be a thick Almond Milk, then put it into a Skillet, and make it boiling hot, that it simper, then take a spoonful of the Juice of a Limon, and put into it, stirring of it in, and when you perceive it ready to turn, then take it from the fire, and take a large fine Cloth, and cast your Liquor all over the Cloth with a Ladle, then scrape it altogether into the middle with a Spoon, then tie it hard with a Packthred, so let it hang till the next morning, then put in a Dish, and sweeten it with Rosewater and Sugar, put a little Ambergreece if you please. 118. _For the Ptisick._ Take a Pottle of small Ale, one Pound of Raisins of the Sun stoned, with a little handful of Peniroyal, boil these together, and add a little Sugar-candy to it, and take five or six spoonfuls at a time four or five times in a day for a good while. 119. _Marmalade of Apricocks._ Take the ripest and stone them and pare them, and beat them in a Mortar, then boil the Pulp in a Dish over a Chafing-dish of Coals, till it be somewhat dry, then take the weight in fine Sugar, and boil it to a Candy height, with some Rosewater, then put in your Pulp, and boil them together till it will come from the bottom of the Skillet, and always keep it stirring, for fear it burn, then put it into Glasses. 120. _Syrup of Turneps._ Take of the best and pare them, and bake them in a Pot, then take the clear Juice from them, and with the like weight in fine Sugar make it into a Syrup, and a little Licoras to it, and take it often. 121. _To make a good Jelly._ Take a lean Pig, dress it clean, and boil it in a sufficient quantity of Fair Water, with four Ounces of green Licoras scraped and bruised, Maidenhair two handfuls, Colts-foot one handful, Currans half a Pound, Dates two Ounces stoned and sliced, Ivory one Ounce, Hartshorn one Ounce, boil these to a strong Jelly, and strain it, and take off the Fat, then put to it half a Pound of Sugar, and half a Pint of white Wine, and so eat it at your pleasure. 122. _A most excellent Cordial proved by very many._ Take three Grains of East Indian Bezoar, as much of Ambergreece, powder them very fine with a little Sugar, and mingle it with a spoonful and half of the Syrup of the juice of Citrons, one Spoonful of Syrup of Clovegilliflowers, and one spoonful of Cinamon Water, so take it warmed. 123. _To make the black Juice of Licoras._ Take two Gallons of running Water, three handfuls of unset Hysop, three pounds and half of Licoras scraped, and dried in the Sun and beaten, then cover it close, and boil it almost a whole day in the Water, when it is enough, it will be as thick as Cream, then let it stand all night, the next morning strain it, and put it in several Pans in the Sun to dry, till it work like wax, then mould it with White Sugar Candy beaten and searced, then print it in little Cakes, and print them with Seals, and dry them. 124. _To make Marchpane._ Take two Pounds of Jordan Almonds, blanch and beat them in a Mortar with Rosewater, then take one Pound and half of Sugar finely searced, when the Almonds are beaten to a fine Paste with the Sugar, then, take it out of the Mortar, and mould it with searced Sugar, and let it stand one hour to cool, then roll it as thin as you would do for a Tart, and cut it round by the Plate, then set an edge about it, and pinch it, then set it on a bottom of Wafers, and bake it a little, then Ice it with Rosewater and Sugar, and the White of an Egg beaten together, and put it into the Oven again, and when you see the Ice rise white and high, take it out, and set up a long piece of Marchpane first baked in the middle of the Marchpane, stick it with several sorts of Comfits, then lay on Leaf-gold with a Feather and the White of an Egg beaten. 125. _To preserve Green Pippins._ Scald some green Pippins carefully, then peel them, and put them into warm water, and cover them, and let them stand over a slow fire till they are as green as you would have them, and so tender as that a straw may run through them, then to every pound of Apples, take one pound of fine Sugar, and half a pint of water, of which make a Syrup, and when you have scumm'd it clean, put in your Apples, and let them boil a while, then set them by till the next day, then boil them throughly, and put them up. 126. _To preserve Peaches._ Take your Peaches when you may prick a hole through them, scald them in fair water and rub the Fur off from them with your Thumb, then put them in another warm water over a slow fire, and cover them till they be green, then take their weight in fine Sugar and a little water, boil it and scum it, then put in your Peaches, and boil them till they are clear, so you may do green Plumbs or green Apricocks. 127. _Marmalade of Damsons._ Take two Pounds of Damsons, and one Pound of Pippins pared and cut in pieces, bake them in an Oven with a little sliced Ginger, when they are tender, poure them into a Cullender, and let the Syrup drop from them, then strain them, and take as much sugar as the Pulp doth weigh, boil it to a Candy height with a little water, then put in your Pulp, and boil it till it will come from the bottom of the Skillet, and so put it up. 128. _Marmalade of Wardens._ Bake them in an earthen pot, then cut them from the Core and beat them in a Mortar, then take their weight in fine Sugar, and boil it to a Candy height with a little beaten Ginger, and boil it till it comes from the bottom of the Posnet; and so do with Quinces if you please. 129. _Marmalade of green Pippins to look green._ Scald them as you do to preserve, then stamp them in a Mortar, and take their weight in fine Sugar, boil it to a Candy height with a little water, then boil it and the Pulp together, till it will come from the bottom of Posnet. 130. _To preserve green Walnuts._ Take them and steep them all night in water, in the morning pare them and boil them in fair water till they be tender, and then stick a Clove into the head of each of them, then take one Pound and half of Sugar to every pound of Walnuts, and to every pound of Sugar one Pint of Rosewater, make a Syrup of it, and scum it, then put in your Walnuts, and boil them very leasurely till they are enough; then put in a little Musk or Ambergreece with a little Rosewater, and boil them a little more, and put them up; it is a very good Cordial, and will keep seven years or more. 131. _To dry old Pippins._ Pare them, and bore a hole through them with a little Knife or Piercer, and cut some of them in halves, take out the Cores of them as you cut them, then put them into a Syrup of Sugar and water, as much as will cover them in a broad preserving Pan, let them boil so fast as may be; taking them sometimes from the fire, scumming them clean; when you perceive your Apples clear, and Syrup thick, then take them up, and set them into a warm Oven from the Syrup, all night, the next morning turn them, and put them in again, so do till they are dry; if you please to glister some of them, put them into your Candy-pot but one night, and lay them to dry the next day, and they will look like Crystal. 132. _To preserve Bullace as green as grass._ Take them fresh gathered, and prick them in several places, scald them as you do your green Peaches, then take their weight in fine sugar, and make a Syrup with a little water, then put in your Bullace, and boil them till they be very clear, and the Syrup very thick. 133. _To preserve Medlars._ Take them at their full growth, pare them as thin as you can, prick them with your Knife, and parboil them reasonable tender, then dry them with a Cloth, and put to them as much clarified sugar as will cover them; let them boil leisurely, turning them often, till they have well taken the sugar, then put them into an earthen Pot, and let them stand till the next day, then warm them again half an hour; then take them up and lay them to drain, then put into that Syrup half a pint of water wherein Pippins have been boiled in slices, and a quarter of a Pound of fresh sugar, boil it, and when it will jelly, put it to the Medlars in Gallipots or Glasses. 134. _To make Conserve of Violets._ Take a pound clean cut from the whites, stamp them well in a Mortar, and put to them two or three Ounces of white Sugar-Candy, then take it out and lay it upon a sleeked Paper, then take their weight in fine sugar, and boil it to a Candy height with a little water, then put in your Violets, and a little Juice of Limon, and then let them have but one walm or two over the fire, stirring it well; then take it off; and when it is between hot and cold, put it up, and keep it. 135. _To cast all kinds of shapes, what you please, and to colour them._ Take half a pound of refined Sugar, boil it to a Candy height with as much Rosewater as will melt it, then take moulds made of Alabaster, and lay them in water one hour before you put in the hot Sugar, then when you have put in your Sugar turn the mould about in your hand till it be cool, then take it out of the mould, and colour it according to the nature of the Fruit you would have it resemble. 136. _To dry Pears without Sugar._ Pare them, and leave the stalks and pipps on them, then bake them in an earthen pot with a little Claret Wine, covered, then drain them from the Syrup, and dry them upon Sieves in a warm Oven, turning them morning and evening, every time you turn them hold them by the stalk and dip them in the Liquor wherein they were baked and flat them every time a little. If you do them carefully they will look very red and clear and eat moist, when they are dry put them up. 137. _To make Rasberry Wine._ Take Rasberries and bruise them with the back of a spoon, and strain them, and fill a bottle with the juyce, stop it, but not very close, let it stand four or five days, then pour it from the Grounds into a Bason, and put as much White-wine or Rhenish as your juyce will well colour, then sweeten it with Loaf Sugar, then bottle it and keep it, and when you drink it you may perfume some of it with one of the Lozenges spoken of before. 138. _To preserve Oranges in jelly._ Take the thickest rind Oranges, chipped very thin, lay them in water three or four days, shifting them twice every day, then boil them in several waters, till you may run a straw through them, then let them lye in a Pan of water all night, then dry them gently in a Cloth, then take to every Pound of Oranges one Pound and an half of Sugar, and a Pint of water, make thereof a syrup; then put in your Oranges, and boil them a little, then set them by till the next day, and boil them again a little, and so do for four or five days together, then boil them till they are very clear, then drain them in a sieve, then take to every Pound of Oranges one quarter of a Pint of water wherein sliced Pippins have been boiled into your syrup, and to every quarter of a Pint of that water, add a quarter of a Pound of fresh Sugar, boil it till it will jelly, then put your Oranges into a Pot or a Glass, and put the jelly over them; you may if you please, take all the Meat out of some of your Oranges at one end, and fill it with preserved Pippin, and if you put in a little Juice of Orange and Limon into your Syrup when it is almost boiled, it will be very fine tasted. 138. [Transcriber's note: so numbered in original] _To make Cristal Jelly._ Take a Knuckle of Veal and two Calves Feet, lay them in water all night, then boil them in Spring water, till you perceive it to be a thick Jelly, then take them out, and let your Jelly stand till it be cold, then take the clearest, and put it into a Skillet, and sweeten it with Rosewater and fine Sugar, and a little whole Spice, and boil them together a little, and so eat it when it is cold. 139. _To make_ China-_Broth._ Take three Ounces of _China_ sliced thin, and three Pints of fair water, half an ounce of Harts-horn, let it steep together twelve hours, then put in a Red Cock cut in pieces and bruised, one Ounce of Raisins of the Sun stoned, one ounce of Currans, one ounce of Dates stoned, one Parsley root, one Fennel-root, the Pith being taken out, a little Burrage and Bugloss, and a little Pimpernel, two Ounces of Pearl Barley; boil all these together till you think they be well boiled, then strain it out. 140. _To make Court Perfumes._ Take three Ounces of Benjamin, lay it all night in Damask Rose buds clean cut from the white, beat them very fine in a stone Mortar till it come to a Paste, then take it out and mix it with a dram of Musk finely beaten, as much Civet, mould them up with a little searced Sugar, and dry them between Rose Leaves each of them, then dry them very well and keep them to burn, one at a time is sufficient. 141. _A Syrup for a Cold._ Take Long-wort of the Oak, Sage of _Jerusalem_, Hysop, Colts-foot, Maidenhair, Scabious, Horehound, one handful of each, four Ounces of Licoras scraped, two Ounces of Anniseeds bruised, half a pound of Raisins of the Sun stoned, put these together into a Pipkin with two quarts of Spring water, let them stand all night to infuse close stopped, when it is half boiled away, strain it out, and put to it to every pint of liquor a pound of Sugar and boil it to a Syrup. 142. _To make white Marmalade of Quinces._ Coddle them so tender that a straw may run thorow them, then take grated Quinces and strain the Juice from them, then slice your scalded Quinces thin and weigh them, and take a little above their weight in fine Sugar, wet your Sugar with the raw juice, boil it and scum it, then put in your sliced Quinces and boil them up quick till they jelly, then put them into Glasses. 143. _The white juice of Licoras._ Take one pound of Licoras clean scraped, cut it thin and short, and dry it in an Oven, then beat it fine in a Mortar, then put it into a stone Jugg, and put thereto of the water of Colts-foot, Scabius, Hysop and Horehound, as much as will stand four fingers deep above the Licoras, then set this Jugg, close stopped, into a Kettle of water, and keep the water boiling, let it be stuffed round with hay that it jog not, let it stand so four hours, and so do every other day for the space of ten days; then strain it into a dish, set the dish over boiling water, and let it vapour away till it be thick, then add to it one pound of fine Sugar-Candy, the best and whitest you can get, beaten very well, then put it into several dishes and dry it in the Sun, or in a warm Oven, beating it often with bone knives till it be stiff, then take as much Gum Dragon steeped in Rose-water as will make it pliable to your hand, then make it into little Rolls, and add two grains of Musk or Ambergreece and a few drops of Oyl of Anniseed, and so make them into little Cakes, and print them with a Seal and then dry them. 144. _To dry Plumbs naturally._ Take of any sort and prick them and put them into the bottom of a Sieve dusted with Flower to keep them from sticking, let them stand in a warm Oven all night, the next morning turn them upon a clean Sieve, and so do every day till you see that they are very dry. 145. _To dry preserved Pears._ Wash them from their Syrup, then take some fine Sugar and boil it to a Candy height with a little water, then put in your Pears, and shake them very well up and down, then lay them upon the bottom of a Sieve, and dry them in a warm Oven and so keep them. 146. _To make little Cakes with Almonds._ Put into a little Rosewater two grains of Ambergreece, then take a pound of blanched Almonds and beat them with this Rosewater, then take a Pound of your finest Sugar, beaten and searced, and when your Almonds are well beaten, mix some of the Sugar with them, then make your Cakes, and lay them on Wafer sheets; and when they are half baked, take the rest of the Sugar, being boiled to a Candy height with a little Rosewater, and so with a Feather wash them over with this, and let them stand a while longer. 147. _To make very pretty Cakes that will keep a good while._ Take a Quart of fine Flower and the yolks of 4 Eggs, a quarter of a pound of Sugar, and a little Rosewater, with some beaten Spice, and as much Cream as will work it into a Paste, work it very well and beat it, then rowl it as thin as possible, and cut them round with a Spur, such as the Pastry Cooks do use; then fill them with Currans first plumped a little in Rosewater and Sugar, so put another sheet of Paste over them and close them, prick them, and bake them but let not your Oven be too hot; you may colour some of them with Saffron if you please, and some of them you may ice over with Rosewater and Sugar, and the White of an Egg beaten together. 148. _To make a Paste to wash your hands withal._ Take a Pound of bitter Almonds, blanch them and beat them very fine in a Mortar with four Ounces of Figgs, when it is come to a paste, put it into a Gallipot and keep it for your use; a little at a time will serve. 149. _To keep Flowers all the Year._ Take any sort of pretty Flowers you can get, and have in readiness some Rosewater made very slippery by laying Gum Arabick therein. Dip your Flowers very well, and swing it out again, and stick them in a sieve to dry in the Sun, some other of them you may dust over with fine Flower, and some with searced Sugar, after you have wetted them, and so dry them. Either of them will be very fine, but those with Sugar will not keep so well as the other; they are good to set forth Banquets, and to garnish Dishes, and will look very fresh, and have their right smell. 150. _Conserve of Barberries._ Take Barberries, infuse them in a pot as other Fruits spoken of before, then strain them, and to every pound of liquor take two pounds of Sugar, boil them together over the fire till it will come from the bottom of the Posnet, and then put it into Gally-pots and keep it with fine Sugar strewed over it. 151. _To preserve Barberries without Fire._ Take your fairest bunches and lay a Lay of fine Sugar into the bottom of the pot, and then a Lay of Barberries, and then Sugar again, till all be in, and be sure to cover them deep with Sugar last of all, and cover your pot with a bladder wet and tyed on, that no Air get in, and they will keep and be good, and much better to garnish dishes with than pickled Barberries, and are very pleasant to eat. 152. _To Candy Almonds to look as though they had their Shells on._ Take Jordan Almonds and blanch them, then take fine Sugar, wet it with water, and boil it to a Candy height, colour it with Cochineal, and put in a grain of Ambergreece; when you see it at a Candy height, put in your Almonds well dried from the Water, and shake them over the fire till you see they are enough, then lay them in a Stove or some other warm place. 153. _To Candy Carrot Roots._ Take of the best and Boil them tender then pare them, and cut them in such pieces as you like; then take fine Sugar boiled to a Candy height with a little Water, then put in your Roots, and boil them till you see they will Candy; but you must first boil them with their weight in Sugar and some Water, or else they will not be sweet enough; when they are enough, lay them into a Box, and keep them dry: thus you may do green Peascods when they are very young, if you put them into boiling water, and let them boil close covered till they are green, and then boiled in a Syrup, and then the Candy, they will look very finely, and are good to set forth Banquets, but have no pleasant taste. 154. _To make Syrup of Violets._ Take Violets clipped clean from the Whites, to every Ounce of Violets take two Ounces of Water, so steep them upon Embers till the Water be as blew as a Violet, and the Violets turned white, then put in more Violets into the same Water, and again the third time, then take to every Quart of Water four Pounds of fine Sugar, and boil it to a Syrup, and keep it for your use; thus you may also make Syrup of Roses. 155. _To make a Syrup for any Cough._ Take four Ounces of Licoras scraped and bruised, Maidenhair one Ounce, Aniseeds half an Ounce, steep them in Spring water half a day, then boil it half away; the first quantity of water which you steep them in must be four Pints, and when it is half boiled away, then add to it one Pound of fine Sugar, and boil it to a Syrup, and take two spoonfuls at a time every night when you go to rest. 156. _A pretty Sweet-meat with Roses and Almonds._ Take half a Pound of Blanched Almonds beaten very fine with a little Rosewater, two Ounces of the Leaves of Damask Roses beaten fine, then take half a pound of Sugar, and a little more, wet it with water, and boil it to a Candy height, then put in your Almonds and Roses, and a grain of Musk or Ambergreece, and let them boil a little while together, and then put it into Glasses, and it will be a fine sort of Marmalade. 157. _The best sort of Hartshorn Jelly to serve in a Banquet._ Take six Ounces of Hartshorn, put it into two Quarts of Water and let it infuse upon Embers all night, then boil it up quick, and when you find by the Spoon you stir it with, that it will stick to your mouth, if you do touch it, and that you find the Water to be much wasted, strain it out, and put in a little more than half a Pound of fine Sugar, a little Rosewater, a Blade of Mace, and a Stick of Cinamon, the Juice of as many Limons will give it a good taste, with two Grains of Ambergreece, set it over a slow fire, and do not let it boil, but when you find it to be very thick in your mouth, then put it softly into Glasses; and set it into a Stove, and that will make it to jelly the better. 158. _To make Orange or Limon Chips._ Take the parings of either of these cut thin, and boil them in several waters till they be tender, then let them lie in cold water a while, then take their weight in Sugar or more, and with as much water as will wet it, boil it and scum it, then drain your Chips from the cold water, and put them into a Gally-pot; and pour this Syrup boiling hot upon them, so let them stand till the next day, then heat the Syrup again and pour over them, so do till you see they are very clear, every day do so till the Syrup be very thick, and then lay them out in a Stove to dry. 159. _To make Cakes of Almonds in thin slices._ Take four Ounces of Jordan Almonds, blanch them in cold water, and slice them thin the long way, then mix them with little thin pieces of Candied Orange and Citron Pill, then take some fine Sugar boiled to a Candy height with some water, put in your Almonds, and let them boil till you perceive they will Candy, then with a spoon take them out, and lay them in little Lumps upon a Pie-plate or sleeked Paper, and before they be quite cold strew Caraway Comfits on them, and so keep them very dry. 160. _To make Chips of any Fruit._ Take any preserved Fruit, drain it from the syrup, and cut it thin, then boil Sugar to a Candy height, and then put your Chips therein, and shake them up and down till you see they will Candy, and then lay them out; or take raw Chips of Fruit boiled first in Syrup, and then a Candy boiled, and put over them hot, and so every day, till they begin to sparkle as they lie, then take them out, and dry them. 161. _To preserve sweet Limons._ Take the fairest, and chip them thin, and put them into cold water as you chip them, then boil them in several waters till a straw may run through them, then to every pound of limon, take a pound and half of fine Sugar, and a pint of water, boil it together, and scum it, then let your Limons scald in it a little, and set them by till the next day, and every other day heat the syrup only and put to them; so do 9 times, and then at last boil them in the Syrup till they be clear, then take them out, and put them into Pots, and boil the Syrup a little more, and put to them; if you will have them in Jelly, make your Syrup with Pippin water. 162. _To make a Custard for a Consumption._ Take four Quarts of Red Cows Milk, four Ounces of Conserve of Red Roses, prepared Pearl, prepared Coral, and white Amber, of each one Dram, two Ounces of white Sugar Candy, one grain of Ambergreece, put these into an earthen pot with some leaf gold, and the yolks and whites of twelve Eggs, a little Mace and Cinamon, and as much fine Sugar as will sweeten it well; Paste the Pot over and bake it with brown Bread, and eat of it every day so long as it will last. 163. _To make Chaculato._ Take half a Pint of Claret Wine, boil it a little, then scrape some Chaculato very fine and put into it, and the Yolks of two Eggs, stir them well together over a slow Fire till it be thick, and sweeten it with Sugar according to your taste. 164. _To dry any Sort of Plumbs._ Take to every pound of Plumbs three quarters of a pound of Sugar, boil it to a Candy height with a little water, then put in your Plumbs ready stoned, and let them boil very gently over a slow fire, if they be white ones they may boil a little faster, then let them by till the next day, then boil them well, and take them often from the fire for fear of breaking, let them lie in their Syrup for four or five days, then lay them out upon Sieves to dry, in a warm Oven or Stove, turning them upon clean Sieves twice every day, and fill up all the broken places, and put the skins over them, when they are dry, wash off the clamminess of them with warm water, and dry them in the Oven, and they will look as though the dew were upon them. 165. _To make Jelly of Quinces._ Take your Quinces, pare them and core them, and cut them in quarters, then put them into a new earthen pot with a narrow mouth, put in some of the cores in the bottom, and then the Quinces, paste it up and bake it with brown Bread, then run it thorough a bagg of boulting stuff as fast as you can, and crush it pretty hard, so long as it will run clear, to every pound of it take a pound of fine Sugar, and put into it, and let it stand till it be dissolved, then set it over a slow fire, and scum it well, and keep it stirring till it jelly, then put it into Glasses and keep it in a stove. 166. _To make a Posset._ Take a Quart of White-wine and a quart of Water, boil whole Spice in them, then take twelve Eggs and put away half the Whites, beat them very well, and take the Wine from the fire, then put in your Eggs and stir them very well, then set it on a slow fire, and stir it till it be thick, sweeten it with Sugar, and strew beaten Spice thereon, then serve it in. You may put in Ambergreece if you like it, or one perfumed Lozenge. 167. _To make a Sack Posset._ Take two quarts of Cream and boil it with Whole Spice, then take twelve Eggs well beaten and drained, take the Cream from the fire, and stir in the Eggs, and as much Sugar as will sweeten it, then put in so much Sack as will make it taste well, and set it on the fire again, and let it stand a while, then take a Ladle and raise it up gently from the bottom of the Skillet you make it in, and break it as little as you can, and so do till you see it be thick enough; then put it into a Bason with the Ladle gently; if you do it too much it will whey, and that is not good. 168. _Another way for a Posset._ Boil a Quart of Cream as for the other, then take the Yolks of fourteen Eggs and four Whites, beat them and strain them, take the Cream from the fire, and stir in your Eggs, then have your Sack warmed in a Bason, and when the Cream and Eggs are well mixed, put it to the Sack, and sweeten it to your taste with fine Sugar, and let it stand over a Skillet of seething water for a while. 169. _To preserve Pippins in thin slices in Jelly._ Take of the fairest Pippins, pare them, and slice them into cold water, to every pound of Pippins take a pound of Sugar, and a Pint of Water, boil it and scum it, then shake your Pippins clean from the water, and put them into the Syrup, boil them very clear and apace, then put in some thin Chips, or Orange or Citron preserved, and to one Pound of Pippin, put the Juice of two Oranges and one Limon, then boil them a little longer till you see they will jelly, and then put them into Glasses, but take heed you lay them in carefully, and lay the Chips here and there between, and warm the Jelly and put softly over them. 170. _To preserve Currans in Jelly._ Take the fairest and pick them from the Stalks, and stone them, and take their weight in sugar, wet it with water, boil it and scum it, then put in your Currans, and boil them up quick, shake them often and scum them, and when they will jelly, they are enough; then put them into Glasses; thus you may do white and red both, and they will be in a stiff Jelly, and cut very well, do not cover them before they be cold. 171. _To preserve ripe Apricocks._ Take them and stone them, and weigh them, and to every Pound of Apricocks take a Pound of fine Sugar beaten small, then pare your Fruit, and as you pare them, cast some Sugar over them, and so do till all be done, then set them on the fire, and let the Sugar melt but gently, then boil them a little in the Syrup, and set them by till the next day, then boil them quick, and till they be very clear, then put them in Pots, and boil the Syrup a little more, and put it to them, if you would have them in Jelly, you must put some of the Infusion of Goosberries, or of Pippins into your Syrup, and add more Sugar to it. 172. _To preserve Cornelions._ Take the fairest and weigh them, then take their weight in Sugar, and lay a Lay of Sugar into the Pan, and then lay a Lay of Cornelions till all be in, and let your last Lay be Sugar, then put a little water into the midst of the Pan, and set it on the fire, and when the Sugar is melted boil them up quick, and take them often and shake them, and scum them, when you do perceive them to be very clear, they are enough. 173. _To make Marmalade of Cornelions._ Take them and stone them, and weigh them, and to every pound of Fruit take a pound of Sugar, wet it with water, and boil it to a Candy height, then put in your Fruit and boil it very clear and quick, and shake it often, and scum it clean; when you see it very clear and very thick, it is enough; you must keep it in a Stove or some warm place. 174. _To preserve Damsons._ Take the fairest, not too ripe, and take their weight in Sugar, wet your Sugar with a little water, boil it and scum it, then put in your Damsons and boil them a little, then set them by till the next day, then boil them till they be very clear, and take them from the fire sometimes, and let them stand a while to keep them from breaking, when they are clear, take them out, and put them into Glasses, and boil the Syrup to a Jelly and pour on them; be very careful how you take them to put them into your Pots or Glasses for fear of breaking them. 175. _To make Orange Marmalade._ Take half a Pound of Orange Chips tenderly boiled in several waters, and beaten fine in a Mortar, then take a Pound of fine sugar, wet it with water, boil it and scum it, then put in your Orange, and half a Pound of Pippin also beaten fine, and let them boil together till they are very clear; then put in the Juice of one Orange and one Limon, and stir it well, and let it boil a while longer, and then take it off and put it into Glasses. 176. _To make Jelly of Pippins._ Take Pippins, pare them thin into a long Gallipot, and set that into boiling water close covered, and so let it stand three or four hours, they must be sliced thin as well as pared; when you think they are infused enough, pour the Liquor from them, and to every Pint, take a pound of Sugar double refined and put it into your Liquor, boil them together till you find it will Jelly, then put little small pieces of Orange Pill into it finely shred, the Juice of one Orange and one Limon, and let it boil a little longer, and so put it into Glasses, and set them into a Stove, with the Pulp that is left you may make Paste if you please. 177. _To candy Angelica._ Take the tender green stalks and boil them in water till they be tender, then peel them, and put them into another warm water, and cover them till they are very green over a slow fire, then lay them on a clean Cloth to dry, then take their weight in fine Sugar, and boil it to a Candy height with some Rosewater, then put in your stalks, and boil them up quick, and shake them often and when you judge they be enough, lay them on a Pie-plate, and open them with a little stick, and so they will be hollow, and some of them you may braid, and twist some of them, so keep them dry. 178. _To make Seed-stuff of Rasberries._ Take Rasberries and bruise them, and take their weight in fine Sugar, and boil it to a Candy height with a little water, then put in your bruised Rasberries, and boil them till you see they will jelly very well. 179. _To make Syrup of Gilly-flowers._ Take Clove-gilly-flowers, and cut them from the Whites, then take their weight in Sugar beaten fine, then put a little sugar into your Gally-pot, and then a Lay of Flowers, and then sugar again, till all be spent, and let sugar be the last, then put in a Clove or two, according to your quantity, and a little Malago Sack; and so tie your Pot up close, and set it into a Pot or Kettle of boiling water, and let them stand till they are infused; then poure out the Liquor and strain the rest, but not too hard, then take this liquor and vapour it away over seething water till it be of a good thickness, then take your strained Gilliflowers and put them into a Pot with some White-wine Vinegar, and cover them over with fine Sugar, and so keep them; they are a better Sallad than those you pickle up alone; as you make this, you may make syrup of any Herbs or Flowers. 180. _To make most excellent Cake._ Take a strik'd Peck of Flower, six pounds of Currans, half an Ounce of Mace, half an Ounce of Cinamon, a quarter of an Ounce of Cloves, as much of Nutmeg, half a pound of fine Sugar, and as much Rosewater as you please; beat your Spice, and put that and your Fruits with a little Salt into your Flower, then take Cream or new Milk as much as you think fit, dissolve thereinto two pounds of fresh Butter, then put it in a Basin with the sugar and a Pint of Sack, knead it with a Wine-Pint of Ale-Yest, knead it till it rise under your hand, let all things be ready and your Oven hot before you go to knead the Cake. 181. _To make Pomatum the best way._ Take the Caul of a Lamb new killed, pick it clean from the Skin, and lay it in Spring-water nine days, shifting it every day twice, then melt it, then take yellow Snails, stamp them, and put them into a Glass with Rosewater four days, stop the Glass and shake it three or four times a day, then take white Lilly roots, stamp them, and strain them, put the Juice of them into the Glass with the Snails, then set a Skillet on the fire with fair water, and let it boil, then put your dried Lambs Caul into an earthen basin, and let it melt, then take your Glass with Snails and roots, and drain it through a thick cloth, then put it into that tried stuff, then take half an Ounce of white Sugar-Candy unbeaten put it in, and stir it over the fire, till that be dissolved, then take it from the fire, and put in three Ounces of sweet Almonds, keep it boiling and stirring a little longer, then take it off, and let it stand till it be reasonably cool, then beat it with a wooden Slice till it be very white, then put in a little Rosewater, and beat it a little longer, and then keep it in Gallipots; you must put in a crust of bread when you melt it in the Skillet, and when the Sugar-Candy goes in, take it out. 182. _To make the Bean Bread._ Take a pound of the best Jordan Almonds; blanch them in cold water, and slice them very thin the long way of the Almond with a wet Knife, then take a pound of double refined Sugar well beaten, and mix with your Almonds, then take the White of one Egg beaten with two spoonfuls of Rosewater, and as the Froth ariseth, cast it all over your Almonds with a Spoon, then mix them well together, and lay them upon Wafer sheets, upon flowered Plates, and shape them as you please with your knife and your fingers; then strew Caraway Comfits, and Orange and Citron Pill cut thin, or some Coriander Comfits, so set them into an Oven not too hot, and when they have stood about half an hour, raise them from their Plates, and mend what you find amiss before they be too dry, then set them into the Oven again, and when they are quite dry, break away the Wafers with your fingers, and then clip them neatly with a pair of Scizzers, and lay on some Leaf-Gold if you please. 183. _To make an excellent Cake with Caraway Comfits._ Take five Pounds of Manchet Paste mingled very stiff and light without Salt, cover it, and let it be rising half an hour, when your Oven is almost hot, take two pounds and half of Butter, very good, and melt it, and take five Eggs, Yolks and Whites beaten, and half a pound of Sugar, mingle them all together with your Paste, and let it be as lithe as possible you can work it, and when your Oven is hot and swept, strew into your Cake one Pound of Caraway Comfits, then butter a baking-Pan, and bake it in that, let it stand one hour and quarter; when you draw it, lay a course Linnen Cloth and a Woollen one over it, so let it lie till it be cold, then put it into an Oven the next day, for a little time, and it will eat as though it were made of Almonds, you must put in your Sugar after your Butter. 184. _To make Diet Bread or Jumbolds._ Take a Quart of fine Flower, half a Pound of fine Sugar, Caraway seeds, Coriander seeds and Aniseeds bruised, of each one Ounce, mingle all these together, then take the Yolks of eight Eggs, and the Whites of three, beat them well with four spoonfuls of Rosewater, and so knead these all together and no other Liquor, when it is well wrought, lay it for one hour in a linnen cloth before the Fire, then rowl it out thin, tie them in Knots and prick them with a Needle, lay them upon Butter'd Plates, and bake them in an Oven not too hot. 185. _To make Cider or Perry as clear as Rock water._ Take two Quarts of Cider, half a Pint of Milk, put them both in an Hipocras bag, and when it runs clear, bottle it up, and when it is a Month old, it will sparkle in the Glass as you drink it. 186. _To make Almond Bread._ Take a pound of Almonds blanched, and beaten with Rosewater, then take a pound of Sugar beaten fine, and a little grated Bread finely searced, put them into a Platter with your Almonds, and stir them well together, set them over a Chafing dish of Coals, and boil them till they are as stiff as Paste, stirring them continually, then mould them well and put them in what shape you you please; print them, and set them into some warm place to dry. 187. _To make good Almond Milk._ Take Jordan Almonds blanched and beaten with Rose water, then strain them often with fair water, wherein hath been boiled Violet Leaves and Sliced Dates; when your Almonds are strained, take the Dates and put to it some Mace, Sugar, and a little Salt, warm it a little, and so drink it. 188. _To make white Leach._ Take sweet Almonds blanched and beaten with Rosewater, then strained with fair water, wherein hath been boiled Aniseeds and Ginger, put to it as much cream, wherein pure Isinglass hath been boiled, as will make it stiff, and as much Sugar as you please; let it be scalding hot, then run it through a strainer, and when it is cold, slice it out, it is very good for a weak body. 189. _To make Red Leach or Yellow._ Red by putting Tornsel into it, or Cochineal; Yellow by putting Saffron in it. 190. _Cinamon or Ginger Leach._ Take your Spices beaten and searced, and mix them with your searced Sugar, mould them up with Gum Arabick infused in Rosewater, and so print them and dry them. 191. _To make Leach of Dates._ Take your Dates stoned and peeled very clean within, beat them fine with Sugar, Ginger and Cinamon, and a little Rosewater till it will work like Paste, then print them and keep them dry. 192. _To make fine Cakes._ Take a Quart of Flower, a Pound of sugar, a Pound of Butter, with three or four Yolks of Eggs, a little Rosewater, and a spoonful of Yest, then roul them out thin, while the Paste is hot, prick them, and set them into the Oven not too hot. 193. _To make Cornish Cakes._ Take Claret Wine, the Yolks of Eggs, and Mace beaten fine, and some Sugar and Salt, mingle all these with Flower and a little Yeast, knead it as stiff as you can, then put in Butter, and knead it stiff again, and then shape them and bake them. 194. _A Cordial Syrup._ Take one Pound of Juice of Burrage, and half so much of the Juice of Balm, boil them together, and when the grossness of the Juice ariseth, then put in the Whites of two Eggs beaten with Rosewater, and when you see them begin to grow hard, put in a little Vinegar, let them boil together, and scum it clean, and run it through a Jelly-Bag, then set it over the fire again, and add to it one Pound of fine Sugar, and a little Saffron, and so boil it till you think it be enough. 195. _For a Consumption._ Take of Harts-tongue and Maidenhair, of each one handful, Hysop and Balm, of each half a handful, Licoras sliced, one Ounce, Piony Root one Ounce, boil these together in two Pints and half of Spring water until it be half consumed, then strain the Liquor from the Herbs, then take four Ounces of Currans washed clean, dried and beaten in a Mortar, boil them in the Liquor a little while, then strain it, and put to the Liquor half a Pound of Sugar, and so boil it to a Syrup, and take often of it. 196. _For a Consumption._ Take a Pint of good Wine-Vinegar, and half a Pint of Colts-foot-water, half a Pound of Figs well bruised, then strain it, and boil it with a Pound of Sugar to a thick Syrup. 197. _A very good Perfume._ Six Spoonfuls of Rosewater, Musk, Ambergreece and Civet, of each two Grains, a little Sugar beaten fine, mould them up together with Gum-Dragon steeped in Rosewater, make them in little Cakes and dry them. 198. _A Cordial to cause sleep._ Two spoonfuls of Poppy water, two spoonfuls of Red Rosewater, one spoonful of Clove-Gillyflower Syrup, and a little Diascordium, mingle them together, and take them at the time of rest. 199. _To perfume Gloves._ Take four Grains of Musk and grind it with Rosewater, and also eight Grains of Civet, then take two spoonfuls of Gum dragon steeped all night in Rosewater, beat these to a thin Jelly, putting in half a spoonful of Oil of Cloves, Cinamon and Jessamine mixed together, then take a Spunge and dip it therin, and rub the Gloves all over thin, lay them in a dry clean place eight and forty hours; then rub them with your hands till they become limber. 200. _A very good Perfume to burn._ Take 2 ounces of the Powder of Juniper Wood, 1 Ounce of Benjamin, one Ounce of Storax, 6 drops of oil of Limons, as much oil of Cloves, 10 grains of Musk, 6 of Civet, mold them up with a little Gum dragon steeped in Rosewater, make them in little Cakes, and dry them between Rose Leaves, your Juniper wood must be well dried, beaten and searced. 201. _To preserve Cherries in Jelly._ Take fair ripe Cherries, and stone them, then take a little more than their weight in fine Sugar, then take the juyce of some other Cherries, and put a spoonful of it in the bottom of the Posnet, then put some of your Sugar beaten fine into the Posnet with it, and then a little more juyce, then put in your Cherries, then put in Sugar, and then juyce, and then Cherries again, thus do till you have put in all, then let them boil apace till the Sugar be melted, shaking them sometimes, then take them from the fire, and let them stand close covered one hour, then boil them up quick till the Syrup will jelly. 202. _To dry Apricocks or Pippins to look as clear as Amber._ Take Apricocks and take out the Stones, and take Pippins and cut them in halves and core them, let your Apricocks be pared also; lay these Fruits in an earthen dish, and strew them over with fine Sugar, set them into a warm Oven, and as the Liquor comes from them put it away, when all the Liquor is come away turn them and strew them thick with Sugar on every side, set them into the Oven again, and when the Sugar is melted lay them on a dry dish, and set them in again, and every day, turn them till they be quite dry, Thus you may dry any sort of Plumbs or Pears as well as the other, and they will look very clear. 203. _To dry Pears or Pippins without Sugar._ Take of the fairest and lay them in sweetwort two or three days, then lay them in a broad preserving Pan of earth, and bake them, but let the Oven be but gently hot, then lay them upon lattice Sieves and set them into a warm Oven, and turn them twice a day till they are dry. 204. _The Spanish Candy._ Take any sort of Flowers well picked and beaten in a Mortar, and put them into a Syrup, so much as the Flowers will stain, boil them, and stir them till you see it will turn Sugar again, then pour it upon a wet trencher, and when it is cold cut it into Lozenges, and that which remaineth in the bottom of the Posnet scrape it clean out, and beat it and searce it, then work it with some Gum Dragon steeped in Rosewater and a little Ambergreece, so make it into what shape you please, and dry it. 205. _To make Naples Bisket._ Take four Ounces of Pine Apple seeds, two Ounces of sweet Almonds blanched, the Whites of two Eggs, one spoonful of Ale-Yeast, one spoonful of Rice Flower, one spoonful of sweet Cream, beat all these together in a Mortar, then add to it Musk or Ambergreece, drop it upon a Pie-plate, and make it in what shape you please, and so bake it. 206. _To make Italian Bisket._ Take Sugar searced fine, and beat in a Mortar with Gum Dragon steeped in Rosewater, and also the White of an Egg, till it come to a perfect Paste, then mould it up with searced Sugar, powder of Aniseeds, and a little Musk, and make them in what shape you please, and bake them on Pie-Plates, but not too much. 207. _To make Hippocras._ Take to every Gallon of Sack or White Wine, one Pound of Sugar, one Ounce of Cinamon, one Ounce of Ginger, one quarter of an Ounce of Nutmegs, a quarter of an Ounce of Coriander seed, with a few Cloves, and a little Long Pepper or a few Grains, let all these steep together four and twenty hours, stir it twice or thrice in that time; then put to every Gallon one Pint of Milk, and run it through a Jelly-Bag, and then bottle it, and let them be stopped very close, set them in a cool place, it will keep a Month. 208. _To make Tuff-Taffity Cream._ Take a quart of thick Cream, the whites of eight Eggs beaten to a Froth with Rosewater, then take off the Froth and put in into the Cream, and boil it, and always stir it, then put in the Yolks of eight Eggs well beaten, and stir them in off the Fire, and then on the fire a little while, then season it with Sugar, and pour it out, and when it is cold, lay on it Jelly of Currans or Rasberries, or what you please. 209. _Caraway Cake._ Take one Quart of Flower, and one pound of Butter, rub your Butter into your Flower very well, then take two Yolks of Eggs and one White, two spoonfuls of Cream, half a Pint of Ale-Yest, mix them all together, do not knead it, but pull it in pieces, then set it to the fire to rise, and so let it lie almost one hour, turning it often, then pull it in pieces again, and strew in half a pound of Caraway Comfits, mingle them with the Paste, then take it lightly with your hand, fashion it like an Oval, and make it higher in the middle than the sides, let your Oven be as hot as for a Tart, be sure your Oven or Cake be ready both at once, put it upon a double paper buttered, and let it stand almost an hour, when it goes into the Oven, strew it thick with Caraway-Comfits, and lay a paper over least it scorch. 210. _To Candy Barberries._ Stone the fairest Bunches you can get, and as you stone them strew in a little Sugar, then take so much water as you think will cover them, and let them boil in it with a little Sugar a little while, then put them into a deep thing that the Syrup may cover them, then boil a little water and sugar to a Candy height, then having your Barberries drained well from the Syrup put them into the hot Candy, stir them gently til the Sugar be dissolved, but do not let them boil in it, then open every branch and lay them upon the brims of dishes, shift them often on clean dishes and open them every time, then set them into an Oven or Stove to dry. 211. _To make a very fine Sillibub._ Take one Quart of Cream, one Pint and an half of Wine or Sack, the Juice of two Limons with some of the Pill, and a Branch of Rosemary, sweeten it very well, then put a little of this Liquor, and a little of the Cream into a Basin, beat them till it froth, put that Froth into the Sillibub pot, and so do till the Cream and Wine be done, then cover it close, and set it in a cool Cellar for twelve hours, then eat it. 212. _Fine sweet Powder for the hair._ Take one pound of the best starch you can get, put it into a Basin with half a Pint of Rosemary water, as much Rosewater, stir them well together with a Spoon, then dry them well in the Sun, then take the searced Powder of Damask Roses, and four grains of Ambergreece, mix it well with your Starch, and sift it fine. 213. _To make Cakes of Pistachoes._ Take half a pound of Almonds Blanched, half a pound of Pistachoes blanched, four Ounces of Pine-Apple seeds, beat these together in a Mortar with a little Rosewater till it come to perfect Paste, then put in the weight of it in Sugar, and beat it again, then mould it with searced Sugar, and lay it upon Wafer sheets, and fashion them as you please; then stick them with quartered Pistachoes; that they may make it look like a Hedghog, then with a Feather Ice them over with the White of an Egg, Rosewater and Sugar, then bake them carefully. 214. _To make Cakes of Apricocks in Lumps._ Take Apricocks, and pare them and cut them in halves, then take their weight in Sugar, put half this Sugar and the Apricocks into a Posnet, let them boil apace till they look clear, then boil the other part of the Sugar to a Candy height, then put them together, and stir them a while, then put them into Glasses and set them into a Stove, and when the one side is dry, turn the other. 215. _To make Rasberry Sugar._ Take the Juice of Rasberries and wet your Sugar with it, and dry it in a Stove in little Cakes; this will keep all the year, a little of it being put into a Glass of Wine, will give it as good a taste, as you can desire, and as good a colour; in this manner you may make Sugar of any Fruit, Flower, or Herb. 216. _To dry Apricocks._ Take your fairest Apricocks and stone them, then weigh them, and as you pare them, throw them into cold water, have in readiness their weight in fine sugar, wet it with some of the water they lie in, and boil it to a Candy height, then put in your Apricocks, and boil them till they are clear, when they have lain three or four days in the Syrup, lay them out upon Glasses to dry in a stove, and turn them twice a day. 217. _To make rough Marmalade of Cherries._ Stone your Cherries, and infuse them in a long Gallipot in a Kettle of boiling water, when they are all to pieces, then take their weight in fine Sugar boiled to a Candy height with a little water, then put in your Apricocks and stir them over a slow fire, but do not let it boil, when it will jelly, put it into Glasses. 218. _To make smooth Marmalade of Cherries._ Infuse them as you do the other, then strain them hard, and boil the Juice with a Candy as you do the other. 219. _To make white Trencher-Plates which may be eaten._ Take two Eggs beaten very well, Yolks and Whites, two spoonfuls of Sack, one spoonful of Rosewater, and so much flower as will make it into a stiff Paste, then roule it thin, and then lay it upon the outsides of Plates well-buttered, cut them fit to the Plates, and bake them upon them, then take them forth, and when they are cold, take a pound of double refin'd Sugar beaten and searced, with a little Ambergreece, the White of an Egg and Rosewater, beat these well together, and Ice your Plates all over with it, and set them into the Oven again till they be dry. 220. _To make the Froth Posset._ Take three Pints of Cream or new Milk, set it on the fire, then take sixteen Eggs and put the Whites into a Basin very deep, and beat the Yolks by themselves, make a Custard with them, and the Cream which is on the fire, then beat the Yolks to a Froth with a little Sack, and a little Sugar, when it is a thick Froth, cast it into another Dish with a Spoon, then take half a Pint of Sack, and sweeten it with Sugar, set it on a Chafing-dish of Coals in a large Basin, when it is hot, put in as much Froth as the Sack will receive, stir it in very well, then take your Custard and pour upon it, stir it all one way when you put it in, then if the Froth do not cover the top of the Posset, put in more, and stir it very well, and cover it close with a warm Dish, let it stand a while upon Coals, but not too hot; you may know when it is enough by putting your Spoon into the Basin, for then it will be clear in the bottom, Curd in the middle, and Froth on the top. 221. _To make_ Banbury _Cakes._ Make a Posset of Sack and Cream, then take a Peck of fine Flower, half an Ounce of Mace, as much of Nutmeg, as much of Cinamon, beat them and searce them, two pounds of Butter, ten Eggs, leaving out half their Whites, one Pint and half of Ale-Yest, beat your Eggs very well, and strain them, then put your Yest, and some of the Posset to the Flower, stir them together, and put in your Butter cold in little pieces, but your Posset must be scalding hot; make it into a Paste, and let it lie one hour in a warm Cloth to rise, then put in ten pounds of Currans washed and dried very well, a little Musk and Ambergreece dissolved in Rosewater, put in a little Sugar among your Currans break your Paste into little pieces, when you go to put in your Currans, then lay a Lay of broken Paste, and then a Lay of Currans till all be in, then mingle your Paste and Currans well together, and keep out a little of your Paste in a warm Cloth to cover the top and bottom of your Cake, you must rowl the Cover very thin, and also the Bottom, and close them together over the Cake with a little Rosewater; prick the top and bottom with a small Pin or Needle, and when it is ready to go into the Oven, cut in the sides round about, let it stand two hours, then Ice it over with Rosewater or Orange Flower and Sugar, and the White of an Egg, and harden it in the Oven. 222. _To make_ Cambridge _Almond Butter._ Take a Quart of Cream and sixteen Eggs well beaten, mix them together and strain them into a Posnet, set them on a soft fire, and stir them continually; when it is ready to boil, put in half a quarter of a Pint of Sack, and stir it till it run to a Curd, then strain the Whey from it as much as may be, then beat four Ounces of blanched Almonds with Rosewater, then put the Curd and beaten Almonds and half a pound of fine Sugar into a Mortar, and beat them well together, then put it into Glasses and eat it with bread, it will keep a Fortnight. 223. _To make a Sack Posset without Milk or Bread._ Take a Quart of Ale and half a Pint of Sack, boil them with what spice you please, then take three quarters of a pound of sugar, and twenty Eggs, Yolks and Whites well beaten and strained, then take four Ounces of Almonds blanched and beaten with Rosewater, put them to the Eggs, and put them to the other things in the Posnet upon the fire, and keep them stirring, and when it boileth up, put it into a Bason, and strew on beaten spice and sugar, you must also sweeten it when the Eggs go in. 224. _To preserve Figs and dry them._ To every pound of your large ripe English Figs, take a pound of Sugar, and one Pint of Water boil your Sugar and Water, and scum it, then put in your Figs, and boil them very well till they are tender & clear; boil them very fast, when they have been in the Syrup a week, boil some sugar to a Candy height, and put in the Figs, and when you perceive they are enough, lay them out to dry. 225. _To pickle Mushromes._ Take them of one nights growth, and peel them inside and outside, boil them in Water and Salt one hour, then lay them out to cool, then make a pickle of White Wine and White Wine Vinegar, and boil in it whole Cloves, Nutmegs, Mace, and Ginger sliced, and some whole Pepper, when it is cold, put them into it, and keep them for Sauces of several Meats; and if you would dress them to eat presently, put them in a Dish over a Chafingdish of Coals without any Liquor, and the fire will draw out their natural Liquor, which you must pour away, then put in whole Spice, Onions and Butter, with a little Wine, and so let them stew a while, then serve it in. 226. _To preserve whole Quinces to look red._ When they are pared and cored, put them into cold water, and for every Pound of Quince take one Pound of Sugar, and a Pint of Water, make a Syrup thereof, then put in your Quinces, and set them on a slow fire, close covered, till you see they are of a good Colour and very tender, then take them out, and boil your Syrup till it will Jelly. 227. _To make very good Marmalade of Quinces to look red._ Weigh your Quinces and pare them, cut them in quarters and core them, and keep them in cold water, then take their weight in sugar, and a little water, and boil it, and scum it, then put in your Quinces, and set them on a slow fire, close covered, till you see it of a good colour, then uncover it, and boil it up very quick till you find that it will jelly very well. 228. _To make Musk Sugar._ Bruise six grains of Musk and tie them in a piece of Tiffany, lay it in the bottom of a Gallipot, and then fill it with sugar, and tie it up close, when you have spent that sugar, put in some more, it will be well perfumed. 229. _An excellent way to make Syrup of Roses, or of any other Flower._ Fill a Silver Bason three quarters full of Spring water, then fill it up with Rose-Leaves or any other, and cover it, and set it upon a pot of seething water one hour, then strain it, and put in more; and do in like manner, and so do seven times, then take to every Pint one Pound of Sugar, and make a Syrup therewith. 230. _To dry Rose Leaves._ Pick your Roses, and dry them upon the Leads of a house in a Sun-shine day, and turn them as you do Hay, and when they are through dry, keep them in broadmouth'd Glasses close stopped. 231. _To Candy Flowers._ Boil some Rosewater and Sugar together, then put in your Flowers being very dry and boil them a little, then strew in some fine Sugar over them, and turn them, and boil them a little more, then take them from the fire, and strew some more Sugar over them, then take them out and lay them to dry, and open them, and strew Sugar over them; they will dry in a few hours in a hot day. 232. _The making of Sugar-Plate and casting of it into Moulds._ Take one Pound of double refin'd Sugar beaten and searced, and three Ounces of pure white Starch beaten and searced, then have some Gum-Dragon steeped in Rosewater, and put some of it with the Sugar and Starch and a little of Ambergreece into a Mortar, and beat them till they come to a perfect Paste, you must also put in a little White of an Egg with the Gum, then mould it with searced Sugar, then dust your Moulds with Sugar, then roul out your Paste and lay it into the Mould, pressing it down into every hollow part with your fingers, and when it hath taken impression, knock the Mould on the edge against a Table and it will come out, or you may help it with the point of your knife; if you find you have put in too much Gum, then add more Sugar, if too much Sugar, then more Gum, work it up as fast as you can, when they come out of the Moulds trim them handsomely; if you would make saucers, dishes, or bowls, you must rowl it out thin and put your Paste into a saucer, dish, or bowl for a Mould, and let them stand therein till they be very dry, then gild them on the edges with the white of and Egg laid round about the edge with a pencil, and press the Gold down with some Cotton, and when it is dry brush off the superfluous loose Gold with the foot of an Hare, and if you would have your Paste exceeding smooth, as for Cards or the like, then roul your Paste upon a slicked paper with a very smooth Rouling-pin; if you would colour any of it, you must take the searced powder of any Herbs or Flowers, first dryed, and put to it when you beat it in a Mortar with the Gum. 233. _To make Paste of Almonds._ Take four Ounces of _Valentia_ Almonds, blanched and beaten with Rosewater till it come to perfect Paste, then take stale white bread, grate it and sift it, and dry it by the fire, then put that to your Almonds with the weight of all in fine Sugar, beat them very well, and put in some Spice beaten and searced, then when it is a little cool, roul it out, dust your Moulds and print it, and dry it in an Oven, you may if you please put the juice of a Limon into it when it is beating, you may make some of it into Jumbolds, and tie them in knots and bake them upon Buttered Plates, and when they are baked, ice them over with Rosewater, Sugar, and the White of an Egg, and set them into the Oven again for a while. 234. _To make French Bisket._ Take half a Peck of fine Flower, two Ounces of Coriander seeds, the Whites of four Eggs, half a Pint of Ale Yest, and as much water as will make it up into a stiff Paste, let your water be blood warm, then bake it in a long Roll as big as your Thigh, let it be in the Oven but one hour, when it is two days old, pare it and slice it thin over-thwart, then ice it over thin, and set it into the Oven to dry. 235. _To make Ginger-bread._ Take three stale Manchets grated and sifted, then put to them half an Ounce of Cinamon, as much Ginger, half an Ounce of Licoras and Aniseeds together, beat all these and searce them, and put them in with half a Pound of fine Sugar, boil all these together with a quart of Claret, stirring them continually till it come to a stiff Paste, then when it is almost cold, mould it on a Table with some searced Spice and Sugar, then bake it in what shape you please. 236. _Another sort of Ginger-bread._ Take half a pound of sweet Almonds blanched and beaten, half a pound of fine Flower first dried in an Oven, one Pound of fine Sugar, what sorts of Spices you please, beaten and searced, and also Seeds, beat all these together with two Eggs, both Yolks and Whites, then mould it with flower and Sugar together, and so bake it in what shape you please. 237. _To make Puff-Paste._ Take a quart of the finest Flower, the Whites of three Eggs, and the Yolks of two, and a little cold water, make it into a perfect Paste, then roul it abroad thin, then lay on little bits of Butter, and fold it over again, then drive it abroad again, and lay on more Butter, and then fold it over, and so do ten times, make it up for your use, and put your Fruit or Meat therein and bake it. 238. _Another way for Puff-Paste._ Take fine Flower half a Peck, the Yolks of five Eggs and one White, one Pound of Butter, half a pint of Cream, and a little fair water, break your Butter in little Bits and do not mould it too much, but roul it abroad so soon as you can, and let the Butter be seen in spots, for that will make it hollow when it comes into the Oven, then put in your Meat or Fruit, and close it over, and wash it over with the Yolk of an Egg and Cream beaten together, just when you set it into the Oven; let your Oven be quick, but do not let it stand too long, for that will spoil it. 239. _To make short Paste without Butter._ Bake your Flower first, then take a quart of it, and the Yolks of three Eggs and a Pint of Cream, two Ounces of fine Sugar, and a little Salt, and so make it into Paste. 240. _To Candy whole Spices with a hard Rock-Candy._ Take one Pound of fine Sugar, and eight spoonfuls of Rosewater, and the weight of six pence of Gum Arabick that is clear, boil them together till a drop will run as small as a hair; then put it into an earthen Pipkin, and having before steeped your spices one night or two in Rosewater, put your spices into the Pipkin, and stop it up close that no Air get in, keep it in a hot place three weeks, then break your Pot with a Hammer. Thus you may do with preserved Oranges and Limons, any kinds of Fruits and flowers, or Herbs if you please. 241. _To make very fine Bisket._ Take half a Pound of searced Sugar, the Yolks of six Eggs, a little searced spice and Seeds, and a little Ambergreece or Musk, your Eggs must be very hard, then put all these into a Mortar and beat them to a Paste with a little Gum Dragon steeped in Rosewater all night, then mould it up with fine Sugar; and make it into pretty Fancies, and dry them in a warm Oven. 242. _To make Orange, or Limon or Citron Bisket._ Take either of these preserved and washed from their Syrup, beat them well in a Mortar, and then put in a little Gum Dragon as before, beat them again together till it be a perfect Paste, then mould it up with Sugar searced, and make them up in what shape you please and dry it. 243. _To make Bisket of Potato-Roots or Parsneps._ Take their Roots boil'd very tender, and beat them in a Mortar with their weight of searced Sugar, then put in a little Gum dragon as before, beat them to a Paste, and mould them up with Sugar searced, and make them up in what shape you please, and dry them. 244. _To pickle Oranges or Limons, taught me by a Seaman._ Take those which are free from any spots, and lay them gently in a Barrel, then fill up the Barrel with Sea-water, and so cover your Vessel close, for want of Sea-water, you may take fair water, and make it so strong with Bay Salt, that it will bear an Egg, and put to them in like manner. 245. _To keep Grapes fresh and green, taught me by a Sea-Captain._ Take your fairest Grapes without any blemish, then lay some Oats in a Box; and then a Lay of Grapes, and then more Oats, and so do till you have laid all in, then cover the Grapes well with Oats, and close your box fast that no Air get in. 246. _To dry Grapes to keep longer._ Take your best Clusters and hang them up in a Room upon Lines, and be sure you do not let them touch one another, they will keep four months. 247. _To make Marmalade of Oranges or Limons._ Boil the Rinds of them in several Waters till they be very tender, beat them small with their weight of Pippins, then take the weight of all in fine Sugar, and to every Pound of Sugar, a Pint of Water, boil your Water and Sugar together, and make a Syrup, then put in your Pulp, and boil it a good while till it be clear, then put in the Juice of some Orange and Limon, so much as will give it a fine taste, then boil it a little longer till you see it will jelly very well, then put it into Glasses, and keep it in a reasonable warm place; this is very Cordial, and stoppeth Rheum. 248. _To make green Ginger wet._ Take one pound of Ginger, and steep it in Red-Wine and Vinegar equally mixed, let it stand so close covered twelve days, and twice every day stir it up and down, then take two quarts of Red-Wine and as much Vinegar, and boil them together a little while, then put in three pounds of Sugar and make a Syrup therewith, then put in your Ginger and boil it a while, then set it by till the next day, so boil it every day a little, till it be very clear, and so keep it in the Syrup. 249. _To make a Sallad of Limons._ Take the rinds of Limons cut in halves, and boil them in several waters till they are very tender, then take Vinegar, Water and Sugar, and make a Syrup, then put in your Limons, first cut as you would an Apple-paring, round and round till you come at the top, boil them a while in the Syrup, then set them by till the next day, then boil them again a little, and so do till you see they be clear, and the Syrup thick; when you serve them to the Table, wash them in Vinegar. 250. _To stew Prunes without fire._ Take your largest Prunes well washed, and put them into a broad mouthed Glass, then put to them some Claret Wine, and whole Spice, and cover your Glass very well, and set it in the Sun ten days or more, and they will eat very finely; you must also put a little Sugar into the Glass with them. 251. _To make Syrup of the Juice of Citrons or Limons._ Take the Juyce of either of them, and put twice the weight of fine Sugar therein, put it into a long Gallipot, and set that pot into a Kettle of boiling water, till you see they be well incorporated, then take it out, and when it is cold put it up. 252. _To make Punch._ Take one Quart of Claret wine, half a Pint of Brandy, and a little Nutmeg grated, a little Sugar, and the Juice of a Limon, and so drink it. 253. _To make Limonado._ Take one Quarrt of Sack, half a Pint of Brandy, half a Pint of fair Water, the Juyce of two Limons, and some of the Pill, so brew them together, with Sugar, and drink it. 254. _To make Paste of Pomewaters._ Take your Pomewater Apples, and put them in a long Gallipot, and set that Pot in a Kettle of boiling water, till your Apples are tender, then pare them, and cut them from the Core, and beat them in a Mortar very well, then take their weight in fine Sugar, and boil it to a Candy height with a little water, then put in your Apples, and boil them till it will come from the bottom of the Posnet, when it is almost cold mould it with searced Sugar, and make it in Cakes and dry them. 255. _To make Syrup of Rasberries, or of other Fruits, as Grapes or the like._ Take the Juyce of your Fruits and the weight thereof in fine Sugar, mix them together, and put them into a long Gally-pot, and set that pot into a Kettle of seething water, and when you see it is enough let it cool, and then put it up; after you have strained out your Juice, you must let it stand to settle three or four days before you put the Sugar into it, and then take only the clearest, this is exceeding good and comfortable in all Feavers. 256. _To make a Caudle for a sick body both pleasant and comfortable._ Take a quart of white Wine, and boil it a while with a Blade of large Mace, and a little whole Cinamon, then take four Ounces of sweet Almonds blanched and beaten with a little Rosewater, then strain your Almonds with the Wine, and set it over the fire again, and when it is scalding hot, put in the Yolks of four Eggs, and as much Sugar as you think fit. 257. _How to cover all kinds of Seeds, or little pieces of Spices, or Orange or Limon Pill, with Sugar for Comfits._ First of all you mast have a deep bottomed Basin of Brass or Latin, with two ears of Iron to hang it with two Cords over some hot Coals. You must also have a broad Pan to put Ashes in, and hot Coals upon them. You must have a Brass Ladle to let run the Sugar upon the Seeds. You must have a Slice of Brass to scrape away the Sugar from the sides of the hanging Basin if need be. Having all these things in readiness, do as followeth; Take fine white Sugar beaten, and let your Seeds and Spice be dry, then dry them again in your hanging Basin: Take to every two pounds of Sugar one quarter of a pound of Spices or Seeds, or such like. If it be Aniseeds, two pounds of Sugar to half a pound of Aniseeds, will be enough. Melt your Sugar in this manner, put in three Pounds of Sugar into the Basin, and one Pint of Water, stir it well till it be wet, then melt it very well and boil it very softly until it will stream from the Ladle like Turpentine, and not drop, then let it seeth no more, but keep it upon warm Embers, that it may run from the Ladle upon the seeds. Move the Seeds in the hanging Basin so fast as you can or may, and with one hand, cast on half a Ladle full at a time of the hot Sugar, and rub the Seeds with your other hand a pretty while, for that will make them take the Sugar the better, and dry them well after every Coat. Do thus at every Coat, not only in moving the Basin, but also with stirring of the Comfits with the one hand, and drying the same: in every hour you may make three pounds of Comfits; as the Comfits do increase in bigness, so you may take more Sugar in your Ladle to cast on: But for plain Comfits, let your Sugar be of a light decoction last, and of a high decoction first, and not too hot. For crisp and ragged Comfits make your decoction so high, as that it may run from the Ladle, and let it fall a foot high or more from the Ladle, and the hotter you cast on your sugar, the more ragged will your Comfits be; also the Comfits will not take so much of the sugar, as upon a light decoction, and they will keep their raggedness long; this high decoction must serve for eight or ten Coats, and put on at every time but one Ladle full. A quarter of a pound of Coriander seeds, and three pounds of sugar, will serve for very great Comfits. See that you keep your Sugar in the Basin always in good temper, that it burn not in Lumps, and if at any time it be too high boiled, put in a spoonful or two of water, and keep it warily with your Ladle, and let your fire be always very clear, when your Comfits be made, set them in Dishes upon Paper in the Sun or before the Fire, or in the Oven after Bread is drawn, for the space of one hour or two, and that will make them look very white. 257. [Transcriber's note: so numbered in original] _To make a fine Cullis or Jelly._ Take a red Cock, scald, wash, and dress him clean, seeth it in white Wine or Rhenish Wine, and scum it clean, put in a Pint of thick cream to it, then put in whole Spices, Sugar and Rosewater, and boil them together. 258. _A white Jelly with Almonds._ Take Rosewater and Gum Dragon first steeped, or Isinglass dissolved, and some Cinamon whole, seeth these together, then take one pound of Almond blanched and beaten with Rosewater, then put them in and seeth them with the rest, stir them always, and when it is enough, sweeten it to your taste, and when it is cold eat it. 259. _To make sweet Cakes without Sugar._ Wash some Parsnep roots, scrape them and slice them very thin dry them in a Dish in an Oven, and beat them to a Powder, mix them with an equal quantity of fine Flower, mix them with Cream, beaten Spice and Salt, and so make them and bake them. 260. _To keep Roses or Gilliflowers very long._ Take them when they are very fresh, and in the bud, and gathered very dry, dip them in the whites of Eggs well beaten, and presently strew thereon searced sugar, and put them up in luted Pots, and set them in a cool place, in sand or gravel, and with a Filip of your finger at any time you may strike off the coat, and you will have the Flower fresh and fair. 261. _How to keep Walnuts long fresh and good._ Make a lay of the dry stampings of Crabs when the Verjuice is pressed forth, then a Lay of Walnuts, and then Crabs again, till all be in, then cover the Vessel very well, and when you eat them, they will be as though they were new gathered. 262. _To pickle Quinces._ Put them into a Vessel, and fill up the Vessel with small Ale, or white Wine Lees, which is better, and cover your Vessel well that no Air get in. 263. _To keep Artichokes._ Take your Artichokes, and cut off the stalks within two inches of the Apple, and of these stalks make a strong Decoction, slicing them into thin and small pieces, and boil them with water and salt; when it is cold, put in your Artichokes, and keep them from the Air. When you spend them, lay them first in warm water, and then in cold, to take away the bitterness. 264. _To make Clove or Cinamon Sugar._ Put Sugar in a Box, and lay Spices among it, and close up the Box fast, and in short time it will smell and tast very well. 265. _To make Irish_ Aquavitæ. Take to every Gallon of good _Aquavitæ_, two Ounces of Licoras bruised, two ounces of Aniseeds bruised, let them stand six days in a Vessel of Glass close stopped, then pour out as much of it as will run clear, dissolve in that clear six great spoonfuls of the best Molasses, then put it into another Glass, then add to it some Dates and Raisins of the Sun stoned; this is very good for the Stomach. 266. _To distil Roses speedily._ Stamp your Roses in a Mortar with a little Rosewater, and then distill them: This way will yield more water by much than the common way. 267. _To make Scotch Brewis._ Take a Manchet and pare off the crust then slice it thin and whole round the Loaf, and lay these slices into a deep dish cross ways, one slice lying upon the edge of the other a little, that they may lye quite cross the dish, then fill it up with Cream and put whole Spice therein, so set it over a Chafing-dish of Coals very hot, and always cast the Cream all over the Bread with a spoon till all be spent, which will be above an hour, then take some Sack and sweeten it with Sugar, and pour all over it, and serve it to the Table. 268. _To make fine Black Puddings._ Take the Blood of a Hog, and strain it, and let it stand to settle, putting in a little Salt while it is warm, then pour off the water on the top of the Blood, and put so much Oatmeal as you think fit, let it stand all night, then put in eight Eggs beaten very well, as much Cream as you think fit, one Nutmeg or more grated, some Pennyroyal and other Herbs shred small, good store of Beef Sewet shred very small, and a little more Salt, mix these very well together, and then have your Guts very well scoured, and scraped with the back of a Knife, fill them but not too full, then when you have tyed them fast, wash them in fair water, and let your water boil when they go in; then boil them half an hour, then stir them with the handle of a Ladle and take them up and lay them upon clean straw, and prick them with a Needle, and when they are a little cool put them into the boiling water again, and boil them till they are enough. 269. _To make the best Almond-Puddings._ Take a quart of thick Cream and boil it a while with whole Spice, then put in half a pound of sweet Almonds blanched and beaten to a Paste with Rosewater, boil these together till it will come from the bottom of the Posnet, continually stirring it for fear it burn: Then put it out, and when it is cool, put in twelve yolks of Eggs, and six Whites, some Marrow in big Bits, or Beef Suet shred small, as much Sugar as you think fit, then fill your Guts being clean scraped; you may colour some of them if you please, and into some put plumped Currans, and boil them just as you do the other. 270. _To make a Rice pudding to bake._ Take three Pints of Milk or more, and put therein a quarter of a Pound of Rice, clean washed and picked, then set them over the fire, and let them warm together, and often stir them with a wooden Spoon, because that will not scrape too hard at the bottom, to make it burn, then let it boil till it be very thick, then take it off and let it cool, then put in a little Salt, some beaten Spice, some Raisins and Currans, and some Marrow, or Beef Suet shred very small, then butter your Pan, and so bake it, but not too much. 271. _To make a Pudding of wild Curds._ Take wild Curds and Cream with them, put thereto Eggs, both yolks and whites, Rosewater, Sugar, and beaten Spice with some Raisins and Currans, and some Marrow, and a little Salt, then butter a Pan, and bake it. 272. _To make Pudding of Plum Cake._ Slice your Cake into some Cream or Milk, and boil it, and when it is cold, put in Eggs, Sugar, a little Salt and some Marrow, so butter a Pan and bake it, or fill guts with it. 273. _To make Bisket Pudding._ Take Naples Biskets and cut them into Milk, and boil it, then put in Eggs, Spice Sugar, Marrow, and a little Salt, and so boil it and bake it. 274. _To make a dry Oatmeal Pudding._ Take your Oatmeal well picked, and put into it a little Salt, some Raisins and Currans, and some beaten spice, and good store of Beef Suet finely shred, so tie it up hard in a Cloth, and let your water boil when you put it in; and let it boil very well; if you would butter it, then leave out the Suet; and if you would leave out the Fruit, then put in sweet herbs good store. 275. _To make Almond puddings a different way from the other._ Take two Manchets and grate them, then scald them in some Cream, then put in some Almonds Blanched and beaten as you do other, with Rosewater, let there be about half a pound, then put in eight Eggs well beaten, some Spice, Sugar, Salt and Marrow, and having your Guts well scowred and scraped, fill them, but not too full, and boil them as you do the other; or bake it if you please; Currans will do well in it. 276. _To make a Quaking Pudding._ Take Grated Bread, a little Flower, Sugar, Salt, beaten Spice, and store of Eggs well beaten, mix these well, and beat them together, then dip a clean Cloth in hot water, and flower it over, and let one hold it at the four corners till you put it in, so tie it up hard, and let your Water boil when you put it in, then boil it for one hour, and serve it in with Sack, Sugar and Butter. 277. _To make good Dumplings._ Take some Flower and a little Salt, and a little Ale-Yest, and so much water as will make it into a Paste, so let your water boil when you do put them in; boil them but a little while, and then butter them. 278. _Another way to make Dumplings._ Take half a quarter of a Peck of Flower, and one Egg, yolk and white, half a Pound of Butter broke in little Bits, mix them together with so much cold Milk as will make it up, do not break your Butter too small, for then they will not flake; make them up like Rouls of Butter, and when your water boils, put them in, and do not boil them too much, then butter them. 279. _Another way to make Dumplings._ Take Flower and temper it very light with Eggs, Milk, or rather Cream, beaten Spice, Salt, and a little Sugar, then wet a Cloth in hot water, and flower it, and so boil it for a Pudding, or else make it pretty stiff with the Flower and a little grated Bread, and so boil them for Dumplings, then butter them, and serve them in. 280. _To make a green Pudding to Butter._ Take a Quart of Cream and boil it, then put in twelve Eggs, yolks and whites well beaten, and one Manchet grated small, a little salt, beaten Spice and some Sugar: Then colour it well with some Juice of Spinage, or if you will have it yellow, colour it with Saffron, so boil it in a wet Cloth flowred as before, and serve it in with Wine, Sugar and Butter, and stick it with blanched Almonds split in halves, and pour the sauce over it, and it will look like a Hedghog. You may at some time stick it with Candied Orange Pill or Limon Pill, or Eringo Roots Candied, you may sometimes strew on some Caraway Comfits, and if you will bake it, then put in some Marrow, and some Dates cut small: thus you have many Puddings taught in one. 281. _To make a Pudding of a Hogs Liver._ Take your liver and boil it in water and salt, but not too much; Then beat it fine in a Mortar, and put to it one Quart of Cream, a little Salt, Rosewater, Sugar, beaten Spice and Currans, with six Eggs beaten very well: mix it well. And if you bake it, put in Marrow, or if you boil it in Skins. But if you boil it in a Cloth, then leave it out; and butter it when it is boiled. 282. _To make a Rasberry Pudding._ Take a Quart of Cream and boil it with whole Spice a while, then put in some grated Bread, and cover it off the Fire, that it may scald a little; then put in eight Eggs well beaten, and sweeten it with Sugar; then put in a Pint or more of whole Rasberries, and so boil it in a Cloth, and take heed you do not boil it too much, then serve it in with Wine, Butter and Sugar. You may sometimes leave out the Rasberries, and put in Cowslip Flowers, or Goosberries. 283. _To make a Calves foot Pudding._ Take those which are tenderly boiled and shred them small with Beef-Suet, then put to four Feet one quart of Cream and eight Eggs well beaten, a little Salt, some Rosewater and Sugar, some beaten Spice, and one pound of Currans; mix all these well together, and boil it or bake it; but if you would Butter it, then do not put in Suet. 284. _To make a Pudding to rost._ Take a Pint of Cream, scald a little grated Bread in it, then put in three Eggs beaten, a little Flower, Currans, beaten Spice, Suet, Sugar and Salt, with some Beef Suet finely shred, make it pretty stiff, and wrap it in a Lambs Caul, and rost it on a Spit with a Loin of Lamb; if you please, you may put in a little Rosewater. 285. _To make Cream of divers things._ Take a Quart of Cream and boil it a while, then put in eight yolks of Eggs, and six Whites well beaten, put them in over the Fire, and stir them lest they turn, then when it is almost enough, put in some Candied Eringo Root, Orange or Limon Pill Candied, and cut thin, preserved Plums, without the Stones, Quince, Pippin, Cherries, or the like; if you do not like it so thick, put fewer Eggs into it. 286. _To make Cream of Artichoke Bottoms._ Take a Quart of Cream and boil it with a little whole Mace a while; then have your Artichoke Bottoms boiled very tender, and bruise them well in a Mortar, then put them into the Cream, and boil them a while, then put in so many yolks of Eggs as you think fit, and sweeten it to your taste; when you think it is enough, pour it out, and serve it in cold. 287. _To pickle Barberries._ Take your Barberries and pick out the fairest Bunches of them, then take the Refuse, and with some Water and Salt, so strong as will bear an Egg, boil them together for half an hour or more, then lay your fair Bunches into a Pot, and when the Liquor is cold, pour it over them. 288. _To pickle French Beans._ Take them before they be too old, and boil them tender, then put them into a pickle made with Vinegar and Salt, and so keep them; it is a very good and pleasant Sallad. 289. _To pickle Oysters._ Take your great Oysters, and in opening them save the Liquor, then strain it from dross, add to it some White Wine, and White Wine Vinegar, and a little Salt, and so let them boil together a while, putting in whole Mace, whole Cloves, whole Pepper, sliced Ginger, and quartered Nutmegs, with a few Bay leaves; when the Liquor is boiled almost enough, put in your Oysters and plump them, then lay them out to cool, then put them into a Gally-pot or Barrel, and when the Liquor is cool, pour it over them, and keep them from the Air. 290. _To make the best sort of Mustard._ Dry your Seed very well, then beat it by little and little at a time in a Mortar, and sift it, then put the Powder into a Gally-pot, and wet it with Vinegar very well, then put in a whole Onion, pilled but not cut, a little Pepper beaten, a little Salt, and a lump of stone Sugar. 291. _Another sort of Mustard._ Dry your Horse-Radish Roots in an Oven very dry, then beat them to Powder and sift them, and when you would use any, wet it with Wine Vinegar, and so it will rather be better than the other. 292. _To keep boiled powdered Beef long after it is boiled._ When your Beef is well powdered, and boiled thorowly, and quite cold, wrap it up close in a linnen cloth, and then a woollen one, and so keep it in a Chest or Box from the Air. 293. _To make Clouted Cream._ Take three Gallons of new Milk, set it on the fire, and boil it, then put in two Quarts of Cream, and stir it about for a while over the fire, then pour it out into several pans, and cover it till the next morning, then take it off carefully with a Skimmer, and put it all into one dish one upon another, then eat it with Wine and Sugar. 294. _An excellent Damask Powder._ Take of Orrice half a Pound, Rose leaves four Ounces, Cloves one Ounce, _Lignum Rhodium_ two Ounces, _Storax_ one Ounce and an half, _Benjamin_ one Ounce and an half, Musk and Civet of each ten Grains, beat them altogether grosly, save the Rose leaves you must put in afterwards. This is a very fine Powder to lay among Linnen. _The End of the First Part._ THE SECOND PART OF The Queen-like Closet: Having an Addition of what hath already been treated of, and directing a very true and excellent way for all manner of COOKERY, both FISH, FLESH, and PASTRY; _Shewing_, The true SEASONING of all Things for Compleat TABLES: _Also_ All Kinds of SAUCES & PICKLES, in a very brevious way. Here is to be noted, that in divers of these Receipts there are Directions for two or three several Things in one, not confounding the Brains with multitudes of Words, to little or no purpose, or vain Expressions of things with are altogether unknown to the Learned as well as to the Ignorant: This is really imparted for the good of all the FEMALE SEX. By _Hannah Wolley_, alias _Chaloner_. _London_, Printed for _R. Lowndes_. 1672 THE Queen-like CLOSET, OR Rich Cabinet. THE SECOND PART. 1. _To make Elder Vinegar and to colour it._ Take of your best white Wine Vinegar, and put such a quantity of ripe Elder Berries into it as you shall think fit, in a wide mouth'd Glass, stop it close, and set it in the Sun for about ten days, then pour it out gently into another Glass, and keep it for your use; thus you may make Vinegar of Red Roses, Cowslipps, Gilliflowers, or the like. 2. _To make Metheglin, either Brown or White, but White is best._ Take what quantity you please of Spring-Water, and make it so strong with Honey that it will bear an Egg, then boil it very well, till a good part be wasted, and put in to it boiling a good quantity of whole Spice, Rosemary, Balm, and other cordial and pleasant Herbs or Flowers. When it is very well boiled, set it to cool, it being strained from the Herbs, and the Bag of Spices taken out; When it is almost cold, put in a little Yest, and beat it well, then put it into Vessels when it is quite cold, and also the Bag of Spice, and when it hath stood a few days, bottle it up; if you would have it red, you must put the Honey to strong Ale Wort in stead of Water. 3. _To make Collar'd Beef._ Take a good Flank of Beef, and lay it in Pump water and Salt, or rather Saltpeter, one day and one night, then take Pepper, Mace, Nutmegs, Ginger, and Cloves, with a little of the Herb called Tarragon, beat your Spice, shred your Tarragon, and mingle these with some Suet beaten small, and strew upon your Beef, and so rowl it up, and tie it hard, and bake it in a pot with Claret Wine and Butter, let the pot be covered close, and something in the pot to keep the Meat down in the Liquor that it may not scorch, set it into the Oven with Houshold bread, and when it is baked, take it out, and let it cool, then hang it up one night in the Chimney before you eat it, and so as long as you please. Serve it in with Bay Leaves, and eat it with Mustard and Sugar. 4. _To make Almond Puddings with French Rolls or Naples Biskets._ Take a Quart of Cream, boil it with whole Spice, then take it from the Fire, and put in three Naples Biskets, or one Penny French Roll sliced thin, and cover it up to scald; when it is cold, put in four Ounces of sweet Almonds blanched, and beaten with Rosewater, the Yolks of eight Eggs, and a little Marrow, with as much Sugar as you think fit, and a little Salt; you may boil it, or bake it, or put it into Skins; if it be boiled or baked, put Sugar on it when you serve it in. 5. _To make Barley Cream._ Take two Ounces of French Barley, and boil it in several Waters, then take a quart of Cream, and boil it with whole Spice, put in your Barley, and boil them together very well, Then put in the yolks of six Eggs well beaten, and as much Sugar as you think fit; stir them well over the fire, then poure it out, and when it is cold serve it in; thus you may make Rice Cream, onely do not boil that, but a very little in Milk, before you put it into the Cream. 6. _To make Cheese-cakes._ Take four Gallons of new Milk, set it with a little Runnet, and when it is come, break it gently, and whey it very well, then take some Manchet, first scalded well in new Milk, let the Milk be thick with it, and while it is hot, put in a quarter of a pound of fresh Butter, and stir it in, when it is cold, mix that and your curd together very well, then put in one Pound and half of plumped Currans, some beaten Spice, a very little Salt, Rosewater, and the yolks of eight Eggs, half a Pint of Cream, and a little Sugar, mix them well together, then make some Paste, with Flower, Butter, the yolk of an Egg and fair water, and roul it out thin, and so bake them in bake-pans, and do not let them stand too long in the Oven. 7. _Another way for Cheese-cakes._ Take the Curd of four Gallons of new Milk, and put thereto half a pound of Almonds blanched and beaten fine with Rosewater, then put in one Pint of Raw Cream, the yolks of ten Eggs, some beaten Spice, a little Salt, one pound and half of plumped Currans, a little Rosewater, and some Sugar, and so mix them very well, and put them into your Crust and bake them. 8. _Another way for Cheese-cakes._ Take the Curd of four Gallons of new Milk, beat it well in a Mortar with half a pound of fresh Butter, and then season it as you do the other above-named. 9. _Another way for Cheese-cakes._ Take the same quantity of Curd, and mix it with half a Pound of Rice boiled tender in Milk, one quarter of a pound of fresh Butter, the yolks of eight Eggs, one Pint of Cream, beaten Spice, two pounds of Currans first plumped, Rosewater and Sugar, and a little Salt, and so bake them, not too much. 10. _To make fresh Cheese._ Take some very tender Cheese-Curd, stamp it very well in a Mortar with a little Rosewater, wherein whole Spice hath been steeped, then let it stand in a little Cullender about half an hour, then turn it out into your Dish, and serve it to the Table with Cream, Wine, and Sugar. 11. _Another way for a fresh Cheese._ Take a quart of Cream, and boil in it whole Spice, then stir in the yolks of eight Eggs, and four whites well beaten, and when they are hot, put in so much Sack as will give it a good taste, then stir it over the Fire till it runneth on a Curd, then beat it in a Mortar as the other, and serve it to the Table with Cream and Sugar. 12. _To make Oatmeal Pudding._ Take Oatmeal beaten fine, put to it some Cream, beaten Spice, Rosewater and Sugar, some Currans, some Marrow, or Beef Suet shred fine, and a little Salt, then Butter your pan and bake it. 13. _Puddings in Balls to stew or to fry._ Take part of a Leg of Veal, parboil it, and shred it fine with some Beef Suet, then take some Cream, Currans, Spice, Rosewater, Sugar and a little Salt, a little grated Bread, and one handful of Flower, and with the yolks of Eggs make them in Balls, and stew them between two Dishes, with Wine and Butter, or you may make some of them in the shape of Sausages, and fry them in Butter, so serve them to the Table with Sugar strewed over them. 14. _To boil Pigeons._ Take your largest Pigeons and cut them in halves, wash them and dry them, then boil a little water and Salt with some whole Spice, and a little Faggot of sweet Herbs, then put in your Pigeons and boil them, and when they are enough, take some boiled Parsley shred small, some sweet Butter, Claret Wine, and an Anchovy, heat them together, then put in the yolks of Eggs, and make it thick over the Fire, then put in your Pigeons into a Dish, garnished with pickled Barberries and raw Parsley, and so pour over them your Sawce, and serve it to the Table. 15. _To make an Apple Tansie._ Take a Quart of Cream, one Manchet grated, the yolks of ten Eggs, and four Whites, a little Salt, some Sugar, and a little Spice, then cut your Apples in round thin slices, and lay them into your Frying-Pan in order, your Batter being hot, when your Apples are fried, pour in your Butter, and fry it on the one side, then turn it on a Pie-Plate and slide it into the Pan again, and fry it, then put it on a Pie-Plate, and squeez the Juice of a Limon over it, and strew on fine Sugar, and serve it so to the Table. 16. _To make a green Tansie to fry, or boil over a Pot._ Take a Quart of Cream, the yolks of one dozen of Eggs and half, their Whites well beat, mix them together, and put in one Nutmeg grated, then colour it well with the Juice of Spinage, and sweeten it with Sugar; then fry it with Butter as you do the other, and serve it in the same manner; but you must lay thin slices of Limon upon this. If you will not fry it, then butter a Dish, and pour it therein, and set it upon a Pot of boiling water till it be enough; this is the better and easier way. Thus you may make Tansies of any other things, as Cowslips, Rasberries, Violets, Marigolds, Gilliflowers, or any such like, and colour them with their Juice; you may use green Wheat instead of Spinage. 17. _To make an Amulet._ Take twelve Eggs, beat them and strain them, put to them three or four spoonfuls of Cream, then put in a little Salt, and having your frying-pan ready with some Butter very hot, pour it in, and when you have fryed it a little, turn over both the sides into the middle, then turn it on the other side, and when it is fryed, serve it to the table with Verjuice, Butter and Sugar. 18. _To make a Chicken-Pie._ Make your Paste with cold Cream, Flower, Butter and the yolk of an Egg, roul it very thin, and lay it in your Baking-pan, then lay Butter in the Bottom. Then lay in your Chickens cut in quarters with some whole Mace, and Nutmeg sliced, with some Marrow, hard Lettuce, Eryngo Root, and Citron Pill, with a few Dates stoned and sliced: Then lay good store of Butter, Close up your Pie and Bake it: Then Cut it open, and put in some Wine, Butter, and Sugar with the Yolks of two or three Eggs well beaten together over the fire, till it be thick, so serve it to the Table, and garnish your Dish with some pretty Conceits made in Paste. 19. _To make a Collar of Brawn of a Breast of Pork._ Take a large Breast of Pork, and bone it, then roul it up, and tie it hard with a Tape, then boil it water and Salt till it be very tender, then make Souce drink for it with small Beer, Water and Salt, and keep it in it: Serve it to the Table with a Rosemary Branch in the middle of it, and eat it with Mustard. 20. _To souce Veal to eat like Sturgeon._ Take what part of Veal you like best, and boil it with water and salt, and a bundle of sweet herbs, and a little Limon Pill; when it is boiled enough, put into your Liquor so much Vinegar as will make it tast sharp, and a Limon sliced, and when it is cold, put in your Veal, and when it hath lain four or five days, serve it to the Table with Fennel, and eat it with some Vinegar; you must tie it up as you do Brawn. 21. _To make a Pasty of a Breast of Veal._ Take half a peck of fine Flower, and two pounds of Butter broken into little bits, one Egg, a little Salt, and as much cold Cream, or Milk as will make it into a Paste; when you have framed your Pasty, lay in your Breast of Veal boned, and seasoned with a little Pepper and Salt, but first you must lay in Butter. When your Veal is laid in, then put in some large Mace, and a Limon sliced thin, Rind and all, then cover it well with Butter, close it and bake it, and when you serve it in, cut it up while it is very hot, put in some white wine, sugar, the yolks of Eggs, and Butter being first heated over the Fire together; this is very excellent meat. 22. _To make a Pigeon-Pie._ Make your Paste as for the Pasty, roul it thin, and lay it into your baking-pan, then lay in Butter, then mix Pepper and Salt and Butter together, and fill the bellies of your Pigeons, then lay them in, and put in some large Mace, and little thin slices of Bacon, then cover them with Butter, and close your Pie, and bake it not too much. 23. _To boil a Capon or Hen with Oysters._ Take either of them, and fill the Belly of it with Oysters, and truss it, then boil it in white Wine, Water, the Liquor of the Oysters, a Blade or two of Mace, a little Pepper whole, and a little Salt; when it is boiled enough, take the Oysters out of the belly, and put them into a Dish, then take some Butter, and some of the Liquor it was boiled in, and two Anchoves with the yolks of Eggs well beaten, heat these together over the fire, and then put your Oysters into it, then garnish your Dish with Limon sliced thin, and some of the Oysters, also some pickled Barberries and raw Parsley, then lay your Capon or Hen in the middle of it, and pour the sauce upon the Breast of it, then lay on sliced Limon and serve it in. 24. _To make an Olio._ First lay in your Dish a Fricasy made of a Calves-head, with Oisters and Anchovies in it, then lay Marrow-bones round the Dish, within them lay Pigeons boiled round the Dish, and thin slices of Bacon, lay in the middle upon your Fricasy a powdred Goose boiled, then lay some sweet-breads of Veal fryed, and balls of Sawsage-meat here and there, with some Scotch Collops of Veal or of Mutton: Garnish your Dish with Limon or Orange and some toasts for the Marrow so serve it in. 25. _To make Cracknels._ Take half a Pound of fine Flower, and as much fine Sugar, a few Coriander seeds bruised, and some Butter rubbed into the Flower, wet it with Eggs, Rosewater and Cream, make it into a Paste, and rowl it in thin Cakes, then prick them and bake them; then wash them over with Egg and a little Rosewater, then dry them again in the Oven to make them crisp. 26. _To make good Sauce for a boiled Leg of Mutton._ Take the best Prunes and stew them well with white Wine or Claret, and some whole Spice, then drain them into a Dish and set it over a Chafing dish of Coles; put to it a little grated Bread, juice of Limon and a little salt, then lay your Mutton in a Dish, being well boiled with water and salt, pour your sauce to it: Garnish your Dish with Limon, Barberries, Parsly, and so serve it in. 27. _To rost Pork without the Skin._ Take any joint of small Pork, not salted and lay it to the fire till the Skin may be taken off, then take it from the fire and take off the Skin, then stick it with Rosemary and Cloves, and lay it to the fire again, then salt it and rost it carefully, then make Sauce for it with Claret Wine, white bread sliced thin, a little water, and some beaten Cinamon; boil these well together, then put in some Salt, a little Butter, Vinegar, or Juice of Limon, and a little sugar, when your Pork is rosted enough, then flower it, and lay it into a Dish with the Sauce, and serve it in. 28. _To roste a Pig like Lamb._ Take a Pig--cut it in quarters, and truss it like quarters of Lamb, then spit it, and rost it till you may take off the Skin, then take the Spit from the fire, and take the skin clean off, then draw it with Parsly, and lay it to the fire, baste it with Butter, and when it is enough, flower it and serve it to the Table with Butter, the Juice of Orange, and gross Pepper, and a little Salt. 29. _To make Codling Cream._ Take fair Codling Apples, and when you have scalded them very well, peel them, and put them into warm water over a few Embers covered close till they are very green, then take a quart of Cream and boil it with a blade of Mace, and then bruise six of your Codlings very well, and when your Cream is almost cold, put in your Codlings, and stir them very well over a slow fire for fear they turn, then put in the yolks of Eggs well beaten, and what Sugar you think fit, and let it be upon the fire, stirring it till you think it be enough, then serve it in cold. 30. _A very dainty Summer Dish._ Set a little morning Milk with Runnet, as for a Cheese, when it is come, slice it out with a thin Slice, and lay it into the Dish you mean to serve it in, and put to it a little raw Cream, what Wine you please, and some Sugar, and so eat it. 31. _To Butter Lobsters, Crabs or Crafish._ Take out their Meat and Mince it small, and set it over a Chafing dish of Coals with a little white Wine, a little Salt, and a blade of Mace, and when it is very hot, put in some Butter and some Crums of white bread, then warm the shells against the fire, and fill them again with their Meat, and so serve them in. You may do Shrimps or Prawns thus, only you must not put them into the shells, again, but garnish your Dish with them. 32. _To make a very good Cheese._ Take a Pail full of Morning Milk and Stroakings, and set it together with two spoonfuls of Runnet, and cover it; when it is come, put it into the wheying-Cloth gently, and break it as little as you can; when the Whey is run clean from it, put it into the Vat, and turn it in the Evening, next morning take it out and salt it a little, and turn it twice a day upon a clean Board, and when it is a week old, lay it into some Nettles, and that will mellow it. Before you set your Milk, you may if you please, colour it with the juice of Marigolds, Spinage or Sage. 33. _To boil a Rump of Beef._ Take a Rump of Beef a little salted, and boil it in as much Water, as will cover it, and boil a Net full of hard Lettice with it, and when it is boiled, take your hard Lettice, some Wine, either White or Claret, some Gravie, some Butter and some Nutmeg, and warm them together; then Dish your Meat, and pour your Sauce over it, and garnish your Dish with Parsley. 34. _To make fritters of Liver or of any other Meat._ Take your Liver, Capon or Veal, parboil it, mince it small, and then put to it some Cream, Eggs, Spice and Salt, and make it pretty thick, and so fry them; you may add a little Flower if you will, serve them in with beaten Spice and Sugar strewed over them. 35. _To make an Almond Pudding to be baked and Iced over._ Take a pound of Almonds blanched and beaten with Rosewater, the Yolks and Whites of twelve Eggs well beaten and strained, then put in Sugar, beaten Spice and Marrow, with a little Salt, not in too hot an Oven; let this be baked; when it is baked, stick it full of blanched Almonds, and Ice it over with Sugar, Rosewater, and the White of an Egg beaten together, then set it into the Oven again, that the Ice may rise and dry, then serve it to the Table with fine Sugar strewed upon the brims of the Dish. 36. _To souce a Pig in Collars._ Take the two sides of a large fat Pig and bone them, then take Sage, Salt and grated Nutmeg a good quantity, and strew all over the insides of them, then roul them up hard, and tie them well with a Tape, then boil them, and also the Head very well in Salt and Water till they be tender; then take them out of the Liquor, and lay them to cool, then put some Vinegar and a Limon sliced into your Liquor, and heat it again, and when it is cold, put in your Collars and Head, and when they have lain a week, serve them to the Table with Mustard. 37. _To bake Venison or Mutton to keep six or eight Months._ Take a haunch of Venison, or for want of it, take a large Leg of Mutton, bone it, and stuff it well with gross Pepper, Cloves, Mace and Nutmeg mingled, with Salt, then rub it all over with the like, then put it into a Pot with good store of Butter, and bake it with Houshold Bread, and let it be pasted over. Then pour out all the Liquor, and when it is cold, take only the Fat, and some more Butter, and melt them together in a Stone-Pot set into a Kettle of boiling water, then pour it into the Pot to your Venison or Mutton, and so keep it, slice it out, and serve it to the Table with Mustard and Sugar, and garnish it with Bay Leaves. 38. _To pot Pigeons, or wild Fowl, or a Goose or Rabbits._ Take either of these, and fill their bellies with the before named Spices and Salt and Butter, and rub them over with the same, then do just as you do the Venison. 39. _To boil a large Pike and Eels together._ Take a large Pike, and gut him and wash him, and be sure to save what is good within him, then take two great Eels and scowr them well, throw away their Heads, gut them, and wash them well, and cut them in pieces, then boil some white Wine and Water, Salt and sweet Herbs together, with some whole Spice, and when it boils apace, put in your Fish, and when it is enough, take some of the Liquor, two Anchovies, some Butter and some Shrimps taken out of their Shells, and heat all these together, then put in the yolks of two or three Eggs, and heat all together, then lay some Sippets of French Bread into your Dish, and set over a Chafingdish of Coals, and lay your Fish in order upon them, then pour your Sawce all over it, and garnish your Dish with Shrimps, Barberries and raw Parsley, so serve it to the Table very hot. 40. _To roste Eels with Bacon._ Take great Eels and scour them well, and throw away the Heads, gut them, and cut them in pieces, then cut some fat Bacon very thin, and wrap them in it, and some Bay Leaves, and so tie them fast to the Spit, and roste them, and baste them well with Claret Wine and Butter, and when they are enough dredge them over with grated bread, and serve them with Wine, Butter, and Anchovies; Garnish your Dish as you please. 41. _To make a Pie with Eels and Oisters._ Make your Paste, and roul it thin, and lay it into your baking Pan, then take great Eels and flay them, and gut them, cut them in pieces, and wash them, and dry them, then lay some Butter into your Pie, and season your Eels with Pepper, Salt, Nutmeg, Cloves and Mace, and lay them in, then cover them all over with greast Oisters, and put in three or four Bay Leaves, then put in more of your beaten Spices and Salt, then cover them well with Butter, and put in two or three Spoonfuls of white Wine, so close it and bake it, then serve it in hot to the Table. 42. _To make a Pie with Parsneps and Oisters very good._ Take your Parsneps tenderly boiled; and slice them thin, then having your Paste ready laid in your baking-pan, put in a good store of Butter, then lay in a Lay of Parsneps, and some large Mace, and Pepper cracked, then some Oisters and Yolks of Eggs hard boiled, then more Spice and butter, then more Parsneps, then more Oisters, then more hard Eggs, more Spice, and cover it well, and bake it, and serve it in hot. 43. _To dress Artichoke Suckers._ Take your Suckers of Artichokes, and pare them as you would an Apple, and cast them into water to keep their Colour; and to take away the bitterness of them, put also to them the meat which is in the stalks of great Artichokes, then boil Water and Salt together, and when it is boiling apace, put in your Suckers and Stalks tied up in a thin Cloth with a blade or two of Mace, and when they are enough, melt some Butter and Vinegar together very thick and hot, and a little Pepper with it, then lay them in a Dish, and pour the Sauce over them, strew on a little Salt, and about the Dishes, and so serve it in. 44. _To boil Cucumbers._ Take your largest Cucumbers, and wash them and put them into boiling water made quick with Salt, then when they are boiled enough, take them and peel them and break them into a Cullender, and when the Water is well drained from them, put them into a hot Dish, and pour over them some Butter and Vinegar a little Pepper and Salt, strew Salt on your Dish brims, lay some of the Rind of them about the Dish cut in several Fancies, and so serve them to the Table. 45. _To make several Sallads, and all very good._ Take either the stalks of Mallows, or Turnip stalks when they run to seed, or stalks of the herb Mercury with the seedy head, either of these while they are tender put into boiling Water and Salt, and boiled tender, and then Butter and Vinegar over them. 46. _To make a Sallad of Burdock, good for the Stone, another of the tender stalks of Sow-thistles._ Take the inside of the Stalks of Burdock, and cut them in thin slices, and lay them in water one whole day, shifting them sometimes, then boil them, and butter them as you do the forenamed. Also the tender Stalks of Sow-thistles done in like manner, are very good and wholsome. 47. _To make a Tart of Spinage._ Take a good quantity of green Spinage, boil it in water and salt, and drain it well in a Cullender, then put to it plumped Currans, Nutmeg, Salt, Sugar and Butter, with a little Cream, and the yolks of hard Eggs beaten fine, then having your Paste ready laid in your baking-pan, lay in a little butter, and then your Spinage, and then a little Butter again; so close it, and bake it, and serve it to the Table hot, with Sugar strewed over it. 48. _Artichoke Cream._ Take the tender bottoms of Artichokes, and beat them in a Mortar, and pick out all the strings, then boil a quart of Cream with large Mace and Nutmeg, then put in your bottoms, and when they have boiled a while, put in the yolks of six Eggs well beaten, and so much Sugar as you think fit, and heat them together over the fire, then pour it into a Dish, and when it is cold serve it in with Sugar strewed over it. 49. _To make very fine Rolls for Noble Tables._ Take half a Peck of fine Flower, the yolks of 4 Eggs and a little Salt, with a Pint of Ale yest, mix them together, and make them into a Paste with warm Milk and a little Sack, them mould it well, and put it into a warm Cloth to rise, when your Oven is hot, mould it again, and make it into little Rolls, and bake them, then rasp them, and put them into the Oven again for a while, and they will eat very crisp and fine. 50. _To make short Rolls._ Take half a peck of fine Flower, and break into it one pound and half of fresh Butter very small, then bruised Coriander seeds, and beaten Spice with a very little Salt and some Sugar, and a Pint of Ale-yest, mix them well together, and make them into a Paste with warm Milk and Sack: Then lay into it a warm Cloth to rise, and when your Oven is hot, make it into Rolls, and prick them, and bake them, and when they are baked, draw them and cover them till they be cold; these also eat very finely, if you butter some of them while they are hot. 51. _To dress Soals a fine way._ Take one pair of your largest Soals, and flay them on both sides, then fry them in sweet Suet tried up with Spice, Bay leaves, and Salt, then lay them into a Dish, and put into them some Butter, Claret Wine and two Anchovies, cover them with another Dish, and set them over a Chafingdish of Coals, and let them stew a while, then serve them to the Table, garnish your Dish with Orange or Limon, and squeeze some over them. 52. _To stew Fish in the Oven._ Take Soals, Whitings or Flounders, and put them into a Stew-pan with so much water as will cover them, with a little Spice and Salt, a little white Wine or Claret, some Butter, two Anchovies, and a bundle of sweet herbs, cover them and set them into an Oven not too hot; when they are enough, serve them in; Garnish your Dish wherein they lie with Barberries, raw Parsley, and slices of Limon, and lay Sippets in the bottom. 53. _To bake Collops of Bacon and Eggs._ Take a Dish and lay a Pie-plate therein, then lay in your Collops of Bacon, and break your Eggs upon them. Then lay on Parsley, and set them into an Oven not too hot, and they will be rather better than fried. 54. _To make Furmity._ Take some new Milk or Cream, and boil it with whole Spice, then put in your Wheat or Pearl Barley boiled very tender in several Waters, when it hath boiled a while, thicken it with the yolks of Eggs well beaten, and sweeten it with Sugar, then serve it in with fine Sugar on the Brims of the Dish. 55. _To make Barly Broth._ Take French Barley boiled in several waters, and to a Pound of it, put three quarts of water, boil them together a while with some whole Spice, then put in as many Raisins of the Sun and Currans as you think fit, when it is well boiled, put in Rosewater, Butter and Sugar, and so eat it. 56. _To make Barley Broth with Meat._ Take a Knuckle of Veal, and the Crag-end of a Neck of Mutton, and boil them in water and salt, then put in some Barly, and whole Spice, and boil them very well together, then put in Raisins stoned, and Currans, and a few Dates stoned and sliced thin; when it is almost enough, put in some Cream, and boil it a while, then put in plumped Prunes, and the yolks of Eggs, Rosewater and Sugar, and a little Sack, so serve it in; Garnsh your Dish with some of the Raisins and Prunes and fine Sugar; this is very good and nourishing for sick or weak people. 57. _To make Furmity with Meat-Broth._ Boil a Leg of Beef in water and salt, and put in a little whole Spice; when it is boiled tender; take it up, and put into the Broth some Wheat ready boiled, such as they sell in the Market, and when that hath boiled a while, put in some Milk, and let that boil a while, then thicken it with a little Flower, or the yolks of Eggs, then sweeten it with Sugar, and eat it. 58. _To make Furmity with Almonds._ Take three Quarts of Cream, and boil it with whole Spice, then put in some pearled Barley first boiled in several waters, and when they have boiled together a while, then put in so many blanched Almonds beaten fine with Rosewater, as you think may be enough, about four Ounces of Barly to this quantity of Cream will be enough, and four Ounces of Almonds, boil them well together, and sweeten it with Sugar, and so serve it in, or eat it by the way, you may put in Saffron if you please. 59. _To make a hasty Pudding._ Take one quart of Cream and boil it, then put in two Manchets grated, and one pound almost of Currans plumped, a little Salt, Nutmeg and Sugar, and a little Rosewater, and so let them boil together, stirring them continually over the Fire, till you see the butter arise from the Cream, and then pour it into a Dish and serve it in with fine Sugar strewed on the brims of the Dish. 60. _Another way to make a hasty Pudding._ Take good new milk and boil it, then put in Flower, plumped Currans, beaten spice, Salt and Sugar, and stir it continually till you find it be enough, then serve it in with Butter and Sugar, and a little Wine if you please. 61. _To make Spanish Pap._ Boil a quart of Cream with a little whole Spice, when it is well boiled, take out the Spice, and thicken it with Rice Flower, and when it is well boiled, put in the yolks of Eggs, and Sugar and Rosewater, with a very little Salt, so serve it to the Table either hot or cold, with fine Sugar strewed on the brims of the Dish. 62. _To make Gravie Broth._ Take a good fleshy piece of Beef, not fat, and lay it down to the fire, and when it begins to rost, slash it with a Knife to let the Gravie run out, and continually bast it with what drops from it and Claret Wine mixed together, and continually cut it, and bast it till all the Gravie be out, then take this Gravie and set it over a Chafingdish of Coals with some whole Spice, Limon Pill, and a little Salt, when you think it is enough, lay some Sippets into another Dish, and pour it in, and serve it to the Table; Garnish your Dish with Limon and Orange; if you please you may leave out the Sippets and put in some poach'd Eggs, done carefully. 63. _To make French Pottage._ Take an equal quantity of Chervil, hard Lettice and Sorrel, or any other Herb as you like best, in all as much as a Peck will hold pressed down, pick them well, and wash them, and drain them from the water, then put them into a Pot with half a pound of fresh Butter, and set them over the fire, and as the Butter melts, stir them down in it till they are all within the Butter, then put some water in, and a Crust of bread, with some whole Cloves and a little Salt, and when it is well boiled, take out the Crust of bread, and put in the yolks of four Eggs well beaten, and stir them together over the fire, then lay some thin slices of white bread into a deep dish, and pour it in. 64. _To make Cabbage Pottage._ Take a Leg of Beef and a Neck of Mutton, and boil them well in water and salt, then put in good store of Cabbage cut small, and some whole Spice, and when it is boiled enough, serve it in. 65. _To make a Sallad of cold meat._ Take the brawn of a cold Capon, or a piece of cold Veal, and mince it very small, with some Limon pill, then put in some Oil, Vinegar, Capers, Caviare, and some Anchovies, and mix them very well, then lay it in a Dish in the form of a Star, and serve it in; Garnish your Dish with Anchovies, Limon and Capers. 66. _To dry a Goose._ Take a fair fat Goose, and powder it about a Month or thereabouts, then hang it up in a Chimney as you do Bacon, and when it is throughly dry, boil it well and serve it to the Table with some Mustard and Sugar, Garnish your Dish with Bay leaves: Hogs Cheeks are very good dried thus. 67. _To dress Sheeps Tongues with Oysters._ Take your Sheeps Tongues about six of them, and boil them in water and salt till they be tender, then peel them, and slice them thin, then put them into a Dish with a quart of great Oisters; a little Claret wine and some whole Spice, let them stew together a while, then put in some Butter and the yolks of three Eggs well beaten, shake them well together, then lay some Sippets into a Dish, and put your Tongues upon them; Garnish your Dish with Oisters, Barberries, and raw Parsley, and serve it in. 68. _To make a Neats-tongue Pie._ Let two small Neats tongues or one great one be tenderly boiled, then peel them and slice them very thin, season them with Pepper and Salt, and Nutmeg; then having your Paste ready laid into your baking-pan, lay some Butter in the bottom, then lay in your Tongues, and one pound of Raisins of the Sun, with a very little Sugar, then lay in more butter, so close it and bake it, then cut it up, and put in the yolks of three Eggs, a little Claret Wine and Butter, stir it well together, and lay on the Cover, and serve it; you may add a little Sugar if you please. 69. _A Capon with white Broth._ Take a large Capon, and draw him, and truss him, and boil him in water and a little salt, with some whole Spice: When you think it is almost enough, put in one pound of Currans well washed and picked, four Ounces of Dates stoned and diced thin, and when they have boiled enough, put in half a pound of sweet Almonds blanched and beaten fine with Rose-water, strain them in with some of the Liquor, then put in some Sack and Sugar; then lay some thin slices of white bread into a deep Dish, and lay your Capon in the midst, then pour your Broth over it. Garnish your dish with plumped Raisins and Prunes, and serve it in. 70. _To make a Calvesfoot Pie._ Take six Calves feet tenderly boiled, and cut them in halves, then make some Paste with fine Flower, Butter, cold Cream and the yolk and white of one Egg, rowl it very thin, and lay it into your baking-pan, then lay some butter in the bottom, and then your Calves feet with some large Mace, half a pound of Raisins of the Sun, half a pound of Currans, then lay more butter and close it and bake it, then cut it up, and put in the yolks of three Eggs, some white Wine, Butter and a little Salt, and so serve it to the Table; Garnish your Dish with pretty Conceits made in Paste, and baked a little. 71. _To make an Artichoke Pie._ Make your Paste as before named, and roul it thin, and lay it into your baking-pan. Then lay in Butter sliced thin, and then your bottoms of Artichokes tenderly boiled, season it with a little Salt, a little gross Pepper, and some sliced Nutmeg, with a blade or two of Mace and a little Sugar, then lay in some Marrow, Candied Orange and Citron Pill, with some Candied Eringo Roots; then cover it with butter, and close it with your Paste, and so bake it, then cut it up, and put in white Wine, Butter, and the yolks of Eggs and Sugar; cover it again, and serve it to the Table. 72. _To make an Oyster-Pie._ Make your Paste as before, and lay it in your Pan, then lay in Butter, and then put in as many great Oysters as will almost fill your Pan, with their Liquor strained, some whole Pepper, Mace and Nutmeg; then lay in Marrow and the Yolks of hard Eggs, so cover them with Butter, close them, and bake your Pie, then put in White Wine, Anchovies, Butter and the Yolks of Eggs; cover it again and serve it the Table. 73. _To make a Pig-Pie._ Take a large Pig and slit it in two, and bone it, onely the two sides, not the head, then having your Paste ready laid in your Pan, and some Butter in the bottom, lay in your Pig, season it with Pepper, Salt, Nutmeg and Mace, and one handful of Sage shred small and mixed with the Spice and Salt, then lay in more Butter, close it, and bake it. Serve it in cold with Mustard, and garnish your Dish with Bay Leaves. If you would eat it hot, you must leave out the Pepper and some of the Salt, and put in store of Currans, and when it comes out of the Oven, put in some Butter, Vinegar, and Sugar, and so serve it. 74. _To make a Rasberry Tart._ Take some Puff-paste rolled thin, and lay it into your Baking-Pan, then lay in your Rasberries and cover them with fine Sugar, then close your Tart and bake it; then cut it up, and put in half a Pint of Cream, the yolks of two or three Eggs well beaten, and a little Sugar; then serve it in cold with the Lid off, and sugar strewed upon the brims of the Dish. 75. _To make a Carp Pie._ Have your Paste ready laid in your bake-pan, and some Butter in the bottom. Then take a large Carp, scale him, gut him, and wash him clean, and dry him in a Cloth, then lay him into your Pan with some whole Cloves, Mace, and sliced Nutmeg, with two handfuls of Capers, then put in some White Wine, and mix some Butter with Salt, and lay all over; then close it, and bake it; this is very good to be eaten either hot or cold. 76. _To boil a Goose or Rabbits with Sausages._ Take a large Goose a little powdered, and boil it very well, or a couple of Rabbits trussed finely; when either of these are almost boiled, put in a Pound of Sausages, and boil them with them, then lay either of these into a Dish, and the Sausages here and there one, with some thin Collops of Bacon fryed, then make for Sauce, Mustard and Butter, and so serve it in. 77. _To make a Fricasie of Veal, Chicken, or Rabbits, or of any thing else._ Take either of these and cut them into small pieces, then put them into a frying pan with so much water as will cover them with a little salt, whole Spice, Limon Pill and a bundle of sweet herbs, let them boil together till the Meat be tender, then put in some Oysters, and when they are plumped, take a little Wine, either White or Claret, and two Anchovies dissolved therein with some Butter, and put all these to the rest, and when you think your Meat is enough, take it out with a little Skimmer, and put it into a Dish upon Sippets; then put into your Liquor the yolks of Eggs well beaten, and mix them over the fire, then pour it all over your Meat; Garnish your Dish with Barberries, and serve it in; this Dish you may make of raw meat or of cold meat which hath been left at Meals. 78. _To make Scotch Collops of Veal or Mutton._ Take your meat and slice it very thin, and beat it with a rolling-pin, then hack it all over, and on both sides with the back of a Knife, then fry it with a little Gravie of any Meat, then lay your Scotch Collops into a Dish over a Chafingdish of Coals, and dissolve two Anchovies in Claret Wine, and add to it some butter and the yolks of three Eggs well beaten, heat them together, and pour it over them: Then lay in some thin Collops of Bacon fryed, some Sausage meat fried, and the yolks of hard Eggs fryed after they are boiled, because they shall look round and brown, so serve it to the Table. 79. _To make a Pudding of a Manchet._ Take a Manchet, put it into a Posnet, and fill the Posnet up with Cream, then put in Sugar and whole Spice, and let it boil leisurely till all the Cream be wasted away, then put it into a Dish, and take some Rosewater, and Butter and Sugar, and pour over it, so serve it in with fine Sugar strewed all over it. Your Manchet must be chipped before you put it into the Cream. 80. _To make a Calves head Pie._ Make your Paste, and lay it into your Pan as before, then lay in Butter, and then your Calves Head, being tenderly boiled, and cut in little thin bits, and seasoned with Pepper, Salt and Nutmeg, then put in some Oysters, Anchovies and Claret Wine, with some yolks of hard Eggs and Marrow, then cover it with Butter, and close it and bake it; when it is baked, eat it hot. 81. _To dry Tongues._ Take some Pump water and Bay salt, or rather refined Saltpeter, which is better; make a strong Brine therewith, and when the Salt is well melted in it, put in your Tongues, and let them lie one Week, then put them into a new Brine, made in the same manner, and in that let them lie a week longer, then take them out, and dry-salt them with Bay Salt beaten small, till they are as hard as may be, then hang them in the Chimney where you burn Wood, till they are very dry, and you may keep them as long as you please; when you would eat of them, boil them with [Transcriber's note: word missing] in the Pot as well as Water, for that will make them look black, and eat tender, and look red within; when they are cold, serve them in with Mustard and Sugar. 82. _To make Angelot Cheese._ Take some new Milk and strokings together, the quantity of a Pail full, put some Runnet into it, and stir it well about, and cover it till your Cheese be come, then have ready narrow deep Moats open at both ends, and with your flitting Dish fill your Moats as they stand upon a board, without breaking or wheying the Cheese, and as they sink, still fill them up, and when you see you can turn them, which will be about the next day, keep them with due turning twice in a day, and dry them carefully, and when they are half a year old, they will be fit to be eat. 83. _To make a Hare-Pie._ Take the flesh of a very large Hare, and beat it in a Mortar with as much Marrow or Beef Suet as the Hare contains, then put in Pepper, Salt, Nutmeg, Cloves and Mace, as much as you judge to be fit, and beat it again till you find they be well mixed, then having your Paste ready in your Baking-Pan, lay in some Butter, and then your Meat, and then Butter again; so close it, and bake it, and when it is cold, serve it in with Mustard and Sugar, and garnish your Dish with Bay leaves; this will keep much longer than any other Pie. 84. _To rost a Shoulder of Venison or of Mutton in Bloud._ Take the Bloud of either the Deer or the Sheep, and strain it, and put therein some grated Bread and Salt, and some Thyme plucked from the Stalks, then wrap your Meat in it and rost it, and when you see the bloud to be dry upon it, baste it well with butter, and make sauce for it with Claret Wine, Crums of Bread and Sugar, with some beaten Cinamon, salt it a little in the rosting, but not too much; you may stick it with Rosemary if you will. 85. _To stew a Pig._ Lay a large Pig to the Fire, and when it is hot, skin it, and cut it into divers pieces, then take some white wine and strong broth, and stew it therein with an Onion or two cut very small, a little Pepper, Salt, Nutmeg, Thyme, and Anchovies, with some Elder Vinegar, sweet Butter and Gravie; when it is enough, lay Sippets of French Bread in your Dish, and put your Meat thereon. Garnish your Dish with Oranges and Limons. 86. _To make a Fricasie of Sheeps feet._ Take your Sheeps feet tenderly boiled, and slit them, and take out the knot of hair within, then put them into a Frying-pan with as much water as will cover them, a little Salt, Nutmeg, a blade of Mace, and a bundle of sweet herbs, and some plumped Currans; when they are enough, put in some Butter, and shake them well together, then lay Sippets into a Dish, and put them upon them with a Skimmer, then put into your Liquor a little Vinegar, the yolks of two or three Eggs, and heat it over the fire, and pour it over them; Garnish your Dish with Barberries, and serve it to the Table. 87. _To make a Steak-Pie with Puddings in it._ Lay your Paste ready in your Pan, and lay some butter in the bottom, then lay a Neck of Mutton cut into steaks thereon, then take some of the best of a Leg of Mutton minced small, with as much Beef Suet as Mutton; season it with beaten Spice and Salt, and a little Wine, Apples shred small, a little Limon Pill, a little Verjuice and Sugar, then put in some Currans, and when they are well mixed, make it into Balls with the yolks of Eggs, and lay them upon the steaks, then put in some Butter and close your Pie and bake it, and serve it in hot. 88. _To dress Salmon or other Fish by Infusion, a very good way._ Take a Joul of Salmon, or a Tail, or any other part, or any other Fish which you like, put it into a Pot or Pan, with some Vinegar, Water and Salt, Spice, sweet herbs, and white Wine; when it is enough, lay it into a Dish, and take some of the Liquor with an Anchovie or two, a little Butter and the yolks of Eggs beaten; heat these over the fire, and poure over your Fish; if you please, you may put in shrimps, but then you must put in the more Butter; Garnish your Dish with some Limon or Orange, and some Shrimps. 89. _To make Loaves to Butter._ Take the yolks of twelve Eggs, and six Whites, a little Yeast, Salt and beaten Ginger, wet some Flower with this, and make it into a Paste, let it lie to rise a while, and then make it into Loaves, and prick them, and bake them, then put in white wine and butter and sugar, and serve it in. 90. _To make a Calves Chaldron Pie, and Puddings also of it._ Take a fat Calves Chaldron boiled tender, and shred it very small, then season it with beaten spice and salt: Then put in a pound of Currans and somewhat more, and as much Sugar as you think fit, and a little Rosewater; then having your Pie ready, fill it with this, and press it down; close it and bake it, then put some Wine into it, and so eat it. If you will make Puddings of it, you must add a little Cream and grated bread, a little Sack, more Sugar, and the yolks of Eggs, and so you may bake them, or boil, or fry them. 91. _To make Rice-Cream._ Boil a quart of Cream, then put in two handfuls of Rice Flower, and a little fine Flower, as much Sugar as is fit, the yolk of an Egg, and some Rosewater. 92. _To make a Pompion-Pie._ Having your Paste ready in your Pan, put in your Pompion pared and cut in thin slices, then fill up your Pie with sharp Apples, and a little Pepper, and a little Salt, then close it, and bake it, then butter it, and serve it in hot to the Table. 93. _To fry Pompion._ Cut it in thin slices when it is pared, and steep it in Sack a while, then dip it in Eggs, and fry it in Butter, and put some Sack and Butter for Sauce, so serve it in with salt about the Dish brims. 94. _To make Misers for Children to eat in Afternoons in Summer._ Take half a Pint of good small Beer, two spoonfuls of Sack, the Crum of half a penny Manchet, two handfuls of Currans washed clean and dried, and a little of grated Nutmeg, and a little Sugar, so give it to them cold. 95. _To fry Toasts._ Take a twopenny white Loaf, and pare away the Crust, and cut thin slices of it, then dip them first in Cream, then in the yolks of Eggs well beaten, and mixed with beaten Cinamon, then fry them in Butter, and serve them in with Verjuice, Butter and Sugar. 96. _To boil or rather stew Carps in their own Blood._ Take two fair Carps, and scowr them very well from slime with water and a little salt, then lay them in a Dish and open their bellies, take away their Guts, and save the Blood and Rows in the Dish, then put in a Pint of Claret Wine, some whole Spice and some Salt, with a little Horse-Radish Root, then cover them close, and let them stew over a Chafingdish of Coals, and when they are enough, lay them into a Dish which must be rubbed with a Shelots, and Sippets laid in, then take a little of the Liquor, and an Anchovie or two, with a little Butter, heat them together, and pour it over them, then garnish your Dish with Capers, Oranges or Limons, and serve it in very hot. 97. _To make Fritters._ Take half a Pint of Sack and a Pint of Ale, a little Yest, the yolks of twelve Eggs, and six Whites, with some beaten Spice and a very little salt, make this into thick Batter with fine Flower, then boil your Lard, and dip round thin slices of Apples in this Batter, and fry them; serve them in with beaten spice and sugar. 98. _To pickle Coleflowers._ Take some white wine Vinegar and salt, with some whole Spice, boil them together very well, then put in your Coleflowers, and cover them, and let them stand upon Embers for one hour, then take them out, and when they are cold, put them into a Pot, and boil the Liquor again with more Vinegar, and when it is cold, put it to them, and keep them close from the Air. 99. _To preserve Orange or Limon Pills in thin slices in Jelly._ Take the most beautiful and thickest Rinds, and then cut them in halves, and take their Meat clean out, then boil them in several waters till a straw will run through them, then wash them in cold water, and pick them and dry them: Then take to a Pound of these, one quart of water wherein thin slices of Pippins have been boiled, and that the water feels slippery, take to this water three pounds of Sugar, and make thereof a Syrup, then put in your Pills and scald them, and set them by till the next day, then boil them till you find that the Syrup will jelly, then lay your Pills into your Glasses, and put into your Syrup the Juice of three Oranges and one Limon; then boil it again till it be a stiff Jelly, and put it to them. 100. _To make Cakes of the Pulp of Limons, or rather the Juice of Limons._ Take out all the juice part of the Limon without breaking the little skins which hold it, then boil some Sugar to a Candy height, and put in this Juice, and stir it about, and immediately put it into a warm Stove, and put in fire twice or thrice a day; when you see that it doth Candy on the one side, then turn them out of the Glasses with a wet knife on the other upon a sleeked Paper, and then let that candy also, and put them up in a Box with Papers between them. 101. _To make good minced Pies._ Take one pound and half of Veal parboiled, and as much Suet, shred them very fine, then put in 2 pound of Raisins, 2 pound of Currans, 1 pound of Prunes, 6 Dates, some beaten Spice, a few Caraway seeds, a little Salt, Verjuice, Rosewater and Sugar, to fill your Pies, and let them stand one hour in the Oven: When they go to Table strew on fine Sugar. 102. _To make a Loaf of Curds._ Take the Curds of three quarts of Milk rubbed together with a little Flower, then put in a little beaten Ginger, and a little Salt, half a Pint of Yest, the yolks of ten Eggs, and three Whites: work these into a stiff Paste with so much Flower as you see fit, then lay it to rise in a warm Cloth a while, then put in Butter, Sugar, Sack, and some beaten Spice, and so serve it in. 103. _To make Cheese Loaves._ Take the Curds of three quarts of Milk, and as much grated Bread as Curd, the yolks of twelve Eggs, and six Whites, some Cream, a little Flower, and beaten Spice, a little Salt, and a little Sack; when you have made it in a stiff Paste with a little flower, roul some of it thin to fry, and serve them in with beaten Spice and Sugar strewed over them. Then make the rest into a Loaf, and bake it, then cut it open, and serve it in with Cream, Butter and Sugar. 104. _To fry Oysters._ Take of your largest Oysters, wash them and dry them, and beat an Egg or two very well, and dip them in that, and so fry them, then take their Liquor, and put an Anchovy to it, and some Butter, and heat them together over the fire, and having put your fryed Oysters in a Dish, pour the Sawce over them and serve them in. 105. _To broil Oysters._ Take your largest Oysters, and put them into Scollop Shells, or into the biggest Oyster shells with their own Liquor, and set them upon a Gridiron over Charcoals, and when you see they be boiled in the Liquor, put in some Butter, a few Crums of Bread, and a little Salt, then let them stand till they are very brown, and serve them to the Table in the Shells upon a Dish and Pie-Plate. 106. _To rost Oysters._ Take the largest, and spit them upon little long sticks, and tie them to the Spit, then lay them down to the fire, and when they are dry, bast them with Claret Wine, and put into your Pan two Anchovies, and two or three Bay-leaves, when you think they are enough, bast them with Butter, and dredge them, and take a little of that liquor in the Pan, and some Butter, and heat it in a Porringer, and pour over them. 107. _To make most excellent and delicate Pies._ Take two Neats tongues tenderly boiled, and peel them, and mince them small with some Beef Suet or Marrow, then take a pound of Currans and a pound of Raisins of the Sun stoned, some beaten Spice, Rosewater, a little Salt, a little Sack and Sugar. Beat all these with the minced meat in a Mortar till it come to a perfect Paste, then having your Paste ready laid in your baking-Pan, fill it or them with this meat, then lay on the top some sliced Dates, and so close them, and bake them, when they are cold they will cut smooth like Marmalade. 108. _To make fine Custards._ Take two quarts of Cream and boil it well with whole Spice, then put in the yolks of twelve Eggs, and six Whites well beaten and strained, then put in these Eggs over the fire, and keep them stirring lest they turn, then when they are thoroughly hot, take it off and stir it till it be almost cold, then put in Rosewater and Sugar, and take out the whole Spice, then put your Custard into several things to bake, and do not let them stand too long in the Oven; when you serve them in, strew on small French Comfits of divers colours, or else fine Sugar, which you please. 109. _To make a Stump Pie._ Take a pound of Veal and as much Suet, parboil your Veal, and shred them together, but not very small, then put in one pound of Raisins, one pound of Currans, four Ounces of Dates stoned and sliced thin, some beaten Spice, Rosewater and Sugar, and a little Salt, then take the yolks of Eggs well beaten, and mix amongst the rest of the things very well, then having your Pie ready, fill it and press it down, then lid it, and bake it. 110. _To make Egg-Pies._ Take the yolks of eight hard Eggs, and shred them small with their weight of Beef Suet minced very small also, then put in one pound of Currans, four Ounces of Dates stoned and sliced, some beaten Spice, Limon pill, Rosewater and Sugar, and a little Salt, mix them well together, if you please, you may put in an Apple shred small, so fill your Pies and bake them, but not too much, serve them to the Table with a little Wine. 111. _To make hashed Meat._ Take a Leg or Shoulder of Mutton, lay it down to the fire, and as it doth rost, cut it off in little bits, and let it lie in the Pan, bast it with Claret wine and Butter, and a little Salt, and put two or three Shelots in your Pan, when you have cut off so much as you can, lay the bones into a Dish over a Chafingdish of Coals, and put your Meat to it with the Liquor, and two Anchovies, cover it, and let it stew a while; when it is enough, put in some Capers, and serve it in with Sippets; Garnish your Dish with Olives and Capers, and Samphire; thus you may do with any cold meat between two Dishes. 112. _To make a Fricasie of Oysters._ Take a quart of Oysters and put them into a frying pan with some white Wine and their own Liquor, a little Salt, and some whole Spice, and two or three Bay Leaves, when you think they be enough, lay them in a dish well warmed, then add to their Liquor two Anchovies, some Butter, and the yolks of four Eggs; Garnish your Dish with Barberries. 113. _To make a Fricasie of Eels._ Take a midling sort of Eels, scour them well, and cut off the heads and throw them away, then gut them, and cut them in pieces, then put them into a frying pan with so much white Wine and water as will cover them, then put in whole Spice, a bundle of sweet herbs and a little Salt, let them boil, and when they be very tender, take them up and lay them into a warm Dish, then add to their Liquor two Anchovies, some Butter and the yolks of Eggs, and pour over them: Thus you may make Fricasies of Cockles or of Shrimps, or Prawns. Garnish your Dish with Limon and Barberries. 114. _To make an Eel-Pie._ Take your largest Eels, and flay them, and cut them in pieces, then having your Pie ready with Butter in the bottom, season your Eels with Pepper, Salt and Nutmeg, then lay them in and cover them with Butter, so close it and bake it, if you please, you may put in some Raisins of the Sun, and some large Mace, it is good hot or cold. 115. _To souce an Eel and Collar it._ Take a very large fat Eel and scour it well, throw away the head and gut her, and slit her down the back, season her with Pepper, Salt, Nutmeg and Mace, then boil her in white Wine, and Salt and Water, with a bundle of sweet herbs and some Limon Pill, when it is well boiled, take it up and lay it to cool; then put good store of Vinegar into the Liquor, and when it is cold, put in your Eel, and keep it: You must roul it up in a Collar and tie it hard with a Tape, and sew it up in a Cloth, then put it in to boil; when it hath lain a week, serve it to the Table with a Rosemary Branch in the middle, and Bay Leaves round the Dish sides, eat it with Mustard. 116. _To stew Eels._ Take them without their heads, flay them and cut them in pieces, then fill a Posnet with them, and set them all on end one by one close to one another, and put in so much White Wine and Water as will cover them, then put in good store of Currans to them, whole Spice, sweet herbs, and a little Salt, cover them and let them stew, and when they are very tender, put in some Butter, and so shake them well, and serve them upon Sippets; Garnish your Dish with Orange or Limon and raw Parsley. 117. _To make a Herring Pie._ Take four of the best pickled Herrings, and skin them, then split them and bone them, then having your Pie in readiness with Butter in the bottom, then lay your Herrings in halves into your Pie one lay of them, then put in Raisins, Currans and Nutmeg, and a little Sugar, then lay in more Butter, then more Herrings, Fruit and Spice, and more Butter, and so close it, and bake it; your Herrings must be well watered. 118. _To rost a Pike and to lard it._ Take a large Pike, and scale it, gut it, and wash it clean, then lard it on the back with pickled Herring and Limon Pill, then spit it and lay it down to the fire to rost, bast it often with Claret Wine and Butter, when it is enough, make Sauce for it with Claret Wine and Butter, and serve it in. 119. _To boil fresh Salmon._ Take a Joll or a Tail of fresh Salmon, then take Vinegar and Water, Salt and whole Spice, and boil them together, then put in your Salmon, and when it is boiled, take some Butter and some of the Liquor with an Anchovie or two, and a little white Wine and a quart of Shrimps out of their Shells, heat these together, and so Dish your Salmon, and pour this over it. Garnish your Dish with Shrimps and Anchovies, and Slices of Limon. 120. _To boil a Cods Head._ Boil Wine, Water and Salt together, with whole Spice and sweet herbs, and a little Horse-Radish Root, then put in your Cods head, and boil it very well, then drain it well from the Water, and lay it in a dish over a Chafingdish of Coals: Then take some of the Liquor and two Anchovies, some butter and some Shrimps, heat them over the fire, and pour over it, then poach some Eggs and lay over it, and also about the Brims of the Dish; Garnish your Dish with Limon and Barberries, so serve it to the Table very hot: Thus you may do Haddocks or Whitings, or any other fresh Fish you like best. 121. _To make Olives of Veal._ Take thin slices of a Leg of Veal, and have ready some Suet finely shred, some Currans, beaten Spice, sweet herbs, and hard yolks of Eggs, and a little salt mixed well together, then strew it upon the insides of your slices of Meat, and roul them up hard, and make them fast with a scure, so spit them and roste them, baste them with Butter, and serve them in with Vinegar, Butter and Sugar. 122. _To make an Olive Pie._ Having your Paste in readiness with Butter in the bottom, lay in some of the forenamed Olives, but not fastned with a Scure, then put in Currans, hard Eggs, and sweet Butter, with some herbs shred fine; be sure you cover it well with Butter, and put in a little white Wine and Sugar, and close it, and bake it, eat it hot or cold, but hot is better. 123. _To make a Ball to take Stains out of Linnen, which many times happens by Cooking or Preserving._ Take four Ounces of hard white Sope, beat it in a Mortar, with two small Limons sliced, and as much Roch Allom as a Hazle Nut, when they are beaten well together, make it up in little Balls, rub the stain therewith and then wash it in warm water, till you see it be quite out. 124. _To make a fine Pomander._ Take two Ounces of Laudanum, of Benjamin and Storax one Ounce, Musk six gr. as much of Civet, as much of Ambergreece, of Calamus Aromaticus, and Lignum Aloes, of each the weight of a Groat, beat all these in a hot Mortar and with a hot Pestel, till it come to a perfect Paste, then take a little Gum Dragon steeped in Rosewater, and rub your hand withal, and make it up with speed, and dry them, but first make them into what shapes you please, and print them. 125. _A very fine washing-Ball._ Take three Ounces of Orrice, half an Ounce of Cypress-wood, 2 Ounces of Calamus Aromaticus, 1 ounce of Damask-Rose leaves, 2 Ounces of Lavender-flowers, a quarter of an Ounce of Cloves, beat all these and searce them fine, then take two pounds and an half of Castile Sope dissolved in Rose water, and beat all these forenamed things with the Sope in a Mortar, and when they are well incorporated, make it into Balls, and keep them in a Box with Cotton as long as you please. 126. _To make French Broth called Kink._ Take a leg of Beef and set it over the fire with a good quantity of fair water, when it boils, scum it, and what meat soever you have to dress that day, either of Fowl or small meat, put it all into this Liquor and parboil it, then take out those small meats, and put in some French Barley, and some whole Spice, one Clove or two of Garlick, and a handful of Leeks, and some Salt; when it is boiled enough, pour it from the Barley, and in put a little Saffron; so serve it in; and garnish your Dish with sliced Oranges or Limons, and put a little of the juice therein. 127. _To make Broth of a Lambs Head._ Boil it with as much water as will cover it, with whole Spice, and a little Salt, and a bundle of sweet herbs, then put in strained Oatmeal and Cream, and some Currans, when you take it up, put in Sack and Sugar, then lay the Head in a Dish, and put the Broth to it, and serve it in. 128. _To season a Chicken-Pie._ Having your Paste rolled thin, and laid into your baking-pan, lay in some Butter, then lay in your Chickens quartered, and seasoned with Pepper, Nutmeg and a little Salt, then put in Raisins, Currans, and Dates, then lay Butter on the top, close it and bake it, then cut it up, and put in Clouted Cream, Sack and Sugar. 129. _To make an Herb Pie._ Take Spinage, hard Lettice, and a few sweet herbs, pick them, wash them, and shred them, and put them into your Pie with Butter, and Nutmeg and Sugar, and a little Salt, to close it and bake it, then draw it and open it, and put in Clouted Cream; Sack and Sugar, and stir it well together, and serve it in. 130. _To roste Lobsters._ Take two fair Lobsters alive, wash them clean, and stop the holes as you do to boil, then fasten them to a Spit, the insides together; make a good fire, and strew Salt on them, and that will kill them quickly, bast them with Water and Salt till they be very red, then have ready some Oysters stewed and cut small; put them into a Dish with melted Butter beaten thick with a little water, then take a few spoonfuls of the Liquor of the stewed Oysters, and dissolve in it two Anchovies, then put it to the melted Butter, then take up your Lobsters, and crack the shells that they may be easie to open. 131. _To make a Pumpion Pie._ Take a Pumpion, pare it, and cut it in thin slices, dip it in beaten Eggs and Herbs shred small, and fry it till it be enough, then lay it into a Pie with Butter, Raisins, Currans, Sugar and Sack, and in the bottom some sharp Apples; when it is baked, butter it and serve it in. 132. _To make an Artichoke Pudding._ Boil a quart of Cream with whole Spice, then put in half a pound of sweet Almonds blanched, and beaten with Rosewater; when they have boiled well, take it from the fire, and take out the Spice, when it is almost cold, put in the yolks of ten Eggs, some Marrow and some bottoms of Artichokes, then sweeten it with Sugar and put in a little Salt, then butter a Dish, and bake it in it, serve it to the Table stuck full of blanched Almonds, and fine Sugar strewed over it. 133. _To pickle Sprats like Anchovies._ Take a Peck of the biggest Sprats without their heads, and salt them a little over night, then take a Pot or Barrel, and lay in it a Lay of Bay salt, and then a lay of Sprats, and a few Bay leaves, then salt again; thus do till you have filled the Vessel, put in a little Limon Pill also among your Bay leaves, then cover the Vessel and pitch it, that no Air get in, set it in a cool Cellar, and once in a week turn it upside down; in three Months you may eat of them. 134. _To keep Artichokes all the Year._ Gather your Artichokes with long stalks, and then cut off the stalks close to them, then boil some water, with good Pears and Apples sliced thin, and the Pith of the great stalks, and a Quince or two quartered to give it a relish; when these have boiled a while, put in your Artichokes, and boil all together till they be tender, then take them up and set them to cool, then boil your Liquor well and strain it, when your Artichokes be cold, put them into your Barrel, and when the Liquor is cold, pour it over them, so cover it close that no Air get in. 135. _To make Pasty of a Joll of Ling._ Make your Crust with fine Flower, Butter, cold Cream, and two yolks of Eggs: Roul it thin and lay it in your Bake-pan, then take part of a Joll of Ling well boiled, and pull it all in Bits, then lay some Butter into your Pasty and then the Ling, then some grated Nutmeg, sliced Ginger, Cloves and Mace, Oysters, Muscles, Cockles, and Shrimps, the yolks of raw Eggs, a few Comfits perfumed, Candied Orange Pill, Citron Pill, and Limon Pill, with Eringo Roots: Then put in white Wine, and good store of Butter, and put on a thick lid, when it is baked, open it, and let out the steam. 136. _To make French Servels._ Take cold Gammon of Bacon, fat and lean together, cut it small as for Sausages, season it with Pepper, Cloves and Mace, and a little Shelots, knead it into a Paste with the yolks of Eggs, and fill some Bullocks Guts with it, and boil them; but if you would have them to keep, then do not put in Eggs. When you have filled the Guts, boil them, and hang them up, and when you would eat them, serve them in thin slices with a Sallad. 137. _To make a Pallat Pie._ Take Oxe Pallats and boil them so tender that you may run a straw through them; to three Palates take six Sheeps tongues boiled tender and peeled, three sweet-Breads of Veal, cut all these in thin slices, then having your Pie ready, and Butter in the bottom, lay in these things, first seasoned with Pepper, Salt and Nutmeg, and Thyme and Parsley shred small, and as the Season of the year is, put into it Asparagus, Anchovies, Chesnuts, or what you please else, as Candied Orange Pill, Limon Pill, or Citron Pill, with Eringo roots, and yolks of hard Eggs, some Marrow and some Oysters, then lay in good store of Butter on the top, so close it and bake it, then put in white Wine, buter, the yolks of Eggs, and Vinegar and Sugar; heat them together over the fire, and serve it in. 138. _To make Sauce for Fowles or Mutton._ Take Claret Wine, Vinegar, Anchovies, Oisters, Nutmeg, Shelot, Gravie of Mutton or Beef, sweet Butter, Juice of Limon, and a little Salt, and if you please Orange or Limon Pill. 139. _To make Oat-Cakes._ Take fine Flower, and mix it very well with new Ale Yest, and make it very stiff, then make it into little Cakes, and roul them very thin, then lay them on an Iron to bake, or on a baking stone, and make but a slow fire under it, and as they are baking, take them and turn the edges of them round on the Iron, that they may bake also, one quarter of an hour will bake them; a little before you take them up, turn them on the other side, only to flat them; for if you turn them too soon, it will hinder the rising, the Iron or Stone whereon they are baked, must stand at a distance from the fire. 140. _To make a rare Lamb Pie._ Take a Leg of Lamb, and take the meat clean out of it at the great end, but keep the skin whole, then press the Meat in a Cloth, and mince it small, and put as much Beef Suet to it as the Meat in weight, and mince it small, then put to it Naples Bisket grated fine, season it with beaten Spice, Rosewater, and a little Salt, then put in some Candied Limon Pill, Orange Pill, and Citron Pill shred small, and some Sugar, then put part of the Meat into the skin, then having your Pie in readiness, and Butter in the bottom, lay in this Meat, then take the rest of your Meat, and make it into Balls or Puddings with yolks of Eggs, then lay them into the Pie to fill up the Corners, then take Candied Orange, Limon and Citron Pill, cut in long narrow slices and strew over it; you may put in Currans and Dates if you please, then lay on Butter, and close up your Pie and bake it, and leave a Tunnel, when it is baked, put in Sack, Sugar, yolks of Eggs and Butter heat together, if you put in Marrow, it will be the better. 141. _To fry Garden Beans._ Boil them and blanch them, and fry them in Sweet Butter, with Parsley and shred Onions and a little Salt, then melt Butter for the Sauce. 142. _To make a Sorrel Sallad._ Take a quantity of French Sorrel picked clean and washed, boil it with water and a little Salt, and when it is enough, drain it and butter it, and put in a little Vinegar and Sugar into it, then garnish it with hard Eggs and Raisins. 143. _To make good cold Sallads of several things._ Take either Coleflowers, or Carrots, or Parsneps, or Turneps after they are well boiled, and serve them in with Oil, Vinegar and Pepper, also the Roots of red Beets boiled tender are very good in the same manner. 144. _To make the best sort of Pippin Paste._ Take a pound of raw Pippins sliced and beaten in a Mortar, then take a pound of fine Sugar and boil it to a candy height with a little fair water, then put in your Pippins, and boil it till it will come from the bottom of the Posnet, but stir it for fear it burn. 145. _To make Sauce for a Leg of Veal rosted._ Take boiled Currans, and boiled Parsley, and hard Eggs and Butter and Sugar hot together. 146. _To make Sauce for a Leg of Mutton rosted with Chesnuts._ Take a good quantity of Chesnuts, and boil them tender, then take the shells off, and bruise them small, then put to them Claret Wine, Butter and a little Salt, so put it into the Dish to the Meat, and serve it in. 147. _To keep Quinces white, either to preserve whole, or for white Marmalade or Paste._ Coddle them with white Wine and Water, and cover them with sliced Pippins in the Codling. 148. _To make little Pasties with sweet Meats to fry._ Make some Paste with cold water, butter and flower, with the yolk of an Egg, then roul it out in little thin Cakes, and lay one spoonful of any kind of Sweet meats you like best upon every one, so close them up and fry them with Butter, and serve them in with fine Sugar strewed on. 149. _To boil a Capon on the French fashion._ Boil your Capon in water and salt, and a little dusty Oatmeal to make it look white, then take two or three Ladles full of Mutton Broth, a Faggot of sweet herbs, two or three Dates cut in long pieces, a few parboiled Currans, and a little whole Pepper, a little Mace and Nutmeg, thicken it with Almonds; season it with Verjuice, Sugar, and a little sweet Butter, then take up your Capon and lard it well with preserved Limon, then lay it in a deep Dish, and pour the broth upon it; then Garnish your Dish with Suckets and preserved Barberries. 150. _To Souce a Pike, Carp or Bream._ Draw your Fish, but scale it not, and save the Liver of it; wash it very well, then take white Wine, as much water again as Wine, boil them together with whole Spice, Salt and a bundle of sweet Herbs, and when boiles put in your Fish, and just before it a little Vinegar; for that will make it crisp: when it is enough, take it up and put it into a Trey, then put into the Liquor some whole Pepper, and whole Ginger, and when it is boiled enough, take it off and cool it, and when it is quite cold, put in your Fish, and when you serve it in, lay some of the Jelly about the Dish sides, and some Fennel and Sawcers of Vinegar. 151. _To boil a Gurnet on the French fashion._ Draw your Gurnet and wash it, boil it in water and salt and a bundle of sweet herbs; when it is enough, take it up and put it into a Dish with Sippets over a Chafingdish of Coals; then take Verjuice, Butter, Nutmeg and Pepper, and the yolks of two Eggs, heat it together, and pour over it; Garnish your Dish as you please. 152. _To rost a Leg of Mutton on the French fashion._ Take a Leg of Mutton, and pare off all the Skin as thin as you can, then lard it with sweet Lard, and stick it with Cloves, when it is half rosted, cut off three or four thin pieces, and mince it with sweet herbs, and a little beaten Ginger, put in a Ladle full of Claret wine, and a little sweet butter, two sponfuls of Verjuice and a little Pepper, a few Capers, then chop the yolks of two hard Eggs in it, then when these have stewed a while in a Dish, put your bonie part which is rosted into a Dish, and pour this on it and serve it in. 153. _To rost a Neats tongue._ Chop sweet herbs fine with a piece of raw Apple, season it with Pepper and Ginger, and the yolk of an Egg made hard and minced small, then stuff your Tongue with this, and rost it well, and baste it with Butter and Wine; when it is enough, take Verjuice, Butter, and the Juice of a Limon, and a little Nutmeg, then Dish your Tongue and pour this Sauce over it and serve it in. 154. _To boil Pigeons with Rice._ Take your Pigeons and truss them, and stuff their bellies with sweet herbs, then put them into a Pipkin with as much Mutton broth as will cover them, with a blade of Mace and some whole Pepper; boil all these together until the Pigeons be tender, and put in Salt: Then take them from the fire, and scum off the Fat very clean, then put in a piece of sweet Butter, season it with Verjuice, Nutmeg and a little Sugar, thicken it with Rice boiled in sweet Cream. Garnish your Dish with preserved Barberries and Skirret Roots boiled tender. 155. _To boil a Rabbit._ Take a large Rabbit, truss it and boil it with a little Mutton Broth, white Wine and a blade of Mace, then take Lettuce, Spinage, and Parsley, Winter-Savory and sweet Marjoram, pick all these and wash them clean, and bruise them a little to make the Broth look green, thicken it with the Crust of a Manchet first steeped in a little Broth, and put in a little sweet Butter, season it with Verjuice and Pepper, and serve it to the Table upon Sippets; Garnish the Dish with Barberries. 156. _To boil a Teal or Wigeon._ Parboil either of these Fowls and throw them into a pail of fair Water, for that taketh away the Rankness, then rost them half, and take them from the fire, and put sweet herbs in the bellies of them, and stick the Brests with Cloaves, then put them in a Pipkin with two or three ladles full of Mutton broth, very strong of the Meat, a blade of whole Mace, two or three little Onions minced small; thicken it with a Toast of Houshold bread, and put in a little Butter, then put in a little Verjuice, so take it up and serve it. 157. _To boil Chickens or Pigeons with Goosberries or Grapes._ Boil them with Mutton Broth and white Wine, with a blade of Mace and a little Salt, and let their bellies be filled with sweet herbs, when they are tender thicken the Broth with a piece of Manchet, and the yolks of two hard Eggs, strained with some of the Broth, and put it into a deep Dish with some Verjuice and Butter and Sugar, then having Goosberries or Grapes tenderly scalded, put them into it, then lay your Chickens or Pigeons into a Dish, and pour the Sauce over them, and serve them in. 158. _A made Dish of Rabbits Livers._ Take six Livers and chop them fine with sweet herbs and the yolks of two hard Eggs, season it with beaten Spice, and Salt, and put in some plumped Currans, and a little melted Butter, so mix them very well together, and having some Paste ready rouled thin, make it into little Pasties and fry them, strew Sugar over them and serve them. 159. _To make a Florentine with the Brawn of a Capon, or the Kidney of Veal._ Mince any of these with sweet Herbs, then put in parboiled Currans, and Dates minced small, and a little Orange or Limon Pill which is Candied shred small, season it with beaten Spice and Sugar, then take the yolks of two hard Eggs and bruise them with a little Cream, a piece of a short Cake grated, and Marrow cut in short pieces, mix all these together with the forenamed Meat, and put in a little Salt and a little Rosewater, and bake it in a Dish in a Puff-Past, and when you serve it strew Sugar over it. 160. _A Friday Pie without Fish or Flesh._ Wash a good quantity of green Beets, and pluck out the middle string, then chop them small, with two or three ripe Apples well relished, season it with Pepper, Salt, and Ginger, then add to it some Currans, and having your Pie ready, and Butter in the bottom, put in these herbs, and with them a little Sugar, then put Butter on the top, and close and bake it, then cut it up, and put in the juice of a Limon and Sugar. 161. _To make Umble Pies._ Boil them very tender, and mince them very small with Beef Suet and Marrow then season it with beaten Spice and Salt, Rosewater and Sugar and a little Sack, so put it into your Paste with Currans and Dates. 162. _To bake Chickens with Grapes._ Scald your Chickens and truss them, and season them with Pepper, Salt and Nutmeg, and having your Pie ready, and Butter laid in the bottom, put in your Chickens, and then more butter, and bake them with a thin Lid on your Pie, and when it is baked, put in Grapes scalded tender, Verjuice, Nutmeg, Butter and Sugar, and the Juice of an Orange; so serve it in. 163. _To make a good Quince-Pie._ Take your fairest Quinces and Coddle them until a straw will run through them, then core them and pare them, then take their weight in fine Sugar, and stuff them full of Sugar, then having your Pie ready, lay in your Quinces, and strew the rest of your Sugar over them, and put in some whole Cloves and Cinamon, then close it, and bake it; you must let it stand in the Oven four or five hours; serve it in cold and strew on Sugar. 164. _To make Tarts of Pippins._ Having some Puff-Past ready in a Dish or Pan, lay in some preserved Pippins which have Orange Pill in them, and the Juice of Orange or Limon, so close them and bake them a little. 165. _To make a good pie of Beef._ Take the Buttock of a fat Oxe, slice it thin, mince it small and beat it in a Mortar to a Paste, then lard it very well with Lard, and season it with beaten Spice, then make your Pie, and put it in with some Butter and Claret Wine, and so bake it well, and serve it in cold with Mustard and Sugar, and garnish it with Bay-leaves. 166. _To bake a Swan._ Scald it and take out the bones, and parboil it, then season it very well with Pepper, Salt and Ginger, then lard it, and put it in a deep Coffin of Rye Paste with store of Butter, close it and bake it very well, and when it is baked, fill up the Vent-hole with melted Butter, and so keep it; serve it in as you do the Beef-Pie. 167. _To bake a Turkey or Capon._ Bone the Turkey but not the Capon, parboil them, and stick Cloves on their brests, lard them and season them well with Pepper and Salt, and put them in a deep Coffin with good store of Butter, and close your Pie, and bake it, and soak it very well; when it is baked, fill it up with melted Butter, and when it is quite cold, serve it in and eat it with Mustard and Sugar: garnish it with Bay Leaves. 168. _To make Fritters._ Take the Curds of a Sack Posset, the Yolks of six Eggs, and the Whites of two, with a little fine Flower to make it into a thick Batter, put in also a Pomewater cut in small pieces, some beaten Spice, warm Cream, and a spoonful of Sack, and a little strong Ale; mingle all these very well, and beat them well, and fry them in very hot Lard, and serve them in with beaten Spice and fine Sugar. 169. _To bake Woodcocks, Black-birds Sparrows or Larks._ Truss and parboil them, then season them with Pepper and Salt, and put them into a Pie with good store of Butter, and so bake them, then fill them up with Butter. 170. _To bake a Goose._ Bone your Goose and parboil it, and season it with Pepper and Salt, and lay it into a deep Coffin with good store of Butter top and bottom, then bake it very well, and when it is baked, fill up the pie at the Vent-hole with melted Butter, and so serve it in with Mustard and Sugar and Bay-Leaves. 171. _To make Pancakes so crisp as you may set them upright._ Make a dozen or a score of them in a little Frying-pan, no bigger than a Sawcer, then boil them in Lard, and they will look as yellow as Gold, and eat very well. 172. _To make blanched Manchet._ Take six Eggs, half a Pint of sweet cream, and a penny Manchet grated, one Nutmeg grated, two spoonfuls of Rosewater, and two Ounces of Sugar, work it stiff like a Pudding, then fry it in a very little frying-pan, that it may be thick. Fry it brown, and turn it upon a Pie-Plate; cut it in quarters and strew Sugar on it and serve it in. 173. _To make a sierced Pudding._ Mince a Leg of Mutton with sweet herbs, and some Suet, make it very fine, then put in grated Bread, minced Dates, Currans, Raisins of the Sun stoned, a little preserved Orange or Limon, and a few Coriander seeds bruised, Nutmeg, Ginger, and Pepper, mingle all together with Cream and raw Eggs wrought together like a Paste, and bake it, and put for Sauce the yolk of an Egg, Rosewater, Sugar and Cinamon, with a little Butter heat together, when you serve it in, stick it with Almonds and Rosemary; you may boil it also if you please, or rost some of in a Lambs Cawl. 174. _To make a Fricasie of Eggs._ Beat twelve Eggs with Cream, Sugar, beaten spice and Rosewater, then take thin slices of Pomewater Apple, and fry them well with sweet Butter; when they are enough, take them up, and cleanse your pan, then put in more butter and make it hot, and put in half your Eggs and fry them; then when the one side is fryed lay your Apples all over the side which is not fryed, then pour in the rest of your Eggs, and then turn it and fry the other side, then serve it in with the Juice of an Orange and Butter, and Sugar. 175. _To make a_ Cambridge_-Pudding._ Take grated bread searced through a Cullender, then mix it with fine Flower, minced Dates, Currans, beaten Spice, Suet shred small, a little salt, sugar and rosewater, warm Cream and Eggs, with half their Whites; mould all these together with a little Yest, and make it up into a Loaf, but when you have made it in two parts, ready to clap together, make a deep hole in the one, and put in butter, then clap on the other, and close it well together, then butter a Cloth and tie it up hard, and put it into water which boiles apace, then serve it in with Sack, Butter and Sugar. You may bake it if you please in a baking-pan. 176. _To make a Pudding of Goose Blood._ Save the blood of a Goose, and strain it, then put in fine Oatmeal steeped in warm Milk, Nutmeg, Pepper, sweet Herbs, Sugar, Salt, Suet minced fine, Rosewater, Limon Pill, Coriander seeds, then put in some Eggs, and beat all these together very well, then boil them how you do like, either in a buttered Cloth or in Skins, or rost it within the Neck of the Goose. 177. _To make Liver Puddings._ Take a Hogs Liver boiled and cold, grate it like Bread, then take new Milk and the Fat of a Hog minced fine, put it to the Bread and the Liver, and divide it into two parts, then dry herbs or other if you can minced fine, and put the Herbs into one part with beaten Spice, Anniseeds, Rosewater, Cream and Eggs, Sugar and Salt, so fill the Skins and boil them. To the other part put preserved Barberries, diced Dates, Currans, beaten Spice, Salt, Sugar, Rosewater, Cream and Eggs, so mix them well together, and fill the Skins and boil them. 178. _To make a Chiveridge Pudding._ Take the fattest Guts of your Hog clean scoured, then fluff them with beaten Spice and sliced Dates, sweet herbs, a little Salt, Rosewater, Sugar, and two or three Eggs to make it slide; so fill them, tie them up like Puddings and boil them; when they are enough serve them. 179. _To make Rice Puddings in Skins._ Take two quarts of Milk and put therein as it is yet cold, two good handfuls of Rice clean picked and washed, set it over a slow fire and stir it often, but gently; when you perceive it to swell, let it boil apace till it be tender and very thick, then take it from the fire, and when it is cold, put in six Eggs well beaten, some Rosewater and Sugar, beaten Spice and a little Salt, preserved Barberries and Dates minced small, some Marrow and Citron Pill; mingle them well together and fill your Skins, and boil them. 180. _To make a stewed Pudding._ Take the yolks of three Eggs and one White, six spoonfuls of sweet Cream, a little beaten spice, and a quarter of a pound of Sewet minced fine, a quarter of a pound of Currans, and a little grated bread, Rosewater, Sugar and Salt; mingle them well together, and wrap them up in little pieces of the Cawl of Veal, and fasten them with a little stick, and tie each end with a stick, you may put four in one dish, then take half a pint of strong Mutton Broth, and 6 spoonfuls of Vinegar, three or four blades of large Mace, and one Ounce of Sugar, make this to boil over a Chafingdish of Coals, then put in your Puddings, and when they boil, cover them with another Dish, but turn them sometimes, and when you see that they are enough, take your Puddings and lay them in a warm Dish upon Sippets, then add to their Broth some Sack, Sugar, and Butter, and pour over them; garnish your Dish with Limon and Barberries. 181. _To make a_ Sussex _Pudding._ Take a little cold Cream, Butter and Flower, with some beaten Spice, Eggs, and a little Salt, make them into a stiff Paste, then make it up in a round Ball, and as you mold it, put in a great piece of Butter in the middle; and so tye it hard up in a buttered Cloth, and put it into boiling water, and let it boil apace till it be enough, then serve it in, and garnish your dish with Barberries; when it is at the Table cut it open at the top, and there will be as it were a Pound of Butter, then put Rosewater and Sugar into it, and so eat it. In some of this like Paste you may wrap great Apples, being pared whole, in one piece of thin Paste, and so close it round the Apple, and throw them into boiling water, and let them boil till they are enough, you may also put some green Goosberries into some, and when either of these are boiled, cut them open and put in Rosewater Butter and Sugar. 182. _To make_ French _Puffs._ Take Spinage Parsley and Endive, with a little Winter savory, and wash them, and mince them very fine; season them with Nutmeg, Ginger and Sugar, season them with Eggs, and put in a little Salt, then cut a Limon into thin round slices, and upon every slice of Limon lay one spoonful of it. Then fry them, and serve them in upon some Sippets, and pour over them Sack, Sugar and butter. 183. _To make Apple Puffs._ Take a Pomewater, or any other Apple that is not hard or harsh in taste, mince it with a few Raisins of the Sun stoned, then wet them with Eggs, and beat them together with the back of a Spoon, season them with Nutmeg, Rosewater, Sugar, and Ginger, drop them into a frying pan with a Spoon into hot Butter, and fry them, then serve them in with the juice of an Orange and a little Sugar and Butter. 184. _To make Kickshaws, to bake or fry in what shape you please._ Take some Puff-paste and roul it thin, if you have Moulds work it upon them with preserved Pippins, and so close them, and fry or bake them, but when you have closed them you must dip them in the yolks of Eggs, and that will keep all in; fill some with Goosberries, Rasberries, Curd, Marrow, Sweet-breads, Lambs Stones, Kidney of Veal, or any other thing what you like best, either of them being seasoned before you put them in according to your mind, and when they are baked or fryed, strew Sugar on them, and serve them in. 185. _To make an_ Italian _Pudding._ Take a penny white loaf and pare off the crust, then cut it like Dice, then take some Beef Suet shred small, and half a pound of Raisins of the Sun stoned, with as many Currans, mingle them together and season them with beaten Spice and a little Salt, wet them with four Eggs, and stir them gently for fear of breaking the Bread, then put it in a dish with a little Cream and Rosewater and Sugar, then put in some Marrow and Dates, and so butter a dish and bake it, then strew on Sugar and serve it. 186. _To hash Calves Tongues._ Boil them tender and pill them, then lard them with Limon Pill, and lard them also with fat Bacon, then lay them to the Fire and half rost them; then put them in a Pipkin with Claret Wine, whole Spice and sliced Limon, and a few Caraway Seeds, a little Rosemary and a little Salt, boil all together and serve them in upon Toasts. Thus you may do with Sheeps Tongues also. 187. _To boil a Capon._ Take strong Mutton Broth, and truss a Capon, and boil him in it with some Marrow and a little Salt in a Pipkin, when it is tender, then put in a pint of White Wine, half a pound of Sugar, and four Ounces of Dates stoned and sliced, Potato Roots boiled and blanched, large Mace and Nutmeg sliced, boil all these together with a quarter of a pint of Verjuyce, then dish the Capon, and add to the Broth the yolks of six Eggs beaten with Sack, and so serve it; garnish dish with several sorts of Candied Pills and Preserved Barberries, and sliced Limon with Sugar upon every slice. 188. _To boil a Capon with Rice._ Truss your Capon and boil him in water and salt, then take a quarter of a pound of Rice, first boiled in Milk, and put in with some whole Spice and a little Salt, when it is almost enough put in a little Rosewater, and half a pound of Almonds blanched and beaten, strain them in, and put in some Cream and Sugar, then when your Capon is enough, lay it in a dish, and pour the Broth thereon; garnish your Dish as you please, and serve it in. 189. _To boil a Capon with Pippins._ Parboil your capon after it is trussed, then put it into a pipkin with Mutton Broth and Marrow, and a little Salt, with a quart of White-Wine, a little Nutmeg and Dates stoned and sliced, then put in a quarter of a pound of fine Sugar, then take some Pippins stewed with Sugar, Spice and a little water, and put them in, then lay your Capon into a Dish, and lay some Naples Biskets for Sippets, then bruise the yolks of eight hard Eggs and put into your Broth, with a little Sack, and pour it over your Capon; Garnish your Dish and serve it in. 190. _To boil Chickens with Lettuce the very best way._ Parboil your Chickens and cut them in Quarters, and put them into a Pipkin with some Mutton Broth, and two or three sweet Breads of Veal, and some Marrow, and some Cloves, and a little Salt, and a little Limon Pill; then take good store of hard Lettuce, cut them in halves and wash them, and put them in; then put in Butter and Sack and white Wine, with a little Mace and Nutmeg, and sliced Dates, let all these stew upon the Fire, and when they be enough, serve them in with Toasts of white Bread for Sippets; Garnish the Dish with Limon and Barberies, and what else you please; thus you may do Pigeons. 190. [Transcriber's Note: so numbered in original] _To boil a Rabbit with Grapes or with Goosberries._ Truss your Rabbit whole, and boil it in some Mutton Broth till it be tender; Then take a pint of White Wine, and a good handful of Spinage chopped, the yolks of hard Eggs cut in quarters, put these to the Rabbit with some large Mace; a Fagot of sweet Herbs and a little Salt and some Butter, let them boil together a while, then take your Rabbet and lay it in a Dish and some Sippets, then lay over it some Grapes or Goosberries, scalded with Sugar, and pour your Broth over it. 191. _To boil a Rabbit with Claret Wine._ Boil a Rabbet as before, then slice Onions and a Carrot root, a few Currans and a Fagot of sweet herbs, and a little Salt, minced Parsley, Barberries picked, large Mace, Nutmeg and Ginger, put all these into a Pipkin with the Rabbet, half a Pound of Butter, and a Pint of Claret Wine, and let them boil together till it be enough, then serve it upon Sippets. 192. _To boil a wild Duck._ Truss and parboil it, then half rost it, then carve it, and save the Gravie, then take Onions and Parsley sliced, Ginger and Pepper, put the Gravie into a Pipkin, with Currans, Mace, Barberries, and a quart of Claret Wine, and a little Salt, put your Duck with all the forenamed things into it, and let them boil till it be enough, then put in butter and sugar, and serve it in upon Sippets. 193. _To boil a tame Duck._ Take your Duck and truss it, and boil it with water and salt, or rather Mutton broth, when it hath boiled a while, put in some whole Spice, and when it is boiled enough, take some white wine and butter, and good store of Onions boiled tender in several waters, with a little of the Liquor wherein the Duck hath boiled, and a little Salt: put your Duck into a Dish, and heat these things together and pour over it; and serve it; garnish the Dish with boiled Onions and Barberries. 194. _To boil Pigeons with Capers and Samphire._ Truss your Pigeons, and put them into a Pipkin with some Mutton broth and white Wine, a bundle of sweet herbs, when they are boiled, lay them into a Dish, then take some of the broth with some Capers and Limon sliced, and some butter, heat these together and pour over them; then fry thin slices of Bacon, and lay upon them, and some Samphire washed from the Salt, and some slices of Limon; Garnish your Dish with the same and serve it in. 195. _To boil Sausages._ Take two pounds of Sausages, and boil them with a quart of Claret Wine and a bundle of sweet herbs, and whole Cloves and Mace; then put in a little Butter, when they are enough, serve them in with this Liquor and some Mustard in Sawcers. 196. _To boil Goose Giblets._ Boil them with water and salt, and a bundle of sweet herbs, Onions and whole spice, when they are enough, put in Verjuice and Butter, and some Currans plumped, and serve them upon Sippets. Thus you may dress Swans Giblets. 197. _To boil Giblets with Roots and good Herbs._ Boil them in a quart of Claret, Ginger and Cloves, and a Faggot of sweet herbs, Turneps and Carots sliced, with good store of Spinage and a little salt; when they are enough, serve them upon Sippets. And add to the Broth some Verjuice and the yolks of Eggs; Garnish your Dish with Parsley and pickled Barberries. 198. _To smoor a Neck of Mutton._ Cut your Steaks, and put them into a Dish with some Butter, then take a Faggot of sweet herbs and some gross Pepper and a little Salt, and put them to them; cover your Dish, and let them stew till they are enough, turning them sometimes, then put in a little Claret Wine and Anchovies, and serve them upon Sippets. 199. _To smoor Veal._ Cut thin slices of Veal and hack them over with the back of a Knife, then lard them with Lard, and Fry them with strong Beer or Ale till they be enough, then stew them in Claret wine with some whole Spice and Butter and a little salt. Garnish your Dish with Sausages fryed; and with Barberries, to serve them in. 200. _To smoor Steaks of Mutton another way._ Cut part of a Leg of Mutton into steaks, and fry it in White Wine and a little salt, a bundle of herbs, and a little Limon Pill, then put it into a Pipkin with some sliced Limon, without the Rind, and some of the Liquor it was fried in, and Butter and a little Parslie, boil all together till you see it be enough, then serve it in, and garnish your Dish with Limon and Barberries. 201. _To smoor Chickens._ Cut them in Joints and fry them with sweet Butter, then take white Wine, Parsley and Onions chopp'd small, whole Mace and a little gross Pepper, a little Sugar, Verjuice and Butter, let these and your fried Chicken boil together, then fry the Leaves of Clary with Eggs, put in a little Salt to your Chickens, and when they are enough, serve them in this fried Clary, and garnish your Dish with Barberries. 202. _To fry Museles, or Oysters, or Cockles to serve in with Meat, or by themselves._ Take any of these and parboil them in their own Liquor, then dry them, flower them, and fry them, then put them into a Pipkin with Claret wine, whole Spice and Anchovies, and a little butter, so let them stew together, and serve them in either with a Duck, or by themselves, as you like best. 204. [Transcriber's note: so numbered in original] _To dress Calves feet._ Take Calves feet tenderly boiled, and slit them in the middle, then put them in a Dish with sweet Butter, Parsley and Onions chopped a little Thyme, large Mace, Pepper with a little Wine Vinegar, and a little salt, let all these stew together till they are enough, then lay your Calves feet in a Dish, and pour the Sauce over them, then strew some raw Parsley and hard Eggs chopped together over them with slices of Limon and Barberries. 205. _To hash Neats tongues._ Boil them and blanch them, and slice them thin then take Raisins of the Sun, large Mace, Dates sliced thin, a few blanched Almonds and Claret wine with a little salt; boil all these together with some sweet butter, verjuice and sugar; when they are enough, serve them in and thicken the Sauce with yolks of Eggs; garnish your Dish with Barberries. 206. _Another way to hash Neats Tongues._ Boil Neats Tongues very tender, peel them and slice them thin, then take strong meat broth, blanched Chesnuts, a Faggot of sweet herbs, large Mace, and Endive, a little Pepper and whole Cloves and a little Salt; boil all these together with some butter till they be enough; garnish your Dish as before. 207. _To boil Chickens in white-broth._ Take three Chickens and truss them, then take two or three blades of Mace, as many quartered Dates, four or five Lumps of Marrow, a little Salt and a little Sugar, the yolks of three hard Eggs, and a quarter of a Pint of Sack, first boil your Chickins in Mutton broth, and then add these things to them, and let them boil till they are enough, then lay your Chickens in a Dish, and strain some Almonds blanched and beaten into it, serve it upon Sippets of French Bread; garnish your Dish with hard Eggs and Limons. 208. _To boil Partridges._ Put two or three Partridges into a Pipkin with as much water as will cover them, then put in three or four blades of Mace, one Nutmeg quartered, five or six Cloves, a piece of sweet Butter, two or three Toasts of Manchet toasted brown, soke them in Sack or Muskadine, and break them, and put them into the Pipkin with the rest, and a little Salt, when they are enough, lay them in a Dish, and pour this Broth over them, then garnish your Dish with hard Eggs and sliced Limon, and serve it in. 209. _To boil a Leg of Mutton._ Take a large Leg of Mutton and stuff it well with Mutton Suet, Salt and Nutmeg, boil it in water and Salt, but not too much, then put some of that broth into another Pot, with three or four blades of Mace, some Currans and Salt, boil them till half be consumed, then put in some sweet Butter, and some Capers and a Limon cut like Dice with the Rind on, a little Sack, and the yolks of two hard Eggs minced; then lay your Mutton into a Dish upon Sippets, and pour this Sauce over it; scrape Sugar on the sides of your Dish, and lay on slices of Limon and Barberries. 210. _To stew Trouts._ Put two Trouts into a fair dish with some white Wine, sweet butter, and a little whole Mace, a little Parsley, Thyme and Savory minced, then put in an Anchovy and the yolks of hard Eggs; when your Fish is enough, serve it on Sippets, and pour this over it, and garnish your Dish with Limon and Barberries, and serve them in: you may add Capers to it if you please, and you may do other Fish in this manner. 211. _To boil Eels in Broth to serve with them._ Flay and wash your Eels and cut them in pieces about a handful long, then put them into a pot with so much Water as will cover them, a little Pepper and Mace, sliced Onions, a little grated bread, and a little Yest, a good piece of sweet butter, some Parsley, Winter Savory and Thyme shred small; let them boil softly half an hour, and put in some Salt, with some Currans; when it is enough, put in Verjuice and more Butter, and so serve it; Garnish your Dish with Parsley, Limon and Barberries, put Sippets in your Dish. 212. _To boil a Pike with Oysters._ Take a fair Pike and gut it and wash it, and truss it round with the tail in the mouth, then take white Wine, Water and Salt, with a bundle of sweet herbs, and whole Spice, a little Horse-radish; when it boils, tie up your Pike in a Cloth, and put it in, and let it boil till it swims, for then it is enough; then take the Rivet of the Pike, and a Pint of great Oysters with their Liquor, and some Vinegar, large Mace, gross Pepper, then lay your Pike in a Dish with Sippets, and then heat these just named things with some Butter and Anchovies, and pour over it; garnish your Dish as you please. 213. _To make a grand Sallad._ Take a fair broad brimm'd dish, and in the middle of it lay some pickled Limon Pill, then lay round about it each sort by themselves, Olives, Capers, Broom Buds, Ash Keys, Purslane pickled, and French Beans pickled, and little Cucumbers pickled, and Barberries pickled, and Clove Gilliflowers, Cowslips, Currans, Figs, blanched Almonds and Raisins, Slices of Limon with Sugar on them, Dates stoned and sliced. Garnish your Dish brims with Candied Orange, Limon and Citron Pill, and some Candied Eringo roots. 214. _To rost Pig with a Pudding in his Belly._ Take a fat Pig and truss his head backward loking over his back, then make such Pudding as you like best, and fill his belly with it, your Pudding must be stiff, then sew it up, and rost your Pig, when it is almost enough, wring upon it the Juice of a Limon, and when you are ready to take it up, wash it over with yolks of Eggs, and before they can dry, dredge it with grated bread mixed with a little Nutmeg and Ginger, let your Sauce be Vinegar, Butter and Sugar, and the yolks of hard Eggs minced. 215. _To rost a Leg of Mutton with Oisters._ Take a large Leg of Mutton and stuff it well with Mutton Sewet, with Pepper, Nutmeg Salt and Mace, then rost it and stick it with Cloves, when it is half rosted cut off some of the under side of the fleshy end, in little thin Bits, then take a Pint of Oisters and the Liquor of them, a little Mace, sweet Butter and Salt, put all these with the Bits of Mutton into a Pipkin till half be consumed; then Dish your Mutton and pour this Sauce over it, strew Salt about the Dish side and serve it in. 216. _To make a Steak-Pie._ Cut a Neck of Mutton in steaks, then season it with Pepper and Salt, lay your Paste into your Baking Pan, and lay Butter in the bottom, then lay in your steaks, and a little large Mace, and cover it with Butter, so close it, and bake it; and against it is baked, have in readiness good store of boiled Parslie minced fine, and drained from the water, some white Wine and some Vinegar, sweet Butter and Sugar, cut open your Pie, and put in this Sauce, and shake it well, and serve it to the Table; it is not so good cold as hot. 217. _To rost a Haunch or a Shoulder of Venison, or a Chine of Mutton._ Take either of these, and lard it with Lard, and stick it thick with Rosemary, then roft it with a quick fire, but do not lay it too near; baste it with sweet butter: then take half a Pint of Claret wine, a little beaten Cinamon and Ginger, and as much sugar as will sweeten it, five or six whole Cloves, a little grated bread, and when it is boiled enough, put in a little Sweet butter, a little Vinegar, and a very little Salt, when your meat is rosted, serve it in with Sauce, and strew salt about your Dish. 218. _To rost a Capon with Oysters and Chesnuts._ Take some boiled Chesnuts, and take off their shells, and take as many parboil'd Oysters, then spit your Capon, and put these into the belly of it, with some sweet Butter, rost it and bast it with sweet Butter, save the Gravie, and some of the Chesnuts, and some of the Oysters, then add to them half a Pint of Claret Wine, and a pice of sweet Butter and a little Pepper, and a little Salt, stew these altogether till the Capon be ready, then serve them in with it; Garnish your Dish as you please. 219. _To rost Shoulder or Fillet of Veal with farcing herbs._ Wash your meat and parboil it a little, then take Parsley, Winter-savory, and Thyme, of each a little minced small, put to them the yolks of three or four hard eggs minced, Nutmeg, Pepper and Currans and Salt, add also some Suet minced small; work all these with the yolk of a raw Egg, and stuff your Meat with it, but save some, and set it under the meat while it doth rost, when your meat is almost rosted enough, put to these in the Dish, a quarter of a pint of White Wine Vinegar, and some Sugar, when your meat is ready, serve it in with this Sauce, and strew on Salt. 220. _To make boiled Sallads._ Boil some Carots very tender, and scrape them to pieces like the Pulp of an Apple, season them with Cinamon and Ginger and Sugar, put in Currans, a little Vinegar, and a piece of sweet Butter, stew these in a Dish, and when they begin to dry put in more Butter and a little Salt, so serve them to the Table, thus you may do Lettuce, or Spinage or Beets. 221. _To boil a Shoulder of Veal._ Take a Shoulder of Veal and half boil it in Water and Salt, then slice off the most part of it, and save the Gravie; then take that sliced meat, and put it in a Pot with some of the Broth that boiled it, a little grated Bread, Oister Liquor, Vinegar, Bacon scalded and sliced thin, a Pound of Sausages out of their skins, and rolled in the yolks of Eggs, large Mace and Nutmeg, let these stew about one hour, than put in one Pint of Oisters, some sweet herbs, and a little Salt, stew them together, then take the bone of Veal and broil it and Dish it, then add to your Liquor a little Butter, and some minced Limon with the Rind, a Shelot or two sliced, and pour it over, then lay on it some fryed Oysters; Garnish your Dish with Barberries and sliced Limon, and serve it in. 222. _To boil a Neck of Mutton._ Boil it in water and salt, then make sauce for it with Samphire and a little of the Broth, Verjuice, large Mace, Pepper and Onion, the yolks of hard Eggs minced, some sweet herbs and a little salt, let these boil together half an hour or more: Then beat it up with Butter and Limon; then dish your Meat upon Sippets, and pour it on; garnish your Dish with the hard Whites of Eggs and Parsley minced together, with sliced Limon, so serve it; thus you may dress a Leg or a Brest of Mutton if you please. 223. _To stew a Loin of Mutton._ Cut your meat in Steaks, and put it into so much water as will cover it, when it is scummed, put to three or four Onions sliced, with some Turneps, whole Cloves, and sliced Ginger, when it is half stewed, put in sliced Bacon and some sweet herbs minced small, some Vinegar and Salt, when it is ready, put in some Capers, then dish your Meat upon Sippets and serve it in, and garnish your Dish with Barberries and Limon. 224. _To boil a Haunch of Venison._ Boil it in water and salt, with some Coleflowers and some whole spice; then take some of the Broth, a little Mace, and a Cows Udder boiled tender and sliced thin, a little Horse-radish root searced, and a few sweet herbs; boil all these together, and put in a little Salt, when your Venison is ready, dish it, and lay your Cows Udder and the Coleflowers over it, then beat up your Sauce, and pour over it; then garnish your Dish with Limon and Parsley and Barberries, and so serve it; this Sauce is also good with a powdered Goose boiled, but first larded. 225. _To make white Broth with Meat or without._ Take a little Mutton broth, and as much of Sack, and boil it with whole Spice, sweet herbs, Dates sliced, Currans and a little Salt, when it is enough, or very near, strain in some blanched Almonds, then thicken it with the yolks of Eggs beaten, and sweeten it with Sugar, and so serve it in with thin slices of white Bread: Garnish with stewed Prunes, and some plumped Raisins. This may be served in also with any meat proper for to be served with white Broth. 226. _To make good stewed Broth._ Take a hinder Leg of Beef and a pair of Marrow Bones, boil them in a great Pot with water and a little Salt, when it boiles, and is skimmed, put in some whole Spice, and some Raisins and Currans, then put in some Manchet sliced thin, and soaked in some of the Broth, when it is almost enough, put in some stewed Prunes, then Dish your Meat, and put into your Broth a little Saffron or red Saunders, some white Wine and Sugar, so pour it over your Meat, and serve it in; Garnish your Dish with Prunes, Raisins and fine Sugar. 227. _To stew Artichokes._ Take the bottoms of Artichokes tenderly boiled, and cut them in Quarters, stew them with white Wine, whole Spice and Marrow, with a little Salt: When they are enough, put in Sack and Sugar, and green Plumbs preserved, so serve them; garnish the Dish with Preserves. 228. _To stew Pippins._ Take a pound of Pippins, pare them and core them, and cut them in quarters. Then take a pint of water and a pound of fine Sugar, and make a Syrup, and scum it, then put in your Pippins and boil them up quick, and put in a little Orange or Limon Pill very thin; when they are very clear, and their Syrup almost wasted, put in the juice of Orange and Limon, and some Butter; so serve them in upon Sippets, and strew fine Sugar about the Dish sides. 229. _To make a Sallad with fresh Salmon._ Your Salmon being boiled and souced, mince some of it small with Apples and Onyons, put thereto Oyl, Vinegar, and Pepper; so serve it to the Table: Garnish your Dish with Limon and Capers. 230. _To rost a Shoulder of Mutton with Oisters._ Take a large Shoulder of Mutton, and take sweet herbs chopped small, and mixed with beaten Eggs and a little Salt, take some great Oisters, and being dried from their Liquor, dip them in these Eggs, and fry them a little, then stuff your meat well with them, then save some of them for sauce, and rost your Mutton, and baste it with Claret Wine, Butter, and Salt, save the Gravie, and put it with the Oisters into a Dish to stew with some Anchovies, and Claret Wine: when your meat is enough, rub the Dish with a Shelot, and lay your meat in it, and then put some Capers into your Sauce, and pour over it, so serve it in; Garnish your Dish with Olives, Capers, and Samphire. 231. _To rost a Calves Head with Oisters._ Split your Calves Head as to boil, and let it lie in water a while, then wash it well, and cut out the Tongue, then boil your Head a little, also the Tongue and Brains, then mince the Brains and Tongue with a little Sage, Oisters and Marrow put amongst it when it is minced, three or four Eggs well beaten, Ginger, Pepper, Nutmeg, Grated Bread and Salt, and a little Sack, make it pretty thick, then take the Head and fill it with this, and bind it close, and spit it and rost it, and save the Gravie which comes from it in a Dish, baste it well with Butter, put to this Gravie some Oisters, and some sweet Herbs minced fine, a little white Wine, and a sliced Nutmeg; when the Head is rosted, set the Dish of Sauce upon hot Coals with some Butter and a little salt, and the Juice of an Orange, beat it up thick and Dish your Head, and serve it in with this Sauce; garnish your Dish with stewed Oisters and Barberries. 232. _Sauce for Woodcocks Snites._ When you spit your Fowl, put in an Onion in the Belly, when it is rosted, take the Gravie of it, and some Claret Wine, and an Anchovie with a little Pepper and Salt, so serve them. 233. _To make Sauce for Partridges._ Take grated Bread, Water and Salt, and a whole Onion boiled together, when it is well boiled, take out the Onion, and put in minced Limon, and a piece of Butter, and serve them in with it. 234. _To rost Larks with Bacon._ When your Larks are pull'd and drawn, wash them and spit them with a thin slice of Bacon and a Sage Leaf between the Legs of every one, make your Sauce with the Juice of Oranges and a little Claret Wine, and some Butter, warm them together, and serve them up with it. 235. _To make Sauce for Quails._ Take some Vine Leaves dried before the fire in a dish and mince them, then put some Claret Wine and a little Pepper and Salt to it, and a piece of Butter, and serve them with it. This Sauce is also for rosted Pigeons. 236. _To rost a whole Pig without the Skin, with a Pudding in his Belly._ Make ready the Pig for the Spit, then spit it and lay it down to the fire, and when you can take off the Skin, take it from the fire and flay it, then put such a Pudding as you love into the Belly of it, then sew it up, and stick it with Thyme and Limon Pill, and lay it down again, and rost it and bast it with Butter, and set a Dish under it to catch the Gravie, into which put a little sliced Nutmeg, and a little Vinegar, and a little Limon and some Butter; heat them together: when your Pig is enough, bread it, but first froth it up with Butter and a little Salt, then serve it in with this Sauce to the Table with the Head on. 237. _To fry Artichokes._ Take the bottoms of Artichokes tenderly boiled, and dip them in beaten Eggs and a little Salt, and fry them with a little Mace shred among the Eggs; then take Verjuice, Butter and Sugar, and the Juice of an Orange, Dish your Artichokes, and lay on Marrow fried in Eggs to keep it whole, then lay your Sauce, or rather pour it on, and serve them in. 238. _To make Toasts of Veal._ Take a rosted Kidney of Veal, cold and minced small, put to it grated bread, Nutmeg, Currans, Sugar and Salt, with some Almonds blanched and beaten with Rosewater, mingle all these together with beaten Eggs and a little Cream, then cut thin slices of white Bread, and lay this Compound between two of them, and so fry them, and strew Sugar on them, and serve them in. 239. _To make good Pancakes._ Take twenty Eggs with half the Whites, and beat them well and mix them with fine flower and beaten Spice, a little Salt, Sack, Ale, and a little Yeste, do not make your Batter too thin, then beat it well, and let it stand a little while to rise, then fry them with sweet Lard or with Butter, and serve them in with the Juice of Orange and Sugar. 240. _To fry Veal._ Cut part of a Leg of Veal into thin slices, and hack them with the back of a Knife, then season them with beaten Spice and Salt, and lard them well with Hogs Lard, then chop some sweet herbs, and beat some Eggs and mix together and dip them therein, and fry them in Butter, then stew them with a little white Wine and some Anchovies a little while, then put in some Butter, and shake them well, and serve them in with sliced Limon over them. 241. _To make good Paste._ Take to a peck of fine flower three pound of butter, and three Eggs, and a little cold Cream, and work it well together, but do not break your Butter too small, and it will be very fine Crust, either to bake meat in, or fruit, or what else you please. It is also a very fine Dumplin, if you make it into good big Rolls, and boil them and butter them, or roul some of it out thin, and put a great Apple therein, and boil and butter them, with Rosewater, Butter and Sugar. 242. _To make good Paste to raise._ Take to a Peck of Flower two pounds of Butter and a little tried Suet, let them boil with a little Water or Milk, then put two Eggs into your Flower, and mix them well together, then make a hole in the middle of your Flower, and put in the top of your boiling Liquor, and so much of the rest as will make it in to a stiff Paste, then lay it into a warm Cloth to rise. 243. _Paste for cold Baked meats._ Take to every Peck of Flower one pound of Butter or a little more, with hot Liquor as the other, and put a little dissolved Isinglass in it, because such things require strength; you may not forget Salt in all your Pastes, and work these Pastes made with hot Liquor much more than the other. 244. _To make a Veal Pie in Summer._ Take thin slices of a Fillet of Veal, then having your Pie ready and Butter in it, lay in your Veal seasoned with a little Nutmeg and Salt so cover it with Butter, and close it and bake it, then against it be drawn, scald some Goosberries or Grapes in Sugar and water as to preserve, and when you open your Pie, put in pieces of Marrow boiled in white Wine with a little blade of Mace: Then put these Grapes or Goosberries over all, or else some hard Lettuce or Spinage boiled and buttered. 245. _To make a Pie of Shrimps, or of Prawns._ Pick them clean from their Shells, and have in readiness your Pie with Butter in the bottom, then lay in your Fish with some large Mace and Nutmeg, and then Butter again, and so bake it: Then cut it up and put in some White Wine and an Anchovy or two, and some Butter, and so serve them in hot; thus you may do with Lobsters or Crabs, or with Crafish. 246. _To make a Pie of Larks, or of Sparrows._ Pluck your Birds and draw them, then fill the Bellies of them with this mixture following, grated bread, sweet herbs minced small, Beef Suet or Marrow minced, Almonds blanched and beated with Rosewater, a little Cream; beaten Spice, and a little Salt, some Eggs and some Currans, mix these together, and do as I have said, then having your Pie ready raised or laid in your baking-pan, put in Butter, and then fill it with Birds. Then put in Nutmeg, Pepper and Salt, and put in the yolks of hard Eggs, and some sweet herbs minced, then lay in pieces of Marrow, and cover it with Butter, and so close it and bake it; then cut it open and wring in the Juice of an Orange and some Butter, and serve it. 247. _To make a Lettuce Pie._ Take your Cabbage Lettuce and cut them in halves, wash them and boil them in water and salt very green, then drain them from the water, so having your Pie in readiness, put in Butter; then put in your boiled Lettuce, with some Marrow, Raisins of the Sun stoned, Dates stoned and sliced thin, with some large Mace, and Nutmeg sliced, then put in more Butter, close it and bake it; then cut it open, and put in Verjuice, Butter and Sugar, and so serve it. [Transcriber's note: no number in original] _To stew a Neck of Mutton._ Put your Neck of Mutton cut in Steaks into so much Wine and Water as will cover it, with some whole Spice, let it stew till it be enough, then put in two Anchovies, and a handful of Capers, with a piece of sweet Butter shake it very well, and serve it upon Sippets. 248. _To make a Pie of a rosted Kidney of Veal._ Mince the Kidney with the Fat, and put to it some sweet herbs minced very small, a quarter of a pound of Dates stoned, and sliced thin and minced, season it with beaten Spice, Sugar and Salt, put in half a pound of Currans, and some grated bread, mingle all these together very well with Verjuice and Eggs, and make them into Balls, so put some Butter into your Pie, and then these Balls, then more Butter, so close it and bake it; Then cut it open, and put in Verjuice, Butter and Sugar made green with the Juice of some Spinage, add to it the yolks of Eggs. 249. _To make a Potato Pie._ Having your Pie ready, lay in Butter, and then your Potatoes boiled very tender, then some whole Spice and Marrow, Dates and the yolks of hard Eggs blanched Almonds, and Pistacho Nuts, the Candied Pills of Citron, Orange and Limon, put in more Butter close it and bake it, then cut it open, and put in Wine, Sugar, the yolks of Eggs and Butter. 250. _To make a Pig Pie._ Spit a whole Pigg and rost it till it will flay, then take it off the Spit, and take off the Skin, and lard it with Hogs Lard; season it with Pepper, Salt, Nutmeg and Sage, then lay it into your Pie upon some Butter, then lay on some large Mace, and some more Butter, and close it and bake it: It is either good hot or cold. 251. _To make a Carp Pie._ Take a large Carp and scale him, gut and wash him clean, and dry him well, then lay Butter into your Pie, and fill your Carps belly with this Pudding; grated bread, sweet herbs, and a little Bacon minced small, the yolks of hard Eggs and an Anchovie minced, also a little Marrow, Nutmeg, and then put in a little Salt, but a very little, and make some of this up in Balls, then Lard the Carp, sew up his Belly, and lay him into your Pie, then lay in the Balls of Pudding, with some Oysters, Shrimps and Capers, and the yolks of hard Eggs and a little Slices of Bacon, then put in large Mace and Butter, so close it and bake it, then cut off the Lid, and stick it full of pretty Conceits made in Paste, and serve it in hot. 252. _To make an Almond Tart._ Take a Quart of Cream, and when it boils, put in half a pound of sweet Almonds blanched and beaten with Rosewater, boil them together till it be thick, always stirring it for fear it burn, then when it is cold, put in a little raw Cream, the yolks of twelve Eggs, and some beaten Spice, some Candied Citron Pill and Eringo Roots sliced, with as much fine Sugar as will sweeten it, then fill your Tart and bake it, and stick it with Almonds blanched, and some Citron Pill, and strew on some small French Comfits of several colours, and garnish your Dish with Almonds blanched, and preserved Barberries. 253. _To make a dainty White-Pot._ Take a Manchet cut like Lozenges, and scald it in some Cream, then put to it beaten Spice, Eggs, Sugar and a little Salt, then put in Raisins, and Dates stoned, and some Marrow; do not bake it too much for fear it Whey, then strew on some fine Sugar and serve it in. 254. _To make a Red Deer Pie._ Bone your Venison, and if it be a Side, then skin it, and beat it with an Iron Pestle but not too small, then lay it in Claret wine, and Vinegar, in some close thing two days and nights if it be Winter, else half so long, then drain it and dry it very well, and if lean, lard it with fat Bacon as big as your finger, season it very high with all manner of Spices and Salt, make your Pie with Rye Flower, round and very high, then lay store of Butter in the bottom and Bay Leaves, then lay in your Venison with more Bay leaves and Butter; so close it, and make a Tunnel in the middle, and bake it as long as you do great Loaves, when it is baked, fill it up with melted Butter, and so keep it two or three months, serve it in with the Lid off, and Bay Leaves about the Dish; eat it with mustard and sugar. 255. _To make a Pie of a Leg of Pork._ Take a Leg of Pork well powdred and stuffed with all manner of good Herbs, and Pepper, and boil it very tender, then take off the Skin, and stick it with Cloves and Sage Leaves, then put it into your Pie with Butter top and bottom, close it and bake it, and eat it cold with Mustard and Sugar. 256. _To make a Lamprey Pie._ Take your Lamprey and gut him, and take away the black string in the back, wash him very well, and dry him, and season him with Nutmeg, Pepper and Salt, then lay him into your Pie in pieces with Butter in the bottom, and some Shelots and Bay Leaves and more Butter, so close it and bake it, and fill it up with melted Butter, and keep it cold, and serve it in with some Mustard and Sugar. 257. _To make a Salmon Pie._ Take a Joll of Salmon raw, and scale it and lay it into your Pie upon Butter and Bay leaves, then season it with whole spice and a little Salt, then lay on some Shrimps and Oysters with some Anchovies, then more Spice and Butter, so close the lid and bake it, but first put in some White Wine, serve it hot, then if it wants, put in more Wine and Butter. 258. _To make a Pudding of French Barley._ Take French Barley tenderly boiled, then take to one Pint of Barley half a Manchet grated, and four Ounces of sweet Almonds blanched and beeten with Rosewater, half a Pint of Cream, and eight Eggs with half the Whites, season it with Nutmeg, Mace, Sugar and Salt, then put in some Fruit, both Raisins and Currans, and some Marrow, mingle these well together, and fill Hogs Guts with it. 259. _To make a hasty Pudding in a Bag or Cloth._ Boil a Quart of thick Cream with six spoonfuls of fine Flower, then season it with Nutmeg and Salt, then wet a Cloth, and flower it and butter it, then boil it, and butter it, and serve it in. 260. _To make a Shaking Pudding._ Take a Quart of Cream and boil it, then put in some Almonds blanched and beaten, when it is boiled and almost cold, put in eight Eggs, and half the Whites, with a little grated Bread, Spice and Sugar, and a very little Salt; Then wet Flower and Butter, and put it in a Cloth and boil it, but not too much, serve it in with Rosewater, Butter and Sugar, and strew it with small French Comfits. 261. _To make a Haggus Pudding._ Take a Calves Chaldron well scowred, boiled, and the Kernels taken out, mince it small, then take four or five Eggs, and half the Whites, some thick Cream, grated bread, Rosewater and Sugar, and a little Salt, Currans and Spice, and some sweet herbs chopped small, then put in some Marrow or Suet finely shred, so fill the Guts, and boil them. 262. _To make an Oatmeal Pudding._ Take the biggest Oatmeal and steep it in warm Cream one night, then put in some sweet herbs minced small, the yolks of Eggs, Sugar, Spice, Rosewater and a little Salt, with some Marrow, then Butter a Cloth, and boil it well, and serve it in with Rosewater, Butter and Sugar. 263. _To make Puddings of Wine._ Slice two Manchets into a Pint of White Wine, and let your Wine be first mulled with Spice, and with Limon Pill, then put to it ten Eggs well beaten with Rosewater, some Sugar and a little Salt, with some Marrow and Dates, so bake it a very little, strew Sugar on it, and serve it; instead of Manchet you may use Naples Bisket, which is better. 264. _To make Puddings with Hogs Lights._ Parboil them very well, and mince them small with Suet of a Hog, then mix it with bread grated, and some Cream and Eggs, Nutmeg, Rosewater, Sugar and a little Salt, with some Currans, mingle them well together, and fill the Guts and boil them. 265. _To make Stone Cream._ Boil a quart of Cream with whole spice then pour it out into a Dish, but let it be one quarter consumed in the boiling, then stir it till it be almost cold, then put some Runnet into it as for a Cheese, and stir it well together, and colour it with a little Saffron, serve it in with Sack and Sugar. 266. _To make a Posset Pie with Apples._ Take the Pulp of rosted Apples and beat it well with Sugar and Rosewater to make it very sweet, then mix it with sweet Cream, and the yolks of raw Eggs, some Spice and Sack, then having your Paste ready in your Bake-pan, put in this stuff and bake it a little, then stick it with Candied Pills, and so serve it in cold. 267. _To dry Pippins about_ Christmas _or before._ When your Houshold Bread is drawn, then set in a Dish full of Pippins, and about six hours after take them out and lay them in several Dishes one by one, and flat them with your hands a little, so do twice a day, and still set them into a warm Oven every time till they are dry enough; then lay them into Boxes with Papers between every Lay. 268. _To make Snow Cream._ Take a Quart of Cream, and 4 Ounces of blanched Almonds, beaten and strained, with half a Pint of White Wine, a piece of Orange Pill and a Nutmeg sliced, and three Sprigs of Rosemary, mix these things together, and let them stand three hours, then strain it, and put the thick part into a deep Dish, and sweeten it with Sugar, then beat some Cream with the Whites of Eggs till it be a thick Froth, and cast the Froth over it to a good thickness. 269. _To boil Whitings or Flounders._ Boil some White Wine, Water, and Salt, with some sweet Herbs and whole Spice; when it boils put in a little Vinegar, for that will make Fish crisp, then let it boil apace and put in your Fish, and boil them till they swim, then take them out and drain them, and make Sauce for them with some of the Liquor and an Anchovie or two, some Butter and some Capers, heat them over the Fire, and beat it up thick and pour it over them; garnish your Dish with Capers and Parsley, Oranges and Limons and let it be very hot when you serve it in. 270. _To make a Pie of a Gammon of Bacon._ Take a _Westphalia_ Gammon, and boil it tender with hay in the Kettle, then take off the Skin and stick it with Cloves and strew it with Pepper, then make your Pie ready, and put it therein with Butter at the bottom, then cover your Bacon with Oysters, parboiled in Wine and their own Liquor, and put in Balls made of Sausage meat, then put in the Liquor of the parboiled Oysters, some whole Spice and Bay Leaves, with some Butter, so close it, and bake it and eat it cold, you may put into it the yolks of hard Eggs if you please, serve it with Mustard Sugar and Bay Leaves. 271. _To bake a Bulloks Cheek to be eaten hot._ Take your Cheek and stuff it very well with Parsley and sweet herbs chopped, then put it into a Pot with some Claret wine and a little strong Beer, and some whole Spice, and so season it well with Salt to your taste, and cover your Pot and bake it, then take it out, and pull out the Bones, and serve it upon tosted bread with some of the Liquor. 272. _To bake a Bullocks Cheek to eat cold, as Venison._ Take a Bullocks Cheek, or rather two fair fat Cheeks, and lay them in water one night, then take out every bone, and stuff it very well with all manner of Spice and Salt, then put it into a Pot, one Cheek clapped close together upon the other, then lay it over with Bay Leaves, and put in a Quart of Claret Wine, so cover the Pot and bake it with Houshold Bread, when you draw it, pour all the Liquor out, and take only the fat of it and some melted Butter, and pour in again, serve it cold with Mustard and Sugar, and dress it with Bay Leaves, it will eat like Venison. 273. _To make a Bacon Froize._ Take eight Eggs well beaten, and a little Cream, and a little Flower, and beat them well together to be like other Batter, then fry very thin slices of Bacon, and pour some of this over, then fry it, and turn the other side, and pour more upon that, so fry it and serve it to the Table. 274. _To make fryed Nuts._ Take Eggs, Flower, Spice and Cream, and make it into a Paste, then make it into round Balls and fry them, they must be as big as Walnuts, be sure to shake them well in the Pan and fry them brown, then roul some out thin, and cut them into several shapes, and fry them, so mix them together, and serve them in with Spice beaten and Sugar. 275. _To make a_ Sussex _Pancake._ Take only some very good Pie Paste made with hot Liquor, and roul it thin, and fry it with Butter, and serve it in with beaten spice and sugar as hot as you can. 276. _To make a Venison Pasty._ Take a Peck of fine Flower, and three Pounds of fresh Butter, break your Butter into your Flower, and put in one Egg, and make it into a Past with so much cold cream as you think fit, but do not mould it too much, then roul it pretty thin and broad, almost square, then lay some Butter on the bottom, then season your Venison on the fleshy side with Pepper grosly beaten, and Salt mixed, then lay your Venison upon your butter with the seasoned side downward, and then cut the Venison over with your Knife quite cross the Pasty to let the Gravie come out the better in baking, then rub some seasoning in those Cuts, and do not lay any else because it will make it look ill-favoured and black, then put some paste rouled thin about the Meat to keep it in compass, and lay Butter on the top, then close it up and bake it very well, but you must trim it up with several Fancies made in the same Paste, and make also a Tunnel or Vent, and just when you are going to set it into the Oven, put in half a Pint of Clarret Wine, that will season your Venison finely, and make it shall not look or taste greasie, thus you may bake Mutton if you please. 277. _To make a brave Tart of several Sweet Meats._ Take some Puff-paste, and roule it very thin, and lay it in the bottom of your baking-pan, then lay in a Lay of preserved Rasberries, then some more Paste very thin to cover them, then some Currans preserved, and then a Sheet of Paste to cover them, then Cherries, and another Sheet to cover them, then any white Sweet-Meat, as Pippins, white Plumbs or Grapes, so lid it with Puff-paste, cut in some pretty Fancy to shew the Fruit, then bake it, and stick it full of Candied Pills, and serve it in cold. 278. _To make Ice and Snow._ Take new Milk and some Cream and mix it together, and put it into a Dish, and set it together with Runnet as for a Cheese, and stir it together, when it is come, pour over it some Sack and Sugar, then take a Pint of Cream and a little Rosewater, and the Whites of three Eggs, and whip it to a froth with a Birchen Rod, then as the Froth arises, cast it upon your Cream which hath the Runnet in it, till it lies deep, then lay on Bunches of preserved Barberries here and there carelesly, and cast more Snow upon them, which will look exceeding well; then garnish your Dish being broad brim'd with all kind of Jellies in pretty-fancies, and several Colours. 279. _To make a Mutton Pie._ Cut a Loin or Neck of Mutton in steaks, and season it with Pepper and Salt, and Nutmeg, then lay it in your Pie upon Butter; then fill up your Pie with Apples sliced thin, and a few great Onions sliced thin, then put in more Butter, and close it and bake it, and serve it in hot. 280. _To poach Eggs the best way._ Boil Vinegar and Water together with a few Cloves and Mace, when it boiles break in your Eggs, and turn them about gently with a Tin slice till the White be hard, then take them up, and pare away what is not handsom, and lay them on Sippets, and strew them over with plumped Currans, then take Verjuice, Butter and Sugar heat together, and pour over, and serve them in hot. 281. _A good Sallad in Winter._ Take a good hard Cabbage, and with a sharp Knife shave it so thin as you may not discern what it is, then serve it with Oil and Vinegar. 282. _Another Sallad in Winter._ Take Corn Sallad clean picked and also well washed, and clear from the water, put it into a Dish in some handsom form with some Horse Radish scraped, and some Oil and Vinegar. 283. _To make Sorrel Sopps for Green Geese or Chickens, or for a Sick Body to eat alone._ Take a good quantity of French Sorrel clean picked, and stamp it in a Mortar, then strain it into a Dish, and set it over a Chafing dish of Coals, and put a little Vinegar to it, then when it is thick by wasting, wring in the Juice of a Limon and sweeten it with Sugar, and put in a little grated bread and Nutmeg, then warm another Dish with thin slices of white bread, and put some butter to your Sorrel Liquor, and pour over them, serve them in with Slices of Limon and fine Sugar. 284. _To make Green Sauce for a powdred Leg of Pork, or for a Spring._ Take a great quantity of French Sorrel, and pick out the Strings and wash it well, and drain it clean from the water, then stamp it in a Mortar till it be extream fine, then put in grated bread and beat it again, then a few Currans and the yolks of hard Eggs, and when it is beaten to a kind of Pap, put in a little Vinegar and Sugar into it; so serve it in upon a Plate with your Meat. 285. _To make_ Vin de Molosso, _or Treacle Wine._ Take fair Water and make it so strong with Molossoes, otherwise called Treacle, as that it will bear an Egg, then boil it with a Bag of all kinds of Spices, and a Branch or two of Rosemary, boil it and scum it, and put in some sweet herbs or flowers, according to the time of the year, boil it till a good part be consumed, and that it be very clear, then set it to cool in several things, and when it is almost cold, work it with yest, as you do Beer, the next day put it into the Vessel, and so soon as it hath done working stop it up close, and when it hath stood a fortnight, bottle it, this is a very wholesom Drink against any Infection, or for any that are troubled with the Ptisick. 286. _For a Consumption, an excellent Medicine._ Take Shell Snails, and cast Salt upon them, and when you think they are cleansed well from their slime, wash them, and crack their Shells and take them off, then wash them in the distilled Water of Hysop, then put them into a Bag made of Canvas, with some white Sugar Candy beaten, and hang up the Bag, and let it drop as long as it will, which if you bruise the Snails before you hang them up, it is the better; this Liquor taken morning and evening a Spoonful at a time is very rare. 287. _A Suitable Dish for Lent._ Take a large Dish with broad Brims, and in the middle put blanched Almonds round about them, Raisins of the Sun, and round them Figs, and beyond them all coloured Jellies, and on the Brims Fig-Cheese. 288. _To make a Rock in Sweet-Meats._ First take a flat broad voiding Basket, then have in readiness a good thick Plum Cake, then cut your Cake fit to the bottom of the Basket, and cut a hole in the middle of it, that the foot of your Glass may go in, which must be a Fountain-Glass, let it be as high a one as you can get; put the foot of it in the hole of the Cake edgling that it may stand the faster, then tie the Cake fast with a Tape to the Basket, first cross one way and then another, then tie the foot of the Glass in that manner too, that it may stand steady, then cut some odd holes in your Cake carelesly, then take some Gum Dragon steeped in Rosewater, and mix it with some fine Sugar, not too thick, and with that you must fasten all your Rock together, in these holes which you cut in your Cake you must fasten some sort of Biskets, as Naples Biskets, and other common Bisket made long, and some ragged, and some coloured, that they may look like great ill-favoured, Stones, and some handsome, some long, some short, some bigger, and some lesser, as you know Nature doth afford, and some of one colour and some of another, let some stand upright and some aslannt, and some quite along, and fasten them all with your Gum, then put in some better Sweet-meats, as Mackeroons and Marchpanes, carelesly made as to the shape, and not put on the Rock in a set form, also some rough Almond Cakes made with the long slices of Almonds (as I have directed before;) so build it up in this manner, and fasten it with the Gum and Sugar, till it be very high, then in some places you must put whole Quinces Candied, both red and white, whole Orange Pills and Limon Pills Candied; dried Apricocks, Pears and Pippins Candied, whole Peaches Candied, then set up here and there great lumps of brown and white Sugar-candy upon the stick, which much resembles some clusters of fine Stones growing on a Rock; for Sand which lies sometimes among the little Stones, strew some brown Sugar; for Moss, take herbs of a Rock Candy; then you must make the likeness of Snakes and Snails and Worms, and of any venomous Creature you can think of; make them in Sugar Plate and colour them to their likeness, and put them in the holes that they may seem to lurk, and some Snails creeping one way and some other; then take all manner of Comfits, both rough and smooth, both great and small, and colour many of them, some of one colour and some of another, let some be white and some speckled, then when you have coloured them, and that they are dry, mix them together and throw them into the Clefts, but not too many in one place, for that will hide the shape of your work, then throw in some Chips of all sorts of Fruit Candied, as Orange, Limon, Citron, Quince, Pear, and Apples, for of all these you may make Chips; then all manner of dryed Plumbs, and Cherries, Cornelions dryed, Rasps and Currans; and in some places throw a few Prunelles, Pistacho Nuts, blanched Almonds, Pine Kernels, or any such like, and a pound of the great round perfumed Comfits; then take the lid off the top of the Glass and fill it with preserved Grapes, and fill another with some Harts-horn Jelly, place these two far from one another, and if you set some kind of Fowl, made in Marchpanes, as a Peacock, or such like, and some right Feathers gummed on with Gum Arabick, let this Fowl stand as though it did go to drink at the Glass of Harts-horn Jelly, and then they will know who see it, that those two liquid Glasses serve for resemblance of several Waters in the Rock. Then make good store of Oyster shells and Cockle shells of Sugar Plate, let some be pure white as though the Sea water had washed them, some brown on the outside, and some green, some as it were dirty, and others worn away in some Places, some of them broke, and some whole, so set them here and there about the Rock, some edgling, and some flat, some the hollow side upward, and some the other, then stick the Moss, some upon the shells, and some upon the stones, and also little branches of Candied Fruits, as Barberries, Plums, and the like, then when all is done, sprinkle it over with Rosewater, with a Grain or two of Musk or Ambergreece in it; your Glass must be made with a reasonable proportion of bigness to hold the Wine, and from that, in the middle of it, there must be a Conveyance to fall into a Glass below it, which must have Spouts for the Wine to play upward or downward, then from thence in another Glass below, with Spouts also, and from thence it hath a Conveyance into a Glass below that, somewhat in form like a Sillibub Pot, where the Wine may be drunk out at the Spout; you may put some Eringo Roots, and being coloured, they will shew very well among the other Sweet-Meats, tie your Basket about with several sorts of small Ribbons: Do not take this for a simple Fancy, for I assure you, it is the very same that I taught to a young Gentlewoman to give for a Present to a Person of Quality. TO THE READER. _Courteous Reader, I Think it not amiss, since I have given you, as I think, a very full Direction for all kinds of Food both for Nourishment and Pleasure, that I do shew also how to eat them in good order; for there is a Time and Season for all things: Besides, there is not anything well done which hath not a Rule, I shall therefore give you several Bills of Service for Meals according to the Season of the Year, so that you may with ease form up a Dinner in your Mind quickly; afterwards I shall speak of ordering of Banquets; but these things first, because Banquets are most proper after Meals. All you who are knowing already and Vers'd in such things, I beseech you to take it only as a_ Memorandum; _and to those who are yet unlearned, I presume they will reap some Benefit by these Directions; which is truly wished and desired by_ Hanna Woolley _alias_ Chaloner. * * * * * _A Bill of Service for extraordinary Feasts in the Summer._ 1. A Grand Sallad. 2. A boiled Capon or Chickens. 3. A boiled Pike or Bream. 4. A Florentine in Puff Paste. 5. A Haunch of Venison rosted. 6. A Lomber Pie. 7. A Dish of Green Geese. 8. A Fat Pig with a Pudding in the belly. 9. A Venison Pasty. 10. A Chicken Pie. 11. A Dish of young Turkeys. 12. A Potato Pie. 13. A couple of Caponets. 14. A Set Custard. _The Second Course_ 1. A Dish of Chickens rosted. 2. Souced Conger or Trouts. 3. An Artichoke Pie. 4. A Cold Baked Meat. 5. A Souced Pig. 6. A Dish of Partridges. 7. An Oringado Pie. 8. A Dish of Quails. 9. Another cold Baked Meat. 10. Fresh Salmon. 11. A Dish of Tarts. 12. A Joll of Sturgeon. _The Third Course._ 1. Dish of fried Perches. 2. A Dish of Green Pease. 3. A Dish of Artichokes. 4. A Dish of Lobsters. 5. A Dish of Prawns or Shrimps. 6. A Dish of Anchovies. 7. A Dish of pickled Oysters. 8. Two or three dried Tongues. * * * * * _Another Bill of Fare for Winter Season._ 1. A Collar of Brawn. 2. A Capon and White Broth. 3. A boiled Gurnet. 4. A Dish of boiled Ducks or Rabbits. 5. A rosted Tongue and Udder. 6. A made Dish in Puff-Paste. 7. A Shoulder of Mutton with Oysters. 8. A Chine of Beef. 9. A Dish of Scotch Collops of Veal. 10. Two Geese in a Dish. 11. An Olive Pie. 12. A Pig. 13. A Loin of Veal. 14. A Lark Pie. 15. A Venison Pasty. 16. A Dish of Capons, two in a Dish or three. 17. A Dish of Set Custards. _The Second Course._ 1. Young Lamb cut in Joints, three Joints in a Dish Larded. 2. A couple of Fat Rabbets. 3. A Kickshaw fried or baked. 4. A Dish of rofted Mallards. 5. A Leash of Partridges. 6. A Pigeon Pie. 7. Four Woodcocks in a Dish. 8. A Dish of Teal, four or six. 9. A cold baked Meat. 10. A good Dish of Plover. 11. Twelve Snites in a Dish. 12. Two Dozen of Larks in a Dish. 13. Another cold baked Meat. _The Third Course._ 1. An Oister Pie hot. 2. A Dish of fried Puffs. 3. Three or four dried Neats Tongues. 4. A Joll of Sturgeon. 5. Laid Tarts in Puff-paste. 6. Pickled Oisters. 7. A Dish of Anchovies and Caveare. 8. A Warden Pie or Quince Pie. _Note_, That when your last Course is ended, you must serve in your Meat-Jellies, your Cheeses of several sorts, and your Sweet-meats. * * * * * _A Bill of Fare for lesser Feasts._ 1. An Almond Pudding boiled or baked. 2. A Dish of boiled Pigeons with Bacon. 3. A Leg of Mutton, boiled with good Sauce, or a leg of Pork. 4. A Dish of rosted Olives of Veal. 5. A Dish of Collops and Eggs. 6.A piece of rosted Beef. 7. A Dish of Scotch Collops. 8. A Loin of Veal. 9. A fat Pig rosted. 10. Two Turkies in a Dish. 11. A Venison Pasty. 12. A Dish of Pheasants or Partridges. 13. A Dish of Custards in little China Pots. _The Second Course._ 1. Three or four Joints of Lamb rosted asunder, though never so small. 2. A Couple of Rabbits. 3. A Dish of Mallard, Teal or Widgeon. 4. A Leash of Partridges or Woodcocks. 5. A Pigeon Pie. 6. A Dish of Plovers or Snites. 7. A Dish of fat Chickens rosted. 8. A Warden or Quince Pie. 9. A Sowced Pig. 10. A Dish of Tarts of several sorts. 11. A Dish of Lobsters, or Sturgeon. 12. A Dish of pickled Oysters. * * * * * _A Bill of Fare for Fish Days and Fasting Days in Ember week, or in Lent._ 1. A Dish of Butter newly Churned. 2. A Dish of Rice Milk or Furmity. 3. A Dish of Buttered Eggs. 4. A Dish of stewed Oysters. 5. A Dish of Gurnets boiled. 6. A boiled Sallad. 7. A boiled Pike or two Carps stewed. 8. A Dish of Buttered Loaves. 9. A Pasty of Ling. 10. A Dish of Buttered Salt Fish. 11. A Dish of Smelts. 12. A Dish of White Herrings broiled. 13. A Potato Pie or Skirret Pie. 14. A Dish of Flounders fryed. 15. An Eel Pie or Carp Pie. 16. A Dish of fryed Whitings. 17. A Dish of Salt Salmon. 18. A Dish of Custards. 19. A Joll of Sturgeon. 20. A Dish of Pancakes or Fritters. _The Second Course._ 1. A Dish of Eels spichcockt. 2. A Fricasie of Eels. 3. A Dish of fryed Puffs. 4. A Dish of Potatoes stewed. 5. A Dish of fryed Oysters. 6. A Dish of blanched Manchet. 7. An Oyster Pie with Parsneps. 8. A Pippin Pie Buttered. 9. A Dish of Buttered Shrimps. 10. Two Lobsters rosted. 11. A Dish of Tarts of Herbs. 12. A Dish of souced Fish. 13. A Dish of pickled Oysters. 14. A Dish of Anchovies and Caveare. * * * * * _A Bill of Fare without feasting; only such a number of Dishes as are used in Great and Noble Houses for their own Family, and for familiar Friends with them._ _The First Course in Summer Season._ 1. A Fine Pudding boiled or baked. 2. A Dish of boiled Chickens. 3. Two Carps stewed or a boiled Pike. 4. A Florentine in Puff-Paste. 5. A Calves head, the one half hashed, and the other broiled. 6. A Haunch of Venison rosted. 7. A Venison Pasty. 8. A Couple of fat Capons, or a Pig, or both. _The Second Course._ 1. A Dish of Partridges. 2. An Artichoke Pie. 3. A Dish of Quails. 4. A cold Pigeon Pie. 5. A Souced Pig. 6. A Joll of fresh Salmon. 7. A Dish of Tarts of several sorts. 8. A Westphalia Gammon and dried Tongues about it. * * * * * _A Bill of Fare in Winter in Great Houses._ 1. A Collar of Brawn. 2. A Capon and White Broth, or two boiled Rabbits. 3. Two rosted Neats Tongues and an Udder between them. 4. A Chine of Beef rosted. 5. A made Dish in Puffpaste. 6. A Shoulder of Mutton stuffed with Oysters. 7. A fine Sallad of divers sorts of Herbs and Pickles. 8. An Eel Pie or some other Pie. 9. Three young Turkies in a Dish. 10. A Dish of souced Fish, what is most in season. _The Second Course in Winter in great Houses._ 1. A Quarter of Lamb rosted, the Joints Larded with several things, and rosted asunder. 2. A Couple of Rabbits. 3. A Kickshaw fried. 4. A Dish of Mallard or Teals. 5. A Cold Venison Pasty, or other cold Baked meat. 6. A Dish of Snites. 7. A Quince or Warden Pie. 8. A Dish of Tarts. 9. A Joll of Sturgeon. 10. A Dish of pickled Oysters. * * * * * _A Bill of Fare for Fish Days in Great Houses and at familiar Times._ 1. A Dish of Milk, as Furmity, or the like. 2. A Dish of stewed Oysters or buttered Eggs. 3. A boiled Gurnet, or such like. 4. A Dish of Barrel Cod buttered. 5. A Dish of Buttered Loaves or fryed Toasts. 6. A Pasty made of a Joll of Ling. 7. A Potato Pie, or Skirret Pie. 8. A Dish of Plaice or Flounders. 9. A Piece of salt Salmon. 10. A Carp Pie cold, or Lamprey Pie. _The Second Course to the Same._ 1. A Dish of Eels spitchcockt. 2. A Chine of Salmon broiled. 3. A Dish of Oysters fryed. 4. An Apple pie buttered. 5. A Dish of fryed Smelts. 6. A Dish of buttered Shrimps. 7. A Dish of Skirrets fryed. 8. Two lobsters in a Dish. 9. A Dish of pickled Oysters. 10. A Dish of Anchovies. When all these are taken away, then serve in your Cheeses of all sorts, and also your Creams and Jellies, and Sweet-meats after them, if they be required. Thus I have done with the Bills of Fare in Great Houses, although it be impossible to name half which are in season for one Meal; but this will serve you for the number of Dishes, and any Person who is ingenious, may leave out some, and put in other at pleasure. * * * * * _A Bill of Fare for Gentlemens Houses of Lesser Quality, by which you may also know how to order any Family beneath another, which is very requisite._ _The First Course in Summer season._ 1. A Boiled Pike or Carp stewed. 2. A very fine Pudding boiled. 3. A Chine of Veal, and another of Mutton. 4. A Calves head Pie. 5. A Leg of Mutton rosted whole. 6. A couple of Capons, or a Pig, or a piece of rost Beef, or boiled Beef. 7. A Sallad, the best in season. _The Second Course to the same._ 1. A Dish of fat Chickens rosted. 2. A cold Venison Pasty. 3. A Dish of fryed Pasties. 4. A Joll of fresh Salmon. 5. A couple of Lobsters. 6. A Dish of Tarts. 7. A Gammon of Bacon or dried Tongues. After these are taken away, then serve in your Cheese and Fruit. _Note_, That this Bill of Fare is for Familiar times. * * * * * _A Bill of Fare for Gentlemens Houses at Familiar Times Winter Season._ _The First Course._ 1. A Collar of Brawn. 2. A rosted Tongue and Udder. 3. A Leg of Pork boiled. 4. A piece of rost Beef. 5. A Venison Pasty or other Pie. 6. A Marrow Pudding. 7. A Goose, or Turkie, or Pig. 8. A Sallad of What's in season. _The Second Course to the same._ 1. Two Joints of Lamb rosted. 2. A Couple of Rabbits. 3. A Dish of wild Fowl or Larks. 4. A Goose or Turkie Pie cold. 5. A fryed Dish. 6. Sliced Venison cold. 7. A Dish of Tarts or Custards. 8. A Gammon of Bacon, or dried Tongues, or both in one Dish. When these are taken away, serve in your Cheese and Fruit as before I have told you. * * * * * _A Bill of Fare for Gentlemens Houses upon Fish Days, and at Familiar Times._ 1. A Dish of Buttered Eggs. 2. An Almond Pudding Buttered. 3. A Dish of Barrel Cod Buttered. 4. A Sallad of what's in season. 5. A Dish of Fresh Fish boiled. 6. A Dish of Eels Spitchcockt. 7. An Oyster Pie or Herring Pie. 8. A Fricasie of Eels and Oysters. 9. A Carp Pie cold, or Lamprey Pie. _. The Second Course to the same._ 1. An Apple Pie buttered, or some Pancakes or Fritters. 2. A Dish of fryed Smelts. 3. A Dish of broiled Fish. 4. A Dish of buttered Crabs. 5. A Dish of Lobsters and Prawns. 6. A Joll of Sturgeon or Fresh Salmon. 7. A Dish of Tarts or Custards. 8. A Dish of Anchovies or Pickled Herring. When these are taken away, serve in your Cheese and Fruit as before I have told you. * * * * * Now because I would have every one Compleat who have a Desire to serve in Noble or Great Houses, I shall here shew them what their Office requires; And, First, _For the Kitchin, because without that we shall look lean, and grow faint quickly._ The Cook, whether Man or Woman, ought to be very well skilled in all manner of things both Fish and Flesh, also good at Pastry business, seasoning of all things, and knowing all kinds of Sauces, and pickling all manner of Pickles, in making all manner of Meat Jellies; also very frugal of their Lords or of their Masters, Ladies or Mistresses Purse, very saving, cleanly and careful, obliging to all persons, kind to those under them, and willing to inform them, quiet in their Office, not swearing nor cursing, nor wrangling, but silently and ingeniously to do their Business, and neat and quick about it; they ought also to have a very good Fancy: such an one, whether Man or Woman, deserves the title of a fit Cook. * * * * * _For a Maid under such a Cook._ She ought to be of a quick and nimble Apprehension, neat and cleanly in her own habit, and then we need not doubt of it in her Office; not to dress her self, specially her head, in the Kitchin, for that is abominable sluttish, but in her Chamber before she comes down, and that to be at a fit hour, that the fire may be made, and all things prepared for the Cook, against he or she comes in; she must not have a sharp Tongue, but humble, pleasing, and willing to learn; for ill words may provoke Blows from a Cook, their heads being always filled with the contrivance of their business, which may cause them to be peevish and froward, if provoked to it; this Maid ought also to have a good Memory, and not to forget from one day to another what should be done, nor to leave any manner of thing foul at night, neither in the Kitchin, nor Larders, to keep her Iron things and others clean scowred, and the Floors clean as well as places above them, not to sit up junketing and gigling with Fellows, when she should be in bed, such an one is a Consumer of her Masters Goods, and no better than a Thief; and besides, such Behaviour favoureth much of Levity. But such an one that will take the Counsel I have seriously given, will not only make her Superiours happy in a good Servant, but she will make her self happy also; for by her Industry she may come one day to be Mistress over others. * * * * * _Now to the Butler._ He ought to be Gentile and Neat in his Habit, and in his Behaviour, courteous to all people, yet very saving of his Masters Goods, and to order himself in his Office as a faithful Steward, charge and do all things for the honour of his Master or Lady, not suffering their Wine or Strong Drink to be devoured by ill Companions, nor the small to be drawn out in waste, nor Pieces of good Bread to lie to mould and spoil, he must keep his Vessels close stopped, and his Bottles sweet, his Cellars clean washed, and his Buttery clean, and his Bread-Bins wholsom and sweet, his Knives whetted, his Glasses clean washed that there be no dimness upon them, when they come to be used, all his Plate clean and bright, his Table, Basket and Linnen very neat, he must be sure to have all things of Sauce ready which is for him to bring forth, that it may not be to be fetched when it is called for, as Oil, Vinegar, Sugar, Salt, Mustard, Oranges and Limons, and also some Pepper; he must also be very neat and handy in laying the Clothes for the Chief Table, and also the Side-boards, in laying his Napkins in several Fashions, and pleiting them, to set his Glasses, Plate, and Trencher-Plates in order upon the Side-boards, his Water-Glasses, Oranges or Limons; that he be careful to set the Salts on the Table, and to lay a Knife, Spoon and Fork at every Plate, that his Bread be chipped before he brings it in; that he set drink to warm in due time if the season require; that he observe a fit time to set Chairs or Stools, that he have his Cistern ready to set his Drink in; that none be spilt about the Room, to wash the Glasses when any one hath drunk, and to wait diligently on them at the Table, not filling the Glasses too full; such an one may call himself a Butler. * * * * * _To the Carver._ If any Gentleman who attends the Table, be employed or commanded to cut up any Fowl or Pig, or any thing else whatsoever, it is requisite that he have a clean Napkin upon his Arm, and a Knife and Fork for his use, that he take that dish he should carve from the Table till he hath made it ready for his Superiours to eat, and neatly and handsomly to carve it, not touching of it so near as he can with his Fingers, but if he chance unawares to do so, not to lick his Fingers, but wipe them upon a Cloth, or his Napkin, which he hath for that purpose; for otherwise it is unhandsom and unmannerly; the neatest Carvers never touch any Meat but with the Knife and Fork; he must be very nimble lest the Meat cool too much, and when he hath done, return it to the Table again, putting away his Carving Napkin, and take a clean one to wait withal; he must be very Gentile and Gallant in his Habit, lest he be deemed unfit to attend such Persons. * * * * * _To all other Men-Servants or Maid-Servants who commonly attend such Tables._ They must all be neat and cleanly in their Habit, and keep their Heads clean kembed, always ready at the least Call and very attentive to hear any one at the Table, to set Chairs or Stools, and not to give any a foul Napkin, but see that every one whom their Lord or Master is pleased to admit to their Table, have every thing which is fit for them, and that they change their Plates when need shall be; also that they observe the eyes of a Stranger what they want, and not force them still to want because they are silent, because it is not very modest for an Inferiour to speak aloud before their Betters; and it is more unfit they should want, since they have leave to eat and drink: they must wait diligently, and at a distance from the Table, not daring to lean on the Chaires for soiling them, or shewing Rudeness; for to lean on a Chair when they wait, is a particular favour shewn to any superiour Servant, as the Chief Gentleman, or the Waiting Woman when she rises from the Table; they must not hold the Plates before their mouths to be defiled with their Breath, nor touch them on the right side; when the Lord, Master, Lady or Mistress shew that favour to drink to any Inferiour, and do command them to fill for them to pledge them, it is not modesty for them to deny Strangers that favour, as commonly they do, but to fulfill their Commands, or else they dishonour the Favour. When any Dish is taken off the Table, they must not set it down for Dogs to eat, nor eat it themselves by the way, but haste into the Kitchin with it to the Cook, that he may see what is to be set away, and what to be kept hot for Servants; when all is taken away, and Thanks given, they must help the Butler out with those things which belong to him, that he may not lose his Dinner. They must be careful also to lay the Cloth for themselves, and see that nothing be wanting at the Table, and to call the rest of the Servants to Meals, whose Office was not to wait at the Table, then to sit down in a handsom manner, and to be courteous to every Stranger, especially the Servants of those Persons whom their Lord or Master hath a kindness for. If any poor Body comes to ask an Alms, do not shut the Door against them rudely, but be modest and civil to them, and see if you can procure somewhat for them, and think with your selves, that though you are now full fed, and well cloathed, and free from care, yet you know not what may be your condition another day: So much to Inferiour Servants. * * * * * _To the Gentlewomen who have the Charge of the Sweet-Meats, and such like Repasts._ _Gentlewomen_, Perhaps you do already know what belongs to serving in fine Cream Cheeses, Jellies, Leaches or Sweet-meats, or to set forth Banquets as well as I do; but (pardon me) I speak not to any knowing Person, but to the Ignorant, because they may not remain so; besides really there are new Modes come up now adays for eating and drinking, as well as for Clothes, and the most knowing of you all may perhaps find somewhat here which you have not already seen; and for the Ignorant, I am sure they may ground themselves very well from hence in many accomplishments, and truly I have taken this pains to impart these things for the general good of my Country, as well as my own, and have done it with the more willingness, since I find so many Gentlewomen forced to serve, whose Parents and Friends have been impoverished by the late Calamities, _viz._ the late Wars, Plague, and Fire, and to see what mean Places they are forced to be in, because they want Accomplishments for better. I am blamed by many for divulging these Secrets, and again commended by others for my Love and Charity in so doing; but however I am better satisfied with imparting them, than to let them die with me; and if I do not live to have the Comfort of your Thanks, yet I hope it will cause you to speak well of me when I am dead: The Books which before this I have caused to be put in Print, found so good an acceptance, as that I shall still go on in imparting what I yet have so fast as I can. Now to begin with the Ordering those things named to you: If it be but a private Dinner or Supper in a Noble House, where they have none to honour above themselves, I presume it may be thus: In Summer time, when the Meat is all taken away, you may present your several sorts of Cream Cheeses; One Meal one Dish of Cream of one sort, the next of another; one or two Scollop Dishes with several sorts of Fruit, which if it be small fruit, as Rasps or Strawberries, they must be first washed in Wine in a Dish or Bason, and taken up between two Spoons, that you touch them not. With them you may serve three or four small Dishes also with Sweet-meats, such as are most in season, with Vine Leaves and Flowers between the Dishes and the Plates, two wet Sweet-meats, and two dry, two of one colour, and two of another, or all of several colours. Also a Dish of Jellies of several colours in one Dish, if such be required. If any be left, you may melt them again, and put them into lesser Glasses, and they will be for another time: If any dry ones be left, they are soon put into the Boxes again. If any persons come in the afternoon, if no greater, or so great as the Person who entertains them, then you may present one or two Dishes of Cream only, and a whipt Sillibub, or other, with about four Dishes of Sweet-meats served in, in like manner as at Dinner, with Dishes of Fruit, and some kind of Wine of your own making; at Evenings, especially on Fasting Days at Night, it is fit to present some pretty kind of Creams, contrary from those at Dinner, or instead of them some Possets, or other fine Spoon Meats, which may be pleasant to the taste, with some wet and dry Sweet-meats, and some of your fine Drinks, what may be most pleasing. At a Feast, you may present these things following. So soon as the Meat is quite taken away, have in readiness your Cream Cheeses of several sorts and of several of Colours upon a Salver, then some fresh Cheese with Wine and Sugar, another Dish of Clouted Cream, and a Noch with Cabbage Cream of several Colours like a Cabbage; then all sorts of Fruits in season, set forth as followeth: First, You must have a large Salver made of light kind of Wood, that it may not be too heavy for the Servitor to carry, it must be painted over, and large enough to hold six Plates round about and one larger one in the middle, there must be places made in it to set the Plates in, that they may be very fast and sure from sliding, and that in the middle the seat must be much higher than all the rest, because that is most graceful; your Plates must not be so broad as the Trencher Plates at Meat, and should be either of Silver or China. Set your Plates fast, then fill every one with several sorts of Fruits, and the biggest sort in the middle, you must lay them in very good order, and pile them up till one more will not lie; then stick them with little green Sprigs and fine Flowers, such as you fancy best; then serve in another such Salver, with Plates piled up with all manner of Sweet-meats, the wet Sweet-meats round about and the dry in the middle, your wet Sweet-meats must be in little glasses that you may set the more on, and between every two glasses another above the first of all, and one on the top of them all; you must put of all sorts of dryed Sweet-meats in the middle Plate, first your biggest and then your lesser, till you can lay no more; then stick them all with Flowers and serve them: And in the Bason of Water you send in to wash the Hands or Fingers of Noble Persons, you must put in some Orange Flower Water, which is very rare and very pleasant. In Winter you must alter, as to the season, but serve all in this manner; and then dryed Fruits will also be very acceptable; as dryed Pears and Pippins, Candied Oranges and Limons, Citrons and Eringoes, Blanched Almonds, Prunelles, Figs, Raisins, Pistachoes and Blanched Walnuts. _FINIS._ The CONTENTS of the First Part. A. Artichoke Cream. 152 Almond Pudding. 147 Almond Pudding. 144 Artichokes kept. 141 Almond Jelly white. 140 Almond Paste. 126 Almond Butter. 120 Apricocks dried. 116 Apricocks in Lumps. 115 Apricocks dried clear. 109 Almond Bread. 104 Almond Milk. Ib. Angelica Candied. 98 Apricocks preserved. 94 Almond Bakes. 88 Almonds candied. 85 Almond Butter white. 67 Artificial Walnuts. 57 Almond Ginger-Bread. 59 Ale to drink speedily. 42 Ale very rare. 41 Aqua Mirabilis. 1 B. Bisket Pudding. 146 Black Pudding. 143 Bisket very fine. 130 Banbury Cake. 119 Barberries candied. 113 Bean Bread. 101 Barberries preserved without fire. 84 Bullace preserved. 74 Black Juice of Licoras. 69 Barberries preserved. 62 Bisket Cake. 26 Balm Water Green. 21 Bisket Orange, Limon or Citron. 130 C. Clouted Cream. 154 Cream of divers things. 151 Curd Pudding. 146 Clove Sugar. 142 Cinamon Sugar. ib. Cake without Sugar. 140 Cullis or Jelly. 139 Comfits of all Sorts. 137 Caudle for a sick body. 136 Candy as hard as a Rock. 129 Caroway Cake. 112 Cherries in Jelly. 108 Cordial for sleep. 106, 107 Consumption. 106 Cordial Syrup. Ib. Cornish Cake. Ib. Cakes very fine. 105 Cider clear. 103 Clear Perry. Ib. Caroway Cake. 102 Cake. 99 Cornelions preserved. 95 Currans in Jelly. 94 Custard for a Consumption. Ib. Chips of Fruit. 89 Chips of Orange or Limon. 88 Candied Carrots. 85 Conserve of Barberries. 84 Cordial most excellent. 69 Cakes to keep long. 82 Cakes with Almonds. 48, 82 Court Perfumes. 79 China Broth. 78 Cristal Jelly. Ib. Conserve of Violets. 75 Cakes very good. 61 Cakes of Violets. 60 Collops like Bacon in Sweet meats. 59 Cough of the Lungs. Ib. Cordial Infusion. 58 Cakes very short. 57 Conserve of Red Roses. 53 Cucumbers pickled. 51 Cake with Almonds. 47 Cake with Almonds. 48 Cordial. 45 Cake without Fruit. 44 Consumption. 41 Chine Cough. Ib. Cream. Ib. Cabbage-Cream. 39 Cakes of Quinces. 33 Consumption Ale. Ib. Consumption. Ib. Cream very fine. 31 Cucumbers pickled. 30 Candied Flowers. 29 Clouted Cream. 28 Cough of the Lungs. 25 Cordial. 14 Cordial. 13 Cock-water most excellent. 11 Cordial Cherry Water. 9 Cordial Orange water. 5 D. Damask Powder for Cloths. 155 Dumplings. 148 Dumplings. Ib. Dumplings. Ib. Distilled Roses. 143 Diet Bread. 103 Damsons preserved. 96 Damsons preserved white. 60 Damson Wine. 50 Devonshire White-pot. 28 Doctor Butlers Water. 8 Doctor Chambers Water. 3 E. Elder Water. 20 F. French Bisket. 126 Flowers Candied. 131 Figs dried. 121 Flowers the best way to Candy. 40 Froth Posset. 118 Flowers kept long. 83 French Bread. 46 G. Green Pudding. 149 Green Ginger wet. 133 Grapes dried. 132 Grapes kept fresh. 131 Ginger-Bread. 127 Green Walnuts preserved. 130 Gooseberries preserved. 65 Gooseberry Fool. 63 Grapes preserved. 59 Gooseberry Wine. 50 Gooseberries green. 45 Griping of the Guts. 43 H. Hipocras. 111 Heart Water. 15 I. Irish Aquavitæ. 142 Italian Bisket. 111 Jumbolds. 184 Jelly of Pippins. 97 Jelly of Quinces. 91 Jelly of Harts-Horn. 87 Juice of Licoras white. 80 Jelly very good. 68 Iringo Root candied. 64 Jelly of Currans. 63 L. Lemonalo. 135 Limon Sallad. 133 Leach white. 104 Leach yellow. 105 Leach of Ginger. Ib. Leach of Cinamon. Ib. Leach of Dates. Ib. Limons preserved. 89 Leach. 65 Lozenges perfumed. 64 Limon Cream. 48 [Transcriber's note: there are no page numbers in the original for some of the following entries.] Limon Cakes. Limon Water. M. Mustard. Mustard. Marmalade of Limons. Marmalade of Oranges. Musk Sugar. Marmalade of Quinces. Mushroms pickled. Marmalade of Cherries. 116 Marmalade of Oranges. Marmalade of Cornelions. Marmalade white. Medlars preserved. Marmalade of Pippins. Marmalade of Wardens. Marmalade of Damsons. Marchpane. Marmalade of Apricocks. Morphew or Freckles. Marmalade of Oranges. Made Dish. Marmalade of Cherries and Currans. Marmalade of Apricocks. Melancholy Water. N. Naples Bisket. O. Oatmeal Pudding. 146 Oranges in Jelly preserv'd. 77 Orange Pudding. 46 Oranges and Limons to preserve. 56 P. Pickled Oysters. 153 Pickled French Beans. Ib. Pickled Barberries. 152 Poudered Beef kept long. 154 Pudding to rost. 151 Pudding of Calves feet. Ib. Pudding of Rasberries. 150 Pudding of Hogs Liver. Ib. Pudding of Cake. 146 Pudding of Rice. 145 Paste of Pomewaters. 135 Punch. 134 Prunes stewed without Fire. Ib. Pickled Oranges or Limmons. 131 Potato Bisket. Ib. Parsnep Bisket. 131 Paste short without Butter. 129 Puffpaste. 128 Puffpaste. Ib. Pistacho Cakes. 115 Powder for the Hair. 114 Pears or Pippins dried. 110 Pippins dry and clear. 109 Perfume to burn. 108 Perfumed Gloves. Ib. Perfume to burn. 107 Pomatum. 100 Pippins in Jelly. 93 Posset. Ib. Posset with Sack. 93 Posset. Ib. Plumbs dried. 91 Preserved Pears dried. 81 Pretty Sweet-meat. 87 Paste for the Hands. 83 Plumbs dried naturally. 81 Pears dried. 76 Pippins dried. 73 Pippins green preserved. 71 Peaches preserved. Ib. Phtisick Drink. 67 Paste of Pippins. 62 Paste royal. 61 Paste of Pippins. 54 Paste of Plumbs. Ib. Plain Bisket Cake. 53 Posset without Milk. 44 Pennado. 43 Purslane pickled. 40 Portugal Eggs. 29 Perfumed Roses. 27 Palsie water by Dr. Mathias. 23 Plague Water. 16 Precious Water. 7 Plague Water. 2 Q. Quaking Pudding. 147 Quince pickled. 141 R. Roses kept long. 140 Rose Leaves dried. 124 Red Quinces whole. 122 Rasberry Sugar. 115 Rasberry Wine. 76 Red Roses preserved. 58 Rasberries preserved. 36 Rosa Solis. 14 Rosemary Water. 7 S. Scotch Brewis. 143 Syrup of Rasberries, or other Fruits, as Grapes, &c. 135 Syrup of Citrons. 134 Sugar Plate. 124 Syrup of Roses or other Flowers. 123 Sack Posset. 120 Sillibub. 114 Spanish Candy. 110 Syrup of Gilliflowers. 99 Seed stuff of Rasberries. 98 Syrup for a Cough. 86 Syrup of Violets. 86 Syrup for a Cold. 79 Syrup of Turneps. 68 Signs of Small Pox taken away. 66 Sugar Plate. 56 Snow Cream. 55 Shrewsberry Cakes. 49 Sillibub. 47 Sack Posset. 43 Sheeps Guts stretched. 40 Samphire boiled. 38 Stepony or Raisin Wine. Ib. Sillibub whipt. 37 Syrup of Ale. Ib. Syrup of Turneps. 32 Sugar Cakes. 31 Signs of Small Pox taken away. 28 Surfet Water the best. 18, 22 Sweet Water. 18 Snail Water. 17 Spirit of Oranges and Limons. 5 Spirit of Mints. 4 Soveraign Water. 3 T. To cast all kinds of Shapes and to colour them. 75 Tuff taffity Cream. 112 Thick Cream. 40 Trifle. 39 Tincture of Caroways. 27 Treacle Water. 8 & 16 W. Walnuts kept long. 141 White Plates to eat. 117 White Quinces preserved. 52 Water Gruel. 48 Wafer. 35 Water against Infection. 19 Wormwood water. 13 Walnut water. 12 Water for the Stone. 10 Water for Fainting. 6 The End of the Contents of the First Part. The CONTENTS of the Second Part. A. Artichoke Suckers dressed. 182 Artichoke Cream. 184 Artichoke Pie. 196 Artichoke Pudding. 223 Artichokes kept long. 229 Artichokes stewed. 277 Artichokes fryed. 282 Artichoke Pudding. 223 Almond Pudding. 161 Apple Tansie. 167 An Amulet. 168 Almond Pudding. 177 Angelot Cheese. 202 Apple Puffs. 253 Almond Tart. 290 B. Brown Metheglin. 159 Beef Collered. 160 Barly Cream. 162 Barly Broth without Meat. 188 Barly Broth with Meat. 188 Balls to take out Stains. 228 Broth of a Lambs Head. 225 Beef-Pie very good. 244 Blanched Manchet. 247 Bullocks cheek baked to eat hot. 299 Bullocks cheek baked to eat cold. ib. Bacon Froize. 300 C. Cheesecakes. 163 Cheesecakes. 164 Chicken Pie. 168 Collar of Brawn. 169 Capon boiled. 171 Cracknels. 172 Codling cream. 174 Cheese very stood. 175 Cucumbers boiled. 182 Collops of Bacon and Eggs. 187 Cabbage Pottage. 192 Capon with white Broth. 195 Calves foot Pie. ib. Carp Pie. 198 Calves head Pie. 201 Calves chaldron Pie with Puddings in it. 207 Coleflower pickled. 210 Cheese Loaves. 213 Custards very fine. 216 Cods head boiled. 222 Chicken Pie. 226 Capon boiled. 236 Chickens boiled with Goosberries. 241 Chickens baked with Grapes. 243 Capon baked. 245 Cambridge Pudding. 249 Chiveridge Pudding. 250 Calves Tongue hashed. 255 Capon boiled. Ib. Capon boiled with Rice. 256 Capon boiled with Pippins. Ib. Chickens boiled with Lettuce. 257 Chickens smoored. 263 Calves feet hashed. 264 Chickens in white Broth. 265 Capon rosted with Oysters. 271 Calves head with Oysters. 279 Carp Pie. 289 Consumption Remedy. 306 D. Dried Tongues. 202 Delicate Pies. 215 Ducks boiled. 259 E. Elder Vinegar. 159 Eels and Pike Together. 179 Eels rosted with Bacon. 180 Eels and Oister Pie. 183 Egg Pie. 217 Eel Pie. 219 Eel souced and collered. Ib. Eels stewed. 220 Eels in broth. 267 F. Fresh Cheese. 164 Furmity. 187 Furmity with Meat Broth. 189 Furmity with Almonds. Ib. French Pottage. 102 Fricasies of several sorts. 199 Fricasie of Sheeps feet. 205 Fried Toasts. 209 Fritters. 246 Fricasie of Oisters. 218 Fricasie of Eels. Ib. Fresh Salmon boiled. 221 French Broth. 225 Fine washing Balls for the Hands. 224 French Servels. 230 Florentine baked. 242 Friday Pie without fish or flesh. Ib. Fritters. 246 Farced Pudding. 247 Fricasie of Eggs. 248 French Puffs. 253 Flounders boiled. 298 G. Green Tansie. 167 Gravie Broth. 191 Goose dried. 193 Goose Giblets with Sausages. 199 Garden Beans dried. 234 Gurnet boiled. 238 Goose baked. 246 Goose Giblets boiled with Roots and Herbs. 261 Goose Giblets boiled. 260 Grand Sallad. 268 Gammon of Bacon Pie. 298 Green Sauce for Pork. 305 H. Hasty Pudding. 199 Hasty Pudding. Ib. Hasty Pudding. Ib. Hare Pie. 203 Hashed Meats. 217 Herring Pie. 220 Herb Pie. 226 Haunch of Venison rosted. 273 Haunch of Venison boiled. 275 Haggus Pudding. 294 Hasty Pudding. Ib. I. Italian Pudding. 254 Ice and Snow. 303 K. Kickshaws to bake or fry. 254 L. Lobsters buttered. 175 Liver Fritters. 177 Loaves to Butter. 206 Limon Cakes. 212 Loaves of Curds. 213 Lobsters rosted. 227 Lamb Pie. 233 Leg of Mutton rosted. 266 Leg of Mutton boiled. 238 Leg of Mutton with Oysters. 270 Loin of Mutton stewed. 274 Lark pie. 286 Lettuce pie. 287 Lampry pie. 292 Lenten Dish. 307 M. [Transcriber's note: heading omitted in original.] Metheglin. 160 Misers for Childrens Collation. 208 Minced Pies. 212 Made Dish of Rabbet Livers. 241 Mutton smoored. 261 Mutton smoored. 262 Mutton Pie. 303 N. Neats Tongue Pie. 194 Neats Tongue rosted. 239 Neats Tongue hashed. 264 Neck of Mutton boiled. 274 Neck of Mutton stewed. 287 Nuts fried. 300 O. Oatmeal Pudding. 165 Olio of several Meats. 172 Oysters and Eels in a Pie. 197 Oysters and Parsneps in a Pie. 181 Oyster Pie. 197 Oranges and Limons in Jelly. 212 Oisters fried. 214 Oisters broiled. ib. Oysters rosted. ib. Olives of Veal. 222 Oatmeal Pudding. 295 Oat-Cakes. 232 Olive Pie. 223 P. Puddings in Balls. 165 Pigeons boiled. 166 Pasty of Veal. 170 Pigeon Pie. ib. Pork rosted without the Skin. 173 Pig rosted like Lamb. 174 Potted Fowl. 179 Parsnep Pie with Oysters. 181 Pig Pie. 197 Pudding of Manchet. 201 Pompion Pie. 208 Pompion fryed. ib. Pike rosted and larded. 221 Pomander very fine. 224 Pompion Pie. 227 Pickled Sprats. 223 Pasty of Ling. 229 Pallat Pie. 231 Pippin Pie. 235 Pasties to fry. 236 Pigeons boiled with Rice. 239 Pigeons boiled with Gooseberries. ib. Pippin Tart. 244 Pancakes crisp. 247 Pudding of Goose Bloud. 249 Pudding of Liver. 250 Pigeons boiled with Capers and Samphire. 260 Partridges boiled. 266 Pike boiled with Oysters. 268 Pig rosted with a Pudding in his Belly. 269 Pippins stewed. 277 Pig rosted without the skin with a Pudding in his Belly. 281 Pancakes very good. 283 Paste very good. 294 Paste to raise. Ib. Paste for baked Meat to eat cold. Pie of Veal. Pie of Shrimps or Prawns. Pie of rosted Kidney. Potato Pie. Pig Pie. Pork Pie. Pudding of French Barlie. Pomander very fine. Pudding of wine. Pudding of Hogs Lights. Posset Pie. Pippins dried. Poached Eggs. Pippin Paste. Pippins stewed. Q. Quodling Cream. Quinces to look white. Quince Pie very good. R. Rump of Beef boiled. Rolls for Noble Tables. Rolls very short. Rasberry Tarts. Rabbets with Sausages. Rice Cream. Rabbet boiled. Rice Pudding. Rabbet boiled with Grapes. 258 Rabbet boiled with Claret. ib. Red Deer Pie. 291 Rock of Sweet Meats. 309 S. Souced Veal. 169 Sauce for Mutton. 273 Summer Dish. 175 Souced Pig. 178 Several Sallads. 183 Several Sallads. ib. Soles dressed very fine. 186 Spinage Tart. 184 Stewed Fish. ib. Spanish Pap. 190 Sallad of cold Meat. 193 Sheeps Tongues with Oysters. ib. Scotch Collops. 200 Shoulder of Venison, or Shoulder of Mutton rosted in Blood. 204 Stewed Pig. ib. Steak Pie with Puddings. 205 Salmon dressed by Infusion. 206 Stewed Carps in blood. 209 Stump pie. 216 Sauce for Fowl. 232 Sorrel Sallad. 234 Sallad cold. ib. Sauce for Veal. 235 Sauce for a Leg of Mutton. Souced Fish. Swan baked. Small Birds baked. Stewed Pudding. Sussex Pudding. Sausages boiled. Shell-fish fryed. Steak Pie. Shoulder of Venison rosted. Sallads boiled. Shoulder of Veal boiled. Stewed Broth good. Sallad of Salmon. Shoulder of Mutton with Oysters. Stewed Artichokes. Sauce for Fowl. Sauce for Partridges. Sauce for Quails. Salmon Pie. Shaking Pudding. Stone Cream. Snow Cream. Sussex Pancake. Snow and Ice. Sallad in Winter. Sallad in Winter. Sorrel Sops. T. To boil a Teal or Wigeon. 240 Turkey baked. 245 Trouts stewed. 267 Toasts of Veal fried. 282 Tarts of several Sweet-meats. 302 Treacle Wine. 306 V. Venison baked to keep. 178 Umble Pies. 243 Veal smoored. 262 Veal rosted with farcing herbs. 273 Veal fried. 283 Venison Pasty. 301 Vin de Molosso. 306 W. White Broth with Meat. 225 White Broth without Meat. ib. White Pot. 291 Whitings boiled. 298 _Postscript._ Now good Readers, here are three hundred and ten choice Receipts added for a Second Part of the _Queen-like Closet_, and you may, I am sure, make many more of them if you observe how many I have taught in one; if I had not taken that course, only for brevity sake, & that it might not be tedious and impertinent to you, I might have enlarged this Volume very much. _FINIS._ 
27947	----	The Home Medical Library By KENELM WINSLOW, B.A.S., M.D. _Formerly Assistant Professor Comparative Therapeutics, Harvard University; Late Surgeon to the Newton Hospital; Fellow of the Massachusetts Medical Society, etc._ With the Coöperation of Many Medical Advising Editors and Special Contributors IN SIX VOLUMES _First Aid :: Family Medicines :: Nose, Throat, Lungs, Eye, and Ear :: Stomach and Bowels :: Tumors and Skin Diseases :: Rheumatism :: Germ Diseases Nervous Diseases :: Insanity :: Sexual Hygiene Woman and Child :: Heart, Blood, and Digestion Personal Hygiene :: Indoor Exercise Diet and Conduct for Long Life :: Practical Kitchen Science :: Nervousness and Outdoor Life :: Nurse and Patient Camping Comfort :: Sanitation of the Household :: Pure Water Supply :: Pure Food Stable and Kennel_ NEW YORK The Review of Reviews Company 1907 Medical Advising Editors Managing Editor ALBERT WARREN FERRIS, A.M., M.D. _Former Assistant in Neurology, Columbia University; Former Chairman, Section on Neurology and Psychiatry, New York Academy of Medicine; Assistant in Medicine, University and Bellevue Hospital Medical College; Medical Editor, New International Encyclopedia._ Nervous Diseases CHARLES E. ATWOOD, M.D. _Assistant in Neurology, Columbia University; Former Physician, Utica State Hospital and Bloomingdale Hospital for Insane Patients; Former Clinical Assistant to Sir William Gowers, National Hospital, London._ Pregnancy RUSSELL BELLAMY, M.D. _Assistant in Obstetrics and Gynecology, Cornell University Medical College Dispensary; Captain and Assistant Surgeon (in charge), Squadron A, New York Cavalry; Assistant in Surgery, New York Polyclinic._ Germ Diseases HERMANN MICHAEL BIGGS, M.D. _General Medical Officer and Director of Bacteriological Laboratories, New York City Department of Health; Professor of Clinical Medicine in University and Bellevue Hospital Medical College; Visiting Physician to Bellevue, St. Vincent's, Willard Parker, and Riverside Hospitals._ The Eye and Ear J. HERBERT CLAIBORNE, M.D. _Clinical Instructor in Ophthalmology, Cornell University Medical College; Former Adjunct Professor of Ophthalmology, New York Polyclinic; Former Instructor in Ophthalmology in Columbia University; Surgeon, New Amsterdam Eye and Ear Hospital._ Sanitation THOMAS DARLINGTON, M.D. _Health Commissioner of New York City; Former President Medical Board, New York Foundling Hospital; Consulting Physician, French Hospital; Attending Physician, St. John's Riverside Hospital, Yonkers; Surgeon to New Croton Aqueduct and other Public Works, to Copper Queen Consolidated Mining Company of Arizona, and Arizona and Southeastern Railroad Hospital; Author of Medical and Climatological Works._ Menstruation AUSTIN FLINT, JR., M.D. _Professor of Obstetrics and Clinical Gynecology, New York University and Bellevue Hospital Medical College; Visiting Physician, Bellevue Hospital; Consulting Obstetrician, New York Maternity Hospital; Attending Physician, Hospital for Ruptured and Crippled, Manhattan Maternity and Emergency Hospitals._ Heart and Blood JOHN BESSNER HUBER, A.M., M.D. _Assistant in Medicine, University and Bellevue Hospital Medical College; Visiting Physician to St. Joseph's Home for Consumptives; Author of "Consumption: Its Relation to Man and His Civilization; Its Prevention and Cure."_ Skin Diseases JAMES C. JOHNSTON, A.B., M.D. _Instructor in Pathology and Chief of Clinic, Department of Dermatology, Cornell University Medical College._ Diseases of Children CHARLES GILMORE KERLEY, M.D. _Professor of Pediatrics, New York Polyclinic Medical School and Hospital; Attending Physician, New York Infant Asylum, Children's Department of Sydenham Hospital, and Babies' Hospital, N. Y.; Consulting Physician, Home for Crippled Children._ Bites and Stings GEORGE GIBIER RAMBAUD, M.D. _President, New York Pasteur Institute._ Headache ALONZO D. ROCKWELL, A.M., M.D. _Former Professor Electro-Therapeutics and Neurology at New York Post-Graduate Medical School; Neurologist and Electro-Therapeutist to the Flushing Hospital; Former Electro-Therapeutist to the Woman's Hospital in the State of New York; Author of Works on Medical and Surgical Uses of Electricity, Nervous Exhaustion (Neurasthenia), etc._ Poisons E. ELLSWORTH SMITH, M.D. _Pathologist, St. John's Hospital, Yonkers; Somerset Hospital, Somerville, N. J.; Trinity Hospital, St. Bartholomew's Clinic, and the New York West Side German Dispensary._ Catarrh SAMUEL WOOD THURBER, M.D. _Chief of Clinic and Instructor in Laryngology, Columbia University; Laryngologist to the Orphan's Home and Hospital._ Care of Infants HERBERT B. WILCOX, M.D. _Assistant in Diseases of Children, Columbia University._ Special Contributors Food Adulteration S. JOSEPHINE BAKER, M.D. _Medical Inspector, New York City Department of Health._ Pure Water Supply WILLIAM PAUL GERHARD, C.E. _Consulting Engineer for Sanitary Works; Member of American Public Health Association; Member, American Society Mechanical Engineers; Corresponding Member of American Institute of Architects, etc.; Author of "House Drainage," etc._ Care of Food JANET MCKENZIE HILL _Editor, Boston Cooking School Magazine._ Nerves and Outdoor Life S. WEIR MITCHELL, M.D., LL.D. _LL.D. (Harvard, Edinburgh, Princeton); Former President, Philadelphia College of Physicians; Member, National Academy of Sciences, Association of American Physicians, etc.; Author of essays: "Injuries to Nerves," "Doctor and Patient," "Fat and Blood," etc.; of scientific works: "Researches Upon the Venom of the Rattlesnake," etc.; of novels: "Hugh Wynne," "Characteristics," "Constance Trescott," "The Adventures of François," etc._ Sanitation GEORGE M. PRICE, M.D. _Former Medical Sanitary Inspector, Department of Health, New York City; Inspector, New York Sanitary Aid Society of the 10th Ward, 1885; Manager, Model Tenement-houses of the New York Tenement-house Building Co., 1888; Inspector, New York State Tenement-house Commission, 1895; Author of "Tenement-house Inspection," "Handbook on Sanitation," etc._ Indoor Exercise DUDLEY ALLEN SARGENT, M.D. _Director of Hemenway Gymnasium, Harvard University; Former President, American Physical Culture Society; Director, Normal School of Physical Training, Cambridge, Mass.; President, American Association for Promotion of Physical Education; Author of "Universal Test for Strength," "Health, Strength and Power," etc._ Long Life SIR HENRY THOMPSON, Bart., F.R.C.S., M.B. (Lond.) _Surgeon Extraordinary to His Majesty the King of the Belgians; Consulting Surgeon to University College Hospital, London; Emeritus Professor of Clinical Surgery to University College, London, etc._ Camp Comfort STEWART EDWARD WHITE _Author of "The Forest," "The Mountains," "The Silent Places," "The Blazed Trail," etc._ [Illustration: WALTER REED. In the year 1900, Major Walter Reed, a surgeon in the United States Army, demonstrated, by experiments conducted in Cuba, that a mosquito of a single species, Stegomyia fasciata, which has sucked the blood of a yellow-fever patient may transmit the disease by biting another person, but not until about twelve days have elapsed. He also proved, as described in Volume I, Part II, that the malady is not contagious. "With the exception of the discovery of anæsthesia," said Professor Welch, of Johns Hopkins University, "Dr. Reed's researches are the most valuable contributions to science ever made in this country." General Leonard Wood declared the discovery to be the "greatest medical work of modern times," which, in the words of President Roosevelt, "renders mankind his debtor." Major Reed died November 23, 1902.] The Home Medical Library VOLUME V :: SANITATION Edited by THOMAS DARLINGTON, M.D. _Health Commissioner of New York City; Former President Medical Board, New York Foundling Hospital, etc.; Author of Medical and Climatological Works_ WATER SUPPLY AND PURIFICATION By WILLIAM PAUL GERHARD, C.E. _Consulting Engineer for Sanitary Works; Author of "House Drainage," "Sanitary Engineering," "Household Wastes," etc._ PURE FOOD FOR THE HOUSEKEEPER By S. JOSEPHINE BAKER, M.D. _Medical Inspector, New York City Department of Health_ THE HOUSE AND GROUNDS By GEORGE M. PRICE, M.D. _Former Medical Sanitary Inspector, Department of Health, New York City; Author of "Tenement-House Inspection," "Handbook on Sanitation," etc._ NEW YORK The Review of Reviews Company 1907 Copyright, 1907, by THE REVIEW OF REVIEWS COMPANY THE TROW PRESS, NEW YORK _Contents_ PART I CHAPTER PAGE I. COUNTRY SOURCES OF WATER SUPPLY 19 Relation of Water to Health--Collection of Rain Water--Cisterns--Springs--Various Kinds of Wells--Laws Regulating Supply. II. APPLIANCES FOR DISTRIBUTING WATER 39 Pumping Machines--The Hydraulic Ram--Use of Windmills--Engines--Steam and Electric Pumps--Reservoirs and Tanks--Appliances for Country Houses. III. PURIFYING WATER BY COPPER SULPHATE 52 Clear Water Often Dangerous--Pollution Due to Plants--Copper Sulphate Method--Directions for the Copper Cure. IV. RIDDING STAGNANT WATER OF MOSQUITOES 70 Malaria Due to Mosquitoes--Cause of Yellow Fever--Effect of a Mosquito Bite--Destruction of Larvæ--Best Preventive Measures--Use of Kerosene. PART II I. HOW TO DETECT FOOD ADULTERATION 87 Definition of Adulteration--Food Laws--Permissible Adulterants--How to Select Pure Food--Chemical Tests. II. MUSHROOM POISONING 112 Symptoms and Treatment--Coffee and Atropine the Best Antidotes--How to Tell the Edible Kind--"Horse," "Fairy-ring," and Other Varieties--Poisonous Species. PART III I. SOIL AND SITES 131 Constituents of the Soil--Influence on Health--Improving Defective Soil--Street Paving and Tree Planting--Proper Construction of Houses--Subsoil Drainage. II. VENTILATION 146 What is Meant by Ventilation--Quantity of Air Required--Natural Agents of Ventilation--Special Appliances. III. WARMING 160 Various Methods--Materials of Combustion--Chimneys--Fireplaces and Grates--Stoves--Hot-air Warming--Hot-water Systems--Principles of Steam Heating. IV. DISPOSAL OF SEWAGE 170 Refuse and Garbage--Discharge into Waters--Cremation--Precipitation--Intermittent Filtration--Immediate Disposal, etc. V. SEWERS 182 Definition--Materials Used in Construction--Levels of Trenches--Joints of Pipes--The Fall and Flow of the Contents--Connections--Tide Valves--Sewer Gas. VI. PLUMBING 189 Purposes and Requisites--Materials Used--Joints and Connections--Construction of Traps--Siphonage and Back Pressure--The Vent-pipe System. VII. PLUMBING PIPES 206 Construction of House Drains--Fall, Position, and Connection--Main Traps--Extension of Vertical Pipes--Fresh-air Inlets--Soil and Waste Pipes--Branch Pipes, etc. VIII. PLUMBING FIXTURES 216 Sinks--Washbasins--Washtubs--Bathtubs--Refrigerators, etc.--Safes and Wastes--Pan, Valve, and Hopper Closets--Flush Tanks--Yard Closets--Drains. IX. DEFECTS IN PLUMBING 231 Poor Work--Improper Conditions--How to Test Traps, Joints, and Connections--Detect Sewer Gas--Water-pressure, Smoke, and Scent Tests--Special Appliances. X. INFECTION AND DISINFECTION 238 Physical and Chemical Disinfectants--Use of Sulphur Dioxide--Formaldehyde--Hydrocyanic Acid--Chlorine--Carbolic Acid--Bichloride of Mercury--Formalin--Potassium Permanganate, etc. XI. COST OF CONVEYED HEATING SYSTEMS 254 Cost of Hot-air Systems--Cast-iron Hot-water Heater--Advantages and Disadvantages--Cost for a Ten-room House--Steam Heating--Cost of Equipment. _The Editor's Preface_ The character and scope of this volume render it a most useful book for the home maker. The question of sanitation is one that closely affects the life of each individual, and many of its aspects are treated here in a lucid and comprehensive manner. Designed for wide distribution, these articles have been written to meet the needs of the dweller in the more densely populated communities, as well as those living in the less thickly settled portion of the country. In large cities the water supply is a problem that is cared for by regularly constituted sanitary authorities. Pure water is a vital necessity, but the inhabitant of a city has no need to personally concern himself with the source of supply. In the country, however, the home builder must often decide the matter for himself, and it is the aim of this book to give him the needed directions for avoiding many errors and pitfalls that abound in this direction. House construction, with its intricate problems, is also a more serious matter for the country dweller than for his city brother. In the matter of food supply, the inhabitant of a country district is more fortunate. Fresh vegetables and dairy products are much more easily obtained, and their freshness and purity more dependable. The article on water supply by Mr. Gerhard is authoritative, written, as it is, by a most eminent sanitarian. The publishers are to be congratulated upon the following valuable contribution to the same subject as regards the use of copper sulphate and the concise presentation of plans for mosquito extermination, while the extended work of Dr. Price and Dr. Baker's "Food Adulteration" are much to be commended. The two latter have been connected with the Department of Health of New York City, and have the advantage of experience in an organization which gives to the citizens of New York the protection to health that the wise use of science, knowledge, and money afford. I trust that the notes I have added in the light of recent practice of the New York City Department of Health may make this material of the utmost practical value to the householder of to-day. Through this Department of Health, New York City spent, during 1905, over $1,500,000, and for 1906 it has appropriated over $1,800,000. This vast sum of money is used for the sole purpose of safeguarding its citizens from disease. Sanitation in its varied branches is pursued as an almost exact science, and the efforts of trained minds are constantly employed in combating disease and promoting sanitation. The cities care for their own, but the greater number of the inhabitants of this country must rely upon their individual efforts. Therefore, any dissemination of knowledge regarding sanitation is most worthy. This book has a useful mission. It is pregnant with helpful suggestions, and I most heartily commend its purpose and its contents. THOMAS DARLINGTON, _President of the Board of Health_. NEW YORK CITY. Part I WATER SUPPLY AND PURIFICATION BY WILLIAM PAUL GERHARD CHAPTER I =Country Sources of Water Supply= The writer was recently engaged to plan and install a water-supply system for a country house which had been erected and completed without any provision whatever having been made for supplying the buildings and grounds with water. The house had all the usual appointments for comfort and ample modern conveniences, but these could be used only with water borrowed from a neighbor. In all parts of the country there are numerous farm buildings which are without a proper water-supply installation. These facts are mentioned to emphasize the importance of a good water supply for the country home, and to point out that water is unquestionably the most indispensable requirement for such structures. _Adequate Water Supply Important_ But the advantages of a water supply are not limited to the dwelling house, for it is equally useful on the farm, for irrigation, and in the garden, on the golf grounds and tennis courts, in the barns and stables; it affords, besides, the best means for the much-desired fire protection. And, most important of all, an unstinted and adequate use of water promotes cleanliness and thereby furthers the cause of sanitation, in the country not less than in the city home. The water supply for country houses has been so often discussed recently that the writer cannot hope to bring up any new points. This article should, therefore, be understood to offer simple suggestions as to how and where water can be obtained, what water is pure and fit for use, what water must be considered with suspicion, what water is dangerous to health, and how a source of supply, meeting the requirements of health, can be made available for convenient use. Right here I wish to utter a warning against the frequent tendency of owners of country houses to play the rôle of amateur engineers. As a rule this leads to failure and disappointment. Much money uselessly spent can be saved if owners will, from the beginning, place the matter in experienced hands, or at least seek the advice of competent engineers, and adopt their suggestions and recommendations as a guide. _Points to be Borne in Mind_ Many are the points to be borne in mind in the search for water. Science teaches us that all water comes from the clouds, the atmospheric precipitation being in the form of either rain, or dew, or snow. After reaching the earth's surface, the water takes three different courses, and these are mentioned here because they serve to explain the different sources of supply and their varied character. A part of the water runs off on the surface, forming brooks, streams, and lakes, and if it falls on roofs of houses or on prepared catchment areas, it can be collected in cisterns or tanks as rain water. Another part of the water soaks away into pervious strata of the subsoil, and constitutes underground water, which becomes available for supply either in springs or in wells. A third part is either absorbed by plants or else evaporated. In our search for a source of supply, we should always bear in mind the essential requirements of the problem. Briefly stated, these are: the wholesomeness of the water, the adequateness and steadiness of the supply, its availability under a sufficient pressure, insuring a good flow, and the legal restrictions with which many water-supply problems are surrounded. The first essential requirement is that of _wholesomeness_. The quality of a water supply is dependent upon physical properties and upon chemical and bacteriological characteristics. Water, to be suitable for drinking, must be neither too hard nor too soft; it should not contain too many suspended impurities, nor too much foreign matter in solution. Pure water is colorless and without odor. But it must be understood that the quality cannot be decided merely by the color, appearance, taste, and odor. The chemical and bacteriological examinations, if taken together, form a much safer guide, and with these analyses should go hand in hand a detailed survey of the water source and its surroundings. _Relation of Water to Health_ Any pronounced taste in the water renders it suspicious; an offensive smell points to organic contamination; turbidity indicates presence of suspended impurities, which may be either mineral or organic. But even bright and sparkling waters having a very good taste are sometimes found to be highly polluted. Hence, it should be remembered that neither bright appearance nor lack of bad taste warrants the belief that water is free from dangerous contamination. It is a well-established fact now that there is a relation between the character of the water supply and the health of a community; and what is true of cities, villages, and towns, is, of course, equally true of the individual country house. _How Water Becomes Contaminated_ There are numerous ways in which water may become polluted, either at the source or during storage or finally during distribution. Rain water, falling pure from the clouds, encounters dust, soot, decaying leaves and other vegetable matters, and ordure of birds on the roofs; its quality is also affected by the roofing material, or else it is contaminated in the cisterns by leakage from drains or cesspools. Upland waters contain generally vegetable matter, while surface water from cultivated lands becomes polluted by animal manure. River water becomes befouled by the discharge into it of the sewers from settlements and towns located on its banks. Subsoil water is liable to infiltration of solid and liquid wastes emanating from the human system, from leaky drains, sewers, or cesspools, stables, or farmyards; and even deep well water may become contaminated by reason of defects in the construction of the well. During storage, water becomes contaminated in open reservoirs by atmospheric impurities; a growth of vegetable organisms or algæ often causes trouble, bad taste, or odor; water in open house tanks and in cisterns is also liable to pollution. During distribution, water may become changed in quality, owing to the action of the water on the material of the pipes. From what source shall good water be obtained? This is the problem which confronts many of those who decide to build in the country. The usual sources, in their relative order of purity, are: deep springs and land or surface springs, located either above or below the house, but not too near to settlements; deep subterranean water, made available by boring or drilling a well; upland or mountain brooks from uninhabited regions; underground water in places not populated, reached by a dug or driven well; lake water; rain water; surface water from cultivated fields; pond and river water; and finally, least desirable of all, shallow well water in villages or towns. These various sources of supply will be considered farther on. _An Ample Volume Necessary_ The second essential requirement is _ample quantity_. The supply must be one which furnishes an ample volume _at all seasons_ and for all purposes. What is a reasonable daily domestic consumption? The answer to this question necessarily depends upon the character of the building and the habits and occupation of its inmates. It is a universal experience that as soon as water is introduced it is used more lavishly, but also more recklessly and regardless of waste. For personal use, from twenty to twenty-five gallons per person should prove to be ample per day: this comprises water for drinking and cooking, for washing clothes, house and kitchen utensils, personal ablutions, and bathing; but, taking into account other requirements on the farm or of country houses, we require at least sixty gallons per capita per diem. To provide water for the horses, cows, sheep, for carriage washing, for the garden, for irrigation of the lawn, for fountains, etc., and keep a suitable reserve in case of fire, the supply should be not less than 150 gallons per person per day. _A Good Pressure Required_ The third essential requirement is a _good water pressure_. Where a suitable source of water is found, it pays to make it conveniently available, so as to avoid carrying water by hand, which is troublesome and not conducive to cleanliness. A sufficient pressure is attained by either storing water at, or lifting it to, a suitable elevation above the point of consumption. In this respect many farm and country houses are found to be but very imperfectly supplied. Often the tank is placed only slightly higher than the second story of the house. As a result, the water flows sluggishly at the bathroom faucets, and, in case of fire, no effective fire stream can be thrown. Where a reservoir is suitably located above the house, the pressure is sometimes lost by laying pipes too small in diameter to furnish an ample stream. Elevated tanks should always be placed so high as to afford a good working pressure in the entire system of pipes. Where a tower of the required height is objectionable, either on account of the cost or on account of appearance, pressure tanks may be installed which have many advantages. In selecting a source of water supply, the following points should be borne in mind for guidance: first, the wholesomeness of the water; next, the cost required to collect, store, and distribute the water; finally, where a gravity supply is unavailable, the probable operating expenses of the water system, cost of pumping, etc. _Collection of Rain Water_ The collection of rain water near extensive manufacturing establishments is not advisable, except where arrangements are provided for either filtering or distilling the water. In the country, rain water is pure and good, if the precaution is observed to allow the first wash from roofs to run to waste. The rain may be either caught on the roofs, which must always have a clean surface and clean gutters, or else on artificially prepared catchment areas. As an example, I quote: "All about the Bermuda Islands one sees great white scars on the hill slopes. These are dished spaces, where the soil has been scraped off and the coral rock exposed and glazed with hard whitewash. Some of these are a quarter acre in size. They catch and carry the rainfall to reservoirs, for the wells are few and poor, and there are no natural springs and no brooks." (Mark Twain, "Some Rambling Notes of an Idle Excursion.") After the close of the Boer War the English sent about 7,000 Boer prisoners of war to Bermuda, where they were encamped on some of the smaller islands of the group, and the entire water supply for the encampment was obtained by building artificial catchment areas as described in the above quotation. Sometimes, instead of building underground cisterns, rain water is caught and stored in barrels above ground; if so, these should always be well covered, not only to avoid pollution, but to prevent the barrels from becoming mosquito breeders. Cisterns should always be built with care and made water-tight and impervious. The walls should be lined with cemented brickwork. In soil consisting of hard pan, cisterns in some parts of the country are built without brick walls, the walls of the excavation being simply cemented. I do not approve of such cheap construction, particularly where the cistern is located near a privy or cesspool. Pollution of cistern water is often due to the cracking of the cement lining. Overflows of cisterns should never be connected with a drain, sewer, or cesspool. Run the overflow into some surface ditch and provide the mouth with a fine wire screen, to exclude small animals. It is not recommended to build cisterns in cellars of houses. _Quality of Water Obtained from Lakes_ Lakes yield, as a rule, a supply of clear, bright, and soft water. This is particularly the case with mountain lakes, because they are at a distance from sources of contamination. The character of the water depends upon whether the lake is fed by brooks, that is, by the rain falling upon the watershed, or also by springs. In one case the water is surface water exclusively; in the other, it is surface and underground water mixed. The purity also depends upon the depth of the lake and upon the character of its bottom. Deep lakes furnish a better supply and clearer water than shallow ones. The solid matter brought into the lake by the brooks or rivers which feed it does not remain long in suspension, but soon settles at the bottom, and in this way some lakes acquire the wonderfully clear water and the beautiful bluish-green color for which they are far famed. _Strong Winds Dangerous on Lakes_ Strong winds or currents at times stir up the mud from the bottom; hence, in locating the intake, the direction of the prevailing winds should be considered, if practicable. The suction pipe should always be placed in deep water, at a depth of at least fifteen to twenty feet, for here the water is purer and always cooler. Settlements on the shores of a lake imply danger of sewage contamination, but the larger the lake, the less is the danger of a marked or serious pollution, if the houses are scattered and few. Pools and stagnant ponds are not to be recommended as a source of supply. In artificially made lakes there is sometimes danger of vegetable pollution, and trouble with growth of algæ. The bottom of such lakes should always be cleared from all dead vegetation. Surface water may be obtained from brooks flowing through uninhabited upland or from mountain streams. Such water is very pure and limpid, particularly where the stream in its downward course tumbles over rocks or forms waterfalls. But, even then, the watershed of the stream should be guarded to prevent subsequent contamination. Larger creeks or rivers are not desirable as a source of supply, for settlements of human habitations, hamlets, villages, and even towns are apt to be located on the banks of the river, which is quite generally used--wrong as it is--as an outlet for the liquid wastes of the community, thus becoming in time grossly polluted. Down-stream neighbors are sure to suffer from a pollution of the stream, which the law should prevent. _The Water of Springs_ The water of springs is subterranean, or ground water, which for geological reasons has found a natural outlet on the surface. We distinguish two kinds of springs, namely, land or surface springs, and deep springs. The former furnish water which originally fell as rain upon a permeable stratum of sand or gravel, underlaid by an impervious one of either clay or rock. Such water soaks away underground until it meets some obstacle causing it to crop out on the surface. Such spring water is not under pressure and therefore cannot again rise. Water from deep springs is rain water fallen on the surface of a porous stratum on a high level, and which passes under an impermeable stratum, and thus, being under pressure, rises again where an opening is encountered in the impervious stratum; these latter springs are really artesian in character. Deep-spring water is less apt to be polluted than water from surface or land springs, for it has a chance in its flow through the veins of the earth to become filtered. Land springs always require careful watching, particularly in inhabited regions, to prevent surface contamination. _Not all Spring Water Pure_ It is a popular fallacy that all spring water is absolutely pure and healthful. The above explanation will be helpful in pointing out how, in some cases, spring water may be nothing but contaminated ground water. Land springs in uncultivated and uninhabited regions, particularly in the mountains, yield a good and pure supply. But it is always advisable, when tapping a spring for water supply, to study its probable source, and carefully to inspect its immediate surroundings. The spring should be protected by constructing a small basin, or reservoir, and by building a house over this. The basin will also serve to store the night flow of the spring. Before deciding upon a supply from a spring, its yield should be ascertained by one of the well-known gauging methods. Springs are usually lowest in the months of October and November, though there is some difference in this respect between land springs and deep springs. The minimum yield of the spring determines whether it forms a supply to be relied upon at all times of the year. If the spring is located higher than the grounds and buildings to be supplied, a simple gravity supply line may be carried from it, with pipes of good size, thus avoiding undue friction in the line, and stoppages. If lower than the house, the water from the spring must be raised by some pumping method. All water found underground owes its origin to the rainfall. If concealed water is returned to the surface by _natural processes_ it is called spring water, but if recovered by _artificial means_ it is called well water. _Different Kinds of Wells_ There are numerous kinds of wells, distinguished from one another by their mode of construction, by their depth from the surface, by the fact of their piercing an impervious stratum or merely tapping the first underground sheet of water, and by the height to which the water in them rises or flows. Thus we have shallow and deep wells, horizontal wells or infiltration galleries, open or dug wells, tube wells, non-flowing and flowing wells, bored, drilled, and driven wells, tile-lined and brick-lined wells, and combination dug-and-tubular wells. When it is desired to provide a water supply by means of wells some knowledge of the geology of the region, of the character of the strata and of their direction and dip, will be very useful. In the case of deep wells, it is really essential. By making inquiries as to similar well operations in the neighborhood, one may gain some useful information, and thus, to some extent, avoid guesswork. When one must drill or bore through rock for a very deep well, which necessarily is expensive, much money, often uselessly spent, may be saved by consulting the reports of the State geologist, or the publications of the United States Geological Survey, or by engaging the services of an expert hydrogeologist. "_Water Finders_" It used to be a common practice to send for so-called "water finders," who being usually shrewd observers would locate by the aid of a hazel twig the exact spot where water could be found. In searching for water one sometimes runs across these men even to-day. The superstitious faith in the power of the forked twig or branch from the hazelnut bush to indicate by its twisting or turning the presence of underground water was at one time widespread, but only the very slightest foundation of fact exists for the belief in such supernatural powers. In Europe, attention has again, during the past years, been called to this "method" of finding water, and it has even received the indorsement of a very high German authority in hydraulic engineering, a man well up in years, with a very wide practical experience, and the author of the most up-to-date hand-book on "Water Supply," but men of science have not failed to contradict his statements. _Definition of "Ground-water Level"_ Water percolating through the soil passes downward by gravity until it reaches an impervious stratum. The surface of this underground sheet of water is technically called "water table" or ground-water level. The water is not at rest, but has a slow and well-defined motion, the rate of which depends upon the porosity of the soil and also upon the inclination or gradient of the water table. A shallow well may be either excavated or driven into this subsoil sheet of water. In populous districts, in villages, towns, but also near habitations, the soil from which water is obtained must, of necessity, be impregnated with organic waste matter. If, in such a surface well, the level of the water is lowered by pumping, the zone of pollution is extended laterally in all directions. Ordinary shallow well water should always be considered "suspicious water." There are two distinct ways in which surface wells are contaminated: one is by leakage from cesspools, sewers, privies, etc.; the other, just as important and no less dangerous, by direct contamination from the surface. The latter danger is particularly great in wells which are open at the surface, and from which water is drawn in buckets or pails. A pump well is always the safer of the two. Frogs, mice, and other small animals are apt to fall into the water; dust and dirt settle into it; the wooden curb and the rotten cover also contribute to the pollution; even the draw-buckets add to it by reason of being often handled with unclean hands. Always avoid, in the country, drinking water from farmers' wells located near cesspools or privies. Such shallow wells are particularly dangerous after a long-protracted drought. It is impossible to define by measurement the distance from a cesspool or manure pit at which a well can be located with safety, for this depends entirely upon local circumstances. Contamination of shallow wells may, in exceptional cases, be avoided by a proper location of the well with reference to the existing sources of impurity. A well should always be placed _above_ the source of pollution, using the word "above" with reference to the direction in which the ground water flows. _Precautions Regarding Wells_ Other precautions to be observed with reference to surface wells are the following: Never dig a well near places where soil contamination has taken or is taking place. Line the sides of the well with either brick, stone, or tile pipe, cemented in a water-tight manner to a depth of at least twenty feet from the surface, so that no water can enter except from the bottom, or at the sides near the bottom. Raise the surface at the top of the well above the grade; arrange it so as to slope away on all sides from the well; cover it with a flagstone, and cement the same to prevent foreign matters from dropping into the well; make sure that no surface water can pass directly into the well; make some provision to carry away waste water and drippings from the well. Shallow wells made by driving iron tubes with well points into the subsoil water are preferable to dug wells. Use a draw-pump in preference to draw buckets. When a well is sunk through an impervious stratum to tap the larger supply of water in the deeper strata, we obtain a "deep well." Water so secured is usually of great purity, for the impurities have been filtered and strained out by the passage of the water through the soil. Moreover, the nature of the construction of deep wells is such that they are more efficiently protected against contamination, the sides being made impervious by an iron-pipe casing. In some rare cases, even deep wells show pollution due to careless jointing of the lining, or water follows the outside of the well casing until it reaches the deeper water sheet. Deep wells usually yield more water than shallow driven wells, and the supply increases perceptibly when the water level in the well is lowered by pumping. While surface wells draw upon the rainfall percolating in their immediate vicinity, deep wells are supplied by the rainfall from more remote districts. Deep wells are either non-flowing or flowing wells. When the hydrostatic pressure under which the water stands is sufficient to make it flow freely out on the surface or at the mouth of the well, we have a flowing, or true artesian well. _Character of Water From Deep Wells_ Water from deep wells is of a cool and even temperature. It is usually very pure, but in some cases made hard by mineral salts in the water. Sulphur is also at times present, and some wells on the southern Atlantic coast yield water impregnated with sulphur gases, which, however, readily pass off, leaving the water in good condition for all uses. In many cases the water has a taste of iron. No general rule can be quoted as to the exact amount of water which any given well will yield, for this depends upon a number of factors. Increasing the diameter of very deep wells does not seem to have any marked effect in increasing the supply. Thus, a two-foot well gives only from fifteen to thirty per cent more water than a three-inch-pipe well. This rule does not seem to apply to shallow wells of large diameter, for here we find that the yield is about in proportion to the diameter of the well. It is interesting to note the fact that wells located near the seashore, within the influence of the tide, vary in the hourly flow. According to Dr. Honda, of the University of Tokio, there is "a remarkable concordance between the daily variations in the level of the tides and the water level in wells." The water in wells one mile from the seashore was found to stand highest at high tide. The daily variation amounted to sixteen centimeters, or a little over six inches. A similar variation was observed by the writer in some flowing wells located on the north shore of Long Island. Dr. Honda found also that the water level in wells varied with the state of the barometer, the water level being lowered with a rise in the barometer. Where a large supply is wanted a series of wells may be driven, and, as the expense involved is considerable, it is always advisable to begin by sinking a smaller test well to find out whether water may be had. Ground water may also be recovered from water-bearing strata by arranging horizontal collecting galleries with loose-jointed sides through which the water percolates. Such infiltration galleries have been used in some instances for the supply of towns and of manufacturing establishments, but they are not common for the supply of country houses. _Laws Regulating Appropriation of Water_ Persons contemplating the establishment of a system of water supply in the country should bear in mind that the taking of water for supply purposes is, in nearly all States, hemmed in by legal restrictions. The law makes a distinction between subterranean waters, surface waters flowing in a well-defined channel and within definite banks, and surface waters merely spread over the ground or accumulated in natural depressions, pools, or in swamps. There are separate and distinct laws governing each kind of water. It is advisable, where a water-supply problem presents itself, to look up these laws, or to consult a lawyer well versed in the law of water courses. If it is the intention to take water from a lake, the property owner should make sure that he owns the right to take such water, and that the deed of his property does not read "to high-water mark only." The owner of a property not abutting on a lake has no legal right to abstract some of the water from the lake by building an infiltration gallery, or a vertical well of large diameter intended for the same purpose. On the other hand, an owner may take subterranean water by driving or digging a well on his own property, and it does not matter, from the law's point of view, whether by so doing he intercepts partly or wholly the flow of water in a neighboring well. But, if it can be shown that the subterranean water flows in a well-defined channel, he is not permitted to do this. The water from a stream cannot be appropriated or diverted for supply or irrigation purposes by a single property holder without the consent of the other riparian owners, and without compensation to them. CHAPTER II =Appliances for Distributing Water= We have so far discussed only the various sources of potable water. We must now turn our attention to the mechanical means for making it available for use, which comprise appliances for lifting, storing, conveying, distributing, and purifying the water. The location of the source of supply with reference to the buildings and grounds decides generally the question whether a gravity supply is feasible or whether water must be pumped. The former is desirable because its operating expenses are almost nothing, but it is not always cheapest in first cost. Rather than have a very long line of conduit, it may be cheaper to pump water, particularly if wind or water power, costing nothing, can be used. _Machines for Pumping_ When it becomes necessary to pump water, there are numerous machines from which to choose; only the more important ones will be considered. We may use pumps operated by manual labor, those run by animal power, pumping machinery using the power of the wind or that of falling or running water; then there are hot-air, steam, and electric pumps, besides several forms of internal-combustion engines, such as gas, gasoline, and oil engines. Each has advantages in certain locations and under certain conditions. Of appliances utilizing the forces of Nature, perhaps the simplest efficient machine is the hydraulic ram. While other machines for lifting water are composed of two parts, namely, a motor and a pump, the ram combines both in one apparatus. It is a self-acting pump of the impulse type, in which force is suddenly applied and discontinued, these periodical applications resulting in the lifting of water. Single-acting rams pump the water which operates them; double-acting rams utilize an impure supply to lift a pure supply from a different source. The advantages of the ram are: it works continuously, day and night, summer and winter, with but very little attendance; no lubrication is required, repairs are few, the first cost of installation is small. Frost protection, however, is essential. The disadvantages are that a ram can be used only where a large volume of water is available. The correct setting up is important, also the proper proportioning in size and length of drive and discharge pipes. The continual jarring tends to strain the pipes, joints, and valves; hence, heavy piping and fittings are necessary. A ram of the improved type raises water from twenty-five to thirty feet for every foot of fall in the drive pipe, and its efficiency is from seventy to eighty per cent. Running water is a most convenient and cheap power, which is often utilized in water wheels and turbines. These supply power to run a pump; the water to be raised may come from any source, and the pump may be placed at some distance from the water wheel. Where sufficient fall is available--at least three feet--the overshot wheel is used. In California and some other Western States an impulse water wheel is much used, which is especially adapted to high heads. _Windmills Used for Driving Pumps_ The power of the wind applied to a windmill is much used for driving pumps. It is a long step forward from the ancient and picturesque Dutch form of windmill, consisting of only four arms with cloth sails, to the modern improved forms of wheels constructed in wood and in iron, with a large number of impulse blades, and provided with devices regulating the speed, turning the wheel out of the wind during a gale, and stopping it automatically when the storage tank is filled. The useful power developed by windmills when pumping water in a moderate wind, say of sixteen miles an hour velocity, is not very high, ranging from one twenty-fifth horse-power for an eight and one-half foot wheel to one and one-half horse-power for a twenty-five foot wheel. The claims of some makers of windmills as to the power developed should be accepted with caution. The chief advantage is that, like a ram, the windmill may work night and day, with but slight attention to lubrication, so long as the wind blows. But there are also drawbacks; it requires very large storage tanks to provide for periods of calm; the wheel must be placed sufficiently exposed to receive the full wind force, either on a tower or on a high hill, and usually this is not the best place to find water. Besides, a windmill tower, at least the modern one, is not an ornamental feature in the landscape. It is expensive when built sufficiently strong to withstand severe winter gales. During the hot months of the year, when the farmer, the gardener, and the coachman require most water, the wind is apt to fail entirely for days in succession. _The Use of Engines_ If water is not available, and wind is considered too unreliable, pumping must be accomplished by using an engine which, no matter of what form or type, derives its energy from the combustion of fuel, be the same coal, wood, charcoal, petroleum or kerosene, gas, gasoline, or naphtha. The use of such pumping engines implies a constant expense for fuel, operation, maintenance, and repairs. In some modern forms of engines this expense is small, notably so in the oil engine, and also in the gasoline engine; hence these types have become favorites. _Advantages of Pumping Engines_ An advantage common to all pumping engines is that they can be run at any time, not like the windmill, which does not operate in a light breeze, nor like the ram, which fails when the brook runs low. Domestic pumping engines are built as simple as possible, so that the gardener, a farm hand, or the domestic help may run them. Skill is not required to operate them, and they are constructed so as to be safe, provided ordinary intelligence is applied. In using a fuel engine it is desirable, because of the attendance required, to take a machine of such capacity and size that the water supply required for two or three days may be pumped to the storage tank in a few hours. _Expansive Force of Heated Air Utilized_ A favorite and extensively used type of domestic pump is the hot-air engine, in which the expansive force of heated air is used to do useful work. Among the types are simple and safe machines which do not easily get out of order. They are started by hand by giving the fly wheel one or more revolutions. If properly taken care of they are durable and do not require expensive repairs. _Gas and Gasoline Engines_ In gas engines power is derived from the explosion of a mixture of gas and air. Where a gas supply is available, such engines are very convenient, for, once started, they will run for hours without attention. They are economical in the consumption of gas, and give trouble only where the quality of gas varies. Owing to the unavailability of gas on the farm and in country houses, two other forms of pumping engines have been devised which are becoming exceedingly popular. One is the gasoline, the other is the oil engine. Both resemble the gas engine, but differ from it in using a liquid fuel which is volatilized by a sprayer. Gasoline engines are now brought to a high state of perfection. _Kerosene or Crude Oil as Fuel_ In recent years, internal-combustion engines which use heavy kerosene or crude oil as fuel have been introduced. These have two palpable advantages: first, they are safer than gasoline engines; second, they cost less to run, for crude oil and even refined kerosene are much cheaper than gasoline. Oil engines resemble the gas and gasoline engines, but they have larger cylinders, because the mean effective pressure evolved from the explosion is much less than that of the gasoline engines. Oil engines for pumping water are particularly suitable in regions where coal and wood cannot be obtained except at exorbitant cost. Usually, the engine is so built as to be adapted for other farm work. It shares this advantage with the gasoline engine. Oil engines are simple, reliable, almost automatic, compact, and reasonable in first cost and in cost of repairs. There are many forms of such engines in the market. To be successful from a commercial point of view, an oil engine should be so designed and built that any unskilled attendant can run, adjust, and clean it. The cost of operating them, at eight cents per gallon for kerosene, is only one cent per hour per horse-power; or one-half of this when ordinary crude oil is used. The only attention required when running is periodical lubrication and occasional replenishing of the oil reservoir. The noise of the exhaust, common to all engines using an explosive force, can be largely done away with by using a muffler or a silencer. The smell of oil from the exhaust likewise forms an objection, but can be overcome by the use of an exhaust washer. _Steam and Electric Pumps_ The well-known forms of steam-pumping engines need not be considered in detail, because high-pressure steam is not often available in country houses. Where electric current is brought to the building, or generated for lighting purposes, water may be pumped by an electric pump. Electric motors are easy and convenient to run, very clean, but so far not very economical. Electric pumps may be arranged so as to start and stop entirely automatically. Water may be pumped, where electricity forms the power, either by triplex plunger pumps or by rotary, screw, or centrifugal pumps. _Pumps Worked by Hand_ Space forbids giving a description of the many simpler devices used for lifting water. In small farmhouses lift and force pumps worked by hand are now introduced, and the old-fashioned, moss-covered draw-bucket, which is neither convenient nor sanitary, is becoming a relic of past times. _Reservoirs and Storage Tanks_ The water pumped is stored either in small masonry or earth reservoirs, or else in storage tanks of either wood, iron, or steel, placed on a wood or steel tower. Wooden tanks are cheap but unsightly, require frequent renewal of the paint, and give trouble by leaking, freezing, and corrosion of hoops. In recent years elevated tanks are supplanted by pressure tanks. Several such systems, differing but little from one another, are becoming quite well known. In these water is stored under suitable pressure in air-tight tanks, filled partly with water and partly with air. _A Simple Pressure System_ One system consists of a circular, wrought-steel, closed tank, made air- and water-tight, a force pump for pumping water into the tank, and pipe connections. The tank is placed either horizontally or vertically in the basement or cellar, or else placed outdoors in the ground at a depth below freezing. Water is pumped into the bottom of the tank, whereby its air acquires sufficient pressure to force water to the upper floors. This simple system has some marked advantages over the outside or the attic tank. In these, water gets warm in summer and freezes in winter. Vermin and dust get into the tank, and the water stagnates. In the pressure tank, water is kept aërated, cool, and clean. Another pressure tank has an automatic valve, controlled by a float and connected with suction of pump. It prevents the tank from becoming water-logged by maintaining the correct amount of air inside. _An Ideal System for a Country House_ Still another system using pressure tanks is more complete than either of the others, comprising engine, pump, air compressor, a water tank, and also an air tank. It is best described by a recent example constructed from plans and under the direction of the writer. The buildings supplied with water comprise the mansion, the stable, the cottage, and a dairy, and the pumping station is placed near the shore of the lake from which the supply is taken. See Figs. 1 and 2. [Illustration: FIG. 1. DIAGRAM OF COMPRESSED AIR TANK SYSTEM.] [Illustration: FIG. 2. PRESSURE-TANK PUMPING STATION. Interior view of pumping station of compressed air-tank system (see plan on opposite page) showing 3,000 gallon water tank, air tank of 150 pounds pressure and 10 horse-power gasoline engine.] The pump house is about 20 feet by 27 feet, and contains a water-storage tank 6 feet in diameter and 13-1/2 feet long, of a capacity of 3,000 gallons; an air tank of same dimensions as the water tank, holding air under 150 pounds pressure; a 10 horse-power gasoline engine, direct-connected, by means of friction clutch, with an air compressor and also with a triplex pump of 75 gallons capacity per minute. The water in the tank is kept under 75 pounds pressure, and at the hydrant near the house, located about 100 feet above the pumping station, there is an available pressure of 33 pounds. The last drop of water flows from the water tank under the full pressure of 75 pounds at the pumping station. The suction pipe into the lake is 4 inches and is provided with well strainers to prevent clogging. The cost of pumping water by this system is quite reasonable. The gasoline engine requires per horse-power per hour about 1-1/4 gallons of gasoline, and at sixteen cents per gallon this makes the cost for 1,000 gallons pumped about five cents. To this expense should, however, be added the cost of lubricating oil, repairs, amount for depreciation, and the small cost for labor in running the engine. Water pipes forming a distribution system should always be chosen generous in diameter, in order to avoid undue loss of pressure by friction. Where fire hydrants are provided, the size of the water main should not be below four inches. All branches should be controlled by shut-offs, for which the full-way gate valves are used in preference to globe valves. Pipe-line material is usually galvanized, screw-jointed wrought iron for sizes up to four inches. In conclusion, a word about water purification. Where the quality of the water supply is not above suspicion it may be improved by filtration. A filter should never be installed without the advice of a qualified expert, for there are numerous worthless devices and few really efficient ones. Where a filter is not available, the water used for drinking should be boiled or sterilized if there is the slightest doubt as to its wholesomeness. CHAPTER III =Purifying Water by Copper Sulphate= From the standpoint of the health of the community, the most vital problem is to get pure water. Almost equally important, when comfort and peace of mind is considered, is the procuring of sweet water. The wise owner of a country home looks to the water supply upon which his family is dependent. The careful farmer is particular about the water his stock, as well as his family, must drink. But careless persons constitute the large majority. Most people in the city and in the country pay no attention to their drinking water so long as it "tastes all right." _Clear Water Often Dangerous_ Some years ago the inhabitants of Ithaca, N. Y., furnished a pitiful example of this foolhardy spirit. For a year previous to the breaking out of the typhoid epidemic, the public was warned, through the local and the metropolitan press, of the dangerous condition of Ithaca's water supply. Professors of Cornell College joined in these warnings. But the people gave no heed, probably because the water was _clear_ and its taste sweet and agreeable. As was the case in this instance, bacteria are tolerated indefinitely, and it is only an alarming increase in the death rate that makes people careful. Then they begin to boil the water--when it is too late for some of them. _Bad-Tasting Water not Always Poisonous_ But let the taste become bad and the odor repulsive, and a scare is easily started. "There must be dead things in the water, or it wouldn't taste so horrible," is the common verdict. Some newspaper seizes upon the trouble and makes of it a sensation. The ubiquitous reporter writes of one of "the animals" that it "looks like a wagon wheel and tastes like a fish." With such a remarkable organism contaminating one's drink no wonder there is fear of some dread disease. The water is believed to be full of "germs"; whereas the pollution is entirely due to the presence of algæ--never poisonous to mankind, in some cases acting as purifying agents, but at certain seasons of the year imparting a taste and odor to the water that cannot be tolerated. Algæ--what are they? They are aquatic plants. Algæ are not to be confounded with the water vegetation common to the eye and passing by the term weeds. Such plants include eelgrass, pickerel weed, water plantain, and "duckmeat"--all of which have roots and produce flowers. This vegetation does not lend a bad odor or taste to the water. In itself it is harmless, although it sometimes affords a refuge for organisms of a virulent type. But when the aquatic vegetation of the flowering variety is eliminated from consideration, there still remains a group of water plants called algæ. They comprise one-fifth of the known flowerless plants. They are the ancestors of the entire vegetable kingdom. Those whose habitat is the sea number the largest plants known in nature. Certain forms found in the Pacific are supposed to be 800 feet in length; others are reported to be 1,500 feet long. The marine variety are familiar as the brown kelps and the wracks, which are very common along our Northern coast. _Plants Which Pollute Drinking Water_ The fresh-water algæ are usually grass green in color. This green variety is often seen as a spongy coating to the surface of stagnant pools, which goes by the name of "frog spawn" or "pond scum." One of this description, _Spirogyra_, has done thousands of dollars' worth of damage by smothering the life out of young water-cress plants in artificial beds constructed for winter propagation. When the cress is cut the plants are necessarily left in a weakened condition, and the algæ form a thick mat over the surface of the water, thus preventing the growth of the cress plants and oftentimes killing them. The absolute necessity of exterminating these algæ led to the perfection of the copper-purification process. It is, however, a variety of algæ not easily detected that contaminates the water. So long as they are in a live, healthy condition they benefit drinking water by purifying it. Indeed, some scientists have attributed the so-called self-purification of a stream entirely to the activities of these plants. Of such, one form, _Chlamydomonas_, is bright grass green in appearance. But the largest group--the plants which have the worst reputation as polluters of drinking water--are popularly known as the "blue-green algæ" (_Schizophyceæ_). The common name tells the color of these plants, although there are exceptions in this respect, some of them showing shades of yellow, brown, olive, chocolate, and purplish red. This variety of algæ flourishes in the summer months, since a relatively high temperature and shallow stagnant water favor its germination. If the pond begins to dry up, the death of the organisms takes place, and the result is a most disagreeable, persistent odor which renders the water unfit for drinking purposes. This result is chemically due to the breaking down of highly organized compounds of sulphur and phosphorus in the presence of the large amount of nitrogen contained in these plants. Decomposition is not necessary for some of the blue greens to give off a bad odor, however. A number of them, on account of their oil-content, produce an odor when in a healthy condition that is sometimes likened to raw green corn or to nasturtiums, but usually it cannot be so pleasantly described. The Department of Agriculture has been able to solve the problem of exterminating algæ from water supplies.[1] The department has done more; for it has succeeded in perfecting a method by which a reservoir contaminated with typhoid or other pathogenic bacteria can be purified. The work was begun with an inquiry into the extent of the trouble from algal pollution. Letters were addressed to some five hundred engineers and superintendents of water companies scattered all over the United States. The replies, which came from almost every State in the Union, were burdened with one complaint--"Algæ are our worst pest"; and with one prayer--"Come over into Macedonia, and help us." _A Cheap and Available Remedy for Algæ_ Convinced of the need of earnest work, extensive laboratory experiments were inaugurated. The problem presented was this: the remedy must not only be readily available, but it must be cheap, that advantage may be taken of it by the poorest communities, as well as by those owning large reservoirs. Above all, the remedy must be absolutely harmless to man; the poison used to exterminate algæ must not in any way affect the water drinkers. A large number of substances were used in the experiments before the final decision rested with copper sulphate. This salt is very poisonous to algæ. On the other hand, copper in solution just strong enough to destroy algal growth could not possibly injure man; in fact, the temporary presence of such a small amount of copper in drinking water could not be detected. _A Practical Demonstration_ The results in the laboratory being successful, the next step was to make a practical demonstration of the value of the method. This was first done in the fall of 1901. At Ben, Va., water cress is grown in large quantities during the winter, when it is a valuable market crop. Dams are constructed across a stream in such a manner as to enable the maintenance of a water level not too high for the growth of plants; when a freeze is threatened the plants can be flooded. In the cress beds selected for the experiments the water is obtained from a thermal spring whose temperature throughout the year is about 70° F. This temperature is particularly favorable to the growth of "frog spawn." After the cress was cut for market, the algæ frequently developed so rapidly as to smother the life out of the weakened plants. When this occurred, the practice was to rake out both water cress and algæ and reset the entire bed. This was not only expensive; half the time it failed to exterminate the pest. It was, therefore, most desirable to devise a method of ridding the bed of algal growth without injuring the cress. _The Copper-sulphate Method Tested_ Here the copper-sulphate method was put to a practical test. At the outset a strong solution was sprayed on the algæ which coated the surface of the pond. This only killed the algal growth with which the particles of copper came in contact and left the main body of algæ unaffected. Then trial was made of dissolving the copper directly in the water, and the result was most satisfactory. The solution used was that of 1 part of copper to 50,000,000 parts of water. Growers need have no trouble in the future. They need have no fear of employing the method, as the copper solution required for killing the algæ could not possibly injure water cress, provided ordinary care is used in the work. As to the frequency of treatment required, one or two applications a year will generally be found sufficient, as this letter, received from the manager of the Virginia company, goes to show: "The 'moss' has given me no trouble at all this winter; in fact, I have for six months had to resort to the copper sulphate only once.... All the conditions were favorable last fall and early winter for a riot of 'moss,' but it did not appear at all until just a few days ago, and then yielded to treatment much more readily than it did when I first began to use the copper." This letter was written over three years after Dr. Moore made his experiment in these cress beds. Satisfied with the results attained in exterminating algal growth in water-cress beds, attention was next given to reservoirs. Some fifty water supplies were treated during the summer of 1904, and in every case success attended the copper cure. In one respect the results were surprising. It was found that in practice the copper-sulphate method worked better than in theoretic experimentation; results in large reservoirs were more pronounced than in the laboratory. In fact, it developed that the solution necessary to kill algæ in the laboratory must contain from five to twenty times as much copper as that contained in a solution which will exterminate algal growth in its natural habitat. This is not easily explained, if it can be explained at all. The test reason advanced is that only the most resistant organisms stand transplanting to an artificial environment. But, after all, the important point is that the new method works better in practice than was expected. _A Prescription for the Copper Cure_ Thus the department is able to announce that the process is no longer in the experimental stage, and also to say what conditions must be known in determining the proper quantity of copper sulphate for destroying algæ, together with a prescription for the copper cure. Here it is, for the benefit of careful persons who will use the method with proper intelligence: "The importance of knowing the temperature of the contaminated water is second only to the necessity of knowing the organism present. With increase of temperature the toxicity of a given dilution increases, and _vice versa_. Assuming that 59° F. is the average temperature of reservoirs during the seasons when treatment is demanded, the quantity of copper should be increased or decreased approximately 2.5 per cent for each degree below or above 59° F. "Similar scales should be arranged for the organic content and the temporary hardness of the water. With the limited data at hand it is impracticable to determine these figures, but an increase of 2 per cent in the quantity of copper for each part per 100,000 of organic matter and an increase of 0.5 to 5 per cent in the proportion of copper for each part per 100,000 of temporary hardness will possibly be found correct. The proper variation in the increase due to hardness will depend upon the amount of dissolved carbon dioxide; if very small, 5 per cent increase is desirable; if large, 0.5 per cent is sufficient." The information in this prescription is to be used in connection with a table[2] published by the Department of Agriculture. This table gives the number of parts of water to one part of copper sulphate necessary to kill the various forms of algæ which are listed. The formulæ vary from 1 part of copper to 100,000 parts of water, necessary to destroy the most resistant and very rare forms (three of these are listed), to 1 part of copper in 25,000,000 parts of water, which is a sufficiently strong solution to exterminate _Spirogyra_, the cress-bed pest. By far the majority of forms do not require a solution stronger than that of 1 part of copper to 1,000,000 parts of water. _What the Agricultural Department is Doing_ It is true that the department is not now holding out, directly, a helping hand to the owner of a country place, or to the farmer, in this campaign of purifying drinking water. In the first place, the greatest good of the greatest number demands that large reservoirs, which supply a great number of people with drinking water, ought to be considered first. Such supplies, moreover, are most frequently contaminated. Where fifty reservoirs were treated last summer, ten times that number will be "cured" this summer. It will be readily seen, therefore, that in conducting such a large number of experiments--considering preliminary reports, prescribing for treatment, and keeping proper account of results--the department, with a limited force and limited facilities, has its hands more than full. More important still, there is an absolute need of the services of some expert on the ground. While an algologist is a functionary not generally employed by water companies--in fact, a man trained in the physiology of algæ is difficult to find--nevertheless, it is highly important, as the department views it, to have the coöperation of an expert versed to some extent in the biological examination of drinking water. In other words, the copper cure is not a "patent medicine," with printed directions which any person could follow. Intelligence and care are absolutely essential in the use of this treatment. Furthermore, each case must be treated as a distinct and separate case, as a physician would treat a patient. _Actual Purification Simple_ Suppose, however, an owner of a country place, which is dependent upon a fresh-water pond for its water supply, finds that his drinking water is contaminated, that the taste and odor are such as to render the water unfit for use. There is no reason why he should not treat the supply, provided he is properly careful. When the nature of the polluting organism is definitely determined and the average temperature of the water observed, then the necessary formula can be decided upon. First, of course, the pond must be plotted, the depth found, and the capacity computed. The department will willingly furnish data for this purpose, together with blanks upon which to submit details as to contaminating organisms and water temperature, to any applicant. Once the proper solution is determined upon, the actual work of purification is most simple. In the following directions the department outlines the most practicable method of introducing the copper sulphate into a water supply: _Directions for the Copper Cure_ "Place the required number of pounds of copper sulphate in a coarse bag--gunny sack or some equally loose mesh--and, attaching this to the stern of a row-boat near the surface of the water, row slowly back and forth over the reservoir, on each trip keeping the boat within ten to twenty feet of the previous path. In this manner about a hundred pounds of copper sulphate can be distributed in one hour. By increasing the number of boats, and, in the case of deep reservoirs, hanging two or three bags to each boat, the treatment of even a large reservoir may be accomplished in from four to six hours. It is necessary, of course, to reduce as much as possible the time required for applying the copper, so that for immense supplies, with a capacity of several billion gallons, it would probably be desirable to use a launch, carrying long projecting spars to which could be attached bags containing several hundred pounds of copper sulphate. "The substitution of wire netting for the gunny-sack bag allows a more rapid solution of the sulphate, and the time required for the introduction of the salt may thus be considerably reduced. It is best to select as warm a day for treatment as circumstances will permit." _Cost of the Treatment_ Not difficult, one would say. No--when the proper solution is determined; to reach that determination is the difficulty. That the method can be tried "at home" is proved by the results obtained by the owner of a country home in the vicinity of New York. Tired of consulting engineers, who looked at his water supply, informed him that they could do nothing, and then charged him a big fee (to one he paid $250), this owner resorted to the copper-sulphate treatment. The cure cost the man just $2--but let his letter to the department tell the story: "My place in the country is located at Water Mill, in the township of Southampton, in Long Island. I purchased it in April, 1902, and was largely influenced in selecting this piece of land by the beauty of a pond which bounds it on the east. This little body of water covers about two acres, is fed by numerous springs, and discharges into Mecox Bay, the southern boundary of the land. When I bought the place the pond was filled with clear water. About the middle of the following June algæ began to show, and in August the surface was almost entirely covered by the growth. The odor was offensive, and myriads of small insects hovered over the masses of algæ much of the time. I consulted two engineers interested in the storage of water, and they told me that nothing could be done. The condition was so objectionable that I planned to plant a thick hedge of willows along the bank to shut off the view of the pond from the house.... I examined the pond on June 15th and found large masses of algæ covering an area several hundred feet in length and from twenty to forty feet in width. No microscopical examination was made of the growth, but I was informed that it seemed to be largely composed of filaments of _Spirogyra_ and other _Confervæ_. On June 18th the treatment was begun.... In one week the growth had sunk and the pond was clear water. I examined the pond September 15th and found it still clear. "The use of the sulphate of copper converted an offensive insect-breeding pond into a body of beautifully clear water. The pond was full of fish, but the copper did not seem to harm them." _Effect of Copper Sulphate on Fish_ Native trout were not injured when the large reservoir at Cambridge, N. Y., was purified by the copper treatment. A slightly different result, in this respect, was reported from Elmira, N. Y., however. Part of the report is as follows: "The effect of the copper-sulphate treatment on the different animal life was as follows: numerous 'pollywogs' killed, but no frogs; numerous small (less than two inches long) black bass and two large ones (eight inches long) killed; about ten large 'bullheads' were killed, but no small ones; numerous small (less than two inches long) 'sunfish' were killed, but no large ones. "The wind brought the dead fish to the corners of the reservoir, and it was very little trouble to remove them. No dead fish were seen twenty-four hours after completion of the treatment." The injury done by copper sulphate to fish is a more serious matter than was at first supposed. Brook trout are, apparently, the least resistant to the salt. A Massachusetts trout pond stocked with eight-inch trout lost forty per cent as a result of the introduction of a strong solution of copper sulphate. The Bureau of Fisheries is working in conjunction with the Division of Plant Physiology in this matter, and it is hoped to secure reliable information. In the meantime, owners of ponds stocked with game fish would do well to take great care before resorting to the copper cure for algæ--that is, if they hesitate to lose a part of the fish. _Water May be Drunk During Treatment_ When a pond or reservoir is treated with the proper amount of copper sulphate to remove algæ--except in the case of the few very resistant forms requiring a stronger solution than 1 part of copper to 1,000,000 parts of water--there is no need of discontinuing the use of the water supply during treatment; the water may be drunk with impunity. But when water known to be polluted with pathogenic bacteria is sterilized by means of copper sulphate in strong solution, it is just as well to discontinue the use of the water for drinking purposes for not more than twenty-four hours. Even then, this is an overcareful precaution rather than a necessity. Experiments conducted with great care and thoroughness demonstrate that at room temperature, which is near the temperature of a reservoir in summer, a solution of 1 part of copper to 100,000 parts of water will destroy typhoid bacteria in from three to five hours. Similar experiments have proved that a copper solution of like strength is fatal to cholera germs in three hours, provided the temperature is above 20° F. As was the case with algæ, bacteria were found to be much more sensitive to copper when polluting water than when grown in artificial media. _The Use of Copper Tanks_ The toxic effect of metallic copper upon typhoid bacteria in water gives some hints as to prevention of the disease by the use of copper tanks. This should not altogether take the place of the boiling of the water; it is useful in keeping it free from contamination, although water allowed to stand in copper receptacles for a period of from twenty-four to forty-eight hours at room temperature would be effectively sterilized, no matter what its contamination and no matter how much matter it held in suspension. But in order to insure such results the copper must be kept thoroughly clean. This polishing is not, as was popularly supposed, to protect the consumer from "copper poisoning," but to prevent the metal from becoming so coated with foreign substances that there is no contact of the copper with the water, hence no antiseptic quality. Dr. Henry Kreamer, of Philadelphia, proved that within four hours typhoid germs were completely destroyed by the introduction into the polluted water of copper foil. "Granting the efficiency of the boiling of water for domestic purposes, I believe that the copper-treated water is more natural and more healthful.... The intestinal bacteria, like colon and typhoid, are completely destroyed by placing clean copper foil in the water containing them. "Pending the introduction of the copper treatment of water on a large scale, the householder may avail himself of a method for the purification of drinking water by the use of strips of copper foil about three and one-half inches square to each quart of water, this being allowed to stand overnight, or from six to eight hours at the ordinary temperature, and then the water drawn off or the copper foil removed." Although a splendid antiseptic, copper in weak solution is not harmful, no more so than the old copper utensils used by our forefathers were harmful. Undoubtedly they were of benefit, and the use of them prevented the growth of typhoid and other bacteria. People of to-day might well go back to copper receptacles for drinking water. FOOTNOTES: [1] For published reports of the work, see Bulletins 64 and 76, Bureau of Plant Industry, U. S. Department of Agriculture; reports prepared by Dr. George T. Moore and his assistant, Mr. Karl F. Kellerman. [2] See Bulletin No. 76, supra. CHAPTER IV =Ridding Stagnant Water of Mosquitoes= Because of the serious and often fatal injury it inflicts on man, the most dangerous animal known is the mosquito. Compared with the evil done by the insect pest, the cobra's death toll is small. This venomous serpent is found only in hot countries, particularly in India, while mosquitoes know no favorite land or clime--unless it be Jersey. Arctic explorers complain of them. In Alaska, it is recorded by a scientist that "mosquitoes existed in countless millions, driving us to the verge of suicide or insanity." A traveler on the north shore of Lake Superior, when the snow was several feet deep, and the ice on the lake five feet in thickness, relates that "mosquitoes appeared in swarms, literally blackening the banks of snow in sheltered places." _Mosquitoes Responsible for Yellow Fever_ In the temperate zone this evil-breeding insect was, until recent years, considered more in the light of an exasperating pest. It is now known, however, that malaria is due entirely to the bites of mosquitoes. But it is in the tropical countries that their deadliest work is done. There, it has been proved beyond question, the mosquitoes are responsible for the carriage of yellow fever. If, in a yellow-fever ridden region, one were to live entirely in an inclosure, carefully protected with proper screens--as certain entomologists did--there practically would be no danger from the dread disease, even if all other precautions were neglected. _Effect of a Mosquito Bite_ The crime committed by the mosquito against its innocent victim, man, is more in the nature of manslaughter than of murder, according to the authorities. There is no _premeditated malice_. "A mosquito bites primarily to obtain food," says a leading entomologist; "there is neither malice nor venom in the intent, whatever there may be in the act." There isn't great comfort in the intelligence conveyed by the scientist, nor in his further observation: "Theoretically, there would seem to be no reason why there should be any pain from the introduction of the minute lancets of the insects, and the small amount of bloodletting is usually a benefit rather than otherwise. Unfortunately, however, in its normal condition the human blood is too much inclined to clot to be taken unchanged into the mosquito stomach; hence, when the insect bites, a minute droplet of poison is introduced, whose function it is to thin out the fluid and make it more suitable for mosquito digestion. It is this poison that sets up the inflammation and produces the irritation or swelling.... The pain is caused entirely by the action of the poison in breaking up the blood, and, as the first act of a biting mosquito is to introduce the poison into the wound, the pain and inflammation will be the same, whether the insect gets its meal or not. In fact, it has been said that if a mosquito be allowed to suck its fill and then fly, the bite will not itch, and there is just a basis of justification for this." To make a scientific inquiry into the habits of the mosquito, and to do it patiently, one should be far from the maddening swarms, or at least effectively screened in. Then it would be possible to believe the statement of the Government's entomologist that not "one mosquito in a million" ever gets the opportunity to taste the blood of a warm-blooded animal. As proof of this there are, in this country, great tracts of marshy land never frequented by warm-blooded animals, and in which mosquitoes are breeding in countless numbers. The point is emphasized by the prevalence of mosquitoes in the arctic circle and other uninhabited regions. If this gory insect does not live by blood alone, how is it nourished? Female mosquitoes are by nature vegetarians; they are plant feeders. Why they should draw blood at all is a question which remains unsolved by entomologists--as well as by the suffering victims. The females have been observed sucking the nectar from flowers; obtaining nutriment from boiled potatoes, even from watermelon rinds, from which they extract the juice. As regards the blood habit, the male mosquito is a "teetotaler." Just how this male insect lives, scientists have not determined. He may not take nourishment at all. At any rate, the mouth parts of the male are so different from those of the female that it is probable his food is obtained differently. The male is often seen sipping at drops of water, and a taste for molasses is ascribed to the male mosquito by one authority. _Presence of Mosquitoes Depends Upon Winds_ A common remark heard along the Jersey shore, also on Long Island, is this: "When we have a sea breeze we are not troubled with mosquitoes, but when there comes a land breeze they are a pest." While this observation is true, the reasons therefore entertained by the unscientific mind are erroneous. The matter of the absence or abundance of mosquitoes in varying winds is closely related to the inquiry which entomologists have made: how far will mosquitoes fly? Says one investigator: "The migration of mosquitoes has been the source of much misapprehension on the part of the public. The idea prevalent at our seaside resorts that a land breeze brings swarms of mosquitoes from far inland is based on the supposition that these insects are capable of long-sustained flight, and a certain amount of battling against the wind. This is an error. Mosquitoes are frail of wing; a light puff of breath will illustrate this by hurling the helpless creature away, and it will not venture on the wing again for some time after finding a safe harbor. The prevalence of mosquitoes during a land breeze is easily explained. It is usually only during the lulls in the wind that Culex can fly. Generally on our coast a sea breeze means a stiff breeze, and during these mosquitoes will be found hovering on the leeward side of houses, sand dunes, and thick foliage.... While the strong breezes last, they will stick closely to these friendly shelters, though a cluster of houses may be but a few rods off, filled with unsuspecting mortals who imagine their tormentors are far inland over the salt meadows. But if the wind dies down, as it usually does when veering, out come swarms upon swarms of females intent upon satisfying their depraved taste for blood. This explains why they appear on the field of action almost immediately after the cessation of the strong breeze; on the supposition that they were blown inland, this sudden reappearance would be unaccountable." A sultry, rainy period of midsummer is commonly referred to as "good mosquito weather." The accepted idea is that mosquitoes are much more abundant at such times. This is true, and the explanation is simple. Mosquito larvæ, or wrigglers, as they are termed, require water for their development. A heavy shower leaves standing water, which, when the air is full of moisture, evaporates slowly. Then, too, the heat favors the growth of the microörganisms on which the larvæ feed; wrigglers found in the water forty-eight hours after their formation will have plenty of food, and adult mosquitoes will appear six to eight days after the eggs are laid. Clear weather, with quick evaporation, interferes with the development of the wrigglers, so that a season with plenty of rain, but with sunshiny, drying weather intervening, is not "good mosquito weather." _Destroy the Larvæ_ Inasmuch as a generation of mosquitoes appear to torment man within ten days, at the longest, after the eggs are laid; as a batch laid by a female mosquito contains from two hundred to four hundred eggs; as from each egg may issue a larva or wriggler which in six days will be an adult mosquito on the wing--it is to the destruction of the larvæ that attention should be directed. The larva is a slender organism, white or gray in color, comprising eight segments. The last of these parts is in the form of a tube, through which the wriggler breathes. Although its habitat is the water, it must come to the surface to breathe, therefore its natural position is head down and tail, or respiratory tube, up. Now, if oil is spread on the surface of a pool inhabited by mosquito larvæ, the wrigglers are denied access to the air which they must have. Therefore, they drown, just as any other air-breathing animal would drown under similar circumstances. _Best Preventive Measures_ As to the best methods to employ in ridding a country place, or any other region, of mosquitoes, the directions furnished by Dr. L. O. Howard, the Government entomologist, who has been a careful student of the problem since 1867, are of great value: "Altogether,[3] the most satisfactory ways of fighting mosquitoes are those which result in the destruction of the larvæ or the abolition of their breeding places. In not every locality are these measures feasible, but in many places there is absolutely no necessity for the mosquito annoyance. The three main preventive measures are the draining of breeding places, the introduction of small fish into fishless breeding places, and the treatment of such pools with kerosene. These are three alternatives, any one of which will be efficacious and any one of which may be used where there are reasons against the trial of the others." _Quantity of Kerosene to be Used_ "The quantity of kerosene to be practically used, as shown by the writer's experiments, is approximately one ounce to fifteen square feet of water surface, and ordinarily the application need not be renewed for one month.... The writer is now advising the use of the grade known as lubricating oil, as the result of the extensive experiments made on Staten Island. It is much more persistent than the ordinary illuminating oils.... On ponds of any size the quickest and most perfect method of forming a film of kerosene will be to spray the oil over the surface of the water.... It is not, however, the great sea marshes along the coast, where mosquitoes breed in countless numbers, which we can expect to treat by this method, but the inland places, where the mosquito supply is derived from comparatively small swamps and circumscribed pools. In most localities people endure the torment or direct their remedies against the adult insect only, without the slightest attempt to investigate the source of the supply, when the very first step should be the undertaking of such an investigation. "The remedy which depends upon draining breeding places needs no extended discussion. Naturally the draining off of the water of pools will prevent mosquitoes from breeding there, and the possibility of such draining and the means by which it may be done will vary with each individual case. The writer is informed that an elaborate bit of work which has been done at Virginia Beach bears on this method. Behind the hotels at this place, the hotels themselves fronting upon the beach, was a large fresh-water lake, which, with its adjoining swamps, was a source of mosquito supply, and it was further feared that it made the neighborhood malarious. Two canals were cut from the lake to the ocean, and by means of machinery the water of the lake was changed from a body of fresh to a body of salt water. Water that is somewhat brackish will support mosquitoes, but water that is purely salt will destroy them." _Employing Fish to Destroy Larvæ_ "The introduction of fish into fishless breeding places is another matter. It may be undesirable to treat certain breeding places with kerosene, as, for instance, water which is intended for drinking, although this has been done without harm in tanks where, as is customary, the drinking supply is drawn from the bottom of the tank. The value of most small fishes for the purpose of destroying mosquito larvæ was well indicated by an experience described to us by Mr. C. H. Russell, of Bridgeport, Conn. In this case a very high tide broke away a dike and flooded the salt meadows of Stratford, a small town a few miles from Bridgeport. The receding tide left two small lakes, nearly side by side and of the same size. In one lake the tide left a dozen or more small fishes, while the other was fishless. An examination by Mr. Russell in the summer of 1891 showed that while the fishless lake contained tens of thousands of mosquito larvæ, that containing the fish had no larvæ. The use of carp for this purpose has been demonstrated, but most small fish will answer as well. The writer knows of none that will be better than either of the common little sticklebacks (_Gasterosteus aculeatus_ or _Pygosteus pungitius_)." Is mosquito fighting a success? This question is an all-important one, not only to the summer resident, but also to cities and towns contiguous to salt-water marshes, or to swampy lands, well suited for mosquito breeding. The answer is this: Mosquito control is possible; actual extermination impossible with an insect that develops so rapidly. The "Jersey mosquito," the unscientific name popularly given to an insect of huge size and ravenous appetite, has become famous. As a matter of fact, the species of mosquitoes found in New Jersey are no more rare or varied than those found on Staten Island or on Long Island. But until very recently the region lying between Jersey City and Newark has been particularly favorable to the development of mosquito larvæ. It has been announced in the press that mosquitoes have been driven out of the Newark meadows. This is an exaggeration, of course, but the work accomplished there is remarkable, and other infected regions may take heart from the marked success which has attended the efforts of Dr. John B. Smith, Entomologist of the New Jersey State Agricultural Experiment Station. _Remarkable Work Accomplished_ The salt marsh lying within the limits of the city of Newark covers an area of about 3,500 acres. It extends from a point on the Passaic River to the mouth of Bound Creek, where it empties into Newark Bay. Its length is about eight miles and it has an extreme width of three miles. The Newark marsh problem was a very complex one. The meadows are cut into many sections by the several traversing railroads and by creeks; this materially influences the drainage. The Peddie Street sewer crosses the marsh in a straight line of about three miles from the city to the bay. This sewer is twenty feet wide, and its banks are from three to four feet above the marsh land. An experiment with machine ditching was made in 1903. The worst parts of the marsh were selected, and about 40,000 feet of ditches were cut. These ditches were six inches wide, two feet deep, and the drainage was perfect from the outset. The section of meadow thus drained became so dry in consequence that the grass growing there can now be cut by a machine in summer, whereas formerly the hay could be mown only in winter. The work was so successful that the Newark Common Council appropriated $5,000 to complete the mosquito drainage of the marsh. Of the results obtained up to this spring, Dr. Smith says: "This Newark marsh problem was an unusual one, and one that would not be likely to recur in the same way at any other point along the coast. Nevertheless, of the entire 3,500 acres of marsh, not 100 acres remain on which there is any breeding whatever, and that is dangerous only in a few places and under certain abnormal conditions. Including old ditches cleaned out, about 360,000 running feet of ditches have been dug on the Newark marshes, partly by machine and partly by hand, and if the work is not entirely successful, that is due to the defects which were not included in the drainage scheme. It is a safe prediction, I think, that Newark will have no early brood of mosquitoes in 1905, comparable with the invasions of 1903 and 1904." This prophecy has proved true. _The Campaign on Long Island_ The wealthy summer residents along the north shore of Long Island, keenly alive to the necessity of driving mosquitoes from the region where they spend so much of their time, have attacked the problem in a scientific, as well as an energetic way. The North Shore Improvement Association intrusted the work to Henry Clay Weeks, a sanitary engineer, with whom was associated, as entomologist, Prof. Charles B. Davenport, Professor of Entomology at the University of Chicago and head of the Cold Spring Biological Laboratory; also F. E. Lutz, an instructor in biology at the University of Chicago. Prof. N. S. Shaler, of Harvard University, the most eminent authority in the country on marine marshes, was retained to make a special examination of the salt marshes with a view to recommending the best means of eliminating what were the most prolific breeding grounds of mosquitoes. A detailed examination of the entire territory was made. Practically every breeding place of mosquitoes, including the smaller pools and streams, and even the various artificial receptacles of water, were located and reported on. Mr. Weeks, with his assistant, then examined each body of water in which mosquito larvæ had been found, with a view to devising the best means of preventing the further breeding of mosquitoes in these plague spots. Finally, a report was prepared, together with a map on which was located every natural breeding place. _Investigations in Connecticut_ Important investigations have been made in Connecticut by the Agricultural Experiment Station, under the direction of W. E. Britton and Henry L. Viereck, and the results have been most encouraging. Dr. Howard, in his directions for fighting mosquitoes, acknowledges his indebtedness to the very successful experiments carried on at Staten Island. Maryland is aroused to the point of action. Dr. Howard A. Kelley, of Johns Hopkins University, is to coöperate with Thomas B. Symons, the State entomologist, in carrying the war to the shores of Chesapeake Bay. "Home talent," moreover, can accomplish much. To fight intelligently, let it not be forgotten that the battle should be directed against the larvæ. These wrigglers are bred for aquatic life; therefore, it is to all standing water that attention should be directed. Mosquito larvæ will not breed in large ponds, or in open, permanent pools, except at the edges, because the water is ruffled by the wind. Any pool can be rendered free from wrigglers by cleaning up the edges and stocking with fish. Every fountain or artificial water basin ought to be so stocked, if it is only with goldfish. The house owner should not overlook any pond, however small, or a puddle of water, a ditch, or any depression which retains water. A half-filled pail, a watering trough, even a tin receptacle will likely be populated with mosquito larvæ. Water barrels are favorite haunts for wrigglers. _A Simple Household Remedy_ There are those, however, who will obstinately conduct their campaign against the adult mosquito. If energetic, such persons will search the house with a kerosene cup attached to a stick; when this is held under resting mosquitoes the insects fall into the cup and are destroyed. Those possessed of less energy daub their faces and hands with camphor, or with the oil of pennyroyal, and bid defiance to the pests. With others it is, Slap! slap!--with irritation mental as well as physical; for the latter, entomologists recommend household ammonia. FOOTNOTES: [3] See Bulletin No. 25, U. S. Department of Agriculture, Division of Entomology. Part II PURE FOOD FOR THE HOUSEKEEPER BY S. JOSEPHINE BAKER CHAPTER I =How to Detect Food Adulteration= Adulteration when applied to foodstuffs is a broad, general term, and covers all classes of misrepresentation, substitution, deterioration, or addition of foreign substances; adulteration may be either intentional or accidental, but the housekeeper should be prepared to recognize it and so protect herself and her household. Food is considered adulterated when it can be classified under any of the following headings: =DEFINITIONS OF ADULTERATION.=--(1) If any substance has been mixed or packed with it so as to reduce or lower or injuriously affect its quality or strength. (2) If any inferior substance has been substituted for it, wholly or in part. (3) If any valuable constituent has been wholly or in part abstracted from it. (4) If it consists wholly or in part of diseased or decomposed or putrid or rotten animal or vegetable substance, or any portion of an animal unfit for food, whether manufactured or not, or if it is the product of a diseased animal or one who has died otherwise than by slaughter. (5) If it be colored or coated or polished or powdered, whereby damage is concealed or it is made to appear better than it really is. (6) If it contains any added poisonous ingredient or any ingredient which may render such article injurious to health; or if it contains any antiseptic or preservative not evident or not known to the purchaser or consumer. =FOOD LAWS.=--There is now in effect in the United States a rigid law against the offering for sale of any article intended for human consumption which is adulterated in any way, without the fact and nature of such adulteration being plainly stated on a label attached to the package containing the article. This law, however, applies only to articles of this nature which originate, or are produced, in one State and offered for sale in another. The purchaser is, therefore, in a great degree protected, but many foodstuffs or manufactured articles may have their origin within the State wherein they are sold, and in this case the only safeguards are those afforded by the laws of the State, city, or town immediately concerned. If these restraining laws do not exist or if they are not enforced the housekeeper must rely upon her own efforts to protect her family from adulterated food. =PERMISSIBLE ADULTERANTS.=--In this class are included articles having a food value such as salt, sugar, vinegar, spices, or smoke used as preservatives of meats; or starch when added to the salts composing baking powder, where a certain amount is permissible for the purpose of absorbing moisture. =GENERAL DIRECTIONS.=--The ability to select fresh, wholesome meats, poultry, fish, fruits, and vegetables, to determine readily the purity of dairy products, and to detect adulteration or misrepresentation in all classes of foodstuffs must, in most instances, be acquired. Common sense and good reasoning powers are needed here as in every problem of life. While some adulterants can be detected only by trained chemists and by means of tests too difficult and involved for general use, the average housekeeper may amply protect herself from gross imposition by simply cultivating her powers of observation and by making use of a few simple tests well within her grasp and easily applied. =First--Sight, Taste, and Smell.=--All are of prime importance in determining the freshness and wholesomeness of foods, especially meats, poultry, fish, vegetables, and fruits. Avoid all highly colored bottled or canned fruits or vegetables; pure preserved fruits, jams, jellies, or relishes may have a good bright color, but never have the brilliant reds and greens so often shown in the artificially colored products.[4] The same is true of canned peas, beans, or Brussels sprouts; here the natural product is a dull, rather dingy green, and all bright green samples must be suspected. Foreign articles of this class are the worst offenders. All food products should have a clean wholesome odor, characteristic of their particular class. The odor of decomposition can be readily detected; stale and musty odors are soon recognized. It should be rarely necessary to use the sense of taste, but any food with a taste foreign to the known taste of a similar product of known purity should be discarded or at least suspected. =Second--Price.=--Remember that the best and purest food, however high priced, is cheapest in the end. Its value in purity, cleanliness, food value, and strength gives a greater proportionate return than foods priced lower than one might legitimately expect from their supposed character. To cite a few instances: pure Java and Mocha coffee cannot be retailed at twenty cents per pound; therefore, when the housekeeper pays that price she must expect to get chicory mixed with the coffee; if it contains no other adulterant, she may consider herself fortunate. Cheap vanilla is not made from the vanilla bean. These beans sell at wholesale for from ten to fifteen dollars a pound, and the cheap extracts are made from the Tonka bean or from a chemical product known as vanillin. These substances are not harmful, but they are not vanilla. Pure virgin olive oil is made from the flesh of olives after the stones and skin have been removed; cheaper grades are made from the stones themselves and have little food value, while the virgin oil is one of the most nutritious and wholesome of foods. Such instances might be cited almost without end. Good, pure food demands a good price, and economy defeats its own purpose when it is practiced at the expense of one of the most vital necessities of health and life. =Third--Reliable Dealers.=--Select your tradesmen with the same care you bestow in the choice of a physician. A grocer or butcher who has once sold stale, adulterated, or impure wares has forfeited his right to be trusted. A man who is honestly trying to build up a good trade must have the confidence of his customers and it is to his interest to sell only worthy goods; this confidence he can gain only by proving his trustworthiness. When you are convinced of your dealer's honesty give him your trade and do not be lured away by flashy advertisements and the promise of "something for nothing." =PREPARATION FOR CHEMICAL TESTS.=--Although the housekeeper will rarely need the use of any chemical tests for the purpose of determining the purity of food, the following directions must be kept in mind if such an expedient is deemed necessary. It will be wise, however, in the majority of cases when the presence of chemical preservatives and adulterants is suspected, to send the article to a chemist for analysis. 1. All refuse matter, such as shells, bones, bran, and skin, must be removed from the edible portion of the food to be tested. 2. If the sample is solid or semi-solid, divide it as finely as possible. All vegetables and meats may be minced in the common household chopping machine. Tea, coffee, whole spices, and the like may be ground or crushed in a mortar or in a spice mill. 3. Milk must be thoroughly stirred or shaken so that the cream is well mixed with the body of the milk. =FLESH FOODS--Meat.=--Fresh, wholesome meat is neither pink nor purple; these colors indicate either that the animal was not slaughtered or that it was diseased. Good meat is firm and elastic and when dented with the finger does not retain the impression; it has the same consistency and color throughout; the flesh is marbled, due to the presence of fat distributed among the muscular fibers; it will hardly moisten the finger when touched; it has no disagreeable odor and has a slightly acid reaction so that red litmus paper applied to it should not turn blue. Wet, sodden, or flabby meat with jellylike fat, a strong putrid odor, and alkaline reaction should be avoided. These signs indicate advanced decomposition, and such meat is unfit for food. =Beef.=--This meat should have a fine grain, be firm in texture, with rosy-red flesh and yellowish-white fat. =Lamb and Mutton= should have a clear, hard, white fat with the lean part juicy, firm, and of rather light-red color. The flesh should be firm and close of grain. =Veal.=--The meat should not be eaten unless the animal was at least six weeks old before slaughtering. The sale of this immature veal, or "bob veal" as it is sometimes called, is prohibited by law in many States. It is unwholesome and may be recognized by its soft, rather mushy consistency and bluish tinge. Good veal has a firm white fat with the lean of a pale-red color. =Pork.=--This meat when fresh has a fat that is solid and pure white; if yellow and soft it should be rejected; the lean is pink and the skin like white translucent parchment. =Poultry.=--Good poultry is firm to the touch, pink or yellowish in color, is fairly plump, and has a strong skin showing an unbroken surface. It has a fresh odor. Stale poultry is flabby and shows a bluish color; it becomes green over the crop and abdomen, and the skin is already broken or easily pulled apart in handling. The odor of such a bird is disagreeable and may even be putrid. =Fish.=--With the exception of the salted or preserved varieties fish should always be perfectly fresh when eaten. Probably no other article of food is more dangerous to health than fish when it shows even the slightest traces of decomposition. The ability to recognize the earliest signs of staleness is of the utmost importance. Fish deteriorate rapidly and should always be carefully inspected before purchasing. Fresh fish are firm to the touch, the scales moist and bright, the gills red, and the eyes clear and slightly prominent. When held flat in the hand the fish should remain rigid and the head and tail droop slightly, if at all. Stale fish are soft and flabby, the skin is dull and the eyes sunken and often covered with a film. The tendency of the head and tail to droop is marked and the fish has a characteristic disagreeable odor. This odor of decomposition is best detected in the gills. =Lobsters and Crabs.=--These shellfish should always be alive when purchased. This condition is easily demonstrated by their movements, and the rule should never be disregarded. =Oysters and Clams.=--Oysters should not be eaten during the months of May, June, July, and August; these are their breeding months and they are unwholesome during that period. That oysters sometimes contain the germs of typhoid fever is an assured fact; these germs are acquired not from the natural habitat of the oyster in salt water but from the fresh-water, so-called "fattening beds," where the oysters are placed for a season to remove the brackish and salty taste of the sea and to render them more plump. These beds are frequently subject to pollution, and the housekeeper should only purchase oysters from reliable dealers where the purity of the source of the supply is unquestioned. Clams are in season and may be eaten throughout the year. All shellfish when fresh have an agreeable fresh odor. The shells should be firmly closed or should close when immersed in water and touched with the finger. If they have been removed from their shells when purchased, the flesh of the fish itself should be firm, clean in appearance and not covered with slime or scum; the odor should be fresh. The odor of dead or decomposed oysters and clams is pungent and disagreeable. =MEAT PRODUCTS--Canned or Potted Meats.=--The label on cans containing meat products should state clearly the exact nature of the contents. Deception as to the character of the meat is easy to practice and difficult to detect by any but a trained analyst. The presence of preservatives can also only be detected by chemical analysis. As these products are practically all put on the market by the large packing houses and designed for interstate commerce, they are subject to government inspection, and, therefore, if they bear the government stamp may be considered pure. The point that the housekeeper may consider is the length of time the meat has remained in the can. Put up under proper precautions these canned goods retain their wholesomeness for an almost indefinite period. The heads of the cans should always present a concave surface; if they are convex, it is a sign of decomposition of the contents. When the can is opened the meat should have a clean appearance, free from mold or greenish hue, and the odor should be fresh and not tainted. =Sausages.=--If possible, sausages should be homemade, then one may be assured of their purity and freedom from adulteration. Owing to the rapid color changes and early decomposition of fresh meat, artificial colors are often used to conceal the former, and preservatives like boric acid or saltpeter to retard the latter. The artificial colors, such as carmine and aniline red, may be detected by observation or by warming the finely divided material on a water bath with a five per cent solution of sodium salicylate. This fluid will extract the color, if present. =Lard.=--Good lard is white and granular and has a firm consistency. It has an agreeable characteristic odor and taste. The choicest leaf lard is made from the fat about the kidneys of the hog; the cheaper grades are made from the fat of the whole animal. =FRESH VEGETABLES AND FRUITS--Vegetables.=--All green vegetables to be eaten uncooked should be carefully washed and examined for insects, dirt, and foreign matter generally. The ova or eggs of the tapeworm may be ingested with improperly cleaned vegetables. Running water and a clean brush (kept for this purpose) should be used. Green vegetables should have a fresh, unwilted appearance; any sign of staleness or decay should cause their rejection. Overripe or underripe vegetables are harmful. Lettuce, celery, and all leaved or stemmed vegetables should be examined to see if the outer leaves have been removed; this may be determined by the distance of the leaves from the stem head. The general signs of disease in vegetables are softening, change of color, and mold. The following characteristics indicate fresh and wholesome vegetables: =Asparagus.=--Firm and white in the stalk with a green, compact tip. =Beans and Peas= should have green, not yellow, pods, brittle, and easily snapped open. The vegetable itself should be tender, full and fleshy, not wrinkled or shrunken. =Cabbage=, crisp and firm, with a well-rounded and compact head. =Carrots=, light red or yellow, with a regular, conical shape, sweet and crisp. =Cauliflower=, white, compact head; any tinge of yellow or green generally indicates an inferior quality. =Celery=, nearly white in color; large, crisp, and solid stalks, nutty in flavor. =Cucumbers=, firm, crisp, with a smooth skin and white flesh. =Lettuce=, the head close and compact; the leaves clean, crisp, and sweet. When it is too young or running to seed the taste is bitter. Pale patches on the leaves are caused by mildew and are a sign of decay. =Parsnips=, buff in color, with unforked roots, sweet and crisp. =Potatoes=, underripe, green potatoes are unfit for food; they contain a poisonous substance which renders them actually harmful. Good potatoes should have a smooth skin and few eyes; the flesh pale and of a uniform color and of a firm consistency. A rough skin, with little depressions, indicates a disease called "scab"; dark-brown patches on the skin are due to a disease called "smut." Potatoes with such diseases are of inferior quality. If green on one side, due to exposure to the sun when growing, the potatoes are unwholesome. =Fruits.=--Underripe or green fruit should never be eaten. This condition may be easily detected by the color and consistency of the fruit. Diseased or decayed fruit is known by its change of color, softening, and external mold. Spots on fruit are often caused by a fungus which lowers its quality and renders it less wholesome. =CEREALS AND THEIR PRODUCTS--Cereals.=--Particularly when bought in original packages cereals are generally pure and unadulterated. When bought in bulk there may be found dust, dirt, worms, insects, and excessive moisture. These may all be determined by careful inspection. The presence of an undue amount of moisture adds greatly to the weight of cereals and is therefore a fraud. Cereals should be dry to the touch and the individual kernels or particles separate and distinct. =Flour.=--By this general term is meant the ordinary wheat flour. It should not be too moist, should have a fine white appearance, remain lumpy, or hold its form, on pressure, not show any particles which cannot be crushed, and when a handful is thrown against the wall, part of it should adhere. The odor and taste should be fresh and clean and not musty or moldy. The common adulterants are corn and rice meal. If a sample of the flour be thrown on the surface of a glassful of water, the corn and rice, being heavier, will sink; grit and sand may be detected in the same way. If the flour has been adulterated with mineral substances it may be shown by burning a portion down to an ash; the ash of pure flour should not exceed two per cent of the total amount; if mineral substances are present the amount of ash will be greatly increased. Alum is sometimes added to flour in order to give it a whiter appearance and to produce whiter and lighter bread; it is most unwholesome. It can be detected by the so-called "logwood" test, which is prepared and used as follows: Make two solutions. The first: a five per cent solution of logwood chips in alcohol. The second: a fifteen per cent solution of ammonium carbonate in water. Make a paste of one teaspoonful of the flour and an equal amount of water; mix with it one-quarter of a teaspoonful of the logwood solution; follow this immediately with one-quarter of a teaspoonful of the ammonium carbonate solution. If alum is present, the paste will show a lavender or blue color; if absent, the mass will become pink, fading to a dirty brown. If the result is doubtful, set the paste aside for several hours, when the colors will show more plainly. =Bread.=--Bread should be well baked and not too light or too heavy; the crust should be light brown and adherent to the substance of the bread. The center should be of even consistency, spongy, and firm; it should not pit or be soggy or doughy. The pores or holes should be of practically the same size throughout. Exceedingly white, light, or porous bread shows the presence of alum. It may be detected by means of the solutions already mentioned in the "logwood" test. Mix one teaspoonful of each solution and add three ounces (six tablespoonfuls) of water; pour this over a lump of bread, free from crust and about an inch square. After the bread has become thoroughly soaked, pour off the excess of liquid and dry the bread in the dish; if alum is present, the mass will show a violet or blue tint, more marked on drying; if absent, a brownish color will appear. =Baking Powders.=--Baking powders are of three classes, all having sodium bicarbonate (baking soda) as their alkaline salt. The first style is the commonly used and wholesome mixture of cream of tartar and baking soda; the second has calcium phosphate for the acid salt, and the third contains alum. All have a certain proportion of starch to absorb moisture. Of these the alum powders are the most harmful and should be avoided. Practically all of the well-known brands of baking powder are of the first-mentioned class and wholesome, and are rarely adulterated. =DAIRY PRODUCTS--Milk.=--Pure milk should have a specific gravity of from 1.027 to 1.033. Its normal reaction is neutral or slightly acid; it should never be strongly acid. If it is strongly alkaline, i. e., turning red litmus paper blue, it is pretty certain that something in the way of a preservative has been added to it. When left standing for a few hours the cream should show as a slightly yellowish top layer, one-tenth or more of the whole amount; the milk below the cream should be lighter in color and with the slightest bluish tinge. If the color is of a yellowish tinge throughout, the addition of coloring matter must be suspected. "Annatto," a vegetable pigment, is used to give a "rich" tint to milk. To detect it, add one teaspoonful of baking soda to one quart of milk and immerse in it a strip of unglazed paper; in a few hours examine the paper; if annatto is present, it will have become an orange color.[5] If the whole milk has a blue and thin appearance, or if the cream is scant in quantity, it has probably been diluted with water. The popular idea that chalk is sometimes added to poor milk to make it appear of better quality is erroneous; chalk would always show as a precipitate, as it does not dissolve, and the presence of such a sediment would be a too obvious adulteration to be practiced. Milk should always be kept at a temperature below 50° F.; above that temperature the bacteria in it multiply with great rapidity and render it unfit for use. Milk may be preserved for several days if "pasteurized" or "sterilized." Pasteurization consists of heating milk to a temperature of about 167° F., and maintaining it at that degree for twenty minutes. Sterilization means keeping the milk at a temperature of 212° F. for two hours and a half. Immediately after either process the milk should be cooled, then placed in absolutely clean, covered bottles and kept on ice. These methods are not only harmless but actually beneficial in that they destroy any disease germs that might be present. Chemical preservatives are occasionally found in milk. They may be suspected if the milk is alkaline in reaction and has a disguised taste. The ones most commonly used are boric and salicylic acids and formaldehyde; the two former can only be detected by chemical tests too delicate and intricate to be used by the housewife. Formaldehyde may be tested for by using a solution of one drop of a ten per cent solution of ferric chloride to one ounce of hydrochloric acid.[6] Fill a small porcelain dish one-third full of this solution; add an equal volume of milk and heat slowly over a flame nearly to the boiling point, giving the dish a rotary motion to break up the curd. If formaldehyde is present, the mass will show a violet color, varying in depth with the amount present; if it is absent, the mass turns brown. =Butter.=--Good butter has a fresh, sweet odor and an agreeable taste. It should be of the same color and consistency throughout, easily cut and adherent and not crumbly when molded into shapes. Pure butter is very light in color; nearly all that is sold is colored, in order to meet the popular demand for "yellow" butter; annatto and other vegetable and mineral substances are sometimes employed for this purpose. These coloring matters are generally harmless but may be detected by dissolving a portion of the butter in alcohol; the natural color will dissolve, while foreign coloring will not. Butter should consist of eighty-five per cent fat, with the remainder water, casein, and salt. The most common methods of adulteration consist in an excess of water and the addition of oleomargarine. If an excess of water has been added it may be shown by melting the butter; the water and fat will separate in two distinct layers. Oleomargarine has a distinctive meaty smell, like that of cooked meat, and lacks the characteristic odor of pure butter. If pure butter is melted in a spoon, it will not sputter; if oleomargarine is present, it will. The preservatives sometimes used, namely, boric and salicylic acids and formaldehyde, can only be detected by chemical tests. =Eggs.=--Two methods may be used to detect stale eggs. First: make a solution of one part of table salt to ten parts of water and immerse the suspected egg; if it sinks, it is perfectly fresh; if it remains in the water below the surface, it is at least three days old, and if it floats, it is five or more days old. Second: hold the egg between a bright light and the eye. If it is fresh, it will show a rosy tint throughout, without dark spots, as the air chamber is small; if not fresh, it will look cloudy, with many dark spots present. =TEA AND COFFEE.=--These substances are extensively adulterated, but the adulterants are almost without exception harmless. =Tea.=--The commonest forms of adulteration of tea are as follows: (_a_) Exhausted tea leaves which have already been used are dried and added. Their presence may be detected by the weakness of the infusion, made from a given quantity of the suspected tea, compared with a similar infusion made from tea known to be pure. (_b_) Leaves from other plants are sometimes dried and added; these are easily shown if an infusion is made and when the leaves are thoroughly wet unrolling and comparing them. (_c_) Green teas may be "faced" or colored with Prussian blue, indigo, French chalk, or sulphate of lime; black teas may be similarly treated with plumbago or "Dutch pink." If teas so treated are shaken up in cold water the coloring matter will wash off. (_d_) Sand and iron filings are occasionally added for weight; observation, and the fact that they sink when tea is thrown in water, will show their presence. Iron filings may be readily found by using a magnet. (_e_) The presence of starch may be shown by washing the tea in cold water, straining it, and testing the solution in the following manner: dissolve one-half teaspoonful of potassium iodide in three ounces of water and add as much iodine as the solution will dissolve; a few drops of this solution added to the suspected sample will give a blue color if starch is present. =Coffee.=--Coffee should always be purchased in the bean, as ground coffee is much more frequently adulterated and the foreign substances are more difficult to detect. The adulterants commonly used are: chicory, peas, beans, peanuts, and pellets of roasted wheat flour, rye, corn, or barley. Fat globules are always present in pure coffee; their presence may be shown by the fact that imitation coffee sinks in water, while pure coffee floats. Chicory is the most frequently used adulterant; it is added for flavor and to produce a darker infusion, thus giving the impression of greater strength. It is perfectly harmless and as a drink is actually preferred by some people. Its detection is comparatively easy. Chicory grains are dark, gummy, soft, and bitter; coffee grains are hard and brittle; a small amount put in the mouth will demonstrate the difference. Chicory will often adhere to the wheels of a coffee grinder, clogging them on account of its gummy consistency. When a sample of adulterated coffee is thrown in water the pure coffee floats and leaves the water unstained; chicory sinks almost instantly, coloring the water, while peas and beans sink more slowly but also color the water. Peas and beans are also detected by the polished appearance of the broken or crushed grains in marked contrast to the dull surface of crushed coffee. The presence of peas, beans, rye, wheat, bread crumbs, and allied substances may be shown by the fact that they all contain starch. Make a ten per cent infusion of the suspected coffee; filter it, and decolorize the solution by boiling it with a piece of animal charcoal. Test the decolorized solution by slowly adding a few drops of the "potassium-iodide-iodine solution," directions for preparing which were given under heading of "Tea." A resulting blue color will indicate the presence of starch. =COCOA AND CHOCOLATE.=--The adulterants of these substances are generally harmless, as they usually consist of flavoring extracts, sugar, starch, flour, and animal fats. No tests other than flavor, consistency, and smoothness need be considered. Good cocoa and chocolate should be slightly bitter, with a pleasant characteristic odor and taste; they should have a smooth, even consistency and be free from grit or harsh particles. =CANNED AND BOTTLED VEGETABLES AND FRUITS.=--In general, acid substances, such as tomatoes and fruits, should not be canned in tin, as the action of the acid tends to dissolve the tin. It is better, therefore, to purchase these articles in glass. After opening the can the odor and appearance of the contents should be noted. The odor should be clean and fresh, and the slightest trace of any sour, musty, or disagreeable smell should cause the rejection of the food. The appearance should be clean, with no mold; the consistency and color of the fruit or vegetables should be uniform throughout. If the color is brighter than that of a similar article when canned at home, the presence of artificial coloring matter must be suspected. The brilliant green of some brands of peas, beans, or Brussels sprouts is produced by the addition of the salts of copper. This may be proved by leaving the blade of a penknife in the contents of the can for a short time; if copper is present it will be deposited on, and discolor, the blade. Brightly colored fruits should excite suspicion; this same dictum applies to all brightly colored jams and jellies, as the colors are usually produced by the addition of carmine or aniline red. The presence of preservatives, salicylic and boric acids, the benzoates, etc., can only be proved by delicate chemical tests. =SUGAR.=--Pure granulated or powdered sugar is white and clean. The presence of glucose should be suspected in sugar sold below the market price; it is perfectly harmless, but has a sweetening power of only about two-thirds that of sugar and is added on account of its cheapness and to increase the bulk. If sand, dirt, or flour are present they may be detected by observation, or by washing the suspected sample in water; flour will not dissolve, sand will sink, and dirt will discolor the water. =SPICES.=--Spices should be bought whole and ground in a spice mill as needed; if this is done, there need be little fear of their impurity, for whole spices are difficult to simulate or adulterate. Ground spices may be adulterated with bark, flour, starches, or arrowroot; these adulterants are harmless, but are fraudulent, as they increase the bulk and decrease the strength. Their actual presences can only be demonstrated by a microscopical or chemical examination. =Peppers.=--Black pepper is made from the whole berry; white pepper is made from the same berry with the outer husk removed. The adulterants are usually inert and harmless substances, such as flour, mustard, or linseed oil; their presence is obviated by the use of the whole peppercorns, ground as needed. =Red Pepper.=--This may be adulterated with red lead; when pure it will be entirely suspended in water; if a sediment falls it is probably red lead. =Mustard.=--Practically all of the adulterants of mustard can only be detected by intricate chemical tests. The presence of turmeric may be detected by the appearance of an orange-red color when ammonia is added to a solution of the sample. =Tomato Catsup.=--Artificial dyestuffs are common, giving a brilliant crimson or magenta color. Such catsup does not resemble the natural dull red or brown color of the homemade article. Preservatives, such as boric, salicylic, or benzoic acids and their salts, are sometimes added. While their presence cannot be condoned, yet they are usually present in small amounts and therefore practically harmless. =Pickles.=--These should be of a dull-green color. The bright emerald green sometimes observed is due to the presence of the salts of copper; this may be proved by dipping the blade of a penknife in the liquor, as described under the heading of "Canned Goods." Alum is sometimes used as a preservative and in order to make the pickles crisp. Its presence may be demonstrated by means of the "logwood" test mentioned under the heading of "Flour." =VINEGAR.=--Cider vinegar is of a brownish-yellow color and possesses a strong odor of apples. Wine vinegar is light yellow if made from white wine, and red if made from red wine. Malt vinegar is brown and has an odor suggestive of sour beer. Glucose vinegar has the taste and odor of fermented sugar. Molasses vinegar has the distinctive odor and taste of molasses. =OLIVE OIL.=--Pure olive oil has a pleasant, bland taste and a distinctive and agreeable odor, unmistakable in character for that of any other oil. The finest virgin oil is pale green in color, the cheaper grades are light yellow. The adulterants consist of cotton-seed, corn, mustard, and peanut oils. When pure olive oil is shaken in a glass or porcelain dish with an equal quantity of concentrated nitric or sulphuric acid[7] it turns from a pale to a dark green color in a few minutes; if under this treatment a reddish to an orange or brown color is produced the presence of a foreign vegetable oil is to be suspected. =FLAVORING EXTRACTS--Vanilla.=--This may be wholly or in part the extract of the Tonka bean or may be made from a chemical substance known as vanillin. The best practical working tests as to its purity are the price, taste, and odor. The distinctive odor and taste of vanilla are characteristic and cannot be mistaken.[8] =Lemon.=--This extract is often made from tartaric or citric acid. They may be tested for as follows: to a portion of the extract in a test tube add an equal volume of water to precipitate the oil; filter, and add one or two drops of the filtrate to a test tube full of cold, clear limewater; if tartaric acid is present a precipitate will fall to the bottom of the tube. Filter off this precipitate (if present) and heat the contents of the tube; if citric acid is present it will precipitate in the hot limewater. FOOTNOTE.--Dr. Baker wishes to acknowledge her indebtedness to the following authorities and the volumes mentioned for many helpful suggestions. Pearman and Moore, "Aids to the Analysis of Foods and Drugs"; Albert E. Leach, "Food Inspection and Analysis"; Francis Vacher, "Food Inspector's Hand Book." FOOTNOTES: [4] The presence of aniline dyes may be detected by mixing a portion of the suspected sample with enough water to make a thin paste. Wet a piece of white wool cloth or yarn thoroughly with water and place it with the paste in an agate saucepan. Boil for ten minutes, stirring frequently. If a dye has been used the wool will be brightly colored; a brownish or pinkish color indicates the natural coloring matter of the fruit or vegetable.--EDITOR. [5] A little vinegar added to heated cream or milk produces in the curd a distinct orange color if an aniline dye has been used to make the cream look "rich." The curd will be brown if annatto or caromel has been used. If pure, the curd will be white.--EDITOR. [6] This acid must be used with great care; no portion of it should ever come in contact with the skin or clothing. [7] These acids must be used with great care. They should never be allowed to come in contact with the skin or clothing. [8] Add a little sugar-of-lead solution to the suspected extract; true vanilla extract will give a yellowish-brown precipitate and a pale, straw-colored liquid. If the extract is artificial, the addition of the lead solution will have little or no effect.--EDITOR. CHAPTER II =Mushroom Poisoning= _Symptoms--Treatment--How to Tell Mushrooms--The Common Kind--Other Varieties--The Edible Puffball--Poisonous Mushrooms Frequently Mistaken._ =MUSHROOM POISONING.=--Vomiting, cramps, diarrhea, pains in legs; possibly confusion, as if drunk, stupidity, followed by excitement, and perhaps convulsions. Lips and face may be blue. Pulse may be weak. _First Aid Rule 1.--Rid the stomach and bowels of remaining poison. Give emetic of mustard, tablespoonful in three glasses of warm water, unless vomiting is already excessive. When vomiting ceases, give tablespoonful of castor oil, or compound cathartic pill._ GIVE NO SALTS. _Also empty bowels with injection of tablespoonful of glycerin in pint of warm soapsuds and water._ _Rule 2.--Antidote the poison. Give a cup of strong coffee and fifteen drops of tincture of belladonna to adult. Repeat both once, after two hours have passed._ _Rule 3.--Rest and stimulate. Put patient to bed. Give whisky, a tablespoonful in twice as much water. Give tincture of digitalis, ten drops every two hours, till two or three doses are taken by adult._ =Symptoms.=--Vomiting and diarrhea come on in a few hours to half a day, with cramps in the stomach and legs. The face and lips may grow blue. There is great prostration. In the case of poisoning by the _fly amanita_, stupor may appear early, the patient acting as if drunk, and difficult breathing may be a noticeable symptom. Afterwards the patient becomes excited and convulsions develop. The pulse becomes weak and slow. The patient may die in a few hours, or may linger for three or four days. If treatment be thorough, recovery may result. =Treatment.=--Unless vomiting has already been excessive, the patient should receive a tablespoonful of mustard mixed with a glassful of tepid water. After the vomiting ceases he should receive a tablespoonful of castor oil, or any cathartic except salts. If the cathartic is vomited, he should receive an injection into the rectum of a tablespoonful of glycerin mixed with a pint of soapsuds and water. Coffee and atropine (or belladonna) are the best antidotes. If a physician be secured, he will probably give a hypodermic injection of atropine. If a physician is not procurable, the patient should receive a cup of strong coffee, and a dose of ten or fifteen drops of tincture of belladonna in a tablespoonful of water, if an adult. This dose should be repeated once after the lapse of two hours. The patient should be kept in bed, a bedpan being used when the bowels move. When the pulse begins to grow weak, two tablespoonfuls of whisky and ten drops of the tincture of digitalis should be given to an adult in quarter of a glass of hot water. The digitalis should be repeated every two hours till three or four doses have been taken. The patient must be kept warm with hot-water bottles and blankets. =HOW TO KNOW MUSHROOMS.=--One-sixth of one of the poisonous mushrooms has caused death. It is, therefore, impossible to exert too much care in selecting them for food. A novice would much better learn all the characteristics of edible and poisonous mushrooms in the field from an expert before attempting to gather them himself, and should not trust to book descriptions, except in the case of the few edible species described hereafter. It is not safe for a novice to gather the immature or button mushrooms, because it is much more difficult to determine their characteristics than those of the full grown. As reference books, the reader is advised to procure Bulletin No. 15 of the United States Department of Agriculture, entitled "Some Edible and Poisonous Fungi," by Dr. W. G. Farlow, which will be sent without charge on request by the Agricultural Department at Washington; "Studies of American Fungi," by Atkinson, and Miss Marshall's "Mushroom Book," all of which are fully illustrated, and will prove helpful to those interested in edible fungi. There are no single tests by which one can distinguish edible from poisonous fungi, such as taste, odor, the blackening of a silver spoon, etc., although contrary statements have been made. Even when the proper mushrooms have been eaten, ill effects, death itself, may follow if the mushrooms have been kept too long, have been insufficiently cooked, have been eaten in too large a quantity (especially by children), or if the consumer is the possessor of an unhappy idiosyncrasy toward mushrooms. No botanic distinction exists between toadstools and mushrooms; mushrooms may be regarded as edible toadstools. They are all, botanically speaking, edible or poisonous fungi. A description follows of the five kinds of fungi most commonly eaten, and the poisonous species which may be mistaken for them. =EDIBLE MUSHROOMS.=--=1. The Common Mushroom= (_Agaricus Campestris_).--The fungi called agarici are those which have gills, that is, little plates which look like knife blades on the under surface of the top of the mushroom, radiating outward from the stem like the spokes of a wheel. This is the species most frequently grown artificially, and sold in the markets. The top or cap of this mushroom is white, or of varying shades of brown, and measures from one and a half to three or even four inches in diameter. It is found in the latter part of August, in September, and in October, growing in clusters on pastures, fields, and lawns. The gills are pink or salmon colored in the newly expanded specimen; but as it grows older, or after it is picked, the gills turn dark purple, chestnut brown, or black. This is the important point to remember, since the poisonous species mistaken for it all have white gills. The gills end with abrupt upward curves at the center of the cap without being attached to the stem. In the young mushroom, when the cap is folded down about the stem, the gills are not noticeable, as they are covered by a veil or filmy membrane, a part of which remains attached to the stem (when the top expands), as a ring or collar about the stem a little more than halfway up from the ground. The stem is solid and not hollow, and there is no bulbous enlargement at the base of the stem, surrounded by scales or a collar, as occurs in the _fly amanita_ and other poisonous species. Neither the _campestris_ nor any other mushroom should be eaten when over a day old, since decomposition quickly sets in. [Illustration: FIG. 35. THE FIELD MUSHROOM. (_Agaricus Campestris._) An edible variety; very common.] =2. Horse Mushroom= (_Agaricus Arvensis_).--This species may be considered with the foregoing, but it differs in being considerably larger (measuring four to ten inches across) and in having a more shiny cap, of a white or brown hue. The ring about the stem is noticeably wider and thicker, and is composed of two distinct layers. The gills are white at first, turning dark brown comparatively late, and the stem is a little hollow as it matures. In some localities it is more common than the _campestris_ in fields and pastures, while in other places it is found only in rich gardens, about hot beds, or in cold frames. It is not distinguished from the _campestris_ by market people, but is often sold with the latter. [Illustration: FIG. 36. THE HORSE MUSHROOM. (_Agaricus Arvensis._) This variety is edible.] =3. Shaggy Mane, Ink Cap, or Horsetail Fungus= (_Coprinus Comatus_).--This mushroom possesses the most marked characteristics of any of the edible species; it would seem impossible to mistake its identity from written descriptions and illustrations. It is considered by many superior in flavor to the _campestris_. The top or cap does not expand in this mushroom, until it begins to turn black, but remains folded down about the stem like a closed umbrella. Mature specimens are usually three to five, occasionally from eight to ten, inches high. The stem is hollow. The inside of the cap or gills and the stem are snow white. The outer surface of the cap, which is white in young plants, becomes of a faint, yellow-brown or tawny color in mature specimens, and also darker at the top. Delicate scales often rolled up at their lower ends are seen on the exterior of the cap, more readily in mature mushrooms, hence the name "shaggy mane." There is a ring around the stem at the lower margin of the cap, and it is so loosely attached to either the cap or stem that it sometimes drops down to the base of the latter. The most salient feature of shaggy mane is the change which occurs when it is about a day old; it turns black and dissolves away into an inky fluid, whence the other common name "ink cap." The mushroom should not be eaten when in this condition. The ink cap is usually found growing in autumn, rarely in summer, in richer earth than the common mushroom. One finds it in heaps of street scrapings, by roadsides, in rich lawns, in soils filled with decomposing wood and in low, shaded, moist grounds. [Illustration: FIG. 37. THE HORSE-TAIL FUNGUS. (_Coprinus Comatus._) Edible; cut shows entire plant and section.] =4. Fairy-ring Mushroom= (_Marasmius Oreades_).--This species usually grows on lawns, in clusters which form an imperfect circle or crescent. The ring increases in size each year as new fungi grow on the outside, while old ones toward the center of the circle perish. This mushroom is small and slender, and rarely exceeds two inches in breadth. The cap and the tough and tubular stem are buff, and the gills, few in number and bulging out in the middle, are of a lighter shade of the same color. There is no ring about the stem. Several crops of the fairy-ring mushroom are produced all through the season, but the most prolific growth appears after the late fall rains. There are other fungi forming rings, some of which are poisonous, and they may not be easily distinguished from the edible species; hence great care is essential in gathering them. The under surface of the cap is brown or blackish in the mature plants of poisonous species. [Illustration: FIG. 38. THE FAIRY-RING MUSHROOM. (_Marasmius Oreades._) An edible variety.] =5. Edible Puffball= (_Lycoperdon Cyathiforme_).--Edible puffballs grow in open pastures, and on lawns and grassplots, often forming rings. They are spherical in form, generally from one and a half to two inches, occasionally six inches, in diameter, broad and somewhat flattened at the top, and tapering at the base, white or brown outside. They often present an irregularly checkered appearance, owing to the fact that the white interior shows between the dark raised parts. The interior is at first pure white and of solid consistency, but later becomes softer and yellowish, and then contains an amber-colored juice. After the puffball has matured, the contents change into a brown, dustlike mass, and the top falls off; and it is then inedible. All varieties of puffball with a pure white interior are harmless, if eaten before becoming crumbly and powdery. There is only one species thought to be poisonous, and that has a yellow-brown exterior, while the interior is purple-black, marbled with white. [Illustration: FIG. 39. THE EDIBLE PUFFBALL. (_Lycoperdon Cyathiforme._) Upper illustration shows entire plant; lower, a section.] =POISONOUS MUSHROOMS FREQUENTLY MISTAKEN.= _To escape eating poisonous mushrooms do not gather the buttons, and be suspicious of those growing in woods and shady spots that show any bright hue, or have a scaly or dotted cap, or white gills.[9] By so doing the following species will be avoided._ =Fly Amanita= (_Amanita Muscaria_).--Infusions of this mushroom made by boiling in water are used to kill flies. This species grows in woods and shady places, by roadsides, and along the borders of fields, and is much commoner than the _campestris_ in some localities. It prefers a poor, gravelly soil, and is found in summer. The stem is hollow and its gills are white. The cap is variously colored, white, orange, yellow, or even brilliant red, and dotted over with corklike particles or warty scales which are easily rubbed off. There is a large, drooping collar about the upper part of the hollow, white stem, and the latter is scaly below with a bulbous enlargement at its base. The young mushrooms, or buttons, do not exhibit the dotted cap, and the bulbous scaly base may be left in the ground when the mushroom is picked. The _fly amanita_ is usually larger than the common mushroom. [Illustration: FIG. 40. A POISONOUS FUNGUS. (_Amanita Muscaria._) The Fly Agaric.] =Death Cup or Deadly Agaric= (_Amanita Phalloides_).--This species is more fatal in its effects than the preceding. Its salient feature is a bulbous base surmounted and surrounded by a collar or cup out of which the stem grows. This is often buried beneath the ground, however, so that it may escape notice. The gills and stem are white like the preceding, but the cap is usually not dotted but glossy, white, greenish, or yellow. There is also a broad, noticeable ring about the stem, as in the _fly amanita_. This mushroom frequents moist, shady spots, also along the borders of fields. It occurs singly, and rarely in fields or pastures. [Illustration: FIG. 41. THE DEADLY AGARIC. (_Amanita Phalloides._) This variety is very poisonous.] FOOTNOTES: [9] The shaggy mane has white gills, but its other features are characteristic. Part III THE HOUSE AND GROUNDS BY GEORGE M. PRICE _Acknowledgment_ We beg to tender grateful acknowledgment to author and publisher for the use of Dr. George M. Price's valuable articles on sanitation. The following extracts are taken from Dr. Price's "Handbook on Sanitation," published by John Wiley & Son, and are covered by copyright. CHAPTER I =Soil and Sites= =Definition.=--By the term "soil" we mean the superficial layer of the earth, a result of the geological disintegration of the primitive rock by the action of the elements upon it and of the decay of vegetable and animal life. =Composition.=--Soil consists of solids, water, and air. =Solids.=--The solid constituents of the soil are inorganic and organic in character. The inorganic constituents are the various minerals and elements found alone, or in combination, in the earth, such as silica, aluminum, calcium, iron, carbon, sodium, chlorine, potassium, etc. The characteristics of the soil depend upon its constituents, and upon the predominance of one or the other of its composing elements. The nature of the soil also depends upon its physical properties. When the disintegrated rock consists of quite large particles, the soil is called a _gravel soil_. A _sandy soil_ is one in which the particles are very small. _Sandstone_ is consolidated sand. _Clay_ is soil consisting principally of aluminum silicate; in _chalk_, soft calcium carbonate predominates. The organic constituents of the soil are the result of vegetable and animal growth and decomposition in the soil. =Ground Water.=--Ground water is that continuous body or sheet of water formed by the complete filling and saturation of the soil to a certain level by rain water; it is that stratum of subterranean lakes and rivers, filled up with alluvium, which we reach at a higher or lower level when we dig wells. The level of the ground water depends upon the underlying strata, and also upon the movements of the subterranean water bed. The relative position of the impermeable underlying strata varies in its distance from the surface soil. In marshy land the ground water is at the surface; in other places it can be reached only by deep borings. The source of the ground water is the rainfall, part of which drains into the porous soil until it reaches an impermeable stratum, where it collects. The movements of the ground water are in two directions--horizontal and vertical. The horizontal or lateral movement is toward the seas and adjacent water courses, and is determined by hydrostatic laws and topographical relations. The vertical motion of the ground water is to and from the surface, and is due to the amount of rainfall, the pressure of tides, and water courses into which the ground water drains. The vertical variations of the ground water determine the distance of its surface level from the soil surface, and are divided into a persistently low-water level, about fifteen feet from the surface; a persistently high-water level, about five feet from the surface, and a fluctuating level, sometimes high, sometimes low. =Ground Air.=--Except in the hardest granite rocks and in soil completely filled with water the interstices of the soil are filled with a continuation of atmospheric air, the amount depending on the degree of porosity of the soil. The nature of the ground air differs from that of the atmosphere only as it is influenced by its location. The principal constituents of the air--nitrogen, oxygen, and carbonic acid--are also found in the ground air, but in the latter the relative quantities of O and CO2 are different. AVERAGE COMPOSITION OF ATMOSPHERIC AIR IN 100 VOLUMES Nitrogen 79.00 per cent. Oxygen 20.96 " Carbonic acid 0.04 " AVERAGE COMPOSITION OF GROUND AIR Nitrogen 79.00 per cent. Oxygen 10.35 " Carbonic acid 9.74 " Of course, these quantities are not constant, but vary in different soils, and at different depths, times, etc. The greater quantity of CO2 in ground air is due to the process of oxidation and decomposition taking place in the soil. Ground air also contains a large quantity of bacterial and other organic matter found in the soil. Ground air is in constant motion, its movements depending upon a great many factors, some among these being the winds and movements of the atmospheric air, the temperature of the soil, the surface temperature, the pressure from the ground water from below, and surface and rain water from above, etc. =Ground Moisture.=--The interstices of the soil above the ground-water level are filled with air _only_, when the soil is absolutely dry; but as such a soil is very rare, all soils being more or less damp, soil usually contains a mixture of air and water, or what is called _ground moisture_. Ground moisture is derived partly from the evaporation of the ground water and its capillary absorption by the surface soil, and partly by the retention of water from rains upon the surface. The power of the soil to absorb and retain moisture varies according to the physical and chemical, as well as the thermal, properties of the soil. Loose sand may hold about 2 gallons of water per cubic foot; granite takes up about 4 per cent of moisture; chalk about 15 per cent; clay about 20 per cent; sandy loam 33 to 35 per cent; humus[10] about 40 per cent. =Ground Temperature.=--The temperature of the soil is due to the direct rays of the sun, the physicochemical changes in its interior, and to the internal heat of the earth. The ground temperature varies according to the annual and diurnal changes of the external temperature; also according to the character of the soil, its color, composition, depth, degree of organic oxidation, ground-water level, and degree of dampness. In hot weather the surface soil is cooler, and the subsurface soil still more so, than the surrounding air; in cold weather the opposite is the case. The contact of the cool soil with the warm surface air on summer evenings is what produces the condensation of air moisture which we call dew. =Bacteria.=--Quite a large number of bacteria are found in the soil, especially near the surface, where chemical and organic changes are most active. From 200,000 to 1,000,000 bacteria have been found in 1 c.c. of earth. The ground bacteria are divided into two groups--saprophytic and pathogenic. The saprophytic bacteria are the bacteria of decay, putrefaction, and fermentation. It is to their benevolent action that vegetable and animal _débris_ is decomposed, oxidized, and reduced to its elements. To these bacteria the soil owes its self-purifying capacity and the faculty of disintegrating animal and vegetable _débris_. The pathogenic bacteria are either those formed during the process of organic decay, and which, introduced into the human system, are capable of producing various diseases, or those which become lodged in the soil through the contamination of the latter by ground water and air, and which find in the soil a favorable lodging ground, until forced out of the soil by the movements of the ground water and air. =Contamination of the Soil.=--The natural capacity of the soil to decompose and reduce organic matter is sometimes taxed to its utmost by the introduction into the soil of extraneous matters in quantities which the soil is unable to oxidize in a given period. This is called contamination or pollution of soil, and is due: (1) to surface pollution by refuse, garbage, animal and human excreta; (2) to interment of dead bodies of beasts and men; (3) to the introduction of foreign deleterious gases, etc.[11] _Pollution by Surface Refuse and Sewage._--This occurs where a large number of people congregate, as in cities, towns, etc., and very seriously contaminates the ground by the surcharge of the surface soil with sewage matter, saturating the ground with it, polluting the ground water from which the drinking water is derived, and increasing the putrefactive changes taking place in the soil. Here the pathogenic bacteria abound, and, by multiplying, exert a very marked influence upon the health by the possible spread of infectious diseases. Sewage pollution of the soils and of the source of water supply is a matter of grave importance, and is one of the chief factors of high mortality in cities and towns. _Interment of Bodies._--The second cause of soil contamination is also of great importance. Owing to the intense physicochemical and organic changes taking place within the soil, all dead animal matter interred therein is easily disposed of in a certain time, being reduced to the primary constituents, viz., ammonia, nitrous acid, carbonic acid, sulphureted and carbureted hydrogen, etc. But whenever the number of interred bodies is too great, and the products of decomposition are allowed to accumulate to a very great degree, until the capacity of the soil to absorb and oxidize them is overtaxed, the soil, and the air and water therein, are polluted by the noxious poisons produced by the processes of decomposition. _Introduction of Various Foreign Materials and Gases._--In cities and towns various pipes are laid in the ground for conducting certain substances, as illuminating gas, fuel, coal gas, etc.; the pipes at times are defective, allowing leakage therefrom, and permitting the saturation of the soil with poisonous gases which are frequently drawn up by the various currents of ground air into the open air and adjacent dwellings. =Influence of the Soil on Health.=--The intimate relations existing between the soil upon which we live and our health, and the marked influence of the soil on the life and well-being of man, have been recognized from time immemorial. The influence of the soil upon health is due to: (1) the physical and chemical character of the soil; (2) the ground-water level and degree of dampness; (3) the organic impurities and contamination of the soil. The physical and chemical nature of the soil, irrespective of its water, moisture, and air, has been regarded by some authorities as having an effect on the health, growth, and constitution of man. The peculiar disease called cretinism, as well as goitre, has been attributed to a predominance of certain chemicals in the soil. The ground-water level is of great importance to the well-being of man. Professor Pettenkofer claimed that a persistently low water level (about fifteen feet from the surface) is healthy, the mortality being the lowest in such places; a persistently high ground-water level (about five feet from the surface) is unhealthy; and a fluctuating level, varying from high to low, is the most unhealthy, and is dangerous to life and health. Many authorities have sought to demonstrate the intimate relations between a high water level in the soil and various diseases. A damp soil, viz., a soil wherein the ground moisture is very great and persistent, has been found inimical to the health of the inhabitants, predisposing them to various diseases by the direct effects of the dampness itself, and by the greater proneness of damp ground to become contaminated with various pathogenic bacteria and organisms which may be drawn into the dwellings by the movements of the ground air. As a rule, there is very little to hinder the ground air from penetrating the dwellings of man, air being drawn in through cellars by changes in temperature, and by the artificial heating of houses. The organic impurities and bacteria found in the soil are especially abundant in large cities, and are a cause of the evil influence of soil upon health. The impurities are allowed to drain into the ground, to pollute the ground water and the source of water supply, and to poison the ground air, loading it with bacteria and products of putrefaction, thus contaminating the air and water so necessary to life. =Diseases Due to Soil.=--A great many diseases have been thought to be due to the influence of the soil. An ætiological relation had been sought between soil and the following diseases: malaria, paroxysmal fevers, tuberculosis, neuralgias, cholera, yellow fever, bubonic plague, typhoid, dysentery, goitre and cretinism, tetanus, anthrax, malignant Oedema, septicæmia, etc. =Sites.=--From what we have already learned about the soil, it is evident that it is a matter of great importance as to where the site for a human habitation is selected, for upon the proper selection of the site depend the health, well-being, and longevity of the inhabitants. The requisite characteristics of a healthy site for dwellings are: a dry, porous, permeable soil; a low and nonfluctuating ground-water level, and a soil retaining very little dampness, free from organic impurities, and the ground water of which is well drained into distant water courses, while its ground air is uncontaminated by pathogenic bacteria. Exposure to sunlight, and free circulation of air, are also requisite. According to Parkes, the soils in the order of their fitness for building purposes are as follows: (1) primitive rock; (2) gravel, with pervious soil; (3) sandstone; (4) limestone; (5) sandstone, with impervious subsoil; (6) clays and marls; (7) marshy land, and (8) made soils. It is very seldom, however, that a soil can be secured having all the requisites of a healthy site. In smaller places, as well as in cities, commercial and other reasons frequently compel the acquisition of and building upon a site not fit for the purpose; it then becomes a sanitary problem how to remedy the defects and make the soil suitable for habitation. =Prevention of the Bad Effects of the Soil on Health.=--The methods taught by sanitary science to improve a defective soil and to prepare a healthy site are the following: (1) Street paving and tree planting. (2) Proper construction of houses. (3) Subsoil drainage. _Street Paving_ serves a double sanitary purpose. It prevents street refuse and sewage from penetrating the ground and contaminating the surface soil, and it acts as a barrier to the free ascension of deleterious ground air.[12] _Tree Planting_ serves as a factor in absorbing the ground moisture and in oxidizing organic impurities. _The Proper Construction of the House_ has for its purpose the prevention of the entrance of ground moisture and air inside the house by building the foundations and cellar in such a manner as to entirely cut off communication between the ground and the dwelling. This is accomplished by putting under the foundation a solid bed of concrete, and under the foundation walls damp-proof courses. The following are the methods recommended by the New York City Tenement House Department for the water-proofing and damp-proofing of foundation walls and cellars: _Water-proofing and Damp-proofing of Foundation Walls._--"There shall be built in with the foundation walls, at a level of six (6) inches below the finished floor level, a course of damp-proofing consisting of not less than two (2) ply of tarred felt (not less than fifteen (15) pounds weight per one hundred (100) square feet), and one (1) ply of burlap, laid in alternate layers, having the burlap placed between the felt, and all laid in hot, heavy coal-tar pitch, or liquid asphalt, and projecting six (6) inches inside and six (6) inches outside of the walls. "There shall be constructed on the outside surface of the walls a water-proofing lapping on to the damp-proof course in the foundation walls and extending up to the soil level. This water-proofing shall consist of not less than two (2) ply of tarred felt (of weight specified above), laid in hot, heavy coal-tar pitch, or liquid asphalt, finished with a flow of hot pitch of the same character. This water-proofing to be well stuck to the damp course in the foundation walls. The layers of felt must break joints." _Water-proofing and Damp-proofing of Cellar Floors._--"There shall be laid, above a suitable bed of rough concrete, a course of water-proofing consisting of not less than three (3) ply of tarred felt (not less than fifteen (15) pounds weight per one hundred (100) square feet), laid in hot, heavy coal-tar pitch, or liquid asphalt, finished with a flow of hot pitch of the same character. The felt is to be laid so that each layer laps two-thirds of its width over the layer immediately below, the contact surface being thoroughly coated with the hot pitch over its entire area before placing the upper layer. The water-proofing course must be properly lapped on and secured to the damp course in the foundation walls." Other methods of damp-proofing foundations and cellars consist in the use of slate or sheet lead instead of tar and tarred paper. An additional means of preventing water and dampness from coming into houses has been proposed in the so-called "dry areas," which are open spaces four to eight feet wide between the house proper and the surrounding ground, the open spaces running as deep as the foundation, if possible. The dry areas are certainly a good preventive against dampness coming from the sides of the house. [Illustration: FIG. 4. CONCRETE FOUNDATION AND DAMP-PROOF COURSE.] _Subsoil Drainage._--By subsoil drainage is meant the reducing of the level of the ground water by draining all subsoil water into certain water courses, either artificial or natural. Subsoil drainage is not a modern discovery, as it was used in many ancient lands, and was extensively employed in ancient Rome, the valleys and suburbs of which would have been uninhabitable but for the draining of the marshes by the so-called "_cloacæ_" or drains, which lowered the ground-water level of the low parts of the city and made them fit to build upon. The drains for the conduction of subsoil water are placed at a certain depth, with a fall toward the exit. The materials for the drain are either stone and gravel trenches, or, better, porous earthenware pipes or ordinary drain tile. The drains must not be impermeable or closed, and sewers are not to be used for drainage purposes. Sometimes open, V-shaped pipes are laid under the regular sewers, if these are at the proper depth. By subsoil drainage it is possible to lower the level of ground water wherever it is near or at the surface, as in swamps, marsh, and other lands, and prepare lands previously uninhabitable for healthy sites. FOOTNOTES: [10] Humus is vegetable mold; swamp muck; peat; etc.--EDITOR. [11] A leak in a gas main, allowing the gas to penetrate the soil, will destroy trees, shrubbery, or any other vegetation with which it comes in contact.--EDITOR. [12] Town and village paving plans will benefit by knowledge of the recent satisfactory experience of New York City authorities in paving with wood blocks soaked in a preparation of creosote and resin. As compared with the other two general classes of paving, granite blocks, and asphalt, these wood blocks are now considered superior. The granite blocks are now nearly discarded in New York because of their permeability, expense, and noise, being now used for heavy traffic only. Asphalt is noiseless and impermeable (thereby serving the "double sanitary purpose" mentioned by Dr. Price). But the wood possesses these qualities, and has in addition the advantage of inexpensiveness, since it is more durable, not cracking at winter cold and melting under summer heat like the asphalt; and there is but slight cost for repairs, which are easily made by taking out the separate blocks. These "creo-resinate" wood blocks, recently used on lower Broadway, Park Place, and the congested side streets, are giving admirable results.--EDITOR. CHAPTER II =Ventilation= =Definition.=--The air within an uninhabited room does not differ from that without. If the room is occupied by one or more individuals, however, then the air in the room soon deteriorates, until the impurities therein reach a certain degree incompatible with health. This is due to the fact that with each breath a certain quantity of CO2, organic impurities, and aqueous vapor is exhaled; and these products of respiration soon surcharge the air until it is rendered impure and unfit for breathing. In order to render the air pure in such a room, and make life possible, it is necessary to change the air by withdrawing the impure, and substituting pure air from the outside. This is _ventilation_. _Ventilation_, therefore, is the maintenance of the air in a confined space in a condition conducive to health; in other words, "ventilation is the replacing of the impure air in a confined space by pure air from the outside." =Quantity of Air Required.=--What do we regard as impure air? What is the index of impurity? How much air is required to render pure an air in a given space, in a given time, for a given number of people? How often can the change be safely made, and how? These are the problems of ventilation. An increase in the quantity of CO2 [carbon dioxide gas], and a proportionate increase of organic impurities, are the results of respiratory vitiation of the air; and it has been agreed to regard the relative quantity of CO2 as the standard of impurity, its increase serving as an index of the condition of the air. The normal quantity of CO2 in the air is 0.04 per cent, or 4 volumes in 10,000; and it has been determined that whenever the CO2 reaches 0.06 per cent, or 6 parts per 10,000, the maximum of air vitiation is reached--a point beyond which the breathing of the air becomes dangerous to health. We therefore know that an increase of 2 volumes of CO2 in 10,000 of air constitutes the maximum of admissible impurity; the difference between 0.04 per cent and 0.06 per cent. Now, a healthy average adult at rest exhales in one hour 0.6 cubic foot of CO2. Having determined these two factors--the amount of CO2 exhaled in one hour and the maximum of admissible impurity--we can find by dividing 0.6 by 0.0002 (or 0.02 per cent) the number of cubic feet of air needed for one hour,==3,000. Therefore, a room with a space of 3,000 cubic feet, occupied by one average adult at rest, will not reach its maximum of impurity (that is, the air in such a room will not be in need of a change) before one hour has elapsed. The relative quantity of fresh air needed will differ for adults at work and at rest, for children, women, etc.; it will also differ according to the illuminant employed, whether oil, candle, gas, etc.--an ordinary 3-foot gas-burner requiring 1,800 cubic feet of air in one hour. It is not necessary, however, to have 3,000 cubic feet of space for each individual in a room, for the air in the latter can safely be changed at least three times within one hour, thus reducing the air space needed to about 1,000 cubic feet. This change of air or ventilation of a room can be accomplished by mechanical means oftener than three times in an hour, but a natural change of more than three times in an hour will ordinarily create too strong a current of air, and may cause draughts and chills dangerous to health. In determining the cubic space needed, the height of the room as well as the floor space must be taken into consideration. As a rule the height of a room ought to be in proportion to the floor space, and in ordinary rooms should not exceed fourteen feet, as a height beyond that is of very little advantage.[13] =Forces of Ventilation.=--We now come to the question of the various modes by which change in the air of a room is possible. Ventilation is natural or artificial according to whether artificial or mechanical devices are or are not used. Natural ventilation is only possible because our buildings and houses, their material and construction, are such that numerous apertures and crevices are left for air to come in; for it is evident that if a room were hermetically air-tight, no natural ventilation would be possible. The properties of air which render both natural and artificial ventilation possible are diffusion, motion, and gravity. These three forces are the natural agents of ventilation. There is a constant diffusion of gases taking place in the air; this diffusion takes place even through stone and through brick walls. The more porous the material of which the building is constructed, the more readily does diffusion take place. Dampness, plastering, painting, and papering of walls diminish diffusion, however. The second force in ventilation is the motion of air or winds. This is the most powerful agent of ventilation, for even a slight, imperceptible wind, traveling about two miles an hour, is capable, when the windows and doors of a room are open, of changing the air of a room 528 times in one hour. Air passes also through brick and stone walls. The objections to winds as a sole mode of ventilation are their inconstancy and irregularity. When the wind is very slight its ventilating influence is very small; on the other hand, when the wind is strong it cannot be utilized as a means of ventilation on account of the air currents being too strong and capable of exerting deleterious effects on health. The third, the most constant and reliable, and, in fact, principal agent of ventilation is the specific gravity of the air, and the variations in the gravity and consequent pressure which are results of the variations in temperature, humidity, etc. Whenever air is warmer in one place than in another, the warmer air being lighter and the colder air outside being heavier, the latter exerts pressure upon the air in the room, causing the lighter air in the room to escape and be displaced by the heavier air from the outside, thus changing the air in the room. This mode of ventilation is always constant and at work, as the very presence of living beings in the room warms the air therein, thus causing a difference from the outside air and effecting change of air from the outside to the inside of the room. =Methods of Ventilation.=--The application of these principles of ventilation is said to be accomplished in a natural or an artificial way, according as mechanical means to utilize the forces and properties of air are used or not. But in reality natural ventilation can hardly be said to exist, since dwellings are so constructed as to guard against exposure and changes of temperature, and are usually equipped with numerous appliances for promoting change of air. Windows, doors, fireplaces, chimneys, shafts, courts, etc., are all artificial methods of securing ventilation, although we usually regard them as means of natural ventilation. =Natural Ventilation.=--The means employed for applying the properties of diffusion are the materials of construction. A porous material being favorable for diffusion, some such material is placed in several places within the wall, thus favoring change of air. Imperfect carpenter work is also a help, as the cracks and openings left are favorable for the escape and entrance of air. Wind, or the motion of air, is utilized either directly, through windows, doors, and other openings; or indirectly, by producing a partial vacuum in passing over chimneys and shafts, causing suction of the air in them, and the consequent withdrawal of the air from the rooms. The opening of windows and doors is possible only in warm weather; and as ventilation becomes a problem only in temperate and cold weather, the opening of windows and doors cannot very well be utilized without causing colds, etc. Various methods have therefore been proposed for using windows for the purposes of ventilation without producing forcible currents of air. The part of the window best fitted for the introduction of air is the space between the two sashes, where they meet. The ingress of air is made possible whenever the lower sash is raised or the upper one is lowered. In order to prevent cold air from without entering through the openings thus made, it has been proposed by Hinkes Bird to fit a block of wood in the lower opening; or else, as in Dr. Keen's arrangement, a piece of paper or cloth is used to cover the space left by the lifting or lowering of either or both sashes. Louvers or inclined panes or parts of these may also be used. Parts or entire window panes are sometimes wholly removed and replaced by tubes or perforated pieces of zinc, so that air may come in through the apertures. Again, apertures for inlets and outlets may be made directly in the walls of the rooms. These openings are filled in with porous bricks or with specially made bricks (like Ellison's conical bricks), or boxes provided with several openings. A very useful apparatus of this kind is the so-called Sheringham valve, which consists of an iron box fitted into the wall, the front of the box facing the room having an iron valve hinged along its lower edge, and so constructed that it can be opened or be closed at will to let a current of air pass upward. Another very good apparatus of this kind is the Tobin ventilator, consisting of horizontal tubes let through the walls, the outer ends open to the air, but the inner ends projecting into the room, where they are joined by vertical tubes carried up five feet or more from the floor, thus allowing the outside air to enter upwardly into the room. This plan is also adapted for filtering and cleaning the incoming air by placing cloth or other material across the lumen of the horizontal tubes to intercept dust, etc. McKinnell's ventilator is also a useful method of ventilation, especially of underground rooms. [Illustration: FIG. 5. HINKES BIRD WINDOW. (TAYLOR.)] [Illustration: FIG. 6. ELLISON'S AIR INLETS. (KNIGHT.)] [Illustration: FIG. 7. SHERINGHAM VALVE. (TAYLOR.)] [Illustration: FIG. 8. THE TOBIN VENTILATOR. (KNIGHT.)] [Illustration: FIG. 9. McKINNELL'S VENTILATOR. (TAYLOR.)] To assist the action of winds over the tops of shafts and chimneys, various cowls have been devised. These cowls are arranged so as to help aspirate the air from the tubes and chimneys, and prevent a down draught. The same inlets and outlets which are made to utilize winds may also be used for the ventilation effected by the motion of air due to difference in the specific gravity of outside and inside air. Any artificial warming of the air in the room, whether by illuminants or by the various methods of heating rooms, will aid in ventilating it, the chimneys acting as powerful means of removal for the warmer air. Various methods have also been proposed for utilizing the chimney, even when no stoves, etc., are connected with it, by placing a gaslight within the chimney to cause an up draught and consequent aspiration of the air of the room through it. [Illustration: FIG. 10. VENTILATING THROUGH CHIMNEY. (KNIGHT.)] The question of the number, relative size, and position of the inlets and outlets is a very important one, but we can here give only an epitome of the requirements. The inlet and outlet openings should be about twenty-four inches square per head. Inlet openings should be short, easily cleaned, sufficient in number to insure a proper distribution of air; should be protected from heat, provided with valves so as to regulate the inflow of air, and, if possible, should be placed so as to allow the air passing through them to be warmed before entering the room.[14] Outlet openings should be placed near the ceiling, should be straight and smooth, and, if possible, should be heated so as to make the air therein warmer, thus preventing a down draught, as is frequently the case when the outlets become inlets. [Illustration: FIG. 11. COWL VENTILATOR. (KNIGHT.)] =Artificial Ventilation.=--Artificial ventilation is accomplished either by aspirating the air from the building, known as the vacuum or extraction method, or by forcing into the building air from without; this is known as the plenum or propulsion method. The extraction of the air in a building is done by means of heat, by warming the air in chimneys or special tubes, or by mechanical means with screws or fans run by steam or electricity; these screws or fans revolve and aspirate the air of the rooms, and thus cause pure air to enter. [Illustration: FIG. 12. AN AIR PROPELLER.] The propelling method of ventilation is carried out by mechanical means only, air being forced in from the outside by fans, screws, bellows, etc. Artificial ventilation is applicable only where a large volume of air is needed, and for large spaces, such as theaters, churches, lecture rooms, etc. For the ordinary building the expense for mechanical contrivances is too high. On the whole, ventilation without complex and cumbersome mechanisms is to be preferred.[15] FOOTNOTES: [13] In cerebro-spinal meningitis, tuberculosis, and pneumonia, fresh air is curative. Any person, sick or well, cannot have too much fresh air. The windows of sleeping rooms should always be kept open at night.--EDITOR. [14] These outlets may be placed close to a chimney or heating pipes. Warm air rises and thus will be forced out, allowing cool fresh air to enter at the inlets.--EDITOR. [15] The ordinary dwelling house needs no artificial methods of ventilation. The opening and closing of windows will supply all necessary regulation in this regard. The temperature of living rooms should be kept, in general, at 70° F. Almost all rooms for the sick are unfortunately overheated. Cool, fresh air is one of the most potent means of curing disease. Overheated rooms are a menace to health.--EDITOR. CHAPTER III =Warming= =Ventilation and Heating.=--The subject of the heating of our rooms and houses is very closely allied to that of ventilation, not only because both are a special necessity at the same time of the year, but also because we cannot heat a room without at the same time having to ventilate it by providing an egress for the products of combustion and introducing fresh air to replace the vitiated. =Need of Heating.=--In a large part of the country, and during the greater period of the year, some mode of artificial heating of rooms is absolutely necessary for our comfort and health. The temperature of the body is 98° to 99° F., and there is a constant radiation of heat due to the cooling of the body surface. If the external temperature is very much below that of the body, and if the low temperature is prolonged, the radiation of heat from the body is too rapid, and colds, pneumonia, etc., result. The temperature essential for the individual varies according to age, constitution, health, environment, occupation, etc. A child, a sick person, or one at rest requires a relatively higher temperature than a healthy adult at work. The mean temperature of a room most conducive to the health of the average person is from 65° to 75° F. =The Three Methods of Heating.=--The heating of a room can be accomplished either _directly_ by the rays of the sun or processes of combustion. We thus receive _radiant_ heat, exemplified by that of open fires and grates. Or, the heating of places can be accomplished by the heat of combustion being conducted through certain materials, like brick walls, tile, stone, and also iron; this is _conductive_ heat, as afforded by stoves, etc. Or, the heat is _conveyed_ by means of air, water, or steam from one place to another, as in the hot-water, hot-air, and steam systems of heating; this we call _convected_ heat. There is no strict line of demarcation differentiating the three methods of heating, as it is possible that a radiant heat may at the same time be conductive as well as convective--as is the case in the Galton fireplace, etc. =Materials of Combustion.=--The materials of combustion are air, wood, coal, oil, and gas. Air is indispensable, for, without oxygen, there can be no combustion. Wood is used in many places, but is too bulky and expensive. Oil is rarely used as a material of combustion, its principal use being for illumination. Coal is the best and cheapest material for combustion. The chief objection against its use is the production of smoke, soot, and of various gases, as CO, CO2, etc. Gas is a very good, in fact, the best material for heating, especially if, when used, it is connected with chimneys; otherwise, it is objectionable, as it burns up too much air, vitiates the atmosphere, and the products of combustion are deleterious; it is also quite expensive. The ideal means of heating is electricity. =Chimneys.=--All materials used for combustion yield products more or less injurious to health. Every system of artificially heating houses must therefore have not only means of introducing fresh air to aid in the burning up of the materials, but also an outlet for the vitiated, warmed air, partly charged with the products of combustion. These outlets are provided by chimneys. Chimneys are hollow tubes or shafts built of brick and lined with earthen pipes or other material inside. These tubes begin at the lowest fireplace or connection, and are carried up several feet above the roof. The thickness of a chimney is from four to nine inches; the shape square, rectangular, or, preferably, circular. The diameter of the chimney depends upon the size of the house, the number of fire connections, etc. It should be neither too small nor too large. Square chimneys should be twelve to sixteen inches square; circular ones from six to eight inches in diameter for each fire connection. The chimney consists of a _shaft_, or vertical tube, and _cowls_ placed over chimneys on the roof to prevent down draughts and the falling in of foreign bodies. That part of the chimney opening into the fireplace is called the _throat_. =Smoky Chimneys.=--A very frequent cause of complaint in a great many houses is the so-called "smoky chimney"; this is the case when smoke and coal gas escape from the chimney and enter the living rooms. The principal causes of this nuisance are: (1) A too wide or too narrow diameter of the shafts. A shaft which is too narrow does not let all the smoke escape; one which is too wide lets the smoke go up only in a part of its diameter, and when the smoke meets a countercurrent of cold air it is liable to be forced back into the rooms. (2) The throat of the chimney may be too wide, and will hold cold air, preventing the warming of the air in the chimneys and the consequent up draught. (3) The cowls may be too low or too tight, preventing the escape of the smoke. (4) The brickwork of the chimney may be loose, badly constructed, or broken into by nails, etc., thus allowing smoke to escape therefrom. (5) The supply of air may be deficient, as when all doors and windows are tightly closed. (6) The chimney may be obstructed by soot or some foreign material. (7) The wind above the house may be so strong that its pressure will cause the smoke from the chimney to be forced back. (8) If two chimneys rise together from the same house, and one is shorter than the other, the draught of the longer chimney may cause an inversion of the current of air in the lower chimney. (9) Wet fuel when used will cause smoke by its incomplete combustion. (10) A chimney without a fire may suck down the smoke from a neighboring chimney; or, if two fireplaces in different rooms are connected with the same chimney, the smoke from one room may be drawn into the other. =Methods of Heating.= =Open Fireplaces and Grates.=--Open fireplaces and fires in grates connected with chimneys, and using coal, wood, or gas, are very comfortable; nevertheless there are weighty objections to them. Firstly, but a very small part of the heat of the material burning is utilized, only about twelve per cent being radiated into the room, the rest going up the chimney. Secondly, the heat of grates and fireplaces is only local, being near the fires and warming only that part of the person exposed to it, leaving the other parts of the room and person cold. Thirdly, the burning of open fires necessitates a great supply of air, and causes powerful draughts. The open fireplace can, however, be greatly improved by surrounding its back and sides by an air space, in which air can be warmed and conveyed into the upper part of the room; and if a special air inlet is provided for supplying the fire with fresh air to be warmed, we get a very valuable means of heating. These principles are embodied in the Franklin and Galton grates. A great many other grates have been suggested, and put on the market, but the principal objection to them is their complexity and expense, making their use a luxury not attainable by the masses. [Illustration: FIG. 13. A GALTON GRATE. (TRACY.)] =Stoves.=--Stoves are closed receptacles in which fuel is burned, and the heat produced is radiated toward the persons, etc., near them, and also conducted, through the iron or other materials of which the stoves are made, to surrounding objects. In stoves seventy-five per cent of the fuel burned is utilized. They are made of brick, tile, and cast or wrought iron. Brick stoves, and stoves made of tile, are extensively used in some European countries, as Russia, Germany, Sweden, etc.; they are made of slow-conducting material, and give a very equable, efficient, and cheap heat, although their ventilating power is very small. Iron is used very extensively because it is a very good conductor of heat, and can be made into very convenient forms. Iron stoves, however, often become superheated, dry up, and sometimes burn the air around them, and produce certain deleterious gases during combustion. When the fire is confined in a clay fire box, and the stove is not overheated, a good supply of fresh air being provided and a vessel of water placed on the stove to reduce the dryness of the air, iron stoves are quite efficient. =Hot-air Warming.=--In small houses the warming of the various rooms and halls can be accomplished by placing the stove or furnace in the cellar, heating a large quantity of air and conveying it through proper tubes to the rooms and places to be warmed. The points to be observed in a proper and efficient hot-air heating system are the following: (1) The furnace must be of a proper size in proportion to the area of space to be warmed. (2) The joints and parts of the furnace must be gas-tight. (3) The furnace should be placed on the cold side of the house, and provision made to prevent cellar air from being drawn up into the cold-air box of the furnace. (4) The air for the supply of the furnace must be gotten from outside, and the source must be pure, above the ground level, and free from contamination of any kind.[16] (5) The cold-air box and ducts must be clean, protected against the entrance of vermin, etc., and easily cleaned. (6) The air should not be overheated. (7) The hot-air flues or tubes must be short, direct, circular, and covered with asbestos or some other non-conducting material. [Illustration: FIG. 14. A HOT-AIR FURNACE. The cold air from outside comes to the COLD-AIR INTAKE through the cold-air duct, enters the furnace from beneath, and is heated by passing around the FIRE POT and the annular combustion chamber above. It then goes through pipes to the various registers throughout the house. The coal is burnt in the fire pot, the gases are consumed in the combustion chamber above, while the heat eventually passes into the SMOKE FLUE. The WATER PAN supplies moisture to the air.] =Hot-water System.=--The principles of hot-water heating are very simple. Given a circuit of pipes filled with water, on heating the lower part of the circuit the water, becoming warmer, will rise, circulate, and heat the pipes in which it is contained, thus warming the air in contact with the pipes. The lower part of the circuit of pipe begins in the furnace or heater, and the other parts of the circuit are conducted through the various rooms and halls throughout the house to the uppermost story. The pipes need not be straight all through; hence, to secure a larger area for heating, they are convoluted within the furnace, and also in the rooms, where the convoluted pipes are called _radiators_. The water may be warmed by the low- or high-pressure system; in the latter, pipes of small diameter may be employed; while in the former, pipes of a large diameter will be required. The character, etc., of the boilers, furnace, pipes, etc., cannot be gone into here. =Steam-heating System.=--The principle of steam heating does not differ from that of the hot-water system. Here the pressure is greater and steam is employed instead of water. The steam gives a greater degree of heat, but the pipes must be stronger and able to withstand the pressure. There are also combinations of steam and hot-water heating. For large houses either steam or hot-water heating is the best means of warming, and, if properly constructed and cared for, quite healthy.[17] FOOTNOTES: [16] Great care should be taken that the air box is not placed in contaminated soil or where it may become filled with stagnant or polluted water.--EDITOR. [17] See Chapter XI for practical notes on cost of installation of these three conveyed systems--hot-air, hot-water, and steam.--EDITOR. CHAPTER IV =Disposal of Sewage= =Waste Products.=--There is a large amount of waste products in human and social economy. The products of combustion, such as ashes, cinders, etc.; the products of street sweepings and waste from houses, as dust, rubbish, paper, etc.; the waste from various trades; the waste from kitchens, e. g., scraps of food, etc.; the waste water from the cleansing processes of individuals, domestic animals, clothing, etc.; and, finally, the excreta--urine and fæces--of man and animals; all these are waste products that cannot be left undisposed of, more especially in cities, and wherever a large number of people congregate. All waste products are classified into three distinct groups: (1) refuse, (2) garbage, and (3) sewage. The amount of _refuse_ and _garbage_ in cities is quite considerable; in Manhattan, alone, the dry refuse amounts to 1,000,000 tons a year, and that of garbage to 175,000 tons per year. A large percentage of the dry refuse and garbage is valuable from a commercial standpoint, and could be utilized, with proper facilities for collection and separation. The disposal of refuse and garbage has not as yet been satisfactorily dealt with. The modes of waste disposal in the United States are: (1) dumping into the sea; (2) filling in made land, or plowing into lands; (3) cremation and (4) reduction by various processes, and the products utilized. =Sewage.=--By sewage we mean the waste and effete human matter and excreta--the urine and fæces of human beings and the urine of domestic animals (the fæces of horses, etc., has great commercial value, and is usually collected separately and disposed of for fertilizing purposes). The amount of excreta per person has been estimated (Frankland) as 3 ounces of solid and 40 ounces of fluid per day, or about 30 tons of solid and 100,000 gallons of fluid for each 1,000 persons per year. In sparsely populated districts the removal and ultimate disposal of sewage presents no difficulties; it is returned to the soil, which, as we know, is capable of purifying, disintegrating, and assimilating quite a large amount of organic matter. But when the number of inhabitants to the square mile increases, and the population becomes as dense as it is in some towns and cities, the disposal of the human waste products becomes a question of vast importance, and the proper, as well as the immediate and final, disposal of sewage becomes a serious sanitary problem. It is evident that sewage must be removed in a thorough manner, otherwise it would endanger the lives and health of the people. The dangers of sewage to health are: (1) From its offensive odors, which, while not always directly dangerous to health, often produce headaches, nausea, etc. (2) The organic matter contained in sewage decomposes and eliminates gases and other products of decomposition. (3) Sewage may contain a large number of pathogenic bacteria (typhoid, dysentery, cholera, etc.). (4) Contamination of the soil, ground water, and air by percolation of sewage. The problem of sewage disposal is twofold: (1) immediate, viz., the need of not allowing sewage to remain too long on the premises, and its immediate removal beyond the limits of the city; and (2) the final disposition of the sewage, after its removal from the cities, etc. =Modes of Ultimate Disposal of Sewage.=--The chief constituents of sewage are organic matter, mineral salts, nitrogenous substances, potash, and phosphoric acid. Fresh-mixed excrementitious matter has an acid reaction, but within twelve to twenty hours it becomes alkaline, because of the free ammonia formed in it. Sewage rapidly decomposes, evolving organic and fetid matters, ammonium sulphide, sulphureted and carbureted hydrogen, etc., besides teeming with animal and bacterial life. A great many of the substances contained in sewage are valuable as fertilizers of soil. The systems of final disposal of sewage are as follows: (1) Discharge into seas, lakes, and rivers. (2) Cremation. (3) Physical and chemical precipitation. (4) Intermittent filtration. (5) Land irrigation. (6) "Bacterial" methods. _Discharge into Waters._--The easiest way to dispose of sewage is to let it flow into the sea or other running water course. The objections to sewage discharging into the rivers and lakes near cities, and especially such lakes and rivers as supply water to the municipalities, are obvious. But as water can purify a great amount of sewage, this method is still in vogue in certain places, although it is to be hoped that it will in the near future be superseded by more proper methods. The objection against discharging into seas is the operation of the tides, which cause a backflow and overflow of sewage from the pipes. This backflow is remedied by the following methods: (1) providing tidal flap valves, permitting the outflow of sewage, but preventing the inflow of sea water; (2) discharging the sewage intermittently, only during low tide; and (3) providing a constant outflow by means of steam-power pressure. _Cremation._--Another method of getting rid of the sewage without attempting to utilize it is by cremation. The liquid portion of the sewage is allowed to drain and discharge into water courses, and the more or less solid residues are collected and cremated in suitable crematories. _Precipitation._--This method consists in separating the solid matters from the sewage by precipitation by physical or chemical processes, the liquid being allowed to drain into rivers and other waters, and the precipitated solids utilized for certain purposes. The precipitation is done either by straining the sewage, collecting it into tanks, and letting it subside, when the liquid is drawn off and the solids remain at the bottom of the tanks, a rather unsatisfactory method; or, by chemical processes, precipitating the sewage by chemical means, and utilizing the products of such precipitation. The chemical agents by which precipitation is accomplished are many and various; among them are lime, alum, iron perchloride, phosphates, etc. _Intermittent Filtration._--Sewage may be purified mechanically and chemically by method of intermittent filtration by passing it through filter beds of gravel, sand, coke, cinders, or any such materials. Intermittent filtration has passed beyond the experimental stage and has been adopted already by a number of cities where such a method of sewage disposal seems to answer all purposes. _Land Irrigation._--In this method the organic and other useful portions of sewage are utilized for irrigating land, to improve garden and other vegetable growths by feeding the plants with the organic products of animal excretion. Flat land, with a gentle slope, is best suited for irrigation. The quantity of sewage disposed of will depend on the character of the soil, its porosity, the time of the year, temperature, intermittency of irrigation, etc. As a rule, one acre of land is sufficient to dispose of the sewage of 100 to 150 people. _Bacterial Methods._--The other biological methods, or the so-called "bacterial" sewage treatment, are but modifications of the filtration and irrigation methods of sewage disposal. Properly speaking the bacterial purification of sewage is the scientific application of the knowledge gained by the study of bacterial life and its action upon sewage. In intermittent filtration the sewage is passed through filter beds of sands, etc., upon which filter beds the whole burden of the purification of the sewage rests. In the bacterial methods the work of purification is divided between the septic tanks where the sewage is first let into and where it undergoes the action of the anaërobic bacteria, and from these septic tanks the sewage is run to the contact beds of coke and cinders to further undergo the action of the aërobic bacteria, after the action of which the nitrified sewage is in a proper form to be utilized for fertilization of land, etc. The septic tanks are but a modification of the common cesspool, and are constructed of masonry, brick, and concrete. There are a number of special applications of the bacterial methods of sewage treatment, into which we cannot go here. =Sewage Disposal in the United States.=--According to its location, position, etc., each city in the United States has its own method of final disposition of sewage. Either one or the other, or a combination of two of the above methods, is used. The following cities discharge their sewage into the sea: Portland, Salem, Lynn, Gloucester, Boston, Providence, New York, Baltimore, Charleston, and Savannah. The following cities discharge their sewage into rivers and lakes: Philadelphia, Cincinnati, St. Louis, Albany, Minneapolis, St. Paul, Washington, Buffalo, Detroit, Richmond, Chicago, Milwaukee, and Cleveland. "Worcester uses chemical precipitation. In Atlanta a part of the soil is cremated, but the rest is deposited in pits 8 × 10 feet, and 5 feet deep. It is then thoroughly mixed with dry ashes from the crematory, and afterwards covered with either grain or grass. In Salt Lake City and in Woonsocket it is disposed of in the same way. In Indianapolis it is composted with marl and sawdust, and after some months used as a fertilizer. A portion of the sewage is cremated in Atlanta, Camden, Dayton, Evansville, Findlay, Ohio; Jacksonville, McKeesport, Pa.; Muncie, and New Brighton. In Atlanta, in 1898, there were cremated 2,362 loads of sewage. In Dayton, during 30 days, there were cremated 1,900 barrels of 300 pounds each." (_Chapin, Mun. San. in U. S._) =The Immediate Disposal of Sewage.=--The final disposition of sewage is only one part of the problem of sewage disposal; the other part is how to remove it from the house into the street, and from the street into the places from which it is finally disposed. The immediate disposal of sewage is accomplished by two methods--the so-called _dry_, and the _water-carriage_ methods. By the _dry method_ we mean the removal of sewage without the aid of water, simply collecting the dry and liquid portions of excreta, storing it for some time, and then removing it for final disposal. By the _water-carriage method_ is understood the system by which sewage, solid and liquid, is flushed out by means of water, through pipes or conduits called sewers, from the houses through the streets to the final destination. =The Dry Methods.=--The dry or conservacy method of sewage disposal is a primitive method used by all ancient peoples, in China at the present time, and in all villages and sparsely populated districts; it has for its basic principle the return to mother earth of all excreta, to be used and worked over in its natural laboratory. The excreta are simply left in the ground to undergo in the soil the various organic changes, the difference in methods being only as regards the vessels of collection and storage. The methods are: (1) Cesspool and privy vault. (2) Pail system. (3) Pneumatic system. _The Privy Vault_ is the general mode of sewage disposal in villages, some towns, and even in some large cities, wherever sewers are not provided. In its primitive and unfortunately common form, the privy vault is nothing but a hole dug in the ground near or at some distance from the house; the hole is but a few feet deep, with a plank or rough seat over it, and an improvised shed over all. The privy is filled with the excreta; the liquids drain into the adjacent ground, which becomes saturated, and contaminates the nearest wells and water courses. The solid portion is left to accumulate until the hole is filled or the stench becomes unbearable, when the hole is either covered up and forgotten, or the excreta are removed and the hole used over again. This is the common privy as we so often find it near the cottages and mansions of our rural populace, and even in towns. A better and improved form of privy is that built in the ground, and made water-tight by being constructed of bricks set in cement, the privy being placed at a distance from the house, the shed over it ventilated, and the contents of the privy removed regularly and at stated intervals, before they become a nuisance. At its best, however, the privy vault is an abomination, as it can scarcely be so well constructed as not to contaminate the surrounding soil, or so often cleaned as to prevent decomposition and the escape of poisonous gases. _The Pail System_ is an economic, simple, and, on the whole, very efficient method of removing fresh excreta. The excreta are passed directly into stone or metal water- and gas-tight pails, which, after filling, are hermetically covered and removed to the places for final disposal. This system is in use in Rochedale, Manchester, Glasgow, and other places in England. The pails may also be filled with dried earth, ashes, etc., which are mixed with the excreta and convert it into a substance fit for fertilization. _The Pneumatic System_ is a rather complicated mechanical method invented by Captain Lieurneur, and is used extensively in some places. In this system the excreta are passed to certain pipes and receptacles, and from there aspirated by means of air exhausts. =The Water-carriage System.=--We now come to the modern mode of using water to carry and flush all sewage material. This method is being adopted throughout the civilized world. For it is claimed a reduction of the mortality rate issues wherever it is introduced. The water-carriage system presupposes the construction and existence of pipes from the house to and through the street to the place of final disposition. The pipes running from the house to the streets are called house sewers; and when in the streets, are called street sewers. =The Separate and Combined Systems.=--Whenever the water-carriage system is used, it is either intended to carry only sewage proper, viz., solid and liquid excreta flushed by water, or fain water and other waste water from the household in addition. The water-carriage system is accordingly divided into two systems: _the combined_, by which all sewage and all waste and rain water are carried through the sewers, and the _separate_ system, in which two groups of pipes are used--the sewers proper to carry sewage only, and the other pipes to dispose of rain water and other uncontaminated waste water. Each system has its advocates, its advantages and disadvantages. The advantages claimed for the separate system are as follows: (1) Sewers may be of small diameter, not more than six inches. (2) Constant, efficient flow and flushing of sewage. (3) The sewage gained is richer in fertilizing matter. (4) The sewers never overflow, as is frequently the case in the combined system. (5) The sewers being small, no decomposition takes place therein. (6) Sewers of small diameter need no special means of ventilation, or main traps on house drains, and can be ventilated through the house pipes. On the other hand, the disadvantages of the separate system are: (1) The need of two systems of sewers, for sewage and for rain water, and the expense attached thereto. (2) The sewers used for sewage proper require some system for periodically flushing them, which, in the combined system, is done by the occasional rains. (3) Small sewers cannot be as well cleaned or gotten at as larger ones. The separate system has been used in Memphis and in Keene, N. H., for a number of years with complete satisfaction. Most cities, however, use the combined system. CHAPTER V =Sewers= =Definitions.=--A sewer is a conduit or pipe intended for the passage of sewage, waste, and rain water. A _House Sewer_ is the branch sewer extending from a point two feet outside of the outer wall of the building to its connection with the street sewer, etc. =Materials.=--The materials from which sewers are manufactured is earthenware "vitrified pipes." Iron is used only for pipes of small diameter; and as most of the sewers are of greater diameter than six inches, they are made of other material than iron. Cement and brick sewers are frequently used, and, when properly constructed, are efficient, although the inner surface of such pipes is rough, which causes adherence of sewage matter. The most common material of which sewers are manufactured is earthenware, "vitrified pipes." "Vitrified pipes are manufactured from some kind of clay, and are salt-glazed inside. Good vitrified pipe must be circular and true in section, of a uniform thickness, perfectly straight, and free from cracks or other defects; they must be hard, tough, not porous, and have a highly smooth surface. The thicknesses of vitrified pipes are as follows: 4 inches diameter 1/2 inch thick 6 " " 1/16 " " 8 " " 3/4 " " 12 " " 1 " " The pipes are made in two- and three-foot lengths, with spigot, and socket ends." (Gerhardt.) Sewer pipes are laid in trenches at least three feet deep, to insure against the action of frosts. =Construction.=--The level of the trenches in which sewers are laid should be accurate, and a hard bed must be secured, or prepared, for the pipes to lie on. If the ground is sandy and soft, a solid bed of concrete should be laid, and the places where the joints are should be hollowed out, and the latter embedded in cement. =Joints.=--The joints of the various lengths must be gas-tight, and are made as follows: into the hub (the enlargement on one end of the pipe) the spigot end of the next length is inserted, and in the space left between the two a small piece, or gasket, of oakum is rammed in; the remaining space is filled in with a mixture of the best Portland cement and clean, sharp sand. The office of the oakum is to prevent the cement from getting on the inside of the pipe. The joint is then wiped around with additional cement. =Fall.=--In order that there should be a steady and certain flow of the contents of the sewer, the size and fall of the latter must be suitable; that is, the pipes must be laid with a steady, gradual inclination or fall toward the exit. This fall must be even, without sudden changes, and not too great or too small. [Illustration: FIG. 15. A BRICK SEWER.] The following has been determined to be about the right fall for the sizes stated: 4-inch pipe 1 foot in 40 feet 6 " " 1 " " 60 " 9 " " 1 " " 90 " 12 " " 1 " " 120 " =Flow.=--The velocity of the flow in sewers depends on the volume of their contents, the size of the pipes, and the fall. The velocity should not be less than 120 feet in a minute, or the sewer will not be self-cleansing. =Size.=--In order for the sewer to be self-cleansing, its size must be proportional to the work to be accomplished, so that it may be fully and thoroughly flushed and not permit stagnation and consequent decomposition of its contents. If the sewer be too small, it will not be adequate for its purpose, and will overflow, back up, etc.; if too large, the velocity of the flow will be too low, and stagnation will result. In the separate system, where there is a separate provision for rain water, the size of the sewer ought not to exceed six inches in diameter. In the combined system, however, when arrangements must be made for the disposal of large volumes of storm water, the size of the sewer must be larger, thus making it less self-cleansing. =Connections.=--The connections of the branch sewers and the house sewers with the main sewer must be carefully made, so that there shall be no impediment to the flow of the contents, either of the branches or of the main pipe. The connections must be made gas-tight; not at right angles or by T branches, but by bends, curves, and Y branches, in the direction of the current of the main pipe, and not opposite other branch pipes; and the junction of the branch pipes and the main pipe must not be made at the crown or at the bottom of the sewer, but just within the water line. =Tide Valves.=--Where sewers discharge their contents into the sea, the tide may exert pressure upon the contents of the sewer and cause "backing up," blocking up the sewer, bursting open trap covers, and overflowing into streets and houses. To prevent this, there are constructed at the mouth of the street sewers, at the outlets to the sea, proper valves or tide flaps, so constructed as to permit the contents of the sewers to flow out, yet prevent sea water from backing up by immediately closing upon the slightest pressure from outside. =House Sewers.=--Where the ground is "made," or filled in, the house sewer must be made of cast iron, with the joints properly calked with lead. Where the soil consists of a natural bed of loam, sand, or rock, the house sewer may be of hard, salt-glazed, and cylindrical earthenware pipe, laid in a smooth bottom, free from projections of rock, and with the soil well rammed to prevent any settling of the pipe. Each section must be wetted before applying the cement, and the space between each hub and the small end of the next section must be completely and uniformly filled with the best hydraulic cement. Care must be taken to prevent any cement being forced into the pipe to form an obstruction. No tempered-up cement should be used. A straight edge must be used inside the pipe, and the different sections must be laid in perfect line on the bottom and sides. Connections of the house sewer (when of iron) with the house main pipe must be made by lead-calked joints; the connection of the iron house pipe with the earthenware house sewer must be made with cement, and should be gas-tight. =Sewer Air and Gas.=--Sewer gas is not a gas at all. What is commonly understood by the term is the air of sewers, the ordinary atmospheric air, but charged and contaminated with the various products of organic decomposition taking place in sewers. Sewer air is a mixture of gases, the principal gases being carbonic acid; marsh gas; compounds of hydrogen and carbon; carbonate and sulphides of ammonium; ammonia; sulphureted hydrogen; carbonic oxide, volatile fetid matter; organic putrefactive matter, and may also contain some bacteria, saprophytic or pathogenic. Any and all the above constituents may be contained in sewer air in larger or smaller doses, in minute or toxic doses. It is evident that an habitual breathing of air in which even minute doses of toxic substances and gases are floating will in time impair the health of human beings, and that large doses of those substances may be directly toxic and dangerous to health. It is certainly an error to ascribe to sewer air death-dealing properties, but it would be a more serious mistake to undervalue the evil influence of bad sewer air upon health. =Ventilation.=--To guard against the bad effects of sewer air, it is necessary to dilute, change, and ventilate the air in sewers. This is accomplished by the various openings left in the sewers, the so-called lamp and manholes which ventilate by diluting the sewer air with the street air. In some places, chemical methods of disinfecting the contents of sewers have been undertaken with a view to killing the disease germs and deodorizing the sewage. In the separate system of sewage disposal, where sewer pipes are small and usually self-cleansing, the late Colonel Waring proposed to ventilate the sewers through the house pipes, omitting the usual disconnection of the house sewer from the house pipes. But in the combined system such a procedure would be dangerous, as the sewer air would be apt to enter the house. Rain storms are the usual means by which a thorough flushing of the street sewers is effected. There are, however, many devices proposed for flushing sewers; e. g., by special flushing tanks, which either automatically or otherwise discharge a large volume of water, thereby flushing the contents of the street sewers. CHAPTER VI =Plumbing= =Purpose and Requisites for House Plumbing.=--A system of house plumbing presupposes the existence of a street sewer, and a water-supply distribution within the house. While the former is not absolutely essential, as a house may have a system of plumbing without there being a sewer in the street, still in the water-carriage system of disposal of sewage the street sewer is the outlet for the various waste and excrementitious matter of the house. The house-water distribution serves for the purpose of flushing and cleaning the various pipes in the house plumbing. The purposes of house plumbing are: (1) to get rid of all excreta and waste water; (2) to prevent any foreign matter and gases in the sewer from entering the house through the pipes; and (3) to dilute the air in the pipes so as to make all deleterious gases therein innocuous. To accomplish these results, house plumbing demands the following requisites: (1) _Receptacles_ for collecting the waste and excreta. These receptacles, or plumbing fixtures, must be adequate for the purpose, small, noncorrosive, self-cleansing, well flushed, accessible, and so constructed as to easily dispose of their contents. (2) _Separate Vertical Pipes_ for sewage proper, for waste water, and for rain water; upright, direct, straight, noncorrosive, water- and gas-tight, well flushed, and ventilated. (3) Short, direct, clean, well-flushed, gas-tight branch pipes to connect receptacles with vertical pipes. (4) _Disconnection_ of the house sewer from the house pipes by the main trap on house drain, and disconnection of house from the house pipes by traps on all fixtures. (5) _Ventilation_ of the whole system by the fresh-air inlet, vent pipes, and the extension of all vertical pipes. =Definitions.=--The _House Drain_ is the horizontal main pipe receiving all waste water and sewage from the vertical pipes, and conducting them outside of the foundation walls, where it joins the house sewer. The _Soil Pipe_ is the vertical pipe or pipes receiving sewage matter from the water-closets in the house. The _Main Waste Pipe_ is the pipe receiving waste water from any fixtures except the water-closets. _Branch Soil and Waste Pipes_ are the short pipes between the fixtures in the house and the main soil and waste pipes. _Traps_ are bends in pipes, so constructed as to hold a certain volume of water, called the water seal; this water seal serves as a barrier to prevent air and gases from the sewer from entering the house. _Vent Pipes_ are the special pipes to which the traps or fixtures are connected by short-branch vent pipes, and serve to ventilate the air in the pipes, and prevent siphonage. The _Rain Leader_ is the pipe receiving rain and storm water from the roof of the house. =Materials Used for Plumbing Pipes.=--The materials from which the different pipes used in house plumbing are made differ according to the use of each pipe, its position, size, etc. The following materials are used: cement, vitrified pipe, lead; cast, wrought, and galvanized iron; brass, steel, nickel, sheet metal, etc. _Cement and Vitrified Pipes_ are used for the manufacture of street and house sewers. In some places vitrified pipe is used for house drains, but in most cities this is strongly objected to; and in New York City no earthenware pipes are permitted within the house. The objection to earthenware pipes is that they are not strong enough for the purpose, break easily, and cannot be made gas-tight. _Lead Pipe_ is used for all branch waste pipes and short lengths of water pipes. The advantage of lead pipes is that they can be easily bent and shaped, hence their use for traps and connections. The disadvantage of lead for pipes is the softness of the material, which is easily broken into by nails, gnawed through by rats, etc. _Brass, Nickel, Steel_, and other such materials are used in the manufacture of expensive plumbing, but are not commonly employed. _Sheet Metal_ and _Galvanized Iron_ are used for rain leaders, refrigerator pipes, etc. _Wrought Iron_ is used in the so-called Durham system of plumbing. Wrought iron is very strong; the sections of pipe are twenty feet long, the connections are made by screw joints, and a system of house plumbing made of this material is very durable, unyielding, strong, and perfectly gas-tight. The objections to wrought iron for plumbing pipes are that the pipes cannot be readily repaired and that it is too expensive. _Cast Iron_ is the material universally used for all vertical and horizontal pipes in the house. There are two kinds of cast-iron pipes manufactured for plumbing uses, the "standard and the extra heavy." The following are the relative weights of each: Standard. Extra Heavy. 2-inch pipe, 4 lbs. per foot 5-1/2 lbs. 3 " " 6 " " " 9-1/2 " 4 " " 9 " " " 13 " 5 " " 12 " " " 17 " 6 " " 15 " " " 20 " 7 " " 20 " " " 27 " 8 " " 25 " " " 33-1/2 " The light-weight pipe, though extensively used by plumbers, is generally prohibited by most municipalities, as it is not strong enough for the purpose, and it is difficult to make a gas-tight joint with these pipes without breaking them. Cast-iron pipes are made in lengths of five feet each, with an enlargement on one end of the pipe, called the "hub" or "socket," into which the other, or "spigot," end is fitted. All cast-iron pipe must be straight, sound, cylindrical and smooth, free from sand holes, cracks, and other defects, and of a uniform thickness. The thickness of cast-iron pipes should be as follows: 2-inch pipe, 5/16 inches thick 3 " " " " " 4 " " 3/8 " " 5 " " 7/16 " " 6 " " 1/2 " " Cast-iron pipes are sometimes coated by dipping into hot tar, or by some other process. Tar coating is, however, not allowed in New York, because it conceals the sand holes and other flaws in the pipes. =Joints and Connections.=--To facilitate connections of cast-iron pipes, short and convenient forms and fittings are cast. Some of these connections are named according to their shape, such as L, T, Y, etc. [Illustration: FIG. 16. DIFFERENT FORMS AND FITTINGS.] _Iron Pipe_ is joined to _Iron Pipe_ by lead-calked joints. These joints are made as follows: the spigot end of one pipe is inserted into the enlarged end, or the "hub," of the next pipe. The space between the spigot and hub is half filled with oakum or dry hemp. The remaining space is filled with hot molten lead, which, on cooling, is well rammed and calked in by special tools made for the purpose. To make a good, gas-tight, lead-calked joint, experience and skill are necessary. The ring of lead joining the two lengths of pipe must be from 1 to 2 inches deep, and from 1/2 to 3/4 of an inch thick; 12 ounces of lead must be used at each joint for each inch in the diameter of the pipe. Iron pipes are sometimes connected by means of so-called rust joints. Instead of lead, the space between the socket and spigot is filled in with an iron cement consisting of 98 parts of cast-iron borings, 1 part of flowers of sulphur, and 1 part of sal ammoniac. [Illustration: FIG. 17.] All connections between _Lead Pipes_ and between _Lead_ and _Brass_ or _Copper_ pipes must be made by means of "wiped" solder joints. A wiped joint is made by solder being poured on two ends of the two pipes, the solder being worked about the joint, shaped into an oval lump, and wiped around with a cloth, giving the joint a bulbous form. All connections between _Lead Pipes_ and _Iron Pipes_ are made by means of brass ferrules. Lead cannot be soldered to iron, so a brass fitting or ferrule is used; it is jointed to the lead pipe by a wiped joint, and to the iron pipe by an ordinary lead-calked joint. _Putty_, _Cement_, and _Slip_ joints should not be tolerated on any pipes. [Illustration: FIG. 18.] =Traps.=--We have seen that a trap is a bend in a pipe so constructed as to hold a quantity of water sufficient to interpose a barrier between the sewer and the fixture. There are many and various kinds of traps, some depending on water alone as their "seal," others employing mechanical means, such as balls, valves, lips, also mercury, etc., to assist in the disconnection between the house and sewer ends of the pipe system. The value of a trap depends: (1) on the depth of its water seal; (2) on the strengths and permanency of the seal; (3) on the diameter and uniformity of the trap; (4) on its simplicity; (5) on its accessibility; and (6) on its self-cleansing character. The depth of a trap should be about three inches for water-closet traps, and about two inches for sink and other traps. Traps must not be larger in diameter than the pipe to which they are attached. The simpler the trap, the better it is. Traps should be provided with cleanout screw openings, caps, etc., to facilitate cleaning. The shapes of traps vary, and the number of the various kinds of traps manufactured is very great. Traps are named according to their use: gully, grease, sediment, intercepting, etc.; according to their shape: D, P, S, V, bell, bottle, pot, globe, etc.; and according to the name of their inventor: Buchan, Cottam, Dodd, Antill, Renk, Hellyer, Croydon, and others too numerous to mention. The S trap is the best for sink waste pipes; the running trap is the best on house drains. [Illustration: FIG. 19. FORMS OF TRAPS.] [Illustration: FIG. 20. FORMS OF TRAPS.] =Loss of Seal by Traps.=--The seals of traps are not always secure, and the causes of unsealing of traps are as follows: (1) _Evaporation._--If a fixture in a house is not used for a long time, the water constituting the seal in the trap of the fixture will evaporate; the seal will thus be lost, and ingress of sewer air will result. To guard against evaporation, fixtures must be frequently flushed; and during summer, or at such times as the house is unoccupied and the fixtures not used, the traps are to be filled with oil or glycerin, either of which will serve as an efficient seal. (2) _Momentum._--A sudden flow of water from the fixture may, by the force of its momentum, empty all water in the trap and thus leave it unsealed. To prevent the unsealing of traps by momentum, they must be of a proper size, not less than the waste pipe of the fixture, the seal must be deep, and the trap in a perfectly straight position, as a slight inclination will favor its emptying. Care should also be taken while emptying the fixture to do it slowly so as to preserve the seal. (3) _Capillary Attraction._--If a piece of paper, cotton, thread, hair, etc., remain in the trap, and a part of the paper, etc., projects into the lumen of the pipe, a part of the water will be withdrawn by capillary attraction from the trap and may unseal it. To guard against unsealing of traps by capillary attraction, traps should be of a uniform diameter, without nooks and corners, and of not too large a size, and should also be well flushed, so that nothing but water remains in the trap. _Siphonage and Back Pressure._--The water in the trap, or the "seal," is suspended between two columns of air, that from the fixture to the seal, and from the seal of the trap to the seal of the main trap on house drain. The seal in the trap is therefore not very secure, as it is influenced by any and all currents and agitations of air from both sides, and especially from its distal side. Any heating of the air in the pipes with which the trap is connected, any increase of temperature in the air contents of the vertical pipes with which the trap is connected, and any evolution of gases within those pipes will naturally increase the weight and pressure of the air within them, with the result that the increased pressure will influence the contents of the trap, or the "seal," and may dislodge the seal backward, if the pressure is very great, or, at any rate, may force the foul air from the pipes through the seal of the traps and foul the water therein, thus allowing foul odors to enter the rooms from the traps of the fixtures. This condition, which in practice exists oftener than it is ordinarily thought, is called "back pressure." By "back pressure" is therefore understood the _forcing back_, or, at least, the _fouling_, of the water in traps, due to the increased pressure of the air within the pipes back of the traps; the increase in air pressure being due to heating of pipes by the hot water occasionally circulating within them, or by the evolution of gases due to the decomposition of organic matter within the pipes. [Illustration: FIG. 21. NON-SYPHONING TRAP. Copyright by the J. L. Mott Iron Works.] A condition somewhat similar, but acting in a reverse way, is presented in what is commonly termed "siphonage." Just as well as the seal in traps may be forced back by the increased pressure of the air within the pipes, the same seal may be _forced out_, pulled out, aspirated, or siphoned out by a sudden withdrawal of a large quantity of air from the pipes with which the trap is connected. Such a sudden withdrawal of large quantities of air is occasioned every time there is a rush of large column of water through the pipes, e. g., when a water-closet or similar fixture is suddenly discharged; the water rushes through the pipes with a great velocity and creates a strong down current of air, with the result that where the down-rushing column passes by a trap, the air in the trap and, later, its seal are aspirated or siphoned out, thus leaving the trap without a seal. By "siphonage" is therefore meant the emptying of the seal in a trap by the aspiration of the water in the trap due to the downward rush of water and air in the pipes with which the trap is connected. To guard against the loss of seal through siphonage "nonsiphoning" traps have been invented, that is, the traps are so constructed that the seal therein is very large, and the shape of the traps made so that siphonage is difficult. These traps are, however, open to the objection that in the first place they do not prevent the fouling of the seals by back pressure, and in the second place they are not easily cleansable and may retain dirt in their large pockets. The universal method of preventing both siphonage and back pressure is by the system of vent pipes, or what plumbers call "back-air" pipes. Every trap is connected by branches leading from the crown or near the crown of the trap to a main vertical pipe which runs through the house the same as the waste and soil pipes, and which contains nothing but air, which air serves as a medium to be pressed upon by the "back-pressure" air, or to be drawn upon by the siphoning, and thus preventing any agitation and influence upon the seal in the traps; for it is self evident that as long as there is plenty of air at the distal part of the seal, the seal itself will remain uninfluenced by any agitation or condition of the air within the pipes with which the trap is connected. The vent-pipe system is also an additional means of ventilating the plumbing system of the house, already partly ventilated by the extension of the vertical pipes above the roof and by the fresh-air inlet. The principal objection urged against the installation of the vent-pipe system is the added expense, which is considerable; and plumbers have sought therefore to substitute for the vent pipes various mechanical traps, also nonsiphoning traps. The vent pipes are, however, worth the additional expense, as they are certainly the best means to prevent siphonage and back pressure, and are free from the objections against the cumbersome mechanical traps and the filthy nonsiphoning traps. CHAPTER VII =Plumbing Pipes= =The House Drain.=--All waste and soil matter in the house is carried from the receptacles into the waste and soil pipes, and from these into the house drain, the main pipe of the house, which carries all waste and soil into the street sewer. The house drain extends from the junction of the soil and waste pipes of the house through the house to outside of the foundations two to five feet, whence it is called "house sewer." The house drain is a very important part of the house-plumbing system, and great care must be taken to make its construction perfect. _Material._--The material of which house drains are manufactured is extra heavy cast iron. Lighter pipes should never be used, and the use of vitrified pipes for this purpose should not be allowed. _Size._--The size of the house drain must be proportional to the work to be performed. Too large a pipe will not be self-cleansing, and the bottom of it will fill with sediment and slime. Were it not for the need of carrying off large volumes of storm water, the house drain could be a great deal smaller than it usually is. A three-inch pipe is sufficient for a small house, though a four-inch pipe is made obligatory in most cities. In New York City no house drains are allowed of smaller diameter than six inches. [Illustration: FIG. 22. SYSTEM OF HOUSE DRAINAGE, SHOWING THE PLUMBING OF A HOUSE. (H. BRAMLEY.)] _Fall._--The fall or inclination of the house drain depends on its size. Every house drain must be laid so that it should have a certain inclination toward the house sewer, so as to increase the velocity of flow in it and make it self-flushing and self-cleansing. The rate of fall should be as follows: For 4-inch pipe 1 in 40 feet " 5 " " 1 " 50 " " 6 " " 1 " 60 " _Position._--The house drain lies in a horizontal position in the cellar, and should, if possible, be exposed to view. It should be hung on the cellar wall or ceiling, unless this is impracticable, as when fixtures in the cellar discharge into it; in this case, it must be laid in a trench cut in a uniform grade, walled upon the sides with bricks laid in cement, and provided with movable covers and with a hydraulic-cement base four inches thick, on which the pipe is to rest. The house drain must be laid in straight lines, if possible; all changes in direction must be made with curved pipes, the curves to be of a large radius. _Connections._--The house drain must properly connect with the house sewer at a point about two feet outside of the outer front vault or area wall of the building. An arched or other proper opening in the wall must be provided for the drain to prevent damage by settling. All joints of the pipe must be gas-tight, lead-calked joints, as stated before. The junction of the vertical soil, waste, and rain-leader pipes must not be made by right-angle joints, but by a curved elbow fitting of a large radius, or by "Y" branches and 45° bends. When the house drain does not rest on the floor, but is hung on the wall or ceiling of the cellar, the connection of the vertical soil and waste pipes must have suitable supports, the best support being a brick pier laid nine inches in cement and securely fastened to the wall. Near all bends, traps, and connections of other pipes with the house drain suitable hand-holes should be provided, these hand-holes to be tightly covered by brass screw ferrules, screwed in, and fitted with red lead. "No steam exhaust, boiler blow-off, or drip pipe shall be connected with the house drain or sewer. Such pipes must first discharge into a proper condensing tank, and from this a proper outlet to the house sewer outside of the building must be provided." _Main Traps._--The disconnection of the house pipes from the street sewer is accomplished by a trap on the house drain near the front wall, inside the house, or just outside the foundation wall but usually inside of the house. The best trap for this purpose is the siphon or running trap. This trap must be constructed with a cleaning hand-hole on the inside or house side of the trap, or on both sides, and the hand-holes are to be covered gas-tight by brass screw ferrules. _Extension of Vertical Pipes._--By the main trap the house-plumbing system is disconnected from the sewer, and by the traps on each fixture from the air in the rooms; still, as the soil, waste, and drain pipes usually contain offensive solids and liquids which contaminate the air in the pipes, it is a good method to ventilate these pipes. This ventilation of the soil, waste, and house drain pipes prevents the bad effects on health from the odors, etc., given off by the slime and excreta adhering in the pipes, and it is accomplished by two means: (1) by extension of the vertical pipes to the fresh air above the roof, and (2) by the fresh-air inlet on the house drain. By these means a current of air is established through the vertical and horizontal pipes. Every vertical pipe must be extended above the roof at least two feet above the highest coping of the roof or chimney. The extension must be far from the air shafts, windows, ventilators, and mouths of chimneys, so as to prevent air from the pipes being drawn into them. The extension must be not less than the full size of each pipe, so as to avoid friction from the circulation of air. The use of covers, cowls, return bends, etc., is reprehensible, as they interfere with the free circulation of air. A wire basket may be inserted to prevent foreign substances from falling into pipes. _Fresh-air Inlet._--The fresh-air inlet is a pipe of about four inches in diameter; it enters the house drain on the house side of the main trap, and extends to the external air at or near the curb, or at any convenient place, at least fifteen feet from the nearest window. The fresh-air inlet pipe usually terminates in a receptacle covered by an iron grating, and should be far from the cold-air box of any hot-air furnace. When clean, properly cared for, and extended above the ground, the fresh-air inlet, in conjunction with the open extended vertical pipe, is an efficient means of ventilating the air in the house pipes; unfortunately most fresh-air inlets are constantly obstructed, and do not serve the purpose for which they are made. =The Soil and Waste Pipes.=--The soil pipe receives liquid and solid sewage from the water-closets and urinals; the waste pipe receives all waste water from sinks, washbasins, bath tubs, etc. The material of which the vertical soil and waste pipes are made is cast iron. The size of main waste pipes is from three to four inches; of main soil pipes, from four to five inches. In tenement houses with five water-closets or more, not less than five inches. The joints of the waste and soil pipe should be lead calked. The connections of the lead branch pipes or traps with the vertical lines must be by Y joints, and by means of brass ferrules, as explained above. The location of the vertical pipes must never be within the wall, built in, nor outside the house, but preferably in a special three-foot square shaft adjacent to the fixtures, extending from the cellar to the roof, where the air shaft should be covered by a louvered skylight; that is, with a skylight with slats outwardly inclined, so as to favor ventilation. The vertical pipes must be accessible, exposed to view in all their lengths, and, when covered with boards, so fitted that the boards may be readily removed. Vertical pipes must be extended above the roof in full diameter, as previously stated. When less than four inches in diameter, they must be enlarged to four inches at a point not less than one foot below the roof surface by an "increaser," of not less than nine inches long. All soil and waste pipes must, whenever necessary, be securely fastened with wrought-iron hooks or straps. Vertical soil and waste pipes must not be trapped at their base, as the trap would not serve any purpose, and would prevent a perfect flow of the contents. =Branch Soil and Waste Pipes.=--The fixtures must be near the vertical soil and waste pipes in order that the branch waste and soil pipes should be as short as possible. The trap of the branch soil and waste pipes must not be far from the fixture, not more than two feet from it, otherwise the accumulated foul air and slime in the waste and soil branch will emit bad odors. The minimum sizes for branch pipes should be as follows: Kitchen sinks 2 inches Bath tubs 1-1/2 to 2 " Laundry tubs 1-1/2 to 2 " Water-closets not less than 4 " Branch soil and waste pipes must have a fall of at least one-quarter inch to one foot. The branch waste and soil pipes and traps must be exposed, accessible, and provided with screw caps, etc., for inspection and cleaning purposes. Each fixture should be separately trapped as close to the fixture as possible, as two traps on the same line of branch waste or soil pipes will cause the air between the traps to be closed in, forming a so-called "cushion," that will prevent the ready flow of contents. "All traps must be well supported and rest true with respect to their water level." =Vent Pipes and Their Branches.=--The purpose of vent pipes, we have seen, is to prevent siphoning of traps and to ventilate the air in the traps and pipes. The material of which vent pipes are made is cast iron. The size of vent pipes depends on the number of traps with which they are connected; it is usually two or three inches. The connection of the branch vent to the trap must be at the crown of the trap, and the connection of the branch vent to the main vent pipe must be above the trap, so as to prevent friction of air. The vent pipes are not perfectly vertical, but with a continuous slope, so as to prevent condensation of air or vapor therein. The vent pipes should be extended above the roof, several feet above the coping, etc.; and the extension above the roof should not be of less than four inches diameter, so as to avoid obstruction by frost. No return bends or cowls should be tolerated on top of the vent pipes. Sometimes the vent, instead of running above the roof, is connected with the soil pipe several feet above all fixtures. [Illustration: FIG. 23. LEADER PIPE.] =Rain Leaders.=--The rain leader serves to collect the rain water from the roof and eaves gutter. It usually discharges its contents into the house drain, although some leaders are led to the street gutter, while others are connected with school sinks in the yard. The latter practice is objectionable, as it may lead the foul air from the school sink into the rooms, the windows of which are near the rain leader; besides, the stirring up of the contents of the school sink produces bad odors. When the rain leader is placed within the house, it must be made of cast iron with lead-calked joints; when outside, as is the rule, it may be of sheet metal or galvanized-iron pipe with soldered joints. When the rain leader is run near windows, the rules and practice are that it should be trapped at its base, the trap to be a deep one to prevent evaporation, and it should be placed several feet below the ground, so as to prevent freezing. CHAPTER VIII =Plumbing Fixtures= The receptacles or fixtures within the house for receiving the waste and excrementitious matter and carrying it off through the pipes to the sewer are very important parts of house plumbing. Great care must be bestowed upon the construction, material, fitting, etc., of the plumbing fixtures, that they be a source of comfort in the house instead of becoming a curse to the occupants. =Sinks.=--The waste water from the kitchen is disposed of by means of sinks. Sinks are usually made of cast iron, painted, enameled, or galvanized. They are also made of wrought iron, as well as of earthenware and porcelain. Sinks must be set level, and provided with a strainer at the outlet to prevent large particles of kitchen refuse from being swept into the pipe and obstructing it. If possible the back and sides of a sink should be cast from one piece; the back and sides, when of wood, should be covered by nonabsorbent material, to prevent the wood from becoming saturated with waste water.[18] No woodwork should inclose sinks; they should be supported on iron legs and be open beneath and around. The trap of a sink is usually two inches in diameter, and should be near the sink; it should have a screw cap for cleaning and inspection, and the branch vent pipe should be at the crown of the trap. =Washbasins.=--Washbasins are placed in bathrooms, and, when properly constructed and fitted, are a source of comfort. They should not be located in bedrooms, and should be open, without any woodwork around them. The washbowls are made of porcelain or marble, with a socket at the outlet, into which a plug is fitted. =Wash Tubs.=--For laundry purposes wooden, iron-enameled, stone, and porcelain tubs are fitted in the kitchen or laundry room. Porcelain is the best material, although very expensive. The soapstone tub is the next best; it is clean, nonabsorbent, and not too expensive. Wood should never be used, as it soon becomes saturated, is foul, leaks, and is offensive. In old houses, wherever there are wooden tubs, they should be covered with zinc or some nonabsorbent material. The wash tubs are placed in pairs, sometimes three in a row, and they are generally connected with one lead waste pipe one and a half to two inches in diameter, with one trap for all the tubs. =Bath Tubs.=--Bath tubs are made of enameled iron or porcelain, and should not be covered or inclosed by any woodwork. The branch waste pipe should be trapped and connected with the main waste or soil pipe. The floor about the tub in the bathroom should be of nonabsorbent material.[19] =Refrigerators.=--The waste pipes of refrigerators should not connect with any of the house pipes, but should be emptied into a basin or pail; or, if the refrigerator is large, its waste pipe should be conducted to the cellar, where it should discharge into a properly trapped, sewer-connected and water-supplied open sink. =Boilers.=--The so-called sediment pipe from the hot-water boiler in the kitchen should be connected with the sink trap at the inlet side of the trap. =Urinals.=--As a rule, no urinals should be tolerated within a house; they are permissible only in factories and office buildings. The material is enameled iron or porcelain. They must be provided with a proper water supply to flush them. =Overflows.=--To guard against overflow of washbasins, bath tubs, etc., overflow pipes from the upper portion of the fixtures are commonly provided. These pipes are connected with the inlet side of the trap of the same fixture. They are, however, liable to become a nuisance by being obstructed with dirt and not being constantly flushed; whenever possible they should be dispensed with. =Safes and Wastes.=--A common usage with plumbers in the past has been to provide sinks, washbasins, bath tubs, and water-closets, not only with overflow pipes, but also with so-called safes, which consist of sheets of lead turned up several inches at the edge so as to catch all drippings and overflow from fixtures; from these safes a drip pipe or waste is conducted to the cellar, where it empties into a sink. Of course, when such safe wastes are connected with the soil or waste pipes, they become a source of danger, even if they are trapped, as they are not properly cared for or flushed; and their traps are usually not sealed. Even when discharging into a sink in the cellar, safes and safe waste are very unsightly, dirty, liable to accumulate filth, and are offensive. With open plumbing, and with the floors under the fixtures of nonabsorbent material, they are useless. =Water-closets.=--The most important plumbing fixtures within the house are the water-closets. Upon the proper construction and location of the water-closets greatly depends the health of the inhabitants of the house. Water-closets should be placed in separate, well-lighted, perfectly ventilated, damp-proof, and clean compartments, and no water-closet should be used by more than one family in a tenement house. The type and construction of the water-closets should be carefully attended to, as the many existing, old, and obsolete types of water-closets are still being installed in houses, or are left there to foul the air of rooms and apartments. There are many water-closets on the market, some of which will be described; the best are those made of one piece, of porcelain or enameled earthenware, and so constructed as always to be and remain clean. [Illustration: FIG. 24. PAN WATER-CLOSET. (GERHARD.)] _The Pan Closet._--The water-closet most commonly used in former times was a representative of the group of water-closets with mechanical contrivances. This is the _pan closet_, now universally condemned and prohibited from further use. The pan closet consists of four principal parts: (1) basin of china, small and round; (2) a copper six-inch pan under the basin; (3) a large iron container, into which the basin with the pan under it is placed; and (4) a D trap, to which the container is joined. The pan is attached with a lever to a handle, which, when pulled, moves the pan; this describes a half circle and drops the contents into the container and trap. The objections to pan closets are the following: (1) There being a number of parts and mechanical contrivances, they are liable to get out of order. (2) The bowl is set into the container and cannot be inspected, and is usually very dirty beneath. (3) The pan is often missing, gets out of order, and is liable to be soiled by adhering excreta. (4) The container is large, excreta adhere to its upper parts, and the iron becomes corroded and coated with filth. (5) With every pull of the handle and pan, foul air enters rooms. (6) The junctions between the bowl and container, and the container and trap, are usually not gas-tight. (7) The pan breaks the force of the water flush, and the trap is usually not completely emptied. _Valve and Plunger Closets_ are an improvement upon the pan closets, but are not free from several objections enumerated above. As a rule, all water-closets with mechanical parts are objectionable. _Hopper Closets_ are made of iron or earthenware. Iron hopper closets easily corrode; they are usually enameled on the inside. Earthenware hoppers are preferable to iron ones. Hopper closets are either long or short; when long, they expose a very large surface to be fouled, require a trap below the floor, and are, as a rule, very difficult to clean or to keep clean. Short hopper closets are preferable, as they are easily kept clean and are well flushed. When provided with flushing rim, and with a good water-supply cistern and large supply pipe, the short hopper closet is a good form of water-closet. The washout and washdown water-closets are an improvement upon the hopper closets. They are manufactured from earthenware or porcelain, and are so shaped that they contain a water seal, obviating the necessity of a separate trap under the closet. [Illustration: FIG. 25. LONG HOPPER WATER-CLOSET. (GERHARD.)] [Illustration: FIG. 26. SHORT HOPPER WATER-CLOSET. (GERHARD.)] [Illustration: FIG. 27. STYLES OF WATER-CLOSETS.] _Flush Tanks._--Water-closets must not be flushed directly from the water-supply pipes, as there is a possibility of contaminating the water supply. Water-closets should be flushed from flush tanks, either of iron or of wood, metal lined; these cisterns should be placed not less than four feet above the water-closet, and provided with a straight flush pipe of at least one and one-quarter inch diameter. The cistern is fitted with plug and handle, so that by pulling at the handle the plug is lifted out of the socket of the cistern and the contents permitted to rush through the pipe and flush the water-closet. A separate ball arrangement is made for closing the water supply when the cistern is full. The cistern must have a capacity of at least three to five gallons of water; the flush pipe must have a diameter of not less than one and one-quarter inch, and the pipe must be straight, without bends, and the arrangement within the closets such as to flush all parts of the bowl at the same time. [Illustration: FIG. 28. FLUSHING CISTERN.] =Yard Closets.=--In many old houses the water-closet accommodations are placed in the yard. There are two forms of these yard closets commonly used--the school sink and the yard hopper. The _school sink_ is an iron trough from five to twelve or more feet long, and one to two feet wide and one foot deep, set in a trench several feet below the surface with an inclination toward the exit; on one end of the trough there is a socket fitted with a plug, and on the other a flushing apparatus consisting simply of a water service-pipe. Above the iron trough brick walls are built up, inclosing it; over it are placed wooden seats, and surrounding the whole is a wooden shed with compartments for every seat. The excreta are allowed to fall into the trough, which is partly filled with water, and once a day, or as often as the caretaker chooses, the plug is pulled up and the excreta allowed to flow into the sewer with which the school sink is connected. These school sinks are, as a rule, a nuisance, and are dangerous to health. The objections to them are the following: (1) The excreta lies exposed in the iron trough, and may decompose even in one day; and it is always offensive. (2) The iron trough is easily corroded. (3) The iron trough, being large, presents a large surface for adherence of excreta. (4) The brickwork above the trough is not flushed when the school sink is emptied, and excreta, which usually adheres to it, decomposes, creating offensive odors. (5) The junction of the iron trough with the brickwork, and the brickwork itself, is usually defective, or becomes defective, and allows foul water and sewage to pass into the yard, or into the wall adjacent to the school sink. By the Tenement House Law of New York, the use of school sinks is prohibited even in old buildings. [Illustration: FIG. 29. SCHOOL SINK AFTER SEVERAL MONTHS' USE. (J. SULLIVAN.)] _Yard Hopper Closets._--Where the water-closet accommodations cannot, for some reason, be put within the house, yard hopper closets are commonly employed. These closets are simply long, iron-enameled hoppers, trapped, and connected with a drain pipe discharging into the house drain. These closets are flushed from cisterns, but, in such case, the cisterns must be protected from freezing; this is accomplished in some houses by putting the yard hopper near the house and placing the cistern within the house; however, this can hardly be done where several hoppers must be employed. In most cases, yard hoppers are flushed by automatic rod valves, so constructed as to flush the bowl of the hopper whenever the seat is pressed upon. These valves, as a rule, frequently get out of order and leak, and care must be taken to construct the vault under the hopper so that it be perfectly water-tight. An improved form of yard hopper has been suggested by Inspector J. Sullivan, of the New York Health Department, and used in a number of places with complete satisfaction. The improvement consists in the doors and walls of the privy apartment being of double thickness, lined with builders' lining on the inside, and the water service-pipes and cistern being protected by felt or mineral wool packing. [Illustration: FIG. 30. J. SULLIVAN'S IMPROVED YARD HOPPER CLOSET.] [Illustration: FIG. 31. A MODERN WATER-CLOSET. (J. L. Mott Iron Works.)] =Yard and Area Drains.=--The draining of the surface of the yard or other areas is done by tile or iron pipes connecting with the sewer or house drain in the cellar. The "bell" or the "lip" traps are to be condemned and should not be used for yard drains. The gully and trap should be made of one piece; the trap should be of the siphon type and should be deep enough in the ground to prevent the freezing of seal in winter. FOOTNOTES: [18] Waterproof paint or tiling should be used for this purpose.--EDITOR. [19] Tiling, linoleum, concrete, etc., as opposed to wood or carpets.--EDITOR. CHAPTER IX =Defects in Plumbing= The materials used in house plumbing are many and various, the parts are very numerous, the joints and connections are frequent, the position and location of pipes, etc., are often inaccessible and hidden, and the whole system quite complicated. Moreover, no part of the house construction is subjected to so many strains and uses, as well as abuses, as the plumbing of the house. Hence, in no part of house construction can there be as much bad work and "scamping" done as in the plumbing; and no part of the house is liable to have so many defects in construction, maintenance, and condition as the plumbing. At the same time, the plumbing of a house is of very great importance and influence on the health of the tenants, for defective materials, bad workmanship, and improper condition of the plumbing of a house may endanger the lives of its inhabitants by causing various diseases. =Defects in Plumbing.=--The defects usually found in plumbing are so many that they cannot all be enumerated here. Among the principal and most common defects, however, are the following: _Materials._--Light-weight iron pipes; these crack easily and cannot stand the strain of calking. Sand-holes made during casting; these cannot always be detected, especially when the pipes are tar-coated. Thin lead pipe; not heavy enough to withstand the bending and drawing it is subjected to. _Location and Position._--Pipes may be located within the walls and built in, in which case they are inaccessible, and may be defective without anyone being able to discover the defects. Pipes may be laid with a wrong or an insufficient fall, thus leaving them unflushed, or retarding the proper velocity of the flow in the pipes. Pipes may be put underground and have no support underneath, when some parts or lengths may sink, get out of joint, and the sewage run into the ground instead of through the pipes. The pipes may be so located as to require sharp bends and curves, which will retard the flow in them. _Joints._--Joints in pipes may be defective, leaking, and not gas-tight because of imperfect calking, insufficient lead having been used; or, no oakum having been used and the lead running into the lumen of the pipe; or, not sufficient care and time being taken for the work. Joints may be defective because of iron ferrules being used instead of brass ferrules; through improperly wiped joints; through bad workmanship, bad material, or ignorance of the plumber. Plumbers often use T branches instead of Y branches; sharp bends instead of bends of forty-five degrees or more; slip joints instead of lead-calked ones; also, they often connect a pipe of larger diameter with a pipe of small diameter, etc. _Traps._--The traps may be bad in principle and in construction; they may be badly situated or connected, or they may be easily unsealed, frequently obstructed, inaccessible, foul, etc. _Ventilation._--The house drain may have no fresh-air inlet, or the fresh-air inlet may be obstructed; the vent pipes may be absent, or obstructed; the vertical pipes may not be extended. _Condition._--Pipes may have holes, may be badly repaired, bent, out of shape, or have holes patched up with cement or putty; pipes may be corroded, gnawed by rats, or they may be obstructed, etc. The above are only a few of the many defects that may be found in the plumbing of a house. It is, therefore, of paramount importance to have the house plumbing regularly, frequently, and thoroughly examined and inspected, as well as put to the various tests, so as to discover the defects and remedy them. =Plumbing Tests.=--The following are a few minor points for testing plumbing: (1) To test a trap with a view to finding out whether its seal is lost or not, knock on the trap with a piece of metal; if the trap is empty, a hollow sound will be given out; if full, the sound will be dull. This is not reliable in case the trap is full or half-full with slime, etc. Another test for the same purpose is as follows: hold a light near the outlet of the fixture; if the light is drawn in, it is a sign that the trap is empty. (2) Defects in leaded joints can be detected if white lead has been used, as it will be discolored in case sewer gas escape from the joints. (3) The connection of a waste pipe of a bath tub with the trap of the water-closet can sometimes be discovered by suddenly emptying the bath tub and watching the contents of the water-closet trap; the latter will be agitated if the waste pipe is discharged into the trap or on the inlet side of trap of the water-closet. (4) The presence of sewer gas in a room can be detected by the following chemical method: saturate a piece of unglazed paper with a solution of acetate of lead in rain or boiled water, in the proportion of one to eight; allow the paper to dry, and hang up in the room where the escape of sewer gas is suspected; if sewer gas is present, the paper will be completely blackened. The main tests for plumbing are: (1) the _Hydraulic_ or water-pressure test; (2) the _Smoke_, or sight test, and (3) the _Scent_, or peppermint, etc., test. The _Water-pressure Test_ is used to test the vertical and horizontal pipes in new plumbing before the fixtures have been connected. It is applied as follows: the end of the house drain is plugged up with a proper air-tight plug, of which there are a number on the market. The pipes are then filled with water to a certain level, which is carefully noted. The water is allowed to stand in the pipes for half an hour, at the expiration of which time, if the joints show no sign of leakage, and are not sweating, and if the level of the water in the pipes has not fallen, the pipes are water-tight. This is a very reliable test, and is made obligatory for testing all new plumbing work. _The Smoke Test_ is also a very good test. It is applied as follows: by means of bellows, or some exploding, smoke-producing rocket, smoke is forced into the system of pipes, the ends plugged up, and the escape of the smoke watched for, as wherever there are defects in the pipes the smoke will appear. A number of special appliances for this test are manufactured, all of them more or less ingenious. _The Scent Test_ is made by putting into the pipes a certain quantity of some pungent chemical, like peppermint oil, etc., the odor of which will escape from the defects in the pipes, if there are any. Oil of peppermint is commonly used in this country for the test. The following is the way this test is applied: all the openings of the pipes on the roof, except one, are closed up tightly with paper, rags, etc. Into the one open pipe is poured from two to four ounces of peppermint oil, followed by a pail of hot water, and then the pipe into which the oil has been put is also plugged up. This is done, preferably, by an assistant. The inspector then proceeds to slowly follow the course of the various pipes, and will detect the smell of the oil wherever it may escape from any defects in the pipes. If the test is thoroughly and carefully done, if care is taken that no fixture in the house is used and the traps of same not disturbed during the test, if the openings of the pipes on the roofs are plugged up tightly, if the main house trap is not unsealed (otherwise the oil will escape into the sewer), and if the handling of the oil has been done by an assistant, so that none adheres to the inspector--if all these conditions are carried out, the peppermint test is a most valuable test for the detection of any and all defects in plumbing. Another precaution to be taken is with regard to the rain leader. If the rain leader is not trapped, or if its trap is empty, the peppermint oil may escape from the pipes into the rain leader. Care must be taken, therefore, that the trap at the base of the rain leader be sealed; or, if no trap is existing, to close up the connection of the rain leader with the house drain; or, if this be impossible, to plug up the opening of the leader near the roof. Instead of putting the oil into the opening of a pipe on the roof, it may be put through a fixture on the top floor of the house, although this is not so satisfactory. Various appliances have been manufactured to make this test more easy and accurate. Of the English appliances, the Banner patent drain grenade, and Kemp's drain tester are worthy of mention. The former consists "of a thin glass vial charged with pungent and volatile chemicals. One of the grenades, when dropped down any suitable pipe, such as the soil pipe, breaks, or the grenade may be inserted through a trap into the drain, where it is exploded." (Taylor.) Kemp's drain tester consists of a glass tube containing a chemical with a strong odor; the tube is fitted with a glass cover, held in place by a string and a paper band. When the tester is thrown into the pipes and hot water poured after it, the paper band breaks, the spring opens the cover, and the contents of the tube fall into the drain. Recently Dr. W. G. Hudson, an inspector in the Department of Health of New York, has invented a very ingenious "peppermint cartridge" for testing plumbing. The invention is, however, not yet manufactured, and is not on the market. CHAPTER X =Infection and Disinfection= Disinfection is the destruction of the infective power of infectious material; or, in other words, disinfection is the destruction of the agents of infection. An infectious material is one contaminated with germs of infection. The germs of infection are organic microörganisms, vegetable and animal--protozoa and bacteria. The germs of infection once being lodged within the body cause certain reactions producing specific pathological changes and a variety of groups of symptoms which we know by the specific names of infectious diseases, e. g., typhoid, typhus, etc. Among the infectious diseases known to be due to specific germs are the following: typhoid, typhus, relapsing fevers, cholera, diphtheria, croup, tuberculosis, pneumonia, malaria, yellow fever, erysipelas, _septicæmia_, anthrax, _tetanus_, gonorrhea, etc.; and among the infectious diseases the germs of which have not as yet been discovered are the following: scarlet fever, measles, smallpox, syphilis, varicella, etc. The part of the body and the organs in which the germs first find their entrance, or which they specifically attack, vary with each disease; thus, the mucous membranes, skin, internal organs, secretions, and excretions are, severally, either portals of infection or the places where the infection shows itself the most. The agents carrying the germs of infection from one person to the other may be the infected persons themselves, or anything which has come in contact with their bodies and its secretions and excretions; thus, the air, room, furniture, vessels, clothing, food and drink, also insects and vermin, may all be carriers of infection. =Sterilization= is the absolute destruction of _all_ organic life, whether infectious or not; it is therefore _more_ than disinfection, which destroys the germs of infection alone. A =Disinfectant= is an agent which destroys germs of infection. A =Germicide= is the same; an agent destroying germs. An =Insecticide= is an agent capable of destroying insects; it is not necessarily a disinfectant, nor is a disinfectant necessarily an insecticide. An =Antiseptic= is a substance which inhibits and stops the growth of the bacteria of putrefaction and decomposition. A disinfectant is therefore an antiseptic, but an antiseptic may not be a disinfectant. A =Deodorant= is a substance which neutralizes or destroys the unpleasant odors arising from matter undergoing putrefaction. A deodorant is not necessarily a disinfectant, nor is every disinfectant a deodorant. The ideal disinfectant is one which, while capable of destroying the germs of disease, does not injure the bodies and material upon which the germs may be found; it must also be penetrating, harmless in handling, inexpensive, and reliable. The ideal disinfectant has not as yet been discovered. For successful scientific disinfection it is necessary to know: (1) the nature of the specific germs of the disease; (2) the methods and agents of its spread and infection; (3) the places where the germs are most likely to be found; (4) the action of each disinfectant upon the germs; and (5) the best methods of applying the disinfectant to the materials infected with germs of disease. Disinfection is not a routine, uniform, unscientific process; a disinfector must be conversant with the basic principles of disinfection, must make a thorough study of the scientific part of the subject, and moreover must be thoroughly imbued with the importance of his work, upon which the checking of the further spread of disease depends. _Physical Disinfectants_ The physical disinfectants are sunlight, desiccation, and heat. =Sunlight= is a good disinfectant provided the infected material or germs are directly exposed to the rays of the sun. Bacteria are killed within a short time, but spores need a long time, and some of them resist the action of the sun for an indefinite period. The disadvantages of sunlight as a disinfectant are its superficial action, its variability and uncertainty, and its slow action upon most germs of infection. Sunlight is a good adjunct to other methods of disinfection; it is most valuable in tuberculosis, and should be used wherever possible in conjunction with other physical or chemical methods of disinfection.[20] =Desiccation= is a good means of disinfection, but can be applied only to very few objects; all bacteria need moisture for their existence and multiplication, hence absolute dryness acts as a good germicide. Meat and fish, certain cereals, and also fruit, when dried, become at the same time disinfected. _Heat_ is the best, most valuable, all-pervading, most available, and cheapest disinfectant. The various ways in which heat may be used for disinfection are burning, dry heat, boiling, and steam. =Burning= is of course the best disinfectant, but it not only destroys the germs in the infected materials, but the materials themselves; its application is therefore limited to articles of little or no value, and to rags, rubbish, and refuse. =Dry Heat.=--All life is destroyed when exposed to a dry heat of 150° C. for one hour, although most of the bacteria of infection are killed at a lower temperature and in shorter time. Dry heat is a good disinfectant for objects that can stand the heat without injury, but most objects, and especially textile fabrics, are injured by it. =Boiling.=--Perhaps the best and most valuable disinfectant in existence is boiling, because it is always at command, is applicable to most materials and objects, is an absolutely safe sterilizer and disinfectant, and needs very little if any preparation and apparatus for its use. One half hour of boiling will destroy all life; and most bacteria can be killed at even a lower temperature. Subjection to a temperature of only 70° C. for half an hour suffices to kill the germs of cholera, tuberculosis, diphtheria, plague, etc. Boiling is especially applicable to textile fabrics and small objects, and can readily be done in the house where the infection exists, thus obviating the necessity of conveying the infected objects elsewhere, and perhaps for some distance, to be disinfected. =Steam.=--Of all the physical disinfectants steam is the most valuable because it is very penetrating, reliable, and rapid; it kills all bacteria at once and all spores in a few minutes, and besides is applicable to a great number and many kinds of materials and objects. Steam is especially valuable for the disinfection of clothing, bedding, carpets, textile fabrics, mattresses, etc. Steam can be used in a small way, as well as in very large plants. The well-known Arnold sterilizers, used for the sterilization of milk, etc., afford an example of the use of steam in a small apparatus; while municipal authorities usually construct very large steam disinfecting plants. A steam disinfector is made of steel or of wrought iron, is usually cylindrical in shape, and is covered with felt, asbestos, etc. The disinfector has doors on one or both ends, and is fitted inside with rails upon which a specially constructed car can be slid in through one door and out through the other. The car is divided into several compartments, in which the infected articles are placed; when thus loaded it is run into the disinfector. The steam disinfectors may be fitted with thermometers, vacuum formers, steam jackets, etc. _Gaseous Chemical Disinfectants_ Physical disinfectants, however valuable and efficient, cannot be employed in many places and for many materials infected with disease germs, and therefore chemicals have been sought to be used wherever physical disinfectants could not for one or more reasons be employed. Chemicals are used as disinfectants either in gaseous form or in solutions; the gaseous kinds are of especial value on account of their penetrating qualities, and are employed for the disinfection of rooms, holds of ships, etc. There are practically but two chemicals which are used in gaseous disinfection, and these are sulphur dioxide and formaldehyde. =Sulphur Dioxide.=--Sulphur dioxide (SO2) is a good surface disinfectant, and is very destructive to all animal life; it is one of the best insecticides we have, but its germicidal qualities are rather weak; it does not kill spores, and it penetrates only superficially. The main disadvantages of sulphur dioxide as a disinfectant are: (1) that it weakens textile fabrics; (2) blackens and bleaches all vegetable coloring matter; (3) tarnishes metal; and (4) is very injurious and dangerous to those handling it. There are several methods of employing sulphur in the disinfection of rooms and objects, e. g., the pot, candle, liquid, and furnace methods. In the pot methods crude sulphur, preferably ground, is used; it is placed in an iron pot and ignited by the aid of alcohol, and in the burning evolves the sulphur dioxide gas. About five pounds of sulphur are to be used for every 1,000 cubic feet of space. As moisture plays a very important part in developing the disinfecting properties of sulphur dioxide, the anhydrous gas being inactive as a disinfectant, it is advisable to place the pot in a large pan filled with water, so that the evaporated water may render the gas active. For the purpose of destroying all insects in a room an exposure of about two hours to the gas are necessary, while for the destruction of bacteria an exposure of at least fifteen to sixteen hours is required. In the application of disinfection with sulphur dioxide, as with any other gas, it must not be forgotten that gases very readily escape through the many apertures, cracks, and openings in the room and through the slits near doors and windows; and in order to confine the gas in the room it is absolutely necessary to hermetically close all such apertures, cracks, etc., before generating the gaseous disinfectant. The closing of the openings, etc., is done by the pasting over these strips of gummed paper, an important procedure which must not be overlooked, and which must be carried out in a conscientious manner. When sulphur is used in candle form the expense is considerably increased without any additional efficiency. When a solution of sulphurous acid is employed, exposure of the liquid to the air suffices to disengage the sulphur dioxide necessary for disinfection. The quantity of the solution needed is double that of the crude drug, i. e., ten pounds for every 1,000 cubic feet of room space. =Formaldehyde.=--At present the tendency is to employ formaldehyde gas instead of the sulphur so popular some time ago. The advantages of formaldehyde over sulphur are: (1) its nonpoisonous nature; (2) it is a very good germicide; (3) it has no injurious effect upon fabrics and objects; (4) it does not change colors; and (5) it can be used for the disinfection of rooms with the richest hangings, bric-a-brac, etc., without danger to these. Formaldehyde is evolved either from paraform or from the liquid formalin; formerly it was also obtained by the action of wood-alcohol vapor upon red-hot platinum. Formaldehyde gas has not very great penetrating power; it is not an insecticide, but kills bacteria in a very short time, and spores in an hour or two. Paraform (polymerized formaldehyde; trioxymethylene) is sold in pastilles or in powder form, and when heated reverts again to formaldehyde; it must not burn, for no gas is evolved when the heating reaches the stage of burning. The lamps used for disinfection with paraform are very simple in construction, but as the evolution of the gas is very uncertain, this method is used only for small places, and it demands two ounces of paraform for every 1,000 cubic feet of space, with an exposure of twelve hours. Formaldehyde is also used in the form of the liquid formalin either by spraying and sprinkling the objects to be disinfected with the liquid, and then placing them in a tightly covered box, so that they are disinfected by the evolution of the gas, or by wetting sheets with a formalin solution and letting them hang in the room to be disinfected. The method most frequently employed is to generate the formaldehyde in generators, retorts, and in the so-called autoclaves, and then to force it through apertures into the room. Of the other gaseous disinfectants used, hydrocyanic acid and chlorine may be mentioned, although they are very rarely used because of their irritating and poisonous character. =Hydrocyanic Acid= is frequently used as an insecticide in ships, mills, and greenhouses, but its germicidal power is weak. =Chlorine= is a good germicide, but is very irritating, poisonous, and dangerous to handle; it is evolved by the decomposition of chlorinated lime with sulphuric acid. Chlorine gas is very injurious to objects, materials, and colors, and its use is therefore very limited. _Chemicals Used as Disinfectants_ Solution of chemicals, in order to be effective, must be used generously, in concentrated form, for a prolonged time, and, if possible, warm or hot. The strength of the solution must depend upon the work to be performed and the materials used. The method of applying the solution differs. It may consist in immersing and soaking the infected object in the solution; or the solution may be applied as a wash to surfaces, or used in the form of sprays, atomizers, etc. The most important solutions of chemicals and the ones most frequently employed are those of carbolic acid and bichloride of mercury. =Carbolic Acid.=--In the strength of 1:15,000 carbolic acid prevents decomposition; a strength of 1:1,000 is needed for the destruction of bacteria, and a three per cent to five per cent solution for the destruction of spores. Carbolic acid is used, as a rule, in two per cent to five per cent solutions, and is a very good disinfectant for washing floors, walls, ceilings, woodwork, small objects, etc. The cresols, creolin, lysol, and other solutions of the cresols are more germicidal than carbolic acid, and are sometimes used for the same purposes. =Bichloride of Mercury= (corrosive sublimate) is a potent poison and a powerful germicide; in solutions of 1:15,000 it stops decomposition; in solutions of 1:2,000 it kills bacteria in two hours; and in a strength of 1:500 it acts very quickly as a germicide for all bacteria, and even for spores. Corrosive sublimate dissolves in sixteen parts of cold and three parts of boiling water, but for disinfecting purposes it should be colored so that it may not be inadvertently used for other purposes, as the normal solutions are colorless and may accidentally be used internally. The action of the bichloride is increased by heat. =Formalin= is a forty per cent solution of formaldehyde gas, and its uses and methods of employment have already been considered. =Potassium Permanganate= is a good germicide, and weak solutions of it are sufficient to kill some bacteria, but the objections against its use are that solutions of potassium permanganate become inert and decompose on coming in contact with any organic matter. Furthermore, the chemical would be too expensive for disinfecting purposes. =Ferrous Sulphate= (copperas) was formerly very extensively used for disinfecting purposes, but is not so used at present, owing to the fact that it has been learned that the germicidal power of this material is very slight, and that its value depends mostly upon its deodorizing power, for which reason it is used on excreta in privy vaults, etc. =Lime.=--When carbonate of lime is calcined the product is common lime, which, upon being mixed with water, produces slaked lime; when to the latter considerable water is added, the product is milk of lime, and also whitewash. Whitewash is often used to disinfect walls and ceilings of cellars as well as of rooms; milk of lime is used to disinfect excreta in privy vaults, school sinks, etc. Whenever lime is used for disinfecting excreta it should be used generously, and be thoroughly mixed with the material to be disinfected. _Disinfection of Rooms_ Practical disinfection is not a routine, uniform, and thoughtless process, but demands the detailed, conscientious application of scientific data gained by research and laboratory experiments. Disinfection to be thorough and successful cannot be applied to all objects, material, and diseases in like manner, but must be adjusted to the needs of every case, and must be performed conscientiously. Placing a sulphur candle in a room, spilling a quart of carbolic acid or a couple of pounds of chlorinated lime upon the floors or objects, may be regarded as disinfection by laymen, but in municipal disinfection the disinfector must be thoroughly versed in the science of disinfection and be prepared to apply its dictates to practice. =Rooms.=--In the disinfection of rooms the disinfectant used varies with the part of the room as well as with the character of the room. When a gaseous disinfectant is to be used sulphur dioxide or formaldehyde is employed, with the tendency lately to replace the former by the latter. Wherever there are delicate furnishings, tapestries, etc., sulphur cannot be used on account of its destructive character; when sulphur is employed it is, as a rule, in the poorer class of tenement houses where there is very little of value to be injured by the gas, and where the sulphur is of additional value as an insecticide. Whenever gaseous disinfectants are used the principal work of the disinfector is in the closing up of the cracks, apertures, holes, and all openings from the room to the outer air, as otherwise the gaseous disinfectant will escape. The closing up of the open spaces is accomplished usually by means of gummed-paper strips, which are obtainable in rolls and need only to be moistened and applied to the cracks, etc. Openings into chimneys, ventilators, transoms, and the like must not be overlooked by the disinfector. After the openings have already been closed up the disinfectant is applied and the disinfector quickly leaves the room, being careful to close the door behind him and to paste gummed paper over the door cracks. The room must be left closed for at least twelve, or better, for twenty-four hours, when it should be opened and well aired. =Walls and Ceilings= of rooms should be disinfected by scrubbing with a solution of corrosive sublimate or carbolic acid; and in cases of tuberculosis and wherever there is fear of infection adhering to the walls and ceilings, all paper, kalsomine, or paint should be scraped off and new paper, kalsomine, or paint applied. =Metal Furniture= should first be scrubbed and washed with hot soapsuds, and then a solution of formalin, carbolic acid, or bichloride applied to the surfaces and cracks. =Wooden Bedsteads= should be washed with a disinfecting solution and subjected to a gaseous disinfectant in order that all cracks and openings be penetrated and all insects be destroyed. =Bedding, Mattresses, Pillows, Quilts, etc.=, should be packed in clean sheets moistened with a five per cent solution of formalin, and then carted away to be thoroughly disinfected by steam in a special apparatus. =Sheets, Small Linen and Cotton Objects, Tablecloths, etc.=, should be soaked in a carbolic-acid solution and then boiled. =Rubbish, Rags, and Objects of Little Value= found in an infected room are best burned. =Glassware and Chinaware= should either be boiled or subjected to dry heat. =Carpets= should first be subjected to a gaseous disinfectant, and then be wrapped in sheets wetted with formalin solution and sent to be steamed. Spots and stains in carpets should be thoroughly washed before being steamed, as the latter fixes the stains. =Woolen Goods and Wool= are injured by being steamed, and hence may be best disinfected by formalin solutions or by formaldehyde gas. =Books= are very difficult to disinfect, especially such books as were handled by the patient, on account of the difficulty of getting the disinfectant to act on every page of the book. The only way to disinfect books is to hang them up so that the leaves are all open, and then to subject them to the action of formaldehyde gas for twelve hours. Another method sometimes employed is to sprinkle a five per cent solution of formalin on every other page of the book; but this is rather a slow process.[21] =Stables= need careful and thorough disinfection. All manure, hay, feed, etc., should be collected, soaked in oil, and burned. The walls, ceilings, and floors should then be washed with a strong disinfecting solution applied with a hose; all cracks are to be carefully cleaned and washed. The solution to be used is preferably lysol, creolin, or carbolic acid. After this the whole premises should be fumigated with sulphur or formaldehyde, and then the stable left open for a week to be aired and dried, after which all surfaces should be freshly and thickly kalsomined. =Food= cannot be very well disinfected unless it can be subjected to boiling. When this is impossible it should be burned. =Cadavers= of infected persons ought to be cremated, but as this is not always practicable, the next best way is to properly wash the surface of the body with a formalin or other disinfecting solution, and then to have the body embalmed, thus disinfecting it internally and externally. Disinfectors, coming often as they do in contact with infected materials and persons, should know how to disinfect their own _persons and clothing_. So far as clothing is concerned the rule should be that those handling infected materials have a special uniform[22] which is cleaned and disinfected after the day's work is done. The hands should receive careful attention, as otherwise the disinfector may carry infection to his home. The best method of disinfecting the hands is to thoroughly wash and scrub them for five minutes with green soap, brush, and water, then immerse first for one minute in alcohol, and then in a hot 1:1,000 bichloride solution. The nails should be carefully scrubbed and cleaned. FOOTNOTES: [20] Blankets, carpets, and rugs should be frequently hung out on the line in the bright sunlight.--EDITOR. [21] Unless books are valuable it is best to burn them. Paper will hold germs for several weeks. Recent experiments show that certain pathogenic bacteria, including the bacilli of diphtheria, will live for twenty-eight days on paper money.--EDITOR. [22] Duck, linen, or any washable material will do.--EDITOR. CHAPTER XI =Cost of Conveyed Heating Systems=[23] In our variable climate, with its sudden and extreme changes in temperature, the matter of heating and ventilation demands the serious attention of all houseowners and housebuilders. The most common method of heating the modern dwelling is by a hot-air furnace in the cellar, with sheet-metal ducts for conveying the heated air to the various rooms. The advantages of a furnace are cheapness of installation and, in moderate weather, a plentiful supply of warm but very dry air. The disadvantages are the cost of fuel consumed, the liability of the furnace to give off gas under certain conditions, and the inability to heat certain rooms with some combinations of temperature and wind. The cost of installing a furnace and its proper ducts in a ten-room house is from $250 to $350; such a furnace will consume fifteen to twenty tons of anthracite coal in a season in the latitude of New York City. The hot-air system works better with compact square houses than with long, "rangy" structures. For a house fully exposed to the northwest blasts, one of the other systems should be considered. Perhaps the next most popular arrangement is a sectional cast-iron hot-water heater, with a system of piping to and from radiators in the rooms to be heated. Hot-water heating has many advantages, some of which are the warmth of the radiators almost as soon as the fire is started and after the fire is out; the moderation of the heat; the freedom from sudden changes in amount of heat radiated; the absence of noise in operation, and the low cost in fuel consumed. Some of the disadvantages are the high cost of installation and the lack of easy or ready control (as the hot water cools slowly, and shutting the radiator valves often puts the whole system out of adjustment). A hot-water heating plant for a ten-room house will cost $400 to $600, according to the type of boiler; the corresponding fuel consumption will be twelve to sixteen tons of coal per season. The third system in common use is by steam through radiators or coils of pipe connected to a cast-iron sectional boiler, or a steel tubular boiler set in brickwork. This system is in use in practically all large buildings; and its advantages are the moderate cost of installation (as the single-pipe system is very efficient and the pressure to be provided against in connections and fittings is slight); the ease of control (since any good equipment will furnish steam in twenty minutes from the time the fire is started, and fresh coal thrown upon the fire with a closing of dampers will stop the steam supply in five minutes--or any radiator may be turned on or off in an instant); the ability to heat the entire house in any weather, or any single room or suite of rooms only; and, lastly, the moderate fuel consumption. The disadvantages of steam heat are no heat, or next to none, without the production of steam, involving some noise in operation, and danger of explosion. Steam equipment in a ten-room house will cost $300 to $550, the lower price being for a sectional boiler and the higher for a steel boiler set in brickwork. The fuel consumed will be from ten to fifteen tons per season. Both hot-water and steam systems require supplementary means of ventilation. Placing the radiators in exposed places, as beneath windows, in the main hall near the front door, in northwest corners and near outside walls, will insure some circulation of air; and, if one or two open fire places be provided on each floor, there will be, in most cases, sufficient ventilation without the use of special ducts. FOOTNOTES: [23] See Chapter III for full discussion.--EDITOR. +--------------------------------------------------------------------+ | TRANSCRIBER'S NOTE. | | =================== | | | | 1) Figure numbers (which aren't contiguous) have been preserved. | | | | 2) Part III, Chapter V. The table showing thickness of vitrified | | pipes reads: | | | | 4 inches diameter 1/2 inch thick | | 6 " " 1/16 " " | | 8 " " 3/4 " " | | 12 " " 1 " " | | | | The thickness figure for the 6 inch pipe has been left as | | originally printed, but probably is incorrect (logically it should | | be somewhere between 1/2 inch and 3/4 inch thick). | | | +--------------------------------------------------------------------+ 
27944	----	The Home Medical Library By KENELM WINSLOW, B.A.S., M.D. _Formerly Assistant Professor Comparative Therapeutics, Harvard University; Late Surgeon to the Newton Hospital; Fellow of the Massachusetts Medical Society, etc._ With the Coöperation of Many Medical Advising Editors and Special Contributors IN SIX VOLUMES _First Aid :: Family Medicines :: Nose, Throat, Lungs, Eye, and Ear :: Stomach and Bowels :: Tumors and Skin Diseases :: Rheumatism :: Germ Diseases Nervous Diseases :: Insanity :: Sexual Hygiene Woman and Child :: Heart, Blood, and Digestion Personal Hygiene :: Indoor Exercise Diet and Conduct for Long Life :: Practical Kitchen Science :: Nervousness and Outdoor Life :: Nurse and Patient Camping Comfort :: Sanitation of the Household :: Pure Water Supply :: Pure Food Stable and Kennel_ NEW YORK The Review of Reviews Company 1907 Medical Advising Editors Managing Editor ALBERT WARREN FERRIS, A.M., M.D. _Former Assistant in Neurology, Columbia University; Former Chairman, Section on Neurology and Psychiatry, New York Academy of Medicine; Assistant in Medicine, University and Bellevue Hospital Medical College; Medical Editor, New International Encyclopedia._ Nervous Diseases CHARLES E. ATWOOD, M.D. _Assistant in Neurology, Columbia University; Former Physician, Utica State Hospital and Bloomingdale Hospital for Insane Patients; Former Clinical Assistant to Sir William Gowers, National Hospital, London._ Pregnancy RUSSELL BELLAMY, M.D. _Assistant in Obstetrics and Gynecology, Cornell University Medical College Dispensary; Captain and Assistant Surgeon (in charge), Squadron A, New York Cavalry; Assistant in Surgery, New York Polyclinic._ Germ Diseases HERMANN MICHAEL BIGGS, M.D. _General Medical Officer and Director of Bacteriological Laboratories, New York City Department of Health; Professor of Clinical Medicine in University and Bellevue Hospital Medical College; Visiting Physician to Bellevue, St. Vincent's, Willard Parker, and Riverside Hospitals._ The Eye and Ear J. HERBERT CLAIBORNE, M.D. _Clinical Instructor in Ophthalmology, Cornell University Medical College; Former Adjunct Professor of Ophthalmology, New York Polyclinic; Former Instructor in Ophthalmology in Columbia University; Surgeon, New Amsterdam Eye and Ear Hospital._ Sanitation THOMAS DARLINGTON, M.D. _Health Commissioner of New York City; Former President Medical Board, New York Foundling Hospital; Consulting Physician, French Hospital; Attending Physician, St. John's Riverside Hospital, Yonkers; Surgeon to New Croton Aqueduct and other Public Works, to Copper Queen Consolidated Mining Company of Arizona, and Arizona and Southeastern Railroad Hospital; Author of Medical and Climatological Works._ Menstruation AUSTIN FLINT, JR., M.D. _Professor of Obstetrics and Clinical Gynecology, New York University and Bellevue Hospital Medical College; Visiting Physician, Bellevue Hospital; Consulting Obstetrician, New York Maternity Hospital; Attending Physician, Hospital for Ruptured and Crippled, Manhattan Maternity and Emergency Hospitals._ Heart and Blood JOHN BESSNER HUBER, A.M., M.D. _Assistant in Medicine, University and Bellevue Hospital Medical College; Visiting Physician to St. Joseph's Home for Consumptives; Author of "Consumption: Its Relation to Man and His Civilization; Its Prevention and Cure."_ Skin Diseases JAMES C. JOHNSTON, A.B., M.D. _Instructor in Pathology and Chief of Clinic, Department of Dermatology, Cornell University Medical College._ Diseases of Children CHARLES GILMORE KERLEY, M.D. _Professor of Pediatrics, New York Polyclinic Medical School and Hospital; Attending Physician, New York Infant Asylum, Children's Department of Sydenham Hospital, and Babies' Hospital, N. Y.; Consulting Physician, Home for Crippled Children._ Bites and Stings GEORGE GIBIER RAMBAUD, M.D. _President, New York Pasteur Institute._ Headache ALONZO D. ROCKWELL, A.M., M.D. _Former Professor Electro-Therapeutics and Neurology at New York Post-Graduate Medical School; Neurologist and Electro-Therapeutist to the Flushing Hospital; Former Electro-Therapeutist to the Woman's Hospital in the State of New York; Author of Works on Medical and Surgical Uses of Electricity, Nervous Exhaustion (Neurasthenia), etc._ Poisons E. ELLSWORTH SMITH, M.D. _Pathologist, St. John's Hospital, Yonkers; Somerset Hospital, Somerville, N. J.; Trinity Hospital, St. Bartholomew's Clinic, and the New York West Side German Dispensary._ Catarrh SAMUEL WOOD THURBER, M.D. _Chief of Clinic and Instructor in Laryngology, Columbia University; Laryngologist to the Orphan's Home and Hospital._ Care of Infants HERBERT B. WILCOX, M.D. _Assistant in Diseases of Children, Columbia University._ Special Contributors Food Adulteration S. JOSEPHINE BAKER, M.D. _Medical Inspector, New York City Department of Health._ Pure Water Supply WILLIAM PAUL GERHARD, C.E. _Consulting Engineer for Sanitary Works; Member of American Public Health Association; Member, American Society Mechanical Engineers; Corresponding Member of American Institute of Architects, etc.; Author of "House Drainage," etc._ Care of Food JANET MCKENZIE HILL _Editor, Boston Cooking School Magazine._ Nerves and Outdoor Life S. WEIR MITCHELL, M.D., LL.D. _LL.D. (Harvard, Edinburgh, Princeton); Former President, Philadelphia College of Physicians; Member, National Academy of Sciences, Association of American Physicians, etc.; Author of essays: "Injuries to Nerves," "Doctor and Patient," "Fat and Blood," etc.; of scientific works: "Researches Upon the Venom of the Rattlesnake," etc.; of novels: "Hugh Wynne," "Characteristics," "Constance Trescott," "The Adventures of François," etc._ Sanitation GEORGE M. PRICE, M.D. _Former Medical Sanitary Inspector, Department of Health, New York City; Inspector, New York Sanitary Aid Society of the 10th Ward, 1885; Manager, Model Tenement-houses of the New York Tenement-house Building Co., 1888; Inspector, New York State Tenement-house Commission, 1895; Author of "Tenement-house Inspection," "Handbook on Sanitation," etc._ Indoor Exercise DUDLEY ALLEN SARGENT, M.D. _Director of Hemenway Gymnasium, Harvard University; Former President, American Physical Culture Society; Director, Normal School of Physical Training, Cambridge, Mass.; President, American Association for Promotion of Physical Education; Author of "Universal Test for Strength," "Health, Strength and Power," etc._ Long Life SIR HENRY THOMPSON, Bart., F.R.C.S., M.B. (Lond.) _Surgeon Extraordinary to His Majesty the King of the Belgians; Consulting Surgeon to University College Hospital, London; Emeritus Professor of Clinical Surgery to University College, London, etc._ Camp Comfort STEWART EDWARD WHITE _Author of "The Forest," "The Mountains," "The Silent Places," "The Blazed Trail," etc._ [Illustration: HARVEY WASHINGTON WILEY, Ph.D., LL.D. The researches of Dr. Wiley, Chief of the Bureau of Chemistry in the United States Department of Agriculture, were important factors in hastening the enactment of the present pure food law. He analyzed the various food products and made public the deceptions practiced by unscrupulous manufacturers. He aroused attention throughout the country by pointing out the necessity of a campaign of education, in order, as stated in Volume V, Part II, that the housekeeper might be able to determine the purity of every article of food offered for sale. As an example of his methods, he organized a "poison squad" of government employees who restricted themselves to special diets, consisting of food preparations containing drugs commonly used as adulterants. In this way he actually demonstrated the effect of these substances upon the human system.] The Home Medical Library Volume II THE EYE AND EAR THE NOSE, THROAT AND LUNGS SKIN DISEASES TUMORS :: RHEUMATISM HEADACHE :: SEXUAL HYGIENE By KENELM WINSLOW, B.A.S., M.D. (Harv.) _Formerly Assistant Professor Comparative Therapeutics, Harvard University; Late Surgeon to the Newton Hospital; Fellow of the Massachusetts Medical Society, etc._ INSANITY By ALBERT WARREN FERRIS, A.M., M.D. _Former Assistant in Neurology, Columbia University; former Chairman, Section on Neurology and Psychiatry, New York Academy of Medicine; Assistant in Medicine, University and Bellevue Hospital Medical College; Medical Editor, "New International Encyclopedia"_ NEW YORK The Review of Reviews Company 1907 Copyright, 1907, by THE REVIEW OF REVIEWS COMPANY THE TROW PRESS, NEW YORK _Contents_ PART I CHAPTER PAGE I. THE EYE AND EAR 13 Foreign Bodies in the Eye--Black Eye--Twitching of the Eyelids--Wounds and Burns--Congestion-- Conjunctivitis--"Pink Eye"--Strain--Astigmatism-- Deafness--Foreign Bodies in the Ear--Earache--Simple Remedies. II. THE NOSE AND THROAT 51 Nosebleed--Foreign Bodies in the Nose--Cold in the Head--Toothache--Mouth-Breathing--Sore Mouth-- Pharyngitis--How to Treat Tonsilitis--Quinsy-- Diphtheria--Croup--Laryngitis. III. THE LUNGS AND BRONCHIAL TUBES 87 Acute and Chronic Bronchitis--Coughs in Children-- Liniments and Poultices--Cough Mixtures--Treatment of Pneumonia--Consumption--Asthma--Influenza, its Symptoms and Cure. IV. HEADACHES 113 Causes of Sick Headache--Symptoms and Treatment-- Headaches Caused by Indigestion--Organic Disease a Frequent Source--Nervous and Neuralgic Headaches-- Effect of Poison--Heat-Stroke. PART II I. GROWTHS AND ENLARGEMENTS 123 Cancers--Fatty Tumors--Use of Patent Preparations Dangerous--Symptoms and Cure of Rupture--The Best Kind of Truss--Varicose Veins--Varicocele--External and Internal Piles--Operations the Most Certain Cure. II. SKIN DISEASES AND RELATED DISORDERS 139 Itching, Chafing, and Chapping--Treatment of Hives--Nettlerash--Pimples--Fever Blisters--Prickly Heat--Cause of Ringworm--Freckles and Other Skin Discolorations--Ivy Poison--Warts and Corns-- Boils--Carbuncles. III. RHEUMATISM AND KINDRED DISEASES 169 Inflammatory Rheumatism--Symptoms and Treatment-- Muscular Rheumatism--Lumbago--Stiff Neck--Rheumatism of the Chest--Chronic Rheumatism--Rheumatic Gout-- Scurvy in Adults and Infants--Gout, its Causes and Remedies. PART III I. HEALTH AND PURITY 191 Duties of Parents--Sexual Abuse--Dangers to Health--Physical Examination of Infants--Necessary Knowledge of Sex Functions Natural--The Critical Age of Puberty--Marriage Relations. II. GENITO-URINARY DISEASES 199 Gonorrhea in Men and Women--Dangers of Infection-- Syphilis, its Causes, Symptoms, and Treatment-- Incontinence and Suppression of Urine--Bed-wetting-- Inflammation of the Bladder--Acute and Chronic Bright's Disease. PART IV I. INSANITY 229 Mental Disorder Not Insanity--Illusions of the Insane--Hallucinations and Delusions--Signs and Causes of Insanity--Paranoia--How the Physician Should Be Aided--The Best Preventive. _Appendix._ PATENT MEDICINES 245 Advice Regarding the Use of Patent Medicines--Laws Regulating the Sale of Drugs--Proprietary Medicines--Good Remedies--Dangers of So-called "Cures"--Headache Powders--The Great American Fraud. Part I THE EYE AND EAR, THE NOSE AND THROAT, THE LUNGS AND BRONCHIAL TUBES, HEADACHES BY KENELM WINSLOW CHAPTER I =The Eye and Ear= _Injuries to the Eye--Inflammatory Conditions--"Pink Eye"--Nearsightedness and Farsightedness--Deafness--Remedies for Earache._ =CINDERS AND OTHER FOREIGN BODIES IN THE EYE.=--Foreign bodies are most frequently lodged on the under surface of the upper lid, although the surface of the eyeball and the inner aspect of the lower lid should also be carefully inspected. A drop of a two-per-cent solution of cocaine will render painless the manipulations. The patient should be directed to continue looking downward, and the lashes and edge of the lid are grasped by the forefinger and thumb of the right hand, while a very small pencil is gently pressed against the upper part of the lid, and the lower part is lifted outward and upward against the pencil so that it is turned inside out. The lid may be kept in this position by a little pressure on the lashes, while the cinder, or whatever foreign body it may be, is removed by gently sweeping it off the mucous membrane with a fold of a soft, clean handkerchief. Hot cinders and pieces of metal may become so deeply lodged in the surface of the eye that it is necessary to dig them out with a needle (which has been passed through a flame to kill the germs on it) after cocaine solution has been dropped into the eye twice at a minute interval. Such a procedure is, of course, appropriate for an oculist, but when it is impossible to secure medical aid for days it can be attempted without much fear, if done carefully, as more harm will result if the offending body is left in place. It is surprising to see what a hole in the surface of the eye will fill up in a few days. If the foreign body has caused a good deal of irritation before its removal, it is best to drop into the eye a solution of boric acid (ten grains to the ounce of water) four times daily. "=BLACK EYE.="--To relieve this condition it is first necessary to reduce the swelling. This can be done by applying to the closed lids, every three minutes, little squares of white cotton or linen, four fold and about as large as a silver dollar, which have laid on a cake of ice until thoroughly cold. This treatment is most effective when pursued almost continuously for twenty-four hours. The cold compresses should not be permitted to overlap the nose, or a violent cold in the head may ensue. The swelling having subsided, the discoloration next occupies our attention. This may be removed speedily by applying, more or less constantly below the lower lid, little pieces of flannel dipped in water as hot as can be borne. The cloths must be changed as often as they cool. Repeat this treatment for a half hour every two hours or so during the day. =STYE.=--A stye is a boil on the eyelid; it begins at the root of a hair as a hard swelling which may extend to the whole lid. The tip of the swelling takes on a yellowish color, breaks down and discharges "matter" or pus. There are pain and a feeling of tension in the lid, and, very rarely, some fever. When one stye follows another it is well to have the eyes examined by an oculist, as eye-strain is often an inviting cause of the trouble, and this can be corrected by the use of glasses. Otherwise the patient is probably "run down" from chronic constipation and anæmia (poverty of the blood) and other causes, and needs a change of air, tonics, and exercise out of doors. In a depreciated condition, rubbing the lids causes introduction of disease germs. The immediate treatment, which may cut short the trouble, consists in bathing the eyelid for fifteen minutes at a time, every hour, with a hot solution of boric acid (half a teaspoonful to the cup of water). Then at night the swelling should be painted with collodion, several coats, being careful not to get it in the eye, as it would cause much smarting. If the stye persists in progressing, bathing it in hot water will cause it to discharge pus and terminate much sooner. =TWITCHING OF THE EYELIDS.=--This condition may be due to eye-strain, and can be relieved if the eyes are fitted to glasses by an oculist (not an optician). It is frequently an accompaniment of inflammation of the eyes, and when this is cured the twitching of the lids disappears. When the eyes are otherwise normal the twitching is frequently one of the signs of nerve fag and overwork. =WOUNDS AND BURNS ABOUT THE EYES.=--Slight wounds of the inner surface of the eyelids close readily without stitching if the boric-acid solution (ten grains to the ounce of water) is dropped into the eye four times daily. Burns of the inner surface of the lids follow the entrance of hot water, hot ashes, lime, acids, and molten metals. Burns produced by lime are treated by dropping a solution of vinegar (one part of vinegar to four of water) into the eye, while those caused by acids are relieved by similar treatment with limewater or solution of baking soda (half a teaspoonful to the glass of water). If these remedies are not at hand, the essential object is attained by washing the eye with a strong current of water, as from a hose or faucet. If there is much swelling of the lids, and inflammation after the accident, drop boric-acid solution into the eye four times daily. Treatment by cold compresses, as recommended for "black eye," will do much also to quiet the irritation, and the patient should wear dark glasses. =SORE EYES; CONJUNCTIVITIS.=--The mucous membrane lining the inner surface of the eyelids also covers the front of the eyeball, although so transparent here that it is not apparent to the observer. Inflammation of this membrane is more commonly limited to that portion covering the inner surfaces of the lids, but may extend to the eyeball when the eye becomes "bloodshot" and the condition more serious. For the sake of convenience we may speak of a mild form of sore eye, as _congestion of the eyelids_, and the more severe type, as true _conjunctivitis_ (see p. 18). =CONGESTION OF THE EYELIDS.=--This may be caused by smoke or dust in the atmosphere, by other foreign bodies in the eye; frequently by eye-strain, due to far- or near-sightedness, astigmatism, or muscular weakness, which may be corrected by an oculist's (never an optician's) prescription for glasses. Exposure to an excessive glare of light, as in the case of firemen, or, on the other hand, reading constantly and often in a poor light, will induce irritation of the lids. The germs which cause "cold in the head" often find their way into the eyes through the tear ducts, which connect the inner corner of the eyes with the nose, and thus may set up similar trouble in the eyes. =Symptoms.=--The eyes feel weary and "as if there were sand in them." There may be also smarting, burning, or itching of the lids, and there is disinclination for any prolonged use of the eyes. The lids, when examined, are found to be much deeper red than usual, and slightly swollen, but there is no discharge from the eye, and this fact serves to distinguish this mild type of inflammation from the more severe form. =Treatment.=--The use of dark glasses and a few drops of zinc-sulphate solution (one grain to the ounce of water) in the eye, three times daily, will often cure the trouble. If this does not do so within a few days then an oculist should be consulted, and it will frequently be found that glasses are needed to secure freedom from irritation of the eyes. In using "eye-drops" the head should be held back, and several drops be squeezed from a medicine dropper into the inner corner of the eye. =CONJUNCTIVITIS; CATARRHAL INFLAMMATION OF THE EYES.=--In this disorder there is discharge which sticks the lids together during the night. The inner surface of the lids is much reddened, the blood vessels in the lining membrane are much enlarged, and the lids are slightly swollen. The redness may extend to the eyeball and give it a bloodshot appearance. There is no interference with sight other than momentary blurring caused by the discharge, and occasionally there is very severe pain, as if a cinder had suddenly fallen in the eye. This symptom may occur at night and awaken the patient, and may be the reason for his first consulting a physician. One eye is commonly attacked twenty-four to thirty-six hours before the other, and even if it is thought that the cause is a cinder, in case of one eye, it can hardly be possible to sustain this belief in the case of the involvement of both eyes. There is a feeling of discomfort about the eyes, and often a burning, and constant watering, the tears containing flakes of white discharge. When the discharge is a copious, creamy pus or "matter," associated with great swelling of the lids and pain on exposure to light, the cause is usually a germ of a special disease, and the eyesight will very probably be lost unless a skillful physician be immediately secured. Early treatment is, however, of great service, and, until a physician can be obtained, the treatment recommended below should be followed conscientiously; by this means the sight may be saved. This dangerous variety of inflammation of the eyes is not rare in the newborn, and infants having red eyes within a few days of birth should immediately receive proper attention, or blindness for life will be the issue. This is the usual source of that form of blindness with which babies are commonly said to have been born. All forms of severe inflammation of the lids are contagious, especially the variety last considered, and can be conveyed, by means of the discharge, through the agency of towels, handkerchiefs, soap, wash basins, etc., and produce the same or sometimes different types of inflammation in healthy eyes. Therefore, if the severe form of conjunctivitis breaks out among any large number of people, as in schools, prisons, asylums, and almshouses, isolation of the patients should be enforced. "=PINK EYE.="--This is a severe epidemic form of catarrh of the eye, which is caused by a special germ known as the "Koch-Weeks bacillus." The treatment of this is the same as that outlined below. The germ of pneumonia and that of grippe also often cause conjunctivitis, and "catching cold," chronic nasal catarrh, exposure to foul vapors and gases, or tobacco smoke, and the other causes enumerated, as leading to congestion of the lids, are also responsible for catarrhal inflammation of the eye. =Treatment.=--In the milder attacks of conjunctivitis the treatment should be that recommended above for congestion of the lids. The swelling and inflammation, in the severer types, are greatly relieved by the application of the cold-water compresses, advised under the section on "black eye," for an hour at a time, thrice daily. Confinement in a dark room, or the use of dark glasses, and drops of zinc sulphate (one grain in an ounce of water) three times a day, with hourly dropping of boric acid (ten grains to the ounce of water) constitute the ordinary treatment. In inflammations with copious discharge of creamy pus, and great swelling of the lids, the eyes should be washed out with the boric-acid solution every half hour, and a solution of silver nitrate (two grains to the ounce of water) dropped into the eye, once daily, followed immediately by a weak solution of common salt in water to neutralize the nitrate of silver, after its action has been secured. The constant use of ice cloths, already mentioned, forms a necessary adjunct to treatment. The sound eye must be protected from the chance of contagion, arising from a possible infection from the pus discharging from its mate. This may be secured by bandaging the well eye, or, better, by covering it with a watch crystal kept in place by surgeon's plaster. In treating sore eyes with discharge, in babies, the infant should be held in the lap with its head backward and inclined toward the side of the sore eye, so that in washing the eye no discharge will flow into the sound eye. The boric acid may then be dropped from a medicine dropper, or applied upon a little wad of absorbent cotton, to the inner corner of the eye, while the eyelids are held apart. Hemorrhages occurring under the conjunctiva (or membrane lining the inner surface of the lids and covering the front surface of the eyeball) may be caused by blows or other injury to the eye, by violent coughing, by straining, etc. Dark-red spots may appear in the white of the eyeball, slightly raised above the surface, which are little blood clots under the conjunctival membrane. No special trouble results and there is nothing to be done except to wait till the blood is absorbed, which will happen in time. If the eyes water, solution of zinc sulphate (one grain to the ounce of water) may be dropped into the eye, twice daily. Hot applications are beneficial here to promote absorption of the clot. =EYE-STRAIN.=--Eye-strain is commonly due to either astigmatism, nearsightedness, farsightedness, or weakness of the eye muscles. The farsighted eye is one in which parallel rays entering the eye, as from a distance, come to a focus behind the retina. The retina is the sensitive area for receiving light impressions in the back of the eyeball. Sight is really a brain function; one sees with the brain, since the optic nerve endings in the back of the eye merely carry light impressions to the brain where they are properly interpreted. In order that vision be clear and perfect, it is essential that the rays of light entering the eye be bent so that they strike the retina as a single point. In the farsighted or hyperopic eye, the eyeball is usually too short for the rays to be properly focused on the sensitive nerve area in the back of the eye. This defect in vision is, however, overcome by the act of "accommodation." There is a beautiful transparent, double-convex body, about one-third of an inch thick, which looks very much like an ordinary glass lens, and is situated in the eye just back of the pupil. This is what is known as the crystalline lens, and the rays of light are bent in passing through it so as to be properly focused on the retina. The foregoing statements have been made as though objects were always at a distance from the eye, so that the rays of light coming from them were almost parallel. Yet when one is looking at an object within a few inches of the eye the rays diverge or spread out, and these the normal eye (if rigid) could not focus on the retina--much less the farsighted eye. But the eye is adaptable to change of focus through the action of a certain muscle, situated within the eyeball about the lens, which controls to a considerable extent the shape of the lens. When the muscle contracts it allows the lens to bulge forward by virtue of its elasticity, and, therefore, become more convex. This is what happens when one looks at near objects, the increased convexity of the lens bending the rays of light so that they will focus as a point on the retina. (See Plate I, p. 30.) Now in the farsighted eye this muscular control or "accommodative action" must be continually exercised even in looking at distant objects, and it is this constant attempt of nature to cure an optical defect of the eye which frequently leads to nervous exhaustion or eye-strain. The nerve centers, which animate and control the nerves supplying the eye muscles to which we have just alluded, are in close proximity to other most important nerve centers in the brain, so irritation of the eye centers will produce sympathetic irritation of these other centers, leading to manifold and complex symptoms which we will describe under this head. But these symptoms do not necessarily develop in everyone having farsightedness or astigmatism, since both are often present at birth. The power of accommodation is sufficient to overcome the optical defect of the eye, providing that the general health is good and the eye is not used much for near work. If, on the other hand, excessive use of the eyes in reading, writing, figuring, sewing, or other fine work is required, and especially if the health becomes impaired, it happens that the constant drain on the eye center in the brain will result in a group of symptoms which we will consider later. Failure of accommodation comes on at about forty, and gradually increases until all accommodation is lost at the age of seventy-five. For this reason it is necessary for persons over forty-five years of age, having normal or farsighted eyes, to wear convex glasses in reading or doing near work, and these should be changed for stronger ones every year or two. These convex glasses save the eyes in their attempt to make the lens more convex when looking at near objects in farsightedness, and also prove serviceable in the same manner when accommodation begins to fail in the case of what is called "old sight." The neglect to provide proper glasses for reading any time after the age of forty-five, and the failure to replace them by stronger lenses when required, distinctly favor the occurrence of cataract in later life. In the act of accommodation, in addition to the muscular action by which the lens is made more convex, there is the tendency for the action of another group of muscles outside the eyeball, which turn the eyes inward when they are directed toward a near object. Here then is another source of trouble resulting from farsightedness, i. e., the not infrequent occurrence of inward "squint" occasioned by the constant use of the muscles pulling the eyes inward during accommodation for near objects. Again, inflammation of the eyelids, and sometimes of deeper parts of the eyeball, follows untreated hyperopia. Early distaste for reading is often acquired by farsighted persons, owing to the strain on the accommodative apparatus. The convex lens is that used to correct farsightedness. =NEARSIGHTED EYE.=--In the nearsighted eye the eyeball is too long for parallel rays entering the eye to be focused upon the retina; they are bent, instead, to a point in front of the retina, and then diverge making the vision blurred. (Plate I, p. 30.) The act of accommodation in making the lens more convex will not aid this condition, but only make it worse, so that it is not attempted. Eye-strain in this optical defect is brought on by constant use of the eye muscles (attached to the outside of the eyeball) in directing both eyes inward so that they will both center on near objects; the only ones which can be seen. Outward squint frequently results, because the muscular efforts required to direct both eyes equally inward to see near objects are so great that the use of both eyes together is given up, and the poorer eye is not used and squints outward, while the better eye is turned inward in the endeavor to see. Nearsighted persons are apt to stoop, owing to the habitual necessity for coming close to the object looked at. Their facial expression is also likely to be rather vacant, since they do not distinctly see, and do not respond to the facial movements of others. Nearsightedness, or myopia, is not a congenital defect, but is usually acquired owing to excessive near work which requires that the eye muscles constantly direct both eyes inward to see near objects. In so acting the muscles compress the sides of the eyeballs and tend to increase their length, interfere with their nutrition, and aggravate the condition when it is once begun. (See Diagram.) Concave lenses are used to correct myopia, and they must be worn all the time. =ASTIGMATISM.=--This is a condition caused by inequality of the outer surface of the front of the eyeball, and rarely by a similar defect in the surfaces of the lens. The curvature of the eyeball in the astigmatic eye is greater in one meridian than in the opposite. In other words, the front of the eyeball is not regularly spherical, but bulges out along a certain line or meridian, while the curvature is flattened or normal in the other meridian. For instance, if two imaginary lines were drawn, one vertically, and the other horizontally across the front of the eyeball intersecting in the center of the pupil, they would represent the principal meridians, the vertical and the horizontal. As a rule the meridian of greatest curvature is approximately vertical, and that of least curvature is at right angles to it, or horizontal. Rays of light in passing through the different meridians of the astigmatic eye are differently bent, so that in one of the principal meridians rays may focus perfectly on the retina, while in the other the rays may focus on a point behind the retinal field. In this case the eye is made farsighted or hyperopic in one meridian, and is normal in the other. Or again, the rays may be focused in front of the retina in one meridian, and directly on the retina in the other; this would be an example of nearsighted or myopic astigmatism. Farsightedness and nearsightedness are then both caused by astigmatism, although in this case not by the length of the eyeball, but by inequality in the curvature of the front part (cornea) of the eyeball. For example, in simple astigmatism one of the principal meridians is hyperopic (turning the rays so that they focus behind the retina) or myopic (bending the rays so that they focus in front of the retina), while the other meridian is normal. In mixed astigmatism, one of the principal meridians is myopic, the other hyperopic; in compound astigmatism the principal meridians are both myopic, or both hyperopic, but differ in degree; while in irregular astigmatism, rays of light passing through different parts of the outer surface of the eyeball are turned in so many various directions that they can never be brought to a perfect focus by glasses. It is not by any means possible for a layman to be able always to inform himself that he is astigmatic, unless the defect is considerable. If a card, on which are heavy black lines of equal size and radiating from a common center like the spokes of a wheel, be placed on a wall in good light, it will appear to the astigmatic eye as if certain lines (which are in the faulty meridian of the eyeball) are much blurred, while the lines at right angles to these are clear and distinct. Each eye should be tested separately, the other being closed. The chart should be viewed from a distance as great as any part of it can be seen distinctly. All the lines on the test card should look equally black and clear to the normal eye. Astigmatism is corrected by a cylindrical lens, which is in fact a segment of a solid cylinder of glass. The axis of the cylindrical lens should be at right angles to the defective meridian of the eye, in order to correct the astigmatism. Eye-strain is caused by astigmatism in the same manner that it is brought about in the simple farsighted eye, i. e., by constant strain on the ciliary muscle, which regulates the convexity of the crystalline lens. For it is possible for the inequalities of the front surface of the eyeball or of the lens to be offset or counterbalanced by change in the convexity of the lens produced by the action of this muscle, and it is conceivable that the axis of the lens may be tilted one way or another by the same agency, and for the same purpose. But, as we have already pointed out, this continual muscular action entails great strain on the nerve centers which animate the muscle, and if constant near work is requisite, or the health is impaired, the nervous exhaustion becomes apparent. The lesser degrees of astigmatism often give more trouble than the greater. [Illustration: PLATE I =Plate I= =ANATOMY OF THE EYE= The upper illustration shows the six muscles attached to the eye. The =Superior Rectus Muscle= pulls and directs the eye upward; the =Inferior Rectus=, downward; the =External= and =Internal Rectus Muscles= pull the eye to the right and left; the =Oblique Muscles= move the eye slantwise in any direction. Lack of balance of these muscles, and especially inability to focus both eyes on a near object without effort, constitute "eye-strain." The lower cut illustrates the relation of the crystalline lens to sight. =Lens Nearsight Focus= shows the lens bulging forward and very convex; =Lens Farsight Focus= shows it flat and less convex. This adjustment of the shape of the crystalline lens is called "accommodation"; it is effected by a small muscle in the eyeball. In the normal eye, the rays of light from an object pass through the lens, adjusted for the proper distance, and focus on the retina. In the nearsighted eye, these rays focus at a point in front of the retina; while in the farsighted eye these rays focus behind the retina; the nearsighted eye being elongated, and the farsighted eye being shortened.] =WEAKNESS OF THE EYE MUSCLES.=--There are six muscles attached to the outside of the eyeball which pull it in various directions, and so enable each eye to be directed upon a common point, otherwise objects will appear double. Weakness of these muscles or insufficiency, especially of those required to direct the eyes inward for near work, may lead to symptoms of eye-strain. When reading, for example, the muscles which pull the eye inward soon grow tired and relax, allowing the opposing muscles to pull the eye outward so that the eyes are no longer directed toward a common point, and two images may be perceived or, more frequently, they become fused together producing a general blurring on the page. Then by a new effort of will the internal muscles pull the eyes into line again, only to have the performance repeated, all of which entails a great strain upon the nervous system, and may lead to permanent squint, as has been pointed out. In addition to these symptoms caused by weakness of the eye muscles--seeing double, blurred vision, and want of endurance for close work--there are others which are common to eye-strain in general, as headache, nausea, etc., described in the following paragraph. =Symptoms of Eye-strain.=--Headache is the most frequent symptom. It may be about the eyes, but there is no special characteristic which will positively enable one to know an eye headache from that arising from other sources, although eye-strain is probably the most common cause of headache. The headache resulting from eye-strain may then be in the forehead, temples, top or the back of the head, or limited to one side. It frequently takes the form of "sick headache" (p. 113). It is perhaps more apt to appear after any unusual use of the eyes in reading, writing, sewing, riding, shopping, or sight-seeing, and going to theaters and picture galleries, but this is not by any means invariably the case, as eye headache may appear without apparent cause. Nausea and vomiting, with or without headache, nervousness, sleeplessness, and dizziness often accompany eye-strain. Sometimes there is weakness of the eyes, i. e., lack of endurance for eye work, twitching of the eyelids, weeping, styes, and inflammation of the lids. In view of the extreme frequency of eye-disorders which lead to eye-strain, it behooves people, in the words of an eminent medical writer, to recognize that "the subtle influence of eye-strain upon character is of enormous importance" inasmuch as "the disposition may be warped, injured, and wrecked," especially in the young. Some of the more serious nervous diseases, as nervous exhaustion, convulsions, hysteria, and St. Vitus's dance may be caused by the reflex irritation of the central nervous system following eye-strain. =Treatment of Eye-strain.=--The essential treatment of eye-strain consists in the wearing of proper glasses. It should be a rule, without any exception, to consult only a regular and competent oculist, and never an optician, for the selection of glasses. It is as egregious a piece of folly to employ an optician to choose the glasses as it would be to seek an apothecary's advice in a general illness. Considerably more damage would probably accrue from following the optician's prescription than that of the apothecary, because nature would soon offset the effects of an inappropriate drug; but the damage to the eyes from wearing improper glasses would be lasting. Properly to determine the optical error in astigmatic and farsighted eyes it is essential to place drops in the eye, which dilate the pupil and paralyze the muscles that control the convexity of the crystalline lens, and to use instruments and methods of examination, which can only be properly undertaken and interpreted by one with the general and special medical training possessed by an oculist. The statement has been emphasized that farsighted and astigmatic persons, up to the age of forty-five or fifty, can sometimes overcome the optical defects in their eyes by exercise of the ciliary muscle which alters the shape of the lens, and, therefore, it would be impossible for an examiner to discover the fault without putting drops in the eye, which temporarily paralyze the ciliary muscles for from thirty-six to forty-eight hours, but otherwise do no harm. After the age of fifty it may be unnecessary to use drops, as the muscular power to alter the convexity of the lens is greatly diminished. Opticians are incompetent to employ these drops, as they may do great damage in certain conditions of the eye which can only be detected by a medical man specially trained for such work. Opticians are thus sure to be caught on one of the horns of a dilemma; either they do not use drops to paralyze the ciliary muscle, or, if they do employ the drops, they may do irreparable damage to the eye. Any abnormality connected with the vision, especially in children, should be a warning to consult an oculist. Squint, "cross-eye" (_Strabismus_), as has been stated, may often result from near- or far-sightedness, and it may be possible in young children to cure the squint by the use of glasses or even drops in the eye, whereas in later life it may be necessary to cut some of the muscles of the eyeball to correct the condition. It is a wise rule to subject every child to an oculist's examination before entering upon school life. =DEAFNESS.=--Sudden deafness without apparent reason is more apt to result from an accumulation of wax than from any other cause. It is a very common ear disorder. The opening into the ear is about an inch long, or a little more, and is separated from that part of the ear within, which is known as the middle ear, by the eardrum membrane. The drum membrane is a thin, skinlike membrane stretched tightly across the bottom of the external opening in the ear or auditory canal, and shuts it off completely from the middle ear within, and in this way protects the middle ear from the entrance of germs, dust, and water, but only secondarily aids hearing. The obstruction caused by wax usually exists in about the middle of the auditory canal or opening in the ear, and only causes deafness when it completely blocks this passage. The deafness is sudden because, owing to the accidental entrance of water, the wax quickly swells and chokes the canal; or, in attempts to relieve irritation in the ear, the finger or some other object is thrust into the opening in the ear (auditory canal) and presses the wax down on the ear drum. The obstruction in the ear is usually a mixture of waxy secretion from the canal, and little scales of dead skin which become matted together in unwise efforts at cleansing the ear by introducing a twisted towel or some other object into the ear passage and there turning it about; or it may occur owing to disease of the ear altering the character of the natural secretion. In the normal state, the purpose of the wax is, apparently, to repel insects and to glue together the little flakes of cast-off skin in the auditory canal, and these, catching on the hairs lining the canal, are thrown out of the ears upon the shoulders by the motion of the jaws in eating. Nothing should be introduced into the ear with the idea of cleansing it, as the skin growing more rapidly from within tends naturally to push the dead portions out as required, and so the canal is self-cleansing. =Symptoms.=--Sudden deafness in one ear usually calls the attention of the patient to an accumulation of wax. There is apt to be more or less wax in the other ear as well. Noises in the deaf ear and a feeling of pressure are also common. Among rarer symptoms are nausea and dizziness. But the only way to be sure that deafness is due to choking of the ear passage with wax is to see it. This is usually accomplished by a physician in the following way: he throws a good light from a mirror into a small tube introduced into the ear passage. This is, of course, impossible for laymen to do, but if the ear is drawn upward, backward, and outward, so as to straighten the canal, it may be possible for anyone to see a mass of yellowish-brown or blackish material filling the passage. And in any event, if the wax cannot be seen, one is justified in treating the case as if it were present, if sudden deafness has occurred and competent medical aid is unobtainable, since no harm will be done if wax is absent, and, if it is present, the escape of wax will usually give immediate relief from the deafness and other symptoms. =Treatment.=--The wax is to be removed with a syringe and water as hot as can be comfortably borne. A hard-rubber syringe having a piston, and holding from two teaspoonfuls to two tablespoonfuls, is to be employed--the larger ones are better. The clothing should be protected from water by towels placed over the shoulder, and a basin is held under the ear to catch the water flowing out of the canal. The tip of the syringe is introduced just within the entrance of the ear, which is to be pulled backward and upward, and the stream of water directed with some force against the upper and back wall of the passage rather than directly down upon the wax. The water which is first returned is discolored, and then, on repeated syringing, little flakes of dry skin, with perhaps some wax adhering, may be seen floating on the top of the water which flows from the ear, and finally, after a longer or shorter period, a plug of wax becomes dislodged, and the whole trouble is over. This is the rule, but sometimes the process is very long and tedious, only a little coming away at a time, and, rarely, dizziness and faintness will require the patient to lie down for a while. The water should always be removed from the ear after syringing by twisting a small wisp of absorbent cotton about the end of a small stick, as a toothpick, which has been dipped into water to make the cotton adhere. The tip of the toothpick, thus being thoroughly protected by dry cotton applied so tightly that there is no danger of it slipping off, while the ear is pulled backward and upward to straighten the canal, is gently pushed into the bottom of the canal and removed, and the process repeated with fresh cotton until it no longer returns moist. Finally a pledget of dry cotton should be loosely packed into the ear passage, and worn by the patient for twelve or twenty-four hours. =PERSISTENT AND CHRONIC DEAFNESS.=--A consideration of deafness requires some understanding of the structure and relations of the ear with other parts of the body, notably the throat. It has been pointed out that the external ear--comprising the fleshy portion of the ear, or auricle, and the opening, or canal, about an inch long--is separated from that portion of the ear within (or middle ear) by the drum membrane. The middle ear, while protected from the outer air by the drum, is really a part of the upper air passages, and participates in disorders affecting them. It is the important part of the ear as it is the seat of most ear troubles, and disease of the middle ear not only endangers the hearing, but threatens life through proximity to the brain. In the middle ear we have an air space connected with the throat by the Eustachian tube, a tube about an inch long running downward and forward to join the upper air passage at the junction of the back of the nose and upper part of the throat. If one should run the finger along the roof of the mouth and then hook it up behind and above the soft palate one could feel the openings of these tubes (one for each ear) on either side of the top of the throat or back of the nose, according to the view we take of it. Then the middle ear is also connected with a cavity in the bone back of the ear (mastoid cavity or cells), and the outer and lower wall is formed by the drum membrane. Vibrations started by sound waves which strike the ear are connected by means of a chain of three little bones from the drum through the middle ear to the nervous apparatus in the internal ear. The head of one of these little bones may be seen by an expert, looking into the ear, pressing against the inside of the drum membrane. Stiffening or immovability of the joints between these little bones, from catarrh of the middle ear, is most important in producing permanent deafness. The middle ear space is lined with mucous membrane continuous with that of the throat through the Eustachian tube. This serves to drain mucus from the middle ear, and also to equalize the air pressure on the eardrum so that the pressure within the middle ear shall be the same as that without. When there is catarrh or inflammation of the throat or nose it is apt to extend up the Eustachian tubes and involve the middle ear. In this way the tubes become choked and obstructed with the oversecretion or by swelling. The air in the middle ear then becomes absorbed in part, and a species of vacuum is produced with increased pressure from without on the eardrum. The drum membrane will be pressed in, and through the little bones pressure will be made against the sensitive nervous apparatus, irritating it and giving rise to deafness, dizziness, and the sensation of noises in the ear. Noises from without will also be intensified in passing through the middle ear when it is converted into a closed cavity through the blocking of the Eustachian tube. A very important feature following obstruction of the Eustachian tubes, and rarefaction of the air in the middle ear, is that congestion of the blood vessels ensues and increased secretion, because the usual pressure of the air on the blood vessels within the middle ear is taken away. This then is the cause of most permanent deafness, to which is given the name catarrhal deafness, because every fresh cold in the head, or sore throat, tends to start up trouble in the ear such as we have just described. Repeated attacks leave vestiges behind until permanent deafness remains. In normal conditions every act of swallowing opens the apertures of the Eustachian tubes in the throat, and allows of equalization of the air pressure within and without the eardrum, but if the nose is stopped up by a cold in the head, or enlargement of the tonsil at the back of the nose (as from adenoids, see p. 61), the process is reversed and air is exhausted from the Eustachian tubes with each swallowing motion. The moral to be drawn from all the foregoing is to treat colds properly when they are present, keeping the nose and throat clean and clear of mucus, and to have any abnormal obstruction in the nose or throat and source of chronic catarrh removed, as enlarged tonsils, adenoids, and nasal outgrowths. =FOREIGN BODIES IN THE EAR.=--Foreign bodies, as buttons, pebbles, beans, cherry stones, coffee, etc., are frequently placed in the ear by children, and insects sometimes find their way into the ear passage and create tremendous distress by their struggles. Smooth, nonirritating bodies, as buttons, pebbles, etc., do no particular harm for a long time, and may remain unnoticed for years. But the most serious damage not infrequently results from unskillful attempts at their removal by persons (even physicians unused to instrumental work on the ear) who are driven to immediate and violent action on the false supposition that instant interference is called for. Insects, it is true, should be killed without delay by dropping into the ear sweet oil, castor, linseed, or machine oil or glycerin, or even water, if the others are not at hand, and then the insect should be removed in half an hour by syringing as recommended for wax (p. 35). To remove solid bodies, turn the ear containing the body, downward, pull it outward and backward, and rub the skin just in front of the opening into the ear with the other hand, and the object may fall out. Failing in this, syringing with warm water, as for removal of wax, while the patient is sitting, may prove successful. The essentials of treatment then consist, first, in keeping cool; then in killing insects by dropping oil or water into the ear, and, if syringing proves ineffective, in using no instrumental methods in an attempt to remove the foreign body, but in awaiting such time as skilled medical services can be obtained. If beans or seeds are not washed out by syringing, the water may cause them to swell and produce pain. To obviate this, drop glycerin in the ear which absorbs water, and will thus shrivel the seed. =EARACHE.=--Earache is due usually not to neuralgia of the ear, but to a true inflammation of the middle ear, which either subsides or results in the accumulation of inflammatory products until the drum is ruptured and discharge occurs from the external canal. The trouble commonly originates from an extension of catarrhal disease of the nose or throat; the germs which are responsible for these disorders finding their way into the Eustachian tubes, and thus into the middle ear. Any source of chronic catarrh of the nose or throat, as enlarged and diseased tonsils, adenoids in children, or nasal obstruction, favor the growth of germs and the occurrence of frequent attacks of acute catarrh or "colds." The grippe has been the most fruitful cause of middle-ear inflammation and earache in recent years. Any act which forces up fluid or secretions from the back of the nose into the Eustachian tubes (see section on Deafness) and thus into the middle ear, is apt to set up inflammation there, either through the introduction of germs, or owing to the mechanical injury sustained. Thus the use of the nasal douche, the act of sniffing water into the nose, or blowing the nose violently when there is secretion or fluid in the back of the nose, or the employment of the post-nasal syringe are one and all attended with this danger. Swimming on the back, diving, or surf bathing also endangers the ear, as cold water is forcibly driven not only into the external auditory canal, but, what is more frequently a source of damage, into the Eustachian tubes through the medium of the nose or throat. In this case the plugging of the nose with cotton would be of more value than the external canal, as is commonly practiced. If water has entered the Eustachian tube, blowing the nose and choking merely aggravate the trouble. The wiser plan is to do nothing but trust that the water will drain out, and if pain ensues treat it as recommended below for earache. Water in the ears is sometimes removed by jumping about on one foot with the troublesome ear held downward, and if it is in the external canal it may be wiped out gently with cotton on the end of a match, as recommended in the article on treating wax in the ear (see p. 35). In the treatment of catarrh in the nose or throat only a spray from an atomizer should be used, as Dobell's or Seiler's solutions followed by menthol and camphor, twenty grains of each to the ounce of alboline or liquid vaseline.[1] Exposure to cold and the common eruptive diseases of children, as scarlet fever, measles, and also diphtheria, are common causes of middle-ear inflammation. In the latter disorders the protection afforded by a nightcap which comes down over the ears, and worn constantly during the illness, is frequently sufficient to ward off ear complications. Although earache or middle-ear inflammation is common, its dangers are not fully appreciated, since the various complications are likely to arise, and the result is not rarely serious. Extension of the inflammation to the bone behind the ear may necessitate chiseling away a part of the skull to liberate pus or dead bone in this locality, and the occurrence of abscess of the brain will necessitate operation. The use of leeches in the beginning of the attack is of great value, and though unpleasant are not difficult or painful in their application. One should be applied just in front of the opening into the ear (which should be previously closed with cotton to prevent the entrance of the leech), and the other behind the ear in the crease where it joins the side of the head and at a point a little below the level of the external opening into the ear. A drop of milk on these spots will often start the leeches immediately at work, or a drop of blood obtained with a pin prick. When the leeches are gorged with blood and cease to suck, they should be removed and bleeding encouraged for half an hour with applications of absorbent cotton dipped in hot water. Then clean, dry absorbent cotton is applied, and pressure made on the wounds if bleeding does not soon stop or is excessive. The after treatment of the bites consists in cleanliness and the use of vaseline. The patient must stay in bed, and the hot-water bag be constantly kept on the ear till all pain ceases. If the drum perforates, a discharge will usually appear from the external ear. Then the canal must be cleansed, once or more daily, by injecting very gently into the ear a solution of boric acid (as much of boric acid as the water will dissolve), following this by wiping the water out of the canal with sterilized cotton, as directed for the treatment of wax in the ear (p. 35). The syringing is permissible only once daily, unless the discharge is copious, but the canal may be wiped out in this manner several times a day with dry cotton. It is well to keep the opening into the ear greased with vaseline, and a plug of clean absorbent cotton loosely packed into the canal to keep out the cold. Excessive or too forcible syringing may bring about that complication most to be feared, although it may appear through no fault in care, i. e., an implication of the cavity in the bone back of the ear (mastoid disease). Germs find their way through the connecting passage by which this cavity is in touch with the middle ear, or may be forced in by violent syringing. When this happens, earache, or pain just back of the ear, commonly returns during the first or second week after the first attack, and tenderness may be observed on pressing on the bone just back of the ear close to the canal. Fever, and local redness and swelling of the parts over the bone in this region may also occur. Confinement to bed, and constant application of a rubber bag containing cracked ice, to the painful parts must be enforced. If the tenderness on pressure over the bone and pain do not subside within twenty-four to forty-eight hours, surgical assistance must be obtained at any cost, or a fatal result may ensue. The opening in the drum membrane, caused by escape of discharge in the course of middle-ear inflammation, usually closes, but even if it does not deafness is not a necessary sequence. The eardrum is not absolutely essential to hearing, but it is of great importance to exclude sources of irritation, dust, water, and germs which are likely to set up middle-ear trouble. More ordinary after-effects are chronic discharge from the ear following acute inflammation and perforation of the eardrum, which may mean at any time a sudden return of pain with the occurrence of the more dangerous conditions just recited, together with deafness. Bearing all this in mind it is advisable never to neglect a severe or persistent earache, but to call in expert attention. When this is not obtainable the treatment outlined below should be carefully followed. =Symptoms.=--Pain is severe and often excruciating in adults. It may be felt over the temple, side and back of the head and neck, and even in the lower teeth, as well as in the ear itself. The pain is increased by blowing the nose, sneezing, coughing, and stooping. There is considerable tenderness usually on pressing on the skin in front of the ear passage. In infants there may be little evidence of pain in the ear. They are apt to be very fretful, refuse food, cry out in sleep, often lie with the affected ear resting on the hand, and show tenderness on pressure immediately in front or behind the ear passage. Dullness, fever, chills, and convulsions are not uncommon in children, but, on the other hand, after some slight illness it is not infrequent for discharge from the ear to be the first sign which calls the attention of parent or medical attendant to the source of the trouble. For this reason the careful physician always examines the ear in doubtful cases of children's diseases. Unless the inflammation subsides with treatment, either a thin, watery fluid (serum) is formed in the middle ear, or pus, when we have an "abscess of the ear." The drum if left to itself breaks down in three to five days, or much sooner in children who possess a thinner membrane. A discharge then appears in the canal of the external ear, and the pain is relieved. It may occasionally happen that the Eustachian tube drains away the discharge, or that the discharge from the drum is so slight that it is not perceived, and recovery ensues. Discharge from the ear continues for a few weeks, and then the hole in the drum closes and the trouble ceases. This is the history in favorable cases, but unfortunately, as we have indicated, the opposite state of affairs results not infrequently, especially in neglected patients. =Treatment.=--The patient with severe earache should go to bed and take a cathartic to move the bowels. He should lie all the time with the painful ear on a rubber bag containing water as hot as can be comfortably borne. Every two hours a jet of hot water, which has been boiled and cooled just sufficiently to permit of its use, is allowed to flow gently from a fountain syringe into the ear for ten minutes, and then the ear is dried with cotton, as described under the treatment of wax in the ear (p. 35). No other "drops" of any kind are admissible for use in the ear, and even this treatment is of less importance than the dry heat from the hot-water bag, and may be omitted altogether if the appliances and skill to dry the ear are lacking. Ten drops of laudanum[2] for an adult, or a teaspoonful of paregoric for a child six years old, may be given by the mouth to relieve the pain. The temperature of the room should be even and the food soft. If the pain continues it is wiser to have an aurist lance the drum, to avoid complications, than to wait for the drum membrane to break open spontaneously in his absence. Loss or damage of the eardrums may call for "artificial eardrums." They do not act at all like the drumhead of the musical instrument by their vibrations, but only are of service in putting on the stretch the little bones in the middle ear which convey sound. Some of those advertised do harm by setting up a mechanical irritation in the ear after a time, and a better result is often obtained with a ball of cotton or a paper disc introduced into the ear by an aurist. [Illustration: PLATE II =Plate II= =ANATOMY OF THE EAR= The illustration on the opposite page shows the interior structure of the ear. The concha and =Meatus=, or canal, comprise the external ear, which is separated from the middle ear by the =Drum Membrane=. Wax is secreted by glands located in the lining of the meatus, and should be detached by the motion of the jaws during talking and eating. If it adheres to the drum membrane it causes partial deafness. The internal ear, or labyrinth, a cavity in the bone, back of the middle ear, consists of three parts: the =Cochlea=, the =Semicircular Canals=, and a middle portion, the =Vestibule=. The middle ear is connected with the throat by the =Eustachian Tube=. Sound vibrations, which strike the drum membrane, are conveyed by means of a chain of three small bones through the middle ear to the nervous apparatus of the internal ear. The Eustachian tube and middle ear are lined throughout with mucous membrane, and any severe inflammation of the throat may extend to and involve the tube and the middle ear, causing deafness.] =MODERATE OR SLIGHT EARACHE.=--A slight or moderate earache, which may, however, be very persistent, not sufficient to incapacitate the patient or prevent sleep, is often caused by some obstruction in the Eustachian tube, either by swelling or mucous discharge. This condition gives rise to the train of effects noted in the section on deafness. The air in the middle ear is absorbed to some extent, and therefore the pressure within the ear is less than that outside the drum, so that the latter is pressed inward with the result that pain, and perhaps noises and deafness ensue, and, if the condition is not relieved, inflammation of the middle ear as described above. =Treatment.=--Treatment is directed toward cleaning the back of the nose and reducing swelling at the openings of the Eustachian tubes in this locality, and inflating the tubes with air. A spray of Seiler's solution[3] is thrown from an atomizer through the nostrils, with the head tipped backward, until it is felt in the back of the throat, and after the water has drained away the process is repeated a number of times. This treatment is pursued twice daily, and one hour after the fluid in the nose is well cleared away the Eustachian tubes may be inflated by the patient. To accomplish this the lips are closed tightly, and the nostrils also, by holding the nose; then an effort is made to blow the cheeks out till air is forced into the tubes and is felt entering both ears. This act is attended with danger of carrying up fluid into the tubes and greatly aggravating the condition, unless the water from the spray has had time to drain away. Blowing the nose, as has been pointed out, is unwise, but the water may be removed to some extent by "clearing the throat." The reduction of swelling at the entrance of the Eustachian tube in the back of the nose can be properly treated only by an expert, as some astringent (glycerite of tannin) must be applied on cotton wound on a curved applicator, and the instrument passed above and behind the roof of the mouth into the region back of the nose. Rubbing the parts just in front of the external opening into the ear with the tip of one finger for a period of a few minutes several times a day will also favor recovery in this trouble. FOOTNOTES: [1] See p. 49. [2] Caution. Ask the doctor first. [3] Tablets for the preparation of Seiler's solution are to be found at most druggists. CHAPTER II =The Nose and Throat= _Cold in the Head--Mouth-Breathing--Toothache--Sore Mouth--Treatment of Tonsilitis--Quinsy--Diphtheria._ =NOSEBLEED.=--Nosebleed is caused by blows or falls, or more frequently by picking and violently blowing the nose. The cartilage of the nasal septum, or partition which divides the two nostrils, very often becomes sore in spots, owing to irritation of dust-laden air, and these crust over and lead to itching. Then "picking the nose" removes the crusts, and frequent nosebleed results. Nosebleed also is common in both full-blooded and anæmic persons; in the former because of the high pressure within the blood vessels, in the latter owing to the thin walls of the arteries and capillaries which readily rupture. Nosebleed is again an accompaniment of certain general disorders, as heart disease and typhoid fever. The bleeding comes usually from one nostril only, and is a general oozing from the mucous membrane, or more commonly flows from one spot on the septum near the nostril, the cause of which we have just noted. The blood may spout forth in a stream, as after a blow, or trickle away drop by drop, but is rarely dangerous except in infants and aged persons with weak blood vessels. In the case of the latter the occurrence of bleeding from the nose is thought to indicate brittle vessels and a tendency to apoplexy, which may be averted by the nosebleed. This is uncertain. If nosebleed comes on at night during sleep, the blood may flow into the stomach without the patient's knowledge, and on being vomited may suggest bleeding from the stomach. =Treatment.=--The avoidance of excitement and of blowing the nose, hawking, and coughing will assist recovery. The patient should sit quietly with head erect, unless there is pallor and faintness, when he may lie down on the side with the head held forward so that the blood will flow out of the nose. There is no cause for alarm in most cases, because the more blood lost the more readily does the remainder clot and stop bleeding. As the blood generally comes from the lower part of the partition separating the nostrils, the finger should be introduced into the bleeding nostril and pressure made against this point, or the whole lower part of the nose may be simply compressed between the thumb and forefinger. If this does not suffice a lump of ice may be held against the side of the bleeding nostril, and another placed in the mouth. The injection into the nostril of ice water containing a little salt is sometimes very serviceable in stopping nosebleed. Blowing the nose must be avoided for some time after the bleeding ceases. If none of these methods arrest the bleeding the nostril must be plugged. A piece of clean cotton cloth, about five inches square, should be pushed gently but firmly into the nostril with a slender cylinder of wood about as large as a slate pencil and blunt on the end. This substitute for a probe is pressed against the center of the cloth, which folds about the stick like a closed umbrella, and the cotton is pressed into the nostril in a backward and slightly downward direction, for two or three inches, while the head is held erect. Then pledgets of cotton wool are packed into the bag formed by the cotton cloth after the stick is withdrawn. The mouth of the bag is left projecting slightly from the nostril, so that the whole can be withdrawn in twenty-four hours. The bleeding nostril may be more readily plugged by simply pressing into it little pledgets of cotton with a slender stick, but it would be impossible for an unskilled person to get them out again, and a physician should withdraw them inside of forty-eight hours. =FOREIGN BODIES IN THE NOSE.=--Children often put foreign bodies in their nose, as shoe buttons, beans, and pebbles. They may not tell of it, and the most conspicuous symptoms are the appearance of a thick discharge from one nostril, having a bad odor, and some obstruction to breathing on the same side. If the foreign body can be seen, the nostril on the unobstructed side should be closed and the child made to blow out of the other one. If blowing does not remove the body it is best to secure medical aid very speedily. [Illustration: PLATE III =Plate III= =THE NASAL CAVITY= In the illustration on the opposite page, the =Red Portion= indicates the =Septum= of the nose, the partition which separates the nostrils. Inflammation of the membrane lining the nasal cavity is the condition peculiar to catarrh or "cold in the head." Deformity of the septum may obstruct the entrance of air into the nose and create suction on the walls of the nasal cavity, causing an overfilling of the blood vessels, or "congestion," with subsequent thickening of the mucous membrane. Polypi, small growths which form in the nose, or enlargement of the glands in the upper part of the throat (just beyond dotted line at inner edge of red portion) also block the air passages and give rise to mouth-breathing and its attendant disorders. Another cause of mouth-breathing is extreme swelling of the membrane which covers the turbinated bones of the nose.] =COLD IN THE HEAD FROM OVERHEATING.=--Chilling of the surface of the body favors the occurrence of colds, in which lowered bodily vitality allows the growth of certain germs always present upon the mucous membrane lining the cavities of the nose. Dust and irritating vapors also predispose to colds. Overwarm clothing makes a person susceptible to colds, while the daily use of cold baths is an effective preventive. There is no sufficient reason for dressing more warmly in a heated house in winter than one would dress in summer. It is, moreover, unwise to cover the chest more heavily than the rest of the body. Some one has wisely said: "The best place for a chest protector is on the soles of the feet." The rule should always be to keep the feet dry and warm, and adapt the clothing to the surrounding temperature. Among the germs which cause colds in the head, that of pneumonia is the one commonly found in the discharge from the nose. When pneumonia is epidemic it is therefore wise to take extra precautions to avoid colds, and care for them when they occur. The presence of chronic trouble in the throat and nose, such as described under Mouth-Breathing, Adenoids, etc. (p. 60), is perhaps the most frequent cause of colds, because the natural resistance of the healthy mucous membrane to the attack of germs is diminished thereby, and the catarrhal secretions form a source of food for the germs to grow upon. It should also be kept in mind that cold in the head is the first sign of measles and of _grippe_. Colds are more common in the spring and fall. =Symptoms.=--Colds begin with chilliness and sneezing, and, if severe, there may be also headache, fever, and pain in the back and limbs, as in _grippe_. The nose at first feels dry, but soon becomes more or less stopped with secretion. The catarrh may extend from the back of the nose through the Eustachian tube to the ear, causing earache, noises in the ear, and deafness (see p. 41). This unfortunate result may be averted by proper spraying of the nose, and avoidance of blowing the nose violently. =Treatment.=--Treatment must be begun at the first suspicion of an attack to be of much service. The bowels should be opened with calomel or other cathartic; two-fifths of a grain for an adult, half a grain for a child. Rest in bed for a day or two, after taking a hot bath and a glass of hot lemonade containing a tablespoonful or two of whisky, is the most valuable treatment. The Turkish bath is also very efficacious in cutting short colds, but involves great risk of increasing the trouble unless the patient can return home in a closed carriage directly from the bath. Of the numerous remedies which are commonly used to arrest colds in the first stages are two which possess special virtue; namely, quinine and Dover's powder, given in single dose of ten grains of each for an adult. Both of these remedies may be taken, but while the Dover's powder is most effective it is often necessary for the patient to remain in bed twelve to eighteen hours after taking it on account of nausea and faintness which would be produced if the patient were up and moving about. Rhinitis tablets should never be used. They are generally abused, and, indeed, some fatal cases are on record in which they caused death. Drugs are of little value except in the beginning of a cold, when they are given with the hope of cutting short an attack. The local applications of remedies to the inflamed region is of service. At the onset of the cold, Seiler's solution (conveniently made from tablets which are sold in the shops) or Dobell's solution should be sprayed from an atomizer, into the nostrils, every half hour, and, when the discharge becomes thick and copious, this is to be discarded for a spray consisting of alboline (four ounces) and camphor and menthol (each thirty grains), used in the same manner as long as the cold lasts. Containing bottles should be stood in hot water, in order that all sprays for the nostrils may be used warm. It is well to give babies a teaspoonful of castor oil and a warm bath, and keep them in bed. If there is fever with the cold, five drops of sweet spirit of niter may be given in a teaspoonful of sweetened water every two hours. Liquid vaseline, or the alboline mixture advised for adults, may be dropped into the nostrils with a medicine dropper more conveniently than applied by spray. =TOOTHACHE.=--When there is a cavity in an aching tooth it should be cleaned of food, and a little pledget of cotton wool wrapped on a toothpick may be used to wipe the cavity dry. Then the cavity should be loosely packed, by means of a toothpick or one prong of a hairpin, with a small piece of absorbent cotton rolled between the fingers and saturated with one of the following substances, preferably the first: oil of cloves, wood creosote or chloroform. If wood creosote is used the cotton must be well squeezed to get rid of the excess of fluid, as it is poisonous if swallowed, and will burn the gum and mouth if allowed to overflow from the tooth. =ALVEOLAR ABSCESS= (_improperly called "Ulcerated Tooth"_).--An "ulcerated tooth" begins as an inflammation in the socket of a tooth, and, if near its deepest part, causes great pain, owing to the fact that the pus formed can neither escape nor expand the unyielding bony wall of the socket. This explains why an abscess near the tooth is so much more painful than a similar one of soft parts. There may be no cavity in the tooth, but the tooth is commonly dead, or its nerve is dying, and the tooth is frequently darker in color. It often happens that threatened abscess at the root of a tooth, which has been filled, can be averted by a dentist's boring down into the root of the tooth, or removing the filling. It is not always possible to locate the troublesome tooth, from the pain, but by tapping on the various teeth in turn with a knife, or other metal instrument, special soreness will be discovered in the "ulcerated" tooth. The ulcerated tooth frequently projects beyond its fellows, and so gives pain when the jaws are brought together in biting. =Treatment.=--The treatment for threatened abscess near a tooth consists in painting tincture of iodine, with a camel's hair brush, upon the gum at the root of the painful tooth, and applying, every hour or so, over the same spot a toothache plaster (sold by all druggists). The gum must be wiped dry before applying the moistened toothache plaster. Water, as hot as can be borne, should be held in the mouth, and the process repeated for as long a time as possible. Then the patient should lie with the painful side of the face upon a hot-water bag or bottle. The trouble may subside under this treatment, owing to disappearance of the inflammation, or to the unnoticed escape of a small amount of pus through a minute opening in the gum. If the inflammation continues the pain becomes intense and throbbing; there is often entire loss of sleep and rest, fever, and even chills, owing to a certain degree of blood poisoning. The gum and face swell on the painful side, and the patient often suffers more than with many more serious diseases. After several days of distress, the bony socket of the tooth gives way, and the pus makes its exit, and, bulging out the gum, finally escapes through this also, to the immediate relief of the patient. But serious results sometimes follow letting nature alone in such a case, as the pus from an eyetooth may burrow its way into the internal parts of the upper jaw, or into the chambers of the nose, while that from a back tooth often breaks through the skin on the face, leaving an ugly scar, or, if in the lower jaw, the pus may find its way between the muscles of the neck, and not come to the surface till it escapes through the skin above the collar bone. Pulling the tooth is the most effective way of relieving the condition, the only objection being the loss of the tooth, which is to be avoided if possible. If the pain is bearable and there are no chills and fever, the patient may save the tooth by remaining in bed with a hot-water bottle continually on the face, and taking ten drops of laudanum to relieve the pain at intervals of several hours. Then many hours of suffering may be prevented if the gum is lanced with a sharp knife (previously boiled for five minutes) as soon as the gum becomes swollen, to allow of the escape of pus. The dentist is, of course, the proper person to consult in all cases of toothache, and the means herein suggested are to be followed only when it is impossible to obtain his services. =MOUTH-BREATHING= (_including Adenoids, Chronic Tonsilitis, Deviation of the Nasal Septum, Enlarged Turbinates, and Polypi_).--Any obstruction in the nose causes mouth-breathing and gives rise to one or more of a long train of unfortunate results. Among the disorders producing mouth-breathing, enlargement of the glandular tissue in the back of the nose and in the throat of children is most important. Glandular growths in the upper part of the throat opposite the back of the nasal cavities are known as "adenoids"; they often completely block the air passage at this point, so that breathing through the nose becomes difficult. Associated with this condition we usually see enlargement of the tonsils, two projecting bodies, one on either side of the entrance to the throat at the back of the mouth. In healthy adult throats the tonsils should be hardly visible; in children they are active glands and easily visible. We are unable to see adenoids because of their position, but can be reasonably sure of their presence in children where we find symptoms resulting from mouth-breathing as described below. The surgeon assures himself positively of the existence of adenoids by inserting a finger into the mouth of the patient and hooking it up back of the roof of the mouth, when they may be felt as a soft mass filling the back of the nose passages. Other less common causes of mouth-breathing, seen in adults as well as children, are deviation of the nasal septum, swelling of the mucous membrane covering certain bones in the nose (turbinates), and polypi. Deviation of the nasal septum means displacement of the partition dividing the two nostrils, so that more or less obstruction exists. This condition may be occasioned by blows on the nose received in the accidents common to childhood. The deformity which results leads in time to further obstruction in the nose, because when air is drawn in through the narrowed passages a certain degree of vacuum is produced and suction on the walls of the nose, as would occur if we drew in air from a large pair of bellows through a small thin rubber tube. This induces an overfilling of the blood vessels in the walls of the passages of the nose, and the continued congestion is followed by increased thickness of the lining mucous membrane, thus still further obstructing the entrance of air. A one-sided nasal obstruction in a child with discharge from that side leads one to suspect that a foreign body, as a shoe button, has been put in by the child. Polypi are small pear-shaped growths which form on the membrane lining the nasal passages and sometimes completely block them. They resemble small grapes without skins. These, then, are the usual causes of mouth-breathing, but of most importance, on account of their frequency and bearing on the health and development, are adenoids and enlarged throat tonsils in children. Adenoids and enlarged tonsils are often due to inflammation of these glands during the course of the contagious eruptive disorders, as scarlet fever, measles, or diphtheria; probably, also, to constant exposure to a germ-laden atmosphere, as in the case of children herded together in tenements. =Symptoms.=--The mouth-breathing is more noticeable during sleep; snoring is common, and the breathing is of a snorting character with prolonged pauses. Children suffering from enlarged tonsils and adenoids are often backward in their studies, look dull, stupid, and even idiotic, and are often cross and sullen; the mouth remains open, and the lower lip is rolled down and prominent; the nose has a pinched aspect, and the roof of the mouth is high. Air drawn into the lungs should be first warmed and moistened by passing through the nose, but when inspired through the mouth, produces so much irritation of the throat and air passages that constant "colds," chronic catarrh of the throat, laryngitis, and bronchitis ensue. The constant irritation of the throat occurring in mouth-breathers weakens the natural resistance against such diseases as acute tonsilitis, scarlet fever, and diphtheria, so that they are especially subject to these diseases. But these are not the only ailments to which the mouth-breather is liable, for earache and deafness naturally follow the catarrh, owing to obstruction of the Eustachian tubes (see Earache, p. 40, and Deafness, p. 38). Deformity of the chest is another result of obstruction to nose-breathing, the common form being the "pigeon breast," where the breastbone is unduly prominent. The voice is altered so that the patient, as the saying goes, "talks through the nose," although, in reality, nasal resonance is reduced and difficulty is experienced in pronouncing N and M correctly, while stuttering is not uncommon. Nasal obstruction leads to poor nutrition, and hence children with adenoids and enlarged tonsils are apt to be puny and weakly specimens. =Treatment.=--The treatment is purely surgical in all cases of nasal obstruction: removal of the adenoid growths, enlarged tonsils, and polypi, straightening the displaced nasal septum, and burning the thickened mucous lining obstructing the air passages in the nose. None of the operations are dangerous if skillfully performed, and should be generally done, even in the case of delicate children, as the very means of overcoming this delicacy. The after treatment is not unimportant, consisting in the use of simple generous diet, as plenty of milk, bread and butter, green vegetables and fresh meat, and the avoidance of pastries, sweets, fried food, pork, salt fish and salt meats, also the roots, as parsnips, turnips, carrots and beets, and tea and coffee. Life in the open air, emulsion of cod-liver oil, daily sponging with cold water while the patient stands in warm water, followed by vigorous rubbing, will all assist the return to health. =SORE MOUTH; INFLAMMATION OF THE MOUTH.=--There are various forms of inflammation of the mouth, generally dependent upon the entrance of germs, associated with indigestion or general weakness following some fever or other disease. Unclean nipples of the mother or of the bottle, or unclean bottles, allow entrance of germs, and are frequent causes. Irritation of a sharp tooth, or from rubbing the gum, or from too vigorous cleansing of the mouth, may start the disease. Some chemicals, especially mercury improperly prescribed, produce the disease. The germs may gain admission in impure milk in some cases. Inflammation of the mouth is essentially a children's disease, only the ulcerated form being common in adults. =Symptoms.=--In general, the mouth is hot, very red, dry, and tender; the child is fretful and has difficulty in nursing, often dropping the nipple and crying; the tongue is coated, and there may be fever and symptoms of indigestion, as vomiting; sometimes the disease occurs during the course of fevers; later in the course of the disorder the saliva often runs freely from the mouth. =Simple Form.=--In this there are only redness, swelling, and tenderness of the inside of the mouth. The tongue is at first dry and white, but the white coating comes off, leaving it red in patches. After a while the saliva becomes profuse. The treatment consists in washing the mouth often in ice water containing about one-half drachm of boric acid to four ounces of water by means of cotton tied on a stick, and holding lumps of ice in the mouth wrapped in the corner of a handkerchief. It is well also to give a teaspoonful of castor oil. =Aphthous Form.=--In this there are yellow-white spots, resulting in little shallow depressions or ulcers, on the inside of the cheeks and lips, and on the tongue and roof of the mouth. These occur in crops and last from ten to fourteen days. The disease is often preceded by vomiting, constipation, and fever, with pain in the mouth and throat, and is accompanied by lumps or swelling of the glands under the jaw and in the neck. The treatment consists in the use of castor oil, and swabbing the mouth, several times a day, after each feeding, with boric-acid solution, as advised before, or better with permanganate of potash solution, using ten grains to the cup of water. =Thrush= (_Sprue_).--This form is due to the growth of a special fungus in the mouth, causing the appearance of white spots on the inside of the cheeks, lips, tongue, and roof of the mouth, looking like flakes of curdled milk, but not easily removed. There are also symptoms of indigestion, as vomiting, diarrhea, and colic. The disease is contagious, and is due to some uncleanliness, often of the bottles, nipples, or milk. Sometimes ulcers or sore depressions are left in the mouth, and in weak children, in which the disease is apt to occur, the result may be serious, and a physician's services are demanded. The treatment consists in applying saleratus and water (one teaspoonful in a cup of water) to the whole inside of the mouth, between feedings, with a camel's-hair brush or with a soft cloth. A dose of castor oil is also desirable, and great care as regards cleanliness of the bottles and nipples should be exercised. =Ulcerous Form.=--This does not occur in children under five, but may attack persons of all greater ages. It is often seen following measles and scarlet fever, and in the poor and ill nourished, and after the unwise use of calomel. There are redness and swelling of the gum about the base of the lower front teeth, and the gums bleed easily. Matter, or pus, forms between the teeth and the gum, and the mouth has a foul odor. The gum on the whole lower jaw may become inflamed, and a yellow band of ulceration may appear along the gums. The glands under the jaw and in the neck are enlarged, feeling like tender lumps, and saliva flows freely. In severe cases the gums may become destroyed and eaten away by the ulceration, and the bone of the jaw be diseased and exposed. As in the graver cases it may become necessary to remove dead bone and teeth, and the very dangerous form next described may sometimes follow it, it will be seen that it is a disease requiring skilled medical attention. The treatment consists in using, as a mouth wash and gargle, a solution of chlorate of potash (fifteen grains to the ounce) every two hours. Cases usually last at least a week. =Gangrenous Form.=--This is a rare and fatal form of inflammation of the mouth and occurs in children weak and debilitated from other diseases, as from the contagious eruptive fevers, chronic diarrhea, and scurvy. It is seen more often in hospitals and is contagious. A foul odor is noticed about the mouth, in which will be seen an ulcer on the gum or inside of the cheek. The cheek swells tremendously, with or without pain, and becomes variously discolored--red, purple, black. The larger proportion of patients die of exhaustion and blood poisoning within one to three weeks, and the only hope is through surgical interference at the earliest possible moment. =CANKER.=--A small, shallow, yellow ulcer, appearing on the inside of the lips or beneath the tongue during some disorder of the digestion. It is very tender when touched and renders chewing or talking somewhat painful. Treatment consists of touching the ulcer carefully with the point of a wooden toothpick which has been dipped in pure carbolic acid (a poison) and then rinsing the resulting white spot and the whole mouth very carefully, so as not to swallow any of the acid. Inflammation of the mouth occurs in two other general diseases, in syphilis and rarely in diphtheria. In children born of syphilitic parents, deep cracks often appear at either side of the mouth and do not heal as readily as ordinary sores, but continue a long time, and eventually leave deep scars. In diphtheria the membrane which covers the tonsils sometimes spreads to the cheeks, tongue, and lips, but in either case the general symptoms will serve to distinguish the diseases, and neither can be treated by the layman. =MILD SORE THROAT= (_Acute Pharyngitis_).--The milder sore throat is commonly the beginning of an ordinary cold, although sometimes it is caused by digestive disorders. Exposure to cold and wet is, however, the most frequent source of this form of sore throat. Soreness, dryness, and tickling first call attention to the trouble, together with a feeling of chilliness and, perhaps, slight fever. There may be some stiffness and soreness about the neck, owing to swelling of the glands. If the back of the tongue is held down by a spoon handle, the throat will be seen to be generally reddened, including the back, the bands at the side forming the entrance to the throat at the back of the mouth, and the uvula or small, soft body hanging down from the middle of the soft palate at the very back of the roof of the mouth. The tonsils are not large and red nor covered with white dots, as in tonsilitis. Neither is there much pain in swallowing. The surface of the throat is first dry, glistening, and streaked with stringy, sticky mucus. =Treatment.=--The disorder rarely lasts more than a few days. The bowels should be moved in the beginning of the attack by some purge, as two compound cathartic pills or three grains of calomel, and the throat gargled, six times daily, with potassium chlorate solution (one-quarter teaspoonful to the cup of water), or with Dobell's solution. In gargling, simply throw back the head and allow the fluid to flow back as far as possible into the throat without swallowing it. The frequent use of one of these fluids in an atomizer is even preferable to gargling. As an additional treatment, the employment of a soothing and pleasant substance, as peppermints, hoarhound or lemon drops, or marshmallows or gelatin lozenges, is efficacious, and will prove an agreeable remedy to the patient in sad contrast with many of our prescriptions. The use of tobacco must be stopped while the throat is sore. [Illustration: PLATE IV =Plate IV= =THE LARYNX= The illustration on the opposite page shows the upper part of the larynx and the base of the tongue. During the inspiration of a full breath, or when singing a low note, the =Epiglottis= lies forward and points upward, as shown in the cut, with the glottis (the passage leading into the windpipe between the vocal cords) wide open. During the act of swallowing, the epiglottis is turned downward and backward until it touches the =Cricoid Cartilage=, thus closing the glottis. The cricoid cartilage, which forms the upper part of the framework of the larynx, rests on the "Adam's apple." The =False Vocal Cords= are bands of ligament, and take no part in the production of sound. The =True Vocal Cords= move during talking or singing, and relax or contract when sounding, respectively, a low or high note. Hoarseness and cough occurring during laryngitis, diphtheria, and croup, are the result of inflammation of the mucous membrane lining the larynx.] =TONSILITIS= (_Follicular Tonsilitis_).--Tonsilitis is a germ disease and is contagious. Exposure to cold and wet and to germ-laden air renders persons more liable to attacks. It is more likely to occur in young people, especially those who have already suffered from the disease and whose tonsils are chronically enlarged, and is most prevalent in this country in spring. The disease appears to be often associated with rheumatism. Tonsilitis begins much like _grippe_, with fever, headache, backache and pain in the limbs, sore throat, and pain in swallowing. On inspecting the throat (with the tongue held down firmly by a spoon handle and the mouth widely open in a good light, preferably sunlight) the tonsils will be seen to be swollen, much reddened, and dotted over with pearl-white spots. Sometimes only one tonsil is so affected, but the other is likely to become inflamed also. Occasionally there may be only one spot of white on the tonsil. The swelling differs in degree; in some cases the tonsils may be so swollen as almost to meet together, but there is no danger of suffocation from obstruction of the throat, as occurs in diphtheria and very rarely in quinsy. The characteristic appearance then consists in large, red tonsils covered with white spots. The spots represent discharge which fills in the depressions in the tonsil. The fever lasts three days to a week, generally, and then subsides together with the other symptoms. With apparent tonsilitis there must always be kept in mind the possibility of diphtheria, and, unfortunately, it is at times impossible for the most acute physician to distinguish between these two diseases by the appearances of the throat alone. In order to do so it is necessary to rub off some of the discharge from the tonsils, and examine, microscopically, the kind of germs contained therein. The general points of difference are: in diphtheria the tonsils are usually completely covered with a gray membrane. In the early stage, or in mild cases of diphtheria, there may be only a spot on one tonsil, but it is apt to be yellow in color, and is thicker than the white spots in tonsilitis. These are the difficult cases. Ordinarily, in diphtheria, not only are the tonsils covered with a grayish membrane, but this soon extends to the surrounding parts of the throat, whereas in tonsilitis the spots are always found on the tonsil alone. The white spot can be readily wiped off with a little absorbent cotton wound on a stick, in the case of tonsilitis, but in diphtheria the membrane can be removed in this way only with difficulty, and leaves underneath a rough, bleeding surface. The breath is apt to have a bad odor in diphtheria, and the temperature is lower (not much over 100° F.) than in tonsilitis, when it is frequently 101° to 103° F. Notwithstanding these points, it is never safe for a layman to undertake the diagnosis when a physician's services are obtainable. On the other hand, when this is not possible and the patient's tonsils present the white, dotted appearance described, especially if subject to similar attacks, one may be reasonably sure that the case is tonsilitis. =Treatment.=--The patient should be put to bed and kept apart from children and young persons, and, if living among large numbers of people, should be strictly quarantined. For, although the disease is not dangerous, it quickly spreads in institutions, boarding schools, etc. If the tonsils are painted with a solution of silver nitrate (one drachm to the ounce of water), applied carefully with a camel's-hair brush, at the beginning of the attack, and making two applications twelve hours apart, the disease may sometimes be arrested. It is well also at the start to open the bowels with calomel, giving three grains in a single dose, or divided doses of one-half grain each until three grains have been taken. Pain is relieved by phenacetin in three- to five-grain doses as required, but not taken oftener than once in three hours, while at night five to ten grains of Dover's powder (for an adult) will secure sleep. For children one-half drop doses of the (poisonous) tincture of aconite is preferable to phenacetin. The outside of the throat should be kept covered with wet flannel wrung out in cold water and covered with oil silk, or an ice bag may be conveniently used in its place. A half teaspoonful of the following prescription is beneficial unless it disagrees with the stomach. It must not be taken within half an hour of a meal, and is not to be diluted with water, as it acts, partly through its local effect, on the tonsils when allowed to flow from a spoon on the back of the tongue. [Rx] Glycerin 4 ounces Tincture of chloride of iron 1/2 ounce Mix. Directions, half teaspoonful every half hour. A mixture of hydrogen dioxide, equal parts, with water can also be used to advantage as a spray in an atomizer every two hours. The phenacetin and Dover's powder must be discontinued as soon as the pain and sleeplessness cease, but the iron preparation and spray should be continued until the throat regains its usual condition. A liquid diet is desirable during the first part of the attack, consisting of milk, cocoa, eggnog (made of the white of egg), soups, and gruels; orange juice may be allowed, also grapes. The bowels must be kept regular with mild remedies, as a Seidlitz powder in a glass of water in the morning, or one or two two-grain tablets of extract of cascara sagrada at night. =QUINSY.=--Quinsy is a peritonsilitis; that is, it is an inflammatory disease of the tissues in which the tonsil is imbedded, an inflammation around the tonsil. The swelling of these tissues thrusts the tonsil out into the throat; but the tonsil is little affected. Quinsy involves the surrounding structures of the throat, and usually results in abscess. The disease is said to be frequently hereditary, and often occurs in those subject to rheumatism and gout. It is seen more often in spring and autumn and in those living an out-of-door existence, and having once had quinsy the victim is liable to frequent recurrences of the disease. Quinsy is characterized by much greater pain in the throat and in swallowing than is the case in tonsilitis, and the temperature is often higher--sometimes 104° to 105° F. When the throat is inspected, one or both tonsils are seen to be enlarged and crowded into its cavity from the swelling of the neighboring parts. The tonsils may almost block the entrance to the throat. The voice is thick and indistinct, the glands in the side of the neck become swollen, and the neck is sore and stiff in consequence, while the mouth can be only partially opened on account of pain. For the same reason the patient can swallow neither solid nor liquid food, and sits bent forward, with saliva running out of the mouth. The secretion of saliva is increased, but is not swallowed on account of the pain produced by the act. Sleep is also impossible, and altogether a more piteous spectacle of pain and distress is rarely seen. Having reached this stage the inflammation usually goes on to abscess (formation behind or above or below the tonsil), and, after five to ten days from the beginning of the attack, the pus finds its way to the surface of the tonsil, and breaks into the mouth to the inexpressible relief of the patient. This event is followed by quick subsidence of the symptoms. Quinsy is rarely a dangerous disease, yet, occasionally, it leads to so much obstruction in the throat that death from suffocation ensues unless a surgeon opens the throat and inserts a tube. Occasionally the pus from the ruptured abscess enters the larynx and causes suffocation. Quinsy differs from tonsilitis in the following respects: the swelling affects the immediate surrounding area of the throat; there are no white spots to be seen on the tonsil unless the trouble begins as an ordinary tonsilitis; there is great pain on swallowing, and finally abscess near the tonsil in most cases. =Treatment.=--A thorough painting of the tonsils at the onset of a threatened attack of quinsy with the silver-nitrate solution, as recommended under tonsilitis, may cut short the disorder. A single dose of calomel (three to five grains) is also useful for the same purpose. The tincture of aconite should be taken hourly in three-drop doses until five such have been swallowed, when the drug is to be no longer used. The constant use of a hot flaxseed poultice (as large as the whole hand and an inch thick, spread between thin layers of cotton and applied as hot as can be borne, and changed every half hour) gives more relief than anything else, and may possibly lead to disappearance of the trouble if employed early enough. The use of the poultices is to be kept up until recovery, although they need not be applied so frequently as at first. A surgeon's services are especially desirable in this disorder, as early puncture of the peritonsillar tissue may save days of suffering in affording exit for pus as soon as it forms. =DIPHTHERIA.=--The consideration of diphtheria will be limited to emphasizing the importance of calling in expert medical advice at the earliest possible moment in suspicious cases of throat trouble. For, as we noted under tonsilitis, it is impossible in some cases to decide, from the appearance of the throat, whether the disease is diphtheria or tonsilitis. A specimen of secretion removed from the throat for microscopical examination by a bacteriologist as to the presence of diphtheria germs alone will determine the point. When such an examination is impossible, it is always best to isolate the patient, especially if a child, and treat the case as if it were diphtheria. Diphtheria may invade the nose and be discoverable in the nostrils. A chronic membranous rhinitis should be treated as a case of walking diphtheria. Antitoxin is the treatment above all other remedies. It has so altered the outlook in diphtheria that, formerly regarded by physicians with alarm and dismay, it is now rendered comparatively harmless. The death rate has been reduced from an average of about forty per cent, before the introduction of antitoxin, to only ten per cent since its use, and, when it is used at the onset of the disease, the results are much more favorable still. This latter fact is the reason for obtaining medical advice at the earliest opportunity in all doubtful cases of throat ailments; and, we might add, that the diagnosis of any case of sore throat is doubtful, particularly in children, whenever there is seen a whitish, yellowish-white, or gray deposit on the throat. Antitoxin is an absolutely safe remedy, its ill effects being sometimes the production of a nettlerash or some mild form of joint pains. In small doses, it will prevent the occurrence of diphtheria in those exposed, or liable to exposure, to the disease. The proper dose and method of employing antitoxin it is impossible to impart in a book of this kind. Paralysis of throat, of vocal cords, or of arms or legs--partial or entire--is a frequent sequel of diphtheria. It is not caused by antitoxin. The points which it is desirable for everyone to know are, that any sore throat--with only a single white spot on the tonsil--may be diphtheria, but that when the white spot or deposit not only covers the tonsil or tonsils (see Tonsilitis) but creeps up on to the surrounding parts, as the palate (the soft curtain which shuts off the back of the roof of mouth from the throat), the uvula (the little body hanging from the middle of the palate in the back of the mouth), and the bands on either side of the back of the mouth at its junction with the throat, then the case is probably one of diphtheria. But it is often a day or two before the white deposit forms, the throat at first being simply reddened. The fever in diphtheria is usually not high (often not over 100° to 102° F.), and the headache, backache, and pains in the limbs are not so marked as in tonsilitis. =MEMBRANOUS CROUP.=--Membranous croup is diphtheria of the lower part of the throat (larynx), in the region of the Adam's apple. If in a case of what appears to be ordinary croup (p. 83) the symptoms are not soon relieved by treatment, or if any membrane is coughed up, or if, on inspection of the throat, it is possible to see any evidence of white spots or membrane, then a physician's services are imperative. It is not very uncommon for patients with mild forms of diphtheria to walk about and attend to their usual duties and, if children, to go to school, and in that inviting field to spread the disease. These cases may present a white spot on one tonsil, or in other cases have what looks to be an ordinary sore throat with a simple redness of the mucous membrane. Sore throats in persons who have been in any way exposed to diphtheria, and especially sore throats in children under such circumstances, should always be subjected to microscopical examination in the way we have alluded to before, for the safety of both the patient and the public. There is still another point perhaps not generally known and that is the fact that the germs of diphtheria may remain in the throat of a patient for weeks, and even months, after all signs in the throat have disappeared and the patient seems well. In such cases, however, the disease can still be communicated in its most severe form to others. Therefore, in all cases of diphtheria, examination of the secretion in the throat must show the absence of diphtheria germs before the patient can rightfully mix with other people. Gargling and swabbing the throat with the (poisonous) solution of bichloride of mercury, 1 part to 10,000 parts of water (none of which must be swallowed), should be employed every three or four hours each day till the germs are no longer found in the mucus of the tonsils. =HOARSENESS= (_Acute Laryngitis_).--This is an acute inflammation of the mucous membrane of the larynx. The larynx is that part of the throat, in the region of the Adam's apple, which incloses the vocal cords and other structures used in speaking. Hoarseness is commonly due to extension of catarrh from the nose in cold in the head and _grippe_. It also follows overuse of the voice in public speakers and singers, and is seen after exposure to dust, tobacco, or other smoke, and very commonly in those addicted to alcohol. =Symptoms.=--Hoarseness is the first symptom noticed, and perhaps slight chilliness, together with a prickling or tickling sensation in the throat. There is a hacking cough and expectoration of a small amount of thick secretion. There may be slight difficulty in breathing and some pain in swallowing. The patient feels generally pretty well, and is troubled chiefly by impairment of the voice, which is either husky, reduced to a mere whisper, or entirely lost. This condition lasts for some days or, rarely, even weeks. There may be a mild degree of fever at the outset (100° to 101° F.). Very uncommonly the breathing becomes hurried and embarrassed, and swallowing painful, owing to excessive swelling and inflammation of the throat, so much so that a surgeon's services become imperative to intube the throat or to open the windpipe, in order to avoid suffocation. This serious form of laryngitis may follow colds, but more often is brought about by swallowing very hot or irritating liquids, or through exposure to fire or steam. In children, after slight hoarseness for a day or two, if the breathing becomes difficult and is accompanied by a crowing or whistling sound, with blueness of the lips and signs of impending suffocation, the condition is very suggestive of membranous croup (a form of diphtheria), which certainly is the case if any white, membranous deposit can be either seen in the throat or is coughed up. Whenever there is difficulty of breathing and continuous hoarseness, in children or adults, the services of a competent physician are urgently demanded. =Treatment.=--The use of cold is of advantage. Cracked ice may be held in the mouth, ice cream can be employed as part of the diet, and an ice bag may be applied to the outside of the throat. The application of a linen or flannel cloth to the throat wrung out of cold water and covered with oil silk or waterproof material, is also beneficial, and often more convenient than an ice bag. The patient must absolutely stop talking and smoking. If the attack is at all severe, he should remain in bed. If not so, he must stay indoors. At the beginning of the disorder a teaspoonful of paregoric and twenty grains of sodium bromide are to be taken in water every three hours, by an adult, until three doses are swallowed. Inhalation of steam from a pitcher containing boiling water is to be recommended. Fifteen drops of compound tincture of benzoin poured on the surface of a cup of boiling water increases the efficacy of the steam inhalation. The head is held above the pitcher, a towel covering both the head and pitcher to retain the vapor. The employment, every two hours, of a spray containing menthol and camphor (of each, ten grains) dissolved in alboline (two ounces) should be continued throughout the disease. If the hoarseness persists and tends to become chronic, it is most advisable for the patient to consult a physician skilled in such diseases for local examination and special treatment. =CROUP.=--Croup is an acute laryngitis of childhood, usually occurring between the ages of two and six years. The nervous element is more marked than in adults, so that the symptoms appear more alarming. The trouble frequently arises as part of a cold, or as a forerunner of a cold, and often is heralded by some hoarseness during the day, increasing toward night. The child may then be slightly feverish (temperature not over 102° F., usually). The child goes to bed and to sleep, but awakens, generally between 9 and 12 P.M., with a hard, harsh, barking cough (croupy cough) and difficulty in breathing. The breathing is noisy, and when the air is drawn into the chest there is often a crowing or whistling sound produced from obstruction in the throat, due to spasm of the muscles and to dried mucus coating the lining membrane, or to swelling in the larynx. It is impossible to separate these causes. The child is frightened, as well as his parents, and cries and struggles, which only aggravates the trouble. The worst part of the attack is, commonly, soon over, so that as a rule the doctor arrives after it is past. While it does last, however, the household is more alarmed than, perhaps, by any other common ailment. Death from an attack of croup, pure and simple, has probably never occurred. The condition described may continue in a less urgent form for two or three hours, and very rarely reappears on following nights or days. The child falls asleep and awakens next morning with evidences of a cold and cough, which may last several days or a week or two. The only other disease with which croup is likely to be confused is membranous croup (diphtheria of the larynx), and in the latter disorder the trouble comes on slowly, with hoarseness for two or three days and gradually increasing fever (103° to 105° F.) and great restlessness and difficulty in breathing, not shortly relieved by treatment, as in simple croup. In fifty per cent of the cases of membranous croup it is possible to see a white, membranous deposit on the upper part of the throat by holding the tongue down with a spoon handle and inspecting the parts with a good light. Croup is more likely to occur in children suffering from adenoids, enlarged tonsils, indigestion, and decayed teeth, and is favored by dry, furnace heat, by exposure to cold, and by screaming and shouting out of doors. =Treatment.=--Place the child in a warm bath (101° F.) and hold a sponge soaked in hot water over the Adam's apple of the throat, changing it as frequently as it cools. Hot camphorated oil rubbed over the neck and chest aids recovery. If the bowels are not loose, give a teaspoonful of castor oil or one or two grains of calomel. The most successful remedies are ipecac and paregoric. It is wise to keep both on hand with children in the house. A single dose of paregoric (fifteen drops for child of two years; one teaspoonful for child of seven years) and repeated doses of syrup of ipecac (one-quarter to one-half teaspoonful) should be given every hour till the child vomits and the cough loosens, and every two hours afterwards. The generation of steam near the child also is exceedingly helpful in relieving the symptoms. A kettle of water may be heated over a lamp. A rubber or tin tube may be attached to the spout of the kettle and carried under a sort of sheet tent, covering the child in bed. The tent must be arranged so as to allow the entrance of plenty of fresh air. Very rarely the character of the inflammation in croup changes, and the difficulty in breathing, caused by swelling within the throat, increases so that it is necessary to employ a surgeon to pass a tube down the throat into the larynx, or to open the child's windpipe and introduce a tube through the neck to prevent suffocation. The patient recovering from croup should generally be kept in a warm, well-ventilated room for a number of days after the attack, and receive syrup of ipecac three or four times daily, until the cough is loosened. If ipecac causes nausea or vomiting, the dose must be reduced. The disease is prevented by a simple diet, especially at night; by the removal of enlarged tonsils and adenoids; by daily sponging, before breakfast, with water as cold as it comes from the faucet, while the child stands, ankle deep, in hot water; and by an out-of-door existence with moderate school hours; also by evaporating water in the room during the winter when furnace heat is used. When children show signs of an approaching attack of croup, give three doses of sodium bromide (five grains for child two years old; ten grains for one eight years old) during the day at two-hour intervals and give a warm bath before bedtime, and rub chest and neck with hot camphorated oil. CHAPTER III =The Lungs and Bronchial Tubes= _Meaning of Bronchitis--Symptoms and Treatment--Remedies for Infants--Pneumonia--Consumption the Great Destroyer--Asthma--La Grippe._ =COUGH= (_occurring in Bronchitis, Pneumonia, Consumption or Tuberculosis, Asthma, and Influenza or Grippe_).--Cough is a symptom of many disorders. It may be caused by irritation of any part of the breathing apparatus, as the nose, throat, windpipe, bronchial tubes, and (in pleurisy and pneumonia) covering membrane of the lung. The irritation which produces cough is commonly due either to congestion of the mucous membrane lining the air passages (in early stage of inflammation of these tissues), or to secretion of mucus or pus blocking them, which occurs in the later stages. Cough is caused by a sudden, violent expulsion of air from the chest following the drawing in of a deep breath. A loose cough is to be encouraged, as by its means mucus and other discharge is expelled from the air passages. A dry cough is seen in the early stages of various respiratory diseases, as bronchitis, pneumonia, pleurisy, consumption, whooping cough, and with irritation from enlarged tonsils and adenoids (see p. 61) occurring in children. Irritation produced by inhaling dust, or any irritation existing in the nose, ear, or throat may lead to this variety of cough. The dry cough accomplishes no good, and if continuous and excessive may do harm, and demands medicinal relief. =Bronchitis.=--Cough following or accompanying cold in the head and sore throat generally means bronchitis. The larynx or lower part of the throat ends just below the "Adam's apple" in the windpipe. The windpipe is about four and a half inches long and three-quarters to an inch in diameter, and terminates by dividing into the two bronchial tubes in the upper part of the chest. Each bronchial tube divides and subdivides in turn like the branches of a tree, the branches growing more numerous and smaller and smaller until they finally end in the microscopic air sacs or air cells of the lungs. The bronchial tubes convey air to the air cells, and in the latter the oxygen is absorbed into the blood, and carbonic acid is given up. Bronchitis is an inflammation of the mucous membrane lining these tubes. In cough of an ordinary cold only the mucous membrane of the windpipe and, perhaps, of the larger tubes is inflamed. This is a very mild disorder compared to inflammation of the smaller and more numerous tubes. In bronchitis, besides the ordinary symptoms of a severe cold in the head, as sneezing, running of mucus from the nose, sore throat and some hoarseness perhaps, and languor and soreness in the muscles, there is at first a feeling of tightness, pressure, and rawness in the region of the breastbone, with a harsh, dry cough. The coughing causes a strain of the diaphragm (the muscle which forms the floor of the chest), so that there are often pain and soreness along the lower borders of the chest where the diaphragm is attached to the inside of the ribs. After a few days the cough becomes looser, greatly to the patient's comfort, and a mixture of mucus and pus is expectorated. In a healthy adult such a cough is usually not in itself a serious affair, and apart from the discomfort of the first day or two, there is not sufficient disturbance of the general health to interfere with the ordinary pursuits. The temperature is the best guide in such cases; if it is above normal (98-3/5° F.) the patient should stay indoors. In infants, young children, enfeebled or elderly people, bronchitis may be a serious matter, and may be followed by pneumonia by extension of the inflammation from the small bronchial tubes into the air sacs of the lungs, and infection with the pneumonia germ. The principal signs of severe attacks of bronchitis are rapid breathing, fever, and rapid pulse. The normal rate of breathing in adults is seventeen a minute, that is, seventeen inbreaths and seventeen outbreaths. In children of one to five years the normal rate is about twenty-six breathing movements a minute. In serious cases of bronchitis the rate may be twenty-five to forty in adults, or forty to sixty in children, per minute. Of course the only exact way of learning the nature of a chest trouble is thorough, careful examination by a physician, for cough, fever, rapid breathing and rapid pulse occur in many other diseases besides bronchitis, particularly pneumonia. Pneumonia begins suddenly, often with a severe chill, headache, and general pains like _grippe_. In a few hours cough begins, short and dry, with violent, stabbing pain in one side of the chest, generally near the nipple. The breathing is rapid, with expanding nostrils, the face is anxious and often flushed. The matter coughed up at first is often streaked with blood, and is thick and like jelly. The temperature is often 104°-105° F. If the disease proceeds favorably, at the end of five, seven, or ten days the temperature, breathing, and pulse become normal suddenly, and the patient rapidly emerges from a state of danger and distress to one of comfort and safety. The sudden onset of pneumonia with chill, agonizing pain in side, rapid breathing, and often delirium with later bloody or rusty-colored, gelatinous expectoration, will then usually serve to distinguish it from bronchitis, but not always. Whenever, with cough, rapid and difficult breathing occur with rise of temperature (as shown by the thermometer) and rapid pulse, the case is serious, and medical advice is urgently demanded. =Treatment of Acute Cough and Bronchitis.=--In the case of healthy adults with a cough accompanying an ordinary cold, the treatment is very simple, when there is little fever or disturbance of the general health. The remedies recommended for cold in the head (p. 55) should be taken at first. It is also particularly desirable for the patient to stay in the house, or better in bed, for the first day or two, or until the temperature is normal. The feeling of tightness and distress in the chest may be relieved by applying a mild mustard paper over the breastbone, or a poultice containing mustard, one part, and flour, three parts, mixed with warm water into a paste and spread between two single thicknesses of cotton cloth about eight inches square. The tincture of iodine painted twice over a similar area forms another convenient application instead of the mustard. If the cough is excessive and troublesome at night the tablets of "ammonium chloride compound with codeine" are convenient. One may be taken every hour or two by an adult, till relieved. Children suffering from a recent cough and fever should be kept in bed while the temperature is above normal. It is well to give infants at the start a grain of calomel or half a teaspoonful of castor oil, and to children of five to eight years double the dose. The chest should be rubbed with a liniment composed of one part of turpentine and two parts of camphorated oil. It is well also to apply a jacket made of sheet cotton over the whole chest. It is essential to keep the room at a temperature of about 70° F. and well ventilated, not permitting babies to crawl on the floor when able to be up, or to pass from a warm to a cold room. Sweet spirit of niter is a serviceable remedy to use at the beginning: five to fifteen drops every two hours in water for a child from one to ten years of age, for the first day or two. If the cough is harsh, hard, or croupy (see p. 83), give syrup of ipecac every two hours: ten drops to an infant of one year or under, thirty drops to a child of ten years, unless it causes nausea or vomiting, when the dose may be reduced one-half. If children become "stuffed up" with secretion so that the breathing is difficult and noisy, give a teaspoonful of the syrup of ipecac to make them vomit, for until they are six or seven years old children cannot expectorate, and mucus which is coughed up into the mouth is swallowed by them. Vomiting not only gets rid of that secretion which has been swallowed, but expels it from the bronchial tubes. This treatment may be repeated if the condition recurs. In infants under a year of age medicine is to be avoided as much as possible. A teaspoonful of sweet oil and molasses, equal parts, may be given occasionally to loosen the cough in mild cases. In other cases use the cough tablet for infants described on p. 91. A paste consisting of mustard, one part, and flour, twenty parts, is very useful when spread on a cloth and applied all about the chest, front and back. The diet should be only milk for young children during the first day or two, and older patients should not have much more than this, except toast and soups. In feeble babies with bronchitis it is wise to give five or ten drops of brandy or whisky in water every two hours, to relieve difficulty in breathing. Children who are subject to frequent colds, or those in whom cough is persistent, should receive Peter Möller's cod-liver oil, one-half to one teaspoonful, according to age, three times daily after eating. One of the emulsions may be used instead if the pure oil is unpalatable. Adenoids and enlarged tonsils are a fruitful source of constant colds and sore throat, and their removal is advisable (see p. 61). Hardening of the skin by daily sponge baths with cold salt water, while the child stands or sits in warm water, is effective as a preventive of colds, as is also an out-of-door life with proper attention to clothing and foot gear. =Treatment of Pneumonia.=--Patients developing the symptoms described as suggestive of pneumonia need the immediate attention of a physician. If a person is unfortunate enough to have the care of such a case, when it is impossible to secure a physician, it may afford some comfort to know that good nursing is really the prime requisite in aiding recovery, while skillful treatment is of most value if complications arise. One in every ten cases of pneumonia in ordinarily healthy people proves fatal. In specially selected young men, as soldiers, the death rate from pneumonia is only one in twenty-five cases. On the other hand, pneumonia is the common cause of death in old age; about seventy out of every hundred patients who die from pneumonia are between sixty and eighty years of age. Infants under a year old, and persons enfeebled with disease or suffering from excesses, particularly alcoholism, are also likely to die if stricken with the disease. The patient should go to bed in a large, well-ventilated, and sunny room. The temperature of the room should be about 70° F., and the patient must not be covered so warmly with clothing as to cause perspiration. A flannel jacket may be made to surround the chest, and should open down the whole front. The nightshirt is worn over this; nothing more. Daily sponging of the patient with tepid water (85° to 90° F.) should be practiced. The body is not to be all exposed at once, but each limb and the trunk are to be separately sponged and dried. If the fever is high (104° F.) the water should be cold (77° to 72° F.), and the sponging done every three hours in the case of a strong patient. Visitors must be absolutely forbidden. No more than one or two persons are to be allowed in the sick room at once. The diet should consist chiefly of milk, a glass every two hours, varied with milk mixed with thin cooked cereal or eggnog. It is wise to give at the beginning of the disease a cathartic, such as five grains of calomel followed in twelve hours by a Seidlitz powder, if the bowels do not act freely before that time. To relieve the pain in the side, if excruciating, give one-quarter grain morphine sulphate,[4] and repeat once, if necessary, in two hours. The application of an ice bag to the painful side frequently stops the pain, and, moreover, is excellent treatment throughout the course of the disease. The seat of pain usually indicates that the lung on that side is the inflamed one, so that the ice bag should be allowed to rest against that portion of the chest. Water should be freely supplied, and should be given as well as milk even if the patient is delirious. The bowels are to be moved daily by glycerin suppositories or injection of warm water. Dover's powder in doses of five grains is useful to assuage cough. It may be repeated once, after two hours' interval if desirable, but must not be employed at the same time as morphine. After the first two or three days are passed, or sooner in weak subjects, give strychnine sulphate, one-thirtieth grain, every six hours in pill or tablet form. The strychnine is to be continued until the temperature becomes normal, and then reduced about one-half in amount for a week or ten days while the patient remains in bed, as he must for some time after the temperature, pulse, and breathing have become normal. =CONSUMPTION; TUBERCULOSIS OF THE LUNGS; PHTHISIS.=--This disease demands especial attention, not only because it is above all others the great destroyer of human life, causing one-seventh of all deaths, but because, so far from being a surely fatal disease as popularly believed, it is an eminently curable disorder if recognized in its earliest stage. The most careful laboratory examinations of bodies dead from other causes, show that very many people have had tuberculosis at some time, and to some extent, during life. The reason why the disease fails to progress in most persons is that the system is strong enough to resist the inroads of the disease. The process becomes arrested by the germs being surrounded by a barrier of healthy tissue, and so perishing in their walled-in position. These facts prove that so far from being incurable, recovery from consumption frequently occurs without even our knowledge of the disease. It is only those cases which become so far advanced as to be easily recognized that are likely to result fatally. Many more cases of consumption are now cured than formerly, because exact methods have been discovered which enable us to determine the existence of the disease at an early stage of its development. Consumption is due to the growth of a special germ in the lungs. The disease is contagious, that is, it is capable of being communicated from a consumptive to a healthy person by means of the germs present in the sputum (expectoration) of the patient. The danger of thus acquiring the disease directly from a consumptive is slight, if one take simple precautions which will be mentioned later, except in the case of a husband, wife, or child of the patient who come in close personal contact, as in kissing, etc. This is proved by the fact that attendants in hospitals for consumptives, who devote their lives to the care of these patients, are rarely affected with consumption. The chief source of danger to persons at large is dust containing the germs derived from the expectoration of human patients, and thus finding entrance into the lungs. Consumption is said to be inherited. This is not the case, as only most rarely is an infant born actually bearing the living germs of the disease in its body. A tendency to the disease is seen in certain families, and this tendency may be inherited in the sense that the lung tissue of these persons possesses less resistance to the growth of the germ of consumption. It may well be, however, that the children of consumptive parents, as has been suggested, are more resistant to the disease through inherited immunity (as is seen in the offspring of parents who have had other contagious diseases), and that the reason that they more often acquire tuberculosis is because they are constantly exposed to contact with the germ of consumption in their everyday home life. It is known that there are certain occupations and diseases which render the individual more susceptible to consumption. Thus, stone cutters, knife grinders and polishers, on account of inhaling the irritating dust, are more liable to the disease than any other class. Plasterers, cigar makers, and upholsterers are next in order of susceptibility for the same reason; while out-of-door workers, as farmers, are less likely to contract consumption than any other body of workers except bankers and brokers. Among diseases predisposing to consumption, ordinary colds and bronchitis, influenza, pneumonia, measles, nasal obstruction causing mouth-breathing, and scarlet fever are the most important. No age is exempt, from the cradle to the grave, although the liability to the disease diminishes markedly after the age of forty. About one-third more women than men recover from consumption, probably because it is more practicable for them to alter their mode of life to suit the requirements of treatment. It is, then, the neglected cold and cough (bronchitis) which offers a field most commonly favorable for the growth of the germs in the lungs which cause consumption. And it is essential to discover the existence of the disease at its beginning, what is called the incipient stage, in order to have the best chance of recovery. It becomes important, therefore, that each individual know the signs and symptoms which suggest beginning consumption. Cough is the most constant early symptom, dry and hacking at first, and most troublesome at night and in the early morning. Expectoration comes later. Loss of weight, of strength, and of appetite are also important early symptoms. Dyspepsia with cough and loss of weight and strength form a common group of symptoms. The patient is pale, has nausea, vomiting, or heartburn, and there is rise of temperature in the afternoon, together with general weakness; and, in women, absence of monthly periods. Slight daily rise of temperature, usually as much as a half to one degree, is a very suspicious feature in connection with chronic cough and loss of weight. To test the condition, the temperature should be taken once in two hours, and will commonly be found at its highest about 4 P.M., daily. The pulse is also increased in frequency. Night sweats are common in consumption, but not as a rule in the first stage; they occur more often in the early morning hours. Chills, fever, and sweating are sometimes the first symptoms of consumption, and in a malarial region would very probably lead to error, since these symptoms may appear at about the same intervals as in ague. But the chills and fever are not arrested by quinine, as in malaria, and there are also present cough and loss of weight, not commonly prominent in malaria. Persistently enlarged glands, which may be felt as lumps beneath the skin along the sides of the neck, or in the armpits, should be looked upon with suspicion as generally tuberculous, containing the germ of consumption. They certainly demand the attention of early removal by a surgeon. The spitting of bright-red blood is one of the most certain signs of consumption, and occurs in about eighty per cent of all cases, but rarely appears as an early warning. The pupils of the eyes may be constantly large at the onset of the disease, but this is a sign of general weakness. Pain is also a frequent but not constant early symptom in the form of "stitch in the side," or pain between or beneath the shoulder blades, or in the region of the breastbone. This pain is due to pleurisy accompanying the tuberculosis. Shortness of breath on exertion is present when consumption is well established, but is not so common as an early symptom. The voice is often somewhat hoarse or husky at the onset of consumption, owing to tuberculous laryngitis. To sum up then, one should always suspect tuberculosis in a person afflicted with chronic cough who is losing weight and strength, especially if there is fever at some time during the day and any additional symptoms, such as those described. Such a one should immediately apply to a physician for examination of the chest, lungs, and sputum (expectoration). If the germs of tuberculosis are found on microscopical inspection of the sputum, the existence of consumption is absolutely established. Failure to find the germs in this way does not on the other hand prove that the patient is free from the disease, except after repeated examinations at different times, together with the inability to discover any signs by examination of the chest. This examination in some instances produces no positive results, and it may be impossible for the physician to discover anything wrong in the lungs at the commencement of consumption. But, generally, examination either of the lungs or of the sputum will decide the matter, one or both giving positive information. The use of the X-rays in the hands of some experts sometimes reveals the presence of consumption before it is possible to detect it by any other method. There is also a substance called tuberculin, which, when injected under the skin in suspected cases of consumption causes a rise of temperature in persons suffering from the disease, but has no effect on the healthy. This method is that commonly applied in testing cattle for tuberculosis. As the results of tuberculin injection in the consumptive are something like an attack of _grippe_, and as tuberculin is not wholly devoid of danger to these patients, this test should be reserved to the last, and is only to be used by a physician. =Treatment.=--There is no special remedy at our disposal which will destroy or even hinder the growth of the germs of tuberculosis in the lungs. Our endeavors must consist in improving the patient's strength, weight, and vital resistance to the germs by proper feeding, and by means of a constant out-of-door life. The ideal conditions for out-of-door existence are pure air and the largest number of sunshiny days in the year. Dryness and an even temperature, and an elevation of from 2,000 to 3,000 feet, are often serviceable, but not necessarily successful. When it is impossible for the patient to leave his home he should remain out of doors all hours of bright days, ten to twelve hours daily in summer, six to eight hours in winter without regard to temperature, and should sleep on a porch or on the roof, if possible. In the Adirondacks, patients sit on verandas with perfect comfort while the thermometer is at ten degrees below zero. A patient (a physician) in a Massachusetts sanitarium has arranged a shelf, protected at the sides, along the outside of a window, on which his pillow rests at night, while he sleeps with his head out of doors and his body in bed in a room inside. If it becomes stormy he retires within and closes the window. If the temperature ranges above 100° F. patients should rest in bed or on a couch in the open air, but, if below this, patients may exercise. A steamer chair set inside of a padded, wicker bath chair, from which the seat has been removed, makes a convenient protected arrangement in which a consumptive can pass his time out of doors. If the patient is quite weak and feverish he may remain in bed, or on a couch, placed on a veranda or balcony during the day, and in a room in which all the windows are open at night. Screens may be used to protect from direct draughts. No degree of cold, nor any of the common symptoms, as night sweats, fever, cough, or spitting of blood, should be allowed to interfere with this fresh-air treatment. The treatment may seem heroic, but is most successful. The patient must be warmly clothed or covered with blankets, and protected from strong winds, rain, and snow. During clear weather patients may sleep out of doors on piazzas, balconies, or in tents. Nutritious food is of equal value with the open-air life. A liberal diet of milk and cream, eggs, meat and vegetables is indicated. Raw eggs swallowed whole with a little sherry, or pepper and salt on them, may be taken between meals, beginning with one and increasing the number till three are taken at a time, or nine daily. If the appetite is very poor it is best that a glass of milk be taken every two hours, varied by white of egg and water and meat juice. Drug treatment depends on individual symptoms, and can, therefore, only be given under a physician's care. Sanitarium treatment is the most successful, because patients are under the absolute control of experts and usually in an ideal climate. Change of climate is often useful, but patients should not leave their homes without the advice of a competent physician, as there are many questions to consider in taking such a step.[5] There is a growing tendency among physicians to give consumptives out-of-door treatment at their homes, if living out of cities, as careful personal supervision gives much better results than a random life in a popular climatic resort. =Prevention.=--Weakly children and those born of consumptives must receive a generous diet of milk, eggs, meat, and vegetables, and spend most of their time in the open air. Their milk should be heated for fifteen minutes to a temperature of 160° F., in order to kill any germs of tuberculosis, unless the cows have been tested for this disease. The patient must have a separate sleeping room, and refrain from kissing or caressing other members of the family. The care of the sputum (expectoration) is, however, the essential means of preventing contagion. Out of doors, it should be deposited in a bottle which is cleaned by rinsing in boiling water. Indoors, paper bags or paper boxes made for the purpose are used to receive the sputum, and burned before they become dry. The use of rags, handkerchiefs, and paper napkins is dirty, and apt to cause soiling of the hands and clothes and lead to contagion. Plenty of sunlight in the sick room will cause destruction of the germs of consumption, besides proving beneficial to the patient. No dusting is to be done in the invalid's room; only moist cleansing. All dishes used by a consumptive must be boiled before they are again employed. =ASTHMA.=--This is a disorder caused by sudden narrowing of the smaller air tubes in the lungs. This narrowing is produced by swelling of the mucous membrane lining them, or is due to contraction of the tubes through reflex nervous influences. It may accompany bronchitis, or may be uncomplicated. It may be a manifestation of gout. The sufferers from asthma are usually apparently well in the period between the attacks. The attack often comes on suddenly in the night; the patient wakening with a feeling of suffocation. The difficulty in breathing soon becomes so great that he has to sit up, and often goes to a window and throws it open in the attempt to get his breath. The breathing is very labored and panting. There is little difficulty in drawing the breath, but expiration is very difficult, and usually accompanied by wheezing or whistling sounds. The patient appears to be on the brink of suffocation; the eyeballs protrude; the face is anxious and pale; the muscles of the neck stand out; the lips may be blue; a cold sweat covers the body; the hands and feet are cold, and talking becomes impossible. Altogether, a case of asthma presents a most alarming appearance to the bystander, and the patient seems to be on the verge of dying, yet death has probably never occurred during an attack of this disease. The attacks last from one-half to one or several hours, if not stopped by treatment, and they often return on several successive nights, and then disappear, not to recur for months or years. Attacks are brought on by the most curious and diverse means. Atmospheric conditions are most important. Emanations from plants, or animals, are common exciting agencies. Fright or emotion of any kind; certain articles of diet; dust and nasal obstruction are also frequent causes. Patients may be free from the disease in cities and attacked on going into the country. Men are subject to asthma more than women, and the victims belong to families subject to nervous troubles of various kinds. The attack frequently subsides suddenly, just when the patient seems to be on the point of suffocation. There is often coughing and spitting of little yellowish, semitransparent balls of mucus floating in a thinner secretion. Asthma is not likely to be mistaken for other diseases. The temperature is normal during an attack, and this will enable us to exclude other chest disorders, as bronchitis and pneumonia. Occasionally asthma is a symptom of heart and kidney disease. In the former it occurs after exercise; in the latter the attack continues for a considerable time without relief. But, as in all other serious diseases, a physician's services are essential, and it is our object to supply only such information as would be desirable in emergencies when it is impossible to obtain one. =Treatment.=--An attack of asthma is most successfully cut short by means of one-quarter of a grain of morphine sulphate[6] with 1/20 of a grain of atropine sulphate, taken in a glass of hot water containing a tablespoonful of whisky or brandy. Ten drops of laudanum,[7] or a tablespoonful of paregoric, may be used instead of the morphine if the latter is not at hand. Sometimes the inhalation of tobacco smoke from a cigar or pipe will stop an attack in those unaccustomed to its use. In the absence of morphine, or opium in the form of laudanum or paregoric, fifteen drops of chloroform or half a teaspoonful of ether may be swallowed on sugar. A useful application for use on the outside of the chest consists of mustard, one part, and flour, three parts, mixed into a paste with warm water and placed between single thicknesses of cotton cloth. Various cigarettes and pastilles, usually containing stramonium and saltpeter, are sold by druggists for the use of asthmatic patients. They are often efficient in arresting an attack of asthma, but it is impossible to recommend any one kind, as one brand may agree with one patient better than another. Amyl nitrite is sold in "pearls" or small, glass bulbs, each containing three or four drops, one of which is to be broken in and inhaled from a handkerchief during an attack of asthma. This often affords temporary relief. To avoid the continuance of the disease it is emphatically advisable to consult a physician who may be able to discover and remove the cause. The diet should consist chiefly of eggs, fish, milk, and vegetables (with the exception of beans, large quantities of potatoes, and roots, as parsnips, beets, turnips, etc.). Meat should be eaten but sparingly, and also pastries, sugar, and starches (as cereals, potato, and bread). The evening meal ought to be light, dinner being served at midday. Any change of climate may stop asthmatic seizures for a time, but the relief is apt to be temporary. Climatic conditions affect different patients differently. Warm, moist air in places destitute of much vegetation (as Florida, Southern California, and the shore of Cape Cod and the Island of Nantucket, in summer) enjoy popularity with many asthmatics, while a dry, high altitude influences others much more favorably. =INFLUENZA; LA GRIPPE.=--Influenza is an acute, highly contagious disease due to a special germ, and tending to spread with amazing rapidity over vast areas. It has occurred as a world-wide epidemic at various times in history, and during four periods in the last century. A pandemic of influenza began in the winter of 1889-90, and continued in the form of local epidemics till 1904, the disease suddenly appearing in a community and, after a prevalence of about six weeks, disappearing again. One attack, it is, perhaps, unnecessary to state, does not protect against another. The mortality is about 1 death to 400 cases. The feeble and aged are those who are apt to succumb. Fatalities usually result from complications or sequels, such as pneumonia or tuberculosis; neurasthenia or insanity may follow. =Symptoms.=--There are commonly four important symptoms characteristic of _grippe_: fever; pain, catarrh; and depression, mental and physical. _Grippe_ attacks the patient with great suddenness. While in perfect health and engaged in ordinary work, one is often seized with a severe chill followed by general depression, pain in the head, back, and limbs, soreness of the muscles, and fever. The temperature varies from 100° to 104° F. The catarrh attacks the eyes, nose, throat, and larger tubes in the lungs. The eyes become reddened and sensitive to light, and movements of the eyeballs cause pain. Sneezing comes on early, and, after a day or two, is followed by discharge from the nose. The throat is often sore and reddened. There may be a feeling of weight and tightness in the chest accompanied by a harsh, dry cough, which, after a few days, becomes looser and expectoration occurs. Bodily weakness and depression of spirits are usually prominent and form often the most persistent and distressing symptoms. After three or four days the pains decrease, the temperature falls, and the cough and oppression in the chest lessen, and recovery usually takes place within a week, or ten days, in serious cases. The patient should go to bed at once, and should not leave it until the temperature is normal (98-3/5° F.). For some time afterwards general weakness, associated with heart weakness, causes the patient to sweat easily, and to get out of breath and have a rapid pulse on slight exertion. Such is the picture of a typical case, but it often happens that some of the symptoms are absent, while others are exaggerated so that different types of _grippe_ are often described. Thus the pain in the back and head may be so intense as to resemble that of meningitis. Occasionally the stomach and bowels are attacked so that violent vomiting and diarrhea occur, while other members of the same family present the ordinary form of influenza. There is a form that attacks principally the nervous system, the nasal and bronchial tracts escaping altogether. Continual fever is the only symptom in some cases. _Grippe_ may last for weeks. Whenever doubt exists as to the nature of the disorder, a microscopic examination of the expectoration or of the mucus from the throat by a competent physician will definitely determine the existence of influenza, if the special germs of that disease are found. It is the prevailing and erroneous fashion for a person to call any cold in the head the _grippe_; and there are, indeed, many cases in which it becomes difficult for a physician to distinguish between _grippe_ and a severe cold with muscular soreness and fever, except by the microscopic test. Influenza becomes dangerous chiefly through its complications, as pneumonia, inflammation of the middle ear, of the eyes, or of the kidneys, and through its depressing effect upon the heart. These complications can often be prevented by avoiding the slightest imprudence or exposure during convalescence. Elderly and feeble persons should be protected from contact with the disease in every way. Whole prisons have been exempt from _grippe_ during epidemics, owing to the enforced seclusion of the inmates. The one absolutely essential feature in treatment is that the patient stay in bed while the fever lasts and in the house afterwards, except as his strength will permit him to go out of doors for a time each sunny day until recovery is fully established. =Treatment.=--The medicinal treatment consists at first in combating the toxin of the disease and assuaging pain, and later in promoting strength. Hot lemonade and whisky may be given during the chilly period and a single six- to ten-grain dose of quinine. Pain is combated by phenacetin,[8] three grains repeated every three hours till relieved. At night a most useful medicine to afford comfort when pain and sleeplessness are troublesome, is Dover's powder, ten grains (or codeine, one grain), with thirty grains of sodium bromide dissolved in water. After the first day it is usually advisable to give a two-grain quinine pill together with a tablet containing one-thirtieth of a grain of strychnine three times a day after meals for a week or two as a tonic (adult). Only mild cathartics are suitable to keep the bowels regular as a Seidlitz powder in the morning before breakfast. The diet should be liquid while the fever lasts--as milk, cocoa, soups, eggnog, one of these each two hours. A tablespoonful of whisky, rum, or brandy may be added to the milk three times daily if there is much weakness. The germ causing _grippe_ lives only two days, but successive crops of spores are raised in a proper medium. Neglected mucus in nose or throat affords an inviting field for the germ. Therefore it is essential to keep the nostrils free and open by means of spraying with the Seiler's tablet solution (p. 49), and then always breathing through the nostrils. FOOTNOTES: [4] Caution. Dangerous. Use only on physician's order. [5] Arizona, New Mexico, Colorado, and the Adirondacks contain the most favorable climatic resorts in this country. [6] Caution. Dangerous. Use only on physician's order. [7] This dose is only suitable for strong, healthy adults of average weight and those who are not affected peculiarly by opium. Delicate women and others not coming under the above head should take but half the dose and repeat in an hour if necessary. [8] Caution. A powerful medicine. CHAPTER IV =Headaches= _Treatment of Sick Headache--Effects of Indigestion--Neuralgia--Headaches Occasioned by Disease--Other Causes--Poisoning--Heat Stroke._ Headache varies according to its nature and causes. The first variety to be considered is "sick headache" or migraine. =SICK HEADACHE.=--This is a peculiar, one-sided headache which takes the form of severe, periodic attacks or paroxysms, and is often inherited. It recurs at more or less regular intervals, as on a certain day of each week, fortnight or month, and the attacks appear and disappear at regular hours. The disorder generally persists for years and then goes away. If it begins in childhood, as it frequently does between the years of five and ten, it may stop with the coming of adult life, but if not outgrown at this time it commonly vanishes during late middle life, about the age of fifty-one in a man, or with the "change of life" in a woman. While in many instances arising without apparent cause, yet in others sick headache may be precipitated by indigestion, by eye-strain, by enlarged tonsils and adenoids in children, or by fatigue. There may be some warning of the approach of a sick headache, as mental depression, weariness, disturbances of sight, buzzing in the ears, or dizziness. The pain begins at one spot on one side of the head (more commonly the left), as in the eye, temple, or forehead, and later spreads over the whole side of the head and, in some cases, the neck and arm. The face may be pale, or pale on one side and red on the other. The headache is of a violent, boring nature, aggravated by light and noise, so that the patient is incapacitated for any exertion and is most comfortable when lying down in a quiet, dark room. Vomiting usually comes on after a while, and often gives relief. The headache lasts several hours or all day, rarely longer. The duration is usually about the same in the case of any particular individual who is suddenly relieved at a certain hour generally after vomiting, a feeling of well-being and an enormous appetite following often. Patients may feel perfectly well between the attacks, but if they occur frequently the general health suffers. In the majority of cases there is no apparent cause discoverable save heredity, and for these the following treatment is applicable. Each case should, however, be carefully studied by a physician, if possible, as only in this way can any existing cause be found and removed. =Treatment.=--Any article of diet which experience has shown to provoke an attack should naturally be avoided. A Seidlitz powder, or tablespoonful of Epsom salts in a glassful of water, is advisable at the onset of an attack. Rubbing the forehead with a menthol pencil will afford some relief. Hot strong tea with lemon juice is sometimes of service. To actually lessen the pain _one_ of the following may be tried: phenacetin (eight grains) and repeat once in an hour if necessary until three doses are taken by an adult; or, migraine tablets, two in number, and do not repeat; or fluid extract of cannabis indica, two drops every half hour until relieved, or until six doses are taken. =HEADACHE FROM VARIOUS CAUSES.=--It is impossible to decide from the location or nature of the pain alone to what variety of headache it belongs, that is, as to its cause. It is only by considering the general condition of the body that such a decision can be attained. =Headache from Indigestion.=--The pain is more often in the forehead, but may be in the top or back of the head. The headache may last for hours, or "off and on" for days. Dull headache is seen in "biliousness" when the whites of the eyes are slightly tinged with yellow and the tongue coated and yellowish, and perhaps dizziness, disturbances of sight and a feeling of depression are present. Among other signs of headache due to indigestion are: discomfort in the stomach and bowels, constipation, nausea and vomiting, belching of wind, hiccough, and tender or painful eyeballs. In a general way, treatment for this sort of headache consists in the use of a cathartic, such as calomel (three-fifths of a grain) at night, followed by a Seidlitz powder or a tablespoonful of Epsom salts in a glass of cold water in the morning. A simple diet, as very small meals of milk, bread, toast, crackers with cereals, soups, and perhaps a little steak, chop, or fresh fish for a few days, may be sufficient to complete the cure. =Sympathetic Headaches.=--These are caused by irritation in various parts of the body, which is conveyed through the nervous system to the brain producing headache. Headache from eye-strain is one of this class, and probably the most common, and, therefore, most important of all headaches. There is unfortunately no sure sign by which we can tell eye-headaches from others, except examination of the eyes (see p. 29). Redness, twitching, and soreness of the eyelids, and watering of the eyes, together with headache, after their excessive use may suggest the cause in some cases. The pain may be occasioned or almost constant, and either about the eyes, forehead, top or back of the head, and often takes the form of "sick headache." The headache may at times appear to have no connection with use of the eyes. When headache is frequent the eyes should always be examined by a competent oculist (a physician) not by any sort of an optician. =Decayed Teeth.=--These not uncommonly give rise to headache. =Disorders of the Nose and Throat.=--Such troubles, especially adenoids and enlarged tonsils in children, enlarged turbinates, and polypi (see Nose Disorders, p. 60) are fruitful sources of headache. In nose-headaches there is often tenderness on pressing on the inner wall of the bony socket inclosing the eyeball. =Diseases of the Maternal Organs.=--These in women produce headache, particularly pain in the back of the head. If local symptoms are also present, as backache (low down), leucorrhea, painful monthly periods, and irregular or excessive flowing, or trouble in urinating, then the cause of the headache is probably some disorder which can be cured at the hands of a skillful specialist in women's diseases. =Nervous Headaches.=--These occur in brain exhaustion and anæmia, and in nervous exhaustion. There is a feeling of pressure or weight at the back of the head or neck, rather than real pain. This is often relieved by lying down. Headache from anæmia is often associated with pallor of the face and lips, shortness of the breath, weakness, and palpitation of the heart. Rest, abundance of sleep, change of scene, out-of-door life, nourishing food, milk, cream, butter, eggs, meat, and iron are useful in aiding a return to health (see Nervous Exhaustion, Vol. III, p. 17). =Neuralgic Headaches.=--The pain is usually of a shooting character, and the scalp is often exceedingly tender to pressure. They may be caused by exposure to cold, or by decayed teeth, or sometimes by inflammation of the middle ear (see Earache, p. 40). =Headache from Poisoning.=--Persons addicted to the excessive use of tea, coffee, alcohol, and tobacco are often subject to headache from poisoning of the system by these substances. In tea, coffee, and tobacco poisoning there is also palpitation of the heart in many cases; that is, the patient is conscious of his heart beating, irregularly and violently (see Palpitation, Vol. III, p. 171), which causes alarm and distress. Cessation of the habit and sodium bromide, twenty grains three times daily, dissolved in water, administered for not more than three days, may relieve the headache and other trouble. Many drugs occasion headache, as quinine, salicylates, nitroglycerin, and some forms of iron. The poisons formed in the blood by germs in acute diseases are among the most common sources of headache. In these disorders there is always fever and often backache, and general soreness in the muscles. One of the most prominent symptoms in typhoid fever is constant headache with fever increasing toward night, and also higher each night than it was the night before. The headache and fever, together often with occasional nosebleed and general feeling of weariness, may continue for a week or two before the patient feels sick enough to go to bed. The existence of headache with fever (as shown by the thermometer) should always warn one of the necessity of consulting a physician. Headache owing to germ poisons is also one of the most distressing accompaniments of _grippe_, measles, and smallpox, and sometimes of pneumonia. The headache caused by the poison of the malarial parasite in the blood is very violent, and the pain is situated usually just over the eye, and occurring often in the place of the paroxysm of the chill and fever at a regular hour daily, every other day, or every fourth day. If the headache is due to malaria, quinine will cure it (Malaria, Vol. I, p. 258). The headache of rheumatism is owing also to a special poison in the blood, and is often associated with soreness of the scalp. If there are symptoms of rheumatism elsewhere in the body, existing headache may be logically attributed to the same disease (see Rheumatism, p. 169). The poison of gout circulating in the blood is sometimes a source of intense headache. The headache of Bright's disease of the kidneys and of diabetes is dull and commonly associated with nausea or vomiting, swelling of the feet or ankles, pallor and shortness of breath in the former; with thirst and the passage of a large amount of urine (normal quantity is three pints in twenty-four hours) in the case of diabetes. The headaches of indigestion are also of poisonous origin, the products of imperfectly digested food being absorbed into the blood and acting as poisons. Another variety of headache due to poisoning is seen in children crowded together in ill-ventilated schoolrooms and overworked. Still another kind is due to inhalation of illuminating gas escaping from leaky fixtures. =Headache from Heat Stroke.=--Persons who have been exposed to excessive heat or have actually had a heat stroke (Vol. I, p. 40) are very prone to headache, which is made worse by movements of the head. Sodium bromide, twenty grains dissolved in water, may be given to advantage three times daily between meals in these cases for not more than two days. Phenacetin in eight-grain doses may also afford relief, but should not be used more often than once or twice a day. =Constant Headache.=--This, afflicting the patient all day and every day, and increasing in severity at night, is suggestive of some disease of the brain, as congestion, brain tumor, or meningitis, and urgently demands skillful medical attention. Part II TUMORS SKIN DISEASES RHEUMATISM BY KENELM WINSLOW AND ALBERT WARREN FERRIS CHAPTER I =Growths and Enlargements= _Benign and Malignant Tumors--Treatment of Rupture--Hernia in Children--Varicocele--Causes of Varicose Veins--External and Internal Piles._ =TUMORS.=--A tumor--in its original meaning--signifies a swelling. As commonly used it means a new growth or enlargement of a part, which is not due to injury or inflammation. Tumors occur at all ages, in both sexes, and may attack any part of the body. Tumors are usually divided into benign and malignant growths. In a general way the malignant tumors are painful; they do not move about freely but become fixed to the adjacent parts; their growth is more rapid; they often have no well-defined borders; frequently they return after removal; the skin covering them is often attached and cannot be moved readily without also moving the tumor. Malignant tumors are divided into cancers (carcinomata) and sarcomas (sarcomata). Cancer is much more frequent than sarcoma. Cancer occurs more often in persons over thirty; there appears to be a hereditary tendency to it in some families, and a number of individuals in the same house or locality sometimes develop cancer as if it were in some way communicated from one to another. The common situations of cancer are the breast and womb in women, and the lip and stomach of men. The neighboring glands become enlarged, as are shown by the lumps which form under the jaw in cancer of the lip, and which may be felt sometimes in the armpit in cancer of the breast; these are, however, late signs, and the growth should never be permitted to remain long enough for them to develop. Paleness, weakness, and loss of strength often attend the development of cancer, but many do not exhibit these symptoms. Sarcoma is often seen in the young and well nourished; it grows very rapidly; the skin is usually not adherent to the tumor; there is generally no pain; heredity has no relation to its development; paleness is absent in many cases; the favorite seats are the muscle, bone, glands of neck, brain, and many other localities; it is not nearly so common as cancer. Cancer of the breast begins as a lump, occurring more often to the outside of the nipple, but may develop in any part. It may or may not be painful at first, but the skin becomes attached to it; and sooner or later the nipple is drawn in. It is seen in women over forty, as a rule. Lumps in the breast, occurring during the nursing period, are often due to inflammation, but these generally have no relation to cancer unless they persist for a long time. Any lump which appears in the breast without apparent cause, or which persists for a considerable time after inflammation ceases, should be promptly removed by the surgeon, as without microscopic examination the most skilled practitioners will be unable absolutely to distinguish between a harmless and malignant tumor. As even so-called benign tumors often become cancerous (e. g., inflammatory lumps in the breast, warts, and moles), an eminent surgeon (Dr. Maurice Richardson) has recently formulated the rule that all tumors, wherever situated, should if possible be removed, whatever their apparent nature. Cancer of the womb may be suspected in middle-aged women if flowing is more profuse than is usual, or occurs at irregular times; if there is a discharge (often of offensive odor) from the front passage; and sometimes pain, as backache, and perhaps paleness. Early examination should be sought at the hands of a physician; it is suicidal to delay. Cancer of the stomach is observed more often in men over forty, and begins with loss of appetite; nausea or vomiting; vomiting of blood; pain in the stomach; loss of weight, and paleness. Some of these symptoms may be absent. Improved methods of surgery have rendered early operation for cancer of the stomach a hopeful measure, and if cure does not result, the life will be prolonged and much suffering saved. Cancer of the lip arises as a small lump, like a wart generally, on the lower lip in men from forty to seventy. Sometimes it appears at first simply as a slight sore or crack which repeatedly scabs over but does not heal. Its growth is very slow and it may seem like a trivial matter, but any sore on the lower lip in a man of middle age or over, which persists, should demand the immediate attention of a surgeon, because early removal is more successful in cancer of the lip than in any other form. There are, of course, many comparatively harmless or benign forms of tumors which will not return if removed and do not endanger life unless they grow to a large size. Among these are the soft, flattened, fatty tumors of the shoulders, back, buttocks, and other parts, and the wen. This is often seen on the head and occurs frequently on the scalp, from the size of a pea to an egg, in groups. Wens are elastic lumps, painless and of slow growth, and most readily removed. Space does not permit us to recount the other forms of benign tumors and it would be impossible to describe how they could be distinguished from malignant growths. =Causes.=--The causes of tumors are almost wholly unknown. There is no other branch of medicine which is receiving more scientific study the world over than cancer, and some definite and helpful knowledge may soon be expected. A cancer can be communicated by introduction of cancerous material into healthy tissues. This and other reasons have led many to believe that the disease was caused by a special germ; a chemical cause is thought to be the origin of cancer by other authorities. Neither of these theories has been substantiated and we are still completely at sea in the matter. Cancer appears to be excited sometimes by local irritation, as in the lip by the constant irritation of the hard, hot stem of a clay pipe; cancer of the tongue by the irritation of a rough, sharp tooth. Blows and injuries are also occasional agencies in the development of cancer. Malignant growths not rarely arise from moles and warts. =Treatment.=--Early removal by the knife is the only form of treatment which is to be considered in most cases. Delay and neglect are suicidal in malignant disease. Cure is successful in just so far as the operation is done early. If dread of surgical operation were not so prevalent, the results of removal of cancer would be immeasurably better. The common, bad results of operation--that is, return of the disease--are chiefly due to the late stage in which surgeons are compelled to operate through the reluctance of the patient and, strangely enough, often of his family medical man. Cancer should be removed in so early a stage that its true nature can often not be recognized, except by microscopical examination after its removal. If Maurice Richardson's rule were followed, many cancers would never occur, or would be removed before they had developed sufficiently to show their nature. All treatment by chemical pastes and special remedies is simply courting fatal results. Most special cures advertised to be performed in sanitoriums are money-getting humbugs. Even the X-ray has proved useless except in the case of most superficial growths limited to the skin or when directed against the scar left by removal of a cancer; and while the growth may disappear during treatment, in a large proportion of cases there is a recurrence. But when tumors are so far advanced that removal by the knife is inoperable, then other means will often secure great relief from suffering and will prolong life for a very considerable period in many cases. =RUPTURE.=--Hernia or rupture consists in a protrusion of a portion of the contents of the abdomen (a part of the bowel or its covering, or both) through the belly wall. The common seats of rupture are at the navel and in the groin. Rupture at the navel is called umbilical hernia; that in the groin either inguinal or femoral, according to slight differences in site. Umbilical hernia is common in babies and occurs as a whole in only five per cent of all ruptures, whereas rupture in the groin is seen to the extent of ninety-four per cent of all ruptures. There is still another variety of hernia happening in the scars of wounds of the belly after injuries or surgical operations, and this may arise at almost any point. =Causes.=--Rupture is sometimes present at birth. In other cases it is acquired as a result of various causes, of which natural weakness of the part is the chief. Twenty-five per cent of persons with rupture give a history of the same trouble in their parents. Rupture is three times more frequent in men than in women, and is favored by severe muscular work, fatness, chronic coughing, constipation, diarrhea, sudden strain, or blows on the abdomen. =Symptoms.=--Rupture first appears as a fullness or swelling, more noticeable on standing, lifting, coughing, or straining. It may disappear entirely on lying down or on pressure with the fingers. In the beginning there may be discomfort after standing or walking for any length of time, and later there is often a dragging pain or uneasiness complained of, or a sensation of weakness or griping at the seat of the rupture. In case the rupture cannot be returned, it is called irreducible and is a more serious form. The great danger of hernias is the likelihood of their being strangulated, as the term is; that is, so nipped in the divided abdominal wall that the blood current is shut off and often the bowels are completely obstructed. If this condition is not speedily relieved death will ensue in from two to eight days. Such a result is occasioned, in persons having rupture, by heavy lifting, severe coughing or straining, or by a blow or fall. The symptoms of strangulated hernia are sudden and complete constipation, persistent vomiting, and severe pain at the seat of the rupture or often about the navel. The vomiting consists first of the contents of the stomach, then of yellowish-stained fluid, and finally of dark material having the odor of excrement. Great weakness, distention of the belly, retching, hiccough, thirst, profound exhaustion, and death follow if the condition is not remedied. In some cases, where the obstruction is not complete, the symptoms are comparatively milder, as occasional vomiting and slight pain and partial constipation. If the patient cannot return the protrusion speedily, a surgeon should be secured at all costs--the patient meanwhile lying in bed with an ice bag or cold cloths over the rupture. The surgeon will reduce the protrusion under ether, or operate. Strangulation of any rupture may occur, but of course it is less likely to happen in those who wear a well-fitting truss; still it is always a dangerous possibility, and this fact and the liability of the rupture's increasing in size make a surgical operation for complete cure advisable in proper subjects. =Treatment.=--Two means of treatment are open to the ruptured: the use of the truss and surgical operation. By the wearing of a truss, fifty-eight per cent of ruptures recover completely in children under one year. In children from one to five years, with rupture, ten per cent get well with the truss. Statistics show that in rupture which has been acquired after birth but five per cent recover with a truss after the age of fifteen, and but one per cent after thirty. The truss must be worn two years after cure of the rupture in children, and in adults practically during the rest of their lives. A truss consists of a steel spring which encircles the body, holding in place a pad which fits over the seat of hernia. The Knight truss is one of the best. The truss is most satisfactory in ruptures which can be readily returned. In very small or large hernias, and in those which are not reducible, the action of the truss is not so effective. In irreducible ruptures there is likely to be constipation and colic produced, and strangulation is more liable to occur. A truss having a hollow pad may prove of service in small irreducible ruptures, but no truss is of much value in large hernias of this kind. Every person with a reducible rupture should wear a proper truss until the rupture is cured by some means. Such a truss should keep in the hernia without causing pain or discomfort. It should be taken off at night, and replaced in the morning while the patient is lying down. In cases where the protrusion appears during the night a truss must be worn day and night, but often a lighter form will serve for use in bed. To test the efficiency of a truss let the patient stoop forward with his knees apart, and hands on the knees, and cough. If the truss keeps the hernia in, it is suitable; if not, it is probably unsuitable. Operation for complete cure of the hernia is successful in 95 cases out of 100, in suitable subjects, in the ruptures in the groin. The death rate is but about 1 in 500 to 1,000 operations when done by surgeons skilled in this special work. Patients with very large and irreducible hernias, and those who are very fat and in advanced life, are unfavorable subjects for operation. In young men operation--if it can be done by a skillful surgeon and in a hospital with all facilities--is usually to be recommended in every case of rupture. Umbilical hernias and ventral hernias, following surgical operations, may be held in place by a wide, strong belt about the body, which holds a circular flat or hollow plate over the rupture. These have been the most difficult of cure by operation; but recent improvements have yielded very good results--thirty-five cures out of thirty-six operations for umbilical rupture, and one death, by Mayo, of Rochester, Minn.--and they are usually the very worst patients, of middle age, or older, and very stout. Umbilical rupture in babies is very common after the cord has dropped off. There is a protrusion at the navel which increases in size on coughing, straining, or crying. If the rupture is pushed in and the flesh is brought together from either side in two folds over the navel, so as to bury the navel out of sight, and held in this position by a strip of surgeon's plaster, reaching across the front of the belly and about two and one-half inches wide, complete recovery will usually take place within a few months. It is well to cover the plaster with a snug flannel band about the body. The plaster should be replaced as need be, and should be applied in all cases by a physician if one can be secured. =VARICOSE VEINS.=--Varicose veins are enlarged veins which are more commonly present on the legs, but are also seen in other parts of the body. They stand out from the skin as bluish, knotty, and winding cords which flatten out when pressure is made upon them, and shrink in size in most cases upon lying down. Sometimes bluish, small, soft, rounded lumps, or a fine, branching network of veins may be seen. Oftentimes varicose veins may exist for years--if not extensive--without either increasing in size or causing any trouble whatsoever. At other times they occasion a feeling of weight and dull pain in the legs, especially on long standing. When they are of long duration the legs may become swollen and hard, and eczema, with itching, is then not uncommon. This leads to scratching and sores, and these may enlarge and become what are called varicose ulcers, which are slow and difficult of healing. Occasionally an old varicose vein may break open and give rise to profuse bleeding. =Causes.=--Varicose veins are more frequent in women, especially in those who stand much, as do cooks. Any obstruction to the return flow of the blood from the veins toward the heart will produce them, as a tight garter about the leg; or the pressure of the large womb in pregnancy upon the veins, or of tumors in the same region. Heart and lung diseases also predispose to the formation of varicose veins. =Treatment.=--Varicose veins are exceedingly common, and if they are not extensive and produce no discomfort they may be ignored. Otherwise, it is well to have an elastic stocking made to come to, or above, the knee. The stocking should be put on and removed while lying down. Cold bathing, outdoor exercise, and everything which will improve the general health and tone are desirable, also the avoidance of constipation. In the most aggravated cases surgical operation will cure varicose veins. Bleeding from a broken vein is stopped by pressure of a bandage and lying on the back with the foot raised on a pillow. =VARICOCELE.=--This consists of an enlargement of the veins in the scrotum above the testicle of the male, on the left side in most cases. The large veins feel more like a bunch of earthworms than anything else. If they cause no discomfort they may be entirely neglected and are not of the slightest consequence. Even when they produce trouble it is chiefly imaginary, in most instances, since they are a common source of worry in young men in case of any irregularities in the sexual functions. Advantage is taken of this fact by quacks, who find it for their profit to advertise all sorts of horrible and impossible results of the condition. The testicle on the diseased side may become smaller than its fellow, but in few cases does any serious consequence result from varicocele. Pain in the hollow of the back may be the only symptom of varicocele in cases where there are any symptoms. A dragging pain in the groin, a pain in the testicles and about the rectum and in the bladder may cause complaint. =Causes.=--Varicocele occurs usually in young, unmarried men and often disappears of itself in later life. Undue sexual excitement may produce the condition. =Treatment.=--When any treatment is necessary, the application of a snugly fitting suspensory bandage--which can be procured at any good drug shop--and bathing the testicles night and morning in cold water, with the avoidance of constipation and of the cause noted, will be generally sufficient to relieve any discomfort arising from varicocele. The enlargement of the veins will not, of course, be altered by this treatment, and absolute cure can only be effected by a surgical removal of the veins, which is not a serious undertaking, but is rarely necessary. =PILES--HEMORRHOIDS.=--Piles consist of enlarged, and often inflamed, veins in the rectum, or lower part of the bowel. =External Piles.=--These are bluish swellings or little lumps which project from the bowel, interfering with walking or the toilet of the parts, and are sometimes exquisitely tender and painful when inflamed. In the course of time these become mere projections or fringes of flesh and cause no trouble unless through uncleanliness or other reasons they are irritated. The treatment of external piles may be summed up in great cleanliness--washing the parts after each movement of the bowels; rest in bed, if the soreness is great; the application of cold water or powdered ice in a rubber bag, or of hot poultices, and of various drugs. Among these are hamamelis extract, or witch-hazel, with which the parts may be frequently bathed; an ointment of nut-gall and opium; or extract of belladonna and glycerin, equal parts. Sitting in cold water, night and morning, in a tub also will prove serviceable. The more rapid and effectual method of cure consists in opening of the recent pile by the surgeon, or clipping off the fleshy projections. The bowels should always be kept regular in any form of piles by small doses of Glauber's or Epsom salts taken in a glass of hot water on rising, or some mineral water. In case these do not agree, extract of cascara or compound licorice powder may be taken at night. Equal parts of sulphur and cream of tartar is an old-fashioned domestic cathartic of which a teaspoonful may be taken each morning to advantage in piles. =Internal Piles.=--In the beginning patients with internal piles feel as if the bowels were not wholly emptied after a passage, and sometimes there is difficulty in urinating and also pains in the hollow of the back and in the thighs. There is often pain on movement of the bowels, and blood follows the passage. Later, blood may be lost at other times, and the loss may be so great as to cause pronounced paleness and weakness. Itching is a frequent occurrence. Mucus and pus (matter such as comes from an abscess) may also be discharged. Loss of sexual desire and power is not uncommonly present. There may be no external protrusions; but bleeding, itching, and pain during movement of the bowels are the chief symptoms. If the pain is very severe during and also after a passage, it is probable that there is also present a fissure or crack in the flesh, or ulcer at the exit of the bowel which needs surgical attention. It not infrequently happens that the piles come out during the bowel movement, when they should be thoroughly washed, greased, and pushed back. Sometimes this is impossible, although after lying down for a while and applying ice or cold water the mass may shrink so as to admit of its return. When a large mass is thus protruded and cannot be returned, and becomes nipped by the anus muscles, it undergoes inflammation and is very painful, but a cure often results from its destruction. Such a mode of cure is not a safe or desirable one, however. =Treatment.=--The cold sitz baths in the morning or injections of a half pint of ice water after a passage are useful. Ointments may be introduced into the bowel upon the finger, or, better, with hard rubber plugs sold for the purpose; or suppositories may be employed. An ointment, containing sixty grains of iron subsulphate to the ounce of lard (or, if there is much itching, an ointment consisting of orthoform, thirty grains, with one-half ounce of lard), will prove of value. Also the injection of one-half pint cold water, containing a teaspoonful of extract of hamamelis, after a passage, affords relief. Two or three grains of the subsulphate of iron may be employed in suppositories, and one of these may be introduced three times daily. The compound gall ointment or the glycerite of tannin will be found to act successfully in some cases. When one remedy does not serve, try another. The only positive cure for piles consists in surgical operation for their removal. Self-treatment is not recommended, as the physician can do better, and an examination is always advisable to rule out other conditions which may be mistaken by the layman for piles. =Causes.=--Piles are seen chiefly in adults, in those in advanced life, and in those who exercise little but eat much. Constipation favors their occurrence, and the condition is commonly present in pregnant women. Fatigue, exposure, horseback exercise, or an alcoholic debauch will cause their appearance. Certain diseases also occasion the formation of piles. CHAPTER II =Skin Diseases and Related Disorders= _Household Remedies for Itching--Chafing and Chapping--Hives, Cold Sores and Pimples--Ringworms, Warts and Corns--Eczema and other Inflammatory Disorders._ No attempt will be made to give an extended account of skin diseases, but a few of the commoner disorders which can be readily recognized by the layman will be noticed. Although these cutaneous troubles are often of so trivial a nature that a physician's assistance is unsought, yet the annoyance is often sufficient to make it worth while for the patient to inform himself about the ailment. Then the affections are so frequent that they may occur where it is impossible to procure medical aid. Whenever an eruption of the skin is accompanied by fever, sore throat, headache, pains in back and limbs, vomiting, or general illness, one of the serious, contagious, eruptive diseases should be suspected, particularly in children, and the patient must be removed from contact with others, kept in isolation, and a physician immediately summoned. =ITCHING= (_Pruritus_).--Itching is not a distinct disease by itself, but a symptom or sign of other skin or general disorders. Occasionally it must be treated as if it were a separate disease, as when it occurs about the entrance to the bowel (_anus_), or to the external female sexual parts (_vulva_), or attacks the skin generally, and is not accompanied by any skin eruption except that caused by scratching, and the cause be unascertainable. Itching, without apparent cause, may be due to parasites, as lice and fleas, and this must always be kept in mind; although debilitated states of the body and certain diseases, as gout and diabetes, are sometimes the source. Commonly, itching is caused by one of the many recognized skin diseases, and is accompanied by an eruption characteristic of the particular disorder existing, and special treatment by an expert, directed to remedy this condition, is the only reasonable way to relieve the itching and cure the trouble. It may not, however, be improper to suggest means to relieve such a source of suffering as is itching, although unscientific, with the clear understanding that a cure cannot always be expected, but relief may be obtained until proper medical advice can be secured. The treatment to be given will be appropriate for itching due to any cause, with or without existing eruption on the skin, unless otherwise specified. If one remedy is unsuccessful, try others. For itching afflicting a considerable portion of the skin, baths are peculiarly effective. Cold shower baths twice daily, or swimming in cold water at the proper time of year, may be tried, but tepid or lukewarm baths are generally more useful. The addition of saleratus or baking soda, one to two pounds to the bath, is valuable, or bran water obtained by boiling bran tied in a bag in water, and adding the resulting solution to the bath. Even more efficient is a bath made by dissolving half a cupful of boiled starch and one tablespoonful of washing or baking soda in four gallons of warm water. The tepid baths should be as prolonged as possible, without chilling the patient. The bran water, or starch water, may be put in a basin and sopped on the patient with a soft linen or cotton cloth and allowed to evaporate from the skin, without rubbing, but while the skin is still moist a powder composed of boric acid, one part, and pulverized starch, four parts, should be dusted on the itching area. Household remedies of value include saleratus or baking soda (one teaspoonful to the pint of cold water), or equal parts of alcohol, or vinegar and water, which are used to bathe the itching parts and then permitted to dry on them. Cold solution of carbolic acid (one teaspoonful to the pint of hot water) is, perhaps, the most efficacious single remedy. But if it causes burning it must be washed off at once. Dressings wet with it must never be allowed to become dry, as then the acid becomes concentrated and gangrene may result. Calamine lotion (p. 145) is also a serviceable preparation when there is redness and swelling of the skin. When the itching is confined to small areas, or due to a pimply or scaly eruption on the skin, the following ointments may be tried: a mixture of tar ointment and zinc ointment (two drams each) with four drams of cold cream, or flowers of sulphur, one part, and lard, twelve parts. =CHAFING AND CHAPPING.=--Chafing occurs when two opposing skin surfaces rub together and are irritated by sweat, as in the armpits, under the breasts and beneath overlapping parts of the belly of fat people, and between the thighs and buttocks. The same result is caused by the irritation induced by discharges constantly running over the skin, as that seen in infants, due to the presence of urine and bowel discharges, and that irritation which arises from saliva when the lips are frequently licked. The latter condition of the lips is commonly called chapping, but it is proper to consider chafing and chapping together as the morbid state of the skin, and the treatment is the same for both. Chafing occurs more often in hot weather and after violent exercise, as rowing, riding, or running, and is aggravated by the friction of clothing or of tight boots. It may, on the other hand, appear in persons who sit a great deal, owing to constant pressure and friction in one place. The parts are hot, red, and tender, and emit a disagreeable odor when secretions are retained. The skin becomes sodden by retained sweat, and may crack and bleed. The same redness and tenderness are seen in chapping of the face and lips, and cracking of the lips is frequent. In chafing the first requisite is to remove the cause, and then thoroughly wash the part with soap and water. Then a saturated solution of boric acid in water should be applied with a soft cloth, and the parts dusted with a mixture of boric acid and powdered starch, equal parts, three times daily. If the lips are badly cracked, touching them, once daily, with a stick of silver nitrate (dipped in water) is of service. =HIVES; NETTLERASH= (_Urticaria_).--Hives is characterized by the sudden appearance of hard round or oval lumps in the skin, from the size of a pea to that of a silver dollar, of a pinkish-white color, or white in the center and often surrounded by a red blush. The rash is accompanied by much itching, burning, or tingling, especially at night when the clothes are removed. The peculiarity of this eruption is the suddenness with which the rash appears and disappears; the itching, the whitish or red lumps, the fact that the eruption affects any part of the body and does not run together, are also characteristic. Scratching of the skin often brings out the lumps in a few minutes. The swellings may last a few minutes or hours, and suddenly disappear to reappear in some other place. The whole trouble usually continues only a few days, although at times it becomes a chronic affection. Scratching alters the character of the eruption, and causes red, raw marks and crusts, but the ordinary swellings can be seen usually in some part of the body. Rarely, the eruption comes in the throat and leads to sudden and sometimes dangerous swelling, so that suffocation has ensued. With hives there are no fever, sore throat, backache, headache, which are common to the contagious eruptive disorders, as measles, scarlet fever, etc. Indigestion is the most frequent cause. Certain articles of diet are almost sure to bring on an attack of hives in susceptible persons; these include shellfish, clams, lobsters, crabs, rarely oysters; also oatmeal, buckwheat cakes, acid fruits, particularly strawberries, but sometimes raspberries and peaches. Nettlerash is common in children, and may follow any local irritation of the skin caused by rough clothes, bites of mosquitoes and fleas, and the stings of jellyfish, Portuguese man-of-war, and nettles. =Treatment.=--Remove any source of irritation in the digestive canal, or externally, and employ a simple diet for a few days, as bread and milk. A dose of castor oil, one teaspoonful for children; one tablespoonful for adults, or some other cathartic is advisable. Locally we use, as domestic remedies, a saturated solution of baking soda (or saleratus) in water, or equal parts of alcohol or vinegar and water to relieve the itching. The bath containing soda and starch (p. 141) is the most useful treatment when the nettlerash is general. Calamine lotion is one of the best applications which can be employed for this disorder. It should be sopped on frequently with a soft cloth and allowed to dry on the skin. CALAMINE LOTION Zinc oxide 1/4 ounce Powdered calamine 1/4 " Limewater 6 ounces Mix and shake before applying to the skin. If choking is threatened, give an emetic of mustard, one teaspoonful, and warm water, half a pint. =PIMPLES; BLACKHEADS= (_Acne_).--This eruption is situated chiefly on the face, but often on the back, shoulders, and chest as well. It is a disorder which is seen mostly in young men and women at about the age of puberty. It consists of conical elevations of the skin, from a pin head to a pea in size, often reddened and tender on pressure, and having a tendency to form matter or pus, as shown by a yellow spot in the center of the pimple. After three to ten days the matter is discharged, but red elevations remain, which later become brown and disappear without scarring, except in rare cases. "Blackheads" appear as slightly elevated black points, sometimes having a yellowish tint from which a little, thin, wormlike mass may be pressed. Pimples and blackheads are both due to inflammation about the glands of the skin which secrete oily material; the mouths of the glands become plugged with dust, thus retaining the oily secretion and causing blackheads. Then if these glands are invaded by germs producing pus, we have a pimple, which usually results in the formation of matter as described above. Constipation and indigestion favor the occurrence of pimples and blackheads; also a poor state of the blood, or anæmia. =Treatment.=--Tea, coffee, tobacco, and alcohol should be avoided, together with veal, pork, fats, and cheese. The bowels must be moved daily by some proper cathartic, as cascara tablets containing two grains each of the extract. The dose is one to two tablets at night. The blackheads should be squeezed out with a watch key, or with an instrument made for the purpose, not finger nails, and pimples containing matter must be emptied after being pricked with a needle (which has been passed through a flame to kill germs on it). If there is redness of the skin and irritation associated with pimples, it is sufficient to bathe the skin with very hot water and green soap three times daily, and apply calamine lotion (see p. 145) at night. In other cases, when the skin is not sensitive, and zinc or mercury has not been used, the employment of sulphur soap and hot water at bedtime, allowing the suds to dry and remain on the face during the night, is to be recommended. An ointment consisting of half a dram of precipitated sulphur with half an ounce each of powdered starch and vaseline applied each night, and hot water used on the face three times daily are also efficacious. Sulphur lotion is better than sulphur ointment. =COLD SORE; FEVER BLISTER.=--Cold sores occur usually about the lips or at the angles of the mouth, although they may appear anywhere on the face. Cold sore has a round, oval, or irregular outline, from the size of a pea to that of a quarter of a dollar, and is seen as a slightly raised patch on the skin on which is a group of very minute blisters, three to twelve in number. Cold sore may be single or multiple, and near together or widely separated on the face. Having first the appearance of a red patch, it later becomes covered with a brown crust from the drying of the contents of the tiny blisters. Cold sore often gives rise to burning, itching, or tingling, the disfigurement usually causing more annoyance, however, than the pain. The duration of the trouble is from four to twelve days. Cold sores are commonly induced by indigestion and fevers, and also are occasioned by local irritation of any sort, as from nasal discharge accompanying cold in the head (from which the name is derived), by the irritation produced by a pipestem or cigar, and by rubbing the skin. =Treatment.=--Picking and scratching are very harmful, and cigar or pipe smoking must be stopped. Painting the sore with collodion, by means of a camel's-hair brush, is poor treatment in the early stages. Better use spirits of camphor, and afterwards, if there is much itching or burning, sopping the eruption with calamine lotion (p. 145) will relieve the discomfort. =PRICKLY HEAT= (_Miliaria_).--This is a common eruption of adults in hot weather, and very frequently attacks children. It consists of fine, pointed, red rash, or minute blisters, and occurs on parts of the body covered by clothing, more often on the chest. The eruption is caused by much sweating, leading to congestion and swelling of the sweat glands. Burning, stinging, and itching accompany the disorder. The condition must be distinguished from the contagious skin eruptions. In the latter there are fever, sore throat, backache, headache, and general sickness, while in prickly heat there is no general disturbance of the system, or fever, unless the eruption comes out in the course of fevers, when it is of no significance except as one of the symptoms of fever. =Treatment.=--The treatment of prickly heat, occurring in hot weather, consists in avoiding heat as much as possible and sponging the surface with cold water, and then dusting it with some simple powder, as starch or flour, or better, borated talcum. To relieve the itching, sponging with limewater or a saturated solution of baking soda (as much as will dissolve) in water, or bran baths, made by tying one pound of bran in a towel which is allowed to soak in the bath, are all good remedies. =RINGWORM OF THE BODY; RINGWORM OF THE SCALP.=--This skin disease is caused by a vegetable fungus and not by a worm as the name suggests. The disease on the body and scalp is caused by the same parasite, but ringworm of the body may attack adults as well as children, and is readily cured; ringworm of the scalp is a disease confined to children, and is difficult of cure. Ringworm is contagious and may be acquired from children with the disease, and therefore patients suffering from it should not be sent to school, and should wear a skull cap and have brush, comb, towels, and wash cloths reserved for their personal use alone. Children frequently contract the disease from fondling and handling cats and dogs. =Symptoms.=--On the body, ringworm attacks the face, neck, and hands. It appears first as small, red, scaly spots which may spread into a circular patch as large as a dollar with a red ring of small, scaly pimples on the outside, while the center exhibits healthy skin, or sometimes is red and thickened. There may be several patches of ringworm near each other and they may run together, or there may be only one patch of the disease. Ringworm of the scalp occurs as a circular, scaly patch of a dusty-gray or pale-red color on which there are stubs of broken hairs pointing in different directions, and readily pulled out. The disease in this locality is very resistant to treatment. There are no crusts or itching as in eczema. =Treatment.=--The application of pure tincture of iodine or carbolic acid to the spots with a camel's-hair brush, on one or two occasions, will usually cure ringworm on the skin. On the scalp the hairs should be pulled out of the patch of ringworm, and each day it should be washed with soap and water and a solution of boric acid (as much acid as the water can dissolve), destroying the cloth used for washing. The following ointment is then applied: sulphur, one part; tar, two parts; and lard, eight parts. It is desirable to secure the services of a physician in this disease, in which various remedies may have to be tried to secure recovery. If untreated, ringworm is likely to last indefinitely. =FRECKLES, TAN, AND OTHER DISCOLORATIONS OF THE SKIN.=--Freckles appear as small, yellowish-brown spots on the face, arms, and hands, following exposure to the sun in summer, and generally fading away almost completely in winter. However, sometimes they do not disappear in winter, and do occur on parts of the body covered by clothing. Freckles are commonly seen in red-haired persons, rarely in brunettes, and never on the newborn. Their removal is accomplished by the employment of agents which cause a flaking off of the superficial layer of discolored skin, but after a few weeks the discolorations are apt to return. Large, brown spots of discoloration appearing on the face are observed more often in women, and are due to disorder of digestive organs of the sexual organs or to pregnancy; they also occur in persons afflicted with exhausting diseases. Tan, freckles, and discolorations of the skin generally are benefited by the same remedies. =Treatment.=--Prevention of tan and freckles is secured through nonexposure of the unprotected skin to the sun, though it is doubtful whether the end gained is worth the sacrifice, if carried so far as to the avoidance of the open air and sunlight whenever possible. Boric acid (sixteen grains to the ounce of water) is an absolutely harmless and serviceable agent for the removal of skin pigmentations. The skin may be freely bathed with it night and morning. Corrosive sublimate is the most effective remedy, but is exceedingly poisonous if swallowed accidentally, and must be kept out of children's way, and should not be applied over any large or raw surface of skin or on any mucous membrane. Its application is inadvisable as soon as any irritation of the skin appears from its use. The following preparation containing it is to be painted on the skin with a camel's-hair brush, night and morning: POISONOUS SUBLIMATE SOLUTION Corrosive sublimate 7 grains Alcohol 1-1/2 ounces Glycerin 1-1/2 " Oil of lavender 10 drops Mix. The following lotion is also efficacious: Zinc oxide 30 grains Powdered starch 30 " Kaolin 60 " Glycerin 2 drams Rose water 2 ounces Mix. DIRECTIONS.--Shake and paint on spots, and allow the preparation to dry; wash it off before each fresh application. It is best to use only cold water, rarely soap, on the healthy skin of the face. Warm water favors relaxation of the skin and formation of wrinkles. =IVY POISON.=--The poison ivy (_Rhus toxicodendron_), poison sumach (_Rhus venenata_), and poison oak (_Rhus diversiloba_ of the Pacific Coast, U. S. A.) cause inflammation of the skin in certain persons who touch either one of these plants, or in some cases even if approaching within a short distance of them. The plants contain a poisonous oil, and the pollen blown from them by the wind may thus convey enough of this oil to poison susceptible individuals who are even at a considerable distance. Trouble begins within four to five hours, or in as many days after exposure to the plants. The skin of the hands becomes red, swollen, painful, and itching. Soon little blisters form, and scratching breaks them open so that the parts are moist and then become covered with crusts. The poison is conveyed by the hands to the face and, in men, to the sexual organs, so that these parts soon partake of the same trouble. The face and head may become so swollen that the patient is almost unrecognizable. There is a common belief that ivy poison recurs at about the same time each year, but this is not so except in case of new exposures. Different eruptions on the same parts often follow ivy poisoning, however. =Treatment.=--A thorough washing with soap, especially green soap, will remove much of the poison and after effects. Saleratus or baking soda (a heaping tablespoonful of either to the pint of cold water) may be used to relieve the itching, but ordinary "lead and opium wash" is the best household remedy. Forty minims of laudanum[9] and four grains of sugar of lead dissolved in a pint of water form the wash. The affected parts should be kept continually wet with it. Aristol in powder, thoroughly rubbed in, is almost a specific. =WARTS.=--Warts are flattened or rounded outgrowths from the outer and middle layers of the skin, varying in size from a pin head to half an inch in diameter. There are several varieties. _Seed Warts._--These have numerous, little, fleshy projections over their surface, which are enlarged normal structures (_papillæ_) of the middle layer of the skin, together with the thickened, outer, horny layer. _Threadlike Warts._--These are seen along the edge of the nails, on the face, neck, eyelids, and ears. They are formed by the great prolongation and growth of the projections, or _papillæ_ of the middle layer of the skin just described. _Flat Warts_, raised but slightly above the surface are more common in old people. _Moist Warts_ occur where they are softened by secretions of the body, as about the sexual organs (in connection with diseases of the same), and about the anus (or opening of the bowel). They are of a white, pink, or red color, and consist of numerous, little, fleshy projections, usually covered with a foul-smelling secretion. Warts most commonly appear on the hands of children, but may appear on any part of the body and at all ages. They may disappear quickly or remain indefinitely. They are not communicable from one person to another. =Treatment.=--Warts may be removed by painting them frequently with the fresh juice of the milkweed, or with acetic acid or tincture of iodine. These remedies are all harmless, but somewhat slow and not always effective. Application, morning and evening, of a saturated solution of "washing soda" (impure bicarbonate of potash) will often remove a wart. =CORNS.=--Corns are local, cone-shaped thickenings of the outer layer of the skin of the feet, due to pressure and friction of the shoes, or opposed surfaces of skin between the toes. They are not in themselves sensitive, but pain follows pressure upon them, as they act as foreign bodies in bearing down upon the sensitive lower layers of the skin. Continued irritation often leads to inflammation of the skin around and beneath the corn with the formation of pus. Ordinarily, corns are tough, yellowish, horny masses, but, when moistened by sweat between the toes, they are white, and are called "soft corns." =Treatment.=--Comfortable shoes are the first requisite; well-fitting and neither tight nor loose. Pressure may be taken off the corns by surrounding them with felt rings or corn plaster. To remove the corn the foot should be soaked for a long time in warm water, in which is dissolved washing soda, and then the surface of the corn is gently scraped off with a clean, sharp knife. Another useful method consists in painting the corn, night and morning for five days, with the following formula, when both the coating and corn will come off on soaking the same for some time in warm water: Salicylic acid 30 grains Tincture of iodine 10 drops Extract of Cannabis Indica 10 grains Collodion 4 drams Mix. When the tissues about the corn become inflamed the patient must rest with the foot elevated and wrapped in a thick layer of absorbent cotton saturated with a hot solution of corrosive sublimate (one tablet to the pint of water) and covered with oil silk or rubber cloth. Pus must be let out with a knife which has been laid in boiling water. If corns are removed by the knife the foot should be previously made absolutely clean, the knife boiled, and the paring not carried to the extent of drawing blood. The too-close removal of a corn may lead to infection of the wounded tissues with germs, and in old people, and those with feeble circulation, gangrene or erysipelas may result. Soft corns are treated by removal of the surface layer, by soaking in washing soda and hot water and scraping as above stated, and then the corn should be dusted with a mixture of boric acid and zinc oxide, equal parts, and the toes kept apart by pads of absorbent cotton. =CALLUS AND CRACKS OF THE SKIN.=--Callus consists of round or irregular, flattened, yellowish thickenings of the upper or horny layer of the skin. The skin becomes hypertrophied and resembles a thick, horny layer, caused by intermittent pressure of tools, shoes, etc. The whole palm of the hand or soles of the feet may be the seats of a continuous callus. Callus is not harmful, except in leading to cracks of the skin near the bend of joints, and, rarely, in causing irritation, heat, pain, and even the formation of pus in the skin beneath. Callus usually disappears when the exciting cause or pressure is removed. =Treatment.=--The hands and feet should be soaked continuously in hot baths containing washing soda, and then should be covered with diachylon (or other) ointment. This may be done each night; or collodion (one ounce containing thirty grains of salicylic acid) may be painted, night and morning for several days, on the callus, and then, after soaking for some time in hot water, the surface should be scraped off with a dull knife and the process repeated as often as necessary to effect a cure. Fissure or cracks of the skin caused by callus are treated in the same manner: by prolonged soaking in hot water, paring away the edges, and applying diachylon ointment or cold cream to the part. Inflammation about callus must be cared for as recommended above for inflamed corns. =BOILS.=--A boil is a circumscribed inflammatory process, caused by the entrance of pus-producing germs into the skin either through the pores (the mouths of the sweat glands) or along the shafts of the hair, and in this way invading the glands which secrete a greasy material (sebaceous glands). In either case the pus germs set up an inflammation of the sweat or sebaceous glands, and the surrounding structures of the skin, and a small, red, itching pimple results. Rarely, after a few days, the redness and swelling disappear, and the pus, if any, dries and the whole process subsides. This is called a "blind boil." But usually the boil increases in size for several days, until it may be as large as a pigeon's egg. It assumes a bright-red sharply defined, rounded shape, with a conical point, and is at first hard and then softens as pus or "matter" forms. There is severe pain of a throbbing, boring character, which is worse at night, and destroys the patient's sleep and appetite. There may be some fever. The glands in the neighborhood may be enlarged and tender, owing to some of the pus germs' escaping from the boil and lodging in the glands. If the boil is not lanced, it reaches its full development in seven to ten days with the formation of a central "core" of dead tissue and some pus, which gives to the center of the boil a whitish or yellowish-brown appearance. The boil then breaks down spontaneously in one or more places (usually only one) and discharges some pus, and, with a little pressure, also the white, central core of dead tissue. The remaining wound closes in and heals in a week or two. Boils occur singly or in numbers, and sometimes in successive crops. When this happens it is because the pus germs from the previous boils have invaded fresh areas of skin. =Causes.=--Boils are thus contagious, the pus germs being communicated to new points on the patient's skin, or to that of another person. Local irritation of the skin, from whatever cause, enables the germs to grow more readily. The existence of skin diseases, as eczema ("salt rheum"), prickly heat, and other sources of itching and scratching, is conducive to boils, as the pus germs contained in ordinary dirt are rubbed into the irritated skin. Whenever the skin is chafed by rough clothing, as about the wrists and neck by frayed collars and sweaters, etc., boils are likely to occur. Also when the face and neck are handled by barbers with dirty hands or instruments, a fruitful field is provided for their invasion. While boils are always the result of pus germs gaining entrance to the skin glands, and, therefore, strictly due to local causes, yet they are more prone to occur when the body is weakened and unable to cope with germs which might do no harm under other circumstances. The conditions favoring the occurrence of boils are: an impoverished state of the blood, errors of diet and indigestion, overwork, dissipation, and certain diseases, as typhoid fever, diabetes, and smallpox. Boils are thought to occur more frequently in persons with rough skin and with a vigorous growth of dark hair. They may be situated on any part of the body, but certain localities are more commonly attacked, as the scalp, the eyelids, cheeks, neck, armpits, back, and buttocks. Boys and young men are generally the sufferers. =Treatment.=--The importance of cleanliness cannot be overestimated in the care of boils if we keep their cause in mind. Dirty underclothes or fingers used in squeezing or otherwise handling the boil, may carry the trouble to fresh parts. Any sort of local irritation should be removed; also all articles of clothing which have come in contact with the boils should not be worn until they have been washed in boiling water. There is no single remedy of much value for the cure of boils, although pills of calcium sulphide (each one-tenth grain) are commonly prescribed by physicians, every three hours. The most rational measure consists in removing the general causes, as noted above, if this is possible. When the patient is thin and poorly nourished, give food and cod-liver oil; and if the lips and skin are pale, iron arsenate pills (one-sixteenth grain each) are to be taken three times daily for several weeks. A boil may sometimes be arrested by painting it with tincture of iodine until the boil is almost black, or with a very heavy coating of collodion. If a boil continues to develop, notwithstanding this treatment, one should either use an ointment of vaseline containing ten per cent of boric acid spread on soft cotton over the boil, or, if the latter is very painful, resort to the frequent application of hot flaxseed poultices. When the boil has burst, and pus is flowing out on the surrounding skin, it should be kept very clean by frequent washing with hot water and soap and the application of a solution of corrosive sublimate (one part to 1,000) made by dissolving one of the tablets, sold everywhere for surgical purposes, in a pint of warm water. This will prevent the lodgment of the pus germs in the skin and the formation of more boils. Poultices mixed with bichloride (corrosive sublimate) solution are less likely to encourage inoculation of neighboring areas. The poultices should be stopped as soon as the pain ceases, and the boil dressed as recommended above, dusted with pure boric acid and covered with clean absorbent cotton and bandage. After pus has begun to form in a boil recovery will be materially hastened by the use of a knife, although this is not essential. The boil should be thoroughly cleaned, and a sharp knife, which has been boiled in water for five minutes, is inserted, point first, into the center of the boil, far enough to liberate the pus and dead tissue. By this means healing is much more rapid than by nature's unassisted methods. Pure carbolic acid, applied on the tip of a toothpick, thrust into the head of a boil, is generally curative. When many boils occur, consult a physician. =CARBUNCLE.=--A carbuncle is similar to a boil in its causation and structure, but is usually a much more serious matter having a tendency to spread laterally and involve the deeper layers of the skin. It is commonly a disease of old persons, those prematurely old or debilitated, and occurs most frequently on the neck, back, or buttocks. It is particularly dangerous when attacking the back of the neck, upper lip, or abdomen. Carbuncle often begins, with a chill and fever, as a pimple, and rapidly increases in size forming a hot, dusky red, rounded lump which may grow until it is from three to six inches in diameter. Occasionally it runs a mild course, remains small, and begins to discharge pus and dead tissue at the end of a week and heals rapidly. More commonly the pain soon becomes intense, of a burning, throbbing character, and the carbuncle continues to enlarge for a week or ten days, when it softens and breaks open at various points discharging shreds of dead tissue and pus. The skin over the whole top of the carbuncle dies and sloughs away, leaving an angry-looking excavation or crater-like ulcer. This slowly heals from the edges and bottom, so that the whole period of healing occupies from a week to two, or even six months. The danger depends largely upon blood poisoning, and also upon pain, continuous fever, and exhaustion which follow it. Sweating and fever, higher at night, are the more prominent signs of blood poisoning. Carbuncles differ from boils in being much larger, in having rounded or flat tops instead of the conical shape of boils, in having numerous, sievelike openings, in the occurrence of death of the skin over the top of the carbuncle, and in being accompanied by intense pain and high fever. =Treatment.=--Carbuncle demands the earliest incision by a skilled surgeon, as it is only by cutting it freely open, or even removing the whole carbuncle as if it were a tumor, that the best results are accomplished. However, when a surgeon cannot be obtained, the patient's strength should be sustained by feeding every two hours with beef tea, milk and raw eggs, and with wine or alcoholic liquors. Three two-grain quinine pills and ten drops of the tincture of the chloride of iron in water should be given three times daily. The local treatment consists in applying large, hot, fresh flaxseed poultices frequently, with the removal of all dead tissue with scissors, which have been boiled in water for ten minutes. When the pain is not unbearable, dressings made by soaking thick sheets of absorbent cotton in hot solution of corrosive sublimate (1 to 1,000 as directed under Boils, p. 161) should be applied and covered by oil silk or rubber cloth and bandage. They are preferable to poultices as being better germ destroyers, but are not so comfortable. When the dead tissue comes away and the carbuncle presents a red, raw surface, it should be washed twice a day in the 1 to 1,000 corrosive-sublimate solution, dusted with pure boric acid, and covered with clean, dry absorbent cotton and bandage. =ECZEMA; SALT RHEUM; TETTER.=--Eczema is really a catarrhal inflammation of the skin, with the exudate (fluid that escapes) concealed beneath the surface, or appearing on the surface after irritation has occurred. The many varieties are best classified as follows: (1) Eczema of internal origin, including cases due to morbid agencies produced within the body, cases due to drugs, and possibly reflex cases. (2) Eczema of external origin, including cases caused by occupation, by climate, or by seborrhea. Eczema of internal origin almost invariably appears on both sides of the body at once, as on both cheeks, or both arms, or both thighs. Its border shades into the surrounding skin, it is dotted with papules (or heads) filled with fluid, and its surface is clean and not greasy. As it spreads, the symmetry of distribution is lost. Among the morbid agencies producing this variety of eczema are the products of indigestion. Among the drugs producing it is cod-liver oil. Occupation eczema occurs first on exposed parts, as the hands, arms, face, and neck, in those who handle irritant dyes, sugar, formalin, etc. Climatic eczema includes the "winter itch," common in this latitude, appearing on wrists and ankles in the form of clean, scaly patches, often ringed. The seborrheic variety spreads from the scalp to the folds of the skin. Its borders are sharply defined, and its crusts and scales yellowish and greasy. It spreads from a center in all directions at once. =Treatment.=--The treatment of eczema puzzles a physician, and only specialists in skin diseases are able easily to diagnose the subacute or chronic forms. It may appear different, and need different treatment almost from day to day, and consequently only general suggestions can be made for home management of a case of this disease. The outlook is always good; and even in the case of weak and debilitated patients, there is excellent chance of cure. The diet must be regulated at once. Meat should be eaten in small quantities once a day only, and none but very digestible meats should be eaten, as fowl, beef, and lamb. Sugar and sweet food need be cut down only when there is indigestion with a production of gas. Fresh air and exercise are imperative. Five grains of calomel, at night, followed by one heaped tablespoonful of Rochelle salts dissolved in a full tumbler of water the next morning before breakfast, should be repeated twice a week till marked improvement is seen. Meanwhile, external treatment must be pushed. Generally speaking, ointments must not be used on weeping or exuding surfaces; all scales and crusts must be removed from the surface; and acute patches must be soothed, chronic patches stimulated. Water is harmful and increases the trouble; but it is necessary to use it once, in cleansing the affected area, in the form of soap and water. If there are thick, adherent crusts, a poultice of boiled starch, covered with a muslin cloth, will loosen them in a night. Thickened or horny layers on the palms and soles may be covered with salicylic plaster (ten per cent strength), which is removed after two days, and the whole part soaked in warm water, when the horny layer is to be peeled off. Thickened surfaces are best treated with wood tar, in the form of oil of cade ointment, or the "pix liquida" of the drug shops mixed with twice its amount of olive oil. This should be well rubbed into the affected part. Seborrheic eczema of the scalp and neighboring areas is best treated with a four per cent ointment of ammoniated mercury, rubbed in once a day for five days, followed by the application of a solution of resorcin in water, four grains to the ounce. Weeping and exuding patches should be treated with powdered stearate of zinc, or oleate of bismuth, or aristol, either one dusted on till the area is fairly covered. When the surface begins to dry up, the following paste may be applied: Salicylic acid 5 to 15 grains Zinc oxide 2 drams Powdered starch 2 drams Vaseline 1 ounce If weeping returns, stop the ointment and resume the powder treatment, or use the following lotion: Zinc oleate 1 dram Magnesium carbonate 1 dram Ichthyol 1/2 ounce Lime water 4 ounces When the skin after scaling off becomes thin, all swelling having disappeared, lead plaster is of service, or diachylon ointment twenty-five per cent, made with olive oil. An eczema of moderate extent should recover after four to six weeks' treatment, unless the soles or palms be attacked, when six or more months of treatment may be necessary. If itching is pronounced, remove crusts and scabs after soaking with olive oil, dust borax, finely powdered on the surface. If the itching is not controlled in twenty minutes, wipe off the borax with a very oily cloth (using olive oil), and then apply a little solution of carbolic acid (made by adding a half teaspoonful of carbolic acid to a pint of hot water). If this does not allay the itching, wipe it off thoroughly with the oiled cloth, and rub in the tar ointment made of equal parts of "pix liquida" and olive oil. After the itching ceases, treat as directed according to the variety existing. Itching often disappears after a good saline cathartic has acted--Rochelle salts, solution of magnesia citrate, or phosphate of soda. Scratching must be avoided. In the case of children it is prevented by putting mittens of muslin on the hands. The best cathartic for young children is a teaspoonful of castor oil. Carbolic-acid solution must not be used on them. The folds and creases of their skin must be kept dry and powdered with borated talcum. A great point in the treatment of all eczema is to avoid the use of water, and to substitute oiling with olive oil and wiping off for the usual washing of the affected area. =BALDNESS AND DANDRUFF.=--Baldness is commonly caused by seborrhea of the scalp, an affection probably due to a microbe, and consisting of an inflammation of the skin, with great increase of dandruff of a thick, greasy variety. Sometimes it appears as a thick film, not only covering the scalp, but also the forehead and back of the neck. The greasy substance should be removed with olive oil or vaseline, and the scalp treated with ointment of ammoniated mercury, four per cent strength. Shampoos with tar-soap suds should be given once in four or five weeks, and the hair should not be wet with water between the shampoos. The hair must be arranged by combing, the brush being used to smooth the surface of the hair only. Deep and repeated brushing does great damage, which is equalled only by the frequent washing some ill-advised sufferers employ. Massage of the scalp is useless to control seborrheic eczema, which is practically always present in these cases. Tight hats are sometimes a cause of baldness. The lead used in the preparation of the "sweat leather" of hats is said to be a cause of loss of hair over the temples. When once killed, hair can rarely be made to grow again. Early treatment of seborrhea is the best preventive of baldness. The baldness occurring during an attack of syphilis, when the hair falls out in round patches, is treated and often relieved by antisyphilitic remedies (see p. 210). FOOTNOTES: [9] Caution. Poisonous. CHAPTER III =Rheumatism and Kindred Diseases= _Causes of Rheumatic Fever--Relief of Pain in the Joints--Lumbago--Stiff Neck--Gout--Symptoms and Cure of Scurvy._ =RHEUMATIC FEVER; INFLAMMATORY RHEUMATISM; ACUTE RHEUMATISM.=--This variety of rheumatism is quite distinct from the other forms, being in all probability due to some special germ. It occurs in temperate climates during the fall, winter, and spring--less often in summer. Persons more frequently suffer between the ages of ten and forty years. It is rare in infants; their pain and swelling of the limbs can be attributed more often to scurvy (p. 180), or to surgical disease with abscess of joint or bone. Exposure to cold and damp, in persons insufficiently fed, fatigued, or overworked, is the most common exciting cause. =Symptoms.=--Rheumatic fever may begin with tonsilitis, or other sore throat, with fever and pains in the joints. The joints rapidly become very painful, hot, red, swollen, and tender, the larger joints, as the knees, wrists, ankles, and elbows, being attacked in turn, the inflammation skipping from one joint to another. The muscles near the joints may be also somewhat swollen and tender. With the fever, which may be high (the temperature ranging from 102° to 104° F.), there are rapid pulse, copious sweating, and often the development of various rashes and minute blisters on the skin. There is also loss of appetite, and the bowels are constipated. The urine is usually very dark-colored. Altogether, victims of the disease are truly pitiable, for they suffer agony, and are unable to move without increasing it. The weakness and prostration are marked. Small, hard lumps, from the size of a shot to that of a pea, sometimes appear on the skin of the fingers, hands, wrists, knees, and elbows. These are not tender; they last for weeks and months. They are seen more often in children, and are most characteristic of rheumatic fever, but do not show themselves till late in the disease. Complications of rheumatic fever are many. In about half the cases the heart becomes involved, and more or less permanent crippling of the heart persists in after life. Unconsciousness and convulsions may develop--more often when the fever runs high. Lung trouble and pleurisy are not infrequent. Chorea or St. Vitus's dance follows inflammatory rheumatism, in children, in some instances. Repeated attacks at intervals, varying from one to four or five years, are rather the rule--more particularly in young persons. Acute rheumatism frequently takes a milder form, with slight fever (the temperature running not over 100° or 101° F.) and slight pain, and swelling of the joints. In children this is a common occurrence, but heart disease is just as apt to follow, and, therefore, such cases should receive a physician's attention at the earliest moment. Recovery from rheumatic fever is the usual result, but with an increased tendency to future attacks, and with the possibility of more or less permanent weakness of the heart, for acute rheumatism is the most common origin of chronic heart troubles. The milder form often follows the more severe, and may persist for a long time. The duration of rheumatic fever is variable; in severe cases the patient is bedridden for six weeks or so. Rheumatism may be named through a mistake in diagnosis. There are numerous other febrile disorders in which inflammation of the joints may occur. Among these are gonorrhea, pneumonia, scarlet fever, blood poisoning, diphtheria, etc. The joint trouble in these cases is caused by the toxins accompanying the special germ which occasions the original disease, and the joint inflammation is not in any way connected with rheumatism. The constant attention of a physician is emphatically demanded in every case of rheumatic fever, since the complications are so numerous, and since permanent damage of the heart may be prevented by proper care. Only frequent examinations of the heart by the medical man will reveal the presence or absence of heart complications. =Treatment.=--It appears extremely doubtful whether rheumatic fever can be cut short by any form of treatment. The disease is self-limited, that is, it will pass away of itself after a certain time. The pain, however, can be rapidly abated by treatment. Warmth is of great value. It is best for the patient to sleep between blankets instead of sheets, and to wear flannel nightgowns, changing them as often as they become damp with sweat. To facilitate the changing, it is well to have the nightgowns slit all down the front, and also on the outside of the sleeves. Wrapping the joints in cotton batting and applying splints to secure absolute rest are great aids to comfort. The diet should be fluid, consisting of gruels, milk, broths, and soups. To relieve pain in the joints, cloths, wrung out of a saturated solution of baking soda and very hot water, wrapped about the joint and covered with oil silk will be found extremely serviceable. Oil of wintergreen is another remedy which has proven of value when applied to the joints on cloths saturated in the oil and covered with cotton wool. The bed must be smooth and soft, with good springs. High fever is reduced by the employment of cold to the head and by sponging the body with cool water at intervals of two hours or so. The two drugs of most value are some form of salicylic acid and an alkali. Sodium salicylate in solution in water should be given to the adult in doses of ten to fifteen grains every two hours till the pain is relieved, and then once in four hours as long as the fever lasts. At the same time baking soda should be administered every three hours, one-half a level teaspoonful dissolved in water, and this may be continued as long as the fever persists. The patient must use a bedpan in relieving the bladder and bowels, and should remain in bed for a great while if the heart is damaged. It is a disease which no layman should think of treating if it is possible to obtain the services of a medical man. =MUSCULAR RHEUMATISM= (_Myalgia_).--In this disease there is pain in the muscles, which may be constant, but is more pronounced on movement. Exposure to cold and wet, combined with muscular strain, frequently excite an attack. On the other hand, it often occurs during hot, dry, fine weather. Attacks last usually but a few days, but may be prolonged for weeks. The pain may be dull, as if the muscle had been bruised, but is often very sharp and cramplike. There is, commonly, slight, if any, fever, and no general disturbance of the health. The following are the most common varieties: =LUMBAGO.=--This attacks the muscles in the small part of the back. It comes on often with great suddenness, as on stooping or lifting. It may be so severe that the body cannot be moved, and the patient may fall in the street or be unable to rise or turn in bed. In less severe cases the pain "catches" the patient when attempting to straighten up after stooping. Pain in the back is often attributed by the laity to Bright's disease, but is rarely seen in the latter disorder, and is much more often due to rheumatism. =STIFF NECK.=--This is a very common variety of muscular rheumatism, and is seen more especially in young persons. It may appear very suddenly, as on awakening. It attacks the muscles of one side and back of the neck. The head is held stiffly to one side, and to turn the head the body must be turned also, as moving the neck causes severe pain. Sometimes the pain on moving the neck suddenly, or getting it into certain positions, is agonizing, but when it is held in other positions a fair amount of comfort may be secured. =RHEUMATISM OF THE CHEST.=--In this form there is more or less constant pain, much increased by coughing, sneezing, taking long breaths, or by movements. It attacks usually one side, more often the left. It may resemble neuralgia or pleurisy. In neuralgia the pain is more limited and comes in sharper attacks, and there are painful spots. The absence of fever in rheumatism of the chest will tend to separate it from pleurisy, in which there is, moreover, often cough. Examination of the chest by a physician, to determine the breath sounds, is the only method to secure certainty in this matter. Muscular rheumatism also affects the muscles about the shoulder and shoulder blade and upper part of the back; sometimes also the muscles of the belly and limbs. =Treatment.=--Rest, heat, and rubbing are the most satisfactory remedies. In stiff neck, rub well with some liniment, as chloroform liniment, and lie in bed on a hot-water bag. Phenacetin or salophen in doses of ten grains, not repeated more frequently than once in four hours for an adult, may afford relief; only two or three doses should be taken in all. In lumbago the patient should remain in bed and have the back ironed with a hot flatiron, the skin being protected by a piece of flannel. This should be repeated several times a day. Or a large, hot, flaxseed poultice may be applied to the back, and repeated as often as it becomes cool. At other times the patient may lie on a hot-water bag. Plasters will give comfort in milder cases, or when the patient is able to leave the bed. A good cathartic, as two compound cathartic pills, sometimes acts very favorably at the beginning of the attack. Salicylate of sodium is a useful remedy in many cases, the patient taking ten grains three times daily, in tablets after eating, for a number of days. In rheumatism of the chest, securing immobility by strapping the chest, as recommended for broken rib (Vol. I, p. 84), gives more comfort than any other form of treatment. Many other measures may be employed by the physician, and are applicable in persistent cases, as electricity and tonics. The hot bath, or Turkish bath, will sometimes cut short an attack of muscular rheumatism if employed at the onset of the trouble. =CHRONIC RHEUMATISM.=--Chronic rheumatism is a disease attacking persons of middle age, or after, and is seen more commonly in poor, hard-working individuals who have been exposed to cold and damp, as laborers and washerwomen. Several of the larger joints, as the knees, shoulders, and hips, are usually affected, but occasionally only one joint is attacked. There is little swelling and no redness about the joint; the chief symptoms are pain on motion, stiffness, and tenderness on pressure. The pain is increased by cold, damp weather, and improved by warm, dry weather. There is no fever. The general health suffers if the pain is severe and persistent, and patients become pale, dyspeptic, and weak. The disease tends rather to grow worse than recover, and the joints, after a long time, to become immovable and misshapen. Life is not, however, shortened to any considerable degree by chronic rheumatism. Heart disease is not caused by this form of rheumatism, although it may arise from somewhat similar tendencies existing in the same patient. It may be distinguished from other varieties of rheumatism by the fact that the larger joints are those attacked, and also by the age of the patients and general progress of the disease. It very rarely follows acute rheumatism. =Treatment.=--The treatment of chronic rheumatism is generally not very successful unless the patient can live in a warm, dry climate the year round. Painting the joint with tincture of iodine and keeping it bandaged in flannel affords some relief. The application of a cold, wet cloth covered with oil silk and bandage, by night, also proves useful. Hot baths at night, Turkish baths, or special treatment conducted under the supervision of a competent medical man at one of the hot, natural, mineral springs, as those in Virginia, often prove of great value. Rubbing and movement of the joints is of much service in all cases; any liniment may be used. Drugs are of minor importance, but cod-liver oil and tonics may be required. These should be prescribed by a physician. =RHEUMATIC GOUT= (_Arthritis_).--Notwithstanding the name, this disease has no connection with either gout or the other forms of rheumatism described. It occurs much more frequently in women, with the exception of that form in which a single joint is attacked. The disease may appear at any age, but more often it begins between the years of thirty and fifty-five. The cause is still a matter of doubt, although it often follows, or is associated with, nervous diseases, and in other cases the onset seems to be connected with the existence of influenza or gonorrhea, so that it may be of germ origin. Constant exposure to cold and dampness, excessive care and anxiety, and injury are thought to favor the disease. The disease is sometimes limited to the smaller joints of the fingers and toes, little, hard knobs appearing on them. At times the joints may be swollen, tender, and red, and are usually so at the beginning of the disease, as well as at irregular intervals, owing to indigestion, or following injury. At first only one joint, as of the middle finger, may be attacked, and often the corresponding finger on the other hand is next affected. The joints of the fingers become enlarged, deformed, and stiffened. The results of the disease are permanent so far as the deformity is concerned and the stiffness which causes interference with the movement of the finger joints, but the disease may stop during any period of its development, leaving a serviceable, though somewhat crippled, hand. In these cases the larger joints are not generally involved. There is some evidence to indicate that this form of the disease is more commonly seen in the long-lived. =General Form.=--In this type the disease tends to attack all the joints, and, in many cases, to go from bad to worse. The hands are usually first attacked, then the knees, feet, and other joints. In the worst cases every joint in the body becomes diseased, so that even movements of the jaw may become difficult. There are at first slight swelling, pain and redness about the joints, with tenderness on pressure. Creaking and grating are often heard during motion of the affected joints. This condition may improve or subside for intervals, but gradually the joints become misshapen and deformed. The joints are enlarged, and irregular and stiff; the fingers become drawn over toward the little finger, or bent toward the palm, and are wasted and clawlike. The larger limbs are often bent and cannot be straightened, and the muscles waste away, making the joints look larger. In the worst cases the patient becomes absolutely crippled, helpless, and bedridden, and the joints become immovable. The pain may be great and persistent, or slight. Usually the pain grows less as the disease advances. Numbness and tingling of the skin often trouble the patient, and the skin is sometimes smooth and glossy or freckled. The general health suffers, and weakness, anæmia, and dyspepsia are common. Even though most of the joints become useless, there is often sufficient suppleness in the fingers to allow of their use, as in writing or knitting. In old men the disease is seen attacking one joint alone, as the hip, shoulder, knee, and spine. Children are occasionally sufferers, and in young women it may follow frequent confinements or nursing, and often begins in them like a mild attack of rheumatic fever. The heart is not damaged by rheumatic gout. It is frequently impossible to distinguish rheumatic gout from chronic rheumatism in the beginning. In the latter, creaking and grating sounds on movement of the joints are less marked, the small joints, as of the hand, are not so generally attacked, nor are there as great deformity and loss of motion as is seen in late cases of rheumatic gout. =Outlook.=--It often happens that after attacking several joints, the disease is completely arrested and the patient becomes free from pain, and only a certain amount of interference with the use of the joint and stiffness remain. Life is not necessarily shortened by the disease. The deformity and crippling are permanent. =Treatment.=--Rheumatic gout is a chronic disease in most instances, and requires the careful study and continuous care of the medical man. He may frequently be able to arrest it in the earlier stages, and prevent a life of pain and helplessness. In a general way nourishing food, as milk, eggs, cream, and butter, with abundance of fresh vegetables, should be taken to the extent of the digestive powers. Everything that tends to reduce the patient's strength must be avoided. Cod-liver oil and tonics should be used over long periods. Various forms of baths are valuable, as the hot-air bath, and hot natural or artificial baths. A dry, warm climate is most appropriate, and flannel clothing should be worn the year round. Moderate exercise and outdoor life, in warm weather, are advisable, and massage, except during the acute attacks of pain and inflammation, is beneficial. Surgical measures will sometimes aid patients in regaining the usefulness of crippled limbs. =SCURVY.=--Scurvy used to be much more common than it is now. In the Civil War there were nearly 50,000 cases in the Union Army. Sailors and soldiers have been the common victims, but now the disease occurs most often among the poorly fed, on shore. It is caused by a diet containing neither fresh vegetables, preserved vegetables, nor vegetable juices. In the absence of vegetables, limes, lemons, oranges, or vinegar will prevent the disease. It is also thought that poisonous substances in the food may occasion scurvy, as tainted meat has experimentally produced in monkeys a disease resembling it. Certain conditions, as fatigue, cold, damp quarters, mental depression and homesickness, favor the development of the disease. It attacks all ages, but is most severe in the old. =Symptoms.=--Scurvy begins with general weakness and paleness. The skin is dry, and has a dirty hue. The gums become swollen, tender, spongy, and bleed easily, and later they may ulcerate and the teeth loosen and drop out. The tongue is swollen, and saliva flows freely. The appetite is poor and chewing painful, and the breath has a bad odor. The ankles swell, and bluish spots appear on the legs which may be raised in lumps above the surface. The patient suffers from pain in the legs, which sometimes become swollen and hard. The blue spots are also seen on the arms and body, and are due to bleeding under the skin, and come on the slightest bruising. Occasionally there is bleeding from the nose and bowels. The joints are often swollen, tender, and painful. Constipation is rather the rule, but in bad cases there may be diarrhea, nausea, and vomiting, and the victim becomes a walking skeleton. Mental depression or delirium may be present. =Treatment.=--Recovery is usually rapid and complete, unless the disease is far advanced. Soups, fresh milk, beef juice, and lemon or orange juice may be given at first, when the digestion is weak, and then green vegetables, as spinach (with vinegar), lettuce, cabbage, and potatoes. The soreness of the mouth is relieved by a wash containing one teaspoonful of carbolic acid to the quart of hot water. This should be used to rinse the mouth several times daily, but must not be swallowed. Painting the gums with a two per cent solution of silver nitrate in water, by means of a camel's-hair brush, twice daily, will also prove serviceable. To act as a tonic, a two-grain quinine pill and two Blaud's pills of iron may be given three times daily. =INFANTILE SCURVY.=--Scurvy occasionally occurs in infants between twelve and eighteen months of age, and is due to feeding on patent foods, condensed milk, malted milk, and sterilized milk. In case it is essential to use sterilized or pasteurized milk, if the baby receives orange juice, as advised under the care of infants, scurvy will not develop. Scurvy is frequently mistaken for either rheumatism or paralysis in babies. =Symptoms.=--The lower limbs become painful, and the baby cries out when it is moved. The legs are at first drawn up and become swollen all around just above the knees, but not the knee joints themselves. Later the whole thigh swells, and the baby lies without moving the legs, with the feet rolled outward and appears to be paralyzed, although it is only pain which prevents movement of the legs. Sometimes there is swelling about the wrist and forearm, and the breastbone may appear sunken in. Purplish spots occur on the legs and other parts of the body. The gums, if there are teeth present, become soft, tender, spongy, and bleed easily. There may be slight fever, the temperature ranging from 101° to 102° F. The babies are exceedingly pale, and lose all strength. =Treatment.=--The treatment is very simple, and recovery rapidly takes place as soon as it is carried out. The feeding of all patent baby foods--condensed or sterilized milk--must be instantly stopped. A diet of fresh milk, beef juice, and orange juice, as directed under the care of infants, will bring about a speedy cure. =GOUT.=--Notwithstanding the frequency with which one encounters allusions to gout in English literature, it is unquestionably a rare disease in the United States. In the Massachusetts General Hospital there were, among 28,000 patients admitted in the last ten years, but four cases of gout. This is not an altogether fair criterion, as patients with gout are not generally of the class who seek hospitals, nor is the disease one of those which would be most likely to lead one into a hospital. Still, the experience of physicians in private practice substantiates the view of the rarity of gout in this country. We are still ignorant of the exact changes in the bodily condition which lead to gout, but may say in a general way that in this disease certain products, derived from our food and from the wear and tear of tissues, are not properly used up or eliminated, and are retained in the body. One of these products is known as sodium biurate, and is deposited in the joints, giving rise to the inflammation and changes to be described. Gout occurs chiefly in men past forty. The tendency to the disease is usually inherited. Overeating, together with insufficient exercise and indulgence in alcohol, are conducive to its development in susceptible persons. Injuries, violent emotion, and exposure to cold are also thought to favor attacks. The heavier beers and ales of England, together with their stronger wines, as port, Madeira, sherries, and champagne, are more prone to induce gout than the lighter beers drunk in the United States and Germany. Distilled liquors, as brandy and whisky, are not so likely to occasion gout. "Poor man's gout" may arise in individuals who lead the most temperate lives, if they have a strong inherited tendency to the disease, or when digestion and assimilative disorders are present, as well as in the case of the poor who drink much beer and live in bad surroundings, and have improper and insufficient food. Workers in lead, as typesetters and house painters, are more liable to gout than others. =Symptoms.=--There is often a set of preliminary symptoms varying in different persons, and giving warning of an approaching attack of gout, such as neuralgic pains, dyspepsia, irritability, and mental depression, with restless nights. An acute attack generally begins in the early morning with sudden, sharp, excruciating pain in the larger joint of one of the big toes, more often the right, which becomes rapidly dark red, mottled, swollen, hot, tense, shiny, and exceedingly sensitive to touch. There is commonly some fever; a temperature of 102° to 103° F. may exist. The pain subsides in most cases to a considerable degree during the day, only to return for several nights, the whole period of suffering lasting from four to eight days. Occasionally the pain may be present without the redness, swelling, etc., or _vice versa_. Other joints may be involved, particularly the joint of the big toe of the other foot. Complete recovery ensues, as a rule, after the first attack, and the patient may thereafter feel exceptionally well. A return of the disease is rather to be expected. Several attacks within the year are not uncommon, or they may appear at much longer intervals. Occasionally the gout seems to "strike in." In this case it suddenly leaves the foot and attacks the heart, causing the patient severe pain in that region and great distress in breathing; or the abdomen becomes the seat of violent pain, and vomiting, diarrhea, collapse and death rarely result. In the later history of such patients, the acute attacks may cease and various joints become chronically diseased, so that the case assumes the appearance of a chronic form of rheumatism. The early history of attacks of sharp pain in the great toe and the appearance of hard deposits (chalk stones) in the knuckles and the ears are characteristic of gout. The greatest variety of other disorders are common in those who have suffered from gout, or in those who have inherited the tendency. "Goutiness" is sometimes used to describe such a condition. In this there may never be any attacks of pain or inflammation affecting the joints, but eczema and other skin diseases; tonsilitis, neuralgia, indigestion and biliousness, lumbago and other muscular pains, sick headache, bronchitis, disease of heart and kidneys, with a tendency to apoplexy, dark-colored urine, stone in the bladder, and a hot, itching sensation in the palms of the hands and soles of the feet, all give evidence of the gouty constitution. =Treatment.=--One of the most popular remedies is colchicum--a powerful drug and one which should only be taken under the direction of a physician. A cathartic at the beginning is useful; for instance, two compound cathartic pills or five grains of calomel. It is well to give five grains of lithium citrate dissolved in a glass of hot water every three hours. Laville's antigout liquid, imported by Fougera of New York, taken according to directions, may suffice during the absence of a physician. The inflamed toe should be raised on a chair or pillow, and hot cloths may be applied to it. The general treatment, between the attacks, consists in the avoidance of all forms of alcohol, the use of a diet rich in vegetables, except peas, beans, and oatmeal, with meats sparingly and but once daily. Sweets must be reduced to the minimum, but cereals and breadstuffs are generally allowable, except hot bread. All fried articles of food, all smoked or salted meats, smoked or salted fish, pastry, griddle cakes, gravies, spices and seasoning, except red pepper and salt, and all indigestibles are strictly forbidden, including Welsh rarebit, etc. Fruit may be generally eaten, but not strawberries nor bananas. Large quantities of pure water should be taken between meals--at least three pints daily. Mineral waters offer no particular advantage. Part III SEXUAL HYGIENE BY KENELM WINSLOW CHAPTER I =Health and Purity= _Duties of Parents--Abuse of the Sexual Function--False Teachings--Criminal Neglect--Secure the Child's Confidence--The Best Corrections--Marriage Relations._ Every individual should know how to care for the sexual organs as well as those of any other part of the body, providing that the instruction be given by the proper person and at the proper time and place. Such information should be imparted to children by parents, guardians, or physicians at an early age and, if this is neglected through ignorance or false modesty, erroneous ideas of the nature and purpose of the sexual function will very surely be supplied later by ignorant and probably evil-minded persons with correspondingly bad results. There is no other responsibility in the whole range of parental duties which is so commonly shirked and with such deplorable consequences. When the subject is shorn of the morbid and seductive mystery with which custom has foolishly surrounded it in the past, and considered in the same spirit with which we study the hygiene of the digestion and other natural functions, it will be found possible to give instruction about the sexual function in a natural way and without exciting unhealthy and morbid curiosity. A word in the beginning as to the harm produced by abuse of the sexual function. The injury thus received is purposely magnified tenfold for reasons of gain by quacks who work upon the fears of their victims for their own selfish purposes. The voluntary exercise of the sexual function--unlike that of any other important organs--is not necessary to health until maturity has been reached; on the contrary, continence is conducive to health, both physical and mental. Even after maturity, unless marriage occurs, or by improper living the sexual desires are unnaturally stimulated, it is quite possible to maintain perfect health through life without exercising the sexual function at all. Undue irritation of the sexual organs causes disorder of the nervous system, and if continued it will result ultimately in overfatigue and failure of the nervous activities which control the normal functions of every organ in the body. In other words, it will result in nervous exhaustion. Damage is also wrought by exciting local irritation, congestion, and inflammation of the sexual organs which result in impairment of the proper functions of these parts and in local disorders and distress. It is unnecessary further to particularize other than to state that abuse of the sexual organs in the young is usually owing to the almost criminal neglect or ignorance of the child's parents. But so far from increasing alarm in the patient it is almost always possible to enable the child to be rid of the habit by kindly instruction and judicious oversight in the future, and no serious permanent local damage to the sexual organs or general injury to the nervous system will be likely to persist. The opposite teaching is that peculiar to the quack who prophesies every imaginable evil, from complete loss of sexual function to insanity. Any real or fancied disorder of the sexual function is extremely apt to lead to much mental anxiety and depression, so that a cheerful outlook is essential in inspiring effort to correct bad habits and is wholly warranted in view of the entire recovery in most cases of the young who have abused their sexual organs. Insanity or imbecility are seldom the result but more often the cause of such habits. It is a sad fact, however, that, under the prevailing custom of failure of the parents to exercise proper supervision over the sexual function of their children, self-abuse is generally practiced in youth, at least by boys. This often leads to temporary physical and mental suffering and is very prejudicial to the morals, but does not commonly result in permanent injury except in the degenerate. Children at an early age--three to four years--should be taught not to touch, handle, rub, or irritate their sexual organs in any way whatsoever except so far as is necessary in urination or in the course of the daily cleansing. If there seems to be any inclination to do so it will usually be found that it is due to some local trouble to which a physician's attention should be called and which may generally be readily remedied by him. It is always advisable to ask the medical adviser to examine babies for any existing trouble and abnormality of the sexual organs, as a tight, adherent, or elongated foreskin in boys--and rarely a corresponding condition in girls--may give rise to much local irritation and remote nervous disturbances. The presence of worms may lead to irritation in the bowel, which excites masturbation in children. Girl babies should be watched to prevent them from irritating the external sexual parts by rubbing them between the inner surfaces of the thighs. As the child begins to play with other children he or she should be cautioned to avoid those who in any way try to thwart the parents' advice, and be instructed to report all such occurrences. It is wise also to try and gratify the child's natural curiosity about the sexual function so far as may be judicious by explanations as to the purpose of the sexual organs, when the child is old enough to comprehend such matters. The reticence and disinclination of parents to instruct their children in matters relating to sex cannot be too strongly condemned. It is perfectly natural that the youth should wish to know something of the origin of life and how human beings come into the world. The mystery and concealment thrown around these matters only serve to stimulate his curiosity. It is a habit of most parents to rebuke any questions relating to this subject as improper and immodest, and the first lesson the child learns is to associate the idea of shame with the sexual organs; and, since he is not enlightened by his natural instructors, he picks up his knowledge of the sex function in a haphazard way from older and often depraved companions. Evasive replies with the intent of staving off the dreaded explanation do no good and may result in unexpected evil. By securing the child's confidence at the start, one may not only keep informed of his actions but protect him from seeking or even listening to bad counsels. At the age of ten or twelve it is well that the family physician or parent should give instruction as to the special harm which results from unnaturally exciting the sexual nature by handling and stimulating the sexual organs and also warning the child against filthy literature and improper companions. At the age of puberty he should be warned against the moral and physical dangers of sexual intercourse with lewd women. The physical dangers refer to the great possibility of infection with one or both of the common diseases--syphilis and gonorrhea--acquired by sexual contact with one suffering from these terrible disorders (p. 199). It is usually quite impossible for a layman to detect the presence of these diseases in others, or rather, to be sure of their absence, and the permanent damage which may be wrought to the sufferer and to others with whom he may have sexual relations is incalculable. It is generally known that syphilis is a disease to be dreaded, but not perhaps that it not only endangers the life and happiness of the patient, but the future generation of his descendants. Gonorrhea--the much more common disease--while often treated lightly by youth, frequently leads to long, chronic, local disease and may even result fatally in death; later in life it may cause infection of a wife resulting in chronic invalidism and necessitating surgical removal of her maternal organs. These possibilities often occur long after the patient thinks he is wholly free from the disease. Gonorrhea in women is the most frequent cause of their sterility, and also is a common source of abortion and premature birth. It is the cause in most cases of blindness in infants (p. 205) and also of vulvo-vaginitis in girl babies. Furthermore, gonorrhea is so alarmingly prevalent that it is stated on good authority that the disease occurs in eighty per cent of all males some time during their lives. The disease is not confined to prostitutes, but is common, much more frequently than is suspected, in all walks and classes of life and at all ages. Even among boys attending boarding schools and similar institutions the disease is only too frequent. It is particularly important that the true situation be explained to boys about to enter college or a business career, for it is at this period of life that their temptations become greatest. Alcohol is the most dangerous foe--next to bad companions--with which they must contend in this matter, for, weakened by its influence and associated with persuasive friends, their will gives way and the advice and warning, which they may have received, are forgotten. Idleness is also another influential factor in indirectly causing sexual disease; hard physical and mental work are powerful correctives of the passions. It may be of interest to readers to know that but recently an association of American physicians, alarmed by the fearful prevalence of sexual diseases in this country, has been taking measures to inform youths and adults and the general public, through special instruction in schools, and by means of pamphlets and lectures to teachers and others, of the prevalence and great danger of this evil. When young adult life has been attained it is also desirable for the parent, or the family physician, to inform the young man or woman--especially if either is about to enter a marriage engagement--that close and frequent personal contact with the opposite sex, especially when the affections are involved, will necessarily, though involuntarily, excite local stimulation of the sexual organs and general irritability and exhaustion of the entire nervous system. Long engagements--when the participants are frequent companions--are thus peculiarly unfortunate. It is only when the sexual functions are normally exercised in adult life, as in sexual intercourse, that sexual excitement is not harmful. Young women about to marry should receive instruction from their mothers as to the sexual relations which will exist after marriage. Most girls are allowed to grow up ignorant of such matters and in consequence may become greatly shocked and even disgusted by the sexual relations in marriage--fancying that there must be something unnatural and wrong about them because the subject was avoided by those responsible for their welfare. Any excess in frequency of sexual intercourse after marriage is followed by feelings of depression and debility of some sort which may be readily attributed to the cause and so corrected. Any deviation from the natural mode of intercourse is pretty certain to lead to physical disaster; thus, unnatural prolongation of the act, or withdrawal on the part of the man before the natural completion of the act in order to prevent conception, often results in deplorable nervous disorders. In conclusion, it may be said that parents must take upon themselves the burden of instructing their children in sexual hygiene or shift it upon the shoulders of the family physician, who can undertake it with much less mental perturbation and with more intelligence. Otherwise they subject their offspring to the possibility of incalculable suffering, disease, and even death--largely through their own inexcusable neglect. CHAPTER II =Genito-Urinary Diseases= _Contagious Disorders--Common Troubles of Children--Inflammation of the Bladder--Stoppage and Suppression of Urine--Causes and Treatment of Bright's Disease._ =GONORRHEA.=--Gonorrhea is a contagious inflammation of the urethra, accompanied by a white or yellowish discharge. It is caused by a specific germ, the _gonococcus_, and is acquired through sexual intercourse with a person suffering from this disease. Exceptionally the disease may be conveyed by objects soiled with the discharge, as basins, towels, and, in children, diapers, so that in institutions for infants it may be thus transferred from one to the other, causing an epidemic. The mucous membrane of the lower part of the bowel and the eyes are also subject to the disease through contamination with the discharge. The disease begins usually three to seven days after sexual intercourse, with symptoms of burning, smarting, and pain on urination, and a watery discharge from the passage, soon followed by a yellowish or white secretion. Swelling of the penis, frequent urination, and painful erections are also common symptoms. The disease, if uncomplicated and running a favorable course, may end in recovery within six weeks or earlier, with proper treatment. On the other hand, complications are exceedingly frequent, and the disorder often terminates in a chronic inflammation which may persist for years--even without the knowledge of the patient--and may result in the infection of others after all visible signs have ceased to appear. =Treatment.=--Rest is the most important requisite; at first, best in bed; if not, the patient should keep as quiet as possible for several days. The diet should consist of large quantities of water or milk, or milk and vichy, with bread, cereals, potatoes, and vegetables--absolutely avoiding alcohol in any form. Sexual intercourse is harmful at any stage in the disease and will communicate the infection. Aperient salts should be taken to keep the bowels loose. The penis should be soaked in hot water three times daily to reduce the inflammation and cleanse the organ. A small wad of absorbent cotton may be held in place by drawing the foreskin over it to absorb the discharge, or may be held in place by means of a bag fitting over the penis. All cloths, cotton, etc., which have become soiled with the discharge, should be burned, and the hands should be washed after contact with the discharge; otherwise the contagion may be conveyed to the eyes, producing blindness. It is advisable for the patient to take one-half teaspoonful of baking soda in water three times daily between meals for the first four or five days, or, better, fifteen grains of potassium citrate and fifteen drops of sweet spirit of nitre in the same way. Painful erections may be relieved by bathing the penis in cold water, urinating every three hours, and taking twenty grains of sodium bromide at night in water. After all swelling and pain have subsided, local treatment may be begun. Injections or irrigations with various medicated fluids constitute the best and most efficient measures of local treatment. They should be used only under the advice and management of the physician. No greater mistake can be made than to resort to the advertising quack, the druggist's clerk, or the prescription furnished by an obliging friend. Skillful treatment, resulting in a complete radical cure, may save him much suffering from avoidable complications and months or years of chronic trouble. At the same time the first medicines advised are stopped and oleoresin of cubebs, five grains, or copaiba balsam, ten grains--or both together--are to be taken three times daily after meals, in capsules, for several weeks, unless they disturb the digestion too much. A suspensory bandage should be worn throughout the continuance of the disease. The approach of the cure of the disease is marked by a diminution in the quantity and a change in the character of the discharge, which becomes thinner and less purulent and reduced to merely a drop in the passage in the early morning, but this may continue for a great while. Chronic discharge of this kind and the complications cannot be treated properly by the patient, but require skilled medical care. In this connection it may be said that most patients have an idea that the subsidence or disappearance of the discharge is an evidence of the cure of the disease. Experience shows that the disease may lapse into a latent or chronic form and remain quiescent, without visible symptoms, during a prolonged period, while susceptible of being revived under the influence of alcoholic drinks or sexual intercourse. It is important that treatment should be continued until all disease germs are destroyed, which can only be determined by an examination of the secretions from the urethra under the microscope. The more common complications of gonorrhea are inflammation of the glands in the groin (bubo), acute inflammation of the prostate glands and bladder, of the seminal vesicles, or of the testicles. The latter complication is a most common cause of sterility in men. Formerly it was thought that gonorrhea was a local inflammation confined to the urinary canal and neighboring parts, but advances in our knowledge have shown that the germs may be taken up into the general circulation and affect any part of the body, such as the muscles, joints, heart, lungs, liver, spleen, kidneys, etc., with results always serious and often fatal to life. One of the most common complications is gonorrheal arthritis, which may affect one or several joints and result in stiffness or complete loss of movement of the affected joint, with more or less deformity and permanent disability. Another complication is gonorrheal inflammation of the eye, from direct transference of the pus by the fingers or otherwise, and resulting in partial or complete blindness. =GONORRHEA IN WOMEN.=--Gonorrhea in women is a much more frequent and serious disease than was formerly supposed. The general impression among the laity is that gonorrhea in women is limited to the prostitute and vicious classes who indulge in licentious relations. Unfortunately, this is not the case. There is perhaps more gonorrhea, in the aggregate, among virtuous and respectable wives than among professional prostitutes, and the explanation is the following: A large proportion of men contract the disease at or before the marrying age. The great majority are not cured, and the disease simply lapses into a latent form. Many of them marry, believing themselves cured, and ignorant of the fact that they are bearers of contagion. They transmit the disease to the women they marry, many of whom, from motives of modesty and an unwillingness to undergo an examination do not consult a physician, and they remain ignorant of the existence of the disease until the health is seriously involved. In women, gonorrhea is not usually so acute and painful as in men, unless it involves the urethra. It usually begins with smarting and painful urination, with frequent desire to urinate and with a more or less abundant discharge from the front passage. In the majority of cases the infection takes place in the deeper parts, that is, in the neck or body of the womb. In this location it may not give rise at first to painful symptoms, and the patient often attributes the increased discharge to an aggravation of leucorrhea from which she may have suffered. The special danger to women from gonorrhea is that the inflammation is apt to be aggravated during the menstrual period and the germs of the disease ascend to the cavity of the womb, the tubes, and ovaries, and invade the peritoneal covering, causing peritonitis. Pregnancy and childbirth afford favorable opportunities for the upward ascension of the germs to the peritoneal cavity. The changes caused by gonorrheal inflammation in the maternal organs are the most common cause of sterility in women. It is estimated that about fifty per cent of all sterility in women proceeds from this cause. In addition to its effects upon the child-bearing function, the danger to the health of such women is always serious. In the large proportion of cases they are made permanent invalids, no longer able to walk freely, but compelled to pass their lives in a reclining position until worn out by suffering, which can only be relieved by the surgical removal of their maternal organs. It is estimated that from fifty to sixty per cent of all operations performed on the maternal organs of women are due to disease caused by gonorrheal inflammation. =Treatment.=--Rest in bed, the use of injections of hot water, medicated with various astringents, by means of a fountain syringe in the front passage three times daily, and the same remedies and bath recommended above, with hot sitz baths, will usually relieve the distress. In view of the serious character of this affection in women and its unfortunate results when not properly treated, it is important that they should have the benefit of prompt and skillful treatment by a physician. Otherwise, the health and life of the patient may be seriously compromised. The social danger of gonorrhea introduced after marriage is not limited to the risks to the health of the woman. When a woman thus infected bears a child the contagion of the disease may be conveyed to the eyes of the child in the process of birth. Gonorrheal pus is the most virulent of all poisons. A single drop of the pus transferred to the eye may destroy this organ in from twenty-four to forty-eight hours. It is estimated that from seventy-five to eighty per cent of all babies blinded at birth have suffered from this cause, while from twenty to thirty per cent of blindness from all causes is due to gonorrhea. While the horrors of this disease in the newborn have been mitigated by what is called the Crédé method (instillation of nitrate of silver solution in the eye immediately after birth), it still remains one of the most common factors in the causation of blindness. Another social danger is caused by the pus being conveyed to the genital parts of female children, either at birth or by some object upon which it has been accidentally deposited, such as clothes, sponges, diapers, etc. These cases are very common in babies' hospitals and institutions for the care of children. Quite a number of epidemics have been traced to this cause. The disease occurring in children is exceedingly difficult of cure and is often followed by impairment in the development of their maternal organs. Much of the ill health of young girls from disordered menstruation and other uterine diseases may be traced to this cause. Another serious infection in babies and young children is gonorrheal inflammation of the joints, with more or less permanent crippling. =SYPHILIS; THE POX; LUES.=--Syphilis is a contagious germ disease affecting the entire system. While commonly acquired through sexual intercourse with a person affected with the disorder, it may be inherited from the parents, one or both. It is often acquired through accidental contact with sources of contagion. Syphilis and tuberculosis are the two great destroyers of health and happiness, but syphilis is the more common. =Symptoms.=--Acquired syphilis may be divided into three stages: the primary, secondary, and tertiary. The first stage is characterized by the appearance of a pimple or sore on the surface of the sexual organ not usually earlier than two, nor later than five to seven, weeks after sexual intercourse. The appearance of this first sore is subject to such variations that it is not always possible for even the most skillful physician to determine positively the presence of syphilis in any individual until the symptoms characteristic of the second stage develop. Following the pimple on the surface of the penis comes a raw sore with hard deposit beneath, as of a coin under the skin. It may be so slight as to pass unnoticed or become a large ulcer, and may last from a few weeks to several months. There are several other kinds of sores which have no connection with syphilis and yet may resemble the syphilitic sore so closely that it becomes impossible to distinguish between them except by the later symptoms to be described. Along with this sore, lumps usually occur in one or both groins, due to enlarged glands. The second stage appears in six to seven weeks after the initial sore, and is characterized by the occurrence of a copper-colored rash over the body, but not often on the face, which resembles measles considerably. Sometimes a pimply or scaly eruption is seen following this or in place of the red rash. At about, or preceding, this period other symptoms may develop, as fever, headache, nausea, loss of appetite, and sleeplessness, but these may not be prominent. Moist patches may appear on the skin, in the armpits, between the toes, and about the rectum; or warty outgrowths in the latter region. There is sore throat, with frequently grayish patches on the inside of the cheeks, lips, and tongue. The hair falls out in patches or, less often, is all lost. Inflammation of the eye is sometimes a symptom. These symptoms do not always occur at the same time, and some may be absent or less noticeable than others. The third stage comes on after months or years, or in those subjected to treatment may not occur at all. This stage is characterized by sores and ulcerations on the skin and deeper tissues, and the occurrence of disease of different organs of the body, including the muscles, bones, nervous system, and blood vessels; every internal organ is susceptible to syphilitic change. A great many affections of the internal organs--the heart, lungs, liver, kidneys, brain, and cord--which were formerly attributed to other causes, are now recognized as the product of syphilis. The central nervous system is peculiarly susceptible to the action of the syphilitic poison, and when affected may show the fact through paralysis, crippling, disabling, and disfiguring disorders. Years after cure has apparently resulted, patients are more liable to certain nervous disorders, as locomotor ataxia, which attacks practically only syphilitics; and general paresis, of which seventy-five per cent of the cases occur in those who have had syphilis. =Inherited Syphilis.=--Children born with syphilis of syphilitic parents show the disease at birth or usually within one or two months. They present a gaunt, wasted appearance, suffer continually from snuffles or nasal catarrh, have sores and cracks about the lips, loss of hair, and troublesome skin eruptions. The syphilitic child has been described as a "little old man with a cold in his head." The internal organs are almost invariably diseased, and sixty to eighty per cent of the cases fortunately die. Those who live to grow up are puny and poorly developed, so that at twenty they look not older than twelve, and are always delicate. It is to be noted that syphilis is not necessarily a venereal disease, that is, acquired through sexual relations. It may be communicated by kissing, by accidental contact with a sore on a patient's body, by the use of pipes, cups, spoons, or other eating or drinking utensils, or contact with any object upon which the virus of the disease has been deposited. Any part of the surface of the body or mucous membrane is susceptible of being inoculated with the virus of syphilis, followed by a sore similar to what has been described as occurring upon the genital parts and later the development of constitutional symptoms. The contagiousness of the disease is supposed to last during the first three years of its existence, but there are many authentic cases of contagion occurring after four or five years of syphilis. =Diagnosis.=--The positive determination of the existence of syphilis at the earliest moment is of the utmost importance in order to set at rest doubt and that treatment may be begun. It is necessary to wait, however, until the appearance of the eruption, sore throat, enlargement of glands, falling out of hair, etc., before it is safe to be positive. =Treatment.=--The treatment should be begun as soon as the diagnosis is made, and must be continuously and conscientiously pursued for three years or longer. If treatment is instituted before the secondary symptoms, it may prevent their appearance so that the patient may remain in doubt whether he had the disease or not, for it is impossible for the most skilled specialist absolutely to distinguish the disease before the eruption, no matter how probable its existence may seem. This happens because there are several kinds of sores which attack the sexual organs and which may closely simulate syphilis. The treatment is chiefly carried out with various forms of mercury and iodides, but so much knowledge and experience are required in adapting these to the individual needs and peculiarities of the patient that it is impossible to describe their use. Patients should not marry until four or five years have elapsed since the appearance of syphilis in their persons, and at least twelve months after all manifestations of the disease have ceased. If these conditions have been complied with, there is little danger of communicating the disease to their wives or transmitting it to their offspring. They must moreover, have been under the treatment during all this period. Abstinence from alcohol, tobacco, dissipation, and especial care of the teeth are necessary during treatment. =Results.=--The majority of syphilitics recover wholly under treatment and neither have a return of the disease nor communicate it to their wives or children. It is, however, possible for a man, who has apparently wholly recovered for five or six years or more, to impart the disease. Without proper treatment or without treatment for the proper time, recurrence of the disease is frequent with the occurrence of the destructive and often serious symptoms characteristic of the third stage of the disease. While syphilis is not so fatal to life as tuberculosis, it is capable of causing more suffering and unhappiness, and is directly transmitted from father to child, which is not the case with consumption. Syphilis is also wholly preventable, which is not true of tuberculosis at present. It is not probable that syphilis is ever transmitted to the third generation directly, but deformities, general debility, small and poor teeth, thin, scanty growth of hair, nervous disorders, and a general miserable physique are seen in children whose parents were the victims of inherited syphilis. In married life syphilis may be communicated to the wife directly from the primary sore on the penis of the husband during sexual intercourse, but contamination of the wife more often happens from the later manifestations of the disease in the husband, as from secretion from open sores on the body or from the mouth, when the moist patches exist there. It is possible for a child to inherit syphilis from the father--when the germs of syphilis are transmitted through the semen of the father at the time of conception--and yet the mother escape the disease. On the other hand, it is not uncommon for the child to become thus infected and infect its mother while in her womb; or the mother may receive syphilis from the husband after conception, and the child become infected in the womb. The chief social danger of syphilis comes from its introduction into marriage and its morbid radiations through family and social life. Probably one in every five cases of syphilis in women is communicated by the husband in the marriage relation. There are so many sources and modes of its contagion that it is spread from one person to another in the ordinary relations of family and social life--from husband to wife and child, from child to nurse, and to other members of the family, so that small epidemics of syphilis may be traced to its introduction into a family. Syphilis is the only disease which is transmitted in full virulence to the offspring, and its effect is simply murderous. As seen above, from sixty to eighty per cent of all children die before or soon after birth. One-third of those born alive die within the next six months, and those that finally survive are blighted in their development, both physical and mental, and affected with various organic defects and deformities which unfit them for the battle of life. Syphilis has come to be recognized as one of the most powerful factors in the depopulation and degeneration of the race. =INVOLUNTARY PASSAGE OF URINE--BED-WETTING IN CHILDREN.=--(_Incontinence of Urine_).--This refers to an escape of urine from the bladder uncontrolled by the will. It naturally occurs in infants under thirty months, or thereabouts, and in the very old, and in connection with various diseases. It may be due to disease of the brain, as in idiocy or insanity, apoplexy, or unconscious states. Injuries or disorders of the spinal cord, which controls the action of the bladder (subject to the brain), also cause incontinence. Local disorders of the urinary organs are more frequent causes of the trouble, as inflammation of any part of the urinary tract, diabetes, nephritis, stone in the bladder, tumors, and malformations. The involuntary passage of urine may arise from irritability of bladder--the most frequent cause--or from weakness of the muscles which restrain the escape of urine, or from obstruction to flow of urine from the bladder, with overflow when it becomes distended. It is a very common disorder of children and young persons, and in some cases no cause can be found; but in many instances it is due to masturbation (p. 193), to a narrow foreskin and small aperture at the exit of the urinary passage, to worms in the bowels or disease of the lower end of the bowels, such as fissure or eczema, to digestive disorders, to retaining the urine overlong, to fright, to dream impressions (dreaming of the act of urination), and to great weakness brought on by fevers or other diseases. In old men it is often due to an enlargement of a gland at the neck of the bladder which prevents the bladder from closing properly. A concentrated and irritating urine, from excessive acidity or alkalinity, may induce incontinence. Children may recover from it as they approach adult life, but they should not be punished, as it is a disease and not a fault. Exception should be made in case children wet their clothing during play, through failure to take the time and trouble to pass water naturally. It is more common among children at night, leading to wetting of the bed, but may occur in the day, and often improves in the spring and summer, only to return with the cold weather. Children who sleep very soundly are more apt to be subject to this disorder. =Treatment.=--In the case of a disorder depending upon one of so many conditions it will be realized that it would be folly for the layman to attempt to treat it. Children who are weak need building up in every possible way, as by an outdoor life, cold sponging daily, etc. If there is in boys a long foreskin, or tight foreskin, hindering the escape of urine and natural secretions of this part, circumcision may be performed to advantage by the surgeon, even in the infant a few months old. Sometimes a simpler operation, consisting of stretching or overdistending the foreskin, can be done. A somewhat corresponding condition in girls occasionally causes bed-wetting and other troubles. It can be discovered by a physician. Children who wet their beds, or clothes, should not drink liquid after five in the afternoon, and should be taken up frequently during the night to pass water. The bed covering must be light, and they should be prevented from lying on the back while asleep by wearing a towel knotted in the small part of the back. Elevation of the foot of the bed a few inches is recommended as having a corrective influence. Masturbation, if present, must be corrected. It is a very difficult disorder to treat, and physicians must be excused for failures even after every attempt has been made to discover and remove the cause. Even when cure seems assured, the disorder may recur. =INFLAMMATION OF THE BLADDER= (_Cystitis_).--The condition which we describe under this head commonly causes frequent painful urination. Primarily there is usually some agency which mechanically or chemically irritates the bladder, and if the irritation does not subside, inflammation follows owing to the entrance of germs in some manner. The introduction into the bladder of unboiled, and therefore unclean, instruments is a cause; another cause is failure to pass urine for a long period, from a feeling of delicacy in some persons when in unfavorable surroundings. Nervous spasm of the urinary passage from pain, injuries, and surgical operations constitutes another cause. Inflammation may extend from neighboring parts and attack the bladder, as in gonorrhea, and in various inflammations of the sexual organs of women, as in childbed infection. Certain foods, waters, and drinks, as alcohol in large amounts, and drugs, as turpentine or cantharides applied externally or given internally, may lead to irritation of the bladder. Exposure to cold in susceptible persons is frequently a source of cystitis, as well as external blows and injuries. The foregoing causes are apt to bring on sudden or acute attacks of bladder trouble, but often the disease comes on slowly and is continuous or chronic. Among the causes of chronic cystitis, in men over fifty, is obstruction to the outflow of urine from enlargement of the prostate gland, which blocks the exit from the bladder. In young men, narrowing of the urethra, a sequel to gonorrhea, may also cause cystitis; also stone in the bladder or foreign bodies, tumors growing in the bladder, tuberculosis of the organ. Paralysis of the bladder, which renders the organ incapable of emptying itself, thus retaining some fermenting urine, is another cause of bladder inflammation. =Symptoms.=--The combination of frequency of and pain during urination, with the appearance of blood or white cloudiness and sediment in the urine, are evidences of the existence of inflammation of the bladder. The trouble is aggravated by standing, jolting, or active exercise. The pain may be felt either at the beginning or end of urination. There is also generally a feeling of weight and heaviness low down in the belly, or about the lower part of the bowel. Blood is not frequently present, but the urine is not clear, if there is much inflammation, but deposits a white and often slimy sediment on standing. In chronic inflammation of the bladder the urine often has a foul odor and smells of ammonia. =Treatment.=--The treatment of acute cystitis consists in rest--preferably on the back, with the legs drawn up, in bed. The diet should be chiefly fluid, as milk and pure water, flaxseed tea, or mineral waters. Potassium citrate, fifteen grains, and sweet spirit of nitre, fifteen drops, may be given in water to advantage three times daily. Hot full baths or sitz baths two or three times a day, and in women hot vaginal douches (that is, injections into the front passage), with hot poultices or the hot-water bag over the lower part of the abdomen, will serve to relieve the suffering. If, however, the pain and frequency attending urination is considerable, nothing is so efficient as a suppository containing one-quarter grain each of morphine sulphate and belladonna extract, which should be introduced into the bowel and repeated once in three hours if necessary. This treatment should be employed only under the advice of a physician. In chronic cystitis, urotropin in five-grain doses dissolved in a glass of water and taken four times daily often affords great relief, but these cases demand careful study by a physician to determine their cause, and often local treatment. Avoidance of all source of irritation is also essential in these cases, as sexual excitement and the use of alcohol and spices. The diet should consist chiefly of cereals and vegetables, with an abundance of milk and water. The bowels should be kept loose by means of hot rectal injections in acute cystitis. =RETENTION, STOPPAGE, OR SUPPRESSION OF URINE.=--Retention refers to that condition where the urine has been accumulating in the bladder for a considerable time--over twelve hours--and cannot be passed. It may follow an obstruction from disease, to which is added temporary swelling and nervous contraction of some part of the urinary passage; or it may be due to spasm and closure of the outlet from nervous irritation, as in the cases of injuries and surgical operations in the vicinity of the sexual organs, the rectum, or in other parts of the body. Overdistention of the bladder from failure to pass water for a long time may lead to a condition where urination becomes an impossibility. Various general diseases, as severe fevers, and conditions of unconsciousness, and other disorders of the nervous system, are frequently accompanied by retention of urine. In retention of urine there is often an escape of a little urine from time to time, and not necessarily entire absence of outflow. =Treatment.=--Retention of urine is a serious condition. If not relieved, it may end in death from toxæmia, caused by back pressure on the kidneys, or from rupture of the bladder. Therefore surgical assistance is demanded as soon as it can be obtained. Failing this, begin with the simpler methods. A hot sitz bath, or, if the patient cannot move, hot applications, as a hot poultice or hot cloths applied over the lower part of the belly, may afford relief. Injections of hot water into the bowel are often more efficient still. A single full dose of opium in some form, as fifteen drops of laudanum[10] or two teaspoonfuls of paregoric[10] or one-quarter grain of morphine,[10] will frequently allow of a free passage of urine. The introduction of a suppository into the bowel, containing one-quarter grain each of morphine sulphate,[10] and belladonna extract, is often preferable to giving the drug by the mouth. These measures proving of no avail, the next endeavor should be to pass a catheter. If a soft rubber or elastic catheter is used with reasonable care, little damage can be done, even by a novice. The catheter should be boiled in water for ten minutes, and after washing his hands thoroughly the attendant should anoint the catheter with sweet oil (which has been boiled) or clean vaseline and proceed to introduce the catheter slowly into the urinary passage until the urine begins to flow out through the instrument. A medium-sized catheter is most generally suitable, as a No. 16 of the French scale, or a No. 8-1/2 of the English scale. =BRIGHTS DISEASE OF THE KIDNEYS.=--Bright's disease of the kidneys is acute or chronic, and its presence can be definitely determined only by chemical and microscopical examination of the urine. Acute Bright's disease coming on in persons previously well may often, however, present certain symptoms by which its existence may be suspected even by the layman. =ACUTE BRIGHT'S DISEASE; ACUTE INFLAMMATION OF THE KIDNEYS.=--Acute Bright's disease is often the result of exposure to cold and wet. Inflammation of the kidneys may be produced by swallowing turpentine, many of the cheap flavoring extracts in large amounts, carbolic acid, and Spanish flies; the external use of large quantities of turpentine, carbolic acid, or Spanish flies may also lead to acute inflammation of the kidneys. It occurs occasionally in pregnant women. The contagious germ diseases are very frequently the source of acute Bright's disease either as a complication or sequel. Thus scarlet fever is the most frequent cause, but measles, smallpox, chickenpox, yellow fever, typhoid fever, erysipelas, diphtheria, cholera, and malaria are also causative factors. =Symptoms.=--Acute Bright's disease may develop suddenly with pallor and puffiness of the face owing to dropsy. The eyelids, ankles, legs, and lower part of the belly are apt to show the dropsy most. There may be nausea, vomiting, pain and lameness in the small part of the back, chills and fever, loss of appetite, and often constipation. In children convulsions sometimes appear. The urine is small in amount, perhaps not more than a cupful in twenty-four hours, instead of the normal daily excretion of three pints. Occasionally complete suppression of urine occurs. It is high-colored, either smoky or of a porter color, or sometimes a dark or even bright red, from the pressure of blood. Stupor and unconsciousness may supervene in severe cases. Recovery usually occurs, in favorable cases, within a few weeks, with gradually diminishing dropsy and increasing secretion of urine, or the disease may end in a chronic disorder of the kidneys. If acute Bright's disease is caused by, or complicated with, other diseases, the probable result becomes much more difficult to predict. =Treatment.=--The failure of the kidneys to perform their usual function of eliminating waste matter from the blood makes it necessary for the skin and bowels to do double duty. The patient should remain in bed and be kept very warm with flannel night clothes and blankets next the body. The diet should consist wholly of milk, a glass every two hours, in those with whom it agrees, and in others gruels may be substituted to some extent. The addition to milk of mineral waters, limewater, small amounts of tea, coffee, or salt often makes it more palatable to those otherwise disliking it. As the patient improves, bread and butter, green and juicy vegetables, and fruits may be permitted. An abundance of pure water is always desirable. The bowels should be kept loose from the outset by salts given in as little water as possible and immediately followed by a glass of pure water. A teaspoonful may be given hourly till the bowels move. Epsom or Glauber's salts are efficient, but the compound jalap powder is the best purgative. Children, or those to whom these remedies are repugnant, may take the solution of citrate of magnesia, of which the dose is one-half to a whole bottle for adults. The skin is stimulated by the patient's lying in a hot bath for twenty minutes each day or, if this is not possible, by wrapping the patient in a blanket wrung out of hot water and covered by a dry blanket, and then by a rubber or waterproof sheet, and he is allowed to remain in it for an hour with a cold cloth to the head. If the patient takes the hot bath he should be immediately wrapped in warmed blankets on leaving it, and receive a hot drink of lemonade to stimulate sweating. For treatment of convulsions, see Vol. I, p. 188. Vomiting is allayed by swallowing cracked ice, single doses of bismuth subnitrate (one-quarter teaspoonful) once in three hours, and by heat applied externally over the stomach. Recovery is hastened by avoiding cold and damp, and persisting with a liquid diet for a considerable period. A course of iron is usually desirable after a few weeks have elapsed to improve the quality of the blood; ten drops of the tincture of the chloride of iron taken in water through a glass tube by adults; for children five to ten drops of the syrup of the iodide of iron. In either case the medicine should be taken three times daily after meals. =CHRONIC BRIGHT'S DISEASE.=--This includes several forms of kidney disease. The symptoms are often very obscure, and the condition may not be discovered or suspected by the physician until an examination of the urine is made, which should always be done in any case of serious or obscure disorder. Accidental discovery of Bright's disease during examination for life insurance is not rare. The disease may exist for years without serious impairment resulting. =Causes.=--Chronic Bright's disease often follows and is the result of fevers and acute inflammation of the kidneys. It is more common in adults. Overeating, more especially of meat, and overdrinking of alcohol are frequent causes. Gout is a frequent factor in its causation. The disease has in the past been regarded as a local disease of the kidneys, but recent research makes it probable that there is a general disorder of the system due to some faulty assimilation of food--especially when the diet itself is faulty--with the production of chemical products which damage various organs in the body as well as the kidneys, notably the heart and blood vessels. =Symptoms.=--The symptoms are most diverse and varied and it is not possible to be sure of the existence of the disease without a careful physical examination, together with a complete examination of the urine, both made by a competent physician. Patients may be afflicted with the disease for long periods without any symptoms until some sudden complication calls attention to the underlying trouble. Symptoms suggesting chronic Bright's disease are among the following: indigestion, diarrhea and vomiting, frequent headache, shortness of breath, weakness, paleness, puffiness of the eyelids, swelling of the feet in the morning, dropsy, failure of eyesight, and nosebleed, and sometimes apoplexy. As the disease comes on slowly the patient has usually time to apply for medical aid, and attention is called to the foregoing symptoms merely to emphasize the importance of attending to such in due season. =Outcome.=--While the outlook as to complete recovery is very discouraging, yet persons may live and be able to work for years in comparative comfort in many cases. When a physician pronounces the verdict of chronic Bright's disease, it is not by any means equivalent to a death warrant, but the condition is often compatible with many years of usefulness and freedom from serious suffering. =Treatment.=--Medicines will no more cure Bright's disease than old age. Out-of-door life in a dry, warm, and equable climate has the most favorable influence upon the cause of chronic Bright's disease, and should always be recommended as a remedial agent when available. Proper diet is of great importance. Cereals, vegetables, an abundance of fat in the form of butter and cream--to the amount of a pint or so a day of the latter, and the avoidance of alcohol and meat, fish and eggs constitute the ideal regimen when this can be carried out. Tea and coffee in much moderation are usually allowable and water in abundance. The underclothing should be of wool the year round, and especial care is essential to avoid chilling of the surface. Medicines have their usefulness to relieve special conditions, but should only be taken at the advice of a physician, whose services should always be secured when available. Part IV DISEASE AND DISORDER OF THE MIND BY ALBERT WARREN FERRIS CHAPTER I =Insanity= Insanity is the name given to a collection of symptoms of disease of the brain or disorder of brain nutrition or circulation. The principal test of insanity lies in the adjustment of the patient to his surroundings, as evidenced in conduct and speech. Yet one must not include within the field of insanity the improper conduct and speech of the vicious, nor of the mentally defective. Crime is not insanity, though there are undoubtedly some insane people confined in prisons who have been arrested because of the commission of crime. Then, too, while mental defect may exist in the insane, there is a certain class of mental defectives whose condition is due not to disease of the brain, but to arrest of development of the brain during childhood or youth, and these we call idiots or imbeciles; but they are not classed with the insane. _Mental Disorder Not Insanity_ We frequently hear repeated the assertion, "Everybody is a little insane," and the quotation is reported as coming from an expert in insanity. This quotation is untrue. The fact is that anyone is liable to mental disorder; but mental disorder is not insanity. To illustrate: a green glove is shown to a certain man and he asserts that its color is brown, and you cannot prove to him that he is wrong, because he is color-blind. Green and brown appear alike to him. This is mental disorder, but not insanity. Again, a friend will explain to you how he can make a large profit by investing his money in a certain way. He does so invest it and loses it, because he has overlooked certain factors, has not given proper weight to certain influences, and has ignored probable occurrences, all of which were apparent to you. He was a victim of his mental disorder, his judgment, reason, and conception being faulty; yet he was not insane. Again, you answer a letter from a correspondent, copying on the envelope the address you read at the head of his letter. A few days later your answer is returned to you undelivered. In astonishment, you refer to his letter and find that you have misread the address he gave, mistaking the number of his house. This was an instance of mental disorder in your not reading the figure aright; but it was not insanity. _What Autopsies of the Brain Reveal_ The changes in the brain accompanying or resulting from disease, as found in some chronic cases of insanity in which autopsies are made, consist largely in alteration of the nerve cells of the brain. The cells are smaller and fewer than they should be, they are altered in shape, and their threads of communication with other cells are broken. Nerve cells and often large areas of gray matter are replaced by connective tissue (resembling scar tissue), which grows and increases in what would otherwise be vacant spaces. All areas which contain this connective tissue, this filling which has no function, of course, cease to join with other parts of the brain in concerted action, and so the power of the brain is diminished, and certain of its activities are restricted or abolished. _Curious Illusions of the Insane_ In the normal brain certain impressions are received from the special senses: impressions of sight or of hearing, for example. These impressions are called conscious perceptions, and the healthy brain groups them together and forms concepts. For instance, you see something which is flat and shiny with square-cut edges. You touch it, and learn that it is cold, smooth, and hard. Lift it and you find it heavy. Grouping together your sense perceptions you form the concept, and decide that the object is a piece of marble. Again, you enter a dimly lighted room and see a figure in a corner the height of a woman, with a gown like a woman's. You approach it, speak to it and get no reply, and you find you can walk directly through it, for it is a shadow. Perhaps you were frightened. Perhaps you imagined she was a thief. Your first judgment was wrong and you correct it. The insane person, however, has defective mental processes. He cannot group together his perceptions and form proper conceptions. His imagination runs riot. His emotions of fear or anger are not easily limited. He has to some extent lost the control over his mental actions that you and other people possess if your brains are normal. The insane man will insist that there is a woman there, and not a shadow, and to his mind it is not absurd to walk directly through this person. He cannot correct the wrong idea. Such a wrongly interpreted sense perception is called an illusion. Another example of illusion is the mistaking the whistle of a locomotive for the shriek of a pursuing assassin. _What Hallucinations Are_ The insane man may also suffer from hallucinations. A hallucination is a false perception arising without external sensory experience. In a hallucination of sight, the disease in the brain causes irritation to be carried to the sight-centers of the brain, with a result that is similar to the impression carried to the same centers by the optic nerves when light is reflected into the eyes from some object. An insane man may be deluded with the belief that he sees a face against the wall where there is nothing at all. When the air is pure and sweet and no odor is discoverable, he may smell feathers burning, and thus reveal his hallucination of smell. _Delusions Common to Insanity_ The insane man may have wrong ideas without logical reason for them. Thus, an insane man may declare that a beautiful actress is in love with him, when there is absolutely no foundation for such an idea. Or, he may believe that he can lift 500 pounds and run faster than a locomotive can go, while in reality he is so feeble as scarcely to be able to walk, and unable to dress himself. Such ideas are delusions. Sane people may be mistaken; they may have hallucinations, illusions and delusions; but they abandon their mistaken notions and correct their judgment at once, on being shown their errors. Sane people see the force of logical argument, and act upon it, abandoning all irrational ideas. The insane person, on the other hand, cannot see the force of logical argument; cannot realize the absurdity or impossibility of error. He clings to his own beliefs, for the evidence of his perverted senses or the deductions from his disease-irritation are very real to him. When we find this to be the fact we know he is insane. Yet we must not confound delirium of fever with insanity. A patient suffering from typhoid fever may have a delusion that there is a pail by his bed into which he persists in throwing articles. Or he may have the hallucination that he is being called into the next room, and try to obey the supposed voice. Certain delusions are commonly found in certain types of insanity. Depressed patients frequently manifest the delusion that they have committed a great sin, and are unfit to associate with anyone. Excited and maniacal patients often believe they are important personages--kings or queens, old historical celebrities, etc. Paranoiacs commonly have delusions of persecution and of a conspiracy among their relatives or their associates or rivals. Victims of alcoholic insanity have delusions regarding sexual matters, and generally charge with infidelity those to whom they are married. General paretics in most cases have delusions of grandeur; that is, false ideas of great strength, wealth, political power, beauty, etc. The emotion which accompanies mental activity is generally exaggerated in all insane people except the demented. One sees extreme depression, or undue elation and exaltation, or silly glee and absurd joy. Intensity of emotion is frequent. _Crimes Impulsively Committed by the Insane_ An interesting mental feature of many insane patients is the imperative conception, or imperative impulse. This is a strong urging felt by the patient to commit a certain act. He may know the act is wrong and dread the punishment which he expects will follow its commission. But so constantly and strongly is he impelled that he finally yields and commits the act. Crimes are thus perpetrated by the insane, with a full knowledge of their enormity. The fact that such impulses undoubtedly exist should modify the common test, as to an insane person's responsibility before the law. The statute in many countries regards an insane criminal as responsible for his act, if he knows the difference between right and wrong. This decision is unjust and the basis is wrong; for an impulse may be overwhelming, and the patient utterly helpless during its continuance. However, a patient who has committed a crime under stress of such an irresistible impulse should be put under permanent custodial care. _Physical Signs of Insanity_ The physician who is skilled in psychiatry finds in very many insane patients marked physical signs. There are pains, insensitive areas, hypersensitive areas, changes in the pupils of the eyes, unrestrained reflex action, and partial loss of muscular control, as shown in talking, walking, and writing. Constipation and insomnia are very early symptoms of disease in a very large proportion of the insane. It is productive of no good result for a layman to try to classify the insane. The matter of classification will be for several years in a condition of developmental change. It is enough to speak of the patient as depressed or excited, agitated or stupid, talkative or mute, homicidal, suicidal, neglectful, uncleanly in personal habits, etc. _Illustrations of Various Types_ There are very interesting features connected with typical instances of several varieties of insanity, as they were noted in certain cases under the writer's care. A depressed patient with suicidal tendencies cherished the delusion that war with Great Britain was imminent, and that in such an event British troops would be landed on Long Island between New York City and the spot where he conceived the cattle to be kept. This, he argued, would cut off the beef and milk supply from the city. He therefore decided to do his part toward husbanding the present supply of food by refusing to eat; an act which necessitated feeding him through a rubber tube for many weeks. He also attempted suicide by drowning, throwing himself face downward in a shallow swamp, whence he was rescued. This young man was an expert chess player even during his attack. A maniacal patient wore on her head a tent of newspaper to keep the devil from coming through the ceiling and attacking her. She frequently heard her husband running about the upper floor with the devil on his back. As a further precaution she stained her gray hair red with pickled beet juice, and would occasionally hurl loose furniture at the walls and ceilings of her rooms and assault all who approached her. A man who presented a case of dementia pulled the hairs from his beard and planted them in rows in the garden, watering them daily, and showing much astonishment that they did not grow. He spent hours each day in spelling words backward and forward, and also by repeating their letters in the order in which they appear in the alphabet. When he wanted funds he signed yellow fallen leaves with a needle, and they turned into money. A case of general paresis (commonly though improperly called "softening of the brain") passed into the second stage as a delusion was uppermost to the effect that there was opium everywhere; opium in his hat, opium in his newspaper, opium in his bath sponge, opium in his food. He thereupon refused to eat, and was fed with a tube for two years, at the end of which time he resumed natural methods of nutrition and ate voraciously. Another general paretic promised to his physician such gifts as an ivory vest with diamond buttons, boasted of his great strength while scarcely able to walk alone, and declared he was a celebrated vocalist, while his lips and tongue were so tremulous he could scarcely articulate. _Fixed Delusions of Paranoia_ Paranoia is an infrequent variety of insanity in which the patient is dominated by certain fixed delusions, while for a long time his intellect is but slightly impaired. The delusions are usually persecutory, and the patient alleges a conspiracy. He is generally deluded with the belief that he is a prominent person in history, or an Old Testament worthy, and there is usually a religious tinge to his delusions. A patient of the writer believed himself to be the reincarnation of Christ, appearing as "the Christ of the Jews and the Christ of the Christians" in one. Over the head of his landlord, who requested overdue rent, the patient fired a revolver, "to show that the reign of peace had begun in the world." He wrote a new bible for his followers, and arranged for a triumphal procession headed by his brother and himself on horseback, wearing white stars. _How the Physician Should Be Aided_ When there is a suspicion of irrationality in a person's conduct, and certain acts or speeches suggest insanity, the whole surroundings and the past life must be considered. Frequently when the eyes are once opened to the fact of insanity, a whole chapter of corroborating peculiarities can be recalled. It is wise to recall as many of these circumstances as possible and note them in order as they occurred, for the use of the physician. Strikingly eccentric letters should be saved. Odd arrangement of clothes, or the collecting of useless articles, should be noted in writing. Changes in character, alteration in ideas of propriety, changes in disposition, business or social habits, and great variation in the bodily health should be noted in writing. Delusions, hallucinations, and illusions should be reported in full. It conveys nothing to anyone's mind to say that the patient is queer; tell what he does or says that leads you to think he is queer, and let the physician draw his own inferences from the deeds or speeches. Write down, for example, that the patient talks as if answering voices that are imaginary; or that the patient brought an ax into the dining room and stood it against the table during the meal; or that he paraded up and down the lawn with a wreath of willow branches about his neck; in each case stating the actual fact. It is important to ascertain exactly what the patient's habits are, as to the use of alcoholic beverages, tobacco, and drugs (such as opium), and also as to sexual matters. To secure such information is extremely difficult, and the help of a close friend or companion will be necessary. After the mind begins to waver many a patient plunges into dissipation, though formerly a model of propriety. _The Causes of Insanity_ The two great causes of insanity are heredity and stress or strain. Lunacy is not infrequent in children of epileptic, alcoholic, or insane parents, and those born of parents suffering from nervous disease frequently are in such condition that shock, intense emotion, dissipation, or exhausting diseases render them insane. Drinking alcoholic beverages is the most potent factor in the production of insanity. Mental strain, overwork, and worry come next. Adverse conditions, bereavement, business troubles, etc., rank third, equally with heredity. The arterial diseases of old age, epilepsy, childbirth (generally in the neurotic), change of life, fright and nervous shock, venereal diseases, sexual excesses or irregularities follow in the order named. _A Temperate, Virtuous Life the Best Preventive_ To avoid insanity, therefore, one should lead a righteous, industrious, sensible life, preserve as much equanimity as possible, and be content with moderate pleasure and moderate success. In many cases, people who are neurotic from early youth are so placed that unusual demands are made upon them. Adversity brings necessity for overwork, duties are manifold, and responsibilities are heavy. In ignorance of the fact that they are on dangerous ground and driven by circumstances, they overwork, cut short their sleep, and, conscientiously pressing on, finally lose their mental balance and insanity is the result, a great calamity which is really no fault of theirs. Undoubtedly such is frequently the sad history; and for this reason, as well as for the general reason that the insane are simply ill, all insane should be cared for sympathetically. To consider the insane as constantly malevolent is a relic of the old-time, absurd belief that insane people were "possessed of the devil." It is no disgrace to be insane, and the feeling of chagrin at discovering disease of the brain in a relative is another absurdity. Avoidance of insanity should be studied with as much devotion as avoidance of tuberculosis. Yet there should be no detraction from the fact that the heredity is strong. No one should be allowed to marry who has been insane, for the offspring of the insane are defective. The tendency of the times is toward nervous and mental disorder. In the large cities the strain is too constant, the struggle is too keen, the pace is too swift. Haste to be rich, desire to appear rich, or ambition for social distinction has wrecked many a bright, strong intellect. This is the age of the greatest luxury the world has ever seen, and a large proportion of people in cities are living beyond their means, in the gratification of luxurious desires or the effort to appear as well as others. Stress and strain are voluntarily invited. Children are pushed in their studies and overloaded with too many subjects. Genius and insanity, worry and dementia, proceed among us hand in hand; the overwrought brain finally totters. _False Ideas Regarding Insanity_ Curious ideas regarding insanity are common, and are apparently fostered by the reportorial writers of the daily papers. We read of people who are "insane on a subject." This is an impossibility. Many people can be drawn out and led into a betrayal of their mental condition only when a certain topic or idea is discussed. But although exhibiting their insane condition only when this topic is broached, they are in no respect sane. Not every act of an insane man is an insane act, we must remember. Forgetfulness of this fact leads to errors in the superficial. You will hear people say that a certain person must be sane, because during a half day's companionship nothing astray was noticed. True, there may be a long period of self-control, or of absence of test; but occasional conduct will establish the fact of constant insanity. Again, we hear the expression: "He cannot be insane; there is too much method in such madness." The answer to this silly remark is that there is method in all madness except some epileptic insanity and terminal dementia. Insane people prepare careful plans, with all the details thoroughly considered, and perfect methods to escape from hospitals with the greatest cunning. One must never take it for granted that the insane person is so demented mentally as to be unable to appreciate what is said and done. One should never talk about the insane man in his presence, but should include him in the conversation as if sane, as a general rule, allaying his suspicions and avoiding antagonism. Do not agree with the delusions of an insane person, except so far as may be necessary to draw them out. Yet avoid argument over them. Simply do not agree, and do not strengthen them by appearing to share them. His food should be prepared for him, and his medicines administered to him as to any other sick person. His baths should be regularly taken. A depressed patient should be very carefully watched. If the slightest suspicion of a suicidal impulse be present, the patient should never be left alone. Many a valuable life has been saved through the moral support of constant companionship; while we read very frequently of the death of an insane patient who sprang from a window during a brief period of relaxation of watchful care. Some people think it a protection to one insane to elicit from him a promise not to be depressed, and not to do anything wrong. One might as well secure a promise not to have a rise of temperature. The gloom of despondency and the suicidal impulse are as powerful as they are unwelcome and unsought; and the wretchedly unhappy patient cannot alone meet the issue and resist. It is unreasonable to be offended by acts or speeches of an insane patient, to bear a grudge or expect an apology. Very frequently such a patient will turn savagely upon the nearest and dearest, and make cutting remarks and accusations or exhibit baseless contempt. All this conduct must be ignored and forgotten; for the unkind words of an unaccountable and really ill person should not be taken at all seriously. Should a patient escape from home, it is the duty of the one in charge without hesitation to overtake him, and then accompany him or at least follow at a short distance. The nurse should go with and stay with the patient, telephoning or telegraphing home when opportunity offers, and finally securing aid; he should know where the patient is at all times, foregoing sleep if necessary to protect his charge, and should avoid as long as prudence permits the publicity of an arrest; though the latter may finally be essential to safety, and to the prevention of embarking on a voyage, or taking a train to a distance, or purchasing weapons. =Diversions.=--Music favorably affects many patients, so the pleasure of listening to it should be afforded at frequent intervals. Patients should be encouraged to absorb themselves in it. It is often possible to take insane people to opera, musical comedy, or concert. Vocal and instrumental practice at suitable intervals is of great value in fixing the attention, filling the mind with desirable thoughts and memories, and allaying irritability. Drawing and painting are of service when within the number of the patient's accomplishments. Intellectual pastimes, as authors, anagrams, billiards, chess, and many games with playing cards, are generally helpful. Gardening, croquet, and tennis are very desirable. Golf, rowing, swimming, and skating are excellent, but are within the reach of very few insane patients. All regular occupation that necessitates attention and concentration is of supreme value; in fact, insane patients not infrequently ask for occupation and find relief in the accomplishment of something useful, as well as in the healthful sleep and increased appetite that attend judicious physical fatigue. _The Beneficial Atmosphere of Sanitariums_ After caring for an insane patient for a time at home, the question arises as to the desirability of sending him away to a sanitarium. Generally this is a wise course to pursue. The constant association with an insane person is undermining; the responsibility is often too heavy; children, often inheriting the same neurotic tendency and always impressionable, should not be exposed to the perverting influence; it may not be safe to keep a patient with suicidal or homicidal impulses in his home; the surroundings amid which the insane ideas first started may tend to continue a suggestion of these ideas. Removal to strange locality and new scenes, the influence of strangers, the abandonment of all responsibilities and duties, and the atmosphere of obedience, routine, and discipline are all beneficial. An insane person will generally make a greater effort for a stranger than for a familiar relative. Discipline, in the form of orders of the physicians, and exact obedience is very often very salutary. There is a feeling with some that all discipline is cruel. This is not so, for the conduct of an insane person is not all insane, but frequently needs correction. Many cases of mental alienation improve promptly under custodial care, many need it all their lives. A great many cases of insanity are never obliged to go away from home, and there is a considerable number who carry on a business while still insane, rear a family, and take care of themselves. In general, a depressed patient should be kept at home as long as there is absolute safety in so doing. Most other forms of mental disease progress more rapidly toward recovery in sanitariums or hospitals equipped for such patients. Prospects of recovery are never jeopardized by confinement in a proper institution. Mental and physical rest, quiet, regularity of eating, exercising, and sleeping are the essentials which underlie all successful treatment of these cases. Dietetics, diversion by means of games, music, etc., regular occupation of any practicable sort, together with the association with the hopeful, tactful, and reasoning minds of physicians and nurses trained for this purpose are of great value. It must be remembered that in wholly civilized localities madhouses have been replaced by hospitals, keepers have been replaced by nurses and attendants, and the old methods of punishment and coercion have been long since abandoned, in the light of modern compassionate custody. Certain forms of insanity are hopeless from the start. Few recover after two years of mental aberration. Omitting the hopeless cases, over forty per cent of the cases of insanity recover. About sixty per cent recover of the cases classed as melancholia and mania. Most recoveries occur during the first year of the disease; but depressed patients may emerge and recover after several years' treatment. FOOTNOTES: [10] Caution. Dangerous. Use only on physician's order. APPENDIX =Patent Medicines=[11] The term "patent medicine" is loosely used to designate all remedies of a secret, non-secret, or proprietary character, which are widely advertised to the public. This use of the name is erroneous, and it is better first to understand the exact difference between the different classes of medicines generally comprised under this heading. Only in this way can one comprehend their right and wrong use. =A Patent Medicine= is a remedy which is patented. In order to secure this patent, an exact statement of the ingredients and the mode of manufacture must be filed with the government. These true "patent medicines" are generally artificial products of chemical manufacture, such as phenacetin. The very fact of their being patented makes them non-secret, and if an intelligent idea is held of their nature and mode of action, they may be properly used. Physicians with a full knowledge of their uses, limitations, and dangers often, and legitimately, prescribe them, and thus used they are the safest and most useful of all drugs and compounds of this class. =A Nostrum.=--The Century Dictionary defines a nostrum as "a medicine the ingredients of which, and the methods of compounding them, are kept secret for the purpose of restricting the profits of sale to the inventor or proprietor." Some nostrums have stated, on their label, the names of their ingredients, but not the amount. There has been no restriction upon their manufacture or sale in this country, therefore the user has only the manufacturer's statement as to the nature of the medicine and its uses, and these statements, in many instances, have been proved utterly false and unreliable. =A Proprietary Medicine= is a non-secret compound which is marketed under the maker's name. This is usually done because the manufacturer claims some particular merit in his product and its mode of preparation, and as these drugs are perfectly ethical and largely used by physicians, it is to the maker's interest to maintain his reputation for the purity and accuracy of the drug. Familiar instances of this class are: Squibb's Ether and Chloroform, and Powers & Weightman's Quinine. From the above definition it may be seen that the only unreliable medicines are those which are, in reality, nostrums. In regard to all of these medicines the following rules should be observed: _First._--Don't use any remedy that does not show its formula on the label. _Second._--No matter what your confidence in the medicine, or how highly recommended it is, consult a physician before using very much of it. _Third._--Take no medicine internally without a physician's advice. Throughout this chapter the word "patent medicine" will be used in its widely accepted form, in the everyday sense, without regard to its legal definition, and will be held to include any of the above-mentioned classes, unless a direct statement is made to the contrary. In Germany the contents of patent medicines are commonly published, and in this country, notably in Massachusetts, the State Boards of Health are analyzing these preparations, and making public their findings. In North Dakota a law has been passed which requires that a proprietary medicine containing over five per cent of alcohol, or any one of a number of specified drugs, be labeled accordingly. =PURE FOOD BILL.=--A far-reaching and important step, in the movement for reform of patent medicines and for the protection of the public, has now been taken by the United States Government. On June 30, 1906, an act was approved forbidding the manufacture, sale, or transportation of adulterated, misbranded, or poisonous or deleterious foods, drugs, medicines, or liquors. This act regulates interstate commerce in these articles, and went into effect January 1, 1907. Section 7 of this act states: "That for the purposes of this Act an article shall be deemed to be adulterated: in case of drugs: "_First._ If, when a drug is sold under or by a name recognized in the United States Pharmacopoeia or National Formulary, it differs from the standard of strength, quality, or purity, as determined by the test laid down in the United States Pharmacopoeia or National Formulary official at the time of investigation; _Provided_, that no drug defined in the United States Pharmacopoeia or National Formulary shall be deemed to be adulterated under this provision if the standard of strength, quality, or purity be plainly stated upon the bottle, box or other container thereof although the standard may differ from that determined by the test laid down in the United States Pharmacopoeia or National Formulary. "_Second._ If its strength or purity fall below the professed standard or quality under which it is sold." Section 8 states that a drug shall be deemed misbranded: "_First._ If it be an imitation of or offered for sale under the name of another article. "_Second._ If it (the package, bottle or box) fails to bear a statement on the label of the quantity or proportion of any alcohol, morphine, opium, cocaine, heroin, alpha or beta eucaine, chloroform, cannabis indica, chloral hydrate, or acetanilid, or any derivative or preparation of any such substances contained therein." What are the motives which impel persons to buy and use patent medicines? The history of medicine offers a partial explanation. In somewhat remote times we find that the medicines in use by regular physicians were of the most vile, nauseating, and powerful nature. We read of "purging gently" with a teaspoonful of calomel. Then during the wonderful progress of scientific medicine, beginning a little more than a half century ago, the most illustrious and useful workers were so busily engaged in finding the causes of disease and the changes wrought in the various organs, in observing the noticeable symptoms and in classifying and diagnosticating them, that treatment was given but scant attention. This was nowhere more noticeable than in Germany, the birthplace, home, and world-center of scientific medicine, to which all the medical profession flocked. Patients became simply material which could be watched and studied. This was an exemplary spirit, but did not suit the patients who wanted to be treated and cured. This fact, together with the peculiar wording of the laws regulating the practice of medicine, which allow anyone with the exception of graduates to treat patients, but not to prescribe or operate upon them, accounts for the number of quacks in Germany. Dr. Jacobi states that "there is one quack doctor to every two regular physicians in Saxony and Bavaria."[12] Another cause for the use of patent medicines is mysticism. Ignorance is the mother of credulity. It is reported[13] that Cato, the elder, recommended cabbages as a panacea for all sorts of ills, that he treated dislocations of the limbs by incantations, and ordered the Greek physicians out of Rome. The ignorant are greatly influenced by things that they cannot understand. Therefore, as the mass of people are utterly ignorant of the changes in structure and function of the body caused by disease, and also the limitations of medicines in their power of healing such alterations, their belief in the mysterious power said to attach to patent medicines is not surprising. When testimonials of the efficacy of patent medicines purporting to come from respectable divines, merchants, and statesmen are offered, the proof of their power seems incontestable. Economy and convenience are added incentives to the employment of patent medicines. This method of saving the doctor's fee is engendered by those physicians who themselves write prescriptions for nostrums. "Why not, indeed, eliminate this middleman (the doctor) and buy the nostrums direct?" So say the unthinking. But what doctor worthy of the name would prescribe a medicine the composition of which he was ignorant? Yet it is frequently done. As Dr. Cabot has so aptly put it, what would be thought of a banker or financial adviser who recommended his client to buy a security simply on the recommendation of the exploiter of the security? Yet that is exactly the position of a doctor who recommends a nostrum. In view of the fact, therefore, that persons of undoubted intelligence are in the habit of purchasing and using remedies of this character and since many of the most widely advertised preparations are extremely harmful, even poisonous, we have taken the liberty of pointing out a few "danger signals," in the guise of extravagant assertions and impossible claims, which are characteristic signs of the patent medicines to be avoided. =DANGER SIGNALS.=--There are many picturesque and easily grasped features in the literature, labels, and advertising of patent medicines that spell danger. When these features are seen, the medicine should be abandoned immediately, no matter what your friends tell you about it, or how highly recommended it may have been by others than your physician. =Claiming a Great Variety of Cures.=--Perhaps of all features of patent medicine advertising, this is the most alluring. No one drug or combination of drugs, with possibly one or two exceptions, can or does "cure" any disease. Patients recover only when the resistance of the body is greater than the strength of the disease. This body resistance varies in different persons, and is never just alike in any two individuals or illnesses. The patient must be treated and not the disease, so it is the aim of every conscientious physician to conserve and strengthen the vital forces and, at the same time, guard against further encroachment of the disease. There is no cure-all, and even if a drug or combination of drugs were helpful in any single case, they might easily be totally unsuited, or even harmful, in another case, with apparently similar symptoms. When a maker claims that his particular concoction will cure a long list of diseases, the assertion bears on its face evidence of its falsity. One of the most widely advertised and largely sold catarrh remedies claims to cure pneumonia, consumption, dyspepsia, enteritis, appendicitis, Bright's disease, heart disease, canker sores, and measles. _This is absolute fraud._ No matter what virtues this medicine might have in the treatment of one or two ailments, no one remedy could possibly be of service in such a varied list of diseases, and it could not "cure" one of them. Another remedy bases its assertion of "cures" on the fact that it claims to be a germ killer, and assumes that all disease is caused by germs. To quote from its advertising literature, it claims to cure thirty-seven diseases which are mentioned by name, and then follows the assertion that it cures "all diseases that begin with fever, all inflammations, all catarrhal contagious diseases, all the results of impure or poisoned blood. In nervous diseases--acts as a vitalizer, accomplishing what no drugs can do." It would seem that an intellect of any pretensions would recognize the fraudulent nature of this claim, yet thousands of bottles of this stuff are annually sold to a gullible public. These wide and unjustifiable claims are real danger signals, and any medicine making them should be avoided. There are many other remedies for which just as great claims are made; the two instances cited are merely representative of a large class. It is a waste of time, money, and health to buy them with any idea that they can fulfill their pretensions. =Claiming to Cure Headaches.=--The use of any "headache powders" or "tablets" should be avoided, except on the advice of a physician. The presence of pain in the head, or in any other part of the body, may be a symptom of a serious and deep-seated disorder, and it may often be a serious matter to temporize with it. At the best, these "pain relievers" can give only temporary relief, and their use may prove to be dangerous in the extreme. Their action is dependent upon one of the modern coal-tar products, usually acetanilid, because it is the cheapest. But, unfortunately, acetanilid is also the one with the most depressant action on the heart. The danger of headache powders lies in the habit which they induce, because of their quick pain-relieving qualities and their easy procurability, and from overdosage. If a person is otherwise in good health, the use of one headache powder will in all probability do no harm, but the dose should not be repeated without a doctor's authority. Many deaths have occurred from their continued use, or because of an idiosyncrasy on the part of the taker, but it is their abuse more than their use which has brought upon them such almost universal condemnation. Therefore, while the physician may advocate their use, do not take them without his advice and specific directions as to kind and dosage. =Claiming Exhilaration.=--These medicines, by their insidious character, constitute a particularly dangerous variety. They depend, for their effect, upon the amount of alcohol that they contain. Many conscientious temperance workers have not only unsuspectingly taken them, but have actually indorsed them. Recently the published analyses of several State Boards of Health and the investigations made by Samuel Hopkins Adams, and published in his series on "The Great American Fraud" have shown that a majority of the "tonics," "vitalizers," and "reconstructors" depend for their exhilarating effect upon the fact that they contain from seventeen to fifty per cent of alcohol; while beer contains only five per cent, claret eight per cent, and champagne nine per cent. Pure whisky contains only fifty per cent of alcohol, yet few people would drink "three wineglassfuls in forty-five minutes"[14] as a medicine pure and simple. The United States Government has prohibited the sale of one of these medicines to the Indians, simply on account of the fact that as an intoxicant it was found too tempting and effective.[15] If one must have a stimulant it is better to be assured of its purity. These medicines are not only costly, but contain cheap, and often adulterated, spirits. Their worst feature is that they often induce the alcoholic habit in otherwise upright people. Commencing with a small dose, the amount is gradually increased until the user becomes a slave to drink. Could the true history of these widely used medicines be written, it would undoubtedly show that many drunkards were started on their downward career by medicinal doses of these "tonics" and "bracers." =Claiming Pain-relieving or Soothing Qualities.=--The properties of this class of remedies depend generally upon the presence of cocaine, opium, or some equally subtle and allied substance. It should be needless to state that such powerful drugs should be taken only upon a physician's prescription. Habit-forming and insidious in character, they are an actual menace. When present in cough syrups, they give by their soothing qualities a false sense of security, and when present in "soothing syrups" or "colic cures" for babies, they may be given with fatal result. Never take a medicine containing these drugs without a full understanding of their dangerous character, and a realization of the possible consequences. =Testimonials.=--These may mean anything or nothing; generally the latter. They are usually genuine, but, as Mr. Adams observes, "they represent, not the average evidence, but the most glowing opinions which the nostrum-vender can obtain, and generally they are the expression of a low order of intelligence."[16] It is a sad commentary on many men and women, prominent in public life, that they lend their names and the weight of their "testimony" to further the ends of such questionable ventures. Political and newspaper interests are responsible for the collection of this class of testimonials. An investigation of some men, who permitted the use of their names for this purpose, revealed that many of them had never tasted the compound, but that they were willing to sign the testimonials for the joy of appearing in print as "prominent citizens."[17] "Prominent ministers" and "distinguished temperance workers" are often cited as bearing testimony to the virtues of some patent medicine. It has been shown that, while the testimonials were real, the people who signed them had little right of credence, and were possessed of characters and attributes which would show their opinions to be of little value. Money and energy can be productive of any number of testimonials for any remedy. While some of them may be authentic, yet the fact that a medicine "cured" any one of the signers is no evidence that it will cure or even help anyone else. Many people recover from diseases with no medicine at all, and isolated "cures" can never be taken as a criterion of the value of any remedy or method. =Offering "Money Back Unless Cured."=--Careful reading of this clause in most advertising literature will show that there is "a string attached." The manufacturers are usually safe in making this proposition. In the first place, the average person will not put the matter to a test. The second reason why this is a safe proposition for the maker is, that if the medicine does not cure, the patient may die, and dead men are hardly possible claimants. =Claiming to Cure Diseases Incurable by Medicine Alone.=--Probably no class of people are greater users of patent medicines than those unfortunates afflicted with the so-called incurable diseases. The very fact of the serious nature of their complaint, and the dread of surgical intervention, makes them easy victims to the allurement of "sure cures." The committee on the prevention of tuberculosis of the Charity Organization Society of New York City has announced in decided terms that there is no specific medication for consumption. Cancer, likewise, cannot be cured by the use of internal medicine alone. Surgery holds out the greatest hope in this dread disease. The medicines claiming to cure these diseases are, therefore, of the most fraudulent nature. Their use is positively harmful, for in taking them priceless time is lost. Never temporize if there is any suspicion of the existence of such diseases as consumption or cancer. Self-treatment with patent medicines in such cases is worse than useless--it is actually dangerous to life itself. Consult a physician at the earliest possible moment, and put no faith in patent medicines. There are, however, as has been pointed out, certain patent and proprietary medicines which may properly be employed by the physician. These include the newly discovered, manufactured chemicals of known composition and action; and single substances or combinations of known drugs in known proportions, which can only be made to best advantage by those having the adequate facilities. The habit of prescribing proprietary mixtures of several substances for special diseases is, however, generally a matter of laziness, carelessness, or ignorance on the doctor's part. This follows because no disease is alike in any two patients; because any one disease has many phases and stages; and because a doctor should always treat the patient and not the disease. Thus a doctor, after carefully questioning and examining the patient, should adjust the remedy to the peculiarities of the patient and disease. It is impossible to make a given combination of drugs fit all patients with the same disease. The quantity of patent medicine sold in the United States is enormous. A series of articles by Samuel Hopkins Adams appeared in _Collier's Weekly_ during 1905 and 1906, in which he not only showed the fraudulent character of many of the best-known patent medicines, giving their names and most minute details concerning them, but furnished much reliable information in an interesting and convincing manner. In the course of these articles he pointed out that about one hundred millions of dollars are paid annually for patent medicines in the United States. As explaining this, in part, he affirmed that as many as five companies each expended over one million dollars annually in advertising patent medicines. _What Are the Good Ones Good For?_--In any great movement, when a dormant public suddenly awakens to the fact that a fraud has been perpetrated or a wrong committed, the instinctive and overwhelming desire is for far-reaching reform. In efforts to obtain needed and radical improvement, and with the impetus of a sense of wrong dealing, the pendulum of public opinion is apt to swing too far in an opposite direction. There are bad patent medicines--the proof of their fraudulent character is clear and overwhelming; but there are good ones whose merits have been obscured by the cloud of wholesale and popular condemnation. It is true that the manufacturers of even some of the valuable ones have an absurd habit of claiming the impossible. This attitude is to be regretted, for the makers have thus often caused us to lose faith in the really helpful uses to which their products might be put. However, it is well in condemning the bad not to overlook the good. The mere fact that a medicine is patented, or that it is a so-called proprietary remedy, does not mean that it is valueless or actually harmful. The safety line is knowledge of the medicine's real nature, its uses and its dangers; the rules given above should be rigorously followed. It is far easier to give general indications for the guidance of those wishing to shun unworthy patent medicines than to enable the reader to recognize the worthy article. It is safe to assume, however, that there are certain simple remedies, particularly those for external application, which have a definite use and are dependable. In justice it must be said that great improvement has taken place, and is now taking place in the ethical character of patent medicines, owing to recent agitation, and what is true concerning them to-day may not be true to-morrow. The only proper, ethical patent medicine is the one showing its exact composition, and refraining from promise of a cure in any disease. Such a one might, nevertheless, advertise its purity, reliability, advantageous mode of manufacture, and the excellence of its ingredients with more modest and truthful claims as to its use. The purchaser of a patent medicine pays not only for the ingredients, the cost of combining them, and the maker's just profit, but he also pays the exploiter's bills for advertising and distributing the finished product. With such standard remedies as those mentioned above, this added cost is usually a good investment for the purchaser, because trade-marked remedies which have "made good" possess two advantages over those less advertised, and over their prototypes in crude form: procurability and integrity. Even at remote cross-roads stores, it is possible to obtain a popular remedy, one which has been well pushed commercially. And an article sold in packages sealed by the makers gets to the consumer just as pure as when it left the laboratory. This is not always true of ingredients held in bulk by the retailer; witness the evidence brought forward in recent prosecutions for drug adulteration. It is not the purpose of this chapter, in any sense, to advertise or place the seal of its unrestricted approval upon any one article of a class. Its position in the matter is absolutely impartial. But in order that it may be as helpful as possible, it definitely mentions the most widely known, and therefore the most easily obtainable, remedies. There are other equally good remedies in each case, but as it would be almost impossible to mention each individual remedy with similar virtues now on the market, the ones discussed must be taken as representative of their class in each instance. Do not forget that the use of these simple remedies does not justify their abuse. They may make great claims while their use is really limited. Do not rely upon them to do the impossible. =Vaseline.=--This is pure and refined petroleum, and will be found of much service in many forms of skin irritation. It is useful in the prevention of "chapping," for softening rough skin, for preventing and healing bleeding and cracked lips, as a protective dressing in burns, cuts, or any acute inflammation of the skin where the cuticle has been injured or destroyed, or where it is desirable that a wound should be protected and kept closed from the air. Rubbed over the surface of the body when a patient is desquamating or "peeling" after scarlet fever or measles, it keeps the skin smooth, soothes the itching, and prevents the scales from being carried about in the air and so infecting others. Vaseline is a soothing, nonirritating, and bland protective ointment for external use. It is perfectly harmless, but should not be used for severe skin disease or for internal use, unless recommended by a physician in conjunction with other means of healing. =Pond's Extract.=--Although the makers have claimed special virtues for this remedy, it is in reality an extract of hamamelis or witch-hazel, and probably differs little in its application or results from the ordinary marketed extract made by the average druggist. It is mild and bland, harmless when used externally, but should not be used internally unless ordered by a physician. It is soothing and healing when applied to wounds, sprains, and bruises; diluted with water it is a pleasant gargle for a sore throat, and may be applied externally on the throat by means of a flannel wrung out in a solution of it in hot water. For nosebleed it is often efficient when snuffed up the nose, or when pledgets of cotton are soaked in it and placed in the nostrils. It may be used as an application in ulcers or varicose veins, and from two to four teaspoonfuls with an equal amount of water injected into the rectum two or three times daily will often prove of great help in piles, particularly if bleeding. It gives relief when used for sore or inflamed eyes or eyelids, but in this, as in all other serious inflammations, it is not a "cure all," and the physician should be consulted if the relief is not prompt. =Listerine.=--Of the many mild liquid antiseptics "Listerine" is probably the best known. The remarks and recommendations concerning it, however, are equally applicable to many other remedies of a somewhat similar nature, such as glycothymoline, borolyptol, lythol, alkalol, formalid, etc. Listerine is a solution of antiseptic substances with the addition of thymol and menthol in quantities sufficient to give it a pleasant odor and taste. It has a very strong hold on the public, and is a deservedly useful remedy. Listerine has many helpful uses. It is potent enough to kill many germs, and is excellent for this purpose when used as a mouth wash, particularly during illness. In acute cold in the head it is soothing to the mucous membrane of the nose, if used diluted with warm water as a nasal douche. It serves a similar purpose when used as a gargle in mild sore throat. If there is any reason to suspect that dirt or other foreign matter has come in contact with a sore or cut, the wound may be freely washed with a solution of listerine in order to clean it and render it as nearly aseptic as possible. When there are distinct signs of inflammation it should not be relied upon. Do not use it internally without a physician's advice. =Scott's Emulsion.=--This is a good emulsion of cod-liver oil, widely prescribed by physicians for the many patients who are too delicate-stomached to retain the pure oil. For those who can take the refined oil straight, Peter Möller's brand is in a class by itself. In certain conditions cod-liver oil is one of the most valuable remedies known. As a concentrated and reconstructive food in many wasting diseases it is of great service. Weak and puny children, and all suffering from malnutrition may take it with benefit. It does help produce flesh, increase strength, and add to the body's resisting powers. It does not contain any medicinal properties, and its virtue is largely in its fat or oil, but as an aid to other remedies, or alone, when increased nutrition is desired, it is a reliable and helpful remedy. =Antiphlogistine.=--There are many clay poultices on the market: antiphlogistine, antithermoline, cretamethyl, sedol, unguentum, yorkelin, and the Emplastrum Kaolini of the U. S. Pharmacopoeia. Antiphlogistine, being probably the most widely known, is here discussed. It is of value when a poultice is indicated. It is preferable to the homemade varieties in that it retains heat for a longer period of time and is antiseptic. It should never be used in deep-seated inflammations, such as peritonitis, appendicitis, deep abscesses of any part of the body, or other serious conditions, unless recommended by a physician; for such ailments need more thorough treatment than can be afforded by any poultice. It is perfectly harmless, and may be used with decided benefit in aborting or preventing many inflammatory diseases. Applied in the early stages of a boil, felon, or carbuncle it may either abort the trouble or, if the disease has already progressed too far, it will hasten suppuration and shorten the course of the disease. When a poultice is indicated in bronchitis or pleurisy it is an excellent one to use; it will afford much comfort, and often hasten recovery. In nursing mothers, when the breasts become full and tender and signs of beginning inflammation are present, antiphlogistine spread in a warm and thick coat over the breasts will often afford relief. =Platt's Chlorides.=--When it is desirable to use a liquid disinfectant Platt's Chlorides will be found a useful article, as will lysol and other marketed products. The source of a foul smell or dangerous infection should never be overlooked. No disinfectant can offer a safeguard if plumbing is defective, or other unsanitary conditions exist; in fact, disinfectants are often deprecated, since they afford a false sense of security. If a contagious disease exists in a household, other means than the use of a disinfectant must be taken in order to prevent the spread of the contagion. Disinfectants do have their uses, however, and are often essential. In case of an illness of a contagious or infectious nature, a solution of Platt's Chlorides or a similar disinfectant should be kept in all vessels containing or receiving discharges from the body. Pails containing such a solution should be in readiness to receive all cloths, bedding, or washable clothes which have come, in any way, in contact with the patient. FOOTNOTES: [11] The publishers announce this chapter as prepared independent of Dr. Winslow or any of the Advising Editors. Considered as an effort to give helpful information, free of advertising on the one hand and sensational exposures on the other, the article meets with the approval of conservative physicians. But the problems dealt with are too involved at present for discussion direct from the profession to the public. [12] Jacobi, Jour. Am. Med. Assn., Sept. 29, 1906. [13] Ibid. [14] S. H. Adams, "The Great American Fraud." [15] Ibid. [16] S. H. Adams, "The Great American Fraud." [17] S. H. Adams, "The Great American Fraud." +--------------------------------------------------------------------+ | TRANSCRIBER'S NOTE. | | =================== | | | | The prescription symbol has been transcribed as [Rx]. | | | +--------------------------------------------------------------------+ 
27943	----	The Home Medical Library By KENELM WINSLOW, B.A.S., M.D. _Formerly Assistant Professor Comparative Therapeutics, Harvard University; Late Surgeon to the Newton Hospital; Fellow of the Massachusetts Medical Society, etc._ With the Coöperation of Many Medical Advising Editors and Special Contributors IN SIX VOLUMES _First Aid :: Family Medicines :: Nose, Throat, Lungs, Eye, and Ear :: Stomach and Bowels :: Tumors and Skin Diseases :: Rheumatism :: Germ Diseases Nervous Diseases :: Insanity :: Sexual Hygiene Woman and Child :: Heart, Blood, and Digestion Personal Hygiene :: Indoor Exercise Diet and Conduct for Long Life :: Practical Kitchen Science :: Nervousness and Outdoor Life :: Nurse and Patient Camping Comfort :: Sanitation of the Household :: Pure Water Supply :: Pure Food Stable and Kennel_ NEW YORK The Review of Reviews Company 1907 Medical Advising Editors Managing Editor ALBERT WARREN FERRIS, A.M., M.D. _Former Assistant in Neurology, Columbia University; Former Chairman, Section on Neurology and Psychiatry, New York Academy of Medicine; Assistant in Medicine, University and Bellevue Hospital Medical College; Medical Editor, New International Encyclopedia._ Nervous Diseases CHARLES E. ATWOOD, M.D. _Assistant in Neurology, Columbia University; Former Physician, Utica State Hospital and Bloomingdale Hospital for Insane Patients; Former Clinical Assistant to Sir William Gowers, National Hospital, London._ Pregnancy RUSSELL BELLAMY, M.D. _Assistant in Obstetrics and Gynecology, Cornell University Medical College Dispensary; Captain and Assistant Surgeon (in charge), Squadron A, New York Cavalry; Assistant in Surgery, New York Polyclinic._ Germ Diseases HERMANN MICHAEL BIGGS, M.D. _General Medical Officer and Director of Bacteriological Laboratories, New York City Department of Health; Professor of Clinical Medicine in University and Bellevue Hospital Medical College; Visiting Physician to Bellevue, St. Vincent's, Willard Parker, and Riverside Hospitals._ The Eye and Ear J. HERBERT CLAIBORNE, M.D. _Clinical Instructor in Ophthalmology, Cornell University Medical College; Former Adjunct Professor of Ophthalmology, New York Polyclinic; Former Instructor in Ophthalmology in Columbia University; Surgeon, New Amsterdam Eye and Ear Hospital._ Sanitation THOMAS DARLINGTON, M.D. _Health Commissioner of New York City; Former President Medical Board, New York Foundling Hospital; Consulting Physician, French Hospital; Attending Physician, St. John's Riverside Hospital, Yonkers; Surgeon to New Croton Aqueduct and other Public Works, to Copper Queen Consolidated Mining Company of Arizona, and Arizona and Southeastern Railroad Hospital; Author of Medical and Climatological Works._ Menstruation AUSTIN FLINT, JR., M.D. _Professor of Obstetrics and Clinical Gynecology, New York University and Bellevue Hospital Medical College; Visiting Physician, Bellevue Hospital; Consulting Obstetrician, New York Maternity Hospital; Attending Physician, Hospital for Ruptured and Crippled, Manhattan Maternity and Emergency Hospitals._ Heart and Blood JOHN BESSNER HUBER, A.M., M.D. _Assistant in Medicine, University and Bellevue Hospital Medical College; Visiting Physician to St. Joseph's Home for Consumptives; Author of "Consumption: Its Relation to Man and His Civilization; Its Prevention and Cure."_ Skin Diseases JAMES C. JOHNSTON, A.B., M.D. _Instructor in Pathology and Chief of Clinic, Department of Dermatology, Cornell University Medical College._ Diseases of Children CHARLES GILMORE KERLEY, M.D. _Professor of Pediatrics, New York Polyclinic Medical School and Hospital; Attending Physician, New York Infant Asylum, Children's Department of Sydenham Hospital, and Babies' Hospital, N. Y.; Consulting Physician, Home for Crippled Children._ Bites and Stings GEORGE GIBIER RAMBAUD, M.D. _President, New York Pasteur Institute._ Headache ALONZO D. ROCKWELL, A.M., M.D. _Former Professor Electro-Therapeutics and Neurology at New York Post-Graduate Medical School; Neurologist and Electro-Therapeutist to the Flushing Hospital; Former Electro-Therapeutist to the Woman's Hospital in the State of New York; Author of Works on Medical and Surgical Uses of Electricity, Nervous Exhaustion (Neurasthenia), etc._ Poisons E. ELLSWORTH SMITH, M.D. _Pathologist, St. John's Hospital, Yonkers; Somerset Hospital, Somerville, N. J.; Trinity Hospital, St. Bartholomew's Clinic, and the New York West Side German Dispensary._ Catarrh SAMUEL WOOD THURBER, M.D. _Chief of Clinic and Instructor in Laryngology, Columbia University; Laryngologist to the Orphan's Home and Hospital._ Care of Infants HERBERT B. WILCOX, M.D. _Assistant in Diseases of Children, Columbia University._ Special Contributors Food Adulteration S. JOSEPHINE BAKER, M.D. _Medical Inspector, New York City Department of Health._ Pure Water Supply WILLIAM PAUL GERHARD, C.E. _Consulting Engineer for Sanitary Works; Member of American Public Health Association; Member, American Society Mechanical Engineers; Corresponding Member of American Institute of Architects, etc.; Author of "House Drainage," etc._ Care of Food JANET MCKENZIE HILL _Editor, Boston Cooking School Magazine._ Nerves and Outdoor Life S. WEIR MITCHELL, M.D., LL.D. _LL.D. (Harvard, Edinburgh, Princeton); Former President, Philadelphia College of Physicians; Member, National Academy of Sciences, Association of American Physicians, etc.; Author of essays: "Injuries to Nerves," "Doctor and Patient," "Fat and Blood," etc.; of scientific works: "Researches Upon the Venom of the Rattlesnake," etc.; of novels: "Hugh Wynne," "Characteristics," "Constance Trescott," "The Adventures of François," etc._ Sanitation GEORGE M. PRICE, M.D. _Former Medical Sanitary Inspector, Department of Health, New York City; Inspector, New York Sanitary Aid Society of the 10th Ward, 1885; Manager, Model Tenement-houses of the New York Tenement-house Building Co., 1888; Inspector, New York State Tenement-house Commission, 1895; Author of "Tenement-house Inspection," "Handbook on Sanitation," etc._ Indoor Exercise DUDLEY ALLEN SARGENT, M.D. _Director of Hemenway Gymnasium, Harvard University; Former President, American Physical Culture Society; Director, Normal School of Physical Training, Cambridge, Mass.; President, American Association for Promotion of Physical Education; Author of "Universal Test for Strength," "Health, Strength and Power," etc._ Long Life SIR HENRY THOMPSON, Bart., F.R.C.S., M.B. (Lond.) _Surgeon Extraordinary to His Majesty the King of the Belgians; Consulting Surgeon to University College Hospital, London; Emeritus Professor of Clinical Surgery to University College, London, etc._ Camp Comfort STEWART EDWARD WHITE _Author of "The Forest," "The Mountains," "The Silent Places," "The Blazed Trail," etc._ [Illustration: A DESIRABLE METHOD OF CARRYING THE INJURED. By this plan even the unconscious victim of an accident may be transported a long distance, because the bearers' hands are left entirely free and thus prevented from becoming cramped or tired, as when a "seat" is made with clasped hands. In the method illustrated above the patient is placed in a seat made by tying a blanket, sheet, rope, or strap in the form of a ring. Each bearer then places his inner arm about the patient's body and with his outer hand holds the patient's arm around his neck.] The Home Medical Library Volume I FIRST AID IN EMERGENCIES By KENELM WINSLOW, B.A.S., M.D. (Harv.) _Formerly Assistant Professor Comparative Therapeutics, Harvard University; Late Surgeon to the Newton Hospital; Fellow of the Massachusetts Medical Society, etc._ ASSISTED BY ALBERT WARREN FERRIS, A.M., M.D. _Former Assistant in Neurology, Columbia University; former Chairman, Section on Neurology and Psychiatry, New York Academy of Medicine; Assistant in Medicine, University and Bellevue Hospital Medical College; Medical Editor, "New International Encyclopedia"_ GERM DISEASES By KENELM WINSLOW, B.A.S., M.D. (Harv.) NEW YORK The Review of Reviews Company 1907 Copyright, 1907, by THE REVIEW OF REVIEWS COMPANY THE TROW PRESS, NEW YORK _Contents_ PART I CHAPTER PAGE I. RESTORING THE APPARENTLY DROWNED 27 Reviving the Patient--How to Expel Water from the Stomach and Chest--Instructions for Producing Respiration--When Several Workers are at Hand--When One must Work Alone--How to Save a Drowning Person. II. HEAT STROKE AND ELECTRIC SHOCK 39 First-aid Rules--Symptoms of Heat Exhaustion--Treatment of Heat Prostration--What to Do in Case of Electric Shock--Symptoms--Artificial Respiration--Mortality in Lightning Strokes. III. WOUNDS, SPRAINS, AND BRUISES 50 Treatment of Wounds--Bleeding from Arteries and Veins--Punctured Wounds--Oozing--Lockjaw--Bruises-- Abrasions--Sprains and Their Treatment--Synovitis-- Bunions and Felons--Weeping Sinew--Foreign Bodies in Eye, Ear, and Nose. IV. FRACTURES 80 How to Detect Broken Bones--Fracture of Rib and Collar Bone--Instructions for Applying Dressings--Bandage for Broken Jaw--Fracture of Shoulder-blade, Arm, Hip, Leg, and Other Bones--Compound Fractures. V. DISLOCATIONS 118 Varieties of Dislocations--Method of Reducing a Dislocated Jaw--A Dislocated Shoulder--Indications when Elbow is Out of Joint--Dislocation of Hip, etc.--Forms of Bandages. VI. ORDINARY POISONS 139 Unknown Poisons--Symptoms and Antidotes--Poisoning by Carbolic and Other Acids--Alkalies--Metal Poisoning--Aconite, Belladonna, and Other Narcotics--Chloral--Opium, Morphine, Laudanum, Paregoric, and Soothing Sirups--Tobacco, Strychnine, etc. VII. FOOD POISONS 147 Poisons in Shellfish and Other Food--Symptoms and Remedies--How Bacteria are Nourished--Infected Meat and Milk--Treatment of Tapeworm--Trichiniasis--Potato Poisoning. VIII. BITES AND STINGS 155 Country and City Mosquitoes--How Yellow Fever is Communicated--Treatment of Mosquito Bites--Bee, Wasp, and Hornet Stings--Lice--Fleas and Flies--Centipedes and Scorpions--Spiders--Poisonous Snakes--Cat and Dog Bites. IX. BURNS, SCALDS, FROSTBITES, ETC. 171 General Rules for Treating Burns and Scalds--Hints on Dressings--Burns Caused by Acids and Alkalies--Remedies for Frostbite--Care of Blisters and Sores--Chilblains--Ingrowing Toe Nails--Fainting and Suffocation--Fits. PART II I. CONTAGIOUS MALADIES 191 Symptoms and Treatment of Scarlet Fever--Diagnosis--Duration of Contagion--Difference Between True and German Measles--Smallpox--Cure a Matter of Good Nursing--Chickenpox. II. INFECTIOUS DISEASES 221 Typhoid Fever--Symptoms and Modes of Communication--Duration of the Disease--The Death Rate--Importance of Bathing--Diet--Remedies for Whooping Cough--Mumps--Erysipelas. III. MALARIA AND YELLOW FEVER 247 Malaria Caused by Mosquitoes--Distribution of the Disease--Severe and Mild Types--Prevention and Treatment--Yellow Fever not a Contagious Disease--Course of the Malady--Watchful Care and Diet the only Remedies. INDEX _To First Aid and General Topics_ NOTE.--The Roman numerals I, II, III, IV, V, and VI indicate the volume; the Arabic figures 1, 2, 3, etc., indicate the page number. Abrasions, I, 64 Abscess, alveolar, II, 58 Acids, burns by, I, 176, 177 poisoning by, I, 140 Acne, II, 145 Adenoids, II, 61 Adulterated food, tests for, V, 91 Adulteration of food, V, 87 Ague, I, 247 cake, I, 254 Air-bath, the, IV, 159 Albumen, IV, 262 Alcohol, use of, IV, 44, 153 Alcoholic drinks, IV, 153 Alcoholism, III, 47, 52 Algæ, remedy for, V, 56 Alkalies, burns by, I, 177 poisoning by, I, 140 Amenorrhoea, III, 75 Anæmia, III, 174 Ankle, sprain of, I, 65, 67, 68 Ankle-joint fracture, I, 115 Antitoxin, II, 77 Apoplexy, III, 49 Appendicitis, III, 256 Arm, fracture of, I, 91 Arteries, systemic, III, 168 Artery, bleeding from an, I, 51, 52 Arthritis, II, 177 Artificial respiration, I, 28 Asthma, II, 104 Astigmatism, II, 26 Athletics, home, IV, 69 Auricles of the heart, III, 168 =BABY=, bathing the, III, 109 care of the, III, 108 clothing of the, III, 110 diet for the, III, 134 food for the, III, 132; IV, 261 nursing the, III, 114 teething, III, 113 temperature of the, III, 110 weaning the, III, 117 weighing the, III, 112 Bacteria, destruction of, V, 238-253 in food, I, 147-154 in soil, V, 135 Baldness, II, 167; IV, 21 =BANDAGES=, I, 133 forms of, I, 132, 134, 136, 137 for bruises, I, 62-64 for fractures, I, 83-117 for sprains, I, 65-72 for wounds, I, 51-61 Barley water, IV, 263 Bathing, indoor, IV, 19, 155 outdoor, IV, 16 in convulsions, III, 35 in malaria, I, 259 in pneumonia, II, 94 in scarlet fever, I, 197 in skin irritations, II, 140 in smallpox, I, 216 in typhoid fever, I, 231 in yellow fever, I, 266 =BATHS=, cold, IV, 15 foot, IV, 157 hot, IV, 19, 156 tepid, IV, 19 Turkish, IV, 20, 159 warm, IV, 19 Bed sores, I, 233 Bed-wetting, II, 213 Bee stings, I, 158 Beef, broth, IV, 261 juice, IV, 262 parts of, IV, 198 scraped, IV, 262 tea, IV, 261 Bellyache, III, 247 Bilious fever, I, 247 Biliousness, III, 184 =BITES=, cat, I, 170 dog, I, 170 flea, I, 162 fly, I, 164 lice, clothes, I, 161 lice, crab, I, 162 lice, head, I, 160 mosquito, I, 155 snake, I, 166 spider, I, 164 tarantula, I, 164 wood tick, I, 159 Black eye, II, 14 Blackheads, II, 145 Black water fever, I, 256 Bladder, inflammation of the, II, 215 stone in the, III, 264 =BLEEDING=, from an artery, I, 51, 52 from a vein, I, 51, 52 from punctured wounds, I, 52, 53 from the lungs, I, 62 from the nose, I, 61 from the scalp, I, 60 from the stomach, I, 62 from the womb, III, 82 Blood, deficiency of, III, 174 oozing of, I, 54 Bloody flux, III, 222 Boils, II, 157 Bottles, milk, III, 128 Bowel, prolapse of the, III, 143 =BOWELS=, catarrh of the, III, 205 diseases of the, III, 205 inflammation of the, III, 252 obstruction of the, III, 268 passages from the, IV, 247 Bowleg, III, 162 Brain, anatomy of the, III, 22 arteries of the, III, 22 autopsies of the, II, 230 Breasts, care of, after childbirth, III, 105 inflammation of the, III, 140 Breath, holding the, III, 153 Breathing, how to test the, IV, 248 to produce artificial, I, 28, 34, 43, 178, 186 Bright's disease, acute, II, 220 chronic, II, 222 =BROKEN BONE=, I, 80 ankle, I, 115 arm, I, 91 collar bone, I, 85 finger, I, 101 forearm, I, 94 hand, I, 101 hip, I, 104 how to tell a, I, 80 jaw, I, 89 kneepan, I, 109 leg, I, 111 rib, I, 83 shoulder blade, I, 91 thigh, I, 106 wrist, I, 99 Bronchial tubes, diseases of the, II, 87 Bronchitis, II, 88, 91 Broth, beef, IV, 261 chicken, IV, 261 clam, IV, 263 mutton, IV, 261 oyster, IV, 267 veal, IV, 261 =BRUISES=, bandages for, I, 63 treatment of, I, 62, 63 Bunion, I, 72 =BURNS=, I, 171 about the eyes, II, 16 from acids, I, 176 from alkalies, I, 177 from electric shock, I, 45 first class, I, 172 second class, I, 172 third class, I, 173 severe, I, 174 Callus of the skin, II, 156 Camp comfort (See Contents VI) Camp cookery (See Contents VI) Camp cure (See Contents VI) =CAMPING=, in the North Woods, VI, 195 in the Western Mountains, VI, 214 outfit, VI, 212 Cancer, II, 123 of the breast, II, 124 of the lip, II, 125 of the stomach, II, 125 of the womb, II, 125 Canker, II, 68 Capillaries, systemic, III, 168 Carbuncle, II, 161 Carotid arteries, III, 22 Catarrh, II, 41, 54, 55 of the bowels, III, 205 effect of, on the ears, II, 38, 41 of the stomach, III, 185 Catarrhal deafness, II, 39 inflammation of eye, II, 18 Cat bite, I, 170 Catheter, how to use a, II, 219; IV, 252 Centipede sting, I, 164 Cereals as food, IV, 35, 229 Cerebellum, III, 22 Cerebral arteries, III, 22 Chafing, II, 142 Chagres fever, I, 256 Change of life, III, 70 Chapping, II, 142 Chicken broth, IV, 261 Chickenpox, I, 217 Chilblains, I, 182 Childbed fever, III, 107 Childbirth, after-pains in, III, 105 articles needed during, III, 96 bleeding after, III, 86 care after, III, 103 care in, III, 98 =CHILDREN, DISEASES OF=, III, 140 adenoids, II, 61 bed-wetting, II, 213 bowel, prolapse of the, III, 143 bowels, catarrh of the, III, 209 bowleg, III, 162 breath, holding the, III, 153 breasts, inflammation of the, III, 140 chickenpox, I, 217 cholera infantum, III, 211 chorea, III, 155 colic, III, 267 constipation, III, 238 convulsions, III, 34 cord, bleeding of the, III, 142 cough, II, 91 croup, II, 83 diarrhea, III, 208, 209 diphtheria, II, 77 dysentery, III, 213 epilepsy, III, 39 earache, II, 48 fever, III, 146 food for, III, 132-139 foreskin, adhering, III, 141 glands, enlarged, III, 149 hip disease, III, 161 holding the breath, III, 153 knock knees, III, 163 larynx, spasm of the, III, 153 measles, I, 198 German measles, I, 203 membranous croup, II, 79 milk poisoning, III, 209, 211 mumps, I, 235 navel, sore, III, 142 pains, growing, III, 146 Pott's disease, III, 157 rickets, III, 151 ringworm, II, 149 rupture, II, 128 scarlatina, I, 192 scarlet fever, I, 192 scrofula, III, 149 scurvy, II, 182 sore mouth, II, 65 spine, curvature of the, III, 157, 159 St. Vitus's Dance, III, 155 stomach, catarrh of the, III, 209 urine, painful passage of, III, 141 urine, retention of, III, 141 wasting, III, 144 whooping cough, I, 238 worms, III, 240 Chills and fever, I, 247 Cholera, III, 228 infantum, III, 211 morbus, III, 226 Chorea, III, 158 Cinder in the eye, I, 176; II, 13 Circulation, the, III, 168 Circumcision, III, 142 Clam broth, IV, 263 Climacteric, the, III, 70 Clothing, proper, IV, 22 Cochlea, II, 46 Coffee, use of, IV, 43 Cold, exposure to, I, 181 in the head, II, 55 sore, II, 147 =COLIC=, III, 247 gallstone, III, 261 in babies, III, 267 intestinal, III, 249 mucous, III, 219 renal, III, 263 Collar-bone fracture, I, 85 Complexion, the, IV, 20 Confinement, III, 97 Congestion of the eyelid, II, 17 Conjunctivitis, II, 16, 18 Constipation, in adults, III, 233 in children, 238 Consumption, II, 96 fresh-air treatment for, II, 102 outdoor life for, VI, 72 prevention of, II, 104 Contagion, in cholera, 229 in conjunctivitis, II, 19 in diphtheria, II, 80 in eruptive fever, I, 191-220 in gonorrhea, II, 199 in grippe, II, 108 in mumps, I, 236 in syphilis, II, 206, 209 in whooping cough, I, 238 =CONTAGIOUS DISEASES=, I, 191 Convalescence (See Contents VI) Convulsions, in children, III, 34 in adults, I, 188 =COOKING= (See Contents IV) baking, IV, 171 boiling, IV, 180 braising, IV, 182 broiling, IV, 172 camp, VI, 220 cereals, IV, 229 eggs, IV, 184 entrées, IV, 219 fish, IV, 188 frying, IV, 175 game, IV, 202 poultry, IV, 202 roasting, IV, 171 sauces, IV, 216 sautéing, IV, 174 shellfish, IV, 195 soups, IV, 207 stewing, IV, 181 time of, IV, 177 utensils, IV, 232 vegetables, IV, 223 Copper sulphate method, V, 52 Copper vessels, use of, V, 67 Cord, bleeding of the, III, 142 Corns, II, 154 Costiveness, III, 233 =COUGH=, acute, II, 87, 91 whooping, I, 238 Cricoid cartilage, II, 70 Cross eye, II, 33 Croup, membranous, II, 79 ordinary, II, 83, 92 Curvature of the spine, III, 157, 159 Cystitis, II, 215 Dandruff, II, 167 Deafness, catarrhal, II, 39 chronic, II, 36 temporary, II, 33 Delirium tremens, III, 50 =DIARRHEA=, acute, III, 205 chronic, III, 217 of children, III, 208, 209 =DIET=, IV, 26, 107, 123, 138, 153 animal, IV, 39 details of, IV, 146 errors of, IV, 107 for babies, III, 132 for brain workers, IV, 126 for long life, IV, 107 for the aged, IV, 112 proper, IV, 138 relation to climate, IV, 108 rules for, IV, 110, 123 simplicity of, IV, 138 vegetable and animal, IV, 39 Digestion, effect of dress on, IV, 42 hygiene of, IV, 26 processes of, IV, 28 Diphtheria, II, 77 =DISINFECTANTS=, chemical, V, 243 physical, V, 240 solutions for, V, 247 Disinfection, V, 238 of rooms, V, 249 =DISLOCATIONS=, elbow, I, 125 hip, I, 129 jaw, I, 118, 120 knee, I, 119 shoulder, I, 122 Dog bite, I, 170 Doses of drugs, IV, 255 Dressings, for bruises, I, 63, 64 for wounds, I, 53, 57 surgical, I, 131 Drink, nutritious, IV, 118 Drinking, steady, III, 52 =DROWNED=, arousing the, I, 27 producing respiration in the, I, 28, 34 restoring the, I, 27 saving the, I, 36 Drowning person, death grasp of a, I, 37 saving a, I, 36 swimming to relief of a, I, 36 Drugs, doses of, IV, 255 Drum membrane, II, 33, 43, 45, 46, 48 Dysentery, in adults, III, 222 in children, III, 213 Dysmenorrhea, III, 71 =DYSPEPSIA=, III, 185 causes of, IV, 27 nervous, III, 190 =EAR=, anatomy of the, II, 33, 37, 46 diseases of the, II, 33 foreign bodies in the, I, 78; II, 39 water in the, II, 42 wax in the, II, 35 Earache, II, 40 moderate, II, 48 Eating, proper mode of, IV, 140-149 Eczema, II, 163 climatic, II, 164 occupation, II, 164 seborrheic, II, 164, 165, 167 Eggnog, IV, 268 Eggs, as food, IV, 33, 184 soft-boiled, IV, 266 Egg water, IV, 262 Elbow, dislocation of, I, 125 =ELECTRIC SHOCK=, I, 43, 46 Enteric fever, I, 221 Enteritis, catarrhal, III, 205 Entero-colitis, III, 209 Enteroptosis, IV, 43 Environment, importance of, III, 65 Epiglottis, II, 70 Epilepsy, III, 39 spasms in, III, 39 without spasms, III, 40 Erysipelas, I, 244 Eustachian tube, II, 37, 38, 41, 46, 49, 50 Exhaustion, mental and nervous, VI, 91-145 =EXERCISE=, IV, 48, 66 corrective, IV, 57 effect of, IV, 51 excessive, IV, 52 for all-round development, IV, 59, 101 for boyhood, IV, 69 for children, IV, 67 for elderly men, IV, 79 for everyone, IV, 66 for girls, IV, 73 for middle-aged men, IV, 77 for women, IV, 76 for young men, IV, 71 for youth, IV, 69 home, IV, 57 regular, IV, 53, 58 results of, IV, 98 without apparatus, IV, 57 =EYE=, anatomy of the, II, 30 astigmatism of the, II, 26 black, II, 14 catarrhal inflammation of the, II, 18 cinder in the, I, 76 cross, II, 33 diseases of the, II, 13 farsighted II, 21 foreign bodies in the, I, 76; II, 13 hyperopic, II, 22 lens of the, II, 30 muscles of the, II, 30 nearsighted, II, 25 pink, II, 19 retina of the, II, 30 sore, II, 16 strain, II, 21 wounds and burns of the, II, 16 Eyelid, congestion of the, II, 17 stye on the, II, 15 twitching of the, II, 15 Eye muscles, weakness of the, II, 28 Eye-strain, II, 21 Facial, neuralgia, III, 28 paralysis, III, 25 =FAINTING=, I, 185; III, 45 Farsightedness, II, 21 Fat as a food, IV, 35 Fatigue, causes of, IV, 50 Felon, I, 74, 75 =FEVER=, bilious, I, 247 black water, I, 256 Chagres, I, 256 chills and, I, 247 enteric, I, 221 gastric, III, 179 intermittent, I, 247 marsh, I, 247 remittent, I, 247 rheumatic, II, 169 scarlet, I, 192 swamp, I, 247 typhoid, I, 221 yellow, I, 261 Fever blister, II, 147 Fevers, eruptive contagious, I, 191 Fish as food, IV, 188 Finger, fracture of, I, 101 =FIT=, I, 188 Flea bites, I, 162 Fly bites, I, 164 Food, adulteration of, V, 87 containing parasites, I, 152 elements of, IV, 29 for babies, III, 132; IV, 261 for the sick, IV, 261 infected, I, 150 laws, V, 88 poisoning, I, 147 preparation of, IV, 171 pure, selection of, V, 89 Foods, advertised, IV, 116 Foot gear, IV, 24 Forearm fracture, I, 94 =FOREIGN BODIES=, in the ear, I, 78; II, 39 in the eye, I, 76; II, 13 in the nose, I, 79; II, 53 Foreskin, adhering, III, 141 Fourth-of-July accidents, I, 56 =FRACTURE= (See Broken Bone) Colles', I, 99 compound, I, 80, 116 how to tell a, I, 81 simple, I, 80 Freckles, II, 150 Freezing, I, 178 =FROSTBITE=, I, 178, 180 Gallstone colic, III, 261 Ganglion, I, 75 Garbage, disposal of, V, 171 Gastric fever, III, 179 Genito-urinary diseases, II, 199 Germs (See Bacteria) Girls, exercises for, IV, 73 physical training for, IV, 72; VI, 39 Glands, enlarged, III, 149 Gonorrhea, II, 199 in women, II, 203; III, 90 Gout, common, II, 183 rheumatic, II, 177 Grippe, la, II, 56, 108 Growing pains, III, 146 Hair, the, IV, 21 Hallucinations, II, 232 Hand, anatomy of the, III, 30 arteries of the, III, 30 fracture of the, I, 101 nerves of the, III, 30 tendons of the, III, 30 =HEADACHE=, constant, II, 120 due to disease, II, 117 due to eye strain, II, 29 due to heat stroke, II, 120 due to indigestion, II, 115 due to poisoning, II, 118 nervous, II, 117 neuralgic, II, 117 sick, II, 113 sympathetic, II, 116 Head gear, IV, 24, 160 Head injuries, III, 46 =HEART=, anatomy of the, III, 167, 168 enlargement of the, III, 169 palpitation of the, III, 171 Heart disease, III, 167 Heat exhaustion, I, 39, 40 Heating, cost of, V, 254 methods of, V, 161 =HEAT STROKE=, I, 39, 41 Hemorrhage (See Bleeding) Hemorrhoids, II, 135 Heredity, III, 57 in consumption, II, 97 Hernia, II, 128 (See Rupture) strangulated, II, 129 umbilical, II, 128 ventral, II, 128 Hiccough or hiccup, III, 21 Hip disease, III, 161 Hip, dislocation of, I, 129 fracture of, I, 104 Hives, II, 143 Hoarseness, II, 80 Hornet stings, I, 158 "Horrors," the, III, 50 House, proper construction of, V, 141 Housemaid's knee, I, 72 Hypodermic syringe, the, IV, 250 Hysteria, VI, 20 =INDIGESTION=, acute, III, 178 a result of errors, IV, 130 chronic, III, 185 intestinal, III, 202 not disease, IV, 134 Infants, bathing, III, 109 care of, III, 108 clothing for the, III, 110 feeding of, III, 118 Infection, V, 238 in erysipelas, I, 244 in malaria, I, 247 in typhoid fever, I, 221 in yellow fever, I, 261 =INFECTIOUS DISEASES=, I, 221 Influenza, II, 108 Ingrowing toe nail, I, 184 Injections, III, 238, 239 =INJURED, CARRYING THE=, I, Frontispiece Insane, criminal, II, 234 delusions of the, II, 233 illusions of the, II, 231 sanitariums for the, II, 245 Insanity, II, 229; VI, 164 causes of, II, 239 false ideas regarding, II, 241 physical signs of, II, 235 prevention of, II, 240 types of, II, 236 Insensibility, III, 44 Insomnia, III, 23 Intermittent fever, I, 247 Invalids, care of, VI, 155 Itching, II, 139 Ivy poison, II, 152 Jaundice, III, 180 Jaw, dislocation of, I, 118, 120 fracture of, I, 89 Joint, injury of a, I, 65, 69 Junket, IV, 266 Kerosene, extermination of mosquitoes by, V, 77 Kidneys, inflammation of the, II, 220 Bright's disease of the, II, 219 stone in the, III, 265 Knee, dislocation of, I, 119 sprain of, I, 67, 70 Kneepan fracture, I, 109 Knock knees, III, 163 Laryngitis, II, 80 Larynx, anatomy of the, II, 70 spasm of the, III, 153 Leeches, use of, II, 43 Leg bones, fracture of, I, 111, 116 Leucorrhoea, III, 86 Lice, body, I, 161 clothes, I, 161 crab, I, 162 head, I, 160 Life-saving service, U. S., I, 27 Lightning stroke, I, 43 Limewater, IV, 268 =LOCKJAW=, I, 56 Long life, rules for (See Contents IV, Part III) Lotions, II, 145, 151, 152, 155, 166 Lues, II, 206 Lumbago, II, 173 =LUNGS=, bleeding from the, I, 62 diseases of the, II, 87 inflammation of the, II, 93 tuberculosis of the, II, 96 =MALARIA=, I, 247 chronic, I, 253 mosquito as cause of, I, 157, 247 pernicious, I, 255 remittent, I, 254 Malt soup, IV, 267 Marasmus, III, 144 Marketing, hints on, IV, 232 Marriage relations, II, 197 Marsh fever, I, 247 Measles, common, I, 198 German, I, 203 Meat as food, IV, 32 Median nerve, III, 30 Medicine chest, contents of the, IV, 243 =MEDICINES, PATENT=, II, 245 antiphlogistine, II, 258 belladonna plasters, II, 257 dangers of, II, 260 hamamelis, II, 255 headache powders, II, 262 Listerine, II, 256 Platt's Chlorides, II, 259 Pond's Extract, II, 255 proprietary, II, 246 Scott's Emulsion, II, 257 vaseline, II, 254 witch-hazel, II, 255 Medulla oblongata, III, 22 Membranous croup, II, 79 Menopause, the, III, 70 Menstruation, III, 67 absence of, III, 75 arrest of, III, 79 cessation of, III, 78 delayed, III, 79 painful, III, 71 scanty, III, 79 Metals, poisoning by, I, 141 Miliaria, II, 148 =MILK=, as food, IV, 33 curd, IV, 266 mixtures, III, 124 peptonized, IV, 264 poisoning, III, 209, 211 porridge, IV, 267 Mind cure, VI, 31 disorder of the, II, 229 Miscarriage, danger of, III, 80 =MOSQUITO= bites, I, 155, 158; V, 71 destruction of the, I, 258; V, 75 exterminating the, V, 70 malaria due to the, I, 248 yellow fever due to the, I, 261; V, 70 Motor nerve, III, 38 Mouth-breathing, II, 60 Mouth, inflammation of the, II, 64 sore, II, 64 Mumps, I, 235 Muscular action, IV, 48 development, by will power, IV, 63 =MUSHROOM POISONING=, V, 112 Mushrooms, edible, V, 115 how to tell, V, 114 poisonous, V, 124 Mutton broth, IV, 261 Myalgia, II, 173 Myopia, II, 25 Narcotics, poisoning by, I, 142 Nasal cavity, II, 54 Navel, sore, III, 142 Nearsightedness, II, 25 Nervous debility, III, 13 diseases, III, 13 exhaustion, III, 13; VI, 70, 167 =NERVOUSNESS= (See Contents VI) remedy for, VI, 70, 167; III, 20 Nervous system, reflex action of the, III, 38 Nettlerash, II, 143 Neuralgia, III, 27 facial, III, 28 of the chest, III, 29 Neurasthenia, III, 13 =NOSE=, anatomy of the, II, 54 bleeding from the, II, 51 catarrh of the, II, 55 diseases of the, II, 51 foreign bodies in the, I, 79; II, 53 obstructions in the, II, 60 septum of the, II, 51, 54, 61 Nosebleed, I, 61; II, 51 Nostrum, II, 248 Nurse and patient (See Contents VI) Nurse, selection of the, VI, 150 Nursing, VI, 146 Oatmeal water, IV, 263 Olfactory nerves, III, 22 Oozing of blood, I, 54, 55 Optic nerves, III, 22 =OUTDOOR LIFE= (See Contents VI) for consumption, VI, 72 for nervous exhaustion, VI, 70, 167 Overworked, hints for the, VI, 91 Oyster broth, IV, 267 Palmar arch, III, 30 Pains, growing, III, 146 Palpitation of the heart, III, 171 Paralysis, facial, III, 25 Paranoia, II, 237 Parasites, malarial, I, 247 yellow fever, I, 261 Paresis, II, 237 Patent medicines, II, 247 Peritonitis, III, 252 Petit mal, III, 40 Pharyngitis, II, 69 Phthisis, II, 96 Pigeon breast, II, 63 Piles, external, II, 135 internal, II, 136 Pimples, II, 145 Pink eye, II, 19 Plumbing, connections, V, 194 defects in, V, 231 drains, V, 206 fixtures, V, 216 joints, V, 194 pipes, V, 191, 206 tests, 233 traps, V, 198 Pneumonia, II, 93 =POISONING= (See Poisons) by canned meats, I, 150 by fish, I, 148 by meat, I, 148, 150, 151 by milk, I, 148, 150, 151 food, bacterial, I, 147 food, containing parasites, I, 152 food, infected, I, 150 mushroom, V, 112 potato, I, 154 Poison ivy, II, 152 =POISONS=, acetanilid, I, 146 acid, carbolic, I, 140 acid, nitric, I, 140 acid, oxalic, I, 140 acid, sulphuric, I, 140 acids, I, 140 aconite, I, 142 alcohol, I, 143 alkalies, I, 140 ammonia, I, 141 antidotes, I, 139 antimony, I, 142 arsenic, I, 141 belladonna, I, 142 bichloride of mercury, I, 141 blue vitriol, I, 141 bug poison, I, 141 camphor, I, 142 caustic soda, I, 141 chloral, I, 143 cocaine, I, 145 copper, I, 141 corrosive sublimate, I, 141 digitalis, I, 142 ergot, I, 142 Fowler's solution, I, 141 headache powders, I, 146 hellebore, I, 142 ivy, II, 152 knockout drops, I, 143 laudanum, I, 144 lobelia, I, 142 lye, I, 141 matches, I, 142 mercury, I, 141 metals, I, 141 morphine, I, 144 narcotics, I, 142 nux vomica, I, 145 opium, I, 144 paregoric, I, 144 Paris green, I, 141 phenacetin, I, 146 phosphorus, I, 142 potash, I, 141 "rough on rats," I, 141 silver nitrate, I, 141 sleeping medicines, I, 143 soothing sirup, I, 144 strychnine, I, 145 tartar emetic, I, 142 tobacco, I, 144 unknown, I, 139 verdigris, I, 141 washing soda, I, 141 white precipitate, I, 141 Polypi, II, 54, 62 Pons Varolii, III, 22 Pott's disease, III, 157 Poultry as food, IV, 201 Pox, II, 206 Pregnancy, III, 91 diet during, III, 91 exercise during, III, 91 mental state during, III, 95 signs of, III, 80, 93 Prickly heat, II, 148 Proprietary medicines, II, 248 Pruritus, II, 139 Pulse, how to feel the, IV, 247 Punctured wound, bleeding from, a, I, 52, 53 Pure food bill, II, 249 =PURE FOOD, SELECTION OF=, V, 89-111 canned articles, V, 107 cereals, V, 98 chocolate, V, 107 cocoa, V, 107 coffee, V, 104 flavoring extracts, V, III meat, V, 92 meat products, V, 95 olive oil, V, 110 shellfish, V, 94 spices, V, 108 sugar, V, 108 tea, V, 104 vegetables, V, 96 vinegar, V, 110 Purifying water supply, V, 52 Quinsy, II, 75 Radial nerve, III, 30 Recipes, for babies, IV, 261 for the sick, IV, 261 Reflex action illustrated, III, 38; IV, 49 Remittent fever, I, 247 Renal colic, III, 263 Respiration, to produce artificial, I, 28, 34, 43, 178, 186 Respirations, counting the, IV, 248 Rest cure, III, 20 Reversion, III, 59 Rheumatic fever, II, 169 gout, II, 177 =RHEUMATISM=, acute, II, 169 chronic, II, 175 effect on the heart, II, 170 inflammatory, II, 169 muscular, II, 173 of the chest, II, 174 Rhinitis, II, 77 Rib, broken, I, 83 Rice water, IV, 264 Rickets, III, 151 Ringworm, of body, II, 149 of scalp, II, 149 =RUN-AROUND=, I, 73 Rupture, II, 128 Salt rheum, II, 163 Sanitariums for the insane, II, 245 =SANITATION= (See Contents V) Sarcoma, II, 124 =SCALDS=, I, 171 Scalp wounds, I, 60 Scarlatina, I, 192 Scarlet fever, I, 192 Sciatica, III, 31 Scorpion sting, I, 164 Scrofula, III, 149 Scurvy, common, II, 180 infantile, II, 182 Seasickness, III, 195 Self-abuse, II, 192 Semicircular canals, II, 46 Sensory nerve, III, 38 Septum, II, 54 deviation of the, II, 60 Serum, antivenomous, I, 169 Sewage, V, 170 disposal of, V, 172 Sewer gas, V, 187 Sewers, V, 182 Sexual organs, care of the, II, 191 diseases of the, II, 199 Sexual relations, II, 194 Shingles, III, 29 Shoulder, dislocation of, I, 122 sprain of, I, 67 Shoulder-blade fracture, I, 91 Sick, food for the, IV, 261 Sick room, the, VI, 150 =SKIN=, callus of the, II, 156 chafing of the, II, 142 chapping of the, II, 142 cracks in the, II, 156 discolorations of the, II, 150 diseases of the, II, 139 irritation of the, II, 142 itching of the, II, 139 Sleeplessness, III, 23 Sling, how to make a, 87, 88 Smallpox, I, 206 Snake bite, I, 166, 168 Soap, use of, IV, 32 Soil, bacteria in, V, 135 constituents of, V, 131 contamination of, V, 136 diseases due to, V, 139 Soil, improving the, V, 140 influence of, V, 137 Sore mouth, aphthous, II, 66 gangrenous, II, 67 simple, II, 65 ulcerous, II, 67 Sore eyes, II, 16 Sore throat, II, 69 Soup, malt, IV, 267 Soups, IV, 207 Spider bite, I, 164, 165 Spinal cord, III, 38 Spine, curvature of, III, 157, 159 Spleen, enlargement of, II, 254 Splinters, removing, I, 54 Splints, I, 61, 71, 93, 97, 102, 107, 110, 111, 114, 128 =SPRAINS=, bandages for, I, 65, 67 treatment of, 65, 66 Sprue, II, 66 Squint, II, 33 St. Vitus's Dance, III, 155 Stiff neck, II, 174 =STINGS=, bee, I, 158 centipede, I, 164 hornet, I, 158 scorpion, I, 164 wasp, I, 158 Stitching a wound, I, 58 =STOMACH=, bleeding from the, I, 62 catarrh of the, III, 185, 209 diseases of the, III, 178 neuralgia of the, III, 251 Stomachache, III, 247 Stone, in the bladder, III, 265 in the kidney, III, 263 Strabismus, II, 33 Stye, II, 15 =SUFFOCATION=, from gas, I, 186 Sunstroke, I, 40 Surgical dressings, I, 131 Swamp fever, I, 247 =SYNOVITIS=, I, 69 Syphilis, II, 206, 212 Syringe, the bulb, III, 239 the fountain, III, 238 the hypodermic, IV, 250 Tan, II, 150 Tapeworm, I, 152 Tarantula bite, I, 164 Tea, use of, IV, 43 Teeth, artificial, IV, 119 care of the, IV, 26 Teething, III, 113 Temperature, how to tell the, IV, 246 proper, IV, 161, 162 Tetter, II, 163 Thermometer, clinical, use of the, IV, 246 Thigh-bone fracture, I, 106 =THROAT=, diseases of the, II, 51, sore, II, 69 Thrush, II, 66 Tic douloureux, III, 28 Toe nail, ingrowing, I, 184 Tongue, noting appearance of the, IV, 249 Tonsilitis, II, 71 Tonsils, enlarged, II, 63 Tooth, ulcerated, II, 58 Toothache, II, 58 Training, physical, IV, 124; VI, 38 Trichiniasis, I, 153 Truss, use of the, II, 130 Tuberculin, II, 101 Tuberculosis of the bones, III, 157 of the lungs, II, 96 =TUMORS=, II, 123 Turbinates, enlarged, II, 60 Typhoid fever, I, 221 complications of, I, 228 Ulcerated tooth, II, 58 Ulnar nerve, III, 30 =UNCONSCIOUSNESS=, III, 44 due to drunkenness, III, 47 due to epilepsy, III, 48 due to fainting, III, 45 due to head injuries, III, 46 Unconsciousness, due to kidney disease, III, 48 due to opium poisoning, III, 48 due to sunstroke, III, 48 Underclothing, proper, IV, 22 =URINE=, incontinence of, II, 213 involuntary passage of, II, 213 painful passage of, III, 141 retention of, II, 218; III, 141 stoppage of, II, 218 suppression of, II, 218 Urticaria, II, 143 Vaccination, I, 211-215 Varicocele, II, 134 Varicose veins, II, 132 Varioloid, I, 211 Veal broth, IV, 261 Vegetables as food, IV, 34, 223 Vein, bleeding from a, I, 51, 52 Veins, systemic, III, 168 =VENTILATION=, artificial, V, 157 forces of, V, 148 methods of, V, 150 natural, V, 151 Ventricles of the heart, III, 168 Vision, defects of, II, 21-33 Vocal cords, II, 70 =VOMITING=, III, 194 of blood, III, 200 of indigestion, III, 199 of pregnancy, III, 196 Wakefulness, III, 23 Warming, V, 160 Warts, flat, II, 154 moist, II, 154 seed, II, 153 threadlike, II, 153 Wasp stings, I, 158 Wasting, III, 144 =WATER=, barley, IV, 263 egg, IV, 262 lake, V, 27 lime, IV, 268 oatmeal, IV, 263 pure, V, 21, 52 rain, V, 26 rice, IV, 264 spring, V, 29 well, V, 31-37 wheat, IV, 264 Water cure, for nervous exhaustion, III, 20 Water distribution, V, 39 engines for, V, 42 hydraulic rams for, V, 40 pressure systems for, V, 47 storage tanks for, V, 46 windmills for, V, 41 Water supply, laws of, V, 37 plants which pollute, V, 54 pollution of, V, 22 purifying the, V, 52 sources of, V, 19 system for country, V, 47 Wax in the ear, II, 34 Wear and tear (See Contents VI) Weaning, III, 117 =WEEPING SINEW=, I, 75 Wen, II, 126 Wheat water, IV, 264 Whey, mixtures, IV, 265 wine, IV, 266 Whites, III, 87 Whitlow, I, 74, 75 Whooping cough, I, 238 Womb, hemorrhage from the, III, 82 Women, exercises for, IV, 76 Wood tick, bite of, I, 159 =WORMS=, pin, III, 243 round, III, 242 tape, III, 245 =WOUNDS=, I, 50 about the eyes, II, 16 caused by pistols, I, 56 caused by firecrackers, I, 56 cleansing, I, 59 foreign bodies in, I, 54, 56 scalp, I, 60 stitching, I, 58 treatment of, I, 50, 57 Wrist, fracture of the, I, 99 sprain of the, I, 65, 67 Yellow fever, I, 261 mosquito as cause of, I, 157, 261, 265 Preface Medicine, as the art of preserving and restoring health, is the rightful office of the great army of earnest and qualified American physicians. But their utmost sincerity and science are hampered by trying restrictions with three great classes of people: those on whom the family physician cannot call _every day_; those on whom he cannot call _in time_; and those on whom he cannot call _at all_. To lessen these restrictions, thus assisting and extending the healer's work, is the aim of the pages that follow. Consider first the average American household, where the family physician cannot call _every day_. Not a day finds this household without the need of information in medicine or hygiene or sanitation. More efforts of the profession are thwarted by ignorance than by epidemic. Not to supplant the doctor, but to supplement him, carefully prepared information should be at hand on the hygiene of health--sanitation, diet, exercise, clothing, baths, etc.; on the hygiene of disease--nursing and sick-room conduct, control of the nervous and insane, emergency resources, domestic remedies; above all, on the prevention of disease, emphasizing the folly of self-treatment; pointing out the danger of delay in seeking skilled medical advice with such troubles as cancer, where early recognition may bring permanent cure; showing the benefit of simple sanitary precautions, such as the experiment-stations method of exterminating the malaria-breeding mosquito. The volumes treating of these subjects cannot be made too clear, nontechnical, fundamental, or too well guarded by the supervision of medical men known favorably to the profession. Again, the physician cannot come _on time_ to save life, limb, or looks to the victim of many a serious accident. And yet some bystander could usually understand and apply plain rules for inducing respiration, applying a splint, giving an emetic, soothing a burn or the like, so as to safeguard the sufferer till the doctor's arrival--if only these plain rules were in such compact form that no office, store, or home in the land need be without them. Finally, the doctor _cannot come at all_ to hundreds of thousands of sailors, automobilists, and other travelers, to ranchers, miners, and country dwellers of many sorts. This third class has had, hitherto, little choice between some "Practice of Medicine," too technical to be helpful, on the one hand, and on the other, the dubious literature of unsanctioned "systems"; or the startling "cure-all" assertions emanating from many proprietors of remedies; or "Complete Family Physicians," which offer prescriptions as absurd for the layman as would be dynamite in the hands of a child, with superfluous and loathsome pictures appealing only to morbid curiosity, and with a general inaccuracy utterly out of touch with twentieth-century knowledge. What such people need, much more than the dwellers in settled communities, is to learn the views of modern medicine upon the treatment of the ever-present common ailments--the use of standard remedies, cautions against the abuse of narcotics, lessons of discrimination against harmful, useless, or expensive "patent medicines," and proper rules of conduct for diet, nursing, and general treatment. Authentic health literature existed abundantly before the preparation of these volumes, but it was scattered, expensive, and in most cases not arranged for the widest use. Not within our knowledge has the body of facts, most helpful to the layman on Sanitation and Hygiene, First Aid, and Domestic Healing, been brought together as completely, as clearly, as concisely, with a critical editing board so qualified, and with special contributions so authoritative as this work exhibits. "Utmost caution" has been a watchword with the editors from the start. Those to whom the doctor _cannot come every day_ have been repeatedly warned of the follies of self-treatment, and reminded that to-day it is the patient that is treated--not the disease. Those to whom the doctor _cannot come in time_ are likewise warned that the "First-aid Rules" of this Library are for temporary treatment only, in all situations where it is possible to get a physician. And the utmost conservatism has been striven for by the author and the several revisers in every part of the work that appeals particularly to dwellers in localities so removed that the doctor _cannot come at all_. Especial delicacy was also sought in the treatment of a chapter which, it is hoped, will aid parents to guide their children in sexual matters. The illustrations represent helpful, normal conditions (with the exception of some necessary representations of fracture, etc.) with instructive captions aimed to make them less a sensation than a real benefit; and no pictures appear of a sort to stimulate mere morbid curiosity. The greatest sympathy and appreciation of this work have been shown by the progressive and recognized practitioners who have seen early copies. They recognize it as a timely attempt to create and compile health literature in a form most complete within its limits of space, and in a manner most helpful and sane. The eager curiosity regarding _themselves_ that has been sweeping over the American people has been diverted into frivolous and harmful channels by much reckless talk and writing. A prominent newspaper, in its Sunday editions, recently took up the assertion, in a series of articles, that appendicitis operations resulted from a gigantic criminal conspiracy on the part of surgeons; that a sufficient cure for appendicitis, "as any honest doctor would tell you," is an injection of molasses and water! The endless harm done by such outright untruth is swelled by a joining stream of slapdash misinformation and vicious sensation, constantly running through the press. Education is sorely needed from authority. People _will_ read about their bodies. They have a right to information from the highest accredited source. And to apply such knowledge Dr. Winslow has labored for many years during his practicing experience, condensing and setting into clear order the most vitally important facts of domestic disease and treatment; an eminently qualified staff of practicing specialists has coöperated, with criticism and supervision of incalculable value to the reader; and the accepted classics in their field follow: Dr. Weir Mitchell's elegant and inspiring essays on Nerves, Outdoor Life, etc.; Sir Henry Thompson's "precious documents of personal experience" on Diet and Conduct for Long Life; Dr. Dudley A. Sargent's scientific and long-prepared system of exercises without apparatus; Gerhard's clear principles of pure water supply; Dr. Darlington's notes and editing from the unequaled opportunity of a New York City Health Commissioner--and many other "special contributions." It is the widely accepted modern medicine, and no school or "system," that is reflected here. While medicine, as a science, is far from being perfect, partly because of faulty traditions and misinterpreted experience, yet the aim of the modern school is to base practice on _facts_. For example, for many years physicians were aware that quinine cured malaria, in some unexplainable way. Now they not only know that malaria is caused by an animal parasite living and breeding in the blood and that quinine destroys the foe, but they know about the parasite's habits and mode of development and when it most readily succumbs to the drug. Thus a great discovery taught them to give quinine understandingly, at the right time, and in the right doses. An educated physician has at his command all knowledge, past and present, pertaining to medicine. He is free to employ any means to better his patient. Now it is impossible to cure, or even better, all who suffer from certain disease by any one method, and a follower of a special "system" thus ignores many agencies which might prove efficient in his case. While there is a germ of good and truth in the various "systems" of medical practice, their representatives possess no knowledge unknown to science or to the medical profession at large. Many persons are always attracted by "something new." But newness in a medical sect is too often newness in name only. These systems rise and fall, but scientific, legitimate medicine goes ever onward with an eye single to the discovery of new facts. That these volumes will result in an impetus to saner, quieter, steadier living, and will prove a helpful friend to many a physician and many a layman, is the earnest wish of THE PUBLISHERS. Part I FIRST AID IN EMERGENCIES BY KENELM WINSLOW AND ALBERT WARREN FERRIS _Introductory Note_ With the exception of the opening chapter, which contains the valuable Life-saving Service Rules _verbatim_, the Editors have adopted the plan of beginning each article in Part I of this volume with a few simple, practical instructions, telling the reader exactly what to do in case of an accident. For the purpose of distinguishing them from the ordinary text, and making them easy of reference, these _"First-aid Rules" are printed in light-faced type_. CHAPTER I =Restoring the Apparently Drowned= _As Practiced in the United States Life-Saving Service_ NOTE.--These directions differ from those given in the last revision of the Regulations by the addition of means for securing deeper inspiration. The method heretofore published, known as the Howard, or direct method, has been productive of excellent results in the practice of the service, and is retained here. It is, however, here arranged for practice in combination with the Sylvester method, the latter producing deeper inspiration than any other known method, while the former effects the most complete expiration. The combination, therefore, tends to produce the most rapid oxygenation of the blood--the real object to be gained. The combination is prepared primarily for the use of life-saving crews where assistants are at hand. A modification of Rule III, however, is published as a guide in cases where no assistants are at hand and one person is compelled to act alone. In preparing these directions the able and exhaustive report of Messrs. J. Collins Warren, M.D., and George B. Shattuck, M.D., committee of the Humane Society of Massachusetts, embraced in the annual report of the society for 1895-96, has been availed of, placing the department under many obligations to these gentlemen for their valuable suggestions. =IF SEVERAL ASSISTANTS ARE AT HAND.= RULE I. _Arouse the Patient._--Do not move the patient unless in danger of freezing; instantly expose the face to the air, toward the wind if there be any; wipe dry the mouth and nostrils; rip the clothing so as to expose the chest and waist; give two or three quick, smarting slaps on the chest with the open hand. If the patient does not revive, proceed immediately as follows: RULE II. _To Expel Water from the Stomach and Chest_ (see Fig. 1).--Separate the jaws and keep them apart by placing between the teeth a cork or small bit of wood, turn the patient on his face, a large bundle of tightly rolled clothing being placed beneath the stomach; press heavily on the back over it for half a minute, or as long as fluids flow freely from the mouth. [Illustration: FIG. 1. TO EXPEL WATER FROM STOMACH AND CHEST. Patient lying face downward; roll of clothes beneath stomach; jaws separated by piece of wood or cork; note rescuer pressing on back to force out water.] RULE III. _To Produce Breathing_ (see Figs. 2 and 3).--Clear the mouth and throat of mucus by introducing into the throat the corner of a handkerchief wrapped closely around the forefinger; turn the patient on the back, the roll of clothing being so placed as to raise the pit of the stomach above the level of the rest of the body. Let an assistant, with a handkerchief or piece of dry cloth, draw the tip of the tongue out of one corner of the mouth (which prevents the tongue from falling back and choking the entrance to the windpipe), and keep it projecting a little beyond the lips. Let another assistant grasp the arms, just below the elbows, and draw them steadily upward by the sides of the patient's head to the ground, the hands nearly meeting (which enlarges the capacity of the chest and induces inspiration). (Fig. 2.) While this is being done let a third assistant take position astride the patient's hips with his elbows resting upon his own knees, his hands extended ready for action. Next, let the assistant standing at the head turn down the patient's arms to the sides of the body, the assistant holding the tongue changing hands if necessary[1] to let the arms pass. Just before the patient's hands reach the ground the man astride the body will grasp the body with his hands, the balls of the thumb resting on either side of the pit of the stomach, the fingers falling into the grooves between the short ribs. Now, using his knees as a pivot, he will, at the moment the patient's hands touch the ground, throw (not too suddenly) all his weight forward on his hands, and at the same time squeeze the waist between them, as if he wished to force something in the chest upward out of the mouth; he will deepen the pressure while he slowly counts one, two, three, four (about five seconds), then suddenly let go with a final push, which will spring him back to his first position.[2] This completes expiration. (Fig. 3.) [Illustration: FIG. 2. TO PRODUCE BREATHING. First Position: Patient lying face upward; roll of clothes under back; tongue pulled out of mouth with handkerchief; note rescuer drawing arms upward to sides of head to start act of breathing in.] [Illustration: FIG. 3. TO PRODUCE BREATHING. Second Position: Forcing patient to breathe out; note rescuer with thumbs on pit of stomach, pressing against front of chest over lower ribs; also, assistant drawing down arms to body.] At the instant of his letting go, the man at the patient's head will again draw the arms steadily upward to the sides of the patient's head as before (the assistant holding the tongue again changing hands to let the arms pass if necessary), holding them there while he slowly counts one, two, three, four (about five seconds). Repeat these movements deliberately and perseveringly twelve to fifteen times in every minute--thus imitating the natural motions of breathing. If natural breathing be not restored after a trial of the bellows movement for the space of about four minutes, then turn the patient a second time on the stomach, as directed in Rule II, rolling the body in the opposite direction from that in which it was first turned, for the purpose of freeing the air passage from any remaining water. Continue the artificial respiration from one to four hours, or until the patient breathes, according to Rule III; and for a while, after the appearance of returning life, carefully aid the first short gasps until deepened into full breaths. Continue the drying and rubbing, which should have been unceasingly practiced from the beginning by assistants, taking care not to interfere with the means employed to produce breathing. Thus the limbs of the patient should be rubbed, always in an upward direction toward the body, with firm-grasping pressure and energy, using the bare hands, dry flannels, or handkerchiefs, and continuing the friction under the blankets, or over the dry clothing. The warmth of the body can also be promoted by the application of hot flannels to the stomach and armpits, bottles or bladders of hot water, heated bricks, etc., to the limbs and soles of the feet. RULE IV. _After Treatment. Externally._--As soon as breathing is established let the patient be stripped of all wet clothing, wrapped in blankets only, put to bed comfortably warm, but with a free circulation of fresh air, and left to perfect rest. _Internally:_ Give whisky or brandy and hot water in doses of a teaspoonful to a tablespoonful, according to the weight of the patient, or other stimulant at hand, every ten or fifteen minutes for the first hour, and as often thereafter as may seem expedient. _Later Manifestations:_ After reaction is fully established there is great danger of congestion of the lungs, and if perfect rest is not maintained for at least forty-eight hours, it sometimes occurs that the patient is seized with great difficulty of breathing, and death is liable to follow unless immediate relief is afforded. In such cases apply a large mustard plaster over the breast. If the patient gasps for breath before the mustard takes effect, assist the breathing by carefully repeating the artificial respiration. =IF ONE PERSON MUST WORK ALONE.= MODIFICATION OF RULE III [_To be used after Rules I and II in case no assistance is at hand_] _To Produce Respiration._--If no assistance is at hand, and one person must work alone, place the patient on his back with the shoulders slightly raised on a folded article of clothing; draw forward the tongue and keep it projecting just beyond the lips; if the lower jaw be lifted, the teeth may be made to hold the tongue in place; it may be necessary to retain the tongue by passing a handkerchief under the chin and tying it over the head.[3] Grasp the arms just below the elbows and draw them steadily upward by the sides of the patient's head to the ground, the hands nearly meeting. (See Fig. 4.) Next lower the arms to the side, and press firmly downward and inward on the sides and front of the chest over the lower ribs, drawing arms toward the patient's head. (See Fig. 5.) Repeat these movements twelve to fifteen times every minute, etc. [Illustration: FIG. 4. ONE PERSON WORKING. First Position: Note arm movement same as in Fig. 2; also, tongue held between teeth by handkerchief tied under chin pressing teeth against wooden plug.] [Illustration: FIG. 5. ONE PERSON WORKING. Second Position: Note rescuer lowering arms to patient's sides and pressing downward and inward over lower ribs.] =INSTRUCTIONS FOR SAVING DROWNING PERSONS BY SWIMMING TO THEIR RELIEF.= 1. When you approach a person drowning in the water, assure him, with a loud and firm voice, that he is safe. 2. Before jumping in to save him, divest yourself as far and as quickly as possible of all clothes; tear them off, if necessary; but if there is not time, loose at all events the foot of your drawers, if they are tied, as, if you do not do so, they fill with water and drag you. 3. On swimming to a person in the sea, if he be struggling do not seize him then, but keep off for a few seconds till he gets quiet, for it is sheer madness to take hold of a man when he is struggling in the water, and if you do you run a great risk. 4. Then get close to him and take fast hold of the hair of his head, turn him as quickly as possible on to his back, give him a sudden pull, and this will cause him to float, then throw yourself on your back also and swim for the shore, both hands having hold of his hair, you on your back, and he also on his, and of course his back to your stomach. In this way you will get sooner and safer ashore than by any other means, and you can easily thus swim with two or three persons; the writer has even, as an experiment, done it with four, and gone with them forty or fifty yards in the sea. One great advantage of this method is that it enables you to keep your head up, and also to hold the person's head up you are trying to save. It is of primary importance that you take fast hold of the hair, and throw both the person and yourself on your backs. After many experiments, it is usually found preferable to all other methods. You can in this manner float nearly as long as you please, or until a boat or other help can be obtained. 5. It is believed there is no such thing as a _death grasp_; at least, it is very unusual to witness it. As soon as a drowning man begins to get feeble and to lose his recollection, he gradually slackens his hold until he quits it altogether. No apprehension need, therefore, be felt on that head when attempting to rescue a drowning person. 6. After a person has sunk to the bottom, if the water be smooth, the exact position where the body lies may be known by the air bubbles, which will occasionally rise to the surface, allowance being, of course, made for the motion of the water, if in a tide way or stream, which will have carried the bubbles out of a perpendicular course in rising to the surface. Oftentimes a body may be regained from the bottom, before too late for recovery, by diving for it in the direction indicated by these bubbles. 7. On rescuing a person by diving to the bottom, the hair of the head should be seized by one hand only, and the other used in conjunction with the feet in raising yourself and the drowning person to the surface. 8. If in the sea, it may sometimes be a great error to try to get to land. If there be a strong "outsetting tide" and you are swimming either by yourself or having hold of a person who cannot swim, then get on your back and float till help comes. Many a man exhausts himself by stemming the billows for the shore on a back-going tide, and sinks in the effort, when, if he had floated, a boat or other aid might have been obtained. 9. These instructions apply alike to all circumstances, whether as regards the roughest sea or smooth water. FOOTNOTES: [1] Changing hands will be found unnecessary after some practice; the tongue, however, must not be released. [2] A child or very delicate patient must, of course, be more gently handled. [3] If there is stuck through the tongue a pin long enough to rest against the teeth and keep the tongue out of the mouth, the desired effect may be obtained.--EDITOR. CHAPTER II =Heat Stroke and Electric Shock= _How Persons are Overcome by Heat--Treatment of Sunstroke--Peculiar Cases--Dangers of Electric Shocks--How Death is Caused--Rules and Precautions._ =HEAT EXHAUSTION.= _First Aid Rule 1.--Carry patient flat and lay in shade. Loosen clothes at neck and waist._ _Rule 2.--Raise head and give him (a) teaspoonful of essence of ginger in glass of hot water, or give him (b) half a cup of hot coffee, clear._ _Rule 3.--Put him to bed._ =HEAT STROKE.= _First Aid Rule 1.--Send for physician._ _Rule 2.--Remove quickly to shady place, loosening clothes on the way._ _Rule 3.--Strip naked and put on wire mattress (or canvas cot), if obtainable._ _Rule 4.--Sprinkle with ice water from watering pot, or dash it out of basin with hand._ _Rule 5.--Dip sheet in ice water and tuck it snugly about patient._ _Rule 6.--Sprinkle outside of sheet with ice water; rub body, through the sheet, with piece of ice. Put piece of ice to nape of neck._ _Rule 7.--When temperature falls to 98.5° F. put to bed with ice cap on head._ =SUNSTROKE.=--There are two very distinct types of sunstroke: (1) Heat exhaustion or heat prostration. (2) Heat stroke. Heat prostration or exhaustion occurs when persons weakened by overwork, worry, or poor food are exposed to severe heat combined with great physical exertion. It often attacks soldiers on the march, but also those not exposed to the direct rays of the sun, as workers in laundries, in boiler rooms, and in stoke-holes of steamers. The attack begins more often in the afternoon or evening, in the case of those exposed to out-of-door heat. Feelings of weakness, dizziness, and restlessness, accompanied by headache, are among the first symptoms. The face is very pale, the skin is cool and moist, although the trouble often starts with sudden arrest of sweating. There is great prostration, with feeble, rapid pulse, frequent and shallow breathing, and lowered temperature, ranging often from 95° to 96° F. The patient usually retains consciousness, but rarely there is complete insensibility. The pernicious practice of permitting children at seaside resorts to wade about in cold water while their heads are bared to the burning sun is peculiarly adapted to favor heat prostration. Heat stroke happens more frequently to persons working hard under the direct rays of the sun, especially laborers in large cities who are in the habit of drinking some form of alcohol. It often occurs in unventilated tenements on stifling nights. Dizziness, violent headache, seeing spots before the eyes, nausea, and attempts at vomiting, usher in the attack. Compare it with heat prostration, and note the marked differences. The patient becomes suddenly and completely insensible, and falls to the ground, the face is flushed, the breathing is noisy and difficult, the pulse is strong, and the thermometer placed in the bowel registers 107°, 108°, or 110° F., or rarely higher. The muscles are usually relaxed, but sometimes there are twitchings, or even convulsions. Death often occurs within twenty-four or thirty-six hours, preceded by failing pulse, deep unconsciousness, and rapid breathing, often labored or gasping, alternating with long intermissions. Sometimes delirium and unconsciousness last for days. Diminution of fever and returning consciousness herald recovery, but it is a very fatal disorder, statistics showing a death rate of from thirty to fifty per cent. Even when the patient lives, bad after effects are common. Peculiar sensibility to moderate heat is a frequent complaint. Loss of memory, weakened mental capacity, headache, irritability, fits, other mental disturbances, and impairment of sight and hearing are among the more usual sequels, occurring in those who do not subsequently avoid the direct rays of the sun, as well as an elevated temperature, and who indulge in alcoholic stimulants. A high degree of moisture in the air favors sunstrokes, but it is a curious fact that sunstroke is much more frequent in certain localities, and in special years than at other places and times with identical climatic conditions. This has led observers to suggest a germ origin of the disease, but this is extremely doubtful. =Treatment.=--Treatment for heat exhaustion is given in the "first-aid" directions. Little need be added to the directions for treatment of heat stroke. In place of the ice cap suggested in Rule 7, ice in cloths, or in a sponge bag may be substituted. The friction of the body, as directed in Rule 6, is absolutely necessary to stimulate the nervous system and circulation, and to prevent the blood from being driven into the internal organs by the cold applied externally. The cold-water treatment is applied until the temperature falls down to within a few degrees of normal--that is, 98.6° F. Then the patient should be put into bed, there to remain, with ice to the head, until fully restored. It often happens that the fever returns, in which event the whole process of applying cold water must be repeated. The simplest way of reducing the fever consists in laying the patient, entirely nude, on a canvas cot or wire mattress, binding ice to the back of his neck, and having an attendant stand on a chair near by and pour ice water upon the patient from a garden watering pot. While the patient is insensible no attempt should be made to give anything by the mouth; but half a pint of milk and two raw eggs with a pinch of salt may be injected into the rectum every eight hours, after washing it out with cold water on each occasion. Two tablespoonfuls of whisky may be added to the injection, if the pulse is weak. If the urine is not passed spontaneously, it will be necessary to draw it once in eight hours with a soft rubber catheter which has been boiled ten minutes and lubricated with glycerin or clean vaseline. =ELECTRIC SHOCK OR LIGHTNING STROKE.= _First Aid Rule 1.--Protect yourself from being shocked by the victim. Grasp victim only by coat tails or dry clothes. Put rubber boots on your hands, or work through silk petticoat; or throw loop of rubber suspenders or of dry rope around him to pull him off wire, or pry him along with dry stick._ _Rule 2.--Do not lift, but drag victim away from wire toward the ground. When free from wire, hold him head downward for two minutes._ _Rule 3.--Assist heart to regain its strength. Apply mustard plaster (mustard and water) to chest over heart; wrap in blanket wrung out of very hot water; give hypodermic of whisky, thirty minims._ _Rule 4.--Induce artificial respiration. Open his mouth and grasp tongue, pull it forward just beyond lips, and hold it there. Let another assistant grasp the arms just below the elbows and draw them steadily upward by the sides of the patient's head to the ground, the hands nearly meeting (which enlarges the capacity of the chest and induces inspiration, Fig. 2). While this is being done, let a third assistant take position astride the patient's hips with his elbows resting on his own knees, his hands extended, ready for action. Next, let the assistant standing at the head turn down the patient's arms to the sides of the body, the assistant holding the tongue changing hands, if necessary, to let the arms pass. Just before the patient's hands reach the ground, the man astride the body will grasp the body with his hands, the ball of the thumb resting on either side of the pit of the stomach, the fingers falling into the grooves between the short ribs. Now, using his knees as a pivot, he will at the moment the patient's hands touch the ground throw (not too suddenly) all his weight forward on his hands, and at the same time squeeze the waist between them, as if he wished to force something in the chest upward out of the mouth; he will deepen the pressure while he slowly counts one, two, three, four (about five seconds), then suddenly lets go with a final push, which will send him back to his first position. This completes expiration. (A child or delicate person must be more gently handled.)_ _At the instant of letting go, the man at the patient's head will again draw the arms steadily upward to the sides of the patient's head, as before (the assistant holding the tongue again changing hands to let the arms pass, if necessary), holding them there while he slowly counts one, two, three, four (about five seconds)._ _Repeat these movements deliberately and perseveringly twelve to fifteen times in every minute--thus imitating the natural motions of breathing. Continue the artificial respiration from one to four hours, or until the patient breathes; and for a while, after the appearance of returning life, carefully aid the first short gasps until deepened into full breaths._ _Keep body warm with hot-water bottles, hot bricks to limbs and feet, and blankets over exposed lower part of body._ _Rule 5.--Treat burn, if any. If skin is not broken, cover burn with cloths wet with Carron oil (equal parts of limewater and linseed or olive oil). If skin is broken, or raw surface is exposed, spread over it paste of equal parts of boric acid and vaseline, and bandage over all._ =Conditions, Etc.=--A shock produced by contact with an electric current is not of rare occurrence. Lightning stroke is very uncommon; statistics show that in the United States each year there is one death from this cause to each million of inhabitants. There are several conditions which must be borne in mind when considering the accidental effect of an electric current. The pressure and strength of the current (voltage and amperage) are often not nearly so important in regard to the effects on the body, as the area, duration, and location of the points of contact with the current, and the resistance offered by clothing and dry skin to the penetration of the electricity. When the heart lies in the course of the circuit, the danger is greatest. A dog can be killed by a current of ten volts pressure when contacts are made to the head and hind legs, because the current then flows through the heart, while a current of eighty volts is required to kill a dog, under the same conditions, if contacts are made to head and fore leg. In a general way alternating currents of low frequency are the most injurious to the body, and any current pressure higher than two hundred volts is dangerous to life. On the other hand, a current of ninety-five volts has proved fatal to a human being. In this case the circumstances were particularly unfavorable to the victim, as he was standing on an iron tank in boots wet with an alkaline solution, and probably studded on the soles with nails, when he came in accidental contact with an industrial current. Moreover, he was an habitual drunkard. In an instance of the contrary sort, a man received a current of 1,700 volts (periodicity about 130) for fifty seconds, in one of the early attempts at electro-execution, without being killed. The personal equation evidently enters into the matter. A strong physique here, as in other cases, is most favorable in resisting the effects of electric shock. High-pressure alternating currents (1,300 to 2,000 volts) are employed in electro-executions, and the contacts are carefully made, so that the current will enter the brain and pass through the heart to the leg. The two most vital parts are thus affected. In industrial accidents such nice adjustments are fortunately almost impossible, and shocks received from high-pressure currents, even of 25,000 volts, have not proved fatal because both the voltage and amperage have been greatly lessened through poor contacts and great resistance of clothing and dry skin, and also because the heart is not usually included in the circuit. Death is induced in one of three ways: 1. Currents of enormous voltage and amperage, as occur in lightning, actually destroy, burst and burn the tissues through which the stroke passes. 2. Usually death follows accidents from industrial currents, owing to contraction of the heart, the effect being the same as observed on other muscles. The heart instantly ceases beating, and either remains absolutely quiet, or there is a fine quivering of some of its fibers, as seen on opening the chest in experiments upon animals. 3. A fatal issue may result from the passage of the current through the head, so affecting the nerve centers that govern respiration that the breathing ceases. =Symptoms.=--These are generally muscular contractions, faintness, and unconsciousness (sometimes convulsions, if the current passes through the head), with failure of pulse and of breathing. For instance, a man who was removing a brush from a trolley car touched, with the other hand, a live rail. His muscles immediately contracted throwing him back, and disconnecting him from contact with the current (500 volts). He then fainted and became unconscious for a short time. The pulse was rapid and feeble, and the breathing also at first, but it later became slower than usual. On regaining sensibility the patient vomited and got on his feet, although feeling very weak for two hours. Unconsciousness commonly lasts only a few moments in nonfatal cases, but may continue for hours, its continuance being rather a favorable sign of ultimate recovery, if the heart and lungs are acting sufficiently. Bad after effects are rare. It is not uncommon for the patient to declare that the accident had improved his general feelings. Occasionally there is temporary loss of muscular power, and a case has been reported of nervous symptoms following electric shock similar to those observed after any accidental violence. Burns of varying degrees of intensity occur at the point of entrance of the current, from slight blisters to complete destruction of all the tissues. =Treatment.=--The treatment is completely outlined in the "first-aid" directions. Should contact be unbroken, an order to shut off the electric current should at once be telephoned to the station. Protection of the rescuer with thick rubber gloves is of course the ideal safeguard. In fatal cases the heart is instantaneously arrested, and nothing can be done to start it into action. If the current passes through the brain, by contact with the head or neck, then failure of breathing is more apt to be the cause of death. Theoretically, it is in the latter event only that treatment, i. e., artificial respiration, will be of avail. But as in any individual case the exact condition is always a matter of doubt, _artificial respiration_ is the most valuable remedial measure we possess; it should always be practiced for hours in doubtful cases. Two tablespoonfuls of brandy or whisky in a cup of warm water may be injected into the bowel, if a hypodermic syringe is not available and the patient needs decided stimulation. CHAPTER III =Wounds, Sprains and Bruises= _Treatment of Wounds--Rules for Checking Hemorrhage--Lockjaw--Bandages for Sprains--Synovitis--Bunions and Felons--Foreign Bodies in the Eye, Ear and Nose._ =WOUNDS.=--A wound is a condition produced by a forcible cutting, contusing, or tearing of the tissues of the body, and includes, in its larger sense, bruises, sprains, dislocations, and breaks or fractures of bones. As ordinarily used, a wound is an injury produced by forcible separation of the skin or mucous membrane, with more or less injury to the underlying parts. _The main object during the care of wounds should be to avoid contamination with anything which is not surgically clean, from the beginning to the end of the dressing; otherwise, every other step in the whole process is rendered useless._ Three essentials in the treatment of wounds are: 1. The arrest of bleeding. 2. Absolute cleanliness. 3. Rest of the injured part. Dangerous bleeding demands immediate relief. Bleeding is of three kinds: 1. From a large artery. 2. From a vein. 3. General oozing. =BLEEDING FROM LARGE ARTERY IN SPURTS OF BRIGHT BLOOD.= _First Aid Rule 1.--Speed increases safety. Put patient down flat. Make pressure with hands between the wound and the heart till surgeon arrives, assistants taking turns._ _Rule 2.--If arm or leg, tie rubber tubing or rubber suspenders tight about limb between wound and heart, or tie strap or rope over handkerchief or folded shirt wrapped about limb. If arm, put baseball in arm pit, and press arm against this. Or, for arm or leg, tie folded cloth in loose noose around limb, put cane or umbrella through noose and twist up the slack very tight, so as to compress the main artery with knot._ _Rule 3.--Keep limb and patient warm with hot-water bottles till surgeon arrives._ This treatment is of course only a temporary expedient, as it is essential for a surgeon to tie the bleeding vessel itself; therefore a medical man should be summoned with all dispatch. =BLEEDING FROM VEIN; STEADY FLOW OF DARK BLOOD.= _First Aid Rule 1.--Make firm pressure with pad of cloth directly over wound, also with hands between wound and extremity, that is, on side of cut away from the heart._ _Rule 2.--Tie tight bandage about limb at this point, with rubber tubing or suspenders._ _Rule 3.--Keep limb and patient warm with hot-water bottles till surgeon arrives._ In the cases of bleeding from a vein, the flow of blood is continuous, and is of a dark, red hue, and does not spurt in jets, as from an artery. This kind of bleeding is not usually difficult to stop, and it is not necessary that the vein itself be tied--unless very large--provided that the wound be snugly bandaged after it is dressed. After the first half hour, release the limb and see if the bleeding has stopped. If so, and the circulation is being interfered with, owing to the tightness of the bandage, reapply the bandage more loosely. In the case of an injured artery of any considerable size, the amount of pressure required to stop the bleeding will arrest all circulation of blood in the limb, so that great damage, as well as pain, will ensue if it be continued more than an hour or two, and during this time the limb should be kept warm by thick covering and hot-water bags, if they can be obtained. Bleeding _from a deep puncture_ may be stopped by plugging the cavity with strips of muslin which have been boiled, or with absorbent cotton, similarly treated, keeping the plug in place by snug bandaging. =BLEEDING FROM PUNCTURED WOUND.= _First Aid Rule 1.--Extract pin, tack, nail, splinter, thorn, or bullet, IF YOU CAN SEE BULLET; do not probe._ _Rule 2.--Pour warm water on wound and squeeze tissue to encourage bleeding. Send for small hard-rubber syringe._ _Rule 3.--If deep, plug it with absorbent cotton, and put tight bandage over plug. If shallow, cover with absorbent cotton wet with boric-acid solution (one dram to one-half pint of water), or carbolic-acid solution (one teaspoonful to the pint of hot water)._ _Rule 4.--When syringe comes, remove dressing, and clean wound by forcibly syringing carbolic solution directly into wound. Replace dressing._ A small punctured wound should be squeezed in warm water to encourage bleeding and, if pain and swelling ensue, absorbent cotton soaked in a boric-acid solution (containing as much boric acid as the water will dissolve) or in carbolic-acid solution (one teaspoonful of pure acid to the pint of warm water) should be applied over the wound and covered with oil silk or rubber or enamel cloth for a few days, or until the soreness has subsided. The dressing should be wet with the solution as often as it becomes dry. Punctures by nails, especially if deep, should be washed out with a syringe, using one of the solutions just mentioned. A medicine dropper, minus the rubber part, attached to a fountain syringe, makes a good nozzle for this purpose. A moist dressing, like the one described, should then be applied, and the limb kept in perfect rest for a few days. When a surgeon's services are available, however, self-treatment is attended with too much danger, as a thorough opening up of such wounds with proper cleansing and drainage will afford a better prospect of early recovery, and avert the risk of serious inflammation and lockjaw, which sometimes follow punctured wounds of the hands and feet. Foreign bodies, as splinters, may be removed with tweezers or a needle, being careful not to break the splinter in the attempt. If a part remains in the flesh, or if the foreign body is a needle that cannot be found or removed at once, the continuous application of a hot flaxseed or other poultice will lead to the formation of "matter," with which the splinter or needle will often escape after a few days. Splinters finding their way under the nail may be removed by scraping the nail very thin over the splinter and splitting it with a sharp knife down to the point where the end of the splinter can be grasped. =BLEEDING IN FORM OF OOZING.= _First Aid Rule 1.--Apply water as hot as hand can bear._ _Rule 2.--Elevate the part, and drench with carbolic solution (one teaspoonful of carbolic acid to one pint of hot water)._ _Rule 3.--Bandage snugly while wet._ _Rule 4.--Keep patient warm with hot-water bottles._ =GENERAL OOZING= happens in the case of small wounds or from abraded surfaces, and is caused by the breaking of numerous minute vessels which are not large enough to require the treatment recommended for large arteries or veins. It is rarely dangerous, and usually stops spontaneously. When the loss of blood has been considerable, so that the patient is pale, faint, and generally relaxed, with cold skin, and perhaps nausea and vomiting, he should be stripped of all clothing and immediately wrapped in a blanket wrung out of hot water, and then covered with dry blankets. Heat should also be applied to the feet by means of hot-water bags or bottles, with great care not to burn a semiconscious patient's skin. The head should be kept low, and two tablespoonfuls of brandy, whisky, or other alcoholic liquor should be given in a half cup of hot water by the mouth, if the patient can swallow. If much blood has been lost a quart of water, as hot as the hand can readily bear, and containing a teaspoonful of common salt, should be injected by means of a fountain syringe into the rectum. Somewhat the condition just described as due to loss of blood may be caused simply by shock to the nervous system following any severe accident, and not attended by bleeding. The treatment of shock is, however, practically the same as that for hemorrhage, and improvement in either case is shown by return of color to the face and strength in the pulse. Bleeding is apt to be much less in badly torn than in incised wounds, even if large vessels are severed, as when the legs are cut off in railroad accidents, for the lacerated ends of the vessels become entangled with blood and favor clotting. =LOCKJAW.=--In the lesser injuries, where bleeding is not an important feature, and in all wounds as well, after bleeding has been stopped, the main object in treatment consists in cleansing wounds of the germs which cause "matter" or pus, general blood poisoning, and lockjaw. The germs of the latter live in the earth, and even the smallest wounds which heal perfectly may later give rise to lockjaw if dirt has not been entirely removed from the wound at the time of accident. Injuries to the hands caused by pistols, firecrackers, and kindred explosives, seem especially prone to produce lockjaw, and fatalities from this disorder are deplorably numerous after Fourth-of-July celebrations in the United States. The wounds producing lockjaw usually occur in children who explode blank cartridges in the palm of the hand. In this way the germs of the disease are forced in with parts of the dirty skin and more or less of the wad from the shell. Since lockjaw is so frequent after these accidents, and so fatal, it is impossible to exert too much care in treatment. The wound should at once be thoroughly opened with a knife to the very bottom, under ether, by a surgeon, and not only every particle of foreign matter removed, but all the surrounding tissue should be cut out or cauterized. In addition, it is wise to use an injection under the skin of tetanus-antitoxin, to prevent the disease. Proper restriction of the sale of explosives alone will put a stop to this barbarous mode of exhibiting patriotism. =Treatment.=--It is not essential to use chemical agents or antiseptics to rid wounds of germs and so secure uninterrupted healing. The person who is to dress the wound should prepare to do so at the earliest possible moment after giving first aid. He should proceed promptly to boil some pieces of absorbent cotton, as large as an egg, together with a nail brush in water. Some strips of clean cotton cloth may be used in the absence of absorbent cotton. The boiling should be conducted for five minutes, when the basin or other utensil in which the brush and cotton are boiled should be taken off the fire and set aside to cool. Then the attendant should scrub his own hands for five minutes in hot water with soap and brush. He next takes the brush, which has been boiled, out of the water and cleans the patient's skin for a considerable distance about the wound. When this is done, and the water and cotton which have been boiled are sufficiently cool, the wound should be bathed with the cotton and boiled water until all foreign matter has been removed from the wound; not only dirt which can be seen, but germs which cannot be seen. Some of the boiled cotton cloth or absorbent cotton, wet as it is, should be placed over the wound and the whole covered by a bandage. Large gaping wounds are of course more properly closed by stitches, but very deep wounds should be left partly open, so that the discharge may drain away freely. Small, deep, punctured wounds are not to be closed at all, but should be sedulously kept open by pushing in strips of boiled cotton cloth, in order to secure drainage. If the attendant has the requisite confidence, there is no reason why he should not attempt stitching a wound, providing the patient is willing, and a surgeon cannot be obtained within twenty-four hours. In this case a rather stout, common sewing needle or needles are threaded with black or white thread, preferably of silk, and, together with a pair of scissors and a clean towel, are boiled in the same utensil with the cotton and the nail brush. After the operator has scrubbed his hands and cleansed the wound, he places the boiled towel about the wound so that the thread will fall on it during his manipulations and not on the skin. The needle should be thrust into and through the skin, but no lower than this, and should enter and leave the skin about a quarter of an inch from either edge of the wound. The stitches are placed about one-half inch apart, and are drawn together and tied tightly enough to join the two edges of the wound. The ends of the thread should be cut about one-half inch from the knot, being careful while using the needle and scissors not to lay them down on anything except the boiled towel. The wound is then covered with cotton, which has been boiled as described above, bandaged and left undisturbed for a week, if causing no pain. At the end of this time the stitches are taken out after the attendant has washed his hands carefully, and boiled his scissors as before. Court plaster or plaster of any kind is a bad covering or dressing for wounds, as it may be itself contaminated with germs. It effectually keeps in any with which the wound is already infected, and prevents proper drainage. It is impossible in a work of this kind to describe the details of the after treatment of wounds, as this can only be properly undertaken by a surgeon, owing to the varying conditions which may arise. In general it may be stated that the same cleanliness and care should be followed during the whole course of healing as has been outlined for the first attempt at treatment. If the wound is small, and there is no discharge from it, it may be painted with collodion or covered with boric-acid ointment (sixty grains of boric acid to the ounce of vaseline) after the first day. If large, it should be covered with cotton gauze or cloth which have been boiled or specially prepared for surgical purposes. If pus ("matter") forms, the wound must be cleansed daily of discharge (more than once if it is copious) with boiled water, or best with hydrogen dioxide solution followed by a washing with a solution of carbolic acid (one teaspoonful to the pint of hot water), or with a solution of mercury bichloride, dissolving one of the larger bichloride tablets, sold for surgical uses, in a quart of water. It is a surgical maxim never to be neglected that wounds should not be allowed to close at the top before healing is completed at the bottom. As to close at the surface is the usual tendency in wounds that heal slowly and discharge pus, it is necessary at times to enlarge the external opening by cutting or stretching with the blades of a pair of scissors, or, and this is much more rational and comfortable for the patient, by daily packing the outlet of the wound with gauze to keep it open. =BLEEDING FROM SCALP.= _First Aid Rule 1.--Cut hair off about wound, and clean thoroughly with carbolic-acid solution (one teaspoonful to pint of hot water)._ _Rule 2.--Put pad of gauze or muslin directly over wet wound, and make pressure firmly with bandage._ In case of wounds of the scalp, or other hairy parts, the hair should be cut, or better shaved, over an area very much larger than the wounded surface, after which the cleansing should be done. To stop bleeding of the scalp, water is applied as hot as can be borne, and then a wad of boiled cotton should be placed in the wound and bandaged down tightly into it for a time. Closing the wound with stitches will stop the bleeding much more effectively, however, and is not very painful if done immediately after the accident. The stitches should be tied loosely, and not introduced nearer to each other than half an inch, to allow drainage of discharge from the wound. =General Remarks.=--All wounds should be kept at rest after they are dressed. This is accomplished in the case of the lower limbs by keeping the patient in bed with the leg raised on a pillow. The same kind of treatment applies in severe injuries of the hands. In less serious cases a sling may be employed, and the patient may walk about. When the injury is near a joint, as of the fingers, knee, wrist, or elbow, a splint made of thin board or tin (and covered with cotton wadding and bandaged) should be applied by means of surgeon's adhesive plaster and bandage after the wound has been dressed. In injuries of the hand the splint should be applied to the palm side, and reach from the finger tips to above the wrist. Use a splint also. =NOSEBLEED.= _First Aid Rule 1.--Seat patient erect and apply ice to nape of neck._ _Rule 2.--Put roll of brown paper under upper lip, and press lip firmly against it. Press facial artery against lower jaw of bleeding side, till bleeding stops. This artery crosses lower edge of jawbone one inch in front of angle of jaw._ _Rule 3.--Plug nostril with strip of thin cotton or muslin cloth._ _Rule 4.--Do not wash away clots; encourage clotting to close nostril._ =BLEEDING FROM LUNGS; BRIGHT BLOOD COUGHED UP.= =BLEEDING FROM STOMACH; DARK BLOOD VOMITED.= _First Aid Rule for both. Let patient lie flat and swallow small pieces of ice, and also take one-quarter teaspoonful of table salt in half a glass of cold water._ =BRUISE.= _First Aid Rule 1.--Bandage from tips of fingers, or from toes, making same pressure with bandage all the way up as you do over the injury._ _Rule 2.--Apply heat through the bandage, over the injury, with hot-water bottles._ =Cause, Etc.=--A bruise is a hidden wound; the skin is not broken. It is an injury caused by a blunt body so that, while the tougher skin remains intact, the parts beneath are torn and crushed to a greater or lesser extent. The smaller blood vessels are torn and blood escapes under the skin, giving the "black and blue" appearance so common in bruises of any severity. Sometimes, indeed, large collections of blood form beneath the skin, causing a considerable swelling. Use of the bruised part is temporarily limited. Pain, faintness, and nausea follow severe bruises, and, in case of bad bruises of the belly, death may even ensue from damage to the viscera or to the nerves. Dangerous bleeding from large blood vessels sometimes takes place internally, and collections of blood may later break down into abscesses. Furthermore, the bruise may be so great that the injury to muscle and nerve may lead to permanent loss of use of the part. For these reasons a surgeon's advice should always be sought in cases of bad bruises. Pain is present in bruises, owing to the tearing and stretching of the smaller nerve fibers, and to pressure on the nerves caused by swelling. The swelling is produced by escape of blood and fluid from the torn blood vessels. =Treatment.=--Even slight and moderate bruises should be treated by rest of the injured part. A splint insures the rest of a limb (see treatment of Fractures, p. 80). One of the best modes of treatment is the snug application of a flannel bandage which secures a certain amount of rest of the part to which it is applied, and aids in preventing further swelling. Where bandaging is not feasible, as in certain parts of the body, or before bandaging in any kind of a bruise, the use of a cold compress is advisable. One layer of thin cotton or linen cloth should be wet in ice water, and should be put on the bruised part and continually changed for newly moistened pieces as soon as the first grows warm. Alcohol and water, of each equal parts, may be used in the same manner to advantage. When cold is unavailable or unpleasant to the patient, several layers of cotton cloth may be wrung out in very hot water and applied to the part with frequent renewal. The value attributed to witch-hazel and arnica is mainly due to the alcohol contained in their preparations. Cataplasma Kaolini (U. S. P.) is an excellent remedy for simple bruises when spread thickly on the part and covered with a bandage. An ointment containing twenty-five per cent of ichthyol is also a useful application. Following severe bruises, the damaged parts should be kept warm by the use of hot-water bags, or by covering a limb with cotton wool and bandage, until such time as surgical advice may be obtained. When the pain and swelling of bruises begin to subside, treatment should be pursued by rubbing with liniment of ammonia or chloroform, or vaseline if these are not obtainable. Moderate exercise of the part is desirable. =ABRASIONS.=--When the surface skin is scraped off, as often happens to the shin, knee, or head, an ointment containing sixty grains of boric acid to the ounce of vaseline makes a good application, and this may be covered with a bandage. The same ointment is useful to apply to small wounds and cuts after the first bandage is removed. =SPRAIN; NO DISPLACEMENT OF BONES.= _First Aid Rule 1.--Immerse in water, hot as hand can bear, for half an hour._ _Rule 2.--Dry and strap with adhesive plaster, if you know how. If not, bandage snugly, beginning with tips of fingers or with toes, and make same pressure all the way up that you do over injury._ _Rule 3.--Rest. If ankle or knee is hurt, patient must go to bed._ =Conditions, Etc.=--A sprain is an injury caused by a sudden wrench or twist of a joint, producing a momentary displacement of the ends of the bones to such a degree that they are forced against the membrane and ligaments surrounding the joint, tearing one or both to a greater or less extent. The wrist and ankle are the joints more commonly sprained, and this injury is more likely to occur in persons with flabby muscles and relaxed ligaments, as in the so-called "weak-ankled." The damage to the parts holding the joint in place may be of any degree, from the tearing of a few fibers of the membrane enwrapping the joint to its complete rupture, together with that of the ligaments, so that the bones are no longer in place, the joint loses its natural shape and appearance, and we have a condition known as dislocation. In a sprain then, the twist of the joint produces only a temporary displacement of the bones forming the joint, sufficient to damage the soft structures around it, but not sufficient to cause lasting displacement of the bones or dislocation. It will be seen that whether a sprain or dislocation results, depends upon the amount of injury sustained. Since it often happens that the bone entering into the joint is broken, it follows that whenever what appears to be a severe sprain occurs, with inability to move the joint and great swelling, it is important to secure surgical aid promptly. Since the discovery of the X-ray many injuries of the smaller bones of the wrist and ankle joint, formerly diagnosed as sprains by the most skillful surgeons, have, by its use, been discovered to be breaks of the bones which were impossible of detection by the older methods of examination. =Symptoms.=--The symptoms of sprain are sudden, severe pain, often accompanied by faintness and nausea, swelling, tenderness, and heat of the injured parts. The sprained joint can be only moved with pain and difficulty. The swelling is due not so much to leaking of blood from broken blood vessels as to filling up of the joint with fluid caused by the inflammation, although in a few days after a severe sprain the skin a little distance below the injury becomes "black and blue" from escape of blood caused by the injury. =Treatment.=--Since the treatment of severe sprains means first the discrimination between dislocation, a break of bone, and a rupture of muscle, ligament, or tendon, it follows that the methods herein described for treatment should only be employed in slight unmistakable sprains, or until a surgeon can be secured, or when one is unavailable. Nothing is better than immediate immersion of the sprained joint in as hot water as the hand can bear for half an hour. Following this, an elastic bandage of flannel cut on the bias about three and one-half inches wide should be snugly applied to the limb, beginning at the finger tips or at the toes and carrying the bandage some distance above the injured joint. In bandaging a part there is always danger of applying the bandage too tightly, especially if the parts swell under the bandage. If this happens, there is increase of pain which may be followed by numbness of the limb and, what is still more significant, coldness and blueness of the extremities below the bandage, particularly of the fingers and toes. In such cases the bandage must be removed and reapplied with less force. If the ankle or knee be sprained the patient must go to bed for at least twenty-four hours, and give the limb a complete rest. When the wrist or shoulder is sprained the arm should be confined in a sling. In the more serious cases the injured joint should be fixed in a splint before bandaging. An injured elbow joint is held at a right angle by a pasteboard splint, a bandage, and a sling, while the knee and wrist are treated with the limb in a straight line, as far as possible. In the case of the knee, the splint is applied to the back of the leg; in sprained wrist, to the palm of the hand and same side of the forearm. Sheet wadding, which may be bought at any drygoods store, is torn into strips about two inches wide and sewed together forming a bandage ten or fifteen feet long, and this is first wound about the sprained joint. Then pieces of millboard or heavy pasteboard are soaked in water and applied while wet in long strips about three inches wide over the wadding, and the whole is covered with bandage. In the case of the knee it is better to use a strip of wood for the splint, reaching from the lower part of the calf to four inches above the knee. It should be from a quarter to half an inch thick, a little narrower than the leg, and be padded thickly with sheet wadding. It is held in place by strips of surgeon's adhesive plaster, about two inches wide, passed around the whole circumference of the limb above and below the knee joint, and covered with bandage. In ordinary sprains of the ankle, uncomplicated by broken bone or ligament, it is possible for the patient, after resting in bed for a day, to go about on crutches, without bearing any weight on the foot until the third day after the accident. The treatment in the meanwhile consists in immersing the sprained ankle alternately, first in hot water for five minutes and then in cold water for five minutes, followed by rubbing of the parts about the injured joint with chloroform liniment for fifteen minutes, but not at the beginning touching the joint itself. The rubbing should be done by an assistant very gently the first day, with gradual increase in vigor as the days pass, not only kneading the ankle but moving the joint. This treatment should be pursued once daily, and followed by bandaging with a flannel bandage cut on the bias three and a half inches wide. With this method it is possible for the patient to regain the moderate use of the ankle in about two or three weeks. The same general line of treatment applies to the other joints; partial rest and daily bathing in hot and cold water, rubbing and movements of the joint by an assistant. Since sprains vary in severity it follows that some may need only the first day's preliminary treatment prescribed to effect a cure, while others may require fixation by a surgeon in a plaster-of-Paris splint for some time, with additional treatment which only his special knowledge can supply. [Illustration: This picture shows an excellent method of fixing a sprained joint, used by Prof. Virgil P. Gibney, M.D., Surgeon-in-Chief of the N. Y. Hospital for Ruptured and Crippled. It consists of strapping the joint by means of long, narrow strips of adhesive plaster incasing it immovably in the normal position. This procedure may be followed by anyone who has seen a surgeon practice it.] =SYNOVITIS--Severe Injury.=--Generally of ankle or knee from fall, or shoulder from blow. _First Aid Rule 1.--Provide large pitcher of hot water and large pitcher of cold water and basin. Hold joint over basin; pour hot water slowly over joint. Return this water to pitcher. Pour cold water over joint. Return water to pitcher. Repeat with hot water again, and follow with cold. Continue this alternation for half an hour._ _Rule 2.--Put to bed, with hot-water bottles about joint, and wedge immovably with pillows._ _Rule 3.--When tenderness and heat subside, strap with adhesive plaster in overlapping strips._ =Conditions, Etc.=--This condition, which may affect almost any freely movable joints, as the knee, elbow, ankle, and hip, is commonly caused by a wrench, blow, or fall. Occasionally it comes on without any apparent cause, in which case there is swelling and but slight pain or inflammation about the joint. We shall speak of synovitis of the knee ("water on the knee"), as that is the most common form, but these remarks will apply almost as well to the other joints. In severe cases there are considerable pain, redness and heat, and great swelling about the knee. The swelling is seen especially below the kneepan, on each side of the front of the joint, and also often above the kneepan. Frequently the only signs of trouble are swelling with slight pain, unless the limb is moved. =Treatment.=--If the knee is not red, hot, or tender to the touch, it will not be necessary for the patient to remain in bed, but when these symptoms are present a splint of some sort must be applied so that the leg is kept nearly straight, and the patient must keep to his bed until the heat, redness, and tenderness have subsided. In the meantime either an ice bag, hot poultice, cloths wrung out in hot water, or a hot-water bag should be kept constantly upon the knee. A convenient splint consists of heavy pasteboard wet and covered with sheet wadding (or cotton batting) shaped and affixed to the back of the leg, from six inches below to four inches above the joint, by strips of adhesive plaster, as shown in the illustration, and then by bandage, leaving the knee uncovered for applications. A wooden splint well padded may be used instead. In mild cases without much inflammation, and in others after the tenderness and heat have abated, the patient may go about if the knee is treated as follows: a pad of sheet wadding or cotton batting about two inches thick and five inches long and as wide as the limb is placed in the hollow behind the knee, and then the whole leg is encircled with sheet wadding from six inches below to four inches above the knee, covering the joint as well as the pad. Beginning now five inches below the joint, strips of surgeon's adhesive plaster, an inch wide and long enough to more than encircle the limb, are affixed about the leg firmly like garters so as to make considerable pressure. Each strip or garter overlaps the one below about one-third of an inch, and the whole limb is thus incased in plaster from five inches below the knee to a point about four inches above the joint. An ordinary cotton bandage is then applied from below over the entire plaster bandage. When this arrangement loosens, the plaster should be taken off and new reapplied, or a few strips may be wound about the old plaster to reënforce it. The patient may walk about with this appliance without bending the knee. When the swelling has nearly departed, the plaster may be removed and the knee rubbed twice daily about the joint and the joint itself moved to and fro gently by an attendant, and then bandaged with a flannel bandage. Painting the knee with tincture of iodine in spots as large as a silver dollar is also of service at this time. The knee should not be bent in walking until it can be moved by another person without producing discomfort. Such treatment may be applied to the other joints in a general way. The elbow must be fixed by a splint as recommended for dislocation of the joint (p. 128). The ankle is treated as advised for sprain of that joint (p. 68). When a physician can be obtained no layman is justified in attempting to treat a case of water on the knee or similar affection of other joints. =BUNION AND HOUSEMAID'S KNEE.=--Bunion is a swelling of the bursa, or cushion, at the first joint of the great toe where it joins the foot. It may not give much trouble, or it may be hot, red, tender, and very painful. It is caused by pressure of a tight boot which also forces the great toe toward the little toe, and thus makes the great toe joint more prominent and so the more readily injured. A somewhat similar swelling, often as large as an egg, is sometimes seen over the kneepan, more often in those who work upon their knees, hence the name housemaid's knee. The swelling may come on suddenly and be hot, tender, and painful, or it may be slow in appearing and give little pain. =Treatment.=--The treatment for the painful variety of bunion and housemaid's knee is much the same: absolute rest with the foot kept raised, and application of cloths kept constantly wet with ice or cold water; or a thick covering of Cataplasma Kaolini (U. S. P.) may be applied until the inflammation has subsided. If the trouble is chronic, or the acute inflammation does not soon abate under the treatment advised, the case is one for the surgeon, and sometimes requires the knife for abscess formation. In the milder cases of bunion, wearing proper shoes whose inner border forms almost a straight line from heel to toe, so that the great toe is not pushed over toward the little toe, and painting the bunion every few days with tincture of iodine, until the skin begins to become sore, will often be sufficient to secure recovery. =RUN-AROUND; WHITLOW OR FELON.=--"Run-around" consists in an inflammation of the soft parts about the finger nail. It is more common in the weak, but may occur in anyone, owing to the entrance of pus germs through a slight prick or abrasion which may pass unnoticed. The condition begins with redness, heat, tenderness, swelling, and pain of the flesh at the root of the nail, which extends all about the nail and may be slight and soon subside, or there may be great pain and increased swelling, with the formation of "matter" (pus), and result in the loss of the nail, particularly in the weak. Whitlow or felon is a much more serious trouble. It begins generally as a painful swelling of one of the last joints of the fingers on the palm side. Among the causes are a blow, scratch, or puncture. Often there is no apparent cause, but in some manner the germs of inflammation gain entrance. The end of the finger becomes hot and tense, and throbs with sometimes almost unbearable pain. If the inflammation is chiefly of the surface there may be much redness, but if mainly of the deeper parts the skin may be but little reddened or the surface may be actually pale. There is usually some fever, and the pain is made worse by permitting the hand to hang down. If the felon is on the little finger or thumb the inflammation is likely to extend down into the palm of the hand, and from thence into the arm along the course of the tendons or sinews of the muscles. Death of the bone of the last finger joint necessitating removal of this part, stiffness, crippling, and distortion of the hand, or death from blood poisoning may ensue if prompt surgical treatment is not obtained. =Treatment.=--At the very outset it may be possible to stop the progress of the felon by keeping the finger constantly wet by means of a bandage continually saturated with equal parts of alcohol and water, at night keeping it moist by covering with a piece of oil silk or rubber. Tincture of iodine painted all over the end of the finger is also useful, and the hand should be carried in a sling by day, and slung above the head to the headboard of the bed by night. If after twenty-four hours the pain increases, it is best to apply hot poultices to the finger, changing them as often as they cool. If the felon has not begun to abate by the end of forty-eight hours, the end of the finger must be cut lengthwise right down to the bone by a surgeon to prevent death of the bone or extension of the inflammation. Poultices are then continued. "Run-around" is treated also by iodine, cold applications, and, if inflammation continues, by hot poulticing and incision with a knife; but poulticing is often sufficient. Attention to the general health by a physician will frequently be of service. =WEEPING SINEW; GANGLION.=--This is a swelling as large as a large bean projecting from the back or front of the wrist with an elastic or hard feeling, and not painful or tender unless pressed on very hard. After certain movements of the hand, as in playing the piano or, for example, in playing tennis, some discomfort may be felt. Weeping sinew sometimes interferes with some of the finer movements of the hand. The swelling is not red or inflamed, but of the natural color of the skin. It does not continue to increase after reaching a moderate size, but usually persists indefinitely, although occasionally disappearing without treatment. The swelling contains a gelatinous substance which is held in a little sac in the sheath of the tendon or sinew, but the inside of the sac does not communicate with the interior of the sheath surrounding the tendon. =Treatment.=--This consists in suddenly exerting great pressure on the swelling with the thumb, or in striking it a sharp blow with a book by which the sac is broken. Its contents escape under the skin, and in most cases become absorbed. If the swelling returns a very slight surgical operation will permanently cure the trouble. =CINDERS AND OTHER FOREIGN BODIES IN THE EYE.=[4]--Foreign bodies are most frequently lodged on the under surface of the upper lid, although the surface of the eyeball and the inner aspect of the lower lid should also be carefully inspected. A drop of a two per cent solution of cocaine will render painless the manipulations. The patient should be directed to continue looking downward, and the lashes and edge of the lid are grasped by the forefinger and thumb of the right hand, while a very small pencil is gently pressed against the upper part of the lid, and the lower part is lifted outward and upward against the pencil so that it is turned inside out. The lid may be kept in this position by a little pressure on the lashes, while the cinder, or whatever foreign body it may be, is removed by gently sweeping it off the mucous membrane with a fold of a soft, clean handkerchief. (See Figs. 6 and 7.) [Illustration: FIG. 6. FIG. 7. REMOVING A FOREIGN BODY FROM THE EYE. In Fig. 6 note how lashes and edge of lid are grasped by forefinger and thumb, also pencil placed against lid; in Fig. 7 lid is shown turned inside out over pencil.] Hot cinders and pieces of metal may become so deeply lodged in the surface of the eye that they cannot be removed by the method recommended, or by using a narrow slip of clean white blotting-paper. All such cases should be very speedily referred to a physician, and the use of needles or other instruments should not be attempted by a layman, lest permanent damage be done to the cornea and opacity result. Such procedures are, of course, appropriate for an oculist, but when it is impossible to secure medical aid for days it can be attempted without much fear, if done carefully, as more harm will result if the offending body is left in place. It is surprising to see what a hole in the surface of the eye will fill up in a few days. If the foreign body has caused a good deal of irritation before its removal, it is best to drop into the eye a solution of boric acid (ten grains to the ounce of water) four times daily. =FOREIGN BODIES IN THE EAR.=--Foreign bodies, as buttons, pebbles, beans, cherry stones, coffee, etc., are frequently placed in the ear by children, and insects sometimes find their way into the ear passage and create tremendous distress by their struggles. Smooth, nonirritating bodies, as buttons, pebbles, etc., do no particular harm for a long time, and may remain unnoticed for years. But the most serious damage not infrequently results from unskillful attempts at their removal by persons (even physicians unused to instrumental work on the ear) who are driven to immediate and violent action on the false supposition that instant interference is called for. Insects, it is true, should be killed without delay by dropping into the ear sweet oil, castor, linseed, or machine oil or glycerin, or even water, if the others are not at hand, and then the insect should be removed in half an hour by syringing as recommended for wax (Vol. II, p. 35). To remove solid bodies, turn the ear containing the body downward, pull it outward and backward, and rub the skin just in front of the opening into the ear with the other hand, and the object may fall out. Failing in this, syringing with warm water, as for removal of wax, while the patient is sitting, may prove successful. The essentials of treatment then consist, first, in keeping cool; then in killing insects by dropping oil or water into the ear, and, if syringing proves ineffective, in using no instrumental methods in an attempt to remove the foreign body, but in awaiting such time as skilled medical services can be obtained. If beans or seeds are not washed out by syringing, the water may cause them to swell and produce pain. To obviate this, drop glycerin in the ear which absorbs water, and will thus shrivel the seed. =FOREIGN BODIES IN THE NOSE.=--Children often put foreign bodies in their noses, as shoe buttons, beans, and pebbles. They may not tell of it, and the most conspicuous symptoms are the appearance of a thick discharge from one nostril, having a bad odor, and some obstruction to breathing on the same side. If the foreign body can be seen, the nostril on the unobstructed side should be closed and the child made to blow out of the other one. If blowing does not remove the body it is best to secure medical aid very speedily. FOOTNOTES: [4] The Editors have deemed it advisable to repeat here the following instructions, also occurring in Vol. II, Part I, for the removal of foreign bodies in the eye, ear, and nose, as properly coming under the head of "First Aid in Emergencies." CHAPTER IV =Fractures= _How to Tell a Broken Bone--A Simple Sling--Splints and Bandage,--A Broken Rib--Fractures of Arm, Shoulder, Hand, Hips Leg and Other Parts._ =BROKEN BONE; FRACTURE.=[5] _First Aid Rule 1.--Be sure bone is broken. If broken, patient can scarcely (if at all) move the part beyond the break, while attendant can move it freely in his hands. If broken, grating of rough edges of bone may be felt by attendant but should not be sought for. If broken, limb is generally shortened._ _Rule 2.--Do not try to set bone permanently. Send at once for surgeon._ =COMPOUND FRACTURE.= _Important. If there is opening to the air from the break, because of tearing of tissues by end of bone, condition is very dangerous; first treatment may save life, by preventing infection. Before reducing fracture, and without stirring the patient much, after scrubbing your hands very clean, note:_ _First Aid Rule 1.--If hairy, shave large spot about wound._ _Rule 2.--Clean large area about wound with soap and water, very gently. Then wash most thoroughly again with clean water, previously boiled and cooled. Flood wound with cool boiled water._ _Rule 3.--Cover wound with absorbent cotton (or pieces of muslin) which has been boiled. Then attend to broken bone, as hereafter directed, in the case of each variety of fracture._ _After the bone is set, according to directions, then note:_ _Rule 4.--Renew pieces of previously boiled muslin from time to time, when at all stained with discharges. Every day wash carefully about wound, between the splints, with cool carbolic-acid solution (one teaspoonful to a pint of hot water) before putting on the fresh cloths._ =BROKEN BONES OR FRACTURES.=[6]--It frequently happens that the first treatment of fracture devolves upon the inexperienced layman. Immediate treatment is not essential, in so far as the repair of the fracture is directly concerned, for a broken bone does not unite for several weeks, and if a fracture were not seen by the surgeon for a week after its occurrence, no harm would be done, provided that the limb were kept quiet in fair position until that time. The object of immediate care of a broken bone is to prevent pain and avoid damage which would ensue if the sharp ends of the broken bone were allowed to injure the soft tissues during movements of the broken limb. Fractures are partial or complete, the former when the bone is broken only part way through; simple, when the fracture is a mere break of the bone, and compound, when the end of one or both fragments push through the skin, allowing the air with its germs to come in contact with the wound, thus greatly increasing the danger. To be sure that a bone is broken we must consider several points. The patient has usually fallen or has received a severe blow upon the part. This is not necessarily true, for old people often break the thigh bone at the hip joint by simply making a false step. Inability to use the limb and pain first call our attention to a broken bone. Then when we examine the seat of injury we usually notice some deformity--the limb or bone is out of line, and there may be an unusual swelling. But to distinguish this condition from sprain or bruise, we must find that there is a new joint in the course of the bone where there ought not to be any; e. g., if the leg were broken midway between the knee and ankle, we should feel that there was apparently a new joint at this place, that there was increased capacity for movement in the middle of the leg, and perhaps the ends of the fragments of bones could be heard or felt grating together. These, then, are the absolute tests of a broken bone--unusual mobility (or capacity for movement) in the course of the bone, and grating of the broken fragments together. The last will not occur, of course, unless the fragments happen to lie so that they touch each other and should not be sought for. In the case of limbs, sudden shortening of the broken member from overlapping of the fragments is a sure sign. =SPECIAL FRACTURES.= =BROKEN RIB.=--_First Aid Rule.--Patient puts hands on head while attendant puts adhesive-plaster band, one foot wide, around injured side from spine over breastbone to line of armpit of sound side. Then put patient to bed._ A rib is usually broken by direct violence. The symptoms are pain on taking a deep breath, or on coughing, together with a small, very tender point. The deformity is not usually great, if, indeed, any exists, so that nothing in the external appearance may call the attention to fracture. Grating between the fragments may be heard by the patient or by the examiner, and the patient can often place his finger on the exact location of the break. When it is a matter of doubt whether a rib is broken or not the treatment for broken rib should be followed for relief of pain. [Illustration: FIG. 8. METHOD OF BANDAGING BROKEN RIB (SCUDDER). Note manner of sticking one end of wide adhesive plaster along backbone; also assistant carrying strip around injured side.] =Treatment= consists in applying a wide band of surgeon's adhesive plaster, to be obtained at any drug shop. The band is made by overlapping strips four or five inches wide, till a width of one foot is obtained. This is then applied by sticking one end along the back bone and carrying it forward around the injured side of the chest over the breastbone as far as a line below the armpit on the uninjured side of the chest, i. e., three-quarters way about the chest. These four- or five-inch strips of plaster may be cut the right length first and laid together, overlapping about two inches, and put on as a whole, or, what is easier, each strip may be put on separately, beginning at the spine, five inches below the fracture, and continuing to apply the strips, overlapping each other about two inches, until the band is made to extend to about five inches above the point of fracture, all the strips ending in the line of the armpit of the uninjured side. (Fig. 8.) If surgeon's plaster cannot be obtained, a strong unbleached cotton or flannel bandage, a foot wide, should be placed all around the chest and fastened as snugly as possible with safety pins, in order to limit the motion of the chest wall. The patient will often be more comfortable sitting up, and should take care not to be exposed to cold or wet for some weeks, as pleurisy or pneumonia may follow. Three weeks are required for firm union to be established in broken ribs. =COLLAR-BONE FRACTURE.= _First Aid Rule.--Put patient flat on back, on level bed, with small pillow between his shoulders; place forearm of injured side across chest, and retain it so with bandage about chest and arm._ [Illustration: FIG. 9. A BROKEN COLLAR BONE (SCUDDER). Usual attitude of patient with a fracture of this kind; note lowering and narrowed appearance of left shoulder.] Fracture of the collar bone is one of the commonest accidents. The bone is usually broken in the middle third. A swelling often appears at this point, and there is pain there, especially on lifting the arm up and away from the body. It will be noticed that the shoulder, on the side of the injury, seems narrower and also lower than its fellow. The head is often bent toward the injured side, and the arm of the same side is grasped below the elbow by the other hand of the patient and supported as in a sling. (See Fig. 9.) In examining an apparently broken bone _the utmost gentleness may be used_ or serious damage may result. =Treatment.=--The best treatment consists in rest in bed on a hard mattress; the patient lying flat on the back with a small pillow between the shoulders and the forearm of the injured side across the chest. This is a wearisome process, as it takes from two to three weeks to secure repair of the break. On the other hand, if the forearm is carried in a sling, so as to raise and support the shoulder, while the patient walks about, a serviceable result is usually obtained; the only drawback being that an unsightly swelling remains at the seat of the break. To make a sling, a piece of strong cotton cloth a yard square should be cut diagonally from corner to corner, making two right-angled triangles. Each of these will make a properly shaped piece for a sling. (See Figs. 10 and 11.) Fracture of the collar bone happens very often in little children, and is commonly only a partial break or splitting of the bone, not extending wholly through the shaft so as to divide it into two fragments, but causing little more than bending of the bone (the "green-stick fracture"). [Illustration: FIG. 10. HOW TO MAKE A SLING (SCUDDER). In Fig. 10 note three-cornered bandage; No. 2 end is carried over right shoulder, No. 1 over left, then both fastened behind neck; No. 3 brought over and pinned.] [Illustration: FIG. 11. HOW TO MAKE A SLING (SCUDDER). The above illustration shows sling in position. It is made of cotton cloth a yard square cut diagonally from corner to corner.] A fall from a chair or bed is sufficient to cause the accident. A child generally cries out on movement of the arm of the injured side, or on being lifted by placing the hands under the armpits of the patient. A tender swelling is seen at the point of the injury of the collar bone. A broad cotton band, with straps over the shoulders to keep it up, should encircle the body and upper arm of the injured side, and the hand of the same side should be supported by a narrow sling fastened above behind the neck. =LOWER-JAW FRACTURE.= _First Aid Rule.--Put fragments into place with your fingers, securing good line of his teeth. Support lower jaw by firmly bandaging it against upper jaw, mouth shut, using four-tailed bandage. (Fig. 12.)_ Fracture of the lower jaw is caused by a direct blow. It involves the part of the jaw occupied by the lower teeth, and is more apt to occur in the middle line in front, or a short distance to one side of this point. The force causing the break usually not only breaks the bone, but also tears the gum through into the mouth, making a compound fracture. There is immediate swelling of the gum at the point of injury, and bleeding. The mouth can be opened with difficulty. The condition of the teeth is the most important point to observe. Owing to displacement of the fragments there is a difference in the level of the teeth or line of the teeth, or both, at the place where the fracture occurs. Also one or more of the teeth are usually loosened at this point. In addition, unusual movement of the fragments may be detected as well as a grating sound on manipulation. =Treatment.=--The broken fragments should be pressed into place with the fingers, and retained temporarily with a four-tailed bandage, as shown in the cut. Feeding is done through a glass tube, using milk, broths, and thin gruels. A mouth wash should be employed four times daily, to keep the mouth clean and assist in healing of the gum. A convenient preparation consists of menthol, one-half grain; thymol, one-half grain; boric acid, twenty grains; water, eight ounces. [Illustration: FIG. 12. BANDAGE FOR A BROKEN JAW (AMERICAN TEXT-BOOK). Above cut shows a four-tailed bandage; note method of tying; one strip supports lower jaw; the other holds it in place against upper jaw.] =SHOULDER-BLADE FRACTURE.= _First Aid Rule.--There is no displacement. Bandage fingers, forearm, and arm of affected side, and put this arm in sling. Fasten slung arm to body with many turns of a bandage, which holds forearm against chest and arm against side._ Shoulder-blade fracture occasions pain, swelling, and tenderness on pressure over the point of injury. On manipulating the bone a grating sound may be heard and unnatural motion detected. The treatment consists in bandaging the forearm and arm on the injured side from below upward, beginning at the wrist; slinging the forearm bent at a right angle across the front of the body, suspended by a narrow sling from the neck, and then encircling the body and arm of the injured side from shoulder to elbow with a wide bandage applied under the sling, which holds the arm snugly against the side. This bandage is prevented from slipping down by straps attached to it and carried over each shoulder. =ARM FRACTURE.= _First Aid Rule.--Pad two pieces of thin board nine by three inches with handkerchiefs. Carefully pull fragments of bone apart, grasping lower fragment near elbow while assistant pulls gently on upper fragment near shoulder. Put padded boards (splints) one each side of the fracture, and wind bandage about their whole length, tightly enough to keep bony fragments firm in position. Put forearm and hand in sling._ In fracture of the arm between the shoulder and elbow, swelling and shortening may give rise to deformity. Pain and abnormal motion are symptoms, while a grating sound may be detected, but manipulation of the arm for this purpose should be avoided. The surface is apt soon to become black and blue, owing to rupture of the blood vessels beneath the skin. The hand and forearm should be bandaged from below upward to the elbow. The bone is put in place by grasping the patient's elbow and pulling directly down in line with the arm, which is held slightly away from the side of the patient, while an assistant steadies and pulls up the shoulder. Then a wedge-shaped pad, long enough to reach from the patient's armpit to his elbow (made of cotton wadding or blanketing sewed in a cotton case) and about four inches wide and three inches thick at one end, tapering up to a point at the other, is placed against the patient's side with the tapering end uppermost in the armpit and the thick end down. This pad is kept in place by a strip of surgeon's adhesive plaster, or bandage passing through the small end of the wedge, and brought up and fastened over the shoulder. [Illustration: FIG. 13. FIG. 14. BANDAGE FOR BROKEN ARM (SCUDDER). In Fig. 13 note splints secured by adhesive plaster; also pad in armpit; in Fig. 14 see wide bandage around body; also sling.] While the arm is pulled down from the shoulder, three strips of well-padded tin or thin board (such as picture-frame backing) two inches wide and long enough to reach from shoulder to elbow, are laid against the front, outside, and back of the arm, and secured by encircling strips of surgeon's plaster or bandage. The arm is then brought into the pad lying against the side under the armpit, and is held there firmly by a wide bandage surrounding the arm and entire chest, and reaching from the shoulder to elbow. It is prevented from slipping by strips of cotton cloth, which are placed over the shoulders and pinned behind and before to the top of the bandage. The wrist is then supported in a sling, not over two inches wide, with the forearm carried in a horizontal position across the front of the body. Firm union of the broken arm takes place usually in from four to six weeks. (See Figs. 13 and 14.) =FOREARM FRACTURE.= _First Aid Rule.--Set bones in proper place by pulling steadily on wrist while assistant holds back the upper part of the forearm. If unsuccessful, leave it for surgeon to reduce after "period of inaction" comes, a few days later, when swelling subsides. If successful, put padded splints (pieces of cigar box padded with handkerchiefs) one on each side, front and back, and wind a bandage about whole thing to hold it immovably._ Two bones enter into the structure of the forearm. One or both of these may be broken. The fracture may be simple or compound,[7] when the soft parts are damaged and the break of the bone communicates with the air, the ends of the bone even projecting through the skin. In fracture of both bones there is marked deformity, caused by displacement of the broken fragments, and unusual motion may be discovered; a grating sound may also be detected but, as stated before, manipulation of the arm should be avoided. [Illustration: FIG. 15. SETTING A BROKEN FOREARM (SCUDDER). See manner of holding arm and applying adhesive plaster strips; one splint is shown, another is placed back of hand and forearm.] When only one bone is broken the signs are not so marked, but there is usually a very tender point at the seat of the fracture, and an irregularity of the surface of the bone may be felt at this point. If false motion and a grating sound can also be elicited, the condition is clear. The broken bones are put into their proper place by the operator who pulls steadily on the wrist, while an assistant grasps the upper part of the forearm and pulls the other way. The ends of the fragments are at the same time pressed into place by the other hand of the operator, so that the proper straight line of the limb is restored. [Illustration: FIG. 16. FRACTURE OF BOTH BONES IN FOREARM (SCUDDER). This cut shows the position and length of the two padded splints; also method of applying adhesive plaster.] After the forearm is set, it should be held steadily in the following position while the splints are applied. The elbow is bent so that the forearm is held at right angles with the arm horizontally across the front of the chest with the hand extended, open palm toward the body and thumb uppermost. The splints, two in number, are made of wood about one-quarter inch thick, and one-quarter inch wider than the forearm. They should be long enough to reach from about two inches below the elbow to the root of the fingers. They are covered smoothly with cotton wadding, cotton wool, or other soft material, and then with a bandage. The splints are applied to the forearm in the positions described, one to the back of the hand and forearm, and the other to the palm of the hand and front of the forearm. Usually there are spaces in the palm of the hand and front of the wrist requiring to be filled with extra padding in addition to that on the splint. The splints are bound together and to the forearm by three strips of surgeon's adhesive plaster or bandage, about two inches wide. One strip is wound about the upper ends of the splints, one is wrapped about them above the wrist, and the third surrounds the back of the hand and palm, binding the splints together below the thumb. The splints should be held firmly in place, but great care should be exercised to use no more force in applying the adhesive plaster or bandage than is necessary to accomplish this end, as it is easy to stop the circulation by pressure in this part. There should be some spring felt when the splints are pressed together after their application. A bandage is to be applied over the splints and strips of plaster, beginning at the wrist and covering the forearm to the elbow, using the same care not to put the bandage on too firmly. The forearm is then to be held in the same position by a wide sling, as shown above. (See Figs. 15, 16, 17.) [Illustration: FIG. 17. DRESSING FOR BROKEN FOREARM (SCUDDER). Proper position of arm in sling; note that hand is unsupported with palm turned inward and thumb uppermost.] Four weeks are required to secure firm union after this fracture. When the fracture is compound the same treatment should be employed as described under Compound Fracture of Leg, p. 116. =FRACTURE OF THE WRIST; COLLES'S FRACTURE.=--This is a break of the lower end of the bone on the thumb side of the wrist, and much the larger bone in this part of the forearm. The accident happens when a person falls and strikes on the palm of the hand; it is more common in elderly people. A peculiar deformity results. A hump or swelling appears on the back of the wrist, and a deep crease is seen just above the hand in front. The whole hand is also displaced at the wrist toward the thumb side. [Illustration: FIG. 18. A BROKEN WRIST (SCUDDER). Characteristic appearance of a "Colles's fracture"; note backward displacement of hand at wrist; also fork-shaped deformity.] It is not usual to be able to detect abnormal motion in the case of this fracture, or to hear any grating sound on manipulating the part, as the ends of the fragments are generally so jammed together that it is necessary to secure a surgeon as soon as possible to pull them apart under ether, in order to remedy the existing "silver-fork" deformity. (See Figs. 18, 19, 20, 21, 22.) =Treatment.=--Until medical aid can be obtained the same sort of splints should be applied, and in the same way as for the treatment of fractured forearm. If the deformity is not relieved a stiff and painful joint usually persists. It is sometimes impossible for the most skillful surgeon entirely to correct the existing deformity, and in elderly people some stiffness and pain in the wrist and fingers are often unavoidable results. [Illustration: FIG. 19. FIG. 20. FIG. 21. FIG. 22. FRACTURE OF THE WRIST (SCUDDER). Above illustrations show deformities resulting from a broken wrist; Figs. 19 and 20 the crease at base of thumb; Fig. 21 hump on back of wrist; Fig. 22 twisted appearance of hand.] =FRACTURE OF BONE OF HAND, OR FINGER.= _First Aid Rule.--Set fragments of bone in place by pulling with one hand on finger, while pressing fragments into position with other hand. Put on each side of bone a splint made of cigar box, padded with folded handkerchiefs, and retain in place with bandage wound about snugly. Put forearm and hand in sling._ This accident more commonly happens to the bones corresponding to the middle and ring finger, and occurs between the knuckle and the wrist, appearing as a swelling on the back of the hand. On looking at the closed fist it will be seen that the knuckle corresponding to the broken bone in the back of the hand has ceased to be prominent, and has sunken down below the level of its fellows. The end of the fragment nearer the wrist can generally be felt sticking up in the back of the hand. [Illustration: FIG. 23. A BROKEN FINGER (SCUDDER). Note splint extending from wrist to tip of finger; also manner of applying adhesive plaster strips and pad in palm.] If the finger corresponding to the broken bone in the back of the hand be pulled on forcibly, and the fragments be held between the thumb and forefinger of the other hand of the operator, pain and abnormal motion may be detected, and the ends of the broken bone pressed into place. A thin wooden splint, as a piece of cigar box, about an inch wide at base and tapering to the width of the finger should be applied to the palm of the hand extending from the wrist to a little beyond the finger tip, secured by strips of adhesive plaster, as in the cut, and covered by a bandage. The splint should be well padded, and an additional pad should be placed in the palm of the hand over the point of fracture. Three weeks are required for firm union, and the hand should not be used for a month. It is usually easy to recognize a broken bone in a finger, unless the break is near a joint, when it may be mistaken for a dislocation. Pain, abnormal motion, and grating between the fragments are observed. If there is deformity, it may be corrected by pulling on the injured finger with one hand, while with the other the fragments are pressed into line. A narrow, padded wooden or tin splint is applied, as in the cut (p. 102), reaching from the middle of the palm to the finger tip. Any existing displacement of the broken bone can be relieved by using pressure with little pads of cotton held in place by narrow strips of adhesive plaster where it is needed to keep the bone in line. The splint may be removed in two weeks and a strip of adhesive plaster wound about the finger to support it for a week or two more. In fracture of the thumb, the splint is applied along the back instead of on the palm side. =HIP FRACTURE.= _First Aid Rule.--Put patient flat on back in bed, with limb wedged between pillows till surgeon arrives._ [Illustration: FIG. 24. TREATING A BROKEN HIP (SCUDDER). Note the manner of straightening leg and getting broken bone into line; also assistant carefully steadying the thigh.] A fracture of the hip is really a break of that portion of the thigh bone which enters into the socket of the pelvic bone and forms the hip joint. It occurs most commonly in aged people as a result of so slight an accident as tripping on a rug, or in falling on the floor from the standing position, making a misstep, or while attempting to avoid a fall. When the accident has occurred the patient is unable to rise or walk, and suffers pain in the hip joint. When he has been helped to bed it will be seen that the foot of the injured side is turned out, and the leg is perhaps apparently shorter than its fellow. There is pain on movement of the limb, and the patient cannot raise his heel, on the injured side, from the bed. Shortening is an important sign. With the patient lying flat on the back and both legs together in a straight line with the body, measurements from each hip-bone are made with a tape to the bony prominence on the inside of each ankle, in turn. One end of the tape is held at the navel and the other is swung from one ankle to the other, comparing the length of the two limbs. Shortening of less than half an inch is of no importance as a sign of fracture. The fragments of broken bone are often jammed together (impacted) so that it is impossible to get any sound of grating between them, and it is very unwise to manipulate the leg or hip joint, except in the gentlest manner, in an attempt to get this grating. If the ends of the fragments become disengaged from each other it often happens that union of the break never occurs. [Illustration: FIG. 25. TREATMENT FOR FRACTURED HIP (SCUDDER). Note method of holding splints in place with muslin strips; one above ankle, one below and one above knee, one in middle and one around upper part of thigh.] The treatment simply consists in keeping the patient quiet on a hard mattress, with a small pillow under the knee of the injured side and the limb steadied on either side by pillows or cushions until a surgeon can be obtained. (See Thigh-bone Fracture.) =THIGH-BONE FRACTURE.= _First Aid Rule.--Prepare long piece of thin board which will reach from armpit to ankle, and another piece long enough to reach from crotch to knee, and pad each with folded towels or blanket._ _While one assistant holds body back, and another assistant pulls on ankle of injured side, see that the fragments are separated and brought into good line, and then apply the splints, assistants still pulling steadily, and fasten the splints in place with bandage, or by tying several cloths across at three places above the knee and two places below the knee._ _Finally, pass a wide band of cloth about the body, from armpit to hips, inclosing the upper part of the well-padded splint, and fasten it snugly. The hollow between splint and waist must be filled with padding before this wide cloth is applied._ In fracture of the thigh bone (between the hip and knee), there is often great swelling about the break. The limb is helpless and useless. There is intense pain and abnormal position in the injured part, besides deformity produced by the swelling. The foot of the injured limb is turned over to one side or the other, owing to a rolling over of the portion of the limb below the break. With both lower limbs in line with the body, and the patient lying on the back, measurements are made from each hip-bone to the prominence on the inside of either ankle joint. Shortening of the injured leg will be found, varying from one to over two inches, according to the overlapping and displacement of the fragments. =Treatment.=--To set this fracture temporarily, a board about five inches wide and long enough to reach from the armpit to the foot should be padded well with towels, sheets, shawls, coats, blanket, or whatever is at hand, and the padding can best be kept in place by surgeon's adhesive plaster, bicycle tape, or strips of cloth.[8] Another splint should be provided as wide as the thigh and long enough to reach along the back of the leg from the middle of the calf to the buttock, and also padded in the same way. A third splint should be prepared in the same manner to go inside the leg, reaching from the crotch to the inside of the foot. Still a fourth splint made of a thin board as wide as the thigh, extending from the upper part of the thigh to just above the knee, is padded for application to the front of the thigh. When these are made ready and at hand, the leg should be pulled on steadily but carefully straight away from the body to relax the muscles, an assistant holding the upper part of the thigh and pulling in the opposite direction. Then, when the leg has been straightened out and the thigh bone seems in fair line, the splints should be applied; the first to the outside of the thigh and body, the second under the calf, knee, and thigh; the third to the inside of the whole limb, and the fourth to the front of the thigh. Wide pads should be placed over the ribs under the outside splint to fill the space above the hips and under the armpit. Then all four splints are drawn together and held in place by rubber-plaster straps or strips of strong muslin applied as follows: one above the ankle; one below the knee; one above the knee; one in the middle of the thigh, and one around the upper part of the thigh. A wide band of strong muslin or sheeting should then be bound around the whole body between the armpits and hips, inclosing the upper part of the outside splint. The patient can then be borne comfortably upon a stretcher made of boards and a mattress or some improvised cushion. (See Figs. 24 and 25.) When the patient can be put immediately to bed after the injury, and does not have to be transported, it is only necessary to apply the outer, back, and front splints, omitting the inner splint. It is necessary for the proper and permanent setting of a fractured thigh that a surgeon give an anæsthetic and apply the splints while the muscles are completely relaxed. It is also essential that the muscles be kept from contracting thereafter by the application of a fifteen- or twenty-pound weight to the leg, after the splints are applied, but it is possible to outline here only the proper first-aid treatment. =KNEEPAN FRACTURE.= _First Aid Rule.--Pain is immediate and intense. Separated fragments may be felt at first. Swelling prompt and enormous. Even if not sure, follow these directions for safety._ _Prepare splint: thin board, four inches wide, and long enough to reach from upper part of thigh to just above ankle. Pad with folded piece of blanket or soft towels. Place it behind leg and thigh; carefully fill space behind knee with pad; fasten splint to limb with three strips of broad adhesive plaster, one around upper end of splint, one around lower end, one just below knee._ _Lay large flat, dry sponge over knee thus held, and bandage this in place. Keep sponge and bandage wet with ice water. If no sponge is available, half fill rubber hot-water bottle with cracked ice, and lay this over knee joint. Put patient to bed._ Fracture of kneepan is caused either by direct violence or muscular strain. It more frequently occurs in young adults. Immediate pain is felt in the knee and walking becomes impossible; in fact, often the patient cannot rise from the ground after the accident. Swelling at first is slight, but increases enormously within a few hours. Immediately after the injury it may be possible to feel the separate broken fragments of the kneepan and to recognize that they are separated by a considerable space if the break is horizontally across the bone. [Illustration: FIG. 26. A BROKEN KNEEPAN (SCUDDER). A padded splint, supporting knee, is shown reaching from ankle to thigh. Note number and location of adhesive plaster strips.] Nothing can be done to set the fracture until the swelling about the joint has been reduced, so that the first treatment consists in securing immediate rest for the kneejoint, and immobility of the fragments. A splint made of board, about a quarter of an inch thick and about four inches wide for an adult, reaching from the upper part of the thigh above to a little above the ankle below, is applied to the back of the limb and well padded, especially to fill the space behind the knee. The splint is attached to the limb by straps of adhesive plaster two inches and a half wide; one around the lower end of the splint, one around the upper part, and the third placed just below the knee. To prevent and arrest the swelling and pain, pressure is then made on the knee by bandaging. One of the best methods (Scudder's) is to bind a large, flat, dry sponge over the knee and then keep it wet with cold water; or to apply an ice bag directly to the swollen knee; a splint in either case being the first requisite. The patient should of course be put to bed as soon as possible after the accident, and should lie on the back with the injured leg elevated on a pillow with a cradle to keep the clothes from pressing on the injured limb. (See cut, p. 110.) =FRACTURE OF LEG BONES, BETWEEN KNEE AND ANKLE.= _First Aid Rule.--Handle very carefully; great danger of making opening to surface. Special painful point, angle or new joint in bone, disability, and grating felt will decide existence of break. Let assistant pull on foot, to separate fragments, while you examine part of supposed break. If only one bone is broken, there may be no displacement._ _Put patient on back. While two assistants pull, one on ankle and one on thigh at knee, thus separating fragments, slide pillow lengthwise under knee, and, bringing its edges up about leg, pin them snugly above leg._ _Prepare three pieces of thin wood, four inches wide and long enough to reach from sole of foot to a point four inches above knee. While assistants pull on limb again, as before, put one splint each side and third behind limb, and with bandage or strips of sticking plaster fasten these splints to the leg inclosed in its pillow as tight as possible._ In fracture of the leg between the knee and ankle we have pain, angular deformity or an apparent false joint in the leg, swelling and tenderness over the seat of fracture, together with inability to use the injured leg. Two bones form the framework of the leg; the inner, or shinbone, the sharp edge of which can be felt in front throughout most of its course, being much the larger and stronger bone. When both bones are broken, the displacement of the fragments, abnormal motion and consequent deformity, are commonly apparent, and a grating sound may be heard, but should not be sought for. [Illustration: FIG. 27. FRACTURE OF BOTH LEG BONES (SCUDDER). This cut shows the peculiar deformity in breaks of this kind; see position of kneepan; also prominence of broken bone above ankle.] An open wound often communicates with the break, making the fracture compound, a much more serious condition. To avoid making the fracture a compound one, during examination of the leg, owing to the sharp ends of the bony fragments, the utmost gentleness should be used. Under no circumstances attempt to move the fragments from side to side, or backward and forward, in an effort to detect the grating sound often caused by the ends of broken bones. The greatest danger lies in the desire to do too much. We again refer the reader to First Aid Rule 1. [Illustration: FIG. 28. BANDAGE FOR BROKEN LEG (SCUDDER). Note the pillow brought up around leg and edges pinned together; also length and method of fastening splint with straps.] When one bone is broken there may be only a point of tenderness and swelling about the vicinity of the break and no displacement or grating sound. When in doubt as to the existence of a fracture always treat the limb as if a fracture were present. "Black and blue" discoloration of the skin much more extensive than that following sprain will become evident over the whole leg within twenty-four hours. =Treatment.=--When a surgeon cannot be obtained, the following temporary pillowdressing, recommended by Scudder in his book on fractures, is one of the best. With the patient on his back, the leg having been straightened and any deformity removed as far as possible by grasping the foot and pulling directly away from the body while an assistant steadies the thigh, a large, soft pillow, inclosed in a pillowcase, is placed under the leg. The sides of the pillow are brought well up about the leg and the edges of the pillowcase are pinned together along the front of the leg. Then three strips of wood about four inches wide, three-sixteenths to a quarter of an inch thick, and long enough to reach from the sole of the foot to about four inches above the knee, are placed outside of the pillow along the inner and outer aspects of the leg and beneath it. The splints are held in place, with the pillow as padding beneath, by four straps of webbing (or if these cannot be obtained, by strips of stout cloth, adhesive plaster, or even rope); but four pads made of folded towels should be put under the straps where they cross the front of the leg where little but the pillowcase overlaps. These straps are applied thus: one above the knee, one above the ankle, and the other two between these two points, holding all firmly together. This dressing may be left undisturbed for a week or even ten days if necessary. (See Figs. 27 and 28.) The leg should be kept elevated after the splints are applied, and steadied by pillows placed either side of it. From one to two months are required to secure union in a broken leg in adults, and from three to five months elapse before the limb is completely serviceable. In children the time requisite for a cure is usually much shorter. =ANKLE-JOINT FRACTURE.= _First Aid Rule.--One or both bones of leg may be broken just above ankle. Foot is generally pushed or bent outward. Prepare two pieces of thin wood, four inches wide and long enough to go from sole of foot to just below knee:--the splints. Pad them with folded towels or pieces of blanket._ _While assistants pull bones apart gently, one pulling on knee, other pulling on foot and turning it straight, apply the splints, one each side of the leg._ A fracture of the ankle joint is really a fracture of the lower extremities of the bones of the leg. There are present pain and great swelling, particularly on the inner side of the ankle at first, and the whole foot is pushed and bent outward. The bony prominence on the inner side of the ankle is unduly marked. The foot besides being bent outward is also displaced backward on the leg. This fracture might be taken for a dislocation or sprain of the ankle. Dislocation of the ankle without fracture is very rare, and when the foot is returned to its proper position it will stay there, while in fracture the foot drops back to its former displaced state. In sprained ankle there are pain and swelling, but not the deformity caused by the displacement of the foot. This fracture may be treated temporarily by returning the foot to its usual position and putting on side splints and a back splint, as described for the treatment of fracture of the leg. =COMPOUND OR OPEN FRACTURE OF THE LEG.=--This condition may be produced either by the violence which caused the fracture also leading to destruction of the skin and soft parts beneath, or by the end of a bony fragment piercing the muscles and skin from within. In either event the result is much more serious than that of an ordinary simple fracture, for germs can gain entrance through the wound in the skin and cause inflammation with partial destruction or death of the part. =Treatment.=--Immediate treatment is here of the utmost value. It is applicable to open or compound fracture in any part of the body. The area for a considerable distance about the wound, if covered with hair, should be shaved. It should then be washed with warm water and soap by means of a clean piece of cotton cloth or absorbent cotton. Then some absorbent cotton or cotton cloth should be boiled in water in a clean vessel for a few minutes, and, after the operator has thoroughly washed his hands, the boiled water (when sufficiently cool) should be applied to the wounded area and surrounding parts with the boiled cotton, removing in the most painstaking way all visible and invisible dirt. By allowing some of the water to flow over the wound from the height of a few feet this result is favored. Finally some of the boiled cotton, which has not been previously touched, is spread over the wound wet, and covered with clean, dry cotton and bandaged. Splints are then applied as for simple fracture in the same locality (p. 113). If a fragment of bone projects through the wound it may be replaced after the cleansing just described, by grasping the lower part of the limb and pulling in a straight line of the limb away from the body, while an assistant holds firmly the upper part of the limb and pulls in the opposite direction. During the whole process neither the hands of the operator nor the boiled cotton should come in contact with anything except the vessel containing the boiled water and the patient. FOOTNOTES: [5] The engravings illustrating the chapters on "Fractures" and "Dislocations" are from Buck's "Reference Handbook of Medical Science," published by William Wood & Co., New York; also, Scudder's "Treatment of Fractures" and "American Text-Book of Surgery," published by W. B. Saunder's Company, Philadelphia. [6] It should be distinctly understood that the information about fractures is not supplied to enable anyone to avoid calling a surgeon, but is to be followed only until expert assistance can be obtained and, like other advice in this book, is intended to furnish first-aid information or directions to those who are in places where physicians cannot be secured. [7] For treatment of compound fracture, see Compound Fracture of Leg (p. 116). [8] This method follows closely that recommended by Scudder, in his book "The Treatment of Fractures." CHAPTER V =Dislocations= _How to Tell a Dislocation--Reducing a Dislocated Jaw--Stimson's Method of Treating a Dislocated Shoulder--Appearance of Elbow when Out of Joint--Hip Dislocations--Forms of Bandages._ =DISLOCATIONS; BONES OUT OF JOINT.= =JAW.=--Rare. Mouth remains open, lower teeth advanced forward. _First Aid Rule 1.--Protect your thumbs. Put on thick leather gloves, or bind them with thick bandage._ _Rule 2.--Assistant steadies patient from behind, with hands both sides of his head, operator presses downward and backward with his thumbs on back teeth of patient, each side of patient's jaw, while the chin is grasped between forefingers and raised upward. Idea is to stretch the ligament at jaw joint, and swing jaw back while pulling on this ligament. (Fig. 29.)_ _Rule 3.--Tie jaw with four-tailed bandage up against upper jaw for a week. (Fig. 12, p. 90.)_ =SHOULDER.=--Common accident. No hurry. See p. 122. =ELBOW.=--Rare. No hurry. See p. 125. =HIP.=--No hurry. See p. 129. =KNEE.=--Rare. Easily reduced. Head of lower bone (tibia) is moved to one side; knee slightly bent. _First Aid Rule 1.--Put patient on back._ _Rule 2.--Flex thigh on abdomen and hold it there._ _Rule 3.--Grasp leg below knee and twist it back and forth, and straighten knee._ =DISLOCATIONS.=--A dislocation is an injury to a joint wherein the ends of the bones forming a joint are forced out of place. A dislocation is commonly described as a condition in which a part (as the shoulder) is "out of joint" or "out of place." A dislocation must be distinguished from a sprain, and from a fracture near a joint. In a sprain, as has been stated (p. 65), the bones entering into the formation of the joint are perhaps momentarily displaced, but return into their proper place when the violence is removed. But, owing to greater injury, in dislocation the head of the bone slips out of the socket which should hold it, breaks through the ligaments surrounding the joint, and remains permanently out of place. For this reason there is a peculiar deformity, produced by the head of the bone's lying in its new and unnatural situation, which is not seen in a sprain. Also, the dislocated joint cannot be moved by the patient or by another person, except within narrow limits, while a sprained joint can be moved, with the production of pain it is true, but without any mechanical obstacle. In the case of fracture near a joint there is usually increased movement in some new direction. When a dislocated joint is put in proper place it stays in place, whereas when a fractured part is reduced there is nothing to keep it in place and, if let alone, it quickly resumes its former faulty position. Only a few of the commoner dislocations will be considered here, as the others are of rare occurrence and require more skill than can be imparted in a book intended for the laity. The following instructions are not to be followed if skilled surgical attendance can be secured; they are intended solely for those not so fortunately situated. =DISLOCATION OF THE JAW.=--This condition is caused by a blow on the chin, or occurs in gaping or when the mouth is kept widely open during prolonged dental operations. The joint surface at the upper part of the lower jaw, just in front of the entrance to the ear, is thrown out of its socket on one side of the face, or on both sides. If the jaw is put out of place on both sides at once, the chin will be found projecting so that lower front teeth jut out beyond the upper front teeth, the mouth is open and cannot be closed, and the patient is suffering considerable pain. When the jaw is dislocated on one side only, the chin is pushed over toward the uninjured side of the face, which gives the face a twisted appearance; the mouth is partly open and fixed in that position. A depression is seen on the injured side in front of the ear, while a corresponding prominence exists on the opposite side of the face, and the lower front teeth project beyond the upper front teeth. [Illustration: FIG. 29. REDUCING DISLOCATION OF JAW (AMERICAN TEXT-BOOK). Thumbs placed upon last molar teeth on each side; note jaw grasped between fingers and thumbs to force it into place.] =Treatment.=--A dislocation of one side of the jaw is treated in the same manner as that of both sides. The dislocation may sometimes be reduced by placing a good-sized cork as far back as possible between the back teeth of the upper and lower jaws (on one or both sides, according as the jaw is out of place on one or both sides), and getting the patient to bite down on the cork. This may pry the jaw back into place. The common method is for the operator to protect both thumbs by wrapping bandage about his thumbs, or wearing leather gloves, and then, while an assistant steadies the head, the operator presses downward and backward on the back teeth of the patient on each side of the lower jaw with both thumbs in the patient's mouth, while the chin is grasped beneath by the forefingers of each hand and raised upward. When the jaw slips into place it should be maintained there by a bandage placed around the head under the chin and retained there for a week. During this time the patient should be fed on liquids through a tube, so that it will not be necessary for him to open his mouth to any extent. (See Fig. 29.) =DISLOCATION OF THE SHOULDER.=--This is by far the most common of dislocations in adults, constituting over one-half of all such accidents affecting any of the joints. It is caused by a fall or blow on the upper arm or shoulder, or by falling upon the elbow or outstretched hand. The upper part (or head) of the bone of the arm (humerus) slips downward out of the socket or, in some cases, inward and forward. In either case the general appearance and treatment of the accident are much the same. The shoulder of the injured side loses its fullness and looks flatter in front and on the side. The arm is held with the elbow a few inches away from the side, and the line of the arm is seen to slope inwardly toward the shoulder, as compared with the sound arm. The injured arm cannot be moved much by the patient, although it can be lifted up and away from the side by another person, but cannot be moved so that, with the elbow against the front of the chest, the hand of the injured arm can be laid on the opposite shoulder. Neither can the arm, with the elbow at a right angle, be made to touch the side with the elbow, without causing great pain. =Treatment.=--One of the simplest methods (Stimson's) of reducing this dislocation consists in placing the patient on his injured side on a canvas cot, which should be raised high enough from the floor on chairs, and allowing the injured arm to hang directly downward toward the floor through a hole cut in the cot, the hand not touching the floor. Then a ten-pound weight is attached to the wrist. The gradual pull produced by this means generally brings the shoulder back into place without pain and within six minutes. (Fig. 30.) [Illustration: FIG. 30. TREATING A DISLOCATED SHOULDER. (REFERENCE HANDBOOK.) Patient lying on injured side; note arm hanging through hole in cot raised from floor on chairs; also weight attached to wrist.] The more ordinary method consists in putting the patient on his back on the floor, the operator also sitting on the floor with his stockinged foot against the patient's side under the armpit of the injured shoulder and grasping the injured arm at the elbow, he pulls the arm directly outward (i. e., with the arm at right angles with the body) and away from the trunk. An assistant may at the same time aid by lifting the head of the arm bone upward with his fingers in the patient's armpit and his thumbs over the injured shoulder. If the arm does not go into place easily by one of these methods it is unwise to continue making further attempts. Also if the shoulder has been dislocated several days, or if the patient is very muscular, it will generally be necessary that a surgeon give ether in order to reduce the dislocation. It is entirely possible for a skillful surgeon to secure reduction of a dislocation of the shoulder several weeks after its occurrence. After the dislocation has been relieved the arm, above the elbow, should be bandaged to the side of the chest and the hand of the injured side carried in a sling for ten days. =DISLOCATION OF THE ELBOW.=--This is more frequent in children, and is usually produced by a fall on the outstretched hand. The elbow is thrown out of joint, so that the forearm is displaced backward on the arm, in the more usual form of dislocation. The elbow joint is swollen and generally held slightly bent, but cannot be moved to any extent without great pain. The tip of the elbow projects at the back of the joint more than usual, while at the front of the arm the distance between the wrist and the bend of the elbow is less than that of the sound arm. (See cut, p. 126.) [Illustration: FIG. 31. Above cut shows characteristic appearance of a dislocated shoulder; note loss of fullness; also elbow held away from side and inward sloping of arm. FIG. 32. DISLOCATED ELBOW AND SHOULDER. (AMERICAN TEXT-BOOK.) Fig. 32 shows dislocation of elbow backward; note swollen condition of left elbow held slightly bent; also the projection of back of joint.] For further proof that the elbow is out of joint we must compare the relations of three points in each elbow. These are the two bony prominences on each side of the joint (belonging to the bone of the arm above the elbow) and the bony prominence that forms the tip of the elbow which belongs to the bone of the forearm. [Illustration: FIG. 33. TREATMENT OF DISLOCATED ELBOW (SCUDDER). Note padded right-angled tin splint; also three strips of surgeon's plaster on arm and forearm.] In dislocation backward of the forearm, the tip of the elbow is observed to be farther back, in relation to the two bony prominences at the side of the joint, than is the case in the sound elbow. This is best ascertained by touching the three points on the patient's elbow of each arm in turn with the thumb and middle finger on each of the prominences on the side of the joint, while the forefinger is placed on the tip of the elbow. The lower end of the bone of the upper arm is often seen and felt very easily just above the bend of the elbow in front, as it is thrown forward (see Fig. 32, p. 126). Fracture of the lower part of the bone of the arm above the elbow joint may present much the same appearance as the dislocation we are describing, but then the whole elbow is displaced backward, and the relation of the three points described above is the same in the injured as in the uninjured arm. Moreover in fracture the deformity, when relieved, will immediately recur when the arm is released, as there is nothing to hold the bones in place; but in dislocation, after the bones are replaced in their normal position, the deformity will not reappear. =Treatment.=--The treatment for dislocation consists in bending the forearm backward to a straight line, or even a little more, and then while an assistant holds firmly the arm above the elbow, the forearm should be grasped below the elbow and pulled with great force away from the assistant and, while exerting this traction, the elbow is suddenly bent forward to a right angle, when the bones should slip into place. The after treatment is much the same as for most fractures of the elbow. The arm is retained in a well-padded right-angled tin splint which is applied with three strips of surgeon's plaster and bandage to the front of the arm and forearm (see Fig. 33) for two or three weeks. The splint should be removed every few days, and the elbow joint should be moved to and fro gently to prevent stiffness, and the splint then reapplied. =DISLOCATION OF THE HIP.=--This occurs more commonly in males from fifteen to forty-five years of age, and is due to external violence. In the more ordinary form of hip dislocation the patient stands on the sound leg with the body bent forward, the injured leg being greatly shortened, with the toes turned inward so much that the foot of the injured limb crosses over the instep of the sound foot. The injured limb cannot be moved outward and but slightly inward, yet may be bent forward. Walking is impossible. Pain and deformity of the hip joint are evident. The only condition with which this would be likely to be confused is a fracture of bone in the region of the hip. Fracture of the hip is common in old people, but not in youth or middle adult life. In fracture there is usually not enough shortening to be perceived with the eye; the toes are more often turned out, and the patient can often bear some weight on the limb and even walk. =Treatment.=--The simplest treatment is that recommended by Stimson, as follows: the patient is to be slung up in the air in a vertical position by means of a sheet or belt of some sort placed around the body under the armpits, so that the feet dangle a foot or so from the floor, and then a weight of about ten or fifteen pounds, according to the strength of the patient's muscles, is attached to the foot of the injured leg (bricks, flatirons, or stones may be used), and this weight will usually draw the bone down into its socket within ten or fifteen minutes. [Illustration: FIG. 34. REDUCING DISLOCATION OF HIP (REFERENCE HANDBOOK). Patient lying on table; uninjured leg held by assistant; leg of dislocated side at right angles; note weight at bend of knee.] Or the patient may assume the position shown in the accompanying cut, lying prone upon a table with the uninjured leg held horizontally by one person, while another, with the injured thigh held vertically and leg at right angles, grasps the patient's ankle and moves it gently from side to side after placing a five-to ten-pound sand bag, or similar weight of other substance, at the flexure of the knee. When the dislocation has been overcome the patient should stay in bed for a week or two and then go about gradually on crutches for two weeks longer. =SURGICAL DRESSINGS.=--Sterilized gauze is the chief surgical dressing of the present day. This material is simply cheese cloth, from which grease and dirt have been removed by boiling in some alkaline preparation, usually washing soda, and rinsing in pure water. The gauze is sterilized by subjecting it to moist or dry heat. Sterilized gauze may be bought at shops dealing in surgeons' supplies and instruments, and at most drug stores. Gauze or cheese cloth may be sterilized (to destroy germs) by baking in a slow oven, in tin boxes, or wrapped in cotton cloth, until it begins to turn brown. It is well to have a small piece of the gauze in a separate package, which may be inspected from time to time in order to see how the baking is progressing, as the material to be employed for surgical purposes should not be opened until just before it is to be used, any remainder being immediately covered again. Cut the gauze into pieces as large as the hand, before it is sterilized, to avoid cutting and handling afterwards. Gauze may also be sterilized by steaming in an Arnold sterilizer, such as is used for milk, or by boiling, if it is to be applied wet. Carbolized, borated, and corrosive-sublimate gauze have little special value. [Illustration: PLATE I. Fig. I. Fig. II. Fig. III. Fig. IV. APPLYING A ROLLER BANDAGE (REFERENCE HANDBOOK). Fig. I shows method of starting a spiral bandage; Fig. II, ready to reverse; Fig. III, the reverse completed; Fig. IV shows spica bandage applied to groin.] Absorbent cotton is also employed as a surgical dressing, and should also be sterilized if it is to be used on raw surfaces. It is not so useful for dressing wounds as gauze, since it mats down closely, does not absorb secretions and discharges so well, and sticks to the parts. When torn into balls as large as an egg and boiled for fifteen minutes in water, it is useful as sponges for cleaning wounds. Sheet wadding, or cotton, is serviceable in covering splints before they are applied to the skin. Wet antiseptic surgical dressings are valuable in treating wounds which are inflamed and not healing well. They are made by soaking gauze in solutions of carbolic acid (half a teaspoonful of the acid to one pint of hot water), and, after application, covering the gauze with oil silk, rubber dam, or paraffin paper. Heavy brown wrapping paper, well oiled or greased, will answer the purpose when better material is not at hand. =BANDAGES.=--Bandaging is an art that can only be acquired in any degree of perfection by practical instruction and experience. Some useful hints, however, may be given to the inexperienced. Cotton cloth, bleached or unbleached, is commonly employed for bandages; also gauze, which does not make so effective a dressing, but is much easier of application, is softer and more comfortable, and is best adapted to the use of the novice. A bandage cannot be put on properly unless it is first rolled. A bandage for the limbs should be about two and a half inches wide and eight yards long; for the fingers, three-quarters of an inch wide and three yards long. The bandage may be rolled on itself till it is as large as the finger, and then rolled down the front of the thigh, with the palm of the right hand, while the loose end is held taut in the left hand. [Illustration: PLATE II. Fig. I. Fig. II. Fig. III. Fig. IV. DIFFERENT FORMS OF BANDAGES. (AMERICAN TEXT-BOOK AND REFERENCE HANDBOOK.) Fig. I shows application of figure-of-eight bandage; Fig. II, a spica bandage of thumb; Fig. III, a spica bandage of foot; Fig. IV, a T-bandage.] Two forms of bandages are adapted to the limbs, the figure-of-eight, and the spiral reversed bandage. In applying a bandage always begin at the lower extremity of the limb and approach the body. Make a few circular turns about the limb (see Fig. I, p. 132), then as the limb enlarges, draw the bandage up spirally, reversing it each time it encircles the limb, as shown in Fig. I, p. 134. In reversing, hold the bandage with the left thumb so that it will not slip, and then allowing the free end to fall slack, turn down as in Fig. II, p. 132. The T-bandage is used to bandage the crotch between the thighs, or around the forehead and over the top of the skull. (See Fig. IV, p. 134.) In the former case, the ends 1-1 are put about the body as a belt, and the end 2 is brought from behind, in the narrow part of the back, down forward between the thighs, over the crotch, and up to the belt in the lower part of the belly. The figure-of-eight bandage is used on various parts, and is illustrated in the bandage called spica of the groin, Fig. IV, p. 132. Beginning with a few circular turns about the body in the direction of 1, the bandage is brought down in front of the body and groin, as in 2, and then about the back of the thigh up around the front of the thigh, as in 3, across the back and once around the body and down again as in 2. Other bandages appropriate to various parts of the body are also illustrated that by their help the proper method of their application may be understood. See pages 132, 134, 136, 137. The triangular bandage (see p. 88) made from a large handkerchief or piece of muslin a yard square, cut or folded diagonally from corner to corner, will be found invaluable in emergency cases. It is easily and quickly adjusted to almost any part of the body, and may be used for dressing wounds, or as a bandage for fractures, etc. [Illustration: PLATE III. Fig. I. Fig. II. BANDAGES FOR EXTREMITIES (AMERICAN TEXT-BOOK). Fig. I shows a spiral reversed bandage of arm and hand, requiring roller 2-1/2 inches wide and 7 yards long; Fig. II shows a spiral reversed bandage of leg and foot, requiring roller 2-1/2 inches wide and 14 yards long.] [Illustration: PLATE IV. Fig. I. Fig. II. Fig. III. Fig. IV. BANDAGES FOR HEAD AND HAND. (AMERICAN TEXT-BOOK.) Fig. I shows a gauntlet bandage; Fig. II, a circular bandage for the jaw; Fig. III, a circular bandage for the head; Fig. IV, a figure-of-eight bandage for both eyes.] CHAPTER VI =Ordinary Poisons= _Unknown Poisons--Antidotes for Poisoning by Acids and Alkalies--The Stomach Pump--Emetics--Symptoms and Treatment of Metal Poisoning-- Narcotics._ _First Aid Rule 1.--Send at once for physician._ _Rule 2.--Empty stomach with emetic._ _Rule 3.--Give antidote._ In most cases of poisoning emetics and purgatives do the most good. =UNKNOWN POISONS.=--Act at once before making inquiry or investigation. _First Aid Rule.--Give two teaspoonfuls of chalk (or whiting, or whitewash scraped from the wall or a fence) mixed with a wineglass of water. Beat four eggs in a glass of milk, add a tablespoonful of whisky, and give at once._ Meanwhile, turn to p. 186, and be prepared to follow Rule 2 under Suffocation, in case artificial respiration may be necessary, in spite of the stimulant and antidotes. After having taken the first steps, try to ascertain the exact poison used, but waste no time at the start. If you can find out just what poison was swallowed, give the treatment advised under that poison, excepting what you may already have given. =ACIDS.=--Symptoms: Corrosion or bleeding of the parts with which they come in contact, followed by intense pain, and then prostration from shock. Nitric acid stains face yellow; sulphuric blackens; carbolic whitens the mucous membrane, and also causes nausea and stupor. =Treatment.=--_Carbolic:_ Give a tablespoonful of alcohol or wineglass of whisky or brandy at once; or one tablespoonful of castor oil, also a half pint of sweet oil, also a pint of milk. Put to bed, and apply hot-water bottles. _Nitric and Oxalic:_ Chalk, lime off walls, whitewash scraped off fence or wall, one teaspoonful mixed with a quarter of a glass of water. Give one tablespoonful castor oil, and half a pint of sweet oil. Inject into the rectum one tablespoonful of whisky in two of water. _Sulphuric:_ Soapsuds, half a glass; a pint of milk. _Other Acids:_ Limewater, or two teaspoonfuls of aromatic spirit of ammonia diluted with a glass of water. One tablespoonful of castor oil. =ALKALIES.=--Symptoms: Burning and destruction of the mucous membrane of mouth, severe pain, vomiting and purging of bloody matter, rapid death by shock. _Ammonia; Potash; Lye; Caustic Soda; Washing Soda:_ Give half a glass of vinegar mixed with half a glass of water; also juice of four lemons in two glasses of water. One teaspoonful of castor oil in half a glass of olive oil. If prostrated, give tablespoonful of whisky in a quarter of a glass of hot water. =METALS.=--Symptoms: Great irritation, cramps and purging, suppression of urine, delirium or stupor, collapse, and generally death. _Arsenic; Paris Green; Fowler's Solution; "Rough on Rats":_ Intense pain, thirst, griping in bowels, vomiting and bloody purging, shock, delirium. Patient picks at the nose. Send to druggist's for two ounces hydrated sesquioxide of iron, the best antidote, and give tablespoonful every quarter hour in half a glass of water. Meanwhile, or if antidote is not to be had, give a glass or two of limewater, followed by a teaspoonful of mustard dissolved in a glass of water, followed by warm water in any quantity. _Copper; Blue Vitriol; Verdigris:_ Give one tablespoonful of mustard in a glass of warm water. After vomiting, give whites of three eggs, one pint of milk. _Mercury; Corrosive Sublimate; Bug Poison; White Precipitate; Bichloride of Mercury:_ Give whites of four eggs for every grain of mercury suspected; cause vomiting by giving a tablespoonful of mustard mixed with a glass of warm water, or thirty grains of powdered ipecac mixed with half a glass of water. _Silver Nitrate:_ Give two teaspoonfuls of table salt dissolved in two glasses of hot water. After half an hour give a tablespoonful of castor oil. _Phosphorous; Matches:_ Give teaspoonful of mustard mixed in a glass of water. After vomiting has occurred, give a tablespoonful of gum arabic dissolved in a tumblerful of hot water. An hour later give tablespoonful of Epsom salts dissolved in a glass of water. GIVE NO OIL. _Antimony; Tartar Emetic:_ Symptoms as stated for metals. Give thirty grains of powdered ipecac stirred in wineglass of water, even if vomiting has occurred. Give three cups of strong tea, or hot infusion of oak bark, and two teaspoonfuls of whisky in wineglass of hot water. Use hot-water bottles to keep patient warm. =NARCOTICS.=--_Aconite; Belladonna; Camphor; Digitalis; Ergot; Hellebore; Lobelia:_ These all cause nausea, numbness, stupor, rapidity of the heart followed by weakness of heart, delirium or convulsions, coma, and death. There is often an acid taste in mouth, with dryness of throat and mouth, fever, vomiting and diarrhea, with severe pain in the bowels. Pupils are dilated. In either case use the stomach pump at once. If no pump is at hand, siphon out stomach with rubber tube and funnel. If tube is not available, give thirty grains of powdered ipecac stirred in a wineglass of water, followed by two glasses of warm water. As the patient vomits, give more warm water. When vomiting ceases, give two cups of strong hot coffee, and then a tablespoonful of castor oil. Keep patient awake by rubbing; do not exhaust him by walking him about. He must lie flat. If prostration follows, give two teaspoonfuls of whisky in wineglass of hot water from time to time, if repetition is necessary. _Alcohol; Liquors Containing It:_ Symptoms of drunkenness, stupor, drowsiness, irritability of temper, rapid, weak heart, sleep, coma. Breath testifies. If possible, use stomach pump early, or tube and funnel. Or give thirty grains of powdered ipecac stirred in a wineglass of water, and when vomiting ceases give thirty drops of aromatic spirit of ammonia in a wineglass of water every half hour till pulse has become full and rapid. Then apply cold to the head and heat to the extremities. _Chloral; Patent Sleeping Medicines; "Knock-out Drops."_ Symptoms: Nausea, coldness and numbness, stupidity, prostration, often vomiting and purging, sleep, coma. Heart very weak, with pulse at wrist very feeble. Constriction of the mouth and throat, with dryness. Pain in bowels is marked before stupor appears. Use stomach pump if possible, or empty stomach with rubber tube and funnel, siphoning fluids out. Or give thirty grains of powdered ipecac stirred in a wineglass of water. When vomiting ceases, give two teaspoonfuls of whisky in half a glass of hot water. Give hypodermic injection of sulphate of strychnine, one-twentieth of a grain every two or three hours, till patient is roused and weakness is past. Rubbing of the surface, application of hot-water bottles to the body and legs. If breathing ceases, follow Rule 2 under Suffocation (p. 186) till breathing is well established again. _Opium; Morphine; Laudanum; Paregoric; Soothing Syrups._ Symptoms: Drowsiness, sleep, stupor when roused, pupils very small--"pin point" unless patient is used to the drug--constipation, cold skin. Use stomach pump, if at hand. Or give emetic of thirty grains of powdered ipecac stirred in a wineglass of water, followed by two glasses of warm water, as vomiting proceeds. Let the patient inhale ammonia or smelling salts. Give him half a grain of permanganate of potash dissolved in a wineglass of water, every half hour. Inject two ounces of black coffee, at blood heat, into the rectum. Rub the lower part of the body and legs briskly toward the heart, while artificial respiration is being carried out. See Rule 2 under Suffocation (p. 186). Thirty drops of tincture of belladonna to an adult, every hour, will assist the breathing. Do not exhaust the patient by walking him around, slapping him with wet towels, or striking him on the calves; keep him awake by rubbing. _Tobacco when Swallowed:_ Nausea and vomiting occur, with severe pain and great prostration; delirium or convulsions may follow. The heart, at first rapid and full, becomes weak and compressible. Give emetic at once: thirty grains of powdered ipecac stirred in wineglass of water, followed by two glasses of warm water, by degrees. Give whisky, two teaspoonfuls in wineglass of hot water. Keep patient warm. _Nux Vomica; Strychnine._ Symptoms: Excitement, rapid heart action, restlessness, panic of apprehension, twitching of forearms and hands, possibly convulsions, during consciousness. Use stomach pump, if possible, or give thirty grains of powdered ipecac stirred in a wineglass of water. Then, when vomiting has ceased, give twenty grains of chloral, together with thirty grains of bromide of sodium in half a glass of water, at blood heat, injected into the rectum. Give twenty grains of bromide of sodium in a wineglass of water, every hour, by the mouth. If convulsions, put chloroform before nose and mouth, as follows: pour twenty drops of chloroform on a handkerchief and hold it close to the mouth, letting air pass freely under it. Stop when patient relaxes. Resume if he becomes rigid again. _Cocaine._ Symptoms: General nervousness, irritability of temper, wakefulness, followed quickly by great pallor, dilatation of the pupils, unconsciousness, and convulsions. Give the patient two teaspoonfuls of whisky in a wineglass of water every hour. Give, if possible, a hypodermic of a thirtieth of a grain of strychnine, every two hours, or as he may require it, to keep the pulse full and strong. Use hot-water bottles to feet and legs. _Phenacetin; Acetanilid; Headache Powders:_ Give two teaspoonfuls of whisky in a wineglass of hot water. If the heart flags, give tincture of digitalis, five minims in tablespoonful of water, every two hours, or till three doses are given. It is better to use digitalin, one one-hundredth of a grain hypodermically, if possible. CHAPTER VII =Food Poisoning= _Food Containing Bacterial Poisons Resulting from Putrefaction; Food Infected with Disease Germs; Food Containing Parasites--Tapeworm-- Trichiniasis--Potato Poisoning._ =FOOD POISONING.=--Much the same symptoms from all meats, fish, shellfish, milk, cheese, ice cream, and vegetables; namely, vomiting, cramps, diarrhea, headache, prostration, weak pulse, cold hands and feet, possibly an eruption. _First Aid Rule 1.--Rid patient of poison. Cause repeated vomiting by giving three or four glasses of warm water, each containing half a level teaspoonful of mustard. Put finger down throat to assist. Empty bowels by giving warm injection of soapsuds and water by fountain syringe._ _Rule 2.--Support heart and rally nerve force. Give teaspoonful of whisky in tablespoonful of hot water every half hour, as needed. Put hot-water bottles at feet and about body._ =Conditions, Etc.=--Bacterial poisons, constituting irritants of the stomach and bowels, are found in certain mussels, oysters from artificial beds, eels out of stagnant ditches--as well as the uncooked blood of the common river eel--certain fish at all times, certain fish when spawning, putrefied fish, fermented canned fish, sausages of which the ingredients have putrefied, putrefied meat, imperfectly cured bacon, putrefied cheese, milk improperly handled and not cooled before being transported, ice cream which fermented before freezing, or ice cream containing putrid gelatin, and mouldy corn meal and the bread made from it. These poisons are called toxins, or toxalbumins, or bacterial proteids. They are no longer called ptomaines, because many ptomaines are not poisonous. They are formed within the cells of the bacteria, and result from the combination of certain constituents of the food material that nourishes the bacteria, in some way not quite understood. Some decomposition must have taken place in the food before it can furnish to the bacteria the nourishment it needs. If this has happened, the bacteria multiply rapidly, and the toxins that are formed are taken up by the lymphatics and carried away from the tissues as fast as possible. But so great is their virulence that they act on several vital organs before they can be antagonized by the natural elements of the blood. =Symptoms.=--The symptoms are much the same in all the cases of bacterial poisoning mentioned. Sudden and violent vomiting and diarrhea appear a few hours after eating the spoiled food, or may be delayed. There may be headache, colic, and cramps in the muscles. Marked prostration and weak pulse with cold hands and feet are characteristic. The appearance of skin eruptions is not uncommon. The occurrence of such symptoms in several persons, some hours after partaking of the same food, is sufficient to warrant one in pronouncing the trouble food poisoning. =Treatment.=--The objects of treatment are to rid the patient of the poison, and to stimulate the heart and general circulation, and draw on the reserve nerve force. It is best to procure medical aid to wash out the stomach, but when this is impossible, the patient should be encouraged to swallow plenty of tepid water and then vomit it. If there is no natural inclination to do so, vomiting may be brought about by putting the finger in the back of the throat. The same process should be repeated a number of times, and the result will be almost as good as though a physician had used a stomach tube. A teaspoonful of salt or tablespoonful of mustard in the water will hasten its rejection. Then the bowels should likewise be emptied. If vomiting continues this will not be possible by means of drugs given by the mouth, although calomel may be retained given in half-grain tablets hourly to an adult, until the bowels begin to move, or till eight to ten tablets are taken. When vomiting is excessive, emptying of the bowels may be brought about quickly by giving warm injections of soapsuds into the bowel with a fountain syringe. Brandy or whisky in teaspoonful doses given in a tablespoonful of hot water at half-hour intervals should follow the emptying of the stomach and bowels, and the patient must be kept quiet. He must also be kept warm by means of hot-water bags and blankets. =INFECTED FOOD.=--A frequent source of illness is infection by disease germs transmitted in food. The meat of animals slaughtered when sick with abscess, pneumonia, kidney disease, diarrhea, or anthrax (malignant pustule) carries disease germs and causes serious illness; so does the meat of animals killed after recent birth of their young, and probably having fever. Oysters may be contaminated with excrement from typhoid patients, and may then transmit the disease to those who eat them. Milk from diseased animals, or contaminated with germs of typhoid fever, scarlet fever, tuberculosis, diphtheria, etc., is apt to cause the same disease in the human being who drinks it. If such infected food is eaten raw, the diseases with which it is contaminated may be transmitted. If subjected to cooking at a temperature of at least the boiling point, comparative safety is secured; but the toxins accompanying the disease germs in the infected food are not as a rule rendered harmless. Treatment must be directed to each disease thus transmitted. Poisoning resulting from eating canned meats has sometimes been attributed to supposed traces of tin, zinc, or solder, which have become dissolved in the fluids of the meat, but in the vast majority of cases such poisoning is due to toxins accompanying the germs of putrefaction, the meats having been unfit for canning at the outset. In such cases the symptoms are the same as in other food poisoning, and the treatment must be such as is elsewhere directed (see pp. 147 and 149). While human breast milk is germ free, the cows' milk sold in cities is a very common source of disease. Scrupulous care of the cows, of the clothing and hands of the milkers, of the stables at which the herds are quartered, and of the cans, pails, and pans used, reduces to a minimum the amount of filth and impurity otherwise mixed with milk. In the household, as well as during transportation, milk should be kept cool, with ice if necessary. It should also never be left uncovered, for it readily absorbs gases, effluvia, and contaminating substances in the air, and affords an excellent medium for the growth and propagation of germs. When partially or entirely soured, it should not be used, except in the preparation of articles of food by cooking, as directed in cook books. It should never be used if there is any doubt about its purity. Unless all doubt has been removed, it is best to subject milk intended for children's consumption to a temperature of 160° F. for ten minutes, and then put it on the ice, especially during hot weather. Germs are thus rendered harmless, and the nourishing qualities of the milk remain unimpaired. Summer diarrhea of children, also called cholera infantum, occurs as an epidemic in almost all large cities during the hottest days of summer. The disease is largely fatal, especially during the first hot month, because the most susceptible and tender children are the first affected. It is due to the absorption into the systems of these children of the toxins formed during the putrefying of milk in the stomachs and bowels of the little sufferers. Clean, pure sweet milk, free from bacteria should be used to prevent the occurrence of this disease. Its treatment is outlined in Vol. III. Exactly what bacteria cause the disease is not decided. Possibly the milk is infected, but probably the poisonous results come from toxins. =FOOD CONTAINING PARASITES.=--The parasites found in food in this country are echinococcus, guineaworm, hookworm, trichina, and tapeworm. Echinococcus cannot be understood or diagnosed by the layman. Guineaworm is excessively rare in the United States; it gains access into the body through drinking water which contains the individuals. Hookworm is the cause of "miners' anæmia," and is extremely rare in this country. The entrance of living food parasites can be absolutely prevented by thorough cooking of meats, especially pork and beef. Heat destroys the "measles" and the trichina worms. =TAPEWORM.=--This is developed in man after eating "measly" beef or pork. "Measles" are embryo tapeworms called, from their appearance, "bladder worms." In from six to ten weeks after being received into the intestine of a man, these bladder worms become full grown, and measure from ten to thirty feet in length--the tapeworms. =Symptoms.=--Vertigo, impairment of sight and of hearing, itching of the nose, salivation, loss of appetite, dyspepsia, emaciation, colic, palpitation of the heart, and sometimes fainting accompany the presence of the tapeworm. Generally the condition becomes known through the passage in the excrement of small sections of the worm. These sections resemble flat portions of macaroni. =Treatment.=--This, to be successful, must be directed by a physician. When no physician can be procured, the patient may attempt his own relief. After fasting for twenty-four hours, pumpkin seed, from which the outer coverings have been removed by crushing, are soaked overnight in water and taken on an empty stomach in the morning; a child takes one or two ounces thoroughly mashed and mixed with sirup or honey, and an adult four ounces (see Vol. III, p. 245). =TRICHINIASIS.=--This is a dangerous disease caused by the presence in the muscles and other tissues of the trichinæ, little worms which are swallowed in raw or partly cooked pork, ham, or bacon. Nausea, vomiting, colic, and diarrhea appear early, generally on the second day after eating the infected meat. Later, stiffness of the muscles occurs, with great tenderness, swelling of the face and of the extremities, sweating, hoarseness, difficult breathing, inability to sleep, bronchitis, and pneumonia. There is no treatment for the disease. Many cases which are not fatal are probably considered to be obscure rheumatism. Many cases of pneumonia are caused by the worm. =POTATO POISONING.=--There remains one variety of food poisoning which needs mention, since it occurs when least expected, and when proper food has been subjected to natural growth. As the potato belongs to the botanical family containing the dangerous belladonna, tobacco, hyoscyamus, and stramonium, it is not surprising that is should also contain a powerful poisonous alkaloid, namely, solanine. Solanine is developed in potatoes, especially during their sprouting stage. Violent vomiting and diarrhea and inflammation of the stomach and bowels are caused by it. Careful peeling of sprouting potatoes, and removal of their eyes, will lessen, if not wholly obviate, the danger from eating them. This form of food poisoning is rare. CHAPTER VIII =Bites and Stings= _Several Kinds of Mosquitoes--Cause of Yellow Fever--Bee, Wasp, and Hornet Stings--Wood Ticks, Lice, and Fleas--Scorpions and Centipedes--Poisonous Snakes--Dog and Cat Bites._ =MOSQUITOES.=--The female mosquito is the offender. During or after sucking blood she injects a poison into the body which causes itching, swelling, and, in some susceptible persons, considerable inflammation of the skin. The bites of the mosquitoes living on the shores of the Arctic Ocean and in the tropics are the most virulent. The most important relation of mosquitoes to man was only recently discovered. They are probably the sole cause of malaria and yellow fever in the human being. The malarial parasite which lives in the blood of man, when he is suffering from malaria, first inhabits the body of a certain kind of mosquito. The mosquito acquires the undeveloped parasite by biting the human malarial patient, and then acts as a medium of infection by transmitting the active parasite to some healthy man, through the bite. The more common house mosquito, the Culex, does not carry the parasite of malaria, and it is important to be able to distinguish the Anopheles which is the source of malaria. The Anopheles is more common in the country, while the Culex is a city pest. The Culex has very short palpi, the name given to the projections parallel to the proboscis; while those of Anopheles are so large that it appears to have three probosces. There are no markings on the wings of the ordinary species of Culex, while the wings of Anopheles are distinctly mottled. The Culex, sitting on a wall or ceiling, holds its hind legs above its back and its body nearly parallel to the wall or ceiling, but the Anopheles carries its hind legs either against the wall or hanging down (rarely above the back), and its body, instead of lying parallel to the wall or ceiling, hangs away at an angle of about forty-five degrees from it. The Culex lays her eggs in sinks, tanks, cisterns, and water about houses, but the Anopheles deposits her ova in shallow pools and sluggish streams, especially those on which is a growth of green scum or algæ. Such are the main distinguishing features of the malaria-carrying mosquito, the Anopheles, and the commoner house variety, the Culex. To prevent malaria, mosquito bites must be prevented by nettings in houses, especially for the protection of sleepers. Pools, ponds, and marshy districts must be drained in order to destroy the breeding places of Anopheles, and in the malarial season, petroleum (kerosene) must be poured on the surface of such waters to arrest the development of the immature insects (larvæ). The mosquito is believed to be the sole cause of yellow fever, being capable of communicating the germ of the disease to man by its bite two weeks after it has itself been contaminated with the germ in feeding on the blood of a yellow-fever patient. This invaluable discovery was made by Dr. Walter Reed, U. S. A., in 1901, as a result of his labors and those of other members of the yellow-fever commission of the U. S. Army in Cuba, involving the death of one of the members of the commission (Dr. Lazear), and utilizing the heroism of a number of our young soldiers who voluntarily offered themselves to be bitten by mosquitoes that had previously bitten yellow-fever patients, and who experimentally occupied premises containing all sorts of articles infected by yellow-fever patients. The result of their research proves that yellow fever is not contagious at all, in the usual sense, but is communicated only through the medium of mosquitoes. This shows the fallacy of many quarantine rules regarding yellow-fever patients, and of the fear of nursing the sick, and will result in controlling the disease. In the case of malaria or yellow fever, there is a vicious circle into which man and the mosquito enter; malaria and yellow-fever patients contaminate the mosquitoes which bite them, and the mosquitoes in their turn infect man with these diseases. A patient with malaria coming into a nonmalarial place, and being bitten by mosquitoes, may lead to an epidemic of the disorder which becomes endemic. To terminate this condition, it is necessary to prevent the contact of man with mosquitoes and to kill these insects. Both malaria and yellow fever will doubtless be practically eradicated before long through the result of these scientific discoveries. =Treatment of Mosquito Bites.=--To prevent mosquitoes, fleas, lice, horseflies, etc., from biting, it is necessary merely to dip the clean hands into a pail of water in which, while hot, one ounce of pure carbolic acid was dissolved, and while they are thus wet rub the solution over all the exposed skin and allow it to dry naturally. A mixture of kerosene (petroleum) and water used in the same way will also afford protection. All poisons introduced into the body by insects are of an acid nature, and to this quality are due the pain and irritation which it is our object to overcome. The best remedy, naturally, is an alkali of some sort. Water of ammonia, diluted, or a strong solution of saleratus or baking soda in water, are the two most successful remedies to apply, either through bathing, or on cloths saturated in one of the solutions. Clean clay, mixed with water to make a mud poultice, is a useful application in emergencies. =BEE, WASP, AND HORNET STINGS.=--The pain and swelling are produced by the poison of the insect which leaves the poison bag at the base of the barb at the instant that the person is stung. The bee stings but once, as the sting being barbed is broken off, and is retained in the flesh of the victim. The sting of the wasp and hornet is merely pointed, and is not lost during the stinging process so that they can repeat the act. Bee keepers, after being stung a number of times, usually become immune, i. e., they are no longer poisoned by bites of these insects. It is well to extract the sting of bees before all of the poison has come away. A fine pair of forceps is useful for this purpose; or, by pressing the hollow tube of a small key directly down over the puncture made by the sting, it may be squeezed out. Ammonia water, as recommended for mosquitoes, is the best remedy to relieve the pain. =WOOD TICKS.=--Ticks inhabit the woods and bushes throughout the temperate zone, and at certain periods during the summer season attack passing men and animals. The common tick is nearly circular in shape, very flat, with a dark, brown, horny body about one-sixteenth to one-eighth inch in diameter. Each of its eight legs possesses two claws, and the proboscis incloses feelers which are similarly armed. The beetle plunges its barbed proboscis into the flesh of man or animals, and holds on very firmly with its other members till it is gorged with blood, growing as large as a good-sized bean, when it drops off. The bite is painless, and it is not until the insect is engorged with blood that it is perceptible; if, however, attempts are made to remove the tick before it is ready to let go, the proboscis may be torn off and left in the skin, when painful local suppuration will follow. =Treatment.=--As the presence of tick is far from agreeable, the insect may often be removed by painting it with turpentine, which either kills it or causes the claws to be relaxed; in either case the tick loosens its hold and drops to the ground. A tropical variety, carapato, buries the whole head in the flesh of its host before it is perceived, and if turpentine does not loosen its hold, the head must be dug out with a clean needle or knife blade. =LICE= (_Pediculi_).--Head lice are most common. They are gray with black margins, about one-twenty-fifth to one-twelfth inch long, and wingless. The color changes with the host, as the lice are black on the negro, and white in the case of the Eskimos. The female lays fifty to sixty eggs ("nits"), seen as minute, white specks glued to the side of a hair; usually not more than one or two on a single hair. The eggs hatch in six days. The irritation produced by the presence of the parasites on the head leads to general itching, more particularly on the lower part of the back of the head. The constant scratching starts an inflammation of the skin with the formation of pimples, weeping spots, and crusts, from the dried discharge, possessing a bad odor. The denuded spots becoming infected, the neighboring glands enlarge and are felt as tender lumps beneath the skin at the back of the neck, under the jaw, or at either side of the neck. Whenever there are persistent itching and irritation of the scalp, particularly at the back of the head, lice or "nits" should be sought for. Sometimes it is more easy to find them on a fine-tooth comb passed through the hair. Lice are very common in dirty households, and are occasionally seen on the most fastidious persons, who accidentally acquire them in public places or conveyances. =Treatment.=--The hair should be cut short when permissible. Any crusts on the head should be softened by the application of sweet oil, and then removed by washing in soap and warm water. Petroleum or kerosene is a good remedy. It must be rubbed on the head two successive nights, the head being covered by a cap, and washed off each morning with hot water and soap. The patient must be cautioned not to approach an open flame after kerosene has been put on his head. The eggs or "nits" are next to be attacked with vinegar, which is sponged on the hair and the fine-tooth comb plied daily for a week. The remaining irritation of the scalp can be cured by washing the head daily and applying sweet oil. A simpler plan consists of drenching hair and scalp twice with cold infusion of (poisonous) larkspur seed, made by steeping for an hour an ounce of the seed in six ounces of hot water. This treatment will destroy both insects and eggs. After twenty-four hours the hair and scalp must be shampooed with warm water thoroughly. =CLOTHES LICE.=--These insects are a trifle larger than the head lice, being one-twelfth to one-eighth inch long, of a dirty, yellowish-gray color, and only infesting the most filthy people. The lice are generally only seen on the clothes, where they live, coming out on the body only to feed. The visible signs on the body are varying degrees of irritation from redness to ulceration, due to scratching. The treatment is simply cleanliness of the body and clothes. =CRAB LICE.=--The crab louse or "crab" inhabits the skin covered by hair about and above the sexual organs most frequently, and from thence spreads to the hairy region on the abdomen, chest, armpits, beard, and eye lashes. Itching and scratching first call attention to the presence of the parasites, which are even more troublesome than the other species. Application of kerosene to the part is sufficient to kill the lice, but this treatment must be repeated several times at intervals of a week, in order to kill the parasites subsequently hatched. =FLEA.=--Flea bites are recognized by the itching caused by the poison introduced by the insect, and by points of dried blood surrounded for a little while by a red zone. In the case of children and people with delicate skins, red or white lumps appear resembling nettlerash. Generally the skin is simply covered with minute, red points, perhaps raised a little by swelling above the surface, and when very numerous may remotely resemble the rash of measles. Fleas, unlike lice, do not breed on the body, but as soon as they are satiated leave their host. Their eggs are laid in cracks in floors, on dirty clothes and similar spots, and it is only the mature flea which preys upon man. The human flea may infest the dog and return to man, but the dog flea is a distinct species, and never remains permanently on the human host. For these reasons it is not difficult to get rid of fleas after they have attacked the body, unless continually surrounded by them. =JIGGER OR SAND FLEA.=--Also called chique, chigo, and nigua. It is common in Cuba, Porto Rico, and Brazil. About one-half the size of the ordinary flea, it is of a brownish-red color with a white spot on the back. The female lives in the sand and attacks man, on whom she lives, boring into the skin about the toe nail, usually, and laying her eggs under the skin, which gives rise to itching at first and then violent pain. The insect sucks blood and grows as it gorges itself, producing a white swelling of the skin in the center of which is seen a black spot, the front part of the flea. The flea after expelling its eggs drops off and dies. People with habitually sweaty feet are exempt from attacks of the pest. Unless the flea is unattached, one must either wait until the insect comes away of its own free will, or remove it with a red-hot needle in order to destroy the eggs. The negroes peel the skin from the swelling with a needle and squeeze out the eggs. Ordinarily the bites do no permanent injury, but occasionally if numerous, or if the insect is pressed into the skin in the efforts to remove it, or if sores resulting from bites are neglected, then violent inflammation, great pain, and even death of the part may result. Sound shoes and a night and morning inspection of the feet will protect against the inroads of the sand fleas. =FLIES.=--The common housefly does not bite, but is constantly inimical to human health by conveying disease germs of typhoid fever, cholera, and other disorders from bowel discharges of patients suffering from these diseases to articles of food on which the insects light. Flies have been a fruitful source of sickness in military camps, as evidenced in the recent Spanish-American and Anglo-African campaigns. The bites of the sandfly, gadfly, and horsefly may be both relieved and prevented by the same means recommended in the case of mosquitoes for these purposes. =SCORPION OR CENTIPEDE STING.= _First Aid Rule.--Squeeze lemon juice on wound._ =SPIDER OR TARANTULA BITE.= _First Aid Rule.--Pour water of ammonia on bite. If patient is depressed, give strong coffee._ =SCORPIONS AND CENTIPEDES.=--These both inhabit the tropics and semitropical regions, and lurk in dark corners and out-of-the-way places, crawling into the boots and clothing during the night. Scorpions sting with their tails, which are brought over the head and back for the purpose, while holding on to the victim with their lobsterlike claws. The poisonous centipede has a flattened brownish-yellow body, with a single pair of short legs for each body segment, and long, many-jointed antennæ. The wounds made by either of these pests are rarely dangerous, except in young children and those in feeble health. The stings are usually relieved by bathing with a two per cent solution of carbolic acid, with rum, or with lemon juice. =SPIDERS.=--Many of the tropical spiders bite the human being. Trapdoor spiders are among the commonest of these pests. Their bodies grow to great size, two to two and a half inches long, and are covered with hair giving them a horrid appearance. They live in holes bored in the ground, and provided with a trapdoor contrivance which is closed when the insect is at home. The trapdoor spider resembles the tarantula, by which name it is usually known in Cuba and Jamaica, but is somewhat smaller and commoner. Neither the stings of the trapdoor spider nor true tarantula are usually dangerous although the wounds caused by the bites may heal slowly. Application of water of ammonia and of the other remedies recommended for mosquito bites (p. 158) are indicated here, and if the patient is generally depressed by the poison, strong coffee forms a good antidote. =SNAKE BITE.= _First Aid Rule 1.--Make the wound bleed. Cut slit through the wound, lengthwise of limb, two inches long and half an inch deep. Squeeze tissues._ DO NOT SUCK THE WOUND. _Rule 2.--Keep poison out of general circulation. Tie large cord or bandage tightly about part between wound and heart. Loosen in fifteen minutes._ _Rule 3.--Use antidote. Wash wound and cut with fresh solution of chloride of lime (one part to sixty parts of water). Inject anti-venene with hypodermic syringe, ten cubic centimeters, as on label. Or, inject with hypodermic syringe thirty minims of solution of permanganate of potash (five grains to two ounces of water), three times in different places. If no syringe at hand, pour permanganate solution into wound._ _Rule 4.--Support heart if weak. Inject with hypodermic syringe one-thirtieth grain of sulphate of strychnine into leg. Repeat as needed every thirty minutes with caution._ _Rule 5.--Give no whisky or other liquor. Do not burn the wound._ =SNAKE BITE.=--There are many different species of poisonous snakes in the United States. The more common are the rattlesnake, the moccasin, the copperhead, and the common viper. All the venomous snakes have certain characteristics by which they may be distinguished from their harmless brethren. The head is generally broad and flat and of a triangular shape, the wide, heavy jaws tapering to a point at the lips. There is a depression or pit between the nostril and eye on the upper lip, hence the name "pit vipers" given to poisonous snakes. The pupil of the eye is long and vertical, of an oval or elliptical shape. Venomous snakes are thicker in proportion to their length than harmless snakes, the surface of their bodies is rougher, and their tails are blunt or club-shaped. Conversely, harmless snakes possess long narrow heads, the pupils of their eyes are round, not vertical slits, and their bodies are not thick for their length, but long and slim with pointed tails. The bite of vipers of all kinds is much more poisonous in tropical regions, and in the North fatal snake bite is a rare occurrence. If there is a doubt whether a snake is poisonous, the neck may be pressed down against the ground between the jaws of a forked stick, and the poison fangs looked for without danger. These hang directly down from the front part of the upper jaw, or are thrust horizontally forward just in front of the upper lip, and may drip saliva and venom. In Cuba and Porto Rico there is a viper called Juba, or Boaquira, which is a counterpart of the Northern rattlesnake, and the most poisonous of the many species in that region. Among venomous species of the Philippines are two boas and also a viper from nine to ten feet long, which exceptionally pursues and attacks man. This snake is easily killed by a blow on the neck. Another small viper with a club-shaped tail, inhabiting these islands, is nocturnal in its habits, and may get into boots at night. Boots, therefore, should always be inspected before one puts them on in the morning. Usually it is only the young, old, and weak who succumb to snake bite. =Symptoms.=--The symptoms of snake bite of all poisonous species are similar. At first there is some pain in the wound, which rapidly increases together with swelling and discoloration until death of the part may ensue. The vital centers in the brain controlling the heart and breathing apparatus, are paralyzed by the poison. There is often drowsiness and stupor, and the breathing is labored and the pulse weak and irregular, with faintness and cold sweats. =Treatment.=--The treatment consists first in keeping the poison out of the general blood stream. With this purpose in view a handkerchief, piece of cotton clothing, string, or strap should be immediately wound about the bitten limb above the wound, between it and the heart. This will retard absorption of the poison only for a time; it is said twenty-five minutes. The knife is the most effective means of removing the poison by making an oval cut on each side of the wound so that the two incisions meet and remove all the flesh below and around the wound. Bleeding should be encouraged to drain out the poison. The skin containing the wound may be lifted up, and the whole wound cut out by one snip of the scissors where this is practicable. Some advocate burning out the wound with a red-hot wire, or darning needle, instead of cutting, but the treatment is less effective and more painful. Rambaud forbids burning. As to the general condition: if stupor is a prominent symptom the patient must be made to move about and exercise to keep alive his nerve centers. Otherwise one tablespoonful of whisky may be given in half a cup of hot water hourly, to sustain the weakened heart and respiration until recovery ensues. The most effective treatment, according to Dr. George Rambaud, Director of the Pasteur Institute of New York City, is thorough washing of the wound (after it has been opened with the knife) with freshly prepared solution of chloride of lime, in the proportion of one part of lime to sixty of water. The burning of a wound is bad practice. If necessary, chloride-of-lime solution should be injected into the tissues around the wound. One about to go into a place where the most venomous snakes are found should inject into himself a dose of Calmette's antivenomous serum every two or three weeks as a means of prevention. If the serum is used, whisky should not be given in the treatment of one who has been bitten, for the anti-venene is a powerful cell stimulator. Calmette, the Director of the Pasteur Institute in Lille, France, several years ago discovered antivenomous serum. That serum is efficient for the bites of most of the venomous snakes of different countries, including the rattlesnake, cobra, python, etc. It is prepared in the dry form so that it can be carried easily, and will keep almost indefinitely. The proper course to be followed by persons going into countries infested by venomous snakes is always to have on hand a few doses of it. Its value has been positively demonstrated within the last few years in India, where it is used in the British Army, as well as in other countries. In the fluid form it should be used hypodermically, a dose of ten cubic centimeters being injected within eighty or ninety minutes of the reception of the poison. =DOG BITE OR CAT BITE.= (See Hydrophobia, Vol. V, p. 264.) _First Aid Rule 1.--Make sure animal is mad. Send patient to Pasteur institute if one is within reach._ _Rule 2.--Remove poison from wound. Encourage bleeding by squeezing tissue about wound. Suck wound, if you have no cracks in lips, and spit out fluid. Pour hot carbolic solution into wound (a third of a teaspoonful of carbolic acid to a pint of hot water)._ _Rule 3.--Cauterize. Dip wooden meat skewer, or lead pencil, into pure nitric acid, and rub into wound. Or, use red-hot poker, or red-hot nail grasped by tongs or pincers, or red coal from fire._ _Rule 4.--Do not kill the animal. If he is alive and well at the end of a week, he was not mad._ CHAPTER IX =Burns, Scalds, Frostbites, Etc.= _Classes of Burns--Treatment--Burns Caused by Acids and Alkalies--First Aid Rules for Frostbites--Real Freezing--Ingrowing Toe Nail--Fainting--Suffocation--Fits._ =BURNS AND SCALDS.=--If slight, skin very red, unbroken. _First Aid Rule.--Cover with cloths wet in strong solution of baking soda in cold water. Dry gently, and spread with white of egg, thick._ If deeper, blisters, skin broken, thick swelling; there may be some bleeding. _First Aid Rule 1.--Stop pain quickly. Cut away clothing very gently. Break no blisters. Cover with Carron oil (equal parts of limewater and linseed or olive oil) and light bandage. Give fifteen drops of laudanum[9] every half hour in tablespoonful of water, till relieved in part or three doses are taken._ _Rule 2.--Combat shock. If patient is cold, pulse weak, head confused, give tablespoonful of whisky in a quarter of a glass of hot water. Put hot-water bottles at feet._ _Rule 3.--Quench thirst with pieces of ice held in mouth or a swallow of cold milk._ See page 174 for subsequent treatment. A burn is produced by dry heat, a scald by moist heat; the effect and treatment of both are practically identical. Burns are commonly divided into three classes, according to the amount of damage inflicted upon the body. _First Class._--There is redness, pain, and some swelling of the skin, followed, in a few days, by peeling of the surface layer (epidermis) and recovery. Sunburn and burns caused by slight exposures to gases and vapors fall into this category. =Treatment.=--The immediate immersion of the part in cold water is followed by relief, or the application of cloths wet with a saturated solution of saleratus or baking powder is useful. Anything which protects the burned skin from the irritating effect of the air is efficacious, and in emergencies any one of the following may be applied: starch, flour, molasses, white paint, or a mixture of white of egg and sweet oil, equal parts. Usually after the first pain has been relieved by bathing with soda and water, or its application on cloths, the employment of a simple ointment suffices, as cold cream or vaseline. _Second Class._--In this class of cases the inflammation is more severe and the deeper layers of the skin are involved. In addition to the redness and swelling of the skin there are present blisters which appear at once or within a few hours. The general condition is affected according to the size of the burn. If half of the body is only reddened, death usually results, and a burn of a third of the body is often fatal. The shock is so great at times that pain may not be at once intense. Shock is evidenced by general depression, with weakness, apathy, cold feet and hands, and failure of the pulse. If the patient rallies from this condition, then fever and pain become prominent. If steam has been inhaled, there may be sudden death from swelling of the interior of the throat, or inflammation of the lungs may follow inhalation of smoke and hot air. _Third Class._--In this class are included burns of so severe a nature that destruction and death of the tissues follows; not only of the skin but of the flesh and bones in the worst cases. It is impossible to tell by the appearance of the skin what the extent of the destruction may be until the dead parts slough away after a week or ten days. The skin is of a uniform white color in some cases, or may be of a yellow, brown, gray, or black hue, and is comparatively insensitive at first. Pus ("matter") begins to form around the dead part in a few days, and the dead tissue comes away later, to be followed by a long course of suppuration, pain, excessive granulations ("proud flesh"), and, unless skillfully treated, by contraction of the surrounding area, leaving ugly scars and interfering with the appearance and usefulness of the parts. The treatment of such cases after the first care becomes that to be pursued in wounds generally (p. 50), and belongs within the domain of the surgeon. =Treatment of the More Severe Burns.=--If the patient is suffering from shock he should receive some hot alcoholic drink, as hot water and whisky, and be put to bed under warm coverings with hot-water bags or bottles at his feet. The clothing must be cut away from the burned parts with the greatest care, and only a portion of the body should be uncovered at a time and in a warm room. Pain may be subdued by laudanum[10]; fifteen drops may be given to an adult, and the drug may be repeated at hour intervals in doses of ten drops until the suffering has been allayed. Lumps of ice held in the mouth will quench thirst, and the diet should be liquid, as milk, soups, gruels, white of egg, and water. The bowels should be moved daily by rectal injections of soap and warm water. As a matter of local treatment, the surface layer of the skin should be kept intact if possible. Blisters are not to be disturbed unless they are large and tense; if so, their bases may be pricked with a needle sufficiently to let out the fluid contents. Carron oil (equal parts of olive oil and limewater) has been the common remedy for burns, and it is an efficient, though very dirty, dressing, useful if the skin is generally unbroken. It should be applied on clean, soft linen or cotton cloth, which is soaked in the oil, laid over the burned area, and covered with a thick layer of cotton batting and a bandage. When the skin is denuded, leaving a raw surface exposed, the burn must be treated on the same plan as wounds, and should be kept as clean and free from germs as possible. An ointment made of equal parts of boric acid and vaseline, spread thickly on clean cloth, is a good antiseptic preparation in cases where the skin is broken. It is best not to change the dressing oftener than once in two or three days, unless the discharge or odor are considerable. Fresh dressing is very painful and often harmful. When the dressing is removed, warm saline solution (one teaspoonful of common salt in a quart of water) is allowed to flow over the burn until all discharge is washed off. Then the raw surface is dusted over with pure boric acid or aristol, and the boric-acid ointment applied as before. The cloth upon which the ointment is spread should be made free from germs by boiling in water, and then drying it in an oven and keeping it well wrapped in a clean towel except when wanted. The same care is requisite as that described under wounds (p. 50) in regard to cleanliness. Very extensive burns are most satisfactorily treated by complete immersion of the burned limbs or entire body in salt solution (same strength as above), which is kept at a temperature of from 94° to 104° F., according to the feelings of the patient. The patient lies in a bath tub on horsehair, or better, rubber mattress and rubber pillows; completely covered with water except the head. The urine and bowel discharges must be passed in the water, which is then changed, and the temperature is kept at an even mark by allowing warm water to continually run into the tub to displace that which runs out. The latter can be arranged by siphonage with a rubber tube. While this method requires more care, and running hot and cold water, it is the most comfortable treatment for these cases, usually attended by awful suffering, and at the same time it is most favorable to healing. It is beyond the scope of this work to describe the various complications and the details of the after treatment in severe burns, including skin grafting, which may tax all the ingenuity of the skilled surgeon. It is hoped that the foregoing may give a clear idea of the treatment to be pursued in emergencies and may prove of some use to those who may unfortunately be compelled to care for burns during a considerable time without the aid of a physician. =BURN BY STRONG ACID.= _First Aid Rule 1.--Neutralize the acid. Scatter baking soda thickly over burn, or pour limewater over it._ _Rule 2.--Control pain. Wash off soda with stream of water. Apply Carron oil (equal parts of limewater and linseed oil or olive oil). Bandage lightly._ =BURN BY STRONG ALKALI.=--As ammonia, quicklime, lye. _First Aid Rule 1.--Neutralize the alkali. Pour vinegar over the burn._ _Rule 2.--Control pain. Wash off vinegar with stream of water. Dry gently. Apply vaseline or cold cream._ =BURNS CAUSED BY STRONG MINERAL ACIDS OR BY ALKALIES.=--If acids are the cause, the skin should not be washed at first, but either chalk, whiting, or some mild alkali, as baking soda, should be strewn over the burn, and then after the effect of the acid is neutralized, wash off the soda with stream of warm water. Dry gently with gauze. Apply Carron oil or paste of boric acid and vaseline, equal parts. If strong alkalies have been spilled on the skin, as ammonia, potash, or quicklime, then vinegar is the proper substance to employ, followed by washing. Then dry gently. Vaseline or cold cream is usually sufficient as after treatment. Limewater is useful in counteracting the effect of acids spattered in the eye. In the case of alkalies in the eye, the vinegar used should be diluted with three parts of water. Albolene or liquid vaseline is the best agent to drop in the eye after either accident, in order to relieve the irritation and pain, and the patient should stay in a dark room. =FROSTBITE, REAL FREEZING.=--Nose, ears, fingers, toes; insensible to touch, stiff, pale or blue. Person may be unconscious. _First Aid Rule 1.--Restore circulation. Rub gently, then vigorously, with snow._ _Rule 2.--Restore heat very gradually. Sudden heat is fatal. Keep in cold room, and rub with cloth wet with very cold water till circulation is established. Then rub with equal parts of alcohol and water and expose gradually to heat of living room._ _Rule 3.--If person ceases to breathe, resuscitate as if drowned. Open his mouth, grasp his tongue, and pull it forward and keep it there. Let another assistant grasp the arms just below the elbows and draw them steadily upward by the sides of the patient's head to the ground, the hands nearly meeting (which enlarges the capacity of the chest and induces inspiration.) (See pp. 30 and 31.) While this is being done, let a third assistant take position astride the patient's hips with his elbows resting on his own knees, his hands extended ready for action. Next, let the assistant standing at the head turn down the patient's arms to the sides of the body, the assistant holding the tongue changing hands if necessary to let the arms pass. Just before the patient's hands reach the ground the man astride the body will grasp the body with his hands, the ball of the thumb resting on either side of the pit of the stomach, the fingers falling into the grooves between the short ribs. Now, using his knees as a pivot, he will at the moment the patient's hands touch the ground throw (not too suddenly) his whole weight forward on his hands, and at the same time squeeze the waist between them, as if he wished to force something in the chest upward out of the mouth; he will deepen the pressure while he slowly counts one, two, three, four (about five seconds), then suddenly lets go with a final push, which will send him back to his first position. This completes expiration. (A child or a delicate person must be more gently handled.)_ _At the instant of letting go, the man at the head of the patient will again draw the arms steadily upward to the sides of the patient's head as before (the assistant holding the tongue again changing hands to let the arms pass, if necessary), holding them there while he slowly counts one, two, three, four (about five seconds)._ _Repeat these movements deliberately and perseveringly twelve or fifteen times in every minute--thus imitating the natural motions of breathing. Continue the artificial respiration from one to four hours, or until the patient breathes; and for a while after the appearance of returning life carefully aid the first short gasps until deepened into full breaths._ _Keep body warm after this with warm-water bottles._ =FROSTBITE.=--The nose, chin, ears, fingers, and toes are the parts usually frozen, although severe results ending in death of the frozen part occur more often owing to low vitality of the patient than to the cold itself. In the milder degree of frostbite there is stiffness, numbness, and tingling of the frozen member; the skin is of a pale, bluish hue and somewhat shrunken. Recovery ensues with burning pain, tingling, redness, swelling and peeling of the epidermis, as after slight burns. The skin is icy cold, white, and insensitive in severe forms of frostbite, and, if not skillfully treated, becomes, later, either swollen and discolored, or shriveled, dry, and black. In either case the frozen part dies and is separated from the living tissue after the establishment of a sharp line of inflammation which results in ulceration and formation of pus, and thus the dead part sloughs off. It is, however, possible for a part thoroughly frozen to regain its vitality. =Treatment.=--The essential element in the treatment is to secure a very gradual return of blood to the frozen tissues, and so avoid violent inflammation. To obtain this result the patient should be cared for in a cold room, the frozen parts are rubbed gently with snow, or cloth wet with ice water, until they resume their usual warmth. Then it is well to rub them with a mixture of alcohol and water, equal parts, for a time and expose them to the usual temperature of a dwelling room. Warm drinks are now administered to the patient. The frozen member, if hand or foot, is raised high in the air on pillows and covered well with absorbent cotton and bandage. If much redness, swelling, and pain result this dressing is removed and the part is wrapped in a single thickness of cotton cloth kept continually wet with alcohol and water. Subsequent treatment consists in keeping the damaged parts covered with vaseline or cold cream, absorbent cotton, and bandage. If blisters and sores result, the care is similar to that described for like conditions under burns. If death of the frozen part becomes inevitable, the hand or foot should be suspended in a nearly vertical position to keep the blood out, and the part bathed twice daily with a solution of corrosive sublimate (one 7.7 gr. tablet to pint of water), dusted well with aristol, and dressed with absorbent cotton and bandage until the dead tissue separates and comes away. If the frozen part is large it may be necessary to remove it with a knife, but this is not essential when the tips of the fingers or toes are frozen. =General Effect of Cold.=--Sudden exposure to severe cold causes sleep, stupor, and death. Persons found apparently frozen to death should be brought into a cold room, which should be gradually heated, and the body rubbed with snow or ice water, and artificial respiration employed, as just directed. Attempts at resuscitation ought to be persistent, as recoveries have been reported after several hours of unconsciousness and apparent death from freezing. =CHILBLAINS AND MILD FROSTBITES.=--The effects of severe cold on the body are very similar to those of intense heat, though they are very much slower in making their appearance. After a person has frozen a finger or toe he may not notice much inconvenience for days, when suddenly violent inflammation may set in. The fingers, ears, nose, and toes are the members which suffer most frequently from the effects of cold. Similar symptoms of inflammation, described under burns, also result from cold, that is, redness and swelling of the skin, blisters with more severe and deeper inflammatory involvement, or, in case the parts are thoroughly frozen, local death and destruction of the tissues. But it is not essential that the body be exposed to the freezing temperature or be frozen at all, in order that some harm may result, for chilblains often follow when the temperature has not been lower than 40° F., or thereabouts. The effect of cold is to contract the blood vessels, with the production of numbness, pallor, and tingling of the skin. When the cold no longer acts then the blood vessels dilate to more than their usual and normal state, and more or less inflammation results. The more sudden the return to warmth the greater the inflammatory sequel. Chilblains represent the mildest morbid effect of cold on the body. They exist as bluish-red swellings of the skin, usually on the feet or hands, but may attack the nose or ears, and are attended by burning, itching, and smarting. This condition is caused by dilatation of the vessels following exposure to cold. It is more apt to happen in young, anæmic women. Chilblains usually disappear during warm weather. Scratching, friction, or the severity of the attack may lead to the appearance of blisters and sores. In severe cases the fingers and toes present a sausage-like appearance, owing to swelling. =Treatment.=--Susceptible persons should wear thick, warm (not rough) stockings and warm gloves. The chilled members must never be suddenly warmed. Regular exercise and cold shower baths are good to strengthen the circulation, but the feet and hands must be washed in warm water only, and thoroughly dried. If sweating of these parts is a common occurrence, starch or zinc oxide should be dusted on freely night and morning. Cod-liver oil is an efficacious remedy in these cases; one teaspoonful of Peter Möller's pure oil three times daily after meals. The affected parts are bathed twice daily in a solution of zinc acetate (one dram to one pint of water), and followed by the application, on soft linen or cotton, of zinc-oxide ointment containing two per cent of carbolic acid. If this is not curative, iodine ointment mixed with an equal quantity of lard may be tried. Exposure to cold will immediately bring on a recurrence of the trouble. If the affection of the feet is severe the patient must rest in bed. If the parts become blistered and open sores appear, then the same treatment as for burns is indicated. Wash with a weak solution of corrosive sublimate (one tablet for surgical purposes in two quarts of warm water) and apply an ointment of boric acid and vaseline, equal parts, spread on soft, clean cotton or linen. Rest of the part and existence in a warm atmosphere will complete the cure. =INGROWING TOE NAIL.=--This is a condition in which the flesh along the edges of the great toe nail becomes inflamed, owing either to overgrowth of the nail or to pressure of the soft parts against it. Improper footgear is the most common cause, as shoes which are too narrow across the toes, or not long enough, or those with high heels which throw the toes forward so that they are compressed by the toe of the boot, especially in walking downhill. A faulty mode of cutting the toe nails in a healthy foot may favor ingrowing toe nails. Toe nails should be cut straight across, and not trimmed away at the corners to follow the outline of the toes--as then the flesh crowds in at the corners of the nails, and when the nail pushes forward in its growth it presses into the flesh. Nails which have a very rounded surface are more apt to produce trouble, because then the edges are likely to grow down into the flesh. Inflammation in ingrowing toe nail usually arises along the outer edge of the nail. The flesh here becomes red, tender, painful, and swollen so that it overlaps the nail. After a time "matter" or pus forms and finds its way under the nail, and the parts about it ulcerate, and "proud flesh" or excessive granulation tissue springs up and imbeds the edge of the nail. Wearing a shoe, or walking, becomes impossible. The condition may last for months, or even years, if not rightly treated. =Treatment.=--Properly fitting footgear must be worn--broad at the toes with low heels and of sufficient length. If pus ("matter") forms, the cut edge should be raised up by pushing in a little absorbent cotton under the nail every day. Hot poultices of flaxseed meal, or other material will relieve any special pain and inflammation. Soaking the foot frequently in hot water, and observing especial cleanliness, will aid recovery. Tannic acid, or some antiseptic powder like nosophen, should be dusted along the edge of the nail, and the flesh crowded away from the nail by pushing in a little cotton with some tannic acid upon it. If there is a raw surface about the border of the nail, powdered lead nitrate may be dusted upon it each morning for four or five days, till the ulcerated tissue shrinks away and the edge of the nail becomes visible. The toe should be covered with absorbent cotton and a bandage. As soon as the toe is really inflamed the case becomes surgical, and as such demands the care of a surgeon when one can be obtained. =FAINTING.= _First Aid Rule 1.--Remove impediments to respiration. Remove collar, loosen all waist bands and cords, unhook corset or cut the laces at person's back._ _Rule 2.--Assist heart and brain with blood pressure. Put cushion under buttocks, wind skirt close about legs, and raise feet in air. Wait ten seconds._ _Rule 3.--Aid respiration. Put mild smelling salts under nose. Spatter cold water in face._ =SUFFOCATION FROM GAS IN WELLS, CISTERNS, OR MINES, OR FROM ILLUMINATING GAS.= _First Aid Rule 1.--Remove quickly into pure air._ _Rule 2.--Resuscitate as if drowned. Open his mouth, grasp his tongue, pull it forward and keep it there. Let another assistant grasp the arms just below the elbows, and draw them steadily upward by the sides of the patient's head to the ground, the hands nearly meeting, which enlarges the capacity of the chest and induces inspiration. (See pp. 30 and 31.) While this is being done, let a third assistant take position astride the patient's hips with his elbows resting on his own knees, his hands extended ready for action. Next, let the assistant standing at the head turn down the patient's arms to the sides of his body, the assistant holding the tongue, changing hands if necessary to let the arms pass._ _Just before the patient's hands reach the ground, the man astride the body will grasp the body with his hands, the ball of the thumb resting on either side of the pit of the stomach, the fingers falling into the grooves between the short ribs. Now, using his knees as a pivot, he will, at the moment the patient's hands touch the ground, throw (not too suddenly) his whole weight forward on his hands, and at the same time squeeze the waist between them, as if he wished to force something in the chest upward out of the mouth; he will deepen the pressure while he slowly counts one, two, three, four (about five seconds), then suddenly lets go with a final push, which will send him back to his first position. This completes expiration. A child or a delicate person must be more gently handled._ _At the instant of letting go, the man at the head of the patient will again draw the arms steadily upward, to the sides of the patient's head, as before (the assistant holding the tongue again, changing hands if necessary to let the arms pass, holding them there while he slowly counts one, two, three, four (about five seconds))._ _Repeat these movements deliberately and perseveringly twelve or fifteen times in every minute, thus imitating the natural motions of breathing. Continue the artificial respiration from one to four hours, or until the patient breathes; and for a while after the appearance of returning life, carefully aid the first short gasps until deepened into full breaths._ _Keep the body warm with hot-water bottles and blanket._ _Rule 3.--Give oxygen to breathe from a cylinder, for two days, at short intervals, in the case of illuminating gas._ =FIT; CONVULSION.= _First Aid Rule 1.--Aid breathing. Loosen collar, waist bands, and unhook corset, or cut the laces behind._ _Rule 2.--Protect from injury. Gently restrain from falling or rolling against furniture; lay flat on bed._ _Rule 3.--Protect tongue from being bitten. Open jaws and put between teeth rubber eraser tied to stout string, or rubber stopper tied to stout string._ _Rule 4.--Crush pearl of amyl nitrite in handkerchief, and hold close to patient's nose and mouth, till face is red and patient relaxes._ _Rule 5.--Let patient sleep after fit without rousing._ FOOTNOTES: [9] Caution. Dangerous. Use only on physician's order. [10] Caution. Dangerous. Use only on physician's order. Part II GERM DISEASES BY KENELM WINSLOW CHAPTER I =Contagious Diseases= _Scarlet Fever--Symptoms and Treatment--Precautions Necessary--Measles--Communicating the Disease--Smallpox--Vaccination--How to Diagnose Chickenpox._ =ERUPTIVE CONTAGIOUS FEVERS= (_including Scarlet Fever, Measles, German Measles, Smallpox, and Chickenpox_).--These, with the exception of smallpox, attack children more commonly than adults. As they all begin with fever, and the characteristic rash does not appear for from one to four days after the beginning of the sickness, the diagnosis of these diseases must always be at the onset a matter of doubt. For this reason it is wise to keep any child with a fever isolated, even if the trouble seems to be due to "a cold" or to digestive disturbance, to avoid possible communication of the disorder to other children. While colds and indigestion are among the most frequent ailments of children, they must not be neglected, for measles begins as a bad cold, smallpox like the _grippe_, and scarlet fever with a sore throat or tonsilitis, and vomiting. By isolation is meant that the sick child should stay in a room by himself, and the doors should be kept closed and no children should enter, nor should any objects in the room be removed to other parts of the house after the beginning of its occupation by the patient. The services of a physician are particularly desirable in all these diseases, in order that an early diagnosis be made and measures be taken to protect the family, neighbors, and community from contagion. The failure of parents or guardians to secure medical aid for children is regarded by the law as criminal neglect, and is subject to punishment. Boards of health require the reporting of all contagious diseases as soon as their presence is known, and failure to comply with their rules also renders the offender liable to fine or imprisonment in most places. =SCARLET FEVER= (_Scarlatina_).--There is no difference between scarlet fever and scarlatina. It is a popular mistake that the latter is a mild type of scarlet fever. Fever, sore throat, and a bright-red rash are the characteristics of this disease. It occurs most frequently in children between the ages of two and six years. It is practically unknown under one year of age. Prof. H. M. Biggs, of the New York Department of Health, has seen but two undoubted cases in infants under twelve months. It is rare in adults, and one attack usually protects the patient from another. Second attacks have occurred, but many such are more apparent than real, since an error in diagnosis is not uncommon. The disease is communicated chiefly by means of the scales of skin which escape during the peeling process, but may also be acquired at any time from the onset of the attack from the breath, urine, and discharges from the body; or from substances which have come in contact with these emanations. Scarlet fever is probably a germ disease, and the germs may live for weeks in toys, books, letters, clothing, wall paper, etc. Close contact with the patient, or with objects which have come in close touch with the patient, is apparently necessary for contagion. =Period of Development.=--After exposure to the germs of scarlet fever, usually from two to five days elapse before the disease shows itself. Occasionally the outbreak of the disease occurs within twenty-four hours of exposure, and rarely is delayed for a week or ten days. =Symptoms.=--The onset is usually sudden. It begins with vomiting (in very young children sometimes convulsions), sore throat, fever, chilliness, and headache. The tongue is furred. The patient is often stupid; or may be restless and delirious. Within twenty-four hours or so the rash appears--first on the neck, chest, or lower part of back--and rapidly spreads over the trunk, and by the end of forty-eight hours covers the legs and entire body excepting the face, which may be simply flushed. The rash appears as fine, scarlet pin points scattered over a background of flushed skin. At its fullest development, at the end of the second or third day, the whole body may present the color of a boiled lobster. After this time the rash generally fades away and disappears within five to seven days. It is likely to vary much in intensity while it lasts. As the rash fades, scaling of the skin begins in large flakes and continues from ten days to as many weeks, usually terminating by the end of the sixth to eighth week. One of the notable features is the appearance of the tongue, at first showing red points through a white coating, and after this has cleared away, in presenting a raspberry-like aspect. The throat is generally deep red, and the tonsils may be dotted over with white spots (see Tonsilitis) or covered with a whitish or gray membrane suggesting diphtheria, which occasionally complicates scarlet fever. The fever usually is high (103° to 107° F), and the pulse ranges from 120 to 150; both declining after the rash is fully developed, generally by the fourth day. The urine is scanty and dark. There is, however, great variation in the symptoms as to their presence or absence, intensity, and time of occurrence and disappearance. =Complications and Sequels.=--These are frequent and make scarlet fever the most dreaded of the eruptive diseases, except smallpox. Enlarged glands under the jaw and at the sides of the neck are common, and appear as lumps in these sites. Usually not serious, they may enlarge and threaten life. Pain and swelling in the joints, especially of the elbows and knees, are not rare, and may be the precursors of serious inflammation of these parts. One of the most frequent and serious complications of scarlet fever is inflammation of the kidneys, occurring more often toward the end of the second week of the disease. Examination of the urine by the attending physician at frequent intervals throughout the course of the disorder is essential, although puffiness of the eyelids and face, and of the feet, ankles, and hands, together with lessened secretion of urine--which often becomes of a dark and smoky hue--may denote the onset of this complication. The disease of the kidneys usually results in recovery, but occasionally in death or in chronic Bright's disease of these organs. Inflammation of the middle ear with abscess, discharge of matter from the ear externally, and--as the final outcome--deafness, is not uncommon. This complication may be prevented to a considerable extent by spraying the nose and throat frequently and by the patient's use of a nightcap with earlaps, if the room is not sufficiently warm. Inflammation of the eyelids is an occasional complication. The heart is sometimes attacked by the toxins of the disease, and permanent damage to the organ, in the form of valvular trouble, may result. Blindness and nervous disorders are among the rarer sequels including paralyses and St. Vitus's dance. =Determination of Scarlet Fever.=--When beginning with vomiting, headache, high fever, and sore throat, and followed in twenty-four hours with a general scarlet rash, this is not difficult; but occasionally other diseases present rashes, as indigestion, _grippe_, and German measles, which puzzle the most acute physicians. Measles may be distinguished from scarlet fever in that measles appears first on the face, the rash is patchy or blotchy, and does not show for three to four days after the beginning of the sickness. The patient seems to have a bad cold, with cough, running at the nose, and sore eyes. German measles is mild, and while the rash may look something like that of scarlet fever, the patient does not seem generally ill, is hardly affected at all, though rarely troubled with slight catarrh of the nose. In no sickness are the services of a physician more necessary than in scarlet fever; first, to determine the existence of the disease, and then to prevent or combat the complications which often approach insidiously. =Outlook.=--The average death rate of scarlet fever is about ten per cent. It is very fatal in children about a year old, and most of the deaths occur in those under the age of six. But the mortality varies greatly at different times and in different epidemics. In 1904-5, in many parts of the United States, the disease was very prevalent and correspondingly mild, and deaths were rare. =Duration of Contagion.=--The disease is commonly considered contagious only so long as peeling of the skin lasts. But it seems probable that any catarrhal secretion from the nose, throat, or ear is capable of communicating the germs from a patient to another person for many days after other evidences of the disease are past. Scarlet fever patients should always be isolated for as long a period as six weeks--and better eight weeks--without regard to any shorter duration of peeling, and if peeling continues longer, so should the isolation. =Treatment.=--In case a physician is unobtainable the patient must be put to bed in the most airy, sunshiny room, which should be heated to 70° F., and from which all the unnecessary movables should be taken out before the entrance of the patient. A flannel nightgown and light bed clothing are desirable. The fever is best overcome by cold sponging, which at the same time diminishes the nervous symptoms, such as restlessness and delirium. The body is sponged--part at a time--with water at the temperature of about 70° F., after placing a single thickness of old cotton or linen wet with ice or cold water (better an ice cap) over the forehead. The part is thoroughly dried as soon as sponged, and the process is repeated whenever the temperature is over 103° F. There need be no fear that the patient may catch cold if only a portion of the body is exposed at any one time. If there is any chilliness following sponging, a bag or bottle containing hot water may be placed at the feet. It is well that a rubber bag containing ice, or failing this a cold cloth, be kept continually on the head while fever lasts. The throat should be sprayed hourly with a solution of hydrogen peroxide (full strength) and the nose with the same, diluted with an equal amount of water, three times a day. The outside of the throat it is wise to surround with an ice bag, or lacking this, a cold cloth frequently wet and covered with a piece of oil silk (or rubber) and flannel. The diet should consist of milk, broths, or thin gruels, and plenty of water should be allowed. Sweet oil or carbolized vaseline should be rubbed over the whole body night and morning during the entire sickness and convalescence. The bowels must be kept regular by injections or mild cathartics, and, after the fever subsides, vegetables, fruit, cereals, and milk may be permitted, together with meat or eggs once daily. It is imperative for the nurse and also the mother to wear a gown and cap over the outside clothes, to be slipped off in the hall at the door of the sick room when leaving the latter. =MEASLES.=--Measles is a contagious disease, characterized by a preliminary stage of fever and catarrh of the eyes, nose, and throat, and followed by a general eruption on the skin. One attack practically protects a person from another, yet, on the other hand, second attacks occur with extreme rarity. It is more contagious than scarlet fever, and isolation of a patient in a house is of less service in preventing communication to other inmates, whereas in scarlet fever half the number of susceptible children may escape the disease through this precaution. The germs which cause measles perish rapidly, so that infected clothes or other objects merely require a thorough airing to be rendered safe, whereas in scarlet fever the danger of transmission of the contagion may lurk in infected clothing and other substances for weeks, unless they are subjected to proper disinfection. A patient with measles is capable of communicating the disorder from its onset, before the appearance of the rash, through the breath, discharges from the nose and eyes, tears and saliva and all the secretions. At the end of the third week of the disease the patient is usually incapable of giving the disease to others. Close contact with a patient is commonly necessary for one to acquire the disease, but it is frequently claimed that it is carried by a third person in the clothes, as by a nurse. It is infrequent in infants under six months, and most frequent between the second and sixth year. Adults are attacked by measles more often than by scarlet fever. =Development.=--A period of from seven to sixteen days after exposure to measles elapses before the disease becomes apparent. =Symptoms.=--The disease begins like a severe nasal catarrh with fever. The eyes are red and watery, the nose runs, and the throat is irritable, red, and sore, and there is some cough, with chilliness and muscular soreness. The fever, higher at night, varies from 102° to 104° F., and the pulse ranges from 100 to 120. There is often marked drowsiness for a day or two before the rash appears. Coated tongue, loss of appetite, occasional vomiting, and thirst are present during this period. The appearance of minute, whitish spots, surrounded by a red zone, may often be seen in the inside of the mouth opposite the back teeth for some days before the eruption occurs. The preliminary period, when the patient seems to be suffering with a bad cold, lasts for four days usually, and on the evening of the fourth day the rash breaks out. It first appears on the face and then spreads to the chest, trunk, and limbs. Two days are generally required for the complete development of the rash; it remains thus in full bloom for about two days more, then begins to subside, fading completely in another two days--six days in all. The rash appears as bright-red, slightly raised blotches on the face, which is generally somewhat swollen. The same rash extends to the abdomen, back, and limbs. Between the mottled, red rash may be seen the natural color of the skin. At this time the cough may be hoarse and incessant, and the eyes extremely sensitive to light. The fever and other symptoms abate when the rash subsides, and well-marked scaling of the skin occurs. =Complications and Sequels.=--Severe bronchitis, pneumonia, croup, laryngitis, sore eyes, ear abscess and deafness, violent diarrhea, convulsions, and, as a late result, consumption sometimes accompany or follow measles. For the consideration of these disorders, see special articles in other parts of this work. =Outlook.=--The vast majority of healthy patients over two years old recover from measles completely. Younger children, or those suffering from other diseases, may die through some of the complications affecting the lungs. The disease is peculiarly fatal in some epidemics occurring among those living in unhygienic surroundings, and in communities unaccustomed to the ravages of measles. Thus, in an epidemic attacking the Fiji Islanders, over one-quarter of the whole population (150,000) died of measles in 1875. Measles is more severe in adults than in children. =Diagnosis.=--For one not familiar with the characteristic rash a written description of it will not suffice for the certain recognition of the disease, but if the long preliminary period of catarrh and fever, and the appearance of the eruption on the fourth day, be taken into account--together with the existence of sore eyes and hoarse, hard cough--the determination of the presence of measles will not be difficult in most cases. =Treatment.=--The patient should be put to bed in a darkened, well-ventilated room at a temperature of 68° to 70° F. While by isolation of the patient we may often fail to prevent the occurrence of measles in other susceptible persons in the same house, because of the very infectious character of the disease, and because it is probable that they have already been exposed during the early stages when measles was not suspected, yet all possible precautions should be adopted promptly. For this reason other children in the house should be kept from school and away from their companions, and they ought not to be sent away from home to spread the disease elsewhere. The bowels should be kept regular by soapsuds injections or by mild cathartics, as a Seidlitz powder. If the fever is over 103° F. and is accompanied by much distress and restlessness, children may be sponged with tepid water, and adults with water at 80° F., every two hours or so as directed under scarlet fever. When cough is incessant or the rash does not come out well, there is nothing better than the hot pack. The patient is stripped and wrapped from feet to neck in a blanket wrung out of hot water containing two teaspoonfuls of mustard stirred into a gallon of water. This is then covered with two dry blankets and the patient allowed to remain in the blankets for two or three hours, when the application may be repeated. It is well to keep a cold cloth on the head during the process. Cough is also relieved by a mixture containing syrup of ipecac, twenty drops; paregoric, one teaspoonful, for an adult (or one-third the dose for a child of six), which should be given in one-quarter glass of water and may be repeated every two hours. If there is hoarseness, the neck should be rubbed with a mixture of sweet oil, two parts; and oil of turpentine, one part, and covered with a flannel bandage. The cough mixture will tend to relieve this condition also. A solution of boric acid (ten grains of boric acid to the ounce of water) is to be dropped in both eyes every two hours with a medicine dropper. Although usually mild, the eye symptoms may be very severe and require special treatment, and considerably impaired vision may be the ultimate result. Severe diarrhea is combated with bismuth subnitrate, one-quarter teaspoonful, every three hours. For adults, the diet consists of milk, broths, gruels, and raw eggs. Young children living on milk mixtures should receive the mixture to which they are accustomed, diluted one-half with barley water. Nourishment must be given every two hours except during sleep. The patient should be ten days in bed, and should remain three days in his room after getting up (or three weeks in all, if there are others who may contract measles in the house), and after leaving his room should stay in the house a week longer. The principal danger after an attack of measles is of lung trouble--pneumonia or tuberculosis (consumption)--and the greatest care should be exercised to avoid exposure to the wet or to cold draughts. =GERMAN MEASLES= (_Rötheln_).--German measles is related neither to measles nor scarlet fever, but resembles them both to a certain extent--more closely the former in most cases. It is a distinct disease, and persons who have had both measles and scarlet fever are still susceptible to German measles. One attack of German measles usually protects the patient from another. Adults, who have not been previously attacked, are almost as liable to German measles as children, but it is rare that infants acquire the disease. It is a very contagious disorder--but not so much so as true measles--and often occurs in widespread epidemics. The breath and emanations from the skin transmit the _contagium_ from the appearance of the first symptom to the disappearance of the eruption. =Development.=--The period elapsing after exposure to German measles and before the appearance of the symptoms varies greatly--usually about two weeks; it may vary from five to eighteen days. =Symptoms.=--The rash may be the first sign of the disease and more frequently is so in children. In others, for a day or two preceding the eruption, there may be headache, soreness, and redness of the throat, the appearance of red spots on the upper surface of the back of the mouth, chilliness, soreness in the muscles, loss of appetite, watering of the eyes. Catarrhal symptoms are most generally absent, an important point in diagnosis. When present, they are always mild. These preliminary symptoms, if present, are much milder and of shorter duration than in measles, where they last for four days before the rash appears; and the hard, persistent cough of measles is absent in German measles. Also, while there is sore throat in the latter, there is not the severe form with swollen tonsils covered with white spots so often seen in scarlet fever. Fever is sometimes absent in German measles; usually it ranges about 100° F., rarely over 102° F. Thus, German measles differs markedly from both scarlet fever and measles proper. The rash usually appears first on the face, then on the chest, and finally covers the whole body, in the space of a few hours--twenty-four hours at most. The eruption takes the form of rose-red, round or oval, slightly raised spots--from the size of a pin head to that of a pea--sometimes running together into uniform redness, as in scarlet fever. The rash remains fully developed for about two days, and often changes into a coppery hue as it gradually fades away. There are often lumps--enlarged glands--to be felt under the jaw, on the sides and back of the neck, which occur more commonly in German than in true measles. The glands at the back of the neck are the most characteristic. They are enlarged in about two-thirds of the cases. =Determination.=--The diagnosis or determination of the existence of measles must be made, in the absence of a physician, on the general symptoms rather than on the rash, which requires experience for its recognition and is subject to great variations in appearance, at one time simulating measles, at another scarlet fever. German measles differs from true measles in the following points: the preliminary period--before the rash--is mild, short, or absent; fever is mild or absent; the cold in the nose and eyes and cough are slight or may be absent, as contrasted with these symptoms in measles, while the enlarged glands in the neck are more pronounced than in measles. The onset of German measles is not so sudden as in scarlet fever and not accompanied with vomiting as in the latter, while the sore throat and fever are much milder in German measles. The peeling, which is so prominent in scarlet fever with the disappearance of the rash, is not infrequently present. It may be absent. Its presence or absence seems to depend upon the severity of the eruption. The desquamation when present is finer than in either measles or scarlet fever. =Outlook.=--Recovery from German measles is the invariable rule, and without complications or delay. =Treatment.=--Little or no treatment is required. The patient should remain in bed in a darkened room on a liquid diet while fever lasts, and be isolated from others indoors until all signs of the eruption are passed. The eyes should be treated with boric acid as in measles; the diet, during the fever, consisting of milk, broths, thin cereals, beef juice, raw eggs or eggnog, for adults and older children; while infants should have their milk mixture diluted one-half with barley water. A bath and fresh clothing for the patient, and thorough cleansing and airing of the sick room and clothing are usually sufficient after the passing of the disease without chemical disinfection. =SMALLPOX.=--Smallpox is one of the most contagious diseases known. It is extremely rare for anyone exposed to the disease to escape its onslaught unless previously protected by vaccination or by a former attack of the disease. One is absolutely safe from acquiring smallpox if recently and successfully vaccinated, and thus has one of the most frightful and fatal scourges to which mankind has ever been subject been robbed of its dangers. The _contagium_ is probably derived entirely from the scales and particles of skin escaping from smallpox patients, and in the year 1905-6 the true germ of the disease was discovered by Councilman, of Boston. It is not necessary to come in direct contact with a patient to contract the disease, as the _contagium_ may be transmitted some little distance through the air, possibly even outside of the sick room. One attack almost invariably protects against another. All ages are liable to smallpox; it is particularly fatal in young children, and during certain epidemics has proved more so in colored than in white people. =Development.=--A period of ten or twelve days usually elapses after exposure to smallpox before the appearance of the first symptoms of the disease. This period may vary, however, from nine to fifteen days. =Symptoms.=--There is a preliminary period of from twenty-four to forty-eight hours after the beginning of the disease before an eruption occurs. The onset is ushered in by a set of symptoms simulating those seen in severe _grippe_, for which smallpox is often mistaken at this time. The patient is suddenly seized with a chill, severe pains in the head, back, and limbs, loss of appetite and vomiting, dizziness on sitting up, and fever--103° to 105° F. In young children convulsions often take the place of the chill seen in adults. On the second day a rash often appears on the lower part of the belly, thighs, and armpits, which may resemble that characteristic of measles or scarlet fever, but does not last for over a day or two. It is very evanescent and, consequently, rarely seen. Diarrhea often occurs, as well as vomiting, particularly in children. On the evening of the fourth day the true eruption usually appears; first on the forehead or face, and then on the arms, hands, and legs, palms, and soles. The eruption takes successively four forms: first, red, feeling like hard pimples or like shot; then, on the second or third day of the eruption, these pimples become tipped with little blisters with depressed centers, and surrounded by a red blush. Two or three days later the blisters are filled with "matter" or pus and present a yellowish appearance and are rounded on top. Finally, on about the tenth day of the eruption, the pustules dry up and the matter exudes, forming large, yellowish or brownish crusts, which, after a while, drop off and leave red marks and, in severe cases, pitting. The fever preceding the eruption often disappears upon the appearance of the latter and in mild cases does not reappear, but in severe forms the temperature remains about 100° F., and when the eruption is at its height again mounts to 103° to 105° F., and gradually falls with convalescence. The eruption is most marked on the face, hands, and forearms, and occurs less thickly on the body. It appears also in the mouth and throat and when fully developed on the face gives rise to pain and considerable swelling and distortion of the features, so that the eyes are closed and the patient becomes frightfully disfigured and well-nigh unrecognizable. Delirium is common at this time, and patients need constant watching to prevent their escape from bed. In the severe forms the separate eruptive points run together so that the face and hands present one distorted mass of soreness, swelling, and crusting. In these, pitting invariably follows, while in those cases where the eruption remains distinct, pitting is not certain to occur. A still worse form is that styled "black smallpox," in which the skin becomes of a dark-purplish hue, from the fact that each pustule is a small blood blister, and bleeding occurs from the nose, mouth, etc. These cases are almost, without exception, fatal in five to six days. The patient may say that the eruption was the first symptom he observed. This was particularly noticed in negroes, many of whom had never been vaccinated. The eruption may exhibit but a dozen or so points, especially about the forehead, wrists, palms, and soles. After the first four days the fever and all the disagreeable symptoms may subside, and the patient may feel absolutely well. The eruption, however, passes through the stages mentioned, although but half the time may be occupied by the changes; five or six days instead of ten to twelve for crusts to form. In such cases the death rate has been exceedingly low, although it is perfectly possible for a person to contract the most severe smallpox from one of these mild (and often unrecognized) cases, as has unfortunately happened. Smallpox occurring after successful vaccination resembles, in its characteristics, the cases just described, and unless vaccination had been done many years previously, the results are almost always favorable as regards life and absence of pitting. =Detection.=--Smallpox is often mistaken for chickenpox, or some of the skin diseases, in its mild forms. The reader is referred to the article on chickenpox for a consideration of this matter. The mild type should be treated just as rigidly as severe cases with regard to isolation and quarantine, being more dangerous to the community because lightly judged and not stimulating to the adoption of necessary precautions. The preliminary fever and other symptoms peculiar to smallpox will generally serve to determine the true nature of the disease, since these do not occur in simple eruptions on the skin. The general symptoms and course of smallpox must guide the layman rather than the appearance of the eruption, which requires educated skill and experience to recognize. Chickenpox in an adult is less common than in children. Smallpox is very rare in one who has suffered from a previous attack of the disease or in one who has been successfully vaccinated within a few years. =Outlook.=--The death rate of smallpox in those who have been previously vaccinated at a comparatively recent date, or in varioloid, as it is called when thus modified by vaccination, is only 1.2 per cent. There are, however, severe cases following vaccinations done many years previous to the attack of smallpox. While these cannot be called varioloid, yet the death rate is much lower than in smallpox occurring in the unvaccinated. Thus, before the mild epidemic of 1894 the death rate in the vaccinated was sixteen per cent; since 1894 it has been only seven per cent; while in the unvaccinated before 1894 it was fifty-eight per cent; and since that date it has been but seventeen per cent, as reported by Welch from the statistics of 5,000 cases in the Philadelphia Municipal Hospital. =Complications.=--While a variety of disorders may follow in the course of smallpox, complications are not very frequent in even severe cases. Inflammation of the eyelids is very common, however, and also boils in the later stages. Delirium and convulsions in children are also frequent, as well as diarrhea; but these may almost be regarded as natural accompaniments of the disease. Among the less common complications are: laryngitis, pneumonia, diseases of the heart, insanity, paralysis, various skin eruptions, inflammation of the joints and of the eyes and ears, and baldness. =Treatment.=--Prevention is of greatest importance. Vaccination stands alone as the most effective preventive measure in smallpox, and as such has no rival in the whole domain of medicine. The modern method includes the inoculation of a human being with matter taken from one of the eruptive points on the body of a calf suffering with cowpox. Whether cowpox is a modified form of smallpox or a distinct disease is unknown. The period of protection afforded by a successful vaccination is uncertain, because it varies with different individuals. In a general way immunity for about four or five years is thus secured; ten or twelve years after vaccination the protection is certainly lost and smallpox may be then acquired. Every individual should be vaccinated between the second and third month after birth, and between the ages of ten and twelve, and at other times whenever an epidemic threatens. An unvaccinated person should be vaccinated and revaccinated, until the result is successful, as immunity to vaccination in an unvaccinated person is practically unknown. When unsuccessful, the vaccine matter or the technique is faulty. A person continuously exposed to smallpox should be vaccinated every few weeks--if unsuccessful, no harm or suffering follow; if successful, it proves liability to smallpox. A person previously vaccinated successfully may "take" again at any time after four or five years, and, in event of possible exposure to smallpox, should be revaccinated several times within a few weeks--if the vaccination does not "take"--before the attempt is given up. An unvaccinated person, who has been exposed to smallpox, can often escape the disease if successfully vaccinated within three days from the date of the exposure, but is not sure to do so. Diseases are not introduced with vaccination now that the vaccine matter is taken from calves and not from the human being, as formerly. Most of the trouble and inflammation of the vaccinated part following vaccination may be avoided by cleanliness and proper care in vaccinating. In the absence of a physician, vaccination may be properly done by any intelligent person when the circumstances demand it. Vaccination is usually performed upon the outside of the arm, a few inches below the shoulder, in the depression situated in that region. If done on the leg, the vaccination is apt to be much more troublesome and may confine the patient to bed. The arm should be thoroughly washed in soap and warm water, from shoulder to elbow, and then in alcohol diluted one-third with water. When this has evaporated (without rubbing), the dry arm is scratched lightly with a cold needle which has previously been held in a flame and its point heated red hot. The point must thereafter not be touched with anything until the skin is scratched with it. The object is not to draw blood, but to remove the outer layer of skin, over an area about one-fourth of an inch square, so that it appears red and moist but not bleeding. This is accomplished by very light scratching in various directions. Another spot, about an inch or two below, may be similarly treated. Then vaccine matter, if liquid, is squirted on the raw spots, or, if dried on points, the ivory point is dipped in water which has been boiled and cooled, and rubbed thoroughly over the raw places. The arm must remain bare and the vaccination mark untouched until the surface of the raw spot is perfectly dry, which may take half an hour. A piece of sterilized surgical gauze, reaching halfway about the arm and kept in place with strips of adhesive plaster (or an absolutely clean handkerchief bound about the arm, and held by sewing or safety pins), ought to cover the vaccination for three days. After this time the sore must only come in contact with soft and clean old cotton or linen, which may be daily pinned in the sleeve of the under garment. If the scab is knocked off and an open sore results it should be treated like any wound. If the vaccination "takes," it passes through several stages. On the third day following vaccination a red pimple forms at the point of introduction of the matter, which is surrounded by a circle of redness. Some little fever may occur. On the fifth day a blister or pimple containing clear fluid with a depressed center is seen, and a certain amount of hard swelling, itchiness, and pain is present about the vaccination. A sore lump (gland) is often felt under the arm. The full development is reached by the eighth day, when the pimple is full and rounded and contains "matter," and is surrounded by a large area of redness. From the eleventh day the vaccination sore dries, and a brown scab forms over it about the end of the fourteenth day, and the redness and swelling gradually depart. At the end of about three weeks the scab drops off, leaving a pitted scar or mark. Not infrequently the vaccination results in a very slight pimple and redness, which passes through the various stages described, in a week or ten days, in which case the vaccination should be repeated. Unless the vaccination follows very closely the course described, it cannot be regarded as successful, although after the first one or two vaccinations the result is often not so severe, and the time of completion of the various stages somewhat shortened. Rarely an eruption, resembling that at the vaccination site, appears on the vaccinated limb and even becomes general upon the body, due to urticaria or to inoculation, through scratching. The special treatment of an attack of smallpox is largely a matter of careful nursing. A physician or nurse can scarcely lay claim to any great degree of heroism in caring for smallpox patients, as there is no danger of contracting the disease providing a successful vaccination has been recently performed upon them. The patient should be quarantined in an isolated building, and all unnecessary articles should be removed from the sick room, in the way of carpets and other furnishings. It is well that the room be darkened to save irritation of the eyes. The diet should be liquid: milk, broths, and gruels. Laudanum, fifteen drops, or paregoric, one tablespoonful in water, may be given to adults, once in three hours, to relieve pain during the first few days. Sponging throughout the course of the disease is essential; first, with cool water, as directed for scarlet fever, with the use of cold on the head to relieve the itching, fever, and delirium. The cold pack is still more efficient. To give this, the patient is wrapped in a sheet wrung out in water at a temperature between 68° and 75° F. The sheet surrounds the naked body from feet to neck, and is tucked between the legs and between the body and arms; the whole is then covered with a dry blanket, and a cold, wet cloth or ice cap is placed upon the head. The patient may be permitted to remain in the pack for an hour, when it may be renewed, if necessary, to allay fever and restlessness; otherwise it may be discontinued. The cold sponging or cold pack are indicated when the temperature is over 102.5° F., and when with fever there are restlessness and delirium. Great cleanliness is important throughout the disease; the bedclothes should be changed daily and the patient sponged two or three times daily with warm water, unless fever is high. Cloths wet with cold carbolic-acid solution (one-half teaspoonful to the pint of hot water) should be kept continuously on the face and hands. Holes are cut in the face mask for the eyes, nose, and mouth, and the whole covered with a similar piece of oil silk to keep in the moisture. Such applications give much relief, and to some extent prevent pitting. The hair must be cut short, and crusts on the scalp treated with frequent sponging and applications of carbolized vaseline, to soften them and hasten their falling. The boric-acid solution should be dropped into the eyes as recommended for measles, and the throat sprayed every few hours with Dobell's solution. Diarrhea in adults may be checked with teaspoonful doses of paregoric given hourly in water. Vaseline and cloths used on a patient must not be employed on another, as boils are thus readily propagated. All clothing, dishes, etc., coming in contact with a patient must be boiled, or soaked in a two-per cent carbolic-acid solution for twenty-four hours, or burned. When the patient is entirely free from scabs, after bathing and putting on disinfected or new clothes outside of the sick room, he is fit to reënter the world. =CHICKENPOX.=--Chickenpox is a contagious disease, chiefly attacking children. While it resembles smallpox in some respects, at times simulating the latter so closely as to puzzle physicians, it is a distinct disease and is in no way related to smallpox. This is shown by the fact that chickenpox sometimes attacks a patient suffering with, or recovering from, smallpox. Neither do vaccination nor a previous attack of smallpox protect an individual from chickenpox. Chickenpox is not common in adults, and its apparent presence in a grown person should awaken the liveliest suspicion lest the case be one of smallpox, since this mistake has been frequently made, and with disastrous results, during an epidemic of mild smallpox. One attack of chickenpox usually protects against another, but two or three attacks in the same individual are not unknown. The disease may be transmitted from the patient to another person from the time of the first symptom until the disappearance of the eruption. The disease ordinarily occurs in epidemics, but occasionally in isolated cases. =Development.=--A period of two weeks commonly elapses after exposure to the disease before the appearance of the first symptom of chickenpox, but this period may vary from thirteen to twenty-one days. =Symptoms.=--The characteristic eruption is often the first warning of chickenpox, but in some cases there may be a preliminary period of discomfort, lasting for a few hours, before the appearance of the rash; particularly in adults, in whom the premonitory symptoms may be quite severe. Thus, there may be chilliness, nausea, and even vomiting, rarely convulsions in infants, pain in the head and limbs, and slight fever (99° to 102° F.) at this time. The eruption shows first on the body, in most cases, especially the back. It consists of small red pimples, which rapidly develop into pearly looking blisters about as large as a pea to that of the finger nail, and are sometimes surrounded by a red blush on the skin. These blisters vary in number, from a dozen or so to two hundred. They do not run together, and in three to four days dry up, become shriveled and puckered, and covered with a dark-brown or blackish crust, and drop off, leaving only temporary red spots in most cases. The fever usually continues during the eruption. During the first few days successive fresh crops of fresh pimples and blisters appear, so that while the first crop is drying the next may be in full development. This forms one of its distinguishing features when chickenpox is compared with smallpox. In chickenpox the eruption is seen on the unexposed skin chiefly, but may occur on the scalp and forehead, and even on the palms, soles, forearms, and face. In many cases the eruption is found in the mouth, on its roof, and the inside of the cheeks. The blisters rarely contain "matter" or pus, as in smallpox, unless they are scratched. Scratching may lead to the formation of ugly scars and should be prevented, especially when the eruption is on the face. Pitting rarely occurs. =Determination.=--The discrimination between chickenpox and smallpox is sometimes extremely puzzling and demands the skill of an experienced physician. When one is unavailable, the following points may serve to distinguish the two disorders: smallpox usually begins like a severe attack of _grippe_, with pain in the back and head, general pains and nausea or vomiting, with high fever (103° to 104° F.) These last two or three days, and may completely subside when the rash appears. In chickenpox preliminary discomfort is absent, or lasts but a few hours before the eruption. The eruption of smallpox usually occurs first on the forehead, near the hair, or on the palms of the hands, soles of the feet, the arms and legs, but is usually sparse on the body. The eruption appears about the same time in smallpox and not in successive crops, as in chickenpox. Chickenpox is more commonly a disease of childhood; smallpox attacks all ages. The crusts in chickenpox are thin, and appear in four or five days, while those of smallpox are large and yellow, and occur after ten or twelve days. =Outlook.=--Chickenpox almost invariably results in a rapid and speedy recovery without complications or sequels. The young patients often feel well throughout the attack, which lasts from eight to twelve days. =Treatment.=--Children should be kept in bed during the eruptive stage until the blisters have dried. To prevent scratching, the calamine lotion may be used (Vol. II, p. 145), or carbolized vaseline, or bathing with a solution of baking soda, one teaspoonful to the pint of tepid water. The diet should be that recommended for German measles. Patients should be kept in the house and isolated until all signs of the eruption are passed, and then receive a good bath and fresh clothing before mingling with others. The sick room should be thoroughly cleaned and aired; thorough chemical disinfection is not essential. The services of a physician are always desirable in order that it may be positively determined that the disease is not a mild form of smallpox. CHAPTER II =Infectious Diseases= _Typhoid Fever--How it is Contracted--Complications and Sequels--Rest, Diet, and Bathing the Requisites--Mumps--Whooping Cough--Erysipelas._ =TYPHOID FEVER (ENTERIC FEVER).=--Through ignorance which prevailed before the discovery of the germ of typhoid fever and exact methods for determining the presence of the same, the term was loosely applied and is to this day. Thus mild forms of typhoid are called gastric fever, slow fever, malarial fever, nervous fever, etc., all true typhoid in most cases; while typhoid fever, common to certain localities and differing in some respects from the typical form, is often named after the locality in which it occurs, as the "mountain fever" common to the elevated regions of the western United States. This want of information is apt to prevail in regions remote from medical centers, and leads to neglect of the necessary strict measures for the protection of neighboring communities, for the excretion of one typhoid patient has led to thousands of cases and hundreds of deaths. Typhoid fever is a communicable disease caused by a germ which attacks the intestines chiefly, but also invades the blood, and at times all the other parts of the body, and is characterized by continued fever, an eruption, tenderness and distention of the bowels, and generally diarrhea. It is common to all parts of the earth in the temperate zones, and occurs more frequently from July to December in the north temperate zone, from February to July in the south temperate zone. It is most prevalent in the late summer and autumn months and after a hot, dry summer. Individuals between the ages of fifteen and thirty are more prone to typhoid fever, but no age is exempt. The sexes are almost equally liable to the disease, although it is said that for every four female cases there are five male cases. The robust succumb as readily as the weak. =Cause and Modes of Communication.=--While the typhoid germ is always the immediate cause, yet it is brought in contact with the body in various ways. Contamination of water supply through bad drainage is the principal source of epidemics of typhoid. Before carefully protected public water supplies were in vogue in Massachusetts, there were ninety-two deaths from typhoid fever in 100,000 inhabitants, while thirty-five years after town water supplies became the rule, there were only nineteen deaths for the same population. Whenever typhoid is prevalent, the water used for drinking and all other household purposes should be boiled, and uncooked food should be avoided. Flies are carriers of typhoid germs by lighting on the nose, the mouth, and the discharges of typhoid patients, and then conveying the germs to food, green vegetables, and milk. Cooking the food, preventing contact of flies with the patients, and keeping flies out of human habitations becomes imperative. Milk is a source of contagion through contaminated water used to wash cans, or to adulterate it, or through handling of it by patients or those who have come in contact with patients. Oysters growing in the mouths of rivers and near the outlets of drains and sewers are carriers of typhoid germs, and, if eaten raw, sometimes communicate typhoid fever. Dust is an occasional medium of communication of the germ. It is probable, however, that the germ always enters the body by being swallowed with food or drink, and does not enter through the lungs. There is little doubt on this point. Ice may harbor the germ for many months, for freezing does not kill it, and epidemics have been traced to this source. Clothing, wood, utensils, door handles, etc., which have been contaminated by contact with discharges from patients, may also prove mediums of communication of the typhoid germ to healthy individuals. Typhoid germs escape from patients sick with the disease chiefly in the bowel discharges and urine, sometimes in the sweat, saliva, and vomited matter. Sewer gas and emanations from sewage and filth will not communicate typhoid fever directly, but the latter afford nutriment for the growth of the germ, and after becoming infected, may eventually come in contact with drinking water or food, and so prove dangerous. Improper care of discharges of excrement and urine--with the assistance of flies--are responsible for the enormous typhoid epidemics in military camps, so that in the late Spanish-American War one-fifth of all our soldiers in camp contracted the disease. In the upper layers of the soil typhoid germs may live for six months through frosts and thaws. The disease is preventable, and will probably be stamped out in time. In some of the most thickly populated cities in the world, as in Vienna, its occurrence is most infrequent, owing to intelligent sanitary control and pure water supply, while in the most salubrious country districts its inroads are the most serious and fatal through ignorance and carelessness. =Development.=--From eight to twenty-three days elapse from the time of entrance of typhoid germs into the body before the patient is taken sick. One attack usually protects one against another, but two or three attacks are not unheard of in the same person. =Symptoms.=--Typhoid fever is subject to infinite variations, and it will here be possible only to outline what may be called a typical case. In a work of this kind the preliminary symptoms are of most importance in warning one of the probability of an attack, so that the prospective patient can govern himself accordingly, as in no other disease is rest in bed of more value. Patients who persist in walking about with typhoid fever for the first week or so are most likely to die of the disease. The average duration of the disease is about one month. During the first week the onset is gradual, the temperature mounting a little higher each day--as 99.5° F. the first evening, 101° the second, 102° the fourth, 104° the fifth, 105° the sixth, and 105.5° the seventh. In the morning of each day the temperature is usually about a degree or more lower than that of the previous night. From the end of the first week to the beginning of the third the temperature remains at its highest point, being about the same each evening and falling one or two degrees in the morning. During the third week the temperature gradually falls, the highest point each evening being a degree or so lower than the previous day, while in the fourth week the temperature may be below normal in the morning and a degree or so above normal at night. So much for this symptom. After the entrance of typhoid germs into the bowels and before the recognized onset of the disease, there may be lassitude and disinclination for exertion. The disease begins with headache, backache, loss of appetite, sometimes a chill in adults or a convulsion in children, soreness in the muscles, pains in the belly, nosebleed, occasional vomiting, diarrhea, coated tongue, often some cough, flushed face, pulse 100, gradually increasing as described. These symptoms are, to a considerable extent, characteristic of the beginning of many acute diseases, but the gradual onset with constant fever, nosebleed, and looseness of the bowels are the most suggestive features. Then, if at the end of the first week or ten days pink-red spots, about as large as a pin head, appear on the chest and belly to the number of two or three to a dozen, of very numerously, and disappear on pressure (only to return immediately), the existence of typhoid fever is pretty certain. Headache is now intense. These rose spots--as they are called--often appear in crops during the second and third weeks, lasting for a few days, then departing. During the second week there is often delirium and wandering at night; the headache goes, but the patient is stupid and has a dusky, flushed face. The tongue becomes brownish in color, and its coat is cracked, and the teeth are covered with a brownish matter. The skin is generally red and the belly distended and tender. Diarrhea is often present with three to ten discharges daily of a light-yellow, pea-soup nature, with a very offensive odor. Constipation throughout the disease is, however, not uncommon in the more serious cases. The pulse ranges from 80 to 120 a minute. During the third week, in cases of moderate severity, the general condition begins to improve with lowering of the temperature, clearing of the tongue, and less frequent bowel movements. But in severe cases the patient becomes weaker, with rapid, feeble pulse, ranging from 120 to 140; stupor and muttering delirium; twitching of the wrists and picking at the bedclothes, with general trembling of the muscles in moving; slow, hesitating speech, and emaciation; while the urine and fæces may be passed unconsciously in bed. Occasionally the patient with delirium may require watching to prevent him from getting out of bed and injuring himself. He may appear insane. During the fourth week, in favorable cases, the temperature falls to normal in the morning, the pulse is reduced to 80 or 100, the diarrhea ceases, and natural sleep returns. Among the many and frequent variations from the type described, there may be a fever prolonged for five or six weeks, with a good recovery. Chills are not uncommon during the disease, sometimes owing to complications. Relapse, or a return of the fever and other symptoms all over again, occurs in about ten per cent of the cases. This may happen more than once, and as many as five relapses have been recorded in one patient. A slight return of the fever for a day or two is often seen, owing to error in diet, excitement, or other imprudence after apparent recovery. Death may occur at any time from the first week, owing to complications or the action of the poison of the disease. Pneumonia, perforation of and bleeding from the bowels are the most frequent dangerous complications. Unfavorable symptoms are continued high fever (105° to 106° F.), marked delirium, and trembling of the muscles in early stages, and bleeding from the bowels; also intense and sudden pain with vomiting, indicating perforation of the intestines. The result is more apt to prove unfavorable in very fat patients, and especially so in persons who have walked about until the fever has become pronounced. Bleeding from the bowels occurs in four to six per cent of all cases and is responsible for fifteen per cent of the deaths; perforation of the bowels happens in one to two per cent of all cases and occasions ten per cent of the deaths. =Detection.=--It is impossible for the layman to determine the existence of typhoid fever in any given patient absolutely, but when the symptoms follow the general course indicated above, a probability becomes established. Unusual types are among the most difficult and puzzling cases which a physician has to diagnose, and he can rarely be absolutely sure of the nature of any case before the end of the first week or ten days, when examination of the blood offers an exact method of determining the presence of typhoid fever. Typhoid fever--especially where there are chills--is often thought to be malaria, when occurring in malarial regions, and may be improperly called "typhoid malaria." There is no such disease. Rarely typhoid fever and malaria coexist in the same person, and while this was not uncommon in the soldiers returning from Cuba and Porto Rico, it is an extremely unusual occurrence in the United States. Examination of the blood will determine the presence or absence of both of these diseases. =Complications and Sequels.=--These are very numerous. Among the former are diarrhea, delirium, mental and nervous diseases, bronchitis, pleurisy, pneumonia, ear abscess, perforation of and hemorrhage from the bowels, inflammation of the gall bladder, disease of heart, kidney, and bladder, and many rarer conditions, depending upon the organ which the germ invades. Among sequels are boils, baldness, bone disease, painful spine, and, less commonly, insanity and consumption. While convalescence requires weeks and months, the patient often gains greatly in flesh and feels made over anew, as in fact he has been to a great extent, through the destruction and repair of his organs. =Outlook.=--The death rate varies greatly in different epidemics and under different conditions. During the Spanish-American War in the enormous number of cases--over 20,000--the death rate was only about seven per cent, which represents that in the best hospitals of this country and in private practice. Osler states that the mortality ranges from five to twelve per cent in private practice, and from seven to twenty per cent in hospital practice, because hospital cases are usually advanced before admission. The chances of recovery are much greater in patients under fifteen years, and are also more favorable between the twenty-second and fortieth years. =Treatment.=--There is perhaps no disease in which the services of a physician are more desirable or useful than in typhoid fever, on account of its prolonged course and the number of complications and incidents which may occur during its existence. It is the duty of the physician to report cases of typhoid to the health authorities, and thus act as a guardian of the public health. If, however, in any circumstances one should have the misfortune to have the care of a typhoid patient remote from medical aid, it is a consolation to know that the outlook is not greatly altered by medicine or special treatment of any sort. There have been epidemics in remote parts of this country where numbers of persons have suffered with typhoid without any professional care, and yet with surprisingly good results. Thus, in an epidemic occurring in a small community in Canada, twenty-four persons sickened with typhoid and received no medical care or treatment whatever, and yet there was but one death. The essentials of treatment are comprised in _Rest, Diet, and Bathing_. Rest to the extent of absolute quiet in the horizontal position, at the first suspicion of typhoid, is requisite in order to avoid the dangers of bleeding and perforation of the bowels resulting from ulceration of structures weakened by the disease. The patient should be assisted to turn in bed, must make no effort to rise during the sickness, and should pass urine and bowel discharges into a bedpan or urinal under cover. In case of bleeding from the bowels, the bedpan should not be used, but the discharges may be received for a time in cloths, without stirring the patient. =Diet.=--This should consist chiefly of liquids until a week after the fever's complete disappearance. A cup of liquid should be given every two hours except during a portion of the sleeping hours. Milk, diluted with an equal amount of water, forms the chief food in most cases unless it disagrees, is refused, or is unobtainable. In addition to milk, albumen water--white of raw egg, strained and diluted with an equal amount of water, and flavored with a few drops of lemon juice or with brandy--is valuable; also juice squeezed from raw beef--in doses of four tablespoonfuls--coffee, cocoa, and strained barley, rice, or oatmeal gruel, broths, unless diarrhea is marked and increased by the same. Soft custard, jellies, ice cream, milk-and-flour porridge, and eggnog may be used to increase the variety. Finely scraped raw or rare beef, very soft toast, and soft-boiled or poached eggs are allowable after the first week of normal temperature, at the end of the third or fourth week of the disease, and during the course of the disease under circumstances where the fluids are not obtainable or not well borne. An abundance of water should be supplied to the patient throughout the disease. =Bathing.=--The importance of cold, through the medium of water, in typhoid fever accomplishes much, both in reducing the temperature and in stimulating the nervous system and relieving restlessness and delirium. Bathing is usually applied when the temperature rises above 102.5° F., and may be repeated every two or three hours if restlessness, delirium, and high temperature require it. The immersion of patients in tubs of cold water, as practiced with benefit in hospitals, is out of the question for use by inexperienced laymen. The patient should have a woven-wire spring bed and soft hair mattress, over which is laid a folded blanket covered by a rubber sheet. Sponging the naked body with ice water will suffice in some cases; in others, when the temperature is over 102-1/2° F., enveloping the whole body in a sheet wet in water at 65°, and either rubbing the surface with ice or cloths wet in ice-cold water, for ten or fifteen minutes, is advisable. Rubbing of the skin of the chest and sides is necessary during the application of cold to prevent shock. The use of a cold cloth on the head and hot-water bottle at the feet, during the sponging, will also prove beneficial. In children and others objecting to these cold applications, the vapor bath is effective. For this a piece of cheese cloth (single thickness) is wet with warm water--100° to 105°--and is wrapped about the naked body from shoulders to feet, and is continually wet by sprinkling with water at the temperature of 98°. The evaporation of the water will usually, in fifteen to twenty minutes, cool the body sufficiently if the patient is fanned continuously by two attendants. In warm weather the patient should only be covered with a sheet for a while after the bath, which should reduce the temperature to 3°. Hot water at the feet, and a little brandy or whisky given before the sponging if the pulse be feeble, will generally prevent a chill. Patients should be gently dried after the bath and covered with dry bedclothing. The utmost care should be taken not to agitate a feeble patient during sponging. The long period of lying in bed favors the occurrence of bedsores. These are apt to appear about the lower part of the spine, and begin with redness of the skin, underneath which a lump may be felt. Constant cleanliness and bathing with alcohol, diluted with an equal amount of water, will tend to prevent this trouble, while moving the patient so as to take the pressure off this region and avoiding any rumpling of the bedding under his body are also serviceable, as well as the ring air cushion. Medicine is not required, except for special symptoms, and has no influence either in lessening the severity of or in shortening the disease. Brandy or whisky diluted with water are valuable in severe cases, with muttering delirium, dry tongue, and feeble pulse; it is not usually called for before the end of the second week, and not in mild cases at any time. A tablespoonful of either, once in two to four hours, is commonly sufficient. Pain and distention of the belly are relieved by applying a pad over the whole front of the belly--consisting of two layers of flannel wrung out of a little very hot water containing a teaspoonful of turpentine--and covered by a dry flannel bandage wrapped about the body. Also the use of white of egg and water, and beef juice, instead of milk, will benefit this condition. Diarrhea--if there are more than four discharges daily--may be checked by one-quarter level teaspoonful doses of bismuth subnitrate, or teaspoonful doses of paregoric, once in three hours. Constipation is relieved by injections of warm soapsuds, once in two days. Bleeding from the bowels must be treated by securing perfect quiet on the patient's part, and by giving lumps of ice by the mouth, and cutting down the nourishment for six hours. Fifteen drops of laudanum should be given to adults, if there is restlessness, and some whisky, if the pulse becomes feeble, but it is better to reserve this until the bleeding has stopped. Patients may be permitted to sit up after a week of normal temperature, but solid food must not be resumed until two or three weeks after departure of fever, and then very gradually, avoiding all coarse and uncooked vegetables and fruit. The greatest care must be exercised by attendants to escape contracting the disease and to prevent its communication to others. The bowel discharges must be submerged in milk of lime (one part of slaked lime to four parts of water), and remain in it one hour before being emptied. The urine should be mixed with an equal amount of the same, or solution of carbolic acid (one part in twenty parts of hot water), and the mixture should stand an hour before being thrown into privy or sewer. Clothing and linen in contact with the patient must be soaked in the carbolic solution for two hours. The patient's expectoration is to be received on old muslin pieces, which must be burned. The bedpan and eating utensils must be frequently scalded in boiling water. The attendant should wash his hands always after touching the patient, or objects which have come in contact with patient or his discharges, and thus will avoid contagion. If farm or dairy workers come in contact with the patient, the latter precaution is especially important. If there is no water-closet in the house, the disinfected discharges may be buried at least 100 feet from any well or stream. Typhoid fever is only derived from the germs escaping in the urine, and in the bowel, nose, or mouth discharges of typhoid patients. =MUMPS.=--Mumps is a contagious disease characterized by inflammation of the parotid glands, situated below and in front of the ears, and sometimes of the other salivary glands below the jaw, and rarely of the testicles in males and the breasts in females. Swelling and inflammation of the parotid gland also occur from injury; and as a complication of other diseases, as scarlet fever, typhoid fever, etc.; but such conditions are wholly distinct from the disease under discussion. Mumps is more or less constantly prevalent in most large cities, more often in the spring and fall, and is often epidemic, attacking ninety per cent of young persons who have not previously had the disease. It is more common in males, affecting children and youths, but rarely infants or those past middle age. One attack usually protects against another. =Development.=--A period of from one to three weeks elapses, after exposure to the disease, before the first signs develop. The germ has not yet been discovered, and the means of communication are unknown. The breath has been thought to spread the germs of the disease, and mumps can be conveyed from the sick to the well, by nurses and others who themselves escape. =Symptoms.=--Sometimes there is some preliminary discomfort before the apparent onset. Thus, in children, restlessness, peevishness, languor, nausea, loss of appetite, chilliness, fever, and convulsions may usher in an attack. Mumps begins with pain and swelling below the ear on one side. Within forty-eight hours a large, firm, sensitive lump forms under the ear and extends forward on the face, and downward and backward in the neck. The swelling is not generally very painful, but gives a feeling of tightness and disfigures the patient. It makes speaking and swallowing difficult; the patient refuses food, and talks in a husky voice; chewing causes severe pain. After a period of two to four days the other gland usually becomes similarly inflamed, but occasionally only one gland is attacked. There is always fever from the beginning. At first the temperature is about 101° F., rarely much higher than 103° or 104°. The fever continues four or five days and then gradually declines. The swelling reaches its height in from two to five days, and then after forty-eight hours slowly subsides, and disappears entirely within ten to fourteen days. The patient may communicate the disease for ten days after the fever is past, and needs to be isolated for that period. Earache and noises in the ear frequently accompany mumps, and rarely abscess of the ear and deafness result. The most common complication occurs in males past puberty, when, during recovery or a week or ten days later, one or both testicles become painful and swollen, and this continues for as long a time as the original mumps. Less often the breasts and sexual organs of females are similarly affected. =Complications and Sequels.=--Recovery without mishap is the usual result in mumps, with the exception of involvement of the testicles. Rarely there are high fever, delirium, and great prostration. Sometimes after inflammation of both testicles in the young the organs cease to develop, and remain so, but sexual vigor is usually retained. Sometimes abscess and gangrene of the inflamed parotid gland occur. Recurring swelling and inflammation of the gland may occur, and permanent swelling and hardness remain. Meningitis, nervous and joint complications are among the rarer sequels. =Treatment.=--The patient should remain in bed while the fever lasts. A liquid diet is advisable during this time. Fever may be allayed by frequent sponging of the naked body with tepid water. High fever and delirium demand the constant use, on the head, of the ice cap (a rubber bag, made to fit the head, containing ice). The relief of pain in the swollen gland is secured by the frequent application of a thick layer of sheet cotton, large enough to cover the whole side of the neck, wrung out of hot water and covered with oil-silk or rubber sheeting, with a bandage to retain it in place. Paregoric may be given for the same purpose--a tablespoonful for adults; a teaspoonful for a child of eight to ten, well diluted with water, and not repeated inside of two hours, and not then unless the pain continues unabated. Inflammation of the testicles demands rest in bed, elevation of the testicle on a pillow after wrapping it in a thick layer of absorbent cotton, or applying hot compresses, as recommended for the neck. After the first few days of this treatment, adjust a suspensory bandage, which can be procured at any apothecary shop, and apply daily the following ointment: guiacol, sixty grains; lard, one-half ounce, over the swollen testicle. =WHOOPING COUGH.=--A contagious disease characterized by fits of coughing, during which a whooping or crowing sound is made following a long-drawn breath. Whooping cough is generally taken through direct contact with the sick, rarely through exposure to the sick room, or to persons or clothing used by the sick. The germ which causes the disease is probably in the mucus of the nose and throat. Whooping cough is usually more or less prevalent in all thickly settled civilized communities, at times is epidemic, and often follows epidemics of measles. It occurs chiefly in children from six months to six years of age. Girls and all weak and delicate subjects are slightly more susceptible to the disease. Some children are naturally immune to whooping cough. One attack usually protects against another. =Development.=--A variable period elapses between the time of exposure to whooping cough and the appearance of the first symptoms. This may be from two days to two weeks; usually seven to ten days. =Symptoms.=--Whooping cough begins like an ordinary cold in the head, with cough, worse at night, which persists. The coughing fits increase and the child gets red in the face, has difficulty in getting its breath during them, and sometimes vomits when the attack is over. After a variable period, from a few days to two weeks from the beginning of the cough, the peculiar feature of the disease appears. The child gives fifteen or twenty short coughs without drawing breath, the face swells and grows blue, the eyeballs protrude, the veins stand out, and the patient appears to be suffocating, when at last he draws in a long breath with a crowing or whooping sound, which gives rise to the name of the disease. Several such fits of coughing may follow one another and are often succeeded by vomiting and the expulsion of a large amount of phlegm or mucus, which is sometimes streaked with blood. In mild cases there may be six to twelve attacks in twenty-four hours; in severe cases from forty to eighty. The attacks last from a few seconds to one or two minutes. Occasionally the whoop comes before the coughing fit, and sometimes there may be no whooping at all, only fits of coughing with vomiting. Between the attacks, puffiness of the face and eyes and blueness of the tongue persist. The coughing fits and whooping last usually from three to six weeks, but the duration of the disease is very variable. Occasionally it lasts many months, especially when it occurs in winter. The contagiousness of whooping cough continues about two months, or ceases before that time with the cessation of the cough. Oftentimes there may be occasional whooping for months; or, after ceasing altogether for some days, it may begin again. In neither of these conditions is the disease considered still contagious after two months. When an attack of whooping is coming on, the child often seems to have some warning, as he seems terrified and suddenly sits up in bed, or, if playing, grasps hold of something, or runs to his mother or nurse. Coughing fits are favored by emotion or excitement, by crying, singing, eating, drinking, sudden change of temperature, and by bad air. =Complications and Sequels.=--These are many and make whooping cough a critical disease for very young children. Bronchitis and pneumonia often complicate whooping cough in winter, and diarrhea frequently occurs with it in summer. Convulsions not infrequently follow the coughing fits in infants, and, owing to the amount of blood forced to the head during the attacks, nosebleed and dark spots on the forehead and surface of the eyes appear from breaking of small blood vessels in these places. Severe vomiting and diarrhea occasionally aggravate the case, and pleurisy and consumption may occur. The violent coughing may permanently damage the heart. Rupture of the lung tissue happens from the same cause, and paralysis sometimes follows breaking of a blood vessel in the brain. But in the vast majority of cases in children over two years old no dangerous sequel need be feared. =Outlook.=--Owing to the numerous complications, whooping cough must be looked upon as a very serious disease, especially in infants under two years, and in weak, delicate children. It causes one-fourth of all deaths among children, the death rate varying from three to fifteen per cent in different times and under different circumstances. For this reason a physician's services should always be secured when possible. =Treatment.=--A host of remedies is used for whooping cough, but no single one is always the best. It is often necessary to try different medicines till we find one which excels. Fresh air is of greatest importance. Patients should be strictly isolated in rooms by themselves, and it is wise to send away children who have not been exposed. Morally, parents are criminally negligent who allow their children with whooping cough to associate with healthy children. If the coughing fits are severe or there is fever, children should be kept in bed. Usually there is not much fever; perhaps an elevation of a degree or two at first, and at times during the disease. Otherwise, children may be outdoors in warm weather, and in winter on warm, quiet days. Sea air is especially good for them. It is best that the sick should have two rooms, going from one to the other, so that the windows in the room last occupied may be opened and well ventilated. Fresh air at night is especially needful, and the patient should sleep in a room which has been freshly aired. The temperature should be kept at an even 70° F., and the child should not be exposed to draughts. Vaporizing antiseptics in the sick room has proved beneficial. A two per cent solution of carbolic acid in water is useful for this purpose, or a substance called vapo-cresoline, with which is sold a vaporizing lamp and directions for use. A one per cent solution of resorcin, or of hydrogen dioxide, diluted with four parts of water, used in an atomizer for spraying the throat, every two hours, has given good results. In the beginning of the disease, before the whooping has begun, a mixture of paregoric and syrup of ipecac will relieve the cough, ten drops of the former with five of the latter, for a child of two years, given together in water every three hours. The bromide of sodium, five grains in water, every three hours during the day, for a child of two, is serviceable in relieving the fits of coughing in the day; while at night, two grains of chloral, not repeated, may be given in water at bedtime to secure sleep, in a child of two. The tincture of belladonna, in doses of two drops in water, three times daily, for a child of two, is also often efficacious. Quinine, given in the dose of one-sixth grain for each month of the child's age under a year; or in one and one-half grain doses for each year of age under five, is one of the older and more valuable remedies. It should be given three times daily in pill with jelly, or solution in water. Bromoform in doses of two drops for a child of two, and increasing to five drops for a child of six, may be given in syrup three times daily with benefit. Most of these drugs should be employed only with a doctor's advice, when this is possible. To sum up, use the vapo-cresoline every day. When no physician is available, begin with belladonna during the day, using bromide of sodium at night. If this fails to modify the whooping after five days' trial, use bromide and chloral. In severe cases use bromoform. During a fit of coughing and whooping, it is well to support the child's head, and if he ceases to breathe, he should be slapped over the face and chest with a towel wet with cold water. Interference with sleep caused by coughing, and loss of proper nourishment through vomiting, lead to wasting and debility. Teaspoonful doses of emulsion of cod-liver oil three times daily, after eating, are often useful in convalescence, and great care must be taken at this time to prevent exposure and pneumonia. Change of air and place will frequently hasten recovery remarkably in the later stages of the disease. =ERYSIPELAS.=--Erysipelas is a disease caused by germs which gain entrance through some wound or abrasion in the skin or mucous membranes. Even where no wound is evident it may be taken for granted that there has been some slight abrasion of the surface, although invisible. Erysipelas cannot be communicated any distance through the air, but it is contagious in that the germs which cause it may be carried from the sick to the well by nurses, furniture, bedding, dressings, clothing, and other objects. Thus, patients with wounds, women in childbirth, and the newborn may become affected, but modern methods of surgical cleanliness have largely eliminated these forms of erysipelas, especially in hospitals, where it used to be common. Erysipelas attacks people of all ages, some persons being very susceptible and suffering frequent recurrences. The form which arises without any visible wound is seen usually on the face, and occurs most frequently in the spring. The period of development, from the time the germs enter the body until the appearance of the disease, lasts from three to seven days. Erysipelas begins with usually a severe chill (or convulsion in a baby) and fever. Vomiting, headache, and general lassitude are often present. A patch of red appears on the cheeks, bridge of nose, or about the eye or nostril, and spreads over the face. The margins of the eruption are sharply defined. Within twenty-four hours the disease is fully developed; the skin is tense, smooth, and shiny, scarlet and swollen, and feels hot, and is often covered with small blisters. The pain is more or less intense, burning or itching occurs, and there is a sensation of great tightness or tension. On the face the swelling closes the eye and may interfere with breathing through the nose. The lips, ears, and scalp are swollen, and the person may become unrecognizable in a couple of days. Erysipelas tends to spread like a drop of oil, and the borders of the inflammatory patch are well marked. It rarely spreads from the face to the chest and body, and but occasionally attacks the throat. During the height of the inflammation the temperature reaches 104° F, or over. After four or five days, in most cases, erysipelas begins to subside, together with the pain and temperature, and recovery occurs with some scaling of the skin. The death rate is said to average about ten per cent in hospitals, four per cent in private practice. Headache, delirium, and stupor are common when erysipelas attacks the scalp. The appearance of the disease in other locations is similar to that described. Relapses are not uncommon, but are not so severe as the original attack. Spreading may extend over a large area, and the deeper parts may become affected, with the formation of deep abscesses and great destruction of tissue. Certain internal organs, heart, lungs, spleen, and kidneys, are occasionally involved with serious consequences. The old, the diseased, and the alcoholic are more apt to succumb, also the newborn. It is a curious fact that cure of malignant growths (sarcoma), chronic skin diseases, and old ulcers sometimes follows attacks of erysipelas. =Treatment.=--The duration of erysipelas is usually from a few days to about two weeks, according to its extent. It tends to run a definite course and to recovery in most cases without treatment. The patient must be isolated in a room with good ventilation and sunlight. Dressings and objects coming in contact with him must be burned or boiled. The diet should be liquid, such as milk, beef tea, soups, and gruels. The use of cloths wet constantly with cold water, or with a cold solution of one-half teaspoonful of pure carbolic acid to the pint of hot water, or with a poisonous solution of sugar of lead, four grains to the pint, should be kept over small inflamed areas. Fever is reduced by sponging the whole naked body with cold water at frequent intervals. A tablespoonful of whisky or brandy in water may be given every two hours to adults if the pulse is weak. Painting the borders of the inflamed patch with contractile collodion may prevent its spreading. The patient must be quarantined until all scaling ceases, usually for two weeks. CHAPTER III =Malaria and Yellow Fever= _The Malarial Parasite--Mosquitoes the Means of Infection--Different Forms of Malaria--Symptoms and Treatment--No Specific for Yellow Fever._ =MALARIA; CHILLS AND FEVER; AGUE; FEVER AND AGUE; SWAMP OR MARSH FEVER; INTERMITTENT OR REMITTENT FEVER; BILIOUS FEVER.=--Malaria is a communicable disease characterized by attacks of fever occurring at certain intervals, and due to a minute animal parasite which inhabits the body of the mosquito, and is communicated to the blood of man by the bites of this insect. In accordance with this definition malaria is not a contagious disease in the sense that it is acquired by contact with the sick, which is not the case, but it is derived from contact with certain kinds of mosquitoes, and can be contracted in no other way, despite the many popular notions to the contrary. Mosquitoes, in their turn, acquire the malarial parasite by biting human beings suffering from malaria. It thus becomes possible for one malarial patient, coming to a region hitherto free from the disease, to infect the whole district with malaria through the medium of mosquitoes. =Causes.=--While the parasite infesting mosquitoes is the only direct cause of malaria, yet certain circumstances are requisite for the life and growth of the mosquitoes. These are moisture and proper temperature, which should average not less than 60° F. Damp soil, marshes, or bodies of water have always been recognized as favoring malaria. Malaria is common in temperate climates--in the summer and autumn months particularly, less often in spring, and very rarely in winter, while it is prevalent in the tropics and subtropics all the year round, but more commonly in the spring and fall of these regions. The older ideas, that malaria was caused by something arising in vapors from wet grounds or water, or by contamination of the drinking water, or by night air, or was due to sleeping outdoors or on the ground floors of dwellings, are only true in so far as these favor the growth of the peculiar kind of mosquitoes infected by the malarial parasites. Two essentials are requisite for the existence of malaria in a region: the presence of the particular mosquito, and the actual infection of the mosquito with the malarial parasite. The kind of mosquito acting as host to the malarial parasite is the genus _Anopheles_, of which there are several species. The more common house mosquito of the United States is the _Culex_. The _Anopheles_ can usually be distinguished from the latter by its mottled wings, and, when on a wall or ceiling, it sits with the body protruding at an angle of 45° from the surface, with its hind legs hanging down or drawn against the wall. In the case of the _Culex_, the body is held parallel with the wall, the wings are usually not mottled, and the hind legs are carried up over the back. When a mosquito infected with the malarial parasite bites man, the parasite enters his blood along with the saliva that anoints the lancet of the mosquito. The parasite is one of the simplest forms of animal life, consisting of a microscopical mass of living, motile matter which enters the red-blood cell of man, and there grows, undergoes changes, and, after a variable time, multiplies by dividing into a number of still smaller bodies which represent a new generation of young parasites. This completes the whole period of their existence. It is at that stage in the development of the parasite in the human body when it multiplies by dividing that the chills and fever in malaria appear. What causes the malarial attack at this point is unknown, unless it be that the parasites give rise to a poison at the time of their division. Between the attacks of chills and fever in malaria there is usually an interval of freedom of a few hours, which corresponds to the period intervening in the life of the parasite in the human body, between the birth of the young parasites and their growth and final division, in turn, into new individuals. This interval varies with the kind of parasite. The common form of malaria is caused by a parasite requiring forty-eight hours for its development. The malarial attacks caused by this parasite then occur every other day, when the parasite undergoes reproduction by division. However, an attack may occur every day when there are two separate groups of these parasites in the blood, the time of birth of one set of parasites, with an accompanying malarial attack, happening one day; that of the other group coming on the next, so that between the two there is a daily birth of parasites and a daily attack of malaria. In cases of malaria caused by one group of parasites the attacks appear at about the same time of day, but when the attacks are caused by different groups of parasites the times of attack may vary on different days. In the worst types of malaria the parasites do not all go through the same stages of development at the same time, as is commonly the case in the milder forms prevalent in temperate regions, so that the fever--corresponding to the stage of reproduction of the parasites--occurs at irregular intervals. In a not uncommon type of malaria the attacks occur every third day, with two days of intermission or freedom from fever. Different groups of parasites causing this form of malaria, and having different times of reproduction, may inhabit the same patient and give rise to variation in the times of attack. Thus, an attack may occur on two successive days with a day of intermission. The reproduction of the parasite in the human blood is not a sexual reproduction; that takes place in the body of the mosquito. When a healthy mosquito bites a malarial patient, the parasite enters the body of the mosquito with the blood of the patient bitten. It enters its stomach, where certain differing forms of the parasite, taking the part of male and female individuals, unite and form a new parasite, which, entering the stomach wall of the mosquito, gives birth in the course of a week to innumerable small bodies as their progeny. These find their way into the salivary glands which secrete the poison of the mosquito bite, and escape, when the mosquito bites a human being, into the blood of the latter and give him malaria. =Distribution.=--Malaria is very widely distributed, and is much more severe in tropical countries and the warmer parts of temperate regions. In the United States malaria is prevalent in some parts of New England, as in the Connecticut Valley, and in the course of the Charles River, in the country near Boston. It is common in the vicinity of the cities of Philadelphia, New York, and Baltimore, but here is less frequent than formerly, and is of a comparatively mild type. More severe forms prevail along the Gulf of Mexico and the shores of the Mississippi and its branches, especially in Mississippi, Texas, Louisiana, and Arkansas, but even here it is less fatal and widespread than formerly. In Alaska, the Northwest, and on the Pacific Coast of the United States malaria is almost unknown, while it is but slightly prevalent in the region of the Great Lakes, as about Lakes Erie and St. Clair. =Development.=--Usually a week or two elapses after the entrance of the malarial parasite into the blood before symptoms occur; rarely this period is as short as twenty-four hours, and occasionally may extend to several months. It often happens that the parasite remains quiescent in the system without being completely exterminated after recovery from an attack, only to grow and occasion a fresh attack, a month or two after the first, unless treatment has been thoroughly prosecuted for a sufficient time. =Symptoms.=--Certain symptoms give warning of an attack, as headache, lassitude, yawning, restlessness, discomfort in the region of the stomach, and nausea or vomiting. The attack begins with a chilliness or creeping feeling, and there may be so severe a chill that the patient is violently shaken from head to foot and the teeth chatter. Chills are not generally seen in children under six, but an attack begins with uneasiness, the face is pinched, the eyes sunken, the lips and tips of the fingers and toes are blue, and there is dullness and often nausea and vomiting. Then, instead of a chill, the eyelids and limbs begin to twitch, and the child goes into a convulsion. While the surface of the skin is cold and blue during a chill, yet the temperature, taken with the thermometer in the mouth or bowel, reaches 102°, 105°, or 106° F., often. The chill lasts from a few minutes to an hour, and as it passes away the face becomes flushed and the skin hot. There is often a throbbing headache, thirst, and sometimes mild delirium. The temperature at this time, when the patient feels intensely feverish, is very little higher than during the chill. The fever lasts during three or four hours, in most cases, and gradually declines, as well as the headache and general distressing symptoms with the onset of sweating, to disappear in an hour or two, when the patient often sinks into a refreshing sleep. Such attacks more commonly occur every day, every other day, or after intermissions of two days. Rarely do attacks come on with intervals of four, five, six, or more days. The attacks are apt to recur at the same time of day as in the first attack. In severe cases the intervals may grow shorter, in mild cases, longer. In the interval between the attacks the patient usually feels well unless the disease is of exceptional severity. There is also entire freedom from fever in the intervals except in the grave types common to hot climates. Frequently the chill is absent, and after a preliminary stage of dullness there is fever followed by sweating. This variety is known as "dumb ague." =Irregular and Severe Form--Chronic Malaria.=--This occurs in those who have lived long in malarial regions and have suffered repeated attacks of fever, or in those who have not received proper treatment. It is characterized by a generally enfeebled state, the patient having a sallow complexion, cold hands and feet, and temperature below normal, except occasionally, when there may be slight fever. When the condition is marked, there are breathlessness on slight exertion, swelling of the feet and ankles, and "ague cake," that is, enlargement of the spleen, shown by a lump felt in the abdomen extending downward from beneath the ribs on the left side. Among unusual forms of malaria are: periodic attacks of drowsiness without chills, but accompanied by slight fever (100° to 101° F.); periodic attacks of neuralgia, as of the face, chest, or in the form of sciatica; periodic "sick headaches." These may take the place of ordinary malarial attacks in malarial regions, and are cured by ordinary malarial treatment. =Remittent Form (unfortunately termed "bilious").=--This severe type of malaria occurs sometimes in late summer and autumn, in temperate climates, but is seen much more commonly in the Southern United States and in the tropics. It begins often with lassitude, headache, loss of appetite and pains in the limbs and back, a bad taste, and nausea for a day or two, followed by a chill, and fever ranging from 101° to 103° F., or more. The chill is not usually repeated, but the fever is continuous, often suggesting typhoid fever. With the fever, there are flushed face, occasional delirium, and vomiting of bile, but more often a drowsy state. After twelve to forty-eight hours the fever abates, but the temperature does not usually fall below 100° F., and the patient feels better, but not entirely well, as in the ordinary form of malaria, where the fever disappears entirely between the attacks. After an interval varying from three to thirty-six hours the temperature rises again and the more severe symptoms reappear, and so the disease continues, there never being complete freedom from fever, the temperature sometimes rising as high as 105° or 106° F. In some cases there are nosebleed, cracked tongue, and brownish deposit on the teeth, and a delirious or stupid state, as in typhoid fever, but the distention of the belly, diarrhea, and rose spots are absent. The skin and whites of the eyes often take on the yellowish hue of jaundice. This fever has been called typhomalarial fever, under the supposition that it was a hybrid of the two. This is not the case, although it is possible that the two diseases may occur in the same individual at the same time. This, indeed, frequently happened as stated, in our soldiers coming from the West Indies during the Spanish-American War--but is an extremely uncommon event in the United States. =Pernicious Malaria.=--This is a very grave form of the disease. It rarely is seen in temperate regions, but often occurs in the tropics and subtropics. It may follow an ordinary attack of chills and fever, or come on very suddenly. After a chill the hot stage appears, and the patient falls into a deep stupor or unconscious state, with flushed face, noisy breathing, and high fever (104° to 105° F.). Wild delirium or convulsions afflict the patient in some cases. The attack may last for six to twenty-four hours, from which the patient may recover, only to suffer another like seizure, or he may die in the first. In another form of this pernicious malaria the symptoms resemble true cholera, and is peculiar to the tropics. In this there are violent vomiting, watery diarrhea, cramps in the legs, cold hands and feet, and collapse. Sometimes the attack begins with a chill, but fever, if any, is slight, although the patient complains of great thirst and inward heat. The pulse is feeble and the breathing shallow, but the intellect remains clear. Death often occurs in this, as in the former type of pernicious malaria, yet vigorous treatment with quinine, iron, and nitre will frequently prove curative in either form. =Black Water Fever.=--Rarely in temperate climates, but frequently in the Southern United States and in the tropics, especially Africa; after a few days of fever, or after chilliness and slight fever, the urine becomes very dark, owing to blood escaping in it. This sometimes appears only periodically, and is often relieved by quinine. It is apparently a malarial fever with an added infection from another cause. =Chagres Fever.=--A severe form of malarial fever acquired on the Isthmus of Panama, apparently a hemorrhagic form of the pernicious variety, and so treated. =Detection.=--To the well-educated physician is now open an exact method of determining the existence of malaria, and of distinguishing it from all similar diseases, by the examination of the patient's blood for the malarial parasite--its presence or absence deciding the presence or absence of the disease. For the layman the following points are offered: intermittency of chills and fever, or of fever alone, should suggest malaria, particularly in a patient living in or coming from a malarial region, or in a previous sufferer from the disease. In such a case treatment with quinine will solve the doubt in most cases, and will do no harm even if the disease be not malaria. Malaria is one of the few diseases which can be cured with certainty by a drug; failure to stop the symptoms by proper amounts of quinine means, in the vast majority of cases, that they are not due to malaria. There are many other diseases in which chills, fever, and sweating occur at intervals, as in poisoning from the presence of suppuration or formation of pus anywhere in the body, but the layman's ignorance will not permit him to recognize these in many instances. The quinine test is the best for him. =Prevention.=--Since the French surgeon, Laveran, discovered the parasite of malaria in 1880, and Manson, in 1896, emphasized the fact that the mosquito is the medium of its communication to man, the way for the extermination of the disease has been plain. "Mosquito engineering" has attained a recognized place. This consists in destroying the abodes of mosquitoes (marshes, ponds, and pools) by drainage and filling, also in the application of petroleum on their surface to destroy the immature mosquitoes. Such work has already led to wonderful results.[11] Open water barrels and water tanks prove a fruitful breeding place for these insects, and should be abolished. The protection of the person from mosquito bites is obtained by proper screening of habitations and the avoidance of unscreened open air, at or after nightfall, when the pests are most in evidence. Dwellings on high grounds are less liable to mosquitoes. Persons entering a malarial region should take from two to three grains of quinine three times a day to kill any malarial parasites which may invade their blood, and should screen doors and windows. Patients after recovery from malaria must prolong the treatment as advised, and renew it each spring and fall for several years thereafter. A malarial patient is a direct menace to his entire neighborhood, if mosquitoes enter. =Treatment.=--The treatment of malaria practically means the use of quinine given in the proper way and in the proper form and dose. Despite popular prejudices against it, quinine is capable of little harm, unless used in large doses for months, and no other remedy has yet succeeded in rivaling it in any way. Quinine is frequently useless from adulteration; this may be avoided by getting it of a reliable drug house and paying a fair price for the best to be had. Neither pills nor tablets of quinine are suitable, as they sometimes pass through the bowels undissolved. The drug should be taken dissolved in water, or, more pleasantly, in starch wafers or gelatin capsules. When the drug is vomited it may be given (in double the dose) dissolved in half a pint of water, as an injection into the bowels, three times daily. Infants of a few months may be treated by rubbing an ointment (containing thirty grains of quinine sulphate mixed with an ounce and a half of lard) well into the skin of the armpits and groins, night and morning. Children under the age of two can be best treated by quinine made into suppositories--little conical bodies of cocoa butter containing two grains each--one being introduced into the bowel, night and morning. During an attack of malaria the discomfort of the chill and fever may be relieved to considerable extent by thirty grains of sodium bromide (adult dose) in water. Hot drinks and hot-water bottles with warm covering may be used during the chill, while cold sponging of the whole naked body will afford comfort during the hot stage. In the pernicious form, attended with unconsciousness, sponging with very cold water, or the use of the cold bath with vigorous friction of the whole body and cold to the head are valuable. The effect of quinine is greatest during the time of birth of a new generation of young parasites in the blood, which corresponds with the time of the malarial attack. But in order that the quinine shall have time to permeate the blood, it must be given two to four hours before the expected chill, and then will probably prevent the next attack but one. A dose of ten grains of quinine sulphate taken three times daily for the first three days of treatment; then a dose of three grains, three times daily for two weeks; and finally two grains, three times daily for the rest of the month of treatment will, in many cases, complete a cure. If the quinine cause much ringing in the ears and deafness, it will be found that sodium bromide taken with the quinine (in twice the dose) dissolved in water, will correct this trouble. If the patient is constipated and the bowel discharges are light colored, a few one-quarter grain doses of calomel may be taken every two hours, and followed in twelve hours by a dose of Epsom salts, on the first day of treatment, with quinine. It is no use to take quinine by the mouth later than two hours before an attack, and if the patient cannot secure treatment before this time, he should take a single dose of twenty grains of quinine. To children may be given a daily amount of quinine equal to one grain for each year of their age. In the severe forms of remittent and pernicious types of malaria it may be necessary for the patient to take as much as thirty grains of quinine every three days or so to cut short the attack. But, unfortunately, the digestion may be so poor that absorption of the drug does not occur, and in such an event the use of quinine in the form of the bisulphate in thirty-grain doses, with five grains of tartaric acid, will in some cases prove effective. Chronic malaria is best treated with small doses of quinine, together with arsenic and iron. A capsule containing two grains of quinine sulphate, one-thirtieth grain of arsenious acid, and two grains of reduced iron should be taken three times daily for several weeks. =YELLOW FEVER.=--This is a disease of tropical and subtropical countries characterized by fever, jaundice, and vomiting (in severe cases vomiting of blood), caused by a special germ or parasite which is communicated to man solely through the agency of the bites of a special mosquito, _Stegomyia fasciata_. =Distribution.=--Yellow fever has always been present in Havana, Rio, Vera Cruz, and other Spanish-American seaports; also on the west coast of Africa. It is frequently epidemic in the tropical ports of the Atlantic in America and Africa, and there have been numerous epidemics in the southern and occasional ones in the northern seacoast cities of the United States. The last epidemic occurred in the South in 1899. Rarely has the disease been introduced into Europe, and it has never spread there except in Spanish ports. The disease is one requiring warm weather, for a temperature under 75° F. is unsuitable to the growth of the special mosquito harboring the yellow-fever parasite. It spreads in the crowded and unsanitary parts of seacoast cities, to which it is brought on vessels by contaminated mosquitoes or yellow-fever patients from the tropics. Havana has heretofore been the source of infection for the United States, but since the disease has been eradicated by the American army of occupation, that danger has been removed. Yellow fever is not at all contagious in the sense that a healthy person can contract the disease by contact with a yellow-fever patient, or with his discharges from the stomach, bowels, or elsewhere, and is probably only communicated to man by the bite of a particular kind of mosquito harboring the yellow-fever organism in its body. Both these facts have been incontestably proved,[12] in part by brave volunteers from the United States Army who submitted to sleep for twenty-one days on clothes soiled with discharges from patients dying of yellow fever, and escaped the disease; and by others living in uncontaminated surroundings who permitted themselves to be bitten by infected mosquitoes and promptly developed yellow fever. =Development.=--After a person has been bitten by an infected mosquito, from fourteen hours to five days and seventeen hours elapse before the development of the first symptoms--usually this period lasts from three to four days. With the appearance of a single case in a region, a period of two weeks must elapse before the development of another case arising from the first one. This follows because a mosquito, after biting a patient, cannot communicate the germ to another person for twelve days, and two days more must elapse before the disease appears in the latter. =Symptoms.=--During the night or morning the patient has a chill (or feels chilly) and experiences discomfort in the stomach, with sometimes nausea and vomiting. There is pain through the forehead and eyes, in the back and thighs, and often in the calves. The face is flushed and slightly swollen--particularly the upper lip--and the eyes are bloodshot, and gradually, in the course of thirty-six hours, the whites become yellowish. This is one of the most distinguishing features of the fever, but is often absent in children. The tongue is coated, there are loss of appetite, lassitude, sore throat, and constipation. In the beginning the temperature ranges from 101° to 103° F., or in severe cases as high as 105° or 106° F., and the pulse from 110 to 120 beats a minute. The fever continues for several days--except in mild cases--but the pulse usually falls before the temperature does. For example, the temperature may rise a degree during the third day to 103° F., while the pulse falls ten or more beats at the same time and may not be over 70 or 80, while the temperature is still elevated. This is another peculiar feature of the disease. Vomiting often increases on the second or third day, and the dreaded "black vomit" may then occur. This presents the appearance of coffee grounds or tarry matter and, while a dangerous symptom, does not by any means presage a fatal ending. The black color is due to altered blood from the stomach, and bleeding sometimes takes place from the nose, throat, gums, and bowels, with black discharges from the latter. The action of the kidneys is usually interfered with, causing diminution in the amount of urine. It is extremely important to pay regard to this feature, because failure of the patient to pass a proper amount of urine calls for prompt action to avert fatal poisoning from retained waste matters in the blood. The normal amount of urine passed in twenty-four hours in health is over three pints, and while not more than two-thirds of this amount could be expected to be passed by a fever patient, yet in yellow fever the passage of urine may be almost or wholly suppressed. The course of the disease varies greatly. In children--especially of the Creoles--it is frequently so mild as to pass unnoticed. In adults the fever may only last a few hours, or two or three days, with gradual recovery from the various symptoms, and yellowness of the skin lasting for some time. This is not seen readily during the stage of fever when the surface is reddened, but at that time may be detected by pressure on the skin for a minute, when the skin will present a yellow hue on removing the finger before the blood returns to the pressure spot. With fall of fever, and abatement of symptoms after two or three days, the patient, instead of going on to recovery may, after a few hours or a day or two, again become very feverish and have vomiting--perhaps of blood or black vomit--yellow skin, feeble pulse, failure of kidney action with suppression of urine, delirium, convulsions, stupor, and death; or may begin to again recover after a few days. Mild fever, slight jaundice, and absence of bleeding are favorable signs; black vomit, high fever, and passage of little urine are unfavorable signs. The death rate is very variable in different epidemics and among different classes; anywhere from fifteen to eighty-five per cent. Among the better classes it is often not greater than ten per cent in private practice. Heavy drinkers and those living in unfavorable surroundings are apt to succumb. =Prevention.=--Yellow fever, like malaria, is a preventable disease, and will one day be only a matter of historic interest. Dr. W. C. Gorgas, U. S. A., during 1901, by ridding Havana of the mosquito carrying the yellow-fever organism through screening barrels and receptacles holding water, and by treating drains, cesspools, etc., with kerosene, succeeded in also eradicating yellow fever from that city, so that in the following year there was not one death from this disease; whereas, before this time, the average yearly mortality had been 751 deaths in Havana. Spread of the disease is controlled by preventing access of mosquitoes to the bodies of living or dead yellow-fever patients; while personal freedom from yellow fever may be secured by avoiding mosquito bites, through protection by screens indoors, and covering exposed parts of the face, hands, and ankles with oil of pennyroyal or spirit of camphor, while outdoors. =Treatment.=--There is unfortunately no special cure known for yellow fever such as we possess in malaria. The patient should be well covered and surrounded with hot-water bags during chill. It is advisable to give a couple of compound cathartic pills or a tablespoonful of castor oil at the start. Two, or at most three, ten-grain doses of phenacetin at three hours intervals will relieve the pain during the early stage. Cracked ice given frequently by the mouth and the application of a mustard paper or paste (one part mustard, three parts flour, mixed with warm water and applied between two layers of thin cotton) over the stomach will serve to allay vomiting. Cold sponging (see Typhoid Fever, p. 232) is the best treatment for fever. The black vomit may be arrested by one-quarter teaspoonful doses of tincture of the chloride of iron, given in four tablespoonfuls of water, every hour after vomiting. The bowels should be moved daily by injection of warm soapsuds. The patient should not rise from his bed, but should use a bedpan or other receptacle. In addition, a pint of warm water, containing one-half teaspoonful of salt, should be injected into the bowel night and morning and, if possible, retained by the patient. The object of the latter is by its absorption to stimulate the action of the kidneys. The diet should consist of milk, diluted with an equal amount of water, broths, gruels, etc., and only soft food should be given for ten days after recovery. Iced champagne in tablespoonful doses at frequent intervals, or two teaspoonful doses of whisky in a little ice water, given every half hour, relieves vomiting and supports the strength. FOOTNOTES: [11] See Volume V, p. 76, for detailed methods.--EDITOR. [12] See Frontispiece, Vol. V. +--------------------------------------------------------------------+ | TRANSCRIBER'S NOTE. | | =================== | | | | The following change was made: | | | | Part II, Chapter II, Typhoid Fever, Symptoms (p. 225) | | | | Original text: | | | | "... flushed face, pulse 100°, gradually increasing as | | described." | | | | Changed to: | | | | "... flushed face, pulse 100, gradually increasing as | | described." | | | | "Pulse 100" was preferred over "temperature 100°". | | | +--------------------------------------------------------------------+ 
17682	----	--------------------------------------------------------------------- Transcriber's Note: In preparing this ebook I have corrected a small number of obvious typographical errors, including the two which are mentioned in the September issue. I have not interrupted the text by marking each, but they are marked in the html version of this text. --------------------------------------------------------------------- _The_ HEALTHY LIFE The Independent Health Magazine VOLUME V JULY-DECEMBER 1913 LONDON GRAHAM HOUSE, TUDOR ST., E.C. INDEX VOLUME V.--JULY-DECEMBER 1913 Ballade of Skyfaring, A, S. Gertrude Ford, 490 Book Reviews, 532 Breathe, On Learning to, Dr J. Stenson Hooker, 630 Camping Out, C.R. Freeman, 438, 480 Care of Cupboards, Florence Daniel, 530 Castles in the Air, E.M. Cobham, 582 Cloud-capped Towers, E.M. Cobham, 626 Correspondence, 504, 533, 580, 658 Cottage Cheese, 658 Curtained Doorways, The, Edgar J. Saxon, 561 Doctor on Doctors, A, 637 Doctor's Reason for Opposing Vaccination, A, Dr J.W. Hodge, 597 Doctors and Health, 633 Fasting, A Significant Case, A. Rabagliati, M.D., 458, 492 Fear and Imagination, E.M. Cobham, 510 Food and the Source of Bodily Energy, 507 Fruit-Oils and Nuts, 659 Futurist Gardening, G.G. Desmond, 451 Health Queries, Dr H. Valentine Knaggs:-- About Sugar, 540; Bad Case of Self-poisoning, 502; Boils, their Cause and Cure, 498; Canary _versus_ Jamaica Bananas, 579; Can Malaria be Prevented? 466; Cereal Food in the Treatment of Neuritis, 619; Correct Blending of Foods, 655; Concerning Cottage Cheese, 617; Deafness, 615, 616; Diet for Obstinate Cough, 618; Diet for Ulcerated Throat, 575; Dilated Heart, 653; Difficulties in Changing to Non-Flesh Diet, 655; Dry Throat, 653; Eczema as a Sign of Returning Health, 613; Excessive Perspiration, 574; Farming and Sciatica, 575; Faulty Food Combinations, 536; Giddiness and Head Trouble, 468; Going to Extremes in the Unfired Diet, 543; Long Standing Gastric Trouble, 470; Malt Extract, 539; Neuritis, 538; Onion Juice as Hair Restorer, 651; Phosphorus and the Nerves, 577; Refined Paraffin as a Constipation Remedy, 652; Saccharine, 653; Stammering, 654; Severe Digestive Catarrh, 471; Sciatica, 651; Temporary "Bright's Disease" and How to Deal with it, 576; Ulceration of the Stomach, 541; Unfired Diet for a Child, 467; Water Grapes, 619; Why the Red Corpuscles are Deficient in Anaemia, 654 Health and Joy in Hand-weaving, Minnie Brown, 591 Health through Reading, Isabella Fyvie Mayo, 517 Healthy Brains, E.M. Cobham, 448, 474, 510, 546, 582 Healthy Homemaking, Florence Daniel, 495, 528 Healthy Life Abroad, D.M. Richardson, 559 Healthy Life Recipes, 462, 571, 610, 641 Hired Help, Florence Daniel, 495, 528 Holiday Aphorisms, Peter Piper, 508, 527 How Much Should We Eat? 442, 477, 513, 563, 593 Human Magnetism, 505 Imagination in Insurance, E.M. Cobham, 546 Imagination in Play, E.M. Cobham, 474 Imagination in Use, E.M. Cobham, 448 Indication, An, Editors, 437, 473, 509, 545, 581, 621 Learning to Breathe, On, Dr J. Stenson Hooker, 630 Letters of a Layman, I., 633 Lime Juice, Pure, 534 Longevity, A Remedy for, Edgar J. Saxon, 491 Mental Healing, A Scientific Basis for, J. Stenson Hooker, M.D., 456 Midsummer Madness, Edgar J. Saxon, 454 Modern Germ Mania: A Case in Point, Dr H.V. Knaggs, 638 More About Two Meals a Day, Wilfred Wellock, 487 New Race, The, S. Gertrude Ford, 601 Ode to the West Wind, Shelley, 555 Pickled Peppercorns, Peter Piper, 464, 570, 609, 660 Plain Words and Coloured Pictures, Edgar J. Saxon, 622 Play Spirit, The, D.M. Richardson, 602 Play Spirit, The: A Criticism, L.E. Hawks, 628 Quest for Beauty, The, Edgar J. Saxon, 523 Recipes, 462, 571, 610, 641 Remedy for Longevity, A, Edgar J. Saxon, 491 Remedy for Sleeplessness, 533 Salads and Salad Dressings, 462 Salt Cooked Vegetables, 506 Swan Song of September, The, S. Gertrude Ford, 523 Sea-sickness, Some Remedies, Hereward Carrington, 484 Semper Fidelis, "A.R.," 526 Sleeplessness, A Remedy, 533 Scientific Basis for Mental Healing, A, J. Stenson Hooker, M.D., 456 Scientific Basis of Vegetalism, The, Prof. H. Labbe, 549, 584 Significant Case, A, A. Rabagliati, M.D., 458, 492 Symposium on Unfired Food, A, D. Godman, 486, 648 Taste or Theory? Arnold Eiloart, B.Sc., 643 Travels in Two Colours, Edgar J. Saxon, 605 To-morrow's Flowers, G.G. Desmond, 451 Two Meals a Day, More About, Wilfred Wellock, 487 Vaccination, A Doctor's Reason for Opposing, Dr J.W. Hodge, 597 Vegetalism, The Scientific Basis of, Prof. H. Labbe, 549, 584 West Wind, Ode to, Shelley, 555 What makes a Holiday? C., 557 World's Wanderers, The, Shelley, 625 THE HEALTHY LIFE The Independent Health Magazine. 3 AMEN CORNER LONDON E.C. VOL. V JULY No. 24. 1913 _There will come a day when physiologists, poets, and philosophers will all speak the same language and understand one another._--CLAUDE BERNARD. AN INDICATION. Some laymen are very fond of deprecating the work of specialists, holding that specialisation tends to narrowness, to inability to see more than one side of a question. It is, of course, true that the specialist tends to "go off at a tangent" on his particular subject, and even to treat with contempt or opposition the views of other specialists who differ from him. But all work that is worth doing is attended by its own peculiar dangers. It is here that the work of the non-specialist comes in. It is for him to compare the opposing views of the specialists, to reveal one in the light thrown by the other, to help into existence the new truth waiting to be born of the meeting of opposites. Specialisation spells division of labour, and apart from division of labour certain great work can never be done. To do away with such division, supposing an impossibility to be possible, would simply mean reversion to the state of the primitive savage. But we have no call to attempt the abolition of even the minutest division of labour. What is necessary is to understand and guard against its dangers. Specialisation _may_ lead to madness, as electricity _may_ lead to death. But no specialist need go far astray who, once in a while, will make an honest attempt to come to an understanding with the man whose views are diametrically opposed to his own. For thus he will retain elasticity of brain, and gain renewed energy for, and perhaps fresh light on, his own problems.--[EDS.] CAMPING OUT. IV. THE FIVE-FOOT SAUSAGE. The question of blankets and mattresses may be taken as settled. We can now sleep quite comfortably, take our fresh air sleeping and waking, and find shelter when it rains. But that same fresh air brings appetite and we must see how that appetite is to be appeased. Take a frying-pan. It should be of aluminium for lightness; though a good stout iron one will help you make good girdle-cakes, if you get it hot and drop the flour paste on it. You must find some other way of making girdle-cakes, and if you take an iron frying pan with you, don't say that I told you to. Though it is obviously necessary that a frying-pan should have a handle, I was bound to tell Gertrude that I do not find it convenient to take handled saucepans when I go camping. I take for all boiling purposes, including the making of tea, what is called a camp-kettle. Most ironmongers of any standing seem to keep it, and those who have it not in stock can show you an illustration of it in their wholesale list. It is just like the pot in which painters carry their paint, except that it has an ordinary saucepan lid. You should have a "nest" of these--that is, three in diminishing sizes going one inside the other. The big lid then fits on the outer one and the two other lids have to be carried separately. [Illustration: _The Five-Foot Sausage_] You hang these camp-kettles over the fire by their bucket handles, from the tripod or other means of getting over the fire. Sometimes the bough of a tree high out of the reach of the flames will do. Sometimes a stick or oar thrust into the bank or in a crevice of the wall behind the fire is more convenient than a tripod. Again, you can do without any hanging at all, making a little fireplace of bricks or stones and standing the saucepans "on the hob." It is a simple thing to tie the tops of three sticks together and make a tripod. Then from the place where they join you dangle a piece of string, pass it through the handle of the kettle and tie it to itself, in a knot that can be adjusted up or down to raise or lower the kettle from the fire. This knot is our old friend the two half-hitches. Pass the loose end round the down cord, letting it come back under the up cord, then round again with the same finish, and lo! the up cord makes two half-hitches round the down cord. You can slip, them up and put them where you like and they will hold, but you have to undo them to take the kettle clean away from the fire. So we add to our equipment a few pot-hooks or pieces of steel wire shaped like an S. Their use will be obvious. If we have three of them it is quite easy to keep three kettles going over one fire. They swing cheek by jowl when they all want the same amount of fire, but each can be raised or lowered an inch or several inches to let them respectively boil, simmer or just keep warm. These are the cooking utensils. A biscuit tin would make an oven and Gertrude says she must have an oven. For my part I would not attempt baking when camping out and I will say no more about ovens, except that all the biscuit tins in the world won't beat a hole in the ground first filled with blazing sticks and then with the things to be baked and covered with turves till they are done. I had great difficulty in persuading Gertrude to feed out of tin dishes like those which we use sometimes for making shallow round cakes or setting the toffee in. They are ever so much better than plates, being deep enough for soup-plates and not easy to upset when you use them on your lap. Any number of the same size will go into one another and a dozen scarcely take up more room than one. It was worse still when it came to a still more useful substitute, the camp equivalent of the teacup. In the first place we abolish the saucer, for the simple reason that we have no earthly use for it in camp. We take tin mugs with sloping sides and wire bucket handles. They fit into one another in the same accommodating way as the eating dishes. Gertrude was nearly put off this device altogether by Basil's remark that he had only seen them in use in poulterers' shops, where they are put under hares' noses.... "Basil, you, you monster," cried Gertrude, and I had to push those tin mugs as though I had been a traveller interested in the sale of them. The drinking of hot tea out of these mugs is quite a beautiful art. You hold the wire handle between finger and thumb and put the little finger at the edge of the bottom rim. It is thus able to tilt the mug to the exact angle which is most convenient for drinking. When Gertrude had learnt the trick, she became perfectly enamoured of the mugs. She sometimes brings one out at ordinary afternoon tea and insists that the tea is ever so much better drunk thus than out of spode. Smaller mugs of the same shape do for egg-cups, and the egg-spoons I take to camp are the bone ones, seldom asked for but easy to get in most oil-and-colour shops. Dessert spoons and forks and table knives are of the usual pattern, but the former can be had in aluminium and therefore much lighter than Britannia metal. The camping-out valise is by all means the rucksack. Never the knapsack. I am almost ashamed to say this, because as far as my knowledge goes the knapsack is now obsolete. It may be, however, that it lingers here and there. If you see one, buy it for a museum if you like but not for use. The bundle should be allowed to fit itself to the back, as it does in a canvas bag. Suppose now that you fix the V point of a pair of braces somewhere near the top of the sack and bringing the webs over your shoulders, fix them, nicely adjusted, to the lower corners of the sack, it will ride quite comfortably upon your back--that is, you have made it from a plain sack into a rucksack or back-sack. Get or make as many good large strong ones as you have shoulders in the party to carry them. Have them made of a waterproof canvas, green or brown, to reeve up tight with strong cord passed through a series of eyelet-holes and, if you would be quite certain of keeping out the rain, with a little hood to cover the reeved bag end. The great bulk of your luggage you will generally find it best to carry by wheeling it on a bicycle. Spread your ground-sheet on the floor. On that lay your blankets, doubled so as to make a smaller square, tent, mattress cover and bed suits on that, then your camping utensils and all other paraphernalia and roll the whole up into a sausage about five feet long, when the loose ends of the ground-sheet have been tucked over as in a brown-paper parcel. Tie it well with whipcord and fasten it to the top bar of your bicycle frame, leaving freedom of course for the handles and the front wheel to move and steer. Push the tent-poles through the lashings and start for your camp at a comfortable four or five miles an hour. You will find it easy to move camp at the rate of twenty miles a day and will see a great deal of country in the course of a fortnight. The sausage on the bicycle shown in the illustration may be taken to contain all the gear and a little food. The rucksacks will take the rest and each man's most precious personal belongings. There is a small parcel tied to the handle-bar, scarcely to be seen because it is smaller than the end of the sausage. It is a complete tent tied up in its ground-sheet. C.R. FREEMAN. HOW MUCH SHOULD WE EAT: A WARNING. _This article, by one of the pioneers of modern dietetics, is in the nature of a challenge, and is certain to arouse discussion among all who have studied the food question closely._--[EDS.] When men lived on their natural food, quantities settled themselves. When a healthy natural appetite had been sated the correct quantity of natural food had been taken. To-day all this is upside down, there is no natural food and only too often no natural healthy appetite either. Thus the question of quantity is often asked and many go wrong over it. The all-sufficient answer to this question is: "Go back to the foods natural to the human animal and this, as well as a countless number of other problems, will settle themselves." But supposing that this cannot be done, suppose, as is often the case, that the animal fed for years on unnatural food has become so pathological that it can no longer take or digest its natural food? Those who take foods which are stimulants are very likely to overeat, and when they leave off their stimulants they are equally likely to underfeed themselves. Flesh foods are such stimulants, for it is possible to intoxicate those quite unaccustomed to them with a large ration of meat just as well as with a large ration of alcohol. The one leads to the other, meat leads to alcohol, alcohol to meat. Taking any stimulant eventually leads to a call for other stimulants. How are we to tell when a given person is getting enough food, either natural or partly natural? Medically speaking, there is no difficulty; there are plenty of guides to the required knowledge, some of them of great delicacy and extreme accuracy. The trouble generally is that these guides are not made use of, as the cause of the disaster is not suspected. A physiologist is not consulted till too late, perhaps till the disorder in the machinery of life is beyond repair. Diminishing energy and power, decreasing endurance, slowing circulation, lessening blood colour, falling temperature, altered blood pressure, enlarging heart and liver, are some of the most obvious signs with which the physician is brought into contact in such cases. But every one of these may, and very often does, pass unnoticed for quite a long time by those who have had no scientific training. The public are extremely ignorant on such matters because the natural sciences have been more neglected in this country in the last fifty years than anywhere else in Europe, and that is saying a good deal. Hence diet quacks and all those who trade on the ignorance and prejudices of the public are having a good time and often employ it in writing the most appalling rubbish in reference to the important subject of nutrition. Being themselves ignorant and without having studied physiology, even in its rudiments, they do not appear to consider that they should at least abstain from teaching others till they have got something certain for themselves. If the public were less ignorant they would soon see through their pretensions; but, as it is, things go from bad to worse, and it is not too much to say that hundreds of lives have been lost down this sordid by-path of human avarice. On one single day a few weeks ago the writer heard of three men, two of whom had been so seriously ill that their lives were in danger, and one of whom had died. The certified cause of death in this case might not have led the uninitiated to suspect chronic starvation, but those who were behind the scenes knew that this was its real cause. A further extraordinary fact was that two out of these three men were members of the medical profession, whose training in physiology ought, one would have thought, to have saved them from such errors. The conclusion seems to be that they did not use their knowledge because at first they had no suspicion of the real cause of their illness. In other words, chronic starvation is insidious and, if no accurate scientific measurements are made, its results, being attributed to other causes, are often allowed to become serious before they are properly treated. These three men went wrong by following a layman quite destitute of physiological training, who APPEARED to have produced some wonderful results in himself and others on extraordinarily small quantities of food. If the above tests had been made at once by a trained hand the error involved in such results could not have escaped detection, and none of these men would have endangered their lives. I myself examined the layman in question and finding him not up to standard refused to follow him. The writer has no difficulty in recalling at least a dozen cases similar to those above mentioned which have been under his care in the last twelve months, and the three above mentioned were none of them under his care at the time of their danger. What, then, must be our conclusions in reference to these and similar facts of which it is only possible to give a mere outline here? I suggest that they are:-- 1. Food quantities are of extreme importance. 2. These quantities were settled by physiologists many years ago, and no good reasons have since been adduced for altering them. 3. The required quantity is approximately nine or ten grains of proteid per day for each pound of bone and muscle in the body weight. 4. Any considerable departure from this quantity continued over months and years leads to disaster. 5. The nature of this disaster may appear to be very various and its real cause is thus frequently overlooked. I will say a few words about each of these except the first, which is already obvious. The layman above mentioned asserted that he could live on but little more than half this quantity, but the food quantity really required is that which will keep up normal strength, normal circulation, normal colour, normal temperature and normal mental power. As we have got perfectly definite standards of all these normal conditions, serious danger can only be run into by neglecting to measure them. It is also possible to tell fairly accurately the quantity of food a man is taking in a day, and then, by collecting and estimating his excreta, the quantity also out of this food which he is utilising completely and burning up in his body. You would say that no danger should be possible with all these safeguards, and yet the above case history shows that of two trained physiologists, members of the medical profession, one died at least twenty years before his time, and the other was in great danger and only recovered slowly and with difficulty. Another similar case came to the writer suffering from increasing debility and what appeared to be some form of dyspepsia. He was quite unable to pass any of the above-named tests as to physiological standards, and an investigation of his excreta showed that his food was at least one-fifth or one-sixth below its proper quantity and had probably been so for many months past. Some of his doctors had been giving his "disease" a more or less long list of names and yet had not noted the one essential fact of chronic defective nutrition and its cause--underfeeding. Naturally their treatment was of no avail, but when he had been sent to a nursing home and had put back the 20 lbs. of weight he had lost he came slowly back to more normal standards and is now out of danger. In this case there was marked loss of weight, and few people, one would think, would overlook such a sign of under nutrition. But loss of weight is not always present in these cases, at least not at first. Some people tend to grow stout on deficient proteid, and then the fact that some of the essential tissues of the body (the muscles, the heart and the blood) are being dangerously impoverished is very likely to be overlooked. In the case last mentioned the loss of weight was put down to the dyspepsia, whereas the real fact was that the "dyspepsia" and loss of weight were both results of a chronic deficiency in food. It is evident that some care about food quantities must be taken by all those who do not live on natural foods. For physiologists there is no difficulty in settling the question of quantity in accordance with the signs of the physiology of a normal body. That all, even physiologists, may run into danger if, while living on unnatural or partly unnatural foods, or while making any change of food, they do not consider the question of quantity with sufficient care. That the question of nutrition should be considered in relation to _every illness_ even though it may appear on the surface to have no direct connection with foods or quantities. As a matter of fact, the nature of the food and its quantity controls all the phenomena of life. Some twenty years ago most people lived fairly close to the old physiological quantities, now they have been cut adrift from these and completely unsettled and are floundering out of their depth. A most unsatisfactory, even dangerous, condition of affairs. For the public it will now probably suffice if they insist on raising the question of quantity whenever they suffer in any way. If they are unable to answer the question themselves let them go to a trained physiologist who can do so, and not to a diet quack. But muscular strength, endurance, mental and bodily energy, skin circulation, temperature and blood colour are all things which the public can see for themselves and from which they should in all cases be able to get sufficient warning to save them from the worst forms of disaster. Some people imagine that they eat very little, when as a matter of fact they have good healthy appetites. Others again think they are eating a great deal, when as a matter of fact they take very little. In both cases a physiological test of the excreta will give accurate information. I once had a medical patient who imagined that he produced great amounts of force and performed feats of endurance on wonderfully small quantities of food. His excreta showed, however, that he was merely under-estimating the food he took. A fat man may seem to be living on very little, but fat does not require to be fed, and his real bone and muscle weight is not large. A thin man may seem to require a large quantity of food, but he is really very heavy in bone and muscle, the tissues that have to be nourished. In all these ways appearances are apt to be deceptive for those who are ignorant of science and who do not go down to the root of the matter. It is not necessary to follow the given quantity of grains per pound slavishly and without regard to consequences. It is necessary to see that the required physiological results are obtained. If a patient says he can live on less than I ordered for him and if he can pass the physiological tests satisfactorily I know that his bone and muscle weight has been over-estimated. On the other hand, if a patient falls below the physiological tests, though taking and digesting the quantities ordered for him, I conclude that his bone and muscle weight has been under-estimated. In all cases it is possible to obtain the best physiological results and to say when quantities are just right, neither too much nor too little. The evil effects of too much are not serious; they entail perhaps a little "gout" or some temporary loss of freedom from waste products. The evil effects of too little, if persevered in and continued, especially if some of these effects are attributed to causes which have no real existence, are deadly and dangerous, for they bring on an insidious deterioration both of function and structure which leads by several avenues, often miscalled "diseases," to death itself. M.D. HEALTHY BRAINS. _Comparatively few health enthusiasts or food reformers realise the necessity for mental, as distinct from bodily, hygiene, yet all real health has its roots in the mind. Moreover, it is only by studying the hygiene of mind that we are enabled to do work in greater quantity and of better quality than we should otherwise be capable of, and to do this without risk of strain on the nerves or injury to health. The articles under this heading put forward some of the elementary laws of mental hygiene._--[EDS.] IMAGINATION IN USE. To some people any talk about the importance of training the imagination of children through their toys, games and studies seems fantastic and trivial. They compare it to feeding them on sweetmeats; they think it means substituting story books for real life and encouraging the easy exercise of fancy for the careful study of fact. But imagination is not a mere ornament to a life-work; it is rather one of its most valuable and necessary tools. If it did no more than sweeten and adorn the world, it would be well worth having, well worth making considerable sacrifices to attain. But it does more than this. It bears much fruit as well as flowers; fruit that, if it ripens in suitable weather, endures and can be used for the service of man. There is a wonderful palm-tree, called the Tal or Palmyra palm, which in India and Ceylon supports six or seven millions of people, and "works" also in West Africa, where it is probably native. It gives its young shoots and unripe seeds as food; its trunk makes a whole boat, or a drum or a walking-stick, according to size; hats, mats, thread and baskets--in fact, almost all kinds of clothing and utensils--are made from the split and plaited leaves; gum comes from it, and certain medicines, jaggery sugar too and an intoxicating drink for those who desire it. In one of the museums at Kew--a wet day brings always _something_ besides disappointment--there is a book made up of the very leaves of the palm, containing a Tamil poem enumerating more than eight hundred human uses to which this marvellous single plant can be put. Now the imagination is like a Palmyra palm. We stand a long way off and, looking up, say "What a graceful tree! But what a pity it produces that intoxicating 'toddy' and nothing else!" Yet all the while food and clothing and shelter and travel and learning are all wrapped up in it, if only we were not too ignorant to guess, or too idle to seek. We talk as if the poet and painter had need of imagination, but not the student, the doctor, the philanthropist, the business man, whereas none of these can do work at a really human standard without imagination that is living, penetrating, active and yet trained and disciplined. A recent illuminating address to a body of students pointed out that Germany's immense industrial strides have been made possible by an education which draws men's minds out of narrow old grooves, and helps them to see and grasp wider possibilities. But the same speaker went on to point out that the English worker has far more real initiative and imagination than the German, and that in our own country we have not even to make elaborate plans for developing these qualities, but rather to release them in our administrators so far as to prevent actually checking them in the children now growing up. Imagination in business, for instance, means new possibilities, fresh sources of supply and fresh markets to demand, economy of working and better adjustment of work to worker, so as to have less waste of our greatest capital, human time and power. America has taught us something in these respects; what we must do is to take what new light she has developed, while keeping our long-grown, well-earned skill which she has not had the chance to make. In research work, again, we need perpetually the synthetic and constructive imagination if individual work is not to become narrowly specialised and shut off from other divergent or parallel lines which would illuminate it. The other day I was told of a great surgeon who not only has six or seven assistants to help him in his immediate tasks, but also, since he is too busy in the service of humanity to have time for reading, has eight trained assistants whose business it is to read in many languages what is being done all over the civilised world in his own line, and keep him informed as to the development of experience. A wonderful advance on the crystallisation of individual method, this, and yet it needed but the imaginative projection upon scientific work of what every business firm and every political unit has long done. To transfer to our own concerns a method developed elsewhere is one of the most valuable services imagination can render. Almost all educational reform comes about thus, most mechanical inventions, a great part of economy and comfort in individual homes. Also, besides these particular advantages, the incessant coming and going between the different fields of activity, the circulation of attention which this use of the imagination involves, tends to vitalise and enrich not only the individuals who carry it out, but the whole social organism of which they form part. Upon the moral side not much need be said. "Put yourself in his place" is a very old and respectable recipe for growing justice in one's conduct, consideration in one's speech, sympathy in one's heart. As employer or magistrate, as teacher or nurse, as customer or shopman, as parent or husband or child we must all deal somehow with our fellow-men: honestly and truthfully, we mean, kindly and helpfully, we hope. But is it not the more or the less of our imagination that makes such dealings possible? Without it, we are cruel because of something we do not feel, unjust because there is something we do not know, unwittingly deceitful because there is something we do not understand. With it, our justice will support, our kindness uplift, our attempt at help will not be barren, but will awake response and raise the whole level of our human intercourse into a region of higher possibilities. E.M. COBHAM. FUTURIST GARDENING. TO-MORROW'S FLOWERS. These three months of July, August and September are the second seed-time. I think they must be the most proper sowing-time, for is it not clear that Nature sows seed, not in spring, but in autumn? At any rate, now we can do more towards making a perpetually beautiful flower garden than in any other season. The biennials, those that blossom in their second year of life and those jolly perennials that come up year after year and always stronger than before, without any trouble on our part, are best started in life not too long before the winter. Spring-sown seed sometimes forgets that it is biennial and blossoms rather futilely the same summer, and at other times it grows so lush and large by winter that it cannot stand the frost. Now we see the flowers in blossom in the vineyards of our friend Naboth and we know which we should most like in our own garden. There is an exquisite joy in begging or stealing a few seeds and bringing them home to blossom for us as they did for Naboth. I carry at this time a few small envelopes bought for a few pence a hundred at Straker's, and whenever I see something nice in seed I bag it. In another week it would drop beneath the plant it grew on and, not being cared for by a gardener, would be smothered or hoed up. In a nice little seed-bed all to itself it can unfold all manner of pleasure for its abductor. Plant your flower seeds on a nice ripe, rich bed--that is, one compounded of old and even half-used manure. Keep the seedlings watered as they grow and by judicious pricking-out give them the room they need. About October you can plant the best of them in the place where you want a good bush next year, and, if it is a perennial, you have for many years to come a beautiful plant with a personal history. Even if you have bought your penn'orth of seed there may be a pleasant anecdote connected with it. My garden is at present amazingly blue with Dropmore Alkanet (Anchusa). Three years ago I bought three seeds for a penny. Two of them came up. I slashed up the plants and now I have half-a-dozen clumps as well as a similar number left in the old garden whence I have removed. If you asked me what kinds of seed in particular you ought to plant for perennial flowers just now, I might want many more pages to tell you in. Let me give you a very short list of those that most appeal to me on the spur of the moment. It will be enough to go on with:-- Trollius (globe flower). Helianthemum (rock rose). Epilobium (willow herb). Hollyhock. Echinops (globe thistle). Anchusa Italica, Dropmore variety. Lupine. Tritoma (red-hot poker). Heuchera (coral-root). Yarrow. Lychnis (garden campion). Inula (Elecampane). Funkia (Plaintain lily). Eremurus. This list is representative because it includes some species, such as Eremurus, Trollius and Tritoma, that are not usually grown from seed by the amateur. To raise these rather expensive monsters from pennyworths of seed is a floral adventure which brings its own abundant reward. I should be very proud of a garden that consisted entirely of plants that I had raised from seed. It might be one that had never had anything else in or the seedlings might gradually oust the bulbs and corms and grown plants with which the garden began. There would be many things there intrinsically as well as extrinsically valuable. Carnation seed, for example, is constantly producing new varieties, and to grow rose seedlings is even to court fortune. It is a long time before you see your rose. The seed takes sometimes two years to germinate, and then you have to wait a year or two before you get a typical blossom. The growers hurry matters by cutting a very tiny bud from the first sprout and splicing that on to an older stock. One of the advantages of having your roses grown from seed and on their own stocks would be that they could not produce wild suckers. I have just seen a wonderful grove of Aquilegias, the glorified columbine which has the centre of one colour and the outside petals of another--sulphur with mauve or yellow with pink, and many other varieties. The nucleus was grown from shop seed and the rest from the seed of the first-comers. The only thing to choose between them is that the new ones have produced a least one variety not represented in the first batch. You may be sure that I am going to get some seed from here and raise some Aquilegias for myself. Good reader, go thou and do likewise. G.G. DESMOND. MIDSUMMER MADNESS. We had come, "3.7" and I, to the Boundary, a white, unpaved road which winds across the full width of Wimbledon Common, from the old Roman camp to the windmill. Simultaneously we cried a halt, I because I never cross that road without some hesitation, he because he wanted to get out of the folding go-cart in which he had been riding and turn it, with the aid of a small piece of string and a big piece of imagination, into a 40-horse-power motor car. On the map the road is not called the Boundary. If you want to know why I call it so I can only say that once you have crossed it things are different; I do not mean a difference merely of country or scenery, but a difference of atmosphere; better, and more literally, a change of spirit. To put it bluntly, I never knew the reality of fairyland until I blundered across that road one grey gusty evening ten years ago, and heard the tall grasses whistling in the wind. Since then the road has always been a frontier, not to be crossed without preparation. As "3.7" tumbled out of his go-cart I looked at my watch and saw it lacked but a few minutes to noon. It was just such a cloudless June day as must have inspired Shelley's _Hymn of Apollo_. No smallest cloud to break the dazzling blue; and, high above our heads, Apollo, standing "at noon upon the peak of heaven." If it had been Midsummer Day I should have thought twice about crossing the Boundary. As it was, we were quite near enough to the 24th of June to make it risky. So, as "3.7" bent a tangled head over the bonnet of his Daimler, I flung myself down on the level turf beside him and stared across the road. Behind us and on either side were clumps of gorse bushes, and beyond them the immense level expanse of the open heath. Immediately in front was the road, sunk a foot beneath the turf, which comes right up to it, both on this side and that. "Another piece of string, please," said "3.7," rummaging in my pockets without waiting for an answer, "and a pencil, and----" And then I saw it. On the farther side of the road there is a stretch of short turf, some hundred yards wide; and beyond that an irregular line of silver birches; and beyond that the blue of distant hills, for the Common slopes down where the trees begin. Between the silvery wood and the road, through the midst of the wide belt of turf, and parallel with the Boundary, ran a river. There was nothing to be much surprised at, for it was just the kind of river you would expect to see running through the fields of fairyland. It was a river of grass. It was the slender-stalked, tufted, not very tall, grey-headed grass that grows quite generally in open country and wild places. But the wind and the sun now turned it into a river which ran fast between its banks of green, its waves silvery grey, quick-flowing waves, gleaming and dappled, an endless succession. It flowed from somewhere out of sight in the west, and disappeared to the east over the edge of the great slope that brings you down to the woods, vanishing, to all intents and purposes, over the edge of the world. Without taking my eyes off this astonishing spectacle I stretched out a hand and, catching "3.7" by the edge of his white smock, told him to run across the road to the grass and--paddle in it. I said it was better than motor cars. He made no comment on this but, after glancing warily up and down the road (for he has been brought up in wholesome awe of the entire tribe of automobiles), he crossed the Boundary, ran across the turf and plunged up to his knees in the river. I cannot be certain, but it is my considered opinion that Apollo stopped his golden chariot for the space of a whole minute to look down at the golden-haired boy wading in that noiseless, fast-flowing river. In another minute "3.7" was back at my side, both hands full of the tufted grass he had pulled. I regret to say he tickled my ear with it. * * * * * Honest, solemn reader, ardent food reformer, keen educationist, clear-headed moralist, practical-minded housewife, I tell you frankly there is no moral to this little episode. It throws no light on what to eat, or on the purchasing power of an English shilling, or on the ethical training of young children, or on the nature of neurasthenia. Fairyland, of course, is a childish fiction, Apollo a solar myth, a road is a road, grass is grass and heaven is a state of mind. I quite agree with you. But let me whisper something in your ear. If you should ever blunder across your Boundary, don't be surprised if things look queer on the other side; above all, whatever you do, don't let any strange river you may find flowing there carry you away, or it may bring you, spite of all your protests, through one of the gates of pearl into the City of God. EDGAR J. SAXON. A SCIENTIFIC BASIS FOR MENTAL HEALING. There is a vast amount of loose talk, and innumerable assertions from irresponsible individuals concerning the wonders that have been achieved by Mental Healing, but naturally the scientist and physician, when dealing with such a question as this, has to put aside, not all enthusiasm, but certainly all emotionalism, and then, most carefully sift the evidence laid before him. The scientist here wants hard, dry, irrefutable facts; the responsible physician requires to know--by his own careful diagnosis or by an array of tabulated facts--the condition of the patient before and after treatment--that is, of the one who claims to have been cured by mental means. Innumerable claims are thus being made by patients and others, so that it is imperative for the unbiased physician at all events to consider the above question; this in order to give a reason for the faith that is in him, when he is known to be one of those who favour the metaphysical means of healing. Even the sciolist in the matter knows that in the case, say, of blushing, or blanching of the face, the action of mind over matter--of the body--is palpable; all admit that the quality of joy, for instance, will prove a splendid tonic; that despair, on the other hand, will pull down the bodily condition. But all this, we shall be told, is unconscious action; true, but fortunately we are now aware that by a forceful action of the will we can _consciously_ direct or derivate, as the case may be, currents of nerve-force to any part of the body. Occultists have known this for many centuries. Joy, hope, faith: these are very potent factors in improving the health conditions--simply because they act upon the sympathetic nervous system, and this latter acts upon the circulation. Happiness dilates the blood-vessels. Fear contracts them. Thus, unbounded faith; renewed hope; sudden joy; enforced will-power; all have a marked effect upon bringing about an equilibriated condition of the circulation--just the same as a hot bath does, though not so rapidly or so perceptibly. Further, we must remember that all disease more or less is a stasis, a congestion, somewhere; we have only to dissipate this; to separate the cells; to expand the part, as it were, and "resolution," as we call it in congestion of the lungs, takes place. So that it seems to me that we can fairly claim a strictly scientific basis for Mental Healing. I have always, however, maintained that the attitude of the patient's own mind has much to do with the result: in his consciousness there must be faith and hope in order to get the best effect. Judging, then, of the very remarkable and palpable changes which anyone can see occur on such superficial parts as the face and extremities, I can see no reason that, by an enforced mental action, the deeper parts--including any hidden diseased part--should not be altered for good. I am very confident that it is upon these lines, coupled, as they can always be, with advice as to clean feeding and right living generally, the physician of the future will largely depend for his cures. Thus we are fully justified in not only trying the system on "functional," but also for "organic," cases. J. STENSON HOOKER, M.D. A SIGNIFICANT CASE. ACCOUNT OF A FAST, UNDERTAKEN FOR THE CURE OF A PROFOUND BLOOD DISEASE. The following account of a fast is worthy of attention. It is rigidly accurate _in principle_, as far as I could make it so, and I am responsible for its truthfulness. But the subject of it, feeling that he is engaged in a duty and "labour of love," as he expresses it, is yet naturally anxious to prevent his identity from being discovered; and so, while the facts of the narrative are true in principle they have been varied in a few details for the purpose of preventing the recognition of the subject of them. They occurred in the history of a man of about 40 years of age, who fell ill of an infectious disease some 20 years ago, while living abroad. The exact time of the infection is not known. The patient was treated by qualified doctors living in the same country as himself, and there is no reason to believe that he was not properly and skilfully treated. He had, however, for years buoyed himself up with the hope that he should be able to come to England for the best treatment, and recently he found himself in this country for that purpose. It goes without saying that the eminent men consulted treated him after the most modern and approved methods, which were also, so far as knowledge goes, the most likely to benefit him. Not only as to treatment must it be assumed that the best was done, but the diagnosis also is supported by the authority of the doctors seen, and was confirmed by physiological and pathological investigation. This would be recognised if it were possible to publish names, places and dates which are withheld from the courteous reader for the reason already given. I can only say that I entirely concur in the diagnosis and in the suitability of the treatment. The man came under my care on a Sunday, the fast, which is the subject matter of this communication, having been commenced on the Friday six weeks before that day, the last food having been taken on the Thursday at 5 P.M. I saw him, therefore, on the forty-fifth day of the fast. His pulse was 59, soft, steady, regular. Temp. 96.8 degrees, about 11 A.M. He was able to be up, and walked actively, all his bodily movements being active and his mind quite clear and rational. His weight on the day after I first saw him was, in the same clothes as when weighed at the beginning of the fast, 129+1/2 lbs. He said he weighed 171 lbs. on the machine at the commencement, and therefore the loss of bodily weight up to that time was 41.5 lbs. The average loss of weight during the 46 days of the fast was about nine-tenths of a pound daily if the 41.5 lbs. loss is divided by the 46 days of the continuance of the fast up to that time--41.5/46=.9 lbs. almost exactly. When he came to my consulting room on the forty-sixth day, about 2.15 P.M., the pulse was 64, temp. 95.6 degrees (thermometer 3 minutes under tongue). He was much troubled with a nasty expectoration of mucus. His breath was very offensive. No enlarged glands could be felt in either groin--perhaps a trifling enlargement in the right. In middle of front border of right tibia a little irregularity is felt, and a small hollow, which he thinks is filling up; but it might be that the exudation on the bone immediately above and below the hollow is somewhat reduced, as this would equally give the suggestion that the hollow is filling up. There is a similar but rather smaller irregularity on the left tibia also. He felt rather weak that day, which he attributed to not having had his usual walk the day before. The nasal cavity consists of a large grey septumless cavern showing dry crusts. The issuing breath is most offensive. Patient had drunk freely of water, he said, to the extent of 4 or 5 quarts a day during the fast but when I said--do you mean that you have been taking over a gallon of water daily?--he rather hesitated, and did not think it was so much as that. He had not measured it and had taken it cold usually, though occasionally hot, and had taken it without stint as he wanted it. On the forty-eighth day of the fast he complained of being weak but worst of all, he said, his breath was very offensive to himself. It was so to me also--faint, fetid, putrid. His sense of smell was greatly impaired, so much so that he could not smell the offensiveness of the bowel-excreta which came away every day on using the gravitation-enema, and which were horrible to by-standers. It would seem from this as if his distress at the bad smell of his breath was probably due to a perversion of the sense of smell, which can be easily understood if we reflect that the disease-process was going on in the region where the smell-apparatus is specially located. The temperature was 96.2 degrees that morning the patient said. At 2 P.M. when I saw him the pulse was 68, regular, even, steady. He says he was feverish last night. I suppose he felt hot. He sleeps well, but says he hears the clogs of the mill-hands as they go to their work in the mornings. Has lost 2 lbs. weight in last 2 days. Temp. 93.6 degrees to my observation 2.30 P.M. Says he feels "done at the stomach." His voice is poor. Expectorates somewhat freely. A small blob of green thickish mucus in ordinary white mucus came away in my presence. Urine acid 1010. No glucose. Faint trace of albumin to heat and picric acid: also to nitric acid. The right lachrymal punctum is blocked; the tears run down the cheek; and I failed to get even a hair-thick wire into it. Evening, pulse 65, temp. 97.2 degrees in bed with hot-water bottle. Faeces most offensive, no bowel-excreta coming away except to enema. Forty-ninth day. In bed, temp. 97.2 degrees, pulse 65, soft, steady, regular. No great emaciation of limbs. Showed me some green expectoration. He says it is from Salvarsan as it is exactly like what he was injected with! The motion to the enema as offensive as before, but the breath is less offensive to me: not so fetid. On this day patient completed 7 weeks of fasting. Feels sick and as if he would vomit. About midday he did vomit about a teaspoonful of dark green stuff, very bitter and acid (bile, I should call it, though he calls it "pure citric acid") and immediately after that he got rid of a motion without the use of the enema, brown, dark and very offensive still. I think the breath, however, is rather less offensive; and so I thought also two days ago. Temp. 97, pulse 67, soft, steady, regular; about 1.30 P.M. In bed since fiftieth day of fast. Not feeling very ill and not specially emaciated, though the buttocks are thinning; but legs and thighs and arms and forearms not specially thin. He came to me to be weighed on the forty-ninth day and weighed 127+1/2 lbs. Fifty-second day of fast. Still in bed. Condition much the same as to pulse, temperature, etc., and as to emaciation so far as observation goes. Remained in bed, not because unable to be up, but because he thought it would be better for him to be resting. On the fifty-fourth day, as he still felt sick, I gave him, at his request, an emetic in the form of 10 grains of copper-sulphate. This was followed by sickness after about an hour, when he got rid of a very little of the same green stuff as before. Bile? But the difficulty is to understand how, after all this time of fasting, he should still feel sick and with inclination to vomit. On the fifty-fifth and fifty-sixth days of the fast he remained in bed, the condition being much the same. On Thursday, the fifty-sixth day, he broke the fast at 5 P.M., just 8 weeks after beginning it. He had meant to go on for 60 days, and I did not think that there would have been any danger in his doing so; but I did not press him to continue any longer. He took 3 oranges on that day; and on the Friday he took 5 more. I advised him not to increase the quantity of food too quickly. The breath has been quite sweet during the last two days. He has been too weak to take enemata, so we cannot say if motions would still have been offensive. And as there is no weighing machine in his room, we don't know the exact loss of weight sustained during the fast, though there is no reason to think that it has averaged more than .9 lb. a day. Up to the time of stopping the enemata, pieces of mucous membrane and mucus itself came away from the bowel, and the motions were very offensive. He seems to have a mucous enteritis without fever. On the fourth day after breaking the fast, patient took 6 oranges, 4 apples and a banana; and he ordered much more food, which, however, I advised him not to take. On this day his bowels were opened naturally, with a very offensive motion. But the breath was much sweeter, in fact not offensive at all. On the sixth day he came to my consulting-room and weighed 128 lbs. Pulse 80, soft, steady, regular. He had not slept all night and had had to be up no fewer than 6 times to have his bowels opened. No diarrhoea, he said, but full motions, the first 3 very offensive. Breath not offensive. Has dry pharyngitis and is complaining of sore throat. Next day. Weight 133 lbs. Bowels acted again, 1 A.M., 3 A.M., 6 A.M., 9 A.M. and 1 P.M. Large motions. I told him I thought he was taking too much food. Pulse 104. Not sleeping well. Complained of sore throat. Eighth day. Weight 138 lbs., a gain of 5 lbs. a day for 2 days. Pulse 80 at 7 A.M. (his own statement), at 2.30 P.M. pulse 100, temp. 99.4 degrees. Bowels acted at 12 midnight, 3.30 A.M. and about 11 A.M. Went that day to have his photograph taken. The throat was better. Tongue dry and leathery. It was plain to me that he was taking too much food. He was having a mixed diet and taking much and often. He said his "mouth was coming to pieces," and in fact the mucous membrane was glazed and peeling; also the lips. On the ninth day he returned home. The loss of weight can be seen from the following statement. On commencing the fast the weight was 171 lbs. First day weight was 171 lbs. Sixth day " " 165+1/2 " Seventh day " " 163+1/2 " Twelfth day " " 158 " Fifteenth day " " 155+1/2 " Eighteenth day " " 150+1/2 " Twenty-fifth day " " 142+1/2 " Forty-seventh day " " 129+1/2 " Forty-ninth day " " 127+1/2 " Fast ended on fifty-sixth day. On the sixth day after breaking the fast the weight was 128 lbs. On the next day it had risen to 133 lbs. and on the following day to 138 lbs. In the first 47 days of the fast the loss of weight was 43.5 lbs., or an average loss of .888 lbs. daily (43.5/49=.888 lbs.) The loss of weight for the last 8 days before the fast was broken is not known as patient was in bed, though it probably was at much the same rate as during the other times of the fast when the weight was taken on the scales. The following comparative measurements are interesting. Of course he had been eating for a week after the termination of his fast, so that the measurements taken on that day would be higher probably than if they had been taken seven days before, when he broke the fast. BODILY MEASUREMENTS. _At Commencement_ _At Termination_ _of Fast._ _of Fast._ Forearm 11 inches 9+5/8 inches Arm 11+1/2 " 8+3/4 " Hips 38 " 32+1/2 " Thigh 21+1/4 " 16 " Pelvis 37+1/2 " 30+1/2 " Calf[1] 15+1/4 " 13+1/2 " Neck 14+1/2 " 12+1/2 " Chest 38 " 31+1/4 to 34+1/2 " [1] There was a bundle of varicose veins behind right calf. Patient kept a diary during his fast, but it does not seem necessary to reproduce its statements here. It shows that he walked about during the time, notes the state of the weather as foggy or very foggy or freezing, mentions that water was taken, sometimes hot apparently, as on 15th March, "after glass of hot water, pulse 70, temperature 98+1/2 degrees." No doubt drinking the hot water had elevated temporarily the mouth-temperature, as it does. The diary also notes that he felt weak, had a bath, or did not have a bath, notes the pulse-rate, etc., as also the effects of the daily enemata. On the twenty-ninth day of the fast he took a bottle of Apenta Water. Such are samples of statements from the diary. A. RABAGLIATI, M.A., M.D. _The remainder of this article deals with conclusions of great interest and value, and will appear in our next issue._--[EDS.] HEALTHY LIFE RECIPES. SALADS AND SALAD DRESSINGS. For salads it is not necessary to depend entirely upon the usual salad vegetables such as lettuce, watercress, mustard and cress. The very finely shredded hearts of raw brussel sprouts are excellent, and even the heart of a savoy cabbage. Then the finely chopped inside sticks of a tender head of celery are very good; also young spinach leaves, dandelion leaves, endive, sorrel and young nasturtium leaves. Then there are the onion family (for those who can take them), the tender kinds, such as spring onion, chive and shallot being very good when chopped finely and used as a minor ingredient in any salad. The root vegetables should also be added in their season, raw carrot, turnip, beet, artichoke and leek, all finely grated. A taste for all the above-mentioned vegetables, eaten raw, is not acquired all at once. It is best to begin by making the salad of the ingredients usually preferred and mixing in a small quantity of one or two of the new ingredients. For those who find salads very difficult to digest, it is best to begin with French or cabbage lettuce and skinned tomatoes only, or, as an alternative, a saucerful of watercress chopped very finely, as one chops parsley. Any salad, however made up, should be served in as dainty and pleasing a fashion as possible. It is, perhaps, usually best to serve it ready chopped and shredded, and to allow each person at the table to take his or her own helping of "dressing." English people seldom serve salad in the French fashion--that is, quite dry, save that the dressing is well mixed in an hour before the meal. Readers who have been to France may have seen French peasant women whirling a wire salad-basket round their heads in order to dry the materials after the cleansing has been done. When dry, the green-stuff is torn with the hands, the dressing (and the French know all about salad dressings) is added and the whole allowed to stand some little time, so that by the time the meal is served there is a complete blending of all flavours. Not everyone likes this method; but it is certainly better than the customary method here, which too often leaves a little puddle of water at the bottom of the bowl. There are many ways of preparing good salad dressing without resort to vinegar, salt and pepper. The two prime necessities are (1) really good oil and (2) some kind of fresh fruit juice. Most people prefer lemon juice or the juice of fresh West Indian limes, well mixed into either olive oil, nut oil or a blended oil such as the "Protoid Fruit Oil" or Mapleton's Salad Oil. The ordinary "salad oils" obtainable at grocers are seldom to be recommended; they almost invariably contain chemical preservatives and other adulterants. It is better to have the best oil and use it sparingly if need be, than take any faked product just because it is cheap. With most people the addition of pure oil assists the digestion of the salad, as well as serving other purposes in the body. Many excellent salad recipes and suggestions for novel yet simple "dressings" will be found in _Unfired Food in Practice_, by Stanley Gibbon.[2] [2] 1s. net; 1s. 1+1/2d. post paid, from the office of _The Healthy Life_, 3 Amen Corner, London, E.C. PICKLED PEPPERCORNS. _This, which is a regular feature of THE HEALTHY LIFE, is not intended as a household guide or home-notes column, but rather as an inconsequent commentary on current thought._--[EDS.] An interesting booklet by Raymond Blathwayt with samples of Bath Mustard will be sent free on application to J. & J. Colman, Ltd. (Dept. 49) Norwich.--Advt. in _Punch_. Rumours are also afloat that G.K. Chesterton has written a brilliant booklet on Eiffel Tower Lemonade, and that the Attorney General has been commissioned to write a highly interesting brochure on American macaroni. * * * * * "I enclose you a photo of my baby, Willie, aged fifteen months. He was given up by two doctors, and then I consulted another, who advised me to try ----'s Food, which I did, and he is still having it. You can see what a fine healthy boy he is now, and his flesh is as hard as iron."--From an advt. in _Lady's Companion_. Evidently a case of advanced arterio-sclerosis. * * * * * HEALTH BISCUITS. Nice and Tasty, handled by our 55 salesmen daily.--Advt. in _Montreal Daily Star_. One reason, perhaps, why both the public and the sales have declined. * * * * * WHAT WOULD YOU GIVE FOR A PERFECT SKIN? Is 3d. too much? Many perfect skins to-day are traced to a single sample. --Advt. in _Lady's Companion_. The price is reasonable; but I think I would rather see a sample first, wouldn't you? * * * * * OUR SPECIAL FILLING FAST--Headline in _Daily News_. The correct antidote for the well-known "starvation of over-repletion." * * * * * Cold Anniversary Raised Pie and New Potato Salad.--From the _Seventh Anniversary Menu of The Eustace Miles Restaurant_. I am told that one old gentleman, misled by the chef's quite innocent use of adjectives, protested to a waitress that the day was really very warm; also that a youthful wag obliterated the initial C from his menu with a pen-knife and then inquired which was the better vintage, '06 or '09. * * * * * But to contend that there is no difference between a good yellow man and a good white man is like saying that a vegetarian chop of minced peas is like a chop of the chump variety.--_New Witness_. Chop-chop--as the good yellow man might be tempted to say if he came upon this specimen of white wisdom. * * * * * Canvassers can make a very good profit by selling a patent ladies' folding handbag, also wristlet watches.--Advt. in _Daily Mail_. Nevertheless, the only place for a patent lady is a registry office. * * * * * CAKEOMA PUDDING? You cannot know how delicious they are until you have tasted them.--Advt. in _Lady's Companion_. One of the things that would never have occurred to you if you hadn't seen it expressed so clearly. * * * * * SAXON.--How cruel of you. Although I have not the honour of cap and gown, I do possess a Classical Dictionary. If I can help further, write again. Regarding the recipe, it depends upon its nature. Perhaps VERA is the lady to whom you should address your question--_Lady's Companion_. My colleague, Mr Edgar J. Saxon, denies all knowledge of this affair. But I do wish he would be a little more careful in future. PETER PIPER. HEALTH QUERIES. _Under this heading Dr Knaggs deals briefly month by month, and according as space permits, with questions of general interest._ _Correspondents are earnestly requested to write on one side only of the paper, giving full name and address, not for publication, but as a guarantee of good faith. When an answer is required by post a stamped addressed envelope must be enclosed._--[EDS.] CAN MALARIA BE PREVENTED? A. de L. (Lisbon) writes:--For five months I have been a strict "fruitarian," and as I am obliged now to go to Mozambique (Portuguese East Africa) to remain there five rears, I should be much obliged to you if you kindly let me know what I must do to prevent the African fever and biliousness which seem to afflict all Europeans in that part of the world. Any hints you could give me as to maintaining health in such a climate would be most gratefully acknowledged. I do not think that it is possible for any European, whether he adopts fruitarian or ordinary diet, to entirely escape malaria, since it is caused by a minute parasite which is forced into the blood by a certain form of biting mosquito. The parasite will, however, surely gain less hold on one whose blood is clean and pure and whose vital force is strong, than on one who dissipates his strength by partaking of meat, alcohol, tea, coffee and other stimulants, or who otherwise gets his blood into a bad state by faulty diet generally. Therefore, the thing this correspondent should do is to live as much as possible upon the simple frugal fare of the natives. He can take raw coker-nut freely and eat the fresh fruits which grow in this part of Africa. If he can obtain pineapple or papaw he will find these excellent to help him to retain his health and strength in this country. UNFIRED DIET FOR A CHILD: IS IT SUITABLE? Mrs L.B.F. writes:--My husband and I are much interested in _The Healthy Life_, deriving much benefit and good advice from its pages. It is the only magazine, we find, which answers questions that we have long been puzzling over. Reading a work of the "Montessori Method" of training children last night I was disturbed to find I had, according to that book, been feeding my little boy, aged three years, all wrong. It says: "Raw vegetables should not be given to a child and not many cooked ones. Nuts, dates, figs and all dried fruits should be withheld. Soups made with bread, oil, bread and butter, milk, eggs, etc., are the principal foods Dr Montessori recommends. She also advocates the use of sugar." Our boy has nuts, ground and whole, all the fresh fruits and dried ones, salads, brown bread and nut butter, sometimes dairy butter, no milk, his food mostly uncooked, as we ourselves believe in. If Dr Valentine Knaggs would give us his opinion on this I should be very grateful. The boy is healthy, but I notice a slight puffiness below the eyes of late in the morning. Also his temper does not improve as he gets older. Will he be having too much proteid (nuts) for one of his years, or is the temper natural as a result of bad discipline. His father is away all day, and mothers are, as a rule, soft marks, are they not? It is difficult to answer fully a question of this sort, as so much depends on the child's temperament and environment. A frail, delicate child with the promise of high mental development requires a finer and softer grade of nutriment than one of a coarse animal nature with strong, well-developed digestive organs. All healthy children, especially boys (as Mr Saxon will attest!), are full of mischief and restlessness, which it is the duty of a mother or a nurse to divert into right channels.[3] The display of temper is probably an indication of this not being done, though it _may_ be due in part to the raw diet not suiting the child. [3] This correspondent, and all mothers of difficult children, should study the works of Mary Everest Boole, published by C.W. Daniel, Ltd.; also _The Children All Day Long_, by E.M. Cobham.--[EDS.] The advice I would give would be to alter the diet and make it lighter. From my point of view, Dr Montessori has not given sufficient attention to the other side of the diet question, preferring to remain more on the side of orthodoxy. Moreover, her own work has been done in Italy, where a climate prevails which does not call for so free a use of vegetables and salads as is the case in our own cooler and bleaker clime. I suggest, as a beginning, the following diet might be tried, but it is necessarily impossible to guarantee good results unless the cause of the puffy eyes and temper have been definitely located by personal examination:-- _On rising._--A raw ripe apple, finely grated, or simply scraped out with a silver spoon. _Breakfast at 8._--A scrambled egg on a Granose biscuit with a little finely chopped salad or finely grated; raw roots appetisingly served with a dressing of oil, lemon juice and a little honey. This to be followed by an "Ixion" or "P.R." biscuit, with fresh butter. _Dinner at 2._--Home-made cottage cheese, or cream cheese, or a nut meat (served cold out of the tin, or, better still, home-made). Two casserole-cooked vegetables, done with a little fruit juice and lemon to retain colour. This to be followed by a baked apple with cream and a little home-made, unfired pudding made of dried fruits. _Supper at 5._--A slice of "Maltweat" bread, and butter, and a cupful of clear vegetable soup, or some hot water with some lemon juice added, and slightly sweetened with a little honey. GIDDINESS AND HEAD TROUBLE. Mrs L.B.F. also writes:--I sometimes think I must make dietetic mistakes. My husband thinks I am perfectly healthy, so I do not say anything of the giddiness in the morning and after eating, a drowsiness and slight pain at the back of the head and underneath one of my ears. Also under my eyes is on some mornings quite swollen and puffed up. It is not so marked, but I am quite conscious of it. Our diet consists mostly of a salad, with bread or baked potato and cheese or ground nuts or cooked brussels sprouts and a nut meat pie, apple pie and cream, with brown bread and butter, or a raw fruit meal, nuts, apples, grapes, figs, dates and no bread. Two meals a day, first in the morning at eight o'clock, second at two or three in the afternoon. A glass of hot water with lemon at nine P.M., and the same in the morning. I do some exercises night and morning and am out in the fresh air often through the day. We live in the country and I have every chance of keeping myself healthy. Perhaps I should say I do not eat many nuts, finding them rather difficult to digest. Should I use an enema when I feel like this, or wait for natural results? The symptoms of which L.B.F. complains are in all probability due to flatulence and to general disturbances of the digestive process. Perhaps it would be a good plan to make the diet lighter. The nuts could be omitted and cheese or eggs substituted. An evening meal would be helpful. As to the bowels, some senna and camomile tea at bedtime would help to clear them. Unless there is distinct evidence of faecal retention in the colon it is better not to use the enema as a regular thing. _On rising._--A tumblerful of Sanum Tonic Tea made with hot, preferably distilled, water. _Breakfast._--An all-fruit meal consisting of nothing but apples, bananas, grapes, or orange, or any fresh ripe fruit that is in season. _Dinner at 12.30._--A cooked meal consisting of two casserole-cooked vegetables, with grated cheese as a sauce dressing, with some twice-baked or well toasted bakers' bread, followed by a baked apple and cream. (Omit nut meat pie and apple pie.) _Tea meal at 5._--2 oz. of cottage cheese or cream cheese, wholemeal bread and butter, small plateful of finely grated raw roots with an appetising dressing containing some "Protoid Fruit-Oil." _Bedtime._--Tumblerful of hot water (preferably distilled) to which senna leaves and German camomile flowers (very little) have been steeped to infuse; or a cupful of dandelion coffee could be taken if the bowels are regularly acting. LONG-STANDING GASTRIC TROUBLE. W.T. writes:--Having tried a diet, recommended in _The Healthy Life_, for a month I find the nuts and cheese are far too heavy for the apparent weak condition of my stomach, also that the salads and casserole-baked vegetables are too irritating to the membrane of the stomach. I have no desire to return to flesh food and ordinary feeding, which I feel would not be good for me. From eggs I cannot obtain any good results. The continuance of loss of weight is worrying me, being down to eight stone from eleven stone in twelve months. I feel satisfied it is only a question of diet, if I could only strike the correct one. I am naturally most anxious to regain some of my lost strength and weight. I am at present taking bread and butter, cooked fruit, and occasionally an egg, boiled rice, vegetables and a little dried fruit. No matter how light I make my diet I still suffer after every meal with dilated stomach and irregular working of the heart. Blood circulation is still bad and constipation is gradually getting worse. As before stated, I am anxious to succeed with the reformed diet, but I am really at a loss to know which way to proceed to make any progress. As I was in South Africa twenty years, and only returned to England just before this catarrh set in, is the climate here against my progress, do you think? I am so sorry to take up so much of your time, but shall be grateful for any help you can give me which will be greatly appreciated. It is difficult to advise how best to proceed in this case as our correspondent really ought to seek medical advice. Only in this way can he obtain really satisfactory guidance. For without knowing the state of his blood and the organs generally it is impossible to advise correctly. Speaking generally, until salads and casserole-cooked vegetables can be taken freely there can be no possible permanent cure. In many such cases the best way to train the digestive organs into a healthy state is to keep to a diet consisting chiefly of dextrinised cereals, which must be eaten dry, with some vegetables and as little fresh fruit as possible. This to be continued until little by little the raw salad vegetables are found to agree; then the rest is easy. A diet on the following lines would probably be a good temporary measure:-- _Breakfast._--One egg lightly boiled, poached or baked, with two Granose biscuits and fresh butter, eaten dry. _Dinner._--Brusson Jeune bread (one or two rolls) with butter, and small helping of vegetables, cooked at _first_ in the orthodox way. _Supper._--Plateful of boiled rice (cooked dry in the Indian fashion[4]) with a tablespoonful of good malt extract. No sugar, honey, stewed fruit, or dried fruit should be taken until improvement has set in. As little fluid as possible should be taken until the stomach has regained more tone and become more normal in size. [4] See _The Healthy Life Cook Book_. 1s. net (post free, 1s. 1+1/2d.). SEVERE DIGESTIVE CATARRH. Miss S.L.P. writes:--I should like a little help as to diet. I have just had an attack of epidemic influenza with throat trouble, so that I feel very much run down and unfit for a diet too depleting in character. For over four years I have adopted a non-flesh diet on account of a tendency to chronic catarrh of the whole alimentary tract, due to rheumatic tendencies which affect me internally rather than externally. The continuous damp weather has produced much gastric irritation, and frequent acidity. I cannot discover a diet that is convenient and at the same time sufficiently nourishing. I lose flesh on what I take, and I have none to spare, though at one time I was inclined to be stout. My age is forty-eight. I take three meals a day. A light breakfast either of "Maltweat" bread or "P.R." Cracker biscuits and butter, with tomato or fresh fruit or occasionally an egg. For midday meal an egg or milled cheese, or nuts or cream cheese, with a baked potato and a conservatively cooked vegetable. Occasionally I have a little salad and grated carrot, but unless I am better than usual I cannot digest these. The evening meal consists of "Maltweat" bread or "P.R." Cracker biscuits or Granose flakes, with cream cheese. As a child I suffered constantly from colds in the head, but now my troubles are oftener internal. The action of the bowels is irregular. I depend chiefly upon an enema of warm water when constipation is present. I never drink tea, only hot water, or Emprote and water, or occasionally vegetable juices or fruit juices. I find I am better without much fluid. So far as it is possible to judge from this letter, this correspondent is suffering not only from stomach and bowel catarrh, but her condition as a whole is unsatisfactory. The vital force is depleted and the nervous system is not doing efficient work. She needs suitable treatment to remove the acid and toxins with which the system is evidently clogged. This is not an easy task, for as soon as elimination begins trouble arises in the form of influenza or other similar derangements. These are probably little else but attempts on the part of nature to rouse the vital force of the body into action with a view to clearing out the clogging poisons. Waste clearing should be done gradually. The skin should be made to act better by means of home Turkish baths, or by wet-sheet packs. Then mustard poultices can be applied _along the course of the spine_ and massage with suitable manipulations can be applied to the muscles and bones which make up the spine. The daily practising of the excellent and simple breathing and bending exercises described in Muller's _My System for Ladies_[5] will be very helpful. By means such as these the body will be gradually cleared of its poisons, and so the nervous system will be made to do better work. The diet specified can be continued. H. VALENTINE KNAGGS. [5] 2s. 8d. post free from the office of _The Healthy Life_, 3 Amen Corner, London, E.C. * * * * * _May we ask the co-operation of all our readers during the holiday season in the following way. On holidays you are bound to meet fresh people, and make new acquaintances, and even friends. We suggest you purchase a few extra copies of _THE HEALTHY LIFE_ before you start and hand them on to any likely to be interested. People tell us the magazine is its own recommendation. This does not mean that you need not add your own. The circulation grows steadily, but it is far short of what it might easily be if every reader were to gain one fresh reader every month._--[EDS.] MORE APPRECIATIONS. I want to say how very interesting and helpful I find _The Healthy Life_, and it is always a pleasure to buy an extra copy to give to friends, for I always feel it will do them good to read it, and perhaps make regular subscribers of them. H. BARTHOLOMEW, Knebworth. THE HEALTHY LIFE The Independent Health Magazine. 3 AMEN CORNER LONDON E.C. VOL. V AUGUST No. 25. 1913 _There will come a day when physiologists, poets, and philosophers will all speak the same language and understand one another._--CLAUDE BERNARD. AN INDICATION. The pursuit of health, considered from the negative standpoint, is the flight from pain. And pain is the great mystery of life. James Hinton, himself a well-known physician of his time, attempted to solve the mystery of pain by showing that it is the accompaniment of imperfection. That what is now experienced as pain might be exquisite pleasure given a higher stage of human development. But this, after all, only shifts the mystery one step farther. Instead of the mystery of pain we have the mystery of imperfection. Yet to image perfection is always to image something incapable of growth or further development. Take, for example, a perfect circle. So long as it remains unbroken, flawless, the line (or infinite number of lines) composing it cannot be continued or extended. But given a break in the line and it may be continued round and round, up and up (or down and down) into an infinitely ascending spiral. This possibility of extension depends on a break, on an imperfection. It does not follow, of course, that every flaw in human nature is always the starting-point of new growth, every failure a stepping-stone to greater knowledge, but the possibility is there. It is for men to see that they do not neglect their opportunities.--[EDS.] IMAGINATION IN PLAY. _Regular readers will recognise in this wonderfully simple and suggestive article a continuation of the series previously entitled "Healthy Brains." The author of "The Children All Day Long" is an intimate disciple of one of the greatest living psychologists, and she has a message of the first importance to all who realise that true health depends as much on poise of mind as on physical fitness._--[EDS.] The fruit of imagination ripens into deeds actually done in the service of man: its flower brightens the whole of life and makes it fragrant, from the budding-time of children's play and laughter to the developed blossoms of the creative imagination which we call painting or poetry or music. Play and art have this in common, that they are activities pursued for the sake of the activity itself, not as a means to any other object, not aiming at any material usefulness. Actually, of course, there is nothing more useful, on every scale of usefulness, than the development of the individual in art or play, but these would never be really themselves while an ulterior purpose formed a background to them in consciousness. Physical exercises devised for the sake of health are a more or less pleasant form of work; they do not take the place of play. Our ordinary work is usually more or less one-sided and unbalanced in the demands it makes upon us; we therefore try to find what other set of movements will undo this unbalancement and give us back unbiased bodies. When that is done, and not till then, we get freedom, and it is at that moment that real "play" begins--the use of the freed muscles according to our own will and pleasure. The same thing is perhaps true in connection with our minds. We all see the fallacy of the old-fashioned hustlers' cry, "Make your work your hobby; think of nothing else; let every moment be subordinated to the dominating idea of your career; put aside all sentimentalism, all laziness and self-will, all enthusiasm about things not in your own line of work." We have come to see that this kind of effort leads often to nervous breakdown and early death; always to a certain narrowing of sympathy and hardening of method even in the career itself. So we conscientiously "take up" a hobby or a sport and set aside some hour or day for indulgence in it. We make it a duty to lay aside for the time being all idea of duties; part of our work is to learn to rest. So far so good. But does all this go far enough? Work imposed by any set of outer needs puts the whole being under a certain strain. The aim of remedial exercises, prescribed rest-times and legal holidays is to undo this strain, to unwind us from our coil by twisting us the other way. When this has been satisfactorily done, too often the person responsible thinks that this is enough. But it is really and truly at this moment that one is beginning one's real life. When the body is freed from strain and weariness is the time to leap and dance and sing and wrestle. When the mind is free from prejudice and weariness is the time for its original activity to begin; new thoughts spring up unbidden and the creative imagination lives and grows. (In the sphere of will, many great sages have said that an analogous sequence holds good. When the whole emotional and moral nature has thrown itself in a particular direction, and then an unwinding has taken place, the moment of completed renunciation has been said to be the dawn of some great new spiritual light.) Who does not know the peaceful activity of a Sunday evening, the fruitful quiet of a long railway journey or sea-voyage _at the end_ of a holiday? Two friends walk slowly home together after an exciting expedition or debate; two girls give each other their confidence while brushing their hair after a dance. Why is this so? Nowadays people are very ready to answer the question by refusing the fact. It is waste of time not to be _doing_ something strenuously. Rest is almost as strenuous as everything else; it is to be thorough while it is the duty on hand and is to fit exactly on to the work time, without overlapping but without interspace. In this way too often the imagination, the really individual part of the mind, is starved and atrophied. Especially in childhood there ought to be a space left between useful work and ordered play for the individually invented games, the pursuits that are not for any definite end, for dreams and lived-out tales, when the child may make what he likes, do what he likes, and in imagination be what he likes. If we scrupulously respected this growing-time we should soon have a race of sturdier mettle altogether. Just now this particular want is probably most nearly supplied among elementary school children than among those who have more "educational advantages"; they "go out to play" in the streets for hours every day, and one cannot help thinking that it is the vitality thus evolved that keeps most of them healthy and happy in spite of many hardships. In later life, if we really want to make something of our lives, we shall do well to insist an keeping such a margin of free time to ourselves. It need not be long. Five minutes, if one really sails away in the ship of imagination, will take us to fairyland and back again. But the five minutes (or the day in the country, or the week of quiet, or whatever we take or can get) must really and truly be free; we must have the courage to seek for what we really want, and we shall have the inestimable reward of finding what we really are. E.M. COBHAM. HOW MUCH SHOULD WE EAT?[6] [6] See July number. For some years I lived according to the advice given by "M.D." with regard to the quantity of proteid that should be taken. But experience led me to believe that it was wrong. In recent years my diet has consisted of the following quantities per annum:-- Three to four bushels of wheat. Seventy pounds of oats. One bushel of nuts (measured in the shells). And with these foods rich in proteid, I have taken plenty of raw vegetables and fruit, and three to four gallons of olive oil. I do not mention this as an ideal, in order to suggest another and better standard than that of "M.D." I do not think any such thing as a standard really exists or can exist. But I mention it to show how far I have travelled away from where I was. I take it that all food reformers will agree that the main reason for food reform is to make the body a more harmonious instrument for the true life of man, and that carries with it the belief that there is some correspondence, if we cannot yet see absolute unity, between the physical and the spiritual. Now the law of life, according to Christ, is one of continual progress towards perfection and I do not see how this will harmonise with the teaching of a fixed law for the body. All my experience and observation point to a progressive law for the body, and I do not know of a single fact contrary to it. My first point, then, is that there is no such thing as a standard of proteid needed by the body. All that can be said is this, that if you take a man who has been fed on a certain quantity for such and such a time and then feed him on a certain other quantity, alterations in the physical condition will appear. But who can say whether these changes are attributable merely to a deficiency or to a previous excess? If "M.D." and his patients take excessive food they naturally get trouble from stored poisons when they reduce the quantity. But why put all the trouble down to present deficiency instead of to previous excess? To this I can find no satisfactory answer. If we have got our bodies into so hopeless a condition that we cannot use our God-given instincts, tastes and feelings in the first place, the wisdom of troubling much about the continuance of bodily life would be doubtful; and, in the second place, one would need most overwhelming signs of knowledge to substitute for them. But where are they? There is no agreement between those who have been taught physiology. On the one hand, "M.D." gives a proteid standard, now impossible to myself, and I believe to many others, for it would involve eating a nauseating quantity; and, on the other hand, another doctor, presumably acquainted with the same physiology, tells me I cannot eat too little, so long as I do not persistently violate true hunger and taste. Then another doctor gives quite a different standard, and a much lower one. If we discard our natural guides, which of the claimants to knowledge is to be followed, and is there any knowledge at all such as is claimed? Imagine what a mockery it would have been to give such a standard as that of "M.D." to the agricultural labourer about the middle of last century, a typical one with a large family, and one who worked as men do not work to-day, and had to rear his family on a few shillings a week. How could such a one have provided more than a fraction of what "M.D." says is necessary, either for himself or his children? The broad fact is, that all the hardest work of the world has always been done by those who get the least food. As one who has had some experience of labour, I doubt if the workers could have done so much if it had not been for a spare diet. Certain it is, that since they have more to eat, they are much less inclined to work. My contention, then, is that there is no fixed standard of proteid needed by the body, but that the quantity depends on the development that is in progress and is only discoverable by the natural guides of appetite and taste, ruled by reason and love of others. Moreover, I contend that even if there were such a standard as "M.D." says physiology has found, it obviously is not known. I cannot help recognising in "M.D." one whom I gratefully love and respect. He helped me on the road, and now that I differ from him I do not forget it, and I ask his forgiveness if I seem to be arrogant. He thinks I cannot see what he sees because I am underfed, and I think he cannot see what I see because he is overfed. In a sense we are both right, and we form a beautiful illustration of the different states of mind that belong to different physical conditions. I urge the laymen like myself not to be afraid of that musty old ill-shaped monster called Science[7] when he is up against the eternal truths that belong to every simple untutored man. Shun the monster as you would a priest, to whom he has a great likeness, and unite with me in a long strong pull to get "M.D." out of the rut in which the monster holds him, so that we may have him with us on the road, for he carries much treasure and we cannot do without him. A.A. VOYSEY. [7] I do not wish to be misunderstood. No sane man despises real science, but when the mixture of science and ignorance, which usually stalks about in the name of science, wants to usurp our heaven-born instincts we cannot but notice his ugly and monstrous shape. It is the function of science, or a true knowledge of details, to fill in the mosaic of the temple of wisdom, but the mosaic can never be the structure itself and is only useful and good when it is subservient to that structure and harmonious with it. CAMPING OUT. FOOD QUESTIONS. "We have to consider," I said, "the question of what food to take and how to cook it." "Camping out," said Sylvia, "ought to be a complete holiday from the food bother. Why not live on unfired food, such as tinned tongue, sardines and bottled shrimps?" Thereupon Felix laughed a great laugh, and said: "Just try and do a thousand miles on sardines." Felix is Sylvia's brother, who has spent some twenty years in America, travelling for weeks through country that contained no people, and spending nearly two years in a single journey to Dawson City and home again. He plainly knows far more about bed-rock camping than anyone else in the family and we allowed him to take the floor for a time. "The first thing is bread." said Felix, "because you can't do without bread. You must take some yeast or else some baking-powder with you to make it rise, or you must bake it very quickly so that the steam aerates it. You might take a Dutch oven with you, but it's nothing like the Dutch oven that you know in this country. It is an iron pot on three legs, with an iron lid. You stand it in the fire and cover the lid with hot brands and you can cook anything inside it--ducks and chunks of venison, and bread of course." "But Mr Freeman has barred the oven," said Sylvia, "and if we are not going a thousand miles from home perhaps we can do without it." "As you like," answered Felix. "I only mention it so that you can get hold of the general principle. You can make very good bread in a frying-pan. You must mix the dough up stiff so that when the pan is nearly upright it won't tumble out. You fix the pan up with a prop behind it so that the dough faces the fire, quite close, and you draw some more fire behind it so that the back is warmed as well. When it burns a good crust on both sides it is done." "What are flap-jacks," I asked. "Just pan-cakes made without eggs or milk," said Felix. "You mix a quart of flour with a tablespoonful of baking-powder and put in water till it is just so thin that when you take up a spoonful and let it drop back you can see the shape of it for a few seconds before it melts into the rest. You fry the batter in bacon fat or butter just like pan-cakes, and the cakes are very good." [Illustration: _A Summer Idyll_] "That's a good tip for us," I said, "and another good thing to take is cuddy biscuits, a kind of captain's biscuit. Soak them a few minutes in water or milk and fry them. They're nice with tomatoes or anything, or by themselves." "Mebbe," said Felix, and his tone said, "Mebbe not." "I'm only discussing general principles, and you've got to work your own way out in the light of them. I've known an outfit come away without a frying-pan. How do you make bread then?" We had to give it up, and Felix went on: "Open your flour sack, turn down the edge like it is in a baker's shop, make a little hole in the flour and pour in water to make a pond. Mix in what flour you want to use and get your dough into the shape of a snake, wind it round a stick and cook it like that. You've got your bread then like a French roll, and very good it is." We all liked the idea of making bread every day and eating it hot. Here was something to be had in camp that you could not get at home. And we liked the idea of learning our cooking by means of first principles. Whether we liked it or not, Felix liked talking about it, and he began to grow anecdotal. "Once," he said, "I met a whole lot of men, ten of them I should think, camped on a cold frosty night with nothing to eat. They were trying to do a journey of thirty miles on rough prairie and their horses were tired and they could not get on. They had brought their lunch and eaten it long ago, and they told me they were starving. They had nothing to eat, nothing to do any cooking with and no wood to make a fire with. I never saw such hungry people. They were new settlers just out from England and it was up to me to do something for them. "'What have you got in that great waggon?' I asked. They told me they had some sacks of flour and two frozen quarters of beef, but there was nothing to cook it in and no wood to make a fire. "There was any amount of cow-dung on the prairie, and it was dry as chips. I set them collecting that and soon enough had a fire. I filled a bucket with water and put it on to boil. I chopped off some meat and put it in. Then I made some dumplings and put them in. You just put them into boiling water, you know, and then they cook at once on the outside and don't come to pieces. If they boil too much they get pappy, and if not done through they're not good. Most dumplings you eat in England are not done, but mine were just right and those ten hungry men had just as good a supper as anyone could wish for." "Tell us about the coffee you used to make," said Sylvia. "What horrible stuff it must have been." "The very best coffee ever I drank," said Felix. "We used to make it in a pot that was nearly a yard high. We never turned out the grounds, but let them settle and put in a little more every time we made coffee, till the pot was so full that it wouldn't hold any more water." "I don't see anything against it," I said, when Sylvia and Gertrude were both expressing their horror. "There is no tannin or other bad principle in coffee and you never get anything worse out of it than you do at the first soaking." "The fellows that work the logs on the river have their own kind of coffee that they call drip coffee," said Felix. "They have a tall pot like ours was and they tie the coffee in a sack above the water, so that the water never touches it, but the steam goes up and fetches it out in drops. They don't change the sack every time, but keep adding coffee till it won't hold any more." "The moral of which is?" said Basil, who had for some time been growing impatient. "That there are plenty of ways of cooking an egg besides frying it," said Felix, "and that a bit of common-sense is about the best article you can take with you out camping. Take your food as raw as you can get it and know how to cook it. Also know a good herb when you see it, and never overlook a chance of getting a meal from the country that will save your stores." C.R. FREEMAN. _Food reformers will have their own opinion about a diet of shrimps, sardines, tinned tongue and stale coffee when camping out: the most important part of the outfit is doubtless an adequate supply of common-sense._--[EDS.] SEASICKNESS: SOME REMEDIES. _In the April and May numbers of the present year we published an article by Mr Hereward Carrington entitled "Seasickness: How Caused, How Cured." The following supplementary suggestions by the same well-known writer will be useful to many readers._--[EDS.] A very good plan, when you think of undertaking a voyage, is to begin to prepare for it several days in advance. For three or four days, before embarking, eat only very simple and somewhat laxative foods--such as fruits--so as to open the bowels well and tone up the system. This simple diet should be followed for the first two or three days aboard--of course not so rigidly, but taking care not to indulge in many heavy, greasy dishes. Unfortunately, the food on board is usually very rich and plentiful, and tempts one to eat. If one suffers from seasickness, there is not this same temptation, to be sure; but the malady may certainly be warded off, in the majority of cases, if only reasonable care be taken of the diet before and during the voyage, and if instructions herein laid down be followed. As before stated, drugs are as a rule useless for the cure of seasickness; but on occasion a "seasick cure" of some kind may prove effective. The harm which results from the drug may perhaps be more than counterbalanced by the benefits which the system derives from the cessation of seasickness. A preparation of this kind which is very highly recommended by many travellers is known as "Antimermal," and though none of these remedies are to be recommended with assurance, this one--and perhaps one or two others--might at least be tried, in cases of dire necessity, when seasickness has already supervened. It is hardly necessary to say that the patient should remain in the open air continuously, until all symptoms of seasickness have paused. _Live_ in your deck chair until you feel quite well and able to get up and walk round. Do not attempt to go downstairs into the dining-saloon to meals, if you feel in the slightest "squirmish." Rather have some hot soup or broth of some kind sent up to you, and drink it sitting in your chair. Do not be afraid to drink water at all times, even if you feel ill--as the water is easily returned, and it is less strain on the stomach to be able to bring up something than to find nothing in the stomach when an effort is made to eject what is not there. Water will serve to allay this strain, and thus serve a useful purpose. In very severe cases of seasickness, the stomach of the patient should be emptied and washed out at once. This is usually an easy matter. Have the patient drink one or two glasses of water, warm or cold, with a little salt or bi-carbonate of soda added--say a teaspoonful to a pint of water. This will have the desired result! In extreme cases of seasickness, dry cold, such as ice-bags, placed behind and about the ears, will sooth the patient, and help to allay his suffering. Cold cloths to the forehead will also prove helpful. Full baths had best be omitted, until the attack has worn off, as they are injudicious on account of the reactions they induce. In prolonged cases of seasickness, there is often a craving for acids and fruit juices. The continued absence or diminution of the acid contents of the stomach, and the privation from normal food, accounts in part for this, and it is highly proper to satisfy such a craving--providing due care is taken not to add to the stomach's distress by taking too much juice, or the juice of unripe fruit, or by swallowing the fibre of the fruit, which is allowable only when recovery is complete. HEREWARD CARRINGTON. IMPORTANT. If readers who possess copies of the first number of _The Healthy Life_ (August 1911) will send them to the Editors, they will receive, in exchange, booklets to the value of threepence for each copy. A SYMPOSIUM ON UNFIRED FOOD. _In the November number we published a letter from a reader containing the excellent suggestion that readers who had experimented to any fair extent with unfired diet should be invited to contribute to a conference on the subject in _THE HEALTHY LIFE_, and that the symposium should be gathered round the following points_:-- (1) The effect of the diet in curing chronic disease. (2) Its effect on children so brought up--_e.g._ do they get the so-called "inevitable" diseases of chicken-pox, measles, etc., and _especially_ have they good (_i.e._ perfect) teeth? (3) The effect of the diet in childbirth. (4) The cost of maintaining a household in this way, as compared with the cost under ordinary conditions. (5) Is the diet satisfying, or is there a longing for conventional dietary (often found amongst food reformers)? (6) Is the diet quite satisfactory in winter? _Two letters were published in the January number. Two more in February. Others will appear in future issues. We are anxious to receive a large number of personal experiences, but they must be brief, and classified under the above heads as far as possible._--[EDS.] ST ALBANS. In response to your invitation I am sending you my experience with vegetarian dietary. Although, as you will see, this has not been altogether "unfired," I think it should be of interest to many. (1) I became a vegetarian at the time of my marriage, nearly three years ago, my husband being already a vegetarian of eleven years. I considered this a good opportunity to commence. Previous to this I had for some time suffered from indigestion, which continued for a few months after marriage. I attribute the cure to the change of diet, and drinking hot water after meals. (2) We have one child eighteen months old, totally breast fed for twelve months, and another four months: on breast and Ixion Food and some fruit juice. She has never had any disease whatever, and so far her teeth are perfect and she has cut them quite easily. She is a bonny, sturdy little girl, and very intelligent. (3) With regard to childbirth, I previously followed the advice of Dr Alice Stockholme in "Tokology," avoiding flesh meats and bone-making food and adopting a diet of fruit (chiefly lemons) and rice, brown bread and nut butter, wearing no corsets and taking frequent baths. The effect during pregnancy was highly satisfactory. I enjoyed perfect health the whole time, free from the usual discomforts, and at childbirth I received similar results: a speedy and safe delivery. Indeed, since marriage, my husband, baby and myself, have been singularly free from even minor complaints. (4) As we do not have the specially prepared, expensive vegetarian foods (supposed to substitute meat), but mainly the simple foods, I consider the diet less costly than the meat diet. (5) We are honestly quite free from the craving for meat or meat foods. (6) In the summer-time we live principally on salads, cheese, rissoles, etc., made from beans, peas, lentils, etc., fresh fruits, brown bread and nut butter. In the very cold weather we seem to need rather warmer stuffs, such as porridge (carefully cooked) and cooked vegetables, etc. D. GODMAN. * * * * * BRIGHTON. I have read with the greatest interest the correspondence in _The Healthy Life_ on the unfired diet. As the majority of your correspondents have not been living _exclusively_ on unfired food, or have only done so for short periods, may I suggest that some of your correspondents or contributors live on an _entirely_ unfired diet, _excluding dairy produce_, for a period of six or twelve months and then relate their experiences. In this way some valuable evidence would be obtained. At any rate I am prepared to do this myself. With reference to living on the unfired diet on 4d. a day, I have often had two unfired meals for less than 4d., and two meals a day are sufficient for anyone. Of course to do this one has to buy the food which is in season and therefore cheap. Dried fruit and nuts, followed by a cress salad with oil and lemon dressing, does not cost more than 2d. An unfired rissole made from grated carrot and flaked peanuts cost at most a penny, and if followed by dates or figs would be a sufficient meal, and 2d. would cover the cost. In conclusion, I have no difficulty in producing a "two course" unfired meal for 2d.--but perhaps I should have left the subject of cost for Dr Bell to deal with. Yours faithfully, ALFRED LE HURAY. MORE ABOUT TWO MEALS A DAY. With reference to my article, "Two Meals a Day," which appeared in the May issue of _The Healthy Life_, several correspondents have asked me to give more particulars about my life and diet. I do so gladly; but I must be brief, as the demand upon space in this magazine is now very great. Resolved into a single sentence, what all my correspondents wish to know is this: Is a two-meal dietary best for all? To this question, however, a definite answer cannot be given, for the simple reason that scientific experimentation with respect to food quantities and times of meals, etc., has gone such a little way, so that it would be presumptuous to set a limit in regard to meals and food reduction. To my mind, apart from the question of the quantity of food to be taken, there is a great and important field of inquiry open with respect to the effect of rest upon the stomach and the intestines, upon the digestive and assimilative powers of the body. Now the whole purpose of my article was to show that a reduction of one's dietary was a matter of training, of gradual adaptation, but also--and this is the important fact-of gradual strengthening. My theory is that the two-meal plan is possible owing to the immense economy in digestive energy that is effected through giving the stomach adequate rest, and also through keeping the blood stream pure and unclogged, almost absolutely free from surfeit matter. A rested stomach will get more nutriment out of a small amount of food-stuff than an overworked stomach will get out of a much larger quantity. But experimentation which is sudden and covers a few weeks only, is worse than useless, as it tends to disprove the very principles that a saner method of experimentation would probably establish. And if I can impress this fact upon the reader I shall have performed a good service. Carefully undertaken, and properly graduated, I believe there are few people in these days who would not greatly benefit by a reduction in the number of meals and in the quantity of food they take. By means of a healthy and cheerful habit of introspection--not morbid and feverish--I am firmly convinced that by cutting down their meals most people would not only greatly improve their health, but their mental and spiritual condition as well, and also greatly increase their capacity for work ... And if in this way we can effect such an improvement in our life and condition it does not really matter whether we get to the two or even one meal basis or not. As to myself, my work is chiefly literary and my life moderately sedentary. But the fact is that I now have two moderate meals a day whereas I used to have four pretty good ones. But I have many friends whose work is mechanical, and demands much muscular energy, who are two-mealists. One lady I know, who is one of the healthiest, strongest and best physically developed persons I have ever met, is a two-mealist, and not only does she work at a mechanical occupation for ten hours a day, but on several evenings each week conducts a ladies gymnastics class as well. But in her case, as in mine, the two meal was an ideal that was gradually and slowly attained, and not a sudden reform. Indeed, the main thing to remember is that it is all a matter of training, it being quite impossible to say where the limit is. For of one thing I am quite sure--viz. that most people, were they to adopt a slow process of food and meals reduction, on the lines I suggested in my article, would be astonished at the result. The number of people one meets, chiefly among those whose life is more or less sedentary, who say they can't work as they should, are subject to pains and heaviness in the head, constipation and indigestion, is simply appalling; and on questioning such people I come to the conclusion that in the majority of cases it is because they eat too much or too often. My meals are very simple, and the simpler they are the better I like them. I like a cold lunch about noon, and a hot meal about six. I have tried a wholly uncooked diet, but as yet my body does not seem ready for it: perhaps it will be after a little while. The first meal usually consists of wholemeal bread and fruit, green or vegetable salads, just according to my needs at the time. In winter I take a more liberal supply of dried fruits and nuts. Pulses I eschew altogether. My second meal consists of a substantial entree with one or two conservatively cooked vegetables--occasionally I have a soup and a sweet in addition. But of course it is for everyone to find out his or her own ideal diet; and let me say that it is worth while to do so, even though it involves much confusion and perplexity during the period of experimentation. WILFRED WELLOCK. A BALLADE OF SKYFARING. Ye whom bonds of the city chain, Yet whose heart must with Nature's be; Ye who, bound to a bed of pain, Dream there of torrent and tower and tree, Here behold them--the magic key, Turned by a thought in yon gates of blue, Even now has revealed to me Alps and Mediterranean too. Why of the bondage of earth complain? Wide as heaven is our liberty! Where are the streets and their smoke and stain When to the land of the lark we flee? Where is the sight that we may not see, Cloudland's citadel passing through? Switzerland beckons with Sicily, Alps and Mediterranean too. Here, 'twixt walls with the marble's vein, Oared on a river of gold are we; There we watch, on a sapphire main, White fleets voyage to victory. Day unto day flashes grief or glee; Night to night utters speech anew, Figuring forest and lane and lea-- Alps and Mediterranean too. ENVOY Prince whose course through the world is free, Fare you better than dreamers do? Here are the mountains and here the sea-- Alps and Mediterranean too. S. GERTRUDE FORD. From _Lyric Leaves_, by S. Gertrude Ford. Cloth, 2s. 6d. net; 2s. 8d. post free from _The Healthy Life_, 3 Amen Corner, E.C. This charmingly bound book makes an excellent holiday companion, for it contains many beautiful lyrics, all characterised by serious thought, generous human sympathies and a delicate imaginative quality. A REMEDY FOR LONGEVITY. Once upon a time there was a little boy whose parents took things very seriously. They answered all his questions with painstaking precision. At a comparatively early age he could prove that fairies were non-existent. At the same time his toys were marvels of mechanical perfection. At the age of seven he was sent to a very efficient school, where, being naturally a bright boy, he gained high marks every term and passed all the examinations, for he had a wonderful and well-trained faculty for remembering exactly what his teachers had told him. When he left school he entered a London merchant's office, where his knowledge of arithmetic was of the greatest assistance in bringing him to the front. Moreover, he could argue very tellingly with all the clerks and warehousemen, and always knew what the morning papers were saving about health, neck-ties or religion. In course of time he grew a moustache, joined the Territorials, was made a partner in the firm, married a well-educated young lady and became a strong supporter of the local Liberal Club, where his opinions were so well known that it was unnecessary for anyone seriously to combat them. He was never known to vote for the Conservative candidate or to lose his head. His concluding speech in the historic debate on The National Health Insurance Act will always be remembered, by those who heard it, for its earnest defence of the medical profession. In fact, the Mayor, who was in the chair, and was a doctor himself, warmly congratulated the speaker, who was evidently very pleased. Ten years later he became a Town Councillor, opened several Institutes for the Care of the Poor, and sent his second son to join the eldest at the same kind of school at which he (the father) had been so well trained. About the same date he bought a new edition of the Encyclopaedia Britannica and carefully compiled a list of facts and figures showing that idealists and all new-fangled ideas were the greatest danger to the increasing trade and expansion of the Empire. At the age of fifty he took a house at Surbiton and was continually congratulated on his hale and hearty appearance. His opinions were known and respected by all who met him. His sons were models of what the children of such a father should be, and they supported him in every argument. At the age of fifty-two he retired from business. A month later he had an idea; and it so interfered with all his opinions, and so affected his general health, that he died. EDGAR J. SAXON. A SIGNIFICANT CASE--II. He stopped smoking tobacco on the second day, and does not mean to resume its use. Of course he had no alcohol in any form during the fast, but he never has taken much alcohol, although he was not a pledged abstainer. The temperature was taken many times and seems to have been almost always subnormal, about 97 degrees Fahr., but this is not so unusual a condition as to call for comment. The chief cause of a subnormal temperature, in my opinion, is blocking of the body with too much food. No doubt in prolonged fasting the temperature may fall also; but sometimes a fast will be the cause of raising a subnormal bodily temperature, as happened in a case of mine in which on the twenty-eighth day of the fast there was a large elimination of urates by the kidneys and a rise of temperature from 96 degrees to 98.4 degrees. Subnormal bodily temperature has not received the attention which it deserves. It is usually one of the forerunners, or prodromata as they are called, of the onset of incurable diseases like cancer, Bright's disease or apoplexy. The commonly accepted view that the heat of the body depends upon the food, and that people eat blubber in the Arctic and Antarctic regions to keep the bodily heat up, is one of the chief causes for neglect of the study of subnormal temperature. And it is quite surprising that physiologists have not thought it necessary to explain why nature has provided sugar and palm oil and cocoa-nut oil and ground-nut oil in the tropical regions, as well as abundance of olive oil in the warm temperate regions of the earth if these foods keep the bodily heat up. They ought to have been more abundantly supplied in the Arctic and Antarctic regions if the accepted view is correct. Besides, if we must eat blubber to keep bodily heat up in the Arctic regions when the outside temperature is 50 or 100 or more degrees lower than that of the body, what ought we to eat in the tropics to keep bodily heat down when the outside temperature is 50 or even 80 degrees above that of the body? Physiologists have not explained this, although assuredly an explanation is wanted. But the true explanation, the correct explanation, would have demolished the doctrine that bodily heat is due to the food, and so it has not been given. It is too simple to imagine that the bodily heat is, like the body itself and all its functions, the effect of the life-force that inhabits the body and builds up the body so that the body shall be a fit dwelling-place for itself--this explanation is too simple and too idealistic for modern science, which is less and less disposed, we are told, to invoke the aid of a force of life to account for vital phenomena, although it assumes an attracting force to account for gravitating phenomena, and an electric and chemic force to account for electric and chemic phenomena. Modern science (and ancient science, too, apparently) which sees well enough that an idealistic or a materialistic explanation would equally account for the nexus of the phenomena of the universe, deliberately and almost invariably prefers the materialistic explanation. She is anxious that we should be kept free of superstition. But the superstition that forces are the effects of things does not seem to distress her at all. And so we are told that gravitation is a property of matter, and are forbidden to think that perhaps gravitation, a force, procreates matter, a thing, in order that the effects of the fore may be perceived by dull sense. We are told that the function of the liver and the brain depends on the structure of the liver and the brain respectively and we are not allowed to think that perhaps the force of animal life, feeling the need of an instrument to secrete bile, on the one hand, and to secrete cerebral lymph to act as a vehicle for the conveyance of thought and emotion and higher things, on the other, introduces the liver with its elaborate structure and the brain with its still more complicated structure, in order that both the one function and the other may be well performed. And so, although all forms of kinetic energy (and among them zoo-dynamic, or the force of animal life) manifest warmth and luminosity as qualities, science attributes animal heat to chemic force and refuses to consider that perhaps zoo-dynamic uses chemico-dynamic for its own purposes, even if these purposes are unconscious, because the higher force always dominates the lower. Properly speaking, science is out of her sphere, though she does not seem to know it, in making these suggestions. When she keeps herself to the investigation of facts, their exposition, their sequence and their laws, in her painstaking and accurate manner, we accept her revelations thankfully, and beg her to allow us to make our own philosophic and other explanations in attempting to account for the existence, sequences and relations of the facts of life. After his return home, patient continued to gain weight, as might have been expected. On the seventeenth day after ending the fast he weighed 140 lbs. and on the nineteenth day 144 lbs. On that day he received from a hospital a report that the reaction of the physiologico-pathological test was negative. This has naturally had a great effect on the patient; and it is worthy of very careful consideration. Of course one negative result may not be conclusive although it was positive before the fast. But if the result should be repeated, and especially if it should prove to be permanent, the importance of the fact can hardly be exaggerated, since the suggestion arises in our minds that perhaps we may be able to cure profound blood-poisoning by fasting, neither the usual treatment nor the use of Salvarsan enabling the investigator to say that the result of the pathological reaction was negative; but this has followed after a heroic fast of 56 days. The result if confirmed would not be unique. Quite recently I saw a specific ulcer close to the ankle-joint for which operation had been recommended. It seemed to me that operation would be likely to open the joint, and that therefore it was a risky proceeding. But under a restriction of the diet, putting the young man on barley-water for a few days and then advising him to eat once a day only, the ulcer became very much smaller, and no operation has had to be performed. Blood-poisoning of this nature, of course, is not caused by improper nutrition, but it may readily be believed to be aggravated by the ordinary conventional over-feeding to which, so far as I can see, we are all subjecting ourselves, especially as persons who put themselves in the way of contracting blood-poisoning do not generally belong to the class of those who are attracted by the suggestion that it is noble to keep the body under, and that if we do not strive to keep the body under, it will be very likely to keep us under. Although we shall be liable to be infected, however we live, still we may believe that we shall be more likely to be badly infected (if we put ourselves in the way of contracting disease) if we have been previously subjected to the bad effects of over-feeding. This consideration renders a possible cure by fasting, a not impossible suggestion. And if, therefore, we have in fasting the suggestion of a remedy which offers us the hope of eradicating such a fearful disease from the human system, it certainly behoves us to make use of it. As a rule it seems to me that bad forms of blood-poisoning of this nature are incurable. In three or four generations they destroy the strain affected by it, do what we will. Meantime it shows all the signs and symptoms of a hereditary disease, for the children are born suffering, showing a coppery rash, and old before they are young. And when they get a little older they have no bridges to their noses, their teeth are ill-formed, their vision is imperfect, their intellects dull. It seems as if nature could not forgive crimes of this nature. She seems to treat them as the unpardonable sin. If we find cancer appearing in a family at 55 years of age in 3 or 4 successive generations, there is no proof of heredity in that. Inquire and see if like causes acting on like organisms in 3 or 4 successive generations have not produced the disease each time. The children are not born cancerous, and our efforts to prevent the disease may succeed. But children often _are_ born with specific disease, and there is no doubt at all about its being a hereditary disease. Even now I should not like to sanction marriage in the case of this man who has heroically fasted for 56 days, although he seems for the present to have got rid of his disease. But the outlook is hopeful, more hopeful than I thought, and in the hope that the suggestion may convey a message of hope to those who are willing to do penance for crimes against the body, I send out these remarks. The opinion expressed by the patient that he was getting rid of the Salvarsan which had been injected into his blood to cure his disease is, of course, his own only. I offer no opinion upon it. But I think the whole case very instructive, and it will be deeply interesting to follow it up with special regard to the inquiry whether the pathological test remains negative. The reflective reader of these remarks will need no hint from me to suggest how a study of questions of this sort raises in our minds all sorts of other questions, physical, metaphysical, philosophical, social, religious; what are laws of nature, how they come to be what they are, whether they can be disregarded without paying the penalty, and whether we men are bond or free. Each of us will settle these questions for ourselves, for each of us is responsible for his own conclusion. But as to the inevitableness with which such questions do rise in our minds, I take it there can be no difference of opinion. A. RABAGLIATI. HEALTHY HOMEMAKING. _For the benefit of new readers it seems well to explain that this series of articles is not intended for the instruction of experienced housewives. It was started at the special request of a reader who asked for "a little book on housekeeping, for those of us who know nothing at all about it; and put in all the little details that are presumably regarded as too trivial or too obvious to be mentioned in the ordinary books on domestic economy."_ XXI. HIRED HELP. It does not seem proper to conclude the present series of articles without touching upon the "servant problem," but I do not pretend to be able to solve it. It is a problem usually very difficult of solution by the homemaker of small means. If she has but few persons to cater for, and is not the mother of a young family, she is often very much better off without hired help, except for a periodical charwoman. But it is not always indispensable to the woman who has other duties besides housekeeping. I am not here concerned with the housewife who can afford to keep more than one efficient servant. Indeed, I am hardly concerned with one who can employ a really good "general" at from L20 to L25 per annum. The person I am concerned with is the homemaker who can afford at most to employ an inexperienced young girl at from L10 to L14 per annum. I will draw the worst side of the picture first, for although it _is_ the worst side it is true enough, as so many harassed housewives know. The young "general" often comes straight from a council school where domestic economy had no place in the curriculum, and from a home in name only. Such an one is usually slatternly and careless in all her ways, has no idea of personal cleanliness, and regards her "mistress" as, more or less, her natural enemy! She is "in service" only under compulsion, and envies those of her schoolmates whose more fortunate circumstances have enabled them to become "young lady" shop assistants, typists and even elementary school teachers. If she had her choice she would prefer labour in a factory to domestic work; but either a factory is not available, or the girl's parents consider "service" more "respectable" in spite of its hardships. Its hardships? Yes, it _is_ its hardships that account for its peculiar unpopularity. For there are hardships connected with domestic service in small households that do not apply to other forms of much harder labour. Everyone who is familiar with the small lower middle-class household knows how often the life of the little "general" resembles that of an animal rather than a human being. All day long she drudges in a muddling, inefficient way, continually scolded for her inefficiency yet never really taught how to do anything properly. Her work is never done, for she is always at the beck and call of her employers; yet she lives apart in social isolation, is referred to contemptuously as the "slavey," and even her food is dispensed to her grudgingly and minus the special dainties bought for Sundays and holidays. This is domestic service at its worst, of course, but the prevalence of such "places" in actual fact is undoubtedly at the root of the young girl's objection to it. How can she help gleaning the impression that such work is "menial," when her employers more or less openly despise her? Being human, how can she but envy those of her old friends who have their evenings to themselves? What contentment can she find in a life of drudgery unenlightened by intelligent interest in learning how to do something well? What wonder that all her hopes and ambitions become centred in the possession of a "young man," and that reason--stunted from its birth for lack of room to grow--being entirely absent from her choice, she marries badly and too young, and becomes the mother of a numerous progeny as helpless, hopeless, stunted and inefficient as herself? Some conscientious women try to remedy this state of things by treating the girls they take into their homes as "one of the family." This _may_ answer well sometimes, but it has its drawbacks, both for the girl and the "family." Husband and wife, brother and sister, inevitably find the constant presence of a stranger with whom they have little in common very irksome. While the girl herself is equally conscious of restraint when forced to spend her leisure time with her employers. She would usually infinitely prefer the solitude of the kitchen, if combined with a good fire, a comfortable chair and a story book. Among the girls I have spoken to on the subject I have not found "socialist" households popular. One girl I met refused to stay in such a place for longer than three days, because she "never had the kitchen to herself." Another told me that she found it intensely boring to take meals with the family, because she was not interested in the things they talked about. I think that the ultimate solution of the "servant problem" will not be that every woman will do all her own housework, but that domestic work will become, on the one hand, very much simplified and, on the other, will be put on the same footing as teaching, nursing or secretarial work. That we are beginning to move in this direction is evidenced by the coming into existence of schools of domestic economy, to which "ladies" do not disdain to resort for training. This will undoubtedly result in domestic labour becoming a much higher-priced commodity than it is now, the housewife will have to pay at least as much for three hours help per day as she now does for nine hours, but the fact that the help will be skilled, combined with the greater simplicity of housework, will surely more than compensate for this. But what is the homemaker of limited means, who must have some help, to do under present conditions? This we must consider next month. FLORENCE DANIEL. HEALTH QUERIES. _Under this heading Dr Knaggs deals briefly month by month, and according as space permits, with questions of general interest._ _Correspondents are earnestly requested to write on one side only of the paper, giving full name and address, not for publication, but as a guarantee of good faith. When an answer is required by post a stamped addressed envelope must be enclosed._--[EDS.] BOILS: THEIR CAUSE AND CURE. Miss L.C. writes:--I should be deeply indebted to you if you would advise me in the following matter. I have been suffering from a recurrence of boils on different parts of my body during the last six months. I have consulted a local doctor, but he can find no reason for their appearance, but suggested I should try a mixed diet, to include some animal food, rather than adhere to vegetarianism as I have done for some two years past. My diet is about as follows:-- _On rising._--Tumblerful of hot water. _Breakfast_ (eight o'clock).--One egg, toasted bread (wholemeal) and butter, with either a little lettuce or marmalade and either weak tea or cocoa. _Lunch_ (one o'clock).--Steamed green or root vegetable, with cheese sauce or macaroni cheese or similar savoury, or nuts. Boiled or baked pudding or stewed fruit with custard or blanc mange. _Tea_ (four o'clock).--Tea or cocoa, with or without a little bread and butter and cake. _Supper_ (7 o'clock).--Vegetable soup, milk pudding and a little cheese, butter and salad and wholemeal bread. I am forty-nine years of age, lead a fairly active life, frequently taking walking exercise. I am very tall and weigh twelve stone. Have had no serious illness, but been more or less anaemic all my life. If you can tell me whether there is anything wrong in connection with my diet and suggest the cause of, and treatment for, the boils I shall be exceedingly obliged. In order to help this correspondent to permanently get rid of these boils, we must first ascertain what those troublesome manifestations are and look to the causes which produce them. A boil is a small, tense, painful, inflammatory swelling appearing in or upon the skin, and is due to the local death or gangrene of a small portion of the skin's surface. This eventually comes away in the form of a core, and, until this has cleared away, the boil will not heal or cease to be painful. Boils occur chiefly on the neck, arms or buttocks. If very large they are known as carbuncles, and if they occur on the fingers or toes they are described as whitlows. It is often the friction of a frayed-out collar or cuff, of tight waist clothing, or, in the case of whitlows, the introduction of some irritant or poison between the nail and the skin that determines the precise site at which they will come. Boils, although rarely dangerous to life, are usually accompanied by pain severe out of all proportion to the extent of surface involved. This gives rise to much broken rest and loss of vitality, which at once ceases when the boil has finished its course. Boils usually occur in series or crops. Now large numbers of people wear collars and cuffs with frayed edges, or handle irritants with their fingers, but they do not necessarily contract boils or whitlows. Therefore, we see that there must be other factors to be taken into consideration to account for their presence. The orthodox germ-loving practitioner may tell you that a boil is a purely local disorder and that a certain form of microbe, known as the _Staphylococcus pyogenes_, is the cause of it. This germ, he asserts, lives normally on the surface of the skin and, when this surface becomes broken, it enters the part and infects it, thereby starting the boil. If this is true every person who wears old collars or dabbles his hands in dirt should without exception contract boils. This is obviously untrue. The factor to be considered, then, is this. What is it that induces boils in one person and not in another under identical circumstances? The answer is obvious. The boil is not a local disease at all, but is a manifestation of some constitutional defect, or of some impurity of the blood stream, which enables this microbe to find a congenial breeding ground. The people who suffer most from boils are young or middle-aged adults, and we usually find the two extremes among sufferers. There is the full-blooded, often overfed, individual and there is the pale, debilitated and emaciated person whose constitution is broken down by worry, overwork, sexual troubles, unhealthy surroundings or badly selected foods. If we inquire into the constitutional history of these cases we shall almost invariably discover that the digestive or assimilative processes of the body are not working smoothly. This may be due to the worry or overwork, or to unhealthy surroundings which dis-harmonise the digestive and nutritive functions, or to nervous exhaustion from one cause or another, or it may be due to the wrong diet, which is filling the colon (or large bowel) with fermenting poisons. When the body is clogged in this manner nature often proceeds to get rid of the accumulating waste through the skin. By a vigorous effort on the part of the life-force the impurity is thrown outwards to the surface. Looked at in this light a boil is really a most salutary cleansing agent, and the Nature-Cure practitioner, who calls it a "Crisis," often does everything in his power to produce boils when treating chronic diseases. The alternative is often some more deeply seated form of elimination, resulting in serious organic disease of the organs or tissues. One of the first signs of improvement in disorders like diabetes, consumption, arthritis, Bright's disease, or even cancer, is the appearance of boils, showing that the vitality has improved to an extent sufficient to enable the foreign matter to be expelled by means of relatively harmless boils. The hydropathic expert also tries to induce this condition by means of his mustard and water packs. If our correspondent wants to rid herself of her boils she must adopt all means to improve her vitality and to cleanse her body of its impurities. She can do this along many lines. She can take a holiday and rest from her work; or by positive thinking she can set to work to get rid of her worries. She can learn to laugh as often as possible, and to breathe deeply, slowly and fully. If her house is unsanitary she should make it sanitary, or move elsewhere. Then she must restrict her diet and take only those forms of food which create a minimum amount of poison in the system. _She must cleanse the colon daily_ with warm water enemas, and encourage the action of the kidneys in doing their rightful part in the elimination of poisons by the drinking of distilled water or a good herbal tea on rising, and of clear vegetable broth at night. Clay packs, applied cold, are the best form of treatment for application to the boils themselves. They should never be cut or squeezed, as this only intensifies the trouble. Hot applications, as poultices, are bad, because they induce the boil to mature prematurely, and also are conducive to reinfection of the skin in other parts. Drugs or medicines are of very little use in the treatment of boils, because they do not go to the root of the trouble. The only remedy that I have found of any avail is yeast. In former times this was taken in the form of fresh or dried brewers' yeast, and it was, if unpleasant, a very effectual remedy. Yeast yields a free supply of what is called nuclein and nucleinic acid. These, chemically, are identical with the same substances found in the human cells. Nuclein is a powerful antiseptic. It has been found that the toxins or emanations from diphtheria and other deadly germs are precipitated and destroyed by nucleinic acid. It is for this reason that yeast extracts, such as Marmite, often have a beneficial effect in disorders accompanied by the formation of pus matter. Our correspondent's diet should be amended as follows:-- _On rising._--A cupful of unseasoned Marmite. _Breakfast._--One scrambled or lightly poached egg with stale, yeast-made, wholemeal bread and nut butter, with lettuce or other salad food. No marmalade; no tea or coffee. _Lunch._--1 to 2 oz. of grated cheese or flaked pine kernels, finely shredded raw cabbage, or grated radishes, or grated raw roots with oil and lemon dressing. No cooked savouries, no puddings, nor stewed fruit with custard or blanc mange should be taken. _Tea Meal._--Cupful of Marmite, only. _Supper._--Clear, unseasoned, vegetable broth, with Veda or wholemeal bread, or Granose biscuits, with nut butter and some fresh fruit. _At bedtime._--A cupful of Marmite. NOTE.--The unseasoned Marmite should be used, as the ordinary kind is rather heavily salted. A BAD CASE OF SELF-POISONING. Mrs H.W. writes:--I should be very glad if you would give me enlightenment on one or two points about my diet. I am suffering from a somewhat dilated stomach, also a catarrhal condition of nose, throat and alimentary canal, with constipation and much flatulence in the bowels. My teeth are decaying quickly, my nails have got softer, and I have become anaemic and generally debilitated, being unable to properly assimilate my food. All my joints crack when moved, and the knee joints creak as well. Is this a uric acid condition, or do you think it merely due to a lack of nourishment, causing a lack of synovial fluid? The joints are not swollen and not painful, they merely crack. My whole system seems to be over-acid, and my mouth gets sore and ulcerated. I have got very thin, having lost a stone in twelve months. I notice that you always advise for dilated stomach greatly restricting the liquid part of the diet. Will you tell me just how much one _may_ drink in a day, because when I go without drinking my constipation and other troubles are worse and the urine gets thick and muddy. You also deprecate milk. This puzzled me until you explained to a correspondent last month in _The Healthy Life_. Will you tell me if the same applies to dried milk--will it tend to increase intestinal trouble? I am anxious to know this because I have been relying somewhat on Emprote and Hygiama lately, for I had got so that I could scarcely digest anything. Do you consider it better to use the enema than to take a mild aperient? I do not want to start with the enema again if I can possibly manage to do without, because I found that my bowels depended upon it. And that is why I want to ask if it is absolutely necessary when on an antiseptic diet to entirely avoid fruit. I find it so necessary to keep the bowels working naturally. I _do_ want you to answer me these questions, because I have got so worried and fearful (people's theories are so varied) that I scarcely dare eat any food at all. I am at present taking only two meals daily (I like the two-meal plan best): at eleven A.M. and 6 P.M. I take a cup of weak coffee on rising, without milk or sugar--this warm drink seems to start the peristaltic action and I then get bowel action. I think of changing the coffee for Sanum Tonic Tea or Dandelion Coffee. At eleven o'clock I have an egg with Winter's "Maltweat" bread and almond butter, and some conservatively cooked vegetable (celery or carrot or spinach). At six P.M. I have one or two baked apples, a teaspoonful or two of malted nuts, or Emprote, and more "Maltweat" bread and butter. At four P.M. I take a cup of barley water or carrot water, and at bedtime another cup of barley water. Do you think that if I went on to a milk diet for a time it would do good? This correspondent seems to be suffering from auto-toxaemia, or self-poisoning in a severe form, and a condition of what is termed arterio-sclerosis or premature old age. Associated with it are evidently symptoms of rheumatoid arthritis, which is affecting her joints and teeth. It is not one of ordinary gout or uric acid poisoning. The trouble no doubt has been caused by past errors of diet, so that the present efforts at reform have come too late to be of service to her. Something more than diet is now needed to clear the acids and toxins from the system. It is not a simple case of digestive catarrh, for the whole body is affected. The present diet will answer very well as it stands. The first thing to do is to obtain a well-fitting dilatation belt. This must have leg straps and firmly support the lower half of the abdomen. The next thing is to promote skin action so as to encourage the clearing out of poisons along this line of elimination. Vapour baths, wet-sheet packs or alkaline hot baths can effect this purpose. An alkaline hot bath should be of a temperature of 105 degrees Fahr. or more, and to the bath should be added 1/4 lb. of bicarbonate of soda and 1/4 lb. packet of "Robin" starch. She should remain as long as possible in this so as to well clear the acids from the skin and induce as much skin action or perspiration as possible. The _first_ baths must be of very short duration, and she should be careful to avoid chill after the bath; it is best to lie prone and completely relaxed for half-an-hour at least after the bath. Finally massage and Swedish movements directed to the entire back will help to disencumber the central nervous system, which is evidently very badly depleted of its vital force. It is, of course, a pity the correspondent cannot get away to a properly organised Nature-Cure home and have the continuous attention and treatment which her condition really necessitates. H. VALENTINE KNAGGS. CORRESPONDENCE. AMANZIMTOTI, NATAL. _To the Editors._ SIRS, You will see that your little magazine finds its way even to this out-of-the-way corner of the globe, and you may be sure that it is appreciated. I am specially interested in Dr V. Knaggs' contributions and should like to ask him a few questions. May I say that I have some knowledge of chemistry and that I try and take an interest in the scientific aspects of food reform. (1) P. 237. What grounds has Dr Knaggs for speaking so definitely about human magnetism and that of vegetables? How would he recognise or test for either, and where can I get further information (scientific) on the question of food magnetism. (2) Same page. Dr Knaggs says salt added to cooking vegetables converts organic salts into inorganic. I cannot follow that. _What_ organic salts are so converted? One or two examples would suffice. (3) I have been reading Dr Rabagliati's _Conversations with Women Concerning their Health and that of their Children_.[8] In it he says that food is not the source (cause) of body energy, but is used merely to replace waste material. Elsewhere I read that "Professor Atwater's investigations into nutrition have shown in a most convincing manner that the body derives _all_ its energy from the food consumed. This may be regarded as established." Which of these definite and contradictory assertions does Dr Knaggs support, and why? Where can I get information _re_ Professor Atwater's experiments and other recent works on similar subjects? To me the questions involved are intensely interesting, hence my queries. I hope they do not read as if I were hypercritical or sceptical. With all good wishes for the success of your healthy little magazine. I am, yours, etc., W. BLEWETT. [8] 5s. net. C.W. Daniel, Ltd., 3 Amen Corner, London. We handed the above interesting letter to our contributor, Dr H. Valentine Knaggs, and append his reply:-- HUMAN MAGNETISM. There is very little information available from ordinary scientific sources anent the question of the life-force or of the animal magnetism which animates our bodies and is the motive force common to all organic structures whether animal or vegetable. We do know that fresh fruits and vegetables are strongly magnetic because the magnetism which they emit can be gauged by means of delicate galvanometers. It has been found that leaves, flowers and seeds are positively, and roots negatively, charged. We also know that the same conditions are found in the human subject, since Dr Baraduc, who is a celebrated French Psycho-Therapeutist, in his book, "The Vibrations of Human Vitality," tells us that he has invented a machine called a biometer to test these very vibrations. I have had one of these machines myself and have experimented with it a great deal. By its aid we can make the machine work differently with different persons, and by careful tabulation of records Dr Baraduc has been able to elicit some very remarkable information about the magnetic currents which are constantly flowing into and out of the human body. If our correspondent really wants to know more about the wonders of human magnetism he should read some of the voluminous literature upon the subject published by the Theosophical Society. Just recently also a Dr Kilner has invented a form of coloured screen by which he and others who have some psychic sight can actually see the magnetic emanations which flow through a person placed in a darkened room. SALT-COOKED VEGETABLES. The one object of the vegetable kingdom is to build up, for the use of the animal or organic realm, the constituents found in the mineral or inorganic kingdom. These mineral constituents are dissolved, sorted out and built up in the right proportions for the use of animals when taken as foods. Whenever these foods are not so eaten they are sent back again to the earth by the aid of microbes during the process of decay, to be again available for plant use. Cooking is a process invented by man which is analogous to that of decay, for it dissolves and disintegrates the structures which Nature has built up. When man eats food that is partially disintegrated he does not obtain from it the right sort of nutriment which Nature intended him to have. To intensify the wrong-doings of the cook, man further hastens the disintegrating process by adding to the things that he cooks a due proportion of a common and very stable mineral, called salt. It is powerful, because it is not easily disintegrated. The salt greatly expedites the process of decay, whether in the natural form of fermentation, or whether by the application of heat, as in cooking. Salt is used in Nature to promote the flow of those electric and magnetic currents which are a manifestation of the universal life-force which pervades all things seen and unseen. It is an essential constituent of the sea because the ocean is the life-blood of the earth. It is an essential constituent of our own blood, because it is needed to make the blood stream a good conductor of magnetic currents. When you put this salt into water and then proceed to boil vegetables in it, it quickly sucks out all the life-force from them, and if persisted in reduces them to the state of minerals from which they were originally constructed. FOOD AND THE SOURCE OF BODILY ENERGY. Dr Rabagliati and Professor Atwater are, I believe, both right, but the former does not always explain himself clearly to the lay mind. The life-force or animal magnetism is the real source of bodily energy, and it manifests itself only when it has something that resists or regulates its flow. It does this just as certain forms of wire, or other materials, which possess indifferent conducting power, resist the flow of electricity through them. Electricity cannot manifest as light in the usual electric lights used in our houses, as heat in the electric culinary appliances or stoves, or even as power in the motors which run our trams and trains, unless it be given the requisite apparatus to bring about the manifestation required. In exactly the same way life cannot manifest itself as consciousness, with its flow of thoughts, emotions and bodily activities, without the food which is daily supplied to the body. It consequently depends considerably upon how we select our daily rations as to how this vital force will manifest within us. H. VALENTINE KNAGGS. HOLIDAY APHORISMS. A Sun Bath needs no Soap. * * * * * Man was made for the Weather, not the Weather for man. * * * * * A long drink often makes a short walk. * * * * * You may bring a man to the Sea, but you cannot make him think. * * * * * A tanned face doesn't make a healthy body. * * * * * Dew paddling should be done in the dark. * * * * * The only things that bathing machines make are cowards. * * * * * It is better to board yourself than let others be bored by you. * * * * * "A bore is one who thinks his opinions of greater importance than your own." * * * * * People who throw pebbles into the sea shouldn't dive near shore. * * * * * A toothbrush is what many forget but few should need. * * * * * Scotland Yard is not in the Grampians. * * * * * Cheap food is often dearly bought. * * * * * Lyons have no depots in Skye. * * * * * Orange-trees never yet sprang from scattered peel. * * * * * A pear in the hand is worth two in the can. PETER PIPER. THE HEALTHY LIFE The Independent Health Magazine. 3 AMEN CORNER LONDON E.C. VOL. V SEPTEMBER No. 26. 1913 _There will come a day when physiologists, poets, and philosophers will all speak the same language and understand one another._--CLAUDE BERNARD. AN INDICATION. Food reformers sometimes forget that "man does not live by bread alone," not even when supplemented by an ample supply of fresh air and physical exercise. It has been pointed out by psychologists that the more highly organised and highly developed the creature, the less it depends on nervous energy obtained via the stomach and the more it depends on energy generated by the brain. True, the brain must be healthy for this, and one poisoned by impure blood, due to wrong feeding, cannot be healthy. But something more than clean blood is necessary. For, as change of physical posture is necessary to avoid cramped limbs, so periodic reversal of mental attitude (consideration from other than the one view-point) is necessary to the brain's health. Again, change of air is often prescribed when the patient's real need is a change of the personalities surrounding him. While for the lonely country dweller a bath in the magnetism of a city crowd may be a far more efficacious remedy than the medicinal baths prescribed by his physician. For man lives by _every_ word that proceeds out of the mouth of God.--[EDS.] FEAR AND IMAGINATION. _Regular readers will recognise in this article a continuation of the series previously entitled "Healthy Brains." The author of "The Children All Day Long," is an intimate disciple of one of the greatest living psychologists, and she has a message of the first importance to all who realise that true health depends as much on poise of mind as on physical fitness. We regret that in the previous article, "Imagination in Play," the following misprints occurred:--P. 475, line 4 from top, "movement" should be "moment"; p. 475, line 5 from bottom, "admiration" should be "imagination."_--[EDS.] Some people are given to excusing their own uncharitable thoughts by saying, "I suppose I ought not to have minded her rudeness; I am afraid I am too sensitive." In the same way, people say, "Oh, I _couldn't_ sleep in the house alone" (or let a child go on a water-picnic, or nurse a case of delirium or do some other thing that suggested itself), "I have too much imagination." In both cases the claim, though put in deprecating form, is made complacently enough. The correlative is: "You are so sensible, dear; I know you won't mind," which is a formula under cover of which many kindnesses may be shirked and many unpleasant duties passed on. The sensible, practical people who listen to these sayings sometimes attach importance to them, so that a habit has grown up of describing morbidly neurotic people as "over-sensitive" and cowardly ones as "too quick of imagination." Ultimately, this leads to the thought that both sensitiveness and imagination are mental luxuries too costly for ordinary folk to grow, and that it is safest to check, crush or uproot them when we discover them springing up in others or in ourselves. Is not this attitude of mind due to a misunderstanding? Imagination is an _organ of activity_; it can be kept in the highest possible condition of health by having plenty of exercise; it should be working continually against resistance. A rabbit's gnawing tooth, if the opposing tooth be broken, may grow inwards and cause the creature's death, but the same activity of growth, if working under suitable conditions, enables him to go on living and gnawing at his food year after year without wearing his tools away. The problem, then, in economy of effort is: How shall we use whatever force of sensitiveness and imagination we have, so as to get its maximum efficiency of usefulness and its minimum pain and inconvenience? For many ages man has been dominated by fear. His way to freedom, now, is to step out through his cobweb chains and go right forward with courage and in faith. So we are told with relentless and almost tiresome reiteration. It is the fashion, one might almost say, to have cast off fear, and the one thing an honest "modern thinker" is afraid of is being afraid. (To less honest ones it is the thought of _being thought_ afraid that is a very real and present fear.) But, if this standpoint is right, is not fear at least a vestigial organ, a survival of a mental activity which served its purpose in times gone by? Is it not even truer to go further still and say, as _each particular fear_ serves its purpose it may safely be discarded, but that, as far as our present knowledge goes, other grades of sensitiveness, finer shades of imagination of the type we have called fear, must take its place, to be discarded in their turn for yet other apprehensions? For if we lost the kind of perception that we associate with fear, if our imagination closed itself automatically to the suggestion of all sorts of ugly possibilities, should we not find ourselves soon in the midst of difficulties akin to those of the hero of the German tale of the man who felt no pain? We accept the evidence of pain as a guide to action; when we have decided on action we proceed to get rid of the pain as expeditiously, safely and permanently as we can. The same thing seems true of fear. Over and over again we laugh at ourselves for fearing something that either never happened at all or happened in such a way as to be softened out of all likeness to the monstrous terror we had created. On the other hand, when misfortune falls heavily because of our lack of imagination in not foreseeing possible consequences of particular actions or events, we lament and complain: "If I could only have guessed! If I had only known!" Fear pure and simple--the imagination of possible trouble--is a stage we can hardly yet afford to do without. But when it has roused our attention to a danger, its work is done. Let us practise turning it into action; taking due precautions against accident, guarding against hurting a neighbour's feelings, watching some possibility of evil tendency in ourselves. Then, and not till then, may we let it drop. It may pass; it has done its work. It is no longer our responsibility to foresee, it is our privilege to lay down the fear and live happily and at peace. Even the dread perceptions of eternal laws come under the same method. "The fear of the Lord is the beginning of wisdom," the _beginning_: the end is faith and love. E.M. COBHAM. +--------------------------------------------------------------+ | | | #To Our Readers.# | | | | Readers who appreciate the independence and all-round nature | | of _The Healthy Life_ can materially assist the extension of | | its circulation by tactfully urging their local newsagent to | | have the magazine regularly displayed for sale. An | | attractive monthly poster can always be had free from the | | Publishers, 3 Tudor Street, London, E.C. | | | +--------------------------------------------------------------+ HOW MUCH SHOULD WE EAT? _The article (signed "M.D.") with the above title which we published in the July number has, as we anticipated, aroused considerable discussion. One interesting criticism appeared in the August number. We now publish two further contributions, to be followed, in our next issue, by two further articles by Dr Rabagliati and Mr Ernest Starr._--[EDS.] I As one who has tried the low proteid diet, and came to grief on it, I desire to set my experience against that of Mr Voysey,[9] and to assert that, if it is true for him, it certainly is not true for me. Mr Voysey indulges in many loose and generalised statements which do not help the average man or woman in the least. I imagine it is these that "M.D." has in mind when he advises a certain standard of diet, below which it is not safe to go. If Mr Voysey can, as Horace Fletcher can, exist on a very low proteid diet, that does not prove that all men and women can do the same and be healthily active; it only shows that he and Fletcher are exceptions to the average person, and that it may be dangerous to follow their example. For most men, "M.D.'s" proteid standard is not so nauseating as he finds it. Here is a specimen dietary for a day, for a man of ten stone, following, as most of us do, a sedentary occupation:-- 3 oz. cheese. 9 oz. bread. 8 oz. vegetables and salad. 8 oz. fruit. 1+1/2 pints milk. Will any average person say that that quantity, divided into three meals, would be nauseating to him? And is that diet so very expensive that it would be beyond the means of an agricultural labourer in any country? It is certainly no mockery. The cost to such a labourer would probably not exceed 3d. or 4d. Of course the diet can be made as expensive as one chooses, and widely varied. [9] See August number. Who amongst ordinary men and women has a reliable natural taste that would be an infallible guide in all matters of food? And what a misleading statement that is which asserts "that all the hardest work of the world has always been done by those who get the least food." Put it to the test on the average person and see where it leads to. My contention is that the average person, throwing over his or her accustomed meat diet, requires some definite guidance as to the quantity of proteid, such as Dr Haig's wide experience and much patient research have proved needful, or at least advisable, for the continuance of a healthy and vigorous life; and I will say that it does not help this average person in the least to put before him the misty statement that "the quantity depends on the development that is in progress, and is only discoverable by the natural guides of appetite and taste, ruled by reason and love of others." All very noble and very well in another place, but hardly meeting the case of the ordinary person who is seeking a healthy diet. Nor can you "make the body a more harmonious instrument for the true life of man" by habitually underfeeding it. I thought that was a mediaeval notion that had been knocked on the head long ago. Is there any man, lay or scientific, Mr Voysey notwithstanding, who can claim to have as wide an experience of diet in its relation to health and disease as "M.D.," to say nothing of the trained mind and long years of patient thought that have been exerted in dealing with the facts of this wide experience. For myself, I have come to see that, if "M.D." does not hold in his grasp the absolute truth in the matter of diet, he is nearer to it, and is a safer guide, than all your low proteid advisers, lay or otherwise, where they come much below "M.D.'s" standard. So, using Mr Voysey's phrases, I would urge laymen like myself to shun that weak-kneed manikin, the low proteid diet, and unite with me in a long strong pull to get him and others like him out of the rut in which that sorry weakling holds him. HY. BARTHOLOMEW. II The Editors were quite right in saying that the article under this heading in the July issue would arouse discussion. My wife and I, having discussed "M.D." and many others with the title, feel constrained to put forth a warning against blind faith in anything which the faculty have to say on dietetics. There are of course brilliant exceptions, such as Dr Rabagliati, Dr Knaggs, Dr Haig, the late Dr Keith and others, who give chapter and verse for every statement made; but when we consider the excellent work of laymen such as Albert Broadbent, Joseph Wallace, Horace Fletcher, Alice Braithwaite, Eustace Miles, Hereward Carrington, Edgar J. Saxon, Bernarr MacFadden, Arnold Eiloart, ordinary folks like ourselves may be excused if we venture to give our experience as against that of "qualified" men. With your permission, then, we reply to "M.D.'s" five suggestions in the order he gives them:-- 1. Food qualities are _not_ of extreme importance. 2. Quantity tables may have been "settled" by physiologists to their own satisfaction many years ago; but very good reasons have since been given for altering, or even ignoring, them. 3. The particular number of grains of proteid to be consumed per day is not of serious moment. 4. That departure from the quantity specified has not led to disaster is proved by the fact that the human race still persists, in spite of the very varying eating customs found in different nations. The great majority being poor or ignorant, or both, know neither "tables" nor the need for them. 5. There can be no reply to such a general statement as: "The nature of this disaster may appear to be very various, and its real cause is thus frequently overlooked." In such matters an ounce of personal experience is worth a pound of cut-and-dried theory. We--my wife and I--have been reared in an atmosphere suspicious of doctors, both sets of grandparents having relied rather on herbs, water treatment, goodness of heart and faith in God; and their children have had too many evidences of medical ignorance to accept any dogmas. We are anti-vaccinators, nearly vegetarian, and, to come to the point, we have four children who will persist in thriving on a basis of always too little rather than too much of food. The respective ages are girl 13, boy 10, girl 6, boy 2. All have been brought up on these lines: never pressed to eat, but continually asked to chew thoroughly. Foods "rich in proteid" put sparingly before them. Milk has been well watered; and eggs, bacon and other tempting and rich foods only on rare occasions given to them. We would ask readers who can to make the following experiment: Let your children have a good drink to start the day, and then run and play; don't offer food till asked for. You will almost to a certainty find, if you start this plan immediately after weaning, that day by day and year after year it is twelve to one o'clock before they inquire for "something to eat." We have done this for twelve years, with children of entirely different temperament and of both sexes. They go to school, poor things! breakfastless. During these twelve years light breakfast for father has been on the table--he goes without lunch--and not once in fifty do they ask to join him. Nor, if invited, will they after three or four years of age. The have never had a fever which lasted more than a day or two, and they are all above average height and weight. They get fruit in season just as asked for, and as much to drink as they like, _but not at meal-times_. Our experience is over a period of twelve years, and we have come to the conclusion that the infectious diseases so prevalent and death-dealing amongst children of all classes, rich or poor, are, in the main, the result of over-feeding. We find it wise to keep highly nutritious foods (like eggs, cheese, meat, etc.) away from children--that is, for regular consumption; a little occasionally may do no harm. You will have it borne in on our minds year by year, as your children grow up under such a plan, that Dr Rabagliati, Hereward Carrington and others are quite right. We do not get our strength, nor heat, from food. Let the force of animal life (zoo-dynamic, I believe Dr Rabagliati calls it) have free play, and your children can't help growing up well and strong. In to-day's _London Daily Chronicle_ I see a special article by Dr Saleeby, under this heading: WORLD'S DOCTORS VERSUS DISEASE. 5000 MEDICAL MEN MEET TO-DAY. THE TRIUMPHS OF THREE DECADES. We know how much this wonderful faculty knew thirty years ago about, _e.g._, fresh air for consumptives. There is not a word said in this article (which is a sort of programme of the weighty matters for discussion) on the relation of food to the body. That question probably 4950 of them believe was settled by the eminent physiologists who compiled those "food-tables" years ago--and in so doing went far to pave the way for the modern frightful increase of cancer, Bright's disease, etc., as well as for "scientific" horrors like anti-toxin, tuberculin--not to mention compulsory eugenics! J. METHUEN. HEALTH THROUGH READING. Do many people consider reading from the point of view of health of mind and body--of refreshment in times of struggle--of recuperation after knock-down blows of sorrow, disappointment or misfortune? Let us begin by saying that some of the greatest books are not to be read by everybody at all seasons. When one's heart or ankles are weak, one does not start to climb mountains, or one may end as a corpse or a cripple. So with one's soul under shock or stress. Personally, I can imagine nothing more cruel than the action of two women, one a story-teller of great repute among the "goody," who, to a specially stricken and lonely young widow, tendered as "bed-side books," Victor Hugo's _Les Miserables_ and Browning's poignant _The Ring and the Book_. If they had wished to make her realise to the bitterest depths the awfulness of the world wherein she was left alone, and the blackest depravity of the human nature around her, they could not have done differently. _Les Miserables_ she read till she reached the dreadful scene where a vicious cad hurls snowballs at the helpless Fantine. Then the strong instinct of self-preservation made her put the book aside--not to touch it again for nearly thirty years. With _The Ring and the Book_ her mind was too wrung and too weary to wrestle--all it could receive was a picture of wronged innocence, and especially of the rampant forces of evil with which she was left to contend. With the same want of tact and judgment, if with unconscious cruelty, the gloomy, fateful _Bride of Lammermoor_ was selected out of all Scott's novels for the reading of a very homesick youth, solitary in a strange country! Yet we must always remember that, as in affairs of the body so of the spirit, "what is one man's meat may be another man's poison." Some of the wisest and most successful nurses or doctors will occasionally permit an invalid to indulge in a longed-for diet which would certainly never be prescribed. They know that idiosyncrasy follows no exactly known rule. So we could tell of one who, amid the dry agnosticism of the later half of last century, had felt her faith, not indeed extinguished, but obscured and darkened. From the perusal of certain writers she had shrunk, perhaps with cowardice. They were put on such a pinnacle that she feared she would find no arguments fit to oppose to theirs. Weakly, she locked the skeleton cupboard. Then she was attacked by a malady which, while leaving her mind free and strong, she knew might be very speedily fatal. Straightway she said to her husband: "In two or three days I shall probably 'know'--or cease from all knowing. There will not be long to wait. Therefore bring me three books," which she named, works of authors of extreme agnostic views. Rather reluctantly he complied with her wish. She went steadily through the joyless pages, turned the last with the significant remark: "If this is all they can say, well!--" The skeleton cupboard, once opened, was speedily swept out. She quickly recovered, but never forgot her experience. Yet it must be remembered that this was the patient's own prescription, and was permitted by one who thoroughly understood her temperament. Therefore, though one would never wish to overrule a strong personal desire, that is quite different from offering counsel and furtherance--or proving experiments upon oneself. A celebrated woman writer of the middle of last century was of opinion that young people of both sexes should not indulge in reading "minor poetry." "Let them keep to the great poets, made of granite," was her graphic phrase. A woman of singularly self-controlled nature has confessed that the only time in her whole life that she experienced an unwholesome moral and emotional disturbance, after reading a book, was when, at about twenty-two years of age, she read Emily Bronte's _Wuthering Heights_. She dared not finish it: and when, some time later, a copy was presented to her, she caused it to be exchanged for another book, not wishing it even to be in the house with her. Years afterwards, she read it again, quite unmoved. It may be added that her first reading was made in the course of a systematic study of English literature, which had already led her through the works of Chaucer and Fielding. She has herself asked: "Is it possible that the strong and unpleasant effect was produced because the book was the production of another young woman, perhaps of somewhat 'sympathetic' temperament?" Taken as a whole, probably most fiction and all highly emotional work of any sort should be indulged in sparingly by those in the danger-zone of life, or by any under special mental or moral stress. History, philosophy (with sustained chains of reasoning) and biographies (best, autobiographies) of active and strenuous lives, should be resorted to by those temporarily doomed to spells of suspense and involuntary inaction. Invalids should be encouraged to read Plutarch's _Lives_ rather than the _Memorials_ of other sufferers, however saintly! It may be broadly stated that, during the tragic episodes which seem to occur in all lives, the most wholesome reading is to be found in the books of the great World-Religions--the Bible, and the teachings of Buddha, Confucius and Mahomet. The Bible is of course a library in itself, and many of its books are suited to very widely different circumstances and temperaments. The Psalms, the Gospels, the Epistle of St James, and parts of those great poems known as the "prophetical books" and the more personal and less doctrinal portions of Paul's epistles are perhaps of widest application. From the words of Buddha, Confucius and Mahomet there are many admirable selections--and one remembers a wonderful compilation of more than thirty years ago, called _The Sacred Anthology_, and wonders if it be out of print. It does not follow that these works should not be studied at other times than "tragic episodes." If this were more often the case, perhaps there would be fewer "tragic episodes"! Next to these come such wonderful books of spiritual experience as A Kempis's _Imitation of Christ_, the _Pilgrim's Progress_, the _Devout Life_ of Francis of Sales and others which will occur to the memory. Allusion to the _Pilgrim's Progress_ brings us to the remark that no books are more truly wholesome than some that can be enjoyed by those of all ages, and of very varied types of "culture": in which the children can delight, and which refresh the aged and weary. Like Nature herself, they have hedgerows where the little ones can gather flowers, little witting of the farther horizons of earth and sky lifted up for the eyes of the elders. Let the children read the _Pilgrim's Progress_ simply as "a story," its eternal verities will sink into their souls to reappear when they too are in _Vanity Fair_ or in bitter conflict with _Apollyon_. For the same reason, the Book of Proverbs should be commended to youthful study. Under wise supervision--or rather, in mutual study--it becomes at once a series of vivid pictures of primitive Eastern life--for all allusions should be explained, where possible, pictorially--while at the same time the memory will be insensibly stored with shrewd common sense and knowledge of the world, to be turned to, and drawn upon, as needed. And then, while the children revel in the fun and the fancy of Hans Andersen's _Fairy Tales_, let the sorrowful or sore or wounded heart turn to them for solace, soothing or healing. Hans Andersen enjoys a very special "popularity" and yet some, who have learned to love and value him, doubt whether justice has yet been done to his work. Because it is matchless for the young, it may be easily forgotten that it can be so, only by some quality which makes it matchless for all others. Perhaps some of his most popular stories are not his most wonderful, but have simply caught the popular fancy, because of some artist's illustration, or some personal application to the writer's own history, as in the case of his _Ugly Duckling_. How many--or rather, how few!--can readily recall the pathos and wit of his _Portuguese Duck_ or the deep philosophy of his _Girl Who Trod on a Loaf_? It is told of Hans Andersen, a gentle soul in a homely exterior, which attracted the snubs and neglect which "patient merit of the unworthy takes," on some such occasion was once heard to murmur: "And yet I am the greatest man now in the world!" It was very naive of him to say so, even in a whisper, probably wrung from him only in self-defence, but perhaps he might have thought it, in solemn silence--and--not been so very wrong! It may have been part of the very transparency of his inspired genius that he could not keep the secret to himself! There is at least one reader who declares that she finds the seeds of all vital philosophy--ancient or modern--in his stories. How much he derived from those who went before him, it is not for us to say, but this disciple, herself a devoted student and admirer of the world's latest teacher, Leo Tolstoy, yet puts Hans Andersen above him, as having attained in practically all his work what Tolstoy attained only occasionally--_i.e._ Tolstoy's own ideal of what Art should be and do. In such a paper as this little can be done beyond indicating on the broadest lines the kind of reading which tends to preserve or to restore mental health. Away with your "problem" novels and "realistic" poems stated in the filthy material of moral gutters! Hans Andersen will take some birds, some flowers, some toys, and will state the same problems, and get the same eternal solutions, without making the inquirer run any risk of meanwhile catching moral malaria. Isaiah will help us to build "castles" for the human race and for our own future, but he will take care that we shall remember that righteousness and unceasing vigilance and unflagging repair must go into the laying of foundations and the upholding of walls. David, even in his "cursing psalms," will exemplify for you the power of hate and vengeance in your own heart, and as he holds it up before you, you will see how small a thing it is, how mean, how ludicrous! As a man eats and drinks, so is his body: if he is a gross feeder, his body will be gross and sensual; if his food lacks nourishment, he will pine and fade. So it is with our minds and our morals. With whatever original "spiritual body" we may start, it needs spiritual sustenance, spiritual discipline, spiritual sufficiency and spiritual abstinence. Too often we ill-use it, as bodies are ill-used, goading its weakness with fiery excitement, or gorging its greed with sickly sentiment, or emasculating it by empty frivolity. All who desire spiritual health must find out what books best promote it in themselves: and sometimes they are found, like wholesome herbs, in very lowly places. One good rule is never to recommend what we have not seen proved in ourselves, or on others. ISABELLA FYVIE MAYO. THE SWAN-SONG OF SEPTEMBER. This fine sonnet is from _Lyric Leaves_, poems by S. Gertrude Ford. 2s. 6d. net (postage 2d.). (C.W. Daniel, Ltd., 3 Tudor Street, London, E.C.) Sing out thy swan-song with full throat, September, From a full heart, with golden notes and clear! No rose will wreathe thee; yet the harebell's here, And still thy crown of heath the hills remember. Bright burns thy fire, e'en to its latest ember, The sunset fire that lights thee to thy bier, Flaming and failing not, albeit so near Dun-robed October waits, and grey November. And though, at sight of thee, a chill change passes Through wood and wold, on leaves and flowers and grasses, Thy beauty wanes not; thou hast ne'er grown old; Death-crowned as Cleopatra, lovely lying Even to the end; magnificently dying In pomp of purple and in glare of gold. S. GERTRUDE FORD. THE QUEST FOR BEAUTY. If you have travelled at all frequently on certain of the London "tube" railways you may occasionally have noticed, facing you in the carriage, a small framed poster which for beauty and imaginative power has, I should think, never been surpassed in advertising art. If the first sight of it did not make you catch your breath you will not, I am afraid, be interested in this article. The poster represents a rich landscape, in which noble tree-forms show sombre against a tumultuous sky--the latter an architectural mass of pale cloud, spanned by a vivid rainbow. Across the lower part of the picture is a scroll, on which are written, in musical notation, two bars from Chopin's Twentieth Prelude. At the top are the words, _Studies in Harmony_: it is an advertisement of Somebody & Co.'s wall-papers. In both colour and design this poster is very beautiful. It would be scarcely less so without the rainbow; but "the dazzling prism of the sky" not only intensifies the subtle harmony of colour throughout the picture: it turns the poster into a symbol. And the artist might well have stopped there; only, you see, he had an inspiration. When he wrote across the picture those eight descending chords from the immortal _Largo_ he made of the poster--a poem. I do not know anything about the artist who conceived this advertisement of wall-papers. I do not even know his name. But I believe him to be the herald of an invasion. The invasion of life by beauty. Do you think it a degradation of art that it should be enlisted by the makers of wall-papers? Are there not too many ugly and discordant posters? Do you consider trade and manufacture so sordid that they are beneath the ministrations of beauty? It doesn't matter a new penny whether you answer such questions with a nod or a no: the invasion has begun. It is irresistible. Beauty is stooping--stooping to conquer. Your ardent social reformer is too often obsessed with one idea. Across his mental firmament he sees only one blazing word: INJUSTICE. And, fine fellow though he often is, he is inclined to be impatient with any talk of art or beauty. "How can beauty grow in these vile cities?" he cries. "What is the use of your music, your statuary, your fine pictures, your poetry, to the starving and the oppressed?" And he does not see that his passionate desire for justice is at root the quest for beauty, for fullness and harmony of life. His stormy sky shows no rainbow: yet it is there. And so is the stately music, the transmutation of colour into sound. And if his eyes could be opened to one and his ears to the other, there would be more power to his elbow. For beauty is inspiration and courage-- "My heart leaps up when I behold A rainbow in the sky...." And there is more than that in it. The cultivation of a sense of beauty, of harmony, makes reformers less harsh in their judgments, broadens their sympathies and helps to save them from becoming mere doctrinaires. If you have any love for the beautiful you simply cannot be happy about most Utopias, though they be Justice itself in civic form; and, when our "scientific" Fabian has demonstrated to you how to organise the national life in all its parts into one vast smoothly working State mechanism you will shudder, and then laugh. And then, without any rudeness, you will say: "Hang mechanism and a minimum wage! Live men and women want living crafts, liberty and a maximum beauty!" And really, I am coming to see that there are a great many health-culture enthusiasts (not to mention food reformers) who see no rainbow in the sky and hear no music in the wind; and even if they did, ten to one they would see no connection between the two. I verily believe there are some poor souls who have studied food questions so closely that they cannot see the sun for proteid nor the sea for salts. In all meekness, and knowing the frailty of the human mind (I have written dozens of articles on diet!), I would prescribe for them a course of artistic wall-paper advertisements, combined with the letters of Robert Louis Stevenson. He, poor fellow, had to battle against disease all his short life; but he managed to end one of his letters something like this (I quote from memory): "_Sursum Corda_! Heave ahead! Art and blue heaven! April and God's larks! A stately music.... Enter God." A somewhat ecstatic utterance. A trifle too exclamatory. Perhaps. You and I don't end our letters like that. (Or do you?) More likely we say something about the weather down here being miserably cold (or damp, or dull, or changeable, or hot) and brave out the lie with "yours truly." But O for one little spark from the fire that shone in the soul of R.L.S. Better to die young with a broken heart, if it were a heart as brave and gay as his, than beat Methuselah by means of a mincing, calculating, cold-blooded attention to irritating self-made little rules. Oh yes, I know well the value of little rules. And I know also that Nature offers us only two alternatives--obedience or death (either sudden or slow). But then Nature is something more than Mistress and Lawgiver. She is Beauty. And in that aspect, as in all other aspects, Nature is unescapable. We turn our backs on her only to find her awaiting us at the next turn in the road. Looking at the matter all round, I don't think we can come to any other conclusion than that Nature (or whatever you like to call It, Her or Him) is aiming at beauty all the time. So that we who are literally, if not figuratively, the children of Nature, had best do likewise. Some mystic or other has said that man's search for God is God's search for man. If he was right--and I think he was--it follows that man's quest for beauty is Beauty invading life; and that the only healthy life worth the having is that which begins with "Lift up your hearts!" and issues in "a stately music. Enter God." EDGAR J. SAXON. * * * * * _SEMPER FIDELIS._ Do two things worth doing, every day. Be scrupulously polite and kind, rather than witty or entertaining. Cherish cleanliness, sobriety, frugality and contentment. Cultivate sweetness of disposition and tranquillity of mind. Think before speaking, and so reduce your causes of regret. Seek peace and be peaceable for _lis litem generat_. Begin at home, let home always find you faithfully on duty. Care carefully for those whom Providence has entrusted to your care. And the reward of the faithful will abundantly yours, And your heaven will go with you wherever you go. "A.R." MORE HOLIDAY APHORISMS. Two's company, three's fun. * * * * * Levity is the bane of wit. * * * * * Braggers mustn't be losers. * * * * * Never put on to-day what you can't put on to-morrow. * * * * * It's an ill mind that finds no one any good. * * * * * It's no use crying over spilt milk: you're better without it. * * * * * Look before you sleep. * * * * * Never put an excursion ticket in the mouth. * * * * * Long hair never made true poets. * * * * * Obesity always carries weight. * * * * * Look after your manners and your friends will look after themselves. * * * * * Cranks of a feather fight together. * * * * * All is not toil that blisters. * * * * * _To Sea Anglers_: A live catch is no better than a dead fish. * * * * * Better a place in the sun than a plaice on a hook. PETER PIPER. HEALTHY HOMEMAKING. XXI. HIRED HELP (_continued_). What is the homemaker of limited means, who must have some help, to do under present conditions? Well, meantime, there is only the young "general" for her, either the "daily girl" or one who "lives in." Of the two I prefer the "daily girl," when she can be obtained. And the younger she can be obtained, other things equal, the better. She will have fewer bad habits to overcome. Some housewives object to the daily girl on the score that she may bring dirt or infection from her home, and also because she can seldom arrive early enough to help get breakfast. But a little management overnight can reduce the labour of breakfast getting to a minimum, and if the "outings" of the girl who lives in are as frequent as they ought to be the risk of her carrying infection, etc., will always apply. The "daily girl" has definitely fixed hours of work and the same chance of enjoying a measure of home life, of keeping her friends and individual interests, as the typist or factory worker whose lot the domestic servant so often envies; while her employers are not faced with the alternatives of condemning a young fellow-creature to a solitary existence or forcing an unreal companionship which is equally irksome on both sides. It is true that the wages of the "daily girl" do not equal, in actual money, those of the factory worker, neither does she obtain the Saturday half-holiday or the whole of Sunday free. But to set against this she receives her entire board and, with a kindly mistress, is not tied down to staying her full time on days when she is "forward" with her work. The life of the young "daily girl," if her employer is a conscientious woman, need not be hard nor unpleasant; very little harder and no more unpleasant than the lot of the young "lady" who is paying from L60 to L80 per annum to learn cookery, laundry and housework at a school of domestic economy. Properly conducted, the relations between employer and employee, "mistress" and "servant," are those of mutual aid. Such relations _may_ be, and too often _are_, those of an inefficient little drudge for a "mistress" almost equally ignorant and inefficient. But when the employer is an intelligent woman with a sense of justice (I prefer a sense of justice to sentimental theories about sisterhood--people do not always treat their sisters justly) the weekly money payment and food will be but a small part of the girl's wage. In addition she will receive a training that will equip her for the "higher" branches of domestic service, or for homemaking on her own account. Not every girl has the sense to appreciate this when she gets it, nor the intelligence to profit by it; while it is certainly rather trying to the employer when the girl is "all agog" to "better herself" as soon as she has gained a bare smattering of how to do certain things properly. But all this is "the fortune of war." Some girls never cease to be grateful to their first teachers and leave them reluctantly, while other girls never realise that they have anything to be grateful for. When gratitude and affection come they are pleasant to receive. But the motive power of the really conscientious woman is not the expectation of gratitude or affection. A word to the unconventional homemaker. The young "general" is a bird of passage. Age and experience bring with them the necessity of earning more, and if her first employer cannot periodically raise the girl's wages the latter must in time seek better paid employment, probably with a mistress who is not unconventional. It is unkind, therefore, to refrain from teaching the girl how she will be expected to do things in the ordinary conventional house. I do not mean that the employer ought to slavishly run her home on conventional lines for the instruction of her "help." But it is kinder, for instance, to help a girl regard a cap and apron with good-humoured indifference, or as on a par with a nurse's uniform, rather than as "a badge of servitude." It is kinder, too, to show her that it is not only "servants" who are expected to address their employers as "Sir" and "Ma'am," but that well-mannered young people in all conditions of life can be found who use this form of address to persons older than themselves. I do not suggest for one moment that any attempt should be made to delude a girl into the belief that she will not be expected, in conventional households, to behave with equal deference to persons younger than herself. Such deception would be unpardonable. But it is anything but kind to allow a young girl to drift into careless and familiar habits of speech bound to lead to dismissal for "impudence" in her next "place." There is a type of person, for example, who seems to believe that, in order to show that he is "as good as anybody else," it is necessary to be rude and familiar. But good manners are not necessarily associated with servility. And it is no kindness to help to unfit a girl for getting her living in the world as it is. It may seem that, in this article, I am more concerned for the "hired help" than the homemaker for whom I am ostensibly writing. But the points I have touched on are just those about which I know many thoughtful women are puzzled. I cannot solve their individual problems for them, of course, I can only just barely indicate some of the thoughts that have come to me on a subject that is so intimately bound up with the whole of our present unsatisfactory social and economic conditions that it cannot be adequately discussed in a little tract upon domestic economy. FLORENCE DANIEL. THE CARE OF CUPBOARDS. There are three methods in general use of caring for cupboards. Some housewives prefer their cupboard shelves of bare wood, to be well scrubbed with soap and water at the periodical "turn-out." Others cover all shelves with white American cloth, which only needs wiping over with a wet house-flannel; while still others prefer to dispense with the necessity for wetting the shelves and line them with white kitchen paper, or even clean newspaper, which is periodically renewed. Of the three methods I prefer the last, with the addition of a good scrubbing at the spring clean. The weekly or fortnightly scrubbing is apt to result in permanently damp cupboards, unless they can be left empty to dry for a longer time than is usually convenient. The use of American cloth is perhaps the easiest, most labour-saving method, but the cloth soon gets superficially marked and worn long before its real usefulness is impaired, so that the cupboard shelves never look quite so neat as after scrubbing or relining with white paper. The larder should be thoroughly "turned out" once a week. Once a fortnight is enough for the store-cupboard and for china cupboards in daily use. While cupboards in which superfluous china and other non-perishable goods are stored, and that are seldom opened, need not be touched oftener than once or twice a year. In very small houses one cupboard often must house both china and groceries, thus combining the offices of storeroom and china cupboard. The larder, strictly speaking, is for the food consumed daily. But when larder and store-cupboard have to be combined, the groceries may be packed away on the upper shelves, which can be tidied once a fortnight; but the shelves doing duty for the larder proper should never be left for longer than a week. Nothing betrays the careless housewife like an ill-smelling larder. All food should be examined daily and kept well covered. Hot food should be allowed to cool before storing in the larder. In the summer time special precautions must be taken against flies, all receptacles for food which are minus well-fitting lids being covered with wire-gauze covers or clean butter muslin. If the shelves are lined with paper, care should be taken at the weekly change to examine the wood for stains caused by spilt food that has penetrated through the paper. These should not be just left and covered over, but well washed off. With ordinary carefulness, however, they need not occur. F.D. BOOK REVIEWS. _The New Suggestion Treatment._ By J. Stenson Hooker, M.D. Cloth 1s. net (postage 1+1/2d.) C.W. Daniel, Ltd., 3 Tudor Street, E.C. This book is a striking example of the new synthetic movement in the medical profession. It is an exposition for the general reader of certain basic principles of mental treatment and of the author's methods of applying these; it is also, in reality, an appeal to doctors generally to put aside prejudice and examine the immense potentialities of rational "suggestion" healing methods. After examining the main features and disadvantages of mere hypnotic treatment and passing under review present-day "mental science," the author explains wherein his method of mental treatment both avoids the dangers of hypnotism and reinforces ordinary self-suggestion. Throughout there is the frank recognition that few forms of dis-ease are curable by one means alone; on the other hand, it is contended that most disorders, both mental and physical, are remarkably amenable to a rightly directed course of the new suggestion treatment, supplemented by other natural means. The narrowness of view that too often characterises the specialist is entirely absent from this book. It is throughout thoroughly broad, refreshingly sensible and profoundly convincing. _The Cottage Farm Month by Month_ (illustrated with original photographs). By F.E. Green. Cloth, 1s. net (postage 2d.). C.W. Daniel, Ltd., 3 Tudor Street, London, E.C. Here is a book of immediate social interest, of great practical value, and of uncommon literary quality. In the course of twelve chapters, bearing the titles of the months of the year, it reveals a welding together of two things which in many minds have unfortunately become divorced: the practical problems and arduous labour which no tiller of the soil can escape and--the keen delight of a poetical temperament in the ever-changing, yet annually renewed, beauties of earth and sky and running water. It escapes the dry technicalities of the agricultural text-book, while at the same time conveying innumerable valuable hints on practically every branch of "small farming"--advice which springs from the author's thorough knowledge based on long and often hard experience. On the other hand, while entirely free from that all too common defect of "nature-books"--hot-house enthusiasm--it will delight the most incurable townsman (providing his sense of beauty is not withered) by its joyous yet restrained pictures of open-air things. _Simple Rules of Health._ By Philip Oyler, M.A. (2nd ed.). 3d. net. Post free from the author, Morshin School, Headley, Hants. An admirable epitome of what might be called "advanced health culture without crankiness." The author is an ardent advocate of simplicity in all things and--practises what he preaches. Moreover, he is one of those who sees health from all points of view: he is as much concerned with what the English Bible calls "a right spirit" as with a fit body and a responsive mind. It is a little book deserving of a wide circulation. CORRESPONDENCE. A REMEDY FOR SLEEPLESSNESS. To the Editors SIRS, Would you care to publish the following experience of a cure for sleeplessness:-- I had no difficulty in going to sleep, but usually awoke again at about two A.M. with palpitation, and it often took me two or three hours to go to sleep again. I cured myself in the following way: I left off supper and reduced my tea meal by half, and the result was continuous sleep; the symptoms, however, began to come back again after a time, so I gradually cut the tea meal right away, and half of the midday meal as well. The cure was then permanent and after a time I found that I could resume the tea meal again. At the present time I am having a tea meal of fruit only. In addition I should advise those who suffer from this complaint to keep cheerful, and to avoid excessive physical or mental fatigue and worry. Yours faithfully, "A SIX MONTHS' READER." IS PURE LIME JUICE OBTAINABLE? The Editors have received the following letter from Messrs Rowntree & Co., Ltd.:-- "We note in your issue of July 1913 under the heading of 'Lemon or Orange Squash' a note to the effect that bottled lemon squashes and lime cordials 'are not pure in the strict sense of the term, since they are bound to contain 10 per cent. alcoholic pure spirit by Government regulations.' We should be glad to know what is your authority for this statement. Possibly it is a misprint, because obviously the Government does not require anything of the kind. Our own lemon squash and lime juice cordial are entirely free from any form of preservative, including alcohol. They are made up from pure lemon juice and lime juice respectively, with sugar, and contain no foreign ingredient." The statement complained of was based on an article entitled "Fortified Lime Juice" which appeared in _The Chemist and Druggist_, 13th May 1911 (page 51). On again referring to this article we find that the Government regulation applies only to _exported_ Lime Juice. We regret having made this error, and are genuinely glad to have Messrs Rowntree's assurance that their own "Lime Juice Cordial" and "Lemon Squash" are "entirely free from any form of preservative, including alcohol." Nevertheless, we think our suspicions regarding the presence of preservatives in such articles are justifiable in view of the following authoritative statements made by _The Chemist and Druggist_ in the article referred to:-- "The British Revenue authorities have drawn the line a little tighter in the discharge of their responsibility respecting the soundness of lime-juice intended for exportation or for use on board ship. The new rule henceforth is to grant a 'pass' certificate for unfortified lime-juice to last for fourteen days only, at the end of which time another certificate must be obtained. As this new regulation affects lime-juice in its natural condition before rum or any other spirit is added to it, only lime-juice manufacturers or importers are concerned in the matter.... _With such rapidly deteriorating liquid as lime or lemon juice the addition of the preservative spirit is a necessity, hence the sooner it is fortified the better._ The Revenue authorities permit duty-free spirit to be used for this purpose, but in order that lime-juice manufacturers shall have this advantage of not paying duty on the spirit used the Revenue authorities insist on approval of the juice and its subsequent fortification in bond under supervision of the Crown.... In reference to the proportion of spirit used, previously the regulation was expressed in a permissive sense, but now the emphatic "must" is used. In the last Government Laboratory report it was stated that 396 samples were examined, most of which were lime-juice, representing nearly 50,000 gallons. Even the fortified article is re-tested if more than three months old in cask or two years old in bottle, and this re-testing resulted last year in a condemnation of several hundred gallons owing to deterioration during storage. This juice is principally for use in the Mercantile Marine to combat scurvy." From which it would appear that the use of _some_ kind of preservative is essential with such a rapidly deteriorating liquid as lime or lemon juice; and if not alcohol, there are innumerable chemical preservatives available. We wish we could rely on receiving assurances from other "Lime Juice" importers and manufacturers similar to that we have received from Messrs Rowntree. * * * * * _To People with Strong Convictions:_ A holiday is the best of all opportunities for appreciating the opposite point of view to our own: this is why everyone needs a day's holiday once a week. HEALTH QUERIES. _Under this heading our contributor, Dr Valentine Knaggs, deals briefly month by month, and according as space permits, with questions of general interest to health seekers and others._ _In all Queries relating to health difficulties it is essential that full details of the correspondent's customary diet should be clearly given._ _Correspondents are earnestly requested to write on _one side only of the paper_, giving full name and address, not for publication, but as a guarantee of good faith. When an answer is required by post a stamped addressed envelope must be enclosed._--[EDS.] FAULTY FOOD COMBINATIONS. H.E.H. writes.--I should like your opinion of the statement of the late Mr A. Broadbent, that fruit when taken with starchy food by dyspeptics delays digestion, and that the digestion of starchy foods and vegetables occupied only one-third of the time needed for the digestion of starch with fruit. I have lived on a strict vegetarian diet and observed the laws of hygiene for two and a half years, to rid myself of dyspepsia, with great success, having increased my weight by thirty-six pounds; for the last nine months of this time I have lived on a largely "unfired" diet, but am still troubled with acid risings and flatulence and cannot account for it. Will you kindly enlighten me on the subject? I am a carpenter by trade and get eight hours in the open air every day. I take a tumbler of distilled water hot with the juice of one orange at 6 A.M., breakfast at 7.30 A.M., dinner at 12 noon and tea at 6 P.M., all consisting of Wallace unfermented bread and biscuits, various fruits (mostly apples, bananas and tomatoes) and nuts, about 1/2oz. at a meal; also a little cheese, about 1 oz. at a meal. The late Mr A. Broadbent was quite right, in my opinion, when he asserted that fruit taken with starchy foods delayed digestion. To reap the true benefit from fruit it must be taken alone. The dominant element in fruit is oxygen and the feature of oxygen is its power to start the process of oxidation in decomposing and disintegrating substances. It follows that when the stomach is filled with fermenting food-stuffs, or the tissues are clogged with the products derived from such, the oxidising action of fruit will be correspondingly intense. The Naturist who applies the Schroth Cure for the purpose of curing chronic diseases uses fruit as his chief eliminating agent. The reader will remember that the peasant healer, Schroth, made his patients take dry stale rolls alone for three whole days, with nothing whatever to drink, and on the fourth day, he gave them a full bottle of white wine, which then caused intense oxidation, with marked elimination of poisons. His methods, if successful, were drastic and weakening, and so the latter-day exponents of Schrothism have modified this and give their patients zweiback or twice-baked bread instead of rolls, and on the third or fourth day make the patient partake freely of fresh fruit. This process of alternate dry days and fluid days is continued for some weeks until the cure is complete. I have merely referred to this matter to show the part played by fruit in the body. To a healthy person fruit is in truth a splendid regenerating food, but it should, whenever possible, be eaten alone. To a dyspeptic, fruit is often equally good, if _taken by itself_. The case of vegetables is different, and I hold with Broadbent that salad or properly cooked vegetables do go well with cereals, because they contain, not oxygen and oxygen acids, but mineral elements like soda, lime and magnesia, which neutralise the acids and toxins which form in the body as a result of its work. The vegetable is just as active as the fruit as an eliminant, but it works on different lines. Cereal foods, if eaten slowly in a dry condition are made alkaline by the saliva, so that the vegetables, which are also naturally alkaline, would harmonise well with cereals if eaten with them. Our correspondent should modify his diet as follows, and then, I anticipate, he will cease to be troubled with his acid dyspepsia and flatulence. He should take his fruit alone, and take any of the crisp unsweetened Wallace "P.R." Biscuits in preference to the unfermented bread, which latter is often difficult to digest:-- _On rising._--A tumblerful of hot distilled water. _Breakfast_ (at 7.30).--Fresh fruit only. _Lunch_ (at 12).--1 to 2 oz. of cheese, preferably home-made curd cheese; salad of green leaf vegetables; "P.R." or Ixion biscuits with fresh butter, or nut butter. _Dinner_ (at 6).--1 to 2 oz. of flaked pine kernels, finely grated raw roots or tomatoes, with pure olive oil; Granose biscuits, or Shredded Wheat biscuits, and fresh butter. _At bedtime._--Cupful of dandelion coffee or hot distilled water. NEURITIS. E.M.A. writes.--At the age of five years I had an attack of rheumatic fever through taking a severe cold, and have been troubled more or less with pains since that time, which I feel sure are caused through rheumatism of the nerves. I am now fifty-eight years of age and have been a vegetarian for six years. My diet is:--8 A.M., cup of Sanum Tonic Tea; 9 A.M., Cup of dried milk; 10 A.M., half of an apple and a little crust of wholemeal bread; 1 P.M. conservatively cooked vegetable, using "Emprote" for sauce; 4 P.M., cup of dried milk; 6 P.M., a little green salad with St Ivel lactic cheese (size of one large walnut); 9 P.M., cup of dried milk. Do you think dried milk is harmful to me? I should miss it very much were I to leave it off. I must mention how great a help _The Healthy Life_ magazine is to me in many ways. Neuritis is a painful and wearying form of nerve trouble which mostly affects the arms and legs. It can, however, originate in any other part of the body through the spinal nerve centres. It may sometimes be due to injury, but the usual cause is some form of thickening or misplacement of the spinal structures, which induces pressure upon the nerves as they emerge through the apertures between the spinal bones. A careful examination of the back will show the site, and often the nature, of the thickening or encumbrance which is present. In our correspondent's case the thickening process doubtless occurred as an after effect of the attack of rheumatic fever. The best remedy is suitable osteopathic treatment for the spine, supplemented by _either very_ hot or _quite_ cold spinal sitz baths, by acetic acid skin treatment, or by any other means which will have the effect of disencumbering the spine. By means of our treatment we free the painful nerves from harmful pressure and promote an increased blood circulation in the parts affected. In this way the cause of the disorder is removed. A diet along the following lines would be better than the present one:-- 8 A.M.--Tumblerful of hot distilled water. 9.30.--One raw egg beaten up with cream and vegetable juice or clear vegetable soup made without salt. Wholemeal bread with plenty of butter and some celery or watercress. 1.30 P.M.--Two conservatively cooked vegetables done without salt, with grated cheese as sauce and a Granose biscuit with butter. 4.--Tumblerful of hot distilled water only. 6.30.--2 oz. of cottage cheese or cream cheese, salad and Granose biscuits, or "P.R." crackers, with butter. 9.30.--A raw egg beaten up with cream and vegetable juice or soup. I think dried milk preparations are inadvisable in such cases as these (especially when taken as beverages, as the "milk sugars" present are very prone to ferment and to hinder the cleansing of the digestive tract), and that the required proteid is best obtained from eggs and curd cheese. Fat is very necessary in nervous troubles; hence plenty of cream, fresh butter and cream cheese should be taken; also pure oil with the salad. MALT EXTRACT. L.F.H. writes.--Is malt extract a good thing to take daily with an ordinary non-flesh diet, two teaspoonfuls or so at breakfast? And is the desiccated or dry malt extract to be preferred to the ordinary sticky article? Malt extract of good quality, containing an active form of diastase, is a good form of relish to take with meals. The diastase promotes starch digestion and makes a good addition to foods of the cereal order. The thick sticky form is the best because the diastase is then in an active condition. Dried malt usually will have this diastase destroyed, hence, although much more convenient to handle, it is not so good dietetically as the sticky original extract. ABOUT SUGAR. C.T. writes.--I have read the article on sugar with considerable interest. I have noted nervous disorders, etc., manifest in cases of excessive consumption of manufactured sugar. I have been an abstainer from cane sugar (all commercial sugars, though _I do not know of any objection to milk, sugar_) for many years, regarding it as an unnatural excitant and stimulant as well as being inimical to digestion. As a physiologist I have taken immense interest in longevity, feeling that an active life past the age of ninety-five or a hundred, and upwards, carries with it, in evidence of right living, the force of demonstration, and more conclusively, in direct ratio to the advance of years. I firmly believe that all anomalies will ultimately admit of resolution. In this connection I could mention a number of strange and paradoxical cases for which, as yet, I have obtained no solution. I know of centenarians who began using "sugar" freely late in life. In one case, when past eighty, a new set of teeth (not odd "supernumeraries") appeared all round! How is it, again, that the natives of the West Indies, when living on sugar (in its crude state, I suppose) have excellent teeth and perfect health? Is not raw sugar better the less manufactured it is? On the other side, Captain Diamond, at 114, attributes his health in great measure to abstinence from sugar. Most of these queries are answered in the completed book[10] published this year. The point about "milk sugar" not being injurious he will find answered on page 72. [10] _The Truth about Sugar_, 1s. net. (C.W. Daniel, Ltd.) "Milk sugars" taken to excess with a mixed diet, or in the form of milk as a beverage, break down into lactic, butyric and other destructive acids under the influence of intestinal germs and thus do harm to the body. The natives of the West Indies (page 39) take the sugar cane in its natural state as a living vegetable food--a very different thing from the isolated and chemicalised sugar on our tables at home. Moreover, the chewing required helps digestion. This is very different to the drinking rapidly of sugared beverages, which do not receive this necessary mouth preparation. One is quite prepared to admit that paradoxical cases do occur where sugar seems to agree well even with octogenarians, but they are, in my opinion, the exceptions, and I am constantly coming across cases where the free consumption of table sugars has proved very harmful to both old and young. ULCERATION OF THE STOMACH. A.L.M. writes.--Our domestic servant, a girl aged twenty-four, is suffering from ulceration of the stomach and has had periodical attacks for the past six years. She has apparently, until she came to us, eaten and drunk very unwisely. She has been with us seven months and has been fed on a non-flesh diet since she came. For the last four weeks tea, coffee and cocoa have been forbidden, and as little sugar is consumed as possible. She had a very bad attack in August and we had to call in a doctor is we did not like the responsibility. He strongly recommended the hospital and an operation, which would ensure that there would be no repetition of the complaint. She decided to go and was there six weeks. After much experimenting there, inoculating and wondering whether it was tuberculosis, they operated and in due course she came back. We went to the sea for three weeks and shortly after our return the vomiting of blood and pains recommenced. After four days in bed she returned to light dishes, and a fortnight after another slighter attack came on, which in twenty-four hours. She takes hot boiled water five times a day. She suffers also from a horny skin on the palms of her hands, with deep cracks where the natural lines are. These periodically bleed. This skin exists also on her heels and the soles of her feet. Before and after, an attack this skin seems to be worse than ever. I mentioned the fact of the recurring attacks since the operation to the doctor and he seemed surprised and said the matter must be constitutional and there was no hope for her. My own opinion is that pure food will put her right eventually, and that these attacks will recur in diminishing force until the poisons are eliminated front the system. Her diet is at present as follows:-- _On rising._--Half-pint of boiled water (hot). _Breakfast._--Either Shredded Wheat softened in hot milk or breakfast flakes and cold milk: followed by either bananas or apples. Half-pint boiled water (hot). _Lunch._--Ordinary vegetarian cooked dishes, vegetables conservatively cooked, some fruit. Half-pint boiled water (hot). _Tea meal._--Wholemeal bread (Artox flour), usually non-yeast, nut butter. Lettuces and radishes when obtainable. Half-pint boiled water (hot). _Before retiring._--Half-pint of boiled water (hot). It has been shown by Brandl and other investigators that ulceration of the stomach can always be produced in animals by feeding them with an excess of sugar foods. The same thing applies to human beings, who, if fed with an excess of sweetmeats, sugar, milk or soft mushy cereals, will first contract catarrh of the stomach, which will ultimately deepen into a condition of ulceration. The rationale of the process is this: Fermentation and putrefaction of the foods eaten to excess produce in the stomach various acids and toxins. These become absorbed and pass into the liver. Then the liver becomes clogged, its flow of blood is obstructed and this naturally retards the flow of food from the stomach. That organ becomes congested and inflamed and, when the lower end, or pylorus, is obstructed, this congested state may easily deepen into ulceration. We also nearly always find a tender spine, showing that the nervous system has equally participated in the conditions produced, and this nervous factor intensifies the trouble by retarding the due working of the digestive functions. What we have to do to cure a case of ulcerated stomach is _to withhold the foods which create fermentation_. Then the liver will be allowed time to work off the poisons which are clogging its substance and when this has come about the stomach will slowly return to its normal condition. The diet which our correspondent cites is badly arranged. It is a mistake to give fluid _with_ the meals, and the mushy food at breakfast and the soft food at dinner should be changed to drier and crisper forms of nutriment. The following diet would be a distinct improvement:-- _On rising._--Half-pint of boiled hot water, sipped slowly; or quarter-pint Sanum Tonic Tea, taken hot. _Breakfast._--A Shredded Wheat biscuit _eaten dry_ and well buttered; a lightly boiled egg and some finely grated raw roots, especially carrots and turnips. In a case of this sort it is best not to mix cereals with fruits. An alternative breakfast would consist of _fruit alone_ such as two apples, finely grated at first, or two bananas mashed and mixed with pure olive oil and sprinkled with flaked nuts but care must be taken that the pulped banana is well chewed. _Lunch._--Grated cheese, or cream cheese, with some finely chopped salad, or grated raw roots, or conservatively cooked vegetables (preferably roots or onions baked fairly dry by the casserole method) can be taken at this repast. Follow with a slice or two of cold ordinary toast or rusks with butter. _Tea meal._--Half-pint of hot boiled water with a little lemon or orange juice added to it for flavouring. _Supper_ (about 6.30).--Stale standard bread with butter and curd cheese or an egg. The non-yeast bread should be avoided as in the weak state of the stomach it will not be properly digested; besides, the bran may irritate the lining in the present condition of the stomach. As soon as the stomach has regained its power of digesting food, and the ulcers have healed, then fine wholemeal biscuits of the Wallace or Ixion kind can be taken, but the unfermented bread had better be avoided. _At bedtime._--A half-pint of hot water. GOING TO EXTREMES IN THE UNFIRED DIET. W.O.C. writes.--As a bachelor who (not believing in, and therefore doing without domestic help) is anxious to reduce time spent on cooking to a minimum, I shall be glad if Dr Knaggs will tell me whether the use of the oven, pan and kettle are necessary to healthy diet. For instance (1) would a diet of bread and butter, biscuits, cheese, fruit (fresh and dried), ordinary cold water and cold milk, be as healthy as a diet of hot vegetables, puddings, cocoashell, etc.? (2) Are cooked lentils, butter-beans, macaroni, etc., more beneficial taken hot than after they have cooled? (3) Could uncooked vegetables _of sufficient nutriment_ be substituted for these? I shall be glad if it is quite safe to live entirely on raw foods, whether fresh or "prepared." The use of the oven, pan and kettle is not essential to a healthy diet, but few people in this changeable, and often cold, depressing climate are willing to forgo their occasional use. One cannot get hot water for a drink without a kettle or a small saucepan and a gas ring, and hot water is often a very comforting and useful drink, especially where an effort is being made to break off the tea and coffee habit. A diet of bread and butter, biscuits, cheese, fresh and dried fruits is excellent, provided our correspondent also includes grated raw roots and salads as the medicinal part of the regimen, and keeps the fresh fruit to itself as one meal of the day. Cold water or cold milk could also be taken in the place of hot water or hot milk, although I deprecate the use of milk as a beverage unless a person is willing to live entirely on milk like a baby does. The hot vegetables are uncalled for, provided the raw vegetables are substituted for them. The puddings can well be discarded. Cocoashell beverages are useful in very many cases. Beans or lentils can be eaten sparingly in a raw state if first soaked, then flaked in a Dana machine, and afterwards flavoured with herbs or parsley. I certainly think that, if they _are_ to be cooked, the taste is better if eaten hot; but there is no reason why cold cooked lentils should not be eaten any more than is the case with an other form of cooked food. Uncooked vegetables will not take the place of lentils, because they are of a different order of food-stuff. The uncooked vegetable would go well with the lentils as neutralising agents of the acids into which all nitrogenous foods break down in the body. Most people will find that nuts, cheese and eggs are better sources of proteid than lentils or other "pulse foods." H. VALENTINE KNAGGS. THE HEALTHY LIFE The Independent Health Magazine. 3 AMEN CORNER LONDON E.C. VOL. V OCTOBER No. 27. 1913 _There will come a day when physiologists, poets, and philosophers will all speak the same language and understand one another._--CLAUDE BERNARD. AN INDICATION. Just as there is a pride that apes humility, so there is an egotism that apes selfishness, a cowardice that apes stoicism and an indolence that apes effort. This is especially apparent in matters pertaining to health. How often, on the plea of not causing worry or expense to others, does a man or woman not put off taking necessary rest, or consulting a doctor, until a slight ailment that once would have yielded to treatment becomes an irreparable injury. Such conduct is often admired as unselfish, but for unselfishness and stoicism a psychologist would read fear, indolence and egotism. Fear of being thought hypochondriacal and fear of facing facts; shrinking from the exertion involved in the effort to become healthy and from the pain involved in witnessing the possible distress and anxiety of friends should the complaint prove serious--regardless of the fact that its neglect and resultant incurability would cause infinitely more distress; above all, that mental egotism which breeds in its victim an unreadiness to acknowledge that he does not _know_ what may be wrong and to take prompt steps to remedy his ignorance. It is not fair, of course, to attach too much blame to the patient. Such faults as those cited above are in themselves symptoms of nervous disease. Body and mind act and react upon one another. Nevertheless, the practice of the virtues loses its meaning when there is no pull in the opposite direction.--[EDS.] IMAGINATION IN INSURANCE. _Regular readers will recognise in this article a continuation of the series previously entitled "Healthy Brains." The author of "The Children All Day Long" is an intimate disciple of one of the greatest living psychologists, and she has a message of the first importance to all who realise that true health depends as much on poise of mind as on physical fitness._ It is an unpleasant subject, but have you ever faced the fact that your widow might be left in poverty? We all know the phrases that come so glibly from the lips of the insurance agent. Perhaps the very fact that it pays companies to spend thousands a year on the salaries of agents, and other thousands on broadcast eye-catching advertisements, shows that there are many things which our imagination only accepts "against the grain." Fire, storm, loss by theft or burglary, sickness, disablement and death we do not, by choice, dwell on these things in thought. Now some people are inclined to pet this impulse of turning away. "Do not think dark thoughts," they tell us, "the best insurance is unconsciousness, insouciance, denial. Misfortune will pass you by if you do not look for it." Perhaps there is something to be said for this method when it comes with absolute spontaneity from the innermost nature. But if for the radiant apprehension of beauty and health we substitute an effort to cling to the picture of good when our very bodies and nerves are warning us with suggestions of evil, we run grave risks. By adopting someone else's sense of freedom from danger and repressing our own conviction that for us a certain danger, more or less remote, exists, we are putting great pressure upon ourselves. At times of ill-health or accidental worry, a sleepless night may bring us an agonising succession of imaginative pictures, those very pictures which we have attempted to banish from our daily life. If we have still greater power of repression these grim images, forbidden throughout every moment of waking life, may reappear in dreams. (Of the still more serious dangers of repression and of its relation to various forms of insanity, this is hardly the place to speak.[11] It ought not to be necessary to appeal to alarming instances in order to make us attend to a suggested warning.) [11] See Bernard Hart's illuminating treatment of the whole subject in _The Psychology of Insanity_, Cambridge Manuals of Science. Now if we decide to regard all fear as a suggestion of precaution, the emotional part of it to be laid aside as soon as it has fulfilled its function of arousing interest and directing action, it is easy to see the psychological justification for insurance. Of course pecuniary insurance is but one instance of such sequences of action, though it happens to be a rather obvious one. In a different field, most of us know the delightful feeling of relief experienced after consulting a doctor about some symptom that has perhaps been troubling us for a long time. "May I safely do this? Ought I to refrain from that?" and such perpetually recurring irritations to the attention are replaced by the knowledge that it is now the doctor's business to decide whether this or that is "serious," and that as long as we carry out his orders we may lay aside all worry about the matter. So in the case of fire insurance, what we are really buying with our annual premium is freedom from haunting questions as to the loss that would ensue if our house or shop or office were burnt down or damaged. Whenever the thought comes, it may, as far as the money loss is concerned, be dismissed. We see then that instead of keeping the suggestion of such misfortunes before us, as some people might allege, the act of insurance substitutes for vague and recurrent fears a formal and periodical recognition of possibilities, a recognition, too, that contains within itself a precaution against some of the results of the misfortune should it ever occur. What we buy, at the cost of a fixed number of pounds or shillings of money and a few minutes of time once a year, is the right to put the dangers out of our consciousness altogether and yet leave no residuum of repressed fear to split up our personality or give us indigestion. If we choose, for some reason or other, to let our imagination dwell on the objective side of the possibility we have insured against, we shall find a pleasure in thinking of what can be done by many people working together. If we need help to meet some misfortune, it is ours as a right, not doled out to us through others' pity. And every year that we have made no claim we have the delight of knowing that we are helping those who need. The art of working together is yet in its infancy. But if even the present standard of method devised for money insurance were to be adopted in the deeper matters which we so often allow to trouble us, what an advance in mental development we should have made and what new possibilities of safe action would be opened up! E.M. COBHAM. * * * * * Every youth should learn to do something finely and thoroughly with his hands.--_Ruskin._ THE SCIENTIFIC BASIS OF VEGETALISM. This article has been translated from the French of Prof. H. Labbe, the head of the _laboratoire a la Faculte de Medecine_, in Paris. It reflects a rather characteristic aloofness to any considerations other than scientific or economic. But it will well repay careful study.--[EDS.] I Vegetarianism has been the object of many attacks, and has also been warmly defended. Most of its adepts have sought to give the value of a dogma to its practice. For quite a number of people "vegetarianism" is a kind of religion, requiring of its votaries a sort of baptism, and the sacrifice of many pleasures. It is this which justifies the infatuation of some, and the systematic disparagement of others. "Vegetalism"[12] cannot pretend to play a similar part, or to lend itself to ambiguity. To be a "vegetalist" is to choose in the vegetable kingdom, with a justified preference, foods susceptible of filling the energy-producing needs, and the needs of the reparation of the human system. "Vegetalism" is a chapter of dietetic physiology which must utilise the precise methods and recent discoveries of the science of nutrition. [12] The word "Vegetarianism" implies a judgment of the qualities which such a diet entails. This word is derived, in fact, from the Latin adjective "Vegetus" (strong). The word "Vegetalism," which we oppose to the preceding one, admits only the establishing of a fact, that of the choice--exclusive or preferred--of the nutritious matters in the vegetable kingdom. II Before putting "vegetalism" into practice the first point is to know whether the foods of "vegetal" origin contain, and are susceptible of producing regularly, the divers nutritive principles indispensable to the organisation of an alimentary diet. The principles are the following:--Proteid or albuminoid substances; hydrocarbonated and sweet substances fatty substances; mineral matters, alkalis, lime, magnesia, phosphates and chlorides, etc. In most compound foods, no matter of what origin, mineral materials almost always exist in sufficient quantities. The most important amongst them, at all events, are found combined in liberal, even superabundant, portions in dishes of vegetal origin. The analysis of the ashes of our most common table vegetables fixes us immediately to this subject: Leguminous plants supply from about three to six per cent. of ashes, rich in alkalis, lime and phosphates. Potatoes, green vegetables and fruit as a whole absorbing considerable quantities of mineral elements. These are the elements of a nature to allow a precise reply to this question which we propose to expound briefly. III In order to examine a food thoroughly, for the purpose of ascertaining if it can be advantageously introduced for consumption, whether albumins, fats, hydrate of carbon, or sugar, etc., or again an association of these principles in a composite article of food are in question, divers researches must be carried out before giving a final judgment. If a more or less complex article of food is in question, before considering it as a good nutriment, its centesimal composition, or its immediate composition, should be established; its theoretic calorific power should be known, and it should be measured if this has not yet been done. Besides the calorific yield thus estimated _in vitro_, the real utilisation in the human organism of articles of food alone or mixed with other foods should be determined, taking simultaneously into account their effects, whether tonic, stimulating or depressing. From a different point of view it is no longer allowable to neglect before judging whether such and such a nutritive substance is advantageous, the valuation of what we have called, with Prof. Landouzy, the economic yield--that is to say, the price of the energy, provided by the unity of weight of the article of food. It is only in reviewing "vegetal" substances, taking these divers titles into consideration, that we shall be justified in attributing to the practice of "vegetalism," integral or mitigated, its definite value. IV Only a few years ago, when Schutzenberger, emulator and forerunner of Fischer, Armand Gautier, Kossel, first disjointed the albuminoid molecule, to examine one by one its divers parts, the composition of the various albumins was very little known. Whether, therefore, albumins of the blood, or those of meat or eggs, were in question, these bodies were hardly ever separated, except through physical circumstances, amongst others by constant quantities of different coagulation. As to the centesimal formula and the intimate structure of the different protoid substances, they could be considered as closely brought together. From this fact, the physiological problem of the utilisation of albumin was simpler. No matter which article of food contained this albumin, its nutritive power by unity of weight remained the same. At the present time the number of albumins is no longer limited. It is not now physical characteristics founded difficult separations which arbitrarily distinguish those bodies from each other. The individuality of each of the albumins results from its formula of deterioration, under the influence of digestive ferments, or of chemical bodies acting in a similar way, as do mineral acids and alkalis. For want of constituary formula this methodical deterioration makes known the number of molecules (acids or other bodies) which are responsible for the structure of each albumin. These deleterious formula of proteid matter are not less suggestive than composition ones. They reveal notable differences between "vegetal" and animal albumins. To be sure, animal albumins (beef, veal, mutton, pork, etc.) which we are offered in an alimentary flesh diet, resemble more nearly the structure of our own bodily albumins than do the gluten of bread or the albumin of vegetables. This fact seems actually the best support of the theory which affirms the superiority of the flesh over the vegetable diet. Such a remark is therefore well worth discussing by showing that the consequences which can be deduced from it are paradoxical, and rest upon hypothesis which, not very acceptable in theory, are hardly verified in practice. Admitting that albumin plays in alimentary diet only the plastic part of reconstruction of used-up corporal matter, it might be advantageous to ingest but one albumin the composition of which is very similar to our own. By virtue of the law of least effort such a one in equal weights ought to be of more service than a foreign albumin, as it requires less organic work. For man, albumin of animal origin ought to be more profitable in equal weight than vegetable albumin. In the organism, indeed, albumin passes through a double labour. After the intestinal deterioration, followed by a passage through the digestive mucus membrane, a re-welding of the liberated acids takes place, with a formation of new albumin. If, therefore, alimentary albumin's mission is, not to be definitely burnt up in the organism, but to help in the plastication of the individual, the more its initial formula approaches the definite one to which it must attain, the more profitable it becomes, giving out less useless fragments and waste. Animal albumin approaching more nearly to human albumin, is also the one whose introduction into the daily alimentary diet is most rational. This statement seems to be the defeat of vegetal albumin. But let there be no mistake. It consecrates at the same time the triumph of anthropophagy, for there could not be for man a more profitable albumin than his own, or that of his fellow-man! This should make us pause and reflect, before allowing this deduction to be accepted. Besides, these arguments _ad hominem_ do not appear to us necessary for repelling such an interpretation of facts. Modern works have shown us that the greater proportion of ingested albumin played, in fact, a calorific, and not a plastic, part. Under these conditions one is justified in doubting whether there takes place with regard to the total albumins ingested a work of reconstruction thus complicated in the organism, after their first deterioration. Evidently one may come to believe that this complicated labour applies only to the more or less feeble portion of albumin really integrated. Practically speaking, the best criterion for judging the utilisation of an ingested albumin lies in the persistence of the corporal weight, allied to the ascertained fact of a stable equilibrium in the total azotized balance-sheet which is provided by the comparison of the "Ingesta" with the "Excreta." From this point of view there exists the closest similitude between the albumins of animal and those of vegetable origin; both, in fact, are capable of assuring good health and corporal and cellular equilibrium. However, the digestibility of vegetable albumins seems to remain slightly inferior to that of animal albumins. 97 per cent. of the animal fibrine given in a meal are digested, where 88 to 90 per cent. only of vegetable albumins are absorbed and utilised. It is a small difference, but not one to be overlooked. We must say, however, that the method one employs in determining these digestibilities takes from them a part of their value, and renders difficult the comparison of results obtained. Sensibly pure albumins are too often compared in an artificial diet. One deviates thus from the conditions of practical physiology. In fact, in ordinary meals, all varieties of foods are mixed together, acting and reacting upon each other, reciprocally modifying their digestibility. If one conforms to this way of acting towards alimentary albumins, the results change sensibly. In the presence of an excess of starch, under the shape of bread, for example, vegetable albumin seems to be absorbed in about the same proportions as animal albumin. If, in a flesh diet, animal albumins are always consumed nearly pure (lean meat containing hardly anything but albumin, besides a little fat, and an inferior quantity of glycogen) vegetable albumin is always, on the contrary, mixed with a number of other substances. This is doubtless one of the reasons which causes the digestibility of vegetable albumins to vary, the foreign nutritive matters being able to bring about, under certain circumstances, and in cases of superabundant ingestions, a real albuminous "saving" in the newest sense of the word. Besides, a prejudicial question makes the debate almost vain. When it was admitted by such physiologists as Voit, Rubner and their school that from 140 to 150 grammes of albumin in the minimum were daily necessaries in the human diet, a variation of a few units in the digestive power presented some importance. Nowadays the real utility of albumins is differently appreciated. The need of them seems to have been singularly exaggerated; first lowered to about 75 gr. by A. Gautier, it has dropped successively with Lapicque, Chittenden, Landergreen, Morchoisne and Labbe, by virtue of considerations both ethnological and physiological, to 50 grs., 30 grs. and even to 25 or 20 grammes. The "nutritive relation"--that is to say, the yield from albuminoid matters to the total nutritive matters of diet--is thus brought down from 1/3 its primitive value to 1/15 or 1/20 at most. It follows that the slight inferiority found in the digestive powers of vegetable albumin appears unimportant. It is sufficient to add 2 or 3 more grammes of albumin to a ration already superabundant of from 40 to 50 grammes of vegetable proteins to bring back a complete equilibrium in the use of vegetable and animal varieties. The theoretical inferiority of vegetable albumin thus almost completely disappears. H. LABBE. (_To be continued._) * * * * * If your system has become clogged, go slow--and fast. ODE TO THE WEST WIND. O Wild West Wind, thou breath of Autumn's being, Thou from whose unseen presence the leaves dead Are driven like ghosts from an enchanter fleeing, Yellow, and black, and pale, and hectic red, Pestilence-stricken multitudes! O thou Who chariotest to their dark wintry bed The winged seeds, where they lie cold and low, Each like a corpse within its grave, until Thine azure sister of the Spring shall blow Her clarion o'er the dreaming earth, and fill (Driving sweet buds like flocks to feed in air) With living hues and odours plain and hill Wild Spirit which art moving everywhere; Destroyer and preserver; hear, oh hear! Thou on whose stream, 'mid the steep sky's commotion, Loose clouds like earth's decaying leaves are shed, Shook from the tangled boughs of heaven and ocean, Angels of rain and lightning! there are spread On the blue surface of thine airy surge, Like the bright hair uplifted from the head Of some fierce Maenad, even from the dim verge Of the horizon to the zenith's height, The locks of the approaching storm. Thou dirge Of the dying year, to which this closing night Will be the dome of a vast sepulchre, Vaulted with all thy congregated might Of vapours, from whose solid atmosphere Black rain, and fire, and hail, will burst: Oh hear! Thou who didst waken from his summer dreams The blue Mediterranean, where he lay, Lulled by the coil of his crystalline streams, Beside a pumice isle in Baiae's bay, And saw in sleep old palaces and towers Quivering within the wave's intenser day, All overgrown with azure moss, and flowers So sweet the sense faints picturing them! Thou For whose path the Atlantic's level powers Cleave themselves into chasms, while far below The sea-blooms and the oozy woods which wear The sapless foliage of the ocean know Thy voice, and suddenly grow grey with fear, And tremble and despoil themselves: Oh, hear! If I were a dead leaf thou mightest bear; If I were a swift cloud to fly with thee; A wave to pant beneath thy power, and share The impulse of thy strength, only less free Than thou, O uncontrollable! if even I were as in my boyhood, and could be The comrade of thy wanderings over heaven, As then, when to outstrip thy skiey speed Scarce seemed a vision,--I would ne'er have striven As thus with thee in prayer in my sore need. Oh lift me as a wave, a leaf, a cloud! I fall upon the thorns of life! I bleed! A heavy weight of hours has chained and bowed One too like thee--tameless, and swift, and proud. Make me thy lyre, even as the forest is: What if my leaves are falling like its own? The tumult of thy mighty harmonies Will take from both a deep autumnal tone, Sweet though in sadness. Be thou, Spirit fierce, My spirit! Be thou me, impetuous one! Drive my dead thoughts over the universe, Like withered leaves, to quicken a new birth; And, by the incantation of this verse, Scatter, as from an unextinguished hearth Ashes and sparks, my words among mankind! Be through my lips to unawakened earth The trumpet of a prophecy! O Wind, If Winter comes, can Spring be far behind? PERCY BYSSHE SHELLEY. WHAT MAKES A HOLIDAY? What is it makes a holiday? Some people want Paris, some Monte Carlo, one man cannot be satisfied without big game to hunt, another must have a grouse moor. The student has his sailing boat, the young wage-earner his bicycle, three girl friends look forward to their week in a Hastings boarding-house. Almost anything may be "a change"; most things, to someone or other, are "a holiday." What does it all mean? The sands of West Sussex are wide and free, firm and smooth for walking with bare feet, lovely with little shells and sea-worm curves and ripple marks and the pits of razor-shells. Above them are the slopes of shingle, gleaming with all colours in the September sun. Farther up again, the low, brown crumbling cliffs crowned with green wreaths of tamarisk. The sea comes creeping up, or else the wind raises great white breakers; if the waves are quiet, old breakwaters, long ago broken themselves, smashed fragments here and there of concrete protections put by man, gaps in the cliff and changes in the coast-line, remind us of the vast force behind the gentle and persistent lap of water. The beach itself reminds us of it; there a flint and here a rounded pebble made out of brick or glass, worn down from man's rubbish to sea's proof of power. Over it all are the children, brown-legged and bare-headed. (Is it something in the weather this year that has given us the particular red-brown, suggestive of shrimp and lobster, that is the colour-vintage of 1913?) Babies with oilskin waders, bathers, girls in vividly coloured coats walking along the sands; all make up the picture and give us once again the thrill of holiday. Inland, the Sussex lanes are green and the trees are broad and shady. Thatched cottages are everywhere, and barns with heavy brows; yesterday I saw some pots put for shelter from the sun under the far-projecting thatch of a farmhouse. The gardens are full of sun-flowers and hollyhocks, fuchsia and golden rod; the walls are covered with jasmine and passion-flowers. Old, old churches make us feel like day-flies. The yew in the churchyard five minutes' walk from here is said to be 900 years old; the church itself is thirteenth century, but into its walls were built fragments of a former church, far older, on the same site. It carries us more than half-way back to the foundation of Christianity. Dim tales of heathen earls and Norman kings hang around the villages, and the very floor of the sea beyond the land is richly laden with stores of half-forgotten memories. Which of all these things makes these days my holiday? All of them, perhaps. Present moving life, and long-past history, the mighty movement of nature and the changes of geologic time: sheer beauty too and the gaiety of amusements and excursions; do not all have their place in unwinding us from the tight coils we make for our working days? Freedom to take from the world whatever is there of beauty and of interest--it really hardly matters what or where; freedom enhanced by sympathy, perhaps, for we seem to need some comrade in our play; so many days and nights following each other--no matter exactly how many--for letting ourselves go, and letting the world and all its power and wonder flow into us; that, whatever be place, time and conditions, is the making of a holiday. C +--------------------------------------------------------------+ | | | #To Our Readers.# | | | | Readers who appreciate the independence and all-round nature | | of _The Healthy Life_ can materially assist the extension of | | its circulation by tactfully urging their local newsagent to | | have the magazine regularly displayed for sale. An | | attractive monthly poster can always be had free from the | | Publishers, 3 Tudor Street, London, E.C. | | | +--------------------------------------------------------------+ HEALTHY LIFE ABROAD. "HYGIE." _A New Definition of Neurasthenia._ We cull the following definition of neurasthenia from our French contemporary: Neurasthenia is discouragement of the soul. Being in a state of discouragement the soul ceases to take care of the body and allows it to become encumbered with waste products. The body in its turn becomes so defective that the soul is incapable of repairing the enfeebled organs and throws the body away into the water or leaves it somewhere to be crushed or abandons it by some other means. Neurasthenia may be compared to an indolent mechanic. He neglects to oil his engine. It runs off the rails and is smashed. _Fresh Departures._ The Vegetarian Society of France has introduced three new sections into its organisation. The first is documentary, and aims at the collection, centralisation and classification of all information bearing on food reform. The second deals with domestic economy and hygiene. A number of ladies willing to devote themselves to the popularisation of the leading ideas of vegetarianism have joined this section. They offer advice and instruction to all who wish to familiarise themselves with food reform principles. The third section is concerned with physical training and outdoor games, with special reference to the relationship between these things and a non-flesh regimen. "VEGETARISCHE WARTE." _Nietzsche as Fruitarian._ "A simple life," wrote Nietzsche in 1879, "is very difficult at the present time," and went on to explain its difficulties and to suggest that even the most determined would be obliged to leave the discovery of the way to a wiser generation. He himself, however, took some steps upon the way during his stay in Genoa, when he lived on bread and fruit and spent but a few shillings a week. Eggs were occasionally included, and artichokes--and the little cookery he needed was done by himself over a spirit lamp. His winter in Genoa, he declares, was the happiest in his life and saw the production of his "Twilight of the Gods." _Food Reform in Russia._ The movement goes ahead rapidly in Russia. Hardly a town of any size but has now its vegetarian restaurant. This year the first Russian Vegetarian Congress has been held. It seems to have been a very successful gathering. "Seldom," writes one who was present, "have I experienced such a strong impression as was made upon me by this first vegetarian congress in Moscow." Unity seems to have been the prevailing note. Papers were read on the general significance and the various aspects of vegetarianism, followed by discussions. Amongst the various excursions undertaken was a pilgrimage to Yasnaya Polyana, including a visit to Tolstoy's grave. A Vegetarian Exhibition has also been held in Moscow. It included a fine show of fruits and vegetables, exhibits of various substitutes for leather, soaps made of vegetable oils, an abundance of Russian and foreign vegetarian literature of all sorts, from the noblest reaches of theory to the most invaluable details of practice. The next Congress is arranged for Easter 1914, at Kiev. _A Hopeful Sign._ Fifteen years ago the Berlin municipal authorities stoutly refused Professor Baron's offer to found an orphanage which should be conducted on vegetarian principles. At the present moment it is being arranged that all school children shall be taught the value of vegetables and leguminous preparations and the wholesomeness of a diet that is relatively non-stimulating and practically meatless. D.M. RICHARDSON. THE CURTAINED DOORWAYS. In George Macdonald's _Phantastes: a Faery Romance for Men and Women_ it is told how a man found himself in the midst of a great circular hall built entirely of black marble. On every side and at regular intervals there were archways, all heavily curtained. Hearing a faint sound of music proceeding from one of these hidden doorways he went towards it and, drawing aside the hangings, found a large room crowded with statuary, but no sign of an living creature. Yet he was certain the music had proceeded from that particular archway. Greatly puzzled, he let the curtain fall and stepped back a few paces. At once the music continued. Stepping stealthily and quickly to the curtain, he again lifted it, and received a vivid impression of a crowd of dancing forms suddenly arrested: something told him beyond dispute that at the moment he had drawn the hangings aside what were now lovely but motionless statues had sprung each to its pedestal out of the mazes of an intricate dance. Sound and movement had been frozen, in a flash of time, into a crowd of beautiful forms--in stone. No statue but seemed to tremble into immobility as the intruder's gaze turned this way and that no marble face but seemed to be aglow with the music that had died with his entry; no white limb but seemed to be tremulous with the rhythm of the dance that had ceased so suddenly. If the subtlety and imaginative truth of this story should lead you to read the whole book, I shall have had the privilege of introducing you to what is surely one of the finest and most delicately wrought fantasies in the English language, a fantasy so permeated with beauty and truth that you will neither wish nor need to look for the "moral". But whether you read _Phantastes_ or not, I may be allowed to suggest that the incident I have attempted to describe conveys one of the secrets of healthy living. It is a trite saying, that health is harmony. But I plead for a much wider and fuller interpretation of harmony than is customary. _Mens sana in corpore sano_--a sane mind in a healthy body--does not fill all the requirements of a healthy life. It is but an excellent theme, wanting orchestration. It is good to aim at a harmonious working of one's internal arrangements if one has had the misfortune or the folly to break that harmony. The physical basis of life must be attended to if we would be well. Only, you cannot stop there without imperilling the whole scheme. Again, it is good to train the body by means of exercise, play, singing and handicraft; all these things react both upwards and downwards, outwards and inwards. For example, one of the special virtues of tennis, if it be played at all keenly, is the necessity for making one's feet (those neglected members!) quick and responsive to the messages of eye and brain. In an increasingly sedentary age the rapidly growing popularity of tennis is, for this one reason alone, a good omen. But if you play tennis, or any other healthy outdoor sport, or learn how to sing, or how to breathe, or if you do Muller's exercises daily, for the sole purpose of benefiting your liver or developing your muscles, or of "keeping fit," you will miss the real prize. It is good, also, to train the mind to be logical, critical and balanced: it is good to cultivate a retentive memory and to store up useful facts. But if while you are aiming at intellectual fitness and alertness you allow these good things to obscure other and better things, if, in short, you let means become ends, you will never be healthy, because you will miss half the joys of living. There are many very skilful performers on musical instruments. They have set themselves, or their parents have set them, to gain certain prizes, distinctions or qualifications. No music is now too difficult for them to execute. But that is exactly what they do--they execute it: destroy its head and heart by sheer mechanical perfection. They have mastered the piano, or the organ, or the violin, or their own voice; but music eludes them. You see why I began with that tale of the curtained doors, the mysterious music, and the quivering statuary. There is an elusive, haunting quality about life and all living things which, if we look for it and listen to it, imparts a glamour, a rhythm, a beauty to everything that is worth doing. The great danger is that in the pressure of work, the hurry of play, the pursuit of health, or the training of the mind we miss the very thing which can give meaning and value to all these things. The severely matter-of-fact people don't go near the curtained doors, and if they did, would discover only a lot of cold, lifeless statues. Whoever heard of statues dancing? Whoever heard of music without instruments? And yet this very sense of a lyrical movement imperfectly seen, and of a temporarily frozen music, is not only the very secret of all art: it is a slender guiding clue to the centre of everything.... And in the house of every man, and of every woman, are the curtained doorways. EDGAR J. SAXON. HOW MUCH SHOULD WE EAT? _This discussion arose out of the article with above title, by "M.D.," which was published in our July number._--[EDS.] III I lift my hat to M.D. and trust that, as I don't know him, the somewhat jarring difference that I have with his views will not be put down to personal feeling. A.A. Voysey has put my first objection quite well from the layman's point of view. He says "there is no agreement between those who have been taught physiology." This is true. Playfair's full diet is different from Voit's. Voit's is different from Atwater's. Atwater's is different from Chittenden's. The custom of reducing the diets to calories, inasmuch as it introduces a false theory, has had a disastrous effect on progress, and has been a great hindrance to the attainment of knowledge. If the coal in the fireplace _were_ the cause of the heat of the fire (but is it?), there is no analogy between the elevation of the heat by hundreds and even thousands of degrees when the fire is lighted, and the elevation of half-a-degree or a degree which occurs when food is taken into the body, especially when we remember that a similar elevation of temperature occurs when work is performed by means of the body without eating or drinking at all. It is quite evident to every clear seer, or it ought to be, that the force of animal life or zoo-dynamic is the cause of the heat of the body, just as the electric force is the cause of the liberation of heat through the battery, and the chemic force is the cause of the heat of the fire, and that zoo-dynamic and electro-dynamic and chemico-dynamic are forms or species or varieties of the one omnipotent and eternal energy by which all things in this universe consist. The aggregate of all the particular forces makes up the eternal energy which is one. They are all species of the one, but it is convenient and even necessary for our limited intellects to consider them separately, for the indefinite number of the facts and also their intricacy and complexity stagger and overwhelm us unless we do; and indeed they stagger us even when we try to treat them and take them up separately for consideration and examination. But now for the proof of A.A. Voysey's statement. Ranke found he required 100 grammes proteid; fat 100 grammes; carbo-hydrate 240 grammes to keep him going. These he could have got from 9 oz. of lean meat or 250 grammes, 18 oz. of bread or 500 grammes, 12 oz. or 55 grammes of butter and 1 oz of fat (I do not, of course, suggest that it would have been wise for him to get them so). Moleschott's demands are: proteid 120 grammes, fat 90 grammes, carbo-hydrate 333 grammes. Voit demands for hard work: proteid 145 grammes, fat 100 grammes, carbo-hydrate 450 grammes. Atwater demands for hard work the following:--proteid 177 grammes, fat 250 grammes, carbo-hydrate 650 grammes. Horace Fletcher, we are told by Professor Chittenden, took for a time, when everything was accurately measured and weighed: proteid 44.9 grammes, fat 38 grammes, carbo-hydrate 253 grammes. Cornaro lived on 12 oz. of solid food and 14 oz. of red wine a day for a period of something like 60 years, from 38 years of age to about 97, and had vigorous health during the time except when he transgressed his rule. Of course, he was not a hard physical worker--_i.e._ he did not do the work of a navvy. But how, in view of these differences, can M.D. say: "These quantities were settled by physiologists many years ago, and no good reasons have since been adduced for altering them"? It is amazing to me to read such a statement. It reminds me of a statement by a distinguished physician in London during last year to the effect that we could not give a growing schoolboy too much food--we could not over-feed him. My opinion, on the other hand, after a long experience, during which time my eyes have not been shut, is that the large majority of the diseases of humanity are due to mal-nutrition and that the form of that mal-nutrition is over-feeding--not under-feeding. This opinion should be taken for what it is worth. But to test it we should ask ourselves: What is the reason for the necessity to take food into the body? Is it to give strength and heat to the body? Or is it to restore the waste of the body sustained by the action on it of the force of life or zoo-dynamic which inhabits it? The demands for food will vary and vary much according to the way in which we answer this question. As you allowed me to discuss this question in _Healthy Life_ in July and August of last year I must not take up your space by discussing it again. But the answer we give determines the amounts of food that we require to take, since, obviously, if the strength and heat of the body depend upon the food, the more food we take the more strength and heat shall we have; while, if the function of food in the adult or grown body is only to restore the waste of the body, the question is how much is the waste. There are various ways in which this question can be answered and I cannot go into them now; but I say, in my opinion, the waste is very much less than is commonly supposed. The body, I take it, is made by zoo-dynamic or the life-force to be a fit habitation for itself. The body must waste when the life-force acts through it, and that waste must be restored by food and sleep, or the body will die; since things (the body) cannot act as the medium of conveying forces (zoo-dynamic or the life-force) without wasting under their action. But so beautifully has the body been made by zoo-dynamic that it wastes very little, much less than is commonly supposed, by the action of zoo-dynamic through it. Not seeing this, we ingest into the body far more than is required to restore its waste, and so we fall ill, for, obviously, if we ingest more than the quantity necessary for this purpose we choke the body up and render it inefficient for its purpose as an instrument for work. Now this is precisely what seems to me to happen in life. As we are all under the double delusion that the strength of the body and its heat come from the food, we all with one accord put far too much food into the body, and when we find that we die, all of us, generation after generation, at from 50 to 70 years of age, we make up little proverbs to justify our unphysiological conduct and say that three score years and ten are the measure of the duration of life. M.D. says that "some twenty years ago most people lived fairly close to the old physiological quantities" (but what are these? for we have seen how they vary), "now they have been cut adrift from these and are floundering out of their depth." May I remind M.D. that people are now living longer than they did twenty years ago. How does he account for that? No doubt some of the increase in the length of life is due to the diminution of the birth rate, but still I suppose M.D. would admit that there is an increase in the duration of life over and above what can be accounted for in this way. If so, how does he account for it? M.D. says, further: "For the public it will now probably suffice if they insist on raising (or considering, A.R.) the question of quantity" (of food, A.R.) "wherever they suffer in any way." I agree with all my heart. But M.D. implies, if I read him aright, that the public should increase the quantity of their food when they suffer in any way. I, on the other hand, and rather unhappily for myself, am convinced that the raising of this question implies that it should be answered in the exact opposite way to that of M.D. and that we should diminish our food if we "suffer in any way." And I can point to Nature's own plan as a corroboration of the truth of my view, for her plan when we suffer in any way is to fling us into bed and take away our appetite, or at least to diminish our appetite if we are not so ill as to require to remain in bed. The whole question of medical practice depends on the answer we give to this question, and therefore one might go on indefinitely with its discussion. Neither the Editors' space and patience nor my time allow of this; but I should like to ask M.D., with all respect, if he remembers what Dr King Chambers said of the starvation that comes of over-repletion? Dr King Chambers occupied one of the most prominent places as a consultant in London (very probably, I suppose) when M.D. was a very young man. My late lamented friend, Dr Dewey of Meadville, Pennsylvania, used the phrase "starvation from over-feeding," not knowing that Dr King Chambers had used practically the same expression before him. That I made the same discovery myself, and independently, is not, I take it, a sign of acuteness of intellect or of observation. The amazing thing is that every practitioner is not compelled to make the same discovery. But if it is a true discovery, then it follows that all the signs of lowered vitality referred to by M.D., while they _may_ be caused by under-feeding, may also be caused by over-feeding and may therefore require for proper treatment, not increase of the diet, but diminution of it. A low temperature, therefore, a slow pulse, languor, pallor, inanition, fatigue, good-for-nothingness, inefficiency, anorexia, anaemia, neurasthenia, etc., etc., may all be due to blocking of the body with too much food as well as to supplying it with too little. Fires may be put out by heaping up too much coal on them. To make them burn briskly we ought to push the poker in and gently lift the coal so as to admit of the entrance of air. Then in a while our fire will become brisk and bright. And so it may be in the body. Nay, my opinion is that almost always these marks of depression are caused by blocking up of the body and that therefore the proper treatment is, as a rule, not increase but diminution of the diet. The place in the body in which the blocking first occurs is the connective tissues or the tissues that connect every part with every other. It is here that the lymph is secreted, and as the lymph joins the thoracic duct which conveys the products of digestion to the blood, it is obvious that lymph-secretion is a complementary digestive process and it is also obvious how blocking up of the connective tissues, which is the immediate cause of anorexia and inanition, usually comes to exist in the body. M.D. talks of "natural food." He seems to be a vegetarian? Good. But is not the question of how much food we ought to eat equally urgent whether we are vegetarian or omnivorous? I think it is. I do not think that the chief cause of our illnesses to-day is taking wrong or unsuitable food. In my opinion we are ill mainly because we take suitable food too often and because we take too much of it. My answer to the question, therefore--"How Much Should We Eat?--A Warning"--turns on the previous question: What is the Function performed by Food in the Body? As I think that this function in the grown body is only to restore the waste, the warning in my mind is far rather that we should take less than that we should (as M.D. advises us) take more. I agree with him in the view that "chronic starvation is insidious." But, as I believe that "chronic starvation" is usually a form of Dr King Chambers's "starvation from over-repletion" and of Dr Dewey's "starvation from over-feeding," I am bound to be of the consequent opinion that it is to be met, not by increase, but by diminution of the diet. This is one of my reasons for thinking that none of us ought ever to eat oftener than twice a day, under fifty years of age, and that after that we would do well to eat once a day only. I feel sure that if we altered our habits in these ways, we should add very much both to the duration and to the efficiency of life. This is not a question of dietetics only. The issue is of the most practical character. What an addition of five or ten or fifteen or twenty or twenty-five years to the average duration of life might mean to this people and still more to the people of the whole globe is unpredictable by mortal man. But it is evident that it would be of the very greatest import to humanity. This is the great issue of the discussion of this subject. It seems to me that illness might be enormously diminished and health and efficiency and happiness immensely increased. But I think that these boons might be obtained, not by indulging the body and its appetites, but only by the exercise of a wise restraint and government over it. It is at least very much to be desired that more agreement might be manifested in the opinions and practice of qualified physiologists so that the public might have clear guidance, and not as at present, be advised in ways so conflicting that they do not know what or whom to believe. A. RABAGLIATI, M.D. * * * * * _To Tourists:_ Every little village has a little shop where you can buy nasty little sweets. PICKLED PEPPERCORNS. He was a native of Liverpool, but had liver for many years in the Isle of Wight--_Edmonton_ (Canada) _Journal_. Funny he didn't go to Poole and leave his liver behind him. * * * * * REAL FLESH FOOD FOUND AT LAST. --From an advt. in daily papers. Evidently we have all been vegetarians and knew it not. * * * * * Nothing can replace salt.--From an advt. in _Punch_. Many food reformers advantageously replace salt with nothing. * * * * * The golf craze has been greater this autumn than in any previous year. Nobody is quite safe from the fever. It seizes those who mocked at it, and pays no respect to sex or age.--_British Weekly_. By the time the next Medical Congress comes round it is expected that at least three distinguished bacteriologists will have discovered the golf-fever microbe. They will probably agree to call it _Mashilococcus Caddes_. * * * * * Between lunch and dinner take another tumbler of water cold. Take a glass of cold water half-an-hour after lunch, half-an-hour after tea, half-an-hour after dinner, and before going to bed at night. Never drink between meals.--_Woman's Life_. All other methods failing, try putting your watch half-an-hour on after each meal. * * * * * I once got a circular from a man who grew potatoes containing his photograph, and, I think, an autobiography.--_Musical Standard_. Not nearly so convenient as one of those automatic egg-stamping hens. * * * * * _Stop-Press News._ A "pocket clipper" has been invented (according to a certain catalogue) which can be used for the beard or hair at back of neck. But surely people who can do anything so clever as grow a beard on the back of the neck ought not to be tempted to clip it off. PETER PIPER. HEALTHY LIFE RECIPES. MORE EGG DISHES. In our issue of May 1912 we published a number of special recipes for eggs. These were much appreciated. And even now this and other back numbers are asked for. We now give some further recipes. It should be remembered that eggs are a simple form of animal food and much purer than meat. They are also easily digested by most people. They therefore form a very useful substitute for flesh-foods, especially where the latter have only recently been discarded. The normal progress towards a more or less ideal diet involves, of course, the elimination of eggs as well as of other dairy products. But wise food reform proceeds always by steps. SAVOURY BAKED EGGS. Melt a little butter, or vegetable fat, in an open earthenware baking dish; break into this as many eggs as required. Cover thinly with grated cheese; add a knob of butter and bake till set. The dish can be placed direct on the table. EGG ON TOMATO.[13] One egg, two medium-sized tomatoes, butter. Skin the tomatoes; cut in halves and put them, with a small piece of butter, into a small stewpan. Close lightly, and cook slowly until reduced to a pulp. Break the egg into a cup, and slide it gently on to the tomato. Replace the pan lid and the egg will poach in the steam rising from the tomato. [13] This recipe is from _The Healthy Life Cook Book_, a new and revised edition of which is in contemplation. SAVOURY EGG FRITTERS. Six eggs, two large tomatoes, half-teaspoon mixed dried herbs, about three tablespoons ground biscuits ("Ixion" or any of the unsweetened "P.R." kinds). Hard boil three of the eggs and chop them finely. Skin the tomatoes, mash them and add to the chopped eggs with the remaining eggs (well beaten), herbs and biscuit powder. Should the mixture be too moist to mould add more biscuit powder; if too dry add a little water. Cut and shape into finger shapes and either fry in olive oil or bake on buttered tin or open earthenware baking dish. (The last-mentioned is the best method, as the baking dish can be brought to the table as it is, and there is only one dish instead of two to wash up afterwards.) SAVOURY EGG PATTIES. The above Egg Fritter mixture made rather moist may be used as a filling for savoury patties. Make for these a short crust with 1/2 lb. of Artox meal, 3 oz. of Nutter and water. Slightly bake the shells of pastry (made thin) before adding the filling, and finish to a golden brown. Serve these and the fritters with either brown gravy or white sauce. SWEET EGG SOUFFLE. Five eggs, 3/4 lb. soft cane sugar, 1 oz. ground rice, 2 oz. of butter, rind of half a lemon. Separate the yolks and whites of the eggs. Beat up the yolks and sift in the ground rice, sugar and grated rind of the lemon. To this batter add the well-whisked whites. Well heat the butter in a frying pan, turn in the batter and fry over gentle heat till set. Fold over the edges and place on well-greased flat dish and bake for barely a quarter of an hour. Sift over some soft cane sugar and serve very hot. SNOW EGGS. Three eggs, one and a quarter pints of milk, a teaspoon of soft cane sugar, vanilla flavouring. Separate the yolks and whites of the eggs and whisk the whites to a very stiff froth with the sugar. Put the milk into a saucepan and when it boils drop in whites of eggs in small pieces shaped between two dessert spoons. Only a little should be cooked at a time in this way, and each should be allowed to poach for two minutes, and when done should be taken out with a slice and put on a sieve to drain. When all the whites are used in this way, strain the milk and add it to the well-beaten yolks. Pour into a double saucepan and stir over the fire till the custard thickens; flavour with vanilla to taste. When _cold_ pour into a dish and lay the snow eggs on top. (Kindly supplied by Mrs Edith Wilkinson.) EGG-RAISED CHERRY CAKE. 9 oz. good "standard" flour, 5 oz. Nutter (or other nut fat), 5 oz. cane castor sugar, 2 oz. preserved cherries (glace), 2 oz. well-washed sultanas, 2 oz. ground almonds, four eggs, outer rind of lemon (grated). Beat Nutter and sugar to a cream; add eggs one by one, beating all the time; have ready the flour, with the fruit, grated lemon rind and ground almonds mixed in, and add gradually to the above mixture, beating all the time, and until of even consistency throughout. Line a cake tin with double thickness of buttered paper, pour in the mixture and bake in moderate oven about one and a half hours. _Any housewife who doubts the possibility of making light and dainty cakes without the now customary baking powder and baking soda, etc., should try the above recipe. No one could wish for a more excellent cake._ NOTE ON CASSEROLES. Now that casserole cookery (_i.e._ cooking in earthenware dishes, both open and covered) is becoming more widely known and practised, readers will be glad to know that many housewives believe in boiling new earthenware before using it, as this effectually toughens and hardens it. This is particularly efficacious in the case of ordinary brown kitchenware, the articles being placed in a large pan of cold water which is then brought slowly to the boil. After being allowed to boil for ten minutes remove the pan and allow the water to cool before taking out the ware. HEALTH QUERIES. _Under this heading our contributor, Dr Valentine Knaggs, deals briefly month by month, and according as space permits, with questions of general interest to health seekers and others._ _In all Queries relating to health difficulties it is essential that full details of the correspondent's customary diet should be clearly given._ _Correspondents are earnestly requested to write on _one side only of the paper_, giving full name and address, not for publication, but as a guarantee of good faith. When an answer is required by post a stamped addressed envelope must be enclosed._--[EDS.] EXCESSIVE PERSPIRATION. Miss R.E.N. writes.--I am troubled with excessive perspiration. I neither eat meat nor drink tea. I have a cold sponge bath down to my waist every morning, and I change all my clothes when I go to bed. My diet is, roughly, as follows: _Breakfast._--Oatmeal porridge with toast or bread and jam or golden syrup. Hot water. _Lunch._--Peas, beans or lentils, eggs, cheese. Vegetables: potatoes and onions, or carrots, cabbage, cauliflower, turnips. Puddings, fruit or milk wholemeal bread, not much sugar except for sweetening fruits, etc. _Tea meal._--Wholemeal bread and butter, nuts, jam, cake, pastry; hot water. _At bedtime._--Hot water or coffee. If our correspondent wishes to remedy this excessive perspiration she must get a hot towel-bath daily (all over),[14] wearing porous linen-mesh underclothing next the skin. She should also discontinue the soft sugary and starchy foods, and not mix fruit with other foods (it is best taken by itself, say, for breakfast). She needs more of the cooling salad vegetables. The following diet would be a great improvement:-- _On rising._--Half-pint of hot boiled water, sipped slowly. _Breakfast._--Wholemeal bread or biscuits and butter (all made without salt), with salad or grated raw roots. Stop porridge, jam and golden syrup. Avoid drinking at meals. _Lunch._--Two eggs, or 2 oz. of curd cheese. Two vegetables cooked in casserole without salt; wholemeal bread or biscuits and butter; a few figs, prunes, dried bananas, or raisins, washed but not cooked. Avoid milk puddings or stewed fruits as too fermentative and heating. _Supper meal._--1 to 2 oz. flaked nuts, some crisp "P.R." or "Ixion" biscuits with nut butter. Some fresh salad or grated roots. Stop jam, cake and pastry. _At bedtime._--Half-pint of hot boiled water, or clear vegetable soup, sipped slowly. [14] The Sanum Oxygen Baths are also excellent in a case of this kind. DIET FOR ULCERATED THROAT. Mrs L.B. writes.--Do you think it would be wise for a person suffering from ulcers in the throat and on other mucous membranes to adopt a diet devoid of meat, yeast and salt? It would certainly be wise to discard meat and salt in a case of this kind, but yeast is sometimes useful taken as "unflavoured Marmite." The chief cause of ulcers is the abuse of the soft cereal and sugary foods. In a case of this sort I should advise a diet consisting exclusively of well-dextrinised cereals--_e.g._ Granose, Melarvi, etc.--with plenty of grated raw roots and finely chopped salads and tomatoes. This can be combined with curd cheese, raw or lightly cooked eggs, flaked nuts or Brusson Jeune bread as the proteid part of the diet. FARMING AND SCIATICA. Mrs A.C.B. writes.--For two months my husband, who leads an active open-air life, has had severe pain all down the back of his left leg. It is like neuralgia, and comes on worse when sitting. He has been a farmer all his life, but is anything but strong and constantly taking cold. Are these pains likely to be due to wrong food? This pain is evidence of sciatica. Chills alone will not produce sciatica, which has its real cause in the system being choked up with acids and toxins of various kinds. In such a case as this, warm water enemas should be taken freely to clear the colon well; sugar, milk and all starchy mushy foods should be strictly avoided; vegetables should be taken either as baked roots or as fresh salads; eggs and cheese should be substituted for meat; and plenty of fresh butter should be taken. Boiled water, _between meals_, will be good, but nothing should be given to drink with food. Salt, pickles, and greasy or highly flavoured foods should be avoided. TEMPORARY "BRIGHT'S DISEASE" AND HOW TO DEAL WITH IT. Miss E. would like to know what kind of diet is suitable for one who has been suffering from Bright's Disease following a serious illness. Why should meat have any bad effect upon the kidneys? She does not take it, although her medical man advises the use of it at once. It is not an uncommon thing for people who have suffered from an acute septic fever to find albumen temporarily present in the urine. This is due to the irritant action of the toxins and other poisons (which the fever is the means of ejecting) upon the structure of the kidneys. The kidneys are filters and they remove the bulk of the soluble waste of the body. The practitioner frequently finds albumenuria in cases of scarlet fever, typhoid fever, diphtheria, etc., and the object of his treatment is to prevent this condition of kidney irritation from becoming an established disease (Bright's disease). Flesh foods, and especially meat extracts and meat soups, are the worst possible wherewith to feed these fever cases, because they throw so much extra work upon the kidneys. Meat is composed mainly of proteids. It also contains the urinary wastes and the toxins (due to fear) which were in the animal's body and on the way to elimination when it was killed. This sufferer should take one meal per day consisting of fresh fruit only; the rest of the diet should consist of salad vegetables and finely grated raw roots, home-made curd cheese, dextrinised cereals (such as Melarvi biscuits, Shredded Wheat, "P.R." crackers, Granose biscuits, Grape-Nuts, twice-baked standard bread, etc.) and fresh or nut butter. PHOSPHORUS AND THE NERVES. W.H.H. writes:--I should be very grateful if Dr Knaggs could help me with any information or hints regarding phosphaturia. I suffer much from this troublesome complaint. We have to remember that the nervous system is two-fold. The one, or conscious portion, consists of the brain and spinal cord, from which all the nerves or branches travel to all parts of the body and give us dominion over them. The other, or subconscious, called the sympathetic nervous system, lies on either side of the front of the spine as two long chains with centres, or ganglia, at intervals. This second system is not within our control and has to do with the regulation of our vegetative functions, including the bulk of the digestive process. All nerves, whether they come from the brain or from the sympathetic system, ranging to their smallest terminals, are built alike of cells, and these cells secrete a complex _fatty_ substance, called _lecithin_, whose dominant element is phosphorus. This phosphorus has to be supplied to the body with food, and as food, and it cannot be properly utilised or assimilated by the body or used by the nerves to build up their _lecithin_ unless it is eaten in the form of organic compounds. The tissues of the body are continually dying, as a result of work done, and are continually being replaced by fresh young tissues as needed. It is the function of the nerves to manage this work for us as well as to similarly arrange for reproduction. In order to control the functions of the various organs and tissues and to regulate the rate at which they reproduce themselves, the nerves extend their terminal branches, not only into every tissue, but into every microscopical unit of such tissue, and the part of the cell which represents the nerve terminal is the inner structure called the nucleus. Now it will be obvious that the more the two nervous systems are worked the greater will be their depletion of _lecithin_ and the more need there will be for fresh supplies of phosphorus in the daily food rations. The person who works hard, whether it be manual labour or brain work, needs food and rest at intervals in order that the nerves may recuperate and replenish their stocks of _lecithin_. A goodly proportion of uncooked foods rich in phosphorus must be supplied to make good the wear and tear, and the digestion must equally be efficient if these food-stuffs are to become assimilated. Cooking of food to a large extent breaks down the organic phosphorus salts and makes them inorganic. In this state they are of but little use to the body. Poor digestion associated with putrefactive fermentation equally converts the organic salts into inorganic ones. These pass into the blood and are promptly eliminated by the kidneys as waste (_phosphaturia_) and thus they never reach the nerves at all. We must remember that phosphorus is usually found in natural foods bound up with the proteid and especially with that proteid which has to do with the reproduction of the species. For this reason man instinctively resorts to the use of egg-yolks, and to the various seeds (such as nuts, wheat, barley, etc.) because of their rich phosphorus content. These proteid-bound phosphorus salts can only be properly utilised when the hydrochloric acid of the stomach juice is well formed, for it converts them into acid salts which are readily absorbed. Therefore to ensure free absorption we must always remember to give the phosphorus-containing foods with such meals as will cause free secretion of the gastric acid. When fermentation is active and the stomach juices are weakened the germs of the intestines rapidly break up the phosphorus constituents of the proteids and make them inorganic. Therefore the first thing to do when a person is found to be suffering from _phosphaturia_ is to stop the intestinal fermentation by a right diet, clear the bowels of their accumulated waste poisons and give the nerves plenty of rest. Another consideration to bear in mind is that the nerves need fat wherewith to build up the _lecithin_. An excessive fermentative sourness of the stomach makes the food so acid when sent into the bowels that the bile, pancreatic and other intestinal juices cannot neutralise them, and so the fats themselves are not emulsified and digested, which fully accounts for the mental depression and debility of which these patients complain. People who are suffering from "nerves" in any form need plenty of pure fat (fresh dairy butter, cream, nut butter, fruit-oils, etc.) and an abundance of natural fresh vegetable products at once rich in phosphorus and iron and in organic alkaline acid-neutralising earthy salts. These arrest fermentation and so enable the phosphorus and the fat to become duly assimilated. CANARY _VERSUS_ JAMAICA BANANAS. R.B., Lincoln, would like to know if there is very much difference, as regards food value, between the Jamaica and Canary banana. "I have heard it said that the Jamaica is only fit for the dust-heap. Well, I cannot very easily think it is so useless, and at the same time I have an idea that the Canary is the better of the two. I should be very pleased to know if you think there is much difference between them." The difference between Jamaica and Canary bananas is due to the length of time necessary for them to reach us from their place of growth. It takes, I believe, nearly twice as long for a ship to travel from Jamaica as from the Canary Islands. Hence the fruit imported from the latter place can be picked in a much riper condition than would be the case with the Jamaica article. This probably accounts for the better quality and flavour of the Canary banana. Besides this the climate may have some determining influence. To say that the Jamaica bananas should be discarded because they are of a less satisfactory food value or because their flavour is less developed is uncalled for. The disparity in price is also very marked, so that the poor can readily procure the Jamaica banana where they would not be in a position to afford the better class of fruit coming from the Canaries. I have discussed this subject in p.34 of my book, _The Truth about Sugar_. H. VALENTINE KNAGGS. CORRESPONDENCE. LEYTONSTONE _To the Editors._ SIRS, Enclosed please find P.O. for a copy of _The Healthy Life_ to be sent to Carnegie Public Library, close to Midland Station, Leytonstone, also to The Alexandra Holiday Home, Y.W.C.A., Alexandra Road, Southend-on-Sea. At the latter home there are something like 500 to 600 visitors every year, many of whom are semi-invalids. No doubt the magazine will be scorned by many, yet I am quite certain that there are others amongst the number there who will gladly welcome the truths it teaches, and if only one or two are helped to live a more healthy and therefore more happy life, it will be quite worth while. Please do not mention my name in either case. Yours, etc., X. There is every reason why _The Healthy Life_ should be known and read in every public library in the United Kingdom. In this we are entirely dependent upon those readers who are ready to follow the excellent example of the above correspondent. A year's subscription--2s.--is a very small price to pay for bringing the message of this magazine before the public in this way. We should like to hear from readers in all parts.--[EDS.] +--------------------------------------------------------------+ | | | #Back Numbers# | | | | If readers who possess copies of the first number of _The | | Healthy Life_ (August 1911) will send them to the Editors, | | they will receive, in exchange, booklets to the value of | | threepence for each copy. | | | +--------------------------------------------------------------+ THE HEALTHY LIFE The Independent Health Magazine. 3 AMEN CORNER LONDON E.C. VOL. V NOVEMBER No. 28. 1913 _There will come a day when physiologists, poets, and philosophers will all speak the same language and understand one another._--CLAUDE BERNARD. AN INDICATION. It was the slave-woman who laid her child under a bush that she might spare herself the pain of seeing it die! One of the commonest sources of mental and moral confusion is to mistake the egotistic shrinking from the sight of suffering with the altruistic shrinking from causing it and desire to relieve it. The so-called sensitive person is too often only sensitive to his or her own pain and, therefore, finds it difficult in the presence of another's suffering to do what is needed to relieve it. The healer, the health-bringer, the truly sympathetic person, does not even hesitate to inflict pain when to do so means to restore health.--[EDS.] CASTLES IN THE AIR. _Regular readers will recognise in this wonderfully simple and suggestive article a continuation of the series previously entitled "Healthy Brains." The author of "The Children All Day Long" is an intimate disciple of one of the greatest living psychologists, and she has a message of the first importance to all who realise that true health depends as much on poise of mind as on physical fitness._--[EDS.] Of all the occupations which imagination gives us, surely none is more popular or more delightful than the planning out of future days. Pleasure and fame and honour, work and rest, comfort and adventure: all things take their turn in our romances. Not all the castles are for ourselves alone. In childhood it is our school, our club, our town that is to be the centre of great events. The young man's castle is a nest to which he hopes to bring a mate. The mother sees the future coronet or laurel-wreath round the soft hair of her baby's head. And we all build castles for the world sometimes--at least for our own country or our own race. Sometimes we knock them down and rebuild again in rather different shape--Mr Wells has taught us what a fascinating game it is. Sometimes, especially perhaps in little, unimportant things, our imagination does centre chiefly around our own activities. What we mean to do, what we might do, what we would like to do: there must be something else besides selfishness and waste of time in the constantly recurring thoughts. Who does not know the charm of looking down the theatre-list of the morning paper? One may be too busy or two poor to go often to the play, but the very suggestion of all the colour and interest is pleasant. Who does not like looking over prospectuses of lectures and classes at the beginning of the winter session? "I _should_ like to go to that course on Greek Art. Oh, it is on Mondays, then that is no good. German, elementary and conversation. How useful that would be! Gymnasium and physical culture; how I wish I had another evening in the week to spare!" Railway books, again, and guides and travel bills--how delightful they are! It is easy to plan out tours for one's holidays up to the age of 100. "Brittany; oh yes, I must go there one day. And Norway, that must really be my next trip." The Rockies, the cities of the East, coral islands of the Pacific--they all seem to enrich our lives by the very thought of their possibilities. Again, who does not love a library catalogue? To go through with a pencil, noting down the names of books one wants to read is a form of castle-building by no means to be despised. Some people get the same pleasure out of house-hunting; they see an empty house and go and get the key in order to see over it. The chances of their ever living there are practically none, but the view gives a stimulus to their inventive activity: they plan out how they would furnish the rooms and fill the empty hearths with dreams. Is not the same thing the explanation of shop-gazing? The woman who has bought her winter coat and hat does not as a rule refrain from looking any more into shop windows till the spring; instead, she clothes herself in imagination in all the beautiful stuffs she sees displayed, and if some of the things demand ballroom, racecourse, golf links or perhaps the Alps for the background, why, so much the better, the suggestion puts, as it were, a view from the windows of her castle in the air. A garden--a dozen square yards or reckoned in acres--is full of material for our imagination; indeed, a seedsman's catalogue or a copy of "Amateur Gardening" will often be enough to start us; long lines of greenhouses will build themselves for us, or rockeries, or wild glens with streams in them, and the world will blossom round about us. Sometimes it is ambition that calls us, personal or professional; we get beforehand the sweet taste of power upon the tongue. It may perhaps be sometimes the rewards of work, riches and honour and so on, but more often, I think, the dreams of youth circle round the work itself. We will be of use in the world, we will find new paths and make them safe for those coming after us to walk in, we will get rid of that evil and set up a ladder towards that good; we will heal, teach, feed, amuse, uplift or cherish the other human beings round about us. We will store only for the sake of distributing; we will climb only to be better able to give a helping hand. Well, there are some danger signals at cross-roads of our dream-way, some precautions to be observed if we would not let romance obscure and hinder us in our search after reality. But none of these "castles" are bad in themselves. In so far as they quicken our attention power, deepen our thoughtfulness, make our activities more elastic and keep us from carelessness or sloth, they are surely all to the good as episodes in our development. E.M. COBHAM. THE SCIENTIFIC BASIS OF VEGETALISM. This article, the earlier part of which appeared in the October number, is from the French of Prof. H. Labbe, the head of the _laboratoire a la Faculte de Medecine_, in Paris. It reflects a characteristic aloofness to a any considerations other than scientific or economic. But it will well repay careful study.--[EDS.] V Though the consumption of vegetable foods seems to offer a slight disadvantage from the point of view of albuminoid matters, this is not the case touching hydro-carbonated matters and sugars. The vegetable kingdom constitutes the almost exclusive source of these alimentary principles. One cannot indeed take much account of the consumption of the .5-.6 per cent, of glycogen which exists in the animal muscle partaken of under the shape of butcher's meat. There is hardly enough in this for a large eater of between 200 and 250 grammes of meat, to find in hydrocarbonated matters the 1/300 or the 1/400 of the daily ration. Hydrocarbons are necessarily borrowed from the vegetable foods. This is also the case with sugars which do not exist in the animal kingdom in appreciable quantities. It is the same thing with alcohol which is obtained only from the vegetable kingdom. VI As to fatty matters, animal foods, like vegetable products, are abundantly provided with them. Moreover, from the point of view of digestibility and capability of assimilating, one may say that there is a quasi-absolute identity between animal and vegetable fats. The reason which would induce us to prefer either would not seem to be of a physiological nature. The economics, which we shall see further on, take this upon themselves, as the most serious reproach which can be made against the use of animal dishes is doubtless their dearness, and the reason which militates most in favour of the predominance of a vegetable diet is to a certainty its cheapness. VII Such are, briefly expounded and refuted, the fundamental objections which can be brought against the vegetarian diet and the "vegetalian" customs. There exists, in fact, no serious physiological or chemical reason for not satisfying our needs solely with foods of vegetable origin. It may be interesting to note that, in reality, the most confirmed flesh eaters support their energy-producing needs mainly with vegetable products. In the mixed diet universally practised meat plays but a small part. In meat the waste in preparation and consecutive waste at table is considerable. To really introduce 200 grammes of meat into the stomach, nearly 400 grammes must be purchased, and expensively put into use. What do these 200 grammes really bring in nutritive elements? Meat. 200 gr. (mod. fat.) at 18% albumin = 36 gr. album., about. " " 5% fat = 10 gr. fat, about. ----- 46 gr. These 46 grs. constitute barely the 8 per cent. of the total weight of a ration, averaged in nutritive elements, calculated as follows:-- Albumin 80 Fatty matters 70 Hydrates of carbon 350 This is a very feeble proportion. If one turns to the calorific point of view, in order to estimate the share of energy useful to the organism, we arrive at much the same conclusion. The 46 grs. of nutritive animal elements barely provide 230 thermal units which can be utilised, while the total diet which we are considering brings a power of disposal of nearly 2,350 thermal units. It is, even then, barely 10 per cent. of the total energy. The most convinced flesh eaters, those who buy 400 grs. of meat a day for their consumption, must learn, willingly or unwillingly, that the animal element enters only in an infinitesimal part into their real substance and reparation. VIII Beyond this very feeble nutritive help is there, then, in meat, anything else which makes the use of this article of food necessary, agreeable or particularly strengthening? It is incontestible that meat contains stimulating substances, which, as Prof. Armand Gautier has said, play the part of nerve tonics, and have perhaps a direct action on the circulation. These special meat matters are found concentrated in the gravy. Meat gravy, in fact, beside a feeble proportion of albuminoid matters, or solubly derived quantities, polypeptides, etc., in notable proportion of liberated acids, contains a certain quantity of matters, qualified by the generic name of extractives; a notable quantity of these extractive matters being creatine and creatinine, as well as substances of which the fundamental nucleus is the puric grouping. These purins, by the name which E. Fischer attributes to them, derive from a special grouping which it would be supposed exists in a hypothetic body, but which is not known in a state of liberty, purin. This first term gives rise to a series of bodies in lateral groups, of which the most interesting are caffeine and theobromine. Amongst these substances the one which has the maximum of oxidation is no other than uric acid. Caffeine and theobromine enjoy nervine properties and energetic vascular actions. These properties minutely studied are utilised every day for therapeutic purposes. It is probable that the other bodies of the series which are met with in the extract of meat enjoy analogous physiological properties. These substances are ingested without discernment, often in great excess, and daily, by people who consume meat. Amongst these latter, many would not dare to drug themselves with a centigramme of pharmaceutic caffeine, whereas they absorb each day gr. 5 and more, of its homologous constituents. Therefore, in the same way as chocolate, tea and coffee, meat has a stimulating effect on the system. He who is accidentally deprived of it finds that he experiences a passing depression. This obviously proves that by the exaggerated use of meat, one drugs and doctors oneself without discernment. However this may be, the judicious part played by meat must apparently be reduced to that of a condiment food destined to produce in a measure the whipping-up which is useful, and sometimes indispensable to the system. We cannot here discuss the expediency of action and the harmlessness of the dose of substances reputed stimulating. But one can ask oneself whether, to attain this object of stimulation, carnivorous feeding is indispensable, and if vegetarianism could not supply the need. The reply is easy: the vegetable kingdom disposes of a variety of stimulating articles, such as tea, coffee, kola and cocoa. Through their active substances these foods are nerve tonics of the first order, less dangerous in their use than meat, because more easily assimilated, of far more continuous effects, less mixed with other substances, sometimes noxious, and consequently more measurable. Besides, in pulse food, quantities of purins are found as important as in meat. If the part they play has not been systematically studied from the point of view of their effects on the nervous organism, they still give rise to the same terminal products, such as uric acid. One can quite well argue that the pulse purins have physiological effects comparable to those of meat purins. On the other hand, vegetable purins have the considerable advantage of being less easily precipitated in the urine, after the human interorganic metabolism, than those resulting from the metabolism of flesh material. This explains why a frequent use of a vegetable diet offers appreciable advantages in the amelioration of arthritic diatheses so common amongst us. Certain effects observed in these diatheses arise from the purins, from their localisation in the system, and their vitiated metabolism. The use of a moderate vegetable diet is the best means of treatment in order to relieve, to ameliorate, even to cure, arthritic diathesis. IX Such are the certain physiological advantages which the predominant use of vegetable products are capable of offering. If one takes the pure energy-producing point of view, the superiority of the vegetarian diet becomes greater still. From the fine works of A. Chauveau, modern physiology has shown us that muscle, in working, consumes sugary materials. These are provided by ingestions of sugar in a natural state, of dextrine or of starch; for a less important part, the glycogen of the system may also arise from hydrocarbonated cords existing in the molecule of certain albumins. Therefore it is only in an infinitesimal part, due to the fibrine of meat, and to the small proportions of glycogen which it contains, that flesh diet intervenes in the direct production of kinetic energy. The demonstrations which have been essayed, touching the muscular superiority of vegetarians, appear superfluous to us. Such experiments could only have a positive value if they were made on both series of antagonistic subjects, with alimentary powers of energy-producing equality. It should be distinctly understood that the vegetarian does not profit by any mysterious forces. The habit of preferring to nourish oneself with vegetable foods, can, at most, or at least, favour the physiological integrity of the subject, shield him against disease and assure his revictualment with foods recognised as active and easily measurable. One cannot leave alcohol out of the list of advantageous vegetable foods. In fact, provided one keeps to strictly limited doses, it may be included among the alimentary foods, on a footing comparable to that of sugar. If one knew how to use without misusing it, alcohol might become a daily food. X Another order of ideas which one cannot pass by in silence at the present time militates in favour of vegetable alimentation. Dietetics cannot neglect economic problems. A flesh diet is very costly. In large towns, like Paris, at a time when everything is increasing in cost, one must be favoured by fortune to be able to indulge in the real luxury of consuming the calories of meat. As we said in 1905, with Prof. Landouzy and M. Labbe, in our inquiry into popular Parisian alimentation, the calorific energy of meat comes, on an average, to between 15 to 20 times dearer than that of bread or pulse foods. The diet with a vegetable predominance may therefore, by those who adopt it, be considered as much less costly than a mixed one. Does not this fact, then, deserve to be taken into consideration and compared--startlingly illustrative--to the ingenious calculation recently made by Lefevre in his examination of vegetarianism? One acre of land planted for the purpose of breeding cattle produces three times less living strength than an acre planted with wheat! Is it not criminal, or at any rate ill-judged, for the richness and health of the country to have, by the laws of a draconian protectionism, spurred the French agricultural population along the road to the breeding of cattle, thus turning it away from cultivation? These laws are the cause, on the one hand, of the high price of wheat, owing to the abandonment of its culture and the barriers opposed to its entrance, and on the other, of the dearness of meat, owing to the stock and the land which the cattle require. Under these facts economists have indeed a direct responsibility, as for more than fifty years economic orthodoxy has presented meat as a necessity, whereas it is the least advantageous particle amongst so many others. In conclusion, let us hope that future distinctions of "Vegetalists," vegetarians or flesh eaters may be completely abolished. _In medio stat virtus._ The dietetic regimen, the general adoption of which must henceforth be desired, must reject all preconceived and hereditary ideas, and unite in one harmonious use all foods with a hygienic end in view. The place of each one amongst them and its predominance over the others should be determined only by conforming to reasons at the same time physiological and economic. H. LABBE. +--------------------------------------------------------------+ | | | #To Our Readers.# | | | | Readers who appreciate the independence and all-round nature | | of _The Healthy Life_ can materially assist the extension of | | its circulation by tactfully urging their local newsagent to | | have the magazine regularly displayed for sale. An | | attractive monthly poster can always be had free from the | | Publishers, 3 Tudor Street, London, E.C. | | | +--------------------------------------------------------------+ HEALTH AND JOY IN HAND-WEAVING. _This article gains additional interest from the fact that it has been written by one who works her own loom and teaches others the ancient and healthy art of hand-weaving._--[EDS.] Hand-weaving is an art, a handicraft, one aspect of which we are apt to forget--namely, that it is a splendid health-giver. Indeed, all who have felt the rhythm of the loom, as they throw the shuttle to and fro, and in blending colours and seeing the material grow thread by thread, can witness to the power of the work to banish both the large and small worries that eat away our health of mind and body. The hand-weaver learns to look upon his (or her) loom as a very good friend. The possibilities in weaving are immense, and the great difficulty that always confronts the weaver is the impossibility of letting gussets into the day: the end of the week comes all too soon. One very satisfactory thing about weaving is the fact that from the very first we can use the things woven, even those we learn on. First, there is plain weaving, with which we can make dress materials and many things for household use. Then come fancy and striped materials, which require more knowledge and ingenuity. There are endless varieties in bands of different patterns thrown in with the shuttle, or shuttles, sometimes as many as a dozen of which may be in use at a time. These can be used for the purpose of ornamentation. In weaving these no end of play of colour can be made, by using many colours in rotation, either as the groundwork of plain material, under the patterns, or as the pattern itself. Metal threads can also be used of various kinds, either as an entire texture, or to enrich the fancy bands. Lastly, there is inlay weaving, by which we can put in by hand, with little separate bobbins, as we go along, any cross-stitch design, lettering, monograms, figures and designs of every description. Anyone with a knowledge of carpentry can make his own loom, the construction being of a very simple nature. In fact, the Orientals erect a few sticks, dig a hole in the ground to sit in, tie their warp up to a tree, and then produce the most charming work, both in texture and colour. The warp can also be made as these people often make theirs, by fixing it to sticks stuck into the ground, and walking backwards and forwards with the thread, singing as they go. Yes, singing! I think we English folk might learn from them to put more joy into our work, that fountainhead of life and health. We are apt to take such a serious view of ourselves and of all we do. So often, too, we only feel the dull and quiet colours, instead of using the many brilliant ones that nature loves so well. Once we begin working in, and appreciating, these we realise the exhilarating effect on our spirits. Indeed, I think we are only beginning to realise what a great influence colour has upon us, and all that colour signifies, each colour having various meanings of its own. Many people are now realising that we are surrounded by a halo of colour woven by our character--the most highly developed people being surrounded by clear, bright colours. It is strictly true that we are all weavers, every day of our lives. By following the laws of nature we make the finest texture composed of all the most glorious colours or qualities in the Universe, so by degrees bringing ourselves, and others, into perfect harmony and peace. MINNIE BROWN. HOW MUCH SHOULD WE EAT? _This discussion arose out of the article with above title, by "M.D.," which was published in our July number._--[EDS.] IV In dealing with this vitally important question, we shall most of us, I take it, agree upon certain points. In the light of recent knowledge upon, and extended experience of the subject, one such point which now appears incontrovertible is that there are thousands die annually--directly or indirectly--through overfeeding where one dies through insufficient nourishment. And it may at once be said that, as regards these thousands, the death certificates are practically valueless as data in relation to erroneous dieting, so that in this way we can never get at a correct estimate as to the actual number of deaths due to overfeeding. Bright's disease, gastric and intestinal affections, growths of various kinds, cancer, etc., are each in their turn certified as the "Cause of Death." Most often, however, the initial cause is the overloading of the system with an amount of food beyond that which is necessary or healthful--and thereby clogging up the tissues, the organs and smaller bloodvessels. But it may be said: "How can you substantiate such a general and sweeping statement?" In the first place--and this is profoundly significant--other things being equal, it must be acknowledged by all unbiased people that the small and moderate feeders do not contract disease in anything like the proportion that big feeders do, and as a natural consequence live longer lives. Further, it must surely be quite evident by this time that there is a sufficiently large enough number of people who are thus existing in good health--and steadily regaining it where it has been lost--on the lines of moderate feeding. And the number is accumulating at a rapid pace; more and more are coming into line with those of us who, having thus found health in themselves, their patients and friends, are preaching the practice of two meals a day, and sometimes only one where there is serious organic disease to combat--thus defying the dicta of those eminent physiologists who "settled" the question years ago. Now I quite admit--it would be impertinence to do otherwise--that "M.D.'s" statements and views must not be ignored, must indeed be respected. And he tells us that he "heard of," in one day, three cases which "went wrong" through underfeeding; well, for those three cases we can point to hundreds who are _going right_ through eating just enough and not too much. I am prepared, on the other hand, to admit the danger of a continued semi-starvation diet; our difficulty is to define in each individual case what exactly would be a semi-starvation, and what a sufficient diet. It is impossible to have a fixed standard for everybody. After all, "the proof of the pudding is in the eating"; often it is a matter of experimenting for some little time, and in this way we could judge largely of the result of our dieting by our state of general health. On some main points of the question I am now absolutely convinced--viz.: 1. Excessive bulk is always dangerous, often disastrous, causing sudden death in a large number of cases. 2. Starchy foods are best strictly limited as we get along towards middle age and beyond. 3. A life which is largely mental or sedentary will be healthier and longer on a strictly moderate diet. 4. A life largely of physical labour must be dealt with on its own particular conditions. 5. At all times due regard, of course, must be paid to age, weight, etc. 6. On the whole, "eminent physiologists" have erred on the side of excess of proteid being advised. 7. Middle age is the critical time of life in respect to a man's diet in other words, I would say in axiomatic form that as a man feeds at or about middle age, so will he be for the rest of his life. J. STENSON HOOKER, M.D. V As a very interested reader of this discussion I should be very glad to know exactly what "M.D." means by _each pound_ of _bone_ and _muscle_ in the body weight? What proportion (approximately) is it to total body weight? I have been trying to keep up to Dr Haig's 9 grains per lb. of "body weight" and find that it is too much for my digestive powers, which are very weak owing to chronic nervous dyspepsia. If I take 15 per cent. or 20 per cent. _less_ proteid my troubles are so greatly lessened that I feel that to continue to take the lower amount would mean perpetual relief. But there have been so many warnings, including M.D.'s, of the dangers of under-nutrition, that I am in a quandary; and others of your readers too. If M.D. means grains per lb. of _something less_ than total body weight, a lesser amount of proteid than I try to take may have his sanction, and be safe for me. JNO. A. COOKSON. * * * * * There appears to be a sincere attempt in "M.D.'s" article to prove that a physiologist is the best guide in diet. But, as one can get the degree of M.D. without any scientific knowledge of dietetics, the inference that one would be likely to make from such an alarming article is erroneous. I say "alarming" because vague statements are made as to patients who were rescued just in time to be stimulated by over-feeding into a semblance of health, and we are treated to a list of very alarming symptoms in the last paragraph on p. 443. "M.D." says, "Suppose that the animal fed for years on unnatural food has become so pathological that it can no longer take or digest its natural food." How grateful to M.D. for this statement will be those who long for an excuse to cling to the spoiled, boiled and unnatural dishes of which the popular diet mainly consists! And how they will continue to overeat themselves, content to avoid the truth regarding food quantities. Living on a right and natural diet, a man or woman will correct the effects of wrong living. This will bring crises, and unless they know that this is Nature's attempt to rid the body of unwanted and effete matter they may be duped into returning to their high feeding, either by those whom "M.D." calls diet quacks or by qualified quacks. I do not believe it possible for anyone to die for lack of indication that they were eating too little. The opposite is what people die of. If we carefully read Dr Rabagliati's article in the same issue we shall rightly ask what would be the results of analyses and measurements in such a case. About a year ago we had a young woman under our care who had suffered with deafness and other troubles for years. She had tried dietetic treatments, "uric-acid-free" and otherwise, and had at last been told that her deafness was incurable, being due to heredity and deficiency in the organs of hearing. She was extremely thin when she came to us, but we did not measure her, nor analyse unclean excreta, nor weigh her. She saw an M.D. who was in sympathy with the philosophy of fasting, and she fasted (taking water only) for 28 days. She then had four days of fruit juice, and was so disappointed at having broken her fast prematurely that she continued it for another 12 days, making 44 in all--40 days actual fasting. [_During this period she was living an almost complete out-door life._--EDS.] During the fast many interesting phenomena were witnessed, chief among which was the discharge from ears and nose--significant indeed to all who study Nature's ways. Result: normal hearing restored. This was nearly twelve months ago; and, having heard of her recently, we find that, though she had had a cold, there has been no recurrence of deafness. I wonder what assistance measurements would have been in this true cure. The patient (an adult) weighed 4st. 8 lbs. at the end of her fast and could then walk short distances. The way in which "M.D." dismisses "a little gout" in his last paragraph but one almost leads one to think that he is unaware of the failure of the natural defences of the body that must have gone on in a very serious degree before the manifestation of gout became possible. I respectfully submit this problem to "M.D.":--If a very thin patient can go without food entirely for 40 days, with only benefit accruing, _how many centuries_ will it take for a fairly fat person to die through slightly under-eating? As Dr Haddon has said, the proteid myth will die hard, but there are physiologists who, with their faces to the light, are finding the truth of man's requirements in food and who know that absolute purity and simplicity are the ideals to be sought and that all food we eat more than is absolutely necessary is a diversion of energy to carnal channels. ERNEST STARR. A DOCTOR'S REASONS FOR OPPOSING VACCINATION. In opposing vaccination I am aware that it is a thankless task to brave the abuse and antagonism which everyone who attempts to move forward in the work of medical progress is sure to encounter. In order that I may not be regarded as prejudiced against the dogma of vaccination, I will preface my remarks with the confession that I was at one time myself a confiding dupe of the "tradition of the dairymaids." While attending medical college I was told that inoculation with cow pox virus was a certain preventive of small-pox, and like most other medical students I accepted with childlike faith and credulity the dictum of my teachers as so much infallible wisdom. After an experience derived from treating a number of cases of post-vaccinal small-pox in patients who gave evidence of having been recently and successfully vaccinated, I awoke to a realisation of the unpleasant fact that "protective vaccination" was not all that was claimed for it. I thereupon began a study of the vaccination problem in all its bearings. After several years of reading, observation and experience I became fully convinced that "successful" vaccination not only fails to protect its subjects from small-pox, but that, in reality, it renders them more susceptible to this disease by impairing their health and vitality, and by diminishing their power of resistance. Personally, I have known of recently vaccinated patients dying from small-pox while having the plainest foveated vaccine marks upon their bodies, and I have seen other individuals who had never submitted to vaccine inoculation have variola in its mildest and most benign type. In view of such experience I refused to ignore the evidence of my own senses, and determined to follow the dictates of reason instead of the dogmas of faith, and have, consequently, for the past fifteen years refused to pollute the blood of a single person with vaccine virus. I oppose vaccination because I believe that health is always preferable to disease. The principle and practice of vaccination involves the introduction of the contagion of disease at least twice, and, according to numerous authorities, many times, into the human organism. The disease conveyed by vaccination causes an undeniable impairment of health and vitality, it being a distinctly vaccine "lymph," is taken from a lesion on the body of a diseased beast, and inserted by the vaccinator into the circulation of healthy children. The performance of such an insanitary operation, in the very nature of the case, is a violation of the cardinal principles of hygiene and of sanitary science.... Moreover, this operation is in direct controversion of the basic principles of aseptic surgery, the legitimate aim of which is to _remove_ from the organism the products of disease, but never to _introduce_ them. The prime aim of the modern surgeon is to make every wound aseptic and to keep it so. The careful operator employs every means at his command to clear the field of operations of all bacteria. He utilises every particle of the marvellously minute and intricate technique of asepsis to prevent the entrance through the wounded tissues of any disease elements before, during or after the operation. He fears sepsis equally with death, and yet, under the blighting and blinding influence of an ancient and venerated myth inherited from his ignorant and superstitious forbears of a pre-scientific age, he will deliberately inoculate the virulent infective products of diseased animal tissues into the circulation of a healthy person. And as if to cap the climax of his stupidity and inconsistency, he performs the operation under "aseptic precautions." The poisonous matter which nature wisely eliminates from the body of a diseased calf in an effort to save its life and restore it to health is seized upon by the vaccinator and implanted into the wholesome body of a helpless child. Think of the unparalleled absurdity of purposely infecting the body of a healthy person in this era of sanitary science with the poison from a diseased beast, under the senseless pretext of protecting the victim of the ingrafted disease from the contagion of another disease! Can inconsistency go further? I oppose the practice of vaccination because it is not known what vaccine virus is, except that it is a mixed contagion of disease. We hear much these days about "pure" virus and "pure calf lymph." Nothing could be more absurd and meaningless than the flippant talk indulged in by vaccinators and the purveyors of vaccine virus about "pure calf lymph," a hybrid product of diseased animal tissues. "Pure virus" translated into plain English is pure "animal poison." The phrase "pure calf lymph" is applied to an brand of vaccine virus now in use is a misnomer for two reasons. It is not "pure" and it is not "calf lymph." Calf lymph is the normal nutrient fluid which circulates in the lymphatic vessels of the calf. Lymph is described by physiologists as a "transparent, colourless, nutrient alkaline fluid which circulates in the lymphatic vessels and thoracic ducts of animal bodies." Lymph is a physiological product, while the so-called "pure calf lymph" used by vaccinators is a pathological product, derived from a lesion on a diseased calf. The difference between calf lymph and so-called "pure calf lymph" is as great as is the difference between a food and a poison. The vaccine mixture now most generally used by the medical profession is known under the name of "glycerinized vaccine lymph," but it is not _lymph_ at all. It is made by utilising practically the entire lesion or pock on the heifer when it is in the vesicular stage. Such a lesion is broken open and scraped with a Volkmann spoon until the whole of the tissue is forcibly and roughly curetted away, consisting of pus, morbid serum, epithelium, fibrous tissue of the skin, and any foreign matter on or in it, constituting what is called "pulp." This pulp is then passed between glass rollers for trituration and afterwards mixed with a definite amount of glycerine and distilled water. This complex pathologic product of unknown origin is injected into the wholesome bodies of helpless children under the false but plausible name of "pure calf lymph." ... I oppose the practice of vaccination because under whatever pretext performed the implantation of disease elements into the healthy human organism is irrational and injurious. It is subversive of the fundamental principles of sanitary science, while the attainment of health as a prophylactic measure is rational and in harmony with the ascertained laws of hygiene and consistent with the canons of common-sense. I am firmly convinced that the absurd and unreasonable dogma which assumes to conserve health by propagating disease should receive the open condemnation of every scientific sanitarian. That this health-blighting delusion conceived in the ignorance of a past generation should find lodgment in the minds of intelligent people enjoying the light of the world's highest civilisation is to my mind inexplicable.... Sanitation and isolation of the infected offer the only rational and effective antidote for these disorders. Away, then, with the abominable and filthy subterfuge! Give us health instead of disease. Health is the great prophylactic. No man in perfect health can be truly said to be susceptible to the infection of small-pox, nor to that of any other zymotic disease. Vigorous health confers immunity from disease-producing agents as nothing else can. It is usually after the vital functions have become impaired by the effects of vaccination or some other injurious cause that individuals become susceptible to small-pox infection. J.W. HODGE, M.D. [_The above article can be obtained in pamphlet form from the publisher. Wm. J. Furnival, Stone. Staffs._--EDS.] THE NEW RACE. (_Specially written for THE HEALTHY LIFE._) A new race on the ruins of the old Build we: a temple of the human form Fairer than marble, since with life-blood warm, Well crowned with its appointed crown of gold, Russet or ebony; lines clear and bold Beneath--a citadel no ills can storm, Buttressed with health; a type to be the norm In that great age the world shall yet behold. For now the laws of Health and Heaven are seen In their identity, life's body and soul; Though, like divorce, disease may come between What God hath joined; but at the human goal, Where the New Race rules, splendid and serene, Sit Health and Holiness, made one and whole. S. GERTRUDE FORD. THE PLAY SPIRIT. We all long for reality. Most of the amusements in the world are imitations of the reality for which we long. They promise a satisfaction they are unable to give. Drink, mechanical love-making, all snatched gratification of the senses, religious excitement, revivalist meetings, and so forth, most theatre-going and sports, all simulate the real glory of life. They bring an illusion of well-being. They produce a glow in the nervous system. They cause the outlines of everyday life as we know it to grow suffused. They give us a momentary sense of heightened power and freedom. We float easily in a happy world. A sort of relaxation has been achieved. The less common forms of amusement bring us nearer to the gateway of reality. For some, they have been the rivers leading to the ocean of truth itself. Art, for instance, the interpretation of life in terms of beauty; the "artist," the man in whom sensuous perception is supreme, offers us a sublime aspect of reality. He dwells in the universe constructed for him by his senses and tells us of its glories. He achieves "freedom." The veil covering reality is woven for him far thinner than for common men. He sees life moving eternally behind the forms he separates and "creates." And to those of us who are akin to him, who are temperamentally artistic, he offers freedom of a kind. The contemplation of a work of art releases the tension of the nerves. To use the language of psychology it "arrests" us, suspends the functions of our everyday surface personality, abolishes for a moment time and space, allows the "free," generally suppressed subconscious self to come up and flood the surface intelligence, allows us for a moment to be ourselves. But, still, this momentary relaxation, this momentary "play," this holiday from the surface "I," remains an affair dependent upon suggestive symbols coming from "without." The supreme artist achieves freedom. We, who in matters of art are the imitative mass, can only have "change," a new heaven and earth, a fresh "culture." Then there is love. That promises, at the outset, complete escape into freedom and reality. And supreme lovers, both of individuals and of "Humanity," have indeed found freedom and the pathway to reality in love. But ordinary everyday people rushing idolatrously out to find themselves in others find in the end only another I. The religions perhaps work best and longest. But even here average humanity, where the mystical sense is feeble, are thrown back in the end upon ethics--and go somewhat grimly through life doing their duty, living upon the husks of doctrine, the notions and reports of other men. If the play spirit within us, that longing for the real joy of life, for real relaxation and re-creation, fares so poorly for most of us in the amusements large and small that life offers to our leisure moments, is it any better in the "games" the individual chooses for himself--hobbies, for instance? Can these generally "instructive" and "useful," generally also solitary, occupations be called play? Are they not merely a reversal of life's engine, rather than an unmaking and a remaking. They are merely a variant of life. They are very truly called a "change of occupation." They are led and dominated, commonly, by the intelligence. They contain no element of freedom. The same defect is found in all organised "games." * * * * * Real play, like every other reality, comes from what our mechanical and practical intelligences have called "within." Real play arises when the "I" is in direct contact with the myself, with Life, with God, with the actuality moving beneath all symbolic representations. It is only when "I," the practical, intelligent, abstract-making, idealising, generalising, clever, separated "I," the "I" which has a past, a present and a future, renounces its usurpation of the steering apparatus, that play can be. "I," to play or to pray or to love, must be born again. "I" must relinquish all. "I" must have neither experience nor knowledge, neither loves nor hates, neither "thought" nor "feeling" nor "will"--nor anything that can arrest the action of the inner life. When this complete relaxation, which has its physical as well as its mental aspect, is achieved, then and then only can "I" rise up and play. Then "I" shall rediscover all the plays in the world in their origin. "I" shall understand the war-dance of the "savage." "I" shall know something about the physical convulsions of primitive "conversion." The arts may begin to be open doors to me. "I" shall have stood "under," understood my universe, in the brief moment when "I" abandoned myself to the inner reality. The words of the great "teachers" will grow full of meaning. My own "experiences" will be re-read. I shall see more clearly with my surface intelligence what I must do. I shall be personal in everything, personal in my play. Surface self-consciousness which holds me back from all spontaneous activity will disappear in proportion as "I" am immersed in the greater "me." Look at that woman walking primly down the lane to the sea with her bathing-dress. She is a worker on a holiday. But she cannot play. She goes down every day to bathe in the Cornish sea, the sea that on a calm sunny day is like liquid Venetian glass and flings at you, under the least breeze, long, green, foam-crested billows that carry you off our feet if you stand even waist-high. She potters in the shallows and splashes herself to avoid taking cold. Her intelligent "I" is uppermost. Her world of every day never leaves her. She will go back to it as she came, unchanged. Her wistful face betrays the seeker lost amidst unrealities. If the "I" were a little more intelligent, she might try to defy the surrounding ocean, to pit her powers against it, to swim. She would learn a most practical and useful and withal invigorating accomplishment. If her busy, watchful "I" could be arrested she might "see" the billows, the sky and the headlands reared on either side of her bay. She might dance into the water, and see her world dance back. She would fling herself amongst the wavelets where she stands and splashes. She might give herself up and know nothing but the beauty and strength around her. It would not teach her to swim, but she would have taken a step towards the great game of walking upon the waters. D.M. RICHARDSON. TRAVELS IN TWO COLOURS. One is often tempted to suspect that in some schools there is a deep-laid plot to destroy in the bud any love for poetry which children may possess. Otherwise how is it that little boys and girls are made to commit to memory William Blake at his highest reach of mystical fire, as in _Tiger, Tiger, burning bright_, or William Wordsworth at his lowest ebb of uninspired simplicity, as in _We are seven_? These are very popular, apparently, as poems for children to recite; yet in the one case it is beyond any teacher's power to show children the unearthly flaming beauty which alone gives the poem its peculiar quality and undefinable power; and in the other the maudlin sentimentalism and almost priggish piety of the verses are positively dangerous to the child's health of mind. Both types of recitation work out in the end to this--that when the child attains adolescence, and the great world of literature dawns on the hungry mind, an evil association of ideas has been established--the association of poetry, the highest of all arts, either with the saying of lines without meaning, or with the learning of "poems" devoid of what wholesome youth really desires or enjoys. People may wrangle all night as to whether the normal healthy child is at heart a mystic or a realist; whether he likes fairy tales because they show him a magical world where flowers can talk and umbrellas are turned into black geese, or because they tell of strange romantic things happening to a real human boy like himself; but there can be no shadow of doubt that much of the verse intended for children is either too clever in its humour to make them laugh, or too bald in its matter or tone to stir the romance that is never quite asleep in their hearts. There are really surprisingly few versifiers who have altogether avoided these errors. Some of George Macdonald's _Poems for Children_ are almost perfect, both as regards lyrical form, simplicity of language and in the unobtrusiveness of the inner truth they convey. For example, "The lightning and thunder They go and they come; But the stars and the stillness Are always at home." But others come perilously near mere versified moralising. Lewis Carroll's nonsense verses in the two famous _Alice_ books are supreme among their kind; but are they not sometimes just a shade too ingenious, or too adult in wit? Probably Stevenson, in those seemingly artless poems in _A Child's Book of Verse_, comes nearest to a level perfection. Who has ever approached him in his power to understand and express the small child's world, desires and delights, without a trace of the grown-up's condescension or self-consciousness? Well, these great ones are no longer in the world; yet, with the recognition of their genius, there is the usual danger of bemoaning the lack of worthy successors. Not but what there is some excuse for such lamentation; for this reason that every Christmas there is a veritable flood of children's verse, a great deal of which is either painfully didactic, painfully sentimental, painfully funny or painfully foolish. What I wish to do at the moment is to call attention to the fact that there is one man alive in England--one of many, I do not doubt: but one at a time!--who is doing "nonsense verses" for children which are guiltless of all the faults I have indicated above. Jack Goring is known among some of his friends as "The Jolly Rhymster." He writes his verses first for his own children, and then publishes them from time to time for the pleasure of other children. The secret of his success is partly that he knows that even small children like a story to be an adventure; partly that he understands how their own romances, the things they picture or hum to themselves when well-meaning adults are not worrying them, or rather, trying to amuse them, begin--wherever they may end!--with a perfectly tangible object, such as a pillar-box, a rag-doll or a toy locomotive. One of "The Jolly Rhymster's" best things begins-- "Finger-post, finger-post, why do you stand Pointing all day with your silly flat hand?" --which is exactly the sort of question that a very small child in all probability does really ask itself when it has seen a finger-post day after day at a cross-roads. How the poem continues and where it ends you must find out for yourself. It's all in a book called _The Ballad of Lake Laloo_. In the recently published volume[15] that now lies before me, this telling of a tale of wonder which begins with an ordinary thing is again evident. Nip and Flip, aged six and four respectively, are the adventurers; and they make three voyages in this little book. In the first, _The Fourpenny-Ha'penny Ship_, they circumnavigate the world. Now please note how Mr Goring strikes the right note at the very outset: "Nip and Flip Took a holiday trip On a beautiful fourpenny-ha'penny ship With a dear little handkerchief sail; And they sang, 'Yo ho! We shall certainly go To the end of the world and back, you know, And capture the great Seakale.'" [15] _Nip and Flip._ By Jack Goring. Illustrated by Caterina Patricchio. 1s. net (postage 1+1/2d.). C.W. Daniel, Ltd., 3 Tudor Street, London, E.C. And there follows a picture (in black and gold) of this strange monster, just to make sure that no one will suppose they were out after a vegetable. The tale moves along, as such stories should, very rapidly. Thus-- "And when they came to the end of the world, Their dear little handkerchief sail they furled And put on the kettle for tea." But you have only just time to look at the tea things when-- "But alas! and alack About six o'clock The good ship strack On the Almond Rock And split like a little split pea." So the story goes on, through divers adventures, "From Timbuctoo to Timbucthree" and so at last home again. The next voyage is to the land of Make-Believe on a Christmas Eve, "in a long, long train of thought." In the course of this tale we are given a little picture of Flip herself, and here it is for you to look at. Only, in the book her shoes and stockings, the inside of her skirt, and the squiggly things on the top of her head are a bright golden colour. [Illustration] The third voyage is all the fault of a toy monkey--"six three-farthings and cheap at the price"--and takes them among whales, mermaids, sea-serpents and other deep-sea creatures. Here, then, are delightful little pictures on every page, which even a two-year-old will enjoy. And here are verses which most boys and girls under seven or eight will like to learn. And the best of it is that it doesn't matter a bit if they do "sing-song" them, for they are the kind of verses which only sound right from the lips of quite small children who have never been taught elocution. EDGAR J. SAXON PICKLED PEPPERCORNS. SOUP.--Oxtail from 10 A.M.--From a Restaurant Menu. What it was in the early morning it would be indiscreet to inquire. * * * * * I learn that a serum for mumps is now being made at the Pasteur Institute. "A number of monkeys were inoculated with the serum," says _The Times_ (30th July), "and a mild form of the disease was produced." It is an age of scientific progress, so we may expect news shortly of sera for toothache, hiccough, and the hump. It will not be necessary to inoculate camels for the last. * * * * * You will say--with Mr Arnold Bennett, the distinguished playwright and novelist--"the tonic effect of ********* on me is simply _wonderful_."--From an advt. in _Punch_. You may join in the chorus if you like, but you mustn't all expect to be simply _wonderful_ playwrights and testimonialists. * * * * * A STRANGE SHAMPOO.... "I make my chemist get the stallax for me," said she. "It comes only in sealed packages, enough to make up twenty-five or thirty individual shampoos, and it smells so good I could almost eat it."--_Secrets of Beauty_ column in _The Daily Sketch_. Which only shows how careful one has to be. * * * * * In the days to come every army will fight on bloodless food.--_Herald of the Golden Age_. When every army fights on bloodless food, we may be just as far from the Golden Age as we are now. * * * * * I am told that an obscure practitioner who sent up an account of some interesting discoveries, addressed to MEDICAL CONGRESS, DIETETICS SECTION, LONDON. has had his communication returned by the Post Office, marked _Not Known_. * * * * * There is no truth, it is said, in the rumour that a secret meeting was held during the Congress to discuss the proposed raising of the rate of commission payable by surgeons to physicians. PETER PIPER. HEALTHY LIFE RECIPES. SOME "EMPROTE" RECIPES. Exaggeration is popularly regarded as one of the vices of food reformers; but it is certainly no exaggeration whatever to say that Mr Eustace Miles and the restaurant associated with his name have had a large share in bringing about the more sympathetic attitude towards "food reform" noticeable on all sides to-day. Mr Miles is no amateur in the gentle art of self-advertisement: he would be the first to admit it. But the advertisements have resulted undoubtedly in a very large number of people taking the first steps towards food reform, people who are repelled by the out-and-out "vegetarian" propaganda. There are those who view with disfavour the introduction of manufactured or artificial foods into the health movement; they think it hinders simplicity. There is a truth in this; but, on the other hand, it must be recognised that the great majority cannot be reached save by meeting them half-way. This applies to the flavours of foods, the digestibility of foods and the convenience of foods. Few can go straight from beef to nuts. After generations of abuse the human digestive system has to be humoured if the ideal is to be approached. And in this invaluable work of meeting people half-way and of humouring their tastes and digestions, the restaurant in Chandos Street, London, the specially prepared foods made and sold there and the strongly individual, thoroughly sane and pleasantly straightforward advocacy of Mr. Eustace Miles have been a very important factor. The idea behind "Emprote"--the Eustace Miles Proteid Food--is that, being a blend, in powder form, of various kinds of proteid (the proteids of milk, of wheat, and so forth) it supplies the right kind of substitute for flesh foods not only because it is so easily assimilated, but because it is in a very convenient and easily kept form. We believe such foods have a very definite and necessary part in the progress of the individual from the customary unhealthy diet to the better ways of feeding. The following recipes illustrate some of the methods of using "Emprote." They are taken from the booklet _45 Quick and Easy Recipes for Healthy, Meatless Meals_, to be obtained for 2+1/2d. post free from 40 Chandos Street, London, W.C.-- SAVOURY CHEESE SANDWICHES. _NOTE.--These Savoury Sandwiches can form a complete meal with a little salad (dressed with oil and lemon juice), or celery or lettuce or watercress or other salad material._ 3 oz. of cheddar cheese; 1 oz. of "Emprote"; the juice of half a lemon; two tablespoonfuls of fresh tomato pulp or tomato chutney; a pinch of celery salt. Prepare some slices of not too new bread and butter. Mill the cheese, add to it the "Emprote" and the celery salt, then add the tomato pulp or chutney and the lemon juice. Mix all well together into a smooth stiff paste, and spread upon the slices, and form sandwiches, which may be eaten with watercress or lettuce or cucumber. If the material is too moist, mix in a little more "Emprote," or else "Procrums." MACARONI CHEESE. One teacupful of macaroni; two tablespoonfuls of milled cheese one tablespoonful of butter; one dessertspoonful of flour; one tablespoonful of "Emprote"; one large cupful of milk. Boil the macaroni for half-an-hour in a little water. Strain the macaroni and put it in the bottom of a buttered dish. (Put the liquid in the stock-pot, to thicken a soup.) Mill the cheese, and put half of it over the macaroni. In the small saucepan make a sauce of the butter, flour, milk and "Emprote." Pour this over the macaroni and cheese, sprinkle the rest of the cheese on the top, put in the pan to brown, then serve. STUFFED VEGETABLE MARROW. Mince two large onions very fine, and fry in 1 oz. of butter; add 3 oz. of "Proto-Savoury," one dessertspoonful of Nutril, 1 oz. of breadcrumbs (or "Procrums"), and one egg. Scoop the seeds from one large vegetable marrow, fill with the mixture, and bake for one hour. Serve with Apple Sauce. _NOTE.--"Proto-Savoury," "Nutril," and "Procrums" are special "E.M." products and are readily obtainable from health Food Stores, etc._ A NOURISHING GRAVY READY IN A MINUTE. When cutlets or croquettes are heated up, or when macaroni or vegetables or a vegetable stew (none of which are really adequate substitutes for meat) are to be made nourishing, mix some of the E.M. Savoury (or Mulligatawny, or Blended) Gravy Powder, with hot water, to the thickness of gravy, and add to the dish. * * * * * NEW METHOD OF PREPARING FRUIT FOR THE DINNER-TABLE. In cold weather fruit is often cold, and if heated in an oven may be injured partially or wholly. Here is, perhaps, a new way of warming fruit which has been tried and proves satisfactory. Wash the apples, pears, oranges, bananas and wipe them and place on a dish on the dinner-table. Also place a jug of boiling water and a bowl upon the table. Then when the fruit is required pour the hot water into the bowl and place the fruit in it and cover with a plate until warm enough to eat comfortably. Bananas should be peeled before placing in hot water. "A.R." HEALTH QUERIES. _Under this heading our contributor, Dr Valentine Knaggs, deals briefly month by month, and according as space permits, with questions of general interest to health seekers and others._ _In all Queries relating to health difficulties it is essential that full details of the correspondent's customary diet should be clearly given._ _Correspondents are earnestly requested to write on _one side only of the paper_, giving full name and address, not for publication, but as a guarantee of good faith. When an answer is required by post a stamped addressed envelope must be enclosed._--[EDS.] ECZEMA AS A SIGN OF RETURNING HEALTH. Mrs M.K. writes:--Until the last few years I have been subject to sciatica and a certain amount of dry eczema. About a year ago my health greatly improved, with the exception of the eczema, which has much increased the last year, coming out in large angry spots which irritate. I am 69, small, spare and white, have never been strong until a year ago, have led a sedentary life, being an artist. Three years ago I left off eating meat. My diet at present is: _On rising._--Cup of hot rain-water. _Breakfast_ (8 A.M.)--Unfired Bread with butter and pine nuts; cup of weak tea, no sugar. _At 11._--One raw apple. _Dinner_ (1 P.M.)--One lightly boiled egg or an omelette, with "Artox" home-made bread, and butter conservatively cooked celery or broccoli; stiff milk pudding with eggs in it, or "Artox" pastry. _Tea_ (5 P.M.).--Weak China tea "Artox" bread, and butter, and home-made plain cake. _Supper_ (8.30).--Slice of bread and butter; tumblerful of hot rain-water sipped at bedtime. I have not been able to digest uncooked vegetables, excepting lettuce; nor do I eat other fruit than apples; any sweet things cause acidity. I do not suffer with constipation. In this case it will be noted that the skin disease occurred simultaneously with a marked improvement in health. This shows that Nature was adopting her usual plan of forcing the impurities outwards to the surface and that the change of diet made this possible. With her body less encumbered with waste a return of health became possible. The plan now to adopt is not to check this skin trouble but to cure it along safe lines by amending the diet and purifying the skin itself by means of warm alkaline baths. These baths, which should be taken twice a week at first, are made by adding a 1/4lb. of bicarbonate of soda and a 1/4lb. of "Robin" starch to an ordinary hot bath at a temperature of 105 degrees, which can be gradually increased to 110 degrees as the correspondent can bear it. In this the bather stays for from ten to twenty minutes to well soak out the acids and the oily greasy waste from the surface. The starch is added because it moderates the action of the alkali and leaves a comfortable gloss on the skin after the bath is finished. The bath gradually clears the poisons from the skin and encourages the free action of perspiration, thus promoting the further elimination of waste acid poisons and at the same time clearing the skin and making it healthy. The next thing to do is to amend the diet so that as little waste as possible shall be formed. Rice is the cereal that contains the least amount of waste of any kind and this should therefore be the cereal selected. The wholemeal, although good for most people, is not suited to this case. A strict salt-free diet is also necessary, as it is often the retention of salt in the system that leads to the presence of eczema. The following amended diet should suit the case, and it should be continued until the skin has quite cleared itself:-- _On rising._--Cup of filtered boiled rain-water. _Breakfast._--Cottage cheese, 2 oz.; rice, boiled or steamed without salt (large plateful), with Granose biscuits or toasted "Maltweat" bread. _At_ 11 A.M.--More rain-water (not fruit). _Lunch._--The same as breakfast. _Tea._--Hot rain-water only. _Supper, 6.30._--The same as breakfast. When the skin is quite clear the correspondent can return to the wholemeal bread (but biscuits made with "Artox" would be better than the yeastless bread), and also to a more varied diet generally, as at present. DEAFNESS. J.G. writes:--My hearing got bad about twenty years ago, caused I think by a cold in the head. When in bed I can hear the tick of a watch with the left ear but the other is almost stone deaf. I am not much at a loss in ordinary conversation, but in trying to hear people speak I lose much of what is said. Although I have no real pain, my head is rarely clear, feeling full and congested. I have now and again a slight sensation of giddiness or reeling. The right ear runs some offensive matter, and there is always a hissing sound. I live what is, I think, a simple life, but I must confess to a little smoking. My general health is good. I am a working farmer and fairly active for one of my age (69). My diet is generally as follows: _On rising._--One or two cups of warm water, sometimes with lemon juice. _Breakfast._--An apple or orange, oatcake and dairy butter. Baker's bread and one cup of tea. _Lunch._--Nil, or perhaps I should say that I eat an apple or orange before each meal or a bit of turnip or even cabbage. _Supper._--Potatoes with fish, and milk pudding. On some days it may be broth with meat cooked in it. _Before retiring._--Nothing but water, or at other times oatcake and one cup of milk. There does not seem to be much prospect of this correspondent recovering the hearing of his right ear, as the conditions have lasted so long. He might, however, certainly try by diet and hygiene to get rid of the unpleasant discharge and the noises. To effect this he should carefully syringe the ear once or twice a day with a weak solution (1 grain to the ounce) of permanganate of potash, using an all-rubber ear-syringe. Then he should get someone to well stretch the upper bones of the spine and to massage well the muscles at the back of the neck to induce, thereby, a better circulation in the nerves and blood-vessels which proceed from that part of the spine into the ears. In this way he will be able to ensure a removal of the clogging poisons which are lurking in the bad ear and thus promote less noises and a better health state of the ears generally. The diet should be amended as follows:-- _On rising._--One or two cups of warm water, with lemon juice added. _At 8. Breakfast_.--Apples, oranges or other fruit only. _Take plenty of fruit at this meal and eat it at no other time._ _At 12. Lunch._--One boiled egg or some cream cheese: Oatcakes and butter or good wholemeal biscuits ("P.R." or "Ixion" kinds) and butter, and a plateful of finely grated raw roots (carrots, turnip, etc.). _Tea meal._--One cupful of Hygiama, using water in place of milk. _Dinner._--Cheddar cheese or cottage cheese (the latter is best); potatoes and a green vegetable, cooked by baking or steaming, without salt. No broth or meat. (Meat and especially meat broths are very undesirable in this case.) _Before retiring._--Hot water only. ANOTHER CASE OF DEAFNESS. J.A.B. writes:--I have been a reader of _The Healthy Life_ for the last six months, and am suffering from a complaint since I was three years old. When three years old I was attacked by scarlet fever and on getting better I had a discharge from my right ear. This continued for several years, then it would disappear and reappear at short intervals of say a few weeks. This last few years the discharge has disappeared for six months, only to reappear again for a week with severe pains in back over right shoulder and right side of neck. I always feel weak and tired when discharge reappears and sometimes experience pains in the head and cannot remember anything for a few minutes. This correspondent needs a suitable diet in order to purify his blood stream and to promote elimination of bodily poisons which are evidently affecting his ears. He also needs suitable massage and stretching movements applied to the upper part of the spine, which is functioning badly. Then he can supplement this by taking Turkish baths or wet sheet packs to promote a free action of the skin and thus clear away poisonous waste from the system. The same diet as recommended to the previous correspondent should be tried. CONCERNING COTTAGE CHEESE. Mrs C.E.J. writes:--I have been making cottage cheese curdling the milk with lemon juice, as recommended in _The Healthy Life_. Suppose the milk contains disease germs, would not this cheese be injurious, as the milk is not sterilised by being brought to boiling point? I have also been drinking the whey from the same, as it as given in _The Healthy Life Beverage Book_. I notice in a reply given in this month's issue that Dr Knaggs states that the whey of the milk is the dangerous element. Since reading this answer I have been somewhat in doubt as to drinking the whey. I should like to know if it can be taken without harmful effects. Ordinary unboiled milk, free from preservatives, is far less dangerous to health than boiled milk, because Nature inserts in the raw milk certain germs known as the lactic-acid-producing bacilli, which protect us from the injurious germs. These lactic germs cause the milk to go sour and produce in this way the much-extolled soured or curdled milk. They convert the sugar of the whey into lactic acid by a process of fermentation. If milk is boiled it cannot go sour because the germs natural to it have been destroyed by the heat and it becomes necessary to introduce fresh lactic germs into the boiled milk as is done in the artificial production of curdled milk. Failing this, milk will undergo, not lactic fermentation, but _putrefaction_, and thereby develop highly dangerous qualities. When a person takes soured milk its lactic acid acts as a powerful germ destroyer and in a certain concentration it actually kills the lactic germs as well. It also keeps down the disease-producing germs of putrefaction which work in an alkaline medium (opposite to acid) by depriving them of the sugar of the whey. Boiled milk, if set on one side, in warm weather, speedily becomes alkaline and putrid or putrefactive. It is in this condition that, when babies take it, they are made dreadfully ill with diarrhoea and inflammation of the stomach and bowels. Hence it is the chief cause of the appalling mortality among infants in hot weather. Mrs F.K.J. need have no fear of any harm coming to her as a result of eating cottage cheese, but she should not take the whey unless she has decided to undergo a whey cure and take _nothing but whey_; in this latter case, there being no other foods taken, there will be no germs to act harmfully upon it. If there is much flatulence and stomach or bowel trouble sweet milk or whey will simply feed the germs which are the cause of the digestive trouble, or self-poisoning, and are thus far better discarded. DIET FOR OBSTINATE COUGH. Miss N.S. writes:--For the last three weeks I have been troubled with a very bad cough It started in the first place with a cold in the head and then it got on my chest, and do what will I cannot get rid of it. I have been having honey and lemon juice, and also each morning have taken olive oil and lemon juice beaten up together, but without (apparently) any effect. I have bad coughing fits in the night and the next morning I do not feel up to much. I may say that I have not taken meat for about six years, and I try to follow the kind of diet advocated in _The Healthy Life_. I am 23 years of age and a typist in an office, which is about 4 miles from my home. I try to get out in the fresh air as much as possible to counteract any bad effects which may arise from my work. My people at home are very much opposed to my food reform sympathies and efforts. This correspondent should consult a sensible doctor about this cough and thus be on the safe side. It is unwise to allow a cough to become chronic without ascertaining the cause of it. Coughs are often due to stomach and liver trouble, as distinguished from lung trouble. In either case a salt-free diet will greatly help. Thus _Breakfast._--All fresh fruit, nothing else but fruit. Apples best. (_Not_ stewed fruit). _Lunch._--Boiled or steamed rice, done without salt; about 2 oz. cottage cheese or a poached egg; a little raw carrot, turnip or artichoke, finely grated, with dressing of fruit-oil beaten up with a raw egg. The grated roots must be well chewed; as a change they may be cut up and cooked in a casserole with very little water. _Dinner._--Potato baked in skin, with fresh butter, a little cheese, or flaked nuts, and a few plain rusks, or a saucer of P.R. Breakfast Food, dry, with cream. The honey and lemon juice should be disgarded in favour of liquorice (little bits being sucked at intervals) or of linseed tea. I have often found an obstinate cough yield to a diet which contains lactic acid buttermilk, combined with the use of the new oxygen baths. The lactic acid buttermilk can be obtained from any good dairy and should be taken in the morning fasting and at bedtime. WATER GRAPES. W.G.B. writes:--Referring to article in January number entitled "Grape juice for all," I think perhaps it would interest others besides myself if Dr Knaggs would give us his opinion on the value of what are commonly termed "Water Grapes," as compared with more expensive kinds. On the Continent the grape cure is a popular method of treatment. It is especially good for those who are anaemic and underfed as well as for those who suffer in the opposite way from over-feeding. It depends upon which condition is present as to the kind of grapes selected for the cure. Fully ripe grapes with but little acidity (water grapes) are best suited for persons suffering from anaemia and malnutrition. The unripe or sour grapes answer best for cases of over-eating associated with constipation, gout and allied disorders of nutrition. The excess of acid and cellulose helps the bowels and promotes elimination of the gouty poisons. Our correspondent will note that for thin people who are pale and deficient in vitality the water grapes will be found most salutary. They are best taken alone at breakfast without the addition of any other form of food. CEREAL FOOD IN THE TREATMENT OF NEURITIS. E.J.H. writes:--A friend of mine who is suffering from an attack of neuritis (not badly) is desirous of trying the diet of twice-baked standard bread as recommended by Dr Knaggs in an answer to a query in _The Healthy Life_ some months since. She has asked me if Dr Knaggs would limit the quantity of this bread taken in the course of the day. If Dr Knaggs will very kindly tell me this I shall be greatly obliged. Neuritis is a form of rheumatism or gout which involves the nerves. Its usual starting centre is the spine itself, from which all the nerves of the body spring. The diet needs to be greatly restricted so that the poisons can be eliminated. The most important foods to cut down are the cereals because they are very slow to digest and are apt to cause constipation with its attendant self-poisoning of the system with uric and other acids. Horses and animals suffer from neuritis from over-feeding with cereals and beans, and the stockbreeder or horse expert usually restricts these foods and gives plenty of grass, hay, chaff and green clover, which corrects the trouble. The same thing applies equally to man. He should take his cereals in the form they are the most easily assimilated--namely, twice-baked or dextrinised. Thus "pulled" or twice-baked bread, Granose or Melarvi biscuits, or rusks, or toasted "Maltweat" bread are the best form of cereal for people suffering from neuritis. Other treatment besides diet restriction is, of course, needed to cure neuritis, because we have to clear the clogged tissues of the poisons which are interfering with right nerve action. Thus we can resort hot alkaline baths, Turkish baths, massage and Osteopathic stretching movements to help in this respect. H. VALENTINE KNAGGS. +--------------------------------------------------------------+ | | | #Back Numbers# | | | | If readers who possess copies of the first number of _The | | Healthy Life_ (August 1911) will send them to the Editors, | | they will receive, in exchange, booklets to the value of | | threepence for each copy. | | | +--------------------------------------------------------------+ THE HEALTHY LIFE The Independent Health Magazine. 3 AMEN CORNER LONDON E.C. VOL. V DECEMBER No. 29. 1913 _There will come a day when physiologists, poets, and philosophers will all speak the same language and understand one another._--CLAUDE BERNARD. AN INDICATION. There are some statements, the very simplicity and truth of which create a shock--for some people. For instance, there are certain seekers after health who ignore and are shocked by the very obvious truth that "brain is flesh." A brain poisoned by impure blood is no fit instrument for the spirit to manifest through, and "mental suggestion" must inevitably prove of no avail as a cure if the origin of the impure blood be purely material. It is just as futile, on the other hand, to treat the chronic indigestion that arises from persistent worry, or indulgence in passion, by one change after another in the dietary. The founder of homoeopathy insisted that there was no such thing as a physical "symptom" without corresponding mental and moral symptoms. "Not soul helps flesh more than flesh helps soul." Thus the Scientist and the Poet come to the same truth, albeit by different ways.--[EDS.] PLAIN WORDS AND COLOURED PICTURES. While most of us would at first sight find fault with Mr G.K. Chesterton's sweeping advice-- "And don't believe in anything That can't be told in coloured pictures," many would probably end by endorsing it. But we should do so only because we were able to give a very wide and varied meaning to "coloured pictures." No one ever made a coloured picture of the "wild west wind"; but there are plenty of coloured pictures in which there is no mistaking its presence. We all believe in wireless telegraphy (now that it is an accomplished fact) which is, in itself, untranslatable into colour or line; but its mechanism can be photographed, and its results in the world of men and ships are in all the illustrated papers. Music, which is pure sound, is to some the surest path to the Reality behind this outward show things; yet to some at least of such music is indeed form and colour, even though the colours be beyond the rainbow. For in truth, everything worth believing in, all those things, those ideas, which renew the springs of our life, have form and they have colour. Even to the colour-blind one word differeth from another in glory. This is no idle fancy, no mere subject for academic debate: it is the most practical subject in the world. For even as the body is fed not by food alone but by the living air, so is the spirit nourished not alone by right action but by inspiring ideas. Ideas are pictures; and the best ideas are coloured pictures. Hence the great value of words. It is idle to speak of "words, idle words," as though they were the transient froth on the permanent ocean of thought. They are the vehicle, the body of thought. If the thought be shallow or silly, the words will indeed be "idle." But if the idea be inspiring the words will be the channel of that inspiration. The greater part of this power in words is lost to us to-day. Everything tempts us to hurry over words. We talk too quickly to be able to pay that respect to words which they deserve; and we read the newspaper, the magazine, the novel, the play, the poem, with the same disastrous haste. We devour the words but lose their essence. Hence there is a grave danger that through this neglect we shut out one of the main streams by which our life must be fed if it is not to shrink into mere fretful existence. There is a curious idea in some minds that fine language consists of long words difficult to understand. Nothing could be farther from the truth. Most of the great words--the words of power, as the old Kabalists called them--are short words, words in common use. And how common is the sound of them in the mouth of the preacher! Not long ago I heard an intelligent and cultured man reading one of the many beautiful passages from the English Bible:-- "Ye dragons, and all deeps; Fire and hail, snow and vapour; Stormy wind fulfilling his word; Mountains and all hills; Fruitful trees and all cedars, ..." and he read it as though it were a draper's sale bill. And yet it needs but a very little imagination for such a passage to become a series of vivid pictures. Fire, hail, snow, vapour, hills, mountains, cedars, dragons and deeps--every word is "a word of power" if only there is no hurry, if only each word as it comes is given time to call up the picture of the real thing before the inward eye. And you may hear children of fourteen and fifteen who have passed examinations in "English" recite line after line of, say, Matthew Arnold's _The Forsaken Merman_ with a glib self-assured colourlessness due solely to the fact that no teacher has ever taught them respect for simple words. And what simpler words could there be than these, for example-- "Where great whales come sailing by, Sail and sail, with unshut eye, Round the world, for ever and aye"? Simple, common words; yet if there is that leisurely attention to each one as it comes what an exhilarating picture arises of the great sea-beasts, and of "the round ocean and the living air." I am not pleading for the stylist's concentration on words which exalts them above the things they body forth. The most vivid and beautiful description of dawn in the English language-- "Night's candles are burned out, and jocund morn Stands tiptoe on the misty mountain tops" though spoken by the most sensitively vibrant voice in the world, can never come near the real dawn breaking across real mountains. But the point is that those two lines composed of simple English words have power, if we pay them respect, to create the dawn within the mind, and to supply the spirit with that beauty which is its very breath. If this patience with words, this respect for the familiar fine things of our native tongue, this desire to make them yield up their strength and beauty, if this has nothing to do with healthy living I don't know what has. William Wordsworth's-- "And vital feelings of delight Shall rear her form to stately height" is only a metrical expression of a great and practical truth. You do not need to be a "Christian Scientist" to know that ideas and emotions can affect the stoop of the shoulders or the lines of the mouth. Other people besides "Eugenists" have observed that ugly or mean-spirited parents seldom have beautiful children. But though the power of ideas is a commonplace, and though psychologists tell us how much we may improve mental concentration by letting the words of any sentence call up each its own picture, what they a omit to do is to recognise the need of the human spirit for beauty. You can concentrate your thought on the list of pickles in a grocer's price list: it is doubtless a good exercise. But the same exercise directed to some great phrase, such as Emerson's _Trust thyself: ever' heart vibrates to that iron string_; or some vivid lyrical image such as _All the trees of the field shall clap their hands_, or even a complete poem of simple words but permanent beauty, such as that one of Wordsworth's beginning _I wandered lonely as a Cloud_; this will not only improve concentration and sharpen memory: it will enrich the mind with ever-available sources of inspiration, courage and joy. EDGAR J. SAXON. THE WORLD'S WANDERERS. Tell me, thou star, whose wings of light Speed thee in thy fiery flight, In what cavern of the night Will thy pinions close now? Tell me, moon, thou pale and grey Pilgrim of heaven's homeless way, In what depth of night or day. Seekest thou repose now? Weary wind, who wanderest Like the world's rejected guest, Hast thou still some secret nest On the tree or billow? PERCY BYSSHE SHELLEY. CLOUD-CAPPED TOWERS. Building castles in the air has always been one of the favourite amusements of mankind. To it we owe much, not only of the zest of life, but also of motive power for overcoming difficulties and reaching out towards new possibilities. Yet all literature, and tradition that is earlier than any written literature, is full of a deep note of warning; over and over again we see in the dim past the shadow of a tower that was built in vain, of walls that were piled too high and toppled into ruin, of crests that tapped the thunder-clouds and drew down lightning to their own destruction. Evidently man has seen danger in his own desire! The castle must be built with wisdom as well as with industry and boldness if it is to escape disaster and to become a storehouse, a safe defence or a vantage-ground for surveying earth and sky. There is one obvious precaution we should observe in building our castles, and that is to realise that all which we imagine and think about tends sooner or later to externalise itself and pass into action. Every idea tends to glide into an ideal. Nearly all thinkers have recognised this, and have seen that morality lies much farther back than action, farther back than conscious will. Banquo had dreams of ambition, as had Macbeth, but they dealt differently with them; while Macbeth allowed his visions to lead him on to treachery and murder, Banquo prayed against the temptations that came to him in sleep. To most of us imagination, sleeping or waking, comes in less dramatic form, but we should all think more sanely and act more wisely if we interposed a definite revision by the conscious mind and will of all our plans and ideals between their (perhaps quite automatic) formation in our imagination and their translation into fact. Slack muscle should go with the daydream or picture of the future; we should not strike or clench or lift until we have decided that the action is right and just and wise. The girl who counted her chickens and broke the eggs is a true enough example: every doctor and coroner knows many instances of results far more tragic. But sometimes the vision has nothing in it but what is pure and good and noble. Are there any dangers even here? There is this danger always, that we find the picture so lovely and so satisfying that we cannot summon up courage and energy to turn away from it towards the serious work which it suggests. The castle in the air is radiant and tall, but it is generally meant as a model for a tougher building made out of common earth, by toil and pain, amidst mud and dust. It is so much easier, as Sordello knew, to imagine than to do. Actual circumstances, real life, other people all this that lies round us is sterner stuff than our easily moulded material of dreams. Who has not at some time or other lain sleepily in bed of a morning and gone through in thought the processes of getting up, until a louder call or an alarum bell has awakened the realisation that the task is not yet begun? Who has not been tempted to shirk practice of some sort in thinking of a prize? Who has not sometimes built expectation higher and higher until his demands of fate have become so great that, in despair of making good, he has let the whole plan slip away into the valley of forgotten dreams? These dangers, the almost involuntary carrying out of unworthy aims that have been cherished in thought and the loss of vigour for real achievement, due to too easy an indulgence in blameless aspiration, are fairly obvious and have long been recognised. There is another that has been seen from time to time and occasionally expressed.[16] We have seen that too loose a dream-world may make the world in which we live seem dull and ordinary. But is not the converse at least as often true? If our thought-world is too narrow, too selfish or too weak, all our ordinary work, sound and compact though it may be, is stultified, misdirected, often wasted. We all know how in the industrial world something more than industry is needed; in the emotional world something more than a clumsy and unapprehending goodwill. We need a certain insight to turn these solid qualities of labour and feeling to the best account. "A man's reach should exceed his grasp," a great poet tells us, and even the birds or beavers do not go on quite blindly with their building, but, when effort on effort has been destroyed by wind and water or man's interference, they at last accommodate their instinct to circumstances so as to give themselves a better chance of fulfilling their deeper purpose. In many ways we have hardly outgrown the beaver stage: wars, accidents, disease, disputes--how many times must we try over again the same path which has led us before into trouble and disaster before we put our imagination seriously to work on the problem and try to find some more complete solution? Of all the dangers of the use of the imagination, perhaps the greatest of all is the neglect to use it, the denial of it and its consequent starvation. E.M. COBHAM. [16] Mrs Book sees an allusion to this danger, as well as to the first, in the warnings against covetousness in the Tenth Commandment. THE PLAY SPIRIT[17]: A CRITICISM. [17] See the article, "The Play Spirit," in the November issue. With your contributor's description of the play spirit, that happy leisure from self and its responsibilities in order that time and thought and heart may be filled with wider inspiration, most of your readers will, I think, entirely agree, and all of us will be grateful for the spirited claim on behalf of "play." The one criticism that occurs to the mind is that a touch of professionalism, of patronage towards the ordinary person, has crept into the author's thought and peeps out through many of the sentences. "Common men" ... "ordinary everyday people" ... "average humanity," ... "a worker" who ... "cannot play"; does the writer of the Play Spirit really show us what is in their hearts? He is an artist in words, he is a keen admirer of other arts, he is interested in thinking; it seems all but impossible to him that anyone can have "freedom" without the power of expressing it, without even the consciousness of its possession. We are all too apt, I think, to imagine that our own discoveries of the mystery and magic of life are peculiar to ourselves, or shared only with a sympathetic few, passed on sometimes (by the _very_ few who have both will and power to do so) to such of the outsiders as are interested enough to enter into that enchanted garden and take gifts from it. But has not the supreme discovery of the greatest artists, philosophers and teachers been that the "everyday people" _do_ live as deeply and broadly as the thinkers and artists? They are inarticulate and cannot tell what they see, but to them life is made amusing, or interesting, or consecrated according to their temperament. Who can say what the Cornish sea means to that tired worker? At least it seems a boldness that is almost insolence to decide what it did _not_ mean to her! Has not every life its revelations? Is it not because we do _not_ see as God does that some one particular life which strikes across our path cannot reveal its revelation over again to us? Surely "the commonplace is the highest place." Or rather, there are no hierarchies of the soul. Artist or seamstress or carpenter, we live by the glory that flows to us through whatever curtains of environment are round us. I have not a word of criticism for the writer's ideal. All that I would suggest is that the ideal is really present in the world, "common" as the "everyday" flowers at his feet. Not all can sing or paint or write, but many more can laugh or run and all, perhaps, can love and pray. L.E. HAWKS. ON LEARNING TO BREATHE.[18] [18] This is article has been specially written as a preface for _Health Through Breathing_, by Olga Lazarus, shortly to be published (1s. net). To breathe correctly and sufficiently is to live more healthily. This dictum is incontrovertible, and it becomes my pleasant duty herein to demonstrate its truthfulness. And, after a careful perusal of the hundred exercises which the authoress has so clearly and succinctly described, I am still more convinced of the very great, one might almost say of the tremendous, importance of deep-breathing exercises. What has struck me so forcibly in this little book is the fact that there is no undue enthusiasm evident; no embellishment of the subject; no extravagant claims for the system advocated; just a plain sane, sober and intelligent description of procedures of immense value to all who would either keep, or improve, their health. The authoress has, as it were, laid before the reader a feast of good things in the way of physical culture, and leaves it at that. She seems to have brought into purview a splendid variation of the exercises, and indeed every mode of breathing and exercise likely to be beneficial--to those in health as out of it. Reverting for a moment to the supreme importance of the subject, I may say that it has of late years come home to me more than ever, and with greater insistency, that innumerable ills of to-day are due to faulty breathing and lack of correct physical exercises generally. I wonder how many of us could conscientiously say that we devote fifteen or twenty minutes regularly every day to the system? And yet such a great deal could be done for health in that time! No, we "haven't time," or we "oversleep ourselves so often," or we make some such other flimsy excuse; but of course we ought to "make time," we ought not to "oversleep ourselves." The fact is, rather, that most of us are too lazy to go through the exercises, even though we may know of their transcendent benefit. In the words of the poet: "Let us, then, be up and doing"--that is, up in time in the morning in order to be going through exercises such as described in this little volume. It is within my personal knowledge, and must be within the personal knowledge of every actively engaged physician, that but very few of us yet have any idea, in spite of all the teaching and the advocacy of it, of really deep and scientific breathing. If the system could be made quite general and enforced upon us--especially when young or adolescent--we should not see, as we do now, _thousands_ walking about the streets whose nostrils are too narrow through insufficient breathing, whose lungs are not properly inflated as they inspire; and, as a consequence, who have neither the bloom nor the carriage of health. Perhaps if I show here how vastly important it is for us to have our blood well oxygenated, it may be some sort of encouragement for Mrs Lazarus's readers to persevere with and _work into their lives_ the system she advocates and describes. If we did not renew the oxygen in our lungs to a sufficient extent, we should die in a few minutes. We can do without food for many days; without water for less days, but only for a few minutes without oxygen. Anything which tends to increase the intake of this vitally important element, whether deeper breathing or exercises, will have a very pronounced effect upon our general health. Now deep breathing is, _par excellence_, the way to bring about this desirable condition. It may interest the readers of this little book if I remind them that in the ordinary way the total capacity of the lungs is about 340 cubic inches; as a rule, the amount of air breathed amounts only to some 20 or 30 cubic inches, but this, by special effort, can be increased by some 110 cubic inches. Thus it is demonstrated how much more air we could take into the lungs by better and deeper breathing, thereby securing, sooner or later, a greater natural expansion of the lungs, with the result, of course, of improved health generally. It would surprise most people if they tested their breathing capacity by the aid of the spirometer, to discover how inefficiently they did breathe; in other words, how much below the normal was the amount of air they were usually inspiring. Encouragement might also be found in the matter--incentive, that is, to learn how to breathe and exercise correctly and scientifically--if mention were here made categorically of the very profound influences upon certain physiological processes of our organisation which are brought about if we would but mend our ways in this respect. Space will only allow of a few such to be detailed. 1. The circulation is improved and equalised. This implies much more than appears on the surface: it means that the blood is made to flow from any congested internal organ (such as the liver, stomach, etc.) towards the peripheries--that is, the extremities and everywhere where there is the capillary system--the changing-place between the venous and the arterial blood; thus we at the same time warm our extremities and relieve internal congestion. In other words, "to bring the blood to the surface" in many conditions of ill-health is of paramount importance. 2. It will strengthen the action of the heart and lungs. For lack of proper breathing exercises the heart's walls get thin, the expansive power of the lungs' tissue gets less, and as a consequence, when any little extra strain is thrown upon either, permanent damage is often the result. 3. In any tendency to constipation, indigestion and similar conditions, such exercises are especially beneficial, and that both by flushing the system with more oxygen and by mechanically exerting pressure on the different organs--thus giving those latter what is actually a good massaging! 4. Indirectly, such exercises must of necessity be splendid for "nerves," as we thus get these supplied with a larger amount of purified blood, and of course this must result in better and heightened nerve and brain action. And all this--and much more which we have not space enough to deal with--being so, it might now be well asked, who and what class of individuals would benefit by these exercises. The list is a long one, and would include practically all growing children and adolescents--in order that adenoids, narrow chests, debility in general, malnutrition and a host of other abnormal states might be either cured or prevented. Innumerable adults would also benefit by such exercises: those who are in health, in order to keep so; those who are depressed mentally, or who are suffering from constipation, dyspepsia, anaemia, obesity, debility, etc. Even those who are "getting on" in years could, with care and caution, go through such exercises to advantage, providing, that is, that their heart, lungs and blood vessels are fairly normal; it is only where there is serious organic disease such exercises must be withheld. Thus we have a big field for such a system which Mrs Lazarus has described so fully in this little work of hers; it deserves wide recognition, and my final word to the reader is not only to keep the book as a "boon companion," but to encourage others to purchase it and to carry out its most excellent teachings. J. STENSON HOOKER, M.D. LETTERS OF A LAYMAN. 1.--DOCTORS AND HEALTH. Medicine is a progressive science--and art, if we judge by the statistics given of the fall in the rate of mortality. Even this, however, must be carefully analysed, because a good deal of the fall of mortality is due to the great reduction in the birthrate which has taken place in the last twenty years. Still, after this has been allowed for, there is probably a balance in the doctors' favour--something to the good of the science and art of medicine. Doubtless the science is improved and the practical advice offered by medical men is better and more effectual than it used to be. A layman, nevertheless, may be forgiven if, with all due deference, he is tempted to believe that many of the benefits attributed to medicine have been achieved through attention to sanitation--cleanliness and ventilation. Of course this is due to the work of science, which necessarily includes the members of the medical profession, but it is not due to medical science _qua_ medical science. The terms 'sanitation' and 'sanitary' nearly always connote only ideas associated with cleanliness, free ventilation, etc. They scarcely connote ideas of food management, or, if they do, it is only to the extent of inferring that food shall not be adulterated or of bad quality--and perhaps that there shall be enough of it. Such questions as what food shall we eat, and how much; what are the real reasons for taking food into the body, whether it is to give strength and heat to the body or only to supply the body's waste, as Dr Rabagliati contends--these and other relevant questions are usually left to unorthodox members of the medical profession to declare upon. They seem to be very important questions, but we do not find that they were discussed--or ever mentioned--at the thirty-fourth International Medical Congress, which completed its sittings several months ago. Obviously, the practical questions of food supply are answered very differently, according as one _believes_ they must be answered one way or another, as, for instance, in Dr Rabagliati's or Dr Haig's way. But that they are questions not worthy of consideration by doctors in congress may be taken as an ominous sign. It must not be forgotten that we owe many valuable discoveries of medical science to qualified members of the profession, just as discoveries of mechanical science are made by men working at their respective trades. We have sorrowfully to admit, however, that nearly all the great achievements upon which medicine plumes herself are in the direction of increasing the doctors' power over his patient, and seldom of giving his patient power over disease. It is also true that the advocacy by unorthodox members of the profession of simple and natural remedies often involves them in a charge of charlatanism, and subjects them to persecution by medical associations. If the medical profession were all that it is supposed to be, it might be good that the reformer should suffer in solitude while his experiments and methods were subjected to adequate tests and criticism. If the associated physicians and surgeons jealously guarded the public from quackery while they impartially investigated every fresh discovery, the true reformer would welcome the protection afforded him from the "counter-currents of senseless clamour" within the doctors' own ranks, occasioned by party and vested interests. It may be true that "loneliness tends to save the Seer from becoming a charlatan and to make of him a true Reformer." But it is not that peculiar loneliness of the Seer that the medical trade unions afford the reforming physician. That is inevitably and sufficiently accorded him by the "unwillingness of the masses to enter into the thoughts of the Seers."[19] An ignorant and inert people will always follow a charlatan, because they like to do things which are mysterious and involve no trouble on their part. [19] The reason "Why the Prophet should be lonely" is perfectly elaborated in a chapter under that title in _Logic Taught by Love_, from which I have quoted. The Seer among doctors is boycotted by his fellow medicos _after_ he and his co-workers have tested their experiments for themselves, weeded out what is false from what is true, and proved their methods to be right. Not only that, but too often it turns out that it is proper food selection, cleanliness, personal effort and restraint advocated by doctors as substitutes for serums and drugs, which excites the opprobrium of medical coteries. Whereas, the misguided Serum Specialist, who ought to be saved from himself, and from whom the public ought to be protected, is given full medical honours--and facilities to become that most dangerous type of charlatan, the licensed one. There are doubtless many abstract questions of health and disease which orthodox and unorthodox doctors alike are unable satisfactorily to settle. But if that be admitted, then it is certainly not in the public interest that serum treatments should be accepted as almost the last words in medical science. More anti-social still is it to attempt to justify the compulsory orders of Parliament that expensive sanatoria shall be built to cope with disease that might be more economically and more satisfactorily treated. Is there not too little consideration given to theoretical issues underlying practical experience of disease? Is there not too great an anxiety to force remedies at the public expense before all the bearings of the different questions and their phases have been considered? All new methods savour too much of compulsion. They all require the provision of large armies of officials to carry them out. It is interesting to note that the successors of the men who told us how grievously the Church has failed because she is established, should be so anxious to more firmly establish the medical priesthood. Modern statecraft calls out to us: 'we will appoint officials to inquire into and decide upon what is to be done, but we will make no inquiries into the real nature of this disease and that: we will find out remedies which, in the form of serums to be injected into the blood, shall counteract the effects of disease: we will also appoint, at your expense, doctors to perform these operations: we will force the man whose family may have the misfortune to contract a disease, which the doctors have not told him how to prevent, to submit them to such treatment.' But nothing is said about the desirability of exercising government over oneself, one's body and one's mind! And nothing is _said_ either, but it is suggested, that, if one accepts meekly coercive treatment by official doctors, one may probably be able to ignore the laws of life and health without having to pay the penalty. No sane and properly instructed citizens would be satisfied to have State officials compel them to do what they ought to do for themselves. It is because of this and because the suggestions and compulsions of modern medicine are in keeping with the prevailing philosophy that accumulates knowledge without wisdom, that we need such counteracting influences as are afforded by journals like _The Healthy Life._ LAYMAN. A DOCTOR ON DOCTORS. "I charge that whereas the first duty of a physician is to instruct the people in the laws of health and thus prevent disease, the tendency has ever been towards a conspiracy of mystery, humbug, and silence." "I charge that the general tendency of the profession has been to depreciate the importance of personal and municipal cleanliness, and to inculcate a reliance on drug medicines, vaccination, and other unscientific expedients." ALEXANDER ROSS, M.D., F.R.S. +--------------------------------------------------------------+ | | | #To Our Readers.# | | | | Readers who appreciate the independence and all-round | | advocacy of _The Healthy Life_ can materially assist the | | extension of its circulation by tactfully urging their local | | newsagent to have the magazine regularly displayed for sale. | | An attractive monthly poster can always be had free from the | | Publishers, 3 Tudor Street, London, E.C. | | | +--------------------------------------------------------------+ MODERN GERM MANIA: A CASE IN POINT. Under the sensational heading, _Doomed to Carry Germs: Woman Typhoid Victim for Life_, the following account appeared recently in _News of the World_:-- Almost unique in medical history is the case of a woman typhoid carrier, who, it is said, will carry the bacilli with her through life. The case is described by Dr Barbara Cunningham in a report of the Manchester Medical Officer of Health. In order that the woman shall cease to be a source of danger--as she has been keeping lodgers--the health authorities are giving her 7s. a week, and that, with her old-age pension of 5s., will be sufficient to keep her without lodgers. The case has aroused much interest in Manchester. The principal restrictions on the part of the Health Department are that she must not cook or wash for anyone. Anyone can, however, cook for her. In discussing the case Dr Martin, who for 25 years was Medical Officer of Health for Gorton, remarked that in some cases of typhoid carriers the infection ceased to exist for a time, but it was unusual for it to exist year after year. "The reason for the woman referred to carrying the typhoid bacilli with her through life is," he added, "because of a peculiarity of constitution. There is no remedy to be found for it at present, and no means of freeing her from the germs, hence the reward offered by an American to anyone who can find a remedy for such cases. The germs themselves are proof against remedies, and they go on multiplying. The woman is incurable, and you cannot kill the germs without killing the woman. It is the first case, to my knowledge, where the health authorities have taken such measures to prevent a spread of the infection." The history of the affair is interesting. The woman's case had been reported to the authorities, and when her lodger became ill with typhus she was suspected, and was found to be giving off large numbers of typhoid bacilli. She was placed in Monsall Hospital for two months, during which time she was treated with gradually increasing doses of vaccine prepared in the Public Health Laboratory, York Place. When discharged, three separate tests were made as regards the typhoid bacilli. For one week after her discharge the organisms did not reappear, but during the second week a few colonies were grown, and in the third and fourth weeks the number increased. Shortly after that her lodger developed enteric fever. This case is instructive, because it shows very clearly the utter futility of the modern method of treating infectious diseases by means of drugs and vaccines. It is well known that the infecting agent or microbe found in cases of typhoid fever originates in man himself, that, in fact, it is essentially a man-made disorder. Dr Budd, who was the first to fully investigate this important subject, brought together the most convincing considerations to show this. We know further that impure water and milk, shellfish and certain foods which are contaminated with sewage are capable of giving rise to epidemics of this complaint. This was shown in Paris in May last, when a plumber carelessly connected a pipe along which Seine water flowed to a drinking-water pipe. The typhoid germ is always present in Seine water and this mistake cost the lives of twenty people. Dr Freeman, an American doctor, who has studied the habits of the typhoid germ, tells us that it does not survive so well outside the human body as does the tubercle microbe, but it can, nevertheless, do an incalculable amount of mischief when the local authorities are careless about the matter of sewage disposal. A great deal has been heard of late of what are termed Typhoid Carriers. There are apparently numbers of people who, while they appear to be in good health, yet harbour these germs and are thus liable to infect others with them; and the problem is what to do with them. The orthodox authorities, as happened in the case cited above, would like to isolate them indefinitely and even to pension them off for life, but this seems to be a hopeless way out of the difficulty. The remedy seems obvious to me. Let us stop the drugs and serums and use common-sense hygiene of the body instead. This must be patent to anyone who has any knowledge of the subject; but why the authorities do not put it into execution I am at a loss to imagine. Surely the right thing to do is to clear away the impurities in which the typhoid germs live. _By depriving them of the material or soil in which they grow and propagate we should practically starve them out of existence._ Moreover, this seems to me to be a perfectly easy procedure. If this woman were handed over to me for treatment I should at once place her on an antiseptic diet consisting solely of salads, grated roots, fresh fruits, sour buttermilk and dextrinised cereals. The effect of this diet would be to cleanse and sterilise the entire digestive tract, and thus break up and clear away the soil in which the microbes are living. Supplementary to this cleansing diet other means could be adopted to effect a general purification of the whole body. Thus vapour baths could be used to promote skin action; beverages could be taken morning and night, consisting of distilled water with lemon juice or suitable herbal "teas" to promote free action of the kidneys; and colon-flushing treatment could be used to fully cleanse the colon, or large bowel. By combined treatment of this rational order, I am convinced that this woman would speedily become freed from her unpleasant visitors and would be enabled to return to her relations without, as it were, a stain upon her character. H. VALENTINE KNAGGS. BURIED TALENT COMPETITION. The Editors of _The Healthy Life_ are convinced that there are many men and women who can write well and interestingly on subjects relating to health in its many aspects; and they wish to unearth this talent. They therefore offer a _First Prize_ of _Two Guineas_, a _Second Prize_ of _One Guinea_, and a _Third Prize_ of _Books_ (published at _The Healthy Life_ Office) to the value of Half-a-Guinea, for the best ESSAY, SKETCH or SHORT STORY appropriate to the pages of _The Healthy Life._ Please read the following Conditions carefully:-- CONDITIONS. 1. Each Essay, Short Story, or Sketch must contain _not less than 1000 words_, and _not more than 2000 words._ 2. Each Essay, Short Story, or Sketch must be written (or typed) on one side of the paper only, leaving at least one inch of margin on which each 100 words must be indicated in figures. 3. Each attempt must be accompanied by the front cover (or top part of cover showing date) of either the December or January numbers. (Where more than one MS. is sent in by one contributor, extra covers in proportion must be enclosed.) 4. The full name and address of the competitor must be written at the foot of last page, in addition to the competitor's _nom de plume_ (if any). 5. All Essays, Short Stories or Sketches must be sent in not later than the 31st of January 1914, addressed _Buried Talent_, _The Healthy Life_, 3 Tudor Street, London, E.C. 6. No one who is at present, or has ever been, a regular contributor to _The Healthy Life_ is eligible for a prize. 7. The Editors reserve the right to publish any contribution sent in under this Competition. 8. The decision of the Editors will be final and no correspondence can be entered into with unsuccessful competitors. Competitors are asked to note that legibility of handwriting will carry weight as well as intrinsic merit. HEALTHY LIFE RECIPES. SOUPS. Many cases of ill-health demand that the meals should be as dry as possible. Having granted this, it will be admitted that there is quite a proper place for soups in ordinary everyday food reform catering. The chief objection to ordinary soups is that they are made on a basis of meat stock and flavoured with one of various "meat extract" preparations. Meat stock, meat gravy and meat extract all alike represent the least desirable elements in flesh food, namely, the acids and tissue-wastes of the living animal at the moment of its death--acids and tissue-debris which were on their way to normal excretion via the lymph channels, veins, etc. It is therefore only common-sense to avoid such soup-bases, especially as the most excellent soups can be made without recourse to any animal product. The juices of vegetables, being rich in alkaline "salts" and other organic elements, are the natural cleansing agents in a rational diet. Hence to obtain a maximum _remedial_ effect, vegetable soup should be taken in the form of a clear, unflavoured broth, quite apart from the solid meals, and preferably on retiring. But for the dinner or supper soup, some richness of flavour and creaminess of substance are pleasing and legitimate. The following recipes explain, first, how to prepare vegetable "stock," and then how to make rich, creamy nourishing soups, on the basis of that "stock." Each recipe will, of course, suggest variations. HOW TO MAKE VEGETABLE STOCK. Put any fresh vegetables in season in a large stewpot--being careful not to include _overmuch_ cabbage or other coarse green leaves, as these give a rather strong flavour--with a quart or more of water, cover, and simmer gently for at least two hours. The outer leaves discarded when preparing vegetables for the table, the stalks and stems, and the peelings of apples, potatoes, etc., should all be used for stock, care being taken, of course, to cleanse them well first, cutting out any insect-eaten or decayed parts. ALMOND CREAM SOUP. Mix two tablespoonfuls of fine wholemeal or good "standard" flour into a smooth paste with a little water, add this to the hot stock (as above), and stir till soup is thickened. Just before serving stir in a tablespoonful of Almond Cream (either "P.R." or Mapleton's). _The addition of the almond cream gives the above a nutritive value, apart from the tonic and cleansing elements in the stock._ NOURISHING ARTICHOKE SOUP. Pare, scrub and cut into small pieces, 1 lb. of artichokes and put immediately into a pan with a pint of water or milk and water. Boil till soft, then rub through a wire sieve, using a wooden spoon. Put back in pan, add a little more water, a little chopped parsley, and a small piece of butter (or nut butter). Bring to the boil, stirring well; stir in a tablespoonful of Pinekernel Cream ("P.R." or Mapleton's), and serve at once. LEEK AND CELERY SOUP. Put four well-cleansed medium-sized leeks (cut up small), the outer parts of a head of celery (chopped), a quart of water and 2 oz. unpolished Japan rice, into a pan and simmer for two hours. Rub through wire sieve, return to pan, bring to the boil, and serve. _This soup is not so much nutritive as cleansing and antiseptic._ TASTE OR THEORY? FRUIT AND THE OXALIC ACID BOGEY. Many and varied are the creeds of Health Reformers, but all may be included within two main camps. And the opposing battle-cries are Instinct _versus_ Intellect, Taste _versus_ Theory, _a priori versus a posteriori_, Motives _versus_ Purposes. Some overlapping and confusion of creed may be found in both camps, but in the main one is filled with lovers of Nature, the other with devotees of Science. "We believe in simplicity," cries the Nature-lover from the meadow where he is taking a sun-bath; "you are so complex, so artificial." "We believe in being 'sensible,'" retorts the devotee of Science from the cabinet where he is taking an electric light bath, "you are so extreme." "Not extreme--consistent. Your treatment varies every month as the decrees of 'Science' change." "But your treatment varies every minute as the wind and clouds change. I can keep mine constant with mathematical accuracy, or vary the light to a nicety by pressing a button." And so also is it with regard to diet. The person who talks learnedly about germs and calories (though he never saw a germ or measured a calorie in his life) will be found in the same camp with the electric light advocate, while this other who cultivates a taste in harmony with Nature by consuming what he likes best of her unaltered products, he is found arm in arm with the sun-bather. But Science will by no means allow him to eat his uncooked food in peace. "If we all adopt _that_ diet," her pseudo-disciples cry, "what is to become of the potatoes?" Now, with regard to uncooked foods, it would seem that as little fault can be found with ripe fruit in its natural state as with any article of diet. Yet even here "Science" holds up a warning hand and is succeeding in scaring people away from one of the most harmless, most wholesome and most neglected of foods. Leaving generalities, let us come to a specific case, an actual difficulty propounded to me by a sufferer, one who had spent her substance till she could spend no more in having various parts of herself examined and in learned prescriptions and processes of cure, but who found herself as far from health as ever. Obsessed by certain theories of "Science," this lady had acquired a dread of sugar _in every form_. Hence her query addressed to me: "In your book, _No Rheumatism_, you say that sugar is to be avoided. Why, then, do you recommend fruit, which is mostly sugar?" I replied as follows: "The reason I recommend ripe uncooked fruit--in spite of its containing a certain quantity of sugar--is that it contains also purifying salts, and that for most people it is the pleasantest form in which these salts can be taken. Moreover, fruit sugar appears to be more wholesome than that formed from starch. When you say that 'fruit is mostly sugar,' are you not leaving the water of the fruit out of account? As the water often amounts to 90 per cent. this makes all the difference. Taking the fruits generally grown in this country the average proportion of sugar is seven per cent. [This statement is based on the following figures given in Goodale's Physiological Botany:-- Apples contain 7.73 per cent. sugar Pears " 8.26 " " Plums " 3.56 " " Strawberries 6.28 " " Gooseberries 7.03 " " Grapes are stated to contain 24.36 per cent, but often contain much less and sometimes even more.] "Now a person eating fruit _ad lib._, but allowed other foods, will hardly ever eat more than a pound or two a day (generally less). But suppose him to eat two pounds. Seven per cent. of this is 2+1/4 oz. If he eats only 1 lb. he takes 1+1/8 oz. sugar. Now compare this with the amount he gets from starchy foods, say, bread, which contains fifty per cent. of starch and sugar. As the starch, if it is to be assimilated, must be (and as a general rule practically all is) converted into sugar during digestion, we get from 1 lb. of bread 8 oz. of sugar (to be exact, nearly 9 oz., because starch forms rather more than its own weight of sugar). But the weight of bread allowed for daily food, if no other starchy or sugary food is taken, is--according to orthodox physiology books--1 lb., 11 oz., yielding over 14 oz. of sugar. Now I reduce the starchy food to 8 oz. or less (_No Rheumatism_, p. 34), yielding at most about 4+1/2 oz. of sugar. You see, then, that the patient can now afford to take even 2 lbs. of fruit, because this will bring his total of sugar up to only 6+3/4 oz., as against 14 oz. allowed by the orthodox. And if, as I recommend (p. 33), fruits containing but little sugar (especially cucumbers) are taken, his total sugar under my regime will be even less than 6+3/4 oz. "As so many people fail to distinguish between fruit sugar occurring naturally in fruit and ordinary separated and concentrated cane sugar, or even beet sugar separated by various chemicals--'shop sugar,' in fact--I translate for you a passage from Dr Carton's _Trois Aliments Meurtriers_[20]:-- [20] _Some Popular Foodstuffs Exposed_, translated by D.M. Richardson. 1s. net. Daniel. "'Let us proceed now to the study of the third deadly food. The sugar contained in vegetables and raw fruits is a living aliment, physiologically combined with the protoplasm of the vegetable cells, associated with ferments and with vitalised chemical salts. The absorption of this natural sugar is effected by a harmonious contact, by an exchange of energy between the living vegetable cells and our living digestive cells. "'The sugar of commerce, on the contrary, is a dead food which has lost all association with vegetable protoplasm, with vitalised mineral salts and with oxidising ferments which would render it physiological. It is nothing more than a drug, a dangerous chemical, because Nature has nowhere presented it to us in this form.... Its absorption involves an anti-physiological irritation which over-excites the viscera, and when repeated ends by profoundly altering them.'" "This is all very well," cries Pseudo-Science, "but people may eat too much fruit." "Certainly, but then I warn them at once," quoth Taste. "But they have an idea it is good for them, and they disregard your warnings." "If they 'have an idea' which runs counter to my warnings and my penalties, to say nothing of my promises and my rewards, then they can only get that idea from you, Mr Pseudo-Science, with your theories and your figures and your long words." "Why not from your relative, Unnatural Taste? Anyhow, it is my duty to warn them." "If they don't heed my warning, they certainly won't heed yours," says Taste. "But I can paint such a picture of the trouble they store up for the future if they persist in excessive fruit eating!" "Never mind about persisting and storing up for the future. I punish excess in fruit eating as in everything else by prompt discomfort and pain." "But what do you know about oxalic acid?" "Enough to avoid it. Like every other poison it is repugnant to me." "Yet fruit which is so nice in the mouth may ferment in the intestines and form that very poison. Then what are you going to do about it?" "Take care that not too much fruit is eaten another time." "But in the meantime the oxalic acid already formed must be neutralised at once." "No, no! It would be a pity to do that. Oxalic acid is the latest fashion. What would your patients do without it? And what would you do without your patients?" "It must be neutralised at once. It can only be neutralised at the cost of abstracting lime from the system. Result: oxalate of lime, forming calculus, or 'stone,' which you don't want, and tissues depleted of lime which you do want." "So you get your patients after all. In fact, having 'neutralised their oxalic acid' to escape you, they come back to you with two diseases instead of one. It seems to me you are a very profitable investment, Mr Pseudo-Science." "Really, Mr Taste, you would not, I presume, have me suppress the truth simply because it happens to be profitable?" "But is it the truth? What proof have you?" "I presume you are ignorant of the fact that animals have died with all the symptoms of oxalic acid poisoning, simply through taking too much sugar." "What kind of animals? You chose such as are used to taking shop sugar as part of their ordinary food, of course?" "Well--no; not in that form. The subjects of the experiment were rabbits." "Ah! And from these you draw deductions about man who has been eating artificial sugar for ages. How like a vivisectionist! But what doses of sugar did the rabbits get?" "About one-fortieth of the body-weight." "That would be as if a man of 150 lbs. weight should take 3+3/4 lbs. sugar at a meal! And since it is excessive fruit you are warning us against, can you tell me how many pounds of fruit--say, apples--one must take in order to get that amount of sugar in a day? No less than sixty pounds. Really your warning seems a little superfluous." "It is all very well for you to scoff, Mr Taste, but if it were not for me you would know nothing about the latest diseases. I really believe you would be content to go right through life without knowing that you had a duodenum or an appendix." "Quite" assented Taste cheerfully. ARNOLD EILOART, B.SC. A SYMPOSIUM ON UNFIRED FOOD. _In November, 1912, we published a letter from a reader containing the excellent suggestion that readers who had experimented to any fair extent with unfired diet should be invited to contribute to a conference on the subject in_ THE HEALTHY LIFE, _and that the symposium should be gathered round the following points:--_ (1) The effect of the diet in curing chronic disease. (2) Its effect on children so brought up--_e.g._ do they get the so-called "inevitable" diseases of chicken-pox, measles, etc., and especially have they good (_i.e._ perfect) teeth? (3) The effect of the diet in childbirth. (4) The cost of maintaining a household in this way, as compared with the cost under ordinary conditions. (5) Is the diet satisfying, or is there a longing for conventional dietary (often found amongst food reformers)? (6) Is the diet quite satisfactory in winter? _A number of interesting letters have been published this year, and we shall be glad to receive a large number of personal experiences, but they must be brief, and classified under the above heads as far as possible. The following is a striking piece of personal evidence._--[EDS.] BUCKHURST HILL, ESSEX, _28th April 1913._ To the Editors of _The Healthy Life._ DEAR SIRS, As a slight contribution to the interesting discussion which is taking place in your magazine, will you allow me to give you a short summary of nearly sixty years experience of the effects, in my own case, of flesh eating, vegetarianism and the uncooked food diet. This is not a fairy tale, as some may be inclined to think, but a plain unvarnished statement of facts. The flesh-eating period lasted for seventeen years. When three months old I was the unfortunate victim of vaccination poisoning, and for years afterwards was continually in the doctor's hands. The best medical men in this country and America were consulted; for months daily visits were paid to a noted Chicago specialist in the hope that he might be able to effect a cure, but it was a case of "love's labour lost," and, instead of improving, my condition grew steadily worse. During all these years, drugging was constantly going on, the pills and potions ordered were religiously swallowed, and, strange as it may seem, the ordeal was survived. Flesh meat was eaten daily, and, of all the members of the medical profession consulted, not one of them ever hinted that a change of diet might be beneficial. When 17 years of age my attention was drawn to an article in _The Phonetic Journal_ on the advantages of a non-flesh diet. By this time, being thoroughly tired of taking endless quantities of useless, poisonous and expensive drugs, I decided, there and then, to throw "physic to the dogs," making up my mind that if death did come, and it seemed to be staring me in the face, I would, at any rate, die a vegetarian. Within six months the most dangerous symptom had completely disappeared and has never recurred, but, although greatly benefitting by the new diet, and enjoying on the whole fairly good health, yet there were frequent attacks of rheumatism, lumbago and neuralgia; dyspepsia, with its attendant pain and flatulence, often made life miserable; now and again the liver would rise up in rebellion, bringing in its train vertigo, blurred vision and severe headaches; constipation, that bane of modern life, was a source of endless trouble, in fact, for many years the enema had to be used once or twice a week, and last, but worst of all, came those sharp, shooting, lancinating pains, one of the premonitory symptoms of cancer. Obviously, there was still something radically wrong somewhere, and on retiring from practice, a great deal of time and attention was devoted to the subject, innumerable experiments were made, and, ultimately, results obtained, the value of which cannot be exaggerated. Five years ago the uncooked food diet was commenced, and from the very first week a steady improvement took place. The constipation vanished as if by magic; there has not been the slightest touch of rheumatism or neuralgia for at least three years the liver is now an unknown quantity, the dyspepsia is a thing of the past, and, most important of all, the cancer symptoms are entirely gone, and in their place has come an abounding health, vigour and vitality that is marvellous. The years seem to have "rolled back in their flight"; all the centres of life are rejuvenated; and the hopes, feelings and aspirations of youth sway me now as they did nearly half-a-century ago. Work, mental or physical, is a perfect pleasure, and to feel fatigue is almost unknown. What a glorious gift life really is has never been realised till now, and the wealth of the Indies would not induce me to go back to the flesh-pots, or live on cooked foods again. This diet gives two important advantages: firstly, the elimination of all excess of starchy matter prevents the formation of needless fat, and, secondly, the entire absence of artificially sweetened food removes one of the main causes of over-eating. Will people ever learn that fat, instead of being a sign of health, is the very reverse, that every ounce of superfluous adipose tissue means more work for the heart, diminished vitality, lessened energy, and, when excessive, is not only a distinct menace to longevity, but to life itself? I never take more than two meals a day and very often only one, which consists of raw vegetables, nuts, olive oil and unfired bread; the second meal, when required, is a simple fruit salad. When a vegetarian the writer lived for years on a shilling a week; it costs rather more now, the oil, nuts, fruit and bread being more expensive than beans, rice, meal, etc., but the difference is so trifling that it is not worth talking about. Whilst "Fletcherising," deep breathing, distilled water, olive oil, fasting, saltless food, the open-air life, regular exercise, etc., were valuable allies, it was not until the powerful aid of uncooked food was invoked that the real benefits began to appear and life became a real joy. Yours, etc., JOHN REID, M.B., C.M. HEALTH QUERIES. _Under this heading our contributor, Dr Valentine Knaggs, deals briefly month by month, and according as space permits, with questions of general interest to health seekers and others._ _In all Queries relating to health difficulties it is essential that full details of the correspondent's customary diet should be clearly given._ _Correspondents are earnestly requested to write on _one side only of the paper_, giving full name and address, not for publication, but as a guarantee of good faith. When an answer is required by post a stamped addressed envelope must be enclosed._--[EDS.] _Every inquiry must be accompanied by the front cover (or upper part of same showing date) of a recent number_ of _The Healthy Life_. ONION JUICE AS HAIR RESTORER. Mrs M. McC. writes:--In your book, _Onions and Cress_,[21] on p. 49, it is stated that the juice of onions mixed with honey will change the colour of hair from grey to black. Will you be kind enough to tell me in what proportion these should be mixed, as, of course, if not in a proper mixture, the hair would become so clogged. And will you also kindly tell me how one is to extract the juice from the onions, whether they are to be boiled or squeezed when raw. With regard to the use of a mixture of onion juice and honey as a hair restorative the reader of my little book must remember that it is largely a compilation of quotations from old herbal books, and it gives the history, use and folklore of these interesting edibles. I am not responsible for this recipe and cannot therefore vouch for its utility. We know, however, that onions contain a wonderful sulphured oil and that sulphur in one form or another is an important ingredient of most hair preparations which restore colour. The raw juice evidently should be used, and this can be extracted either by pounding and grating and then extracting the juice under pressure, or it can be readily obtained in any quantity by putting onions through the Enterprise Juice Press. The amount of honey, I think, to be added to this juice should be very small, otherwise, as our correspondent surmises, the preparation would be very sticky and objectionable. Would any reader care to try this and report upon it? [21] _Onions and Cress_, 6d. net (postage 1d). SCIATICA. Mrs M.G. writes:--My husband is a sufferer from sciatica; has had it for some years, on and off, but just lately he seems is to get it constantly--sometimes a little, sometimes a lot. He has been taking some salicylate of soda, and I have tried to persuade him to give it up. His age is 42. For his meals he takes, on rising, an apple or a cup of apple tea; an hour afterwards his breakfast, which consists of two tablespoonfuls of a proteid food mixed with distilled water, and a hard biscuit, two slices of whole meal brown bread, nut butter, and watercress or lettuce. During the morning he drinks barley water. For dinner, a salad and a few ground nuts and hard biscuits and an apple; sometimes home-made nut meat and spinach, hard biscuits and dried or fresh fruit. For tea, a salad or lettuce, tomatoes, onions and cress, and Shredded Wheat and wholemeal bread. Last thing at night, a few steamed onions and distilled water. His bowels are in good condition, very regular, but he has this constant gnawing pain. If you can help me in any way as to a change in his diet, it will be a relief to me. I do not mind the trouble of preparing things for him. It is about two months ago that he has taken to drinking distilled water, which I make myself. His occupation is very sedentary, with long hours, sometimes from six in the morning till nine at night. He has a bicycle, and gets as much exercise as possible. From the description given one would assume that the sedentary occupation and long hours of work have caused this correspondent to fall into bad postural habits of sitting and standing, coupled with excessive depletion of his nervous energy. The diet given is on good lines and, with the addition of home-made curd cheese and eggs as proteid, might certainly be continued as it stands, especially as the bowel action is regular. What the correspondent does need is less hours of work; more physical exercises of a brisk back-stretching nature, and certain spinal stretching manipulations of an Osteopathic nature. Full deep breathing in fresh air will also be beneficial. The lower part of the spine, from which the sciatic nerves originate, needs the most attention. REFINED PARAFFIN AS A CONSTIPATION REMEDY. Mr E.H. writes:--Will Dr Knaggs very kindly say whether Refined Paraffin, now being given so generally for the relief of constipation, may be regarded as a harmless method of overcoming this trouble or whether its use might lead to harmful results. I am told that this preparation of oil is not assimilated, and is therefore harmless, but I should much appreciate Dr Knaggs' opinion on this matter. The use of refined paraffin as a remedy for constipation is just now all the rage with the orthodox medical profession. There is nothing really to be said against its right use, provided it is made to serve as one of the means to an end. It has been proved that this paraffin, which is quite tasteless, odourless and easy to swallow, is not absorbed by the system but passes unchanged and unaltered through it. It acts therefore as a mere mechanical lubricant. The one thing to remember is that its use should be combined with a curative diet, so that it need not be taken indefinitely. (1) DRY THROAT; (2) SACCHARINE; (3) DILATED HEART. Mr L.S. writes:--I have read _The Healthy Life_ from the appearance of the first number, and I have studied the Answers to Correspondents, but have not observed a case identical with my own, hence my reason for troubling you. (1) The back part of mouth next throat has a curious glazed appearance--no cough or expectoration. I am inclined to think it extends to and includes the stomach. I have always a good appetite, but am not well nourished; much under weight. Age 44 years; school officer; cycle 25 miles a week. Eat meat sparingly, not a pound a week. Live principally upon eggs and bread and butter--(three eggs a day): "Digestive Tea" two and three times a day. 2. Is saccharine less harmful than sugar for sweetening? 3. As the result of a nervous breakdown I had five years ago I suffer from a dilated heart, consequently--I suppose--I have palpitation occasionally, oftener when in bed. I don't think my heart is really normal since my breakdown five years ago. 4. Would bathing myself with cold water over the region of the heart strengthen the muscles? Would you please suggest anything for strengthening heart. Are lemons or eggs injurious to the heart? 1. The throat symptoms indicate a dry, irritable, heated condition of the mouth and throat which, as the correspondent surmises, equally affects the stomach and the rest of the digestive organs. He should have a breakfast of fresh fruit only, take salads and grated raw roots with his meals and stop tea altogether. He can drink distilled water and vegetable or lemon drinks (unsweetened) instead. 2. Saccharine is a mineral substance, a fossilised product of putrefactive action in the coal age. It is closely analogous to carbolic acid, which equally originates from microbic action. By leaving off sugar and replacing it by saccharine our correspondent gains nothing. He is simply leaping from the frying pan into the fire. It is best for him to cultivate a taste for unsweetened or even acid drinks. 3. A dilated heart is usually an after effect of a dilated stomach, which strains it, just as it does every other organ, whether in the chest or the abdomen. 4. Bathing the chest with cold water is not desirable. What is needed is that the correspondent should drink as little fluid as possible and pay close attention to the condition of his digestive mechanism. If the organs are dilated or misplaced he should wear a belt and take suitable gentle Osteopathic exercises. TREATMENT FOR STAMMERING. A.M.D. writes:--Could you kindly give in _The Healthy Life_ magazine some suggestions as to the best method to follow in a case of stammering (slight) in a boy of ten or eleven years who has been rather left to himself, the hesitancy in speech being regarded as incurable? This boy should be trained by someone who understands how to cure stammering. The correspondent would do well to consult Miss Behncke of 18 Earl's Court Square, S.W., who makes a speciality of treating such cases. WHY THE RED CORPUSCLES ARE DEFICIENT IN ANAEMIA. A.M.D. writes:--Is there any way, independent of diet, of increasing the red corpuscles in the blood? I have tried walking nine miles a day, thus getting up free perspirations. What of this method? I did imagine that this resulted in a better condition of the skin, the latter losing in a measure the white and parched appearance. A deficiency of red corpuscles in the blood, which shows in anaemia, is usually caused by self-poisoning. When food ferments or putrifies in the colon, owing to faulty diet and other causes, certain toxins are created. These become absorbed into the blood and there destroy the red corpuscles. Walking is a good form of exercise, but it will not suffice alone to remedy this type of anaemia unless the diet and general habits of the patient are so arranged that the unsanitary condition of the colon is also remedied. The correspondent will find, if she studies the replies to others in this magazine, many details as to diet, etc., for rectifying bad conditions in the bowels. THE CORRECT BLENDING OF FOODS. T.B.W. writes:--Is it inadvisable for a dyspeptic (and sufferer from constipation) to eat salad, or cooked vegetables, and stewed fruit at the same meal; also, do I do right in eating bread and butter (preferably crust) or hard biscuits with stewed fruit or soft vegetables, etc.? Would you please inform me the best Still that I can obtain--preferably one that does not require much attention, and is fairly portable, and that does not cost much to work? I do not believe that it is right to mix salads or cooked vegetables with stewed fruits. It is better to take them at separate meals. It is, in my view, equally bad to take cereals (_i.e._ bread, biscuits, etc.) with stewed fruits. The reason is that cereals call for an alkaline form of digestion in the mouth which the acid fruits or the added sugar greatly retard. I believe strongly in the all-fruit breakfast or all-fruit supper, when fresh, dried, or even stewed dried fruits (possibly with some fresh cream) can be taken alone, without either cereals or vegetables. Cereals go best with salads and cooked vegetables, because of the alkalinity of the latter which harmonises with the salivary secretion intended for the digestion of grains. The Gem Still is the best to buy. It is well made and does not need much attention. The large automatic commercial size is, however, the best if any quantity is needed, as it works throughout the day with practically no attention when properly adjusted. DIFFICULTIES IN CHANGING TO NON-FLESH DIET. F.C.W. writes:--I shall be glad if you will inform me from your experience whether, after one has broken from the customary meat diet and adopted a "reform" diet, there is any real difficulty in reverting to the former state. I have seen it stated that vegetarian diet did not call into action all the natural powers of the digestive organs, and, this being so, the tendency was for them to become weakened so that the food reformer eventually found himself unable to digest meat. I believe some health culturists make practice of taking meat twice a week. I have been about seven or eight weeks on reform diet, and though better in some ways have to confess to a feeling of deficient energy and nerve power. I was once told by a doctor that I could not afford to do without the stimulating effect derived from meat. I propose making a test of the two methods, but should like to hear from you in reply to the above query. Another new feature I have noticed on the new diet is a thinness of the teeth and a feeling of weakness in them generally. This correspondent omitted to supply his amended diet, so this was asked for and is as follows:-- _On rising_ (6.40).--Cup of cold water. _Breakfast_ (8 A.M.).--Porridge, boiled egg or white fish done in oven. Turog brown bread and butter; a banana; cup of coffee. _Lunch_ (12.45, _at The Home Restaurant_)--Nut or cheese savoury and one vegetable, a sweet dish, a few dates or a nut and fruit cake. _Tea meal (in office at 5)._--Bread and butter, piece of cake, large cup of cocoa. _Supper._--One of following:-- (a) "Force" with stewed prunes and junket; small piece of cheese with wholemeal biscuit. (b) Milk pudding and stewed fruit; small piece of cheese and biscuit. (c) Vegetable soup with toast. (d) Bread and milk and fruit cake. _On retiring_ (10 P.M.).--Cup of hot milk. The correspondent adds further:-- I have only been about eight weeks on food reform and the general result, so far, is less susceptibility to draughts and ability to sleep with windows open top and bottom, which I could not do before, and a feeling of lightness and freshness. On the other hand, I have not the same nerve force or power. I am of a highly sensitive nervous disposition, and the latest trouble is with my teeth. I was told yesterday by a dentist that a non-flesh diet is harmful to them and that were one to eat meat only, there would be no trouble! Perhaps it is owing to the dates and nut-and-fruit cakes which I have been eating, or to a general weakened condition due to want of finding my natural diet. I have a friend who is a fine specimen of physical development, and on his going on to food reform he had to have his teeth seen to. I suppose it would not be the softer diet giving his teeth less to do. I am at a disadvantage as I can get nothing specially prepared at home and can only add to my diet articles which I can prepare myself. I like my liquids fairly sweet and I like liquid foods. I am a catarrhal subject and when this starts at the back of the nose the hearing is affected. Whenever a person changes from a meat diet to one that is of the non-flesh order the digestive organs have to learn how to adjust their secretions to the altered diet. This applies just as forcibly when a food reformer wishes to return to the "flesh-pots." After a long course of abstinence from meat the food reformer does find it difficult to return to it. This is due not so much to the difficulty in digesting it as to the violent stimulation and grossening of the body which it induces. I have never heard of any food reformer who discarded meat for ethical or humane reasons who willingly returned to meat so that he could if necessary be in a position to digest it. With regard to the loss of energy and nerve power the correspondent must distinguish between real weakness and absence of stimulation. The first effects of discarding meat show a deficient energy due to the absence of stimulation. When this has passed it gives place to a feeling of buoyancy and energy which is permanent. The dental weakness is aggravated, if indeed it is not actually _caused_, by the milk puddings, porridge, cake and sugared beverages which are a feature of this correspondent's diet, and to the absence of salad vegetables. If he amended his diet somewhat as follows he should make steady progress in energy and general fitness:-- _On rising._--Tumblerful of cold water. _Breakfast_ (7.15).--One lightly boiled, baked or poached egg; Veda bread and butter, a little watercress or other salad. A small cup of Hygiama in place of the sugared cocoa. _Lunch_ (12.45).--Nut or cheese savoury and one vegetable; baked pudding by preference for second course, or simply a nut and fruit cake; no dates. _Or_ salad with grated cheese or cream cheese, or flaked pine nuts; followed by a piece of the excellent wholemeal cake supplied at the restaurant this correspondent frequents. _Tea meal._--One cup of Salfon cocoa (unsweetened), preferably without other food. _Supper_ (6 to 7) (This meal is at present far too mushy).--Cream cheese, Veda bread with fresh butter or nut butter, salad, tomatoes, cucumber, etc., with dressing of pure oil and lemon juice. _Or_ simply fresh ripe fruit, with dried fruit and cream; no cereals. _On retiring._--Cupful of hot unsweetened lemon water, or weak barley water; no milk. H. VALENTINE KNAGGS. CORRESPONDENCE. _All Correspondence should be addressed (and all contributions submitted) to the Editors, _THE HEALTHY LIFE_, 3 Tudor Street, London, E.C._ COTTAGE CHEESE. WILDERTON, BOURNEMOUTH. BOURNEMOUTH. _To the Editors_, DEAR SIRS, _Re_ Mrs C.E.J.'s letter and the reply thereto: I should be inclined to doubt the wisdom of making this from unboiled or uncooked milk unless one had it from one's own cows and could supervise the dairy oneself. The average milk that comes into towns from country farms is--well, it's unthinkable. There's a saying that what the eye doesn't see the heart doesn't grieve over, but that doesn't alter the fact that the average cow is none too clean, the average milker's hands and clothes (to say nothing of his face, hat and head) none too clean, the milking-place none too clean, and the circumstances of transit such as don't make for cleanliness. I have put it very moderately, as those who know country dairy farms will admit. Those who particularly want clean cheese from uncooked milk should buy it from a County Council dairy farm or similar institution. Yours truly, B.C. FORDER. WILL OTHER READERS DO LIKEWISE? Mrs E. BUMPUS writes (7th October 1913):-- I am ordering two copies each month from my local newsagent.... I thought he might be induced to show copies of your publication in his window. [An attractive blue poster is supplied each month free by the Publishers to all genuine agents who apply for the same.--EDS.] _THE HEALTHY LIFE_ IN THE LIBRARIES. Mr C.H. GRINLING writes (25th October 1913):-- I note the suggestion on p. 580 of the October number of _The Healthy Life_. A friend enables me to ask you to send _The Healthy Life_ regularly for one year to the Woolwich Public Library, William Street, Woolwich. I enclose 2s. The librarian will see that it appears on the magazine-room table regularly. [There is every reason why _The Healthy Life_ should be known and read in every public library in the United Kingdom. In this we are entirely dependent upon those readers who are ready to follow the excellent example of the above and other correspondents. A year's subscription--2s.--is a very small price to pay for bringing the message of this magazine before the public in this way. We should like to hear from readers in all parts.--EDS.] FRUIT-OILS AND NUTS. WESTCLIFF-ON-SEA, 22nd Oct. 1913. _To the Editors_, SIRS, With reference to the last paragraph of "Phosphorus and the Nerves" on p. 579 of the October number, I should be obliged if I could be informed through your correspondence columns (1) what are the "fruit oils" recommended therein and (2) how they are to be taken. (3) Is olive oil good to take? (4) Is it good for children? If so how is it to be administered? (5) What nuts are richest in phosphorus? I enclose my card, and remain, yours truly, W.W. (1) Any olive oil that bears a thorough guarantee of purity (such as "Minerva" Olive Oil, "Creme d'Or" Olive Oil, etc.); also any pure nut oil (such as supplied by Mapleton's or The London Nut Food Co.); also the pure blended oil sold as "Protoid Fruit Oil." Our advertisement pages should be studied for further details. (2) Suggestions were given on pp. xxxiii and xxxv of the November number. (3) Yes, excellent. (4) Yes, they usually take it more readily than adults, for the latters' palates are generally spoilt. For its use see _Right Diet for Children_, by Edgar J. Saxon, 1s. net. (5) Almonds and walnuts. If the nuts are found difficult to digest try them in a finely prepared form, as in Mapleton's Almond Cream, "P.R." Walnut Butter, or "Protoid" Almond Butter.--[EDS.] PICKLED PEPPERCORNS. Lady Cheylesmore was wearing a magnificent cock pheasant's plume. The eagle eye of the customs official caught sight of it and handed her a pair of scissors to help her detach it.--_Daily News._ Now we know what a really well-trained eagle eye can do. * * * * * Perhaps the only remnant of the awful sameness characteristic of the typically English kitchen is the bacon and egg breakfast to which the average Briton clings with wonderful tenacity. The mere possibility of infidelity to that national dish is enough to make one shudder. No one could be such an iconoclast as to suggest a variant from the traditional breakfast; it would be table-treason of the worst kind.--_Daily Telegraph._ A middle-aged Briton named Leary, Of bacon and eggs got so weary, That for no other reason He committed high treason-- But whether he shuddered's a query. * * * * * Silver-fox furs are rapidly becoming more and more rare, and this fact lends a special interest to the wonderful collection of these skins now being shown this week by Revillon Freres at 180 Regent Street. These beautiful silver foxes, to the number of over a hundred, are grouped in eight large showcases on the ground floor, and represent the latest arrivals from Revillon's Canadian outposts, where they have special facilities for securing these rare skins.--_Daily Chronicle._ A ninth large showcase containing specimens of the steel traps in which "these beautiful silver foxes" are caught, and in which they remain till "collected," would give added interest to the collection at 180 Regent Street. * * * * * Sixty-six persons banqueted at Gorleston on a single "sea-pie," which weighed 200 lbs. Prepared by an old smack skipper, it was built in three stories. The foundation consisted of beef bones, and inside were six large rabbits, half-a-dozen kidneys, thirty pounds of beef steak.--_Daily Chronicle._ Not to be confused with the Gorleston Mausoleum. PETER PIPER. 
21560	----	PAPERS ON HEALTH By PROFESSOR KIRK Edinburgh _NEW AND COMPLETE ONE-VOLUME EDITION REVISED AND EDITED BY_ EDWARD BRUCE KIRK London Simpkin Marshall Hamilton Kent & Co. Paternoster Row Manchester Albert Broadbent 19 Oxford Road Glasgow T. D. Morison 240 Hope Street Philadelphia The Broadbent Press 1023 Foulkrod St. Frankford 1904 COPYRIGHT IN THE UNITED STATES OF AMERICA _Printed by Hurst Bros., Shaw Heath, Stockport._ Transcriber's Note: The topic of Throat, Sore (Clergyman's) includes advice for enunciating the vowels in their natural order ([=a], ay, ee, o, oo). The use of [=a] indicates that the a has a macron over it, since a macron cannot be represented in Latin 1 character set. PREFACE. In his later years my father often expressed to me his desire for the reduction of the eleven volumes of his "Papers on Health" to a compact one-volume edition; but as long as fresh papers were being written, he saw no use in beginning this work. In the end the project was interrupted by his last illness and death. Since then, circumstances have prevented the work being undertaken until the present time. Having been associated with him in his health work for some years, and having often discussed with him all his methods, I have had considerable advantages in undertaking to carry out his intention in the shape of the volume now given to the public. It represents as nearly as possible the book he planned himself; and though greatly reduced in bulk, all that is of importance in the original eleven volumes has been inserted in it. It is complete in every way; and in many details of treatment, improved methods, applied in later years by Dr. Kirk, have been substituted for the older methods he first introduced. The arrangement in alphabetical order has been very carefully attended to, and the treatment for any particular trouble within the scope of the work can be quickly turned up. This edition is sent forth in the hope that it may have even a wider circulation than the last, and may be still more largely blessed than that has been, to the relief of suffering humanity. I would appeal to those who know the value of this treatment to make the book known to the many who would benefit by its teaching. The cost of the original edition was considerable, but this one is sold so cheaply that anyone may possess it. _EDWARD BRUCE KIRK._ E. U. Manse, Barrhead, Scotland. _September, 1899._ PREFACE TO SECOND EDITION. In this edition of "Papers on Health" some changes, as well as some entirely new features are introduced. The large demand for the first one-volume edition has made it clear that the public approve of the methods, both of arrangement and of condensation employed in it. Another edition being called for, it appeared evident that several changes were desirable, in order to bring the book in line with rapidly increasing medical knowledge, and to give full effect to more recent experiences in the application of Dr. Kirk's treatment. Since the "Papers" were first written, medical, and especially surgical, practice has very greatly changed, and some of the practices against which Dr. Kirk most vehemently protested have passed away. Hence, certain modifications introduced into this edition, for which the editor accepts full responsibility. For those who wish to consult the actual writings of Dr. Kirk, the original eleven volume edition is still available. Great advances have also been made in the knowledge of the causes of disease; and preventive methods of treatment by regulation of diet and habits of life are much better understood. To incorporate some reference to these in a work dealing with health generally, appeared to us absolutely necessary. For these additions also the writer accepts responsibility. Where it appeared to be useful, illustrations have been introduced, which may help those to whom the treatment is quite new, to practice it more easily and correctly, and to understand better the theories on which it is founded. These changes have enlarged the book, and somewhat increased the price, which is, however, still such as to place the volume within the reach of all classes. It is most gratifying to know through letters received from almost all parts of the world, that many are benefitted very greatly by the treatments described. We have constant evidence coming before us from our own experience with patients of the powerful effect they have in healing the sick, and even saving life. We send out this new edition in the hope that it may spread still more widely, the knowledge of such simple and yet effective means of cure. _EDWARD BRUCE KIRK_ E. U. Manse, Barrhead, Scotland. _July, 1904._ INTRODUCTION. In this book we set forth a series of simple remedies and preventives of many common troubles. They are all well tried and have been proved by long experience to be effective and safe. We give, as far as we know, the reasons why they are likely to do good, but we acknowledge that there are things which we cannot fully explain. For instance, we do not know why a well aired lather of M'Clinton's Soap should have the soothing effect it undoubtedly possesses, or why spreading handfuls of this lather over the stomach of a person suffering from retching or indigestion should give such relief, we only know that it does! Some may sneer at the remedy and say it is a case of faith healing and assert that any other application, if put on with equal credulity, would have the same effect. But take a case that lately came under our notice. Indigestion and colic had rendered a baby a few weeks old restless and miserable from the day of its birth. The nurse was kept nursing it all night long, trying to soothe it; at last the mother who had frequently tried the soap lather for occasional attacks of indigestion, and always with good effect, determined to try it on the baby. It worked like a charm, the little one was at once soothed and slept all night, only waking once for its food. This was repeated for several nights, for until the lather was applied the child would not settle to sleep. In a few days the child was quite well, the habit of sleeping was established and the application was discontinued. Now it cannot be said that faith in the remedy had anything to do with the result in this case. We only wish every mother would have faith enough to give this simple treatment a fair trial, making up the lather as described in this book and not, as many do, "improving" on our method by rubbing the soap on the wet skin and making a sort of lather with the hand. We may say that the soap used for making this lather is not M'Clinton's shaving soap. The latter is specially made to give a thick durable lather; for curative purposes use the lather from M'Clinton's toilet or household soap. Again, why should the use of the linen underwear we recommend have such a beneficial effect on sufferers from rheumatism and various skin troubles? We have suggested possible explanations, and if these seem inadequate we can only say we know that it has these effects no matter how they are produced. There are many things in nature that we cannot explain, and since the discovery of X Rays, Radium, etc., scientists are much less dogmatic in declaring anything impossible. The diet we recommend for health and disease is as simple and cheap as our other treatment. That plain fare is good for both mind and body was proved by the four youths at the Babylonian Court over 2,000 years ago, but alas people squander that priceless boon, health, by letting appetite rule their lives. We only ask for our treatment a fair trial on our lines. We claim that ours are common sense methods. Anyone can see that if a head is hot and fevered the application of a cold towel is likely to lower that heat and reduce the fever. But it is no use putting a little bit of wet rag on and then saying our treatment has failed. Large towels repeatedly changed for an hour or more may be needed, and this will give more trouble than administering some dose from the chemist's shop, but the results are well worth the additional work. The day is hastening on when men and women will see what fools they have been, not because they had no sense, but certainly because they had failed to use the abundance which God has given to all. Not one of the remedies we have recommended can hurt any one, as they are only those which we have for years seen used successfully by ordinary persons who were willing to do their best to cure the suffering. If we can secure one night of sound sleep, or one day of comfort for another, we are bound to do our very best, and it is a wonderful reward to know that one has secured even this in our suffering world. Our Heavenly Father gives no monopoly of this blessing. [Illustration: 1. Vertebral Column; 2. Skull; 4. Sternum; 7. Collar Bone; 15. Hip Bone; 16. Sacrum; 18. Femur; 19. Knee Pan; 21. Fibula; 22. Tibia; 8. Humerus; 10. Radius; 11. Ulna.] _Note._--It is earnestly requested that _the whole_ of any article, and of those referred to in it, should be read _before_ beginning any treatment. PAPERS ON HEALTH. Abscess.--Let us suppose a swelling appears on some part of the body or limbs, but that there is no discoloration or symptom of the gathering of the dead material beneath it. If it be cut open, a wound is made which is often very difficult to heal. Avoid then, _cutting_ in such cases. If the swelling develops under FOMENTATION (_see_), the uncut flesh through which it will then break will be in a better state eventually for healing than if cut. Where corrupt matter is clearly present, and in seeking an outlet is endangering the surrounding healthy tissue, the cutting open of the swelling will, on the other hand, greatly relieve, and conduce to a more speedy cure. This is best performed by a thoroughly good surgeon. Thorough syringing of the cavity from which the matter comes out (_see_ Wounds, Syringing) is the best means of cure, aided by thorough heating of the swelling and surrounding parts with moist heat for an hour or more twice a day. This heating must embrace a large part of the limb or body, as the case may be. If the trouble be on the hip or groin, the armchair FOMENTATION (_see_) should be employed. Other parts should be treated on the same liberal principle of heating (_see_ Fomentation). Rich diet is extremely hurtful. Egg switched in cream, rum, brandy, and such things are to be carefully avoided. Alcoholic liquors are especially fatal. _See_ Alcohol; Assimilation; Diet; Drinks: Foods, etc. Oatmeal jelly (_see_ Food in Illness), wheaten meal porridge, Saltcoats biscuits (_see_ Biscuits and Water), form the best nutrients in such cases. These are really much stronger diet than the egg, brandy, etc. If the abscess be in the foot or leg, with indications of diseased bone, the leg should be bathed in hot water up to the knee. Dissolve a piece of M'Clinton's soap in the water used, and let it be as hot as can be borne. After drying, rub the limb gently yet firmly with olive oil for five minutes. Dress with oil, lint, and a proper bandage. We have seen a limb which threatened the very life of the patient treated as above. The general symptoms abated almost immediately; growth, as well as healing, set in, and the limb was quite restored to its normal condition. But patient persistence in treatment is needed for a bad case. If under bathing or fomentation the abscess seems to swell, such is only the natural progress of cure, and should not be regarded as increase of the trouble. Where the swelling shews undoubted signs of diseased matter below the surface, it may be opened as above directed. We know of limbs that have been long distorted, and under rubbing and fomenting they are becoming gradually all they ought to be. No one need fear that by such treatment they will grow worse. _See_ Armpit Swelling; Bone, Diseased; Knee; Limbs, Inflamed, etc. Acetic Acid.--For use in our treatment we recommend Coutts' Acetic Acid. It is of uniform strength and purity, and can be had from most druggists. Weak acid may be understood as one part of this to twelve parts of water. In many cases, however, much greater weakness than this is necessary, owing to the tenderness of the parts treated. As a general rule, the dilute acid should only cause a _gentle_ nipping sensation and heat in the sore. If it is painful, no good is done. Frequent gentle applications are always much better than a few severe ones. Tasting the acid is a good test. If it can be swallowed without inconvenience, it may then be tried on a tender part, and if necessary even further reduced in strength. Where more convenient to get it, white wine vinegar may be used instead of this weak acid; it will do equally well. Acidity of the Stomach.--Often caused by unwholesome food, bad or deficient teeth, or by too rapid eating. Where these causes exist, they should be first removed. Eat slowly, and not too much at a time, and see that only _well-cooked_, easily digested food be taken. Pastry, sweets and carbonaceous foods in general should not be taken alone at the same meal, they should always accompany some form of proteid food. If, however, pain in stomach is found after meal it will be found that milk can be substituted with comfort. (_See_ Diet). (_See_ Food in Health). If this does not cure, do not take soda as a remedy. Although soda neutralises the sourness, it produces other effects, and tends to cause disease of the stomach. A wineglassful of hot water, with a teaspoonful of white vinegar in it, is the best cure. Although this is itself acid, it acts so as to remove the _cause_ of the sourness in the stomach, and is most beneficial otherwise. It is still better to take a tablespoonful of this hot water and vinegar every five minutes for an hour daily before dinner. Instead of the vinegar, a slice of lemon may be put in the hot water. This will act more efficiently in some cases. In other cases a teaspoonful of Glauber's Salts, taken in a _large_ tumblerful of hot water, half-an-hour before breakfast, for a few weeks, will relieve almost entirely. Readers must note not to use _both_ the salts and vinegar drink at once. They are intended to cure different sorts of stomach acidity, caused differently. Look also well to the warming of COLD FEET (_see_), and see that the whole skin be cleansed daily with soap lather (_see_ Lather and Soap) and stimulated with olive-oil rubbing. Aconite.--Often in cases where our treatment fails to cure, the failure is due to the patient taking aconite as an allopathic remedy. Used homoeopathically, it may be harmless, but if taken in considerable doses, even once a month, it prevents all cure. It gives relief in heart palpitation, and in case of extreme sensibility, but its other poisonous effects far outweigh the temporary benefits. A gentle, kindly soaping with soap lather (_see_ Lather and Soap) over all the body will relieve extreme sensibility far better than aconite, and can be frequently repeated without injury. Aconite must be avoided if our treatment is to be effective. Action, Balance of.--An excellent guide to the proper treatment of any case is to be found in the distribution of heat in the patient's body. Hot parts are to be cooled, and cold parts warmed, often both at the same time, so as to restore the proper balance of vital action. _Gentle progressive_ measures are always best in this, especially with children. Cold feet are warmed by BATHING (_see_) and FOMENTATION (_see_). A heated head may be cooled with COLD TOWELS (_see_) or with soap LATHER (_see_). This principle of seeking a proper balance should be borne in mind throughout all our treatment. Its importance can hardly be exaggerated, as the restoration of this balance alone will frequently effect an almost magical cure where drugs have been wholly ineffective. After Pains.--_See_ Child-bearing. Air.--The Black Hole of Calcutta is an object lesson of how necessary to life is the renewal of the air supply. Few people, however, reflect that a deficient supply of fresh air may affect the health, though far short of what will cause death. Many hospitable people will invite so many friends to their houses that the amount of air each can get is less than 1-20th of what the law insists shall be provided for the prisoners in our gaols. Superabundant provision is made for the wants of the stomachs of these guests, but none at all for the more important organ--the lungs. The headaches and lack of appetite next morning are attributed to the supper instead of the repeatedly breathed air, for each guest gives off almost 20 cubic feet of used-up air per hour. No one would ask their guests to wash with water others had used; how many offer them air which has been made foul by previous use? Everyone knows that in our lungs oxygen is removed from the air inhaled, and its place taken by carbonic acid gas. Besides this deoxydizing, the air becomes loaded with organic matter which is easily detected by the olfactory organs of those who have just come in, and so are in a position to promptly compare the air inside with what they have been breathing. The exhilaration produced by deep breathing of pure air is well known. What, therefore, prevents everyone enjoying it at all times? Simply the fear of "cold"--an unfortunate name for that low form of fever properly called catarrh, and a name which is largely responsible for this mistaken idea. "Colds" are now known to be infectious, being often caught in close ill-ventilated places of public assembly. Most people suppose that it is the change from the heat to the cold outside that gives them "cold," whereas the "cold" has been contracted inside. There is no lack of evidence that wide open windows day and night, summer and winter, so strengthen and invigorate that colds are rarely taken, and when taken, generally in a mild form. This also applies to influenza. If delicate consumptives can stand, without any gradual breaking-in to it, unlimited fresh air, and can lie by day and night in open sheds, no one need dread at once to adopt the open-window system. Although few will believe it, until they try it, a wide open window does not produce a draught as does one slightly opened, and it is safer and pleasanter to go in for abundant fresh air than to try what might be called a moderate course. Many think that with an open window the heat of the fire is practically wasted. They do not know that the _radiant_ heat of the fire will warm the person it falls on even though the temperature of the room is very low. The Canadian hunter before his fire is comfortably warm, though the air around him may be a long way below zero. Extra clothing may be worn if any chilliness is felt. While the body is warm cold air has an invigorating effect on the lungs. Indeed, the body soon gets accustomed to the colder air, and those who practise keeping open windows winter and summer find that they do not require heavier clothing than those who sit with windows shut. A slight or even considerable feeling of coldness, when due to cold air and not to ill-health, will not harm. This is no new idea. Dr. Henry McCormac, of Belfast, father of the eminent surgeon, Sir William McCormac, wrote forty years ago:--"The mainly unreasoning dread of night air, so termed, is a great impediment to free ventilation by night. And yet day and night air is the same virtually, does not differ appreciably. The air by night, whether damp or dry, is equally pure, equally salubrious with the air by day, and calls not less solicitously for ceaseless admission into our dwellings. Air, ere it reaches the lungs, is always damp. Quite dry air is irrespirable. It needs no peculiar or unusual habitude in order to respire what is termed night air. Exposure to contact with the day air equally prepares us for exposure to the contact with the night air. We can multiply our coverings by night with even greater ease than we can by day, and with the most perfect certainty of producing and obtaining warmth. Good heavens! How is it that people are so wildly mistaken as if the great wise Deity, as he does by every exquisite and perfect adaption, did not intend that we should make use of the purest, sweetest air day and night always? The prospective results of breathing purest air by night are so infinitely desirable, the immediate enjoyment is so great that it only needs a trial to be approved of and adopted for ever.... Reasonable precautions--that is to say, adequate night coverings--being resorted to, no colour of risk to the lungs, even of the most delicate, can possibly ensue. For, it is stagnant air, air pre-breathed only, and not pure unprerespired air that makes lungs delicate. Although air, warmth, food, and cleanliness be cardinal conditions and essential to life, still the most important of all health factors is air--air pure and undefiled alike by day and by night.... The constant uneasy dread of taking cold, which haunts the minds of patients and their friends, is doubtless the one great reason why fresh air is thrust aside. And yet cold will not be caught, were it in Nova Zembla itself, by night, if only the sleeper's body be adequately covered.... The pulses or puffs of air that comes in ceaselessly, winter and summer, through open windows by night inspire just as if one slept in the open air, a sort of ecstasy. Gush follows gush, full of delightfulness, replacing the used-up air and purifying the blood. It has oftimes been said to me, 'I open the windows the moment I get out of bed;' to this I have uniformly replied, 'the moment to open the window is before you get into bed, not when you get out of it.' You cannot otherwise with entire certainty secure the benefit of an ever ceaselessly renewed night air so all essential to the blood's renewal and the maintenance of health.... With abundant night coverings there is no shadow of risk. There is none of rheumatism, none of bronchitis, in short no risk whatever. The only, the real risk, which we incur, is that of closing our sleeping chamber windows, of debarring ourselves of pure air during our repose." Appetite.--Should be an indication that food in general or some certain kind of food is needed by the body. Thus the appetite is the natural test of the amount and kind of food required. Over-eating and indulgence in stimulating foods and drinks, insufficient mastication and bolting of the food (_see_ Over-eating, etc.) give us a false appetite, thus causing over-eating once more. A return to a simple and moderate diet will restore the natural appetite. Air Bath.--This may with advantage to the health of the skin and body in general, be indulged in every morning during some of the toilet operations, such as shaving, or preferably, dumbell exercise or Swedish gymnastics. If exercises are done in a nude condition the utmost freedom for the muscles is obtained. In a short time a notable change will be observed in the skin, which will lose its pasty appearance, and become soft flesh and of a healthy colour. If possible have the bedroom with windows facing the morning sun, so that the sunlight can also shine in. There are many sanitaria on the Continent and in America where this form of "bathing" is practised. Indeed, one of the great benefits of sea-bathing (overlooked in this country) is the exposure of the skin to air and light. Consequently if the weather and social custom permits, as much time as possible should be spent after immersion, lounging on the sand. A child's natural instinct leads it to play about after its bath in the sea instead of coming at once to be dressed. A young infant will enjoy lying on a rug on the floor without any clothing and with the window open. Older children will benefit by running about the garden in summer time in bare feet, and with only one garment, say a cotton frock. It is a great mistake to clothe children too warmly, indeed, the same may be said of adults. Garments should always be loose and porous, so as to allow of the beneficial action of the air on the skin. One of the objections to corsets is that they do not fulfil these conditions (_see_ Tight Lacing, Skin, Care of.) Air-tight Covering.--The covering of oiled silk, or guttapercha, so frequently placed over wet bandages when these are applied to any part of the body, is not only useless, but often positively hurtful. It is true that the waterproof covering retains the moisture in the bandage, but it is also true that great heat is developed, and the waste products in the perspiration are retained on the surface of the skin. The effect of this is injurious in a very high degree. A little soft old linen for the wet bandage, with a piece of double new flannel over it, will leave all the pores of the skin open, and allow all waste products to pass away freely, while the heat and moisture are retained as much as necessary. In other cases two folds of moist flannel next to skin, and two folds of the same, dry, above the moist ones, will make an excellent bandage. This applied all over the abdomen, in case of abdominal dropsy, will have a most beneficial result. The reason why we often say new flannel is simply that few know how to wash it so as to retain its soft and porous nature as it is when good and new. That softness and porousness may be retained in a very easy way. When you have put your soiled flannel through two good washings with soap in the usual way, dip it in clean boiling water, and finish cleaning it with that dipping. You will have it white and fine as when new. M'Clinton's soap, being made from plant ashes and not from soda, is much less liable to shrink and harden flannel; in fact, it is best for all fine washing. Alcohol.--This, in various forms, as brandy, whiskey, rum, wine, cordials, beer and stout, is a frequent prescription in many troubles. In no cases have we known good effects from its use, which is most strongly to be condemned. Various reasons for this statement will be found under the heading of troubles for which alcohol is prescribed. Here we simply give the fundamental truths as to its action on the system. In our system of treatment we ever seek to nurse and stimulate those nerve-masses which constitute the sources of vital action. Every drop of alcohol does so much to weaken and destroy these. A certain quantity, if taken by the strongest man, will kill that man as surely as a bullet in the brain. Half the quantity will only render him insensible. Half that, again, only renders him incapable of controlling his bodily movements. Half that, again, only slightly disturbs the system; but it affects him in the very same manner in which the fatal dose affects him, though not in the same degree. It is a narcotic, and like all such, it always _reduces_ vital action, while nothing is more important in all healing than to _increase_ it. Hence alcohol is the deadly foe of healing, and one chief preparer of the system to fall before disease. The so-called stimulating action of alcohol has been thoroughly explained by the author of these papers in other writings, and shewn to be simply an indirect and temporary effect, obtained at the price of a considerable reduction of the general vitality of the nervous system. Young ladies, as a class, are subject to a terrible danger. Great numbers of mothers actually make their daughters drunkards by ever and again dosing them with brandy. This is done in secret, and imagined to be a most excellent thing. For instance, if the bowels get lax, as is the case in certain stages of disease, brandy is given as a remedy. How little do those who give it know that it is lessening vital energy and making cure impossible! But it is doing nothing else. We have many times over seen the dying sufferer restless and ill with nothing but the effects of constant small doses of brandy, or alcohol in some other form. In looseness of the bowels we give a teaspoonful of lemon juice in a little hot water and sugar. That has as much effect as is desirable, and it has no bad effect whatever. Or enema injections may be employed. (_See_ Diarrhoea, Dysentery, Enema). Even infants are treated with "brandy," till we cannot help believing they die of the drink, and would survive if it were put away. Gradually the cruel folly of all this will, we doubt not, dawn upon the general mind. Amputations.--These are often performed in cases in which proper treatment on the lines of these papers, would save both life and limb. By all means, before consenting to such an irrevocable act as amputating a limb, let the treatment with fomentations, hot water, and acetic acid be well and thoroughly tried. Many limbs which were medically condemned have been thus saved within our personal knowledge. In some cases the disease may be obstinate; but at least let a fair trial be given to our treatment before giving up a limb. The treatment will be found under the headings of the various troubles and parts affected (_see_ Armpit Swelling; Bone, Diseased; Knee-swelling; Pains, etc.) Angina Pectoris.--In a variety of cases, more or less severe spasmodic pains are felt in the chest. Angina Pectoris (literally, _agony of the chest_) is one of the worst of these. All these pains, as a rule, may be removed completely by treatment such as the following:-- Prepare a bed (long enough for the patient to lie at full length upon his back), with a large thick sheet folded on the lower part of it. Spread over this sheet a blanket wrung out of hot water, so as to be both moist (but not wet) and warm (_see_ Fomentation). See that the blanket is not so hot as to burn the patient and add to his pain. It must be tested with the back of the hand, and be just as warm as this can well bear. On this let the patient lie down, and wrap him up tightly in it from the feet up to above the haunches. Have two or three towels folded so as to be about six inches broad, and the length of that part of the patient's spine above the hot blanket. Wring these out of cold water. Place one over the spine, so as to lie close along it; on this, place a dry towel to keep the damp from the bed, and let the patient lie down on his back, so as to bring the cold towel in close contact with the spine. When this towel becomes warm, another cold one must be put in its place. After about half an hour's pack and eight changes of the cold towel, the pain in the chest should be subdued for the time. If the cold towel does not heat in five minutes, the patient's vitality is low, and a _hot_ cloth should be placed along the spine, and renewed several times, and then another cold one; but as a rule this will not be required. When taken out of the pack, let the skin be washed with SOAP (_see_) and warm water; then a slight sponge of nearly cold water, and a gentle rubbing with olive or almond oil. Rub the back first, and gently "shampoo" all the muscles; that is, knead and move the muscles under the skin so as to make them rub over one another. If the pain in the chest be of an inflammatory nature, the cold towels must be applied over the place where it is felt, instead of on the spine (_see_ Inflammation.) Ankle Swelling.--When long continued in connection with disease or accident, this sometimes leads to a partial withering of the limb up to its very root. In such a case it is best to deal first with the roots of those nerves which supply the limb, which are, in the case of the legs, in the lower part of the back. It is important to apply light pressure to these roots by gently squeezing the muscles of the lower back. This raises a feeling of gentle heat, which slowly passes down the limbs even to the toes. Then the gentle pressure and squeezing must be carried all down the limb, avoiding any degree of pain, until all its muscles have had their share. While progressing _down_ the limb with his rubbing, let the rubber be careful that the individual strokes of his hands be _upwards_, towards the hip. The blood will thus be propelled towards the _heart_, while the _stimulus_ of rubbing is conveyed along the nerve trunks towards the foot. The squeezing should be done with a grasping movement of the hands, the limb being held encircled in both hands, thumbs upwards. Warm olive oil is used in this squeezing, and also, if the skin be hard and dry, soap lather (_see_ Lather). Even slight displacements of bones will disappear under such treatment, if patiently continued day after day, as the patient can bear it without fatigue. In such gentle remedies, perseverance plays a large part. (_See_ Abscess; Diet; Exercise). Ankle, Twisted or Crushed.--Place the foot as soon as possible in warm water, as hot as can comfortably be borne; keep it there until free from pain, or for an hour, or even more if necessary. If the flesh be torn, dress with cloths wrung out of vinegar or weak acetic acid before placing in the water. When the bath has done its work, and the limb comes out of the water alarmingly swollen, good and skilful bandaging will do excellent work. If you have at hand an old shirt, or some such thing, tear it into strips about three inches wide, till you have as much material as will swathe the whole limb from behind the toes up to the top of the thigh. This need not be all in one piece, but only so that you may apply it in such a way as to bring a very gentle pressure on the whole surface of the injured limb. It is important that the bandaging should be comfortable. The way in which bandaging is sometimes done is cruel in the extreme. Cases that are a disgrace to humanity are constantly coming under our notice, in which limbs are lost for life by the treatment they receive in this respect. Skilful surgeons do it in the most gentle manner; they even swathe the limbs in soft loose cotton before they apply the bandages, so that a perfectly equal and comforting pressure may be secured. Lay the limb to rest, well and softly supported in a horizontal position. When the swelling falls, gently tighten the bandage from time to time as required. Each time the bandages are removed for this purpose, sponge the limb with warm vinegar or weak ACETIC ACID (_see_). When the swelling subsides, the ankle may be put again in the hot bath for half-an-hour, and then, if any bones be broken, is the time for setting them right. The ankle will probably turn black. If so, do not apply leeches, but allow the black blood to be absorbed by natural process. A twisted or bruised wrist or hand is to be treated in the same way. The swelling may also be removed by gentle rubbing _upwards_ along the limb, so as to help the blood in its course. Armpit Swelling.--Often this comes as the result of a chill, or of enfeeblement of the system from various causes. In the early stage, such a swelling should not be treated so as to develop a sore. Treatment with iodine is to be avoided. The first thing, in this early stage, is to increase vital action in the part, and also in the whole system (_see_ Abscess). Moist heat is to be applied. Make a BRAN POULTICE (_see_), which should come right round from over the spine, over the swelling, and over the whole shoulder. Let this be kept hot for an hour at least. If it can be thus applied twice a day without too much fatigue, do so. If the swelling softens and becomes less under this treatment, a few cold cloths may be applied to brace the part and aid its vitality. Do not, on any account, make the patient shiver. If the swelling increases and becomes discoloured, keep to the hot treatment until it bursts and discharges. For treatment then, _see_ Abscess; Wounds. During all this treatment the whole back should be gently rubbed daily with warm olive oil for half an hour, if as much can be borne. Assimilation.--Is the process whereby the digested food is carried into the blood stream, and thus conveyed to the different parts of the body where the hungry cells are in need of it. [Illustration: Fig. 1.--A bit of the inner coat of the small intestine.] Fine threads of blood vessels (capillaries) take it up from the stomach and intestines. Also along the intestines there are little projections (villi), through which the food passes into a blood stream leading to the liver, where the blood is then purified. These projections also contain lacteals or little vessels containing blood without its red corpuscles. A duct carries this colourless blood mixed with absorbed food to the left side of the neck, where it empties into the blood stream. These lacteals have a special affinity for the fat of the food. Most of the rest of the food, including the proteid and the carbohydrate or starchy portion now in the form of sugar, passes into the capillaries, and then is led to the liver. The liver will not let through more sugar than is required, storing it up for future use. It also acts as a careful guardian, by arresting many poisons which would otherwise pass into the general circulation. The liver requires for the proper performance of its functions plenty of pure blood, hence the necessity for fresh air and exercise, that the lungs may work well. The liver is easily influenced by alcoholic beverages, and by getting too hard work to do through eating rich foods. A consideration of this delicate and intricate process, whereby the digested food is absorbed, will show that badly-digested food can not hope to be well assimilated, consequently attention should be paid to the quantity and quality of the food we eat (_see_ Digestion; Diet). [Illustration: Fig. 2.--Two villi containing lacteals. The white canals are lacteals, the darker lines indicate blood vessels (capillaries). Magnified 100 diameters. (_From "Quain's Anatomy_.")] Whatever thus makes living substance is nourishment; whatever fails to do so is not. If food be taken, and even digested, without being thus assimilated, it becomes an injury to a patient instead of a help. In cases of fever, inflammatory disease, or wasting sores, much rich food feeds the fire. It is like laying rafters on the roof of a burning house for purposes of repair. In such a case small quantities of milk, or milk and hot water (_see_ Digestion), represent the total food which can be effectively used in the body. We write on this subject that in treatment our friends may watch not to injure by making the blood too rich in elements which the system cannot usefully assimilate. Such foods as oatmeal jelly and wheaten porridge will often furnish more real nourishment than pounds of bread, beef, and potatoes. A little careful thought will guide to correct treatment in this matter. An easily assimilated diet is found in Saltcoats biscuits and hot water; many inveterate stomach troubles have yielded to this, when taken as sole diet for some weeks (_see_ Biscuits and Water). Treatment may also be given for lack of assimilative power. The back, especially on either side of the spine, is rubbed with gentle pressure and hot olive oil. This pressure is so applied that a genial heat arises along the whole spinal column. This done twice a day, for half-an-hour at a time, and continued for several weeks, will markedly restore assimilative power. Cases which have been perfectly helpless for eight and even ten years are cured by this simple method, sufficiently and carefully followed. We had a patient who was stout, but weak and weary, with the muscles slack and showing loss of power. The effect of back-rubbing, accompanied by easily assimilated food in small quantities and often, was to lessen his weight by a considerable amount. But the muscular power at once began to increase, and the man was soon like one made anew. Digestion had not been impaired in this case, but the blood formed by it was not converted into good living substance. Sight and hearing have even been restored by these means when the failure in eye or ear has been due to waste material accumulating, as frequently is the case. In connection with many troubles, what may be called _local assimilation_ has to be considered. A foot, say, with a bad abscess or diseased bone (_see_ Pain, Severe) is cured by hot bathing and pressure. From a shrunken and feeble limb, the leg grows to a healthy and strong one. This occurs because the heat and pressure have so stimulated its vitality that the material supplied by the blood can be utilised in the leg for purposes of healthy growth. So with any other part of the body. Such diet as we have indicated supplies easily assimilated substance. The local heating, pressure, and bathing enable this substance to be utilised where it is needed. A little careful thought on this line will guide to proper treatment of almost any case where assimilation has failed, either locally or generally, and will lead the way to a method of cure. Asthma exists in various forms, having equally various causes. One of these causes, giving rise to a comparatively simple form of the disease, is cramp of the ring-muscle of the windpipe, so contracting the windpipe that breathing is rendered difficult. A "wheeze" is heard in breathing, though there is no bronchitis or lung trouble present. The cause of this cramp is an irritation of the ring-muscle's nerve. It can be relieved by pressing cold cloths gently along the spine, from the back of the head to between the shoulders, taking care that the patient remains _generally warm_ during the treatment, and attending to the feet and skin as directed below in this article. Sometimes the cause seems to lie in the air of the place where the sufferer resides. A change either to high ground or the seaside will often entirely remove asthma, especially in the young. In any such case a trial should be made of several places, if that be at all possible, and that place fixed upon where the asthma is least felt. At SEAMILL SANATORIUM (_see_) many asthmatic persons have found complete freedom from their trouble from the day of their arrival, and the treatment given has made this cure permanent. Another cause of asthma is lack of power in the breathing muscles. In such a case the patient clings to a particular _attitude_, in which alone he can breathe. This is in most cases due to a lack of vitality in the root nerve which supply the breathing muscles. An attack of this may often be relieved by rubbing, with the points of the fingers chiefly, gently yet firmly up and down each side of the spine, close to the bone. Even rubbing above the clothing will frequently relieve. The roots of the nerves supplying power to the breathing muscles lie just on each side of the spine, and this kind of rubbing stimulates these roots. It is not rubbing of the skin or backbone which is wanted, but such gentle treatment of the nerve roots on either side of the bone as makes them glow with genial warmth. This rubbing is of course better done on the surface of the skin. See that the patient is warm, then dip the fingers in cold water, and rub as directed. When the water makes the patient feel chilly or he tires of it, use fresh olive oil, warmed if necessary. Avoid all alcoholic drinks, which simply rob the nerves of the very power needed for cure. Temporary relief may be given by such drinks, but it is at the expense of lowered life and reduced chances of recovery. A tablespoonful of _hot_ water every five minutes is the best curative drink. It may be given for several hours if required. To give this rubbing treatment and drinking hot water fair play, however, attention must be paid most carefully to the _feet_ and _skin_ of the patient. The feet frequently are cold, and in bad cases swell, the skin at and above the swelling being pale and soft. In minor cases this state of the feet may be treated by rubbing with hot olive oil. In serious cases rubbing is to be alternated with bathing the feet in hot water, until the feet and limbs glow with heat. This may be done two or three times a day, for half an hour, or even an hour. It increases very greatly the vital power for breathing. Again, the skin in bad cases of asthma becomes dry, hard, and a light brown substance forms on its surface. If the skin thus fails, severe work is thrown on the already overloaded lungs, and the breathing is much worse. Give the patient a night's pack in the SOAPY BLANKET (_see_). If there is not strength to stand the entire treatment, keep in the blanket pack for a shorter time--one, two, or three hours. Not more than two nights of this treatment should be needed at a time. The soapy blanket greatly stimulates the skin, and opens all the closed pores, immensely relieving the lungs. If feet, skin, and back be treated as we have advised, even a very obstinate case of asthma should be cured. _See_ Appendix; Bathing the Feet; Rubbing; Soap; Soapy Blanket. Back Failures.--Often a severe pain in the toe, foot, ankle, or lower leg has its cause, not in anything wrong with the part which is painful, but in some failure of nerve in the patient's _back_. Blistering or other treatment of the painful part will often injure, and cannot do much, in any case, to cure. Pains even in the knee and groin sometimes have the same cause--in back failure. In other cases the symptoms are, weariness, stiffness, inability to stoop, or stand long without support, and pains in the stomach and thighs. A little thought will enable any one to distinguish between pains due to back failure and those due to local causes. If there is no appearance of anything wrong at the part pained, then the evil is probably in the back. It is even a good rule to consider the pain at first as due to back failure rather than local causes, for by treatment of the back the local trouble, when that is present, is much helped and relieved. In the case of pains in the arms or hands, the _upper_ part of the back is indicated; in leg and foot troubles, the _lower_ part. Neuralgic pains are almost always of this class. In any case of this kind, heat may be applied to the spine, and rubbing with hot oil given to it, at its upper or lower part as required. If the heat and rubbing increase the pain, then cold applications may be used. Sometimes heat and cold may be needed alternately; but common sense must guide, and all irritation or chilling of the patient must be carefully avoided. The best manner of applying cold to the spine is described in article on Angina Pectoris. Towels are folded as there directed. The moist one (well wrung out) is placed next the spine, either over the part desired or the whole spine. The dry one is placed over this, and the patient lies down on his back on the top of them; or, if he cannot lie, as sometimes happens, the towels are gently pressed with the hand against the spine until sufficient cooling has resulted. The patient should never be made to shiver. If he feels chilly, hot fomentations to the feet and legs, as described in article on Angina Pectoris, may be applied. Balance, Loss of.--Cases where loss of balance in walking and standing are due to St. Vitus' Dance will be treated under that head. Other cases, where loss of power in the motor nerves causes this unsteadiness, are treated of here. As these cases differ totally from St. Vitus' Dance in cause and treatment, it is well carefully to distinguish between them. In St. Vitus' Dance, then, notice that the patient cannot lie still. In case of simple loss of power, he staggers or falls only when moving, or trying to move. Probably also in the last case there are cold feet and clammy skin. For this, bathe the feet at bedtime in hot water, dry, and rub them with hot oil. Then apply to the back on going to bed a warm cloth, covered with soap lather (_see_ Lather), with dry towel above it. Do this each night for a week. When taking off the cloth, sponge the back with warm vinegar or weak acid (_see_ Acetic Acid), and rub with warm olive oil. After a week of this treatment, apply each night for two or three days, a large BRAN POULTICE (_see_) across the loins for an hour at bedtime, with olive oil before and after. Above all, conscientiously let the patient _rest_. A good deal of lying in bed and on a sofa must be taken, and good nourishment given (_see_ Assimilation, etc.). Some weeks of alternate treatment like this should effect a great improvement, if not a radical cure. Balance of Action--_See_ Action, Balance of. Band, Flannel.--A piece of fine new flannel made to cover the whole back, and sewed under the usual underclothing, has a truly wonderful effect when worn in certain cases of illness. The same effect is not produced by doubling the flannels that are worn. What we have specially to call attention to is the fact that the piece is extra to all that which covers the rest of the body. The heat of the back, which is so very important from the nerve structure of the spinal system, is made to gather under a single ply of flannel, but much more quickly under two folds of the same material. When, therefore, there is anything like natural heat in the back, this piece of new flannel makes it gather quickly, and keeps it stimulating the parts to which it is confined. Then, if the front of the body is more thinly clad, it is very much the same as when a hot bag or a bran poultice is applied to the back, and a cold cloth in front. The effect is not so immediate, but in the course of time it gets to be even greater. We have never been able to see much come of "magnetic" or "electric" belts other than would result from wearing the woollen material they are covered with; but we have seen constantly all the good effects ascribed to the most costly appliances produced by a bit of new flannel. If there can be a good rubbing given with olive oil, and then the extra flannel put on, the effect is delightful. Again, when the skin has been cleansed effectually with the mixture for NIGHT SWEATS (_see_), put the flannel on. It causes a gathering of heat, which stimulates the spinal nerves, and produces good effects all over the body and limbs. A broad band of extra new flannel round the lower half of the body is somewhat equivalent to fomentation got in the armchair, or in the hot pack of the lower body. Those who are exposed, as coachmen are, and subject to lumbago and other troubles, will find a flannel band work wonders. This flannel band on the lower back is valuable in cases of rheumatism, sciatica, and various kidney troubles. On the upper back it is good for bronchitis and some forms of asthma. It may be used in connection with the other forms of treatment given for these in separate articles. When linen underwear is worn, this band should be worn under that, next the skin. Bandage, Four-ply Flannel.--The four-ply flannel bandage is simply what its name implies--a bandage of the shape and size to cover the parts treated, and at least four-ply thick. It is wrung out of cold water, and covered with a thick dry bandage while applied. Bandaging.--_See_ Veins, Swollen, etc. Barley.--If this grain is well grown and thoroughly well cooked, it will be found to be one of the best foods for restoring an exhausted digestive system. Take two or three handfuls of "pot" barley; boil this in water for two hours at least, thoroughly to burst the grain; then water and grain together are turned into a suitable dish, and placed, covered over, in the oven, where it may simmer for another two hours. When turned out, it may be salted to taste. After the four hours' cooking, the grain and water are a kind of barley pudding. A dessertspoonful of this every half-hour, from eight in the morning till eight at night, will help wonderfully a weak stomach, if taken as the _only diet_. This is what is meant when "barley pudding" is prescribed in these articles. Bathing.--Cold baths, while greatly to be recommended to those who are strong, should not be taken by any one who does not feel invigorated by them. As every one should, if possible, bathe daily, the following method is worth knowing, as it combines all the advantages of hot and cold bathing. The principle is the same as explained in Cooling in Heating. Sponge all over with hot water and wash with M'Clinton's soap; then sponge all over with cold water. No chilliness will then be felt. Very weak persons may use tepid instead of cold water. These baths taken every morning will greatly tend to prevent the person catching cold. Cold bathing in water which is _hard_ is a mistake, especially in bathing of infants. The skin under its influence becomes hard and dry. Warm bathing and M'Clinton's soap will remedy this. Bathing the Feet.--This apparently simple treatment, if the best results are desired, must be gone about most carefully. A foot-bath for ten or twenty minutes, though a considerable help in many cases, is not at all sufficient. It must be given, in most cases, for forty minutes to give sensible relief. Some patients faint long before this time if the feet are placed in very hot water from the beginning. To avoid this faintness, proceed as follows: Get a vessel that will hold the feet easily, and be deep enough to reach nearly up to the knees. Put water in this one inch deep, and at blood heat--that is, just to feel warm to an ordinary hand. Set the feet to be bathed in this, and have plenty of hot water at hand. Let the patient be comfortably covered and seated, and wait two minutes or so. Add then a little hotter water, and every two minutes add a little more water, hotter every time, gradually increasing the quantity and temperature of the water. In half an hour a good strong heat and large deep bath will be reached, and in only a very few cases will there be any faintness. If the heat is raised too fast, give a little cold water to drink, and proceed more slowly. This is in cases where simple stimulus to vital action is required. If the bathing be for sores, or disease of joints, the sores should be dressed first with cold cream or vaseline, or covered with a cloth dipped in olive oil. If the skin becomes irritated from prolonged bathing, cover before bathing with a cloth dipped in weak vinegar or very weak ACETIC ACID (_see_). If the patient is too weak for bathing, a fomentation may be applied as described in article on Angina Pectoris, only extending, however, over the knees. Such fomentation may also be used whenever cold cloths applied to a diseased or inflamed part tend to cause a chill. It will quite prevent this. Baths for Head.--In many cases of indigestion and brain exhaustion head-baths are of great value. School teachers, business men, and many others suffering from these, will find a daily head-bath half an hour before dinner of the greatest value. This treatment should be given, however, only to those who are vigorous enough to bear it. Some are too exhausted, and for these other methods must be employed. The head-bath is given by rubbing the whole head well with soap lather (_see_ Lather; Soap); then wash off and treat with cold water poured over the head for a short time--a few seconds only; then rub vigorously with a dry, warm towel till the head glows with friction. In the case of ladies, the hair may be thrown over the front of the head while the back of the head is treated thus, and then thrown back while the front of the head is treated also, the bulk of the hair being thus kept dry. Bedsores.--There are cases in which the outer skin has been taken off by long lying, or wearing wet compresses for a long time. A large part of the body is reduced, as some would say, to "red flesh"--in reality it is reduced to inner skin deprived of its outer layer. We have taken a few handfuls of finely wrought soap lather (_see_ Lather; Soap), and spread them as lightly as possible over this fiery surface. There was an instant change from severe distress to perfect comfort, and healing began at once. This treatment may be applied to any simple abrasions of the skin. Bedsores are not likely to occur if the skin is sponged daily with water and this mild soap, and rubbed with Rectified Spirit of Wine, to which a small piece of camphor has been added. Beef Tea.--It is well to bear in mind that there is scarcely any nourishment even in home-made beef juice (the best form of any extract of meat). Home-made beef juice is prepared by scraping the meat into shreds, placing in a jar, and leaving the water to soak into the meat for about half-an-hour. Then place in a saucepan on the fire for an hour, during which time it must not boil. After being then brought to the boil, it should be removed immediately, and the lump of meat removed. Some idea may be obtained of the relatively small amount of nourishment even in this form of extract when it is remembered that the thin flaky matter which sinks to the bottom in the bowl is practically the only nutritive portion in the dish. All extracts and such-like preparations are inferior to home-made beef tea in value. We do not deny, then, the value of beef extracts as stimulants in certain diseased conditions, but we do not recognise them as a useful food. Further, the stimulating effect upon the heart is largely due to the hot water they are made with (_see_ Bone Diseased). Bile, Black.--For this take two tablespoonfuls of hot water every five minutes for six hours per day. A good many cases, some even given up by the doctors, have been cured by this simple, yet efficient means. Bile on the Stomach.--Take half a teacupful of hot water every ten minutes for ten hours. Next day take the same every twenty minutes for a like period. The third day the same every hour. For ten days after take the same before each meal. We have seen a case of liver complaint of more than twenty years' standing cured thus. See also that the feet and legs are rendered healthful, and kept so. If cold and clammy, they should be bathed in hot water for five minutes or so, dried, and rubbed with warm olive oil. Care must be taken also to give a simple diet. Oatmeal jelly, wheaten meal porridge, barley pudding (_see_ Barley), and such foods, should form the staple nourishment. Avoid eggs, butter, cream, and beef. _See also_ Sea-Sickness. Biscuits and Water.--The biscuits referred to are manufactured in Saltcoats.[A] They are made from the purest whole wheaten flour. The late Mr. Bryden, of the Saltcoats Home, used them along with hot water as sole diet in many serious digestive troubles, with marvellous success. Where no food will lie on the stomach, one small, or half a large, biscuit is to be taken three times a day, as a meal, and at meal-times. This will prove amply sufficient to maintain the system in such a case, until the stomach gains power for more. In the case of SORES and ABSCESSES (_see_), such a diet of biscuits and water provides pure blood, and makes healing by other treatment very much easier. We have known limbs saved from amputation largely by such diet. It will suit equally well the delicate young lady and the strong labourer. Too much of ordinary food goes to increase ulceration and nourish disease. The Saltcoats biscuit provides nothing for these ends, and is of immense value as an aid to cure. One great advantage of this diet is that it is a _dry_ one, and the biscuits _must_ be thoroughly chewed to enable them to be swallowed at all. The saliva is thereby thoroughly mixed with the food, which is all-important to make it digestible. These biscuits are also so plain as not to tempt the patient to eat more than he can digest, which is the great danger in sickness. The slops of gruel and cornflour so often given are never chewed at all, and often do nothing but harm. Such starchy foods really require to be more thoroughly mixed with saliva than any other food, as unless, by action of the saliva, the starch is converted into sugar it cannot be assimilated in the stomach. [Footnote A: By Mr. R. Black, baker.] Bleeding.--In any case of this pack the feet and legs as directed in Lungs, Bleeding from, and press cold cloths to the place the blood comes from, stomach, womb (_see_ Miscarriage), or lungs. If it comes from the nose, apply the cold cloths to the head and back of the neck. Blisters.--The destruction of the skin over any painful part, by means of blisters, is to be always avoided if possible (_see_ Burns, Knee, Pleurisy, etc.) Blood.--A most common trouble is anæmia, a lack of good red blood, showing itself in a waxy paleness and whiteness of lips, often accompanied by exhaustion and great fatigue. To remedy this, first secure a supply of pure water, of which 80 per cent. of the blood is made up. Give this warm in dessertspoonfuls every five minutes. Give two tablespoonfuls, or perhaps only one, of very light food, or milk and boiling water half and half, every half-hour. This may be done in smaller portions every fifteen minutes, or in larger quantities every hour or two hours, according to the state of the digestion. Fruit is a valuable means of quenching the anæmia thirst, besides being very beneficial for the blood. Green vegetables and salads are also most valuable (_see_ Vegetables; Assimilation; Diet; Digestion). As much fresh air as possible is also to be breathed by the patient. Either much time must be spent in the open air, or, if strength forbid this, the room must be thoroughly ventilated. Close air is the enemy of good blood. We know of many cases cured by this simple regimen. Care must also be taken to increase the patient's vitality by various means. If _thoroughly good_ medical advice can be obtained, it should be taken (_see_ Air and Appetite; Balance, Loss of, etc.) Blood Poisoning.--(_See_ Blood, Purifying; Sores). Blood, Purifying.--Fever arising from bad state of the blood may be treated by careful cooling of the spine and head, with towels _well wrung_ out of cold water, frequently changed (_see_ Fever). The pulse in one case so treated was reduced from 130 to 96 by a few applications. If a sore exists, treat it as in article Sores. If an eruption in the skin breaks out, cover the surface at night with soap lather (_see_ Lather; Soap). Wipe that off with weak acetic acid (_see_) in the morning, and the skin will come right. Let the diet be simple and cooling (_see_ Abscess; Assimilation; Skin; Sores; Appendix, etc.). Blood, Supply of.--To supply good blood in cases where it is lacking, either from indigestion or low vitality, nothing is better than milk, diluted with an equal quantity of _boiling water_. It may be less or more diluted, as the patient's power of digestion is greater or less, but in all cases half and half can be tried first. This forms a natural blood supply. Claret, switched egg and brandy, are to be carefully avoided. _Boiling_ water amalgamates with the milk, and care therefore must be taken to see that it is really boiling. Give a teacupful of this every two hours. If the patient is very weak, this may be the only diet. But often he will be going about work or business, and yet needing fresh, good blood supply. Then the cupful may be taken every two hours, in addition to the usual meals. Experience will soon show how this may be done. But two hours after a meal, the milk and water may be given. Boils.--The following treatment will be found effective to heal less severe forms of boils, by soothing the whole fevered system of nerves, and stimulating the skin in its getting rid of waste material. Begin, then, by thoroughly soaping the head (_see_ Head, Soaping). Go to the back next, and soap similarly. The same process may, if desired, be carried over the whole body to the very tips of the fingers and toes. In a delicate case, do this in portions so as not to run any risk of exposing the patient too much. Lay on the boil, after the soaping, and while the patient is under its soothing influence, a large piece of thickly folded flannel, or a small sponge, squeezed out of water as hot as the patient can bear. Continue this, with frequent re-heating of the application for a quarter-of-an-hour, then allow the patient to rest. When you have soaped a patient as we have described, say twice, it is necessary to wash off the particles that may remain on the skin with white vinegar or weak acetic acid. Then, if you have overcooled with the soap and acid, it will be well to rub over with warm oil. By these simple methods of treatment you will banish all tendency to boils. You will change great suffering into comparative comfort, not only without expenditure of strength, but in a way in which you add vigour to the whole frame. One very great advantage of this treatment is that you do not need to move the patient in any distressing way. If you have only tact and gentleness of touch, you can do all that we have described without causing one moment's distress. The severe form of boil known as _Carbuncle_ is very dangerous, and in such cases good surgical aid is necessary, in addition to above treatment (_see_ Diet). Bone, Diseased.--Diseased bone is not incurable. Bone is indeed constantly being replaced as it disappears in the ordinary waste of the body. Defective vitality in any part may cause an accumulation of bad material, which forms the basis of bone disease. To cut off a diseased foot or ankle is easy, and soon done. To cure it, may take a long time and much patience, but is worth a great deal. We know large numbers of limbs that are sound and good now, that were doomed once to be amputated, but which we were able to rescue in time. Moreover, a very short time of well-regulated fomentation improves the general health, and prevents the diseased material spreading from the foot or ankle through the body. Take, then, a case in which the ankle bone has first become painful, perhaps without any perceptible cause, or it may be as the result of an injury to the part. It then swells and becomes inflamed. At this stage two or three fomentations (_see_) well applied may very likely cure it entirely. But if neglected, or leeched, blistered, and the skin spoiled with iodine, what is called disease of the bone may set in, accompanied with discharge of matter at one or more places on the ankle. This discharge, where it is evidently lodging in the limb, may be assisted to escape by careful lancing by a good surgeon. For such a case, fomentation of as much of the limb as possible is the treatment. Let a bath be procured, in which the limb may be immersed in hot water as deeply as possible, even up to the very thigh. Let the water at first be comfortably warm. Increase its temperature gradually until as hot as can be borne without pain. Keep the limb in this bath for an hour, or for such shorter period as the patient may be able to bear it. Gently dry, and rub all over with warm olive oil. Wipe this gently off, and cover the limb with clothing. Then syringe any sores with weak acid (_see_ Acetic Acid; Wounds), and dress with bandage (_see_ Ankle, Twisted). Do this twice each day, and persevere. If it cannot well be bathed, let it be fomented by a large piece of flannel soaked with boiling water, and placed round the diseased part. We have seen a wasting bone healed entirely in a few weeks by this means. We have seen a man with the bones of both his legs splintering off and coming through the skin perfectly healed in a few months. It stands to reason that it should be so. The bathing in his case, like the fomenting in others, were so effectually done that the bones themselves were heated, and strong healing action set in at once. We saw lately a piece of dead bone above four inches long come out of a young man's arm as the result of nothing else but fomentation. The arm was soon as whole and as useful as could be desired, though it had been to all appearance only fit to be taken off at the elbow. The steady supply of moist heat does wonders in this way. We have seen some most remarkable specimens of what was erroneously thought sufficient fomentation. One was a case of diseased thigh-bone. A bit of old flannel, about a quarter of a yard square, had been wrung out of water slightly tepid and laid on the skin, covered by a little cloth scarcely equal in size. The application would not have conveyed activity to the skin on which it was laid, though it required to convey it to the heart of a large mass of bone. The helpless complaint of the operator was that it did no good. How in the world could it do good? Not less than six or seven or even eight yards of a blanket are required. That is to be folded and rolled up so that a good quantity of boiling water may be poured first into one end of it and then into the other. It has to be squeezed and kneaded till the heated water and steam are fairly soaking the inside of the blanket. When this is opened up, it is far too hot to put to the skin, but a double flannel or strong towel may be put on first, so that the heat shall go gradually through to the body, and by-and-by into the bone. This may be done at least once a day--if agreeable, it may be done twice. But it must be so well done that the heat shall effect the bone, or you cannot look for any result of importance. If under the bathing the skin becomes irritated, as it will often do, cover it with cloths soaked in _weak_ vinegar till the bathing is over. If the skin suffers from the fomentation, do the same thing, and if this does not cure, dress it, before putting on the fomentation flannels, with SOAP (_see_) lather as if for shaving, spread like butter on a cloth, and made to shelter the skin from irritation till the fomenting is done. This is of great importance in many cases; the skin is often so sensitive that it cannot well be bathed without being protected. [Illustration: Preparing Blanket for Fomentation.] In the case of hip-joint disease, the ARMCHAIR FOMENTATION (_see_) is the best form of fomenting. For other parts, common sense will guide how to produce an extensive and thorough heating of the diseased part and its neighbourhood by some similar means (_see_ Bathing the Feet; Pains, etc.). It is only heating the failed tissues, only keeping on such heating, and all the elements of perfect cure are supplied. Even limbs which have shrunk and become shorter, grow out to their natural size under this patient heating. Get "steel drops" and all such-like sent down the sewer. The rats may have them if they are disposed. Give wheaten or oatmeal porridge, bread or Saltcoats biscuits, with good buttermilk, and the poor creature, half dead with poisonous "drops," begins ere long to have red on his lips and on his cheeks, some fresh vigour in his muscles, and healthy bone in the course of formation, where bone was only wasting before. How is this explained? On the simple principle that the bodily system can turn wheaten meal into all the elements wanted for good bodily health. Beef tea, soups, "fine things" of all descriptions, never on earth gave human beings solid strength, but in myriads of cases they have been successfully employed to take it away. Above all, they fail to give healthy bone. Get the patient to take wheaten or oaten meal porridge twice a day at least. We are not so stern as some in forbidding all else, though in this we may fall short; but by all means let eating and drinking be considered in the light of what we have been writing (_see_ Food in Health). Good air is important in this, as in all cases of ill-health. Much depends, in this treatment, on cheerfulness of mind. Let the patient feel that he is going to be cured. Avoid opium, tobacco, alcoholic drinks, and all worry. This will actually increase the vital exchange in the body and very much help the cure. Bone, Soft.--Often, in the young, the bones are so soft that they bend more or less, and the beginning of a distressing deformity appears. In such a case plaster jackets and steel bands are of little use, and often very painful. It is better to use bandages, applied so as to support where that is necessary. Also avoid all long sitting, such as is found at school. It is best sometimes not to permit the child to walk at all. Better far to lose two years of schooling than to be deformed for life. Parents should see to it, with all weakly children, that school does not become a means of trouble. Continuous education is not nearly so important as is sometimes supposed. For positive treatment, let the parts be well and carefully rubbed (_see_ Massage) every day with olive oil, in such a way as to direct a flow of blood to the feeble bone. It must largely be left to the healer's common sense how this is to be done, but a little thought will show how. At many Hydropathic Establishments it may be learned. This careful rubbing, with good diet and proper bandaging, will gradually effect a cure in most cases. But here, as elsewhere, patience must rule. Plenty of good porridge and milk, with abundance of fresh air, work wonders in this disease. Bowels, Glands of.--Symptoms of glandular trouble in the bowels are--weariness and pallor, lack of appetite, softness and shrinking of limbs, with swelling of the belly. In its earlier stages, before consumption sets in, this trouble may be perfectly cured. We have seen even apparently hopeless cases recover under proper treatment. In its essence the trouble is a failure of power in the nervous centres upon which health of the bowels depends. To supply this needed power, take a small bag of cotton cloth, like a little pillow-slip, of just the size to cover the patient's whole back. Fill this with bran, prepared as for poultice (_see_ Bran Poultice). Oil the back before applying this, and place, if needed, four ply or so of cloth on the back to moderate the heat to the skin. After half-an-hour, if the patient feels desirous, renew for another hour; do this each day at bedtime for a week at least. Rub the body all over with warm olive oil when this is taken off; then place a bandage with only a gentle tightness in such a way as just to help the relaxed bowels, but only just so much--not by any means to try and force them into what might be thought proper dimensions. Give a teaspoonful of liquorice mixture (_see_ Constipation) thrice a day before meals in a little hot water. Feed on wheaten porridge and generally light diet, being careful to regulate it so as to make the bowels work easily and naturally. If not too bad a case, this treatment will soon tell favourably. Enemas (_see_) of either cold or warm water, as required, will also greatly help. Bowels, Inflammation of.--This (called medically Peritonitis) is an inflammation of the membrane covering the bowels. It results from chill or strain, and sometimes, in the case of child-birth, from dirt introduced into the parts by handling with unwashed hands. In such cases, the utmost care must be taken to ensure cleanliness, which will secure against one fertile cause of the disease. The hands should be always fresh and clean, and all cloths, etc., should be either most carefully washed or burnt. Where the trouble arises from strain, or chill, these lower the vitality, and the membrane becomes gorged with blood at fever heat. To regulate this heat, then, and free the membrane from the blood which over-fills it, is to lead to a cure. Rub the back with warm olive oil, place on it a large BRAN POULTICE (_see_), or an india-rubber bag of hot water covered with _moist_ flannel; this must in either case be large enough to cover the entire lower back. Anything may be used, if these cannot be had, which will powerfully stimulate the back with moist heat. Wring a small thin towel out of cold water, and place it over the bowels. At first this must be _very gently_ laid on. After a little, and when several times freshly applied, this cold cloth may be very gently pressed all over the bowels. Relief will almost certainly come ere this has been done for an hour. Then a rest may be given for two hours, and after that a large fomentation applied to feet and legs (_see_ Fomentation). While this is on, the cold cloths may be changed over the bowels again, and over the chest as well. After an hour of this, great relief should be felt. If there is great thirst a small bit of ice may be sucked, or a few drops of vinegar in water may be taken; but the outside cooling will probably render this unnecessary. Avoid all alcoholic drinks. Shivering and a feeling of cold is often the earliest symptom, and as it is of immense importance that warming measures should be promptly applied. Hot bricks, or bottles, placed merely to the soles of the feet, are but poor helps: it would be vastly better to pack the feet and legs in a hot blanket fomentation at once, and, if pain at all shows itself, to apply a large fomentation to the lower part of the back. The sooner this is done the better; besides, there is the consolation that the treatment can never do any harm even if applied in a case in which there has occurred a harmless chill. The dread which some medical men have of cold applications is wonderful, but we know that the front-rank men have no such fear. When care is taken to have the hot application on first, there is, and can be, no possible danger in any case in cooling down the burning circulation. One or two applications have sufficed in many cases we have seen. Bowels, Lax.--A teaspoonful of lemon juice (freshly expressed), along with hot water and sugar, will often relieve where the bowels are acting excessively. For infants in diarrhoea a mixture of honey and lemon juice is an excellent cure, and has been most successful in our experience. Avoid brandy and alcohol generally. Bowels, Locking of.--Sometimes when one part of the bowels is much more active than another, it passes into that other, and they become _locked_, like a stocking half turned inside out. This causes dreadful pain, and if not soon relieved is fatal. Purgatives are of no use, and usually make matters worse. A surgical operation in very skilful hands will relieve, and must be quickly performed when necessary. In cases in which the one part of the bowels has not yet gone far into the other, nothing more is required than a cold cloth gently pressed over the parts. We have seen relief set in on the fifth or sixth change of such a cloth, when nothing else was used whatever. When a hot bag, or bran poultice, has been put on the back, and cold cloths persistently changed over the bowels, the whole matter has been put to rights, and natural motion of the bowels has been had within an hour after the applications have been begun. [Illustration: Interior of small intestine.] There is, however, a stronger measure than merely heating the back and cooling the front in this way. The patient may be put at once into a sitting bath or small tub, and a panful of cold water poured or dashed on to the bowels; they then contract so powerfully, and shorten themselves so much, that all invagination, as it is called, is made to cease instantly. We should be disposed to try the mildest method in the first instance, unless the case is one in which the lock in the bowels had just taken place. Then it might be well to dash the pailful of water on so as to put all right at once, and afterwards simply to apply such remedies as would tend to prevent a recurrence of the evil. It is, however, usually the case that the distress has lasted some time before an opportunity of doing anything occurs, inflammation, more or less, has set in, weeks may have passed, and blundering treatment may have done great mischief. Then it is safe to use the heat at the back, and frequently changed cold cloths in front, so as to reduce the inflammation, and contract the bowels more slowly, so as to remove the obstruction. When these have been used for some time, if the obstruction is not removed it will be well to resort to the stronger measures. Nothing is more beautifully simple than the ordinary action of the bowels. The healthful movement is like that by which an earth-worm moves along the ground: so long as the tube is thus moving its contents onward, by contraction and expansion, no part can pass inside or outside that which is before it; but when one part loses nervous tension, and expands without contracting quickly enough, the part behind it tends to worm itself into it, and a "knot," as it is sometimes called, is formed. No possible instrument can reach it except by cutting the body outright, but the action of cold is so powerful in contracting the tube that the "loop," as it is also called, is drawn out, and the right state of things is produced. It is important to remark that there are glands near the lower bowel that swell and form tumours. The cold applications reduce these very speedily to their usual size, and if their swelling is an obstruction, it is soon removed. But it is the lock in the tube itself that is the real malady of which so many die, and with which so many more narrowly escape. The trouble is best avoided by attention to the regular action of the bowels. It arises from great irregularity in that action. Bowels, Reversed.--_See_ Bowels, Locking of, above. Brain Exercise.--Proper exercise for the brain is most important. But this is not to be found in that kind of severe mental labour which is sometimes mistaken for it. Children at play have genuine brain exercise. So has a man at what is called a "hobby," such as photography, golf, or cycling. The child at school, the man in his office, are not at exercise, but at wearing work. This distinction is most important. Exercise, again, is not found in careless dreaming, but in some form of "play" which calls for steady, but almost unconscious, and altogether enjoyable thinking. Books sometimes furnish this, when they lift the mind as far as possible out of its usual track, and produce only pleasant thoughts. Tragedies, novels which end miserably, or which are pessimistic, should all be avoided. Perhaps some easy science or art is the best exercise of all, when the brain is suffering from overstrain. But taste will guide in this. The great matter is to have pleasurable, easy, and natural employment for the brain. This and not work is strengthening "exercise," whether in child or man. So far as we can we should see that the weary get it. For he who procures this for his fellow works immense good. We have seen, for instance, a student attacked with dysentery while in the hardest part of the session at the university. His whole system became prostrate, and muscular activity to a very small degree would have killed him; so would the continued mental toil necessary to go on with his studies. Yet his brain was in need of exercise almost from the first appearance of his disease. He must have this or be miserable, and not likely soon to recover. An intensely interesting book fell into his hands, altogether away from his track of toil. He read day after day at this book. This was his "exercise"--that is, it was the activity of that one only part of his physical system which needed such exercise for the time. That exercise allowed all the other organs to recuperate. Brain, Inflammation of.--This arises often from over-schooling of young boys and girls. Care should ever be taken to avoid this. Obstinate constipation in the bowels, chills and exposure, are also fruitful sources. Much worry and anxiety also bring on this serious illness. All sometimes combine to produce a bad case. Pain in the head sets in, followed by convulsive attacks; yet the trouble may be cured in many cases with comparative ease. Leeches, opium, and blistering are to be avoided as most injurious. For treatment it is well to begin at the feet; if these are clammy and cold, wrap in hot fomentation up over the knees (_see_ Fomentation). Proceed to give a pretty warm injection of water into the lower bowel (_see_ Enemas). This should be repeated several times, allowing it to pass off each time. If this increases the pain, try an injection of cold water. This treatment of feet and bowels is most important, and should never be neglected; it renders the treatment of the head tenfold more effective. Cold cloths may now be gently pressed for some time over the head. If the pulse is violent and feverish, let several towels be well wrung out of cold or even iced water, fold one so as to cover the entire head and back of the neck, and have the others ready, similarly folded. Press the first on gently, especially at the back of the head, so that the cooling cloth covers the head all over and soothes the violently heated brain. As soon as one towel grows warm, take a fresh cold one. Relief should come in an hour at least, but longer may be required. During the cooling see that the heat of the fomentation on the legs is well kept up; change if necessary. When the more painful symptoms abate, oil the lower part of the back, and place on it a bran poultice (as recommended in Bowels, Inflammation of). This will go far to prevent any relapse. If the symptoms recur, use the treatment again. _See_ Brow, Weary; Eyes, Failing Sight. _See also_, for other brain troubles: Restlessness; Sleeplessness. Brain Rest.--The need for this is often indicated by irritability of temper. This coming on is generally a warning that a period of rest must be taken. An overheated brow is also another indication. If this shows itself in a child during or after school, together with listlessness and excitability, all idea of lessons should at once be laid aside for a time. It is nothing less than cruelty to work an overheated brain in such a case. Let the child go free from school till all the head trouble is removed. Also let the head be soaped (_see_ Head, Soaping). Sometimes pain in the head sets in from overwork. Even in the young, fainting may show itself. Rest is essential, and will prove a perfect cure, together with a little brain exercise of the kind described in article Brain Exercise, always avoiding fatigue. Let all readers remember that it is better to lose six months in rest than become permanently incapable, therefore let old and young take rest in time. Bran Poultice.--Get a sufficient quantity of good bran in an ordinary washhand basin. _Heat_ the basin before beginning operations. Have also a boiling kettle at hand. Pour the boiling water by little and little into the bran, and mix and stir it up until it is all a moist mass, but not _wet_. The thing is to avoid putting in more water than the bran can easily absorb and hold. Then have ready a flannel bag of the size and shape required for the poultice. Fill this with the bran, and it is ready. The skin to which it is applied should first be oiled with olive oil. The poultice may be fastened on with flannel bands. In any case it must lie tightly on the skin. The patient must lie on it, if it be applied to the back. One or two tablespoonfuls of mustard may be added if great power is required, not otherwise. Instead of this poultice, an india-rubber bag full of hot water may be used, with two or three ply of moist flannel between it and the skin. Our only reason for recommending bran is that many could not afford the india-rubber bag. Bread, Wheaten.--In some cases the bran in whole wheaten bread and Saltcoats biscuits is found to irritate the stomach and bowels. As diet for those able to digest the bran, nothing is better. Where it cannot be digested, ordinary bakers' bread boiled in water to soft pap is found to make a good substitute. This must not be boiled with milk unless where there is diarrhoea to be cured, as milk tends to produce bile and costiveness. Oatmeal jelly (_see_ Food in Illness) is also a good substitute for biscuits and wheaten bread. Often the water with which bread is baked causes it to be difficult of digestion. Hard water is bad for this. For an invalid, bread baked with distilled water, or pure rain water, is often a means of great comfort and help. A slight admixture of pure CANE SYRUP (_see_) or liquorice juice in the water will tend to prevent bile and costiveness. A sufficient action of the bowels is of great importance for where good nutrition is desired. Bread, especially when fresh, is made much more digestible by slowly toasting it in the oven till it is a golden brown throughout. It is then known as "zweibach" (twice baked). When eaten dry, it requires considerable mastication, and for that reason is much better than soft bread. It can be also broken up and eaten with hot milk and sugar. Breast with Corded Muscles.--Often a slight hardness shows itself in a woman's breast, when the muscular tissue becomes what is called "corded." It is well, first of all, in all cases of breast trouble to avoid alarming the patient. Great anxiety is often endured through fear of cancer when there is no need. A "corded" breast may usually quite easily be cured, and the patient should be made perfectly easy in mind about it. Take a good lather of soap (_see_ Lather; Soap). Apply this night and morning, gently lathering the breast for some time. After this, each time, rub the back well with hot olive oil, so as to produce a thorough glow of heat all over it. Sometimes the swelling will disperse under this treatment. It may, however, grow larger and show a tendency to break. In this case treat as in next article. We shall also probably find, on examining, that the skin was failing to do its part well. If rubbed with Cayenne lotion the clean, healthy skin will send off much more waste than was allowed to pass through it before. Breast, Swelling in.--A blow on the breast, or the drain of nursing a child, along with a chill, often produces swelling, sometimes hard and painful. This, if left uncured, may even develop into an ABSCESS (_see_). As it sometimes arises from dirt being left on the nipples, all nursing mothers should be particular about cleanliness, which itself prevents many ills. For cure, bathe the feet in hot water (_see_ Bathing Feet), rub them over with warm olive oil, and wear good cotton stockings if in bed. If going about, put a pair of woollen stockings over the cotton ones. Rub the back as recommended above, using first a little hot vinegar, then the oil. The feet bathing may be every three days, and rubbing the same. If the swelling does not yield to this, place the patient comfortably in bed. Put a good-sized basin of hot water, which has been boiled and allowed to cool so far, tightly under the breast, so that it may be bathed with a sponge. Do not use too hot water, but just comfortably hot. Keep up fresh supplies, and bathe for an hour if patient can bear it. If she becomes fatigued, lay her down to rest for fifteen minutes or so, and then continue treatment. No poulticing is needed when this is well done. A thorough heating of the whole breast is what is wanted; rub gently with olive oil, and cover warmly after bathing (_see_ Cancer). Breast, Sore Nipples on.--Take a little warm vinegar or weak acid (_see_ Acetic Acid). Bathe the sore nipple with this, _avoiding pain_, for about ten minutes. Every two minutes dry, and anoint gently with warm olive oil. We have seen _one application_ cure a bad nipple; but apply twice daily as long as needed. Breath and Blood.--Often difficulty of breathing, especially in close air, mistaken even for asthma, is due simply to the quality of blood supplied to the lungs. Sometimes giving up the use of sugar effects a cure, for sugar produces an excess of carbon in the blood, which requires an excess of oxygen in the lungs to purify it. Thus breathing is difficult, especially where oxygen is deficient in the air breathed. Sometimes the lungs are not strong enough to stand the necessary fresh air required in such cases, or other troubles may prevent a delicate person from exposing themselves. Then it is of importance so to regulate the diet that less oxygen will do all that is needed in the lungs. "Rich" food, much fatty matter, sugar, and all sweets and sweetened things, are to be avoided. If this be done, the need for much oxygen disappears, and the patient will have no difficulty of breathing in suitably ventilated places. But the best treatment is hot oil rubbing along the spine, over the stomach, and even down the limbs to the ankles. An hour of this every day will work wonders. Or a large BRAN POULTICE (_see_) may be laid across the back for an hour twice a day. Cultivate also all cheerful thoughts, and banish sad ones as far as possible. Sad thoughts greatly diminish nerve power. Breath, and the Heart.--Stout people are usually more or less "scant of breath." Accumulations of fatty material, or changing of muscle into fat, cause this, especially if about the chest and heart. To reduce the fat, and grow healthy muscle instead, will perfectly cure the difficulty of breath. Moderate open-air exercise and simple food, such as Saltcoats biscuits, oatmeal jelly, and barley puddings will largely help this. Avoid also all alcoholic liquors, the use of which is often _the sole cause_ of the trouble. Keep the skin active (_see_ Skin). The hot FOMENTATION (_see_) to feet and legs is a truly powerful remedy for all lack of force in the system, especially if followed by the massage treatment described in MASSAGE (_see_). Breath, Hot.--This may be felt either because the breath is actually hot, or because the membranes of the tongue and mouth are unusually tender, and _feel_ the breath hot in consequence when it is not really so. This latter case is usually accompanied by a sore tongue. To heal the tongue, it must be soaked freely with vinegar or weak ACETIC ACID (_see_), so diluted as to give only a very slight feeling of smarting after even prolonged application. Apply it with a good camel's hair brush, and brush with a little fine almond or olive oil after the acid. The mouth may be rinsed with the acid, but brushing is best. But where real heat is found in the breath, it arises from an overheated state of the body internally. This frequently arises from failure in the stomach to digest properly. If the hot breath arises from this, small drinks of hot water, frequently taken, will usually cure it. A warm bran poultice, placed on the back at bedtime opposite the stomach, will prove a more powerful remedy in addition to the hot water. More powerful effect still will be found in such stimulus to the skin as washing it all over twice a week with vinegar or weak acetic acid. On other days let the patient be rubbed over with good olive oil, mixed with enough CAYENNE "TEA" (_see_) to cause a slight burning sensation. Let this also be done twice a week, and twice a week also wash all over with M'Clinton's soap and hot water. A plain diet of course, should be observed (_see_ Digestion; Dyspepsia; Food; Teeth, etc.). Breath, and Muscles.--Sometimes difficulty of breathing is due, not to anything wrong with lungs or windpipe, but to failure in the diaphragm (or large muscular "floor" of the chest), and the other chest muscles, which work the lungs. A feeling of sinking and weakness round the waist indicates in such a case diaphragm failure. Gentle heat at the small of the back, and olive oil rubbing, form treatment for this. For other chest muscles, give a warm washing each night with SOAP (_see_) over the body, and rub, especially the back and chest, with hot olive oil. You soon bring the muscles into good trim. Breath, and Nerve.--Difficult breathing, especially in ascending a hill, is often due simply to the lack of the nerve power by which the breathing muscles work. A teacupful of hot water half-an-hour before each meal, by helping digestion, will often remove the difficulty. Rub each evening along the spinal cord with hot olive oil. Breath, and the Skin.--The organs of breathing remove much waste from the system, but the skin also removes a very large part. If either fails, the other has more work thrown upon it, as we see in the severe "night sweats" which accompany chest and lung failure. In such cases, rub with CAYENNE LOTION (_see_ and Night Sweats). Avoid the use of hard water in washing and bathing, especially with infants. Cold baths for the weakly, chills, damp beds, and such things, cause rheumatism and colds by stopping the proper discharge of waste by the skin. After such chill, or cold in damp bed, a hot wash and good hot oil rubbing will avert all evil. This may not always be available; but, if it can be got at all, should be given as soon as possible. The use of the soapy blanket is of the utmost value in severe cases (_see_ Soapy Blanket). Strict cleanliness of person and underwear should be observed. The AIR BATH (_see_) will also give tone to the skin (_see_ Skin and Underwear). Breathing, and Bronchia.--The _bronchia_ are the branching small tubes which lead from the windpipe to all parts of the lungs. Two different states of these often pass as bronchitis. In one of these the tubes are swelled, congested, and full of fiery heat. The whole body is also fevered, and breathing is difficult, with cough. This is true BRONCHITIS (_see_). But often, with difficult breathing and irritating cough, there is no heat and fever. In this case bronchitis treatment gives no relief. This is, indeed, only an irritated state of the lining of the tubes, and far from dangerous. A change of climate to a drier atmosphere will often entirely cure it. Often also a time spent in a room, where the air is kept dry but fresh, and at one steady temperature of about 60 deg., will cure. Our chief purpose in mentioning it, however, is that this comparatively slight trouble may not be mistaken for true bronchitis. [Illustration: The Lungs and other internal organs.] Breathing, Correct Method of.--The capacity of an ordinary pair of lungs is about 250 cubic inches. In ordinary breathing, however, we only take in from 20 to 30 cubic inches. Hence the necessity for practising correct deep breathing. Correct breathing requires cultivation and effort at first, afterwards it will become unconscious. The head should be thrown back, the shoulders squared, and a slow deep breath gradually inspired through the nose till the lungs are filled throughout with air. The expiration should be just as gradual with relaxation of every muscle. It is most important that the _lower_ part of the chest should first be filled by depressing the diaphragm (the muscular floor of the lungs). Some practise is needed before this habit is acquired, but it is well worth cultivating. Place the hands on the sides of the abdomen while inspiring, to feel that _this_ is expanding. Teachers of singing insist on diaphragmatic breathing, which is also of great benefit to the stomach, liver, and other organs. By the movement it gives to the intestines their action is also assisted, and constipation is prevented. This deep breathing may be practised several times each day (say ten breaths at a time) till the habit of correct breathing is acquired. It will be found to have a wonderfully soothing and calming effect (_see_ Worry). Such exercise should always be taken in the open-air, or in a room with a widely open window. A good plan is to take them in bed before rising, with little or no clothes on, while lying flat on the back. Paleness, langour, irritability, and general ill-health result from insufficient breathing. Furthermore, the system becomes unable to resist disease. We know no aid to beauty more effective than the practice of deep breathing. Breathing, in Going Uphill.--_See_ Breath, and Nerve. British Cholera is to a certain extent epidemic--that is, it affects a large number of people in a particular place, being, it is believed, conveyed mainly by the common house flies. War should be waged against these, and great care taken to guard food, especially that of children, against them, by using covers, etc. If this were done the appalling death-rate in summer from this disease among the young would be largely reduced. Typhoid fever and other diseases are probably also spread by flies. Care should be taken to remove promptly all refuse from about the house, and so prevent flies breeding on it. In ordinary diarrhoea, injections of cold water by the enema will usually cure, especially if a little vinegar or a few drops of acetic acid be added to the water. But in British Cholera this proves insufficient. This is not an affection of merely one part of the system, but of the whole. If, then, you brace with the cold enema one part, no doubt so far you do good and not harm, but you cannot by this, cure an affection of the whole system. British Cholera is a sweating from the surfaces of the whole alimentary organs. This internal sweat flows into the stomach and causes vomiting, and into the bowels causing purging that cannot be stayed by any application to the lower part merely. The problem to be solved is how to give more life force. Whenever the injection of cold water fails, and especially when it rather increases the complaint, and vomiting or sickness shows that the attack is of the nature of British Cholera, you will do well to pack feet and legs in a good blanket fomentation. Put a little olive oil on before and after such a packing. One application may be sufficient; but it may be necessary to repeat the packing. Give frequent sips of hot water. It will be well also to use the cold injection, as it will be found to take good effect whenever the vital force has been increased by the hot packing. If cramp has shown itself, it will be needful to cool the spinal nerves (_see_ Angina Pectoris), but this only when you are effectually heating the limbs. The first injection may be followed by even an excessive motion, but if that is followed up with another injection still of cold water, there will be nothing experienced after but perfect comfort, and no more trouble with the bowels. The violent irritation that follows after a very simple over-action of the lower bowel is quite prevented when this remedy is effectually used. In less severe cases, where fermentation of food is the cause of the disease, frequently a dessertspoonful of castor oil, or other simple purgative, will prove sufficient to cure. Brandy often gets the credit of curing in such cases. It does so simply because the cases in which it _kills_ are not taken into account. It always _lessens_ vital energy, and in British Cholera increase of this is urgently required. Bronchitis.--This frequent and severe trouble results most usually from chill to the skin throwing overwork on the lungs and bronchial tubes. These last become inflamed and swollen. A fiery heat and pain in the chest follows, the whole system becomes fevered, and breathing is difficult, and accompanied by severe cough. Kneipp linen underwear, which is porous, and has a stimulating effect on the skin, assists it to perform its functions, and will therefore prove useful to sufferers from Bronchitis. Abundance of fresh air will often entirely prevent Bronchitis. We have known people who suffered from it every winter for years who never had it again after learning the value of the constantly open window. At the earliest stage, when the chill is first felt, let the patient go to bed. First sponge up and down the back quickly with hot soap and water. Dry this off, and sponge or rub gently with hot vinegar. Dry this off, and rub with warm olive oil. This will often ward off an attack entirely. When the trouble has fairly obtained hold, treatment must be applied to the back and chest as follows. Place on the upper part of the back a BRAN POULTICE (_see_), large enough to cover the entire shoulders and upper back. Let the patient lie in bed comfortably on this. Then apply towels wrung out of _cold_ water on the chest where pain and breath-catching are felt. Let the towels be large, and at least four ply. Change for a fresh one as soon as that on the chest becomes heated. When this has been done as long as the poultice keeps hot, take all off, rub back and chest with hot vinegar, dry off, rub with hot oil, dry off, and cover all with warm new flannel. If needful, repeat the application. We have seldom seen it required twice. If the fever is very great, use no olive oil, and for a strong patient the cold towels may be used without the poultice. But immediately these reduce the fever, the poultice should be used as directed. In many cases where medical men have given up hope, this treatment has effected a cure. Brow, The Weary.--Sometimes in the case of a child at school, the result of overwork shows itself in a weariness and weight in the brow. Often parents are glorying in the school successes of their children, when these are having their brains destroyed. Careful watching should ever be given to the young. The aim in education should be to draw out the faculties, and teach the young to think for themselves, rather than to cram in a mass of facts which will enable them to take prizes and pass examinations with honours. The results of continued overwork are fatal, but in its earlier stages it is easily remedied. Hence the need for watching and treating such an early symptom as head weariness. For treatment see that the feet are warm, bathing them if necessary (_see_ Bathing Feet). Stop school at once, and give as much exercise in the open air, at play, as possible. Then rub gently with both hands up and over the brow and sides of the head over the ears, then up the back and over top of the head. Rub all over the head with the finger points (not nails), so as to raise a glow in the skin of the scalp. This treatment is best done while the patient sits, and the operator stands behind or beside him. Gentleness of touch there must be, and no irritation of the patient. With abstention from all lessons, it will soon cure. Bruises.--For slight bruises, such as children frequently get by falling, a little butter or vaseline, applied immediately, is an excellent remedy. For more serious injuries, such as bruised nails of the fingers or toes, or such as result from violent knocks on any part, the best remedy is hot fomentation or hot bathing, whichever may be most convenient in application. Persistent and repeated treatment in this way, with oil dressing, will cure in almost any case not so severe as to be beyond remedy. Even where it is thought wise to send for a surgeon, this bathing is the proper first treatment, and will do much to relieve the inevitable pain. Burns.--For _slight_ burns, immerse the injured part in cold water, and keep there till the pain abates. This is where only redness of skin is produced. In case of a blister forming, do not break or cut it, but perseveringly cool with cold water, and leave the blister till it comes away of itself, when the sore will be found healed beneath it. Where a large surface is injured, some other part of the body must be _fomented_; best the legs and feet, or the back, while the injured part is persistently cooled. Thus a dangerous chill is avoided. The ARMCHAIR FOMENTATION may be used, or a large BRAN POULTICE (_see both these_), and thus the heat of the body kept up while cold water is applied to the burns. If these cannot be immersed, as in the case of the face, cover them with an air-tight covering, and apply iced or cold cloths above this. The linseed oil and lime-water known as "Carron Oil" forms the best dressing to apply. If a burn has, however, gone so far as to become, owing to neglect, a festering sore, then warm water treatment is required, as recommended for ABSCESS (_see_). _See also_ Wounds. Buttermilk.--Where we prescribe this, either for drinking or for external use in poultices or bathing, it is very important it should be pure and fresh. If kept too long, it causes often terrible pain when applied to eruptive sores. There must be no "watering" or doctoring with cream of tartar, if good results are desired. If the milk be too long kept, and cannot be had fresh, it may be mixed with a little sweet milk and all churned well together. Then it may be used. If still painful, mix again with more sweet milk. To soak diseased skin in good fresh buttermilk is so powerful a means of cure, that to procure it a good deal of trouble is well spent. It is also invaluable as a daily drink for regulating the bowels, and maintaining health. Sterilise all sweet milk used. If buttermilk cannot be had, acetic acid or vinegar, or the juice of lemons, may be mixed with sweet milk or even water, until the mixture attains about the usual sourness of buttermilk. This makes an efficient substitute. Buttermilk Poultice.--Boiled potatoes beaten up with fresh buttermilk make an excellent poultice for all eruptive sores, scabbed heads, and heated skin affections. After these always apply soap lather (_see_ Lather). If buttermilk cannot be had, use acetic acid or vinegar, as above. Cancer.--Swellings in the breast often arouse fear of cancer, but are generally very simple affairs and easily yield to treatment as in article Breast, Swelling in. If not, we should chill the diseased growth so as to arrest it. Now this, as we have proved, may be effectually done, and the sorely tried patient may be saved a world of pain, and perhaps cured. We have seen more than one apparently desperate case, even where the breast had been cut off and the evil was again showing itself, in which effective cooling arrested the growth and saved the sufferer. When a growth of this kind has gone a certain length, there is severe pain. The cooling removes this, and secures the patient unspeakably precious rest without narcotics. But this is not all: it puts an effectual stop to the swelling. If the case has not gone very far, the swelling falls, and may disappear; but even when it has gone too far for this, the disease is stayed, and all symptoms of it are lessened. All swelling but the actual separate growth is removed. For instance, when the swelling has passed from the breast into the armpit it has been dispelled, and entirely confined to the actual substance of the tumour. This is managed simply by the persistent and vigorous use of cold towels. They must be large enough to allow of fourfold covering of the whole breast. They are wrung out of cold water at first, and, if possible, cooled with ice instead of being wrung out after. One at a time is kindly pressed all round and over the swollen breast. It is heated in one or two minutes, and must be changed. The second is pressed round and all over the breast in the same way. It is soon heated too, but you may have three of them in a circle, and if you have a bit of ice for those that are cooling, you have cold enough. Some would put on an ice-bag, and let it lie, but we have never been able to advise this, as it is very apt to destroy the outer skin by too severe cold. This treatment requires work--no doubt of that--but the effects are well worth it. When the cooling treatment, given twice a day, or oftener if it can be without discomfort, has reduced the swelling and put back the tumour, till it may fairly be regarded as capable of absorption, it will be well to try the effect of hot fomentation by bathing (_see_ Breast, Swelling in). This will not do harm, but good, if it is only used so far as to try whether the stage for hot treatment has been reached. If the hot bathing is agreeable, and instead of causing pain, rather soothes and comforts, it may be strongly tried. But this will be only if the effectual cooling has put back the disease, or if it has been really mastered. So long as it shows a tendency to increase, it will be well to continue the cooling. Even if it be not possible to remove the disease, its progress may be arrested, and it may be rendered dormant for the rest of life. We know persons sent off to die with growths who are now quite well and have been so for many years, with these growths only rendered dormant. Even if this is not possible, it may be that we render the growth so slow that it shall come to nothing important in the remainder of even a long life. We should never hesitate to do our utmost in any case. Besides the local treatment given above, vital action in the whole bodily system has to be increased on a definite line. This is the ripening and removing used-up substance from the body. It is sluggish ripening of substance to which we trace the morbid living growth; that sluggishness must be overcome. The first and most important means for this is fresher air for the lungs. The seaside home, if there are no drugs or drinks prescribed in ignorance, nor any other drawback, will be found of immense value here. Next in importance to fresh air is pure distilled water. It should be used both in preparing food and for drinking. This constant use of distilled water is one of the most important remedies in cases of cancer. Comfortable clothing (_see_ Underwear) should be worn by night and day, and damp avoided. The food should be such as can be most easily assimilated. Whole wheaten meal in various forms and pure water work wonders on "hopeless cases." But when all these conditions have been supplied, "pack" the whole body at eight o'clock at night in cloths lightly wrung out of hot vinegar and water, half and half, and covering these with dry sheets and blankets, give the patient an hour in this "pack." On taking out of this, rub gently all over with hot olive oil, dry that off and put to bed. In the morning, at half-past seven or so, pack in a soapy blanket for an hour, then sponge with vinegar and rub with oil. Take a stick of good liquorice, with half an ounce of senna leaves, and put these in a quart of water, boil the whole down to a pint, giving a teaspoonful of this in a little hot water three times a day. Cancer in Face.--Treat as far as possible as recommended for breast cancer. Cancer in Foot.--We have noted one case in which "Cancerous Gangrene" in the foot, pronounced incurable by the medical attendant, was cured by our instructions in the following simple manner. Buttermilk poultices (_see_) were used over the whole foot to thoroughly cleanse the sores. These were then carefully lathered with soap (_see_ Lather and Soap). Vinegar or weak acid was applied with sponges and syringe after this, and made thoroughly to penetrate all the sores to the bottom. This was done twice a day, and in one week improvement set in. In a comparatively short time the patient could walk miles without fatigue. This treatment may be applied to all angry sores. Cane Syrup.--In the original edition, good treacle was recommended as a laxative. This treacle, which was prepared from cane sugar, we understand is now not to be had--what is sold as treacle being largely mixed with glucose. We therefore recommend instead the use of golden syrup made from pure cane sugar. This can be had (in tins), guaranteed by the makers to be genuine. Carbuncle.--_See_ Boil. Catarrh.--Is simply an inflammation due to impurity of the blood. These impurities arise from bad air or wrong food, and remain in the body till a chill of some kind or other forces the blood and the impurities with the blood to some part, resulting in inflammation. Catarrh in the mucous membrane, connected with respiration, is commonly called a "cold," and is decidedly infectious (_see_ Air). A cold must be regarded as an effort of Nature to get rid of these impurities. Breathing of fresh, even cold air, will expedite, not hinder the cure. Washing the hands and face in _cold_ water, and drying vigorously, will often cure it when beginning as "cold in the head." Cold, applied in a certain way, cures the after effects of chill, but it must be so applied as only to affect the part to which it is applied, while the general heat of the body is kept up. Catarrh may occur in any internal membrane of the body. If these can be reached, as the nostrils, or even the bowels, may be by syringing, then nothing is better to effect a cure than cool water and vinegar, or weak acetic acid. Brush the nostrils often with this, and cold in the head will soon be cured. It can be applied still better by means of a nasal douche. Syringing the bowels with this cool acid mixture in the more serious catarrh of these will also cure. Patient perseverance is wanted, however, in the latter case. Get also the external skin to act thoroughly. Where the cause of internal catarrh is exhaustion, through overwork or worry, the cause must be removed. Let the sufferer learn trust in a living Heavenly Father, and cast all burdens upon Him, and the physical treatment will have a fair chance to cure. _See_ Breath and Skin. Cauliflower Growths.--These begin like warts, and in the earlier stages poulticing and soaking with weak acid almost invariably cure. After some months the growth looks like the head of a cauliflower, and becomes dangerous if on a vital region. It is not really a parasite, but rather a diseased state of the skin, which is perfectly curable. First every part is carefully cleansed with a small camel's-hair brush and weak acid (_see_ Acetic Acid). Then the buttermilk poultice is applied all night, or even night and day (_see_ Buttermilk Poultice). Cleanse again after poulticing. Careful and persevering continuance of this treatment will effect a cure. Cayenne and Mustard.--Mustard spread on a _cold_ towel and applied to the spine or lumbar region of the back is often an effective aid to the cold treatment. If such applications have to be made more than once, cayenne pepper is preferable to the mustard, and equally powerful. When cold cloths alone fail, this more powerful treatment may be tried. Pain and burning after cayenne are relieved by applying olive oil. Cayenne Lotion, or "Sweating Mixture."--This is made with one or two tablespoonfuls of cayenne pepper (as desired weak or strong), half a pint of white vinegar, and a pint of boiling water. These are mixed and infused for half-an-hour. The mixture is then carefully strained so as to remove the pepper grains. Dilute, if too strong, with water. Cayenne "Tea."--Infuse an ounce of good cayenne pepper in a pint of boiling water. Strain out the pepper. This produces a glow of heat on the skin when rubbed on, and may be a valuable adjunct to oil rubbing where that is intended to raise such a glow. Changing Treatment.--To wisely alter and arrange the treatment in any case is of the utmost importance. Treatment which at first gives great relief will often become ineffective or even painful. Then some other way of cure must be tried. Sometimes cold applications will become painfully cold. Heating for a time is then effective, and cooling can again be given after the heating. Soapy lather on an inflamed part will do delightful service for a while, then it may become painful. Warm oil may then be used instead. When this becomes irritant, a return to the soap will cure. Or the hot bathing of a sore knee may be most effective for a while, and then may give rise to sore pain. In such a case, cease the bathing, and for a time apply the soapy lather. Do not despair because a thing "loses its effect." Its apparent loss of power only indicates a needed change of treatment. Common sense will guide in this, and the true healer and nurse will be able to judge what is best to do. We have a case in which, after long rubbing with acetic acid, the skin seemed to become so used to it that little or no effect was produced. For a few days an alkali, in the simple form of "hartshorn" (ammonia) was rubbed on instead of the acid. The acid rubbing was then resumed, and produced its usual effect. Such plans will occur to all who are thoughtful, and do not just blindly follow instructions. Cold-water cloths have got in certain circles to be fashionable, so that they are used exclusively in all cases. A knee joint has got wrong, and it is deemed the right thing to wear a cold bandage constantly round it. But this fails to have the desired effect. It may not fail entirely, so long as there is some vital energy on which to "come and go," as we say, the effect of the reaction will be to give a measure of relief. But in very many cases this vital energy is deficient. If in such a case the person advising it has only thought enough to have recourse to an hour's hot fomentation once or twice a day, the effect desired may not be long delayed. Supposing something like inflammation of the lungs has to be dealt with. Cold is applied on the chest, as it is often most successfully applied, when there is still a good deal of energy to be drawn upon. But in this case there is not sufficient energy. Well pack the feet and legs in a thoroughly hot fomentation, such as will renew a full supply of heat all over the body. Then you will find the cooling of the chest thoroughly effectual. In a very considerable correspondence we meet often with this resolve: "We shall continue to do as you direct till we hear from you again." We remember telling a young man to put a hot bran poultice between his shoulders for a troublesome cough. We saw him no more for months, but when we did meet him he apologised for not continuing the application. He said, "I poulticed my shoulders for three weeks, and they began to get soft, so I stopped doing it." We certainly thought his head had been soft to begin with! Why should not sensible men and women get a little independent thought of their own? It may be well to remark that the cessation of all treatment is a change, and often a very beneficial one too. If you do not know what to do when any treatment is "losing its effect," or having the opposite effect to that which it had, just cease to do anything till you see manifestly what is needed. The rest of a week, or even two, may be just the thing wanted. If it is, it will ease the pain; if it does not, you will see that probably the opposite of what you had been doing will suit. Chapped Hands.--Our idea is that this is caused by the soda in the soap used. At any rate, we have never known any one to suffer from chapped hands who used M'Clinton's soap _only_. It is made from the ash of plants, which gives it a mildness not approached by even the most expensive soaps obtainable. If the hands have become chapped, fill a pair of old loose kid gloves with well wrought Lather (_see_), putting these on just when getting into bed, and wearing till morning. Doing this for two or three nights will cure chapped, or even the more painful "hacked" hands, where the outer skin has got hard and cracked down to the tender inner layer. Chest Pains.--_See_ Angina Pectoris. Chest Protectors.--These are often piled on the front of the body, while the far more important _back_ is left exposed. In many cases of delicacy and cough, particularly with women, it is far more effective to protect the upper back with warm extra flannel than to place covering on the chest. This alone will sometimes cure distressing coughs. In every case, such "protection," whether to back or breast, should be such as to secure free escape of perspiration (_see_ Underwear). A sheet of fine wadding is excellent. Where less heat is desired, new flannel is the best. Often, also, chest trouble is best helped by protecting the soles of the feet. If these and the back are kept warm, there is little fear or harm at the front of the chest. Let the back covering, where it is used, come down as far as the top of the hip bones. Chilblains.--These occur in hands and feet where the circulative power is feeble, either from weakness or from tight pressure of boots or gloves. The cold has power, owing to lack of circulation, to partly kill the skin, which thus becomes painfully inflamed, and swells. To increase and maintain circulation in the part is to cure it. In the early stages, when heat and itching are felt, a good rubbing with hot olive oil and cayenne tea will often cure. But if this fail, pack the foot or hand in cloths soaked with vinegar. If the pain is great, place the packed foot or hand in hot water for a few minutes or more. After this immersion repack with vinegar-soaked cloths, cover well up with dry flannel, and wear this packing all night. In cases where weakness is the root of the trouble, rub the back once a day with hot oil until a glow of heat arises all over it. Do this daily for a fortnight _at least_. Where tight boots or gloves are the cause, these must be discarded for more easily fitting ones. Child-bearing.--Simple remedies such as we advocate are found of immense service in mitigating both the pains of child-birth and the troubles coming before and after it. To see that the medical man is one thoroughly competent is the first duty of those responsible in such a case. Incompetent and careless doctors are the cause of much trouble. Get, then, the _best you can_. Much may be done, however, to prevent trouble by very simple means. The sufferings usually accompanying pregnancy and the birth of children in civilized countries are largely confined to the higher classes. Working women escape much of the pain their more luxurious sisters have to endure. Travellers tell us how, among the Red Indians, Negroes, South Sea Islanders and others who live more in a state of nature than we, the women suffer but little in childbirth, and return to their ordinary occupations almost immediately after the event. The adoption of a simple and natural diet, healthy exercise combined with sufficient rest and rational clothing, have been found to ensure an easy delivery as well as good health for mother and child. The _diet_ of the pregnant mother is of great importance. Too much food is worse than useless. Food should only be taken of such a kind and quality as can be easily assimilated. The mother is best who takes only so much light food as she can easily convert into good blood. More, simply loads the system with useless waste or fat. The diet during pregnancy should be mainly vegetables, fruit, salad, rice, tapioca, milk, eggs in moderation, and a small amount of wholemeal bread. A little meat or fish once a day is allowable for those whom it suits, but rich, spicy dishes, pastry, strong tea, coffee and all alcoholic drinks are very injurious. Three meals a day with no "snacks" of any kind between, are sufficient. For those who have reason to dread a hard confinement, oatmeal is best avoided. To avoid fluids while eating is important, especially for those who have a weak digestion. One may drink half-an-hour before meals or three hours after, but if plenty of fruit and salad is eaten and little salt used with the food there will be little thirst. Too much fluid should not be drunk, if thirst is felt, water very slowly sipped will quench it better than copious draughts. During pregnancy there is often a craving for acid fruits, this is nature's call for what is needful at such a time. Fruits and green vegetables supply a large quantity of most valuable salts which go to make good blood and build up all parts of the body. Never force the appetite. Food that is neither relished nor digested will do more harm than good. It must never be forgotten that the blood of the child is being directly derived from that of the mother, consequently if the diet is of such a nature as to induce over-abundance of fat, the child will be born too fat. This does not mean a healthy child by any means, and it may mean considerable extra pain for the mother. A mother inclined to thinness need not fear that this diet will reduce her. The taking of cream, eggs, bacon and other fat foods often has the opposite effect from that desired. A thin person adopting the above light diet will generally get into good condition. Under the head of _exercise_, the first we would recommend is general housework, provided windows are kept open, avoiding the more laborious parts, and always being careful not to get over-fatigued. Light gardening, walks, if not too long, and light gymnastic exercises are all beneficial. The exercises described in the appendix, practised for ten minutes at a time, once or twice a day, are quite suitable for the expectant mother, while deep breathing (_see_ Breathing, Correct Method of) is most valuable. The subject of _dress_ should be particularly studied. Garments which are light, warm, porous, and which in no way impede or restrict the movements and natural functions of the body, should be worn. It has been found that those who wear no corset nor tight band or bodice will suffer but little, if at all, from morning sickness. Corsets, by holding immobile the waist muscles, prevent their getting strong. Anyone who is accustomed to corsets, when she leaves them off for a day will complain of "such a tired feeling, as if she would break in two." This is easily accounted for, the muscles, unused to the task of holding up the body, are flabby and useless. These same muscles when called on, at the moment of delivery, are totally unfit for their work, hence comes a large amount of the unnecessary suffering. The remedy is--discard the corsets, bear with the tiredness for a week or two and regularly practice the exercises recommended above, especially the waist exercises of bending and turning. The muscles will soon gain strength, and the corset be found to be quite unnecessary and most uncomfortable. In the commencement of pregnancy, when there is sickness and vomiting, we have seen it cured, even when so severe as to threaten life, by spreading over the patient's irritated stomach, a soft, fine soap lather (_see_ Lather and Soap). It acts in such cases like a charm. The lather is well and _gently_ spread with a _soft_ brush all over the stomach. Wipe it gently off with a _soft_ cloth. Cover again with fresh lather. Do this five or six times. Then treat the back in the same manner, behind the stomach. In half-an-hour all retching should cease. When the stomach has had a rest of some hours, a small quantity of light food may be given. Half a Saltcoat's biscuit (_see_) thoroughly masticated, and a little milk and boiling water may be enough to take at one time. Do not force the appetite, wait until a desire for food is felt. Pass by degrees to ordinary food. If the mother, at any time, feels faint, on no account give brandy. Drop five drops of tincture of cayenne on a lump of sugar. Dissolve it in half a teacupful of hot water, and give this instead. In cases of heartburn, take small drinks of hot water, say a tablespoonful every five minutes. A very great help to the expecting mother is found in the cold sitz-bath (_see_ Sitting Bath). Baths known as "Matlock Baths" may be had, which suit very well for this purpose; but a tub for washing, of a suitable size, would do very well, or even a large sized bedroom basin will serve. Put in cold water, three inches deep, and let the patient sit in it. In winter have the water cold, but not freezing. The rest of the body may be kept warm with a wrap, and if the patient feels cold, the feet may be placed in hot water. Taken once or twice a day this bath will have a tonic effect on the whole system, and a markedly cheering effect on the mind. The time in the bath is shorter or longer according to the patient's strength and power of reaction. Feeling will be the best guide, but even a dip of half-a-minute will do good. In regard to the actual birth, we repeat that those concerned should see to the attendance of a _really_ skilful medical man. Chloroform in the hands of such a doctor is of immense value, but in unskilful hands it is dangerous. Therefore let expense be no bar, where it is possible, to the obtaining the best medical aid that can be had. Many trivial matters greatly affect the mother during child-birth, and the few succeeding hours. We have known a stupid remark by an incompetent nurse spoil a mother's health for months. The greatest care must be exercised by all concerned to say only cheerful and soothing things to the sufferer. Even the aspect of the room is important. It should look sunwards, if possible, and hideous pictures should be removed, while perhaps some text speaking comfortably of the Good Shepherd, who "will gently lead those that are with young," may be hung up. Trifles these, but their effect is no trifle. Do not keep the patient in too hot a room; fresh air is of great value. Do not leave her for nine days in an unchanged bed. The necessary sponging and changing should be done daily. Cleanliness means comfort here, and comfort health. It is not early sponging and washing, but a nine days' steaming in unchanged bedclothes which causes chills. After cool sponging, a gentle rubbing under the bedclothes with hot olive oil, over the body and limbs, will be very refreshing. All clothes, etc., and the hands of the attendants should be most carefully washed and cleaned before they touch the patient. Too much care in this matter of cleanliness cannot be taken, as it is of the _first importance_ as a preventative of many troubles. What are called "After Pains" often give much distress. Drugs and alcohol should be strictly avoided. The difficulty here is in the objection so many have to cold applications. These, after child-birth, are not dangerous, but form a short and simple road to health. Making handfuls of soapy lather (_see_ Lather) and rubbing these gently over the pains, both back and front, is most powerfully soothing, and has no tendency to chill. Where severe pains, indicating inflammatory action, are felt in the bowels, this lather should at once be applied, and followed up with cold cloths over the bowels, applied as to the chest in Bronchitis (_see_). The bran poultice should always be applied at the same time, putting it on before the cold towels, over all the lower back (_see_ Bran Poultice). Sips of hot water will also powerfully help in all cases of such pain. Treatment on these lines will deal with even very severe cases of After Pains. Children and Teachers.--Children are of the utmost value to society; through any one of them the divine light may shine which will bless many generations. They are very easily hurt by unwise treatment and teaching. We would have the teacher and parent impressed with the preciousness of even the most delicate child. _Health of mind and body_, not attainment, must be the _first consideration_ in the teaching of the young. It ought to be as much the teacher's business to see that pupils do not suffer in health as to see that lessons (often quite useless) are learned (_see_ articles on Brow, Weary, and Eyes, Failing Sight). We would again emphasise the truth that no child should be undervalued for its delicate health. Delicate children have often become men and women without whom the world would be vastly poorer. Children in Fever.--Fevered children, whether in any actual fever, as scarlet, typhoid, or any other, or merely heated from some minor ailment, should be treated as under Fever. Have two small towels, wring them tightly out of cold water, fold one gently round the head. _Press it gently_ all round and over the head. It will be heated in one minute in some cases, longer in others. Change it for the other then, and proceed alternately till the head is cooled. Perhaps that may take half-an-hour. The time will be less for a young infant, more for a boy or girl in their teens. Common sense, and an examination of the pulse, will guide as to the proper time. The head is the chief consideration in this treatment, but attention to the state of the stomach and bowels is also very important. Any indigestible substance must be removed, and sips or small drinks of hot water will greatly help in this, as well as proper medicine. Castor oil is a good, simple drug for ordinary cases. If there is coldness in the feet in such fevered cases, a fomentation may be applied over the legs, or even up to the haunches. This will greatly reinforce the cooling of the head, and prevent any possible chill. The water used for cooling should be about 50 deg. F., or at least near that temperature, in the case of infants. Water which has stood some time in an ordinary room will do excellently. It should neither be icy nor warm. Typhoid fever itself has been cured with this head cooling alone. Children's Clothing.--An infant's clothing should be soft, warm, and light in weight, covering all parts of the body with equal warmth. Tight bands and long, heavy skirts should never be used, the dress and petticoat being just long enough to keep the feet covered and warm. If from the first a baby is "held out" always after being nursed, it learns to urinate at that time, and the clumsy diapers can be dispensed with in a few months. _No ordinary pins_ should be used, and as few safety pins as possible. Tapes properly arranged will keep all secure. Flannelette should never be used, being so very inflammable (_see_ Children's Dangers). With infants, as with older children, it is a mistake to heap on too much clothing. Many children by such coddling, which is intended to prevent them catching cold, are rendered delicate and susceptible to chills. Just enough clothing should be worn to keep the little one comfortably warm and no more. The same applies to bed-clothes; they should be light and not excessive, only enough to keep the child comfortable. Babies thoroughly enjoy a time every day without clothes, when they can kick to their hearts' content. If this is begun by degrees, a short time at first, gradually getting longer every day, there will be no danger of giving the child cold through letting it lie unclothed, on a rug on the floor for half-an-hour at a time, with the window open. The air-bath will invigorate and strengthen the system. Rubbing with the hand all over the little ones body during this time will be enjoyed, and effectually prevent any chilliness, if it is dreaded. Children's Dangers.--Avoidance of the causes of disease requires some idea of the dangers to which children are exposed in the usual upbringing. For instance, sitting on damp ground, cold stones, or even a cool window-sill, is a fruitful cause of bowel trouble. The remedy for such an exposure is proper warm FOMENTATION (_see_) of the chilled parts, followed by hot olive oil rubbing and careful clothing. Again, _rich diet_, especially for delicate children, is a great cause of trouble. What we have written concerning food, and the article Assimilation, should be read to guide on this. Again, the child is exposed to falls, and falls into water, leading sometimes to drowning. Timely thought would prevent nearly all such accidents. Do not wait until the trouble comes. Protect exposed streams and wells near the house. Shut doors and gates in time. Also the directions of the Humane Society for the recovery of the partly drowned (_see_ Drowning) should be in every house, and as soon as possible both boys and girls should learn to swim. Again, children are in danger through careless attendants. They may be let fall, or capsized in perambulators. Spinal injury is often caused by such falls. In case of any broken or disjointed limbs, the bandaging of infants should be of a gentle kind, and encasement in starch or plaster jackets should be avoided. In every way the natural growth and circulation should be helped, not hindered by strapping and tight bandaging. The timely consulting of a _really good_ doctor will often prevent serious trouble in any case of a fall. Another source of danger is the exposure of children to the possibility of burning or scalding. Wherever there are young children fires should be guarded, and matters so arranged that they cannot come in the way of boiling water. Much that seems impossible in such protection becomes easy enough to a determined person, and a great deal of sore illness can be averted by taking a little trouble. A child should never be in the place where there is a pan of boiling water on the floor, nor in any house should it be _possible_ for a child to pull a kettle full of boiling water on its head. If, however, scalding occur, apply the cold treatment as detailed in the article on Burns. In case of contracted limbs or features, occurring from severe burning, the rubbing treatment (_see_ Children's Healthy Growth), will be effective as a cure. Children's clothing should never be made of flannelette, it is so liable to take fire if the child approaches the grate. At hundreds of inquests coroners have directed attention to the terrible loss of life from this cause. Medicines and all poisonous substances should be carefully labelled, and kept out of children's reach. If by accident a child should have taken poison administer an antidote (_see_ Poisoning). Should a child swallow a nail, button or some such hard substance, do not give any purgative medicine. It will pass out more safely when embedded in solid fæces. Examine the stools carefully so that anxiety may be allayed when the foreign substance is seen. Children's Deformed Feet.--_See_ Club Foot. Children's Healthy Growth.--Often either the whole system or some part fails to grow properly. In this way the spine or legs may become curved, or generally the child is small and feeble. Growth depends largely on the organic nerve centres. Lack of power there causes even deformity itself. Treatment, therefore, must be such as to restore to these centres their energy, and increase it. Do not force the child to stand or walk when wearied. If he uniformly refuses these attitudes, have patience till he gathers power. Wash all over at bedtime with warm water and M'Clinton's soap. Dry, and rub all over with warm olive oil. Wipe this also gently off. Let the rubbing be such, along each side of the spine, as will bring the organic nerves into action. Gentle, slow, steady motion of the hand is best for this. All painful or irritating rubbing is positively hurtful. Let this be done every night, and even incipient deformity will be cured in time. The nerves are in some cases irritable, and great restlessness and involuntary movement, accompanied even with twisting of the neck, shows itself. This will yield to skilful cooling of the spinal nerves with damp cloths. _See_ St. Vitus' Dance. An opposite kind of nervous failure shows itself as paralysis. The hand and arm, or foot, trails helplessly, owing to motor nerve failure. This will often yield to the spinal rubbing and poulticing mentioned above. Another state of failure is indicated by "numbness" in the fingers and toes. The spinal rubbing and poulticing with bran will also be effective for this. Sometimes lack of nerve force shows itself as failure to walk at the proper time. The child cannot use its limbs properly, although these are right enough in shape and size. The cure for this is persistent gentle rubbing with warm oil, as recommended above, over the whole body, but especially over the back. Feel for the muscles and bones, and adapt your hand to their shape, going down into the hollows immediately on each side of the spine, and paying particular attention to the _upper_ part in the failure of the _arms_, and the _lower_ part in failure of the _legs_. This rubbing is a most powerful remedy, but it must be patiently and well applied twice a day for a length of time. Bear in mind that gradual cures are most permanent. Even creeping paralysis in adult persons yields to this rubbing. No doubt it is _work_, but it is well repaid. All troubles where failing nerves are concerned may be treated with some modification of this heat and rubbing. Our readers can easily adapt it to particular needs by a little thought. _See_ Spine, Misshapen, and Massage. Children's Limbs.--Frequently a failure of some kind shows itself in the limbs of some children. Usually it appears as either _bending_ or inability to walk at the proper age, or both together. To use "steel boots" and kindred appliances is to ignore the true nature of the trouble, and most likely to increase it. What is wanted is proper growth in the limb. To secure this, the nerve system of the spine must be stimulated, and there is no better stimulus to be had than "massage." When any substance is rubbed on, it is almost always the rubbing, rather than the substance, which has the good effect. Hence we recommend rubbing with simply good olive oil. For an infant, the back must be massaged very gently, taking care not to hurt the child in any way. It should be applied especially up and down each side of the back bone, where there is a softer region, full of important nerve centres. The limbs may also be gently rubbed. A genial heat should be raised in all the infant's body by these means, and, if rightly done, the child will eagerly wish for it again. Half-an-hour a day may be given to this. It is well to persevere for a long time, and never give up hope. Many a weak-limbed child has grown up a strong, healthy man or woman. _See_ Massage. The food in such cases should be good ordinary food. We have never been able to see the good of cod liver oil that is so generally recommended. It seems to us a most unnatural thing for a human being, young or old. Cream and butter will supply a far more easily assimilated fat at much lower cost. We may also say that honey is more wholesome and fattening than malt extract, and costs only one-fifth of the price. The feeding of children on corn flour, often made with but little milk, is a fruitful source of rickets. The same may be said of white bread, the flour having been largely deprived of its food salts. Giving children lime water, with the idea that the body can convert it into bone (as a hen makes her egg shells out of old mortar) is an entire mistake. The human system cannot use such inorganic material. The men of best bone, so far as we can judge, are those who have been nourished in great measure on good oatmeal. Children's Nerves.--The nervous system of children is often damaged by shock or fright, sometimes very seriously, so that paralysis or hysterical affections come on. Blindness, deafness, loss of speech, every possible loss of function may follow a violent shock to a child's mind or bodily system. Care must be taken to avoid this. The moment you see the child affected by any strange sight or sound have, if possible, the child removed or the affecting object put away, or have some one who can soothe the child brought to calm its mind. This properly done, and done quickly, will usually prevent any evil effects. If, however, these come on, treatment can do a very great deal to remedy the ill. If fits come on, lay the child flat on his back, with head slightly raised. Place a piece of cork or wood between the teeth, fastened so as to prevent the possibility of its being swallowed, and loosen all the clothes, until the fit is over. Continue to soothe the mind, and instil happy thoughts such as God gives every Christian the right to think, even in the worst times of trial. Bring before the child's mind some cheery tales or interesting objects. Allay all fears, and soothe all sorrows, as far as possible. If, however, the fits come on again, with blackening of the face, _do not treat harshly_, but apply a cold towel along the spinal cord in the morning in bed. This will soothe even unreasonable passion, and remove stubbornness. Or if the fit is "on," put warmly to bed, and then apply the cold towel. Medical aid, when available, should also be summoned. If a faint comes on, that points to the need of a hot fomentation along the spine instead of a cold towel. It is not difficult as a rule to distinguish between the fit, with its frequent convulsive cramps and blackening of the face, and the simple faint of exhaustion. In the first the patient is all "strung up," and in the last the very opposite. Children's Sleep.--This most important matter of good sleep for the child depends not only on health of body but on ease of the infant's mind. It is wrong to treat the child otherwise than through the understanding, where he is afraid, or in a strange place. Waking up, after being put to sleep in a strange room, the little one may receive a shock which may prevent sleep for the rest of the night. If he be patiently soothed and matters explained, all will be well; but it is a great cruelty to thrash or threaten in such a case. To frighten a child with ghost stories, or "Bogies," IS TO COMMIT A SERIOUS CRIME. It is not dealt with by the law, but it certainly deserves to be. Never bring before a child's mind any _imaginary terrors_; rather teach it to understand them in such a way as to remove any cause of fear. But do not _force_ a child to examine an object which it fears, you may do terrible damage before you can explain. All fears should be most carefully dealt with, and no force employed; the little one who has no imaginary terrors, and is kindly taught to think every fearful image at bottom some innocent cloak or shadow, will sleep soundly and grow healthy in mind. When, however, ill-health is the cause of wakefulness, other means must be used. Cold feet, and chilly feelings generally, frequently keep children from sleep. Pack in such cases the lower limbs up to the waist in thick folded flannel FOMENTATION (_see_). This will often not only give sleep, but prevent more serious trouble. All soothing powders and narcotic drugs should be most strictly avoided. Often the child is sleepless from feverish heat instead of coldness; then cooling applications should be used (_see_ Children in Fever). These may take the form of two caps for the head of thickest cotton cloth: one, tight fitting, to be wrung out of cold water and put on, the other, looser and dry, to be put on over the first. This alone will often secure a night's sleep. Or the head may be soaped (_see_ Head, Soaping). It is inadvisable to rock a child to sleep, it will go to sleep if comfortable. Children's Strength.--The question often arises as to the ability of children to bear certain kinds of treatment. It must ever be remembered, both in hot and cold applications, that the infant should be _gently_ dealt with. Violent cold and burning heat must alike be avoided. With a gentle application of heat before bracing cold is used, considerable power of endurance is imparted. Strong blisters and violent medicines should never be used. Very much less treatment will affect the infant than that required for an older child. And in almost every case the most durable cures are reached by gradual progress. Children's Swellings.--Sometimes these occur as merely relaxed tissue full of blood. In this case everything about the part seems right and healthy except the swelling. The skin is right and the temperature also. Treatment such as restores nerve energy will usually cure these (_see_ Children's Nerves). In other cases the tumour will be full of watery waste, or there may be a simple dropsical swelling owing to failure in kidney action. This last is usually easily cured. It ought never to be "tapped," as this draws off the strength desired. A simple FOUR-PLY BANDAGE (_see_) of new flannel worn round the body will often be enough to cure infants of even dropsical tumours. In other cases this is used in conjunction with the bran poultice and rubbing recommended above for cases of nerve failure. Wherever the swelling is, increase the vital force that supplies the gland, and so you will cure the whole evil at its source. Many will tell you to "purify the blood," but there is no blood purifier like the system which God himself has provided, in the organs of the body made for the purpose. Only increase the action of these, and you will have pure everything as well as pure blood. You will do it by good fomentation, by good rubbing, by judicious clothing, and also by wise feeding. You will do it to some extent even by good kind words. You will help the process by good, clean washing, such as warm vinegar gives over a weakened surface. You will scarcely fail to gain your end if you use these means in time. Children's Teething.--_See_ Teething. Children's Treatment.--This should always be managed so as to soothe and not excite the little patients. They are very sensitive to heat and cold. When these are applied the child often cries, so that the "treatment" is condemned and given up. What should be condemned is the nurse's want of skill. In every case the cold or hot application should be so managed as to be agreeable. Very gentle heat at first may be succeeded by stronger heat without shock. So mildly cool applications may be followed by colder ones in the same way. There is no sense or benefit in dashing a burning poultice or freezing towel on a delicate person, either infant or adult, and sense is above all our guide in these pages. Chills.--(1) Nerve or imaginary chills. These are _feelings_ of cold, where there is no real chilling; the back feels as if cold water were poured down it, or even the whole body feels chilled, when an examination will show that there is no real chill whatever. Nervous patients are peculiarly liable to this, and often are greatly alarmed at it. The treatment in such cases is partly mental; let the patient know that the chilly feeling is only a _feeling_, and nothing alarming. This will often of itself remove it; so will a cheery thought or a cheery talk. Physical treatment may begin with such a rubbing of the head as is recommended in Eyes, Squinting. Then treat the whole body to a gentle massage on similar principles. This will sometimes cause nerve chills at first to increase; but the patient will soon disregard this, and the squeezing very gently of the muscles will stimulate and revive the organic nerves. Warm olive oil used in this squeezing process will help greatly. It may be that a considerable time will be required before these nerve states are entirely overcome, but with anything like careful treatment they will gradually be so. Keep the patient warm in bed the while. Give easily assimilated food (_see_ Assimilation). A mixture of milk and _boiling_ water in equal quantities may be freely taken. This treatment will besides greatly help nervousness of every kind. (2) In the case of _real_ chill to the surface of the body, _shivering_ is an early symptom. If the frame is strong, the shiver may pass off and no evil results follow: but frequently this is not the case, and trouble is apt to intervene. In such a case give a thorough rubbing all over the body, and especially the back and chilled part, with warm olive oil; this, if applied early enough, will probably prevent all ill consequences,--it will at least mitigate them. If the chill has passed into feverishness however, this treatment will not suit; but we only deal here with the cold shivering stage. The rubbing will be greatly assisted by a good hot fomentation to the feet, or even up to the haunches. The use of Kneipp linen underwear, by promoting a healthy action of the skin, and rapidly conducting away the perspiration from its surface, will do much to prevent chills, either real or imaginary. _See_ Angina Pectoris, Underwear, Massage. Chloroform.--_See_ Child-bearing. Circulation of the Blood.--Nothing is more important for the health or healing of any organ or part of the body than a good supply of arterial blood. Venous blood, collected by the veins after it has done its work all over the body, or blood stagnating in congested organs, is useless for growth and healing. To promote a vigorous circulation of blood in any part we wish to cure is, then, of great importance; this may be done by helping the heart in various ways, especially if that be weak. Lying down, and lying comfortably on the face, greatly assists circulation. Placing a fainting person in this position will often suffice to restore him. In congestion of any part, if possible keep that part,--head, hand, or foot, as the case may be--above the level, so that the escape of blood from it may be easy. _Raising_ an inflamed finger or toe thus, and keeping it up, will often relieve severe pain. In inflamed kidneys, make the sufferer lie on his face as much as possible. Other positions in other cases will be suggested by common sense. Again, heat expands the vessels of the body, and cold contracts them. Cooling a congested part assists to drive excess of blood out of it, and heating some other part opens accommodation for the blood so expelled. This explains our hot poultice and fomentation as used with cold cloths. Common sense will show us how to apply it as a principle of treatment in many cases. Again, a congested limb may often be very greatly relieved by proper rubbing along the soft parts, the strokes being firm and steady, and directed from the extremity of the limb towards the body. This rubbing along the thigh relieves very much all swellings in the foot, ankle, leg and knee. This principle may be widely applied by a little common-sense thought. Climate and Soil.--The soil on which one lives is a matter of primary importance; it may be a matter of life or death for a weakly person, but it is important for every one. First, as regards the subsoil on which a house is built. If this be clay, or impervious rock, then no possible system of drainage can make the site a dry one; this condition of affairs will be very bad indeed for health. No house should be built on such a soil if at all possible to avoid it. Light open gravel and sand, as subsoil, make the very best health conditions. The surface soil is also important. If this be such that streets and garden walks dry quickly after rain, you have elements of health; if they remain long wet, then you have elements of unhealthiness. If the soil be right, then the climate is to be considered. The mere situation of two houses, only half a mile apart, will make all the difference in this, and should be carefully watched. A house sheltered on the south and west, exposed to the north and east, is badly situated; the opposite exposure is usually good. Plenty of sun should fall upon the house all day, and on all sides, if that be possible. Yet it must be seen that no hollow or stagnant air be chosen; it is nearly as bad as stagnant water, for in mild winds, dryness of soil and air, and abundant sun, lie much virtue for health and healing. Clothing.--Clothing should be light yet warm, and sufficiently free so as not to interfere with bodily movements. The clothing next the skin should, we think, be linen, as being more porous and absorbent than wool (_see_ Underwear). No woman who values her health should submit to any tight lacing. The organs of the body require every inch of space for the proper performance of their functions, and if they are unduly squeezed many serious complaints may result. Besides the skin is a breathing organ, and it is most important that air should readily reach it (_see_ Tight Lacing). Long trains should not be worn, as they are most effective agents for sweeping up germs of diphtheria, consumption, etc. Skirts should not be hung from the waist, but from the shoulders, and should be light in weight. Tight boots and high heels are both to be condemned. The practice of wearing mufflers, or any tight wrapping round the neck region, is injurious and enervating to this part of the body. The sailor, though exposed to more rough weather than any other class, is free from throat or chest trouble, and can stand both heat and cold better than soldiers. Sailors are, indeed, the only sensibly dressed men in our country. Soldiers, in their tight-fitting tunic and stiff collars, are the worst. They constantly die of heat and apoplexy, when farm labourers doing more work are nothing the worse. Club Foot.--Children are not unfrequently born with this deformity in one or other of its various shapes. The cause is to be sought in such a defective state of the nervous system as hinders the proper growth of these parts. If the nerves are treated rightly, the limbs will so grow that the defect will disappear. We speak from positive knowledge of cases so cured. Treatment must first stimulate the spinal nerves; gentle, continued rubbing on each side of the spine with hot olive oil will do this. Proceed, after some time of this, to rub and knead the haunch, thigh, and leg with the same hot oil. Continue this, gradually descending, until the defective foot is reached and similarly treated. We have known even adults cured in this way, with perseverance. Ten or fifteen minutes of this treatment before a fire, or in a warm room, every night, will do wonders. A skilful surgeon can do much to remedy this, but one _really_ skilful should be chosen. _See_ Massage. Cold in the Head.--Infants often are prevented sucking by this form of cold closing up the nostrils. In such a case have a small cap of cotton to fit the head. Wring this out of cold water, and fit it on the child's head. Put on over it a rather larger and thicker cap of the same material. Often the nostrils will open in two or three seconds, and the cold will speedily be cured, if no more be wrong. Observe that the child be _warm_ during this treatment. If the case is obstinate, secure good medical aid, for constitutional weakness, or even some deformity of the nostrils, may be present as cause, where the trouble exists from birth. For adults similarly affected, a towel wrung out of cold water and wrapped round the head, with another _dry_ one above, will answer the purpose. For severe cases, pack the feet and legs in hot fomentation for an hour, and apply a cold towel as above. This last method should always be pursued where the patient feels chilly. Cold in the head may often be checked by use of dilute vinegar. _See_ Nostrils. Cold, Settled.--A cold is often easily overcome. At other times it "sits down," as country people say, and refuses to be cured, a hard dry cough continuing for a long time, and causing sleeplessness and general weakness. In such a case first try to secure an increase generally of vital energy. At night rub the feet and legs with hot olive oil. Pack them for three-quarters of an hour in a good _large_ blanket fomentation, open out, and dry well, oil and dry again, put on a pair of cotton stockings, and put the patient to bed. In the morning, place a towel tightly wrung out of cold water all round the back and breast. Cover this well with dry towels, and tuck the patient in, so that he becomes warm and comfortable. In three-quarters of an hour open out, dry the skin, oil it and dry again. Then the ordinary clothing may be put on. The second evening it will be well to pack in the SOAPY BLANKET (_see_). Next morning the towel envelope should be repeated as before. The third evening, put a large BRAN POULTICE (_see_) between the shoulders. While this is on apply cold to the chest, as in treatment for BRONCHITIS (_see_). It is good to take sips of hot water at any time if the cough is troublesome. A teaspoonful of boiled liquorice and linseed two or three times a day has a good effect. This treatment usually cures a pretty severe case. Cold, Taking.--Where cold is easily "taken," it is the skin which is defective in its action. The cure must therefore deal with it. Even spasmodic asthma can be traced to the failure of the skin to throw off waste sufficiently. Men exposed to great heats and chills, women and children whose nervous energy is small, are liable to this skin failure. Kneipp linen underwear, besides being more absorbent of perspiration than woollens, has a stimulating effect on the skin owing to a certain hardness (by no means unpleasant) of the fibre. Wearing it is an excellent preventive of skin failure (_see_ Underwear). This may also be treated by careful, kindly rubbing over the whole body with warm olive oil, the patient being kept warm during the operation. This rubbing may with advantage come after a sponging with M'Clinton's soap (_see_ Soap). To face the wintry blast at half-past five in the morning is for many severely trying. This treatment the night before will give immense help to those who are so exposed. It is the best preventive against taking cold known to us. There is one great difficulty that stands in the way of such a remedy as we have suggested--that is, the "trouble" which it implies, not so much to ourselves as to others. Many a useful life is lost lest "trouble" should be given. It needs to be well understood that this is a temptation. If we can buy a quantity of some drug from a chemist according to the prescription of some medical man, and just quietly swallow it, that "troubles" nobody. So powders to sweat us, and powders to stop our sweating, are readily "taken," greatly to increase all tendency to "take cold." Our relatives and others have, as the fruit of such a system, worlds of serious trouble and loss that might all be saved if only a very little trouble were given in the more natural and reasonable way. Cold Cloths.--_See_ Towels, Cold Wet. Constipation.--This trouble is often only aggravated and made chronic by the use of purgatives. Some simple change of diet, such as a ripe uncooked apple, eaten before breakfast, or a fruit diet for a day or two may put all right. So also with the use of wheaten meal porridge or bread. When this can be taken with pure CANE SYRUP (_see_), the two together will make such a change in the food as will frequently banish all inaction of the bowels. Rest must be reckoned on, especially if the patient has been using purgatives freely. Do not act as if castor oil were a necessary article of diet. When the constipation is more obstinate, in the case of a child, good golden syrup may be given, a teaspoonful after each meal. A quarter of a pound of the best Spanish liquorice, costing sixpence, should be boiled in a pint of water down to three-quarters of a pint and strained. A dessertspoonful of this after each meal may be given instead of the treacle. It is the best tonic we know, and infinitely better than quinine and other costlier drugs. If a stronger mixture be desired, put half-an-ounce of senna leaf in the juice while being boiled. This may be increased to a whole ounce of senna if still stronger effect be desired. Some are more liable than others to attacks of constipation, but chronic constipation may generally be put down to errors in diet, or want of sufficient exercise. Indigestible foods, such as pastry and heavy puddings, as well as foods which leave little residue in the intestine, such as white bread, puddings, arrowroot, are highly constipating. Tea has also a similar effect, also large quantities of meat. Constipation is seldom found in vegetarians, since vegetables and fruits act as a stimulus to the intestine. Brown bread and oatmeal porridge have also an aperient effect. If it is suspected that milk has been a cause of constipation in any particular case, it may be boiled and used with coffee instead of tea. Much may be done by judicious exercise to relieve chronic constipation, and help the liver to work (_see_ Appendix; Physical Culture). Deep breathing will also affect the intestines and urge a motion. Bathing and massage of the abdomen are also useful (_see_ Massage). Clothing should be light and loose, tight lacing being a frequent cause of constipation. Every effort should be made to keep the bowels regular, as protracted constipation leads to many painful affections, such as headaches, piles, and even inflammation of the intestine, the various products of putrefaction being absorbed and carried through the blood stream. A daily motion should invariably be solicited at a regular hour. On rising, before the morning bath, is a good time, though some prefer just before retiring to bed, and more, probably, go immediately after breakfast. The great thing is to get into the habit of going daily at a fixed time; nothing should be allowed to interfere with this, and it is highly desirable that children should be accustomed to this habit. Parents should, therefore, see that the schools selected have sufficient closet accommodation, as schools in private houses often have but the one closet for a large number. As a result of this restricted accommodation, the habit of using aperient medicines is acquired with _very_ injurious results, for if the call of nature is neglected the desire passes away, and constipation is inevitable. It soon comes to be a settled condition and will often be the cause of life-long ill-health. The evils from the formation of such a physical habit will far outweigh all the so-called accomplishments that may be acquired. Hot or cold water taken in sips throughout the day has often proved a most valuable cure for constipation. When artificial means are required to move the bowels, an enema is much to be preferred to drugs. The way to administer it, so as to be most effective, is as follows: Use a fountain enema holding three quarts. Put into it two or three quarts of water as warm as can be comfortably borne. A teaspoonful of salt added to the water will make it more effective, or soapy water may be used, made from M'Clinton's soap. The fountain should be hung up as high above the patient as the india-rubber tube will allow. The patient should lie on the right side, with knees drawn up. The tube should then be introduced into the rectum, and should be three or four inches in. The water may then be turned on with the thumb valve. If the abdomen can be rubbed by an attendant in an upward direction it will be better. The water should be retained, if possible, twenty minutes or half-an-hour. A HOT FOMENTATION (_see_) over the liver, before using the enema, will make it more effective. A bulb enema syringe may be used instead of the fountain, and less water--a pint or even less, and the water tepid or cold, may be preferred by some. The disadvantage of a bulb syringe is however that sometimes air gets in along with the water, causing pain and discomfort. Consumption, Prevention of.--This most insidious and deadly disease is caused by a tiny vegetable growth derived from persons or animals already suffering from tuberculosis. The spit of consumptive patients swarms with such germs, and when it dries and becomes dust the germs may be stirred up and breathed, or may mix with food, _e.g._, milk, and so enter the body. A dried handkerchief may also carry the infection. But these germs, though continually carried into the lungs of almost all, do not develop in all. The healthy body can resist them, and it is only in the body which possesses little resistance, owing to a low state of health, that they take root, and so start the disease. Want of pure air, such as is caused by badly ventilated rooms, dark, damp, and dirty houses, want of good food, or bad food, alcoholic drinks, frequent illnesses, dirty habits, are powerful causes in producing this low state of health, which is so favourable to the growth of the consumptive germ. Therefore we insist on fresh air, especially for children in schools, for employees in factories, for clerks in offices. All places of public resort should be provided with proper ventilation. The breath from the lungs is loaded with poisonous organic matter, and if continually re-breathed poisons the blood. The smell of a room is often an indication of whether the air is pure or not, especially in the nostrils of one entering from the outer air. Let all windows be kept open day and night, and let fresh air and sunlight continually flood the room. Nothing will kill disease germs quicker. Avoid choosing a residence with but little open spaces around, such as basement tenements and back to back houses. Have an open fireplace in the room. Gas or oil for lighting, heating, or cooking renders the air impure, and in need of constant renewal. _See_ Air. Dirt, either in the house or around, poisons the air, and refuse should be removed to a distance from the dwelling. Tea leaves should be sprinkled on floors before being swept. Remove dust with damp dusters, which should be boiled. Cleanliness should be strictly attended to, and schools and factories should be plentifully supplied with soap and water. The food consumed by the vast majority of people is far from being as nourishing as it should be. Tea and white bread have replaced porridge and milk. This should not be. Cocoa might with advantage replace tea, and porridge and milk by itself would make a highly nutritious meal (_see_ articles on Diet). Stimulants are not required by the healthy body, and intemperance is a fruitful predisposing cause of consumption. Skim milk is not a suitable food for the young. _See_ Infants' Food. Infectious diseases, such as Typhoid and Scarlatina, are frequently conveyed by cow's milk. There is also reason to believe that in certain cases of Tuberculosis the infection has been conveyed by milk from tuberculous cows. These risks can only be absolutely avoided by sterilising the milk, _i.e._, by placing the jug in a pan of water and bringing the water to the boil, keeping it so for twenty minutes. If the milk is kept covered, and rapidly cooled by placing in another pan of cold water, but little boiled taste will be felt. Sometimes, however, sterilised milk disagrees with an infant; if so, the strictest watch must be kept on the history of the milk used. It should be remembered that this disease is not hereditary. It is only the delicacy of constitution predisposing to the disease that is inherited. This delicacy may, especially in childhood, be remedied. We have known hundreds of tender children made strong by liberal daily MASSAGE (_see_). In all cases where hereditary weakness is feared this should be resorted to. In many cases nothing more is needed to banish consumption out of families than the stimulation of the skin by this massage. Wearing linen underwear (_see_ Underwear) also assists in this direction and prevents chills. As it is of prime importance to increase the chest capacity, and this is most easily done in youth, great attention should be paid to chest expanding exercises (_see_ Appendix) and deep breathing. The cultivation of singing will greatly help. Consumption, Treatment of.--Turning now to the case when consumption has actually shown itself, the above treatment is exactly the course to be pursued. But we would emphasise the fact that unlimited fresh air and good nourishing foods are the only cure. If the patient can afford it, it is best to go to one of the Sanatoria for consumptives in order that he may see how the fresh air cure is practically carried out. It means simply breathing every mouthful of air as pure as it can possibly be obtained. Sleeping out in a hut, with the side completely open, and with protection only from the rain, with abundance of clothing, and, if necessary, hot-water jars to supply the required heat, is strongly recommended, and every hour of the day, as far as possible, should be spent in the open air, reclining or taking gentle exercise. The food should be nourishing and abundant. Plenty of milk, butter, and eggs should form the basis of the diet. The strictest precautions should be taken against spreading infection, and the patient be made to understand that these measures are intended not only to protect the public and his friends, but to allow of his social intercourse with them, and to assist his own cure. The source of danger being the spit, it should be collected in a pocket spittoon or piece of paper, and be destroyed before it has time to dry. Spitting on floors or elsewhere is highly dangerous. The spittoon should be boiled carefully. A consumptive should not swallow his phlegm, as the disease may thus be conveyed to parts of the body not already infected. Kissing a consumptive person on the lips is attended with risk, and consumptive patients should not wear a heavy moustache or beard, as the phlegm drying on the hair is a source of danger. The bed on which the consumptive lies should not be in a corner, but out from the wall, so as to admit of cleaning and ventilation. Curtains and carpets are dust catchers; reduce the amount of such articles as much as possible. In the event of a death from consumption, the room occupied by the invalid should not be used again until it has been thoroughly disinfected. The Public Health Authorities are usually ready to carry out this work. If not, the floor and woodwork should be wiped with damp dusters, and then scoured with soap and water. If the walls are papered, the paper should be well damped, stripped off, and burnt. If the walls have been white-washed, this should be renewed with limewash, containing a quarter of a pound of chlorinated lime to the gallon of limewash. The quilt, pillow case, blankets, and sheets of the patient's bed should be steeped in boiling water and then washed. Often consumption is associated with wasting sores on the neck or other parts, which are extremely difficult to heal. These should be soaked in warm weak ACETIC ACID (_see_) daily, and dressed with olive oil. They may be greatly mitigated, if not cured, by this simple means. _See_ Abscess; Bone, Diseased. The directions as to diet in cases of abscess apply also to these cases. Besides such outward applications, the rubbing along each side of the spine should be applied. _See_ Children's Healthy Growth. The ARMCHAIR FOMENTATION (_see_) may also be used. The very rapid pulse, and extreme fever, which accompany advanced and rapid consumption, may often be greatly mitigated by cooling cloths applied over the heart. Sponging over the whole body with vinegar or weak ACETIC ACID (_see_) also greatly refreshes the patient. It may be done under the bedclothes, so as to avoid all possibility of chill. Cold cloths over the heart and chest, if they cause chilliness, may be accompanied with fomentation of the feet and legs. The temperature of a consumptive should be recorded three times a day, and if above normal the patient should stay in bed till it is reduced. When the temperature has been reduced, gentle exercise is very useful. Gradually increasing walks should be taken each day. Contraction of Sinews.--This often occurs at the knee, bending the joint so that the patient cannot stretch his limb or walk properly. The injury in such a case is usually at the ends of the sinews, where they are inserted into the bone. If the limb be straightened and put up in splints, so as to secure perfect rest, it is well to see that once every twenty-four hours it be removed from its fastenings and treated in some way to obtain a cure. Otherwise the whole limb will harden into a straight and unbendable condition, worse than its original bend. When the fastenings are removed, then, each day, let the limb be rubbed and bathed for an hour. Treat the whole body with soaping and oil rubbing (_see_ Lather and Massage). While bathing the limb it is to be rubbed with this soap, and the lather rubbed gently into all the skin. Rub, after soaping and drying, with hot olive oil. Dry this off, and wrap the limb in warm flannel. With this treatment no splints or plaster jackets are at all likely to be required. The limb usually soon comes right. Sometimes this contraction affects the hip joint, and causes great distress and lameness. The upper end of the thigh bone is even sometimes drawn a little out of its proper position. For this, the muscles of the back, and specially of the side and hip which is lame, are rubbed with gentle pressure and hot olive oil as often and as long as may be convenient. Strong fomentations are also applied for half-an-hour daily (_see_ Armchair Fomentation). We know of one case in which this treatment has cured such contraction both of the knee and hip joint. Whether the cause be rheumatism or other trouble, or an injury, the treatment is the same. Convulsions.--For an ordinary convulsive attack in the case of a child, hold the child's head over a basin and pour tepid water (blood heat, 98 deg. F.) over the head. This will usually be sufficient. If not, seat the child in a bath of hot water nearly up to the waist. If bad, indigestible food causes the fit, give teaspoonfuls of hot water every few minutes for some hours. If the case is obstinate, a BRAN POULTICE (_see_) may be put over the lower back, and cold towels gently pressed over the stomach and bowels. Fits from children's teething are more troublesome. They may often be prevented by placing a compress wrung out of cool water along the spine while the infant is warm in the cradle, and changing it so as to maintain the cooling effect. A handkerchief folded eight ply does very well. Four or five changes may be sufficient. Rub with a little warm oil when the cloth comes off. If the fits do come on, treat as above directed for fits from indigestion. Cooking.--The cooking of vegetables requires particular care. The valuable salts and other nutritive ingredients they contain are easily dissolved by water, and when they are drained, and the water thrown away, as is usually done, all this nutriment is lost. Double cooking pots are easily procurable for meat, porridge, etc. These are quite suitable for vegetables--cabbage, turnips, carrots, peas, etc. The vegetable should be placed, without water, in the inner pot; it will take somewhat longer to cook than when boiled in the usual way. The outer vessel should be partly filled with water kept boiling. Any juice which comes out of the vegetable should be served in the dish along with it. It may be thickened with a little flour and butter, or if a regular white sauce is being made, the juice should be used instead of part of the water. If no double boiler is procurable, an ordinary tin can, inside a saucepan will serve very well. Many who consider certain vegetables indigestible, as usually prepared, will find that when cooked in this way they agree with them perfectly. The fact that the colour of cabbage, peas, etc., is not so green as when boiled in a great deal of water, is not of importance, when the flavour and wholesomeness are so much increased. In stews and vegetable soups the salts are, of course, preserved. Cooling in Heating.--Often it is difficult to get a sufficient cooling effect by means of cold cloths without unduly chilling the patient. When the head has to be cooled, as in the very dangerous disease meningitis, the effect must pass through the mass of the skull before reaching the brain. A large and long continued application is needed for this. The surface is apt then to be overcooled before the interior of the head is affected. In such a case the surface of the head, when the patient feels it too cold, should be gently rubbed, as directed in Eyes, Squinting, until this feeling goes off. Then the cooling may be resumed. Or if rubbing be disagreeable, a warm cloth may be applied for a short time, and cooling then resumed. In this way a succession of _waves_ of heating and cooling can for a long time be sent through the surface, with good effect and no chill. The short heating restores the surface, and does not interfere with the cooling effect reaching the interior parts. The same principle applies to cooling any part of the body (_see_ Bathing). Any _deep-seated_ inflammation is best reached in this way. For instance, in the large hip-joints it is of vast importance to reach inflammatory action in parts that are not near the surface, and cold cloths, pressed constantly, produce distress in the surface, if there is no intermission in supplying them. The patient is apt to rush to the conclusion that he must just yield to be blistered, painted with iodine, covered with belladonna plaster, or burned with red-hot irons! That is, he will yield to be made a great deal worse in every respect than he is, because he is not aware that it is quite possible to cure him without making him worse even for a moment. Coughs.--These will be found treated under the various heads of Colds, Bronchitis, Consumption, etc., but some particular cases of _mere cough_ demand special attention. A tickling cough sometimes comes on, and seems to remain in spite of all efforts to get rid of it. It is worse at night, and keeps the sufferer from sleeping, causing much distress. Where the breathing organs are weak, this cough is caused by an extra flow of blood to them, especially on lying down, the blood acting as an irritant by pressing where it should not. In such cases a BRAN POULTICE (_see_) applied as directed for Bronchitis, with cooling applications to the part where the tickling is felt, should soon effect a cure. _See_ Restlessness. We had a case lately in which these features were very marked. It seemed as if the patient had caught cold and this was showing itself in severe and alarming coughing. The skin was yellow, and there were other signs of failure in the organs that purify the blood. Irritating substances were passing into the lungs because of failure in the liver and kidneys, and not from anything in the lungs themselves. In such cases the cough is merely a way of throwing off everything which ought not to be in the breathing organs. The remedy is very simple. Let the patient take about three tablespoonfuls of hot water every ten minutes for four hours. Before these four hours are expired, the substances causing irritation will be so diluted that they will cease to irritate, and the organs failing to do their duty will be in full working order. Cramp in the Limbs.--The treatment of this is to apply cold cloths to the roots of the nerves which govern the affected limb or limbs. For the legs, the cold is applied to the lower spine; for the arms or hands, it is applied to the upper part. The limbs affected should also be rubbed briskly with the hands, or a rough towel. Often the irritating heat causing the cramp is in but a small part of the spine, and the whole body is cold, or at least too chilly to make the cold cloths a pleasant cure. In such a case FOMENTATION (_see_) of the feet and legs will supply sufficient heat to make the cure by cold pleasant and safe. Cramp in the Stomach.--This very severe trouble, though resisting ordinary methods of treatment, is not difficult to cure by right means. If help is at hand, the patient may be placed in a shallow bath, and cold water splashed with a sponge or towel against the back. A bad case has been cured with two minutes of this treatment. After it, the patient must be well dried and put to bed. When help is not available, a substitute for the cold splashing is a thick cold compress, the length of the spine, which must be laid on the bed, and the patient lie down on it. This must be changed when it grows hot, and a few changes usually give relief. Persons who are suffering have often very strong prejudices. For example, one who has decided most firmly that he "cannot do at all with anything cold," is suffering from cramp, and nothing but cold will relieve him, but you must not even hint at any such application. You must in such a case consider how this prejudice took its rise. You will probably find that cold has been unskilfully applied to this patient, and bad effects have been produced, not by the cold, but by its unskilful application. For instance, in a case of cramp the irritation and excess of heat may be both confined to a very small space, no more than that which is filled by the root of one nerve; the rest of the body may be cold rather than hot. There is need first that this general cold should be dealt with, and a general heat produced by some means or other. This is usually best done by packing feet and legs in a hot blanket fomentation. But this again is not an easy matter when cramp prevails. If you move the limbs in the least the cramp comes on, and the patient screams with pain. Still, you need not be defeated; you can let the limbs lie, and heat them from above by placing the hot blanket over them as they lie. As soon as you get heat raised in the body generally, by some such means as this, you are safe enough to apply all the cold that is needed. That may be so little that a common pocket-handkerchief will be enough. This wrung out of cold water, and folded so as to cover about three inches square of the lower part of the spine, may be gently pressed. If this is really well done, there will be no shivering from the cold, and there probably will be a cessation of the cramp. The one thing wanted is that the cold cloth shall be placed right over the root of the nerve which is irritated, and consequently overheated. The prejudice is thus overcome, and it is seen that cold is not to be absolutely avoided, because it has been once or twice, or many times, wrongly applied. To prevent the cramp returning, means must be adopted to increase vital energy in the system. Entire mental rest for an hour after meals must be taken. If the patient says "I cannot get this," then he simply will soon have to give up all work, and perhaps narrowly escape a departure from this working world altogether. Each morning before rising, the compress should be applied as above for a short time; the back should then be rubbed with hot olive oil before dressing. This treatment, and proper rest, will prevent return of the cramp. If the patient falls asleep on the compress, allow this sleep to continue unbroken: it is invaluable. So also is the avoidance of all anxious thought, which is best secured by complete trust in a loving God and Saviour. Croup, Less Serious Form.--The less serious croup proceeds from a nervous closing of the windpipe, the attack being brought on by any causes of irritation in the nervous system. In this case, when the fit reaches a certain stage, the throat opens, and breathing proceeds as usual. This croup is a cramp of the windpipe; the cramp is caused by an irritation of the nerves controlling it, which are already in a condition to be easily irritated. The cure is to apply cooling cloths to the spine. Take the child warm in bed in the morning, and rub the little back with warm olive oil. Ring out a towel of _cool_, not quite cold, water; fold this into a narrow compress, and place it along the spine; place a dry towel above it and wrap up warm. Change for a fresh cool towel in two or three minutes. If the child falls asleep on this, leave him till he wakes voluntarily. Rub the back again with oil before dressing. The cooling may continue for an hour or so. If this treatment fail, the child may be given medicine to produce vomiting, which frequently relieves. Before putting to bed at night wash the child all over with plenty of M'Clinton's SOAP (_see_), dry and rub over with warm olive oil. Continue this treatment for some days. Croup, More Serious Form.--This is caused by an accumulation of material in the windpipe, which is coughed up in pieces of pipe-like substance, and which, if not removed, threatens suffocation. For treatment, first give sips of hot water (distilled water is best) frequently. We have seen only five teaspoonfuls of this taken by a child followed by the throwing off of such a quantity of matter from the throat as had nearly caused suffocation. The further treatment is the bran poultice between the shoulders, and cold cloths on the chest, as prescribed in the article on Bronchitis. These may not cure in all cases, but will do so in many apparently otherwise hopeless. The moment the symptoms are perceived, treatment should be begun, as this disease is very rapid in its progress. When an actual attack of croup of this kind comes on, and is severe, it is usual to put the child in a warm bath. If the water is a little below blood heat, and laved on the back, this will go far to relieve; but it will not have a tenth of the effect which a cold towel will have, if placed along the spine. It is indeed wonderful how spasms and the various forms of cramp give way to this. When a little warm olive oil is first rubbed on and then off, there is no danger of cold or of any bad effect (_see_ Cramp in Stomach). If this croup is obstinate, there may be more serious disease of the throat, and good medical advice should be had. Cures Losing their Effect.--After a fortnight's treatment often matters seem to come to a standstill in a case, and then the attendants are apt to despair. Such a state of things indicate only the need for some change in treatment, or perhaps for a rest from treatment for some days. Common sense must guide, and the case may be more keenly looked into: it may have changed its character in the time that has passed, and different treatment require to be given. It is well not to give up until all has been tried which in any way seems likely to suit the case. All the various articles bearing on it should be carefully read and pondered, and no doubt the way to change the treatment will open up. _See_ Changing Treatment. Cures, as Self-Applied.--Often young people in lodgings are in difficulty for want of some one to apply the necessary treatment in their own case. It is often, however, possible to treat oneself quite successfully by exercising care and common sense. Help should always be got if possible, but where it cannot, it may be done without. In the case of applying cold cloths to any part, when it is necessary to change these frequently, a basin of cold water may stand by the bedside so that the patient can wring out towels without getting up. A still better plan is to have several towels wrung out to begin with--these may be hung over a rail or chairs until required. When the first has been heated it must be hung over the rail or chair so as to be as much spread out as possible. Evaporation will then cool it sufficiently to be used when its turn comes again. Each towel is to be treated in a similar way in turn. Four towels will give an hour's cooling with very little trouble in this way. So a bran poultice may be prepared and laid on the bed, so that one can lie down on it, and with the cold towels handy, as above, most effective treatment given. Common sense is the guide here, as everywhere in our treatment, and a little thought will solve difficulties at first apparently insoluble. Damp Beds.--An ordinary bed which has not been slept in for some weeks, although perfectly dry to begin with, will _become_ damp, even in a dry house, and, unless properly dried, will be a great danger to its next occupant. This is a preventable danger, and all who entertain guests should see that they are not exposed to it. Many a fatal illness is due to the culpable carelessness of those who put a guest into such a bed. Ignorance in such a matter is shameful. All who have charge in a house should fully understand their responsibility in this matter. But if you are put into such a bed it is infinitely better to rise and dress, and make the best of a night of discomfort, than to sleep among the damp. If, however, you have so slept, and feel the bad effect, the best cure will be the SOAPY BLANKET (_see_). If this cannot be had, a good hot footbath, with the heat kept just comfortable for half-an-hour or more, will do very well. This should be done at the earliest possible moment. It will add greatly to the efficiency of such treatment if hot water can be had to drink in small quantities, and often. A few drops of cayenne "tea" in the water will act as a gentle stimulant. Old-fashioned folk place great confidence in a "hot drink" in such a case. This is all very well if they only keep the alcohol out of it: that destroys vital resources, but never supplies them. We have known cases in which all power was lost through a single night in a damp bed. Possibly in these cases it might not have been easy to restore the lost vitality by any amount of treatment; but we rather think that a speedy application of genial heat all over would have restored it. In some apparently hopeless instances it has done so. Deafness.--_See_ Hearing. Decline.--_See_ Consumption. Declining Limb, A.--_See_ Limbs, Drawn up. Delirium in Fever.--The best way of treating this truly distressing symptom is by cooling and soothing applications to the head. We have seen in one case large cool cloths applied to the head for some time every three hours or so. An almost immediate cessation of the delirium followed this application, and it only returned a few minutes before the time for the next cooling. If the pulse becomes rather slow than rapid, and the body rather cool than hot, while delirium still continues, then hot cloths may be applied to the head. When either hot or cold appliances are removed, rub olive oil into the roots of the hair, and dry off. An excellent treatment is also to cover the whole head with soap lather. _See_ Head, Soaping. It is to be noted that the state of the patient determines the treatment. If he is hot, cold treatment is required. If he is cool or chilly, then give the warm treatment. If he _changes_ from hot to cold, then alter the treatment accordingly. In some diseases delirium occurs, not because of fever, but because of poisonous elements in the blood supplied to the brain. This is the case in liver and kidney troubles, when waste products are not got rid of by these organs as they should be. To get these organs to work, the best thing is to drink half a teacupful of hot water every ten minutes for two hours at a time. Do this once a day for two days. Probably it will cause purging, but that is part of the cure. If the case does not yield in any way to this, a large hot bran poultice should be placed over the whole of the _right_ side under the arm, from the spine right round to the breast-bone (_see_ Bran Poultice). This should be renewed if necessary, so as to keep up the heat for an hour. Next day place a similar poultice over all the lower part of the back, so as to help the kidneys and bowels. Dry after these poultices, and rub gently with warm olive oil. The delirium will usually yield to a few days of such treatment. We have seen the reason under such treatment return with a rapidity that astonished the medical attendant. He had given the patient three months to gain what was complete in less than one. _See_ Fever. Depression.--This is usually a bodily illness, though often regarded as mental only. It appears in loss of interest in all that otherwise would be most interesting. A mother loses interest in her children, a man in his business, and so on. Students, and children overpressed at lessons, are apt to suffer from it. It is simply the result of a drain of energy from the system, until the brain has an insufficient supply. Those who have the care of the young would do well to watch carefully against this state coming on. If it appears, all work should be given up, and as much play take its place as possible. No cramming of ideas into a weakening mind can ever be equal to the possession of health and energy, as a preparation for life. Treatment should be such as to restore energy. The whole back should be fomented with a large blanket fomentation, being rubbed with olive oil before and after. Let this be done for an hour in the morning; in the evening give the ARMCHAIR FOMENTATION (_see_). Carry this on for a week, and then rest for another week, only rubbing the back with a little hot olive oil each night. Cultivate open-air life; sleep as much as possible--eight hours at least, or better nine. Carefully prepared and easily digested food should be given, and change of company, scene, and climate are most effective helps; but rest from work is the chief matter. _See_ Restlessness and Worry. Diabetes.--There are two more or less distinct stages of this serious trouble; the first stage is generally curable, the second stage generally incurable. Yet good natural means of cure will very much alleviate even the incurable stage. The earlier as well as the later stages are marked by extreme _thirst_. This, in the case of some poor sufferers, is enormous. Gallons of water are taken, and the more is taken the more is wanted. But this thirst is not the effect of heat, as fever thirst is. It cannot be quenched by means of cold cloths often changed over the stomach, as fever thirst can. A sufferer in this disease will set a large pitcher down at the bedside to serve for the night, and drink it all before morning; but there is no extra heat anywhere to account for this. The thirst is more like that which is caused by eating very salt food. It points to the character of the juices which are affecting the stomach, and not to any heated condition of the stomach itself. The drinking is a desperate effort to dilute these juices; and, at least by cold water, that cannot be done. A wineglassful of hot water taken every ten minutes for an hour, or two hours, or three, or ten hours, as is felt to be comfortable, will do wonders in the early stages of this disease. This water, when taken at the right heat, at once mixes with the strongly concentrated juices of the stomach, and causes them to be easily managed by that and other organs. It is truly wonderful what this very simple remedy will effect by itself alone. The next thing to be noticed is the excessive hunger. The food, whatever it may be, fails to quell this hunger. Here, again, it is clearly the stomach with which we have to do. When the hunger is developed we should think the case further advanced than when thirst alone is experienced. The hot water meets this symptom as it meets the other. It is also of the very greatest moment to give right food. Oatmeal and buttermilk steeped together for a time and then moderately boiled, a very little salt or sugar being added, produces a food which we do not expect to see excelled by the most costly that can be got anywhere. Wheaten meal, or barley meal, will do as well as, and perhaps in some cases better than, oatmeal, but these may be chosen according to taste. The chief thing is the ease with which this food is converted into a large supply of the best of blood for all purposes of nourishment. Food containing much starchy matter, as white bread, rice, and all sugar, must be forbidden. To make up for this, an abundance of fat should be consumed. The bowels should be kept open by a suitable diet and exercise. Now we come to the excessive urinary discharge which is so strong a feature of this disease. The body seems as if it were melting away in this. We can benefit the kidneys vastly through acting on the liver, as well as on themselves. By a large hot bran poultice over the liver we can add new life to that, and whatever does so tends to benefit the kidneys. After using this large poultice, with plenty of oil rubbed on before and after, say three or four times, place it over the kidneys and use it as often there. If the heat is well kept up for an hour at a time, one poultice a day would do, but, if the patient desires it, twice a day will be all the better. It is good to do the best that can be done with the skin. By means of soap and oil rubbing, and the cleansing effects of diluted acetic acid, very considerable help may be gained. Good can be done by a hot fomentation of the feet and legs to the knees, with oiling after, so as to have these extremities in a comfortable state. Tea, coffee, and sugar _must be avoided_. Diarrhoea.--Sudden attacks of this, though in a mild form, are very troublesome. An enema of _cold_ water is in such cases often an immediate cure. The first injection may be followed by even an excessive motion, but if a second cold injection be given this will cease. But in more troublesome cases, where the patient is an infant, or very weak, this is not applicable. For such cases, mix equal quantities of honey and lemon juice (one or two teaspoonfuls of each), and add enough boiling water to dilute it for taking. Give this three or even four times a day. It will usually and speedily cure, and is relished by infants. Often the cause of diarrhoea in infants is the infection of milk by flies (_see_ British Cholera), or from dirty feeding bottles. Bottles with tubes should _never_ be used. The india-rubber teat should be smelt to see that it is perfectly sweet and clean before the bottle is filled. Unsuitable or too rich food will bring this trouble on. A tablespoonful of blackberry (or brambleberry as it is also called) jelly may be given--it is a powerful and simple remedy. In adults, a dose of castor oil, with a few drops of laudanum in it, will probably remove all trouble, if it be due to nothing more than indigestible food. Where the cold enema is dreaded, one of hot thin starch, with fifteen drops of laudanum in it, may be used for adults. Stale vegetable or animal food, also impure water, are fruitful sources of diarrhoea. The mind has a great effect on this trouble, anxiety and worry are frequent causes. _See_ Worry. A comfortable seat by the fire, and an interesting book, will often relieve. When the diarrhoea is very serious, use the four-ply flannel bandage. _See_ Bandage; British Cholera; Dysentery. Diet.--The composition of different articles of food varies. A turnip is not the same as a piece of cheese. It is more watery, and has more fibre in it, and we speak of it as less nutritious. There are, however, in almost all foods certain chemical substances present which have different duties to perform in the body, and which are present in widely different proportions in the various articles we use for food. _Water_ is the most common of these substances. Soups, vegetables, fruits, puddings, are largely water. Some foods contain less of it than others, but on the whole a very large, if not the largest, part of all food consists of water. This large amount is needed. Water makes up two-thirds of the body, and nearly two quarts are given off daily in the various excretions and secretions. If enough be not taken the tissues get dry, and Nature indicates her want in thirst. Another of these substances is _starch_, or its equivalent, sugar. Rice, bread, and vegetables in general, are largely made up of this starchy or sugary substance, which, as it contains a considerable quantity of carbon, we speak of as the _carbonaceous_ element in food. This is the substance which goes to feed the muscles, replacing the waste from work done, just as fuel is required for the fires of an engine. Yet another substance in food is _fat_. It may be animal, such as beef or mutton fat, and butter, or vegetable, as the oils in nuts, in the olive, etc. Fat, like carbonaceous food, also goes to feed the muscles, but both are required in a healthy diet. Of the first importance, however, is the _proteid_ element in food. Meat, milk, cheese, eggs, peas, etc., contain proteid in considerable quantities. Its use is to repair the exhausted tissues themselves. The muscles and nerves get worn out in their daily work, and require rebuilding. This is what proteid goes to do, and from this, its high import in animal economy, is called Proteid (protos--first). Finally, in all natural foods there are certain _salts_, which also build up, _e.g._, lime, which goes to make up bone. These salts may be seen in the ash of any common vegetable after being burnt. These four kinds of food substance make up our daily food, and a certain amount of each substance is required to replace the daily expenditure, a proportion which varies, however, under different circumstances. _See_ Food in Health. As the relative amount of proteid, carbonaceous matter, water, and salts, may vary considerably in different articles, we rightly have combinations of food at our meals. A pudding of corn-flour and water contains no building material, hence we add milk and eggs, which do. A meal of meat and cheese requires bread and potatoes, etc., etc. Appetite is a good test of the amount and also of the particular kind of food required, provided the appetite is in a healthy condition. If a healthy man refrain from carbonaceous foods for a day or so, he feels a great longing for them, a sign that the body really needs them. It is of immense importance, then, that the appetite should not be accustomed to over-indulgence, for then it is no guide in our selection of foods (_see_ Appetite). If disease indicates such over-indulgence, food should be restricted till the appetite is accustomed to a smaller diet. Bilious people, for example, may have accustomed their appetite to desire more carbonaceous and fatty foods than necessary. On the contrary, badly-fed people often require a coaxing of the appetite to eat strengthening foods, such as oatmeal, cheese, and brown bread. In order to regulate our diet, it is of importance to have some idea of the composition of common articles of food. We get our food, as everybody knows, from the vegetable and animal kingdoms. The majority of the Anglo-Saxon race live on a diet of animal and vegetable combined, but many exclude flesh from their diet. In Southern Asia, for example, the vast bulk of the people rarely, or never, touch meat. The vegetable kingdom supplies us largely with the carbonaceous or muscle-forming food, whereas the animal kingdom is rich in proteid, or tissue-forming food. Much proteid, however, can be obtained from the vegetable kingdom--peas, beans, lentils, dried fruits, and nuts being particularly rich in it. We should endeavour to cultivate an appetite for these vegetables containing proteid, as it is a great mistake to rely entirely for this element on meat, as so many of our race do. The animal products--such as cheese, milk, and eggs--will also form an efficient substitute for much flesh-food. This simple diet suits both the brain-worker and the athlete, though each will have to make a selection of those foods most required by him. Certainly much animal food is liable to produce kidney disease, gout, and kindred troubles. If we have a tendency to corpulence (and many have this in advancing years), to resort to an exclusive meat diet will produce these troubles. Far better abstain from vegetables, such as potatoes, and from sweet dishes, pastry, etc., and eat largely of the green-leaf vegetables and fruits with the articles of a simple diet which build but do not fatten the body. (_See_ Diet and Corpulence; Diet for Middle Age, and the Aged.) Fruit is a very useful article of food. The acid helps to keep the blood alkaline (which alkalinity is necessary for the normal performance of its functions). It prevents acidity of the stomach. The dried fruits, such as dates, figs, raisins, are very rich in proteid. Nuts also are rich in proteid and in fat; they require, however, careful mastication. Mills can be purchased cheaply for grinding nuts; the ground meal, either alone or made into a cream, forms a delicious adjunct to stewed fruit. Green vegetables are a much neglected food. The salts they contain are very useful. They require careful cooking. A cabbage boiled in the ordinary way loses in the water its valuable salts. In case of flatulence arising from indigestion, the use of vegetables may, however, require to be restricted, at least for a time. Some vegetables are palatable raw, such as salads and celery. Indeed, raw vegetables have a tonic effect on the bowels. Bread should never be too fresh, and should be thoroughly chewed. Zwieback (twice baked) can be recommended, especially for those who suffer from indigestion. It is made by cutting bread, preferably wheaten, in thin slices, and putting these in a slow oven till thoroughly dry and lightly browned. Wholemeal bread should always be present on the table, as its use prevents constipation. Indian corn can be made into a number of palatable cakes, and is a very nutritious food. Home-made jam and honey are digestible forms of sugar, but like all sugar foods should be consumed in moderation, especially by sedentary individuals. Condiments should be avoided, the healthy appetite is better without them, and they irritate the stomach. Regarding animal foods, they are often spoilt by over-cooking, and it should be remembered that when lightly done they are easiest to digest. White fish, tender steak, or juicy joint and cutlet are superior to the oily fish, and kidney, liver, and heart. These internal organs should be avoided, as they contain even more than the rest of the animal certain extracts liable to produce URIC ACID (_see_). Milk, cheese, eggs, and butter are not open to these objections. Cheese is a food very rich in proteid. It requires careful chewing, and may with advantage be grated before use. Buttermilk is a valuable and strengthening food. A generation or so ago the Scotch peasants lived almost exclusively on buttermilk and oatmeal, and were a magnificent type of men in every respect. Whey is a pleasant drink, and may be made a substitute for tea where the latter is prohibited. It is also beneficial for the kidneys. Jellies are a pleasant addition to the diet of convalescents, but have little nutritive value. We would strongly urge upon our readers the advantages of simple diet. We mean by this the avoidance of all those rich and spiced dishes which are made up in so many ways to tempt the appetite, of alcohol in every form, of meat to the extent often consumed by the well-to-do, of pastry and such indigestible food as heavy cakes, of fried food in general; and, on the other hand, the adoption of a diet largely consisting of milk, cheese, eggs, butter, cereals, root and green vegetables, fruits, and nuts. It will not be found an expensive diet; on the contrary, it is remarkably cheap; it will give little trouble, for but little cooking will be needed. It may require some little effort at first, and some breakings with social customs, but far less of both than will be imagined. Seeing that a large part of disease is ultimately traceable to a rich and stimulating diet, and to too much food in general, simplicity is imperative on all who seek for the preservation of health. Eat less, eat better (or more slowly, with perfect mastication), eat simpler foods at your meals, eat at these meals only when you require it, and never between your meals. Such eating will ensure good digestion, good assimilation, good blood, and good health. Diet and Corpulence.--A tendency to obesity should always be carefully checked by attention to diet and exercise (_see_ Exercise). The fattening foods are those which contain either fat or carbonaceous substances. Carbonaceous substances are found in bread, sugar, arrowroot, puddings in general, pastry, potatoes. The fats, such as butter, cream, and animal fat, should be much restricted in their use. As we have above indicated, however, it is not wise, as many corpulent people do in their efforts to get rid of this superabundance of fat, to make up for their restriction by an increase in the quantity of meat consumed. Cheese, peas, beans, buttermilk, and oatmeal might with advantage be drawn upon instead. At the same time, if the circulation is good it is well with such proteid diet to increase the amount of water drunk during the day, as this helps to eliminate the waste which would otherwise overtax the kidneys. Green vegetables and fruits should form a large part of the diet. It must be remembered that it is dangerous to strike out at once all fattening foods from the diet; many have injured their health permanently by such injudicious haste, and brought on floating kidneys, etc. Remember, also, that exercise is a much safer reducer of fat than a very great reduction in diet, unless there has been a decided tendency to continually overeat. All alcoholic beverages must be strictly forbidden. Diet for the Lean.--To a large extent the preceding article will suggest what is suitable here, remembering, however, that regular exercise will be also necessary in order to enable the muscles to increase in size. Green vegetables and fruits should be largely used in addition to the carbonaceous foods, as their FOOD SALTS (_see_) are necessary to keep the blood in a condition to allow of proper assimilation. In the case of nervous and consumptive patients, the more digestible forms of fat, such as cream and butter, are to be recommended. Some thin people do not seem able to assimilate much fat. These cases will do better on a smaller quantity. Remember always that it is not what is eaten, but what is assimilated, that goes to increase the weight, therefore if any particular food is found, after a careful trial, to constantly disagree, it must be accepted that for that one at all events, it is not a suitable article of diet. Diet for Middle Age and the Aged.--In advancing years when less exercise is, as a rule, taken, a restriction in the amount of food consumed is highly desirable. The increasing corpulence, which often begins to show itself from 30 to 40, is far from being a healthy sign; indeed, is often the premonitory symptom of serious disease. It should be remembered that a lessening quantity of food is required from middle life on. This applies to all the elements of food. It is noticeable that a fat person seldom lives to old age, most octogenarians being thin and wiry, and almost all attribute their long life to increasing watchfulness over their health, and largely over what they eat. When a person is young and taking active exercise, a good deal of surplus food can be worked off, and if the excess be too great, a bilious attack tends to prevent any more being taken, for a time at least. But as we get on in life, the surplus food, if much is eaten, is deposited in various parts of the body as fatty or gouty accumulations. The liver becomes deranged, and loss of health and strength are at once apparent. It is then, as Sir Henry Thompson has well pointed out, that the fond but foolish wife often does her husband incalculable harm by her efforts to "keep up his system." She urges and tempts him to take more food, fetching him, between meals, cups of beef-tea, soup, or cocoa, when he really would be greatly the better of total abstinence from all food for several days. What we have said about appetite being the best guide applies to the old especially, and if they could but realize what a very small quantity of food is necessary, they would not be perturbed to find that their appetite guided them to eat very much less than at a younger age. Milk, which is the ideal food for the very young, is for that reason often undesirable for the old, and it is a great mistake for such to drink much of it with solid food. Diet for the very aged becomes mainly a question of invalid diet, and it must be remembered that much should be granted to the individual's choice and liking. All foods for the aged should be light and easily digested, and careful attention paid to proper cooking. A striking example of lost health recovered and life and activity prolonged to a great age, by strict temperance in food, is Cornaro, a Venetian nobleman of the sixteenth century, who lived over 100 years. He says:--"Our kind mother Nature, in order that old men may live to still greater age, has contrived matters so that they should be able to subsist on little, as I do, for large quantities of food cannot be digested by old and feeble stomachs. By always eating little, the stomach, not being much burdened, need not wait long to have an appetite. It is for this reason that dry bread relishes so well with me.... When one arrives at old age, he ought to divide that food of which he was accustomed to make but two meals into four, and as in his youth he made but two collations in a day, he should in his old age make four, provided he lessen the quantity as his years increase. And this is what I do, agreeably to my own experience; therefore my spirits, not oppressed by much food, but barely kept up, are always brisk, especially after eating, nor do I ever find myself the worse for writing immediately after meals, nor is my understanding ever clearer, or am I apt to be drowsy, the food I take being in too small a quantity to send up fumes to the brain. Oh, how advantageous it is for an old man to eat but little! Accordingly, I, who know it, eat but just enough to keep body and soul together." Digestion.--Digestion is the process whereby the food we eat is turned into material fit to be assimilated by the blood. It begins in the mouth by the mechanical grinding and crushing of the food, and the chemical conversion of the starchy part into sugar, in which form alone it can be assimilated. This conversion is carried out by the saliva. Hence the necessity for thorough mastication, even of sloppy foods that do not seem to require it, and for attention to the teeth in order that they may thoroughly chew. Alcohol and tobacco, as they spoil the saliva, are very unfavourable to digestion, and should always be avoided. Twenty minutes longer to chew one's dinner is worth a whole box of pills, and no one need expect good digestion who neglects thorough chewing and salivation of the food. This may, with advantage, be increased to an extent which most people would think quite absurd. It has been proved that when all food is chewed until completely reduced to a liquid, its nutritive qualities are so increased that about half as much will suffice. This is of immense importance in all cases of weak digestion, or indeed whenever an absence of vigorous health renders the economy of vital energy important. [Illustration: Digestive System.] In the stomach the food meets with the gastric juice, which has the property of turning proteid (_see_ Diet for the various substances contained in food) into material ready for assimilation. The walls of the stomach are muscular, and their contraction churns the food with the juice. The gastric juice is secreted by glands embedded in the walls of the stomach, and is poured out when food is taken. The whole food, now in the form of a paste, passes into a pipe about 12 inches long (the Duodenum), into which pours the secretion of the pancreas and that of the liver (bile). The pancreatic juice acts upon the starch which has escaped the action of the saliva, and also continues the work of the stomach. It furthermore emulsifies the fat or divides it into extremely fine drops. The food passes now into a long coiled pipe--the small intestine. This secretes the intestinal juice which further assists the pancreatic juice. Absorption has been proceeding from the stomach onwards (_see_ Assimilation). The mass of undigested food is pushed along the small intestine by means of muscles in its walls and passes into the large intestine where a similar process to that of the small intestine goes on, the remains of the food ultimately reaching the vent in a semi solid form, consisting of the undigested part and the débris of digestion. During this complex process much blood and energy is needed for the abdominal region, therefore hard work or exercise should not immediately follow a meal. It will be noticed that each stage of digestion prepares the food for the next stage _e.g._, the mouth prepares the food for the stomach. Now, as the food ceases to be under our control when it leaves the mouth, every effort should, as we have said, there be made to prepare the food for its reception by the stomach. Chew food dry as far as possible, for that excites saliva. It is best not to drink till after the meal. The digestive powers often become weakened in advancing years, but may be greatly preserved, and even restored to health after long debility, by careful attention to the above hints. Drinks made of lemon juice or orange juice and water are often very good to help an invalid digestion, but nothing is better than sips of hot water for some time before a meal. Distilled water is especially a most valuable drink. Cooling applications to a fevered stomach and warm fomentations to a cold one will often promote digestion marvellously. The feet and legs may be fomented if cold while the cold cloth is pressed over the stomach, especially if the process be long continued. Where heat is necessary it should be gradually and cautiously applied, so that sickening the patient may be avoided. (_See also_ Assimilation, Food in Health, Indigestion). Diet, Economy in.--Dr. Hutchison, one of our greatest authorities on the subject of Dietetics, has well said-- "The dearest foods are by no means the best. 'Cheap and nasty' is not a phrase which can be applied to things which you eat. A pound of Stilton cheese at 1s. 2d. contains no more nutriment than a pound of American cheese at sixpence. A given weight of bloater will yield more building material than the same quantity of salmon or sole. "The upper classes in this country eat too much. The labouring classes are insufficiently fed--much worse fed than their brethren in America. One of the chief consequences is an undue craving for alcoholic stimulants; another is that our poor are not properly armed against tuberculosis and epidemic disease. "How can this be rectified? Anyone who knows anything about the poor man's budget knows that he already spends as much on food as he is able. As it is, 50 per cent. of a workman's wages are absorbed in its purchase, so that half the struggle for life is a struggle for food. "The only remedy is to buy the things which are the most nourishing and which yield the most energy. Quite a good diet can be obtained for fourpence a day, yet the average working man spends sevenpence. "I advise the buying of more vegetable foods, particularly peas, beans, and lentils, and the cheaper varieties of fish. The working classes should also be taught how to cook cheese, and thus make it more digestible, as the Italians do. Cheese contains much building material, and is therefore a valuable article of diet. "I strongly recommend one good meal of oatmeal a day, instead of so much bread, butter, and tea, which is the staple diet of so many poor families, because it is easily prepared, and because of human laziness. "Skimmed milk is better than no milk at all, for it contains all the original proteids, and has only lost its fat. More dripping and margarine should be eaten, instead of jam; margarine being quite as digestible and nourishing as butter." Vegetable oils are, however, more digestible than animal fats. Cocoanut butter is a cheap and excellent substitute for margarine or butter. As it contains no water it will go much further. Another instance of bad economy is the use of cod liver oil. Butter or even cream are quite as fattening and much more digestible. Malt extract is much dearer than honey, which is superior to it in value as a food. To supply a healthy man with the amount of proteid required by him daily in beef extracts would cost 7s., in milk (a comparatively expensive food) would only cost about 1s. Diphtheria.--The most striking symptom of diphtheria is the growth of a substance in the upper part of the windpipe, which threatens to close it entirely. Good medical skill is of first importance here, yet much may be done where that is not available. We have often seen the swallowing of a little hot water and treacle enable the children to throw up the entire obstruction and make the breathing perfectly free. Mark at once whether the feet are cold or warm. If cold, oil them well with olive oil, and pack in a hot blanket fomentation to the knees. When the feet and knees are thoroughly warm in this, put a cold cloth on the back of the neck down between the shoulders. Change this as often as felt comfortable. The throat may be brushed out with a weak solution of Condy's Fluid, but a strong solution of common salt will do very well. Good white vinegar and water (_see_ Acetic Acid) is perhaps best of all. We have never seen this fail in changing the character of such growths, and if the windpipe can be washed out repeatedly with it, we should feel sure of a desirable result. Now, we have seen a humble working man's wife wash out the throat of her son as well as any medical man could do it, using Condy's Fluid for the purpose with full success. When you can, have the help of a medical man, but when you are so placed that such help is impossible, you need not fear to try yourself. If there is much fever, cold cloths may be applied to the head to reduce the heat. As the disease is strongly infectious, care should be taken to isolate the patient, and attendants should avoid his breath. Abundance of fresh air and light should be allowed to enter the room, and one window at least should be open as far as possible. Douche, Cold.--In its most powerful form this is a _solid_ stream of water directed down on the patient's shoulders and spine. It may be applied either by an apparatus fixed up for the purpose, or by merely pouring from a watering-can _without_ a rose. Its power depends on the great heating in the skin which springs up when it is withdrawn. This heating power again depends on the strong shock given to the system when it is applied. Thus it will be seen that what is called a "Spray" or "Spray Douche" is of little use for the same purpose, as it gives little or no primary shock. It is with this application as with many. The patient's feeling benefit is the great and true evidence of the treatment being right. When the douche issues in bodily comfort and cheering to the mind, all is right. If it issues in discomfort, then some other treatment must be tried. "Downbearing."--This expression will cover many troubles especially common among women, where the weight of the internal organs becomes distressingly felt. These are usually supported without our being conscious of their weight at all. But in weakness, or after long fatigue and standing, it becomes felt as a severe downward pressure. This is often caused by the pressure of corset and skirts upon the waist. In cases where it is troublesome, much help will be derived by adopting some device for suspending the clothes from the shoulders. This may quite cure the trouble (_see_ Tight Lacing). For more serious cases, take daily a short SITZ-BATH (_see_) in cold water, with the feet in hot water. Internal syringing is often required, which is best done with the "Fountain Enema," and very weak acetic acid and water (_see_ Acetic Acid). A more powerful application is to have cold water poured over the front of the body while sitting in the sitz-bath, from a watering-can with a garden rose on the spout. This must be done gently at first, and afterwards more strongly and with colder water. This also prevents the troublesome "flooding" from the womb, which so often accompanies "down-bearing." The water employed in the douche must be _cold_, but it need not be icy cold. Ordinary cold tap water does very well. In serious cases medical advice should be sought, as the womb may be displaced. A golden rule for the prevention of this distressing ailment is to pass water frequently. If women would always do this before pushing heavy furniture, hanging up pictures, &c., many internal ailments would be prevented, as when the bladder is empty there is little danger of the womb being displaced. After the system has been weakened by a miscarriage, this flooding often occurs. Apply the above treatment: it checks the flooding, and braces the parts. Drinks, Refreshing.--This is a matter of great importance to the sick. Nor is anything more important to be said on them than this, that the foundation of all such drinks must be _water_. This water must be _pure_, and is best distilled, or boiled and filtered. Long boiling will spoil water, and half-an-hour is long enough to boil. To add to this pure water, we may take the juice of half a lemon, sweetened to taste. Few patients will fail to relish this. A whole orange may be used instead of half a lemon. A substitute may be made by taking half-a-teaspoonful of good white vinegar instead of the orange or lemon. Also in many cases where the cold drink is not relished, it may be taken warm. Dropsy.--This trouble is rather a symptom than a disease. It rises from accumulation of watery waste in the body, owing to improper action of the skin, lungs, or kidneys, and sometimes follows scarlet or other fevers and lung affections. By far the greatest danger in such cases arises from fashionable medicines. It is of the last importance that nothing should be given to lessen life by injuring already weakened vital action. It is when this is done by metallic preparations that such cases become very grave and even hopeless. There is a prominent error in connection with all dropsical tendencies, which should be removed. That is the idea that the "water" which collects in such swellings is similar to good drinking water, and that giving the thirsty patient water to drink is increasing his illness. The so-called "water" which swells the face, or the feet, or any other part of the body, in dropsy, is used-up matter such as is, in good health, removed (imperceptibly, in greatest measure) by the organs fitted for that purpose. Water, especially if given about blood heat, is at once used for most important vital purposes. This hot fresh water mingling with the poisonous "water" of dropsy dilutes it--renders it not only so much less injurious, but tends powerfully to its removal. The thirst of the patient is in perfect harmony with this truth, as all natural symptoms are ever in harmony with nature. If there are convulsive attacks, they are the result of used-up matter returning into the circulation, and reaching even the brain and central parts of the nervous system. The cure is gained when the defective organs are brought to act well. It is shortsighted action to deal with the kidneys alone in this trouble. They often fail because they are overloaded through the failure of lungs and skin to do their part. First, it is well to act on the lungs by gentle rubbing with hot olive oil between the shoulders and over all the back--done best in a warm room by the fire, or in bed. This may be continued for half-an-hour or more twice daily. The skin may be stimulated by a smart sponging with vinegar or weak acetic acid, and a rubbing all over with soap lather, and afterwards with hot olive oil. This lathering and rubbing to be done at another time from the first rubbing for the lungs. Then apply a large warm bran poultice to the lower part of the back behind the kidneys. We have often found the following simple treatment effectual, where the patient is not very weak. If there are any signs of heart failure, do not use it. But if the patient is fairly strong, it is most beneficial. You have a case, say, of dropsy in the abdomen: put on two folds of soft flannel, wrung out of cold water; put two folds dry over the moist ones. Keep away all oiled silk and everything of the kind. You will very soon have an astonishing outflow of insensible perspiration, but it passes off through the soft porous flannel without any obstruction whatever. You will find that under this the swelling soon comes down, and even disappears entirely. It is necessary, in such treatment, to renew the bandage so as to keep all fresh and healthful, but your work is abundantly rewarded. In such a case as this the matter to be passed off is so great that a cotton or ordinary linen bandage may fail, as being too impervious, when a flannel bandage will succeed. A Kneipp linen bandage is perfectly porous, and will not irritate the skin as flannel often does. Worn-out underwear can be kept for this purpose. If stronger heat seems to be needed, a soft cloth four-ply thick, large enough to cover the whole lower back, should be dipped in CAYENNE LOTION (_see_), slightly squeezed, and placed on the back. Over this a dry cloth should be placed, and the patient should lie down on a bran poultice or hot-water bag for an hour or two. Afterwards the back should be rubbed with olive oil, and a band of soft new flannel worn round the body. Even if the swelling is caused by rupture this treatment is the best. The rupture must be reduced (_see_ Rupture) and sustained by a proper truss, for which the patient should apply to a responsible surgical instrument maker. This treatment alone has cured many dropsical patients. Where failure of the heart's action complicates the trouble, this treatment will usually relieve the heart as well as kidneys. For drink in such cases see article Drinks. For food give whatever is most easily digested and passed into good blood. Wheaten-meal food, oatmeal jelly, etc., are good. _See also_ Biscuits and Water. Drowning.--Many valuable lives have been saved by an elementary knowledge of what to do in the case of one apparently suffocated or drowned. Commence treatment immediately in the open air, with the face down, neck and chest exposed, and all tight clothing such as braces removed. The points to be aimed at are--first and _immediately_, the Restoration of Breathing; and secondly, after breathing is restored, the promotion of Warmth and Circulation. The efforts to restore Breathing must be commenced immediately and energetically, and persevered in for one or two hours, or until a medical man has pronounced that life is extinct. Efforts to promote Warmth and Circulation beyond removing the wet clothes and drying the skin must not be made until the first appearance of natural breathing, for if circulation of the blood be induced before breathing has recommenced the restoration to life will be endangered. [Illustration: Turning on the Chest.] _First_: Roll the patient over on his chest, with one of the arms under the forehead, when the water will readily leave the mouth. _Second_: If breathing does not recommence then, place him on his face, supporting the chest on a roll of clothing. Turn the body gently on the side, then briskly on the face repeating these movements, about 15 times in the minute. (By placing him on his chest the weight of the body forces the air out; when turned on the side air enters the chest). Five minutes is the longest that can be afforded to this treatment. _Third_: Turn him on his back, draw his tongue forward, keeping it forward by a band passing over it and under the chin, placing the roll of clothing under the shoulder blades. Then, kneeling at his head, grasp the arms just below the elbows, draw them above the head, keeping them stretched for about two seconds. Then turn down the arms and press them firmly for two seconds against the sides of the chest. (The outstretched position allows air to be drawn into the lungs, the other position allows it to be pressed out.) [Illustration: Arms extended.] When a spontaneous effort to respire is observed, proceed to induce Circulation and Warmth. This is accomplished by rubbing the limbs upwards with firm grasp and pressure underneath the warm blankets, or over the dry clothing which through bystanders or other means should have been already procured, apply hot flannels, hot water bottles, heated bricks, etc., to the pit of the stomach, the armpits, between the thighs and the soles of the feet. Allow abundance of fresh air to play about the patient. Administer a teaspoonful of warm water, and then if the power of swallowing have returned, give hot milk, coffee, etc., in small quantities. The patient should be kept in bed and a disposition to sleep encouraged. The above treatment should be persevered in for some hours, as it is an erroneous opinion that persons are irrecoverable because life does not soon make its appearance, persons having been restored after persevering for many hours. The appearances which generally accompany Death, are: Cessation of the heart's action, eyes half-closed, pupils dilated, tongue approaching to the inner edges of the lips, lips and nostrils covered with a frothy mucus. Coldness and pallor of surface increase. [Illustration: Elbows on the Chest.] _Cautions_: Prevent crowding, avoid rough usage; if the body is on the back have the tongue secured. Never hold up the body by the feet. Never place the body in a warm bath, unless under medical direction, and even then only momentarily. Dwining.--We give this name to a trouble from which we have been able to save some patients, as expressing best the general failure and weakness which sometimes constitute a serious danger, even where all specific symptoms are wanting. Some cases of this kind we have cured, when they were supposed to be hopelessly dying, by the use of simple soap lather. The skin of the patient is usually dry, and the pulse feverish. In such a case take lather, made as directed in article Head, Soaping, and spread it gently all over the stomach and heart. Repeat this six or seven times, keeping the patient warm in bed. Then, after drying, do the same thing to the back. This does immense good. For the general skin stimulation, rub over with the mixture for NIGHT SWEATS (_see_). The skin is rubbed over with this five or six times, once a day. Where there is no feverishness, but rather cold feelings, then use the _warm_ lather as directed, and rub well all over afterwards with hot olive oil. This treatment alone we know to have cured many. Dysentery.--This is an affection of the bowels of the nature of diarrhoea, but much worse, as in it _blood_ accompanies the bowel discharge. It usually begins as diarrhoea, and at this stage may be cured by either warm vinegar and water or simple cold water injected into the bowel (_see_ Diarrhoea). Where there is any reason to suspect the water supply, that should be boiled for half-an-hour and cooled before use. Attention to the diet, taking for a time _milk_ diet alone, is also important. Nothing can be better than boiled bread and milk, giving no more than the sufferer feels he needs. When the diarrhoea has passed into true dysentery, with blood discharge, or the trouble begins as such, then enemas of weak acetic acid, or vinegar and water, given _warm_ (_i.e._, a little over blood heat), must be used instead of cold water. As much vinegar should be used as will make the mixture (_see_ Acetic Acid) very slightly smarting when applied to a tender part of the skin--say, to the corner of the eye. What is wanted is just as much acid as will act healingly on the injured vessels, and no more. An enema of this water mixed with acid may be repeated as long as required with perfect safety and good effect every time. Even if the disease has made very serious progress, this will tell upon it powerfully. These warm enemas should be very resolutely followed up as long as they give the least comfortable feeling. No one who has not felt their magical effect can conceive how powerful they are. We have seen a patient on the point of giving in and lying down as a helpless invalid made perfectly fit for work in less than an hour by this mode of treatment. Where the trouble has passed into that stage where the patient is much weakened, in addition to this the ARMCHAIR FOMENTATION (_see_) should be employed; or if the patient be too weak, the fomentation may be properly wrapped round him in bed without rising. If the patient be too weak for wrapping round the body, he may be first wrapped round the legs, and so strengthened as to stand the stronger remedy. Olive oil must be rubbed on the skin before and after fomenting. The heat may be kept up for an hour. If too weak to stand even this, the feet and legs may be first fomented, and afterwards the body. This treatment has saved many cases from disaster. _See also_ British Cholera; Diarrhoea. Dyspepsia.--_See_ Indigestion. Earache.--In the common form this is purely neuralgic. The nerves are in shape and distribution like some tender plant, the root in the brain or spinal cord, and the ends of the branches in the organs supplied by them with nerve power. They are best affected, and most easily cured, by applications to the root rather than the branch ends. This is greatly the case with earache, which is a trouble of the nerves of the ear--not those of hearing, but the ordinary nerves supplying the part. The remedy is to press cold cloths on the _back of the head and neck_. This will often give instant relief. It is best done when the patient is thoroughly warm. If he be cold and clammy in feeling, the feet and legs must be well fomented before applying the cooling. Rub all parts treated with warm olive oil when the treatment is finished. Ears, Running.--In this trouble there is indicated a failure somewhere of the clearance of waste from the body. This matter gathers locally in the ear, where suppuration and discharge take place. A cure must not be directed to the ear alone, but first the general waste-removing system should be stimulated with special reference to its service in the ear. Rubbing the back with hot olive oil and gentle pressure for a long time, say forty minutes daily, will go further to cure the ears than anything which can be done to themselves. Gatherings, by this treatment, are often quickly dissolved and dispersed. Where actual waste matter runs out of the ear, the treatment is to have a round camel's-hair brush and soak the interior of the ear, using the brush, with warm weak vinegar, or weak acetic acid, just sour to the taste; then brush with a little fine almond oil, and wipe very gently as dry as possible. Another way is to syringe the ears very gently with this dilute acetic acid; do not force the acid strongly against the internal parts of the ear, but rather let it soak in. It may be continued as long as is felt agreeable. Do this twice a day; have also a good warm bran poultice placed at the back of the head and neck for an hour each day, oiling the skin before and after. This is best done at bedtime. If this treatment be pursued carefully, the ears should soon come right. Ears, Singing in the.--Partial deafness is often accompanied by noises in the ear, which are very annoying. This is caused by the internal state of the ear, and is often due especially to the state of the aural nerve. Similar noises are heard also when we place our fingers in our ears, or when we hold a shell or hollow vessel against one of them. In the latter case, what we hear is the rush of blood in the vessels of the ear. In this way, singing in the ears often arises in the course of the treatment recommended in the last article for running ears. If it become too loud, a cessation of the heating at the back of the head, and a brief cooling application, will relieve it. Therefore, in such cases, it is well to use COOLING IN HEATING (_see_). Eczema.--Skin eruptions, known under this name, have very various causes. Treatment must vary accordingly. Where the cause is a failure of the skin to act properly, the _whole_ skin of the body, especially the chest and back, will be dry and hard. In this case apply SOAPY BLANKETS (_see_). If the soapy blanket be too severe on the patient, then apply general lathering with M'Clinton's Soap. Use a badger's-hair shaving brush, and have the lather like whipped cream with _no free water_ along with it. We have known a few of these applications cure a case of long standing. Where general debility is present, along with the disease, use all means to increase the patient's vitality. Simple diet is best (_see_ Diet, Saltcoats' Biscuits, Barley, Assimilation, Digestion), and abundance of fresh air, within and without the house, by night and by day. Where the disease results from a parasite, some ointment should be used, and is best applied under the immediate direction of a specialist in Diseases of the Skin. Elbow Joint.--See Armpit Swelling and Bone. Enemas, Cold Water.--Prejudice often exists against _cold_ treatment of any kind, but it must be overcome, unless the sick would lose some of the most precious means of relief which we possess. The Enema Syringe, or Fountain Enema, may be had from any druggist, and is used to inject liquid into the lower bowel. To inject _cold water_ by this means is a most efficient method of relief for internal heat and irritation, as well as for DIARRHOEA (_see_). Sick headaches are also often instantly cured by this means. What we are here concerned with, however, is to say that this remedy is as _safe_ as it is simple, so long as discomfort is not felt by the patient. Cold enemas may be given repeatedly, where they are felt to be comforting, without any danger whatever. If the bowels move after the first application, there is no need to be alarmed. Repeat the cold injection, and the diarrhoea will cease. The _cold_ enema does not produce or aggravate constipation; on the contrary, it often relieves and cures the sluggish bowels. In cases where medicine has to be almost constantly taken, its use, and the disuse of the drugs, will often effect a complete cure. In many instances in which outward cooling cannot be borne, the thermometer will indicate that there is excessive internal heat, and the pulse will be quick also. In such cases it will be possible to give the most delightful relief by cautiously applied internal cold. Fever that might be relieved by cold packing and sponging with vinegar, or some such means, will be far more speedily reduced by these cold injections, and fever which cannot be reduced by these means alone will give way when this is added. There are cases in which a sort of paralysis of the lower bowel renders what is called "opening medicine" constantly necessary. The consequence of these continued doses is to produce greater and greater paralysis, and ultimately death itself; in these cases the cold enema is of great value. If there is lack of power in the bowel, it is well to increase it by a warm bran poultice, or hot bag on the back, and to brace the vessels and muscles within with the cold enema. (_See_ Constipation.) Epidemics.--The key to action in case of epidemics prevailing in the district is found, when we consider that always, many residing amid infection escape it. They do so in virtue of better resisting power, rather than because no seeds of disease ever reach them. In case of epidemic, then, besides daily sponging with acetic acid or vinegar, and _scrupulous cleanliness_, everything should be done to increase health and vitality in the household. Plenty of fresh air and sunlight, open windows day and night, and good plain food, are most powerful aids to resisting disease. The milk and water used in the household should all be boiled and _allowed to cool_ before use, the boiling lasting half-an-hour. The family where all this is done may expect to escape infection, and therefore may maintain that calmness and freedom from fear which is itself a very important help against it. Epilepsy.--The first sign of such an illness is a brief and slight attack of "absence." We notice once or twice that the person "loses himself" for a few moments, but recovers so speedily that we scarcely are sure whether anything of importance has occurred. He is perfectly unaware that he has so "lost himself" or been "absent" at all. That part of the brain on the activity of which consciousness depends has been for the moment inactive. There is another symptom--that is, the "falling" which gives one of its titles to this malady. It is called "the falling sickness." There is a peculiarity in the falling of one who is affected in this way. In some cases consciousness partially remains, but the balancing power of the brain is lost. A patient in this case sees the ground rise till it strikes him violently on the forehead. We remember a friend telling us that he was walking along a railway, when all at once the rail seemed to rise and strike him in the face: he had fallen on the rail, and seriously wounded himself. The same thing occurs to the person who has taken enough alcohol to deprive him for the time of brain action for the usual balancing of his body. Just as there is a certain part of the brain which gives men consciousness, so is there a part which gives muscular control, such as we use in balancing the body, and there is a stream of vital action flowing from the nerve sources by which both are supplied. If this stream is diverted from these organs, "absence" and "falling" are the natural and necessary result. There are many cases in which there are only "absence" and "falling," but in others, symptoms much more alarming appear. The next of these which we notice introduces us to a totally distinct element in our explanation. It is found in the "screaming" that follows instantly on unconsciousness, and precedes the "falling" generally. The sufferer is entirely unaware of all that occurs with him, and screams by no voluntary act on his part. The symptom is purely bodily, and expresses no thought or feeling, good or bad, though it is similar to the scream of terror, and makes the same impression on the uninformed hearer. The muscles are used in the scream of epilepsy, just as the muscles of ordinary movement are used in St. Vitus' Dance, but there is nothing of the mind whatever in the movement. The organ of the mind is unsupplied with vital action, but the organs of voice are over-supplied. It is beyond doubt this over-supply which shows itself in the scream, for there is nothing else to account for it. The same thing is true of the movements of the jaw that are so terribly strong, and so sorely wound the tongue, in the case of those suffering in this way. The jaws open and shut with great force, and without the mind regulating their movement. All the motor nerves are convulsed with strong action, and the muscles they supply are wrought to the utmost, while all consciousness and control are entirely suspended. There is such an overwhelming supply of activity to the mere muscular system that the sources of that supply are soon exhausted, and the motion ceases for a time. Consciousness does not at once return fully, but the convulsions cease, and something like a sleep follows before the brain has its needed supply. How is it that vital action seizes these mere motor nerves and leaves the brain? There is a symptom in cases of epilepsy which tends to throw some light on this question. It is seen in the extreme activity of the brain, indicated by the incessant talking of the patient before a series of convulsions come on, when taken along with the extreme depression and silence that follow such a series. During whole nights, even, the sufferer will talk, till every organ is exhausted; then comes a series of violent convulsions, then a season of perfect silence and bewilderment. This explanation of the disease points to the remedy. That which will nurse the brain, and at the same time lessen nervous force in the system, will tend to cure the evil. Strong fomentations round the lower part of the body may be used. Soap in fine LATHER (_see_) should be made to cover the skin at bedtime, and washed off with weak ACETIC ACID (_see_) in the morning. Easily digested food should be taken, and all so-called stimulants strictly avoided. We should endeavour to secure the soothing of the spinal system of nerves. This is done in a degree that is incredible to those who have not actually witnessed it by a persevering use of the cold treatment of the back. The best time is early in the morning, after the patient has had a good night's sleep. For a whole hour spinal treatment should then be used. We have no faith in any royal road to success in such a cure, but we have faith in common sense and right good work. Taking three towels, and putting two of them in cold water, the "operator" is ready to begin. It will be well first to rub the patient's back gently with a little warm olive oil. This will obviate all danger of shock or shiver when the cold cloth is placed on the skin. Then wring out one of the cold towels thoroughly, so as to have it damp and not dripping; fold it lengthways eight ply. Put the one over the other, place both on the centre of the patient's back as he is sitting up in bed to receive them, keeping the damp towel next the skin. Adjust these cloths nicely, make the patient lie down upon them, and cover him snugly up with the bedclothes. So long as the feeling is nice, let well alone. When the towel becomes hot, wring out the second, and change it on the back. Carry this out for a full hour, and if the patient is disposed to go to sleep again, encourage him to do so. Continued for weeks every morning this humble treatment, without any addition, has an incredibly soothing effect on an excitable system. But it will be well to add to it some nursing of the head and feet, so that every encouragement may be given to a diffusion of nerve action over the body. At night, before going to bed, the feet and legs should be bathed in hot water for a quarter of an hour, dried, rubbed gently with warm olive oil, and a pair of soft cotton stockings drawn on. While the patient is being treated, every possible wearing and irritation of the brain must be avoided, and when lying on the cold towel, the head should be soothingly rubbed by a gentle hand. If an actual violent attack comes on, loose all tight clothes, place a piece of cork between the patient's teeth to prevent biting the tongue, give plenty of fresh air, and keep the patient in a recumbent position. Everything should be done, by training, to increase the patient's self-control, and all stimulants should be avoided as most injurious. _See_ Head, Rubbing the. It is important that those liable to these attacks should be kept employed. Nothing is so harmful as idleness. Everything tending to good health is of value, but the essentials of the treatment are found in soothing the spine as above, and stimulating the brain by the head rubbing. Unless in cases in which the very structure of the system has been, so to speak, altered by long-continued disease of this sort, we should look for good results from such treatment as this. Even in the worst cases it would be possible to mitigate the severity of the distress. A difference in the focus of the eyes often causes a strain on the brain in the effort to adjust them. This sometimes causes epilepsy, and we have known many cases cured by the use of spectacles made to correct this inequality. In all cases of this disease, therefore, an optician should be consulted, to see if there is any defect in the eyes. Other illnesses are sometimes mistaken for epilepsy: for example, the liver and kidneys in a defective state and impurities passing in the blood to the brain, will explain certain forms of that which passes as epilepsy. It is often easy to cure attacks of this nature by merely bringing the liver and kidneys into working order. If there is a yellowness of the skin, or other signs of the blood failing to be purified in a natural way, then that should first be dealt with, and the fits will often be removed as soon as good action is established in the purifying organs. But in all cases in which there is anything like real "fits," it will be found of great importance to study the over-and-under-actions of the nerve system as by far the most essential elements in the disease. _See_ Jaundice. Eruptions.--_See_ Hives; "Outstrikes;" Saltrome, etc. Erysipelas.--This troublesome disease is also known as St. Anthony's Fire, or the Rose. The skin becomes fiery red or even purplish in hue. A violent heat and pain in the part accompany this, and fever and general disturbance of the system follow in a severe case. Swelling of the parts follows, with much distress and danger. _Air_ irritates violently the sore parts, and is usually excluded. In curing the trouble, regard must be had to the cause, which is usually a general failure of strength from overwork, worry, or some other disease. If a cure is to be effected, _rest_ of mind and body is necessary, and must be secured at any possible cost. For local application, the sore parts are thickly dusted with fine fresh flour, and covered with soft wadding or surgeon's lint. The air is excluded, and all is kept _strictly dry_. A waterproof covering over the lint will help this, but is not absolutely necessary. But, now, is there nothing that can be done to quicken that inner action, the slowness of which has paved the way for all this mischief? This might be done in two ways. After the affected parts, say the face, have been secured in this pack of flour, it will be easy to place a hot blanket, soaked partly, but not at all _wet_, with boiling water, all round the head of the patient. As soon as the heat begins to enter the head, a sense of comfort will be experienced. Care must be taken to keep the _inner cloths dry_, and heat is best given by an india-rubber bag. When this cannot be had, however, the blanket may be used. At intervals, as the patient feels it desirable, this fomentation may be renewed. It will hasten recovery as well as arrest the spreading of the malady, while it will secure such recovery as will not readily dispose to a return of the evil. The feet and legs are likely to be cold. As the sufferer lies still in bed, but not when the other fomentation is on, these should be wrapped in a hot fomentation, allowed to lie in it for a good half-hour, taken out of it and dried, rubbed with warm olive oil, and covered with a pair of soft cotton stockings. If this treatment is at all well carried out, the feeling of comfort given will soon tell how it is working. Of course, if the feet and legs are the parts affected, the fomentation must be applied elsewhere, say on the back, or on the haunches. Where erysipelas appears in connection with wounds or sores, the same treatment is to be pursued, as far as possible consistent with dressing the sores. These should be carefully cleansed, dusted with boric acid, and covered with a layer of wadding bandage. The limb should be raised to a horizontal position. Simple food should be given, and the sufferer kept quiet. In all cases of skin trouble, linen should be worn next the skin. _See_ Underwear. Exercise.--Where this is advised medically, it is often taken in a manner far from wise. For weakly people seeking strength, exercise should never be pursued to the extent of fatigue. Up to a certain point it does good; beyond that, harm. The beginning of harm is indicated by the feeling of weariness. At the same time it must be remembered that what is felt as weariness may be merely laziness. This must be energetically combated. There is no royal road to health any more than to learning. In some cases this disinclination for exercise may arise from too much or too rich food, and a more sparing diet may remove it. _See_ Appendix; Physical Culture. When even walking is out of the question, a kind of exercise may be given by gently massaging the limbs while the patient is in bed. The back muscles should also be gently rubbed and kneaded, so as to cause them to move under the skin, without effort on the patient's part. But no fatigue must be caused. The amount may be gradually increased as the patient can stand it. _See_ Brain Exercise; Massage. Exhaustion.--Often very serious trouble takes the form of simple overwhelming weariness. The patient's system has been wrought down till it can no longer respond even to stimulus, and life itself seems ebbing away. In such cases treat as for DEPRESSION (_see_) avoiding too energetic treatment, and gradually infusing new life by massage and fomenting. Expectoration.--What is commonly called a "cough and spit" is sometimes due to some serious trouble of the lungs, and in all cases a doctor should be consulted at once. Often, however, it is due to the failure of the skin or other organs duly to carry off the waste of the body, which then accumulates in the air tubes. If we get a good revivifying treatment of the skin, such cough and spit will speedily be cured. A mild vapour bath, with thorough SOAPING (_see_ Soap) will usually be sufficient in a slight case. Sometimes there is a sweating of the skin itself which does not cure expectoration, but which must itself be cured. That is the night or early morning sweating, which is very reducing. It is the insensible perspiration which is needed to remove the spit. Give one good sponging over the body with acetic acid; follow this the evening after with cayenne "tea," afterwards rubbing with warm olive oil. For two or three evenings repeat this treatment. There should then be a loosening of the phlegm, and a lessening of the flow through the lungs. The sufferer may be very weak, and yet these things may be so gently and kindly done, that no fatigue is experienced. If above treatment does not cure, the SOAPY BLANKET (_see_) may be used once a week, with daily sponging with vinegar or weak acetic acid, and rubbing with warm olive oil. This should cure in a few weeks, where there is no real disease. Eyes, Accidents to.--Three distinct classes of these are to be considered. They require very different treatment. When the eyeball is cut or pierced, if the cut be deep or large, a surgeon must deal with it. But if small, a drop or two of castor oil let fall into the eye will often be all that is required. Where inflammation comes on, the tepid pouring recommended below for bad eyes will greatly help. If more severe, the treatment for inflamed eyes may be given. _Perfect rest_ and _thorough exclusion of light_ are very important. If the eye is bruised, bathe with warm water, to which a little vinegar or boracic acid has been added. If after bathing, pain continues, drop in castor oil, and on the outside of the eyelid lay a pad dipped in a mixture of equal parts of laudanum and water. Change this cloth frequently until the pain is relieved. Treat in this way also for insects stinging the eye. When the eye is burned, either by sparks or by some burning chemical substance, cold cloths should be persistently applied to the eye. The softest rags or surgeon's lint should be cut up into small pieces that will just cover the eye. Dip these in the coldest water, and press it out a little, so that it will not run off. Place these little bits of wet cloth one after another on the eye or eyes affected. The patient will not be able to endure pressure further than the weight of the cloths themselves. These can be taken off and changed for cold ones as the feeling of the sufferer directs. After a time the cooling will be felt to have gone far enough, and the cloths may be allowed to lie; when they get too warm they can be taken off, or if the heat and pain return they can be renewed. While this treatment is going on it will be necessary to open the eyelids at intervals, so as to let off the tears that collect in such cases and cause great distress. These will flow out when in the most gentle way you have laid one thumb on the upper eyebrow, and the other just below the lower eyelid, so that you can draw the lids just slightly open. Eyes, Cataract on.--This disease has been arrested, and in earlier stages even cured, by the treatment described in, Eyes, failing sight. By means of this treatment we have seen a totally blind eye restored in a few weeks. Eyes, Danger to Sight of.--Where inflammation has gone so far as to lead to suppuration, or even to ulceration of the eyes, there is grave danger of blindness, and this is often the case with infants and children who have been wrongly treated or neglected. In such a case, cease at once all irritating and painful treatment and drugs. First, wash the eyes by gently dropping over them distilled water, or boiled rain water which has been cooled. The water should be used about blood heat. After an hour or so, have another warm bathing by means of gentle pouring over the eyes, but do not rub the eyelids. Let there be no friction beyond that of the soft and warm water running over the face in the bathing. Rather have patience till that washes all waste matter away than run any risk of irritating the eyeball. All this time watch what the sufferer evidently likes, and follow his likings--that is, as to warmer or colder water, and so on. It will not be very long before you have thoroughly cleaned the eyes, while at the same time you have infused fresh life into them. To the water used a little vinegar or acetic acid should next be added, or Condy's fluid may be used when it is convenient. But care must be taken that no great smarting is caused. _See_ Acetic Acid. As the discharge from ulcerated eyes is very infectious, care should be taken not to communicate it to other persons' eyes. Strict cleanliness should be observed, and all rags employed should be burnt, and disinfectants used to cleanse the patient's and nurse's hands, etc. Towels should be boiled for half-an-hour before being washed, after they have been used in such a case. Now a most important matter must be attended to. Castor oil is the most soothing that can be used with the eyes. Fresh olive oil comes next, but it is usually just as easy to get the one as the other. With a feather, or fine camel's-hair brush, and as gently as possible, cover the eyelids with this oil heated to about blood heat. Do not try to force it on the eyeballs, but if the lids open so much as to let it in, allow it to lubricate the eyeball also. Rub it gently over the eyebrows and all round the eyes, and dry it gently off. Cover the eyes then with a soft covering, and let them have perfect rest. It sometimes happens that a tiny piece of dust or iron may stick in the surface of the eye, and refuse to be washed away by the tears. Take a square inch of writing paper, curve one of the sides of it, and draw it lightly and quickly over the spot. Never use any sharp instrument or pin. Repeat the operation a few times if unsuccessful. Diet as recommended in article Eyes, Hazy Sight. Eyes, Failing Sight.--This often comes as the result simply of an over-wearied body and mind, without any pain or accident whatever. It appears as an inability to see small distant objects, or to see at all in dusky twilight. The sight is also variable--good when the patient is not wearied, and bad when he is tired. When this comes on under thirty years of age, the eyes have almost certainly been overworked, and need rest. Rest from all reading and other work trying for the eyes is the best cure. If this can be had, it should be taken, with much outdoor exercise. Fresh air is a fine tonic for the eyes. Where total rest cannot be had, take as much as possible, and nurse the failing nerves as follows. Apply the bran poultice, as directed for inflamed eyes, just as long as it is felt to be comforting--with one patient it will be longer, with another shorter. Now there is a cooling of the brow and of the eyes themselves, which is as important almost as the heating of the back of the head. We always find, as a matter of fact, that a cold application opposed to a hot one produces a vastly better result that two hot ones opposed, or one hot one by itself alone. So we find in the case of the eyes. We have now, as we write these lines, eyes under our care that are mending every day by means of a bran poultice at the back of the head and neck, and a cold cloth changed on the brow and eyes. They do not mend anything like so well if heat alone is used. Rub the back of the head and neck with hot olive oil before and after poulticing, and dry well. Do this for an hour at a time, _twice_, or if possible _three times_, a day. Continue for a fortnight, cease treatment for a week, and again treat for another fortnight. This should make such improvement as to encourage to further perseverance with the cure. Sometimes failing sight follows neuralgia. In this case the rubbing described in Eyes, Squinting, given twice a day for fifteen or twenty minutes each day, will be useful in addition to above treatment. Even in cases in which "cataract" is fully formed, we find that the disease is arrested, and the patient at least gets no worse. But where this malady is only threatened the haze soon passes away. We most earnestly wish and pray that this simple treatment should be as widely known as there are failing eyes in this world of trial. Eyes, Hazy Sight.--Frequently, after inflammation, and even when that has ceased, the sight is left in a hazy condition. The eyes may be in such cases rather cold than hot, and not amenable to the cooling applications. The whole system also lacks vital action. First, in such a case, wash the back thoroughly all over at night with hot water and SOAP (_see_). Dry well and rub hot olive oil into the skin until dry. In the morning rub the back for a few minutes with vinegar or weak ACETIC ACID (_see_) before getting out of bed, dry, and rub with warm olive oil. A strip of new flannel should be sewn on the underclothing, so as to cover the whole back. The feet and legs should be bathed (_see_ Bathing Feet) twice a week. All alcoholic drinks, and most drugs, should be avoided, while only such food should be taken as can be converted into good blood. Half a teacupful of _distilled_ water should be taken before each meal. The whole of this diet tends to produce healthy blood, which is the great means of dissolving all haziness in the lenses and humours of the eyes. Every drop of alcohol does so much to reduce that action. We have heard this beautifully described by one of the foremost of living medical men. He began by stating, what no one can doubt, that a certain quantity of alcohol taken by the strongest man will kill that man as effectually as if he were shot through the head with a rifle bullet. Now a certain portion of alcohol takes a man's sight entirely away. Half that quantity will only render his vision "double"--that is, unfit him to see objects as they really are. Half that again will only perceptibly impair the power of the eyes; but the action of the smallest particle of the substance is the same in nature as that of the largest quantity. Hence that action is to reduce the very efficiency of the nerves of the eye, which it is of such immense importance to nurse to the uttermost. No mere dictum, however strongly expressed, can hold for a moment against this transparent reason. Hence, if a person must take alcoholic liquor, the cure of inflammation in his eyes, and of the thickening of the transparent portions of these organs, is simply out of the question unless the disease is comparatively slight, and his nervous constitution strong. The very same reason holds good of tobacco. So of opium. So of every other narcotic, whatever it may be called. Hundreds of men lose their eyesight by the use of tobacco alone. We have seen their eyeballs gradually becoming sightless when no change could be detected in their eyes--only the optic nerve gradually lost its sensibility till they were entirely blind. We are perfectly aware that there are those who will scout the idea of such an effect, and prescribe these very narcotics largely in such cases; it is because such drugs are used and ordered that we are compelled thus to reason about them. In all cases of failing eyesight they should be carefully avoided. So should all foods which are not easily converted into healthful blood. Eyes, Healthy.--Cheap, ill-printed literature is responsible for much eye trouble, and it is well worth while to pay, if possible, a little extra for books well printed, especially in the case of those who read much. When reading sit erect, with the back to the light, so that it falls over the shoulder. Too fine work, dim light, wrong diet, and want of exercise produce the dull and strained eye, which eventually becomes seriously diseased. Opening the eyes under cold water will help to strengthen them, and massaging the muscles of the eye by passing the finger and thumb round the socket (with scarcely any pressure on the ball itself) will be found of advantage. Eyes, Inflamed.--For all kinds of burning inflammatory pain in the eyes, the following treatment is most effective. Place a hot BRAN POULTICE (_see_) beneath the back of the head and neck while the patient lies on the back. Press gently fresh cool damp cloths, frequently changed, all over the eyeballs and sockets, so as to draw out the heat. No one who has not seen this done can imagine how powerful a remedy it is. It may also be necessary, if the feet be cold, to foment up to the knees. This last fomentation is best done at bedtime, and the feet and legs should be rubbed with olive oil, and a pair of cotton stockings put on to sleep in, to keep the feet comfortable. If the eyes are very sensitive the treatment should go on in dim light, as may be felt necessary. The poultice and cold cloths may be used for an hour twice a day. In bad cases, where sight has been seriously affected, a good rubbing of all the skin of the head with the finger tips may be given before the poultice is applied. This rubbing must not be a trial to the patient, but gently done, with kindly good will, and it must be pursued for fifteen or twenty minutes, until the whole head is in a warm glow. Eyes, Inflamed, with General Eruptions over the Body.--In some cases the eye trouble is only a part of a general skin inflammation, accompanied with heat all over the body, and an acrid, irritating discharge from eruptions on the face and elsewhere, especially on the head. The cold cloths and poultice will not work in such a case. The chief agent in the cure is fine soap lather (_see_ Head, Soaping). Let the head be shampooed with it for half-an-hour. The whole body should then be lathered and shampooed for a short time in a warm bath; this is best done at bedtime. Much water is not needed; warm soapy lather, well rubbed all over, is what is required. Ordinary soap will make the skin worse; only M'Clinton's will do to soothe and heal it (_see_ Soap). If white specks show on the eyes, the treatment in article on Eyes, Danger to Sight of, will cure these. When this complaint is obstinate and refuses to heal, medical advice should be sought, as blood poisoning is probably present. Eyes, Paralysis of.--The partial paralysis of the muscles of one eye produces double vision, so that the patient sees two similar objects where there is only one. This double vision is often, however, the result of stomach derangement. If so, it may soon pass away. The true paralysis is more persistent. To cure this, rub the entire skin of the head gently and steadily with the hands and finger-tips (stroking always _upwards_) for some fifteen minutes. Then apply cold cloths to the eyes as already directed. If the cold cloths are uncomfortable, hot ones should be tried. Do this for fifteen minutes also. Continue alternately for an hour twice or three times a day. We have known one such day's treatment remove the double vision _entirely_, and no relapse occur, but in most cases the treatment must be persevered in and returned to until the paralysis is overcome. Eyes, Spots on.--These spots are of two different kinds, and yet they are very much the same in nature and substance. What is called "a cataract" is of a different character. We refer not to this, but to the spots that form on the surface of the eyeball, and those that form in the membrane of the eyelid. When inflammation has gone on for some time on the eyeball itself, portions of whitish matter form on the glassy surface and soon interfere with the sight. When inflammation has gone on in the eyelid, little knots like pin-heads form, producing a feeling as if sand were in the eye. Afterwards these knots grow large and swell the eyelid, and at times the matter in them grows hard, and seems to take up a lasting abode in that tissue. Strong and destructive liquids or powders are sometimes applied, that so affect the whole substance of the eye as to cause blindness. Nothing of this nature is required at all. First, the skin of the head must be dealt with. You will find that this is hot and dry, and somewhat hard on the skull. Rub this gently with the dry hands for a few minutes, then press a cloth tightly wrung out of cold water all round the head. Rub and cool alternately for half-an-hour or more if it continues to produce an agreeable feeling. When the head is all soothed, and good action has been secured, at least on its surface, begin with the eye itself. The same treatment is required for both classes of cases. The eye will be shut at first. You take a fine camel's-hair brush, such as is used by artists, and some vinegar or acetic acid, so weak that you can swallow a portion of it without hurting your throat. This is a very good test of strength for the acid. You carefully brush over the outside of the eyelids and all round the eye with this weak acid. This must be done most carefully and patiently for a length of time, till all sweatiness is washed off, and a fine warm feeling is produced by the acid. The matter softens and breaks up, so that it begins to pass away. We have seen a little ball of hard white matter break up and come away after a single brushing carefully done. When the matter is in the eyelid, and is so situated that you can brush over it in the inside of the lid, it is well to do so; but this operation must be gently and carefully done. When you have brushed with the acid long enough, dry the eyelids and cheek carefully, and rub with a little fresh olive or almond oil. It will be well to cover the eye from the cold, and from any dust that might irritate. You will soon find that it is as clear and sound as could be wished. Eyes, Squinting.--Various affections of the eyeball muscles cause this. To cure it is often easy, sometimes very difficult. The method of treatment is to stimulate all the nerves of the head and face, and at the same time to soothe their irritation. This is accomplished by massaging the brow and entire head. It must be gently and soothingly done. The open hands are drawn upwards over the brow from the eyebrows, the rubber standing behind the patient. Then both sides of the head and the back of the head are stroked similarly. After this the whole head is rubbed briskly with the finger-points. This should be done often, even four or five times in the day. If the patient objects, it is being unskilfully done; the right sort of rubbing is always pleasant. A squinting eye has been cured in a few rubbings, where the case was a simple one. If the head becomes very hot, it may be cooled as directed above for Children's Sleep. Squinting may be produced or increased by that state of the stomach and bowels in which worms are bred. Face, Skin of.--To secure a healthy appearance of this is worth much trouble, and any eruption or unhealthy redness is a great trial, especially to ladies. To cure and prevent these, it is usually necessary to look first to the _diet_. A disagreeable redness of the nose, and pimples in various places, is the common result of too much rich food, not to speak of alcoholic drink, which is always most injurious to the face skin. The use of corsets is another fertile source of this trouble, and many in their desire to improve their figure ruin their faces. Plain, easily digested food is to be taken. Tea must only be used _at most_ twice in the day, and should be exceedingly weak. Half-a-teacupful of hot water should be taken before every meal, and everything possible done to promote digestion. The whole skin must be brought into a healthy state by daily washing with M'Clinton's soap (_see_ Soap); no other should be used for toilet purposes. It is far better than the boasted and expensive "complexion soaps," and can now be had in various forms. Many faces are injured by the kind of soap used in washing. The use of the kind we recommend is remarkably pleasant and beneficial, and a full account of it, and of our motives in recommending it, will be found under article Soap. If, however, the face will not stand the touch of water at all, good BUTTERMILK (_see_) forms the best wash and cooling application. Also a _cloth mask_ may be worn all night, lined inside with soft creamy soap lather. In violent face irritation this last treatment is especially valuable. For pimples on the face, the general treatment for the skin mentioned above (_see_ Eyes, Inflamed) is to be used, especially applied to the skin of the back. The buttermilk wash may also be used, but the best effect comes from the general treatment of the skin. Fainting.--Fatigue, excessive heat, fright, loss of blood, hunger, etc., are common causes. The action of the heart is temporarily interfered with, and pallor, a sweat on the forehead, with an indescribable feeling of sinking away, precede unconsciousness. The first thing to do is to bend down the patient's head till it touches the knees, and keep it there for a few minutes. After he has partially recovered consciousness, the clothing should be loosened, and all tight bands or braces removed. The face and hands should be bathed in cold water, slapping the face with a wet towel. Some stimulant, such as hot tea, coffee, or sal volatile, may then be given. If there is a wound causing loss of blood, it should be attended to at once. In case fainting is due to hunger, the greatest care should be taken to give only small quantities of food after recovery, as a large amount may prove fatal. A sip of cold water, or bathing the face with cold water, will generally prevent a threatened fainting. If there appears any immediate danger of a relapse, keep the patient in a horizontal position for some time. Persons liable to fainting fits should be careful to avoid extremes of temperature, such as very hot or very cold baths. Fall, A.--After a fall from a height, where there is no apparent outward injury, there is often such a severe shock to the spinal cord and brain that continued unconsciousness occurs. In such a case, foment the spine at first, to remove the effects of the concussion. This may bring on serious difficulty of breathing, owing to congestion of the spinal cord. This can be removed by applying cold cloths along the spine. If the difficulty of breathing be present from the first, then apply the cold at once. The first effect of such a fall is to deprive the brain and spinal cord of vital force. This must be restored by _heat_. Subsequent effects due to congestion can be removed by cold. The effects of a shock in a railway accident may be similarly treated. Common sense will guide in using heat or cold by watching the effect. Where heat fails try cold. This is the simple rule. It is good also to give the patient some simple purgative medicine, and some warm drink. _Avoid all doses of alcoholic drinks._ We have known the flickering flame of life almost extinguished by a teaspoonful of brandy. Feeding, Over.--It is well to remember that over-feeding is a relative term. To take more than a weak stomach can digest, is to over-feed, although very little be taken. We give some invalids food every two hours but that food is only two-thirds of a teacupful of milk, mixed with a third of boiling water. In every case we must watch to give the right amount, no less and no more. Every case will require to be considered by itself in the light of common sense. The amount of food eaten should be just sufficient to supply the body with material to replace that consumed in work, build up its wasted tissues and leave a slight surplus over for reserve store. Anything more is harmful. In youth, if too much be eaten, nature relieves herself by giving the transgressor of her laws a bilious attack, during which there is no appetite, and so the excess is worked off. In later years this safety valve does not work, and the surplus is generally stored as useless fat, impeding the action of the heart or other internal organs, or as gouty deposits in various parts. The Anglo-Saxon race at all events does not limit its diet as we think it should, and Sir Henry Thompson, M.D., has stated that in his opinion more ill-health arises from over-eating than from the use of intoxicating liquor, great a source of illness as this last undoubtedly is. Temperance in diet is absolutely necessary therefore, if one would be healthy, and the avoidance of stimulating foods, with a restriction of flesh foods especially, is a precept which the great majority of well-to-do people need to attend to. Bilious attacks, headaches, indigestion, etc., are simply nature's protest against the excess of food being forced upon her, and the natural cure is to severely restrict, or still better, entirely stop the food supply for a day or two. The idea that "the system must be kept up" is a very foolish one; people have lived for forty days and upwards on water alone, and a few days' fasting is a far safer remedy for the troubles we have mentioned than purgative drugs. Those who have a stomach which quickly rebels against too much or unsuitable food, may, as Sir Henry Thompson says, congratulate themselves on having a good janitor preventing the entrance of what would injure. The man who can and does eat anything, rarely lives to old age. The perfect appetite which comes from the moderate use of simple foods is a relish which must be experienced to be appreciated. One way in which the amount of food needed to satisfy the appetite and build up the body may be very largely reduced, is by increasing the amount of mastication. If each bite of food is chewed and chewed until it is all reduced to a liquid state, the amount required will be less than half of what is usually taken, and so much less strain will be thrown on the excretory organs. Feet, Cold.--Continued coldness of the feet gives rise to many more serious troubles, and should always be attended to. There is no better cure than daily BATHING THE FEET (_see_), followed by rubbing for several minutes, say five, with hot olive oil after drying. Rub briskly, until the feet glow. Put on dry warm stockings, and see that all foot-gear is kept as dry as possible. Another method of curing cold _sweaty_ feet is to rub the soles with CAYENNE "TEA" (_see_), and afterwards with warm olive oil. Dry carefully, and wear an extra pair of dry cotton socks or stockings. When the sweating is very abundant and obstinate, there is usually more or less failure in the nerves which keep the skin in order. The feet must then be properly _bathed_ (_see_ Bathing the Feet), then dried and treated with cayenne lotion as above. Feet Giving Way.--Where there is a great deal of standing to be done by any one, the feet sometimes yield more or less at the arch of the instep. This becomes flattened, and even great pain ensues; lameness sometimes follows. Young girls who have to stand much are especially liable to suffer in this way. In the first place _rest must be had_. Wise masters will provide due rest for their employees, foolish ones overwork them. Rest is not against, but in favour of work; work cannot be well done without due rest. The proper rest for feet such as we speak of will be the most easy and comfortable position. _Comfort_ is the test of the right treatment. Bathe the feet in hot water for a good while, using plenty of soap. Rub gently with hot olive oil, pressing any displaced bones into, or near, their place. Carefully avoid giving pain. Massage similarly with oil the whole limb, and also the back (_see_ Massage). Do this every day at least once. You may have months to wait, but a sound limb is worth a good deal of patience. When standing is absolutely necessary, strips of strong sticking plaster passed down from above the ankle bones, and round under the instep, help greatly. Boots are better than shoes, and should be comfortably easy, with low heels. Fever.--In all fevers, to _cool down_ the excessive heat of the patient (_see_ Heat, Internal) is the best process of treatment. This may be best done by continued cooling of the head. Have a towel well wrung out of cold water. Fold it so as to envelop the head. Press it gently to the head all round, changing the place of pressure frequently. Have a second towel ready, and continue cooling with freshly cooled towels perhaps for an hour or an hour-and-a-half. Then leave the last cold towel on, and put a dry towel above it. The next cooling, when the fever heat again arises, may be given, if it can be managed, by placing a cold towel along the spine. Cover this with a dry one, and let the patient lie on it. Change this, though not quite so frequently as in the case of the head. Work _carefully and gently_, so as not to annoy the patient. If ice can be had, it may be put in the water used to cool the cloths. If the feet be cold, foment them in a blanket (_see_ Fomentation). Keep this on the feet for an hour. There will most likely be great relief with even one course of such treatment. It must, however, be _persevered in_ until the fever be conquered. In any case of fever, when a patient is too weak to bear the hot fomentation and cold towels, we would recommend rubbing the feet and limbs if cold with hot oil, and the stomach and chest, and if possible the back with soap lather. It is well at first to soap the stomach only, and for some time; and each time till the last it is well to wipe off what you have rubbed on, so that the skin may be as clean as possible for the next. To do this only once is often quite sufficient to soothe, so that the patient falls off into a gentle, natural sleep. Now, no one need imagine that there is any difficulty in the way of anyone carrying out the right treatment. We have known a young sister who saw her brother brought home in fever. The medical man predicted a long and serious illness, and the necessity of being prepared for all the usual features of such a case. The sister heard all in thoughtful silence, but when the doctor went away she said to herself, "May not I lower this flame? At any rate I will try." So through the night she so effectually cooled her brother's head that when the medical man came next day he expressed his most agreeable disappointment, saying, "It is to be a very light case after all." So it turned out to be, but it would not have been so but for that brave sister's aid. We cannot but earnestly beseech all who have the opportunity to go and do likewise. Often, especially among the poor, dirt and hot, close air have made the fever room a source of frightful danger to all around. Absolute cleanliness, abundance of pure air, and disinfection of the stools, should always be attended to. Fever at Night.--Frequently, in illness, a fever sets in as night approaches, and increases toward midnight, passing away during the day. The treatment may be as below for Intermitting Fever. Fever, Delirium in.--_See_ Delirium. Fever, Gastric.--In this fever, now known as a form of Typhoid, the disease spreads a sort of blight over the nervous centres, and from the first greatly lowers their power. The patient is too weak to bear the powerful cooling recommended in Fever; there is also a tendency to prolonged and "low" fever. First of all, in such a case, the feet and legs must be fomented. Watch against burning the patient, but get as good and powerful a heat as possible right up over the knees. Then after about fifteen minutes the cooling of the head may proceed as in fever. Both cooling and heating must proceed together. We must think of not merely relieving, but of curing the patient, by attacking the poisonous substance where it has lodged in the nerve centres of the bowels. Pure water, with just as much acetic acid or vinegar dropped into it as will make it taste the least sour, should be given in tablespoonfuls (and hot) as frequently as the patient can take it without discomfort. If possible it should be distilled water, or rain water filtered, but certainly as pure and soft as can be procured. There is no drug that can be prescribed that is equal to pure water, and no acid better than common white vinegar. These three things--the strong fomentation of the feet and legs, the cooling of the head, and the dissolution of the poisonous substances by means of pure water, and their counteraction by means of acid in very small strength--will do wonders in gastric fever. The "turn" may be secured in a week instead of three, if these things are skilfully and persistently applied. We should say that the strong fomentation and cooling of the head should not be done oftener than twice a day, and only once if the patient feels too weak for twice. But as a general rule, the person who is ill will wish these things at least twice a day. The sips of water should be given, say in a dozen separate tablespoonfuls at a time, at least thrice a day--oftener if desired by the patient. For food there is nothing equal to good fresh buttermilk. All alcoholic drinks are damaging in a high degree in such an illness as this. Sweet milk, if somewhat diluted with good water, will do, but there is nothing so good as the buttermilk fresh from the churn. Absolute rest in bed is necessary, and no solid food should be given to the patient until his temperature has been ten days at normal point. All food given in the illness should be liquid enough to pass through the meshes of a milk strainer. Care should be taken in this matter, as death has often followed the taking of solid food, when otherwise recovery would have come. Milk should always form the largest portion of the diet, and may be given with arrowroot or oatflour. Beef tea is of little use, and is always to be avoided if there is a tendency to diarrhoea. Plenty of cold water may always be given. In a community which is visited by gastric fever as an epidemic this fact is striking--only a portion of the people are affected by the visitation. Here is one man who drinks the water which gives gastric fever to another; that water goes into his stomach as it does into that of his neighbour, and passes through his system the same, yet death is the result in one case, and not even sickness or inconvenience in the other. In the latter case the system has the power of resistance, and our aim should be to increase this. Therefore we say by all means look to the healthful state of the lungs and bowels when you have the least reason to fear that bad water may bring gastric fever to you or yours. If there is any tendency to constipation get some liquorice, and boil it thoroughly with about half an ounce of senna leaves to a twopenny stick. Strain well, and let all in any danger have a teaspoonful of this thrice a day. It will do wonders in keeping matters in a good state within. If possible, give a good rubbing all over once a week with hot vinegar, and follow that up with warm olive oil. That will do a great deal to keep things right outside. Take and give more rest than usual to the toil-worn when such danger is near, and have as good food provided for all as is possible. There may be danger in the air, and still worse danger in the water to those whose vital force has got low, while there is none in either to those whose systems are in good tune. You are, perhaps, ready to ask if we care nothing about bad water? Certainly; we care a great deal about it, as we do about bad air. By all means condemn wells and streams that are corrupted, and insist on the opening of better ones. Make it a first condition of having anything to do with a place for habitation that it has good air and good water. We are only pointing out the best safeguard when neither the one nor the other can be insured. In all cases where water is suspected, it should be boiled before use. There is, in great numbers of persons, both old and young, what may be called the natural aptitude of healing. They are kept back from trying to help because it is regarded as so dangerous a thing to go near fever, and also to interfere where only professional skill is legally allowed. To apply such a remedy as that which we have here sketched for gastric fever is perfectly safe in both senses. No medical man worthy of being regarded will find any fault with it, and there is no danger to either the patient or the person applying it. The mode we have pointed out involves nothing that may not be easily had by the very poorest. What is wanted is only one or two who shall be Christian enough to care just a little for human bodies as well as human souls, and who shall study such simple and accessible remedies, and be ready to guide their fellow-creatures in a time of trouble. Fever, Hay.--_See_ Hay Fever. Fever, Influenza.--This is a slow, smouldering kind of fever. For treatment, pack the feet and legs in hot fomentation over the knees, and apply cold cloths over the stomach and heart, taking care in applying the cold if the patient is weak. In such a case only moderately cool cloths should be used. Carry out these two processes effectively, and a cure should soon result. Give light food--milk and water, and milk diet generally. Give small quantities frequently rather than a good deal at once. Fever, Intermitting.--For this the treatment may be given as in gastric fever, and, in addition, the stomach and bowels should be carefully lathered over with soap lather (_see_ Lather). This has a wonderfully soothing effect. It may be spread with the hand over the skin, and fresh supplies gently rubbed on until much of the fever is removed. Some five minutes' lathering at a time is enough--this may be done several times a-day. Carefully dry after it, and let the patient rest. It will be well to anticipate such attacks by softening the skin when it shows a tendency to be hard and dry. A gentle rubbing now and again with fine lather and good olive oil will secure this. We say lather and oil because, when there is no fever heat, lather by itself is too cooling, but when mixed with a little oil the mixture is comforting rather than chilling, and softens nicely. Fever, Rheumatic.--This results from severe damp chills, usually following exhaustion from some cause. Its best treatment at an early stage is by heat applied to the spinal nerves. If the trouble be chiefly in the legs, treat the lower back; if in the arms, treat the upper back. The heat is best applied by a large BRAN POULTICE (_see_). A teaspoonful of tincture of Guaiacum may be given before each poulticing, which may be done twice a day for an hour. We have known an illness that threatened to last six weeks cured in one week by this means. Give also teaspoonfuls of hot water from time to time. Where the trouble has advanced to severe fever, and swelling of the joints, an entirely different treatment is best. Let a lather of soap be made (_see_ Lather), and spread over the chest first, and afterwards gradually over the whole body. After four or five coats of lather have been put on, wipe off with a dry cloth, and proceed to lather again. We have seen half-an-hour of this treatment, well done, greatly relieve the fever; it was continued twice a day, and in three days the trouble was conquered. Care must be taken not to chill the patient. The soaping can be accomplished with only a small part of the body uncovered at once, and, with proper precautions, the bed can be kept perfectly dry. If a proper liniment is procured and lints sprinkled with it wrapped round the joints, the pain will be wonderfully relieved. But such liniments are only to be had on the prescription of a really good medical man, who will not, if he really seeks to heal, and knows his business, object to our treatment being applied. Sometimes, after rheumatic fever, one or more of the joints become stiff. This stiffness varies in different cases from an apparently complete solidifying of the joint to only a slight inconvenience in its use. We have seen many such joints, even very bad cases, completely cured by a proper use of _heat_ and _massage_. It is, however, no trifling matter to undertake the necessary work, and perseverance is an absolute requisite. Even very obstinate stiffening will _in time_ be overcome by frequent and strong fomentation, followed by rubbing with olive oil in such a way as to squeeze gently all the muscles and sinews of the limb, and move them under the skin. This should be followed by _gentle_ bending of the joint, back and forward as far as it will go _without pain_. It may need to be done twice a day for many weeks, yet the result is worth even more trouble, when you literally make the "lame to walk" (_see_ Rheumatism). Fever, Scarlet, or Scarlatina.--As a first precaution, when an epidemic of this exists, children should be sponged twice a week all over with hot vinegar before being put to bed. This is a powerful preventive. If anything like sore throat appears, bathe the child's feet in hot water until a free perspiration is produced. Dry well, _under a blanket_, and rub all over with hot vinegar, then put the patient to bed. If in the morning there is no evident fever, repeat the sponging with hot vinegar, dry well, rub with hot olive oil, and dry again. If the fever definitely develops, place the child in a light airy room, from which all unnecessary carpets, curtains and furniture have been removed. No one should enter this room except those on duty in nursing, nor should any from the house ride in public conveyances or attend meetings. These precautions are just as necessary in slight as in severe cases, as infection from a mild case may cause a fatally severe attack in another person. Where the rash of the fever seems reluctant to appear, the SOAPY BLANKET (_see_) will bring it out very speedily. But the above simple treatment is usually sufficient. When vomiting is almost the first symptom, six teaspoonfuls of hot water are to be taken every ten minutes for an hour; then treat as above with foot-bath, hot vinegar, and oil. In a severe case have medical aid if at all possible. Where there is great fever spread a large dry towel or sheet on the bed. Lay one wrung out of lukewarm water on it; let the patient lie down on this. Carefully wrap him up in the damp cloth, then over that wrap the dry one, with a blanket outside over all, and the bedclothes above. This will certainly soothe for a time. It may be repeated every two hours, for twenty minutes or half-an-hour at a time, night and day, till the fever is subdued. For nourishment in succeeding weakness, give milk and boiling water, mixed in equal parts, every two hours. If stimulants are required, give CAYENNE "TEA" (_see_), reduced in strength until it just _slightly_ burns the mouth, half a teacupful every half-hour. Cool the head also if necessary, as directed for typhoid fever. Fever, Typhoid.--Treat as under Fever, Gastric, and Fever. In addition, great care should be taken to disinfect and destroy any stools, and especially to prevent these getting into any drinking water. Keep the patient at rest in bed. No solid food should be given during the _whole course_ of the illness. Milk mixed with an equal quantity of boiling water is best. Give only a wineglassful at a time, as often as the patient can take it. If the patient craves solid food, it must _on no account_ be given. It is almost certain to cause a relapse. Fits.--_See_ Convulsions; Nervous Attack. Flannel Bands.--_See_ Band, Flannel. Flatulence.--This is the accumulation of gases in the body, usually caused by fermentation of the food at some part of the digestive process. A failure of the vital energy in the stomach and related organs is generally the cause. Over-exertion, worry, grief, any prolonged strain, will cause this failure. As first treatment, then, the _cause_ should be removed, if this be at all possible. Do less work, cultivate simple faith in God instead of worry. Do not sorrow over-much. The best material remedy is to take tablespoonfuls of hot water every few minutes for several hours. If cold, the feet should be bathed (_see_ Bathing Feet), or fomented, for about an hour at a time. These two simple remedies will generally prove sufficient, if persevered in. Flushings, Hot.--These are often a really serious trouble, especially to women, at certain stages of life. Most often they come about the age of fifty, but in weakly persons may occur at any time. A disturbance in the nervous system, due to lack of energy, is the cause of such feelings. They are often accompanied by DEPRESSION (_see_). Any treatment ought to be directed to strengthening the nervous system. A good plain diet, easy to digest, is a most important matter. Soaping with soap lather over all the body (_see_ LATHER) will greatly restore the tone of the nerves of the skin. This may be done every night, and the CAYENNE LOTION (_see_) rubbed all over every morning for a week or two. This treatment will usually prove successful in curing. Fomentation.--Some general remarks on this important treatment we give here. First, no fomenting should be done for at least an hour after a meal. And it should usually be followed by a period of complete rest. A very good way to foment any part of the back or front of the body is by an india-rubber bag of hot water of the proper size and shape, with two or three ply of moist flannel between the bag and the skin. These bags can now be had of very various sizes and shapes, and one or more should be in every house. In fomenting a knee, foot, or ankle, a good sized half or even whole blanket is necessary. Fold this one way until it is twenty inches broad. Lay it out on a clean floor or table, and sprinkle _sparingly_ boiling water across one end. Roll this end over and sprinkle the roll, turn over again and sprinkle again, and so on until the whole is rolled up. Thoroughly knead and twist it, so that all is penetrated by the moist heat (_see_ illustration, page 32). Or it may be prepared by soaking the blanket in boiling water, and wringing it out with a wringing machine. It may then be unrolled and unfolded so as to permit proper wrapping round the limb to be fomented. Care must be taken not to _burn_ the patient, or give any shock by applying the fomentation too hot. It must be comfortable. _See_ Heat And Weakness. Sometimes fomentation may seem to increase the pain, say in a swelled limb, and yet we should persevere in the treatment. This may seem to contradict our dictum that we should be guided by the feelings of the patient. The reason is that if some dead matter has lodged deep down in the limb, it will have to be brought up to the surface ere the diseased state can be remedied. If strong fomentation is used in such a case, it is not unlikely to increase the painfulness of the limb, and a swelling may appear. It will at once be said that the disease is "getting worse." This is quite a mistake--the increased pain is arising from such stirring of life as will bring about a complete cure. If the treatment is continued, the swelling will by-and-by come to a head and burst, and can be treated as in Abcess. Fomentation, Armchair.--This is applied as follows. Over a large armchair spread a folded sheet. Provide a good large blanket prepared as above in Fomentation. Then rub the haunches, thighs, lower back and abdomen of the patient with a little olive oil. Wrap these parts in a warm dry towel. Open up the hot blanket and spread it (still some three-ply thick) on the sheet on the armchair. Let the patient sit down upon it as soon as it is cool enough not to hurt. Fold the blanket all round the patient's lower body and thighs. Draw the sheet over all, and cover up well to retain the heat. At the end of an hour, or such less time as the patient can endure, a smart washing with hot vinegar, and a gentle rub with warm olive oil, will complete the treatment. This is best done at bedtime, as the patient must go to bed immediately after it. In cases of failure of the large hip-joints, or of the lower limbs, in sciatica and lumbago, the armchair fomentation is of great use; also when running sores exist from one of the hips or lower back, or even in numbness or lack of vitality in the feet and toes. It is referred to under the headings of the troubles in which it is of advantage. Suppose that we are dealing with lack of vitality in some organ in the lower part of the body. We argue that the nerves supplying this organ are needing in some way to be increased in force. This is to be done by getting them heated. There is an arrangement in nature which hinders this being quickly done. The rapid circulation of the blood which is going on all round these nerves tends to keep them about the same temperature. The heat, as it is applied, passes off rapidly in the stream of the blood. But if the heating process is carried on long enough, the whole blood of the body becomes gently raised in temperature, and by-and-by the heat applied to the surface reaches the roots of the nerves, not only by means of the circulation, but by gradually passing through the skin muscles, and the bones that are near it. New life is infused, and that where it is specially required. The flagging organ soon shows that it responds to this true stimulant. After a few such fomentations it begins to act as perhaps it has ceased to act for months, and even for years. We speak of what we have seen again and again in cases where distress was caused by what is called "sluggishness" in some important organ, or when such an organ was altogether ceasing to act properly. The armchair fomentation is more successful than the hot sitz-bath, though this is by no means to be despised. Food and Mental Power.--Unsuitable or ill-cooked food has a most serious effect on the mental powers; and when we take the case of a mental worker, we see that, in order to carry this power right on through a long life, proper diet is of great importance. Also many good mental workers are more sensitive than ordinary men: they are more easily destroyed by strong drink or opium. The nip of brandy, the soothing draught, are terrible dangers to such. Instances of brain power continued far into old age are always lessons in plainness of diet and temperance. One such temperate man will do as much work as ten who are luxurious eaters, tipplers, and smokers. Diet for mental workers should be light and easily digested, with a preponderance of proteid food (_see_ Diet). Rich, tough and fatty foods, and hot stimulating drinks should be avoided. As mental work is generally sedentary work, and consequently having a constipating tendency, some of the vegetable foods giving a stimulus to the muscles of the intestines should form a part of the diet, such as green vegetables, fruits, and oatmeal. Food in Health.--As will be seen from many of these articles, the question of diet is one of the greatest importance, in health as well as in disease. The onset of disease is, in fact, often due to long-continued abuse of the whole digestive system through the use of unsuitable food. By unsuitable food, we mean not so much food that is bad in itself, but rather that which is not suited to the temperament or work of the eater, or to the climate and circumstances in which he finds himself. A ploughman or fisherman, for example, may thrive on diet which will inevitably produce disease in the system of one whose work confines him to the house for the most of his time. One condition of a healthy life is, therefore, careful consideration of our work and circumstances before deciding on our diet. Also, a man of excitable and irritable temperament will need different diet from one of a slow and quiet nature. The food which will only stimulate the latter will over-excite the former, and may even make him quite ill. What is commonly called bad temper is often only the result of wrong diet, and will disappear under a milder course of food. It will, of course, be seen at once from this, that the case of every man must be considered by itself. A decision as to proper diet can therefore only be made when all the facts about a case are known, and in this matter the man himself must decide a good deal for himself; nevertheless some general directions can be given which will help our readers to a decision in their own case. In the first place, we would guard against a very common error--viz., that a smaller quantity of food, _chemically_ of a less nutritive kind, means less nourishment to the body. On this head we refer to the articles on Digestion and Assimilation. It may only be remarked here that what the _body actually uses_, and what is _taken into the stomach_, are two very different things. It is often the case that food containing less actual nourishment will give greater nourishment to the body than chemically richer food, because the former fits the state of the digestive system better. What each one must consider is, not what food has most of the chemical elements needed by the body, but what food will give up to his own body the most of these elements. Another error is that the use of medicine can for long assist the body to use heavier food. In a case of disease, medicine often is of the greatest value as a temporary aid to digestion, but its continual use is the parent of great evils, and at last defeats the very end for which it was given. If a person needs continually to use medicine, there is probably either some organic disease present, _or, more commonly, great errors in the diet taken_. Avoiding medicine, then, except as a very temporary resource, and remembering that food is to be judged more by the way it agrees with us than by its chemical constitution, what rules can we give for diet in certain common cases? First, diet should vary in summer and winter as the season varies. Foods rich in fat, such as ham and bacon, should be for winter use only, and should even then be more or less used as the weather is cold or mild. For summer diet, milk foods, such as milk puddings, etc., ripe fruits, and green vegetables should predominate, being varied also with the heat or coolness of the weather. In very hot summer weather, animal food should be very sparingly partaken of. It must also be borne in mind that warm clothing or heated rooms may convert a winter climate into a summer one. Second, diet should vary according to the occupation of the eater. The writer and brain-worker will do best, as a rule, on little butcher meat, taking chiefly fish, eggs, and light milk foods, with vegetables and fruits. Alcohol in any form is especially fatal to brain-workers, and must be avoided, if there is to be really good health. Third, food must vary according to temperament, age, etc. To give rules under this head is almost impossible. The growing boy will need proportionately more food than the adult, the man more than the woman. It is indeed true here that what is one man's food is another man's poison, and that every man must find out for himself what he needs. It may be generally said that the food which digests without the eater being aware in any way of the process is the best for him. It may safely be affirmed in relation to this question of food in health, that the middle and upper classes eat quite too much. Hence the stomach trouble and goutiness (often in a disguised form) that they suffer from. Too much carbonaceous food will produce corpulency, and too much animal food URIC ACID (_see_). On the other hand, the poor, for want of knowledge of really economical nourishing foods, suffer from want of nutrition. An opportunity is always present, in case of sickness among the poor, by philanthropic persons to inculcate the value of good food. Instead of bringing a basket of beef tea, tea, and jelly, take oatmeal, fruit, milk, and vegetables. What we have said should be sufficient as a hint to those who wish to regulate their diet on common-sense principles. A little careful thought should enable any one to work out a satisfactory scheme of diet for his own particular case. Regularity in meals is of great importance. There should be fixed hours for meals, with which nothing should be allowed to interfere, no matter how pressing the business may be. Do not assume, however, that it is necessary to eat at meal times, no matter whether appetite for food be present or not. To eat without appetite is an infringement of natural law, and it is far better to go without the meal if nature does not demand it than to yield to custom, or to imagine it necessary to eat because the dinner bell has rung. If not hungry do not eat at all, wait till the next meal time; do not take a "snack" in an hour or two. Three meals are, as a rule, better than more, and many have found two suit them best. Probably one-half the human race (the inhabitants of China and Hindostan) live on two meals a day. Food in Illness.--Light, easily digested food is of the first importance in many illnesses. To know easily procured and simple foods, which are really light, is a great matter. Saltcoats biscuits (_see_ Biscuits and Water) form one of the best and most nourishing foods. So does oatmeal jelly, prepared by steeping oatmeal in water for a night, or for some hours, straining out the coarse part, and boiling the liquor until it will become jelly-like when cold. Oatmeal steeped in buttermilk for a time, and then moderately boiled, makes an excellent diet. Wheaten meal or barley meal may be used for these dishes instead of oatmeal, according to taste. Many other dishes, with rice, arrowroot, sago, etc., will suggest themselves to good cooks; but for sustaining the invalid and producing healthy blood, none surpass those described. Fright.--Some most distressing troubles come as the result of frights. In many cases much may be done to relieve such troubles, which arise from severe shock to the brain and nervous system. The results may be very various--from mere stomach troubles to paralysis--but the cure in all cases lies mainly in giving fresh energy to the nervous system. If a blanket fomentation is placed all up and down the back, over a rubbing of warm olive oil, and the excited person is laid on that, one good step will have been taken in the way of restoration. Then this may be aided by cool cloths very cautiously laid over the stomach and bowels, so as to cool in front, while heat is given at the back. This will be specially desirable if the heat at the back is rather high. When the blanket loses its heat it need not be taken off, but a poultice of bran, highly heated, may be placed under it, so that the heat from the bran may come gradually and comfortably through, and pass into the body in that gradual way. So soon as a sense of genial comfort spreads over the back, it will be found that a right state is stealing over the organs that were threatened by paralysis through the alarm. The defect very soon disappears. Gangrene.--_See_ Cancer in Foot. Gatherings.--_See_ Abscess; Ankle; Armpit; Bone, Diseased. Giddiness and Trembling.--This comes very often as the result of loss of nerve power in the spinal system, due to weakness, shock, or simply old age. A great deal may be done to relieve, and in many cases to completely cure, by the following simple means. Wrap the patient round the middle in a soapy blanket, rubbing well afterwards with hot olive oil. Give an hour's fomentation at a time each night for a few nights; rest for a day or two, and repeat. The fomentation must be a blanket one, but should only extend from the armpits to the hips, not over the limbs. For treatment of giddiness arising from the stomach see Indigestion. Half a teacupful of hot water every ten minutes for five hours is usually an effective cure. This should be done daily for three days. Let it be kept in mind that we must not have "hard" water--that is, water impregnated with mineral substances, such as lime or iron. We must have "soft" water, that is, such as rain water nicely filtered, or "distilled" water, which can be had from any good chemist for twopence a quart. Glands of Bowels.--_See_ Bowels. Glands, Swollen.--This is a very common trouble, especially in the young. To restore the skin to healthy action is the first important matter. This may be done by bathing the feet (_see_ Bathing the Feet) until free perspiration ensues, wrapping the patient meanwhile in a warm blanket. Dry well, and sponge with hot vinegar and water; dry again, rub with hot olive oil, and put to bed. As a diet, Saltcoats biscuits and water for some time have of themselves formed a complete cure (_see_ Biscuits and Water). The _comfort_ of the patient will regulate the amount of bathing. Do this every night for a fortnight, except on the Sabbath (when rest from all treatment seems best). If the swelling be slight, two days' treatment may cure it; if the case be severe and of long standing, a longer time will be required. For treatment of the neck, if there is no sore, put round it a cloth dipped in hot vinegar, and a good poultice of bran or moist hot bag round over this. Put this on for half-an-hour before rising in the morning. After taking them off, rub with warm olive oil, and wipe that off gently. Put a single band of fine new flannel round the neck for the day. If there be suppuration, or running sores, treat in the same way unless the vinegar prove painful, when it may be weakened with water until comfortable. This treatment will, we know, cure even a very bad case of tubercular glands. _See_ Wounds. There are men so skilful in medicine that they can aid wonderfully in such cases, and surgeons so apt at operating that they too, can do much good. But we should not for a moment think of leaving patients to depend on what can be swallowed, or what lancet and probe can do, when the very sources of life itself are neglected, and cures waited on for months that may be secured in a week or even less. Above all, when you know how to do it, infuse new life in the body, and promote the throwing off of that used-up matter which is showing itself in the disease. How many parents bow down before the idea that swollen glands are constitutional to their children, when the fact is that these children have very fine skins, and need to have these kept in extra good order, not merely in the way of washing, but so that they shall perform their part of throwing off this used-up material of the body efficiently. Some of the most beautiful of our race are thus lost to the world when they might easily be saved. In some cases swollen glands are caused by bad teeth, running from the EAR (_see_), sores or insects on the head, or inflamed tonsils. If such causes are present, they should be removed. Extract bad teeth, cure running ears, and properly cleanse the head. Gargle the throat for swollen and inflamed tonsils with warm water, in which a little salt is dissolved. Gout.--Some have a predisposition to this most painful disease, and require to keep a strict watch on their diet. Meat, specially the internal organs, meat extracts, alcohol, tea, and coffee must be avoided, and milk, buttermilk and porridge, cheese, eggs, and vegetables, especially green vegetables, made into light and digestible dishes, should be relied on solely. Further, the diet should be a small one, most thoroughly and slowly masticated, and plenty of pure water is advisable, in order to help the elimination of the waste which causes the trouble. _See_ Uric Acid. If the feet be affected, apply gentle heat to the lower part of the spine by Fomentation (_see_). Sometimes a cold cloth on the lower spine will soothe, but more often heat is the true cure. Wrap the sore foot in softest cotton, and foment _very gently_ through this, using only _warm_ cloths, and taking care to avoid giving pain. The cloths should be just a little _below_ blood heat. Cold cloths are a serious mistake, but at a temperature a little below blood heat a gentle soothing is produced. Care must in every case be taken to do only what the patient feels comforting. Gravel.--Sometimes mere internal inflammation is mistaken for this disease. In the case of inflammation of the bladder, apply a large hot BRAN POULTICE (_see_) to the lower back, and change cold towels over the front of the body where the pain is. Afterwards rub all parts over with hot olive oil, and wipe dry. Take only plain food, oat or wheat-meal porridge, Saltcoats biscuits, etc. Where actual stones are formed, or a tendency to their formation exists, all water drunk should be distilled, or boiled rain water. Where stones are present the heat may be applied to the back, but _no cold in front_. The soft water tends to dissolve the stones, the heat assists in their expulsion from the body. Diet same as in GOUT (_see_). Growth of Body.--See Limb, Saving a. Guaiacum.--This drug is a West Indian gum, and is one of those remedies we are glad to say will do no harm, while in rheumatism and gout it is most beneficial. A teaspoonful of the tincture in a cup of hot water, or one or two of the tabloids now so easily had, may be taken three times a day. Hæmorrhage.--See Bleeding; Wounds. Hair Coming off.--There are many forms of this disfiguring trouble, both in the case of young and old persons. It is chiefly due to a wrong state of the skin of the head, which is best treated with careful rubbing with vinegar or weak acetic acid, and finishing with good olive oil. The acid must not be used too strong--not stronger than ordinary vinegar. This may be done every evening, and should be rubbed on for fifteen minutes, till a comfortable feeling is aroused. Dry the head, and then rub on olive oil for five minutes. The vinegar should rather be dabbed than rubbed on. Wash all over in the morning with M'Clinton's soap. Or this treatment may be applied every other night, and on alternate nights the head may be packed up with lather (_see_ Head, Soaping). This treatment is quite safe, and will usually effect a cure, which is more than can be said of the expensive hair washes so much advertised. Many of these are most dangerous. As far as possible go with the head uncovered, and brush the hair frequently. Brushing stimulates the grease glands, and causes the hair to become glossy. Probably the reason men lose their hair so much more than women is that the brushing and combing the latter must give it stimulates the hair roots. Massaging the skin of the scalp with the fingers night and morning will greatly promote growth of the hair. _See_ Head, Massaging. Hands, Clammy.--Rub the hands and arms well twice a day with CAYENNE LOTION (_see_). Hands, Cold.--Much more than is readily believed depends on the state of the hands and feet. We are already familiar with the subject of coldness in the feet, but we meet with cases in which the coldness of the hands is as striking. It is not readily thought that cold hands have anything to do with such illness, for instance, as that of bad action in the stomach. There are cases in which a very great deal can be done to relieve a congested state of the vessels of the stomach, and even a similar state of the lungs, by only bathing the hands in hot water and then rubbing them with hot oil till they have been thoroughly heated and reddened, as they are when effectually warmed. Half-an-hour's bathing of hands in water just a little above blood heat produces a wonderful effect on an invalid when there is too great weakness to stand longer treatment. This is well known to be true of half-an-hour's good feet bathing. In some cases bathing both of hands and feet is much needed. The overburdened heart finds it a vast benefit when by such a bathing the blood is allowed to flow easily through the vessels of the feet and hands. Hands, Dry and Hard.--Pack the hands in SOAP LATHER (_see_) mixed with a little fine olive oil. The soap must be finely lathered with a brush, not _melted_. Pure soft water, never too hot nor too cold, should be used, and the hands thoroughly dried after washing. _See_ Chapped Hands. Hay Fever.--A most effective preventive and cure for this is the inhaling through the nostrils the vapour of strong acetic acid. The acid may be on a sponge enclosed in a smelling bottle, and its vapour may be freely inhaled. Sponge all over each night with hot acid and water. The head also may be wet with pretty strong acid, and tied up so as to keep in the vapour. Do not, however, use a waterproof covering. Headache.--There is a vast variety of ailments associated with what is called headache. In itself, it is just more or less _pain_ in the head. When there is such pain, it means that some of the nerves in the head are in a wrong state, probably in nearly all cases a state of more or less _pressure_. This pressure hinders the free flow of vital action along the nerve, and this hindrance we feel as pain. To remove the pressure is, then, to relieve the pain. Pressure from overwork often causes headache on week-days, which goes off on Sabbath. The _rest_ here removes the pressure, and so the pain. The pressure results from a failure of energy in some part of the head, slight swelling then taking place. To increase the energy is to effect a cure. This may be done by first, at bedtime, soaping the back with warm water and SOAP (_see_). Then dry, and rub firmly yet gently with hot olive oil, until the whole back glows with warmth. This may take perhaps fifteen minutes. Then give three minutes of warm water pouring over the back. Dry again, and oil with hot oil, and put the patient to bed. Avoid much tea. Avoid altogether tobacco and alcoholic liquors, which of themselves will often cause the trouble. This treatment applies to all that numerous class of headaches which arise from overwork and fag. A cure may often be had by its means, without taking a holiday. But where this can be done, it is well to take it. The headache, however, may be caused indirectly by the failure of some of the organs to do their duty, when other methods must be adopted. The use of tobacco so injuriously affects the whole system that headache often results, and refuses to be cured unless the tobacco be given up. It is hard to do this, but the difficulty must be faced. Cold, damp feet are a common cause of headaches. Let these be well bathed (_see_ Bathing Feet) for some days, even twice or three times a day, and many kinds of headaches will be cured. Constipation, or sluggish action of the bowels, frequently causes headache. The cure is obvious (_see_ Constipation). Imperfect action of the kidneys also causes it. In such a case apply a large, warm bran poultice (_see_) across the back behind the kidneys. Oil the skin before and after poulticing. Do this once a day at bedtime for a week, if necessary, but not longer than a week at a time. Take half a teacupful of water before each meal. Use freely the lemon drink described in Drinks, Refreshing. Headache, Sick.--The stomach and head affect each other powerfully, and a disordered stomach causes severe headache, known as _sick headache_. In many cases a few tablespoonfuls of hot water, taken at intervals of five minutes, will effect a cure. He is himself "simple" who laughs at this as "simple." If a dose of hot water _cures_, and removes any need for expensive drugs, that is a matter for thankfulness and not for laughter. When some substance not easily dissolved has lodged in the stomach, hot water is often all that is needed to remove the trouble. But it must be remembered that over-eating, or the eating of indigestible food, must be given up, and the food must be masticated till it is reduced to a liquid condition. Many will say they have not time for this, but time must be taken, and half the quantity of food well masticated will nourish better than the whole imperfectly masticated. Headache on waking in the morning is a frequent result of stomach disorder. In such a case take two teacupfuls of hot water, with an interval of ten minutes between. In many cases a slice of lemon in the hot water powerfully aids to cure. Especially is this the case where pains in the bowels are felt along with the headache. If lemons cannot be had, a few drops of vinegar will form a good substitute. Continue to take half a teacupful at intervals all day. Sick headache may, however, arise from the head causing disorder in the stomach. The head may then be fomented gently, and if necessary soaped (_see_ Head, Skin of) or massaged (_see_ Head, Rubbing, Massage), which should in most cases remove the trouble if carefully and well done. Headaches are frequently caused by anxiety and worry, which have all the marks of sick headache. Dull pain and heat, more or less persistent, also arise from this cause. The treatment for such cases is given in the preceding article for pressure from overwork. It is well to see, in such cases, that the mental and spiritual cures be applied, as well as the material. Let there be resolute putting away of all worrying ideas at night, and during every leisure time. Let perfect trust in a loving Heavenly Father relieve us of all burdens. Much may thus be done to cure even a sore head and weary brain. We are of "more value than many sparrows" to One whose power and wisdom are really infinite. Take both sides of this great truth, the spiritual and the material, and you will find it a glorious help in worry and disappointing failure. What a remedy it is when good medical treatment and true faith in God come together to give peace to the weary one! _See_ Worry. Head Baths.--_See_ Baths for Head. Head, Massaging the.--This is so important in many cases of neuralgia, headache, and eye troubles, that we here describe it. The brow is first gently stroked _upward_ from behind, with the palm of the hand, while the back of the patient's head rests against the chair or other support. The sides of the head are then similarly treated, using a hand for each side simultaneously. Then the back of the head is stroked upward also. After this is well done, the top of the head is stroked similarly from front to back. Then the whole head, except the forehead, is rubbed briskly but lightly with the tips of the fingers with a scratching motion, but _not_ using the nails. This is best done piece by piece, taking care to do every part in turn. This treatment may be often alternated with the cooling of the head with cold towels, with the best results. In all cases of head uneasiness and neuralgia it is _invaluable_ (_see_ Eyes, Paralysis of; Eyes, Squinting; Massage). Frequently a small part of the head will be found where the rubbing with the finger tips is particularly soothing. Special attention, of course, should be given to this, as it is nature's guide to relief. But if pain and uneasiness result from the rubbing, it should be stopped, and some other cure substituted. Understand that what you have to do is to gently press the returning stream of venous blood on in its course from the weighted brow back over the top of the head. Rub very slowly and deliberately, as the stream you are affecting flows slowly. The frequency with which you change from the rubbing to the cold cloth, and from that again to the rubbing, will depend a good deal on the heat that you find persistent in the head, but usually you may rub two minutes and cool during one minute. More or less relief will come in a very short time, and in ten minutes or a quarter of an hour there will be a very great change for the better. [Illustration] We had a very curious case lately. A little girl was brought to us one morning who had been quite blind of one eye for a fortnight. We tried the eye with a rather powerful lens, but she could see nothing. That eye had a squint, which was also of a fortnight's standing. The pupil of the eye was dilated, but nothing else seemed wrong. The girl was affected with worms in some degree, but otherwise healthy. We gave her head a massaging, such as we have been describing, for some ten minutes or so. She was given the first of four or five doses of santolina next morning, which her mother said she threw up and some bilious matter besides. She was brought to us an hour or so after, and we found that she had forgotten which had been the blind eye. She now saw perfectly with both, and the squint was gone. We had not tried whether the rubbing had had the curative effect before the santolina was given, or whether it was after the latter that the sight was restored, but we are disposed to think that the squinting and blindness both had given way to the head's improvement by the massaging. Head, Skin of the.--The nerves of sensibility are very largely supplied to the skin of the head, and many large nerves pass under it. It is therefore an important matter that it be kept in a right condition. In various troubles it becomes hard and dry, and even contracts and presses very painfully upon the head, feeling as if it were dried parchment. The pain thus caused is different from neuralgia, and cannot be relieved by cooling, but is easily cured by soaping the head (_see_ Head, Soaping). This may be done every night, and the head tied up with the soap lather until morning. It may then be sponged, dried, and a little hot olive oil rubbed into the skin. In a serious case, where the patient is in bed, this treatment may be given night and morning. Always, in treating such a head, be very gentle, for the least touch is often painful to the irritated skin. The use of a pure and proper pomade, such as some preparation of vaseline, is of importance where the skin is dry, and tends powerfully to preserve the skin and hair in healthy condition. Careful brushing of the hair, and rubbing of the skin of the scalp will, too, be of use. _See_ Hair. Head, Soaping.--Have a piece of M'Clinton's soap, a good shaving brush, and a bowl of warm water. Rub the wet brush on the soap, and work the lather up in the hollow of the left hand, taking more soap and water in the brush as necessary, until the left hand is full of creamy, thick lather. Lay this on all over the patient's head. Make another handful, and lay that on also. The lather may be wrought into the mass of hair until it reaches the skin, the brush being dipped in the warm water, and used to work the lather well into the skin of the head. This must be continued until the whole head is thickly covered with fine white lather, like a wig in appearance. You need have no difficulty with ever so much hair. You only comb that nicely back at first, and place the soap lather on the fore part of the head. Then you bring the hair forward, and soap the back part. You may work on at this process for half-an-hour. You will by that time have produced a most delightful feeling in both body and mind of your patient. Tie a soft handkerchief over all, and leave for as long as needed--even all night if required. When removing the lather, use a sponge and warm vinegar or weak acid (_see_ Acetic Acid), and dry gently with a soft towel. This application can be used with good effect in all cases of hard, dry skin on the head, and formation of white scurf. It preserves the hair, and stimulates its growth. It also removes the painful sensitiveness to touch so often felt in the hair and head skin. Care must ever be taken to do it all with a gentle hand. So done it is priceless in its soothing and healing effects on irritable nerves. Head, Sounds in.--As the result and accompaniment of deafness these are sometimes most distressing, even preventing the patient from sleeping. They are often caused by chill producing some inflammation of the ear, and stoppage of the internal or external air passages. Have a large FOMENTATION (_see_) carefully packed round the whole head. If properly done, the patient will be comfortable in it for an hour. The fomentation must then be taken off, the head rubbed quite dry, and a warm covering put on. Do this before bedtime for three or four nights. Then desist for three nights. After this place a hot BRAN POULTICE (_see_) on the back of the head, neck, and spine, so that the patient can lie comfortably upon it for an hour. Oil before and after with olive oil. Give this at bedtime for three or four nights, and rest again for three or four days more. Avoid exposure during this treatment. It is suitable for all cases of ear trouble through chill. It will be specially important to see that the feet are comfortable, and that health generally is looked to. _See_ Ears; Hearing. Health and Money.--It will be noticed that the remedies we recommend are in almost every case very cheap--even, like hot water, costing nothing, as they are in every house. This very simplicity and commonness has turned many against our treatment. We know, indeed, of one curious case where olive oil was derided and despised by a rheumatic patient, until his friends got it labelled "Poison, for external use only." It was then eagerly applied, and effected a cure. We warn our readers very seriously against this folly. It is traded in by some who sell the simplest things as secret cures at exorbitant prices, and impoverish still further those who are poor enough already. The _price_ of a drug or appliance is no indication of its value as a cure. Neither is its lack of price. Nor is the price of any particular food or drink an indication of its value. Good and nutritious foods are generally cheap and easily procured. _See_ Diet, Economy in. Our effort has been to find out cures within the reach of every household; and we have found that, as God has put water and air freely within man's reach, so has He put those things which best cure disease within the reach of the poorest. Let us not then despise such things because they are common. Hearing.--We have had so much success in helping the deaf that we feel warranted in seeking to spread the knowledge of our methods as widely as possible. Deafness is caused in many ways--very often by exposure of the head to a chill, especially in infancy. We have seen it even arise from enclosing the head in a bag of ice with a view to extreme cooling. What is called "throat deafness" is a different matter, but yields to the same treatment as the cases of chill. The process of cure is very similar to that used in cases of failing sight (_see_ under Eyes), for the aural nerve has to be stimulated as the optic nerve in these cases. Rub the back of the head and neck, using hot olive oil, and continuing gently, yet firmly, until all the parts are in a glow of heat. Do this some time during the day. At night apply the BRAN POULTICE (_see_), oiling before and after, to the back of head and neck, the patient lying down on it for an hour at bedtime. _Gently_ syringe the ears with tepid water, but only so far as to cleanse them. Rub with ACETIC ACID (_see_) behind the ears, but _not so as to cause soreness_. In an obstinate case continue treatment for a month, then rest for a fortnight, and continue for another month. Cases of deafness arising from dryness and hardness in the ears are to be treated differently. The ear is brushed internally with soap lather (_see_ Lather and Soap). Dip a brush, such as is used for water-colour drawing, into hot water, rub it on the soap, and gently brush the inside of the ear. Renew the lather frequently, keeping up the heat. With another brush moisten the same parts with fine almond oil. Gently, but thoroughly, dry out the ear with a fine roll of lint or _soft_ cotton. In a fortnight we have seen great benefit from this done daily or twice a day. Be careful not to use pressure on the inside of the ear when washing or drying, as this may cause the wax to harden into balls, pressing on the drum. The whole head may also be rubbed with acetic acid, not so as to cause pain, but simply a strong heat in the skin. In all treatment of so delicate an organ as the ear, avoid giving _pain_. If the deafness proceed simply from a relaxed state of the tissues in the tubes of the ear, the cold douche applied to the head, with careful drying and rubbing afterwards, will often effect a cure. But it is only a _sudden_, _brief_, cold splash which is wanted, not a stream directed for any time on the head, which might do serious injury. In this connection it may be noticed that a child should never be punished by "boxing its _ears_." Children have had their hearing permanently injured by this thoughtless practice. Heartburn.--_See_ Acidity in Stomach. Heat and Weakness.--We have over and over again shown in these papers how heat passes into vital action, and gives strength to failing organs and nerves. But the heat supplied to these organs must be at a certain temperature. All experience goes to show that _gentle_ heating will do all that is required. Moreover, too hot a fomentation, especially if a large one, will weaken the patient, and defeat its own ends. In such a case it is folly to throw up the treatment, and say that heat weakens, when all that is needed is to apply heat at a lower temperature. The right degree of warmth is indicated by the comfort of the patient. It will vary in almost every individual case, and must be found by careful trial. Also it may vary from hour to hour. The heat comfortable during the day may be found insufficient or too great by night, and so on. We must in these matters apply our common sense, and make a real effort of thought, if we wish to be successful. Heat, Internal.--There is a usual (normal) temperature in all the blood and tissues of the body. If the body be either warmer or colder than this point (98.4 deg. Fahr.), its health is interfered with. A "clinical thermometer" is used to ascertain whether the bodily temperature is normal or not. It is to be had at every druggist's, and is of great importance in a household. By its means the rise of temperature can be detected often before any serious symptoms set in, and due means taken to check trouble in its early stages. The instrument is used by putting it under the armpit, or, with children, between the legs, so that the mercury bulb is entirely enfolded and hidden between the arm, or leg, and the body. Left in this position for five minutes, it is taken out and read. It may also be held in the mouth, under the tongue, with lips close on it. Where a good deal of fever is shown, as by a rising of the mercury to 101 deg., measures to reduce it should at once be taken, as shown in the articles on various kinds of Fever. By watching the temperature, and taking it from time to time, we can see when cooling is sufficient. Where the temperature is too low--that is, below 98-2/5 deg.--rub all over with warm olive oil, and clothe in good soft flannel. Other methods for increasing vital action may also be tried, as given in many of our articles. Heel, Sprained.--Often in sprains all attention is given to the bruised and torn _muscles_, while similarly bruised and torn _nerves_ are overlooked; yet upon the nerves the perfect healing of the muscles depends. Hence, in a sprain of the heel we must be careful not to direct attention to the heel exclusively. That may be bathed (_see_ Bathing Feet) and duly rubbed with oil. A good plan is to apply cloths dipped in cold water and vinegar. Keep the limb perfectly still, and do not attempt to use it for at least a fortnight. After this it may be cured to all appearance, yet a weakness may be left which prevents anything like the full and free use of the limb. It may be all right when resting, but suffers when used for any length of time: this indicates pretty plainly that _rest_ is needed, and is an essential thing for cure. But besides this rest, the foot should be packed during the night in soap lather (_see_ Lather and Soap). Wash the foot in vinegar or weak acetic acid, rub the whole limb from the ankle _upwards_ in such a way as to draw the blood up from the foot, avoiding all down-strokes. Use a little olive oil in this rubbing. Note that the whole limb needs treatment. The juice of _Lady Wrack_, such as is to be found on the west coast of Scotland, is an excellent remedy for sprained joints; but we only mention it, as it must be inaccessible to many of our readers. Hiccup.--Though often but slight, disappearing in a few minutes by some simple device, such as holding the breath, when long continued this becomes most serious. Very often it is an added distress in trouble which is itself incurable; but while the patient's life cannot be saved, the hiccup may be relieved. In the common case of infant hiccup, a lessening of the over-supply of food may be all that is required. One or two teaspoonfuls of hot water given to the infant will usually give immediate relief. For a grown-up person with a slight attack, one or two teacupfuls of the same will also usually prove a remedy. For serious cases the treatment is a large BRAN POULTICE (_see_) placed on the back, opposite the stomach. Well oil the back before and after the poultice, and leave it on for an hour. If this fails, after a little, prepare a blanket as directed under Fomentation. Roll it up until it is the size of the patient's back, and let him lie down on it. (Read here article on Heat and Weakness.) Then a small cold towel may be passed gently over the stomach. This will generally relieve. It may be repeated if necessary. Hip-Joint Disease.--Thorough heating, with moist heat is the best treatment for this trouble. This implies time, work, and patience; but all these are well spent. Let a strong fomentation be given twice a day to the hip joint, with oiling before and after, each application lasting at least an hour (_see_ Cooling in Heating; Fomentation; Heat and Weakness). In all probability a gathering of matter will come to the surface and discharge itself. Treat this as recommended in article on Abscess, and persevere until the joint is thoroughly renovated. It may take a time, and the treatment should always be intermitted on Sabbath, and sometimes a few days' rest be given. The patient's _comfort_ is the safe guide in this. Hives.--_See_ Rash. Hoarseness.--This trouble we may consider in _three_ ways:--First, as the effect of overstrain in using the voice; in this case rest must be taken from speaking or other such work. Remedies which restore the voice without rest are very likely to do permanent injury. For application to the throat, use vinegar or weak ACETIC ACID (_see_) of such strength as to cause just slight smarting of the throat when applied as a gargle, or with a proper brush, such as any chemist will supply. This may be done frequently, and, together with rest, will rarely fail to cure. Rubbing the throat externally with acetic acid of full strength until a rash appears is often very helpful. Those engaged in public speaking would do well, especially in youth, to cultivate the habit of correct breathing (_see_ Breathing, Correct Method of). Articulation should be clear, and the words formed sonorously, and from the stomach, as it were. This, indeed, will apply to everyone. Such a method of producing the voice will not only be harmonious, but will exercise insensibly a beneficial influence on the nervous system and mental tone of the individual. It is a fact that actors who study the method of voice production do not suffer from that form of sore throat known as clergymen's sore throat, simply because they have learned to produce their voice in this way. Secondly, hoarseness may arise from exposure to cold, damp air. In this case it is best to apply mild heat to the _roots_ of the nerves which supply the voice organs. This is best done by applying a bran poultice to the back of the neck, oiling before and after with olive oil. Carefully dry the skin, and wear a piece of new flannel, for a time, over the part poulticed. This may be supplemented by brushing as above with the vinegar. Thirdly, failure of skin action, or of the proper action of other waste-removing organs, may be the cause of hoarseness. In addition to the treatment recommended above, we must in this case stimulate the skin: this is best done by rubbing with Cayenne "Tea" (_see_) all over the body at bedtime. Let this be done for four or five nights, and the throat treatment be given in the morning, when a cure may be looked for. _See_ Underwear. Hooping Cough.--_See_ Whooping Cough. Hope and Healing.--The mind has always an influence on the body. Life rises and falls under the influences of ideas, so as to prove that these are a matter of life and death to man. To give an invalid _hope_ is, then, to help mightily in healing the disease, whereas to tell patients that they are incurable is the sure way to make them so. But there is, on the other hand, little good in falsehood and false hope: this has often been found to fail and leave the patient in complete despair. No one can tell the immense power for healing which is exerted when one who truly hopes for the patient looks brightly into his eyes, and speaks with a genuine ring of hope of the possibility of cure. So many cases found incurable by the usual treatment have yielded to that recommended in these papers, that in almost all cases we may see some ground for hope, if not of cure, at least of great alleviation. To give this impression to a patient is to half win the battle. There are many who speak most carelessly, even wickedly, to those in trouble. They think it a duty to dash their hopes and predict gloomy things. Such should never enter a sick-room, and should, indeed, change entirely their manner of speech. To go about the world sowing doubt and gloom in men's hearts is a sorry occupation, and one that will have to be accounted for to Him who is emphatically the "God of hope." Look, then, in treatment for every least sign of improvement. Discourage all doubts and encourage all hopes, and you will make what would be a really hopeless case, if the patient were left to despair, one that can be comparatively easily cured. "A word to the wise is enough." Hot Flushings.--_See_ Flushings. Hot-water Bags.--The flat rubber bags of various shapes, to be had from all rubber shops, make excellent substitutes for poultice or fomentation; but care must be taken to have two or more ply of _moist_ flannel between the bag and the skin of the patient. This ensures a supply of moist heat, which is in almost every case the best. Housemaid's Knee.--To cure a swelling on the knee-joint is, as a rule, easy. _Rest_ is a first and paramount necessity. Bathing with hot water, not too hot for comfort, for at least an hour each day is usually sufficient. If the knee has been blistered, or leeched, it is more difficult to cure; but a cure may be expected if the bathing be continued for a long enough time. It is best done by wrapping a cloth dipped in vinegar round the knee, and placing the foot in a bath, then pouring hot water on the bandaged knee, lifting it from the bath in a jug. When pain in bending is felt in the very centre of the knee-joint, this hot pouring may be needed for a month, or even longer. During the intervals of pouring a large cold compress should be worn, first well oiling the knee. Cover the compress with oiled silk. This will soften even a very stiff knee, so as at least to bring about ability to bend without pain. Of course, if there is any disjointing, good surgical aid must be had, if possible, to replace the bones in their natural position. Hydrocele.--_See_ Dropsy. Hysteria.--This is usually brought on by some excessive strain upon the brain nerves, and may show itself either in the violent or in the fainting form; it may even pass from the one to the other, fainting alternating with violent movements and cries. It may often be checked by plunging the patient's hands into _cold_ water. In the silent stage, where sometimes unconsciousness continues for hours, a dry blanket should be laid on a bed, and another blanket must be rolled up and prepared with hot water as directed in Fomentation. Fold this until it is the size and shape of the patient's back, and lay her down on it, so that the whole back is well fomented. Take care not to burn the patient: soothing heat, not irritation, is required. Consciousness will usually return almost immediately. All except attendants should be excluded from the room. Allow the patient to rest in this comfortable warmth until signs of discomfort appear, then gently rub the back with hot olive oil, dry, and leave to rest or sleep if possible. Do all with great _steadiness of temper and kindness_; such a condition in the nurse is especially essential in these cases. Where the fit is violent, apply every mental soothing influence available, and remove from the room all excited persons. Then apply cold cloths to the spine to soothe the irritated nerves and brain. Two may gently and kindly hold the patient, while a third presses on the cooling cloths. In about half-an-hour the fit should be overcome. A difficulty in treating such cases is the terrifying effect of the violent movements, or unconsciousness; but these should not create fear. As a rule, a little patience and treatment as above remove all distress. Where there is a hysterical tendency, give abundance of good food, and let the patient live as much in the open-air as possible. The patient should be kept employed. God made us all to be workers, and this sad affliction is frequently the punishment of idleness. No one has any excuse for this, for the world is full of those who are overworked and whose burden could be lightened. The girl whose only task is to exchange her armful of novels at the library will never know what true happiness is, nor deserve to. _See_ Imaginary Troubles. Illness, The Root of.--In treating any trouble it is well to get to the root of it. On one occasion a patient complained that the doctor never struck at the _root_ of his illness. The doctor lifted his walking-stick and smashed the brandy bottle which stood on the table, remarking that his patient would not have to say that again. This will illustrate what we mean. Liquor drinking must be given up: it is the root of multitudinous ills; so must excessive tea drinking. Tobacco is one of the most insidious of poisons in its effects on the nerves, and is to be absolutely given up if a cure is expected in nervous cases. Chloral, laudanum, and opium in other forms, may give temporary relief; but they are deadly poisons, paralysing the nerves and ultimately completely wrecking the system. The continued use of digitalis for heart disease is a dreadful danger. We mention these by name as most common, to illustrate the truth that it is vain to treat a patient while the _cause_ of his illness is allowed to act. If any evil habit of indulgence has given rise to trouble, that habit must be given up; a hard fight may have to be fought, but the victory is sure to those who persevere. Often dangerous symptoms appear, but these must be faced: to relieve them by a return to drugs is to fasten the chains more surely on the patient. It is better to suffer a little than to be all one's life a slave. Imaginary Troubles.--These are of two kinds, the one purely imaginary, the other where bodily trouble is mixed with the imagined. In the first case the patient is in agony with a pain, when nothing wrong can be discovered in the part, or even elsewhere, to account for it. In such a case, proper treatment of the BRAIN or SPINE (_see_) will often relieve. Again, a patient has set up such a standard of health that what would not trouble any ordinary person at all, gives him much distress. An intermitting pulse often is a source of great anxiety; but we have known people with intermitting pulses continuing in good health for forty years, and living to old age. So with many other heart symptoms that need give no concern at all. Sprains to some muscles are often taken for serious internal inflammation, and a slight cough and spit are taken for consumption. Care must be taken to resist all such fancies, and if not otherwise removable, _thoroughly competent_ medical advice will often put the patient right. In such a case a medical man of undoubted high standing is best consulted, for an inferior practitioner may nearly kill the patient by arousing needless fears, which are afterwards difficult to remove. _See_ Hysteria. It must be remembered that diseases of the imagination are as actually painful to the patient as if they really were organic troubles. It is, therefore, useless to laugh at or pooh pooh the trouble, or suggest that the sufferer is only humbugging. Attention must be paid to diet, exercise, and to material, mental, and moral surroundings, so as in every way to relieve the patient from those apparent troubles that so annoy him. Great gentleness, firmness, hopefulness, and sympathy will often bring about an almost unconscious cure. If the trouble has been brought about by over-work and worry, complete rest will often be needed. If there is something in the surroundings that jars, a change may be advisable. Indigestion.--(See also Digestion; Assimilation.) This subject leads naturally to a consideration of _food_ in relation to it. The trouble usually is that food easily enough digested by others causes distress to the patient. Here we at once see that _cooking_ plays a most important part. Potatoes, for example, when steeped for half-an-hour in hot water, which is changed before they are boiled, are much more easy of digestion. The water in which they have been steeped is found _green_ with unripe sap, which is all removed. Where _unripe_ juice is present in any root, this method of cookery is a good one. Eggs placed in boiling water, and allowed to remain so till the water is getting cool--say _half-an-hour_--are often found to be much more easily digested than as usually prepared. What we aim at in these illustrations is to show that digestion depends on the _relation of the food taken to the juices of the stomach which are to dissolve it_. It must be brought into a digestible state if weak stomachs are to deal with it. Greasy, heavy dishes must always be avoided. Also unripe fruit. The diet should be spare, as very often indigestion proceeds simply from the stomach having had too much to do. A very easily digested food is fine jelly of oatmeal made in the following way:--Take a good handful of the meal and put it in a basin with hot water, sufficient to make the mixture rather thin. Let it steep for half-an-hour. Strain out all the rough particles, and boil the milky substance till it is a jelly, with a very little salt. To an exceedingly weak patient you give only a dessertspoonful, and no more for half-an-hour. If the patient is not so weak you may give a tablespoonful, but nothing more for half-an-hour. In that time the very small amount of gastric juice which the stomach provides has done its work with the very small amount of food given. Really good blood, though only very little, has been formed. The step you have taken is a small one, but it is real. You proceed in this way throughout the whole day. The patient should not swallow it at once, but retain it in the mouth for a considerable time, so that it may mix with the saliva. By this, or by porridge made from wheaten meal, you may secure good digestion when the gastric juice is scanty and poor; but we should not like to be restricted to that. We want a stomach that will not fight shy of any wholesome thing. We must treat it so that when suitable food is offered it may be comfortably digested. Now, there is an exceedingly simple means for putting the glands in order when they are not so. About half-an-hour before taking any food, take half a teacupful of water as hot as you can sip it comfortably. This has a truly wonderful effect. Before food is taken, the mucous membrane is pale and nearly dry, on account of the contracted state of the arteries. In many cases the glands that secrete the gastric juice are feeble; in others they seem cramped, and far from ready to act when food is presented. The hot water has the same effect on them as it has everywhere else on the body--that of stimulating the circulation and bringing about natural action. It looks a very frail remedy; but when we can, as it were, see these glands opening and filling with arterial blood the instant they are bathed in this same water, and see how ready they become to supply gastric juice for digestion, the remedy does not look so insignificant. We have, in scores of cases, seen its effects in the most delightful way. Persons who have to our knowledge been ill and miserable with their stomachs for years have become perfectly well from doing nothing but taking half a teacupful of hot water regularly before taking any food. It is true that great good is effected in cases of this kind by giving the weakened organ light work to do for a time. Wonders are done by feeding with wheaten-meal biscuits and water for some time, beginning with a very small allowance, and seeing that every mouthful is thoroughly chewed. Great things, too, are accomplished with such wheaten-meal porridge as we have already mentioned. But we feel disposed to regard the half-teacupful of hot water regularly before eating as the chief means of cure. It is wonderfully cheap: it goes hard with the druggist if his customers need nothing but a little hot water. Still, from what we have seen, and from what some of the very highest authorities have told us, we come more and more to look to this simple remedy as about all that is required inwardly to cure the worst cases of indigestion. A little pepsin added to the hot water may be of use; also in cases of acidity a few drops of white vinegar mixed with the water will be found beneficial. Soda, iron, lime, charcoal, even tar pills are used as remedies for indigestion; but none of them do much good, and some are highly injurious. If used at all, their use should be temporary, and under good medical advice. If pain is felt, the stomach may be greatly soothed by soft fine lather (_see_ Lather and Soap). It acts in such cases like a charm. Spread it gently over the stomach, and wipe it off with a soft cloth. Cover again with fresh lather. Do this five or six times, and cover up the last coat with a soft cloth. All indulgences which tend to weaken the stomach are to be avoided. Alcohol and tobacco must be given up. Over-excitement must be avoided, and abundance of fresh air breathed, if a cure is to be expected. Where sudden and violent pain comes on after meals, a poultice or hot fomentation applied directly over the stomach is the best remedy at the time. _See_ Flatulence. Infant Nursing.--A mother who has had strength to bear a child is, as a rule, quite strong enough to nurse it. Suckling is natural, and usually most beneficial to health. Many women have better health and appetite at such a time than at any other. Every mother ought, therefore, unless her health forbids it, to nurse her own child; no other food is so good for it as that which nature provides. We cannot too strongly condemn the mother who from indolence or love of pleasure shirks this sacred duty. By so doing she violates the laws of nature, which can never be done with impunity. Many troubles follow, and her constitution is seriously injured. Alas that we should ever have to say, with Jeremiah: "Even the sea monsters draw out the breast, they give suck to their young ones; the daughter of my people is become cruel, like the ostriches in the wilderness." If a wet-nurse must be employed, great care should be exercised in choosing a healthy person with a child as near as possible to the age of the infant. Let mothers remember that there is great _variety_ in milk. Not only does one mother's milk differ from another, but the same mother's milk varies from time to time. Variation in health and diet affects the milk very much. Many cases of infant trouble are traceable to the mother's milk, which should not be overlooked as a possible cause. Again, an _abundance_ of milk is not always good. An infant may thrive better on a scanty supply of good milk than on an abundance of bad milk. Milk derived from drinking ale, porter, or alcoholic drinks of any kind, though abundant, is very far indeed from good, that produced by plain and simple diet is always best. Again, the _state of the mother's mind_ has a great deal to do with the quality of her milk. A fright, or continued worry, may transform good milk into most injurious food for the child. There need be no fear caused by these ideas: it is only in exceptional cases that nursing need be given up; the natural way is always the best. But where necessary there need be no hesitation in putting an infant on the bottle. The milk of a healthy cow, or condensed milk of first-rate brand, is much to be preferred to that of a wearied, worn-out, and worried mother. Infants' Food.--For infants who cannot be nursed at the breast, cows' milk in the "bottle" is the best substitute. But all milk used from the cow should be sterilised and cooled before use. That is unless it is found on trial that the child thrives better on unsterilised milk. It is not necessary to have "one cow's milk;" but it is important to have the milk adapted in strength to the infant's need. If the milk be too rich, the infant will often break out into spots, or will vomit. A little more boiling water in the bottle mixture will remedy this, and often prevent serious trouble. The same proportion of water and milk will not always do. One dairy's milk, and even one cow's milk, differs from another; and so does the digestive power of infants. We have to find out that strength of milk to suit our own baby, and not be led astray by the advice of other mothers. In health the young infant does not require food oftener than every two hours, sometimes even every three. It may cry because of cold, wet, or discomfort, not from want of food. To overload the stomach with food is harmful and leads to serious disorders. Its food requires a certain time for digestion, even in an infant, and as the child grows, the intervals between meals ought to be increased. A good mixture is two parts of cow's milk to one of water. To every pint of this add four teaspoonfuls of sugar, and a tablespoonful of cream. Barley water may be used instead of common water. The water should be boiling, and should be poured into the milk. The bottle should be thoroughly cleansed, and boiled in boiling water before re-filling. It must be remembered that the saliva does not possess the property of turning starch into sugar till the child is six months old; therefore starchy food, such as bread, arrowroot, etc., should on no account be given before that age. Preparations for weaning may then begin, by giving the child _small_ quantities of oatmeal jelly and milk, or even of porridge and milk, so that the weaning comes on gradually. The time of nursing should not exceed nine months. If, however, a child afterwards be ill, there is no harm in going back for a time to the bottle, even at two years old. Common sense must guide, and not hard-and-fast rule. Easily assimilated food must ever be chosen; and as a food for children, oatmeal porridge, well boiled, holds the first place--far before bread sops. If porridge be not easily digested, try oatmeal jelly. Most of the infant foods so largely advertised cannot be recommended. * * * * * It is now suspected that tuberculosis is transmitted to children mainly from the milk of cows affected with this disease. Cows are exceedingly liable to tuberculous disease of the udder. It is therefore very difficult to get milk guaranteed free from the tubercle bacillus, and recent examinations of that coming into Manchester and Liverpool showed that from 18 to 29 per cent. contained this deadly germ. (Strange to say, tubercular disease of the mother's breast is practically unknown, and children never derive the disease from their mother's milk.) It is therefore of the greatest importance that only the milk of cows proved free from this disease should be used. The disease is easily detected, and if a demand were created for milk guaranteed free from the germs, dairymen would soon supply it. Unless it is _absolutely certain_ the cows supplying the milk are free from disease, the milk should be sterilised by heating to near boiling point, and then cooling _rapidly_. If kept twelve hours, the boiled taste goes off it, and children soon get to like it. Though sterilised milk will keep for some time without getting sour, it should be sterilised each day, specially if for infant use. This treatment makes the milk keep without the use of preservatives, such as boric acid. We regret to say the use of these is not illegal, and they are largely used in preserving milk, butter, hams, etc. We have seen very serious illnesses produced in children (and adults too) by the heavy doses they have got when both the farmer and milk vendor have added these preservatives. This they often do at the season when the milk easily turns sour. Every care should therefore be taken to get milk guaranteed free from these noxious drugs; and if this is impossible, condensed milk should be used instead. As there is a great variety of brands of condensed milk in the market, always choose one which guarantees that the milk taken has been whole milk, and also unsweetened. Infants' Sleep.--_See_ Children's Sleep. Infection.--Few things have so great and distressing effect as the fear of infection in disease. As a rule this fear is not justified by the facts, where ordinary precautions are taken. These precautions, too, need not be costly, and involve in many cases little more than some careful work. Where scarlet fever has shown itself in any household, the very first thing is to see to the continuous freshening of the air in the sick-room and in all the house. Ventilation is, indeed, the first and most important method of disinfection. Chloride of lime and other disinfecting fluids will decompose the offensive and noxious odours, but pure air will sweep the organisms of disease themselves away. Fresh air kills the microbes of certain diseases, _e.g._, consumption, and is hostile to all disease. The stools of typhoid patients should be disinfected, and great care taken that no water or other fluid is contaminated by them through imperfect sanitation, etc. (_see_ Fever, Typhoid). Seeing that the seeds of disease are all around us, the best method of warding off their attacks is to keep the body in a state to resist their inroads by strict attention to diet, exercise and ventilation. Let all be done also, by fires if necessary, to thoroughly _dry_ the room and house. See that all the family breathe fresh air by night as well as by day; have open windows where and when possible. Acetic acid is as powerful a disinfectant as carbolic acid, in proportion to its strength, and has the advantage of being harmless, unless in the glacial form. In all cases of infectious disease these precautions are almost certain to prevent its spread, with, in addition, the special ones given under the head of the disease. Inflammation, Deep-seated.--Often inflammation occurs in the centre of, or beneath, a mass of muscle, as the hip or thigh. We refer not to the formation of an ABSCESS (_see_), but to the violent, hot inflammatory action that often _issues_ in an abscess. For this the treatment should be strong moist heat applied to the back, where the _nerve roots_ of the inflamed part lie, and _persistent_ cooling of the part which is painful. The heat may be by bran poultice, fomentation, or hot-water bag and moist flannel. The cold must not be ice, but only cold water cloths frequently renewed. It is curious to see how people are frightened at the only thing that gives relief, and not at all at that which does the most damage. A gentleman wrote us once that he had had eighteen blisters on, but was afraid to apply a cold cloth. We wrote him that if he still lived after eighteen fly blisters, he would surely not die under a cold cloth. They will say they have tried so many things. We reply, that if they had tried a million wrong things, and shrunk from the right one, they would be only so much the worse. If there is local swelling, and signs that an abscess is forming, then treat as recommended for Abscess. Inflammation of the Bowels.--_See_ Bowels. Inflammation of the Brain.--_See_ Brain. _See also_ Knee; Limbs, Inflamed; Lungs, etc. Inflammatory Outbreaks.--Sometimes a severe out-break and eruption will occur in and around the nostrils or lips, and spread over the face. (If of the nature of erysipelas, treat as under that head.) In ordinary cases, there is need for more than local treatment, as it is probable that more or less failure in the skin exists. Also the feet will be most probably cold and damp. Let these be bathed (_see_ Bathing Feet), and dried. Then rub them with CAYENNE LOTION (_see_) for some ten minutes, until in a glow of heat. Dry well, rub on hot olive oil, and dry again. Do this twice a day for a week. Warm and dry stockings must be worn. The skin of the back will probably be found dry and rough. Wash it down daily with SOAP (_see_) and hot water, and rub with warm olive oil. After a week of this treatment, probably the eruption will be much lessened. If it is still troublesome, apply cool cloths to the whole head, avoiding the sore parts, until it is generally cooled down and the skin softened, or the head may be, instead of this, packed in lather of the soap already mentioned. (_See_ Head, Soaping). For the sore itself, apply weak vinegar or _very weak_ ACETIC ACID (_see_), and a little olive oil after. But it is best if it can be healed in such cases without any local application, through the general treatment of feet and skin. Internal Relaxation.--Pain is often felt in parts of the back or sides which will yield to no medicine such as usually relieves. This most probably arises from relaxation and swelling of some internal part of the body, so that there is more or less constant pressure on some nerves. It will be worse after fatigue or long standing, or any mental worry and excitement. This shows us that one thing necessary to cure is _rest_: entire rest if possible, if not, as much as can be taken. It is well to find out the _easiest_ posture in which to lie, and spend as much time as possible in that posture. Seek, also, by applying cold cloths to the painful parts, to reduce the swollen tissue. There may also be required fomenting of the feet and legs (_see_ Angina Pectoris) to prevent chill during this cooling. Often pain in the urinary organs is due to nothing but this relaxation, and yields to such treatment. Rest, however, is a primary necessity in all such cases. Itch.--_See_ Rash. Jaundice.--This disease, or its approach, may be known by several signs: a more or less yellow colour of the skin where otherwise white; a yellowness of the whites of the eyes, and failure of the bowels to act sufficiently, with lack of appetite. It may come on gradually, or may be induced suddenly by some disgusting mouthful or sight which affects the nervous system, and through this the liver and stomach. Where a disgust, or, as the Scotch call it, a "scunner," is taken at any food, especially with children, they should never be forced to eat it. Jaundice may follow if they are so forced. Those having the care of children should always remember this. The cure is found first in nursing the sympathetic nerves, by a fomentation for an hour of the whole length of the middle of the back, oiling before and after with olive oil. Four hours later treat the stomach and bowels in the same way. In another four hours foment the feet and legs similarly. All this time give a tablespoonful of hot water every ten minutes. Then rest for twelve hours, and repeat the cycle of treatment. During the twelve hours' rest, the hot water may be taken in sips, as desired by the patient. If there is pain in the region of the liver, foment that region more strongly. If severe, place a bran poultice on above the liver, and keep it on all day, or even for twenty-four hours if the patient is comfortable in it. By the second day there should be a marked improvement. Kidney Complaints.--_See_ Urinary Troubles. Knee, Swelling of, or Pain in.--For ordinary slight injuries, complete rest, and rubbing with spirit lotion, should be sufficient. But where there is previous weakness, or constitutional tendency, even slight pain and stiffness, caused by wet or some blow or wrench, the joint must be treated thoroughly. Careless and wrong treatment may be given, and result in severe lameness. We wish, however, to point out that the treatment here recommended has cured many cases where this lameness appeared hopeless, and even restored walking power in limbs which had been ordered to be amputated by surgeons. In the early stages of the trouble, it should be easy to cure in five or six days. First apply the SOAPY BLANKET (_see_) at bedtime. Then, about eleven o'clock in the fore-noon, place the leg so that the knee is over a small tub or bath full of very hot water, as hot as can be borne without pain. Pour this over the knee with a sponge or large soft cloth for an hour, adding hot water as it cools. If the patient becomes sick or faint, discontinue the bathing for a time. Dry the limb, rub with olive oil, and dry again gently. At five in the afternoon repeat the treatment of the knee. At bedtime sponge all over with hot vinegar, rub with hot olive oil, and put to bed. If the joint has been stiffened, gentle efforts to move it may be made during the treatment. Sometimes during this treatment boils will break out over the knee and discharge a good deal, but as soon as their work in removing disease is done, these will heal up. Generally, however, this will not occur. The diet may be such as we recommend in cases of ABSCESS (_see_). In bad cases, the treatment may be continued for weeks before much favourable change is noted. Patience and perseverance, however, will win the day. The soapy blanket should not be given oftener than three times a week, and a rest from all treatment on the Sabbath is best. _See also_ Housemaid's Knee. Often in cases of knee pain and trouble, when local applications have little power, a BRAN POULTICE (_see_) on the lower back will effect a speedy cure. Sensible people will, of course, study and apply fresh treatment in such cases. Where the knee, for instance, is in the _hot_ stage of inflammation, hot applications will be injurious. In such a case, cold cloths on the knee, with bran poultice on the lower back, will be the proper treatment. Try heat first, and if it is hurtful, vary the treatment to cold and heat, continued as above. Here, again, is a knee which gives its owner excruciating pain, and shows only a little swelling and no sign of diseased matter whatever. The hot fomentation and cold towels have both been tried, but there are now and again symptoms that show us that the root of the evil has not been reached. We try cold cloths on this knee, but they greatly increase the pain. We at length suspect that it is not the knee that is seriously diseased, but the root of one or more of the nerves that supply the link from the lower part of the spine. By this time the pain has returned into the knee dreadfully, and everything has failed. But very soon after a large, thick towel, folded and wrung out of cold water, having plenty of mustard spread on it, is placed across the haunches, relief is given in the most charming fashion. The cold cloth absorbs superfluous heat, and superfluous vital action to a certain extent, but the mustard draws it out so much more speedily and powerfully that the deep-seated roots of the nerves are reached and cooled down to their normal action. The pain ceases, and the poor sufferer blesses the mustard. We are just describing what actually occurs. Sometimes a prejudice arises against heat. If, for example, an inflamed knee has been strongly heated during the hot stage of the trouble, the pains and injury will have been greatly increased. But one way or other that hot stage of the trouble has been got over, and now without heat it is impossible to cure. The patient, however, and probably the nurse waiting upon him, are decided against all hot appliances. These do so much mischief that it is believed to be out of the question to try them again. It may be that the prejudice is so strong that you simply can do nothing; it may not be quite so invincible as that. If you are able to point out that it was only because the heat was applied at a wrong time, or in far too great strength, and that now, since the inflammatory power is spent, heat will be sure to have a good effect, if it is only carefully applied, the prejudice may be removed. We have seen a patient in this stage, and with both knees bad, wrapped in a large hot blanket fomentation from the ankles to above the knees; and he was constrained to exclaim, "That's the right thing, beyond all doubt." Then there is no more prejudice. Sufferers should not be disappointed if for a week or two they are not sensibly better. In some cases the effect is apparent in four or five days, but generally a fortnight or three weeks pass without much encouragement. We see great despondency sometimes just before all pain disappears. Still, as a rule, the new health is seen in the cheek and eye very soon. Where a _violent_ inflammation is obviously proceeding in the knee, the TURNIP POULTICE (_see_) is the best remedy. If there be great heat in all the body, there will be little or no need for heating any part; judgment must be used for each individual case in these matters. While resting as much as possible, the patient will find it best to lie on the back, with the sore knee supported a little higher than the body. A gently applied bandaging of the whole limb is also very beneficial, and may be used for all weak limbs, even when the patient is walking about. In the treatment of stiffened knees, even where accidental bending of the joint gives very great pain, it is a grave mistake to put the knee in splints to prevent bending. What is wanted is to encourage bending as far as that can be done without much pain, so that the joint may not permanently stiffen. Even where, by the use of splints, permanent stiffness seems to have been brought on, the warm-water treatment recommended above will bring about a loosening and softening of the joint, which will permit first of a slight bending, and then, with gentle encouragement, a complete flexibility. The _complete_ restoration of the limb should be the object kept in view. No case of a stiffened joint, although it may be free from pain and disease, can be regarded as satisfactory, and hence treatment should be persevered in until all stiffness is gone. Common sense will direct as to hot and cold applications, when to apply each, and how long to continue either; the patient's comfortable feeling being the very best guide. We are glad to know of very many apparently hopeless limbs saved by our treatment, even where it has been imperfectly carried out. Lacing, Tight.--This produces such serious deformity, and in many ways so interferes with the health of women, that we are constrained to write upon the subject. We find in cases which come before us that lacing, both of the feet and the waist, as practised by our women, has caused disease, and prevents our curing it. To begin with the lacing of boots. There is a certain form and size of foot which are supposed to be graceful. To obtain this, boots unsuitable in shape, and far too small in size, are used, and tightly laced down upon the foot and ankle, preventing circulation of the blood in these important parts. This causes corns and misshapen toes and nails; but its bad effects are also felt throughout all the body. We have pointed out in other articles the great curative power of bathing or fomenting the feet. The tight lacing of boots produces exactly the opposite effect. It is as powerful to injure as the other to cure. Cold feet are the cause of many most serious troubles. To keep tight-booted feet warm is almost impossible. True neatness abhors all such mistaken treatment of the feet. Moreover, no supposed good shape, in body or feet, can ever produce the impression of beauty which good health never fails to give, so that the tightly-booted high-heeled girl or woman defeats her own object. A yet more serious evil is the wearing of corsets. From this comes very much of the ill-health from which women suffer. The stomach, liver, and other organs are forced downward, their proper blood supply is cut off, and indigestion, constipation, headache and backache are the inevitable consequence. The pressure of these organs causes falling of the womb and the terrible troubles which employ two-thirds of the fashionable surgeons. These have not failed to denounce the folly which brings so many patients to them. Dr. Herbert Snow, the great authority on cancer, and physician to the London Cancer Hospital, attributes almost wholly to the use of corsets the fact that for one man who dies of cancer two women die of it. The compression of the womb makes it specially liable to be attacked, while the rubbing of the hard edge of the corset on the breast sets up cancer there. Besides its evil effects on the abdominal organs, the lungs also suffer, the ribs are prevented from expanding and so the wearer can never breathe as deeply as is necessary. The muscles of the abdomen and trunk are greatly weakened; indeed to this is due the fact that a woman who is accustomed to corsets has great difficulty in giving them up. She feels as if she would "come to pieces" if not supported by them. The exercises given in the appendix will help to restore tone to these muscles, and with perseverance in these, vigor and health will return, and the deformities such as flat or hollow chest, drooping shoulders, and protuberant abdomen, caused by muscular weakness, will disappear. [Illustration: A Normal Waist.] [Illustration: A Corset formed Waist.] As we have said (_see_ Skin, Care of) clothing should be loose and porous in order that the skin may perform its functions. Corsets are both tight and impervious. The constriction of any part of the body by tight bands, and the hanging of the clothes from the hips, are highly injurious. It is frequently urged that corsets are necessary if a woman is to have well-fitting clothes and a neat figure, but this is by no means the case. We illustrate a "good health waist" which has the advantage of allowing freedom of movement and respiration, producing no constriction of any part, and yet being well-fitting. Buttons are arranged, as shown in the illustration, to support the skirts so that their weight falls equally from the shoulders. This waist can be had from the Good Health Supply Department, 451 Holloway Road, London, N., who will send particulars on receipt of a post card. [Illustration: Good Health Waist (_back view_) Good Health Waist (_front view_)] Lancing Swellings.--See Abscess. Lather, How to make.--One of the most powerful soothing influences which can be had, is found in the lather of M'Clinton's soap, so often recommended in these pages. Applied to the skin over a stomach which has been rejecting all food, and even retching on emptiness, for hours, it will almost at once stop the irritation. Applied to the head it is invaluable (_see_ Brain; Head; Hearing, etc.), and in many cases we have known it perform almost miracles of soothing effect. But the lather must be rightly made, and none but this soap used, if good results are to be got. Lather is first _Soap_, secondly _Water_, and thirdly _Air_, so wrought together to make a mass like whipped cream, or only a little more fluid. To get this, dip a _good_ shaving brush in hot water, rub it on the soap a little, take another slight dip of hot water, and work the brush in the hollow of the left hand patiently, until you have a handful of fine creamy foam, sufficiently solid not to run like water, and yet as soft in its consistency as cream. There is in the hand just the temperature, consistency, and shape that are required for working the lather, and no dish can properly replace it. The lather is to be gathered from the hand with the brush (a soft badger's-hair one preferred), and laid with it on the skin of the patient wherever necessary. Then another handful is quickly made, and so on until the required surface is covered. Or the lather may be transferred to a hot dish, placed over a bowl of boiling water, till enough is ready. After the application, a soft handkerchief may be laid loosely on, and, if the lather is to remain on as a pack, a dry covering put over this. [Illustration: Lather ready for application.] In many cases where it is inconvenient to apply the lather direct to the skin, it may be spread on a warm cloth of soft and clean linen or cotton, and this laid over the part to be treated before it is cold. This will also apply where the patient is too weak to sit or lie in the position required for lathering the skin. A dry cloth must be put on the top of the soapy one, and all fastened on by proper wrapping. In cases, however, where the skin has to be lathered in order to soothe the nervous system or to allay irritation of internal organs, it is well, if at all possible, to apply the lather direct to the skin, as described above. Lather of this soap, made in this way, may be spread on the most sensitive sores (when ulcers have eaten through both outer and inner skins) with only a very slight feeling of smarting to the patient, and with the most healing effect. It is very different with soda soap made in the usual way. When the skin of the head has got inflamed (as we saw in the case of a child the other day, where the back of the head was a matted mass of most distressing sores), it is charming to see the effect of this lather. We took a number of handfuls of it, and soaked the matted hair and inflamed skin till the poor child looked up with an expression of astonished relief. Legs, Pricking Pains in.--Sometimes curious pricking pains are felt in the legs, becoming so severe as even to confine a patient to bed. Nothing can be seen on the skin, and no swelling or other visible sign of trouble is present. Evidently this requires treatment more particularly of the nerves, which go to maintain a proper balanced state of feeling in the skin where the pricking is felt. The patient must give up using alcohol in any form, and should rest in bed. In treatment we do not look to the skin itself, but rather to the nerves, to effect a cure. There is a failure at the nerve roots, and indeed the patient will usually be weak and nervous generally. A popular remedy in such a case might be arsenic, which must be avoided, as likely greatly to injure instead of help. The cure is in increased nutrition of the nerve substances, by rest and light dietary. _See_ Biscuits and Water, Diet. Limb, Saving a.--The proper growth of the body in any part depends on the power furnished by the nervous system and the cells of that part. This power enables these cells to use the nutritive substance in the blood for the formation of new tissue. By this process, growth in the healthy body is continuous through life, replacing equally continuous waste. But this all depends on a due balance of power in the process. Suppose one eats more than can be changed into healthy tissue, the food may all go into blood, but the nervous power of the cells is insufficient to deal with it. Sluggish living in bad air, tobacco, or alcoholic drinks, will all cause this. Then some slight wound or bruise is received, and the overloaded blood fails to act healthfully and heal this. A sore is formed, most likely somewhere in the foot or leg, and the limb goes from bad to worse in spite of all efforts, while this _inequality_ between the blood and the tissues continues. This goes on perhaps for years, and no effort is made to remedy it. Such a case may often be very easily cured, even where doctors pronounce it hopeless, if the patient will submit to proper regimen and treatment. Let the limb be thoroughly bathed, as far above the knee as possible, with water as hot as can be borne (_see_ Bathing Feet). Pour into the water about half-a-pint of strong vinegar. Keep up the heat for an hour. Repeat three times each day--at 11 a.m., 4 p.m., and at bedtime. Rest from treatment on the Sabbath. When perspiration follows this bath, dry the patient all over, and rub with vinegar. Dry this off and rub with olive oil. Dry again, and put on clothes. When we have to foment a foot or knee in long heatings or bathings, we find it well sometimes to cool the lower part of the spinal nerves, and remove all irritation of them. Then for _diet_, let the patient go on good wholesome wheaten biscuits (_see_ Biscuits and Water) three times a day as food, and pure water, with no alcohol of any kind, to drink. And let him give up the use of tobacco entirely. Many times over, when limbs have been condemned by the medical men, we have seen them saved in this way. We have seen the same treatment save arms and fingers, reducing them from swollen and unsightly sores to perfect shape and complete usefulness. Limbs, Disjointed, or Sprained.--In the case of an overstretch, or sprain, which has resulted in a hardened, swollen, and painful state of the muscles of the arm, bathe the arm in hot water, using plenty of SOAP (_see_). While the arm lies in this bath, gently squeeze it with both hands, so as to make the muscles work gently over one another, and the blood run out and in to the stiff parts. Care must be taken to avoid hurting the patient. No such effort is needed as to require great strength--only so much squeezing as urges the blood out of the part squeezed, and lets it in again when the pressure is taken off. Persevere in this for half-an-hour, dry, and rub with warm olive oil. Do this twice daily until the arm is restored. In the case of a broken or disjointed arm, FOMENTATION (_see_) should be vigorously applied until proper surgical aid can be had to set the bones. Even where a joint has been a long time out, such fomentation persevered in will soften the part, and permit of proper setting of the bones. Cold is unfavourable--cold water a decided mistake in such a case. Of course a surgeon should be employed; but if no medical aid can be obtained, a person who understands anatomy may replace a disjointed limb by fomenting and oiling the muscles thoroughly, and then watching for a time when they are relaxed, and when the patient's attention is not fixed on the joint. This is the moment to slip the bone into its place. If medical aid can be obtained, it is always safe, while waiting for the doctor, to foment the broken or disjointed limb. Also a wet compress worn over the disjointed limb will, with the fomentation, make it much easier for him, when he comes, properly to set the bones. When two bones in any part of the body are disjointed, the cords and muscles which tend to keep them firm in their ordinary position usually draw the ends past each other so that they overlap. To get the joint right, the bones must be drawn until the ends can pass each other, and then they must be brought into their proper position. Compare the disjointed bones with those same bones in a right position in some one's body, and thus you will see how they may be drawn right. There is a way of manipulating the muscles and tendons that in most cases renders it unnecessary to use much force, therefore the inexperienced should never draw forcibly. Sometimes a joint will repeatedly fail in this way. In such a case it may be supported; but means must be used by hot fomentations to strengthen the joint, and general rubbing, especially on the spine, must be used to increase vital force. Limbs, Drawn-up.--We have had many cases of contracted limbs, arising from various causes. Some of these have been completely cured, even when the tendons or _cords_ which were contracted were going to be _cut_ by medical advice. In one case, however, of which we knew, the medical man ordered the very treatment we employ. In the first place we must have EXERCISE (_see_). This may be given by massaging the back and limbs with a gentle squeezing motion for half-an-hour twice a day (_see_ MASSAGE). Use hot olive oil for this rubbing, and _persevere_. If the feet be sweaty, rub them with the CAYENNE LOTION (_see_). But the effective cure will be found in the careful and persevering rubbing and pressure. Sometimes we find that a failure occurs in the large haunch joint itself, and that is not only shown by pain and stiffness, but by one or more sores that discharge matter, indicating that the bone is diseased. At the same time, the sinews of the limb affected give signs of contraction, and the heel soon refuses to come to the ground in walking. There is clearly a lack of vital energy, such as is wanted to heal the bone and nourish the leaders in this limb: this lack may have been showing itself for years. Apply the ARMCHAIR FOMENTATION (_see_). Soon the sores begin to put on a healthier appearance, and ere long they heal up. With this and the rubbing, the sinews begin to relax and lengthen out, so that the heel comes nearer the ground. The limb may even have become smaller than the other, but it grows so as to come up with the healthy one: this will be the case though the fomentation is done equally to both. It is a curious thing that the body is so constituted that general healthy growth tends to bring on weaker parts more rapidly than stronger ones, so as to restore proper proportions. The new force applied to the roots of nerves on both sides of the spine does not make the healthy limb grow so as to keep in advance of the weakened one; it makes the weakened one grow so as to come up with the healthier. You do not therefore need to confine the fomenting to one side; it is better to apply it equally to both sides, and to leave the laws of the constitution to arrange all matters as to proportion. These laws never fail to do so perfectly. In the hands of a really skilful surgeon, much may be done to remedy diseased bone by the modern methods of antiseptic treatment and operation, but where these are not available, the above treatment has most excellent effects, and has sometimes cured where the surgeon has failed. Limbs, Fractured.--It is not always easy to say definitely whether a bone is broken or not. In general, however, the following are signs of fracture:--(1) Loss of power in the limb; (2) Swelling or pain at the injured spot; (3) Distortion of the limb, usually shorter than natural; gentle pulling makes it temporarily regain its natural position; (4) When the limb is gently moved, it moves at some spot between the joints, and a grating sound is heard; (5) In case of a bone which lies near the skin, a touch will perceive the irregularity due to the fracture. Pending the surgeon's arrival, if there is a fracture, do not attempt to move the patient till the limb is so secured that the broken bone is prevented from moving. If the arm bone is broken, put one splint inside and another outside the arm, and tie two bandages, one on each side of the fracture. Sling the arm in a small arm-sling like the straw envelope of a bottle. If the thigh be fractured, get a long splint, such as a broom handle or a rifle, placing it from the pit of the arm to the foot. Bandage around the chest, the hip bones, legs, and feet, and then by two bandages, one above and the other below the fracture. [Illustration: A Broken Thigh.] If the leg bone or bones be broken, an umbrella makes a good splint. Another splint should be applied on the inside of the leg, the two firmly bandaged together, and finally the legs tied together. [Illustration: A Broken Leg.] If the knee-cap only be fractured, tie the leg on a splint from hip to foot, and keep the limb raised. Almost any firm substance which can keep the limb at rest can be used for a splint, but if hard it should be padded. If the fracture is accompanied with severe bleeding, stop the flow first before attending to the fracture. (_See_ Wounds.) Limbs, Inflamed.--Entirely different treatment from the above is needed for such a thing as inflammation of the elbow, wrist, shoulder-joint or knee. Say it is an inflamed elbow that is to be treated. We describe this; but similar treatment, with very slight variation, such as common sense will suggest, answers for the other joints. Have two large plain towels wrung out of cold water, and folded so as to wrap six ply thick round the elbow. See that the patient is otherwise warm. Place one of the towels round the joint, and gently press it (avoiding pain) so as to draw the heat out of every part. When this is hot substitute the other, and continue with fresh cooling--for an hour if necessary. The cloth may require to be changed perhaps thirty times; but the guide to this is furnished by its heating. When hot, change it. This may be repeated frequently, until the inflammation is subdued. Limbs, Uncontrollable.--This trouble is found in the double form; first, of limbs which will not move when their owner desires to move them; and, second, limbs moving in excessive jerks when they are not desired to do so. These cases are often combined, the limbs being rigid at one time and jerking violently at another. There is no wasting or unhealthy appearance. We have found this condition caused by excessive walking, running, and standing, combined with exposure to frequent wettings. The result is, in essence, that _motor_ power in the limbs is in excess, while _controlling_ power is defective: the case is indeed similar to St. Vitus' Dance (_see_). Bathe the feet (_see_ Bathing Feet) in hot water, and apply cold towels folded and wrung out of cold water (but not iced) along the spine. Keep this up for an hour-and-a-half at a time. By that time the hard rigid feeling in the limbs will probably have disappeared, but great helplessness will be felt. You have removed the excess of motor energy, and must now increase the voluntary energy. This will be accomplished by gently rubbing the back and limbs with hot olive oil, as in Limbs, Drawn-up. This treatment, repeated daily, will usually soon cure. Liquorice.--_See_ Constipation. Liver, The.--Where biliousness prevails, without any symptom of real liver disease, it is well first to look to the state of the stomach and bowels. Take a teacupful of hot water twenty minutes before meals, and the liquorice mixture (_see_ Constipation) after meals. Then give a strong blanket fomentation to the feet and legs for an hour in the evening. If there be pain or feverish heat in the region of the bowels, press cold cloths over the painful part while the feet are fomented. When the liver is really swollen, hardened, or painful, the pulse will either be quick with feverish symptoms or slow with coldness. If it be a feverish case, press cold cloths over the liver, changing them when warm, for an hour: at the same time foment the feet and legs as directed above. See that there is heat enough to make the patient comfortable under the cold applications. Inflammation of the liver will readily yield to this treatment. When the case is a _cold_ one with slow pulse, use no cold cloths, but apply fomentations over the liver, as well as to the feet and legs. Smoking and alcoholic drinks must be entirely given up--these habits are peculiarly severe on the liver. The treatment will not be likely to cure in a day or in a week, but patient perseverance with the fomentations should eventually effect a cure. Too rich food throws a great strain on the liver, and a plain and spare diet with prolonged mastication is necessary with above treatment if a cure is to be effected. Locomotor Ataxia.--This disease is a most difficult one to deal with, and any healing is very slow work. Patients past middle life are specially difficult cases, but we have known cure, or at least great mitigation in younger persons by the following treatment. Beginning, say on a Tuesday, let the lower back be well rubbed with hot olive oil, the patient sitting with the back to the fire, and well covered, except where being rubbed. Continue this rubbing for half-an-hour and not longer than three-quarters-of-an-hour. On Wednesday, soap the back well with soap lather (_see_) and after the soap rub with oil again. Next night, rub with acetic acid (Coutts's) full strength, until the skin is red and smarts moderately. Repeat this on Friday, and on Saturday and Sabbath do nothing. On Monday rub with acid again, and on Tuesday, etc., proceed as before. All treatment is best done at night, and the patient must be kept warm. He should also spend as much time as possible in the open air. Lumbago.--Lumbago differs from both paralysis and cramp of the lower back in that it is not chiefly nervous, as these are, but is a trouble in the muscular substance itself. The muscles are either sprained or chilled, so as to have lost for the time their elasticity. Blistering, burning, and all such irritating treatment are only so many helps to the disease. The true method is found in gentle moist heating of the lower back by a BRAN POULTICE (_see_), not too hot, but renewed, if need be, for an hour each evening. Follow this up with a rubbing with hot olive oil. Wear a belt of new flannel round the body night and day in winter, or if exposed to cold. The treatment is simple, but if persevered in, cures most obstinate cases. Lungs, Bleeding from.--This is usually taken as a most alarming, and even hopeless, symptom. It is not necessarily so at all, and even when a considerable amount of blood is lost, the patient may recover. Therefore, let friends not be frightened when this occurs, but bend their energies to proper treatment, and all danger may be averted. All alcohol must be avoided; it is most hurtful in such cases. Pack the feet and legs in a hot blanket FOMENTATION (_see_) and press cold cloths gently and equally over the chest or back where the blood is felt to be coming from: thus you stimulate the enfeebled nerves and brace the relaxed lungs at one and the same time. Relief will usually be felt at the end of two or three minutes. Continue the application till all pain and uneasiness are gone. _Before_ taking the legs out of the warm pack, dry the chest carefully, rub it with warm olive oil, and wrap it up in good new flannel. Then take out the feet and dry them well; rub them gently and well with warm oil, put on a pair of soft cotton stockings, and allow the patient to rest. Squeeze an orange and give him an orange drink (_see_ Drinks). When you have used this fomentation to the feet, and cold cloths once or twice, it will be well to place a large bran poultice across the lower part of the back, taking care again that this is only comfortably hot. When you have had the benefit of this once or twice, you may place a similar poultice between the shoulders; but this only after you have so far succeeded in cooling down the inflamed lung or lungs, as the case may be. During the whole of the treatment it will be well to watch what is agreeable to the sufferer. It is not only that a certain treatment, or degree of treatment, comforts, but that it comforts because it heals. Move the patient as little as possible during treatment, and do and say all possible to soothe the mind. The whole treatment should be gone over a second time within twelve hours. The second day give one application of the treatment only, and repeat once again the third day. Except for the first time, the treatment may be limited to half-an-hour. Avoid hot food or drink, but it is not necessary to have it positively _cold_. This treatment we have found perfectly successful in many cases. Lungs, Congestion of the.--Treatment as below. Read preceding and succeeding articles. Lungs, Inflammation of the.--This is a common trouble in our climate, and, fortunately, one not difficult to cure if taken in time and properly treated. It is usually the result of a chill, and is accompanied with pain and inability to breathe properly, distressing fever, and often delirium. To begin with, all its evils arise from the relaxing of the vessels of the lungs, so that these swell, and the excess of blood causes inflammatory action to supervene. To guard against it, then, those influences must be avoided which reduce vitality; where they cannot be avoided, all must be done to counteract them. Mere exposure to cold or wet, unless accompanied by exhaustion from hunger, or grief, or other influence of the kind, rarely causes this trouble. Where the trouble has set in, the treatment is the same as recommended above in Lungs, Bleeding from. If the patient be a very strong person, and the fever very great, the fomentation to the feet may be dispensed with; but if any uncomfortable coldness is felt, or the patient not above average strength, it should always be applied. No one who has not seen it can imagine the magical effect such treatment has. It is simple, but its efficiency has been demonstrated in a very large number of cases of cure. Malaria.--Is now known to be conveyed by the bite of a certain kind of mosquito. Those who live in a malarious district should carefully exclude these from their houses, and by draining swamps and covering water butts prevent their breeding, which is always in stagnant water. If, however, exposure to infection cannot be prevented, much may be done to strengthen the system to resist it. Firstly, note that there is a great deal in the _food and drink_ of a family compelled to live in such a district. If they live largely on animal food, and drink alcoholic liquors, they will seriously add to the power of malarial influence. The use of simple food and _pure water_ will very much lessen it. Let us note that the very opposite of the popular superstition is the truth. A single glassful of gin, whiskey, or brandy, instead of "fortifying" against such infection, actually knocks down the "fortifications" which nature has reared against its power. These drinks, then, must be strictly avoided. [Illustration: Muscles of Back (Surface muscles removed on right side exposing the deeper ones).] [Illustration: Massaging the Back.] [Illustration: Massaging the Back.] Massage.--This seems a very simple thing to do, but is by no means easy to do right, and it is very desirable that any one who can see it done by a qualified person should take advantage of the opportunity. The rubber must keep his attention closely fixed on the work, and though this is fatiguing to body and mind, it is absolutely necessary if the patient is to derive full benefit from the treatment. The skin should first be lightly rubbed with olive oil; except in very special cases "friction" between hand and skin is to be avoided. The hand should move the skin to and fro over the muscles and bones beneath, and should be always elastic, so as to go easily in and out of the hollows, and avoid violent contact with projecting bones in the case of emaciated patients. The good rubber should know anatomy so far as to understand where bones and muscles lie (_See_ Diagram, page 216). An intelligent moving of all the muscles of a part is almost equal in benefit to gymnastic exercise, and can of course be given to those for whom gymnastics are out of the question. Yet such rubbing may fatigue a very weak patient, and care must be taken not to carry it too far at one time. There should also never be any hurting of the skin. Where the hands are felt too rough, the back may be covered with a soft cloth, oiled with olive oil. All _strong_ strokes in rubbing the limbs should be directed _inwards_ to where the limb joins the body. The lighter strokes should be outwards. It is always well to have a light and heavy stroke, as a joiner has in sawing. As an instance of how to squeeze, let us take an arm that has got wrong somehow. If you take this arm between your two hands very gently, you feel that it is harder than it should be. The large muscles, even when the arm is at perfect rest, have a hard feeling to your hands, and not the soft, nice feeling which a perfectly healthy arm has. Probably the muscles have been over-stretched, and sprained, or they have been chilled, and so have lost their elasticity and softness. Well, it will be so far good if you can bathe this arm in hot water. It will be better still if the hot water used is full of SOAP (_see_). You can make this bathing ten times more effective, if you only know what is meant by a proper squeezing of the muscles. You use your two hands in the water of the soapy bath, and taking the arm between them, gently press the muscles between your hands, with a sort of working upon them that makes the blood in the stiff parts rush out and in, according as you press or relieve the pressure. If you can only get hold of the idea, it will not be difficult to do this right. It may be that the cords of the arm are not only hard, but also contracted, so that the arm cannot be straightened or bent as it ought to be, but it is still so squeezable that you can squeeze the blood out of it, and it is still so elastic that when you relieve it of the pressure of your hands the blood rushes back into it. If this squeezing is kindly and slowly done, it will feel very pleasant, and very soon its good effect will be perceptible. [Illustration: Massaging the Arm.] It is sometimes thought that there is some "magic" in one person's hands that is not in another's. Here is a case in which one person has rubbed, he thinks, perfectly right, and no relief has come. Another brings relief in a few minutes. It is concluded that some mysterious "gift" is possessed by the latter. This may do well enough for an excuse when you do not care to have the trouble of curing your fellow-creatures, but it is not true. If we are to "covet earnestly the best gifts," it must be possible for all of us to get them. "The gift of healing" is surely one worth "coveting," and we think must be within reach, or we should not be told so to covet it. _See also_ Head, Rubbing the. [Illustration: Massaging the Arm.] Measles.--An attack of this disease generally begins with a feeling of weariness. Then it appears as running and irritation of the eyes and nostrils, at which stage it is often taken for a common cold, the symptoms being very similar. Then this irritation spreads more or less over all the breathing apparatus, and finally the eruption appears in smaller or larger red patches, sometimes almost covering the face and other parts. The usual advice given is to keep the sufferer warm. It is good to do this so far as _avoiding chills_ is concerned, but if the room be overheated and kept close and dark, only harm will ensue. The blinds of the windows should be kept drawn up to their full height, to admit as much _light_ as possible. _Fresh air_ should be admitted by keeping windows open. If the patient complains of sore eyes, these may be shaded by a screen, but not by lowering the blinds. This admission of free air and light is a very great preventive of the "dregs" which form so troublesome a feature in measles. The room can easily be kept sufficiently warm by fire in winter, even if the window be open. The patient must not be allowed to read or use his eyes much, or very serious mischief may ensue. When it first appears in eyes and nose, a good large BRAN POULTICE (_see_) should be placed at the back of the neck and down between the shoulders. Cold cloths should then be pressed over the brow and upper face. Do this for an hour. Give to drink lemon or orange drinks (_see_ Drinks), taken hot, and in small quantities at a time. If this treatment is well done several times, the trouble may possibly be checked at the beginning. Where it has gone further, and cough shows irritation of the air tubes and lungs, then foment the feet and legs while applying cold cloths over the chest, as in BRONCHITIS (_see_). If there be fever, and no signs of rash, then, to bring it out, pack in the SOAPY BLANKET (_see_). Where this cannot well be done, a most effectual pack is a small sheet wrung out of warm water and wrapped round the whole body, with a blanket wrapped well round it outside to retain the steam about the skin. But the soap is better. As a rule, there is not much need for further treatment when the rash fully develops. If, however, fever still remains, rub all over with hot vinegar. This is best done in the evening. When all fever has subsided, a good rubbing of the _back only_ may be given with warm olive oil. This may be done once a day. The feet should be watched lest they get clammy or cold. For food, wheaten-meal porridge and milk food generally is the best. Do not give too much food at first, and keep the bowels well open. Medicines.--The delusion that health can be restored by swallowing drugs is so widespread that we think it well to quote the following wise words from the _Lancet_:-- "An eminent physician not long deceased was once giving evidence in a will case, and on being asked by counsel what fact he chiefly relied upon as establishing the insanity of the testator, replied without a moment's hesitation: 'Chiefly upon his unquestioning faith in the value of my prescriptions.' It might perfectly well be contended that this evidence failed to establish the point at issue, and that faith in the prescriptions of a physician hardly deserved to be stigmatised in so severe a manner. But admitting this, there is still little to be said in favour of the sagacity, even if we admit the sanity, of the numerous people who spend money and thought over the business of physicking themselves, and who usually, if not indeed always, bring this business to an unfortunate conclusion. The whole tendency of what may be called popular pharmacy during the last few years has been in the direction of introducing to the public a great variety of powerful medicines, put up in convenient forms, and advertised in such a manner as to produce in the unthinking, a belief that they may be safely and rightly administered at all times and seasons, as remedies for some real or supposed malady. All this, of course, has been greatly promoted by column after column of advertisement in magazines and lay newspapers; but we are compelled to admit that the medical profession cannot be held free from some amount of blame in the matter or from some responsibility for the way in which drugs have lately been popularised and brought into common use as articles of domestic consumption. Medical men have failed, we think, sufficiently to impress upon the public and upon patients that the aim of reasonable people should be to keep themselves in health rather than to be always straying, as it were, upon the confines of disease and seeking assistance from drugs in order to return to conditions from which they should never have suffered themselves to depart. The various alkaline salts and solutions, for example, the advertisements of which meet us at every turn, and which are offered to the public as specifics, safely to be taken, without anything so superfluous as the advice of medical men, for all the various evils which are described by the advertisers as gout or as heartburn, or as the consequences of 'uric acid,' do unquestionably, in a certain proportion of cases, afford temporary relief from some discomfort or inconvenience. They do this notwithstanding persistence in the habit or in the indulgence, whatever it may be, the over-eating, the want of exercise, the excessive consumption of alcohol or of tobacco, which is really underlying the whole trouble which the drugs are supposed to cure and which at the very best they only temporarily relieve, while they permit the continuance of conditions leading ultimately to degeneration of tissue and to premature death. This is the moral which it is, we contend, the duty of the profession to draw from the daily events of life. The natural secretions of the human stomach are acid, and the acidity is subservient to the digestive functions. It cannot be superseded by artificial alkalinity without serious disturbance of nutrition; and the aim of treatment, in the case of all digestive derangements, should be to cure them by changing the conditions under which they arise, not to palliate them for a time by the neutralisation of acid, which may, indeed, give relief from present trouble, but which leaves unaltered the conditions upon which the trouble really depends. Those who look down the obituary lists of the newspapers will be struck by the fact that large numbers of people, in prosperous circumstances, die as sexagenarians from maladies to which various names are given but which are, as a rule, evidences of degeneration and of premature senility, while many who pass this period go on to enter upon an eighth or ninth decade of life. The former class, we have no doubt, comprise those who have lived without restraint of their appetites, and who have sought to allay some of the consequences thence arising by self-medication, while the latter class comprises those who have lived reasonably, and who, if annoyed by imperfect digestion, have sought relief by ascertaining and by abandoning the errors from which it sprang." Among the most pernicious and dangerous of all the patent medicines on the market are the so-called "Headache Powders," whose almost instantaneous effects testify to the potency of the drugs they contain. Such powerful agents carry their own condemnation, for they cannot in the nature of things _remove the cause_ of the pain; hence their action is limited to narcotising the nerves. The disease continues, the damage goes on, but the faithful sentinels are put to sleep. These headache powders so increased the deaths from heart failure in New York City a couple of years ago that it became necessary to warn the public against them. Memory, Loss of.--A more or less complete suspension of this faculty is a not uncommon form of mental and bodily illness. We do not so much mean the mere fading of past impressions as the loss of power to recall them, so that we cannot recall what we wish to remember. This is a result of any serious bodily weakness. It will come on through any exhausting exertion, or prolonged and weakening illness. Stomach disorder will also cause it. In this last case, drinking a little hot water at intervals will usually put all right. A cup of very strong tea will so derange the stomach in some cases as to cause temporary suspension of memory. We mention these cases to prevent overdue alarm at a perhaps sudden attack. The loss of mental power in such cases does not always mean anything very serious. Just as the stomach affects the memory, so also much use of memory and mental strain tells severely upon the stomach. Digestive failures in strictly temperate persons often arise from an overstrain of the mind. We explain these two actions, the one of body on mind, and the other of mind on body, so that care may be taken, on both sides, of the complex nature we possess. If this is done, there will be little chance of memory failing. Mind in Disease.--Often a person, because of physical failure, becomes possessed of an utterly erroneous _idea_, which no reasoning can change or remove. Indeed, reasoning in such cases is best avoided. Attention should rather be directed to the physical cause of the mental state, with a view to its removal. Very probably you will find there is want of sleep, with a dry hard state of the skin of the head, and too high an internal temperature. You may then work wonders by soaping the head (_see_ Head, Soaping). The back also should be soaped similarly. If too great a cooling effect is produced by this, wipe off the soap and rub hot olive oil on the back instead. If this is not sufficient, rub the limbs also with the hot oil. We have seen the most pronounced insanity yield to this treatment, where the cause has been _physical_ and not mental. The secret of success is in so balancing the heat and cooling applications that the utmost possible soothing can be given without any chill. Miscarriage.--An expectant mother should lead a quiet, orderly and healthful life (_see_ Child-birth). By this we do not mean laziness nor idleness, nor treating herself as an invalid. On the contrary, plenty of work, both physical and mental, and regular exercise are most beneficial, but care should be taken that work should not go the length of over-fatigue, and excitement, worry and anxiety should be carefully guarded against. The round of parties and other social functions into which many brides are drawn, frequently becomes the cause of miscarriage and other troubles. Any excitement, mental or physical, is most injurious, and the husband and wife who sacrifice present enjoyment will be richly repaid afterwards in the greater vigor and healthiness of the child; while those who live for the present will often have bitter regrets of what might have been. If any weariness, heaviness, or pain are felt in the region of the abdomen, groin, or back, half-a-day, a day, or a few days in bed should, if possible, be taken. If any appearance of bloody discharge be noticed, there is decided danger of miscarriage, and the patient should immediately go to bed, remaining, as far as possible, perfectly flat on the back until the discharge ceases. It is even useful to raise the feet higher than the head, by placing bricks or blocks under the feet of the bed. The covering on the bed should be light, only just what is necessary to keep one comfortable, and the windows should be kept open. Light food should be sparingly taken for a day or two; not much liquid, and nothing hot should be drunk. A towel, wrung out of cold water, placed over the abdomen or wherever pain is felt, and changed when warm for a fresh cold towel (_see_ Bleeding), will help to soothe the pain, allay the hemorrhage, and induce sleep. The mind should be kept at ease, for such precautions, taken in time, will probably put all right. After the hemorrhage has entirely ceased, and all pain disappeared, some days should be spent in bed, and active life be only gradually and cautiously returned to. When there is danger of miscarriage, purgatives should be avoided; a mild enema is a safer remedy, if needful, but for two or three days perfect rest is best, and if the food be restricted, the absence of a motion of the bowels will not do any harm. The patient should, of course, have the bed to herself. Miscarriages most frequently occur from the 8th to the 12th week of pregnancy. The time at which the menses would appear if there were no pregnancy, is a more likely time for a miscarriage than any other. It should be remembered that miscarriages are very weakening and lowering to the general health, and to be dreaded much more than a confinement. The latter is a natural process, and, under healthy conditions, recovery of strength after it is rapid, while a miscarriage is unnatural, and is frequently followed by months of ill-health. Another thing to be remembered is that a habit of miscarriage may be established; after one, or more especially after two or three, there is likelihood of a further repetition of such accidents, resulting in total break-up of health. Muscular Action, Weak.--The heart is the most important of all muscles. Sometimes the action of this is so weak that the pulse in the right wrist is imperceptible, and that in the left extremely feeble. The heart may be beating at the usual rate, only its stroke is much too feeble; and the effects are found in enfeebled life generally, sometimes shown in fainting fits. If such come on, lay the patient flat on his back, and if consciousness does not return shortly, apply a hot FOMENTATION (_see_) to the spine. Sometimes this heart weakness is only a part of a general muscular failure. Muscles elsewhere in the body may even swell and become painful. If strychnine be prescribed, refuse it. It has only a temporary power for good, soon passing into a wholly bad effect. Thoroughly good vapour baths will effect some relief, and may be taken to begin with. The best remedy is found in gentle rubbing and squeezing the muscles in every part, specially attending to any that may be swollen and painful. Squeeze gently the muscular mass, so as to press the blood out of it. Relax the pressure again so as to admit the blood. Where no help can be had, we have known a patient so squeeze herself as to restore action to a useless limb. But of course it is best if it be well and frequently done, say twice a day, by a really careful operator who has some idea of anatomy. This may seem a simple remedy, but we have known two inches added to the length of a shrunken limb by its means, and the patient restored from apparently hopeless lameness to fair walking power. _See_ Massage. Muscular Pains.--These pains occur usually when a patient has been for some time in one position, sitting or lying, and rises suddenly in a particular way. They sometimes take such hold of the breast or back muscles as to make it appear as if some serious disease were present; even in the limbs they may cause great distress on any sudden motion. They may arise from a gradual _overdoing_ of the muscles concerned. They are similar to what is commonly called a sprain, but as they are _gradually_ produced their cause is often overlooked, and needless distress of mind caused by taking the pain for that of cancer or some such trouble. We write to point out that pains do not always mean serious disease, and before any one becomes despairing about their health, they should make sure they understand their case thoroughly. These pains, too, refuse to yield to ordinary hot and cold methods of treatment. The remedy is found internally in half a teaspoonful of _tincture of Guaiacum_ in a teacupful of hot water three times a day. After two or three days, a teaspoonful of the tincture may be taken in the cup of water. Continue until two ounces of tincture have been used. Or the tabloids of _Guaiacum and sulphur_, now found in our drug shops, may be taken, one tabloid representing the half-teaspoonful of tincture. Externally, rub gently yet firmly the affected muscles with warm oil for ten minutes or so once a day for a week or ten days. Of course, rest must be taken, and the overstress which caused the trouble avoided in future. Mustard Oil.--Where this is recommended the cold-drawn oil is meant, not the essential oil. The latter is a fiery blister. Narcotics.--The use of these to give temporary relief, often degenerating into a habit, causes so much serious disease that we have felt constrained to insert an article warning our readers in regard to it. The use of tobacco we have found a fruitful source of dangerous illness. It tends to destroy nerve power, and through this to relax the muscular system. It has a most dangerous effect upon the mind, relaxing the brain, and even causing some of its functions to cease. It hinders clear reasoning, and in many cases brings on incipient paralysis. It is a fruitful source of cancerous diseases of the mouth. It destroys keenness of vision. It is of no use to quote exceptional cases in such an argument. Great men have smoked, as some great men have habitually drunk, to excess. But that is no argument for the average man of whom we speak. The very difficulty he has in giving up the use of tobacco indicates a diseased state of the nerves, which no wise man will willingly bring on himself. The effect of the continued use of opium, chloral, and many drugs taken to gain soothing or sleep is _dreadful_: so much so that we have seen patients who were deprived of them, after some time of continuous use, perfectly _mad_ with agony. Let our readers remember that the relief given in using such drugs comes from a benumbing of the vital nerves. Their influence is _deadening_, and, if strong enough, kills as surely as a bullet. The wise medical man will, if he does administer such drugs, take care they are only taken once or twice. If a doctor orders their continual use he is to be distrusted. By all means let our readers avoid the terrible snare of ease and sleep obtained through narcotics. It is generally easy to give relief, in the various ways described in these papers, without resort to any such hurtful methods. Suppose that you try a very hot application to the roots of the nerves affected, if you can guess about where those roots are. The doctor should help you to know this. The hot poultice is put on--we shall say it fails to relieve. Well, you put on a cold application at the same place. That relieves slightly. Whichever of the applications relieves should be followed up vigorously. Do not say, "Oh, it gives relief for a little, and then the pain returns." Follow up the little relief, and change from heat to cold as the pain or relief indicates. You can do no possible harm by such processes, and in multitudes of cases all will soon be right, and no opiate required at all. But you must not think all remedies at an end when you have tried one or two singly, and relief does not yet come. The large hot poultice may be put on the roots of the affected nerves, and ice-cold cloths placed on the branches of these nerves at the same time. Then the cold ice cloths may be placed on the roots and the hot on the branches. But remedies are not exhausted, by any means, when you have thought of two or three applications of heat and cold. The whole nerve system can be influenced by the rubbing of the head and spinal region, so as to wake up a strong increase of vital action in the nerve centres there. We have seen a patient who had been for months under medical treatment, and in agony except when deadened with narcotics, rendered independent of all such things by a little skilful rubbing alone. Perhaps you object that these remedies are "very simple." Well, that would be no great harm; but if they are so simple, you are surely a simpleton if you let your poor nerves be killed with morphia, while such obvious remedies are at hand. (_See_ Massage.) Neck, Stiff.--For this, rub the whole back with soap lather (_see_ Lather; Soap), and then with acetic acid and olive oil. Rub the neck itself as recommended for Muscular Action. Neck, Twisted.--This arises from the undue contraction of some of the muscles in the neck. It generally shows itself first in the evening, after the day's fatigue, and if neglected, or treated with blistering, iodine, etc., may become a chronic affliction. Yet it is not difficult to cure by right means. Opium should never be used. We have seen terrible suffering follow its use. The true cause must be attacked, which is an undue irritation of the nerve which controls one of the muscles, so that it contracts and pulls the head away. The nerves of the muscles which counteract this pull are also probably low in vitality, so that there is a slackening on one side and a pull on the other. First of all, for a cure, there must be _rest_. Not more than three hours at a time should be spent in an erect posture, and between each spell of three hours let one hour be spent lying down. Avoid _all_ movement while lying, as far as possible. Secondly, soap the back thoroughly with LATHER (_see_) at bedtime. Cover the well-lathered skin with a large, soft cloth, leaving the cloth and lather on all night, and covering over all with flannel in sufficient quantity to keep the patient warm. If the spasmodic twitching comes on, apply cold cloths repeatedly to the back of the neck for an hour in the morning. If this is felt too cold, apply for a shorter time. If the neck has become hard and fixed in a wrong position, rub as recommended in Muscular Action. This treatment has cured many cases. Nerve Centres, Failing.--Many diseases flow from this cause, but at present we only consider one. That is where a "numbness" begins to show itself in fingers and toes, and to creep up the limbs. No time should be lost in treating such a case. It arises from failure in the spinal nerves, and these must be nursed into renewed vitality. This will be greatly helped by wearing over the back next the skin a piece of new flannel. Rub (_see_ Massage) the back with warm olive oil night and morning, working especially up and down each side of the spine. Pursue this rubbing gently but persistently, but do not fatigue the patient, which may easily be done. Cease rubbing the moment fatigue manifests itself. Continue this treatment for weeks even, and also treat, as in next articles, _mind_ as well as body. (_See_ Locomotor Ataxia.) Nerve Pain.--_See_ Pain. Nerve Shock.--After a fright, or some very trying experience, some part of the nervous system is frequently found to have given way. Heat is felt in the stomach. Then, if no treatment is given, curious feelings come on in the back of the head. Even inflammation of the stomach and brain may come on in severe cases. In any such trouble, alcoholic drinks, blisters, opium, and all narcotics are to be strictly avoided. These only lessen the already weak nerve power. Show the patient in the first place that there is no need for anxiety, the vast majority of such cases being easily curable by right treatment. We have seen this relief of mind alone effect a perfect cure. Therefore see to giving it. Wring tightly out of cold water two ply of new flannel, large enough to go round the lower part of the body, from waist downwards to hips. Put these round the patient, with two dry ply of the same flannel above them. Wear this night and day for a week or a fortnight. Keep the feet always warm and dry. Give plain, easily digested food. If St. Vitus' Dance shows itself, treat as directed under that head. Study the case in the light of all said on nervous troubles in these pages, and you will be able to cure almost any symptoms which may arise. Nerves, Shaken.--By this we mean, not the nerve trouble which follows a sudden injury or fright, but the result of long-continued worry and overwork. Sleeplessness, great irritability of temper, depressing thoughts, restlessness, and even a wish for death, are all symptoms of this trouble. In any effort to cure it, the _mind_ must be largely considered. Thoughts of the constant care of a loving, Divine Saviour for even the least of His children, must be encouraged. Work, which is an intolerable burden when depressing thoughts are encouraged, will become easy when these are removed. If you get the sufferer made hopeful for time and for eternity too, you have half won the battle. Again, in bodily matters, food or drink which is exciting must be given up, or very sparingly used. Tea should only be taken weak, and _at most_ twice a-day. Avoid long conversations, and especially discussions and debates. Let the head be soaped (_see_ Head, Soaping) with soap lather at night, and rub all over with hot vinegar and olive oil before rising in the morning. Many a shaken nervous system will speedily recover under such treatment. Take also _eight good hours_ for sleep, and allow no ideas of business or work to intrude upon them. No more valuable habit can be formed, by the healthy as well as by the nervous, than this. The whole will should resolutely be bent to remove the attention from every trying thought, when the hours of work are past, and especially on retiring to rest. Always recollect that this _can_ be _done_; assert mentally, or if necessary, audibly, that it shall. Do not let initial failure disappoint you; persevere and a habit will be formed. When the brain gets a fair rest in its hours of leisure, it is usually equal to all demands in ordinary hours of work. All brain workers, in their leisure hours should let the brain rest, and if they must do something, let it be as diverse from their work, and as easy on the thinking power as is possible. (_See_ Worry). [Illustration: From "Furneaux's Elementary Physiology."] Nerves, Spinal.--The spinal cord is continuous with the back part of the brain. It is a mass of nerve fibres, and from it branch off in pairs, all the way down from the brain, the great nerves which move the limbs and muscles of the body, and receive the impressions of sensation for conveyance to the brain. It is permeated by numerous blood vessels, which supply what is needed for the upkeep of the whole mass. When these relax, and become overfilled with blood, we have congestion of the spinal cord. This may often be easily remedied by cold cloths applied over the spine, with fomentations to the feet if necessary (_see_ Children's Healthy Growth; Fall; Paralysis; St. Vitus' Dance). If, on the other hand, the vessels are contracted, or the blood supply defective, we have great languor and coldness. This usually may be remedied by rubbing over the spine with hot olive oil. Violent heat, or blistering, simply destroys the skin, and hinders healthy action. Gentle heat, or gentle cooling, long continued, is the best treatment. Especially is this true in the case of little children (_see_ Children's Healthy Growth). For treatment of the nervous system, peculiar attention should always be paid to the point where all the spinal nerves enter and issue from the brain. This is at the hollow usually present at the base of the back of the skull, where it is jointed on to the spinal bones. Rubbing here is most powerful, either with acetic acid or olive oil, and hot or cold cloths should always be well pressed into the hollow, when applied to the head or upper spine. (_See_ Diagram, page 234). Failures of muscular power are caused by failure in the spinal cord. If a child cannot walk, but only trails his legs, or if he cannot hold his head erect, skilful rubbing with hot oil on the spine will often quite cure the defects. Do not rub too hard. Feel for the muscles around the spine, and gently insinuate healing influence with your fingers, so as to reach the nerves below. Use a moderate quantity of oil, and the effects will be marvellous. Nerves, Troubled.--Often a state of the nerves exists, without any apparent unhealthiness, which makes the whole system so sensitive, that ordinary sights, sounds, and smells become unbearable, and the patient feels the ordinary round of experience, which would never be noticed otherwise, an intolerable burden. Strange feelings all over the body, and an indescribable series of seemingly "fanciful" troubles, come on. It is of no use, and indeed injurious, to treat such cases as merely fanciful. The wrong bodily condition must be righted if the mental condition is to improve. The first thing needed is _quiet_. Quietness rests the overstrained nervous system very much. Nerve-benumbing drugs are most hurtful (_see_ Narcotics). Let the light in the room be subdued, and strong smells avoided. To rest the skin nerves, wear only Kneipp linen underclothing, and flannels _above_ this if required. Bathe the tongue and palate by taking mildly warm water into the mouth and ejecting it again. Soap the head, and all over the body, if it can be done without chilling, three times a week. (_See_ Head, Soaping; Lather, etc.). Nervous Attacks.--What we call, for want of a better name, "nerve force," or "nerve action," is at any one time a definite quantity. In health it is distributed to all the sets of nerves equally, so that all work in harmony. But if its distribution be altered in certain ways, we find "fits" or "attacks" coming on. Action is greatly exaggerated in one part, and as greatly lessened in another--hence violent movements and complete unconsciousness co-exist. Children often have such fits. Where they arise from _indigestion_ as a result of bad food, the cure is found in teaspoonfuls of hot water, and a hot sitz-bath coming up over the bowels. Where bad blood causes the fits, poultices over the kidneys will usually help greatly. (For fits of teething children, _see_ Teething.) _See also_ Epilepsy. Nervousness.--This frequent and distressing trouble is to be traced to a state of the nervous system in which sensibility has got the upper hand, and self-control is partly lost. It is difficult accurately and briefly to describe, but is an easily recognisable state. Firstly, then, we say this is a physical trouble, and the patient must not be blamed for it, but encouraged kindly to make every effort of _will_ to throw it off. A strong will can be cultivated, just as a strong arm, by _exercise_. Peaceful thoughts and Christian faith can also be cultivated, and anxious and disturbing ideas put down. Uniform, steady conduct on the part of all around is an enormous help to the nervous. For physical remedies, use no alcoholic drinks. These give temporary relief, but are fatal in their after effects. To cure nervousness is impossible unless these are given up. The physical treatment necessary will be found under Nerves, Shaken, and Nerves, Troubled. Nervous Prostration.--Persons suffering from nervous prostration have probably allowed the urgency of seeming duty to drive them on in work till the vital energies have been fairly exhausted. At last they are completely broken down, and the very fountains of life are dried up. The brain itself has become incapable of giving sleep, or sound thought. But there is no need for despondency: this trouble is perfectly curable, only the right means must be employed. In every case of real "nervous prostration," our question must be--How shall we enable this vital element to recreate itself? The answer is, with heat. Here we may detail the process which we know to be successful. Dip a four-ply cotton cloth in cayenne lotion, and lightly wring out. Lay this gently over the stomach and bowels, and over this an india-rubber bag full of hot water. All must be only hot enough to be comfortable. This application may remain on for two hours without any change, then it is repeated. Where no bag can be had, a good thick fomentation should be used instead. _See_ Nerves, Shaken; Nerves, Troubled, and all articles on nervous trouble. Much depends on consideration of the individual case, and careful thought and strong sense are needed on the part of all dealing with such cases. (_See_ Changing Treatment.) Dessertspoonfuls of light food should be given every half-hour, and increased in quantity as the patient can bear it. Avoid alcohol and all narcotics. Nettle Rash.--This is an eruption on the skin, often coming suddenly and going off again, but sometimes of long standing. It resembles in appearance the sting of a nettle--hence the name. It is accompanied by an intolerable itching, and is a very sore trouble where it continues, or frequently recurs. Its cause is usually defective digestion. We should not depend on drugs for a cure, but treat first the whole spinal system. Rub the whole back smartly with vinegar. Wipe this off, and rub again with gentle pressure and warm olive oil. Put on the soapy cloth (_see_ Soap) with the lather very finely wrought (_see_ Lather), and free from excess of moisture. Over this lathered cloth put a good blanket Fomentation (_see_), changing it once or twice, so as to keep up the heat for half-an-hour. When all this is taken off, we should rub again with vinegar and oil, as at first. If the case is a sudden attack, we may soak the worst parts of the eruption with weak vinegar; but if a chronic one, the rash is better left untouched. The treatment to the spine may be continued daily. If the rash has been irritated into running, scabby scores by scratching, it may be cleaned with weak vinegar. A little cream of tartar or powdered rhubarb and carbonate of soda mixed in equal parts may be taken internally after meals--say about one-fourth of a teaspoonful in a little water. If this quantity exercise too great a cooling effect, smaller doses will produce very good results. Kneipp Linen Underwear will in many cases of such skin trouble give great relief. Neuralgia.--This is severe pain in one part or other of the body, sometimes followed by swelling of the painful part, but frequently without much sign of anything wrong at that point. It is, as the name implies, a trouble affecting the _nerves_ which are connected with the painful part, and usually there is nothing whatever wrong where the pain is felt. Where, however, violent pain in the head or jaws results from chill, there is an altogether different trouble, though it is often called by the same name. We have seen a man who had been in agony all night with pain all over his head. We took a large piece of flannel, about the size of a small blanket, rolled it up so as to get about a quart of boiling water poured into the heart of the roll. We kneaded the whole for a little time, to have the heat and moisture well diffused through the flannel. We now placed a large towel fourfold on the pillow under the patient's head, so that it could be brought as a good covering over the hot blanket when that was on. We opened up the blanket steaming hot and laid the head in the heart of it, bringing it carefully up all round, then brought the large towel over all, and tucked him tidily in about the shoulders. In less than two minutes he exclaimed, "I'm in Paradise!" The pain was all gone, and in its place was a positive sensation of delight. There was nothing here but a chilled skull to deal with, and as soon as it felt the heat and relaxed, the man was perfectly relieved. Then came the question as to how what had been got was to be secured, so that he might continue well. After he lay about three-quarters of an hour in this hot fomentation of the head, we took it off, and rubbed gently some warm olive oil into the roots of the hair, and all around the head and neck. We then gave all a good dry rubbing with a hard towel, and covered up his head carefully, and kept it covered for a day or two. He required no more treatment of any kind. But when this treatment increases the pain, or fails altogether to remove it, we have a trouble which calls for the _very opposite treatment_. Then we have true neuralgia, which may be in any part of the body, and which is relieved by cooling the roots of the nerves which supply that part. For the face and jaws, cold must be applied to the back of the head, neck, or brain generally. For pains in arms, cold is to be applied to the upper, and for pain in legs to the lower part of the spine; for pain in the body, cool the whole length of the spine. The cooling is done by cloths moistened in cold water and well wrung out, pressed on gently over the part, and renewed as they grow warm. If the patient feels chilly, foment or bathe the feet and legs up to the knees during the process of cooling. This may require to be done for an hour. Finish by rubbing the parts cooled with hot vinegar and olive oil, and wiping off. Even young people are exposed to a great deal of suffering from this source, and we feel sure that every one of these may be at once relieved and cured by the vigorous use of the cold compress. When the patient is warm in bed, the cold compress is one of the most delightful of applications; and the warm olive oil, to keep what has been got, make up a real blessing for the sufferer. We have seen cases in which the cold compress has been applied up and down the spine, but not with that full effect which could be desired. Somehow it has not power enough in the hands applying it to reach the roots of the evil. The want in such a case is generally of a person sufficiently skilful in the use of the cold towel. There is a way of pressing it gently over all the parts under which the affected nerves lie, which secures the cooling of those roots very effectually. But such skill is not always at hand when needed. Well, mustard is spread over the surface of the cold towel, and the compress, thus increased in power, is placed all along the centre of the back. We find that very soon the pain begins to moderate, and ere long it has ceased. If it has to be applied more than once, cayenne is greatly to be preferred. The pepper does not hurt the skin, the mustard very soon does. A cold damp towel, folded at least four-ply, and placed properly, after being sprinkled well with cayenne, has an excellent effect. In wild toothache, or bad nerve pain in the head, massage all over the head for a considerable time will often cure. We know cases in which agonising pain was thus removed years ago, and it has never returned. There was first rubbing, in a gentle soothing way, over the whole head. At a certain point, that began to lose its soothing influence. The cold towel was then wrapped round the head, and gently pressed. As soon as it warmed it was changed. This was done for perhaps three or four minutes, and the rubbing repeated. The whole was kept up for about an hour. All pain and uneasiness were then gone, and there was no return of either. It will be seen that it is essential properly to distinguish between the pain requiring heat and that requiring cold for treatment. In any case it is safe first to try the heat. Failing relief with this, the cold may be tried. Sometimes the cooling of the head and spine succeeds in driving off several attacks, but eventually fails to relieve. If in such a case the cold is applied over the stomach, there is frequently almost instant relief. Where the attacks can be traced to indigestion, or come on always a certain time after a meal, this is the proper method from the first. Where a decayed tooth is the cause of pain, of course go to the dentist. Night Coughs.--These frequently remain as the so-called dregs of some illness, and are found very persistent. They are also frequently very alarming, as they are thought to indicate some trouble in the lungs, and as immediate steps should be taken to check this, it is well to consult a good doctor. But, though coughing at night does of course accompany lung disease, it is by no means a chief symptom. Also, it is evident that the treatment applicable to bronchitis and other chest inflammations will often fail to relieve a night cough, because the night cough in question is due to nervous irritation or indigestion. Narcotics are useless and hurtful. Great relief is frequently found from inhaling the smoke of burning nitre or saltpetre. Blotting paper may be soaked in a solution of saltpetre, dried and lighted. Place the burning substance near enough the patient for him to inhale the smoke, but not so near as to interfere with _easy_ breathing, especially in cases where there is great weakness. When patients are fairly strong the back should be rubbed with warm olive oil for ten minutes or so in the morning before getting out of bed. Then apply a cold towel, well wrung out, folded lengthwise along the spine, and over it a dry one. Let the patient lie on this, and renew it when heated, continuing altogether for fifteen minutes or so. Give another fifteen minutes' rubbing with the hot oil before dressing. If the patient feels chilly during the cooling, foment the feet and legs at the same time. Nightmare.--In serious cases of this trouble, the patient awakes some time before he gains any power whatever to move, feeling held as in a vice. But in common instances, the attack is entirely during sleep, and accompanied by frightful dreams. A heavily-loaded stomach, pressing on the solar plexus of the nerves, is a very common cause. The burdened nerves partially cease action, and this gives rise to the trouble. Anything similarly affecting these organic nerves will cause it also; but if the stomach be at fault, reduce the food and let the last meal be light and not later than six o'clock. This followed by a cup of hot water, before going to bed, will work a perfect cure. When it is feared there may be an attack, _lying on the face_ in bed will often prevent it, even if the patient so lies for a very short time, and then turns on the side again. When students, or school children, are over-driven (_see_ Children, various articles), nightmare, very persistent, is one of the symptoms. In such cases, there is _urgent need_ of rest, or most serious consequences may follow. Treat as recommended in Depression, and if any nervous troubles show themselves, treat as in various articles on nerve affections. Bad dreams, especially with children, are a sure sign of something wrong with the health, and should always lead to investigation, that their cause may be found and removed. Night Pains.--If these are of the nature of _cramps_, which come on while lying in bed, the treatment is similar to that given above as morning treatment for Night Coughs, only the cooling must be continued for three-quarters of an hour or longer, fomenting the legs if any chilliness is felt. Cold towels may also be wrung out before going to bed, and put within reach. These may be applied when the cramps come on. They will usually relieve speedily. Spasmodic asthma may be relieved by the same treatment. It often comes on when lying down, and cold towels applied as above directed will generally relieve. Fomentations must be given to the feet and legs, if any feeling of chill is felt. Where there is _difficulty in breathing_ on lying down, usually the heart is at fault. Sometimes the heart is all right, and this hard breathing is nervous, caused by too sudden lying down. To lie down, propped up with pillows, which may be removed one by one, is often sufficient to cure it. The treatment in the morning as in Night Coughs will also greatly help. Another set of night troubles are such as arise from unwise use of foods or drinks before going to bed. Tea taken at or near bedtime will often cause sleeplessness, and will be apt also to give spasmodic asthma; so will all indigestible foods. These overpower weary organs that need rest and sleep, and not food. Most people will do well to take their last meal four hours before retiring. Taking supper is a habit, and in many cases a very bad one. Night Sweats.--This distressing symptom, which accompanies various illnesses, can in most cases be easily cured. The whole skin is to be sponged over at bedtime with CAYENNE LOTION (_see_). This is best done under the bed-clothes. Acetic acid, the effective essence in vinegar, has an astonishing power in healing and stimulating the skin. When it is assisted by cayenne its healing power is very great indeed. The nerves are stimulated, the too open pores closed, the skin cleansed, and the whole system invigorated by such a mixture, and as a result the night sweats disappear. Even where the case is hopeless, much suffering may be prevented by the use of this mixture. In conjunction with other treatment, its use may even turn the scale towards recovery. Noise and Disease.--Perhaps nothing shows more the lack of human feeling in many people than the manner in which they inflict sore distress on the sick and dying by means of noise. Moreover, recovery is retarded, and has sometimes been wholly prevented, by nothing but a _noise_. It must be understood that talking, and also singing, which are delightful to some, become intolerable pain to the delicate and weak. They really are _worn out_ by them. And the wearing out is _real_: it is a destruction of nerve substance, when the nerve of the patient is already too feeble. Shutting doors violently, and the endless "house noises," must be avoided. Even a long, loud prayer at the bedside of the sick is utterly out of place. It may become necessary, in order to prevent such abuses, to exclude from the sick-room some who will be greatly offended thereby; but courage to defend a patient against well-meaning intruders is one essential qualification of a good nurse. Oil doors that _squeak_, fasten windows that _rattle_, but above all keep quiet the tongues that _clatter_. Let all whispering in the sick one's hearing be avoided. Speak quietly but distinctly, so that the patient may not think you are hiding anything from him. Wrap the coals in pieces of paper, so that they can be put on the fire by hand, avoiding the noise of shovel or tongs. No one has a right to do what distresses others, and especially when they are sick. This principle should guide action. Acting thus will give untold rest and ease to the troubled. Nostrils, The.--The disease called Polypus, affecting the mouth or nostril with growths which are usually removed by force, is one of those troubles curable by proper use of vinegar or weak acetic acid. The extraction of the Polypi is painful, and we have ourselves seen them so completely cured, that it is a pity not to make very widely known a method of avoiding extraction. A small glass syringe or a "nasal douche" (rubber is best) should be got, such as may easily be used for syringing the nostrils, or gums, if the growth be on these. Syringe the growths well with vinegar or ACETIC ACID (_see_), so diluted with water as only _very slightly_ to smart when it is applied. Use this slightly warm, and force it well up the nostril, so that it goes even back into the throat. This should be done for a considerable time: not so as to feel painful, but long enough to produce a decided effect, which remains on ceasing. Dry the nostrils with a little soft lint or clean rag, and force in a little fine almond oil. Do all this twice a day for a fortnight at least. In a bad case, a BRAN POULTICE (_see_) may be applied to the back of the head and neck, coming down over the spine between the shoulders. Similar growths on other membranes, if accessible, may be cured by acid in a similar way. This treatment is excellent for an ordinary cold in the head. Nourishment.--Nothing is more required in healing than properly to _nourish_ the enfeebled body. In its commencement proper nourishment demands a proper mixture of food and saliva. In fever, if there be little or no saliva present, food requiring much saliva to fit it for digestion only injures. This is the case with so-called _rich_ foods, especially. Excessive thirst usually marks this deficiency of saliva. Always consider carefully the flow of saliva before feeding a patient in a weak state. Get the mouth to "water" somewhat before giving food. We have seen a cold cloth changed several times over the stomach start the flow of saliva almost miraculously, relieving the thirst, and prepare for nourishment which could not be taken before. Going further into the matter, we see that very likely the stomach requires assistance to dispose of even well-salivated food. There may be a lack of gastric juice. In this case, frequent and small quantities of hot water supplied to the stomach will greatly help it. A wineglassful of hot water taken every ten minutes for two, four, or ten hours will be sufficient (_see_ Digestion; Indigestion). It is well to think ten times of the readiness of the system to digest, for once of the food to be taken. If the stomach be either burning hot or cold and chilly, let it be cooled or warmed, as the case may be. Either use cold towels or give hot water as above, as the case demands. When it is brought into something like a natural state of feeling, you may then give food. The hot water will often not only prepare the stomach, but will start the flow of saliva in the mouth, and that even when the cooling cloth has failed to do so. A medical man will, at times, forbid water, however thirsty the patient may be. He is not unlikely to be labouring under a serious mistake. It may be just the want of water which is causing the very symptoms which he thinks to cure by withholding it. We never saw anything but suffering arise from withholding water from the thirsty. Milk is a prime element in nourishing the weak. Mixed with its own bulk of boiling water, or even with twice as much, it is immensely more easy to digest. The simple water is of vast importance, and the milk mixed with boiling water is quite a different substance for digestion from the fresh pure milk. It is better to have a teaspoonful of milk and water really digested than a pint of rich milk overloading the stomach. Many persons put lime-water into the milk to make it digestible. In doing so they put a difficulty in the way, in the shape of the lime. If one tries to wash his hands in "hard" water, he sees how unfit that water is to do the proper work of water in the blood and tissues of the body. Now, it is not difficult to meet this evil where the only water to be had has a great deal of lime in solution. Boiling this water makes it deposit much of its lime. If a very, very small bit of soda is mixed with it in the boiling, it lets down its lime more quickly and completely. Alcoholic drinks--wine, porter, or ale--are often given as means of nourishment. They are hurtful in the extreme, as the spirit contained in them spoils, so far as it acts, both the saliva and the gastric juice. Rum and milk, sack whey, and other such preparations are equally bad, and have killed many a patient. While suitable nourishment is necessary for the sick, great care should be taken to avoid giving too much. Often the amount of food the patient requires or can assimilate is _exceedingly small_. Injudicious attempts to "keep up the strength" by forcing down food that cannot be digested often destroy the little that remains, and remove the only hope of cure. (_See_ also Assimilation; Biscuits and Water; Blood; Bread; Buttermilk; Child-Bearing; Constipation; Diet; Drinks; Dyspepsia; Foods; Heartburn; Infants' Food.) Nourishment, Cold in.--If a person is in fever, and is burning with internal heat, a little bit of ice, sucked in the mouth, gives great relief. The relief is got in this way: the melted ice, in the form of water, is little in bulk in proportion to the heat which is absorbed in melting it. To absorb the same heat by means of merely cold water, would imply a great amount of water, and an inconvenient filling of the stomach. The heat used up in melting the small bit of ice is great, and the amount of water exceedingly small. This gives benefit without inconvenience; hence, to suck a bit of ice is to be much preferred in such a case to taking a drink of cold water. Within proper limits, beyond all question, cold is, in certain cases, essential to nourishment. For example, in a case of thirst such as we have noticed, the heat of the stomach extending to the mouth is drying up all the juices that should go to secure digestion and assimilation. The saliva is dried up, and the gastric juice equally so. Cold is applied to the pit of the stomach (not ice, but a moderate degree of repeated cold), and the result is, these juices begin to flow. Nourishment is the consequence, and very clearly, in such a case, it is the consequence of cold. In other words, it is the result of reducing the excessive internal heat, and leaving something like the proper degree behind. The place which cold has in nourishing is, so to speak, negative--that is, it is useful only in reducing overheating. But when we remember how a frosty morning sharpens appetites and makes the cheeks glow with ruddy health, we see that such reduction of overheat is not infrequently required. Nourishment, Heat in.--Heat is absorbed in building up the bodily tissues, and given off when they are disintegrated. To rightly understand this is of great importance in all treatment. When a living substance is growing, it demands heat. An illustration of this is the sun's heat causing what we call "growing weather." Again, where substances are breaking up, as in burning wood, heat is given out. In the stomach, a certain amount of heat is needed during digestion. If it is not given, indigestion ensues. To swallow ice, where the stomach has already insufficient heat, is then great folly. On the other hand, to take hot water is to do the very thing which gives the stomach what it needs, and so to relieve the indigestion. Many times, when the stomach simply stands still from lack of energy, it will move immediately on getting a glass of hot water to help it. Similarly, a little genial heat assists other failing organs. As we have shown how cold diminishes the excessive action of inflammation and fever, so we now point out that if you can find out what organs are feeble and acting insufficiently, and stimulate them with gentle heat, you are on the way to a cure. Nursing Over.--Few vital processes are more remarkable than that by which food fitted for adults becomes in the mother's breast food fit for the little infant. In nursing it is well to remember that all food is not equally fit to be so changed. Well-boiled porridge, of either oat or wheaten meal, is probably as good as can be got. Malt liquor, though causing a large flow of milk, most seriously deteriorates its quality, and should be entirely avoided. But in this article we think chiefly of the mother, and of the necessary drain of blood and vital force which she bears in nursing. In most cases this drain is easily borne, in others the child is fed at the mother's expense. The supply of power, in such cases, is not equal to the loss of it in feeding the child, and the reserve in the mother's body is slowly used up. She becomes thin and pale, and her nervous system begins to suffer. When this is the case, either means must be used to increase her vital power, or nursing must at once be given up. Of course, where she may have had insufficient or unsuitable food, a change of diet may work a cure; but, as a rule, the drain of nursing will have to be stopped. To help her restoration, whether she ceases to nurse or not, use the following mixture and treatment: Boil a stick of best liquorice for half-an-hour in a quart of good soft water. Add one quarter of an ounce of camomile flowers, and boil for another half-hour. Keep the water up to the quantity by adding _boiling_ water as required. Strain the mixture, and give a dessertspoonful thrice a day before meals. If the dessertspoonful be found too much, a teaspoonful may be taken. The patient, if any heart trouble is felt, should go to bed early, and have the feet and legs fomented, and cold cloths pressed over the heart. This may be done for three or four nights. After this, each night for a fortnight the back should be well washed with SOAP (_see_) and hot water, and rubbed with vinegar and hot olive oil. Let each be dried off before the other is applied. Oil, Olive.--A little oil only should be applied to the skin at once. Any such _smearing_ as dirties the clothes or bedclothes is quite unnecessary. Since the first edition of these papers was published, the use of oil in the "massage" treatment has become so widely known that methods of rubbing are better understood, and its results more appreciated. Hence it is now easier to procure pure oil, and our readers should be able to get it cheaply at any first-class grocer's. Opium.--_See_ Narcotics. Oranges.--Some things regarding this useful fruit require to be noted by those using them in sickness. To eat the whole substance of an orange except the outer rind is to give the digestive system some hard work. We have known most serious stomach disturbance caused to the healthy by doing so. Some parts of the inner rind and partitions of the fruit act almost like poison. These should always be rejected. The juice is most beneficial. It is best given to patients by squeezing the orange into a glass, and _straining_ it through muslin into another glass. Add its own bulk of water and a teaspoonful of sugar, if liked. This may be taken warm or cold, and will do where even milk and water cannot be taken. (_See_ Drinks). "Outstrikes."--These appear on the skin from various causes. In the case of infants, they often appear on the head and face during teething. An experienced medical man is cautious in the extreme of quickly healing the distressed skin. He is afraid of "driving in" the eruption on the brain. Perhaps he refuses to do anything whatever to heal the head. From what we have seen, however, even in the worst cases, when head and face and neck were one great sore, we feel assured that there is no need why this distress should be continued at all. It may be, at least in many cases, safely and not very slowly healed. The _whole_ skin of the infant must be brought into vigorous and healthy action. The head at first need not be touched; but the entire skin not affected should be sponged with warm vinegar, and then dried, rubbed with warm olive oil, and this wiped off carefully and gently, so far as it does not adhere to the skin under the soft dry towel. Quite enough remains to do all the good required; and if more is left on, a chilliness and nastiness are felt, which prejudice many against the use of it altogether. It is well, in many cases, not to touch the child with _water_ or _soap_. The vinegar and oil cleanse the skin and do all that is required. Then vinegar very much diluted should be used warm to apply with a soft rag to the sores. Take a teaspoonful of vinegar in a breakfastcupful of warm water. If this causes the child to cry when applied, then dilute still further. Vinegar weak enough to cause hardly any feeling when it touches the sore, will _heal_; stronger vinegar will _injure_. We have known a nurse try to heal an outstricken face by means of good vinegar at its full strength. She was instructed to use the vinegar very much diluted, but fancied it would heal faster if much stronger. She might just as well have fancied that it is better to put one's cold hands into the fire than to hold them at some distance when wishing to warm them. The child's face was made greatly worse, of course, and the cure abandoned. It is therefore necessary to urge that a strength of acid which secures only the most gentle sensation of smarting is essential to cure. The weak vinegar is first applied to the outer and less fiery parts of the outstrike. Try to heal from this inwards, by gradual advances from day to day. On the less affected parts the weak acid may be applied twice a day; on the sorer parts only when itching is so distressing as to demand it. We have seen a child whose head, face, and neck were one distressing sore; we have taken the cloth with the diluted vinegar and daubed a square inch or so of the skin on which the fiery eruption was so full, and in less than two minutes we have seen the colour change into a healthy pink, and remain that colour when the olive oil was applied. The child's sores yielded gradually, till the whole illness was removed. Sometimes such eruptions, in adults as well as children, arise from suppressed perspiration, or from the perspiration being of an acrid and irritating nature. It is sometimes apparently the result of the rubbing off of a little of the skin, or it comes on without any known accident. For a time it seems scarcely worth noticing, and is consequently neglected; but gradually it spreads on the surface and gives uneasiness, especially after the patient has been some time in bed. It goes on till a large portion of the skin from the knee to the ankle is reddened and roughened with a moist eruption. Now remedies of various kinds are tried, but the evil gets worse and worse. The person affected is often a struggling mother or widow, who has to keep on her feet all day in anxious toil, and neither gets very good food during the day nor proper rest during the night. Month after month goes past, and no relief comes. The positive agony which such persons suffer is incredible to those who have not experienced anything of the kind. Here the great difficulty often is to get the patient the very chief condition for cure--that is, perfect rest for the affected limb. If this can in any way be secured, all else is comparatively plain sailing. But this is sometimes impossible: the children may not be in a position to be left, or the little business cannot be allowed to die, as it would in a month's time if not attended to, or some other hindrance is in the way. We must just do the best in the circumstances. We shall say that we are compelled to do without the rest, probably also without certain other things. Rest is very desirable, and so is a gentle rubbing all over the body, first with warm vinegar and then with olive oil, but there is perhaps no one capable of doing such a thing whose services can be secured. It is easy to "order" very useful processes, but among many who would not be exactly called "poor people" it is not easy to have the "order" carried out. We must often do without this double rubbing, and yet cure the diseased skin of the afflicted limb. Let the reader remember that it is no matter of choice that we dispense with the rest and the rubbing. If they are possible, by all means let them be taken advantage of to the utmost. For treatment, unless distinct running sores are formed, bathe the limb with warm water and M'Clinton's Soap, which will remove all crusts, scabs, &c. Then apply zinc ointment. Do not bathe or poultice after the first time. All secretion can be removed by a piece of cotton wool dipped in warm olive oil. If deep running sores have formed, then we must have a water-tight box of rough deal in which the whole leg up to the knee can be bathed for an hour in hot water. We see no reason why it should cost much over a shilling to get this, and it would be a sore want if it could not be procured. It is so made that the leg and foot can rest easily in it while it is nearly full of hot water. It need not be wider than just to hold the limb easily. Some good-hearted joiner will put five small boards together so as to meet this want. We shall suppose that it is supplied. Now for a few cloths, such as will cover the diseased parts, about three-ply all round. Then for vinegar or acetic acid, so diluted with water that it will just cause a slight smarting when heated and touching the affected skin. It must not be so strong as to cause burning, nor so weak as to give no sense of its presence at all, but between these extremes. It can be tried when too weak, and vinegar or other acetic acid added till a gentle smarting is felt. The cloths are dipped in the diluted and heated vinegar, allowed to drip till no more falls off, and then laid tenderly all round the sore. A strip of dry cloth may then be wound round so as to keep these on, and the leg thus dressed placed in the bath. It should be kept there, with now and again a gentle movement, and the strong comfortable heat of the water kept up for an hour, unless the patient should feel sickness before that time. If this comes on, the water is too hot; but, instead of merely cooling it, the bath may cease for the time, and water not so hot may be tried on a second occasion. Whether the hour has been reached or not, good has been done. The leg is taken out of the hot water and gently dried--not rubbed, but dried without rubbing. Then as much cloth as will go twice round all is dipped in warm olive oil, and this is pressed out a little, so that it may not run. The oiled cloth is wrapped all round the limb. Some dry cloth is also wrapped round, and the first treatment is completed. This should be repeated every night before going to bed, for a week at least. It may be required for a fortnight if the case is bad and no rest at all can be had during the day. We should say the cure may fail for want of this rest, but this is not likely. In the morning as soon as convenient, the diseased skin should be soaked with a warm vinegar cloth, so that it shall smart just a little. It should then be dressed again with the warm olive oil. If at any time during the day or night it gets irritated and troublesome, this morning dressing may be repeated. It will not be very long before the one leg is as good as the other. The general health, too, of the patient will be sensibly improved. It is scarcely necessary to point out that a similar treatment to this will cure "outstrikings" of the same sort in the arms and other parts of the body, as well as upon the legs. There is required only some such modification of the appliances as may meet the particular case. For example, we have seen the outstriking between the shoulders, so that it could not be reached by bathing, unless by appliances utterly out of the question in the circumstances. But dressing with hot vinegar cloths, allowing these to remain on for twenty minutes or so, and then dressing with warm olive oil, allowing this to remain for two or three hours, is quite possible to any one who is so affected; and this will usually be sufficient for a cure. You have, perhaps, been cured temporarily more than once with arsenic, and the evil has returned worse and worse. In that case you may require all the more patience and the longer application of the above treatment; but, once cured in this way, you will not, so far as a good long experience enables us to judge, be likely to have any relapse. In very bad cases we have seen poultices of mashed potatoes made with buttermilk cleanse the diseased parts most effectually, and then the acid takes healing effect very speedily. In these cases ordinary medical treatment had utterly and hopelessly failed. Pain, Severe, in Limbs.--This is often not due to any trouble in the joint itself, but to some disorder in the large nerves which have their roots in the lower part of the back. In the case of severe pains in the back of the leg, ankle, or knee, when a chill to the large limb nerves has been the cause, and has raised inflammation, the patient should be put warm in bed. Take two large towels, thoroughly wrung out of cold water. Fold one six or eight ply thick. Gently press this, avoiding cold shock to the patient, over the lower part of the back. When this towel gets hot, spread it out to cool, and apply the other. Continue this with each towel alternately, and when finished, or after an hour, rub the skin with warm olive oil and cover up with new flannel. Similar cold applications to the _upper_ part of the spine will cure such pains in the wrists. If the cold application intensifies or fails to relieve the pain, it is well to try the ARMCHAIR FOMENTATION (_see_). Sometimes light pressure in the form of squeezing the muscles of the lower back is very useful. A very gentle pressure on the right parts is most pleasant to the sufferer. At first it simply relieves in some degree the weary feeling of the limbs. When it is at all well done, it soon raises a gentle heat, which slowly passes down the limbs, even to the very toes. This is just life itself communicated to the limb. But we must not confine our treatment to the spinal cord. The squeezing, or gentle pressure, must be carried down the limb; and when new life has been infused so far, it will be well to apply the pressure between the hands to the swollen and painful part. _See_ Massage. Palpitation.--Ordinarily we are not aware of the beating of the heart, enormous as is the work it does; but in certain cases this beating becomes distressingly violent, especially on lying down flat or in ascending hills or stairs. The latter cases are the more serious, yet both kinds we have found quite curable. In treatment, fomentation must be avoided, and so must doses of the nerve-damaging drug, digitalis. The best way is to _cool the heart_, and thus relieve its superabundant action. But care must be taken that _cold be not applied to a feeble heart_, but only where action is evidently superabundant. It is usually easy to distinguish the two kinds of palpitation. The cooling can be done by pressing towels wrung out of cold water all over the heart region of the left side. Then rub the part so cooled with olive oil, dry off, and let the patient rest. This may be done in the morning before rising. In cases where the heart is feeble, the following treatment should be carried out instead of the cold towels:--Begin at bedtime with a cloth covered with creamy soap lather, and placed quite warm all over the body of the patient. It should be fastened on with the body of a dress, or thin vest, so that it may be kept close to the skin during the night. In the morning the back should be gently washed with hot vinegar, dried, and gently rubbed with warm olive oil. In those cases where the palpitation is only part of a general nervousness, which causes great distress and sleeplessness at night, the back should be lathered all over with soap (_see_ Lather and Soap) at bedtime, and the cloth with lather left on all night. In the morning, dry off, rub gently with hot vinegar, and then with hot olive oil. If the palpitation resists this treatment, then cold towels should be gently pressed to the _spine_, until the whole system is quieted. The back should then be rubbed with warm olive oil. So far as this restless action is concerned, this is all that is required for complete cure. We are writing thus in view of cases declared hopeless, but the patients are now in perfect health. We remember one at this moment in which the heart's action was so bad that the head could not be raised from the pillow, but the person was in a few weeks as well as any one could wish to be. No one who has not seen how readily the surplus vital action passes out of the system when simple cold is rightly applied, can imagine how easily such cases are cured. It seems to us absurd to speak of "heart disease" in many of the cases in which people talk of it and set the case down as hopeless. It is absurd, simply because it is not heart disease, but only a little more action than is comfortable, and which is reduced in a few minutes by a cold towel. No doubt care and willingness to work a little are required, if one would relieve a sufferer in such a case as this, but that care and energy are sure to have the best of all rewards. Palpitation often arises from indigestion, in which case _see_ Indigestion. Palsy.--_See_ Paralysis. Paralysis.--This serious trouble in slighter forms affects one side of the face, or even one eye only. More serious attacks involve the arm, and even an entire half of the body. It may come suddenly, or may creep slowly over the frame. In very old persons the case is usually hopeless, as life itself is fading. In earlier life, and in less serious cases, a cure is to be expected from proper treatment. Cupping, blistering, or opiates must be avoided, as all tending to reduce vital energy. Treatment must aim at increasing this, not reducing it. Take first the case of paralysis slightly affecting the face. When the patient is warm in bed, place a BRAN POULTICE (_see_) not too hot, on the back of the head and neck. Let the patient lie on it, first rubbing the neck and back of head with olive oil. Do this for an hour each day. At another time wash the back of head and neck with SOAP (_see_) and water, then with vinegar, and finally rub with hot olive oil. Keep the parts warm with good flannel always. If the whole side be affected, foment strongly the whole spine, and treat it in a similar way to the back of the head, as prescribed above. We have known cases of comparatively speedy cure by this simple means. The heat simply vitalises the partially dead nerves. For paralysis of the lower limbs, the treatment is applied to the lower part of the spine principally, but also to the whole spinal system. There is no fear of injuring the patient in this treatment, and we know of many cases of most delightful cure secured by it. What is called the ARMCHAIR FOMENTATION (_see_) is an excellent method of dealing with paralysis of the lower limbs or any part of them, and may be resorted to if the above treatment fails. Care must be taken in any case to avoid a chill after fomenting, which might make matters worse than at first. Perspiration.--By this term we mean not only the sensible perspiration which is felt as a distinct wetness on the skin during exertion or heat, or in some illnesses, but also, and chiefly, the constant insensible perspiration. This latter is far more important than the former. No one could live many hours without it, for by its means several pounds weight of waste is got rid of every day. Its importance we saw lately in the case of a child greatly swollen in dropsy. A flannel BANDAGE (_see_) wrung out of warm water, placed round the body, reduced this swelling completely, without any _sensible_ sign of excretion. A very gentle treatment, increasing this insensible sweating, will often cure without weakening, where violent perspiring medicines or treatment cause great weakness. A damp flannel bandage placed round the lower half of the body all night for a few nights will produce a remarkable increase of insensible perspiration, and in many case forms a good substitute for sweating drugs. Along with this the soapy lather may be used at bedtime all over the skin (_see_ Lather and Soap). We have seen a swelling of the hand, which made a medical man talk of amputation, cured by these means. Acetic acid, or white-wine vinegar, rubbed over the skin, produces a similar increase of insensible perspiration, and may be used without fear of injury. This done once a week will go far to reduce sensitiveness to cold. Indeed, the use of M'Clinton's soap and water, along with good acetic acid sponging once a week, will prevent many serious ills by securing a constant gentle excretion of hurtful waste through the stimulated skin. Piles.--This very common trouble is caused by one or more of the veins in the lower bowel losing their elasticity, so as to protrude more or less from the anus, especially when the stress of a motion of the bowels forces them out. When no blood proceeds from this swollen vein, it is sometimes called a _blind_ pile. If blood comes, it is called a _bleeding_ one. There are few illnesses more prevalent than this, few that seem to be less rationally dealt with, and yet few that are more easily cured. It is distressing to think of what some poor people have to suffer from this disease, while they are still compelled to go on working, and even walking, in the most depressing sufferings. It is still more distressing to think of the painful operations which some have to undergo in having the relaxed portions of these veins cut out. Even when the piles have got to a very advanced stage it is not difficult to cure. It will generally be found that there is Constipation (_see_), so first of all, the bowels must be regulated. This may be done by means of liquorice and senna mixture, and strict attention to diet and exercise. Then the nerve action in the lower back is to be stimulated by applying to the back below the waist a large BRAN POULTICE (_see_). Rub the back after this with hot vinegar, dry, rub with olive oil, and wipe off the oil gently. Do this at bedtime. Into the bowels may be injected (with the fountain enema) first one or two injections of warm water; then an injection of warm water and white-wine vinegar. Be particular to have this mixture not too strong. A trial may be made with one tablespoonful of vinegar to a pint of water. If any pain is caused, inject simple lukewarm water and use the vinegar and water next time weaker. A very weak mixture has a wonderfully healing effect. After one pint of this mixture has been injected, an injection of cool water (but not cold) should follow. The vinegar should be so weak that it will cause no pain, properly speaking,--only just the slightest sensation of smarting. It will be possible to use the water colder and the vinegar stronger as you get on with the cure, but in both, your own feelings and good sense will guide you. This direction will suit other cases of internal syringing, in which membranes have got relaxed, and need to be braced with cold and weak acid. In all such troubles it should be remembered that the warm or tepid water is used at first only because the cold might be felt uncomfortable till the surfaces are prepared for it. It is the cold that does the good. After this, protruding piles may be gently manipulated by the fingers and pushed back into their place. During this the patient must press outwards, as if to discharge fæces from the bowel. The anus will then open and permit of the piles being pressed in. The injecting treatment may be given twice a day. If too painful, even bathing the parts with the vinegar and cold water has great healing power. Let the sufferer, if at all possible, have _entire rest_ for a fortnight during the treatment, and lie down as much as convenient. In mild cases, simply bathe the piles with cold water and press them back into their places. A daily wash of the anus with SOAP (_see_) and warm water, followed by a cold sponging, will do much to prevent piles. Pimples on the Face.--_See_ Face. Pleurisy.--The pleura is the tender double web, or membrane, which lines the inside of the chest on the one side and covers the lung, or rather encloses the lung with its other fold. Each of the two lungs has its pleura in which it works, and each side of the chest is lined by one side of this sensitive organ. The slender lining passes round the greater part of one whole side of the body with one-fold, and round the whole of the lung with the other. Let us suppose (which often takes place) that the front of the body is defended with what is called a "chest protector," but the sides and back are exposed to a chilling atmosphere. Part of the pleura, and that part which is farthest from the surface, is sheltered, but the greater part of it, and that nearest the surface, has no such protection. In the case especially of women this is the state of things. It seems as if people thought that they only need to keep a few inches of the breast warm--that is keeping the chest all right--though the sides just under the arms, and the back under the shoulder-blades, are of far greater importance. The throat is even muffled, and a "respirator" worn, so that fresh air is not allowed to get inside the lungs, while the pleura is exposed to chill at the back. The consequence of this is that vital action is so abstracted from the pleura that the tension of its small vessels is relaxed, and blood is admitted as it is not intended it should be. Severe pain is felt on one or both sides, and round under the shoulder-blade. A painful cough arises, and great fever is produced. In such a case the treatment is on the same principle as that given in Lungs, Inflammation of the, which should be read. The inflamed part must be cooled by applying towels well wrung out of cold water round the side, applying a fresh one when that on the part becomes warm. If the pain does not leave in half-an-hour of this treatment, or if the patient be weak to begin with, or if any chilliness is felt, pack the feet and legs in a large hot fomentation. The cooling of the side may then go on safely until a curative effect is produced. We may not be able to give the theory of action of this treatment, but we know that in many cases it has perfectly and very speedily been successful, and that it leaves no bad results, as blistering and drugging are apt to do. We know of one case in which it took twenty-four hours' constant treatment to effect a cure. But it did effect it. Two friends took "shifts," and saw that all was thoroughly done. This will give an idea of the proper way to go about the matter. Poisoning.--The following are the antidotes and remedies for some of the more common forms of poisoning. Alcohol.--The patient is quite helpless, and there is usually a strong smell of alcohol. If the patient is intoxicated at the time give an emetic. If there is evident prostration from a long bout, keep him quiet and warm. Hot tea not too strong may be given. Alkalis (_e.g._, ammonia, soda or potash).--Give dilute vinegar, followed by white of egg. Arsenic.--Emetic, followed by white of egg. Keep very warm. Carbolic.--Readily identified by smell of tar or carbolic. Wash mouth well with oil. Give an emetic. Chloral.--Emetic; warm coffee, and even an enema of coffee. Artificial respiration (_see_ Drowning) may be necessary if breathing gets very low. Chloroform or Ether (inhaled).--Fresh air. Pull tongue forward, and begin artificial respiration. If heart has stopped, strike chest two or three times over region of heart. Chloroform or Ether (swallowed).--Emetic; enema of hot coffee; keep awake. If necessary, artificial respiration. Copper.--Emetic, white of egg to follow. Laudanum.--There is intense drowsiness and contraction of pupils of eye. Give an emetic and plenty of strong coffee. Walk patient up and down. On no account allow him to give way to the desire for sleep. Mineral Acids and Glacial Acetic.--If any neutralising agent, such, _e.g._, as lime, chalk, soda, or calcined magnesia, is at hand, give it at once. Or give an emetic, followed by oil or milk and water. Mushrooms.--Emetic; castor oil and enema. Nicotine (tobacco).--Emetic; stimulate and keep warm; keep patient lying down. Oxalic Acid.--Neutralise by chalk or lime water, but not by soda or any alkali. Give plenty of water; apply hot fomentations to loins. Phosphorus.--Often caused by children sucking matches. There is a burning in the throat, and often vomiting. Give an emetic. After this some barley water or milk may be given. Prussic Acid.--Almost hopeless. Emetic; artificial respiration. Snake Bite.--Suck the wound, and apply a drop or two of strong ammonia to the bite. Ammonia may be also inhaled. Artificial respiration often necessary. Strychnine.--Emetic; keep quiet and darken the room. Chloral or bromide of potassium may be given. If spasms threaten respiration, artificial respiration is necessary. Tartar Emetic or other Antimonial Poisons.--If vomiting is not present, induce it by an emetic. Give doses of strong tea. Keep very warm by hot blankets. Good domestic emetics are a teaspoonful of mustard in a tumblerful of water, or a tablespoonful of salt in the same quantity of water. Poisoning, Blood.--Where this arises from a more or less putrid wound, what is aimed at in the treatment is to stop the manufacture of the poison in the wound by cleansing and healing it. This done, the other symptoms will subside. The wound should be carefully brushed with a camel's-hair brush and vinegar or dilute ACETIC ACID (_see_). This should be followed up with a poultice of boiled potatoes or turnips, beaten up with the same weak acid. Leave this on all night. Brush again well with the acid in the morning. In the matter of diet eat what will produce healthy blood, and by open-air exercise seek the same end. But the daily brushing and poulticing, or even twice daily if necessary, will work wonders on the poisoned wound. Care should be taken where any cut or wound has been made in the flesh, that it is carefully washed, and any dirt or foreign matter removed. Especially is this to be attended to if a rusty nail or penknife has inflicted the injury. Polypus.--_See_ Nostrils. Potato Poultice.--Potatoes boiled and beaten up with buttermilk, spread out in the usual way, make this useful poultice. Weak acid or vinegar may also be used instead of buttermilk. The potatoes should be boiled as recommended below. Potato, The.--The proper cooking of this root is so important for health, owing to its universal use, that we here give directions which, if followed out, make potatoes a dish acceptable to even a very delicate stomach. Difficulty of digestion often arises from the potatoes not ripening properly, especially in cold soil, and since disease has become so widespread. Their unripe juice is positively poisonous, and when they are merely boiled is not completely expelled. The potatoes should be _steeped_ in warm water for an hour before they are boiled. The water in which they have been steeped will be greenish with bad juice, and must be thrown away, and the roots boiled in fresh water as usual, giving a thorough _drying_ after the boiling water is poured or strained off. So prepared, the potatoes make a very digestible dish. Poultice, Bran.--_See_ Bran Poultice. Prostration, Nervous.--The various articles under Nerves and Nervousness should be read. Here we give simply the treatment for failure in the digestion and bowel action. This arises from failure in the great nerve centres near the middle of the body. External treatment may be given as follows:--Dip a cotton cloth, four-ply thick, and large enough to cover the stomach and bowels, into cayenne Lotion (_see_), and lightly wring it. Lay this gently over the stomach and bowels. Over this an india-rubber bag of hot water is laid. Take care that the heat is not _too great_ or the mixture _too strong_. All must be just hot enough to be comfortable. This application may remain on for two hours, and then be repeated. The cayenne is greatly to be preferred to mustard for many reasons. Give the most easily assimilated food possible. A teaspoonful of gruel each half-hour, increased to a dessertspoonful, if the digestion will bear it, and preceded in all cases by a tablespoonful of hot water. This should be continued for twenty-four hours. Proceed very cautiously then to increase the nourishment, on the lines of Assimilation, Diet, Digestion, etc., giving oatmeal jelly, wheaten porridge, Saltcoats biscuits, and such diet, _gradually_ bringing the patient back to ordinary food. Pulse, Counting the.--Most valuable information as to the nature and progress of disease is derivable from the pulse. Every one should learn to count it, and to distinguish the broad differences in the rapidity and nature of the beat. Such a distinction as that between BRONCHITIS and ASTHMA (_see these articles_), which require almost directly opposite treatment, is at once discerned from the pulse. In bronchitis it beats much too quickly, in asthma it is natural or too slow. In many cases we have seen asthma, which in cough and spit is very like bronchitis, treated as bronchitis, with bad results. These would all have been avoided if the pulse had been intelligently counted. Count the pulse, if at all possible, for _half-a-minute_. This multiplied by two will give the rate per minute, by which it is judged. If this rate per minute be above 100, there is a good deal of feverish or inflammatory action somewhere. If below 60, there is considerable lack of vital power, requiring rest and food to restore it. In adults the rate for males is from 70 to 75 beats per minute, and for females 75 to 80. In infants the healthy pulse may be at birth 130 to 140 per minute, diminishing with increase of age. In the case of any child under five and over one year, if the pulse beats, say, 108 in the minute, it is too fast. The pulse of an adult may go down as low as 60 or even 50 per minute, but there is then something wrong. Cooling the head is always safe with high pulse and feverishness, and often this alone will ward off disease and restore the healthy condition. If the pulse be low, fomentations to the feet should be applied, along with cooling action elsewhere, if necessary. Purple Spots on Skin.--These arise first as small swellings. The swellings fall, and leave purple patches behind, which, if the trouble continues, become so numerous as to spoil the appearance of the skin. This especially occurs in children or young people, whose skin is exceptionally delicate. What has occurred is really much the same as the result of a blow or pinch, leaving the skin "black and blue." Some of the delicate vessels in the skin have given way, and dark blood collects on the spot. The treatment is to sponge all over the body and limbs with warm CAYENNE "TEA" (_see_), only strong enough to cause a slight smarting. It should never cause pain. If it does so, the tea is too strong, and should be diluted with warm water. The soapy LATHER (_see_) may also be used, and olive oil may with advantage be rubbed on as well. Milk and boiling water should be given to the patient every two hours during the day, with a few drops of the cayenne "tea" in it. This is a true stimulant, and worth all the whiskey in the world. The object of the treatment is to nurse the patient's strength, and stimulate the skin. An intelligent study of many articles in this book will guide the thoughtful how to act. Racks from Lifting.--_See_ Muscular Pains; Sprains. Rash, or Hives.--Infants are often troubled with large red, angry-looking spots, breaking out over the body, and causing trouble by their heat and itching. These are commonly known as hives. If the water in which a child is washed be hard, it will sometimes cause the skin to inflame and become "hivey." If the soap has much soda in it, it will also cause this. What is called glycerine soap, and much of what is sold as peculiarly desirable, is utterly unsuitable for an infant's skin. Soda soap will cause serious outbreaks even worse than "hives," and will often not be suspected at all, as a cause. Only M'Clinton's soap, which is made from the ash of plants, should be used on tender skins. When the "hives" are not very troublesome, they are apt to be neglected; but this should not be, as in most cases this is the time they may be easily cured. The true element in cure is found in attention to the _skin_, as distinct from the stomach or blood. M'Clinton's soap (_see_ Soap) applied as fine creamy lather will _cure_ hives, and will never, we think, fail to do so. We know of a nurse plastering an infant's body with this soap, so that it was blistered. This is a totally wrong way of working. The right way is to work the soap and hot water as described in article Lather, and to apply it gently with the brush to the parts affected. After applying it with gentle rubbing for some time, and leaving some on the sore places, the infant will usually be soothed to sleep. Where over-cooling is feared, with a weak child, a little olive oil is gently rubbed on with the second coat of lather. In any case of itchiness the above treatment is almost certain to cure. Often the infant is suffering from too rich diet. (_See_ Children's Food.) In such cases, thinner milk, and a little fluid magnesia administered internally will effect a cure. Remedy, Finding a.--It will sometimes occur, in the case of those endeavouring to cure on our system of treatment, that on applying what is thought to be the correct remedy, the trouble becomes worse. For example, where there are violent pains in the legs, a bran poultice is put on the lower back, and it is rubbed with oil. The pains become worse instead of better, and perhaps our whole system is abandoned and condemned. Now, all that is required here is to think and try until we find the _true_ remedy. If the pain in the legs is rheumatic, the hot poultice is all right. If it has been cramp, what is needed is a cold cloth on the lower back, instead of heat. In the example above given, what is needed is not to abandon the treatment, but to rectify the mistake, and apply cold instead of heat. In a great many forms of illness the same principle holds good. It is safer, where there is any doubt, to try heat first, but not in a very strong manner. If this gentle heating makes matters worse, gentle cooling may be tried. If the heat does good, it may be continued and increased, but never beyond the point of comfort. If the cold does good, it also may be continued on the same principle. What the patient feels relieving and comforting, is almost sure to be the cure for his trouble, if persisted in. _See_ Changing Treatment. Rest.--In every person there is a certain amount only of force which is available for living. Also this force, or _vitality_, is _produced_ at only a certain definite rate. Where the rate is very low, only perfect quiet in bed for a time can bring down the expenditure far enough to enable the vital force gradually to accumulate, and a cure to be effected. Sitting, in such cases, may be serious overwork. When rest is ordered, we are often met by the reply that it is impossible, as work cannot be given up. It is, however, often possible to get a great deal more than is taken. Every spare moment should be spent lying down in the most restful position. It is an important element in nursing to give such a comfortable recumbent position to a patient as constitutes perfect rest, and the nurse who does so, does a great deal to cure. There is with many a prejudice against rest. It is somehow believed that it is a weakening thing to lie still in bed. "You must get up and take exercise, and enjoy the fresh air." This is a very good order for a person who has the strength for bracing exercise and fresh air. But this is absent in a person truly ill. That person's vital force is low, and the organs that supply it are feeble in their action. The fresh air may enter the chest, but the lungs are not in a state to make good use of it. "Exercise and fresh air" only consume the sufferer. On the contrary, rest and fresh air allow the weak vital force to recruit. The sort of exercise which is wanted in such cases is given by others in massaging or such squeezing the muscles as stimulates the organic nerves without using vital force in the sufferer. We have repeatedly succeeded in giving new strength by some weeks in bed, when it could not have been given otherwise. It is all very well for a young, strong person, only a very little out of sorts, to take a cold sitz-bath for ten minutes, and then a walk of a mile or two in mountain or seashore air. But this treatment would be death to one really ill. Perfect rest in bed, with an abundant supply of air through windows open night and day, would save the life which such "exercise and air" would send out of the world. It requires only a little common sense to see this. "He must be weakened by lying in bed so long." There is no such "must" in the nature of things. On the contrary, it may be absolutely necessary to his getting strength that he should lie still for weeks on end. You may, no doubt, give us instances in which a person was compelled to get up, and was thereby made to lose the delusion that he was not able to do so; but such instances in any number will not make one strong who is actually weak. Make sure first that vital energy is supplied, and when that supply rises to a certain degree it will not be easy to keep your patient in bed. We would also note that true rest can never be had in a forced position. A limb bound down is not resting. The agonising desire to change its position shows this. True rest is found always in _freedom_ and _ease_. It may be necessary to put splints on a limb, but it must never be done where rest is aimed at. Usually there is a position of comfort to be found. Let the patient find and keep that. He will then have rest. For instance, an exhausted patient is lying at full length in bed, but under the waist there is a hollow which is bridged over by the back. This part of the back calls for a considerable amount of force to hold it over this hollow, but we get a pillow inserted under the back, the muscles relax, and the patient rests. In packing and fomenting an inflamed knee, for example, it is usually better done in a slightly _bent_ position, which is more restful than a straight one. Employ two or three small pillows to prop it comfortably. And so on, in multitudes of cases, the earnest healer will be guided by the patient's own restful feelings. _See also_ Noise; Veins. Restlessness.--In slight cases, where the patient simply cannot sleep for tossing about in bed, a cold towel placed along the spine, with a dry one above, will usually relieve, especially if changed and cooled several times as it grows warm. If heat be specially in the head, then that may be cooled in the same manner till peace settles down in the brain. But we must go on to consider those cases of restlessness in which there is no extra heat in either spine or brain. Tea may have been taken in a rather strong infusion, or so late that its peculiar influence may be the cause of the restlessness. It is necessary to avoid this beverage if such restlessness is to be escaped; still it will generally be found that in cases in which tea has caused serious wakefulness and restless tossing, that there is more than the mere effect of the herb, and that superabundant heat is present also; then the application already pointed out will give relief. Now take an instance in which it seems to be the mind that causes the tossing rather than the body. Preachers after earnest preaching are in many cases sleepless and restless too; so are almost all persons when currents of exciting thoughts have been set agoing in their minds. Then, no doubt, it is necessary to get at relief from the spiritual side, by means of thought fitted to calm down the excitement that has been raised. But it is never well to forget that in all such cases there is a material as well as a spiritual aspect of the experience. Many preachers take a sitz-bath before going to bed after a day of service, and find that somehow when sitting in the cool water the over-driven brain begins to slacken pace. If from any cause you are restless and cannot lie still, even after the head and spine have been cooled as we have described, it is well to take a sitz-bath in cold water for a few minutes. Dry and wrap up well, and you will be quiet after. Certain forms of coughing apparently cause the most serious restlessness. A warm poultice should be placed between the shoulders, and cold cloths pressed gently on the breast. If there is extreme shrinking from everything in the least degree cold, then you need to go a step back in your treatment. A sponging of the most gentle kind, with CAYENNE LOTION (_see_) and water, all over the body, given very carefully for three or four days, once a day, will put away the shrinking to which we refer. This should be done with tepid water at first, but as the skin freshens it will be found comfortable to do it with cool water. In tender cases the poultice or hot bag will need to be comfortably warm, and not hot. The cool cloth must not be wintry cold, nor even at first summer cold. It is, however, necessary to get at the hot and irritating surfaces that are causing the cough, with more or less that is cooling. We may do this ever so gradually, but we must do it, if we would succeed in giving rest from the cough. In a strong person's case there is really no difficulty. It is an easy matter to put on cloth after cloth till the irritated part is reached and cooled. But when the patient is spent to all but a skeleton, and has restlessness from frequent coughing, it is a very different matter. Still to the very last the irritating heat may be kept down, and long sleeps given, when otherwise it would be hard work indeed to get through the last stages of illness. We write thus because we know it is possible to give precious relief even when it is out of the question to save life. It is possible to make even the last night on earth comparatively a peaceful one, instead of its being so very restless as it often is. This is to be done just by cooling the parts that irritate, and these only. Generally, heat may be required rather than cold, but at the part which is irritating and keeping up the coughing, there must be cooling. The kind and capable nurse who can carry out this cooling is beyond all price. Those only can understand this who have been delivered from an all but incessant cough by means that produce no reaction. It is also well to remember that we now and again give life by means of rest when we had no idea of giving more than temporary comfort. We have repeatedly had cases in which there seemed no hope of doing anything further than giving relief, but that relief has turned out to be the commencement of cure. Rheumatic Fever.--_See_ Fever, Rheumatic. Rheumatism.--We feel urged, in first considering this sore and very common trouble, to quote the old adage that "prevention is better than cure." Many people laugh at wettings, and some foolish young ones even seek exposure. We would impress upon all such that the effects of exposure may be, and often are, cumulative: that is, you may escape any direct effect for years, and then find your recklessness end in rheumatism for the rest of your life. Let care, then, be taken to avoid wettings, unless these lie in the way of duty. Change clothes as speedily as possible when they are wet, and encourage the skin to all healthy action by proper care and exercise. Even with the skin all right, a wise man will not act in a foolhardy way, but if he must get wet and chilled, he will probably not suffer very much. We would strongly recommend the use of Kneipp linen underclothing (_see_ Underwear). It powerfully stimulates the skin, and, by conducting away the perspiration, prevents chills. We have known many who suffered severely from rheumatism being quite cured by the use of this material. It is as comfortable as it is hygienic. But supposing the rheumatism does come on, it may be treated, in mild cases, by gradual and steady moist heating. For the method of applying this, _see_ Fomentation and Armchair Fomentation. If the case is comparatively a fresh one, there will be need for no more than this fomenting, repeated several times at intervals of two to four hours. Where the nervous system has been seriously affected, the fomentation must be gradual, and the moist heat gently insinuated into the parts affected. Where narcotics have been used, these _must_ be given up if a cure is to be hoped for. In certain chronic cases, which are very largely nervous in their origin, a powerful soothing influence is required. This is secured by the use of soap lather (_see_ Lather; Soap). Cover the back and head, piece by piece, with this, rubbing it on and off four or five times. Cover the fifth application with a soft cloth, and leave it on for the day in the morning, and for the night in the evening, the patient being in bed. Hot olive oil or occasionally cold drawn oil of mustard is gently rubbed on the stiff parts; when this cloth is removed, gently knead or squeeze the oil into the muscles. If during the lathering the patient feels too cold, a little olive oil should be mixed with the lather. A change to a dry climate from a damp one sometimes does a patient good, but when that is not possible, great relief, and in many cases cure, is to be had by this treatment. Ringworm.--This distressing and most infectious trouble is due to a small parasite. Where that settles in the skin, a reddish _ring_ soon appears, and gradually widens, leaving a leprous white patch of skin within it. Care should be taken at once to cure this, as, if it spreads widely, serious results follow. Fortunately it is slow in growth, and can easily be checked and cured. The method of cure is to soak the rings well with vinegar or weak acetic acid. Of strong acid use three tablespoonfuls to a quart of water. By even the first good soaking with this, the developed parasites are killed, but the eggs are not. These hatch out by degrees, so that renewed soaking and "dabbing" with the acid and a soft cloth are required. Each application may be continued for fifteen minutes. If the hair, as on the head, interferes, it may be cut closely, but need not be shaved. In a bad case the daily soaking with acid may not be sufficient. Then a poultice of potatoes and buttermilk (_see_ Buttermilk Poultice) may be applied first, and afterwards the weak acid. Secure that there be felt, before the close of each application, a _slight smarting_, to show that the acid has really soaked in. It is not difficult to guard against its spreading in a family or school. All that need be done is, once a week or so, to see that the whole skin of those exposed to infection, head included, is freshened by a wash all over with vinegar, and then protected with a gentle rub of olive oil. If this is done we should have little fear of contagion. Such a weekly freshening would ward off other evils as well as this one. Rose.--_See_ Erysipelas. Rupture.--The abdomen is formed of a series of _rings_ containing the bowels, and holding them in proper position. If the muscles and tissues holding these rings _yield_ so as to permit them to separate a little, what is called "rupture" takes place. It may be caused by violent muscular efforts, heavy weight lifting, jumping from a height, etc., etc. The rings are not broken, but only displaced, and especially with young persons, the "rupture" can soon be brought all right, but even with the aged, in all cases it may be mitigated, if not cured, by proper treatment. The first thing is to replace any part of the bowels which may have escaped through the opening of the rings. Lay the patient flat on his back. He must not be treated in any other attitude. Then rub the swelling gently _downwards_. It _must not_ be rubbed upwards, or it will be made worse. This rubbing will soon bring the bowel into its proper place. Give some time and kindly care to this treatment, which is very important. Then get a surgical instrument maker to fit a proper truss. See that this really fits. If it hurts in any way when first put on, it does not fit well enough. Avoid for a considerable time any effort likely to strain the part. Take light and easily digested food; give up all alcoholic drinks and the use of tobacco. Saliva.--_See_ Digestion; Nourishment. Saltrome.--The disease known by this name in Canada breaks out in the hands, especially on the palms. The skin cracks open and refuses to heal up. Sometimes, if the hands do heal, the trouble comes out on other parts. It is probably due to the long-continued use of bad and strongly irritating soap in washing the hands and face, conjoined, in Canada, with the great dryness of the air. The treatment for prevention is the regular use of M'Clinton's soap (_see_ Soap). Where the trouble has developed, the hands and face, if involved, should be packed in cloths soaked in buttermilk. Then over the packing we should foment with large hot flannel cloths (_see_ Fomentation). Renew, if necessary, the buttermilk packing, and after a thorough fomenting, leave the buttermilk cloths on all night, with dry ones on top. Then gently anoint with OLIVE OIL (_see_). This treatment, with some rest and the use of the above-mentioned soap, should soon effect a cure. Santolina.--This plant is the _Chama Cyparissos_, or ground cypress. It is of the greatest value as a remedy for worms in the bowels (not tapeworm), and also acts as a stomach tonic of no small value. It is cut at the end of the season, made up in small bunches of six stalks or so, and hung up to dry. When required for worms, boil one of these bunches in three teacupfuls of water until it is reduced to two teacupfuls. Half-a-teacupful of this is given to a _child_ with worms, each morning before any food, for four days. In the evening of the fourth day an ordinary dose of liquorice powder is given to move the bowels. For a _grown-up person_ the quantity is a full teacupful each morning. If a child picks at his nostrils, or grinds his teeth while sleeping, the santolina will cure him, even if no other symptom of worms is noticed. It may with advantage be used in all cases where there is indication of the failure of the mucous membrane of the stomach and bowels. Where required as a stomach tonic, santolina should be infused with boiling water, as tea is. About half-an-ounce of the dried herb is infused, and a small teacupful taken as hot as can easily be drunk about an hour after each meal. Half the quantity will do for young people under fourteen. Do this six days in succession. Then take none for six days. Then again take it for three days. This treatment may be repeated after a week. Sciatica.--This is a severe pain in the lower back, shooting sharply down the back and calf of the leg. It arises from inflammation of the large nerve which supplies these parts of the leg with power. Most commonly it is caused by exposure of the hips or lower back to cold and damp, as by sitting on the grass or a stone seat. The cure for it, in the earlier stages, is the application of the ARMCHAIR FOMENTATION (_see_). This may be applied for an hour, and renewed immediately for another hour if the patient can stand it, and then rest given for two hours, and the fomentation applied for two hours again, or at least for one, taking care to rub with oil and wrap up in comfortable flannels between and after the treatment. This may be done again on the second day. The fomentation may then be given once a day until the pain is removed. Be quite sure that no trifling application will succeed with such a disease as this. It will not do to use less heat than will go through and through the haunches of the patient; and that amount of heat is not very small. You must have a good soft blanket if possible, your water must be boiling hot, and you must have plenty of it. If the hot treatment causes increase of pain, this indicates that a stage has arrived in which _cold_ is to be applied instead of heat to the lower back, to subdue nerve irritation. Before or after this stage, cold application will do harm, so it is well always to try heat first, as in the great majority of cases that is what is required. When cold is applied, the patient _must be warm_, and if necessary the feet and legs should be fomented. To keep what is got either by the soothing influence of cold or by the stimulating power of heat, it is good to rub with hot olive oil, and to dry this off well in finishing, and also to wear a good broad band of new flannel round the lower part of the body. This band ought not to be so tight as to confine the perspiration. _See_ Changing Treatment; Remedy, Finding a. Scrofula.--The treatment under Glands, Swollen, should be followed. But besides, the whole membranous system of the glands must be stimulated. Daily rubbing briskly over the whole body with the cold-drawn oil of mustard for a quarter-of-an-hour will have this effect, and even by itself may cure. Good, easily digested food must be taken (_see_ Abscess; Assimilation; Diet; Nourishment), and overwork avoided. Continued work, as with a child at school, may quite prevent a cure, while if the work ceases, the cure will be rapid. It is better to have health and holidays than sickness and school. Where there is a family tendency to scrofula, care should be taken to treat promptly any case of glandular swelling. Scurvy.--Is a disease springing from disordered digestion, and caused sometimes by partial starvation, but more frequently by a deficiency of vegetable acid in the food. It often manifests itself in skin eruptions, the skin peeling off in scales. To ward off or cure this disease, fresh food should always be used, and salted or tinned foods avoided. Especially should abundance of green vegetables and fruit be used, and where such cannot be obtained in sufficient quantity, lemon juice is valuable. Too much exposure, fatigue, and impure air, aided by a wrong diet, are the causes that formerly made scurvy so prevalent in the navy. It has almost disappeared since a regular allowance of vegetable acid has been served out. Seamill Sanatorium and Hydropathic.--Very soon after the appearance of these "Papers on Health," the need was felt for some establishment where the treatment expounded here could be given by trained attendants under Dr. Kirk's personal supervision. The site was fixed on the Ayrshire coast, in the parish of West Kilbride. This region was chosen because special advantages of soil, climate, and scenery recommended it. The soil along the shore is almost pure sand, and dries rapidly after rain. The climate is extremely mild, high hills sheltering the whole region from north and east winds, and the Arran mountains, intervening some sixteen miles over the sea to the west, collect much of the rain. Hence, although near some very rainy districts, the Seamill neighbourhood is peculiarly sunny and dry. In winter the sun reflected from the water, and beating on the face of the hills, makes the shore climate most genial, and when other places only a few miles away are encased in ice, flowers will be blooming in the gardens at Seamill. In the very best part of this district a villa was secured in 1880 by some gentlemen interested in the treatment, with grounds abutting on the sand of the seashore. Here treatment was carried on with great success, until it became evident that larger premises were needed. In 1882 Mr. James Newbigging was secured by Dr. Kirk as manager and head-bathman, and worked under Dr. Kirk until the latter's death in 1886. Mr. Newbigging then bought the establishment. Since that time, it has constantly increased in size and efficiency until it now accommodates close on a hundred patients. Very many have come to Seamill almost or quite hopeless, and have left it with health restored and vigour renewed. It ought to be mentioned here that in all his dealings with this establishment Dr. Kirk never had any pecuniary interest in it, always giving his services free. Nor has the writer, or any of Dr. Kirk's family, any pecuniary connection with the place. All information as to the establishment may be had by writing to the Proprietor or Manager, Seamill Sanatorium, West Kilbride, Scotland. Sea-Sickness.--The cause of this is a nervous derangement of the internal organs, by which the bile passes into the stomach instead of, as it normally does, passing down into the intestines. A tight bandage round the middle of the body, so as to oppose resistance to this, will help _so far_. When the sickness has come on, a teacupful of hot water, at intervals, will very largely mitigate, and will often cure it. Even half a teacupful or a tablespoonful will prove sufficient in many cases where the teacupful cannot be taken. If this small quantity of hot water be taken every ten minutes, the worst effects of sea-sickness will not be felt, and far more relief obtained than most people will believe until they have tried it. Sensitiveness.--When the nervous system is in a certain state, all impressions on it are exaggerated, and the patient suffers from light sounds, and various irritations, far more than is usual or healthy. This state makes treatment difficult, because either cold towel or hot flannel distresses the sufferer, and by this does more harm than good. Narcotics only do harm, without any good, and leave the patient worse. The nervous system may in such cases be soothed by soaping the back with soap lather (_see_ Lather; Soap). The lather is to be blood heat, and very soft and creamy. Spread it all over a soft cloth as large as the back (having first warmed the cloth), and then place it gently on the back, lather side next the skin. Let this be done at bedtime. Fasten the cloth on the back with a bodice that will fasten closely, and let the patient sleep on it. Wash off in the morning with warm vinegar and water half-and-half. Rub with oil and dry off. Let the patient take twice a-day, for eight days, a teaspoonful of well-boiled liquorice and a tablespoonful of hot water. This treatment will usually abate the sensitiveness in a week or so, and bring the patient within reach of other remedies. For example, it will, after a week or so, even in very trying cases, be possible to foment the feet and legs once a day, and rub them with warm olive oil. It will even be possible and well to foment with a hot blanket across the haunches, and in this way to bring on comparatively strong health. Change of air and scene will then be desirable: it is highly refreshing to one who is in the way of recovering, though only harassing to one who is feeling despondent and increasingly ill. We generally, when asked if a "change" would not be good in such cases, reply, "Yes, if once you have got health enough to enjoy it." When that has been fairly secured, stronger measures may be used with advantage. We feel much sympathy with those who suffer from sensitiveness, as so many do, and earnestly pray that these remarks may be blessed to such sufferers. Shampooing.--_See_ Head, Soaping. Shingles.--Though not often fatal, this illness gives serious trouble. Its outstanding feature is a rash which comes out as a more or less regular belt round the body, or over one shoulder. The rash forms, if allowed to go on, into blackish scabs, and is accompanied in some instances by severe pains shooting through the body. It arises from a failure of the digestive system, therefore the stomach must be as little taxed as possible. Let hot water be sipped in teaspoonfuls for half-an-hour at a time, several times a day. For external treatment, wring a small sheet out of cold water and vinegar, and pack the whole trunk of the patient in this for half-an-hour. Do not use olive oil. The vinegar packing may be renewed in an hour, and as often as the patient feels it agreeable. The mixture of vinegar and water must be weak enough not to be painful on the skin. If the pains in the body persist, then cold cloths may be applied, not very large at first, to the spine, while the patient is warm in bed. Should the feet be cold, this cooling of the spine must not be done until they are wrapped in a hot fomentation up to the knees. If the scabby eruption is very obstinate, the SOAPY BLANKET (_see_) applied daily for two or three days should clear it away. Wheaten porridge, gruel, and milk diet is best. A drink may be made of hot water and lemon juice, with five or six drops of tincture of cayenne added to a tumblerful, and sweetened to taste. _See_ Drinks. Shivering.--This is often a trivial matter, but sometimes it is a symptom of a serious chill. It may be only the effect of a thought, or of some mental shock, but in any case it is a nervous disturbance, and failure of energy, causing us to lose control of the nerves which produce the shivering movements. For ordinary shivering, the result of cold, treat as in Cold, Taking. For cases where the vital action has evidently become very low, foment the patient as directed in Angina Pectoris. If pain in some part, as in a nursing breast or tender lung, indicates inflammatory action there, cold towels may be applied to that part while this fomentation is on. Renew the cold cloth as often as the patient feels it agreeable, keeping up the heat of the fomentation all the time. Increase the size of the cold cloth if the patient finds this pleasant; stop if it becomes unpleasant. Many serious troubles are checked in the first stage by treatment on these simple lines. Sick Headache.--_See_ Headache. Sitting (or Sitz) Bath.--This bath, in whatever form administered, is essentially a sitting in cold water with the feet out. The feet, in fact, are better to be warmly covered up while the patient sits in the bath. The most important thing to be considered in all such baths is the degree of vitality possessed by the patient. If he has much vitality, then the bath may be deep and longer continued--as long as even forty minutes. If the vitality be low, the bath must be brief and very shallow--it may be even necessary to make it as short as _one minute_, or even less. In some cases, as a beginning, a mere dip is all that is required. This leaves a large discretion to the nurse, and is a matter which common sense should be able to decide. To try a short bath first, and repeat it several times, rather than to give one long one, is the safest plan. It will soon be found out how much the patient can bear. If the vitality be so low as to make the simple sitz-bath a danger, the feet may be immersed, for the one or two minutes of the bath, in a small bath of hot water, and the patient well wrapped up all over in warm blankets. In some cases it is necessary to _pour_ cold water on relaxed organs, which, especially with females, will sometimes not be braced up by mere immersion. But such pouring must be done with caution. Half-a-minute of it is _a long time_; one quarter-of-a-minute or less will usually be enough, even in important cases. If longer applications have only done harm, then let our friends try the one-minute bath, or the quarter-minute stream of water. In many cases we have known this make all right. Such short baths may be taken twice or thrice a day. Skin, Care of.--Among the vast majority of people air and water far too seldom touch the skin. Want of water makes it unclean, and want of water and air make it slow in reaction. Now, a healthy skin is of the utmost value when one is attacked by disease. It can regulate the temperature of the various organs, and the application of heat or cold to it will cause a reaction at once. Much of our treatment as given in this book is directed towards stimulating the action of the skin. It is obvious that in health as in disease the skin can and does so act on the internal organs. It should be the aim of everyone that this most important part of the body should receive careful attention by a strict watch on the diet, by cleanliness, tonic water baths (cold, tepid, shower, as may be found to suit), and by tonic air baths. Light clothing and porous underwear will also be found of use. We have already drawn attention to the value of Kneipp linen as the most suitable form of underwear (_see_). [Illustration: Section of the Skin, showing glandular structure. Hairs Fat Cells Sebaceous Gland Sweat Gland Nutrient Artery Hair Bulb] Skin, A Wintry.--Something like an epidemic of skin trouble is often experienced in cold, wintry weather. First, the skin becomes dry and hard. A moist and sticky exudation replaces the ordinary sweat, and great irritation is felt when the skin is exposed to the air. If the sticky exudation be completely rubbed off, this irritation ceases. In this, and in the absence of inflammation, "wintry skin" differs entirely from eczema. The remedy is to rub all over every night for three or four nights with the CAYENNE LOTION (_see_). If this does not effectually cure, lather all over with soap and olive oil (_see_ Lather; Soap), before rubbing with the cayenne lotion. If the treatment of the whole skin at once is felt to be too severe, it may be cured by taking it in parts. Skin, Creeping.--A sensation sometimes very much annoys patients, which they describe as like thousands of small creatures creeping over the skin. It most commonly arises from defective working of the pores. A kindred trouble may be noticed along with this creeping. It is as if a stream of cold water were passing down the back. That causes great discomfort in many cases. The cure is sponging frequently with weak ACETIC ACID (_see_) or even good buttermilk. The skin being in such cases very sensitive, it is well to treat it bit by bit, a small part at a time. Take one limb, then another, then part of the back, and then another part. Besides this sponging with acid, and before it is done, the skin should be gently covered with lather (_see_ Lather; Soap). If this treatment is not successful, a little olive oil, with cayenne lotion, may be mixed with the soapy lather, and will make its effect more powerful. This creepy feeling is sometimes the result of cold, and some extra clothing may remove it. _See_ Underwear. Sleep.--No greater mistake could be made than to curtail the hours of sleep. Eight hours should be taken as a minimum, and any weak person should take ten hours. More and better work can be done by a person who takes fully eight hours' sleep than by one who tries to do with less. Sometimes strong tea or coffee is taken to drive away sleep, and so the nervous system is injured and sleep will not come when it is desired. Tea or coffee should never be taken except _very_ weak, and the person who accustoms himself to this will very soon come greatly to prefer it. Sleeplessness.--In search of sleep men do many things both dangerous and foolish--sometimes even fatal. Sleeplessness arises in so many ways and from so many causes, that it is often hard for the patient to find a cure, and he will try anything in desperation. A little thought should prevent this state of mind. For instance, we have a man who tries to get sleep by fatiguing himself by long walks in the open air or hard physical work of some kind, but he only grows worse. Now, a little thought will show that sleep requires a certain amount of brain energy. If the supply be below this amount, the brain is _too tired_ to sleep. Violent exercise of any kind will only make matters worse. So "keeping people awake" all day is tried, to make them sleep at night. It fails from the same reason--that it _reduces_ brain power. All narcotics in the end fail similarly. There comes a time when they have so reduced brain power, that even an enormous dose fails to give sleep, and the patient comes dangerously near poisoning himself--sometimes, indeed, does so outright. In all these cases, that which has worn down the brain _must be given up_ as a first condition of cure. Whether brain work, over-excitement and dissipation, alcohol or tobacco, the cause must be removed, and rest taken in the open air, or in well ventilated rooms. This done, we come to treatment. Soaping the head (_see_ Head, Soaping), or even the application of towels wrung out of cold water, will often, when the cause has been removed, do all that is needed to give sleep. These remedies, especially the first, should be at once applied, if the sleeplessness is accompanied, as is usual, with _heat in the head_. Even where the fevered head is connected with indigestion, the stomach will be powerfully helped by a good soaping of the head at bedtime. If, on the contrary, the head is cold, then warm fomentations to it will be the proper treatment. Perhaps the very best guide will be to aim at what will make both head and feet perfectly comfortable, and _both_ of natural heat. If cold, the feet must be bathed or fomented, and the legs also up to the knees. Sometimes the pouring of warm water in a _douche_ over the head will act perfectly, instead of the fomentation; but pouring _cold_ water must be avoided, or only very cautiously resorted to (_see_ Sitz-Bath and Restlessness). Sometimes sleeplessness proceeds from the use of bad drinking water, through its effect on the stomach and bowels. In this case, of course, the first thing is to see that no bad water is drunk. People cannot be too careful about a water supply. Usually boiling for half-an-hour renders water safe enough, but this is not always the case. Care must then be taken to see that water from any corrupted source is not used. When it is given up, treatment as above may be applied. If the sleeplessness be caused by a nasty tickling cough, put a BRAN POULTICE (_see_), or similar FOMENTATION (_see_) on the back _behind_ where the cough catches. Then change cold towels _in front_ over the same place. Soap the head, and sleep will probably soon come. Where palpitation of the heart causes sleeplessness, change cold towels over the heart, fomenting the feet if necessary, and the palpitation will usually soon yield. _See_ Brain; Children's Sleep; Exercise; Head; Rest. Smallpox.--If an epidemic prevails in the neighbourhood, or a case occurs in the house, after _due and carefully performed_ vaccination of the family, the important matter to regard is _cleanliness_. Frequent and thorough washing and changing of all the clothes worn next the skin will do much to prevent possible infection. If the clothes are often changed, then, and well washed, and the skin gets a daily washing with soap and is sponged with hot vinegar, there is little danger of infection during an epidemic of smallpox, or even when nursing the disease. Acetic acid, or white wine vinegar, is even a more powerful cleansing agent than carbolic acid, and has the advantage of being non-poisonous. It is important in treatment to attack the disease early. We have known an attack completely defeated, and the patient cured, by a wet-sheet pack administered at the right time. The early symptoms are a great weariness and chilliness. In this _cold_ stage, half-a-teaspoonful of cream of tartar, in two tablespoonfuls of hot water, should be given every half-hour. Also (and this is important) wrap the feet and legs up over the knees in a large hot FOMENTATION (_see_). The head also may be packed in hot cloths. If the fever does not rise, the applications may continue. If the fever does come on, _cold_ cloths must be persistently changed on the head. This we have known _reduces_ the bodily temperature two degrees in half-an-hour, when if left alone it would probably have _risen_ two degrees. The whole body may be packed in a damp sheet, covered with dry blanket, and this continued cooling of the head still proceeded with. When the eruption has appeared, and the violent itching set in, the eruption must be persistently _soaked_ with weak ACETIC ACID (_see_), or good white wine vinegar and water. In this soaking, avoid giving the patient pain by too strong acid. The necessary healing power will be found in such a mixture as will only cause the eruption slightly to smart. It is not necessary to treat a patient all over at once. You will do better if you take one or two pimples at a time. You can then pass from part to part slowly, getting over the whole. You can use a little olive oil after this soaking with vinegar, and so keep off all danger of chill such as might occur if too much of the surface were treated at once. If these simple means are well applied from the first, it must be a very bad case indeed which will not be cured, and most likely without any marks being left on the skin. Snake Bites.--A snake bite is only one of a large class of injuries which may be considered under one title. From an insect sting upwards to the most fatal snake bite, we need to note, first, the _blow_ or _shock_ of the bite, and then the fever symptoms which show poison spreading in the system. The blow or shock paralyses or kills a larger or smaller part of the nervous system. The nerve of the heart may be almost instantly so paralysed, with fatal effect. The snake poison especially affects the organic nervous system, and thus attacks the very source of vitality. In smaller stings, rubbing vinegar or weak ACETIC ACID (_see_) into the wound is sufficient almost instantly to cure. The same substance will cure greater evils. In the case of snake bite, first suck the wound thoroughly, watching that the lips and gums of the person who sucks are free from wound or scratch, or use what is called "dry cupping." Much may be done thus in a _few seconds_. But it must not be continued longer, and hinder the next step. This is to inject weak acetic acid _into the bite_. Where snakes are abundant, a small syringe, such as is used to inject morphia, with a rather blunt point, should be always carried, and acetic acid of the right strength. The injection must be _thorough_, and of course pain must be borne to avoid greater evil. Foment cautiously but persistently over the stomach and along the spine. Pay special attention to the lower back if bitten in the foot or leg, and to the upper part if in the hand or arm. During recovery, give careful diet, and rest. Of course this treatment will fail in some cases, as any treatment may. But if immediately applied, it will save a very large number of lives. Soaping the Head.--_See_ Head, Soaping. Soap, M'Clinton's.--Those of our readers who have followed out in practice the suggestions which we have given in these papers, will have seen some reason to believe in the importance of soap. Probably some of them have laughed at patients whose chief need evidently was a good washing of the skin! But there is more in soap applications than mere cleansing. These are found to be of immense value in cases in which there has been no want of perfect cleanliness--in cases even in which the skin has been habitually clean. For instance, in patients with nerves so sensitive that almost no application of any kind can be used, a covering of the back with a fine lather, and over this a soft cloth, has soothed the system so effectively that a great step has been secured by this alone in the direction of cure. When in search of really good soap we soon find that certain soaps are very harmful. Soaps made from "soda ash," as nearly all hard soaps are, tend to dry and harden the skin, and if used often produce bad effects. Soda soap does well enough for many purposes, and if it is not used often, and the skin is strong, no great harm may be done; but when it has to be used frequently, or is applied to a tender sensitive skin or to parts from which the outer skin has been removed, it will not do at all. For years we had been seeking for somebody who could make us hard soap without any mixture of soda. Once, when in Belfast, we spoke of this to a friend. He took us to a soapmaker, to whom we mentioned our desire. This gentleman at once saw what we wanted, and told us frankly that he could not make the soap that would suit us, and that he knew only one firm in the trade who could do so. But he assured us that that firm made a pure hard soap which we should find exactly suitable to our purpose. Thus we were introduced to the manufacturers of M'Clinton's soap. This firm, we found, made the very soap we had been so long in search of. It is made (by a process which is, we believe, a secret in possession of this firm alone) from the ash of plants, and so it may truly be said that it is Nature's soap. There is something in the composition of this soap which makes it astonishingly curative and most agreeable on the skin. Lather made from it, instead of drying and so far burning the skin of those using it, has the most soothing and delightful effect. As yet we do not feel able to explain this, not being sufficiently chemical for the work, but we have tried the matter, and feel assured that this soap is by a long way the best for cleansing and curative purposes. Even soap which possesses the same chemical composition lacks the properties of that made from plants, a fact not without parallel, as chemists know. The substances of the plant ash differ in some unknown way from even those chemically the same, which have been artificially produced. We trust that our noticing the thing in this way will have the effect of calling attention to the whole question of soap-making and using. It is one of those questions on which great ignorance prevails. Many people judge toilet soaps by the perfume and price. If the former is pleasant, and the latter high, they consider they must be getting something specially suitable, and yet the soap itself may be very injurious. Before we had some cases of bad diseases of the skin arising from the use of certain soaps, it did not occur to us to think much of the difference between one sort and another. Hence we just said, "use lather from good soap." Now we see need for care as to the kind of soap used, and especially to warn against all soaps, however fine-looking, that burn the tender skin when lather made from them is much applied. Very especially is it important to distinguish between the qualities of soaps used on the sensitive skins of infants and invalids. If you ever wash an infant in strongly caustic soap, you may look for a state of discomfort in the child which will make it restless and miserable without your being able to tell how it is so. You may ascribe to unhappy "temper" what is due to the bad soap which you have put on the skin. So with sensitive invalids, when they have to be washed or soaped, so as to keep off or heal the bedsores which are apt to appear on them, it is easy to see how much difference there must be between the effect of a caustic soap and one really and delightfully soothing. M'Clinton's soap is the very best and most lasting of the soaps we know for washing purposes, so that in recommending it we are not promoting the use of a merely medical thing, but of one for ordinary purposes of a genuine and excellent character. Every grocer ought to have it in stock, and if it is sought after with some vigour it will be soon brought in general trade within reach of all. It is not one of those things that flame on railway stations and on the covers of magazines. The makers are most quiet, unpretending men, and one would think almost afraid to take their light from under a bushel. But they are in possession of a most valuable secret in knowing how to make this soap. Several soap-makers claim to be makers of this soap, insisting that theirs is as good as M'Clinton's. It is far cheaper. Well, we put it to the test of use. It is not the same thing at all. It won't do, nor will it nearly do: the soda is there beyond all doubt. We are compelled to recommend our readers to make sure that they get M'Clinton's soap, with this name stamped upon it. There is a strong temptation to deception, because M'Clinton's soap requires eight days at least to make, while the fiery stuff is made in one day, or two at most. It is of great importance that the true soap should be secured. The matter is so important that precious life and health depend on so humble a thing as this. Take care you are not cheated by a wrong substance. Do not say you have tried our remedy and found it fail. If you have applied irritating soap instead of soothing, the so-called remedy could not but fail. Make sure you have the right substance, and you will have the right effect.[A] [Footnote A: To prevent an inferior article being substituted if it is asked for as barilla soap simply, it is in this edition called M'Clinton's soap. It is now made solely by D. Brown & Son, Ltd., Donaghmore, Tyrone, Ireland, who have purchased the business and trade secrets of the old firm, and manufacture the soap in the same way. If not stocked by the local chemist or grocer, small samples can be had from the manufacturers free on receipt of 2d. to cover postage, or a large assorted box will be sent on receipt of 2s. 6d.] Fortunately the makers of M'Clinton's soap are sternly honest men, and their soap can be relied on: that we have found out, we think, beyond mistake. We are happy to be able to say that they have not sent us even a bar of soap for our "Papers" on their behalf, but only assured us that they will "reward" our kindness by "making a genuine article." If there is "puffing," there is at least to be no payment for it, and that is a safe way of keeping the "puffer" to the truth! The curative effects of M'Clinton's soap will be found dealt with in the directions for treatment of various troubles throughout this volume. See the articles on Abscess; Asthma; Blood, Purifying; Boils; Cancer; Child-Bearing; Dwining; Fever; Hands; Hives; Pimples on Face; Rheumatism; Skin; Sleeplessness; Soapy Blanket; Stomach Trouble; Vaccination Trouble. Soapy Blanket, The.--It seems necessary, in getting people to use the best means for the recovery of health, carefully to consider, not the diseases to which they are subject only, but especially the processes of cure. We require to go into the very nature of things, so to speak, and to make it all palpable to the inquirer. For example, you prescribe a little olive oil on the skin, and the nurse is horrified at its being suggested that she should "block up the pores." Her idea is that these pores are only little holes in the skin, so that, if you fill them up with oil, the insensible perspiration will not get through. Now let us observe that a pore is a complete organ in itself, and has at least three things that characterise it. (_See_ page 285). First of all, it is a living thing. It is so as really as a finger is a living organ, or an eye, or an ear. When it dies, it is as much an opening as ever, but it ceases to secrete the perspiration which is constantly separated from the current of the blood when it was healthily alive. When it is sickly, though still living in a weak degree, it secretes, but so sluggishly that the substance which it separates from the blood does not pass off easily--it gets, so to speak, thick and sticky, and remains in the pores. In the second place, the substance which a pore secretes will not combine with certain things, and it will chemically combine readily with other things. When the pore is sickly, it may be aided, first, by the introduction of heat, which becomes vital action, and secondly, by the use of such substances as will readily combine with its secretion. The heat makes it secrete more perfectly, and the chemical combination makes the removal of the secretion easy. It is possible to block the pores up, but it is not very easy to do so. A healthy pore will send its secretions out through very close stuff. It is only by something like very strong varnish that it can be prevented. There is wonderfully little danger in ordinary life of any such "block" as this. But there is very great danger of the pore being deprived of its secretive power, and of its power to open its mouth when that is so much wanted. Warm olive oil sets millions of pores to full work sometimes in a few seconds. Now let us look at the application of the soapy blanket in the light of these remarks. Here is a poor patient, sitting in an armchair by the fireside, labouring to get breath. It makes one feel burdened to see him. What is wrong? Are the pores blocked up? No; but they are more than half dead, and what they do secrete is not such an ethereal thing as it should be. Nearly all the work of getting rid of the waste of the body has been thrown for months upon the poor lungs. The kidneys, too, have got far more than their share, just because the pores are sickly. The remedy is the soapy blanket. This most valuable means of stimulating the healthy action of the skin (as prescribed in many articles in this volume) is prepared and applied as follows:--Have a good blanket, and plenty of M'Clinton's soap (_see_ Lather and Soap). Shear down a tablet or two into boiling water--as much water as the blanket will absorb. The blanket may be prepared as directed in article Fomentation, using these boiling _suds_ instead of water. Have the patient's bed ready, and spread on it a double dry sheet. Soak in the suds a piece of thick flannel large enough to go round the body under the armpits. Wring this out and put it on the patient. Wrap the blanket tightly round the patient from the neck downwards. Tie something round the waist to confine it close to the body. Put the patient into bed, and wrap the feet well up in the blanket. If it is not sufficient to cover them, an extra piece of soapy flannel must be used. Then wrap the sheets over the patient above the moist blanket, and cover all nicely up. In removing the blanket, which may remain on half-an-hour, it is well to proceed gradually, uncovering the body bit by bit, sponging each part with hot water and vinegar or weak acetic acid (_see_ Acetic Acid), and rubbing hot oil on after drying. Dry this oil off, and cover each dried part of the body either with clothing or blankets before uncovering a fresh part. There is a modification of this treatment which suits more weakly persons, and suits also those who must do all, or almost all, for themselves. A long flannel or flannelette nightdress is used in this, instead of the blanket. This is covered on the whole of the inner side with well-made soap lather. When so covered it is put on at bedtime, and a dry nightdress put on over it. Both are then fastened as closely as possible to the skin, and the patient goes to sleep thus clothed. If the night is cold, the greatest care must be taken to be well covered, and brought to as good a heat as possible. In the morning a very great change will have come from this treatment. When the whole body is washed down with warm water, dried, and nicely rubbed with fresh oil, the skin is found very considerably changed, and in case of asthma the breathing relieved. If cold is taken when this process is fairly gone through, it would be very astonishing indeed; but if it is badly done, a person might get chilled instead of comforted. Therefore every care must be taken to keep the patient thoroughly warm. The result of one effectual pack is usually sufficient to convince the poor sufferer that he is being treated in the right way. The effect of the second is greater, and so on to the fourth or fifth, beyond which he need not go as a rule. He will do well once a day to wash with hot vinegar and rub after with the oil. These should not be required more than a fortnight at most. If chilliness continues, it is well to put on cotton stockings on going to bed, and even to bathe the feet and oil them before doing so. This bathing may be continued every night for a fortnight. Sores.--These will be found dealt with under many headings throughout this book (_see_ Abscess; Bone, Diseased; Blood; Boils; Breast; Cancer; Carbuncle; Cauliflower Growth; Eruptions; Erysipelas, etc.), therefore we here only treat generally of two kinds of common sores. The first is the surface sore, which eats inwards; the second, the deep-seated sore, which eats outwards. The first usually begins as a small pimple like a pin's head, and, if neglected, breaks, and gradually increases in size. Its origin is something which has caused the minute vessels of the skin at the spot to give way, so that they remain congested with bad blood, which soon becomes practically poisonous, and so the sore enlarges and eats into the surrounding tissue. If such a sore appears on the leg, it is often due to over-pressure through too much standing. Rest, with the leg kept horizontal or inclined slightly upwards to the foot, will often be enough to cure. When complete rest cannot be had, a thigh bandage (_see_ Veins, Swollen) should be worn. To treat the sore, it should be washed twice a day with BUTTERMILK (_see_), and afterwards thoroughly soaked with weak ACETIC ACID (_see_), and dressed with antiseptic lint, or, if that cannot be had, with buttermilk cloths. A buttermilk poultice (_see_ Potato Poultice) may be used. But if no rest can be had, the sore will be extremely difficult, if not impossible, to heal. The second kind of sore, arising from an abscess under the part, or diseased bone or membrane far down beneath the skin, is to be treated on the same principles, using weak acetic acid for the syringing, and buttermilk only for the surface. The method of treatment is such as will secure the contact of the weak acid with _every part_, even the deepest, of the wound. Procure a small pointed glass syringe, which must be kept _thoroughly clean_. The point of this may be inserted into the sore, and care taken that the weak acid penetrates into the very bottom, and thoroughly soaks all the diseased parts. This syringing should be repeated until the wound is thoroughly clean in every part. If pain is set up, the acid is too strong. Syringing with lukewarm water will at once relieve this, and then weaker acid may be used. This treatment may be given twice a day, and the wound properly dressed after it. Attention must be paid in all treatment of sores or wounds to the proper cleansing and boiling of all materials and instruments used. Wash the hands in hot water and M'Clinton's soap, using a nail-brush, before touching or dressing a sore. Boil some soft clean rags for five minutes, and wash the sore with these, using water that has been boiled and allowed to cool to blood-heat, to which a few drops of acetic acid have been added, but not so much as to be painful on the sore. If a syringe is used, boil it before using, and only use boiled or distilled water in all operations. This secures the destruction of the germs (or Bacteria), which are now known as the cause of the inflammation and suppuration of wounds and sores of all kinds. Spinal Congestion.--In some cases of this trouble the symptoms are very alarming, consisting in violent convulsive movements, which seem altogether beyond the possibility of relief. It is something to know that these terrible kickings and strugglings arise from simply an accumulation of blood in the vessels of the spinal cord, irritating it violently, as an electric current might do. Sedatives and narcotics will be useless. Leeches applied to the spine will sometimes cure by withdrawing the blood from it, though such treatment leaves no bracing and strengthening effect, but the very opposite. Use the cold towel, wrung out and placed along the spine, together with a hot blanket FOMENTATION (_see_) to the feet and legs, up over the knees. The patient must be gently held still, as far as possible, so that the treatment may be applied. The applications will not be at once successful, but after an hour's work something like permanent relief should come. Above all, the nurse must keep cool and calm in mind and manner. There is no need for hysterics, and any excitable person should be kept out of the sick-room. If the skin of the back has been broken by blistering or any such treatment, a fine lather (_see_ Lather; Soap) should be spread over all the back, and on this a soft cloth. Above this the cold towels may be safely and comfortably applied. It will do no harm if the treatment be continued for even two or three hours. Spine, Misshapen.--Often in the case of delicate infants or children, the bones of the spine fail to have the necessary hardness to bear the strain which comes upon them, and the spine gets more or less out of its proper shape. If this softness of bone continues, no amount of mechanical support, or lying down, will cure the misshapen spine. Therefore means should be taken by proper diet and nourishment to help the production of good bone substance in the child's body. The best bone-making food we know is good oatmeal, as well-boiled porridge (boiled for two or three hours), or as oatmeal jelly and gruel. Good air and water are also essential, and such treatment as is described in article on Children's Healthy Growth. Especially should attention be paid to constant supply of fresh air to the child's lungs. Windows should be wide open in all weathers, and if the child cannot walk far, it should be wheeled out for as long as possible every day the weather permits. Such supply of fresh air is of _vital importance_, and the want of it is frequently the sole cause of disease. In other cases it is not the bones which are soft, but the muscles and ligaments which hold the spine in a proper position are defective. Where the bone is felt to be good-sized and hard, and the surrounding substance too soft, it is a case of this kind. To proper nourishment, in this case, must be added proper _exercise_ of the muscles concerned. Immovable plaster jackets are bad, because they forbid this. This exercise may best be given by rubbing (_see_ Exercise and Massage). Gentle rubbing and pressure over the back, with hot OLIVE OIL (_see_), will work wonders in such a case. During the rubbing the patient should lie down _at full length_. It must also be done so as to be _pleasant_, or it is of no use. See that the patient has plenty of rest, and only as much walking exercise as is evidently enjoyed. There may be complications with other troubles--for example, a quick pulse and some fever heat, if the temperature is tested. That will require to be itself treated with repeated rubbings of finely wrought lather over the stomach and bowels. Until you have in some measure subdued this fever, you will not do much in the way of improving the muscles of the back. In many cases you will be able to bring the fever down completely, and then you will be free to exercise the muscles, and so to strengthen them that they will bring the spine to something like its proper shape. (_See_ Assimilation; Diet; Digestion; Nerves; Nourishment; Paralysis; Massage.) Spine, Weakness of the.--_See_ Children's Healthy Growth. Sprains or Racks.--A sprain is usually the result of some involuntary stress coming upon the part. If the injury be to the muscular substance only, it is easily healed; hot fomentations should be given to the sprained parts, with perfect rest and every possible ease and comfort by position, etc., and nature will soon effect a cure. If the injury be really to the _nerves_ which control the muscles, as is generally the case, the matter is more difficult. The muscle swells, but this is primarily due to the overstrain of the nerves in the sudden effort they make to bear a crushing load on the muscle. The pain is from pressure in the swelling, and also from inflammatory action. The cure, then, must be applied to the motor nerves controlling the muscles, and is best applied at their roots in the spinal cord. If the arm, hand, or wrist be sprained, rub gently the upper spinal region with warm olive oil, continuing the rubbing _gently_ down the arm to the injured part (_see_ Rubbing) until the whole shoulder and arm glow with comfortable warmth. But all rubbing such as causes pain must be avoided. If such rubbing cannot be managed, then a hot BRAN POULTICE (_see_) must be placed between the shoulders, and a warm fomentation given to the shoulder and arm. The treatment should be given once a day, and ere many days the sprain should be cured. For ankle and knee sprains, the lower back and leg must be treated on similar principles. Where the chest muscles that cover the ribs are sprained, rubbing and moist heat should be applied over the back and round the side where the sprain is, paying especial attention to the spine opposite the sprain, and using hot olive oil before fomentation and after, as well as to rub with. If the belly be sprained, similar treatment should be given lower down the back. If the back muscles are sprained, then the same treatment should be applied, taking special care to stimulate with moist heat and rubbing the part of the spine on a level with the injury, where the roots of the nerves lie which supply the sprained muscles. Care must ever be taken to avoid giving pain--to give pain is to increase the injury. To produce a glow of heat all through the parts is to cure it. (_See_ Muscular Pains.) For a sprained heel, when there is some degree of inflammation about it, we should pack the whole foot in fine soap lather. Let it be in this all night, and also during the day when resting. Wash the foot with a little weak acetic acid, after being packed in the lather, to keep it quite clean. Now rub the whole limb from the ankle upwards in such a way as to press the blood onwards in the veins. Use a little oil, so that the skin may not suffer till a fine heat is raised in the whole limb. This may be done for a quarter-of-an-hour twice or thrice a day. It relieves the heel of all congestion, and lets good arterial blood flow to it, as it would not otherwise. An elastic bandage, not very tight, put on above the knee will help the cure. Sprained joints and muscles should have _perfect rest_ for a fortnight, and be used very cautiously for some time longer. Spring Trouble.--Many persons are distressed by some form of eruption or inflammation in the skin in spring. The change of atmosphere and temperature at this time greatly increases the demands made upon the skin as an organ of perspiration, and this strain it is in many cases unable to stand--hence the trouble referred to. To prevent this, the skin must be brought into a better state of health and fitness for any extra work, so that it can bear without injury even very great changes of air and temperature. This may be done by regular application of soap lather (_see_ Lather and Soap) to the _entire_ skin each evening for three or four days, and then twice a week through all the season. Good olive oil may be rubbed on before and after the lather, or even mixed with it in rubbing on; if the cooling effect is found too great, two or three thick coats of lather should be put on, and then gently wiped off, and the oil applied. This, continued during the later winter and spring, should entirely prevent eruptions. But if these do appear, or have already come on, the irritation is apt to be so great that only very fine and carefully made lather can be used. It is better then to use _buttermilk_ instead of lather. But the BUTTERMILK (_see_) must be _new_, and if necessary weakened by addition of sweet milk; if old and strongly acid buttermilk be used, harm may be done. Do not _rub_ the milk on: _soak_ it into the parts by gentle _dabbing_ with a pad of soft cloth. This done frequently, even twice or three times a day, will almost always effect a cure. It should be remembered that no amount of washing or bathing will do in this state of the skin. Water somehow, especially hard water, fails to produce this fine state of the surface. When spring trouble has set in, we would keep water entirely from the skin. Nothing does so well as good buttermilk. In some forms of spring eruption, a strong mixture of salt and water may be freely applied with great advantage. If this irritates, it should at once be discontinued, but in many cases the eruption will disappear under a few applications. The salt solution should be gently rubbed on, and left to dry on the skin (_see_ Skin, Care of; Underwear). With the increasing warm weather the body ceases to require as much food as in the cold days. Heavy stimulating food in warm weather will certainly cause an unhealthy skin. Squeezing.--_See_ Rubbing. Stammering.--This trouble is simply a loss of command of the vocal organs, and is distinctly _nervous_ in its cause. Especially must we look to the _roots_ of the nerves controlling the vocal organs, if we are to see the real difficulty. There is evidently a state of irritability and undue sensitiveness in these nerves which must be soothed down, if a cure is to be obtained. The roots of such nerves lie in the back of the head and neck, and they are best soothed by application of soap lather (_see_ Lather; Soap). This must be well wrought, and applied warm to the back of the head and neck in three or four coats. Then mix some _hot_ OLIVE OIL (_see_) with the lather, and apply with the brush gently to the parts. Altogether, in applying the various latherings, and the final oil-and-lathering, an hour should be spent, so as to continue the soothing effect during that time. The head may be soaped one night (_see_ Head, Soaping the), and this treatment given the alternate night. Where the case is of long standing, it may take long to cure it, or a cure may be impossible, but some mitigation will result from this treatment. The Sabbath should in all cases be a day of rest from treatment, and generally common sense will indicate that it be not continued too long. The patient may do a great deal for himself by the strictest watch on his enunciation, speaking slowly and deliberately, and breathing deeply. This will be difficult to maintain at first, but practice will make the habit unconscious. An instrument called a metronome may be had from a music shop (used for keeping time in practising), if a book be read aloud by the stammerer, pronouncing one syllable only to each beat, he will soon gain complete control of his voice. Stiffness, General.--This is often an adjunct of old age, and sometimes occurs in the young and middle-aged as the result of chills. In _neither_ case is it incurable, but for a cure _rest_ is a first necessity. If there be standing and working for twelve or fourteen hours a day, we should not expect a cure at all. Rest must be had, at least twelve hours out of the twenty-four, and it is well if sixteen or even eighteen hours' rest can be taken (_see_ Rest). Then there must be heating the spine with moist heat (_see_ Fomentation). This is done to revive the organs which supply oil to the joints, by giving fresh vitality to the roots of the nerves which control these organs. But the heating requisite to do this must be gently and persistently applied. An hour's gradual heating is worth far more than half-an-hour's _half-burning_. Then, after the spine fomentation, which must be applied in bed, rub (_see_ Massage) the back with hot olive oil for a considerable time--say half-an-hour, if the patient can bear it (_see_ Exercise). Then the joints may be similarly fomented and rubbed at another time, back and joints being treated, say, every other day. If there be costiveness, treat as in Constipation, and give easily digested food (_see_ Assimilation; Digestion; Nourishment). Such treatment daily should remove stiffness, even in very bad cases. Stimulants.--_See_ Alcohol; Narcotics. Stomach Trouble.--If you would cure thoroughly, you must first make sure that the skin is doing its part well. Very often indigestion arises from irritation of the stomach, caused by the impurities in the blood which arise from defective skin action. With strong people, exercise causing perspiration will often suffice to cure, in other cases where exercise cannot be had the Soapy Blanket (_see_) is effective. After the blanket, give a warm, gentle rubbing with hot vinegar or diluted acetic acid; and, finally, a similar rubbing with warm olive oil. This rubbing may be given by itself, where the patient is too weak to endure the blanket, or where the lather cannot be well applied. Even the rubbing with oil alone will do much to cure. The problem in this case is to remove from the blood the irritating waste which is inflaming the stomach, and this is better done by cleansing and stimulating the skin than by means of drastic drugs. A lazy man will swallow a peck of pills rather than go through an ordeal of cleansing like this, but in that case he need not be surprised if his poor stomach become only poorer still, while his purse will not get any heavier. Besides this cleansing, take sips of hot water as recommended under Indigestion. A very plain and sparing diet should be taken, and great attention given to chewing all food till reduced to a liquid. For it must be remembered that the majority of stomach troubles have their origin in abuse of this organ, through overloading with food, or other dietetic errors. _See_ Diet; Assimilation; Biscuits and Water; Constipation; Cramp in Stomach; Diarrhoea; Digestion; Flatulence; Indigestion; Weariness. Stomach Ulcers.--Generally the _tongue_ will tell whether the stomach is ulcerated or not. If the tongue is fiery-looking, and small ulcers show themselves on it, while food produces pain in the stomach, there is little doubt of the presence of ulcers there. The tongue may at once, in such a case, be brushed with weak acid (_see_ Acetic Acid) or vinegar, so as to cleanse the surface and produce a _gentle_ smarting. This brushing will quickly produce a healing change in the tongue, which guides us to the cure of the stomach. This will be attained by swallowing teaspoonfuls of the same weak acid. Two or three of these should be taken at intervals half-an-hour before food. If the case is severe, the skin over the stomach must be carefully soaped, as directed in article on HEAD SOAPING (_see also_ Lather; Soap). The four-ply flannel BANDAGE (_see_) should also be worn. Do not use drugs, such as iron, arsenic, or soda, and avoid all narcotics. Persevere with the weak acid, and a cure will come unless in very obstinate cases indeed. Care must be taken to avoid irritating food. Milk, or milk and boiling water is the best diet. A general symptom is severe pain after eating, relieved by vomiting. No fluid should be taken hotter than the finger can be held in it. This is indeed a good rule always in matters of food and drink, which are often taken too hot, to the injury of the stomach. Stone.--_See_ Gravel. Stoutness.--_See_ Breath, and the Heart. Strangulation or Hanging.--Often accidentally caused in children or intoxicated persons. Waste no time in going for or shouting for assistance. At once cut the rope, necktie, or whatever else causes the tightening. Pull out the tongue and secure it, commence artificial respiration at once (_see_ Drowning), open the windows, make any crowd stand back. St. Vitus' Dance.--This proceeds from a simple irritation of the spinal nerves, and is to be cured by soothing the spine with persistent cooling. In mild cases this cooling is easily applied with towels wrung out of cold water, and folded so as to lie at least four-ply thick along the whole spine. If narcotic drugs have been largely used, and the nervous system spoiled thereby, a severer form of the trouble comes on, and requires a good deal of care and persistence in cooling. In all cases the cooling of the spine must only be done when the patient is _warm in bed_. It will be of great importance, in carrying out this process, to use olive oil in such a way, all over the body, as to help in maintaining the general normal heat. In addition to these suggestions, it may be well to remark that the appearances in such cases are, as a rule, worse than the reality. For instance, the motion of the eyes and of the tongue makes one imagine that the sufferer has lost all reason, and even consciousness of normal character. But this is not so; the brain may not be affected at all, and the worst feeling is that of weariness. We have seen a patient smiling through the most distressing contortions--that is, most distressing to the ordinary observer. It is of great importance that any one who treats such cases should be _cool_ and _kind_. It will sometimes be impossible for one person to keep the patient in bed and covered with the clothes so as to keep warm. If so, two must do it. It is, however, to be remembered constantly, that the patient feels it much more agreeable to be held within even close limits than to be allowed to throw arms and legs, and head and body about in all directions. This is a most invaluable truth in such cases. It will not do to hold as with an iron grasp, so that no degree of movement is allowed; but you may hold softly, so that no motion, such as will even disturb the bedclothes, shall take place. This must be done so that all the body shall be comfortably warm when the cold towel is laid along the spine and pressed gently to the centre of the back. In comparatively mild cases, we give an hour of this cooling process every morning only, and the warm washing and anointing with olive oil at bedtime; but in such cases as we sometimes meet with, where drugs have done their mischievous work, it is necessary to cool much more frequently. For instance, when the morning cooling has laid the irritation, and the patient is quiet for an hour, or, perhaps, only half-an-hour, the movement returns. The persons applying the cure are afraid to repeat it till another morning has come. But they need not be so. Or, they apply it for five minutes, and are afraid to continue it longer. They may quite safely apply it as long as they can keep the rest of the body comfortably warm. If they can keep nice, soft blankets well round the patient, as a rule it will not be difficult to keep up all general heat. Let us suppose that, when warm in bed and asleep, the patient wakes up, and the diseased movement begins; it will be well then to ply the back with the cold towel. If the movement is perfectly still in half-an-hour, a rest may be given. If the movement soon returns, the cold can be applied till perfect quiet is had again. This will, perhaps, be secured in twenty minutes or so. A rest and comfortable warming may be given again. If the movement still returns, it may be met by the same cooling process again. If only the heat is kept up all right, the cold towel may be used till the spinal irritation is finally gone. This simple mode of treatment we have found to be perfectly successful, not only in removing every symptom of nervous irritation, but in giving most vigorous health to patients who, to begin with, were truly miserable-looking subjects. This may be looked for, as well as the mere removal of the malady. It should be noted that one outstanding feature of St. Vitus' Dance is that the movement ceases _during sleep_. If this is not the case, other treatment is called for. _See_ Paralysis, and articles under Nerves; Spine, etc. Sunshine.--Is a most valuable aid to health, acting as a physical and mental tonic. The sunbath, for either portions of the body at a time, or for the whole body, will be found very beneficial to nervous sufferers, and also to those having a tendency to certain skin diseases. Its tonic effect is very noticeable on the hair, giving it better growth and richer colour. Sunlight should be admitted freely into bedrooms and sitting-rooms, for it is hostile to the growth of many of those microbes which cause disease. Tapeworm.--The only sure sign of the presence of this parasite in the intestine is the passing from the bowels of some of its joints or ova. Its presence in the body is a serious matter, always giving rise to more or less inconvenience and disturbance to health. We mention it here because we know of a very good and harmless remedy which will completely expel the worm. This may be obtained from D. Napier & Sons, herbalists, 17, Bristo Place, Edinburgh, postage paid, for 2s. One dose will be sufficient. We dislike _secret_ preparations, yet when we come across a remedy which never fails, we confess to putting aside our dislikes and getting it. The best thing is, however, to prevent the worm obtaining access to the body. All food, especially beef and pork, should be thoroughly cooked, and all cooking processes, and all places where meat is kept should be thoroughly clean. Where this is the case, tapeworm will never occur. Tea.--Tea should not be infused longer than three or four minutes, and cream should be used with it. The albuminous matter in milk tends to throw down some of the tannic acid in an insoluble form. It should not be taken too hot, and if taken at a meat meal (which is undesirable), not till quite the conclusion of the meal. Much tea-drinking produces nervousness and indigestion. If taken _very_ weak it forms a pleasing addition to the morning and evening meal, but taken as it usually is, and especially between meals, such as at afternoon tea, it is a serious cause of ill-health. Teeth.--In order to prevent decay, the teeth should be carefully brushed at least once a day, preferably at night, but better still after each meal. There is no better dentifrice than pure soap, and M'Clinton's tooth soap, being specially prepared from the ash of plants and a pure vegetable oil, does not leave the objectionable soapy taste in the mouth which all soda soaps do. The prevalence of bad teeth is believed by many to be due to processes of milling, which remove the bone and enamel making properties of the grain. So much of the natural salts of the grain are removed to make bread white that it ceases to be the staff of life. A contributory cause is the consumption of large quantities of sweets or candies, especially between meals. White bread lodging in the teeth and thereby producing acid fermentation, is believed to have a bad effect on them, also too hot or ice-cold liquids. Remember also that the teeth cannot be healthy if they are not exercised. The Scotch peasant when he ate hard oat-cake had splendid teeth, as the Swedish peasants who eat hard rye-bread still have. Sloppy foods hastily bolted will ruin the digestion and thereby the teeth, besides depriving them of the work essential to their good condition. If teeth do decay they should be seen to by a dentist at once, as their presence in the mouth is injurious to the general health. Teething.--At the outset, it must ever be remembered that this is _not_ a disease. It is a natural growth, and often is accomplished without any trouble at all. It is, however, a comparatively _quick_ growth, accomplishing much in a little time, as a plant in flowering. This _rush_ of growth in one place draws upon the vitality available for general purposes in the child's body, and if this vitality is not very large, trouble ensues. Diarrhoea, cold feet, and lack of spirit and appetite thus arise. If at this stage the lower limbs and body be carefully fomented (_see_ Fomentation), all trouble may cease at once; at least a very great deal will be done to relieve it. Give three teaspoonfuls of warm water, slightly sweetened with pure CANE SYRUP (_see_), three times a day. A little of the confection of senna will do instead of this if desired. The fomentation must never be so hot or so long at a time as to cause discomfort. Irritation is bad for a teething infant, and all must be done soothingly if success is to be gained. Also it will not do to foment and rub with oil a _feverish_ child. Such cases must be treated differently, as we shall see, and it is easy to distinguish them from cases without fever. Meantime we would say that in many cases where vital force is low without fever, the treatment by fomentation as described is of great value. In regard to the artificial "cutting" of the gum by surgical instruments, we would say that such should only be resorted to when the tooth is very near the surface indeed, and by a careful surgeon who knows what he is about. The irritation in the gums which makes it thought of at all can be usually allayed by simple means. Let the mother dip her finger in good vinegar and water, just strong enough to slightly smart the lips, and rub it on the irritated gum. This can of course be done often, and is most powerfully soothing. It may indeed do all that is required. But if more general symptoms appear, such as sleeplessness and heat in the head, cooling of the head is required. Have two little caps made of _thick_ cotton cloth, one slightly larger, so as to fit on above the other on the child's head. Wring the smaller out of cold (but not ice-cold) water, and put it on. Press it gently on the head, and if the heat and restlessness continue, cool it again, perhaps twice or three times. When the restlessness is relieved, leave the damp cap on the head, and place the dry one on over it. If the heat returns, repeat the process. This treatment, though a mere cooling of the brain, has saved ere now both reason and life, and should never be lightly thought of or despised. Often the stomach is seriously disordered during teething, both vomiting and purging resulting. In small degree these are not dangerous, but they are better avoided. If severe, they are the beginning of often fatal trouble. To quiet the excited bowels, nothing is better than enemas of cool water. It need not be too cold, but just a little under blood heat, with a little vinegar added. One tablespoonful of vinegar to a pint of water. Also a "baby's bottle," prepared with water at blood heat (98 deg.), _without any milk or sugar_, will greatly assist the stomach if given to be sucked. In such cases infants usually suck this water greedily. It is most soothing to the stomach. Half a teacupful at a time is enough. In the evening wash the child with warm water and SOAP (_see_) rub all over with warm olive or almond oil, especially the back up and down. Then place a BRAN POULTICE (_see_) over all the back, taking care to have it just comfortably warm. When this is fastened on, an ordinary pocket-handkerchief wrung out of cold water is folded and laid over the bowels. This is changed for a fresh one as soon as heated, and _gently_ pressed all over. The milk, if the child is brought up on the bottle, may be given now, reduced in strength for a time. This treatment will often cure without enemas, which may then be dispensed with. Great improvement in health may be expected after a few days of such treatment. A cool handkerchief, similar to that on the bowels, may also be applied to the head, if that is heated. Some form of head eruption often comes on after a long time of heated head. A little sour buttermilk, vinegar, or weak acetic acid, not stronger than to cause a slight smarting _tried in the nurse's nostrils_, will relieve almost instantly the itching which accompanies this. If strong acid be used, matters are made worse, and great pain caused. The acid, weak as we have described, at once neutralises the irritating substance exuded from the eruption. It also prepares the way for a cure. If astringent lotions are employed, drying the sore, and driving it in on the brain, serious injury may be caused. But if healing takes place under soaking with weak acid, no such result need be feared, for this simply removes the unhealthy state of the part. Water, especially _hard_ water, must be absolutely kept away from such a head. No more must be used than is necessary to dilute the acid; and, if it can be got, the acid of buttermilk is decidedly preferable. The whole body, when feverish, may be cooled in a tepid bath, several times a day if necessary, having the water just at blood heat. Besides these outside effects, teething often causes brain disorders. (_See_ various articles on Children.) The infant should be watched carefully, and if the eye be dull, and the head heavy with feverish symptoms, the head should be cooled at once as above directed, and if the feverish symptoms are not marked, and the feet cold, the feet, legs, and lower body should be wrapped in a good warm fomentation. Where the trouble has gone so far that insensibility comes on, the treatment is the same, only the cloths had better be wrung out of _iced_ water if available. It is important to not only lay the cloths on the head, but to _press_ them. Take the little head in your two hands, and so bring the cool cloth close to every part of it, while you lift up a prayer for help from the Great Healer. Keep at this till your feeling tells you it is time to change the cloth. Take off the hot one and put on the cool one. Go on with the gentle pressure again. It does require work, but it is well worth work to save a precious life. You must so work that you will cause the least disturbance possible to the little sufferer. It may be you may require to keep this up for many hours, but you will probably find that some signs of sense appear ere you have gone on very long, and you may see that natural sleep has succeeded the drowse that lay in the worn-out brain. If so, you will allow the head to lie still in the cold cloth, and change only when it gets very warm. If natural heat has been fully restored to the legs and feet, you will let these rest also. We know of a case where the brain seemed gone, and the medical man abandoned hope; but the head was cooled with ice cloths, while the feet and legs were kept in a hot fomentation, for a whole night, and all danger was passed by the morning. So that, even in very bad cases, this should be perseveringly tried. For diet, in teething, the child must get easily digested food, and all "rich" foods--brandy, beef-tea, etc.--must be avoided. Involuntary starting, and the manifestation of great fear on waking out of sleep, frequently arise from irritation of the spine during teething. The cold compress applied along the spine when the child is warm in bed will relieve this. It may be applied (_see_ Towels, Cold) twice or thrice a day. If the feet are cold, these may be fomented at the same time. If the head is cold, it may be fomented also. If it is hot, cool it. This treatment relieves the irritation of the mouth, as well as removes the starting. If _both_ head and feet are hot, then you need only cool the spine. In all cases, common sense must be used, but we think we have given sufficient indication of principles to enable a thoughtful nurse or mother to treat successfully almost any case. Where very cold cloths on application cause shivering and crying, either use tepid cloths, slightly cooler than the skin, or warm the _surface_ of the cold folded cloth by holding for a short time to a fire, and then apply to the patient. The warm surface thus first touches the skin, and afterwards the cold in the body of the cloth penetrates gradually. Temperature (_see_ Heat, Internal). Tempering Treatment.--Much, if not all, of the success in any case of treatment depends on its being properly tempered to the strength of the patient. In putting on LATHER (_see_), for instance, a delicate and nervous child will be greatly annoyed if soaped all over at once. But if one arm be done and finished, then the other, then the breast, and so on to the abdomen, the back, and the legs, _bit by bit_, the effect will be soothing in the extreme. So with MASSAGE (_see_); so also with applying a cold towel. If it chills and terrifies the patient when suddenly "clapped on," common sense would suggest holding it to the fire till the _surface_ is warm. This warm surface will give no shock when applied to the skin, and the cold in the body of the towel will gradually penetrate and do its work. Also, as we have frequently repeated, the _strength_ of ACETIC ACID (_see_) must be carefully looked to, when it is used. It must ever be remembered that some of the finest and noblest spirits are inhabitants of frail bodies, which, with right treatment, are strong enough, but suffer terribly in rough hands. Thirst.--This forms a severe feature in many cases of illness, and has to be treated variously according to its kind. It may be due first to _dryness_ in the membranes of the throat and stomach; secondly it may be due to a _concentrated_ or _deranged_ state of the juices of the body; thirdly, it may be the result of a _burning heat_ in the body. It will not be difficult for a careful person to say in any case which of them is the cause. The nature of the disease will indicate it. A little cold water may be given first. If this fails, a cold cloth over the stomach (_see_ Changing Treatment) may be tried. If these are not successful, a few tablespoonfuls of hot water may be given. The first of these meets the simple dryness, the second cures the burning heat, the third meets the case of concentrated and deranged juices in the body. A few drops of vinegar, lemon juice, or other fruit acid (_see_ Drinks), will often greatly assist the hot water in its duty. All alcoholic drinks are worse than useless in real thirst. Any power they possess is either due to the effect they have on the artificial thirst they create or to the water they contain. And the danger of rousing or creating the dreadful desire of the drunkard is so great, that they ought never to be given to relieve a patient's thirst. If the cold water is known, from any cause, to be dangerous to the patient, then hot water will do equally well. If the thirst arises from some drug which has been taken, then hot water should always be given. Again, the _locality_ of the dryness causing thirst indicates the best method of quenching it. If only the mouth and tongue be dry, then it will be sufficient to wash out the mouth with the water, or acid drink, not swallowing, so as to avoid unnecessary loading of the stomach. If throat and mouth are cool, and only the stomach burns, then the cold towel above that is the best treatment. There is no need, except in very special cases, for iced water. Tap water is generally cool enough, unless stored in heated cisterns. In this case a little ice may be used to bring it down to a temperature of 45 deg. or so, but not below 40 deg. Throat Hoarseness.--This is best treated by a good large BRAN POULTICE (_see_) on the back of the head and neck. While the patient lies on this, cold towels must be changed on the front above the "apple" of the throat. Do this for an hour twice a day. Or, if the feet be cold, give treatment as in Teething. There must also be _rest from talking_. Procure a good camel's-hair throat-brush from the druggist, and brush the back of the throat well with weak ACETIC ACID (_see_) several times a day, or simply gargle if there is difficulty with the brushing. The brush must be carefully cleansed, and dipped in the _strong_ acid after use. Especially is it necessary to give up, in such cases, the use of tobacco. Where the trouble has lasted for years, it may be slow to heal, and the poulticing may be done only once a week. In ordinary cases, a day or two's treatment should cure. Many times we have seen a good fomentation of feet and legs alone give very sensible relief. Never be satisfied with putting a hot bottle or brick to the feet. This is a lazy way of dealing with a serious case. Have the feet and legs up to the knees rubbed with vinegar and olive oil, and wrapped in a large blanket fomentation. It is not the mere dry skin of the soles of the feet that needs warming: the whole legs, especially the muscles, require the moist heat of a thorough fomentation. Circulation is at once accelerated just where it is wanted, so as to lessen the pressure where the vital stream is pressing too heavily and lodging in a dangerous congestion. It is good even if the feet are not very cold, but only cool, to ply this part of the remedy well. Where the patient is strong enough to sit out of bed, a good hot foot-bath will do instead of this fomentation. Throat, Sore.--The first question in any case of sore throat, is, What is the temperature of the patient? (_see_ Heat, Internal). If this cannot be ascertained, at least we can say whether the patient is feverish or not. Let us first take the case where there is no fever. Get the patient warmly to bed. Foment (_see_ Fomentation) carefully all round the neck, first rubbing on a little olive oil. Renew the fomentation every five minutes for three-quarters-of-an-hour at least. Allow rest for an hour. Then foment thoroughly the feet and legs up over the knees. When this is done, and the heat kept up, cool the throat with constant fresh cold towels. Let this go on for an hour. Finally sponge the whole body with warm vinegar. Rub lightly over with olive oil, dry, and allow to rest. Probably the throat will be cured. If not, repeat the treatment the following day. Where there is fever with the sore throat, first make sure whether the feet are hot or cold. If cold, put on fomentations as above. Even if the feet are only cool this should be done. While the feet and legs are thus fomented thoroughly, change cold towels on the throat every three minutes for an hour. Sponge all over as above directed, and allow to rest. If the feet are hot, cold towels alone are applied to the throat; but if the feet get at all chilled while such cooling is going on, they must be fomented. If there is vomiting and sickness along with the sore throat, the other symptoms of scarlet fever should be looked for, and medical aid obtained if possible. But here is a case where the most experienced eye, aided by the best possible instrument, sees nothing wrong in the throat itself, but the cough and difficulty of breathing point to the throat. The trouble is not there, but in the roots of the nerves by which vital energy is supplied to the windpipe and other vocal organs. You must go to the back of the neck, and to the back between the upper parts of the shoulders, and there affect the roots that are really in a state of distressing over-action. If you are skilful enough in applying cold, and your patient has plenty of general warmth, you need nothing more than a cold towel, changed pretty often, and nicely pressed over the proper parts. If this fails, have recourse to a cloth with mustard spread like thin butter on it, say about six inches broad and a foot long. Lay this gently on the spine at the back of the neck, and down as far as it goes. Apply your cold compresses now over this as well as you can, and the violent spasmodic symptoms will be mitigated. If one trial is not sufficient, sprinkle the cold cloth with cayenne. If the result can be reached by the cold cloth alone, it will be best. If mustard or cayenne must be applied, observe very carefully that they should never distress the patient. As much as can be borne quite easily, and no more, should be employed. Whenever a remedy becomes seriously distressing, we may be pretty sure it has ceased to be remedial, for the time at least. Throat, Sore (Clergyman's).--Those who are in the habit of using their voice much should be very careful to produce it in the proper way. It is noticeable that actors (who learn to produce their voice properly) do not suffer from what is known as clergyman's sore throat. The voice in speaking should be pitched, as a rule, considerably lower than is usually done, especially if speaking in public. Any tightening of the throat muscles should be avoided, and the voice sent out from a full chest well expanded. Those who are musical should take a note on the piano enunciating the vowels in their natural order ([=a], ay, ee, o, oo) on this note. Then proceed to the next note; the whole of the octave may thus be gone over. Choose an octave most consonant with the range of the voice. Then add the consonants: b[=a], bay, bee, c[=a], cay, etc., etc. Thus a perfect command over all the possible combinations of vowels and consonants may be attained. There is absolutely no reason why any musical person should have an unmusical voice, especially since this bad production of the voice often strains the muscles and inflames the mucous membrane of the throat. In connection with this question of music, it should be remembered that almost irretrievable injury to the voice may be done by allowing a boy to continue singing after his voice has begun to "break." It is not a good plan to be constantly "clearing" the throat whilst speaking. One gets to imagine after a while that it needs clearing when it really does not. Alcohol and tobacco are both undoubtedly injurious to the voice. A little honey and lemon juice will be found the best gargle if a gargle is required. Deep breathing is of great assistance in endeavouring to produce the lower note, in fact it is not possible to produce a full note except from a full chest. In this connection it may be said that it has been observed that deep-chested, deep-breathing, slow-speaking people are frequently possessed of certain estimable points of character, such as prudence, firmness, self-reliance, calmness. If one is going to be angry, ten deep breaths might save a world of trouble. (_See_ Breathing, Correct method of). Thumb, Bruised and Broken.--Frequently a tradesman will strike the thumb or finger a serious blow with a hammer, in missing a stroke. If not treated properly, the whole hand may be destroyed, but if promptly plunged into warm clean water and kept there, even the broken bones can be handled quite comfortably, and all pain and uneasiness pass away ere very long. Plenty of bathing in clean warm water, and proper setting and dressing, are all such an injury requires. Toothache.--This trouble appears in two opposite characters. In the one it is cured by rightly applied heat, and in the other by cold. If it is merely the soft substance in the tooth which is affected, local cooling applications will cure, if persisted in. If it be the nerve terminating in the tooth which is irritated, then even the extraction of the tooth may fail to give relief. Both cold and hot applications to the tooth or cheek will then probably prove useless. In such a case, apply COLD TOWELS (_see_) gently pressed over the head and back of the neck. If the case be a bad one, the feet may be put in a hot bath, or fomented. Persevered in for an hour, this treatment is almost certain to cure. It may take away all pain in a few minutes. After the pain is cured, dry well, and keep the head moderately warm. But if the toothache is caused by a severe chill to the head, and that be still cold, it should be packed in a hot fomentation. This gives almost instant relief. Rub on a little oil when the fomentation comes off, and keep the head warm. It should not be difficult to distinguish the cases requiring heat from those requiring cold. In any case, if the first application of either increases the pain, try the other. Towels, Cold Wet.--A towel of the ordinary kind, and full size, is soaked in a basin of cold water and carefully wrung out until it is merely damp. Prejudice against this treatment is often aroused by putting on the cloths wet, and in a slack, blundering way, so as to make the patient most uncomfortable. It is then folded and applied to the skin, as directed. While applying the first, a second towel may be in the water. It is then wrung out and applied, while the first is placed to soak afresh. In prolonged cooling, care must be taken that the water in the basin does not get too warm. It should be frequently changed. The nurse should gently press the towels on the part, frequently changing the position of her hands. They should not merely be laid on, but gently pressed, unless this causes pain. The towels will need to be changed when hot, and will take from two to five minutes to lose their cooling effect, according to circumstances. Where cold increases the patient's distress, it is almost always safe to substitute heat. _See_ Cooling in Heating; Fomentation. Tumours.--A large, soft, fleshy tumour is usually simply an accumulation of waste material, which should have been excreted from the body if all the organs were in healthy working order. Where such a swelling exists, the first consideration is diet. For this, Barley (_see_) as chief food will do very well. Lemon and orange juice (_see_ Drinks) should be the drinks. The barley must _not_ be cooked with milk, and the drinks must be made with _pure water_. This plain diet will help very much towards the removal of the tumour. Then the back should be rubbed (_see_ Massage) with hot olive oil twice a day. This treatment alone has often removed the disagreeable swellings on the neck so often afflicting women. Also, fine soap lather (_see_ Lather; Soap) should be gently rubbed repeatedly over the tumour itself. This _alone_ we have known remove tumours, so it is important. The three forms of treatment, all applied carefully, will cure all but very obstinate cases. _See also_ Armpit Swelling; Hydrocele. Where fibrous tumours exist, the treatment is to _douche_ cold water on the part affected, while the rest of the body is kept warm. In case of such a growth in the abdomen, the patient sits in cold water, while the feet are placed in hot water, and the whole body warmly wrapped in blankets. Cold water is then thrown against the spot where the tumour lies. If the tumour is discovered early, its growth may be entirely stopped by this means. Such treatment for several minutes twice a day has in our own experience cured cases pronounced incurable. _See_ Sitz Bath. Turnip Poultice.--Part of a raw turnip is grated down to a pulp. As much of this is prepared as will cover the inflamed part. It is put on next the skin, and covered with a soft cloth. All is then tied nicely up in another cloth. In violent inflammation of the knee joint, this is a most valuable soothing application. Placed on discoloured and shrivelled skin, it is marvellously curative. When applied, the patient must be _thoroughly warm_. This warmth must be maintained while the poultice is on, as it has a powerful cooling effect. Typhoid Fever.--_See_ Fever, Typhoid. Ulcers.--An ulcer is an "eating sore": that is, a sore containing matter which eats away the skin and flesh, thereby extending itself, and increasing in depth as well. To stop this diseased process, the virulent matter in the ulcer must be killed or neutralised, and this can usually best be done by means of vinegar or weak ACETIC ACID (_see_), which is most powerfully antiseptic. The only difficulty is to avoid irritating the sore by the application of too strong acid. The treatment by weak acid is very effective, but it must be a fairly prolonged and thorough soaking. Apply a little at a time to the sore. Use warm water if pain be caused. Continue the soaking for even an hour at a time, twice or even three times a day. The wound may be dressed with good fresh olive oil after each soaking. Usually, nothing else will be required, but it must be thoroughly done. In a very severe case, mix in a teacupful of hot water as much saltpetre as the water will dissolve. Add to this a teaspoonful of acetic acid, and use this to soak the sore instead of simple weak acid. Then, if healing does not come, it is probably because rest is not taken, and most likely also because there is deficient vitality in the whole system. Let the treatment with the lotion be given in the morning. Secure rest during the day, and in the evening, for an hour, thoroughly foment the feet and legs up over the knees. Once a week for two weeks give the SOAPY BLANKET (_see_) instead of this treatment, and in the morning rub all over the body with hot vinegar. This powerfully stimulates the vitality of the whole system. Even a very bad ulcer should give way under a careful course of united acid soaking, rest, and this stimulating treatment. Unconsciousness.--There are two opposite causes of unconsciousness. One is congestion of the brain, the other sheer nerve exhaustion. Either will produce a prolonged suspension of consciousness very different from a mere passing faint. In the case of congestion, the head will be hot and the feet cold. The cure is therefore at once seen to be to cool the head and foment the feet in a hot blanket up to the knees. This is the treatment usually to be given to young children. When aged people, or those much exhausted from any cause, become unconscious from lack of vitality, there will be rather a _general_ coldness, and no special heat in the head. We have seen such a case of "coma," which had lasted for forty-eight hours, come all right in ten minutes, by simply fomenting the back of the head and neck, and all down the spinal column. Press a thickly-folded piece of flannel wrung out of hot water carefully and gently over these parts, and often in a few minutes the mental power comes back. Care must be taken not to scald the patient. _See_ Fomentation. Underwear.--There is a common and very popular error, namely, that of putting too much clothing on our bodies, under the mistaken idea that additional weight means additional warmth. The fact that the main object of clothing is to preserve the natural heat of the body is lost sight of, and little attention is paid to the selection of proper garments for wearing next the skin. Every day the skin of an average healthy individual gives off so many pints of moisture, which must not be allowed to settle on the body if health is to be maintained. After long and exhaustive trials, we have come to the conclusion that the best material for wearing next the skin is knitted linen, and the best knitted linen of the kind, and in fact, the only pure linen mesh material which we have seen, is known as _Kneipp linen_, and can be obtained from all leading retailers and outfitters in this and other countries. The name of the nearest agent may be had by sending a card to the Kneipp Linen Warehouse, 2 Milk St., London, E.C. In winter light woollen underwear can be worn over the linen if desired, thus retaining the hygienic advantages of the linen, as well as the warmth of the wool. As the wool does not touch the skin, it will not require frequent washing, and so will not become felted up. Linen is the symbol of cleanliness, the priests of old, as we read in Ezekiel, being commanded to wear it, and not wool or any garment causing sweat. Our reason for specially naming Kneipp linen is that we know it is _pure linen_, whereas we know that what is sold as linen mesh is frequently half linen and half cotton. Linen is the most absorbent material for underwear. It soaks up moisture very rapidly, and dries with equal rapidity. Hence linen is always preferred for towels and bandages. Those who use it for underwear will not require to change the clothes after exercise, as they would if wool were worn next the skin. The ordinary woven linen is clean but cold: Kneipp linen is so constructed as to be clean and warm. This material retains air in its meshes, and a layer of dry air next the body is the best method of preserving an even temperature, and thus avoiding colds and chills, which are so prevalent in a climate such as ours. Wool is entirely unsuited for wearing next the skin. It does not absorb the perspiration rapidly nor radiate it freely, and after several washings it becomes felted, and in that condition is absolutely injurious to health. It is the material par excellence for outer clothing, but all inner garments coming in contact with the body should be composed of pure linen. (_See_ Skin, Care of). Uric Acid.--This acid is found in persons of a gouty tendency, such tendencies being a great deal more common than is imagined. It is really a waste product formed by the activity of the body cells, and should properly be mainly transformed into urea and so excreted. If it is not so transformed it accumulates in the blood and deposits in stony formations in different parts of the body, as in the joints, kidneys and bladder, causing very serious disease. Pure air and plenty of exercise will assist its transformation. It is also taken into the body in various foods, particularly meat and tea, which are very rich in it or kindred chemical substances, therefore, anyone having such a tendency should avoid these. The consumption of sugar should also be limited. Avoid alcohol and use plenty of green vegetables and fruits. The tendency to a "uric acid" constitution is hereditary, and is prevalent among families who live high. Such should be continually on the watch lest their diet should precipitate an attack. Water should be freely drunk, and plenty of bathing with subsequent rubbing of the muscles or massage is advisable. Drugs are to be avoided as they often result in painful heart affection, and besides do not strike at the real root of the disease. Soda or lithia water may be taken either with or without milk. Brine baths may be taken when practicable. Urinary Troubles.--A healthy man usually evacuates about 30-40 ozs. of urine daily, the excretion being greater in the winter than in the summer, owing to the checked perspiration. The urine should be of a pale straw colour and transparent. Where any irregularity in the urine, either in quantity or quality, is suspected, it is wise to use soft boiled or distilled water only, for drinking, and to take frequent sips of it throughout the day, and especially early in the morning. Either pure hot water, hot water and lemon juice, or whey, will help the action of the kidneys when this is sluggish. Where the bladder is irritated and painfully sensitive, a large hot BRAN POULTICE (_see_) should be applied to the lower back. While the patient lies on this, cold towels (_see_ Towels, Cold Wet) should be changed over the bladder in front. While giving such treatment once or twice a day, _rest_ must be taken, if a cure is to be obtained. For a patient to say that rest cannot be had, is to say that cure is impossible. Where there is a tendency to stoppage of the urine, a warm sitz-bath should be taken. The patient first sits in three inches deep of comfortably hot water. More water at the same temperature is poured gradually in at intervals, until it rises well up over the abdomen. This will usually relieve even a bad case. Treat with bran poultice and cold towels, as above recommended, after the warm bath has given relief. It should be remembered that the _cold_ is the healing power, bracing the bladder and all its muscles and vessels. Hence more than a slight cooling is needed. But the cooling is only possible when good heat is kept up on the base of the back. This treatment also cures the swelling of the bladder which often accompanies restriction of urine. Where a positive growth interferes with the urinary discharge, this may often be actually _melted away_ by soaking with weak ACETIC ACID (_see_), when it is at all possible to reach it. The power of cure possessed by acetic acid is incredible, except to those who have seen it exercised, and its persistent use would, we are use, save many lives, if people would only try it. We would also advise the four-ply flannel bandage, with two plies damp and two dry. This round the body has a wonderfully soothing effect. So has a nicely applied lathering with SOAP (_see_). As in most other troubles, special care must be taken to keep the feet warm. Vaccination Trouble.--When a child is suffering after vaccination, we should have him gently rubbed all over--thrice at least with M'Clinton's soap (_see_ Lather). No one who has not seen this well done can believe how blessed are its effects on an irritated skin. It soothes incredibly. When thoroughly covered and covered again with well-made lather of this soap, the child will sleep beautifully. We should soap head and all, and let the little man sleep all night in the soap. He may be sponged in the morning with weak vinegar and water to clean off the remains of the soap, if there are any. Now, there will occur a most important question: Is the child cold or feverish? If cold, then mix some good olive oil in your rubbing with the lather. If hot, use no oil. If cold, rub all over with warm oil before applying the lather. It will make no difference, or next to none, if the disease has broken out as a visible skin disease, only it will be necessary to use the vinegar on the unbroken parts of the skin and not to distress the child by painful smarting. The soap will not need to be so restricted. That cures the most tender sores, and soothes in a delightful way. Vegetables, Green, and Fruit.--We would strongly recommend our readers to continually have these valuable foods on their tables. It is possible to obtain them in some form or other during the entire year. They contain very valuable salts, which are of the greatest use in preventing disease. These salts are absolutely necessary for life, and though found in other foods such as meat, are particularly abundant in these vegetables. If cooked they must be carefully prepared, as the salts are very soluble in water (_see_ Cooking). Vegetable salads and fruit salads are to be recommended. Those of gouty or corpulent tendencies will find these of especial use. By keeping the blood alkaline they are a preventive of many diseases. Spinach, cabbage, lettuce, and all the fruits offer a variety from which at each season one may choose. It is to be observed that common salt and salt such as bi-carbonate of soda, do not adequately replace those food salts. Indeed, over-consumption of common salt is harmful, besides leading to unnatural thirst. Fresh fruits and vegetables are always to be preferred to tinned ones. Veins, Swollen.--The swelling of veins in the leg is a very common trouble, especially in middle and later life. At first this may cause no pain, one vein appearing as a little blue lump. Then as the trouble increases, knots of veins seem to rise, especially below and behind the knee. Great pain follows, and sometimes the veins burst, causing bad sores, not easy to heal. All this generally springs from _overstrain_ upon the limbs. Long continued standing, in circumstances otherwise unfavourable to health, is the usual cause. This shows the primary necessity of _rest_. Let the patient lie down as much as possible, or at least sit with the sore limb or limbs supported on a chair so as to be nearly level. If this can be done thoroughly, all work being given up for a month or so, a cure is not very difficult. But where this rest cannot be had, an elastic band, such as is used by bootmakers to make strong boot gussets, about six inches broad and one foot long, should be procured. Fasten this round _above_ the knee, well up the thigh. This will greatly help to relieve the blood pressure on the lower leg, and is better than elastic stockings. Before these bands are slipped on, the leg should be well rubbed or stroked _upwards_, as described at the end of Circulation. This rubbing empties the swollen veins, and gives great relief. We have seen a man with both legs full of swollen veins ready for bursting, and most painful, get on two such bandages, and go on digging and working with perfect ease, while the veins sensibly contracted with no other application. But it is not necessary nor wise to confine medical measures to the use of such bandages. Rest is in some cases absolutely necessary. Even where partial rest can be had, it is important to wear these bands and rub as described. But if possible, the patient should rest in bed for one week. To restore power to the relaxed vessels, a large bran poultice should be applied across the haunches behind, rubbing olive oil before and after. Apply this for fifty minutes each night during the week in bed. Wear a broad band of new flannel over the parts after the poultice. In the morning give the same treatment. If in a week the veins are not better, continue the treatment for another week. The elastic band is, of course, not worn in bed, but may be put on on rising as a security against relapse. We have seen persons over sixty years of age completely cured in this way, when the necessary rest could be had. If the _skin_ give signs, by dryness and hardness, that it is out of order, instead of treatment with the bran poultice, the SOAPY BLANKET (_see_) may be applied on the first night. The patient may on other nights be lathered with soap (_see_ Lather; Soap), and the soapy cloth worn on the back for a night or two, sponging all over with hot vinegar in the morning. Where the veins by bursting have caused sores, treat with weak vinegar as directed for Ulcers, and after each acid soaking, bandage the whole limb (putting lint on the sores and dressing them properly) with an ordinary surgical bandage, just so tightly as to give relief, and not tight enough to cause any pain. Over-pressure injures. This treatment, with the necessary _rest_, will in most cases effect a cure in a few weeks. Vomiting.--In many cases of severe illness, the stomach rejects all food, and the patient comes near to dying of simple starvation. On the slightest nourishment being taken, retching and vomiting ensue, the stomach being irritated beyond all possibility of its doing its work. This occurs in cancer and ulcers in the stomach, as well as in various disorders and stomach inflammations. "Rum and milk," "claret," and all alcoholic drinks are most injurious in such cases, and should _never_ be given. To soothe the irritation, the stomach should be soaped in the same manner as recommended in Head, Soaping the (_see also_ Lather). We have seen, even in very bad cases of cancer, such an application cause all retching to cease almost at once. When this has been carefully and gently done, give exceedingly small quantities at first, of infants' food, or milk and boiling water. To give any "rich" things is a fatal mistake. Oatmeal jelly may be given also, but beginning with a teaspoonful at a time (_see_ Assimilation; Digestion; Nourishment). By gradually working up the amount, a patient's life may be saved on this simple oatmeal jelly which would be lost if richer things were given. Often the stomach rejects food simply because it is surfeited. It may be that the liver is out of order, having had too much to do. Abstinence from food for a day or two, and then reducing the meals to two, taken, say, between 10 and 11, and 5 and 6 o'clock, will greatly help. Masticate the food till it is reduced to a liquid, in this state the quantity required will be wonderfully reduced and the work of the stomach lessened. Water, Hot.--The frequent prescription in these papers of hot water, to be taken often in small quantities, makes it of importance that some explanation of its action should be given. We see, frequently, such a thing as this: a person is confined to bed, sick and ill; there is no desire for food, but rather a loathing at the very idea of eating; distressing symptoms of various sorts are showing that the work of digestion and assimilation is going on badly, if really going on at all. The patient is started on a course of hot water in half-teacupfuls every ten minutes. When this has gone on for perhaps six or seven hours, he begins to be very hungry, and takes food with relish, probably for the first time for months past. In the meantime a greatly increased quantity of water has passed from the body one way and another, but has all passed loaded with waste material. The breath is loaded with carbonic acid and other impurities; the perspiration is loaded with all that makes it differ from pure water; the urine, especially, is loaded with waste separated from the blood and tissues of the body. The space, so to speak, left vacant by all this washing away of waste matter makes its emptiness felt by a call upon the stomach to furnish fresh material. Some will say that the hot water merely passes off by the kidneys without entering the circulation at all. This is impossible, and facts, patent to everyone, demonstrate that they are in error. The substances with which the water becomes impregnated show that it has been mingled with the circulation, and the wholesome effects produced prove that it has made itself useful. "Hard" water, as it is called, will not do so well as "soft" water. Distilled water is best of all. So much superior is it, indeed, that its use cannot be too strongly insisted on. It can be had from the druggist at twopence per quart. Where nourishment is given with too little water, the food will often fail almost entirely to enter the circulation. But a little warm water, somewhat above blood heat, but not too hot, will make all right. This is especially seen in nourishing infants (_see_ Infants' Food). Food, then, will not act as water does, nor will water act as food. Even a little sugar mixed with the hot water completely alters its effect on the body. As it has already dissolved the sugar, it cannot dissolve what is needed to be removed from the body. Sugar and water is not a _bad_ mixture, but it will by no means do instead of pure water in the cases we contemplate. On the other hand, a mixture of alcohol with the water is ruinous, and that just in proportion to the quantity of alcohol, small or great. Beer, for example, can never do what is required of water, nor can wine, or any other alcoholic drink. Tea added to the water also alters its quality. The water _alone_, and as nearly perfect in purity as it can be got, is the only thing which will do the necessary work. Sometimes one finds a great prejudice against hot water. You see one who is miserable through derangement of the stomach and digestive organs, and you mention "hot water." The very phrase is sufficient to put an expression of strong prejudice on the face. Yet that very hot water is perhaps the only thing that will cure the patient. If you wait a little, there will be an opening to explain that hot water is very different to tepid water. Under blood heat, and yet heated, water tends to produce vomiting; above blood heat, nothing will so well set the stomach right. This is true, however, only when the water is taken in very small quantities. You must see that the water is not smoked in the heating or otherwise spoiled. And also that it be not too hot. If it scalds the lips it is too hot. When it is comfortably warm, but not tepid, it does its work most effectively. Water for Drinking.--Every care should be taken to have drinking water absolutely pure. Diarrhoea and many infectious diseases may be conveyed by impure water. In gouty cases as much water should be taken as possible (provided the heart is sufficiently strong) in order to wash away the waste matter. The same applies to fevers. If there is a suspicion of water being contaminated mere filtration should never be relied on, the water should be boiled. After many of the treatments given by us in this book, considerable thirst will be experienced. Cold water in such cases may always be given. In fact, in any internal congested condition cold water will stimulate the nerves of these organs, and make them act on the blood vessels. In all cases where drugs, especially mineral drugs have been recklessly indulged in, cold water should be taken in abundance. Care must be taken, however, not to unduly stimulate the circulation or nervous system, and any signs of this, such as headache or want of sleep indicate the curtailment of the amount drunk. Water in the Head.--In cases where this trouble is suspected, very often there is nothing wrong but a more or less congested state of the brain, owing to some severe chill or some disease elsewhere in the body. There may be violent heat in the head, and even the "drowsiness" which is so serious a symptom, without any real "water in the head" at all. Leeching and blistering in such a case are grave mistakes. Cold towels (_see_ Towels, Cold Wet), or a gentle pouring of cool water on the head, will often be sufficient to remove all trouble. We have seen a bad case of brain congestion cured and consciousness return almost immediately after the pouring had begun. The feet also may be fomented (_see_ Fomentation). The cold towels and pouring may be used alternately on the head, which will give a more powerful effect. Let the water poured be almost lukewarm, a little under blood heat. There is no need to cut the hair, or use any acid or drug in the water. The _cooling_ is all that is needed. Incipient water in the head may in a very large number of cases be checked and cured by the same treatment. It can do no harm in any case, and has saved many lives. Water on the Chest.--Sometimes a large watery swelling appears in one part or another of the chest. It is practically a bag of liquid waste, due to deficient action on the part of the kidneys or skin. Treatment should be given as recommended in Dropsy, and, besides, the four-ply moist flannel bandage should be worn over the skin. This will in many cases speedily effect a cure. Weakness.--Often there follows, after the cure of an inflammatory disease, very great weakness. This in itself is sometimes a great danger, but can usually be removed by proper care and nursing. The common method of administering wine, brandy, or other alcoholic liquor, is the very worst that could be adopted. Hot water will prove a valuable stimulant, when a stimulant is required. Any NOURISHMENT (_see_) to be given should also be just a little warmer than blood heat. For drink, the unfermented wine made by Frank Wright, Chemist, Kensington, London, is of great value. It is simply the pure juice of the grape. If milk be given, it should always be diluted with an equal bulk of boiling water. The fomentation of the feet and legs will greatly help in restoring vigour. This should be done gently at first, where the weakness is great. Afterwards, when the patient can bear it, the ARMCHAIR FOMENTATION (_see_) will be found serviceable. All this, of course, is on the assumption that only _weakness_ and no fever is the trouble. Where fever is present, other treatment is necessary. Sponging all over with warm vinegar is also a most invigorating thing. Do this once, and afterwards the treatment may be varied by the real stimulant of cayenne being used in the form of an infusion strong enough to rouse the nerves, as is done by the acid. This has the advantage of saving the skin, if that is tender, and keeping off eruption, which is apt to come if the acid is often used. We think it well to use the acid once or so, and the cayenne infusion as frequently as anything of the kind is required. Rubbing with olive oil is also most beneficial. But both must be done very cautiously where there is great weakness. To rub the whole body at once will then be too much. But it may be done bit by bit, stopping whenever fatigue or chilliness is felt by the patient. _See also_ Heat and Weakness. Weaning.--Many of the troubles which come in this process arise simply from ignorance or want of thought on the part of the nurse or mother. Sometimes the child, having been burned with a hot teaspoon, will afterwards refuse all that is offered in such a spoon. In such a case use an egg-spoon of bone, or a small cup. Sometimes spoons of various metals, having peculiar tastes, are used, and the child refuses them. When food is refused, it is well therefore always to see that it is not the spoon or dish which is the real reason. Again, food ill-fitted for the child's digestion is offered. In this case the child is doing the right thing in refusing it. Milk and hot water, in equal quantities, with a very little sugar, is a mixture which can always be given with safety. In weaning, the nurse should begin by using this alone. Gradually a very little thin oatmeal jelly may be added, and the strength of the mixture increased. If there should be indigestion, a few teaspoonfuls of hot water will usually cure it. If the bowels are inactive, mix a little pure CANE SYRUP (_see_) with the food. Avoid all drugs as far as possible. If the whole process be _gradual_, there will usually be little or no trouble with the child. If, where teething and weaning are both coming together, the child should be seized with chill and shivering, a good blanket FOMENTATION (_see_) may be wrapped round the body and legs. Dry after this, and rub with warm OLIVE OIL (_see_). Generally this will induce sleep, in which case leave the child _warm_ in the fomentation until it awakes (_see_ Teething). In weaning, the mother often suffers as well as the child. The supply of milk in the breast being over-abundant, the breasts become hard and painful, and feverishness comes on. In this case the breasts must be emptied, either by some other person, or by the various ingenious instruments sold by all druggists. Then a large, cold damp cloth should be placed over the emptied breast, and changed once or twice, rubbing afterwards with a little olive oil. This, in ordinary cases, will cause the flow of milk to cease. Where the swelling is very hard and almost inflammatory, the breast should be fomented for five or ten minutes, then emptied, and a cold cloth applied as above directed. If all this fails, a BRAN POULTICE (_see_), or hot bag with moist flannel covering, should be applied between the shoulders. While the patient lies on this, cold towels (_see_ Towels, Cold Wet) should be changed on the breasts. This will usually effectually stay the secretion of milk. This last treatment is rarely required, but is harmless and most efficient. Where mother and child are both sickly, weaning must be carefully conducted. But it must ever be remembered that a child is far more healthily nourished on a bottle of good cow's milk or condensed milk (of _first-rate quality_) than on a sickly mother's milk. This is the case even if the child be ill. Only let the bottle not be too strong. _See_ Children, numerous articles. Weariness.--Where persistent weariness is felt, and the least exertion brings on a feeling of lassitude, there is evidently an undue exhaustion of nerve force in the body. Too rapid action of the heart is a frequent cause. In such a case all exciting ideas and influences should be kept from the patient's mind, and rest taken. The heart's action should also be reduced by careful lathering with soap (_see_ Lather; Soap). Where the weariness is really serious, great care must be exercised, and treatment very gradually administered. Rest must be given whenever exhaustion shows itself (_see_ Heat and Weakness; Weakness; and articles on Nerves and Nervousness). Where the heart's action is very slow, and requires to be stimulated, REST (_see_) must be taken, and treatment given as recommended in the case elsewhere. _See_ Depression. In other cases we find weariness arising from an irritated state of the stomach. Where there is no particular nerve exhaustion, the fiery and inflamed state of the stomach membranes forbids sleep, and causes a great feeling of tiredness. Headache (_see_), and even fainting fits, sometimes come on in such a case. All the nerves are excited, so that even touching the head or skin is most painful. Yet all can be traced to an inflamed stomach as the cause. Such a case, to be successfully treated, requires considerable resolution. In one case the treatment was as follows: First, the feet and legs up to the knees were wrapped in a large FOMENTATION (_see_). A cold wet towel was then folded lengthwise so as to be four-ply thick. The end was laid on the stomach, and _gently pressed_. In about half-a-minute it was hot. The towel was then shifted so that a fresh cool part lay over the stomach, and so on throughout the length of the towel. Handfuls of finely-wrought soap LATHER (_see_) were then prepared and laid on the stomach. Then the cold cloth was again renewed on top of the lather. For _two hours_ this was continued, and by that time the worst symptoms had abated. A little fresh oil gently rubbed over the stomach completed the treatment for that time. When the heat again arose, the same treatment was repeated, and so on till a cure was effected. Five or ten minutes' cooling would have been utterly useless. The heat evolved in the stomach required two hours steady cooling, and might have required more. The feelings of the patient are ever the best guide in such a case. As long as the cooling feels "delightful" it may safely be continued, if the heat to the feet is kept up. If the weakness is very great, it may be necessary to keep to milk and hot water, such as an infant would thrive on, for a short time. If the weakness is not so great, it will be possible for the patient to take a little gruel or porridge made from wheaten meal, and also good fresh buttermilk. The stomach may be far from ready to take eggs and such things, but quite able to digest the "poorer" food, as it is often called. To give the really weak as perfect rest of mind and as easily digested food as possible, are conditions that must not be overlooked if we would be successful in their cure. White Leg.--When a limb becomes swelled and white, pouring hot water very gently over it with a sponge or cloth will have a blessed effect. It may be continued for an hour at a time for several times. If this ceases to be comforting, it should be discontinued and the limb dressed with warm olive oil, a soft cotton rag being put next the skin, and soft flannel above that. Of course absolute rest should be taken. Whooping Cough.--The cough is a spasmodic action of nerves which are otherwise healthy enough, so that when the violent action ceases, the child's health is much as usual. Any irritation of nerves or temper will, however, bring on an attack, and should therefore be avoided, and all soothing mental influences should be encouraged. Three or four teaspoonfuls of hot water taken frequently, and given whenever an attack comes on, will give great relief. We have ourselves seen a child thought to be dying relieved at once by nothing more than this. Therefore it should never be neglected as too simple. Also the feet should be bathed once in two nights (_see_ Bathing Feet) in warm water (not too hot), dried and rubbed gently with olive oil. On the night when the feet are not bathed, let the back be lathered with _warm_ lather (_see_ Lather; Soap), quickly dried off, and then a little olive oil _gently_ rubbed on. In ordinary cases, this will be sufficient to ward off all danger in the disease, but in severer attacks the feet and legs may be fomented (_see_ Fomentation) while the child is in bed, and cold towels changed along the spine while the fomentation remains on, so as to lower the nerve action over the main centres. This is best done in the morning before the patient arises. If anything like inflammation sets in in any part of the chest, treat as recommended in Bronchitis or Lungs, Inflammation of. As far as possible, all causes of irritation to the patient must be removed or avoided. In the time of whooping cough, the sunniest way of managing the child is the best. The other children, if any, in the house, should have the footbath and oil, and the back wash, as recommended above. This will lessen danger of infection, and make the attack lighter if they should take it. Worms.--Where the juices and organs of the body are thoroughly healthy, worms will not appear. Before they can breed, there must be more or less of failure in the patient's health. This shows us that the cure for worms is not so much some poisonous substance which will destroy them, as such an increase of healthy action in the system as will prevent their development. The bowels must be kept open by suitable diet as it is most important to avoid Constipation (_see_). In case of worms in children, stimulus and help are specially needed by the _mucous membrane_ or inner lining of the stomach and bowels. To give this, and at the same time to neutralise and remove waste material from the membrane, a little vinegar and warm water may be frequently given, in teaspoonfuls. This is best taken from an hour to half-an-hour before meals. It is often needful to use some soothing, nourishing substance, such as liquorice, boiled with a little camomile, taken, say after meals, while the acid is taken before them: this has an excellent effect. At the same time, an enema of warm water and vinegar should be given twice a day. Where Santolina (_see_) can be procured, its use will speedily effect a complete cure. Change of air, holiday from lessons, and any other means of increasing the general health, should also be utilised. Worry.--One of the most fruitful causes of ill-health is the habit of worrying. Many believe this to be unavoidable, and think it even an evidence of interest in their work or of consideration for their friends. But this is not real interest or real consideration. The person who faces the work of the moment without anxiety for the future or useless regret for the past will accomplish his task before the harassed careworn man has thought out how to begin it. It is not work that kills but worry. Illness is frequently brought on by worry. Worry wrinkles the face, makes us look old before our time, often makes us sour and disagreeable, always makes us more or less wanting in true politeness, and is socially a great handicap to a man, a much greater to a woman. Further, worry not only prevents cure but kills, and nothing will help us more in recovering from illness than a calm, contented spirit. Now the first thing to do to overcome this habit is to realise that _worry is a bad habit which it is quite possible to get rid of_. The proof of this is that thousands of people for years slaves to it have got rid of it. Through some means or other they have been brought to exercise their will power and have found, sometimes to their considerable astonishment, always to their inexpressible relief, that they have regained a lost mental power and that their efficiency as workers has been enormously increased. If any matter needs much thought, devote thought to it, reflect and weigh carefully. If it requires time, take it up at separate times. Only make up your mind to this one thing, that you are the master and the arbitrator as to when it shall be taken up. If it intrudes, dismiss it as you would a servant from the room when you no longer require his presence. It is bound to go when you do so dismiss it. When you summon it to your consciousness concentrate your mind upon it. Want of concentration, being a dissipation of the mental powers, is a cause of worry. Worry becomes doubly baneful when it is directed towards the "might have been." Legitimate regret should be an emotion always accompanied by the determination to learn by experience. Every aid to enable the dispossessed will to regain its rightful throne should be employed. Properly chosen books, companions, and surroundings, are of great use, but perhaps quiet persistent self culture of the will, will be found to be the best. It matters little whether you call this "self suggestion" or not. As a matter of fact it is simply the common-sense of the question. It is the making up of the mind to do a thing with certain aspirations, emotions, and desires towards this thing. Thousands of people do it every day, especially in religious matters. It needs an adequate motive or a great ideal to carry it out. Such a motive here, might be the realisation of the uselessness and the positive harm of worry. Actually realise this, then affirm your determination to avoid worry and you have well begun the battle. Go through this mental exercise each time you feel you are worrying again. After a while you may omit it all but the mental determination. The mind cannot act rightly in an unsound body, and there is no doubt that good health wards off worry. Deep breathing of fresh air by producing well oxygenated pure blood, will do much to restore mental balance, especially if this want of mental balance is, as is often the case, partly due to inattention to the laws of health. Worry is by no means a necessary concomitant of high civilisation, it is rather an accompanying mental disease due partly to low nerve power, which itself is due to erroneous methods of life--errors of diet, want of pure air, cleanliness, exercise, etc. Partly, too, is this low nerve power due to mental causes peculiarly Western. The _Asiatic_ with his power of concentration, reflection, contemplation, with his patience, endurance, calmness, knows nothing of this scourge of European and American life. Even the Japanese, progressive and efficient as they are, possess this native contented, sweet, calm disposition, a habit of mind which, if they can retain, will be of enormous value to them in coming years. Wounds, Bleeding of.--After sending for a surgeon the first thing to be looked at in case of any wound is the bleeding. Sometimes this is trifling and needs no particular effort to staunch it. When, however, a vein or artery has been lacerated the flow must immediately be attended to. If the blood be welling up from the wound and of a dark red colour it is venous blood, if it spurt up from the wound and be of a bright red colour it is arterial blood. What has to be done is to place a pressure on the vein or artery to prevent the blood escaping. Venous bleeding may generally be stopped by putting a pad of lint dipped in cold water on the wound and tying it on with a bandage. If the blood continues to flow, tie a bandage round the limb on the side of the wound _away_ from the heart and keep the limb raised. Arterial bleeding must be treated by tying on the pad and bandage, and if the bleeding continues, stopping the flow in the artery on the side of the wound _nearest_ the heart, and at some point where it passes over a bone so that pressure may be efficiently applied. The bandage for thus tying an artery may be simply made by knotting a handkerchief (Diagram IV.), putting something solid inside the knot, then placing the knot on the artery at the desired point and tying tightly. If required this may be tightened by putting a stick under and twisting round, then tying the stick in position (Diagram II.). [Illustration: Fig. I.] [Illustration: Fig. II.] [Illustration: Fig. III.] [Illustration: Fig. IV.] [Illustration: Fig. V.] If the palm of the hand is cut, put a pad inside the hand, close the fingers, and tie the bandage round the clenched fist. If the wound is in the forearm, put a pad in the bend of the elbow, and tie the forearm firmly up on the arm. If the wound is above the elbow stop the main artery in the way above indicated. This artery runs pretty well under the inner seam of the sleeve of a man's coat. Diagram I. shows how this artery may be stopped by direct pressure of the hand; Diagram II. how a tourniquet may be applied. For bleeding in the arm-pit, press in a pad and tie the arm down to the side. It may be necessary here to compress the artery with the thumb. The artery here lies behind the inner bend of the collar bone lying on the first rib. In case of arterial bleeding about the head apply the bandage as in Diagram III. The pressure is here applied right over the wound, as the skull is always behind on which to press the artery. A wound in the leg should be treated in a similar way to a wound in the arm. Diagram V. shows the stopping of bleeding above the knee. Do not remove the pressure until the arrival of a medical man. Wounds, Ill-Smelling.--For all such wounds, the best method is frequent cleansing with vinegar or dilute ACETIC ACID (_see_) by means of a small glass syringe, such as may be got at any druggist's (_see_ Abscess; Wounds, Syringing). We know one case where the patient was expelled from a curative home because of the evil smell of his wounds, three careful cleanings out with dilute acid so removed all odour that the patient was at once readmitted. Where the wound is very tender, soak soft cloths or lint in the dilute acid, and lay them on the wound three or four ply thick. Remove and renew them every quarter-of-an-hour till the smell is gone. Of course the cloths should be immediately washed or, better, burned. In using the syringe, care should be taken _to suck out_ the ill matter, as well as to send the dilute acid well down into the sore. Careful cleaning of the syringe with _boiling_ water before use is necessary. Wounds, Soothing.--During the process of _healing_, wounds often give a great deal of pain, even when all is going well. It is this pain we here show how to relieve. After an operation under chloroform, itself painless, the process of healing is often very painful. We are sure this pain need not be endured, but to prevent or cure it we need to see what is its cause. Two causes are specially notable--_pressure_ and _cold_. By skilful handling and bandaging, undue pressure may be avoided by the surgeon. But a great deal can be done by any one to keep cold from the seat of injury. Have a bag of soft flannel, as fine as possible, made so as to surround the wounded part. This bag is filled with _dry_ bran, heated in an oven or otherwise, without being wet. Of course the heat must not be great enough to cause any discomfort, but sufficient to give a fine sense of relief. This application is for a wound which has _not_ become inflamed, but is doing well. When inflammation has set in, and the patient is fevered, the opposite treatment is applied. Over the dressing apply three or four folds of dry cotton cloth, and over this again apply cold towels (_see_ Towels, Cold Wet) until the pain is relieved. Good sense must regulate this treatment, of course, and excess of cold be avoided. But with ordinary care this need never cause anxiety. Wounds, Syringing.--Very great good can often be done by a little careful syringing of internal wounds. Take, as an illustration, a case of a kind we have often seen. It is that of a young patient with a wound on the lower part of the leg, a good long way below the knee. This wound will run in spite of all that has been done to dry it up. The opening in it is very small, and one would think it ought to be easily cured, but it is not so. The truth is that this wound is from two to three inches distant from where the real sore is situated in the limb. The wound is well down towards the ankle; the real sore is well up towards the knee. There is a corroding matter generated in the internal sore, and that runs down under the skin, and keeps cutting its way out at the wound. Until this is rectified, there will be no successful healing. Ointments that might do well enough on a small external sore have no effect in this case. The real sore, however, is easily reached and cured by the right use of a small pointed syringe. The kind most easily procured is made of glass, and costs about sixpence. Choose one that has a small smooth point, which can be easily inserted into the hole in the wound. This should be done without causing any pain. The point of the syringe should be dipped in hot water till it is as near as possible to blood heat: that is, it should neither be hotter nor colder than the skin it has to touch. If you are sufficiently careful on this point, all else will be comparatively easy. Before you actually try to insert the syringe, observe in what direction the wound is likely to be extended under the skin. It will probably be upwards--almost certainly it will be so, as the waste matter, by its weight, tends to fall down. The sore at the top insertion of a muscle near the knee will send its matter down the leg, perhaps near to the ankle. Fill the syringe with warm water only, as near blood heat as you can have it. When you have got the point of the syringe even a very little way into the wound, you can inject a little water, and in doing this you will probably learn more nearly where the actual sore is to be found. The water will probably come out as fast as you send it in, but it may not come till a good quantity has gone in. Now, as you fill your syringe a second time with water at the same degree of heat, you will add a single drop of strong acetic acid, or twelve drops of white vinegar to a teacupful. You must be careful that this is not exceeded at this stage, or you will cause great pain. Moreover, you do no good to the sore by making the acid so strong as to cause suffering. If it is only just so strong as to cause a comfortable feeling of warmth, it will be all right for its curative purpose. Even very weak acid combines with the irritating waste matter that is keeping the sore diseased, and produces the desired healing effect. You have only to add one drop after another of the acid to your full teacupful of warm water, till the feeling produced by the syringing is all that could be desired. In the case of the limb that we refer to, a sensible mother used the syringe and the acid so skilfully as to heal the internal sore in a very short time, and thus the external wound quickly disappeared. Of course, if the wound is so very deep that the acid cannot be got up to cleanse it thoroughly, surgical aid should be sought. It may be well, however, to take another case or two for further illustration. Here, then, is a decayed tooth extracted, but the part from which it is taken does not heal, as is usual. The hole in the gum does not close, and a discharge of offensive humour flows from it constantly. The bone of the upper jaw is evidently wasting, and the decay has extended somehow considerably up the side of the nose. The hole, however, is so small, that the usual glass syringe cannot enter it. We got an exceedingly small instrument, used for the injection of morphia under the skin. The point of this syringe is a needle with a point that is hollow nearly to the very end. When this point was broken off, the hollow part was so small that it entered the hole in the gum, and so it was easy to inject the weak acid up to the bottom of the sore, which had come to be only a little under the eye. About an inch and a half of hollow had to be washed out with the acid. But in a very short time all discharge ceased, and the cure was perfect. Both of these cases are comparatively simple, but they show clearly the great value of this use of acetic acid. Carbolic acid is much more commonly used for such a purpose. It has the drawback of being liable itself to melt away the healthy tissue, and to make a wound larger. Acetic acid never does this, and so heals more quickly and certainly. We might take a much more difficult case. It was that of an abscess and bad sore in the lower bowels. It was supposed to be necessary to perform a very dangerous operation in order to try to cure this--not much hope was held out of its being possible really to cure. It was, however, quite possible to reach the sore by the injection of acetic acid. The sufferer was directed to have this done regularly. In a very short time there was a complete cure. In such a case all that is wanted is an ordinary india-rubber enema. A much larger quantity of water is required, but about the same strength of acid. First of all, as much acidulated water as can be taken up with comfort is injected: after a minute or so this is passed off. Then another is used in the same way, and passed off also. A third syringing may be employed, when about half-a-teacupful is taken and retained. If the acid gives no comfortable feeling of warmth it needs to be strengthened till it does so, but not so that it produces any pain. The operation really well done is not in the least painful, but, on the contrary, rather comfortable. There is still one syringing which we may notice--that of suppurating ears. If an ear is discharging from some internal sore, nothing is more important than syringing with acetic acid, but it must be done with very peculiar care. The water used should be as nearly as possible of exact blood heat, and the acetic acid of the exact strength at which it will give a fine comfortable feeling in the ear. It must neither feel as if it were a mere wetting of the ear, nor that it gives the least pain. The syringe, too, must be used gently, so as not to force the water strongly against the internal parts that are so tender. It is a soaking operation rather than a forcible urging of the water into the ear which is wanted. If this is nicely done, say twice a day, the acid will reach the sore, and we may confidently look for a cure. Even when the bones are wasting, as we have seen in the case of the upper jaw, if this acid can be really brought to bear upon the sore, it will be cleansed and healed. In this simple way we have seen many, both old and young, delivered from sore trial, and made to enjoy life and health again. PHYSICAL CULTURE. Much weakness might be prevented and often cured by light gymnastic exercises practised twice a day, say on rising and at bedtime, giving tone to the muscles and bringing into regular use many which in ordinary daily life are seldom or never used. The various vital organs of the body owe much of their health to the proper exercise of the surrounding muscles; it will be seen then how necessary a system of regular exercise must be. The best way to learn this is to take a course of Swedish Drill or other good system at one of the gymnasiums which are now so common in Britain and America. But as many of our readers live in places where such cannot be had, we shall try to indicate by diagrams some simple movements which can be practised by anyone. A few general rules should be borne in mind:-- Begin with a short time, say five minutes; omit at first the more fatiguing movements and gradually increase as the strength improves. The time spent need never be long; fifteen or twenty minutes is long enough at any one time. Do the movements slowly and deliberately, stretching the muscles to their full extent. Fix your mind on the particular limb that is being exercised. Practice in a room with open window, with little clothes on, or with none; a daily air-bath is very conducive to health. Each exercise need not be performed more than three times, until strength is fairly great. Never go on with the exercises so long as to be more than just a little tired. It is a good plan to write out the exercises clearly on a good-sized card or sheet of stiff paper, which can be set where it will be easily seen while one is exercising. [Illustration: Fig. 1.] [Illustration: Fig. 2.] [Illustration: Fig. 3.] 1. POSITION 1.--Stand before a glass with head well up, chin in, neck elongated, shoulders down and back, arms hanging straight down, abdomen in, back slightly curved, heels together, toes slightly apart. 2. ARMS BEND.--While in position, bring the arms up at the sides so that the tips of the fingers touch the shoulders. Return to position 1. 3. HIPS FIRM.--Place hands on hips, well back, fingers together, and thumbs to the back. Now, slowly bend the head back as far as it will go, and slowly raise it again, taking care all the time to keep the chin in. Position 1 again. [Illustration: Fig. 4.] [Illustration: Fig. 5.] [Illustration: Fig. 6.] 4. NECK REST.--Bring the arms up on a level with the shoulders, hands straight with forearm and finger tips nearly but not quite touching behind the neck. Head always quite erect. While in this position, bend the body from the waist sideways, first to one side, then to the other, as far as it will go without moving the feet. When bending to the left, _feel_ the muscles of the right stretching and _vice versa_. Return to position 1. 5. Bring arms to position 2, then extend them straight upwards, rising on the toes at same time and drawing the body to its greatest height. Bring arms again to position 2 and then down to position 1. 6. Bring arms to position 2 and extend them sideways, turning palms and hands downwards. Come back to position 2 and then position 1. [Illustration: Fig. 7.] [Illustration: Fig. 8.] [Illustration: Fig. 9.] 7. Bring arms to position 2 and extend them forwards, return to position 2 and position 1. 8. Hips firm (hands placed as in 3). Raise the heels a little, bend the knees slightly outwards and keep the upper part of the body perfectly erect. Lower the body about half-way down, then raise it again. 9. Same as 8, only go down as low as possible. It is not easy at first to keep one's balance, the upper part of the body erect all the time, especially when trying to rise. Return to position 1. [Illustration: Fig. 10.] [Illustration: Fig. 11.] [Illustration: Fig. 12.] 10. Arms bend (_see_ 2). Place the feet sideways, about a foot apart. Now bend the upper part of the body back, curving only the chest back, keeping the waist still. Position 1. 11. Bring arms to position 2 and extend upwards as in fig. 5. Now bend the body forwards till the hands nearly touch the floor, keeping the head between the arms, knees straight and arms straight and parallel to one another. Return to position 5, then position 2 and then position 1. 12. Hips firm (_see_ 3). Raise one knee till the leg is bent as in the illustration, keep toe pointed down. Do the same with the other leg. Return to position 1. [Illustration: Fig. 13.] [Illustration: Fig. 14.] [Illustration: Fig. 15.] 13. Same as 12, only stretch leg backward as in illustration, keeping knees straight. Return to position 1. 14. ARMS FORWARD BEND.--Bend the arms in front of the body, as in the illustration. Extend one foot back and rest toe on ground. Position 1. 15. Arms as in 14. Fling right arm out sideways and turn head to the right as far as it will go without moving the rest of the body. Same to left. Position 1. [Illustration: Fig. 16.] [Illustration: Fig. 17.] [Illustration: Fig. 18.] 16. Hips firm (_see_ 3). Kneel with toes extended backwards. Now bend the body backwards from the knees, as far as possible, keeping straight and firm as in illustration. Rise and return to position 1. 17. One arm, HIP FIRM, the other NECK REST (_see_ 3 and 4). Bend the body as in exercise 4. Return to position 1. 18. Arms bend (_see_ 2). Feet stride (_see_ 10). Now turn the body at the waist as far as possible to right, then to left, taking care not to move the hips. Return to position 1. [Illustration: Fig. 19.] [Illustration: Fig. 20.] 19. LEAP ON THE SPOT.--Hips firm (_see_ 3). Raise the heels, slightly bend at the knees as in illustration, jump and alight on toes again with knees slightly bent. Straighten knees and let heels sink to the ground. Position 1. 20. Hips firm (_see_ 3). Stand near a chair or bed and slip one foot sideways under a rail. Now bend sideways as far as possible. Position 1. [Illustration: Fig. 21.] [Illustration: Fig. 22.] 21. As 20, only stand facing the support and bend back. Position 1. 22. Kneel as in 16. Extend arms as in 6. Now turn the body from the waist as far to the right and as far to the left as possible. Position 1. 23. Deep breathing (_see_ Breathing, Correct method of) should be practised several times during these exercises. Stand in position 1. Now raise the hands slowly to the level of the shoulders, keeping the arms straight and moving them sideways. While raising the arms, slowly fill the lungs with air, and when lowering them let it slowly out. DUMBELL EXERCISE. As an efficient and inexpensive way of developing all the muscles of the body dumbells have no rival. Especially are they valuable for those whose sedentary life forbids much active exercise, and as they only require a very short time each day for their practice, do not interfere materially with the work of the busiest. The accompanying exercises have been given with a view to the complete and symmetrical development of the body. They should be practised in their entirety every morning and evening, after rising and bathing and before retiring, in as nearly a nude a condition as practicable. And they should be practised with a serious and complete concentration of the mind upon each muscle as it is in turn exercised. This concentration is immensely fatiguing at first, but is necessary in order to derive full benefit from them. Just as in practising musical exercises for execution, a short time well spent is more valuable than a longer time with a wandering and uninterested mind, so in dumbell exercise it is above all the quality and not the quantity of the exercise which is of importance. Increase the number of times each exercise is done weekly or daily, beginning say at 10 or 20, according to strength, and endeavouring to be able to be double this number in a short time. [Illustration: Fig. 1a.] 1a.--Arms by side forced well back, finger nails to front. Inhale. [Illustration: Fig. 1b.] 1b.--Raise bells to shoulders, contracting biceps. Exhale. [Illustration: Fig. 2a.] 2a.--Arms by side forced well back, finger nails to rear. Inhale. [Illustration: Fig. 2b.] 2b.--Raise bells to shoulders. Exhale. [Illustration: Fig. 3a.] 3a.--Extend arms sideways in line with shoulders, finger nails up. Inhale. [Illustration: Fig. 3b.] 3b.--Bring bells to shoulders, contracting biceps. Exhale. [Illustration: Fig. 4a.] 4a.--Arms by sides, chest well out. Inhale. [Illustration: Fig. 4b.] 4b.--Cross arms in front, contracting chest muscles. Exhale. [Illustration: Fig. 5a.] 5a.--Arms extended in front level with chin. Exhale. 5b.--Bring bells back sideways in line with shoulders. Inhale. [Illustration: Fig. 6a.] 6a.--Upper arms close to sides, bells level with shoulders. Exhale. 6b.--Raise bells above head as far as possible. Inhale. [Illustration: Fig. 7a.] 7a.--Arms by sides forced well back, finger nails to rear. Inhale. [Illustration: Fig. 7b.] 7b.--Raise arms up level with shoulders rounding back. Exhale. [Illustration: Fig. 8a.] 8a.--Lean over to right, left knee bent, right leg straight. 8b.--Repeat to left. [Illustration: Fig. 9a.] 9a.--Lunge out to left, right leg straight, raising left hand above head, right hand at side. 9b.--Repeat to left. [Illustration: Fig. 10a.] 10a.--Heels together, chest well out, hands on hips. [Illustration: Fig. 10b.] 10b.--Sink on toes, raising heels from ground, gradually resume upright position, keeping back straight. SEX AND HEALTH. The treatment of the relations of the sexes to one another, and the enormous influence over health of both body and mind which these exercise, cannot be attempted in a treatise such as this. Such articles would occupy far too much space, as from the nature of the subject much detail must be given, and explanations must be as complete as possible. The Editor of these Papers has therefore written a book for children, and one each for boys and girls. These will be found advertised at the end. Numbers of persons consult us on these matters, and much has come to our knowledge which is astonishing and saddening as well, in regard to the widely prevailing ignorance of both young and old regarding the sex functions. This is largely due to culpable neglect on the part of parents and others who have charge of the young. Parents are often unwilling to speak of such matters, and would desire rather to place a good book on the subject in their children's hands. Many such books have been published, but none that we have seen have seemed to us quite satisfactory. Due attention must be paid to both the physical and moral sides of the matter. Hence our resolve to write as we have indicated. The books will be found duly advertised at the end of this volume. It will no doubt be said that it is a pity to suggest ideas of sex to an innocent child, but surely those who look back on their own youth will remember that there came a time when the problem of their own origin suggested itself. The pretty fable that the storks or angels fetch the babies cannot long satisfy the growing mind. Children wish to understand, yet it is easy for them to see that parents do not wish to explain the mystery. Curiosity is aroused, for the desire to know is natural and quite legitimate, and the sad thing is that the explanation is generally left to companions and servants who are devoid of delicacy or modesty. Now there is no reason for this reticence and false shame. The whole process of reproduction is a wonderful example of the wisdom and goodness of the Creator, and if properly explained the child will see that it is so. Again, there are physical epochs through which all young people must pass. These are quite natural, but unless explained and the children are prepared to expect them, may cause great alarm. In their distress they are very likely to enquire from impure companions, or get some of the pernicious literature which is issued in quantity by the quacks who prey upon the fears of the young, and upon their dislike to speak to their parents on a subject which the latter have taught them by silence is one which is unmentionable. It may be asked when this information should be given. No rule will fit all cases, as children vary so much in their development. We would urge that it should be given _early_, as Miss Willard well says:--"See that the pure thought gets in first." Besides, children grow up much faster than their parents are apt to realize. The evils of self-pollution are so great, and the cure so difficult, that no risk should be run of such ever being commenced through ignorance. In fact this is the main reason for our undertaking the separate works on this subject. It is so saddening to reflect that a career of vice is often entered upon through the child's ignorance of the laws of its own body, that the natural reticence in speaking of the subject should not be allowed to prevent the information being given. _KIRK SEX SERIES._ "Instruct thy son and labor for him lest his lewd behaviour be an offence unto thee."--_Ecclesiasticus 30, 13._ A Talk with Boys about Themselves BY EDWARD BRUCE KIRK, Editor of "Papers on Health." Introduction by Canon Hon. ED. LYTTELTON, Headmaster of Eton College. Every father should see that his son is not driven for information on the origin of life to impure companions. This book makes the imparting of this knowledge easy. Confidence will beget manliness. _SUBJECTS TREATED:_ Origin of Life; Puberty, its meaning and responsibilities; Evils of Self Pollution; Love and Marriage; Reproduction; Perfect Manhood; Health and Strength. Price 2/= net, Post Free, 2/3. Publishers: SIMPKIN, MARSHALL, HAMILTON, KENT & Co., London. T. D. MORISON, Glasgow. THE FOWLER & WELLS CO., New York. _KIRK SEX SERIES._ A Talk with Girls about Themselves By EDWARD B. KIRK, Editor of "Papers on Health." Introduction by LADY PAGET. This book is intended to be given by the parent to the daughter. Besides much wise counsel about health and self-development, it gives in delicate language, a clear answer to the many questions which must force themselves upon the growing girl. _SUBJECTS TREATED:_ Hints on Health; Diet; Exercise; Pure Air; Evils of Tight Lacing, etc.; Health and Beauty, their inseparability; Courtship; Marriage; True Womanhood; What Men Admire; Vice, its terrible punishment; Reproduction; Pregnancy; Reading and Education. Price 2/= net, Post Free, 2/3. * * * * * The Wonder of Life A Talk with Children about Sex, By MARY TUDOR POLE, Author of "Fairies." Introduction by LADY ISABEL MARGESSON. This book is intended for young children of both sexes. It shows in simple language the analogy between the reproductive processes in plants and human beings. Price 1/= net, Post Free, 1/3. Publishers: SIMPKIN, MARSHALL, HAMILTON, KENT & Co., London. Thos. D. MORISON, Glasgow. THE FOWLER & WELLS CO., New York. 
13444	----	SEARCHLIGHTS ON HEALTH THE SCIENCE OF EUGENICS * * * * * A Guide to Purity and Physical Manhood Advice to Maiden, Wife and Mother Love, Courtship, and Marriage * * * * * By PROF. B.G. JEFFERIS, M.D., PH. D. and J.L. NICOLS, A.M. _With Excerpts from Well-Known Authorities_ REV. LEONARD DAWSON DR. M.J. SAVAGE REV. H.R. HAWEIS DR. PANCOAST DR. STALL DR. J.F. SCOTT DR. GEORGE NAPHEYS DR. STOCKHAM DR. T.D. NICHOLLS DR. R.L. DUGDALE DR. JOHN COWAN DR. M.L. HOLBROOK * * * * * Published by J.L. NICHOLS & COMPANY Naperville, Illinois, U.S.A. 1920 AGENTS WANTED "Vice has no friend like the prejudice which claims to be virtue."--_Lord Lytton._ "When the judgment's weak, the prejudice is strong."--_Kate O'Hare._ "It is the first right of every child to be well born." * * * * * COPYRIGHTED 1919, BY J.L. NICHOLS & CO. OVER 1,000,000 COPIES SOLD * * * * * TABLE OF CONTENTS. [Transcriber's Note: This Table of Contents does not appear in the original book. It has been added to this document for ease of navigation.] Knowledge is Safety, page 3 The Beginning of Life, page 5 Health a Duty, page 7 Value of Reputation, page 9 Influence of Associates, page 11 Self-Control, page 12 Habit, page 17 A Good Name, page 18 The Mother's Influence, page 21 Home Power, page 23 To Young Women, page 26 Influence of Female Character, page 30 Personal Purity, page 31 How To Write All Kinds of Letters, page 34 How To Write a Love Letter, page 37 Forms of Social Letters, page 39 Letter Writing, page 43 Forms of Love Letters, page 44 Hints and Helps on Good Behavior at All Times and at All Places, page 49 A Complete Etiquette in a Few Practical Rules, page 52 Etiquette of Calls, page 56 Etiquette in Your Speech, page 57 Etiquette of Dress and Habits, page 58 Etiquette on the Street, page 59 Etiquette Between Sexes, page 60 Practical Rules on Table Manners, page 63 Social Duties, page 65 Politeness, page 70 Influence of Good Character, page 73 Family Government, page 76 Conversation, page 79 The Toilet or The Care of the Person, page 84 A Young Man's Personal Appearance, page 86 Dress, page 88 Beauty, page 91 Sensible Helps to Beauty, page 95 How to Keep the Bloom and Grace of Youth, page 97 Form and Deformity, page 98 How to Determine a Perfect Human Figure, page 99 The History, Mystery, Benefits and Injuries of the Corset, page 101 Tight-Lacing, page 104 The Care of the Hair, page 107 How to Cure Pimples or Other Facial Eruptions, page 111 Black-Heads and Flesh Worms, page 112 Love, page 114 The Power and Peculiarities of Love, page 118 Amativeness or Connubial Love, page 122 Love and Common Sense, page 123 What Women Love in Men, page 126 What Men Love in Women, page 129 History of Marriage, page 132 Marriage, page 134 The Advantages of Wedlock, page 135 The Disadvantages of Celibacy, page 138 Old Maids, page 140 When and Whom to Marry, page 144 Choose Intellectually--Love Afterward, page 148 Love-Spats, page 154 A Broken Heart, page 159 Former Customs and Peculiarities Among Men, page 162 Sensible Hints in Choosing a Partner, page 165 Safe Hints, page 170 Marriage Securities, page 174 Women Who Make the Best Wives, page 178 Adaptation, Conjugal Affection, and Fatal Errors, page 181 First Love, Desertion and Divorce, page 185 Flirting and Its Dangers, page 190 A Word to Maidens, page 192 Popping the Question, page 194 The Wedding, page 200 Advice to Newly Married Couples, page 201 Sexual Proprieties and Improprieties, page 206 How to Perpetuate the Honey-Moon, page 209 How to Be a Good Wife, page 210 How to Be a Good Husband, page 211 Cause of Family Troubles, page 217 Jealousy--Its Cause and Cure, page 219 The Improvement of Offspring, page 222 Too Many Children, page 229 Small Families and the Improvement of the Race, page 232 The Generative Organs, page 234 The Female Sexual Organs, page 235 The Mysteries of the Formation of Life, page 238 Conception--Its Limitations, page 240 Prenatal Influences, page 244 Vaginal Cleanliness, page 246 Impotence and Sterility, page 248 Producing Boys or Girls at Will, page 252 Abortion or Miscarriage, page 253 The Murder of Innocents, page 256 The Unwelcome Child, page 258 Health and Disease, page 263 Preparation for Maternity, page 266 Impregnation, page 269 Signs and Symptoms of Pregnancy, page 270 Diseases of Pregnancy, page 274 Morning Sickness, page 282 Relation of Husband and Wife During Pregnancy, page 283 A Private Word to the Expectant Mother, page 284 Shall Pregnant Women Work?, page 285 Words for Young Mothers, page 286 How to Have Beautiful Children, page 288 Education of the Child in the Womb, page 292 How to Calculate the Time of Expected Labor, page 295 The Signs and Symptoms of Labor, page 297 Special Safeguards in Confinement, page 299 Where Did the Baby Come From?, page 303 Child Bearing Without Pain, page 304 Solemn Lessons for Parents, page 312 Ten Health Rules for Babies Cut Death Rate in Two, page 314 The Care of New-Born Infants, page 315 Nursing, page 317 Infantile Convulsions, page 319 Feeding Infants, page 319 Pains and Ills in Nursing, page 321 Home Lessons in Nursing Sick Children, page 325 A Table for Feeding a Baby on Modified Milk, page 329 Nursing [Intervals Table], page 329 Schedule for Feeding Healthy Infants During First Year [Table], page 329 How to Keep a Baby Well, page 330 How to Preserve the Health and Life of Your Infant During Hot Weather, page 332 Infant Teething, page 336 Home Treatments for the Diseases of Infants and Children, page 338 Diseases of Women, page 348 Falling of the Womb, page 350 Menstruation, page 351 Celebrated Prescriptions for All Diseases and How to Use Them, page 354 How to Cure Apoplexy, Bad Breath and Quinsy, page 365 Sensible Rules for the Nurse, page 366 Longevity, page 367 How to Apply and Use Hot Water in All Diseases, page 368 Practical Rules for Bathing, page 371 All the Different Kinds of Baths and How to Prepare Them, page 372 Digestibility of Food, page 374 How to Cook for the Sick, page 375 Save the Girls, page 380 Save the Boys, page 390 The Inhumanities of Parents, page 396 Chastity and Purity of Chracter, page 400 Exciting the Passions in Children, page 404 Puberty, Virility, and Hygenic Laws, page 406 Our Secret Sins, page 409 Physical and Moral Degeneracy, page 414 Immorality, Disease, and Death, page 416 Poisonous Literature and Bad Pictures, page 421 Startling Sins, page 423 The Prostitution of Men, page 427 The Road to Shame, page 430 The Curse of Manhood, page 433 A Private Talk to Young Men, page 437 Remedies for the Social Evil, page 440 The Selfish Slaves of Doses of Disease and Death, page 441 Object Lessons of the Effects of Alcohol and Smoking, page 445 The Destructive Effects of Cigarette Smoking, page 449 The Dangerous Vices, page 451 Nocturnal Emissions, page 457 Lost Manhood Restored, page 459 Manhood Wrecked and Rescued, page 461 The Curse and Consequence of Secret Diseases, page 464 Animal Magnetism, page 470 How to Read Character, page 473 Twilight Sleep, page 479 Painless Childbirth, page 479 The Diseases of Women, page 480 Remedies for Diseases of Women, page 483 Alphabetical Index, page 486 * * * * * HE STUMBLETH NOT, BECAUSE HE SEETH THE LIGHT. [Illustration: "Search Me. Oh Thou Great Creator."] * * * * * KNOWLEDGE IS SAFETY. 1. The old maxim, that "Knowledge is power," is a true one, but there is still a greater truth: "KNOWLEDGE IS SAFETY." Safety amid physical ills that beset mankind, and safety amid the moral pitfalls that surround so many young people, is the great crying demand of the age. 2. CRITICISM.--This work, though plain and to some extent startling, is chaste, practical and to the point, and will be a boon and a blessing to thousands who consult its pages. The world is full of ignorance, and the ignorant will always criticise, because they live to suffer ills, for they know no better. New light is fast falling upon the dark corners, and the eyes of many are being opened. 3. RESEARCHES OF SCIENCE.--The researches of science in the past few years have thrown light on many facts relating to the physiology of man and woman, and the diseases to which they are subject, and consequently many reformations have taken place in the treatment and prevention of diseases peculiar to the sexes. 4. LOCK AND KEY.--Any information bearing upon the diseases of mankind should not be kept under lock and key. The physician is frequently called upon to speak in plain language to his patients upon some private and startling disease contracted on account of ignorance. The better plan, however, is to so educate and enlighten old and young upon the important subjects of health, so that the necessity to call a physician may occur less frequently. 5. PROGRESSION.--A large, respectable, though diminishing class in every community, maintain that nothing that relates exclusively to either sex should become the subject of popular medical instruction. But such an opinion is radically wrong; ignorance is no more the mother of purity than it is of religion. Enlightenment can never work injustice to him who investigates. 6. AN EXAMPLE.--The men and women who study and practice medicine are not the worse, but the better for such knowledge; so it would be to the community in general if all would be properly instructed on the laws of health which relate to the sexes. 7. CRIME AND DEGRADATION.--Had every person a sound understanding on the relation of the sexes, one of the most fertile sources of crime and degradation would be removed. Physicians know too well what sad consequences are constantly occurring from a lack of proper knowledge on these important subjects. 8. A CONSISTENT CONSIDERATION.--Let the reader of this work study its pages carefully and be able to give safe counsel and advice to others, and remember that purity of purpose and purity of character are the brightest jewels in the crown of immortality. [Illustration: BEGINNING RIGHT.] * * * * * THE BEGINNING OF LIFE. 1. THE BEGINNING.--There is a charm in opening manhood which has commended itself to the imagination in every age. The undefined hopes and promises of the future--the dawning strength of intellect--the vigorous flow of passion--the very exchange of home ties and protected joys for free and manly pleasures, give to this period an interest and excitement unfelt, perhaps, at any other. 2. THE GROWTH OF INDEPENDENCE.--Hitherto life has been to boys, as to girls, a dependent existence--a sucker from the parent growth--a home discipline of authority and guidance and communicated impulse. But henceforth it is a transplanted growth of its own--a new and free power of activity in which the mainspring is no longer authority or law from without, but principle or opinion within. The shoot which has been nourished under the shelter of the parent stem, and bent according to its inclination, is transferred to the open world, where of its own impulse and character it must take root, and grow into strength, or sink into weakness and vice. 3. HOME TIES.--The thought of home must excite a pang even in the first moments of freedom. Its glad shelter--its kindly guidance--its very restraints, how dear and tender must they seem in parting! How brightly must they shine in the retrospect as the youth turns from them to the hardened and unfamiliar face of the world! With what a sweet sadly-cheering pathos they must linger in the memory! And then what chance and hazard is there in his newly-gotten freedom! What instincts of warning in its very novelty and dim inexperience! What possibilities of failure as well as of success in the unknown future as it stretches before him! 4. VICE OR VIRTUE.--Certainly there is a grave importance as well as a pleasant charm in the beginning of life. There is awe as well as excitement in it when rightly viewed. The possibilities that lie in it of noble or ignoble work--of happy self-sacrifice or ruinous self-indulgence--the capacities in the right use of which it may rise to heights of beautiful virtue, in the abuse of which it may sink to the depths of debasing vice--make the crisis one of fear as well as of hope, of sadness as well as of joy. 5. SUCCESS OR FAILURE.--It is wistful as well as pleasing to think of the young passing year by year into the world, and engaging with its duties, its interests, and temptations. Of the throng that struggle at the gates of entrance, how many may reach their anticipated goal? Carry the mind forward a few years, and some have climbed the hills of difficulty and gained the eminence on which they wished to stand--some, although they may not have done this, have kept their truth unhurt, their integrity unspoiled; but others have turned back, or have perished by the way, or fallen in weakness of will, no more to rise again; victims or their own sin. 6. WARNING.--As we place ourselves with the young at the opening gates of life, and think of the end from the beginning, it is a deep concern more than anything else that fills us. Words of earnest argument and warning counsel rather than of congratulation rise to our lips. 7. MISTAKES ARE OFTEN FATAL.--Begin well and the habit of doing well will become quite as easy as the habit of doing badly. "Well begun is half ended," says the proverb: "and a good beginning is half the battle." Many promising young men have irretrievably injured themselves by a first false step at the commencement of life; while others of much less promising talents, have succeeded simply by beginning well, and going onward. The good, practical beginning is to a certain extent, a pledge, a promise, and an assurance of the ultimate prosperous issue. There is many a poor creature, now crawling through life, miserable himself and the cause of sorrow to others, who might have lifted up his head and prospered, if, instead of merely satisfying himself with resolutions of well-doing, he had actually gone to work and made a good, practical beginning. 8. BEGIN AT THE RIGHT PLACE.--Too many are, however, impatient of results. They are not satisfied to begin where their fathers did, but where they left off. They think to enjoy the fruits of industry without working for them. They cannot wait for the results of labor and application, but forestall them by too early indulgence. * * * * * HEALTH A DUTY. Perhaps nothing will so much hasten the time when body and mind will both be adequately cared for, as a diffusion of the belief that the preservation of health is a duty. Few seem conscious that there is such a thing as physical morality. Men's habitual words and acts imply that they are at liberty to treat their bodies as they please. Disorder entailed by disobedience to nature's dictates they regard as grievances, not as the effects of a conduct more or less flagitious. Though the evil consequences inflicted on their descendents and on future generations are often as great as those caused by crime, they do not think themselves in any degree criminal. It is true that in the case of drunkenness the viciousness of a bodily transgression is recognized; but none appear to infer that if this bodily transgression is vicious, so too is every bodily transgression. The fact is, all breaches of the law of health are physical sins. When this is generally seen, then, and perhaps not till then, will the physical training of the young receive all the attention it deserves. Purity of life and thought should be taught in the home. It is the only safeguard of the young. Let parents wake up on this important subject. [Illustration: GLADSTONE.] * * * * * VALUE OF REPUTATION. 1. WHO SHALL ESTIMATE THE COST.--Who shall estimate the cost of a priceless reputation--that impress which gives this human dross its currency--without which we stand despised, debased, depreciated? Who shall repair it injured? Who can redeem it lost? Oh, well and truly does the great philosopher of poetry esteem the world's wealth as "trash" in the comparison. Without it gold has no value; birth, no distinction; station, no dignity; beauty, no charm; age, no reverence; without it every treasure impoverishes, every grace deforms, every dignity degrades, and all the arts, the decorations and accomplishments of life stand, like the beacon-blaze upon a rock, warning the world that its approach is dangerous; that its contact is death. 2. THE WRETCH WITHOUT IT.--The wretch without it is under eternal quarantine; no friend to greet; no home to harbor him, the voyage of his life becomes a joyless peril, and in the midst of all ambition can achieve, or avarice amass, or rapacity plunder, he tosses on the surge, a buoyant pestilence. But let me not degrade into selfishness of individual safety or individual exposure this individual principle; it testifies a higher, a more ennobling origin. 3. ITS DIVINITY.--Oh, Divine, oh, delightful legacy of a spotless reputation: Rich is the inheritance it leaves; pious the example it testifies; pure, precious and imperishable, the hope which it inspires; can there be conceived a more atrocious injury than to filch from its possessor this inestimable benefit to rob society of its charm, and solitude of its solace; not only to out-law life, but attain death, converting the very grave, the refuge of the sufferer, into the gate of infamy and of shame. 4. LOST CHARACTER.--We can conceive few crimes beyond it. He who plunders my property takes from me that which can be repaired by time; but what period can repair a ruined reputation? He who maims my person effects that which medicine may remedy; but what herb has sovereignty over the wounds of slander? He who ridicules my poverty or reproaches my profession, upbraids me with that which industry may retrieve, and integrity may purify; but what riches shall redeem the bankrupt fame? What power shall blanch the sullied show of character? There can be no injury more deadly. There can be no crime more cruel. It is without remedy. It is without antidote. It is without evasion. [Illustration: GATHERING WILD FLOWERS.] * * * * * INFLUENCE OF ASSOCIATES. If you always live with those who are lame, you will learn to limp.--FROM THE LATIN. If men wish to be held in esteem, they must associate with those who are estimable.--LA BRUYERE. 1. BY WHAT MEN ARE KNOWN.--An author is known by his writings, a mother by her daughter, a fool by his words, and all men by their companions. 2. FORMATION OF A GOOD CHARACTER.--Intercourse with persons of decided virtue and excellence is of great importance in the formation of a good character. The force of example is powerful; we are creatures of imitation, and, by a necessary influence, our tempers and habits are very much formed on the model of those with whom we familiarly associate. Better be alone than in bad company. Evil communications corrupt good manners. Ill qualities are catching as well as diseases; and the mind is at least as much, if not a great deal more, liable to infection, than the body. Go with mean people, and you think life is mean. 3. GOOD EXAMPLE.--How natural is it for a child to look up to those around him for an example of imitation, and how readily does he copy all that he sees done, good or bad. The importance of a good example on which the young may exercise this powerful and active element of their nature, is a matter of the utmost moment. 4. A TRUE MAXIM.--It is a trite, but true maxim, that "a man is known by the company he keeps." He naturally assimilates by the force of imitation, to the habits and manners of those by whom he is surrounded. We know persons who walk much with the lame, who have learned to walk with a hitch or limp like their lame friends. Vice stalks in the streets unabashed, and children copy it. 5. LIVE WITH THE CULPABLE.--Live with the culpable, and you will be very likely to die with the criminal. Bad company is like a nail driven into a post, which after the first or second blow, may be drawn out with little difficulty; but being once driven in up to the head, the pinchers cannot take hold to draw it out, which can only be done by the destruction of the wood. You may be ever so pure, you cannot associate with bad companions without falling into bad odor. 6. SOCIETY OF THE VULGAR.--Do you love the society of the vulgar? Then you are already debased in your sentiments. Do you seek to be with the profane? In your heart you are like them. Are jesters and buffoons your choice friends? He who loves to laugh at folly is himself a fool. Do you love and seek the society of the wise and good? Is this your habit? Had you rather take the lowest seat among these than the highest seat among others? Then you have already learned to be good. You may not make very much progress, but even a good beginning is not to be despised. 7. SINKS OF POLLUTION.--Strive for mental excellence, and strict integrity, and you never will be found in the sinks of pollution, and on the benches of retailers and gamblers. Once habituate yourself to a virtuous course, once secure a love of good society, and no punishment would be greater than by accident to be obliged for half a day to associate with the low and vulgar. Try to frequent the company of your betters. 8. PROCURE NO FRIEND IN HASTE.--Nor, if once secured, in haste abandon them. Be slow in choosing an associate, and slower to change him; slight no man for poverty, nor esteem any one for his wealth. Good friends should not be easily forgotten, nor used as suits of apparel, which, when we have worn them threadbare, we cast them off, and call for new. When once you profess yourself a friend, endeaver to be always such. He can never have any true friends that will be often changing them. 9. HAVE THE COURAGE TO CUT THE MOST AGREEABLE ACQUAINTANCE.--Do this when you are convinced that he lacks principle; a friend should bear with a friend's infirmities, but not with his vices. He that does a base thing in zeal for his friend, burns the golden thread that ties their hearts together. * * * * * SELF-CONTROL. "Honor and profit do not always lie in the same sack."--GEORGE HERBERT. "The government of one's self is the only true freedom for the individual."--FREDERICK PERTHES. "It is length of patience, and endurance, and forbearance that so much of what is called good in mankind and womankind is shown."--ARTHUR HELPS. 1. ESSENCE OF CHARACTER.--Self-control is only courage under another form. It may also be regarded as the primary essence of character. It is in virtue of this quality that Shakespeare defines man as a being "looking before and after." It forms the chief distinction between man and the mere animal; and, indeed, there can be no true manhood without it. [Illustration: RESULT OF BAD COMPANY.] 2. ROOT OF ALL THE VIRTUES.--Self-control is at the root of all the virtues. Let a man give the reins to his impulses and passions, and from that moment he yields up his moral freedom. He is carried along the current of life, and becomes the slave of his strongest desire for the time being. 3. RESIST INSTINCTIVE IMPULSE.--To be morally free--to be more than an animal--man must be able to resist instinctive impulse, and this can only be done by exercise of self-control. Thus it is this power which constitutes the real distinction between a physical and a moral life, and that forms the primary basis of individual character. 4. A STRONG MAN RULETH HIS OWN SPIRIT.--In the Bible praise is given, not to a strong man who "taketh a city," but to the stronger man who "ruleth his own spirit." This stronger man is he who, by discipline, exercises a constant control over his thoughts, his speech, and his acts. Nine-tenths of the vicious desires that degrade society, and which, when indulged, swell into the crimes that disgrace it, would shrink into insignificance before the advance of valiant self-discipline, self-respect, and self-control. By the watchful exercise of these virtues, purity of heart and mind become habitual, and the character is built up in chastity, virtue, and temperance. 5. THE BEST SUPPORT.--The best support of character will always be found in habit, which, according as the will is directed rightly or wrongly, as the case may be, will prove either a benignant ruler, or a cruel despot. We may be its willing subject on the one hand, or its servile slave on the other. It may help us on the road to good, or it may hurry us on the road to ruin. 6. THE IDEAL MAN.--"In the supremacy of self-control," says Herbert Spencer, "consists one of the perfections of the ideal man. Not to be impulsive, not to be spurred hither and thither by each desire that in turn comes upper-most, but to be self-restrained, self-balanced, governed by the joint decision of the feelings in council assembled, before whom every action shall have been fully debated, and calmly determined--that it is which education, moral education at least, strives to produce." 7. THE BEST REGULATED HOME.--The best regulated home is always that in which the discipline is the most perfect, and yet where it is the least felt. Moral discipline acts with the force of a law of nature. Those subject to it yield themselves to it unconsciously; and though it shapes and forms the whole character, until the life becomes crystallized in habit, the influence thus exercised is for the most part unseen and almost unfelt. 8. PRACTICE SELF-DENIAL.--If a man would get through life honorably and peaceably, he must necessarily learn to practice self-denial in small things as well as in great. Men have to bear as well as to forbear. The temper has to be held in subjection to the judgment; and the little demons of ill-humor, petulance, and sarcasm, kept resolutely at a distance. If once they find an entrance to the mind, they are apt to return, and to establish for themselves a permanent occupation there. 9. POWER OF WORDS.--It is necessary to one's personal happiness, to exercise control over one's words as well as acts: for there are words that strike even harder than blows; and men may "speak daggers," though they use none. The stinging repartee that rises to the lips, and which, if uttered, might cover an adversary with confusion, how difficult it is to resist saying it! "Heaven, keep us," says Miss Bremer, in her 'Home', "from the destroying power of words! There are words that sever hearts more than sharp swords do; there are words the point of which sting the heart through the course of a whole life." 10. CHARACTER EXHIBITS ITSELF.--Character exhibits itself in self-control of speech as much as in anything else. The wise and forbearant man will restrain his desire to say a smart or severe thing at the expense of another's feeling; while the fool blurts out what he thinks, and will sacrifice his friend rather than his joke. "The mouth of a wise man," said Solomon, "is in his heart; the heart of a fool is in his mouth." 11. BURNS.--No one knew the value of self-control better than the poet Burns, and no one could teach it more eloquently to others, but when it came to practice, Burns was as weak as the weakest. He could not deny himself the pleasure of uttering a harsh and clever sarcasm at another's expense. One of his biographers observed of him, that it was no extravagant arithmetic to say that for every ten jokes he made himself a hundred enemies. But this was not all. Poor Burns exercised no control over his appetites, but freely gave them the rein: "Thus thoughtless follies laid him low, And stained his name." 12. SOW POLLUTION.--Nor had he the self-denial to resist giving publicity to compositions originally intended for the delight of the tap-room, but which continued secretly to sow pollution broadcast in the minds of youth. Indeed, notwithstanding the many exquisite poems of this writer, it is not saying too much that his immoral writings have done far more harm than his purer writings have done good; and it would be better that all his writings should be destroyed and forgotten, provided his indecent songs could be destroyed with them. 13. MORAL PRINCIPLE.--Many of our young men lack moral principle. They cannot look upon a beautiful girl with a pure heart and pure thoughts. They have not manifested or practiced that self-control which develops true manhood and brings into subordination evil thoughts, evil passions, and evil practices. Men who have no self-control will find life a failure, both in a social and in a business sense. The world despises an insignificant person who lacks backbone and character. Stand upon your manhood and womanhood; honor your convictions, and dare to do right. 14. STRONG DRINK.--There is the habit of strong drink. It is only the lack of self-control that brings men into the depths of degradation; on account of the cup, the habit of taking drink occasionally in its milder forms--of playing with a small appetite that only needs sufficient playing with to make you a demon or a dolt. You think you are safe; I know you are not safe, if you drink at all; and when you get offended with the good friends that warn you of your danger, you are a fool. I know that the grave swallows daily, by scores, drunkards, every one of whom thought he was safe while he was forming his appetite. But this is old talk. A young man in this age who forms the habit of drinking, or puts himself in danger of forming the habit, is usually so weak that he does not realize the consequences. [Illustration: LOST SELF-CONTROL.] * * * * * HABIT. It is almost as difficult to make a man unlearn his Errors as his Knowledge.--COLTON. There are habits contracted by bad example, or bad management, before we have judgment to discern their approaches, or because the eye of Reason is laid asleep, or has not compass of view sufficient to look around on every quarter.--TUCKER. 1. HABIT.--Our real strength in life depends upon habits formed in early life. The young man who sows his wild oats and indulges in the social cup, is fastening chains upon himself that never can be broken. The innocent youth by solitary practice of self-abuse will fasten upon himself a habit which will wreck his physical constitution and bring suffering and misery and ruin. Young man and young woman, beware of bad habits formed in early life. 2. A BUNDLE OF HABITS.--Man, it has been said, is a bundle of habits; and habit is second nature. Metastasio entertained so strong an opinion as to the power of repetition in act and thought, that he said, "All is habit in mankind, even virtue itself." Evil habits must be conquered, or they will conquer us and destroy our peace and happiness. 3. VICIOUS HABITS.--Vicious habits, when opposed, offer the most vigorous resistence on the first attack. At each successive encounter this resistence grows fainter and fainter, until finally it ceases altogether and the victory is achieved. Habit is man's best friend and worst enemy; it can exalt him to the highest pinnacle of virtue, honor and happiness, or sink him to the lowest depths of vice, shame and misery. 4. HONESTY, OR KNAVERY.--We may form habits of honesty, or knavery; truth, or falsehood; of industry, or idleness; frugality, or extravagance; of patience, or impatience; self-denial, or self-indulgence; of kindness, cruelty, politeness, rudeness, prudence, perseverance, circumspection. In short, there, is not a virtue, nor a vice; not an act of body, nor of mind, to which we may not be chained down by this despotic power. 5. BEGIN WELL.--It is a great point for young men to begin well; for it is the beginning of life that that system of conduct is adopted which soon assumes the force of habit. Begin well, and the habit of doing well will become quite easy, as easy as the habit of doing badly. Pitch upon that course of life which is the most excellent, and habit will render it the most delightful. * * * * * A GOOD NAME. 1. THE LONGING FOR A GOOD NAME.--The longing for a good name is one of those laws of nature that were passed for the soul and written down within to urge toward a life of action, and away from small or wicked action. So large is this passion that it is set forth in poetic thought, as having a temple grand as that of Jupiter or Minerva, and up whose marble steps all noble minds struggle--the temple of Fame. 2. CIVILIZATION.--Civilization is the ocean of which the millions of individuals are the rivers and torrents. These rivers and torrents swell with those rains of money and home and fame and happiness, and then fall and run almost dry, but the ocean of civilization has gathered up all these waters, and holds them in sparkling beauty for all subsequent use. Civilization is a fertile delta made by the drifting souls of men. 3. FAME.--The word "fame" never signifies simply notoriety. The meaning of the direct term may be seen from its negation or opposite, for only the meanest of men are called infamous. They are utterly without fame, utterly nameless; but if fame implied only notoriety, then infamous would possess no marked significance. Fame is an undertaker that pays but little attention to the living, but who bedizens the dead, furnishes out their funerals and follows them to the grave. 4. LIFE-MOTIVE.--So in studying that life-motive which is called a "good name," we must ask the large human race to tell us the high merit of this spiritual longing. We must read the words of the sage, who said long centuries ago that "a good name was rather chosen than great riches." Other sages have said as much. Solon said that "He that will sell his good name will sell the State." Socrates said, "Fame is the perfume of heroic deeds." Our Shakespeare said, "He lives in fame who died in virtue's cause." 5. INFLUENCES OF OUR AGE.--Our age is deeply influenced by the motives called property and home and pleasure, but it is a question whether the generation in action today and the generation on the threshold of this intense life are conscious fully of the worth of an honorable name. 6. BEAUTY OF CHARACTER.--We do not know whether with us all a good name is less sweet than it was with our fathers, but this is painfully evident that our times do not sufficiently behold the beauty of character--their sense does not detect quickly enough or love deeply enough this aroma of heroic deeds. 7. SELLING OUT THEIR REPUTATION.--It is amazing what multitudes there are who are willing to sell out their reputation, and amazing at what a low price they will make the painful exchange. Some king remarked that he would not tell a lie for any reward less than an empire. It is not uncommon in our world for a man to sell out all his honor and hopes for a score or a half score of dollars. 8. PRISONS OVERFLOWING.--Our prisons are all full to overflowing of those who took no thought of honor. They have not waited for an empire to be offered them before they would violate the sacred rights of man, but many of them have even murdered for a cause that would not have justified even an exchange of words. 9. INTEGRITY THE PRIDE OF THE GOVERNMENT.--If integrity were made the pride of the government, the love of it would soon spring up among the people. If all fraudulent men should go straight to jail, pitilessly, and if all the most rigid characters were sought out for all political and commercial offices, there would soon come a popular honesty just as there has come a love of reading or of art. It is with character as with any new article--the difficulty lies in its first introduction. 10. A NEW VIRTUE.--May a new virtue come into favor, all our high rewards, those from the ballot-box, those from employers, the rewards of society, the rewards of the press, should be offered only to the worthy. A few years of rewarding the worthy would result in a wonderful zeal in the young to build up, not physical property, but mental and spiritual worth. 11. BLESSING THE FAMILY GROUP.--No young man or young woman can by industry and care reach an eminence in study or art or character, without blessing the entire family group. We have all seen that the father and mother feel that all life's care and labor were at last perfectly rewarded in the success of their child. But had the child been reckless or indolent, all this domestic joy--the joy of a large group--would have been blighted forever. 12. AN HONORED CHILD.--There have been triumphs at old Rome, where victors marched along with many a chariot, many an elephant, and many spoils of the East; and in all times money has been lavished in the efforts of States to tell their pleasure in the name of some general; but more numerous and wide-spread and beyond expression, by chariot or cannon or drum, have been those triumphal hours, when some son or daughter has returned to the parental hearth beautiful in the wreaths of some confessed excellence, bearing a good name. 13. RICH CRIMINALS.--We looked at the utter wretchedness of the men who threw away reputation, and would rather be rich criminals in exile than be loved friends and persons at home. 14. AN EMPTY, OR AN EVIL NAME.--Young and old cannot afford to bear the burden of an empty or an evil name. A good name is a motive of life. It is a reason for that great encampment we call an existence. While you are building the home of to-morrow, build up also that kind of soul that can sleep sweetly on home's pillow, and can feel that God is not near as an avenger of wrong, but as the Father not only of the verdure and the seasons, but of you. [Illustration: AN EGYPTIAN DANCER.] * * * * * THE MOTHER'S INFLUENCE. Mother, O mother, my heart calls for you, Many a Summer the grass has grown green, Blossomed and faded, our faces between; Yet with strong yearning and passionate pain, Long I to-night for your presence again. --_Elizabeth Akers Allen._ A mother is a mother still, The holiest thing alive. --_Coleridge._ There is none, In all this cold and hollow world, no fount Of deep, strong, deathless love, save that within A mother's heart. --_Mrs. Hemans._ And all my mother came into mine eyes, And gave me up to tears. --_Shakespeare._ 1. HER INFLUENCE.--It is true to nature, although it be expressed in a figurative form, that a mother is both the morning and the evening star of life. The light of her eye is always the first to rise, and often the last to set upon man's day of trial. She wields a power more decisive far than syllogisms in argument or courts of last appeal in authority. 2. HER LOVE.--Mother! ecstatic sound so twined round our hearts that they must cease to throb ere we forget it; 'tis our first love; 'tis part of religion. Nature has set the mother upon such a pinnacle that our infant eyes and arms are first uplifted to it; we cling to it in manhood; we almost worship it in old age. 3. HER TENDERNESS.--Alas! how little do we appreciate a mother's tenderness while living. How heedless are we in youth of all her anxieties and kindness! But when she is dead and gone, when the cares and coldness of the world come withering to our hearts, when we experience for ourselves how hard it is to find true sympathy, how few to love us, how few will befriend us in misfortune, then it is that we think of the mother we have lost. 4. HER CONTROLLING POWER.--The mother can take man's whole nature under her control. She becomes what she has been called "The Divinity of Infancy." Her smile is its sunshine, her word its mildest law, until sin and the world have steeled the heart. [Illustration: A PRAYERFUL AND DEVOTED MOTHER.] 5. THE LAST TIE.--The young man who has forsaken the advice and influence of his mother has broken the last cable and severed the last tie that binds him to an honorable and upright life. He has forsaken his best friend, and every hope for his future welfare may be abandoned, for he is lost forever, if he is faithless to mother, he will have but little respect for wife and children. 6. HOME TIES.--The young man or young woman who love their home and love their mother can be safely trusted under almost any and all circumstances, and their life will not be a blank, for they seek what is good. Their hearts will be ennobled, and God will bless them. [Illustration: HOME AMUSEMENTS.] * * * * * HOME POWER. "The mill-streams that turn the clappers of the world arise in solitary places."--HELPS. "Lord! with what care hast Thou begirt us round! Parents first season us. Then schoolmasters Deliver us to laws. They send us bound To rules of reason."--GEORGE HERBERT. 1. SCHOOL OF CHARACTER.--Home is the first and most important school of character. It is there that every human being receives his best moral training, or his worst, for it is there that he imbibes those principles of conduct which endure through manhood, and cease only with life. 2. HOME MAKES THE MAN.--It is a common saying, "Manners make the man;" and there is a second, that "Mind makes the man;" but truer than either is a third, that "Home makes the man." For the home-training includes not only manners and mind, but character. It is mainly in the home that the heart is opened, the habits are formed, the intellect is awakened, and character moulded for good or for evil. 3. GOVERN SOCIETY.--From that source, be it pure or impure, issue the principles and maxims that govern society. Law itself is but the reflex of homes. The tiniest bits of opinion sown in the minds of children in private life afterwards issue forth to the world, and become its public opinion; for nations are gathered out of nurseries, and they who hold the leading-strings of children may even exercise a greater power than those who wield the reins of government. 4. THE CHILD IS FATHER OF THE MAN.--The child's character is the nucleus of the man's; all after-education is but superposition; the form of the crystal remains the same. Thus the saying of the poet holds true in a large degree, "The child is father of the man;" or as Milton puts it, "The childhood shows the man, as morning shows the day." Those impulses to conduct which last the longest and are rooted the deepest, always have their origin near our birth. It is then that the germs of virtues or vices, of feelings or sentiments, are first implanted which determine the character of life. 5. NURSERIES.--Thus homes, which are nurseries of children who grow up into men and women, will be good or bad according to the power that governs them. Where the spirit of love and duty pervades the home, where head and heart bear rule wisely there, where the daily life is honest and virtuous, where the government is sensible, kind, and loving, then may we expect from such a home an issue of healthy, useful, and happy beings, capable as they gain the requisite strength, of following the footsteps of their parents, of walking uprightly, governing themselves wisely, and contributing to the welfare of those about them. 6. IGNORANCE, COARSENESS, AND SELFISHNESS.--On the other hand, if surrounded by ignorance, coarseness, and selfishness, they will unconsciously assume the same character, and grow up to adult years rude, uncultivated, and all the more dangerous to society if placed amidst the manifold temptations of what is called civilized life. "Give your child to be educated by a slave," said an ancient Greek "and, instead of one slave, you will then have two." 7. MATERNAL LOVE.--Maternal love is the visible providence of our race. Its influence is constant and universal. It begins with the education of the human being at the outstart of life, and is prolonged by virtue of the powerful influence which every good mother exercises over her children through life. When launched into the world, each to take part in its labors, anxieties, and trials, they still turn to their mother for consolation, if not for counsel, in their time of trouble and difficulty. The pure and good thoughts she has implanted in their minds when children continue to grow up into good acts long after she is dead; and when there is nothing but a memory of her left, her children rise up and call her blessed. 8. WOMAN, ABOVE ALL OTHER EDUCATORS, educates humanly. Man is the brain, but woman is the heart of humanity; he its judgment, she its feeling; he its strength, she its grace, ornament and solace. Even the understanding of the best woman seems to work mainly through her affections. And thus, though man may direct the intellect, woman cultivates the feelings, which mainly determine the character. While he fills the memory, she occupies the heart. She makes us love what he can make us only believe, and it is chiefly through her that we are enabled to arrive at virtue. 9. THE POOREST DWELLING, presided over by a virtuous, thrifty, cheerful, and cleanly woman may thus be the abode of comfort, virtue and happiness; it may be the scene of every enobling relation in family life; it may be endeared to man by many delightful associations; furnishing a sanctuary for the heart, a refuge from the storms of life, a sweet resting-place after labor, a consolation in misfortune, a pride in prosperity and a joy at all times. 10. THE GOOD HOME IS THUS THE BEST OF SCHOOLS, not only in youth but in age. There young and old best learn cheerfulness, patience, self-control, and the spirit of service and of duty. The home is the true school of courtesy, of which woman is always the best practical instructor. "Without woman," says the Provencal proverb, "men were but ill-licked cubs." Philanthropy radiates from the home as from a center. "To love the little platoon we belong to in society," said Burke, "is the germ of all public affections." The wisest and best have not been ashamed to own it to be their greatest joy and happiness to sit "behind the heads of children" in the inviolable circle of home. [Illustration] [Illustration: DAY DREAMING.] * * * * * TO YOUNG WOMEN. 1. TO BE A WOMAN, in the truest and highest sense of the word is to be the best thing beneath the skies. To be a woman is something more than to live eighteen or twenty years; something more than to grow to the physical stature of women; something more than to wear flounces, exhibit dry goods, sport jewelry, catch the gaze of lewd-eyed men; something more than to be a belle, a wife, or a mother. Put all these qualifications together and they do but little toward making a true woman. 2. BEAUTY AND STYLE are not the surest passports to womanhood--some of the noblest specimens of womanhood that the world has ever seen have presented the plainest and most unprepossessing appearance. A woman's worth is to be estimated by the real goodness of her heart, the greatness of her soul, and the purity and sweetness of her character; and a woman with a kindly disposition and well-balanced temper is both lovely and attractive, be her face ever so plain, and her figure ever so homely; she makes the best of wives and the truest of mothers. 3. BEAUTY IS A DANGEROUS GIFT.--It is even so. Like wealth, it has ruined its thousands. Thousands of the most beautiful women are destitute of common sense and common humanity. No gift from heaven is so general and so widely abused by woman as the gift of beauty. In about nine cases in ten it makes her silly, senseless, thoughtless, giddy, vain, proud, frivolous, selfish, low and mean. I think I have seen more girls spoiled by beauty than by any other one thing, "She is beautiful, and she knows it," is as much as to say that she is spoiled. A beautiful girl is very likely to believe she was made to be looked at; and so she sets herself up for a show at every window, in every door, on every corner of the street, in every company at which opportunity offers for an exhibition of herself. 4. BEWARE OF BEAUTIFUL WOMEN.--These facts have long since taught sensible men to beware of beautiful women--to sound them carefully before they give them their confidence. Beauty is shallow--only skin deep; fleeting--only for a few years' reign; dangerous--tempting to vanity and lightness of mind; deceitful--dazzling of ten to bewilder; weak--reigning only to ruin; gross--leading often to sensual pleasure. And yet we say it need not be so. Beauty is lovely and ought to be innocently possessed. It has charms which ought to be used for good purposes. It is a delightful gift, which ought to be received with gratitude and worn with grace and meekness. It should always minister to inward beauty. Every woman of beautiful form and features should cultivate a beautiful mind and heart. 5. RIVAL THE BOYS.--We want the girls to rival the boys in all that is good, and refined, and ennobling. We want them to rival the boys, as they well can, in learning, in understanding, in virtues; in all noble qualities of mind and heart, but not in any of those things that have caused them, justly or unjustly, to be described as savages. We want the girls to be gentle--not weak, but gentle, and kind and affectionate. We want to be sure, that wherever a girl is, there should be a sweet, subduing and harmonizing influence of purity, and truth, and love, pervading and hallowing, from center to circumference, the entire circle in which she moves. If the boys are savages, we want her to be their civilizer. We want her to tame them, to subdue their ferocity, to soften their manners, and to teach them all needful lessons of order, sobriety, and meekness, and patience and goodness. 6. KINDNESS.--Kindness is the ornament of man--it is the chief glory of woman--it is, indeed, woman's true prerogative--her sceptre and her crown. It is the sword with which she conquers, and the charm with which she captivates. 7. ADMIRED AND BELOVED.--Young lady, would you be admired and beloved? Would you be an ornament to your sex, and a blessing to your race? Cultivate this heavenly virtue. Wealth may surround you with its blandishments, and beauty, and learning, or talents, may give you admirers, but love and kindness alone can captivate the heart. Whether you live in a cottage or a palace, these graces can surround you with perpetual sunshine, making you, and all around you, happy. 8. INWARD GRACE.--Seek ye then, fair daughters, the possession of that inward grace, whose essence shall permeate and vitalize the affections, adorn the countenance make mellifluous the voice, and impart a hallowed beauty even to your motions. Not merely that you may be loved, would I urge this, but that you may, in truth, be lovely--that loveliness which fades not with time, nor is marred or alienated by disease, but which neither chance nor change can in any way despoil. 9. SILKEN ENTICEMENTS OF THE STRANGER.--We urge you, gentle maiden, to beware of the silken enticements of the stranger, until your love is confirmed by protracted acquaintance. Shun the idler, though his coffers overflow with pelf. Avoid the irreverent--the scoffer of hallowed things; and him who "looks upon the wine while it is red;" him too, "who hath a high look and a proud heart," and who "privily slandereth his neighbor." Do not heed the specious prattle about "first love," and so place, irrevocably, the seal upon your future destiny, before you have sounded, in silence and secrecy, the deep fountains of your own heart. Wait, rather, until your own character and that of him who would woo you, is more fully developed. Surely, if this "first love" cannot endure a short probation, fortified by "the pleasures of hope," how can it be expected to survive years of intimacy, scenes of trial, distracting cares, wasting sickness, and all the homely routine of practical life? Yet it is these that constitute life, and the love that cannot abide them is false and must die. [Illustration: ROMAN LADIES.] * * * * * INFLUENCE OF FEMALE CHARACTER. 1. MORAL EFFECT.--It is in its moral effect on the mind and the heart of man, that the influence of woman is most powerful and important. In the diversity of tastes, habits, inclinations, and pursuits of the two sexes, is found a most beneficent provision for controlling the force and extravagance of human passion. The objects which most strongly seize and stimulate the mind of man, rarely act at the same time and with equal power on the mind of woman. She is naturally better, purer, and more chaste in thought and language. 2. FEMALE CHARACTER.--But the influence of female character on the virtue of men, is not seen merely in restraining and softening the violence of human passion. To her is mainly committed the task of pouring into the opening mind of infancy its first impressions of duty, and of stamping on its susceptible heart the first image of its God. Who will not confess the influence of a mother in forming the heart of a child? What man is there who can not trace the origin of many of the best maxims of his life to the lips of her who gave him birth? How wide, how lasting, how sacred is that part of a woman's influence. 3. VIRTUE OF A COMMUNITY.--There is yet another mode by which woman may exert a powerful influence on the virtue of a community. It rests with her in a pre-eminent degree, to give tone and elevation to the moral character of the age, by deciding the degree of virtue that shall be necessary to afford a passport to her society. If all the favor of woman were given only to the good, if it were known that the charms and attractions of beauty and wisdom, and wit, were reserved only for the pure; if, in one word, something of a similar rigor were exerted to exclude the profligate and abandoned of society, as is shown to those, who have fallen from virtue,--how much would be done to re-enforce the motives to moral purity among us, and impress on the minds of all a reverence for the sanctity and obligations of virtue. 4. THE INFLUENCE OF WOMAN ON THE MORAL SENTIMENTS.--The influence of woman on the moral sentiments of society is intimately connected with her influence on its religious character; for religion and a pure and elevated morality must ever stand in the relation to each other of effect and cause. The heart of a woman is formed for the abode of sacred truth; and for the reasons alike honorable to her character and to that of society. From the nature of humanity this must be so, or the race would soon degenerate and moral contagion eat out the heart of society. The purity of home is the safeguard to American manhood. [Illustration] * * * * * PERSONAL PURITY. "Self-reverence, self-knowledge, self-control, These three alone lead life to sovereign power."--Tennyson 1. WORDS OF THE GREAT TEACHER.--Mark the words of the Great Teacher: "If thy right hand or foot cause thee to fall, cut it off and cast it from thee. If thy right eye cause thee to fall, pluck it out. It is better for thee to enter into life maimed and halt, than having two eyes to be cast into hell-fire, where the worm dieth not, and the fire is not quenched." 2. A MELANCHOLY FACT.--It is a melancholy fact in human experience, that the noblest gifts which men possess are constantly prostituted to other purposes than those for which they are designed. The most valuable and useful organs of the body are those which are capable of the greatest dishonor, abuse, and corruption. What a snare the wonderful organism of the eye may become, when used to read corrupt books, or to look upon licentious pictures, or vulgar theater scenes, or when used to meet the fascinating gaze of the harlot! What an instrument for depraving the whole man may be found in the matchless powers of the brain, the hand, the mouth, or the tongue! What potent instruments may these become in accomplishing the ruin of the whole being, for time and eternity! 3. Abstinence.--Some can testify with thankfulness that they never knew the sins of gambling, drunkenness, fornication, or adultery. In all these cases abstinence has been, and continues to be, liberty. Restraint is the noblest freedom. No man can affirm that self-denial ever injured him; on the contrary, self-restraint has been liberty, strength and blessing. Solemnly ask young men to remember this when temptation and passion strive as a floodtide to move them from the anchorage and peace of self-restraint. Beware of the deceitful stream of temporary gratification, whose eddying current drifts towards license, shame, disease and death. Remember how quickly moral power declines, how rapidly the edge of the fatal maelstrom is reached, how near the vortex, how terrible the penalty, how fearful the sentence of everlasting punishment! 4. FRANK DISCUSSION.--The time has arrived for a full and frank discussion of those things which affect the personal purity. Thousands are suffering to-day from various weaknesses, the causes of which they have never learned. Manly vigor is not increasing with that rapidity which a Christian age demands. Means of dissipation are on the increase. It is high time, therefore, that every lover of the race should call a halt, and inquire into the condition of things. Excessive modesty on this subject is not virtue. Timidity in presenting unpleasant but important truths has permitted untold damage in every age. 5. MAN IS A CARELESS BEING.--He is very much inclined to sinful things. He more often does that which is wrong than that which is right, because it is easier, and, for the moment, perhaps, more satisfying to the flesh. The Creator is often blamed for man's weaknesses and inconsistencies. This is wrong. God did not intend that we should be mere machines, but free moral agents. We are privileged to choose between good and evil. Hence, if we perseveringly choose the latter, and make a miserable failure of life, we should blame only ourselves. 6. THE PULPIT.--Would that every pulpit in the land might join hands with the medical profession and cry out with no uncertain sound against the mighty evils herein stigmatized! It would work a revolution for which coming society could never cease to be grateful. 7. STRIVE TO ATTAIN A HIGHER LIFE.--Strive to attain unto a higher and better life. Beware of all excesses, of whatever nature, and guard your personal purity with sacred determination. Let every aspiration be upward, and be strong in every good, resolution. Seek the light, for in light there is life, while in darkness there is decay and death. [Illustration: THE FIRST LOVE LETTER.] [Illustration] * * * * * HOW TO WRITE ALL KINDS OF LETTERS. 1. From the President in his cabinet to the laborer in the street; from the lady in her parlor to the servant in her kitchen; from the millionaire to the beggar; from the emigrant to the settler; from every country and under every combination of circumstances, letter writing in all its forms and varieties is most important to the advancement, welfare and happiness of the human family. 2. EDUCATION.--The art of conveying thought through the medium of written language is so valuable and so necessary, a thorough knowledge of the practice must be desirable to every one. For merely to write a good letter requires the exercise of much of the education and talent of any writer. 3. A GOOD LETTER.--A good letter must be correct in every mechanical detail, finished in style, interesting in substance, and intelligible in construction. Few there are who do not need write them; yet a letter perfect in detail is rarer than any other specimen of composition. 4. PENMANSHIP.--It is folly to suppose that the faculty for writing a good hand is confined to any particular persons. There is no one who can write at all, but what can write well, if only the necessary pains are practiced. Practice makes perfect. Secure a few copy books and write an hour each day. You will soon write a good hand. 5. WRITE PLAINLY.--Every word of even the most trifling document should be written in such clear characters that it would be impossible to mistake it for another word, or the writer may find himself in the position of the Eastern merchant who, writing to the Indies for five thousand mangoes, received by the next vessel five hundred monkies, with a promise of more in the next cargo. 6. HASTE.--Hurry is no excuse for bad writing, because any one of sense knows that everything hurried is liable to be ruined. Dispatch may be acquired, but hurry will ruin everything. If, however, you must write slowly to write well, then be careful not to hurry at all, for the few moments you will gain by rapid writing will never compensate you for the disgrace of sending an ill-written letter. 7. NEATNESS.--Neatness is also of great importance. A fair white sheet with handsomely written words will be more welcome to any reader than a blotted, bedaubed page covered with erasures and dirt, even if the matter in each be of equal value and interest. Erasures, blots, interlineations always spoil the beauty of any letter. 8. BAD SPELLING.--When those who from faulty education, or forgetfulness are doubtful about the correct spelling of any word, it is best to keep a dictionary at hand, and refer to it upon such occasions. It is far better to spend a few moments in seeking for a doubtful word, than to dispatch an ill-spelled letter, and the search will probably impress the spelling upon the mind for a future occasion. 9. CARELESSNESS.--Incorrect spelling will expose the most important or interesting letter to the severest sarcasm and ridicule. However perfect in all other respects, no epistle that is badly spelled will be regarded as the work of an educated gentleman or lady. Carelessness will never be considered, and to be ignorant of spelling is to expose an imperfect education at once. 10. AN EXCELLENT PRACTICE.--After writing a letter, read it over carefully, correct all the errors and re-write it. If you desire to become a good letter writer, improve your penmanship, improve your language and grammar, re-writing once or twice every letter that you have occasion to write, whether on social or business subjects. 11. PUNCTUATION.--A good rule for punctuation is to punctuate where the sense requires it, after writing a letter and reading it over carefully you will see where the punctuation marks are required, you can readily determine where the sense requires it, so that your letter will convey the desired meaning. [Illustration] 12. CORRESPONDENCE.--There is no better school or better source for self-improvement than a pleasant correspondence between friends. It is not at all difficult to secure a good list of correspondents if desired. The young people who take advantage of such opportunities for self-improvement will be much more popular in the community and in society. Letter writing cultivates the habit of study; it cultivates the mind, the heart, and stimulates self-improvement in general. 13. FOLDING.--Another bad practice with those unaccustomed to corresponding is to fold the sheet of writing in such a fantastic manner as to cause the receiver much annoyance in opening it. To the sender it may appear a very ingenious performance, but to the receiver it is only a source of vexation and annoyance, and may prevent the communication receiving the attention it would otherwise merit. 14. SIMPLE STYLE.--The style of letter writing should be simple and unaffected, not raised on stilts and indulging in pedantic displays which are mostly regarded as cloaks of ignorance. Repeated literary quotations, involved sentences, long-sounding words and scraps of Latin, French and other languages are, generally speaking, out of place, and should not be indulged in. 15. THE RESULT.--A well written letter has opened the way to prosperity for many a one, has led to many a happy marriage and constant friendship, and has secured many a good service in time of need; for it is in some measure a photograph of the writer, and may inspire love or hatred, regard or aversion in the reader, just as the glimpse of a portrait often determine us, in our estimate, of the worth of the person represented. Therefore, one of the roads to fortune runs through the ink bottle, and if we want to attain a certain end in love, friendship or business, we must trace out the route correctly with the pen in our hand. [Illustration] * * * * * HOW TO WRITE A LOVE LETTER. 1. LOVE.--There is no greater or more profound reality than love. Why that reality should be obscured by mere sentimentalism, with all its train of absurdities is incomprehensible. There is no nobler possession than the love of another. There is no higher gift from one human being to another than love. The gift and the possession are true sanctifiers of life, and should be worn as precious jewels, without affectation and without bashfulness. For this reason there is nothing to be ashamed of in a love letter, provided it be sincere. 2. FORFEITS.--No man need consider that he forfeits dignity if he speaks with his whole heart: no woman need fear she forfeits her womanly attributes if she responds as her heart bids her respond. "Perfect love casteth out fear" is as true now as when the maxim was first given to the world. 3. TELLING THEIR LOVE.--The generality of the sex is, love to be loved; how are they to know the fact that they are loved unless they are told? To write a sensible love letter requires more talent than to solve, with your pen, a profound problem in philosophy. Lovers must not then expect much from each other's epistles. 4. CONFIDENTIAL.--Ladies and gentlemen who correspond with each other should never be guilty of exposing any of the contents of any letters written expressing confidence, attachment or love. The man who confides in a lady and honors her with his confidence should be treated with perfect security and respect, and those who delight in showing their confidential letters to others are unworthy, heartless and unsafe companions. 5. RETURN OF LETTERS.--If letters were written under circumstances which no longer exist and all confidential relations are at an end, then all letters should be promptly returned. 6. HOW TO BEGIN A LOVE LETTER.--How to begin a love letter has been no doubt the problem of lovers and suitors of all ages and nations. Fancy the youth of Young America with lifted pen, thinking how he shall address his beloved. Much depends upon this letter. What shall he say, and how shall he say it, is the great question. Perseverance, however, will solve the problem and determine results. 7. FORMS OF BEGINNING A LOVE LETTER.--Never say, "My Dearest Nellie," "My Adored Nellie," or "My Darling Nellie," until Nellie has first called you "My Dear," or has given you to understand that such familiar terms are permissible. As a rule a gentleman will never err if he says "Dear Miss Nellie," and if the letters are cordially reciprocated the "Miss" may in time be omitted, or other familiar terms used instead. In addressing a widow "Dear Madam," or, "My Dear Madam," will be a proper form until sufficient intimacy will justify the use of other terms. 8. RESPECT.--A lady must always be treated with respectful delicacy, and a gentleman should never use the term "Dear" or "My Dear" under any circumstances unless he knows it is perfectly acceptable or a long and friendly acquaintance justifies it. 9. HOW TO FINISH A LETTER.--A letter will be suggested by the remarks on how to begin one. "Yours respectfully," "Yours truly," "Yours sincerely," "Yours affectionately," "Yours ever affectionately," "Yours most affectionately," "Ever yours," "Ever your own," or "Yours," are all appropriate, each depending upon the beginning of the letter. It is difficult to see any phrase which could be added to them which would carry more meaning than they contain. People can sign themselves "adorers" and such like, but they do so at the peril of good taste. It is not good that men or women "worship" each other--if they succeed in preserving reciprocal love and esteem they will have cause for great contentment. 10. PERMISSION.--No young man should ever write to a young lady any letter, formal or informal, unless he has first sought her permission to do so. 11. SPECIAL FORMS.--We give various forms or models of love letters to be _studied, not copied._ We have given no replies to the forms given, as every letter written will naturally suggest an answer. A careful study will be a great help to many who have not enjoyed the advantages of a literary education. [Illustration] * * * * * FORMS OF SOCIAL LETTERS. _1.--From a Young Lady to a Clergyman Asking a Recommendation._ Nantwich, May 18th, 1915 Reverend and Dear Sir: Having seen an advertisment for a school mistress in the Daily Times, I have been recommended to offer myself as a candidate. Will you kindly favor me with a testimonial as to my character, ability and conduct while at Boston Normal School? Should you consider that I am fitted for the position, you would confer a great favor on me if you would interest yourself in my behalf. I remain, Reverend Sir, Your most obedient and humble servant, LAURA B. NICHOLS. _2.--Applying for a Position as a Teacher of Music._ Scotland, Conn., January 21st, 1915 Madam, Seeing your advertisement in The Clarion of to-day, I write to offer my services as a teacher of music in your family. I am a graduate of the Peabody Institute, of Baltimore, where I was thoroughly instructed in instrumental and vocal music. I refer by permission to Mrs. A.J. Davis, 1922 Walnut Street; Mrs. Franklin Hill, 2021 Spring Garden Street, and Mrs. William Murray, 1819 Spruce Street, in whose families I have given lessons. Hoping that you may see fit to employ me, I am, Very respectfully yours, NELLIE REYNOLDS. _3.--Applying for a Situation as a Cook._ Charlton Place, September 8th, 1894. Madam: Having seen your advertisement for a cook in to-day's Times, I beg to offer myself for your place. I am a thorough cook. I can make clear soups, entrees, jellies, and all kinds of made dishes. I can bake, and am also used to a dairy. My wages are $4 per week, and I can give good reference from my last place, in which I lived for two years. I am thirty-three years of age. I remain, Madam, Yours very respectfully, MARY MOONEY. _4.--Recommending a School Teacher._ Ottawa, Ill., February 10th, 1894. Col. Geo. H. Haight, President Board of Trustees, etc. Dear Sir: I take pleasure in recommending to your favorable consideration the application of Miss Hannah Alexander for the position of teacher in the public school at Weymouth. Miss Alexander is a graduate of the Davidson Seminary, and for the past year has taught a school in this place. My children have been among her pupils, and their progress has been entirely satisfactory to me. Miss Alexander is a strict disciplinarian, an excellent teacher, and is thoroughly competent to conduct the school for which she applies. Trusting that you may see fit to bestow upon her the appointment she seeks, I am. Yours very respectfully, ALICE MILLER. _5.--A Business Introduction._ J.W. Brown, Earlville, Ill. Chicago, Ill., May 1st, 1915 My Dear Sir: This will introduce to you Mr. William Channing, of this city, who visits Earlville on a matter of business, which he will explain to you in person. You can rely upon his statements, as he is a gentleman of high character, and should you be able to render him any assistance, it would be greatly appreciated by Yours truly, HAIGHT LARABEE. _6.--Introducing One Lady to Another._ Dundee, Tenn., May 5th, 1894. Dear Mary: Allow me to introduce to you my ever dear friend, Miss Nellie Reynolds, the bearer of this letter. You have heard me speak of her so often that you will know at once who she is. As I am sure you will be mutually pleased with each other, I have asked her to inform you of her presence in your city. Any attention you may show her will be highly appreciated by Yours affectionately, LIZZIE EICHER. _7.--To a Lady, Apologizing for a Broken Engagement._ Albany, N.Y., May 10th, 1894. My Dear Miss Lee: Permit me to explain my failure to keep my appointment with you this evening. I was on my way to your house, with the assurance of a pleasant evening, when unfortunately I was very unexpectedly called from home on very important business. I regret my disappointment, but hope that the future may afford us many pleasant meetings. Sincerely your friend, IRVING GOODRICH. _8.--Form of an Excuse for a Pupil._ Thursday Morning, April 4th Mr. Bunnel: You will please excuse William for non-attendance at school yesterday, as I was compelled to keep him at home to attend to a matter of business. MRS. A. SMITH. _9.--Form of Letter Accompanying a Present._ Louisville, July 6, 1895 My Dearest Nelly: Many happy returns of the day. So fearful was I that it would escape your memory, that I thought I would send you this little trinket by way of reminder, I beg you to accept it and wear it for the sake of the giver. With love and best wishes. Believe me ever, your sincere friend, CAROLINE COLLINS. _10.--Returning Thanks for the Present._ Louisville, July 6, 1894. Dear Mrs. Collins: I am very much obliged to you for the handsome bracelet you have sent me. How kind and thoughtful it was of you to remember me on my birthday. I am sure I have every cause to bless the day, and did I forget it, I have many kind friends to remind me of it. Again thanking you for your present, which is far too beautiful for me, and also for your kind wishes. Believe me, your most grateful, BERTHA SMITH. _11.--Congratulating a Friend Upon His Marriage._ Menton, N.Y., May 24th, 1894. My Dear Everett: I have, to-day received the invitation to your wedding, and as I cannot be present at that happy event to offer my congratulations in person, I write. I am heartily glad you are going to be married, and congratulate you upon the wisdom of your choice. You have won a noble as well as a beautiful woman, and one whose love will make you a happy man to your life's end. May God grant that trouble may not come near you but should it be your lot, you will have a wife to whom you can look with confidence for comfort, and whose good sense and devotion to you will be your sure and unfailing support. That you may both be very happy, and that your happiness may increase with your years, is the prayer of Your Friend, FRANK HOWARD. * * * * * LETTER WRITING. Any extravagant flattery should be avoided, both as tending to disgust those to whom it is addressed, as well as to degrade the writers, and to create suspicion as to their sincerity. The sentiments should spring from the tenderness of the heart, and, when faithfully and delicately expressed, will never be read without exciting sympathy or emotion in all hearts not absolutely deadened by insensibility. DECLARATION OF AFFECTION. Dear Nellie: Will you allow me, in a few plain and simple words, respectfully to express the sincere esteem and affection I entertain for you, and to ask whether I may venture to hope that these sentiments are returned? I love you truly and earnestly and knowing you admire frankness and candor in all things, I cannot think that you will take offense at this letter. Perhaps it is self-flattery to suppose I have any place in your regard. Should this be so, the error will carry with it its own punishment, for my happy dream will be over. I will try to think otherwise, however, and shall await your answer with hope. Trusting soon to hear from you, I remain, dear Nellie. Sincerely Yours, J.L. Master To Miss Nellie Reynolds, Hartford, Conn. [Illustration] * * * * * FORMS OF LOVE LETTERS. _12.--An Ardent Declaration._ Naperville, Ill., June 10th, 1915 My Dearest Laura: I can no longer restrain myself from writing to you, dearest and best of girls, what I have often been on the point of saying to you. I love you so much that I cannot find words in which to express my feelings. I have loved you from the very first day we met, and always shall. Do you blame me because I write so freely? I should be unworthy of you if I did not tell you the whole truth. Oh, Laura, can you love me in return? I am sure I shall not be able to bear it if your answer is unfavorable. I will study your every wish if you will give me the right to do so. May I hope? Send just one kind word to your sincere friend. HARRY SMITH. _13.--A Lover's Good-bye Before Starting on a Journey._ Pearl St., New York, March 11th, 1894. My Dearest Nellie: I am off to-morrow, and yet not altogether, for I leave my heart behind in your gentle keeping. You need not place a guard over it, however, for it is as impossible that it should stay away, as for a bit of steel to rush from a magnet. The simile is eminently correct for you, my dear girl, are a magnet, and my heart is as true to you as steel. I shall make my absence as brief as possible. Not a day, not an hour, not a minute, shall I waste either in going or returning. Oh, this business; but I wont complain, for we must have something for our hive besides honey--something that rhymes with it--and that we must have it, I must bestir myself. You will find me a faithful correspondent. Like the spider, I shall drop a line by (almost) every post; and mind, you must give me letter for letter. I can't give you credit. Your returns must be prompt and punctual. Passionately yours, LEWIS SHUMAN. To Miss Nellie Carter, No. -- Fifth Avenue, New York. _14.--From an Absent Lover._ Chicago, Ill., Sept. 10, 1915 My Dearest Kate: This sheet of paper, though I should cover it with loving words, could never tell you truly how I long to see you again. Time does not run on with me now at the same pace as with other people; the hours seem days, the days weeks, while I am absent from you, and I have no faith in the accuracy of clocks and almanacs. Ah! if there were truth in clairvoyance, wouldn't I be with you at this moment! I wonder if you are as impatient to see me as I am to fly to you? Sometimes it seems as if I must leave business and every thing else to the Fates, and take the first train to Dawson. However, the hours do move, though they don't appear to, and in a few more weeks we shall meet again. Let me hear from you as frequently as possible in the meantime. Tell me of your health, your amusements and your affections. Remember that every word you write will be a comfort to me. Unchangeably yours, WILLIAM MILLER. To Miss Kate Martin, Dawson, N.D. _15.--A Declaration of Love at First Sight._ Waterford, Maine, May 8th, 1915 Dear Miss Searles: Although I have been in your society but once the impression you have made upon me is so deep and powerful that I cannot forbear writing to you, in defiance of all rules of etiquette. Affection is sometimes of slow growth but sometimes it springs up in a moment. In half an hour after I was introduced to you my heart was no longer my own, I have not the assurance to suppose that I have been fortunate enough to create any interest in yours; but will you allow me to cultivate your acquaintance in the hope or being able to win your regard in the course of time? Petitioning for a few lines in reply. I remain, dear Miss Searles, Yours devotedly, E.C. NICKS. Miss E. Searles, Waterford, Maine. _16.--Proposing Marriage._ Wednesday, October 20th, 1894 Dearest Etta: The delightful hours I have passed in your society have left an impression on my mind that is altogether indelible, and cannot be effaced even by time itself. The frequent opportunities I have possessed, of observing the thousand acts of amiability and kindness which mark the daily tenor of your life, have ripened my feelings of affectionate regard into a passion at once ardent and sincere until I have at length associated my hopes of future happiness with the idea of you as a life partner, in them. Believe me, dearest Etta, this is no puerile fancy, but the matured results of a long and warmly cherished admiration of your many charms of person and mind. It is love--pure devoted love, and I feel confident that your knowledge of my character will lead you to ascribe my motives to their true source. May I then implore you to consult your own heart, and should this avowal of my fervent and honorable passion for you be crowned with your acceptance and approval, to grant me permission to refer the matter to your parents. Anxiously awaiting your answer, I am, dearest Etta, Your sincere and faithful lover, GEO. COURTRIGHT. To Miss Etta Jay, Malden, Ill. _17.--From a Gentleman to a Widow._ Philadelphia, May 10th, 1915 My Dear Mrs. Freeman: I am sure you are too clear-sighted not to have observed the profound impression which your amiable qualities, intelligence and personal attractions have made upon my heart, and as you nave not repelled my attentions nor manifested displeasure when I ventured to hint at the deep interest I felt in your welfare and happiness, I cannot help hoping that you will receive an explicit expression of my attachments, kindly and favorably. I wish it were in my power to clothe the feelings I entertain for you in such words as should make my pleadings irresistible; but, after all, what could I say, more than you are very dear to me, and that the most earnest desire of my soul is to have the privilege of calling you my wife? Do you, can you love me? You will not, I am certain, keep me in suspense, for you are too good and kind to trifle for a moment with sincerity like mine. Awaiting your answer, I remain with respectful affection, Ever yours, HENRY MURRAY. Mrs. Julia Freeman, Philadelphia. _18.--From a Lady to an Inconstant Lover._ Dear Harry: It is with great reluctance that I enter upon a subject which has given me great pain, and upon which silence has become impossible if I would preserve my self-respects. You cannot but be aware that I have just reason for saying that you have much displeased me. You have apparently forgotten what is due to me, circumstanced as we are, thus far at least. You cannot suppose that I can tamely see you disregard my feelings, by conduct toward other ladies from which I should naturally have the right to expect you to abstain. I am not so vulgar a person as to be jealous. When there is cause to infer changed feelings, or unfaithfulness to promises of constancy, jealousy is not the remedy. What the remedy is I need not say--we both of us have it in our hands. I am sure you will agree with me that we must come to some understanding by which the future shall be governed. Neither you nor I can bear a divided allegiance. Believe me that I write more in sorrow than in anger. You have made me very unhappy, and perhaps thoughtlessly. But it will take much to reassure me of your unaltered regard. Yours truly, EMMA. [Illustration: HEALTHFUL OUTDOOR EXERCISE.] [Illustration: THE HUMAN FACE, LIKE A FLOWER, SPEAKS FOR ITSELF.] * * * * * HINTS AND HELPS ON GOOD BEHAVIOR AT ALL TIMES AND AT ALL PLACES. 1. It takes acquaintance to found a noble esteem, but politeness prepares the way. Indeed, as ontaigne [Transcriber's note: Montaigne?] says, Courtesy begets esteem at sight. Urbanity is half of affability, and affability is a charm worth possessing. 2. A pleasing demeanor is often the scales by which the pagan weighs the Christian. It is not virtue, but virtue inspires it. There are circumstances in which it takes a great and strong soul to pass under the little yoke of courtesy, but it is a passport to a greater soul standard. 3. Matthew Arnold says, "Conduct is three-fourths of character," and Christian benignity draws the line for conduct. A high sense of rectitude, a lowly soul, with a pure and kind heart are elements of nobility which will work out in the life of a human being at home--everywhere. "Private refinement makes public gentility." 4. If you would conciliate the favor of men, rule your resentment. Remember that if you permit revenge or malice to occupy your soul, you are ruined. 5. Cultivate a happy temper; banish the blues; a cheerful saguine spirit begets cheer and hope. 6. Be trustworthy and be trustful. 7. Do not place a light estimate upon the arts of good reading and good expression; they will yield perpetual interest. 8. Study to keep versed in world events as well as in local occurrences, but abhor gossip, and above all scandal. 9. Banish a self-conscience spirit--the source of much awkwardness--with a constant aim to make others happy. Remember that it is incumbent upon gentlemen and ladies alike to be neat in habits. 10. The following is said to be a correct posture for walking: Head erect--not too rigid--chin in, shoulders back. Permit no unnecessary motion about the thighs. Do not lean over to one side in walking, standing or sitting; the practice is not only ungraceful, but it is deforming and therefore unhealthful. 11. Beware of affectation and of Beau Brummel airs. 12. If the hands are allowed to swing in walking, the are should be limited, and the lady will manage them much more gracefully, if they almost touch the clothing. 13. A lady should not stand with her hands behind her. We could almost say, forget the hands except to keep them clean, including the nails, cordial and helpful. One hand may rest easily in the other. Study repose of attitude here as well as in the rest of the body. 14. Gestures are for emphasis in public speaking; do not point elsewhere, as a rule. 15. Greet your acquaintances as you meet them with a slight bow and smile, as you speak. 16. Look the person to whom you speak in the eye. Never under any circumstances wink at another or communicate by furtive looks. 17. Should you chance to be the rejected suitor of a lady, bear in mind your own self-respect, as well as the inexorable laws of society, and bow politely when you meet her. Reflect that you do not stand before all woman-kind as you do at her bar. Do not resent the bitterness of flirtation. No lady or gentleman will flirt. Remember ever that painful prediscovery is better than later disappointment. Let such experience spur you to higher exertion. 18. Discretion should be exercised in introducing persons. Of two gentlemen who are introduced, if one is superior in rank or age, he is the one to whom the introduction should be made. Of two social equals, if one be a stranger in the place his name should be mentioned first. 19. In general the simpler the introduction the better. 20. Before introducing a gentleman to a lady, remember that she is entitled to hold you responsible for the acquaintance. The lady is the one to whom the gentleman is presented, which may be done thus: "Miss A, permit me to introduce to you my friend, Mr. B."; or, "Miss A., allow me to introduce Mr. B." If mutual and near friends of yours, say simply, "Miss A. Mr. B." 21. Receive the introduction with a slight bow and the acknowledgment, "Miss A., I am happy to make your acquaintance"; or, "Mr. B., I am pleased to meet you." There is no reason why such stereotyped expressions should always be used, but something similar is expected. Do not extend the hand usually. 22. A true lady will avoid familiarity in her deportment towards gentlemen. A young lady should not permit her gentlemen friends to address her by her home name, and the reverse is true. Use the title Miss and Mr. respectively. 23. Ladies should be frank and cordial towards their lady friends, but never gushing. 24. Should you meet a friend twice or oftener, at short intervals, it is polite to bow slightly each time after the first. 25. A lady on meeting a gentleman with whom she has slight acquaintance will make a medium bow--neither too decided nor too slight or stiff. 26. For a gentleman to take a young lady's arm, is to intimate that she is feeble, and young ladies resent the mode. 27. If a young lady desires to visit any public place where she expects to meet a gentleman acquaintance, she should have a chaperon to accompany her, a person of mature years When possible, and never a giddy girl. 28. A lady should not ask a gentleman to walk with her. [Illustration] * * * * * A COMPLETE ETIQUETTE IN A FEW PRACTICAL RULES. _1. If you desire to be respected, keep clean. The finest attire and decorations will add nothing to the appearance or beauty of an untidy person._ _2. Clean clothing, clean skin, clean hands, including the nails, and clean, white teeth, are a requisite passport for good society._ _3. A bad breath should be carefully remedied, whether it proceeds from the stomach or from decayed teeth._ _4. To pick the nose, finger about the ears, or scratch the head or any other part of the person, in company, is decidedly vulgar._ _5. When you call at any private residence, do not neglect to clean your shoes thoroughly._ _6. A gentleman should always remove his hat in the presence of ladies, except out of doors, and then he should lift or touch his hat in salutation. On meeting a lady a well-bred gentleman will always lift his hat._ _7. An invitation to a lecture, concert, or other entertainment, may be either verbal or written, but should always be made at least twenty-four hours before the time._ _8. On entering a hall or church the gentleman should precede the lady in walking up the aisle, or walk by her side, if the aisle is broad enough._ _9. A gentleman should always precede a lady upstairs, and follow her downstairs._ _10. Visitors should always observe the customs of the church with reference to standing, sitting, or kneeling during the services._ _11. On leaving a hall or church at the close of entertainment or services, the gentleman should precede the lady._ _12. A gentleman walking with a lady should carry the parcels, and never allow the lady to be burdened with anything of the kind._ _13. A gentleman meeting a lady on the street and wishing to speak to her, should never detain her, but may turn around and walk in the same direction she is going, until the conversation is completed._ _14. If a lady is traveling with a gentleman, simply as a friend, she should place the amount of her expenses in his hands, or insist on paying the bills herself._ _15. Never offer a lady costly gifts unless you are engaged to her, for it looks as if you were trying to purchase her good-will; and when you make a present to a lady use no ceremony whatever._ _16. Never carry on a private conversation in company. If secrecy is necessary, withdraw from the company._ _17. Never sit with your back to another without asking to be excused._ _18. It is as unbecoming for a gentleman to sit with legs crossed as it is for a lady._ _19. Never thrum with your fingers, rub your hands, yawn or sigh aloud in company._ _20. Loud laughter, loud talking, or other boisterous manifestations should be checked in the society of others, especially on the street and in public places._ _21. When you are asked to sing or play in company, do so without being urged, or refuse in a way that shall be final; and when music is being rendered in company, show politeness to the musician by giving attention. It is very impolite to keep up a conversation. If you do not enjoy the music keep silent._ _22. Contentions, contradictions, etc. in society should be carefully avoided._ _23. Pulling out your watch in company, unless asked the time of day, is a mark of the demi-bred. It looks as if you were tired of the company and the time dragged heavily._ _24. You should never decline to be introduced to any one or all of the guests present at a party to which you have been invited._ _25. A gentleman who escorts a lady to a party, or who has a lady placed under his care, is under particular obligations to attend to her wants and see that she has proper attention. He should introduce her to others, and endeavor to make the evening pleasant. He should escort her to the supper table and provide for her wants._ _26. To take small children or dogs with you on a visit of ceremony is altogether vulgar, though in visiting familiar friends, children are not objectionable._ [Illustration: Children should early be taught the lesson of Propriety and Good Manners.] [Illustration: AN EGYPTIAN BRIDE'S WEDDING OUTFIT.] [Illustration] * * * * * ETIQUETTE OF CALLS. In the matter of making calls it is the correct thing: For the caller who arrived first to leave first. To return a first call within a week and in person. To call promptly and in person after a first invitation. For the mother or chaperon to invite a gentleman to call. To call within a week after any entertainment to which one has been invited. You should call upon an acquaintance who has recently returned from a prolonged absence. It as proper to make the first call upon people in a higher social position, if one is asked to do so. It is proper to call, after an engagement has been announced, or a marriage has taken place, in the family. For the older residents in the city or street to call upon the newcomers to their neighborhood is a long recognized custom. It is proper, after a removal from one part of the city to another, to send out cards with one's new address upon them. To ascertain what are the prescribed hours for calling in the place where one is living, or making a visit, and to adhere to those hours is a duty that must not be overlooked. A gentleman should ask for the lady of the house as well as the young ladies, and leave cards for her as well as for the head of the family. [Illustration: _Improve Your Speech by Reading._] * * * * * ETIQUETTE IN YOUR SPEECH. Don't say Miss or Mister without the person's name. Don't say pants for trousers. Don't say gents for gentlemen. Don't say female for woman. Don't say elegant to mean everything that pleases you. Don't say genteel for well-bred. Don't say ain't for isn't. Don't say I done it for I did it. Don't say he is older than me; say older than I. Don't say she does not see any; say she does not see at all. Don't say not as I know; say not that I know. Don't say he calculates to get off; say he expects to get off. Don't say he don't; say he doesn't. Don't say she is some better; say she is somewhat better. Don't say where are you stopping? say where are you staying? Don't say you was; say you were. Don't say I say, says I, but simply say I said. Don't sign your letters yours etc., but yours truly. Don't say lay for lie; lay expresses action; lie expresses rest. Don't say them bonnets; say those bonnets. Don't say party for person. Don't say it looks beautifully, but say it looks beautiful. Don't say feller, winder, to-morrer, for fellow, window, to-morrow. Don't use slangy words; they are vulgar. Don't use profane words; they are sinful and foolish. Don't say it was her, when you mean it was she. Don't say not at once for at once. Don't say he gave me a recommend, but say he gave me a recommendation. Don't say the two first for the first two. Don't say he learnt me French; say he taught me French. Don't say lit the fire; say lighted the fire. Don't say the man which you saw; say the man whom you saw. Don't say who done it; say who did it Don't say if I was rich I would buy a carriage; say if I were rich. Don't say if I am not mistaken you are in the wrong; say if I mistake not. Don't say who may you be; say who are you? Don't say go lay down; say go lie down. Don't say he is taller than me; say taller than I. Don't say I shall call upon him; say I shall call on him. Don't say I bought a new pair of shoes; say I bought a pair of new shoes. Don't say I had rather not; say I would rather not. Don't say two spoonsful; say two spoonfuls. * * * * * ETIQUETTE OF DRESS AND HABITS. Don't let one day pass without a thorough cleansing of your person. Don't sit down to your evening meal before a complete toilet if you have company. Don't cleanse your nails, your nose or your ears in public. Don't use hair dye, hair oil or pomades. Don't wear evening dress in daytime. Don't wear jewelry of a gaudy character; genuine jewelry modestly worn is not out of place. Don't overdress yourself or walk affectedly. Don't wear slippers or dressing-gown or smoking-jacket out of your own house. Don't sink your hands in your trousers' pockets. Don't whistle in public places, nor inside of houses either. Don't use your fingers or fists to beat a tattoo upon floor desk or window panes. Don't examine other people's papers or letters scattered on their desk. Don't bring a smell of spirits or tobacco into the presence of ladies. Never use either in the presence of ladies. Don't drink spirits; millions have tried it to their sorrow. * * * * * ETIQUETTE ON THE STREET. 1. Your conduct on the street should always be modest and dignified. Ladies should carefully avoid all loud and boisterous conversation or laughter and all undue liveliness in public. 2. When walking on the street do not permit yourself to be absent-minded, as to fail to recognize a friend; do not go along reading a book or newspaper. 3. In walking with a lady on the street give her the inner side of the walk, unless the outside if the safer part; in which case she is entitled to it. 4. Your arm should not be given to any lady except your wife or a near relative, or a very old lady, during the day, unless her comfort or safety requires it. At night the arm should always be offered; also in ascending the steps of a public building. 5. In crossing the street a lady should gracefully raise her dress a little above her ankle with one hand. To raise the dress with both hands is vulgar, except in places where the mud is very deep. 6. A gentleman meeting a lady acquaintance on the street should not presume to join her in her walk without first asking her permission. 7. If you have anything to say to a lady whom you may happen to meet in the street, however intimate you may be, do not stop her, but turn round and walk in company with her; you can take leave at the end of the street. 8. A lady should not venture out upon the street alone after dark. By so doing she compromises her dignity, and exposes herself to indignity at the hands of the rougher class. 9. Never offer to shake hands with a lady in the street if you have on dark or soiled gloves, as you may soil hers. 10. A lady does not form acquaintances upon the street, or seek to attract the attention of the other sex or of persons of her own sex. Her conduct is always modest and unassuming. Neither does a lady demand services or favors from a gentleman. She accepts them graciously, always expressing her thanks. A gentleman will not stand on the street corners, or in hotel doorways, or store windows and gaze impertinently at ladies as they pass by. This is the exclusive business of loafers. 11. In walking with a lady who has your arm, should you have to cross the street, do not disengage your arm and go around upon the outside, unless the lady's comfort renders it necessary. In walking with a lady, where it is necessary for you to proceed singly, always go before her. * * * * * ETIQUETTE BETWEEN SEXES. 1. A lady should be a lady, and a gentleman a gentleman under any and all circumstances. 2. FEMALE INDIFFERENCE TO MAN.--There is nothing that affects the nature and pleasure of man so much as a proper and friendly recognition from a lady, and as women are more or less dependent upon man's good-will, either for gain or pleasure, it surely stands to their interest to be reasonably pleasant and courteous in his presence or society. Indifference is always a poor investment, whether in society or business. 3. GALLANTRY AND LADYISM should be a prominent feature in the education of young people. Politeness to ladies cultivates the intellect and refines the soul and he who can be easy and entertaining in the society of ladies has mastered one of the greatest accomplishments. There is nothing taught in school, academy or college, that contributes so much to the happiness of man as a full development of his social and moral qualities. 4. LADYLIKE ETIQUETTE.--No woman can afford to treat men rudely. A lady must have a high intellectual and moral ideal and hold herself above reproach. She must remember that the art of pleasing and entertaining gentlemen is infinitely more ornamental than laces, ribbons or diamonds. Dress and glitter may please man, but it will never benefit him. 5. CULTIVATE DEFICIENCIES.--Men and women poorly sexed treat each other with more or less indifference, whereas a hearty sexuality inspires both to a right estimation of the faculties and qualities of each other. Those who are deficient should seek society and overcome their deficiencies. While some naturally inherit faculties as entertainers others are compelled to acquire them by cultivation. [Illustration: ASKING AN HONEST QUESTION.] 6. LADIES' SOCIETY.--He who seeks ladies' society should seek an education and should have a pure heart and a pure mind. Read good, pure and wholesome literature and study human nature, and you will always be a favorite in the society circle. 7. WOMAN HATERS.--Some men with little refinement and strong sensual feelings virtually insult and thereby disgust and repel every female they meet. They look upon woman with an inherent vulgarity, and doubt the virtue and integrity of all alike. But it is because they are generally insincere and impure themselves, and with such a nature culture and refinement are out of the question, there must be a revolution. 8. MEN HATERS.--Women who look upon all men as odious, corrupt or hateful, are no doubt so themselves, though they may be clad in silk and sparkle with diamonds and be as pretty as a lily; but their hypocrisy will out, and they can never win the heart of a faithful, conscientious and well balanced man. A good woman has broad ideas and great sympathy. She respects all men until they are proven unworthy. 9. FOND OF CHILDREN.--The man who is naturally fond of children will make a good husband and a good father. So it behooves the young man, to notice children and cultivate the art of pleasing them. It will be a source of interest, education and permanent benefit to all. 10. EXCESSIVE LUXURY.--Although the association with ladies is an expensive luxury, yet it is not an expensive education. It elevates, refines, sanctifies and purifies, and improves the whole man. A young man who has a pure and genuine respect for ladies, will not only make a good husband, but a good citizen as well. 11. MASCULINE ATTENTION.--No woman is entitled to any more attention than her loveliness and ladylike conduct will command. Those who are most pleasing will receive the most attention, and those who desire more should aspire to acquire more by cultivating those graces and virtues which ennoble woman, but no lady should lower or distort her own true ideal, or smother and crucify her conscience, in order to please any living man. A good man will admire a good woman, and deceptions cannot long be concealed. Her show of dry goods or glitter of jewels cannot long cover up her imperfections or deceptions. 12. PURITY.--Purity of purpose will solve all social problems. Let all stand on this exalted sexual platform, and teach every man just how to treat the female sex, and every woman how to behave towards the masculine; and it will incomparably adorn the manners of both, make both happy in each other, and mutually develop each other's sexuality and humanity. [Illustration] [Illustration] * * * * * PRACTICAL RULES ON TABLE MANNERS. 1. Help ladies with a due appreciation; do not overload the plate of any person you serve. Never pour gravy on a plate without permission. It spoils the meat for some persons. 2. Never put anything by force upon any one's plate. It is extremely ill-bred, though extremely common, to press one to eat of anything. 3. If at dinner you are requested to help any one to sauce or gravy, do not pour it over the meat or vegetables, but on one side of them. Never load down a person's plate with anything. 4. As soon as you are helped, begin to eat, or at least begin to occupy yourself with what you have before you. Do not wait till your neighbors are served--a custom that was long ago abandoned. 5. Should you, however, find yourself at a table where they have the old-fashioned steel forks, eat with your knife, as the others do, and do not let it be seen that you have any objection to doing so. 6. Bread should be broken. To butter a large piece of bread and then bite it, as children do, is something the knowing never do. 7. In eating game or poultry do not touch the bones with your fingers. To take a bone in the fingers for the purpose of picking it, is looked upon as being very inelegant. 8. Never use your own knife or fork to help another. Use rather the knife or fork of the person you help. 9. Never send your knife or fork, or either of them, on your plate when you send for second supply. 10. Never turn your elbows out when you use your knife and fork. Keep them close to your sides. 11. Whenever you use your fingers to convey anything to your mouth or to remove anything from the mouth, let it be the fingers of the left hand. 12. Tea, coffee, chocolate and the like are drank from the cup and never from the saucer. 13. In masticating your food, keep your mouth shut; otherwise you will make a noise that will be very offensive to those around you. 14. Don't attempt to talk with a full mouth. One thing at a time is as much as any man can do well. 15. Should you find a worm or insect in your food, say nothing about it. 16. If a dish is distasteful to you, decline it, and without comment. 17. Never put bones or bits of fruit on the table cloth. Put them on the side of your plate. 18. Do not hesitate to take the last piece on the dish, simply because it is the last. To do so is to directly express the fear that you would exhaust the supply. 19. If you would be what you would like to be--abroad, take care that you _are_ what you would like to be--at home. 20. Avoid picking your teeth at the table if possible; but if you must, do it, it you can, where you are not observed. 21. If an accident of any kind soever should occur during dinner, the cause being who or what it may, you should not seem to note it. 22. Should you be so unfortunate as to overturn or to break anything, you should make no apology. You might let your regret appear in your face, but it would not be proper to put it in words. [Illustration: A PARLOR RECITATION.] * * * * * SOCIAL DUTIES. Man In Society is like a flower, Blown in its native bed. 'Tis there alone His faculties expanded in full bloom Shine out, there only reach their proper use. --COWPER. The primal duties shine aloft like stars; The charities that soothe, and heal, and bless, Are scatter'd at the feet of man like flowers. --WORDSWORTH. 1. MEMBERSHIP IN SOCIETY.--Many fail to get hold of the idea that they are members of society. They seem to suppose that the social machinery of the world is self-operating. They cast their first ballot with an emotion of pride perhaps, but are sure to pay their first tax with a groan. They see political organizations in active existence; the parish, and the church, and other important bodies that embrace in some form of society all men, are successfully operated; and yet these young men have no part or lot in the matter. They do not think of giving a day's time to society. 2. BEGIN EARLY.--One of the first things a young man should do is to see that he is acting his part in society. The earlier this is begun the better. I think that the opponents of secret societies in colleges have failed to estimate the benefit which it must be to every member to be obliged to contribute to the support of his particular organization, and to assume personal care and responsibility as a member. If these societies have a tendency to teach the lessons of which I speak, they are a blessed thing. 3. DO YOUR PART.--Do your part, and be a man among men. Assume your portion of social responsibility, and see that you discharge it well. If you do not do this, then you are mean, and society has the right to despise you just as much as it chooses to do so. You are, to use a word more emphatic than agreeable, a sneak, and have not a claim upon your neighbors for a single polite word. 4. A WHINING COMPLAINER.--Society, as it is called, is far more apt to pay its dues to the individual than the individual to society. Have you, young man, who are at home whining over the fact that you cannot get into society, done anything to give you a claim to social recognition? Are you able to make any return for social recognition and social privileges? Do you know anything? What kind of coin do you propose to pay in the discharge of the obligation which comes upon you with social recognition? In other words, as a return for what you wish to have society do for you, what can you do for society? This is a very important question--more important to you than to society. The question is, whether you will be a member of society by right, or by courtesy. If you have so mean a spirit as to be content to be a beneficiary of society--to receive favors and to confer none--you have no business in the society to which you aspire. You are an exacting, conceited fellow. 5. WHAT ARE YOU GOOD FOR?--Are you a good beau, and are you willing to make yourself useful in waiting on the ladies on all occasions? Have you a good set of teeth, which you are willing to show whenever the wit of the company gets off a good thing? Are you a true, straightforward, manly fellow, with whose healthful and uncorrupted nature it is good for society to come in contact? In short, do you possess anything of any social value? If you do, and are willing to impart it, society will yield itself to your touch. If you have nothing, then society, as such, owes you nothing. Christian philanthropy may put its arm around you, as a lonely young man, about to spoil for want of something, but it is very sad and humiliating for a young man to be brought to that. There are people who devote themselves to nursing young men, and doing them good. If they invite you to tea, go by all means, and try your hand. If in the course of the evening, you can prove to them that your society is desirable, you have won a point. Don't be patronized. 6. THE MORBID CONDITION.--Young men, you are apt to get into a morbid state of mind, which declines them to social intercourse. They become devoted to business with such exclusiveness, that all social intercourse is irksome. They go out to tea as if they were going to jail, and drag themselves to a party as to an execution. This disposition is thoroughly morbid, and to be overcome by going where you are invited, always, and with a sacrifice of feeling. 7. THE COMMON BLUNDER.--Don't shrink from contact with anything but bad morals. Men who affect your unhealthy minds with antipathy, will prove themselves very frequently to be your best friends and most delightful companions. Because a man seems uncongenial to you, who are squeamish and foolish, you have no right to shun him. We become charitable by knowing men. We learn to love those whom we have despised by rubbing against them. Do you not remember some instance of meeting a man or woman whom you had never previously known or cared to know--an individual, perhaps, against whom you have entertained the strongest prejudices--but to whom you became bound by a lifelong friendship through the influence of a three days' intercourse? Yet, if you had not thus met, you would have carried through life the idea that it would be impossible for you to give your fellowship to such an individual. 8. THE FOOLISHNESS OF MAN.--God has introduced into human character infinite variety, and for you to say that you do not love and will not associate with a man because he is unlike you, is not only foolish but wrong. You are to remember that in the precise manner and decree in which a man differs from you, do you differ from him; and that from his standpoint you are naturally as repulsive to him, as he, from your standpoint, is to you. So, leave all this talk of congeniality to silly girls and transcendental dreamers. 9. DO BUSINESS IN YOUR WAY AND BE HONEST.--Do your business in your own way, and concede to every man the privilege which you claim for yourself. The more you mix with men, the less you will be disposed to quarrel, and the more charitable and liberal will you become. The fact that you do not understand a man, is quite as likely to be your fault as his. There are a good many chances in favor of the conclusion that, if you fail to like an individual whose acquaintance you make it is through your own ignorance and illiberality. So I say, meet every man honestly; seek to know him; and you will find that in those points in which he differs from you rests his power to instruct you, enlarge you, and do you good. Keep your heart open for everybody, and be sure that you shall have your reward. You shall find a jewel under the most uncouth exterior; and associated with homeliest manners and oddest ways and ugliest faces, you will find rare virtues, fragrant little humanities, and inspiring heroisms. 10. WITHOUT SOCIETY, WITHOUT INFLUENCE.--Again: you can have no influence unless you are social. An unsocial man is as devoid of influence as an ice-peak is of verdure. It is through social contact and absolute social value alone that you can accomplish any great social good. It is through the invisible lines which you are able to attach to the minds with which you are brought into association alone that you can tow society, with its deeply freighted interests, to the great haven of your hope. 11. THE REVENGE OF SOCIETY.--The revenge which society takes upon the man who isolates himself, is as terrible as it is inevitable. The pride which sits alone will have the privilege of sitting alone in its sublime disgust till it drops into the grave. The world sweeps by the man, carelessly, remorselessly, contemptuously. He has no hold upon society, because he is no part of it. 12. THE CONCLUSION OF THE WHOLE MATTER.--You cannot move men until you are one of them. They will not follow you until they have heard your voice, shaken your hand, and fully learned your principles and your sympathies. It makes no difference how much you know, or how much you are capable of doing. You may pile accomplishment upon acquisition mountain high; but if you fail to be a social man, demonstrating to society that your lot is with the rest, a little child with a song in its mouth, and a kiss for all and a pair of innocent hands to lay upon the knees, shall lead more hearts and change the direction of more lives than you. [Illustration: GATHERING ORANGES IN THE SUNNY SOUTH.] * * * * * POLITENESS. 1. BEAUTIFUL BEHAVIOR.--Politeness has been described as the art of showing, by external signs, the internal regard we have for others. But one may be perfectly polite to another without necessarily paying a special regard for him. Good manners are neither more nor less than beautiful behavior. It has been well said that "a beautiful form is better than a beautiful face, and a beautiful behavior is better than a beautiful form; it gives a higher pleasure than statues or pictures--it is the finest of the fine arts." 2. TRUE POLITENESS.--The truest politeness comes of sincerity. It must be the outcome of the heart, or it will make no lasting impression; for no amount of polish can dispense with truthfulness. The natural character must be allowed to appear, freed of its angularities and asperities. Though politeness, in its best form, should resemble water--"best when clearest, most simple, and without taste"--yet genius in a man will always cover many defects of manner, and much will be excused to the strong and the original. Without genuineness and individuality, human life would lose much of its interest and variety, as well as its manliness and robustness of character. 3. PERSONALITY OF OTHERS.--True politeness especially exhibits itself in regard for the personality of others. A man will respect the individuality of another if he wishes to be respected himself. He will have due regard for his views and opinions, even though they differ from his own. The well-mannered man pays a compliment to another, and sometimes even secures his respect by patiently listening to him. He is simply tolerant and forbearant, and refrains from judging harshly; and harsh judgments of others will almost invariably provoke harsh judgments of ourselves. 4. THE IMPOLITE.--The impolite, impulsive man will, however, sometimes rather lose his friend than his joke. He may surely be pronounced a very foolish person who secures another's hatred at the price of a moment's gratification. It was a saying of Burnel, the engineer--himself one of the kindest-natured of men--that "spite and ill-nature are among the most expensive luxuries in life." Dr. Johnson once said: "Sir, a man has no more right to say a rude thing to another than to knock him down." 5. FEELINGS OF OTHERS.--Want of respect for the feelings of others usually originates in selfishness, and issues in hardness and repulsiveness of manner. It may not proceed from malignity so much, as from want of sympathy, and want of delicacy--a want of that perception of, and attention to, those little and apparently trifling things, by which pleasure is given or pain occasioned to others. Indeed, it may be said that in self-sacrifice in the ordinary intercourse of life, mainly consists the difference between being well and ill bred. Without some degree of self-restraint in society a man may be found almost insufferable. No one has pleasure in holding intercourse with such a person, and he is a constant source of annoyance to those about him. 6. DISREGARD OF OTHERS.--Men may show their disregard to others in various impolite ways, as, for instance, by neglect of propriety in dress, by the absence of cleanliness, or by indulging in repulsive habits. The slovenly, dirty person, by rendering himself physically disagreeable, sets the tastes and feelings of others at defiance, and is rude and uncivil, only under another form. 7. THE BEST SCHOOL OF POLITENESS.--The first and best school of politeness, as of character, is always the home, where woman is the teacher. The manners of society at large are but the reflex of the manners of our collective homes, neither better nor worse. Yet, with all the disadvantages of ungenial homes, men may practice self-culture of manner as of intellect, and learn by good examples to cultivate a graceful and agreeable behavior towards others. Most men are like so many gems in the rough, which need polishing by contact with other and better natures, to bring out their full beauty and lustre. Some have but one side polished, sufficient only to show the delicate graining of the interior; but to bring out the full qualities of the gem, needs the discipline of experience, and contact with the best examples of character in the intercourse of daily life. 8. CAPTIOUSNESS OF MANNER.--While captiousness of manner, and the habit of disputing and contradicting every thing said, is chilling and repulsive, the opposite habit of assenting to, and sympathizing with, every statement made, or emotion expressed, is almost equally disagreeable. It is unmanly, and is felt to be dishonest. "It may seem difficult," says Richard Sharp, "to steer always between bluntness and plain dealing, between merited praises and lavishing indiscriminate flattery; but it is very easy--good humor, kindheartedness, and perfect simplicity, being all that are requisite to do what is right in the right way. At the same time many are impolite, not because they mean to be so, but because they are awkward, and perhaps know no better." 9. SHY PEOPLE.--Again many persons are thought to be stiff, reserved, and proud, when they are only shy. Shyness is characteristic of most people of the Teutonic race. From all that can be learned of Shakespeare, it is to be inferred that he was an exceedingly shy man. The manner in which his plays were sent into the world--for it is not known that he edited or authorized the publication of a single one of them,--and the dates at which they respectively appeared, are mere matters of conjecture. 10. SELF-FORGETFULNESS.--True politeness is best evinced by self-forgetfulness, or self-denial in the interest of others. Mr. Garfield, our martyred president, was a gentleman of royal type. His friend, Col. Rockwell, says of him: "In, the midst of his suffering he never forgets others. For instance, to-day he said to me, 'Rockwell, there is a poor soldier's widow who came to me before this thing occurred, and I promised her, she should be provided for. I want you to see that the matter is attended to at once.' He is the most docile patient I ever saw." 11. ITS BRIGHT SIDE.--We have thus far spoken of shyness as a defect. But there is another way of looking at it; for even shyness has its bright side, and contains an element of good. Shy men and shy races are ungraceful and undemonstrative, because, as regards society at large, they are comparatively unsociable. They do not possess those elegancies of manner acquired by free intercourse, which distinguish the social races, because their tendency is to shun society rather than to seek it. They are shy in the presence of strangers, and shy even in their own families. They hide their affections under a robe of reserve, and when they do give way to their feelings, it is only in some very hidden inner chamber. And yet, the feelings are there, and not the less healthy and genuine, though they are not made the subject of exhibition to others. 12. WORTHY OF CULTIVATION.--While, therefore, grace of manner, politeness of behavior, elegance of demeanor, and all the arts that contribute to make life pleasant and beautiful, are worthy of cultivation, it must not be at the expense of the more solid and enduring qualities of honesty, sincerity, and truthfulness. The fountain of beauty must be in the heart more than in the eye, and if it does not tend to produce beautiful life and noble practice, it will prove of comparatively little avail. Politeness of manner is not worth much, unless it is accompanied by polite actions. * * * * * INFLUENCE OF GOOD CHARACTER. "Unless above himself he can Erect himself, how poor a thing is man! --DANIEL. "Character is moral order seen through the medium of an individual nature--Men of character are the conscience of the society to which they belong." --EMERSON. The purest treasure mortal times afford, Is--spotless reputation; that away, Men are but gilded loam, or painted clay, A jewel in a ten-times-barr'd-up chest Is--a bold Spirit in a loyal breast. --SHAKESPEARE. 1. REPUTATION.--The two most precious things this side the grave are our reputation and our life. But it is to be lamented that the most contemptible whisper may deprive us of the one, and the weakest weapon of the other. A wise man, therefore, will be more anxious to deserve a fair name than to possess it, and this will teach him so to live, as not to be afraid to die. 2. CHARACTER.--Character is one of the greatest motive powers in the world. In its noblest embodiments, it exemplifies human nature in its highest forms, for it exhibits man at his best. 3. THE HEART THAT RULES IN LIFE.--Although genius always commands admiration, character most secures respect. The former is more the product of brain power, the latter of heart power; and in the long run it is the heart that rules in life. Men of genius stand to society in the relation of its intellect as men of character of its conscience: and while the former are admired, the latter are followed. 4. THE HIGHEST IDEAL OF LIFE AND CHARACTER.--Common-place though it may appear, this doing of one's duty embodies the highest ideal of life and character. There may be nothing heroic about it; but the common lot of men is not heroic. And though the abiding sense of duty upholds man in his highest attitudes, it also equally sustains him in the transaction of the ordinary affairs of every-day existence. Man's life is "centered in the sphere of common duties." The most influential of all the virtues are those which are the most in request for daily use. They wear the best, and last the longest. 5. WEALTH.--Wealth in the hands of men of weak purpose, or deficient self-control, or of ill regulated passions is only a temptation and a snare--the source, it may be, of infinite mischief to themselves, and often to others. On the contrary, a condition of comparative poverty is compatible with character in its highest form. A man may possess only his industry, his frugality, his integrity, and yet stand high in the rank of true manhood. The advice which Burns' father gave him was the best: "He bade me act a manly part, though I had ne'er a farthing, For without an honest, manly heart no man was worth regarding." 6. CHARACTER IS PROPERTY.--It is the noblest of possessions. It is an estate in the general good-will and respect of men; they who invest in it--though they may not become rich in this world's goods--will find their reward in esteem and reputation fairly and honorably won. And it is right that in life good qualities should tell--that industry, virtue, and goodness should rank the highest--and that the really best men should be foremost. 7. SIMPLE HONESTY OF PURPOSE.--This in a man goes a long way in life, if founded on a just estimate of himself and a steady obedience to the rule he knows and feels to be right. It holds a man straight, gives him strength and sustenance, and forms a mainspring of vigorous action. No man is bound to be rich or great--no, nor to be wise--but every man is bound to be honest and virtuous. [Illustration] [Illustration: HOME AMUSEMENTS.] * * * * * FAMILY GOVERNMENT. 1. GENTLENESS MUST CHARACTERIZE EVERY ACT OF AUTHORITY.--The storm of excitement that may make the child start, bears no relation to actual obedience. The inner firmness, that sees and feels a moral conviction and expects obedience, is only disguised and defeated by bluster. The more calm and direct it is, the greater certainty it has of dominion. 2. FOR THE GOVERNMENT OF SMALL CHILDREN.--For the government of small children speak only in the authority of love, yet authority, loving and to be obeyed. The most important lesson to impart is obedience to authority as authority. The question of salvation with most children will be settled as soon as they learn to obey parental authority. It establishes a habit and order of mind that is ready to accept divine authority. This precludes skepticism and disobedience, and induces that childlike trust and spirit set forth as a necessary state of salvation. Children that are never made to obey are left to drift into the sea of passion where the pressure for surrender only tends to drive them at greater speed from the haven of safety. 3. HABITS OF SELF-DENIAL.--Form in the child habits of self-denial. Pampering never matures good character. 4. EMPHASIZE INTEGRITY.--Keep the moral tissues tough in integrity; then it will hold a hook of obligations when once set in a sure place. There is nothing more vital. Shape all your experiments to preserve the integrity. Do not so reward it that it becomes mercenary. Turning State's evidence is a dangerous experiment in morals. Prevent deceit from succeeding. 5. GUARD MODESTY.--To be brazen is to imperil some of the best elements of character. Modesty may be strengthened into a becoming confidence, but brazen facedness can seldom be toned down into decency. It requires the miracle of grace. 6. PROTECT PURITY.--Teach your children to loathe impurity. Study the character of their playmates. Watch their books. Keep them from corruption at all cost. The groups of youth in the school and in society, and in business places, seed with improprieties of word and thought. Never relax your vigilance along this exposed border. [Illustration: BOTH PUZZLED.] 7. THREATEN THE LEAST POSSIBLE.--In family government threaten the least possible. Some parents rattle off their commands with penalties so profusely that there is a steady roar of hostilities about the child's head. These threats are forgotten by the parent and unheeded by the child. All government is at an end. 8. DO NOT ENFORCE TOO MANY COMMANDS.--Leave a few things within the range of the child's knowledge that are not forbidden. Keep your word good, but do not have too much of it out to be redeemed. 9. PUNISH AS LITTLE AS POSSIBLE.--Sometimes punishment is necessary, but the less it is resorted to the better. 10. NEVER PUNISH IN A PASSION.--Wrath only becomes cruelty. There is no moral power in it. When you seem to be angry you can do no good. 11. BRUTISH VIOLENCE ONLY MULTIPLIES OFFENDERS.--Striking and beating the body seldom reaches the soul. Fear and hatred beget rebellion. 12. PUNISH PRIVATELY.--Avoid punishments that break down self-respect. Striking the body produces shame and indignation. It is enough for the other children to know that discipline is being administered. 13. NEVER STOP SHORT OF SUCCESS.--When the child is not conquered the punishment has been worse than wasted. Reach the point where neither wrath nor sullenness remain. By firm persistency and persuasion require an open look of recognition and peace. It is only evil to stir up the devil unless he is cast out. Ordinarily one complete victory will last a child for a lifetime. But if the child relapses, repeat the dose with proper accompaniments. 14. DO NOT REQUIRE CHILDREN TO COMPLAIN OF THEMSELVES FOR PARDON.--It begets either sycophants or liars. It is the part of the government to detect offences. It reverses the order of matters to shirk this duty. 15. GRADE AUTHORITY UP TO LIBERTY.--The growing child must have experiments of freedom. Lead him gently into the family. Counsel with him. Let him plan as he can. By and by he has the confidence of courage without the danger of exposures. 16. RESPECT.--Parents must respect each other. Undermining either undermines both. Always govern in the spirit of love. [Illustration] [Illustration] * * * * * CONVERSATION. Some men are very entertaining for a first interview, but after that they are exhausted, and run out; on a second meeting we shall find them very flat and monotonous; like hand-organs, we have heard all their tunes.--COULTON. He who sedulously attends, pointedly asks, calmly speaks, coolly answers, and ceases when he has no more to say, is in possession of some of the best requisites of man.--LAVATER. Beauty is never so lovely as when adorned with the smile, and conversation never sits easier upon us than when we know and then discharge ourselves in a symphony of Laughter, which may not improperly be called the Chorus of Conversation.--STEELE. The first ingredient in Conversation is Truth, the next Good Sense, the third Good Humor, and the fourth Wit.--SIR WILLIAM TEMPLE. HOME LESSONS IN CONVERSATION. Say nothing unpleasant when it can be avoided. Avoid satire and sarcasm. Never repeat a word that was not intended for repetition. Cultivate the supreme wisdom, which consists less in saying what ought to be said than in not saying what ought not to be said. Often cultivate "flashes of silence." It is the larger half of the conversation to listen well. Listen to others patiently, especially the poor. Sharp sayings are an evidence of low breeding. Shun faultfindings and faultfinders. Never utter an uncomplimentary word against anyone. Compliments delicately hinted and sincerely intended are a grace in conversation. Commendation of gifts and cleverness properly put are in good taste, but praise of beauty is offensive. Repeating kind expressions is proper. Compliments given in a joke may be gratefully received in earnest. The manner and tone are important parts of a compliment. Avoid egotism. Don't talk of yourself, or of your friends or your deeds. Give no sign that you appreciate your own merits. Do not become a distributer of the small talk of a community. The smiles of your auditors do not mean respect. Avoid giving the impression of one filled with "suppressed egotism." Never mention your own peculiarities; for culture destroys vanity. Avoid exaggeration. Do not be too positive. Do not talk of display oratory. Do not try to lead in conversation looking around to enforce silence. Lay aside affected, silly etiquette for the natural dictates of the heart. Direct the conversation where others can join with you and impart to you useful information. Avoid oddity. Eccentricity is shallow vanity. Be modest. Be what you wish to seem. Avoid repeating a brilliant or clever saying. [Illustration: THINKING ONLY OF DRESS.] If you find bashfulness or embarrassment coming upon you, do or say something at once. The commonest matter gently stated is better than an embarrassing silence. Sometimes changing your position, or looking into a book for a moment may relieve your embarrassment, and dispel any settling stiffness. Avoid telling many stories, or repeating a story more than once in the same company. Never treat any one as if you simply wanted him to tell stories. People laugh and despise such a one. Never tell a coarse story. No wit or preface can make it excusable. Tell a story, if at all, only as an illustration, and not for itself. Tell it accurately. Be careful in asking questions for the purpose of starting conversation or drawing out a person, not to be rude or intrusive. Never take liberties by staring, or by any rudeness. Never infringe upon any established regulations among strangers. Do not always prove yourself to be the one in the right. The right will appear. You need only give it a chance. Avoid argument in conversation. It is discourteous to your host. Cultivate paradoxes in conversation with your peers. They add interest to common-place matters. To strike the harmless faith of ordinary people in any public idol is waste, but such a movement with those able to reply is better. Never discourse upon your ailments. Never use words of the meaning or pronunciation of which you are uncertain. Avoid discussing your own or other people's domestic concerns. Never prompt a slow speaker, as if you had all the ability. In conversing with a foreigner who may be learning our language, it is excusable to help him in some delicate way. Never give advice unasked. Do not manifest impatience. Do not interrupt another when speaking. Do not find fault, though you may gently criticise. Do not appear to notice inaccuracies of speech in others. Do not always commence a conversation by allusion to the weather. Do not, when narrating an incident, continually say, "you see," "you know." Do not allow yourself to lose temper or speak excitedly. Do not introduce professional or other topics that the company generally cannot take an interest in. Do not talk very loud. A firm, clear, distinct, yet mild, gentle, and musical voice has great power. Do not be absent-minded, requiring the speaker to repeat what has been said that you may understand. Do not try to force yourself into the confidence of others. Do not use profanity, vulgar terms, words of double meaning, or language that will bring the blush to anyone. Do not allow yourself to speak ill of the absent one if it can be avoided. The day may come when some friend will be needed to defend you in your absence. Do not speak with contempt and ridicule of a locality which you may be visiting. Find something to truthfully praise and commend; thus make yourself agreeable. Do not make a pretense of gentility, nor parade the fact that you are a descendant of any notable family. You must pass for just what you are, and must stand on your own merit. Do not contradict. In making a correction say, "I beg your pardon, but I had the impression that it was so and so." Be careful in contradicting, as you may be wrong yourself. Do not be unduly familiar; you will merit contempt if you are. Neither should you be dogmatic in your assertions, arrogating to yourself such consequences in your opinions. Do not be too lavish in your praise of various members of your own family when speaking to strangers; the person to whom you are speaking may know some faults that you do not. Do not feel it incumbent upon yourself to carry your point in conversation. Should the person with whom you are conversing feel the same, your talk may lead into violent argument. Do not try to pry into the private affairs of others by asking what their profits are, what things cost, whether Melissa ever had a beau, and why Amarette never got married? All such questions are extremely impertinent and are likely to meet with rebuke. Do not whisper in company; do not engage in private conversation; do not speak a foreign language which the general company present may not understand, unless it is understood that the foreigner is unable to speak your own language. [Illustration: WIDOWER JONES AND WIDOW SMITH.] * * * * * THE TOILET. OR The Care of the Person. IMPORTANT RULES. 1. GOOD APPEARANCE.--The first care of all persons should be for their personal appearance. Those who are slovenly or careless in their habits are unfit for refined society, and cannot possibly make a good appearance in it. A well-bred person will always cultivate habits of the most scrupulous neatness. A gentleman or lady is always well dressed. The garment may be plain or of coarse material, or even worn "thin and shiny," but if it is carefully brushed and neat, it can be worn with dignity. 2. PERSONAL CLEANLINESS.--Personal appearance depends greatly on the careful toilet and scrupulous attention to dress. The first point which marks the gentleman or lady in appearance is rigid cleanliness. This remark supplies to the body and everything which covers it. A clean skin--only to be secured by frequent baths--is indispensable. 3. THE TEETH.--The teeth should receive the utmost attention. Many a young man has been disgusted with a lady by seeing her unclean and discolored teeth. It takes but a few moments, and if necessary secure some simple tooth powder or rub the teeth thoroughly every day with a linen handkerchief, and it will give the teeth and mouth a beautiful and clean appearance. 4. THE HAIR AND BEARD.--The hair should be thoroughly brushed and well kept, and the beard of men properly trimmed. Men should not let their hair grow long and shaggy. 5. UNDERCLOTHING.--The matter of cleanliness extends to all articles of clothing, underwear as well as the outer clothing. Cleanliness is a mark of true utility. The clothes need not necessarily be of a rich and expensive quality, but they can all be kept clean. Some persons have an odor about them that is very offensive, simply on account of their underclothing being worn too long without washing. This odor of course cannot be detected by the person who wears the soiled garments, but other persons easily detect it and are offended by it. 6. THE BATH.--No person should think for a moment that they can be popular in society without regular bathing. A bath should be taken at least once a week, and if the feet perspire they should be washed several times a week, as the case may require. It is not unfrequent that young men are seen with dirty ears and neck. This is unpardonable and boorish, and shows gross neglect. Occasionally a young lady will be called upon unexpectedly when her neck and smiling face are not emblems of cleanliness. Every lady owes it to herself to be fascinating; every gentleman is bound, for his own sake, to be presentable; but beyond this there is the obligation to society, to one's friends, and to those with whom we may be brought in contact. 7. SOILED GARMENTS.--A young man's garments may not be expensive, yet there is no excuse for wearing a soiled collar and a soiled shirt, or carrying a soiled handkerchief. No one should appear as though he had slept in a stable, shaggy hair, soiled clothing or garments indifferently put on and carelessly buttoned. A young man's vest should always be kept buttoned in the presence of ladies. 8. THE BREATH.--Care should be taken to remedy an offensive breath without delay. Nothing renders one so unpleasant to one's acquaintance, or is such a source of misery to one's self. The evil may be from some derangement of the stomach or some defective condition of the teeth, or catarrhal affection of the throat and nose. See remedies in other portions of the book. * * * * * A YOUNG MAN'S PERSONAL APPEARANCE. Dress changes the manners.--VOLTAIRE. Whose garments wither, shall receive faded smiles.--SHERIDAN KNOWLES. Men of sense follow fashion so far that they are neither conspicuous for their excess nor peculiar by their opposition to it.--ANONYMOUS. 1. A well-dressed man does not require so much an extensive as a varied wardrobe. He does not need a different suit for every season and every occasion, but if he is careful to select clothes that are simple and not striking or conspicuous, he may use the garment over and over again without their being noticed, provided they are suitable to the season and the occasion. 2. A clean shirt, collar and cuffs always make a young man look neat and tidy, even if his clothes are not of the latest pattern and are somewhat threadbare. 3. Propriety is outraged when a man of sixty dresses like a youth or sixteen. It is bad manners for a gentleman to use perfumes to a noticeable extent. Avoid affecting singularity in dress. Expensive clothes are no sign of a gentleman. 4. When dressed for company, strive to appear easy and natural. Nothing is more distressing to a sensitive person, or more ridiculous to one gifted with refinement, than to see a lady laboring under the consciousness of a fine gown or a gentleman who is stiff, awkward and ungainly in a brand-new coat. 5. Avoid what is called the "ruffianly style of dress" or the slouchy appearance of a half-unbottoned vest, and suspenderless pantaloons. That sort of affectation is, if possible, even more disgusting than the painfully elaborate frippery of the dandy or dude. Keep your clothes well brushed and keep them cleaned. Slight spots can be removed with a little sponge and soap and water. 6. A gentleman should never wear a high hat unless he has on a frock coat or a dress suit. 7. A man's jewelry should be good and simple. Brass or false jewelry, like other forms of falsehood, is vulgar. Wearing many cheap decorations is a serious fault. [Illustration: THE DUDE OF THE 17TH CENTURY.] 8. If a man wears a ring it should be on the third finger of the left hand. This is the only piece of jewelry a man is allowed to wear that does not serve a purpose. 9. Wearing imitations of diamonds is always in very bad taste. 10. Every man looks better in a full beard if he keeps it well trimmed. If a man shaves he should shave at least every other day, unless he is in the country. 11. The finger-nails should be kept cut, and the teeth should be cleaned every morning, and kept clear from tarter. A man who does not keep his teeth clean does not look like a gentleman when he shows them. [Illustration] * * * * * DRESS. We sacrifice to dress, till household joys And comforts cease. Dress drains our cellar dry, And keeps our larder lean. Puts out our fires, And introduces hunger, frost and woe, Where peace and hospitality might reign. --COWPER 1. GOD IS A LOVER OF DRESS.--We cannot but feel that God is a lover of dress. He has put on robes of beauty and glory upon all his works. Every flower is dressed in richness; every field blushes beneath a mantle of beauty; every star is veiled in brightness; every bird is clothed in the habiliments of the most exquisite taste. The cattle upon the thousand hills are dressed by the hand divine. Who, studying God in his works, can doubt, that he will smile upon the evidence of correct taste manifested by his children in clothing the forms he has made them? 2. LOVE OF DRESS.--To love dress is not to be a slave of fashion; to love dress only is the test of such homage. To transact the business of charity in a silken dress, and to go in a carriage to the work, injures neither the work nor the worker. The slave of fashion is one who assumes the livery of a princess, and then omits the errand of the good human soul; dresses in elegance, and goes upon no good errand, and thinks and does nothing of value to mankind. 3. BEAUTY IN DRESS.--Beauty in dress is a good thing, rail at it who may. But it is a lower beauty, for which a higher beauty should not be sacrificed. They love dresses too much who give it their first thought, their best time, or all their money; who for it neglect the culture of their mind or heart, or the claims of others on their service; who care more for their dress than their disposition; who are troubled more by an unfashionable bonnet than a neglected duty. 4. SIMPLICITY OF DRESS.--Female lovliness never appears to so good advantage as when set off by simplicity of dress. No artist ever decks his angels with towering feathers and gaudy jewelry; and our dear human angels--if they would make good their title to that name--should carefully avoid ornaments, which properly belong to Indian squaws and African princesses. These tinselries may serve to give effect on the stage, or upon the ball room floor, but in daily life there is no substitute for the charm of simplicity. A vulgar taste is not to be disguised by gold or diamonds. The absence of a true taste and refinement of delicacy cannot be compensated for by the possession of the most princely fortune. Mind measures gold, but gold cannot measure mind. Through dress the mind may be read, as through the delicate tissue the lettered page. A modest woman will dress modestly; a really refined and intelligent woman will bear the marks of careful selection and faultless taste. 5. PEOPLE OF SENSE.--A coat that has the mark of use upon it, is a recommendation to the people of sense, and a hat with too much nap, and too high lustre, a derogatory circumstance. The best coats in our streets are worn on the backs of penniless fops, broken down merchants, clerks with pitiful salaries, and men that do not pay up. The heaviest gold chains dangle from the fobs of gamblers and gentlemen of very limited means; costly ornaments on ladies, indicate to the eyes that are well opened, the fact of a silly lover or husband cramped for funds. 6. PLAIN AND NEAT.--When a pretty woman goes by in plain and neat apparel, it is the presumption that she has fair expectations, and a husband that can show a balance in his favor. For women are like books,--too much gilding makes men suspicious, that the binding is the most important part. The body is the shell of the soul, and the dress is the husk of the body; but the husk generally tells what the kernel is. As a fashionably dressed young lady passed some gentlemen, one of them raised his hat, whereupon another, struck by the fine appearance of the lady, made some inquiries concerning her, and was answered thus: "She makes a pretty ornament in her father's house, but otherwise is of no use." 7. THE RICHEST DRESS.--The richest dress is always worn on the soul. The adornments that will not perish, and that all men most admire, shine from the heart through this life. God has made it our highest, holiest duty, to dress the souls he has given us. It is wicked to waste it in frivolity. It is a beautiful, undying, precious thing. If every young woman would think of her soul when she looks in the glass, would hear the cry of her naked mind when she dallies away her precious hours at her toilet, would listen to the sad moaning of her hollow heart, as it wails through her idle, useless life, something would be done for the elevation of womanhood. 8. DRESSING UP.--Compare a well-dressed body with a well-dressed mind. Compare a taste for dress with a taste for knowledge, culture, virtue, and piety. Dress up an ignorant young woman in the "height of fashion"; put on plumes and flowers, diamonds and gewgaws; paint her face, girt up her waist, and I ask you, if this side of a painted and feathered savage you can find anything more unpleasant to behold. And yet such young women we meet by the hundred every day on the street and in all our public places. It is awful to think of. 9. DRESS AFFECTS OUR MANNERS.--A man who is badly dressed, feels chilly, sweaty, and prickly. He stammers, and does not always tell the truth. He means to, perhaps, but he can't. He is half distracted about his pantaloons, which are much to short, and are constantly hitching up; or his frayed jacket and crumpled linen harrow his soul, and quite unman him. He treads on the train of a lady's dress, and says, "Thank you", sits down on his hat, and wishes the "desert were his dwelling place." [Illustration] * * * * * BEAUTY. "She walks in beauty, like the night Of cloudless climes and starry skies: And all that's best of dark and bright Meet her in aspect and in her eyes; Thus mellowed to that tender light Which heaven to gaudy day denies." --BYRON. 1. THE HIGHEST STYLE OF BEAUTY.--The highest style of beauty to be found in nature pertains to the human form, as animated and lighted up by the intelligence within. It is the expression of the soul that constitutes this superior beauty. It is that which looks out of the eye, which sits in calm majesty on the brow, lurks on the lip, smiles on the cheek, is set forth in the chiselled lines and features of the countenance, in the general contour of figure and form, in the movement, and gesture, and tone; it is this looking out of the invisible spirit that dwells within, this manifestation of the higher nature, that we admire and love; this constitutes to us the beauty of our species. 2. BEAUTY WHICH PERISHES NOT.--There is a beauty which perishes not. It is such as the angels wear. It forms the washed white robes of the saints. It wreathes the countenance of every doer of good. It adorns every honest face. It shines in the virtuous life. It molds the hands of charity. It sweetens the voice of sympathy. It sparkles on the brow of wisdom. It flashes in the eye of love. It breathes in the spirit of piety. It is the beauty of the heaven of heavens. It is that which may grow by the hand of culture in every human soul. It is the flower of the spirit which blossoms on the tree of life. Every soul may plant and nurture it in its own garden, in its own Eden. 3. WE MAY ALL BE BEAUTIFUL.--This is the capacity of beauty that God has given to the human soul, and this the beauty placed within the reach of all. We may all be beautiful. Though our forms may be uncomely and our features not the prettiest, our spirits may be beautiful. And this inward beauty always shines through. A beautiful heart will flash out in the eye. A lovely soul will glow in the face. A sweet spirit will tune the voice, wreathe the countenance in charms. Oh, there is a power in interior beauty that melts the hardest heart! 4. WOMAN THE MOST PERFECT TYPE OF BEAUTY.--Woman, by common consent, we regard as the most perfect type of beauty on earth. To her we ascribe the highest charms belonging to this wonderful element so profusely mingled in all God's works. Her form is molded and finished in exquisite delicacy of perfection. The earth gives us no form more perfect, no features more symmetrical, no style more chaste, no movements more graceful, no finish more complete; so that our artists ever have and ever will regard the woman-form of humanity as the most perfect earthly type of beauty. This form is most perfect and symmetrical in the youth of womanhood; so that the youthful woman is earth's queen of beauty. This is true, not only by the common consent of mankind, but also by the strictest rules of scientific criticism. 5. FADELESS BEAUTY.--There cannot be a picture without its bright spots; and the steady contemplation of what is bright in others, has a reflex influence upon the beholder. It reproduces what it reflects. Nay, it seems to leave an impress even upon the countenance. The feature, from having a dark, sinister aspect, becomes open, serene, and sunny. A countenance so impressed, has neither the vacant stare of the idiot, nor the crafty, penetrating look of the basilisk, but the clear, placid aspect of truth and goodness. The woman who has such a face is beautiful. She has a beauty which changes not with the features, which fades not with years. It is beauty of expression. It is the only kind of beauty which can be relied upon for a permanent influence with the other sex. The violet will soon cease to smile. Flowers must fade. The love that has nothing but beauty to sustain it, soon withers away. [Illustration: HAND IN HAND.] 6. A PRETTY WOMAN PLEASES THE EYE, a good woman, the heart. The one is a jewel, the other a treasure. Invincible fidelity, good humor, and complacency of temper, outlive all the charms of a fine face, and make the decay of it invisible. That is true beauty which has not only a substance, but a spirit; a beauty that we must intimately know to justly appreciate. 7. THE WOMAN YOU LOVE BEST.--Beauty, dear reader, is probably the woman you love best, but we trust it is the beauty of soul and character, which sits in calm majesty on the brow, lurks on the lip, and will outlive what is called a fine face. 8. THE WEARING OF ORNAMENTS.--Beauty needs not the foreign aid of ornament, but is when unadorned adorned the most, is a trite observation; but with a little qualification it is worthy of general acceptance. Aside from the dress itself, ornaments should be very sparingly used--at any rate, the danger lies in over-loading oneself, and not in using too few. A young girl, and especially one of a light and airy style of beauty, should never wear gems. A simple flower in her hair or on her bosom is all that good taste will permit. When jewels or other ornaments are worn, they should be placed where you desire the eye of the spectator to rest, leaving the parts to which you do not want attention called as plain and negative as possible. There is no surer sign of vulgarity than a profusion of heavy jewelry carried about upon the person. [Illustration] [Illustration] * * * * * SENSIBLE HELPS TO BEAUTY. 1. FOR SCRAWNY NECK.--Take off your tight collars, feather boas and such heating things. Wash neck and chest with hot water, then rub in sweet oil all that you can work in. Apply this every night before you retire and leave the skin damp with it while you sleep. 2. FOR RED HANDS.--Keep your feet warm by soaking them often in hot water, and keep your hands out of the water as much as possible. Rub your hands with the skin of a lemon and it will whiten them. If your skin will bear glycerine after you have washed, pour into the palm a little glycerine and lemon juice mixed, and rub over the hands and wipe off. 3. NECK AND FACE.--Do not bathe the neck and face just before or after being out of doors. It tends to wrinkle the skin. 4. SCOWLS.--Never allow yourself to scowl, even if the sun be in your eyes. That scowl will soon leave its trace and no beauty will outlive it. 5. WRINKLED FOREHEAD.--If you wrinkle your forehead when you talk or read, visit an oculist and have your eyes tested, and then wear glasses to fit them. 6. OLD LOOKS.--Sometimes your face looks old because it is tired. Then apply the following wash and it will make you look younger: Put three drops of ammonia, a little borax, a tablespoonful of bay rum, and a few drops of camphor into warm water and apply to your face. Avoid getting it into your eyes. 7. THE BEST COSMETIC.--Squeeze the juice of a lemon into a pint of sweet milk. Wash the face with it every night and in the morning wash off with warm rain water. This will produce a very beautiful effect upon the skin. 8. SPOTS ON THE FACE.--Moles and many other discolorations may be removed from the face by a preparation composed of one part chemically pure carbolic acid and two parts pure glycerine. Touch the spots with a camel's-hair pencil, being careful that the preparation does not come in contact with the adjacent skin. Five minutes after touching, bathe with soft water and apply a little vaseline. It may be necessary to repeat the operation, but if persisted in, the blemishes will be entirely removed. 9. WRINKLES.--This prescription is said to cure wrinkles: Take one ounce of white wax and melt it to a gentle heat. Add two ounces of the juice of lily bulbs, two ounces of honey, two drams of rose water, and a drop or two of ottar of roses. Apply twice a day, rubbing the wrinkles the wrong way. Always use tepid water for washing the face. 10. THE HAIR.--The hair must be kept free from dust or it will fall out. One of the best things for cleaning it, is a raw egg rubbed into the roots and then washed out in several waters. The egg furnishes material for the hair to grow on, while keeping the scalp perfectly clean. Apply once a month. 11. LOSS OF HAIR.--When through sickness or headache the hair falls out, the following tonic may be applied with good effect: Use one ounce of glycerine, one ounce of bay rum, one pint of strong sage tea, and apply every other night rubbing well into the scalp. * * * * * HOW TO KEEP THE BLOOM AND GRACE OF YOUTH. THE SECRET OF ITS PRESERVATION. [Illustration: MRS. WM. McKINLEY.] 1. The question most often asked by women is regarding the art of retaining, with advancing years, the bloom and grace of youth. This secret is not learned through the analysis of chemical compounds, but by a thorough study of nature's laws peculiar to their sex. It is useless for women with wrinkled faces, dimmed eyes and blemished skins to seek for external applications of beautifying balms and lotions to bring the glow of life and health into the face, and yet there are truths, simple yet wonderful, whereby the bloom of early life can be restored and retained, as should be the heritage of all God's children, sending the light of beauty into every woman's face. The secret: 2. Do not bathe in hard water; soften it with a few drops of ammonia, or a little borax. 3. Do not bathe the face while it is very warm, and never use very cold water. 4. Do not attempt to remove dust with cold water; give your face a hot bath, using plenty of good soap, then give it a thorough rinsing with warm water. 5. Do not rub your face with a coarse towel. 6. Do not believe you can remove wrinkles by filling in the crevices with powder. Give your face a Russian bath every night; that is, bathe it with water so hot that you wonder how you can bear it, and then, a minute after, with moderately cold water, that will make your face glow with warmth; dry it with a soft towel. [Illustration: MALE. FEMALE. Showing the Difference in Form and Proportion.] * * * * * FORM AND DEFORMITY. 1. PHYSICAL DEFORMITIES.--Masquerading is a modern accomplishment. Girls wear tight shoes, burdensome skirts, corsets, etc., all of which prove so fatal to their health. At the age of seventeen or eighteen, our "young ladies" are sorry specimens of feminality; and palpitators, cosmetics and all the modern paraphernalia are required to make them appear fresh and blooming. Man is equally at fault. A devotee to all the absurd devices of fashion, he practically asserts that "dress makes the man." But physical deformities are of far less importance than moral imperfections. 2. DEVELOPMENT OF THE INDIVIDUAL.--It is not possible for human beings to attain their full stature of humanity, except by loving long and perfectly. Behold that venerable man! he is mature in judgment, perfect in every action and expression, and saintly in goodness. You almost worship as you behold. What rendered him thus perfect? What rounded off his natural asperities, and moulded up his virtues? Love mainly. It permeated every pore, and seasoned every fibre of his being, as could nothing else. Mark that matronly woman. In the bosom of her family she is more than a queen and goddess combined. All her looks and actions express the outflowing of some or all of the human virtues. To know her is to love her. She became thus perfect, not in a day or year, but by a long series of appropriate means. Then by what? Chiefly in and by love, which is specially adapted thus to develop this maturity. 3. PHYSICAL STATURE.--Men and women generally increase in stature until the twenty-fifth year, and it is safe to assume, that perfection of function is not established until maturity of bodily development is completed. The physical contour of these representations plainly exhibits the difference in structure, and also implies difference of function. Solidity and strength are represented by the organization of the male, grace and beauty by that of the female. His broad shoulders represent physical power and the right of dominion, while her bosom is the symbol of love and nutrition. * * * * * HOW TO DETERMINE A PERFECT HUMAN FIGURE. The proportions of the perfect human figure are strictly mathematical. The whole figure is six times the length of the foot. Whether the form be slender or plump, this rule holds good. Any deviation from it is a departure from the highest beauty of proportion. The Greeks made all their statues according to this rule. The face, from the highest point of the forehead, where the hair begins, to the end of the chin, is one-tenth of the whole stature. The hand, from the wrist to the end of the middle finger, is the same. The chest is a fourth, and from the nipples to the top of the head is the same. From the top of the chest to the highest point of the forehead is a seventh. If the length of the face, from the roots of the hair to the chin, be divided into three equal parts, the first division determines the point where the eyebrows meet, and the second the place of the nostrils. The navel is the central point of the human body, and if a man should lie on his back with his arms and legs extended, the periphery of the circle which might be described around him, with the navel for its center, would touch the extremities of his hands and feet. The height from the feet to the top of the head is the same as the distance from the extremity of one hand to the extremity of the other when the arms are extended. [Illustration: Lady's Dress in the days of Greece.] The Venus de Medici is considered the most perfect model of the female forms, and has been the admiration of the world for ages. Alexander Walker, after minutely describing this celebrated statue, says: "All these admirable characteristics of the female form, the mere existence of which in woman must, one is tempted to imagine, be even to herself, a source of ineffable pleasure, these constitute a being worthy, as the personification of beauty, of occupying the temples of Greece; present an object finer, alas, than Nature even seems capable of producing; and offer to all nations and ages a theme of admiration and delight." Well might Thomson say: So stands the statue that enchants the world, So, bending, tries to vail the matchless boast-- The mingled beauties of exulting Greece. We beg our readers to observe the form of the waist (evidently innocent of corsets and tight dresses) of this model woman, and also that of the Greek Slave in the accompanying outlines. These forms are such as unperverted nature and the highest art alike require. To compress the waist, and thereby change its form, pushing the ribs inward, displacing the vital organs, and preventing the due expansion of the lungs, is as destructive to beauty as it is to health. * * * * * THE HISTORY, MYSTERY, BENEFITS AND INJURIES OF THE CORSET. [Illustration: The Corset in the 18th Century.] 1. The origin of the corset is lost in remote antiquity. The figures of the early Egyptian women show clearly an artificial shape of the waist produced by some style of corset. A similar style of dress must also have prevailed among the ancient Jewish maidens; for Isaiah, in calling upon the women to put away their personal adornments, says: "Instead of a girdle there shall be a rent, and instead of a stomacher (corset) a girdle of sackcloth." 2. Homer also tells us of the cestus or girdle of Venus, which was borrowed by the haughty Juno with a view to increasing her personal attractions, that Jupiter might be a more tractable and orderly husband. 3. Coming down to the later times, we find the corset was used in France and England as early as the 12th century. 4. The most extensive and extreme use of the corset occurred in the 16th century, during the reign of Catherine de Medici of France and Queen Elizabeth of England. With Catherine de Medici a thirteen-inch waist measurement was considered the standard of fashion, while a thick waist was an abomination. No lady could consider her figure of proper shape unless she could span her waist with her two hands. To produce this result a strong rigid corset was worn night and day until the waist was laced down to the required size. Then over this corset was placed the steel apparatus shown in the illustration on next page. This corset-cover reached from the hip to the throat, and produced a rigid figure over which the dress would fit with perfect smoothness. [Illustration: Steel Corset worn in Catherine's time.] 5. During the 18th century corsets were largely made from a species of leather known as "Bend," which was not unlike that used for shoe soles, and measured nearly a quarter of an inch in thickness. One of the most popular corsets of the time was the corset and stomacher shown in the accompanying illustration. 6. About the time of the French Revolution a reaction set in against tight lacing, and for a time there was a return to the early classical Greek costume. This style of dress prevailed, with various modifications, until about 1810 when corsets and tight lacing again returned with threefold fury. Buchan, a prominent writer of this period, says that it was by no means uncommon to see "a mother lay her daughter down upon the carpet, and, placing her foot upon her back, break half a dozen laces in tightening her stays." 7. It is reserved to our own time to demonstrate that corsets and tight lacing do not necessarily go hand in hand. Distortion and feebleness are not beauty. A proper proportion should exist between the size of the waist and the breadth of the shoulders and hips, and if the waist is diminished below this proportion, it suggests disproportion and invalidism rather than grace and beauty. 8. The perfect corset is one which possesses just that degree of rigidity which will prevent it from wrinkling, but will at the same time allow freedom in the bending and twisting of the body. Corsets boned with whalebone, horn or steel are necessarily stiff, rigid and uncomfortable. After a few days' wear the bones or steels become bent and set in position, or, as more frequently happens, they break and cause injury or discomfort to the wearer. 9. About seven years ago an article was discovered for the stiffening of corsets, which has revolutionized the corset industry of the world. This article is manufactured from the natural fibers of the Mexican Ixtle plant, and is known as Coraline. It consists of straight, stiff fibers like bristles bound together into a cord by being wound with two strands of thread passing in opposite directions. This produces an elastic fiber intermediate in stiffness between twine and whalebone. It cannot break, but it possesses all the stiffness and flexibility necessary to hold the corset in shape and prevent its wrinkling. We congratulate the ladies of to-day upon the advantages they enjoy over their sisters of two centuries ago, in the forms and the graceful and easy curves of the corsets now made as compared with those of former times. [Illustration] [Illustration: Forms of Corsets in the time of Elizabeth of England.] [Illustration: EGYPTIAN CORSET.] * * * * * TIGHT-LACING. It destroys natural beauty and creates an unpleasant and irritable temper. A tight-laced chest and a good disposition cannot go together. The human form has been molded by nature, the best shape is undoubtedly that which she has given it. To endeavor to render it more elegant by artificial means is to change it; to make it much smaller below and much larger above is to destroy its beauty; to keep it cased up in a kind of domestic cuirass is not only to deform it, but to expose the internal parts to serious injury. Under such compression as is commonly practiced by ladies, the development of the bones, which are still tender, does not take place conformably to the intention of nature, because nutrition is necessarily stopped, and they consequently become twisted and deformed. [Illustration: THE NATURAL WAIST. THE EFFECTS OF LACING.] Those who wear these appliances of tight-lacing often complain that they cannot sit upright without them--are sometimes, indeed, compelled to wear them during all the twenty-four hours; a fact which proves to what extent such articles weaken the muscles of the trunk. The injury does not fall merely on the internal structure of the body, but also on its beauty, and on the temper and feelings with which that beauty is associated. Beauty is in reality but another name for expression of countenance, which is the index of sound health, intelligence, good feelings and peace of mind. All are aware that uneasy feelings, existing habitually in the breast, speedily exhibit their signature on the countenance, and that bitter thoughts or a bad temper spoil the human expression of its comeliness and grace. [Illustration: NATURAL HAIR.] * * * * * THE CARE OF THE HAIR. 1. THE COLOR OF THE HAIR.--The color of the hair corresponds with that of the skin--being dark or black, with a dark complexion, and red or yellow with a fair skin. When a white skin is seen in conjunction with black hair, as among the women of Syria and Barbary, the apparent exception arises from protection from the sun's rays, and opposite colors are often found among people of one prevailing feature. Thus red-haired Jews are not uncommon, though the nation in general have dark complexion and hair. 2. THE IMPERISHABLE NATURE OF HAIR.--The imperishable nature of hair arises from the combination of salt and metals in its composition. In old tombs and on mummies it has been found in a perfect state, after a lapse of over two thousand years. There are many curious accounts proving the indestructibility of the human hair. 3. TUBULAR.--In the human family the hairs are tubular, the tubes being intersected by partitions, resembling in some degree the cellular tissue of plants. Their hollowness prevents incumbrance from weight, while their power of resistance is increased by having their traverse sections rounded in form. 4. CAUTIONS.--It is ascertained that a full head of hair, beard and whiskers, are a prevention against colds and consumptions. Occasionally, however, it is found necessary to remove the hair from the head, in cases of fever or disease, to stay the inflammatory symptoms, and to relieve the brain. The head should invariably be kept cool. Close night-caps are unhealthy, and smoking-caps and coverings for the head within doors are alike detrimental to the free growth of the hair, weakening it, and causing it to fall out. HOW TO BEAUTIFY AND PRESERVE THE HAIR. 1. TO BEAUTIFY THE HAIR.--Keep the head clean, the pores of the skin open, and the whole circulatory system in a healthy condition, and you will have no need of bear's grease (alias hog's lard). Where there is a tendency in the hair to fall off on account of the weakness or sluggishness of the circulation, or an unhealthy state of the skin, cold water and friction with a tolerably stiff brush are probably the best remedial agents. 2. BARBER'S SHAMPOOS.--Are very beneficial if properly prepared. They should not be made too strong. Avoid strong shampoos of any kind. Great caution should be exercised in this matter. 3. CARE OF THE HAIR.--To keep the hair healthy, keep the head clean. Brush the scalp well with a stiff brush, while dry. Then wash with castile soap, and rub into the roots bay rum, brandy or camphor water. This done twice a month will prove beneficial. Brush the scalp thoroughly twice a week. Dampen the hair with soft water at the toilet, and do not use oil. 4. HAIR WASH.--Take one ounce of borax, half an ounce of camphor powder--these ingredients fine--and dissolve them in one quart of boiling water. When cool, the solution will be ready for use. Dampen the hair frequently. This wash is said not only to cleanse and beautify, but to strengthen the hair, preserve the color and prevent baldness. ANOTHER EXCELLENT WASH.--The best wash we know for cleansing and softening the hair is an egg beaten up and rubbed well into the hair, and afterwards washed out with several washes of warm water. 5. THE ONLY SENSIBLE AND SAFE HAIR OIL.--The following is considered a most valuable preparation: Take of extract of yellow Peruvian bark, fifteen grains; extract of rhatany root, eight grains; extract of burdoch root and oil of nutmegs (fixed), of each two drachms; camphor (dissolve with spirits of wine), fifteen grains; beef marrow, two ounces; best olive oil, one ounce; citron juice, half a drachm; aromatic essential oil, as much as sufficient to render it fragrant; mix and make into an ointment. Two drachms of bergamot, and a few drops of attar of roses would suffice. 6. HAIR WASH.--A good hair wash is soap and water, and the oftener it is applied the freer the surface of the head will be from scurf. The hair-brush should also be kept in requisition morning and evening. 7. TO REMOVE SUPERFLUOUS HAIR.--With those who dislike the use of arsenic, the following is used for removing superfluous hair from the skin: Lime, one ounce; carbonate of potash, two ounces; charcoal powder, one drachm. For use, make it into a paste with a little warm water, and apply it to the part, previously shaved close. As soon as it has become thoroughly dry, it may be washed off with a little warm water. 8. COLORING FOR EYELASHES AND EYEBROWS.--In eyelashes the chief element of beauty consists in their being long and glossy; the eyebrows should be finely arched and clearly divided from each other. The most innocent darkener of the brow is the expressed juice of the elderberry, or a burnt clove. [Illustration: JAPANESE MOUSINE MAKING HER TOILET.] 9. CRIMPING HAIR.--To make the hair stay in crimps, take five cents worth of gum arabic and add to it just enough boiling water to dissolve it. When dissolved, add enough alcohol to make it rather thin. Let this stand all night and then bottle it to prevent the alcohol from evaporating. This put on the hair at night, after it is done up in papers or pins, will make it stay in crimp the hottest day, and is perfectly harmless. 10. TO CURL THE HAIR.--There is no preparation that will make naturally straight hair assume a permanent curl. The following will keep the hair in curl for a short time: Take borax, two ounces; gum arabic, one drachm; and hot water, not boiling, one quart; stir, and, as soon as the ingredients are dissolved, add three tablespoonfuls of strong spirits of camphor. On retiring to rest, wet the hair with the above liquid, and roll in twists of paper as usual. Do not disturb the hair until morning, when untwist and form into ringlets. 11. FOR FALLING OR LOOSENING OF THE HAIR.--Take: Alcohol, a half pint. Salt, as much as will dissolve. Glycerine, a tablespoonful. Flour of sulphur, teaspoonful. Mix. Rub on the scalp every morning. 12. TO DARKEN THE HAIR WITHOUT BAD EFFECTS.--Take: Blue vitriol (powdered), one drachm. Alcohol, one ounce. Essence of roses, ten drops. Rain-water, a half-pint. Shake together until they are thoroughly dissolved. 13. GRAY HAIR.--There are no known means by which the hair can be prevented from turning gray, and none which can restore it to its original hue, except through the process of dyeing. The numerous "hair color restorers" which are advertised are chemical preparations which act in the manner of a dye or as a paint, and are nearly always dependent for their power on the presence of lead. This mineral, applied to the skin, for a long time, will lead to the most disastrous maladies--lead-palsy, lead colic, and other symptoms of poisoning. It should, therefore, never be used for this purpose. [Illustration] [Illustration] * * * * * HOW TO CURE PIMPLES OR OTHER FACIAL ERUPTIONS. 1. It requires self-denial to get rid of pimples, for persons troubled with them will persist in eating fat meats and other articles of food calculated to produce them. Avoid the use of rich gravies, or pastry, or anything of the kind in excess. Take all the out-door exercise you can and never indulge in a late supper. Retire at a reasonable hour, and rise early in the morning. Sulphur to purify the blood may be taken three times a week--a thimbleful in a glass of milk before breakfast. It takes some time for the sulphur to do its work, therefore persevere in its use till the humors, or pimples, or blotches, disappear. Avoid getting wet while taking the sulphur. 2. TRY THIS RECIPE: Wash the face twice a day in warm water, and rub dry with a coarse towel. Then with a soft towel rub in a lotion made of two ounces of white brandy, one ounce of cologne, and one-half ounce of liquor potasse. Persons subject to skin eruptions should avoid very salty or fat food. A dose of Epsom salts occasionally might prove beneficial. 3. Wash the face in a dilution of carbolic acid, allowing one teaspoonful to a pint of water. This is an excellent and purifying lotion, and may be used on the most delicate skins. Be careful about letting this wash get into the eyes. 4. Oil of sweet almonds, one ounce; fluid potash, one drachm. Shake well together, and then add rose water, one ounce; pure water, six ounces. Mix. Rub the pimples or blotches for some minutes with a rough towel, and then dab them with the lotion. 5. Dissolve one ounce of borax, and sponge the face with it every night. When there are insects, rub on flower of sulphur, dry after washing, rub well and wipe dry; use plenty of castile soap. 6. Dilute corrosive sublimate with oil of almonds. A few days' application will remove them. * * * * * BLACK-HEADS AND FLESH WORMS. [Illustration: A REGULAR FLESH WORM GREATLY MAGNIFIED.] This is a minute little creature, scientifically called _Demodex folliculorum_, hardly visible to the naked eye, with comparatively large fore body, a more slender hind body and eight little stumpy processes that do duty as legs. No specialized head is visible, although of course there is a mouth orifice. These creatures live on the sweat glands or pores of the human face, and owing to the appearance that they give to the infested pores, they are usually known as "black-heads." It is not at all uncommon to see an otherwise pretty face disfigured by these ugly creatures, although the insects themselves are nearly transparent white. The black appearance is really due the accumulation of dirt which gets under the edges of the skin of the enlarged sweat glands and cannot be removed in the ordinary way by washing, because the abnormal, hardened secretion of the gland itself becomes stained. These insects are so lowly organized that it is almost impossible to satisfactory deal with them and they sometimes cause the continual festering of the skin which they inhabit. REMEDY.--Press them out with a hollow key or with the thumb and fingers, and apply a mixture of sulphur and cream every evening. Wash every morning with the best toilet soap, or wash the face with hot water with a soft flannel at bedtime. [Illustration: A HEALTHY COMPLEXION.] * * * * * LOVE. But there's nothing half so sweet in life As love's young dream.--MOORE. All love is sweet, Given or returned. Common as light is love, And its familiar voice wearies not ever.--SHELLEY. Doubt thou the stars are fire, Doubt that the sun doth move; Doubt truth to be a liar, But never doubt I love.--SHAKESPEARE. Let those love now who never loved before, Let those that always loved now love the more. 1. LOVE BLENDS YOUNG HEARTS.--Love blends young hearts in blissful unity, and, for the time, so ignores past ties and affections, as to make willing separation of the son from his father's house, and the daughter from all the sweet endearments of her childhood's home, to go out together and rear for themselves an altar, around which shall cluster all the cares and delights, the anxieties and sympathies, of the family relationship; this love, if pure, unselfish, and discreet, constitutes the chief usefulness and happiness of human life. 2. WITHOUT LOVE.--Without love there would be no organized households, and, consequently, none of that earnest endeavor for competence and respectability, which is the mainspring to human effort; none of those sweet, softening, restraining and elevating influences of domestic life, which can alone fill the earth with the glory of the Lord and make glad the city of Zion. This love is indeed heaven upon earth; but above would not be heaven without it; where there is not love, there is fear; but, "love casteth out fear." And yet we naturally do offend what we most love. 3. LOVE IS THE SUN OF LIFE.--Most beautiful in morning and evening, but warmest and steadiest at noon. It is the sun of the soul. Life without love is worse than death; a world without a sun. The love which does not lead to labor will soon die out, and the thankfulness which does not embody itself in sacrifices is already changing to gratitude. Love is not ripened in one day, nor in many, nor even in a human lifetime. It is the oneness of soul with soul in appreciation and perfect trust. To be blessed it must rest in that faith in the Divine which underlies every other motion. To be true, it must be eternal as God himself. 4. LOVE IS DEPENDENT.--Remember that love is dependent upon forms; courtesy of etiquette guards and protects courtesy of heart. How many hearts have been lost irrevocably, and how many averted eyes and cold looks have been gained from what seemed, perhaps, but a trifling negligence of forms. [Illustration: AGE COUNSELING YOUTH.] 5. RADICAL DIFFERENCES.--Men and women should not be judged by the same rules. There are many radical differences in their affectional natures. Man is the creature of interest and ambition. His nature leads him forth into the struggle and bustle of the world. Love is but the embellishment of his early life, or a song piped in the intervals of the acts. He seeks for fame, for fortune, for space in the world's thoughts, and dominion over his fellow-men. But a woman's whole life is a history of the affections. The heart is her world; it is there her ambition strives for empire; it is there her ambition seeks for hidden treasures. She sends forth her sympathies on adventure; she embarks her whole soul in the traffic of affection; and if shipwrecked her case is hopeless, for it is bankruptcy of the heart. 6. WOMAN'S LOVE.--Woman's love is stronger than death; it rises superior to adversity, and towers in sublime beauty above the niggardly selfishness of the world. Misfortune cannot suppress it; enmity cannot alienate it; temptation cannot enslave it. It is the guardian angel of the nursery and the sick bed; it gives an affectionate concord to the partnership of life and interest, circumstances cannot modify it; it ever remains the same to sweeten existence, to purify the cup of life, on the rugged pathway to the grave, and melt to moral pliability the brittle nature of man. It is the ministering spirit of home, hovering in soothing caresses over the cradle, and the death-bed of the household, and filling up the urn of all its sacred memories. 7. A LADY'S COMPLEXION.--He who loves a lady's complexion, form and features, loves not her true self, but her soul's old clothes. The love that has nothing but beauty to sustain it, soon withers and dies. The love that is fed with presents always requires feeding. Love, and love only, is the loan for love. Love is of the nature of a burning glass, which, kept still in one place, fireth; changed often, it doth nothing. The purest joy we can experience in one we love, is to see that person a source of happiness to others. When you are with the person loved, you have no sense of being bored. This humble and trivial circumstance is the great test--the only sure and abiding test of love. 8. TWO SOULS COME TOGETHER.--When two souls come together, each seeking to magnify the other, each in subordinate sense worshiping the other, each help the other; the two flying together so that each wing-beat of the one helps each wing-beat of the other--when two souls come together thus, they are lovers. They who unitedly move themselves away from grossness and from earth, toward the throne of crystaline and the pavement golden, are, indeed, true lovers. [Illustration: LOVE MAKING IN THE EARLY COLONIAL DAYS.] [Illustration: CUPID'S CAPTURED VICTIM.] * * * * * THE POWER AND PECULIARITIES OF LOVE. LOVE IS A TONIC AND A REMEDY FOR DISEASE, MAKES PEOPLE LOOK YOUNGER, CREATES INDUSTRY, ETC. "All thoughts, all passions, all desires. Whatever stirs this mortal frame, Are ministers of Love, And feed his sacred flame." 1. It is a physiological fact long demonstrated that persons possessing a loving disposition borrow less of the cares of life, and also live much longer than persons with a strong, narrow and selfish nature. Persons who love scenery, love domestic animals, show great attachment for all friends; love their home dearly and find interest and enchantment in almost everything have qualities of mind and heart which indicate good health and a happy disposition. 2. Persons who love music and are constantly humming or whistling a tune, are persons that need not be feared, they are kind-hearted and with few exceptions possess a loving disposition. Very few good musicians become criminals. 3. Parents that cultivate a love among their children will find that the same feeling will soon be manifested in their children's disposition. Sunshine in the hearts of the parents will blossom in the lives of the children. The parent who continually cherishes a feeling of dislike and rebellion in his soul, cultivating moral hatred against his fellow-man, will soon find the same things manifested by his son. As the son resembles his father in looks so he will to a certain extent resemble him in character. Love in the heart of the parent will beget kindness and affection in the heart of a child. Continuous scolding and fretting in the home will soon make love a stranger. 4. If you desire to cultivate love, create harmony in all your feelings and faculties. Remember that all that is pure, holy and virtuous in love flows from the deepest fountain of the human soul. Poison the fountain and you change virtue to vice, and happiness to misery. 5. Love strengthens health, and disappointment cultivates disease. A person in love will invariably enjoy the best of health. Ninety-nine per cent. of our strong constitutioned men, now in physical ruin, have wrecked themselves on the breakers of an unnatural love. Nothing but right love and a right marriage will restore them to health. 6. All men feel much better for going a courting, providing they court purely. Nothing tears the life out of man more than lust, vulgar thoughts and immoral conduct. The libertine or harlot has changed love, God's purest gift to man, into lust. They cannot acquire love in its purity again, the sacred flame has vanished forever. Love is pure, and cannot be found in the heart of a seducer. 7. A woman is never so bright and full of health as when deeply in love. Many sickly and frail women are snatched from the clutches of some deadly disease and restored to health by falling in love. 8. It is a long established fact that married persons are healthier than unmarried persons; thus it proves that health and happiness belong to the home. Health depends upon mind. Love places the mind into a delightful state and quickens every human function, makes the blood circulate and weaves threads of joy into cables of domestic love. 9. An old but true proverb: "A true man loving one woman will speak well of all women. A true woman loving one man will speak well of all men. A good wife praises all men, but praises her husband most. A good man praises all women, but praises his wife most." 10. Persons deeply in love become peculiarly pleasant, winning and tender. It is said that a musician can never excel or an artist do his best until he has been deeply in love. A good orator, a great statesman or great men in general are greater and better for having once been thoroughly in love. A man who truly loves his wife and home is always a safe man to trust. 11. Love makes people look younger in years. People in unhappy homes look older and more worn and fatigued. A woman at thirty, well courted and well married, looks five or ten years younger than a woman of the same age unhappily married. Old maids and bachelors always look older than they are. A flirting widow always looks younger than an old maid of like age. 12. Love renders women industrious and frugal, and a loving husband spends lavishly on a loved wife and children, though miserly towards others. 13. Love cultivates self-respect and produces beauty. Beauty in walk and beauty in looks; a girl in love is at her best; it brings out the finest traits of her character, she walks more erect and is more generous and forgiving; her voice is sweeter and she makes happy all about her. She works better, sings better and is better. 14. Now in conclusion, a love marriage is the best life insurance policy; it pays dividends every day, while every other insurance policy merely promises to pay after death. Remember that statistics demonstrate that married people outlive old maids and old bachelors by a goodly number of years and enjoy healthier and happier lives. [Illustration: THE TURKISH WAY OF MAKING LOVE] [Illustration: PREPARING TO ENTERTAIN HER LOVER.] [Illustration: CONFIDENCE.] * * * * * AMATIVENESS OR CONNUBIAL LOVE. 1. MULTIPLYING THE RACE.--Some means for multiplying our race is necessary to prevent its extinction by death. Propagation and death appertain to man's earthly existence. If the Deity had seen fit to bring every member of the human family into being by a direct act of creative power, without the agency of parents, the present wise and benevolent arrangements of husbands and wives, parents and children, friends and neighbors, would have been superseded, and all opportunities for exercising parental and connubial love, in which so much enjoyment is taken, cut off. But the domestic feelings and relations, as now arranged, must strike every philosophical observer as inimitably beautiful and perfect--as the offspring of infinite Wisdom and Goodness combined. 2. AMATIVENESS AND ITS COMBINATIONS constitute their origin, counterpart, and main medium of manifestation. Its primary function is connubial love. From it, mainly, spring those feelings which exist between the sexes as such and result in marriage and offspring. Combined with the higher sentiments, it gives rise to all those reciprocal kind feelings and nameless courtesies which each sex manifests towards the other; refining and elevating both, promoting gentility and politeness, and greatly increasing social and general happiness. 3. RENDERS MEN MORE POLITE TO WOMEN.--So far from being in the least gross or indelicate, its proper exercise is pure, chaste, virtuous, and even an ingredient in good manners. It is this which renders men always more polite towards women than to one another, and more refined in their society, and which makes women more kind, grateful, genteel and tender towards men than women. It makes mothers love their sons more than their daughters, and fathers more attached to their daughters. Man's endearing recollections of his mother or wife form his most powerful incentives to virtue, study, and good deeds, as well as restraints upon his vicious inclinations; and, in proportion as a young man is dutiful and affectionate to his mother, will he be fond of his wife; for, this faculty is the parent of both. 4. ALL SHOULD CULTIVATE THE FACULTY OF AMATIVENESS OR CONNUBIAL LOVE.--Study the personal charms and mental accomplishments of the other sex by ardent admirers of beautiful forms, and study graceful movements and elegant manners, and remember, much depends upon the tones and accents of the voice. Never be gruff if you desire to be winning. Seek and enjoy and reciprocate fond looks and feelings. Before you can create favorable impressions you must first be honest and sincere and natural, and your conquest will be sure and certain. * * * * * LOVE AND COMMON-SENSE. 1. Do not love her because she goes to the altar with her head full of book learning, her hands of no earthly use, save for the piano and brush; because she has no conception of the duties and responsibilities of a wife; because she hates housework, hates its everlasting routine and ever recurring duties; because she hates children and will adopt every means to evade motherhood; because she loves her ease, loves to have her will supreme, loves, oh how well, to be free to go and come, to let the days slip idly by, to be absolved from all responsibility, to live without labor, without care? Will you love her selfish, shirking, calculating nature after twenty years of close companionship? 2. Do you love him because he is a man, and therefore, no matter how weak mentally, morally or physically he may be, he has vested in him the power to save you from the ignominy of an old maid's existence? Because you would rather be Mrs. Nobody, than make the effort to be Miss Somebody? because you have a great empty place in your head and heart that nothing but a man can fill? because you feel you cannot live without him? God grant the time may never come when you cannot live with him. 3. Do you love her because she is a thoroughly womanly woman; for her tender sympathetic nature; for the jewels of her life, which are absolute purity of mind and heart; for the sweet sincerity of her disposition; for her loving, charitable thought; for her strength of character? because she is pitiful to the sinful, tender to the sorrowful, capable, self-reliant, modest, true-hearted? in brief, because she is the embodiment of all womanly virtues? 4. Do you love him because he is a manly man; because the living and operating principle of his life is a tender reverence for all women; because his love is the overflow of the best part of his nature; because he has never soiled his soul with an unholy act or his lips with an oath; because mentally he is a man among men; because physically he stands head and shoulders above the masses; because morally he is far beyond suspicion, in his thought, word or deed? because his earnest manly consecrated life is a mighty power on God's side? 5. But there always has been and always will be unhappy marriages until men learn what husbandhood means; how to care for that tenderly matured, delicately constituted being, that he takes into his care and keeping. That if her wonderful adjusted organism is overtaxed and overburdened, her happiness, which is largely dependent upon her health, is destroyed. 6. Until men give the women they marry the undivided love of their heart; until constancy is the key-note of a life which speaks eloquently of clean thoughts and clean hearts. 7. Until men and women recognize that self-control in a man, and modesty in a woman, will bring a mutual respect that years of wedded life will only strengthen. Until they recognize that love is the purest and holiest of all things known to humanity, will marriage continue to bring unhappiness and discontent, instead of that comfort and restful peace which all loyal souls have a right to expect and enjoy. 8. Be sensible and marry a sensible, honest and industrious companion, and happiness through life will be your reward. [Illustration: A CALLER.] [Illustration] * * * * * WHAT WOMEN LOVE IN MEN. 1. Women naturally love courage, force and firmness in men. The ideal man in a woman's eye must be heroic and brave. Woman naturally despises a coward, and she has little or no respect for a bashful man. 2. Woman naturally loves her lord and master. Women who desperately object to be overruled, nevertheless admire men who overrule them, and few women would have any respect for a man whom they could completely rule and control. 3. Man is naturally the protector of woman; as the male wild animal of the forest protects the female, so it is natural for man to protect his wife and children, and therefore woman admires those qualities in a man which make him a protector. 4. LARGE MEN.--Women naturally love men of strength, size and fine physique, a tall, large and strong man rather than a short, small and weak man. A woman always pities a weakly man, but rarely ever has any love for him. 5. SMALL AND WEAKLY MEN.--All men would be of good size in frame and flesh, were it not for the infirmities visited upon them by the indiscretion of parents and ancestors of generations before. 6. YOUTHFUL SEXUAL EXCITEMENT.--There are many children born healthy and vigorous who destroy the full vigor of their generative organs in youth by self-abuse, and if they survive and marry, their children will have small bones, small frames and sickly constitutions. It is therefore not strange that instinct should lead women to admire men not touched with these symptoms of physical debility. 7. GENEROSITY.--Woman generally loves a generous man. Religion absorbs a great amount of money in temples, churches, ministerial salaries, etc., and ambition and appetite absorb countless millions, yet woman receives more gifts from man than all these combined: she loves a generous giver. _Generosity and Gallantry_ are the jewels which she most admires. A woman receiving presents from a man implies that she will pay him back in love, and the woman who accepts a man's presents, and does not respect him, commits a wrong which is rarely ever forgiven. 8. INTELLIGENCE.--Above all other qualities in man, woman admires his intelligence. Intelligence is man's woman captivating card. This character in woman is illustrated by an English army officer, as told by O.S. Fowler, betrothed in marriage to a beautiful, loving heiress, summoned to India, who wrote back to her: "I have lost an eye, a leg, an arm, and been so badly marred and begrimmed besides, that you never could love this poor, maimed soldier. Yet, I love you too well to make your life wretched by requiring you to keep your marriage-vow with me, from which I hereby release you. Find among English peers one physically more perfect, whom you can love better." She answered, as all genuine women must answer: "Your noble mind, your splendid talents, your martial prowess which maimed you, are what I love. As long as you retain sufficient body to contain the casket of your soul, which alone is what I admire, I love you all the same, and long to make you mine forever." 9. SOFT MEN.--All women despise soft and silly men more than all other defects in their character. Woman never can love a man whose conversation is flat and insipid. Every man seeking woman's appreciation or love should always endeavor to show his intelligence and manifest an interest in books and daily papers. He should read books and inform himself so that he can talk intelligently upon the various topics of the day. Even an ignorant woman always loves superior intelligence. 10. SEXUAL VIGOR.--Women love sexual vigor in men. This is human nature. Weakly and delicate fathers have weak and puny children, though the mother may be strong and robust. A weak mother often bears strong children, if the father is physically and sexually vigorous. Consumption is often inherited from fathers, because they furnish the body, yet more women die with it because of female obstructions. Hence women love passion in men, because it endows their offspring with strong functional vigor. 11. PASSIONATE MEN--The less passion any woman possesses, the more she prizes a strong passionate man. This is a natural consequence, for if she married one equally passionless, their children would be poorly endowed or they would have none; she therefore admires him who makes up the deficiency. Hence very amorous men prefer quiet, modest and reserved women. 12. HOMELY MEN are admired by women if they are large, strong and vigorous and possess a good degree of intelligence. Looks are trifles compared with the other qualities which man may possess. 13. YOUNG MAN, If you desire to win the love and admiration of young ladies, first, be intelligent; read books and papers; remember what you read, so you can talk about it. Second, be generous and do not show a stingy and penurious disposition when in the company of ladies. Third, be sensible, original, and have opinions of your own and do not agree with everything that someone else says, or agree with everything that a lady may say. Ladies naturally admire genteel and intelligent discussions and conversations when there is someone to talk with who has an opinion of his own. Woman despises a man who has no opinion of his own; she hates a trifling disposition and admires leadership, original ideas, and looks up to man as a leader. Women despise all men whom they can manage, overrule, cow-down and subdue. 14. BE SELF-SUPPORTING.--The young man who gives evidence of thrift is always in demand. Be enthusiastic and drive with success all that you undertake. A young man, sober, honest and industrious, holding a responsible position or having a business of his own, is a prize that some bright and beautiful young lady would like to draw. Woman admires a certainty. 15. UNIFORMED MEN.--It is a well known fact that women love uniformed men. The soldier figures as a hero in about every tale of fiction and it is said by good authority that a man in uniform has three more chances to marry than the man without uniform. The correct reason is, the soldier's profession is bravery, and he is dressed and trained for that purpose, and it is that which makes him admired by ladies rather than the uniform which he wears. His profession is also that of a protector. [Illustration] * * * * * WHAT MEN LOVE IN WOMEN. 1. FEMALE BEAUTY.--Men love beautiful women, for woman's beauty is the highest type of all beauty. A handsome woman needs no diamonds, no silks or satins; her brilliant face outshines diamonds and her form is beautiful in calico. 2. FALSE BEAUTIFIERS.--Man's love of female beauty surpasses all other love, and whatever artificial means are used to beautify, to a certain extent are falsehoods which lead to distrust or dislike. Artificial beauty is always an imitation, and never can come into competition with the genuine. No art can successfully imitate nature. 3. TRUE KIND OF BEAUTY.--Facial beauty is only skin deep. A beautiful form, a graceful figure, graceful movements and a kind heart are the strongest charms in the perfection of female beauty. A brilliant face always outshines what may be called a pretty face, for intelligence is that queenly grace which crowns woman's influence over men. Good looks and good and pure conduct awaken a man's love for women. A girl must therefore be charming as well as beautiful, for a charming girl will never become a charmless wife. 4. A GOOD FEMALE BODY.--No weakly, poor-bodied woman can draw a man's love like a strong, well developed body. A round, plump figure with an overflow of animal life is the woman most commonly sought, for nature in man craves for the strong qualities in women, as the health and life of offspring depend upon the physical qualities of wife and mother. A good body and vigorous health, therefore, become indispensable to female beauty. 5. BROAD HIPS.--A woman with a large pelvis gives her a superior and significant appearance, while a narrow pelvis always indicate weak sexuality. The other portions of the body however must be in harmony with the size and breadth of the hips. 6. FULL BUSTS.--In the female beauty of physical development there is nothing that can equal full breasts. It is an indication of good health and good maternal qualities. As a face looks bad without a nose, so the female breast, when narrow and flat, produces a bad effect. The female breasts are the means on which a new-born child depends for its life and growth, hence it is an essential human instinct for men to admire those physical proportions in women which indicate perfect motherhood. Cotton and all other false forms simply show the value of natural ones. All false forms are easily detected, because large natural ones will generally quiver and move at every step, while the artificial ones will manifest no expression of life. As woman looks so much better with artificial paddings and puffings than she does without, therefore modern society should waive all objections to their use. A full breast has been man's admiration through all climes and ages, and whether this breast-loving instinct is right or wrong, sensible or sensual, it is a fact well known to all, that it is a great disappointment to a husband and father to see his child brought up on a bottle. Men love full breasts, because it promotes maternity. If, however, the breasts are abnormally large, it indicates maternal deficiency the same as any disproportion or extreme. 7. SMALL FEET.--Small feet and small ankles are very attractive, because they are in harmony with a perfect female form, and men admire perfection. Small feet and ankles indicate modesty and reserve, while large feet and ankles indicate coarseness, physical power, authority, predominance. Feet and ankles however must be in harmony with the body, as small feet and small ankles on a large woman would be out of proportion and consequently not beautiful. 8. BEAUTIFUL ARMS.--As the arm is always in proportion with the other portions of the body, consequently a well-shaped arm, small hands and small wrists, with full muscular development, is a charm and beauty not inferior to the face itself, and those who have well-shaped arms may be proud of them, because they generally keep company with a fine bust and a fine figure. 9. INTELLIGENCE.--A mother must naturally possess intelligence, in order to rear her children intelligently, consequently it is natural for man to chiefly admire mental qualities in women, for utility and practicability depend upon intelligence. Therefore a man generally loves those charms in women which prepare her for the duties of companionship. If a woman desires to be loved, she must cultivate her intellectual gifts, be interesting and entertaining in society, and practical and helpful in the home, for these are some of the qualifications which make up the highest type of beauty. 10. PIETY AND RELIGION IN WOMEN.--Men who love home and the companionship of their wives, love truth, honor and honesty. It is this higher moral development that naturally leads them to admire women of moral and religious natures. It is therefore not strange that immoral men love moral and church-loving wives. Man naturally admires the qualities which tend to the correct government of the home. Men want good and pure children, and it is natural to select women who insure domestic contentment and happiness. A bad man, of course, does not deserve a good wife, yet he will do his utmost to get one. 11. FALSE APPEARANCE.--Men love reserved, coy and discreet women much more than blunt, shrewd and boisterous. Falsehood, false hair, false curls, false forms, false bosoms, false colors, false cheeks, and all that is false, men naturally dislike, for in themselves they are a poor foundation on which to form family ties, consequently duplicity and hypocrisy in women is very much disliked by men, but a frank, honest, conscientious soul is always lovable and lovely and will not become an old maid, except as a matter of choice and not of necessity. [Illustration] [Illustration] * * * * * HISTORY OF MARRIAGE. 1. "It is not good for man to be alone," was the Divine judgment, and so God created for him an helpmate; therefore sex is as Divine as the soul. 2. POLYGAMY.--Polygamy has existed in all ages. It is and always has been the result of moral degradation and wantonness. 3. THE GARDEN OF EDEN.--The Garden of Eden was no harem. Primeval nature knew no community of love; there was only the union of two souls, and the twain were made one flesh. If God had intended man to be a polygamist he would have created for him two or more wives; but he only created one wife for the first man. He also directed Noah to take into the ark two of each sort--a male and female--another evidence that God believed in pairs only. 4. ABRAHAM no doubt was a polygamist, and the general history of patriarchal life shows that the plurality of wives and concubinage were national customs, and not the institutions authorized by God. 5. EGYPTIAN HISTORY.--Egyptian history, in the first ostensible form we have, shows that concubinage and polygamy were in common practice. 6. SOLOMON.--It is not strange that Solomon, with his thousand wives, exclaimed: "All is vanity and vexation of spirit." Polygamy is not the natural state of man. 7. CONCUBINAGE AND POLYGAMY continued till the fifth century, when the degraded condition of woman became to some extent matters of some concern and recognition. Before this woman was regarded simply as an instrument of procreation, or a mistress of the household, to gratify the passions of man. 8. THE CHINESE marriage system was, and is, practically polygamous, for from their earliest traditions we learn, although a man could have but one wife, he was permitted to have as many concubines as he desired. 9. MOHAMMEDANISM.--Of the 150,000,000 Mohammedans all are polygamists. Their religion appeals to the luxury of animal propensities, and the voluptuous character of the Orientals has penetrated western Europe and Africa. 10. MORMONISM.--The Mormon Church, founded by Joseph Smith, practiced polygamy until the beginning of 1893, when the church formally declared and resigned polygamy as a part or present doctrine of their religious institution. Yet all Mormons are polygamists at heart. It is a part of their religion; national law alone restrains them. 11. FREE LOVERS.--There is located at Lenox, Madison County, New York, an organization popularly known as Free Lovers. The members advocate a system of complex marriage, a sort of promiscuity, with a freedom of love for any and all. Man offers woman support and love; woman enjoying freedom, self-respect, health, personal and mental competency, gives herself to man in the boundless sincerity of an unselfish union. In their system, love is made synonymous with sexuality, and there is no doubt, but what woman is only a plaything to gratify animal caprice. 12. MONOGAMY (SINGLE WIFE), is a law of nature evident from the fact that it fulfills the three essential conditions of man, viz.: the development of the individual, the welfare of society and reproduction. In no nation with a system of polygamy do we find a code of political and moral rights, and the condition of woman is that of a slave. In polygamous countries nothing is added to the education and civilization. The natural tendency is sensualism, and sensualism tends to mental starvation. 18. CHRISTIAN CIVILIZATION has lifted woman from slavery to liberty. Wherever Christian civilization prevails there are legal marriages, pure homes and education. May God bless the purity of the home. * * * * * MARRIAGE. "Thus grief still treads upon the heel of pleasure, Married in haste we may repent at leisure." --SHAKESPEARE The parties are wedded. The priest or clergyman has pronounced as one those hearts that before beat in unison with each other. The assembled guests congratulate the happy pair. The fair bride has left her dear mother bedewed with tears and sobbing just as if her heart would break, and as if the happy bridegroom was leading her away captive against her will. They enter the carriage. It drives off on the wedding tour, and his arms encircles the yielding waist of her now all his own, while her head reclines on the breast of the man of her choice. If she be young and has married an old man, she will be sad. If she has married for a home, or position, or wealth, a pang will shoot across her fair bosom. If she has married without due consideration or on too light an acquaintance, it will be her sorrow before long. But, if loving and beloved, she has united her destiny with a worthy man, she will rejoice, and on her journey feel a glow of satisfaction and delight unfelt before and which will be often renewed, and daily prove as the living waters from some perennial spring. [Illustration] * * * * * THE ADVANTAGES OF WEDLOCK. 'Tis sweet to hear the watch-dog's honest bark, Bay deep-mouthed welcome as we draw near home 'Tis sweet to know there is an eye will mark Our coming, and look brighter when we come. BYRON, DON JUAN 1. Marriage is the natural state of man and woman. Matrimony greatly contributes to the wealth and health of man. 2. Circumstances may compel a man not to select a companion until late in life. Many may have parents or relatives, dependent brothers and sisters to care for, yet family ties are cultivated; notwithstanding the home is without a wife. 3. In Christian countries the laws of marriage have greatly added to the health of man. Marriage in barbarous countries, where little or no marriage ceremonies are required, benefits man but little. There can be no true domestic blessedness without loyalty and love for the select and married companion. All the licentiousness and lust of a libertine, whether civilized or uncivilized, bring him only unrest and premature decay. 4. A man, however, may be married and not mated, and consequently reap trouble and unhappiness. A young couple should first carefully learn each other by making the courtship a matter of business, and sufficiently long that the disposition and temper of each may be thoroughly exposed and understood. 5. First see that there is love; secondly, that there is adaptation; thirdly, see that there are no physical defects, and if these conditions are properly considered, cupid will go with you. 6. The happiest place on all earth is home. A loving wife and lovely children are jewels without price, as Payne says: "'Mid pleasures and palaces though we may roam. Be it ever so humble, there's no place like home." 7. Reciprocated love produces a general exhilaration of the system. The elasticity of the muscles is increased, the circulation is quickened, and every bodily function is stimulated to renewed activity by a happy marriage. 8. The consummation desired by all who experience this affection, is the union of souls in a true marriage. Whatever of beauty or romance there may have been in the lover's dream, is enhanced and spiritualized in the intimate communion of married life. The crown of wifehood and maternity is purer, more divine than that of the maiden. Passion is lost--emotions predominate. 9. TOO EARLY MARRIAGES.--Too early marriage is always bad for the female. If a young girl marries, her system is weakened and a full development of her body is prevented, and the dangers of confinement are considerably increased. 10. Boys who marry young derive but little enjoyment from the connubial state. They are liable to excesses and thereby lose much of the vitality and power of strength and physical endurance. 11. LONG LIFE.--Statistics show that married men live longer than bachelors. Child-bearing for women is conducive to longevity. 12. COMPLEXION.--Marriage purifies the complexion, removes blotches from the skin, invigorates the body, fills up the tones of the voice, gives elasticity and firmness to the step, and brings health and contentment to old age. 13. TEMPTATIONS REMOVED.--Marriage sanctifies a home, while adultery and libertinism produce unrest, distrust and misery. It must be remembered that a married man can practice the most absolute continence and enjoy a far better state of health than the licentious man. The comforts of companionship develop purity and give rest to the soul. 14. TOTAL ABSTENTION.--It is no doubt difficult for some men to fully abstain from sexual intercourse and be entirely chaste in mind. The great majority of men experience frequent strong sexual desire. Abstention is very apt to produce in their minds voluptuous images and untamable desires which require an iron will to banish or control. The hermit in his seclusion, or the monk in his retreat, are often flushed with these passions and trials. It is, however, natural; for remove these passions and man would be no longer a man. It is evident that the natural state of man is that of marriage; and he who avoids that state is not in harmony with the laws of his being. [Illustration: AN ALGERIAN BRIDE.] 15. PROSTITUTION.--Men who inherit strong passions easily argue themselves into the belief either to practice masturbation or visit places of prostitution, on the ground that their health demands it. Though medical investigation has proven it repeatedly to be false, yet many believe it. The consummation of marriage involves the mightiest issues of life and is the most holy and sacred right recognized by man, and it is the Balm of Gilead for many ills. Masturbation or prostitution soon blight the brightest prospects a young man may have. Manhood is morality and purity of purpose, not sensuality. * * * * * DISADVANTAGES OF CELIBACY. 1. To live the life of a bachelor has many advantages and many disadvantages. The man who commits neither fornication, adultery nor secret vice, and is pure in mind, surely has all the moral virtues that make a good man and a good citizen, whether married or unmarried. 2. If a good pure-minded man does not marry, he will suffer no serious loss of vital power; there will be no tendency to spermatorrhoea or congestion, nor will he be afflicted with any one of those ills which certain vicious writers and quacks would lead many people to believe. Celibacy is perfectly consistent with mental vigor and physical strength. Regularity in the habits of life will always have its good effects on the human body. 3. The average life of a married man is much longer than that of a bachelor. There is quite an alarming odds in the United States in favor of a man with a family. It is claimed that the married man lives on an average from five to twenty years longer than a bachelor. The married man lives a more regular life. He has his meals more regularly and is better nursed in sickness, and in every way a happier and more contented man. The happiness of wife and children will always add comfort and length of days to the man who is happily married. 4. It is a fact well answered by statistics that there is more crime committed, more vices practiced, and more immorality among single men than among married men. Let the young man be pure in heart like Bunyan's Pilgrim, and he can pass the deadly dens, the roaring lions, and overcome the ravenous fires of passion, unscathed. The vices of single men support the most flagrant of evils of modern society, hence let every young man beware and keep his body clean and pure. His future happiness largely depends upon his chastity while a single man. [Illustration: "MADE IN U.S.A."] [Illustration: I WILL NEVER MARRY.] * * * * * OLD MAIDS. 1. MODERN ORIGIN.--The prejudice which certainly still exists in the average mind against unmarried women must be of comparatively modern origin. From the earliest ages to ancient Greece, and Rome particularly, the highest honors were paid them. They were the ministers of the old religions, and regarded with superstitious awe. 2. MATRIMONY.--Since the reformation, especially during the last century, and in our own land, matrimony has been so much esteemed, notably by women, that it has come to be regarded as in some sort discreditable for them to remain single. Old maids are mentioned on every hand with mingled pity and disdain, arising no doubt from the belief, conscious or unconscious, that they would not be what they are if they could help it. Few persons have a good word for them as a class. We are constantly hearing of lovely maidens, charming wives, buxom widows, but almost never of attractive old maids. 3. DISCARDING PREJUDICE.--The real old maid is like any other woman. She has faults necessarily, though not those commonly conceived of. She is often plump, pretty, amiable, interesting, intellectual, cultured, warm-hearted, benevolent, and has ardent friends of both sexes. These constantly wonder why she has not married, for they feel that she must have had many opportunities. Some of them may know why; she may have made them her confidantes. She usually has a sentimental, romantic, frequently a sad and pathetic past, of which she does not speak unless in the sacredness of intimacy. 4. NOT QUARRELSOME.--She is not dissatisfied, querulous nor envious. On the contrary, she is, for the most part, singularly content, patient and serene,--more so than many wives who have household duties and domestic cares to tire and trouble them. 5. REMAIN SINGLE FROM NECESSITY.--It is a stupid, as well as a heinous mistake, that women who remain single do so from necessity. Almost any woman can get a husband if she is so minded, as daily observation attests. When we see the multitudes of wives who have no visible signs of matrimonial recommendation, why should we think that old maids have been totally neglected? We may meet those who do not look inviting. But we meet any number of wives who are even less inviting. 6. FIRST OFFER.--The appearance and outgiving of many wives denote that they have accepted the first offer; the appearance and outgiving of many old maids that they have declined repeated offers. It is undeniable, that wives, in the mass, have no more charm than old maids have, in the mass. But, as the majority of women are married, they are no more criticised nor commented on, in the bulk, than the whole sex are. They are spoken of individually as pretty or plain, bright or dull, pleasant or unpleasant; while old maids are judged as a species, and almost always unfavorable. [Illustration: "I HAVE CHANGED MY MIND."] 7. BECOMES A WIFE.--Many an old maid, so-called, unexpectedly to her associates becomes a wife, some man of taste, discernment and sympathy having induced her to change her state. Probably no other man of his kind has proposed before, which accounts for her singleness. After her marriage hundreds of persons who had sneered at her condition find her charming, thus showing the extent of their prejudice against feminine celibacy. Old maids in general, it is fair to presume, do not wait for opportunities, but for proposers of an acceptable sort. They may have, indeed they are likely to have, those, but not to meet these. 8. NO LONGER MARRY FOR SUPPORT.--The time has changed and women have changed with it. They have grown more sensible, more independent in disposition as well as circumstances. They no longer marry for support; they have proved their capacity to support themselves, and self-support has developed them in every way. Assured that they can get on comfortably and contentedly alone they are better adapted by the assurance for consortship. They have rapidly increased from this and cognate causes, and have so improved in person, mind and character that an old maid of to-day is wholly different from an old maid of forty years ago. [Illustration: CONVINCING HIS WIFE.] * * * * * WHEN AND WHOM TO MARRY. 1. EARLY MARRIAGES.--Women too early married always remain small in stature, weak, pale, emaciated, and more or less miserable. We have no natural nor moral right to perpetuate unhealthy constitutions, therefore women should not marry too young and take upon themselves the responsibility, by producing a weak and feeble generation of children. It is better not to consummate a marriage until a full development of body and mind has taken place. A young woman of twenty-one to twenty-five, and a young man of twenty-three to twenty-eight, are considered the right age in order to produce an intelligent and healthy offspring. "First make the tree good, then shall the fruit be good also." 2. If marriage is delayed too long in either sex, say from thirty to forty-five, the offspring will often be puny and more liable to insanity, idiocy, and other maladies. 3. PUBERTY.--This is the period when childhood passes from immaturity of the sexual functions to maturity. Woman attains this state a year or two sooner than man. In the hotter climates the period of puberty is from twelve to fifteen years of age, while in cold climates, such as Russia, the United States, and Canada, puberty is frequently delayed until the seventeenth year. 4. DISEASED PARENTS.--We do the race a serious wrong in multiplying the number of hereditary invalids. Whole families of children have fallen heir to lives of misery and suffering by the indiscretion and poor judgment of parents. No young man in the vigor of health should think for a moment of marrying a girl who has the impress of consumption or other disease already stamped upon her feeble constitution. It only multiplies his own suffering, and brings no material happiness to his invalid wife. On the other hand, no healthy, vigorous young woman ought to unite her destiny with a man, no matter how much she adored him, who is not healthy and able to brave the hardships of life. If a young man or young woman with feeble body cannot find permanent relief either by medicine or change of climate, no thoughts of marriage should be entertained. Courting a patient may be pleasant, but a hard thing in married life to enjoy. The young lady who supposes that any young man wishes to marry her for the sake of nursing her through life makes a very grave mistake. [Illustration: LIFE INSURANCE COMPANIES DEMAND PHYSICAL EXAMINATION. WHY NOT MATRIMONY?] 5. WHOM TO CHOOSE FOR A HUSBAND.--The choice of a husband requires the coolest judgment and the most vigilant sagacity. A true union based on organic law is happiness, but let all remember that oil and water will not mix: the lion will not lie down with the lamb, nor can ill-assorted marriages be productive of aught but discord. "Let the woman take An elder than herself, so wears she to him-- So sways she, rules in her husband's heart." Look carefully at the disposition.--See that your intended Spouse is kind-hearted, generous, and willing to respect the opinions of others, though not in sympathy with them. Don't marry a selfish tyrant who thinks only of himself. 6. BE CAREFUL.--Don't marry an intemperate man with a view of reforming him. Thousands have tried it and failed. Misery, sorrow and a very hell on earth have been the consequences of too many such generous undertakings. 7. THE TRUE AND ONLY TEST which any man should look for in woman is modesty in demeanor before marriage, absence both of assumed ignorance and disagreeable familiarity, and a pure and religious frame of mind. Where these are present, he need not doubt that he has a faithful and a chaste wife. 8. MARRYING FIRST COUSINS is dangerous to offspring. The observation is universal, the children of married first cousins are too often idiots, insane, clump-footed, crippled, blind, or variously diseased. First cousins are always sure to impart all the hereditary disease in both families to their children. If both are healthy there is less danger. 9. DO NOT CHOOSE ONE TOO GOOD, or too far above you, lest the inferior dissatisfying the superior, breed those discords which are worse than the trials of a single life. Don't be too particular; for you might go farther and fare worse. As far as you yourself are faulty, you should put up with faults. Don't cheat a consort by getting one much better than you can give. We are not in heaven yet, and must put up with their imperfections, and instead of grumbling at them, be glad they are no worse; remembering that a faulty one is a great deal better than none, if he loves you. 10. MARRYING FOR MONEY.--Those who seek only the society of those who can boast of wealth will nine times out of ten suffer disappointment. Wealth cannot manufacture true love nor money buy domestic happiness. Marry because you love each other, and God will bless your home. A cottage with a loving wife is worth more than a royal palace with a discontented and unloving queen. 11. DIFFERENCE IN AGE.--It is generally admitted that the husband should be a few years older than the wife. The question seems to be how much difference. Up to twenty-two those who propose marriage should be about the same age; however, other things being equal, a difference of fifteen years after the younger is twenty-five, need not prevent a marriage. A man of forty-five may marry a woman of twenty-five much more safely than one of thirty a girl below nineteen, because her mental sexuality is not as mature as his, and again her natural coyness requires more delicate and affectionate treatment than he is likely to bestow. A girl of twenty or under should seldom if ever marry a man of thirty or over, because the love of an elderly man for a girl is more parental than conjugal; while hers for him is like that of a daughter to a father. He may pet, flatter and indulge her as he would a grown-up daughter, yet all this is not genuine masculine and feminine love, nor can she exert over him the influence every man requires from his wife. 12. THE BEST TIME.--All things considered, we advise the male reader to keep his desires in check till he is at least twenty-five, and the female not to enter the pale of wedlock until she has attained the age of twenty. After those periods, marriage is the proper sphere of action, and one in which nearly every individual is called by nature to play his proper part. 13. SELECT CAREFULLY.--While character, health, accomplishments and social position should be considered, yet one must not overlook mental construction and physical conformation. The rule always to be followed in choosing a life partner is _identity of taste and diversity of temperament_. Another essential is that they be physically adapted to each other. For example: The pelvis--that part of the anatomy containing all the internal organs of gestation--is not only essential to beauty and symmetry, but is a matter of vital importance to her who contemplates matrimony, and its usual consequences. Therefore, the woman with a very narrow and contracted pelvis should never choose a man of giant physical development lest they cannot duly realize the most important of the enjoyments of the marriage state, while the birth of large infants will impose upon her intense labor pains, or even cost her her life. [Illustration: EXPLAINING THE NEED OF A NEW HAT.] * * * * * CHOOSE INTELLECTUALLY--LOVE AFTERWARD. 1. LOVE.--Let it ever be remembered that love is one of the most sacred elements of our nature, and the most dangerous with which to tamper. It is a very beautiful and delicately contrived faculty, producing the most delightful results, but easily thrown out of repair--like a tender plant, the delicate fibers of which incline gradually to entwine themselves around its beloved one, uniting two willing hearts by a thousand endearing ties, and making of "twain one flesh": but they are easily torn asunder, and then adieu to the joys of connubial bliss! 2. COURTING BY THE QUARTER.--This courting by the quarter, "here a little and there a little," is one of the greatest evils of the day. This getting a little in love with Julia, and then a little with Eliza, and a little more with Mary,--this fashionable flirtation and coquetry of both sexes--is ruinous to the domestic affections; besides, effectually preventing the formation of true connubial love. I consider this dissipation of the affections one of the greatest sins against Heaven, ourselves, and the one trifled with, that can be committed. 3. FRITTERING AWAY AFFECTIONS.--Young men commence courting long before they think of marrying, and where they entertain no thoughts of marriage. They fritter away their own affections, and pride themselves on their conquests over the female heart; triumphing in having so nicely fooled them. They pursue this sinful course so far as to drive their pitiable victims, one after another, from respectable society, who, becoming disgraced, retaliate by heaping upon them all the indignities and impositions which the fertile imagination of woman can invent or execute. 4. COURTING WITHOUT INTENDING TO MARRY.--Nearly all this wide-spread crime and suffering connected with public and private licentiousness and prostitution, has its origin in these unmeaning courtships--this premature love--this blighting of the affections, and every young man who courts without intending to marry, is throwing himself or his sweet-heart into _this hell upon earth._ And most of the blame rests on young men, because they take the liberty of paying their addresses to the ladies and discontinuing them, at pleasure, and thereby mainly cause this vice. 5. SETTING THEIR CAPS.--True, young ladies sometimes "set their caps," sometimes court very hard by their bewitching smiles and affectionate manners; by the natural language of love, or that backward reclining and affectionate roll of the head which expresses it; by their soft and persuasive accents; by their low dresses, artificial forms, and many other unnatural and affected ways and means of attracting attention and exciting love; but women never court till they have been in love and experienced its interruption, till their first and most tender fibres of love have been frost-bitten by disappointment. It is surely a sad condition of society. [Illustration: MOTHERHOOD.] 6. TRAMPLING THE AFFECTIONS OF WOMEN.--But man is a self-privileged character. He may not only violate the laws of his own social nature with impunity, but he may even trample upon the affections of woman. He may even carry this sinful indulgence to almost any length, and yet be caressed and smiled tenderly upon by woman; aye, even by virtuous woman. He may call out, only to blast the glowing affections of one young lady after another, and yet his addresses be cordially welcomed by others. Surely a gentleman is at perfect liberty to pay his addresses, not only to a lady, but even to the ladies, although he does not once entertain the thought of marrying his sweet-heart, or, rather his victim. O, man, how depraved! O, woman, how strangely blind to your own rights and interests! 7. AN INFALLIBLE SIGN.--An infallible sign that a young man's intentions are improper, is his trying to excite your passions. If he loves you, he will never appeal to that feeling, because he respects you too much for that. And the woman who allows a man to take advantage of her just to compel him to marry her, is lost and heartless in the last degree, and utterly destitute of moral principle as well as virtue. A woman's riches is her virtue, that gone she has lost all. 8. THE BEGINNING OF LICENTIOUSNESS.--Man it seldom drives from society. Do what he may, woman, aye, virtuous and even pious woman rarely excludes him from her list of visitors. But where is the point of propriety?--immoral transgression should exclude either sex from respectable society. Is it that one false step which now constitutes the boundary between virtue and vice? Or rather, the discovery of that false step? Certainly not! but it is all that leads to, and precedes and induces it. It is this courting without marrying. This is the beginning of licentiousness, as well as its main, procuring cause, and therefore infinitely worse than its consummation merely. 9. SEARING THE SOCIAL AFFECTIONS.--He has seared his social affections so deeply, so thoroughly, so effectually, that when, at last, he wishes to marry, he is incapable of loving. He marries, but is necessarily cold-hearted towards his wife, which of course renders her wretched, if not jealous, and reverses the faculties of both towards each other; making both most miserable for life. This induces contention and mutual recrimination, if not unfaithfulness, and imbitters the marriage relations through life; and well it may. 10. UNHAPPY MARRIAGES.--This very cause, besides inducing most of that unblushing public and private prostitution already alluded to, renders a large proportion of the marriages of the present day unhappy. Good people mourn over the result, but do not once dream of its cause. They even pray for moral reform, yet do the very things that increase the evil. 11. WEEPING OVER HER FALLEN SON.--Do you see yonder godly mother, weeping over her fallen son, and remonstrating with him in tones of a mother's tenderness and importunity? That very mother prevented that very son marrying the girl he dearly loved, because she was poor, and this interruption of his love was the direct and procuring cause of his ruin; for, if she had allowed him to marry this beloved one, he never would have thought of giving his "strength unto strange women." True, the mother ruined her son ignorantly, but none the less effectually. 12. SEDUCTION AND RUIN.--That son next courts another virtuous fair one, engages her affections, and ruins her, or else leaves her broken-hearted, so that she is the more easily ruined by others, and thus prepares the way for her becoming an inmate of a house "whose steps take hold on hell." His heart is now indifferent, he is ready for anything. 13. THE RIGHT PRINCIPLE.--I say then, with emphasis, that no man should ever pay his addresses to any woman, until he has made his selection, not even to aid him in making that choice. He should first make his selection intellectually, and love afterward. He should go about the matter coolly and with judgment, just as he would undertake any other important matter. No man or woman, when blinded by love, is in a fit state to judge advantageously as to what he or she requires, or who is adapted to his or her wants. 14. CHOOSING FIRST AND LOVING AFTERWARDS.--I know, indeed, that this doctrine of choosing first and loving afterward, of excluding love from the councils, and of choosing by and with the consent of the intellect and moral sentiments, is entirely at variance with the feelings of the young and the customs of society; but, for its correctness, I appeal to the common-sense--not to the experience, for so few try this plan. Is not this the only proper method, and the one most likely to result happily? Try it. 15. THE YOUNG WOMAN'S CAUTION.--And, especially, let no young lady ever once think of bestowing her affections till she is certain they will not be broken off--that is, until the match is fully agreed upon, but rather let her keep her heart whole till she bestows it for life. This requisition is as much more important, and its violation as much more disastrous to woman than to man, as her social faculties are stronger than his. 16. A BURNT CHILD DREADS THE FIRE.--As a "burnt child dreads the fire," and the more it is burnt, the greater the dread: so your affections, once interrupted, will recoil from a second love, and distrust all mankind. No! you cannot be too choice of your love--that pivot on which turn your destinies for life and future happiness. [Illustration: AFTER THE ENGAGEMENT.] * * * * * LOVE-SPATS. Could ever hear by tale or history, The course of true love never did run smooth. --SHAKESPEARE. "Heaven has no rage like love to hatred turned, Nor hell a fury like a woman scorned."--CONGREVE. "Thunderstorms clear the atmosphere and promote vegetation; then why not Love-spats promote love, as they certainly often do?" "They are almost universal, and in the nature of our differences cannot be helped. The more two love, the more they are aggrieved by each other's faults; of which these spats are but the correction." "Love-spats instead of being universal, they are consequent on imperfect love, and only aggravate, never correct errors. Sexual storms never improve, whereas love obviates faults by praising the opposite virtues. Every view of them, practical and philosophical, condemns them as being to love what poison is to health, both before and after marriage. They are nothing but married discords. Every law of mind and love condemns them. Shun them as you would deadly vipers, and prevent them by forestallment."--O.S. Fowler. 1. THE TRUE FACTS.--Notwithstanding some of the above quotations, to the contrary, trouble and disagreement between lovers embitters both love and life. Contention is always dangerous, and will beget alienation if not final separation. 2. CONFIRMED AFFECTIONS.--Where affections are once thoroughly confirmed, each one should be very careful in taking offense, and avoid all disagreements as far as possible, but if disagreements continually develop with more or less friction and irritation, it is better for the crisis to come and a final separation take place. For peace is better than disunited love. 3. HATE-SPATS.--Hate-spats, though experienced by most lovers, yet, few realize how fatal they are to subsequent affections. Love-spats develop into hate-spats, and their effects upon the affections are blighting and should not under any circumstances be tolerated. Either agree, or agree to disagree. If there cannot be harmony before the ties of marriage are assumed, then there cannot be harmony after. Married life will be continually marred by a series of "hate-spats" that sooner or later will destroy all happiness, unless the couple are reasonably well mated. [Illustration: HOME LOVING HEARTS ARE HAPPIEST.] 4. MORE FATAL THE OFTENER THEY OCCUR.--As O.S. Fowler says: "'The poison of asps is under their lips.' The first spat is like a deep gash cut into a beautiful face, rendering it ghastly, and leaving a fearful scar, which neither time nor cosmetics can ever efface; including that pain so fatal to love, and blotting that sacred love-page with memory's most hideous and imperishable visages. Cannot many now unhappy remember them as the beginning of that alienation which embittered your subsequent affectional cup, spoiled your lives? With what inherent repulsion do you look back upon them? Their memory is horrid, and effect on love most destructive." 5. FATAL CONDITIONS.--What are all lovers' "spats" but disappointment in its very worst form? They necessarily and always produce all its terrible consequences. The finer feelings and sensibilities will soon become destroyed and nothing but hatred will remain. 6. EXTREME SORROW.--After a serious "spat" there generally follows a period of tender sorrow, and a feeling of humiliation and submission. Mutual promises are consequently made that such a condition of things shall never happen again, etc. But be sure and remember, that every subsequent difficulty will require stronger efforts to repair the breach. Let it be understood that these compromises are dangerous, and every new difficulty increases their fatality. Even the strongest will endure but few, nor survive many. 7. DISTRUST AND WANT OF CONFIDENCE.--Most difficulties arise from distrust or lack of confidence or common-sense. When two lovers eye each other like two curs, each watching, lest the other should gain some new advantage, then this shows a lack of common-sense, and the young couple should get sensible or separate. 8. JEALOUSY.--When one of the lovers, once so tender, now all at once so cold and hardened; once so coy and familiar now suddenly so reserved, distant, hard and austere, is always a sure case of jealousy. A jealous person is first talkative, very affectionate, and then all at once changes and becomes cold, reserved and repulsive, apparently without cause. If a person is jealous before marriage, this characteristic will be increased rather than diminished by marriage. 9. CONFESSION.--If you make up by confession, the confessor feels mean and disgraced; or if both confess and forgive, both feel humbled; since forgiveness implies inferiority and pity; from which whatever is manly and womanly shrinks. Still even this is better than continued "spats." 10. PREVENTION.--If you can get along well in your courtship you will invariably make a happy couple if you should unite your destinies in marriage. Learn not to give nor take offence. You must remember that all humanity is imperfect at best. We all have our faults, and must keep them in subordination. Those who truly love each other will have but few difficulties in their courtship or in married life. 11. REMEDIES.--Establishing a perfect love in the beginning constitutes a preventive. Fear that they are not truly loved usually paves the way for "spats." Let all who make any pretension guard against all beginnings of this reversal, and strangle these "hate-spats" the moment they arise. "Let not the sun go down upon thy wrath," not even an hour, but let the next sentence after they begin quench them forever. And let those who cannot court without "spats," stop; for those who spat before marriage must quarrel after. [Illustration: "LET NOT THE SUN GO DOWN UPON THY WRATH".] [Illustration: ALONE AND FORSAKEN.] * * * * * A BROKEN HEART. 1. WOUNDED LOVE.--'Tis true that love wields a magic, sovereign, absolute, and tyrannical power over both the body and the mind when it is given control. It often, in case of dissapointment, works havoc and deals death blows to its victims, and leaves many in that morbid mental condition which no life-tonics simply can restore. Wounded love may be the result of hasty and indiscreet conduct of young people; or the outgrowth of lust, or the result of domestic infidelity and discord. 2. FATAL EFFECTS.--Our cemeteries receive within the cold shadows of the grave thousands and thousands of victims that annually die from the results of "broken hearts." It is no doubt a fact that love troubles cause more disorders of the heart than everything else combined. 3. DISRUPTED LOVE.--It has long been known that dogs, birds, and even horses, when separated from their companions or friends, have pined away and died; so it is not strange that man with his higher intuitive ideas of affection should suffer from love when suddenly disrupted. 4. CRUCIFYING LOVE.--Painful love feelings strike right to the heart, and the breaking up of love that cannot be consummated in marriage is sometimes allowed to crucify the affections. There is no doubt that the suffering from disappointed love is often deeper and more intense than meeting death itself. 5. HEALING.--The paralyzing and agonizing consequences of ruptured love can only be remedied by diversion and society. Bring the mind into a state of patriotic independence with a full determination to blot out the past. Those who cannot bring into subordination the pangs of disappointment in love are not strong characters, and invariably will suffer disappointments in almost every department of life. Disappointment in love means rising above it, and conquering it, or demoralization, mental, physical and sexual. 6. LOVE RUNS MAD.--Love comes unbidden. A blind ungovernable impulse seems to hold sway in the passions of the affections. Love is blind and seems to completely subdue and conquer. It often comes like a clap of thunder from a clear sky, and when it falls it falls flat, leaving only the ruins of a tornado behind. 7. BAD, DISMAL, AND BLUE FEELINGS.--Despondency breathes disease, and those who yield to it can neither work, eat nor sleep; they only suffer. The spell-bound, fascinated, magnetized affections seem to deaden self-control and no doubt many suffering from love-sickness are totally helpless; they are beside themselves, irritational and wild. Men and women of genius, influence and education, all seem to suffer alike, but they do not yield alike to the subduing influence; some pine away and die; others rise above it, and are the stronger and better for having been afflicted. 8. RISE ABOVE IT.--Cheer up! If you cannot think pleasurably over your misfortune, forget it. You must do this or perish. Your power and influence is too much to blight by foolish and melancholic pining. Your own sense, your self-respect, your self-love, your love for others, command you not to spoil yourself by crying over "spilt milk." 9. RETRIEVE YOUR PAST LOSS.--Do sun, moon, and stars indeed rise and set in your loved one? Are there not "as good fish in the sea as ever were caught?" and can you not catch them? Are there not other hearts on earth just as loving and lovely, and in every way as congenial; If circumstances had first turned you upon another, you would have felt about that one as now about this. Love depends far less on the party loved than on the loving one. Or is this the way either to retrieve your past loss, or provide for the future? Is it not both unwise and self-destructive; and in every way calculated to render your case, present and prospective, still more hopeless? 10. FIND SOMETHING TO DO.--Idle hands are Satan's workshop. Employ your mind; find something to do; something in which you can find self-improvement; something that will fit you better to be admired by someone else, read, and improve your mind; get into society, throw your whole soul into some new enterprise, and you will conquer with glory and come out of the fire purified and made more worthy. 11. LOVE AGAIN.--As love was the cause of your suffering, so love again will restore you, and you will love better and more consistently. Do not allow yourself to become soured and detest and shun association. Rebuild your dilapidated sexuality by cultivating a general appreciation of the excellence, especially of the mental and moral qualities of the opposite sex. Conquer your prejudices, and vow not to allow anyone to annoy or disturb your calmness. 12. LOVE FOR THE DEAD.--A most affectionate woman, who continues to love her affianced though long dead, instead of becoming soured or deadened, manifests all the richness and sweetness of the fully-developed woman thoroughly in love, along with a softened, mellow, twilight sadness which touches every heart, yet throws a peculiar lustre and beauty over her manners and entire character. She must mourn, but not forever. It is not her duty to herself or to her Creator. 13. A SURE REMEDY.--Come in contact with the other sex. You are infused with your lover's magnetism, which must remain till displaced by another's. Go to parties and picnics; be free, familiar, offhand, even forward; try your knack at fascinating another, and yield to fascinations yourself. But be honest, command respect, and make yourself attractive and worthy. [Illustration: A SURE REMEDY.] * * * * * FORMER CUSTOMS AND PECULIARITIES AMONG MEN. 1. POLYGAMY.--There is a wide difference as regards the relations of the sexes in different parts of the world. In some parts polygamy has prevailed from time immemorial. Most savage people are polygamists, and the Turks, though slowly departing from the practice, still allow themselves a plurality of wives. 2. RULE REVERSED.--In Thibet the rule is reversed, and the females are provided with two or more husbands. It is said that in many instances a whole family of brothers have but one wife. The custom has at least one advantageous feature, viz.: the possibility of leaving an unprotected widow and a number of fatherless children is entirely obviated. 3. THE MORGANATIC MARRIAGE is a modification of polygamy. It sometimes occurs among the royalty of Europe, and is regarded as perfectly legitimate, but the morganatic wife is of lower rank than her royal husband, and her children do not inherit his rank or fortune. The Queen only is the consort of the sovereign, and entitled to share his rank. 4. DIFFERENT MANNERS OF OBTAINING WIVES.--Among the uncivilized almost any envied possession is taken by brute force or superior strength. The same is true in obtaining a wife. The strong take precedence of the weak. It is said that among the North American Indians it was the custom for men to wrestle for the choice of women. A weak man could seldom retain a wife that a strong man coveted. The law of contest was not confined to individuals alone. Women were frequently the cause of whole tribes arraying themselves against each other in battle. The effort to excel in physical power was a great incentive to bodily development, and since the best of the men were preferred by the most superior women, the custom was a good one in this, that the race was improved. 5. THE ABORIGINAL AUSTRALIAN employed low cunning and heartless cruelty in obtaining his wife. Laying in ambush, with club in hand, he would watch for the coveted woman, and, unawares, spring upon her. If simply disabled he carried her off as his possession, but if the blow had been hard enough to kill, he abandoned her to watch for another victim. There is here no effort to attract or please, no contest of strength; his courtship, if courtship it can be called, would compare very unfavorably with any among the brute creation. 6. THE KALMUCK TARTAR races for his bride on horseback, she having a certain start previously agreed upon. The nuptial knot consists in catching her, but we are told that the result of the race all depends upon whether the girl wants to be caught or not. 7. HAWAIIAN ISLANDERS.--Marriage among the early natives of these islands was merely a matter of mutual inclination. There was no ceremony at all, the men and women united and separated as they felt disposed. 8. THE FEUDAL LORD, in various parts of Europe, when any of his dependents or followers married, exercised the right of assuming the bridegroom's proper place in the marriage couch for the first night. Seldom was there any escape from this abominable practice. Sometimes the husband, if wealthy, succeeded in buying off the petty sovereign from exercising his privilege. 9. THE SPARTANS had the custom of encouraging intercourse between their best men and women for the sake of a superior progeny, without any reference to a marriage ceremony. Records show that the ancient Roman husband has been known to invite a friend, in whom he may have admired some physical or mental trait, to share the favors of his wife; that the peculiar qualities that he admired might be repeated in the offspring. [Illustration] [Illustration: PROPOSING.] [Illustration] Hasty marriage seldom proveth well.--_Shakespeare, Henry VI._ The reason why so few marriages are happy is, because young ladies spend their time in making nets, not in making cages.--_Swift, Thoughts on Various Subjects._ * * * * * SENSIBLE HINTS IN CHOOSING A PARTNER. 1. There are many fatal errors and many love-making failures in courtship. Natural laws govern all nature and reduce all they govern to eternal right; therefore love naturally, not artificially. Don't love a somebody or a nobody simply because they have money. 2. COURT SCIENTIFICALLY.--If you court at all, court scientifically. Bungle whatever else you will, but do no bungle courtship. A failure in this may mean more than a loss of wealth or public honors; it may mean ruin, or a life often worse than death. The world is full of wretched and mismated people. BEGIN RIGHT and all will be right; begin wrong and all will end wrong. When you court, make a business of it and study your interest the same as you would study any other business proposition. 3. DIVORCES.--There is not a divorce on our court records that is not the result of some fundamental error in courtship. The purity or the power of love may be corrupted the same as any other faculty, and when a man makes up his mind to marry and shuts his eyes and grabs in the dark for a companion, he dishonors the woman he captures and commits a crime against God and society. In this enlightened age there should be comparatively few mistakes made in the selection of a suitable partner. Sufficient time should be taken to study each other's character and disposition. Association will soon reveal adaptability. 4. FALSE LOVE.--Many a poor, blind and infatuated novice thinks he is desperately in love, when there is not the least genuine affection in his nature. It is all a momentary passion a sort of puppy love; his vows and pledges are soon violated, and in wedlock he will become indifferent and cold to his wife and children, and he will go through life without ambition, encouragement or success. He will be a failure. True love speaks for itself, and the casual observer can read its proclamations. True love does not speak in a whisper, it always makes itself heard. The follies of flirting develops into many unhappy marriages, and blight many a life. Man happily married has superior advantages both social and financially. 5. FLIRTING JUST FOR FUN.--Who is the flirt, what is his reputation, motive, or character? Every young man and woman must have a reputation; if it is not good it is bad, there is no middle ground. Young people who are running in the streets after dark, boisterous and noisy in their conversation, gossiping and giggling, flirting with first one and then another, will soon settle their matrimonial prospects among good society. Modesty is a priceless jewel. No sensible young man with a future will marry a flirt. 6. THE ARCH-DECEIVER.--They who win the affection simply for their own amusement are committing a great sin for which there is no adequate punishment. How can you shipwreck the innocent life of that confiding maiden, how can you forget her happy looks as she drank in your expressions of love, how can you forget her melting eyes and glowing cheeks, her tender tone reciprocating your pretended love? Remember that God is infinitely just, and "the soul that sinneth shall surely die." You may dash into business, seek pleasure in the club room, and visit gambling hells, but "Thou art the man" will ever stare you in the face. Her pale, sad cheeks, her hollow eyes will never cease to haunt you. Men should promote happiness, and not cause misery. Let the savage Indians torture captives to death by the slow flaming fagot, but let civilized man respect the tenderness and love of confiding women. Torturing the opposite sex is double-distilled barbarity. Young men agonizing young ladies, is the cold-blooded cruelty of devils, not men. 7. THE RULE TO FOLLOW.--Do not continually pay your attentions to the same lady if you have no desire to win her affections. Occasionally escorting her to church, concert, picnic, party, etc., is perfectly proper; but to give her your special attention, and extend invitations to her for all places of amusements where you care to attend, is an implied promise that you prefer her company above all others, and she has a right to believe that your attentions are serious. [Illustration: THE WEDDING RING.] 8. EVERY GIRL SHOULD SEAL HER HEART against all manifested affections, unless they are accompanied by a proposal. Woman's love is her all, and her heart should be as flint until she finds one who is worthy of her confidence. Young woman, never bestow your affections until by some word or deed at least you are fully justified in recognizing sincerity and faith in him who is paying you special attention. Better not be engaged until twenty-two. You are then more competent to judge the honesty and falsity of man. Nature has thrown a wall of maidenly modesty around you. Preserve that and not let your affections be trifled with while too young by any youthful flirt who is in search of hearts to conquer. 9. FEMALE FLIRTATION.--The young man who loves a young woman has paid her the highest compliment in the possession of man. Perpetrate almost any sin, inflict any other torture, but spare him the agony of disappointment. It is a crime that can never be forgiven, and a debt that never can be paid. 10. LOYALTY.--Young persons with serious intentions, or those who are engaged should be thoroughly loyal to each other. If they seek freedom with others the flame of jealousy is likely to be kindled and love is often turned to hatred, and the severest anger of the soul is aroused. Loyalty, faithfulness, confidence, are the three jewels to be cherished in courtship. Don't be a flirt. 11. KISSING, FONDLING, AND CARESSING BETWEEN LOVERS.--This should never be tolerated under any circumstances, unless there is an engagement to justify it, and then only in a sensible and limited way. The girl who allows a young man the privilege of kissing her or putting his arms around her waist before engagement will at once fall in the estimation of the man she has thus gratified and desired to please. Privileges always injure, but never benefit. 12. IMPROPER LIBERTIES DURING COURTSHIP KILL LOVE.--Any improper liberties which are permitted by young ladies, whether engaged or not, will change love into sensuality, and her affections will become obnoxious, if not repellent. Men by nature love virtue, and for a life companion naturally shun an amorous woman. Young folks, as you love moral purity and virtue, never reciprocate love until you have required the right of betrothal. Remember that those who are thoroughly in love will respect the honor and virtue of each other. The purity of woman is doubly attractive, and sensuality in her becomes doubly offensive and repellent. It is contrary to the laws of nature for a man to love a harlot. 13. A SEDUCER.--The punishment of the seducer is best given by O.S. Fowler, in his "Creative Science." The sin and punishment rest on all you who call out only to blight a trusting, innocent, loving virgin's affections, and then discard her. You deserve to be horsewhipped by her father, cowhided by her brothers, branded villain by her mother, cursed by herself, and sent to the whipping-post and dungeon. 14. CAUTION.--A young lady should never encourage the attentions of a young man, who shows no interest in his sisters. If a young man is indifferent to his sisters he will become indifferent to his wife as soon as the honey moon is over. There are few if any exceptions to this rule. The brother who will not be kind and loving in his mother's home will make a very poor husband. 15. THE OLD RULE: "Never marry a man that does not make his mother a Christmas present every Christmas," is a good one. The young lady makes no mistake in uniting her destinies with the man that loves his mother and respects his sisters and brothers. [Illustration] [Illustration: A CHINESE BRIDE AND GROOM.] * * * * * SAFE HINTS. 1. Marry in your own position in life. If there is any difference in social position, it is better that the husband should be the superior. A woman does not like to look down upon her husband, and to be obliged to do so is a poor guarantee for their happiness. 2. It is best to marry persons of your own faith and religious convictions, unless one is willing to adopt those of the other. Difference of faith is apt to divide families, and to produce great trouble in after life. A pious woman should beware of marrying an irreligious man. 3. Don't be afraid of marrying a poor man or woman. Good health, cheerful disposition, stout hearts and industrious hands will bring happiness and comfort. 4. Bright red hair should marry jet black, and jet black auburn or bright red, etc. And the more red-faced and bearded or impulsive a man, the more dark, calm, cool and quiet should his wife be; and vice versa. The florid should not marry the florid, but those who are dark, in proportion as they themselves are light. 5. Red-whiskered men should marry brunettes, but no blondes; the color of the whiskers being more determinate of the temperament than that of the hair. 6. The color of the eyes is still more important. Gray eyes must marry some other color, almost any other except gray; and so of blue, dark, hazel, etc. 7. Those very fleshy should not marry those equally so, but those too spare and slim; and this is doubly true of females. A spare man is much better adapted to a fleshy woman than a round-favored man. Two who are short, thick-set and stocky, should not unite in marriage, but should choose those differently constituted; but on no account one of their own make. And, in general, those predisposed to corpulence are therefore less inclined to marriage. 8. Those with little hair or beard should marry those whose hair is naturally abundant; still those who once had plenty, but who have lost it, may marry those who are either bald or have but little; for in this, as in all other cases, all depends on what one is by nature, little on present states. 9. Those whose motive-temperament decidedly predominates, who are bony, only moderately fleshy, quite prominent-featured, Roman-nosed and muscular, should not marry those similarly formed. 10. Small, nervous men must not marry little, nervous or sanguine women, lest both they and their children have quite too much of the hot-headed and impulsive, and die suddenly. 11. Two very beautiful persons rarely do or should marry; nor two extra homely. The fact is a little singular that very handsome women, who of course can have their pick, rarely marry good-looking men, but generally give preference to those who are homely; because that exquisiteness in which beauty originates naturally blends with that power which accompanies huge noses and disproportionate features. [Illustration: LIGHT. LIFE. HEALTH AND BEAUTY.] 12. Rapid movers, speakers, laughers, etc., should marry those who are calm and deliberate, and impulsives those who are stoical; while those who are medium may marry those who are either or neither, as they prefer. 13. Noses indicate characters by indicating the organisms and temperaments. Accordingly, those noses especially marked either way should marry those having opposite nasal characteristics. Roman noses are adapted to those which turn up, and pug noses to those turning down; while straight noses may marry either. 14. Men who love to command must be especially careful not to marry imperious, women's-rights woman; while those who willingly "obey orders" need just such. Some men require a wife who shall take their part; yet all who do not need strong-willed women, should be careful how they marry them. 15. A sensible woman should not marry an obstinate but injudicious, unintelligent man; because she cannot long endure to see and help him blindly follow his poor, but spurn her good, plans. 16. The reserved or secretive should marry the frank. A cunning man cannot endure the least artifice in a wife. Those who are non-committal must marry those who are demonstrative; else, however much they may love, neither will feel sure as to the other's affections, and each will distrust the other, while their children will be deceitful. 17. A timid woman should never marry a hesitating man, lest, like frightened children, each keep perpetually re-alarming the other by imaginary fears. 18. An industrious, thrifty, hard-working man should marry a woman tolerably saving and industrious. As the "almighty dollar" is now the great motor-wheel of humanity, and that to which most husbands devote their entire lives to delve alone is uphill work. [Illustration] [Illustration: FIRESIDE FANCIES.] * * * * * MARRIAGE SECURITIES. 1. SEEK EACH OTHER'S HAPPINESS.--A selfish marriage that seeks only its own happiness defeats itself. Happiness is a fire that will not burn long on one stick. 2. DO NOT MARRY SUDDENLY.--It can always be done till it is done, if it is a proper thing to do. 3. MARRY IN YOUR OWN GRADE IN SOCIETY.--It is painful to be always apologizing for any one. It is more painful to be apologized for. 4. DO NOT MARRY DOWNWARD.--It is hard enough to advance in the quality of life without being loaded with clay heavier than your own. It will be sufficiently difficult to keep your children up to your best level without having to correct a bias in their blood. 5. DO NOT SELL YOURSELF.--It matters not whether the price be money or position. 6. DO NOT THROW YOURSELF AWAY.--You will not receive too much, even if you are paid full price. 7. SEEK THE ADVICE OF YOUR PARENTS.--Your parents are your best friends. They will make more sacrifice for you than any other mortals. They are elevated above selfishness concerning you. If they differ from you concerning your choice, it is because they must. 8. DO NOT MARRY TO PLEASE ANY THIRD PARTY.--You must do the living and enduring. 9. DO NOT MARRY TO SPITE ANYBODY.--It would add wretchedness to folly. 10. DO NOT MARRY BECAUSE SOMEONE ELSE MAY SEEK THE SAME HAND.--One glove may not fit all hands equally well. 11. DO NOT MARRY TO GET RID OF ANYBODY.--The coward who shot himself to escape from being drafted was insane. 12. DO NOT MARRY MERELY FOR THE IMPULSE OF LOVE.--Love is a principle as well as an emotion. So far as it is a sentiment it is a blind guide. It does not wait to test the presence of exalted character in its object before breaking out into a flame. Shavings make a hot fire, but hard coal is better for the Winter. 13. DO NOT MARRY WITHOUT LOVE.--A body without a soul soon becomes offensive. 14. TEST CAREFULLY THE EFFECT OF PROTRACTED ASSOCIATION.--If familiarity breeds contempt before marriage it will afterward. 15. TEST CAREFULLY THE EFFECT OF PROTRACTED SEPARATION.--True love will defy both time and space. 16. CONSIDER CAREFULLY the right of your children under the laws of heredity. It is doubtful whether you have a right to increase the number of invalids and cripples. 17. DO NOT MARRY SIMPLY BECAUSE YOU HAVE PROMISED TO DO SO.--If a seam opens between you now it will widen into a gulf. It is less offensive to retract a mistaken promise than to perjure your soul before the altar. Your intended spouse has a right to absolute integrity. [Illustration: GOING TO BE MARRIED.] 18. MARRY CHARACTER.--It is not so much what one has as what one is. 19. DO NOT MARRY THE WRONG OBJECT.--Themistocles said he would rather marry his daughter to a man without money than to money with a man. It is well to have both. It is fatal to have neither. 20. DEMAND A JUST RETURN.--You give virtue and purity, and gentleness and integrity. You have a right to demand the same in return. Duty requires it. 21. REQUIRE BRAINS.--Culture is good, but will not be transmitted. Brain power may be. 22. STUDY PAST RELATIONSHIP.--The good daughter and sister makes a good wife. The good son and brother makes a good husband. 23. NEVER MARRY AS A MISSIONARY DEED.--If one needs saving from bad habits he is not suitable for you. 24. MARRIAGE IS A SURE AND SPECIFIC REMEDY for all the ills known as seminal losses. As right eating cures a sick stomach and right breathing diseased lungs, so the right use of the sexual organs will bring relief and restoration. Many men who have been sufferers from indiscretions of youth, have married, and were soon cured of spermatorrhoea and other complications which accompanied it. 25. A GOOD, LONG COURTSHIP will often cure many difficulties or ills of the sexual organs. O.S. Fowler says: "See each other often spend many pleasant hours together," have many walks and talks, think of each other while absent, write many love letters, be inspired to many love feelings and acts towards each other, and exercise your sexuality in a thousand forms ten thousand times, every one of which tones up and thereby recuperates this very element now dilapidated. When you have courted long enough to marry, you will be sufficiently restored to be reimproved by it. UP AND AT IT.--Dress up, spruce up, and be on the alert. Don't wait too long to get one much more perfect than you are; but settle on some one soon. Remember that your unsexed state renders you over-dainty, and easily disgusted. So contemplate only their lovable qualities. 26. PURITY OF PURPOSE.--Court with a pure and loyal purpose, and when thoroughly convinced that the disposition of other difficulties are in the way of a happy marriage life, then _honorably_ discuss it and honorably treat each other in the settlement. 27. DO NOT TRIFLE with the feelings or affections of each other. It is a sin that will curse you all the days of your life. * * * * * WOMEN WHO MAKE THE BEST WIVES. 1. CONSCIOUS OF THE DUTIES OF HER SEX.--A woman conscious of the duties of her sex, one who unflinchingly discharges the duties allotted to her by nature, would no doubt make a good wife. 2. GOOD WIVES AND MOTHERS.--The good wives and mothers are the women who believe in the sisterhood of women as well as in the brotherhood of men. The highest exponent of this type seeks to make her home something more than an abode where children are fed, clothed and taught the catechism. The State has taken her children into politics by making their education a function of politicians. The good wife and homemaker says to her children, "Where thou goest, I will go." She puts off her own inclinations to ease and selfishness. She studies the men who propose to educate her children; she exhorts mothers to sit beside fathers on the school-board; she will even herself accept such thankless office in the interests of the helpless youth of the schools who need a mother's as well as a father's and a teacher's care in this field of politics. 3. A BUSY WOMAN.--As to whether a busy woman, that is, a woman who labors for mankind in the world outside her home,--whether such an one can also be a good housekeeper, and care for her children, and make a real "Home, Sweet Home!" with all the comforts by way of variation, why! I am ready, as the result of years practical experience as a busy woman, to assert that women of affairs can also be women of true domestic tastes and habits. 4. BRAINY ENOUGH.--What kind of women make the best wives? The woman who is brainy enough to be a companion, wise enough to be a counsellor, skilled enough in the domestic virtues to be a good housekeeper, and loving enough to guide in true paths the children with whom the home may be blessed. 5. FOUND THE RIGHT HUSBAND.--The best wife is the woman who has found the right husband, a husband who understands her. A man will have the best wife when he rates that wife as queen among women. Of all women she should always be to him the dearest. This sort of man will not only praise the dishes made by his wife, but will actually eat them. 6. BANK ACCOUNT.--He will allow his life-companion a bank account, and will exact no itemized bill at the end of the month. Above all, he will pay the Easter bonnet bill without a word, never bring a friend to dinner without first telephoning home,--short, he will comprehend that the woman who makes the best wife is the woman whom, by his indulgence of her ways and whims, he makes the best wife. So after all, good husbands have the most to do with making good wives. [Illustration: PUNISHMENT OF WIFE BEATERS IN NEW ENGLAND IN THE EARLY DAYS.] 7. BEST HOME MAKER.--A woman to be the best home maker needs to be devoid of intensive "nerves." She must be neat and systematic, but not too neat, lest she destroy the comfort she endeavors to create. She must be distinctly amiable, while firm. She should have no "career," or desire for a career, if she would fill to perfection the home sphere. She must be affectionate, sympathetic and patient, and fully appreciative of the worth and dignity of her sphere. 8. KNOW NOTHING WHATSOEVER ABOUT COOKING OR SEWING OR HOUSEKEEPING.--I am inclined to make my answer to this question somewhat concise, after the manner of a text without the sermon. Like this: To be the "best wife" depends upon three things: first, an abiding faith with God; second, duty lovingly discharged as daughter, wife and mother; third, self-improvement, mentally, physically, spiritually. With this as a text and as a glittering generality, let me touch upon one or two practical essentials. In the course of every week it is my privilege to meet hundreds of young women,--prospective wives. I am astonished to find that many of these know nothing whatsoever about cooking or sewing or housekeeping. Now, if a woman cannot broil a beefsteak, nor boil the coffee when it is necessary, if she cannot mend the linen, nor patch a coat, if she cannot make a bed, order the dinner, create a lamp-shade, ventilate the house, nor do anything practical in the way of making home actually a home, how can she expect to make even a good wife, not to speak of a better or best wife? I need not continue this sermon. Wise girls will understand. 9. THE BEST KEEPER OF HOME.--As to who is the best keeper of this transition home, memory pictures to me a woman grown white under the old slavery, still bound by it, in that little-out-of-the-way Kansas town, but never so bound that she could not put aside household tasks, at any time, for social intercourse, for religious conversation, for correspondence, for reading, and, above all, for making everyone who came near her feel that her home was the expression of herself, a place for rest, study, and the cultivation of affection. She did not exist for her walls, her carpets, her furniture; they existed for her and all who came to her She considered herself the equal of all; and everyone else thought her the superior of all. * * * * * ADAPTATION, CONJUGAL AFFECTION, AND FATAL ERRORS. ADVICE TO THE MARRIED AND UNMARRIED. 1. MARRYING FOR WEALTH.--Those who marry for wealth often get what they marry and nothing else; for rich girls besides being generally destitute of both industry and economy, are generally extravagant in their expenditures, and require servants enough to dissipate a fortune. They generally have insatiable wants, yet feel that they deserve to be indulged in everything, because they placed their husbands under obligation to them by bringing them a dowry. And then the mere idea of living on the money of a wife, and of being supported by her, is enough to tantalize any man of an independent spirit. 2. SELF-SUPPORT.--What spirited husband would not prefer to support both himself and wife, rather than submit to this perpetual bondage of obligation. To live upon a father, or take a patrimony from him, is quite bad enough; but to run in debt to a wife, and owe her a living, is a little too aggravating for endurance, especially if there be not perfect cordiality between the two, which cannot be the case in money matches. Better live wifeless, or anything else, rather than marry for money. 3. MONEY-SEEKERS.--Shame on sordid wife-seekers, or, rather, money-seekers; for it is not a wife that they seek, but only filthy lucre! They violate all their other faculties simply to gratify miserly desire. Verily such "have their reward"! 4. THE PENITENT HOUR.--And to you, young ladies, let me say with great emphasis, that those who court and marry you because you are rich, will make you rue the day of your pecuniary espousals. They care not for you, but only your money, and when they get that, will be liable to neglect or abuse you, and probably squander it, leaving you destitute and abandoning you to your fate. 6. INDUSTRY THE SIGN OF NOBILITY.--Marry a working, industrious young lady, whose constitution is strong, flesh solid, and health unimpaired by confinement, bad habits, or late hours. Give me a plain, home-spun farmer's daughter, and you may have all the rich and fashionable belles of our cities and villages. 6. WASP WAISTS.--Marrying small waists is attended with consequences scarcely less disastrous than marrying rich and fashionable girls. An amply developed chest is a sure indication of a naturally vigorous constitution and a strong hold on life; while small waists indicate small and feeble vital organs, a delicate constitution, sickly offspring, and a short life. Beware of them, therefore, unless you wish your heart broken by the early death of your wife and children. [Illustration: UNTIL DEATH US DO PART.] 7. MARRYING TALKERS.--In marrying a wit or a talker merely, though the brilliant scintillations of the former, or the garrulity of the latter, may amuse or delight you for the time being, yet you will derive no permanent satisfaction from these qualities, for there will be no common bond of kindred feeling to assimilate your souls and hold each spell-bound at the shrine of the other's intellectual or moral excellence. 8. THE SECOND WIFE.--Many men, especially in choosing a second wife, are governed by her own qualifications as a housekeeper mainly, and marry industry and economy. Though these traits of character are excellent, yet a good housekeeper may be far from being a good wife. A good housekeeper, but a poor wife, may indeed prepare you a good dinner, and keep her house and children neat and tidy, yet this is but a part of the office of a wife; who, besides all her household duties, has those of a far higher order to perform. She should soothe you with her sympathies, divert your troubled mind, and make the whole family happy by the gentleness of her manners, and the native goodness of her heart. A husband should also likewise do his part. 9. DO NOT MARRY A MAN WITH A LOW, FLAT HEAD; for, however fascinating, genteel, polite, tender, plausible or winning he may be, you will repent the day of your espousal. 10. HEALTHY WIRES AND MOTHERS.--Let girls romp, and let them range hill and dale in search of flowers, berries, or any other object of amusement or attraction; let them bathe often, skip the rope, and take a smart ride on horseback; often interspersing these amusements with a turn of sweeping or washing, in order thereby to develop their vital organs, and thus lay a substantial physical foundation for becoming good wives and mothers. The wildest romps usually make the best wives, while quiet, still, demure, sedate and sedentary girls are not worth having. 11. SMALL STATURE.--In passing, I will just remark, that good size is important in wives and mothers. A small stature is objectionable in a woman, because little women usually have too much activity for their strength, and, consequently, feeble constitutions; hence they die young, and besides, being nervous, suffer extremely as mothers. 12. HARD TIMES AND MATRIMONY.--Many persons, particularly young men, refuse to marry, especially "these hard time," because they cannot support a wife in the style they wish. To this I reply, that a good wife will care less for the style in which she is supported, than for you. She will cheerfully conform to your necessities, and be happy with you in a log-cabin. She will even help you support yourself. To support a good wife, even if she have children, is really less expensive than to board alone, besides being one of the surest means of acquiring property. 13. MARRYING FOR A HOME.--Do not, however, marry for a home merely, unless you wish to become even more destitute with one than without one; for, it is on the same footing with "marrying for money." Marry a man for his merit; and you take no chances. 14. MARRY TO PLEASE NO ONE BUT YOURSELF.--Marriage is a matter exclusively your own; because you alone must abide its consequences. No person, not even a parent, has the least right to interfere or dictate in this matter. I never knew a marriage, made to please another, to turn out any otherwise than most unhappily. 15. DO NOT MARRY TO PLEASE YOUR PARENTS. Parents can not love for their children any more than they can eat or sleep, or breathe, or die and go to heaven for them. They may give wholesome advice merely, but should leave the entire decision to the unbiased judgment of the parties themselves, who mainly are to experience the consequences of their choice. Besides, such is human nature, that to oppose lovers, or to speak against the person beloved, only increases their desire and determination to marry. 16. RUN-AWAY MATCHES.--Many a run-away match would never have taken place but for opposition or interference. Parents are mostly to be blamed for these elopements. Their children marry partly out of sprite and to be contrary. Their very natures tell them that this interference is unjust--as it really is--and this excites combativeness, firmness, and self-esteem, in combination with the social faculties, to powerful and even blind resistance--which turmoil of the faculties hastens the match. Let the affections of a daughter be once slightly enlisted in your favor, and then let the "old folks" start an opposition, and you may feel sure of your prize. If she did not love you before, she will now, that you are persecuted. 17. DISINHERITANCE.--Never disinherit, or threaten to disinherit, a child for marrying against your will. If you wish a daughter not to marry a certain man, oppose her, and she will be sure to marry him; so also in reference to a son. 18. PROPER TRAINING.--The secret is, however, all in a nutshell. Let the father properly train his daughter, and she will bring her first love-letter to him, and give him an opportunity to cherish a suitable affection, and to nip an improper one in the germ, before it has time to do any harm. 19. THE FATAL MISTAKES OF PARENTS.--_There is, however one way of effectually preventing an improper match, and that is, not to allow your children to associate with any whom you are unwilling they should marry. How cruel as well at unjust to allow a daughter to associate with a young man till the affections of both are riveted, and then forbid her marrying him. Forbid all association, or consent cheerfully to the marriage._ 20. AN INTEMPERATE LOVER.--Do not flatter yourselves young women, that you can wean even an occasional wine drinker from his cups by love and persuasion. Ardent spirit at first, kindles up the fires of love into the fierce flames of burning licentiousness, which burn out every element of love and destroy every vestige of pure affection. It over-excites the passions, and thereby finally destroys it,--producing at first, unbridled libertinism, and then an utter barrenness of love; besides reversing the other faculties of the drinker against his own consort, and those of the wife against her drinking husband. * * * * * FIRST LOVE, DESERTION AND DIVORCE. 1. FIRST LOVE.--This is the most important direction of all. The first love experiences a tenderness, a purity and unreservedness, an exquisiteness, a devotedness, and a poetry belonging to no subsequent attachment. "Love, like life, has no second spring." Though a second attachment may be accompanied by high moral feeling, and to a devotedness to the object loved; yet, let love be checked or blighted in its first pure emotion, and the beauty of its spring is irrecoverably withered and lost. This does not mean the simple love of children in the first attachment they call love, but rather the mature intelligent love of those of suitable age. [Illustration: MUSICAL CULTURE LESSON.] 2. FREE FROM TEMPTATIONS.--As long as his heart is bound up in its first bundle of love and devotedness--as long as his affections remain reciprocated and uninterrupted--so long temptations cannot take effect. This heart is callous to the charms of others, and the very idea of bestowing his affections upon another is abhorrent. Much more so is animal indulgence, which is morally impossible. 3. SECOND LOVE NOT CONSTANT.--But let this first love be broken off, and the flood-gates of passion are raised. Temptations now flow in upon him. He casts a lustful eye upon every passing female, and indulges unchaste imaginations and feelings. Although his conscientiousness or intellect may prevent actual indulgence, yet temptations now take effect, and render him liable to err; whereas before they had no power to awaken improper thoughts or feelings. Thus many young men find their ruin. 4. LEGAL MARRIAGE.--What would any woman give for merely a nominal or legal husband, just to live with and provide for her, but who entertained not one spark of love for her, or whose affections were bestowed upon another? How absurd, how preposterous the doctrine that the obligations of marriage derive their sacredness from legal enactments and injunctions! How it literally profanes this holy of holies, and drags down this heaven-born institution from its original, divine elevation, to the level of a merely human device. Who will dare to advocate the human institution of marriage without the warm heart of a devoted and loving companion! 5. LEGISLATION.--But no human legislation can so guard this institution but that it may be broken in spirit, though, perhaps, acceded to in form; for, it is the heart which this institution requires. There must be true and devoted affection, or marriage is a farce and a failure. 6. THE MARRIAGE CEREMONY AND THE LAW GOVERNING MARRIAGE are for the protection of the individual, yet a man and woman may be married by law and yet unmarried in spirit. The law may tie together, and no marriage be consummated. Marriage therefore is Divine, and "whom God hath joined together let no man put asunder." A right marriage means a right state of the heart. A careful study of this work will be a great help to both the unmarried and the married. 7. DESERTION AND DIVORCE.--For a young man to court a young woman, and excite her love till her affections are riveted, and then (from sinister motives, such as, to marry one richer, or more handsome), to leave her, and try elsewhere, is the very same crime as to divorce her from all that she holds dear on earth--to root up and pull out her imbedded affections, and to tear her from her rightful husband. First love is always constant. The second love brings uncertainty--too often desertions before marriage and divorces after marriage. 8. THE COQUET.--The young woman to play the coquet, and sport with the sincere affections of an honest and devoted young man, is one of the highest crimes that human nature can commit. Better murder him in body too, as she does in soul and morals, and it is the result of previous disappointment, never the outcome of a sincere first love. 9. ONE MARRIAGE. One evidence that second marriages are contrary to the laws of our social nature, is the fact that almost all step-parents and step-children disagree. Now, what law has been broken, to induce this penalty? The law of marriage; and this is one of the ways in which the breach punishes itself. It is much more in accordance with our natural feelings, especially those of mothers, that children should be brought up by their own parent. 10. SECOND MARRIAGE.--Another proof of this point is, that second marriage is more a matter of business. "I'll give you a home, if you'll take care of my children." "It's a bargain," is the way most second matches are made. There is little of the poetry of first-love, and little of the coyness and shrinking diffidence which characterize the first attachment. Still these remarks apply almost equally to a second attachment, as to second marriage. 11. THE CONCLUSION OF THE WHOLE MATTER.--Let this portion be read and pondered, and also the one entitled, "Marry your First Love if possible," which assigns the cause, and points out the only remedy, of licentiousness. As long as the main cause of this vice exists, and is aggravated by purse-proud, high-born, aristocratic parents and friends, and even by the virtuous and religious, just so long, and exactly in the same ratio will this blighting Sirocco blast the fairest flowers of female innocence and lovliness, and blight our noblest specimens of manliness. No sin of our land is greater. [Illustration] [Illustration: A CLASSIC FRIEZE.] [Illustration: HOW MANY YOUNG GIRLS ARE RUINED.] * * * * * FLIRTING AND ITS DANGERS. 1. NO EXCUSE.--In this country there is no excuse for the young man who seeks the society of the loose and the dissolute. There is at all times and everywhere open to him a society of persons of the opposite sex of his own age and of pure thoughts and lives, whose conversation will refine him and drive from his bosom ignoble and impure thoughts. 2. THE DANGERS.--The young man who may take pleasure in the fact that he is the hero of half a dozen or more engagements and love episodes, little realizes that such constant excitement often causes not only dangerously frequent and long-continued nocturnal emissions, but most painful affections of the testicles. Those who show too great familiarity with the other sex, who entertain lascivious thoughts, continually exciting the sexual desires, always suffer a weakening of power and sometimes the actual diseases of degeneration, chronic inflammation of the gland, spermatorrhoea, impotence, and the like.--Young man, beware; your punishment for trifling with the affections of others may cost you a life of affliction. 3. REMEDY.--Do not violate the social laws. Do not trifle with the affections of your nature. Do not give others countless anguish, and also do not run the chances of injuring yourself and others for life. The society of refined and pure women is one of the strongest safeguards a young man can have, and he who seeks it will not only find satisfaction, but happiness. Simple friendship and kind affections for each other will ennoble and benefit. 4. THE TIME FOR MARRIAGE.--When a young man's means permit him to marry, he should then look intelligently for her with whom he expects to pass the remainder of his life in perfect loyalty, and in sincerity and singleness of heart. Seek her to whom he is ready to swear to be ever true. 5. BREACH OF CONFIDENCE.--Nothing is more certain, says Dr. Naphey, to undermine domestic felicity, and sap the foundation of marital happiness, than marital infidelity. The risks of disease which a married man runs in impure intercourse are far more serious, because they not only involve himself, but his wife and his children. He should know that there is nothing which a woman will not forgive sooner than such a breach of confidence. He is exposed to the plots and is pretty certain sooner or later to fall into the snares of those atrocious parties who subsist on black-mail. And should he escape these complications, he still must lose self-respect, and carry about with him the burden of a guilty conscience and a broken vow. 6. SOCIETY RULES AND CUSTOMS.--A young man can enjoy the society of ladies without being a "flirt." He can escort ladies to parties, public places of interest, social gatherings, etc., without showing special devotion to any one special young lady. When he finds the choice of his heart, then he will be justified to manifest it, and publicly proclaim it by paying her the compliment, exclusive attention. To keep a lady's company six months is a public announcement of an engagement. * * * * * A WORD TO MAIDENS. 1. NO YOUNG LADY who is not willing to assume the responsibility of a true wife, and be crowned with the sacred diadem of motherhood, should ever think of getting married. We have too many young ladies to-day who despise maternity, who openly vow that they will never be burdened with children, and yet enter matrimony at the first opportunity. What is the result? Let echo answer, What? Unless a young lady believes that motherhood is noble, is honorable, is divine, and she is willing to carry out that sacred function of her nature, she had a thousand times better refuse every proposal, and enter some honorable occupation and wisely die an old maid by choice. 2. ON THE OTHER HAND, YOUNG LADY, never enter into the physical relations of marriage with a man until you have conversed with him freely and fully on these relations. Learn distinctly his views and feelings and expectations in regard to that purest and most ennobling of all the functions of your nature, and the most sacred of all intimacies of conjugal love. Your self-respect, your beauty, your glory, your heaven, as a wife, will be more directly involved in his feelings and views and practices, in regard to that relation, than in all other things. As you would not become a weak, miserable, imbecile, unlovable and degraded wife and mother, in the very prime of your life, come to a perfect understanding with your chosen one, ere you commit your person to his keeping in the sacred intimacies of home. Beware of that man who, under pretence of delicacy, modesty, and propriety, shuns conversation with you on this relation, and on the hallowed function of maternity. 3. TALK WITH YOUR INTENDED frankly and openly. Remember, concealment and mystery in him, towards you, on all other subjects pertaining to conjugal union might be overlooked, but if he conceals his views here, rest assured it bodes no good to your purity and happiness as a wife and mother. You can have no more certain assurance that you are to be victimized, your soul and body offered up, _slain_ on the altar of his sensualism, than his unwillingness to converse with you on subjects so vital to your happiness. Unless he is willing to hold his manhood in abeyance to the calls of your nature and to your conditions, and consecrate its passions and its powers to the elevation and happiness of his wife and children, your maiden soul had better return to God unadorned with the diadem of conjugal and maternal love than that you should become the wife of such man and the mother of his children. [Illustration: ROMAN LOVE MAKING.] [Illustration: UNIFORMED MEN ARE ALWAYS POPULAR.] * * * * * POPPING THE QUESTION. 1. MAKING THE DECLARATION.--There are few emergencies in business and few events in life that bring to man the trying ordeal of "proposing to a lady." We should be glad to help the bashful lover in his hours of perplexity, embarrassment and hesitation, but unfortunately we cannot pop the question for him, nor give him a formula by which he may do it. Different circumstances and different surroundings compel every lover to be original in his form or mode of proposing. 2. BASHFULNESS.--If a young man is very bashful, he should write his sentiments in a clear, frank manner on a neat white sheet of note paper, enclose it in a plain white envelope and find some way to convey it to the lady's hand. 3. THE ANSWER.--If the beloved one's heart is touched and she is in sympathy with the lover, the answer should be frankly and unequivocally given. If the negative answer is necessary, it should be done in the kindest and most sympathetic language, yet definite, positive and to the point, and the gentleman should at once withdraw his suit and continue friendly but not familiar. 4. SAYING "NO" FOR "YES."-If girls are foolish enough to say "No" when they mean "Yes," they must suffer the consequences which often follow. A man of intelligence and self-respect will not ask a lady twice. It is begging for recognition and lowers his dignity, should he do so. A lady is supposed to know her heart sufficiently to consider the question to her satisfaction before giving an answer. 5. CONFUSION OF WORDS AND MISUNDERSTANDING.--Sometimes a man's happiness, has depended on his manner of popping the question. Many a time the girl has said "No" because the question was so worded that the affirmative did not come from the mouth naturally; and two lives that gravitated toward each other with all their inward force have been thrown suddenly apart, because the electric keys were not carefully touched. 6. SCRIPTURAL DECLARATION.--The church is not the proper place to conduct a courtship, yet the following is suggestive and ingenious. A young gentleman, familiar with the Scriptures, happening to sit in a pew adjoining a young lady for whom he conceived a violent attachment, made his proposal in this way. He politely handed his neighbor a Bible open, with a pin stuck in the following text: Second Epistle of John, verse 5: "And I beseech thee, lady, not as though I wrote a new commandment unto thee, but that we had from the beginning, that we love one another." She returned it, pointing to the second chapter of Ruth, verse 10: "Then she fell on her face, and bowed herself to the ground, and said unto him. Why have I found grace in thine eyes that thou shouldest take knowledge of me, seeing I am a stranger?" [Illustration: SEALING THE ENGAGEMENT. From the Most Celebrated Painting in the German Department at the World's Fair.] He returned the book, pointing to the 13th verse of the Third Epistle of John: "Having many things to write unto you, I would not write to you with paper and ink, but trust to come unto you and speak face to face, that your joy may be full." From the above interview a marriage took place the ensuing month in the same church. 7. HOW JENNY WAS WON. On a sunny Summer morning, Early as the dew was dry, Up the hill I went a berrying; Need I tell you--tell you why? Farmer Davis had a daughter. And it happened that I knew, On each sunny morning, Jenny Up the hill went berrying too. Lonely work is picking berries, So I joined her on the hill: "Jenny, dear," said I, "your basket's Quite too large for one to fill." So we stayed--we two--to fill it, Jenny talking--I was still.-- Leading where the hill was steepest, Picking berries up the hill. "This is up-hill work," said Jenny; "So is life," said I; "shall we Climb it each alone, or, Jenny, Will you come and climb with me?" Redder than the blushing berries Jenny's cheek a moment grew, While without delay she answered, "I will come and climb with you." [Illustration: A PERUVIAN BEAUTY.] 8. A ROMANTIC WAY FOR PROPOSING.--In Peru they have a romantic way of popping the question. The suitor appears on the appointed evening, with a gaily dressed troubadour under the balcony of his beloved. The singer steps before her flower-bedecked window, and sings her beauties in the name of her lover. He compares her size to that of a pear tree, her lips to two blushing rose-buds, and her womanly form to that of a dove. With assumed harshness the lady asks her lover: Who are you, and what do you want? He answers with ardent confidence: "Thy love I do adore. The stars live in the harmony of love, and why should not we, too, love each other?" Then the proud beauty gives herself away: she takes her flower-wreath from her hair and throws it down to her lover, promising to be his forever. [Illustration: THE BRIDE.] * * * * * THE WEDDING. 1. THE PROPER TIME.--Much has been printed in various volumes regarding the time of the year, the influence of the seasons, etc., as determining the proper time to set for the wedding day. Circumstances must govern these things. To be sure, it is best to avoid extremes of heat and cold. Very hot weather is debilitating, and below zero is uncomfortable. 2. THE LADY SHOULD SELECT THE DAY.--There is one element in the time that is of great importance, physically, especially to the lady. It is the day of the month, and it is hoped that every lady who contemplates marriage is informed upon the great facts of ovulation. By reading page 244 she will understand that it is to her advantage to select a wedding day about fifteen or eighteen days after the close of menstruation in the month chosen, since it is not best that the first child should be conceived during the excitement or irritation of first attempts at congress; besides modest brides naturally do not wish to become large with child before the season of congratulation and visiting on their return from the "wedding tour" is over. Again, it is asserted by many of the best writers on this subject, that the mental condition of either parent at the time of intercourse will be stamped upon the embryo hence it is not only best, but wise, that the first-born should not be conceived until several months after marriage, when the husband and wife have nicely settled in their new home, and become calm in their experience of each other's society. 3. THE "BRIDAL TOUR" is considered by many newly married couples as a necessary introduction to a life of connubial joy. There is, in our opinion, nothing in the custom to recommend it. After the excitement and overwork before and accompanying a wedding, the period immediately following should be one of _rest_. Again, the money expended on the ceremony and a tour of the principal cities, etc., might, in most cases, be applied to a multitude of after-life comforts of far more lasting value and importance. To be sure, it is not pleasant for the bride, should she remain at home, to pass through the ordeal of criticism and vulgar comments of acquaintances and friends, and hence, to escape this, the young couple feel like getting away for a time. Undoubtedly the best plan for the great majority, after this most eventful ceremony, is to enter their future home at once, and there to remain in comparative privacy until the novelty of the situation is worn off. 4. IF THE CONVENTIONAL TOUR is taken, the husband should remember that his bride cannot stand the same amount of tramping around and sight-seeing that he can. The female organs of generation are so easily affected by excessive exercise of the limbs which support them, that at this critical period it would be a foolish and cosily experience to drag a lady hurriedly around the country on an extensive and protracted round of sight-seeing or visiting. Unless good common-sense is displayed in the manner of spending the "honey-moon," it will prove very untrue to its name. In many cases it lays the foundation for the wife's first and life-long "backache." [Illustration: THE GYPSY BRIDE.] * * * * * ADVICE TO NEWLY MARRIED COUPLES. 1. "BE YE FRUITFUL AND MULTIPLY" is a Bible commandment which the children of men habitually obey. However they may disagree on other subjects, all are in accord on this; the barbarous, the civilized, the high, the low, the fierce, the gentle--all unite in the desire which finds its accomplishment in the reproduction of their kind. Who shall quarrel with the Divinely implanted instinct, or declare it to be vulgar or unmentionable? It is during the period of the honeymoon that the intensity of this desire, coupled with the greatest curiosity, is at its height, and the unbridled license often given the passions at this time is attended with the most dangerous consequences. 2. CONSUMMATION OF MARRIAGE.--The first time that the husband and wife cohabit together after the ceremony has been performed is called the consummation of marriage. Many grave errors have been committed by people in this, when one or both of the contracting parties were not physically or sexually in a condition to carry out the marriage relation. A marriage, however, is complete without this in the eyes of the law, as it is a maxim taken from the Roman civil statutes that consent, not cohabitation, is the binding element in the ceremony. Yet, in most States of the U.S., and in some other countries, marriage is legally declared void and of no effect where it is not possible to consummate the marriage relation. A divorce may be obtained provided the injured party begins the suit. 3. TEST OF VIRGINITY.--The consummation of marriage with a virgin is not necessarily attended with a flow of blood, and the absence of this sign is not the slightest presumption against her former chastity. The true test of virginity is modesty void of any disagreeable familiarity. A sincere Christian faith is one of the best recommendations. 4. LET EVERY MAN REMEMBER that the legal right of marriage does not carry with it the moral right to injure for life the loving companion he has chosen. Ignorance may be the cause, but every man before he marries should know something of the physiology and the laws of health, and we here give some information which is of very great importance to every newly-married man. 5. SENSUALITY.--Lust crucifies love. The young sensual husband is generally at fault. Passion sways and the duty to bride and wife is not thought of, and so a modest young wife is often actually forced and assaulted by the unsympathetic haste of her husband. An amorous man in that way soon destroys his own love, and thus is laid the foundation for many difficulties that soon develop trouble and disturb the happiness of both. 6. ABUSE AFTER MARRIAGE.--Usually marriage is consummated within a day or two after the ceremony, but this is gross injustice to the bride. In most cases she is nervous, timid, and exhausted by the duties of preparation for the wedding, and in no way in a condition, either in body or mind, for the vital change which the married relation bring upon her. Many a young husband often lays the foundation of many diseases of the womb and of the nervous system in gratifying his unchecked passions without a proper regard for his wife's exhausted condition. 7. THE FIRST CONJUGAL APPROACHES are usually painful to the new wife, and no enjoyment to her follows. Great caution and kindness should be exercised. A young couple rushing together in their animal passion soon produce a nervous and irritating condition which ere long brings apathy, indifference, if not dislike. True love and a high regard for each other will temper passion into moderation. 8. WERE THE ABOVE INJUNCTIONS HEEDED fully and literally it would be folly to say more, but this would be omitting all account of the bridegroom's new position, the power of his passion, and the timidity of the fair creature who is wondering what fate has in store for her trembling modesty. To be sure, there are some women who are possessed of more forward natures and stronger desires than others. In such cases there may be less trouble. 9. A COMMON ERROR.--The young husband may have read in some treatise on physiology that the hymen in a virgin is the great obstacle to be overcome. He is apt to conclude that this is all, that some force will be needed to break it down, and that therefore an amount of urgency even to the degree of inflicting considerable pain is justifiable. This is usually wrong. It rarely constitutes any obstruction and, even when its rupturing may be necessary, it alone seldom causes suffering. There are sometimes certain deformities of the vagina, but no woman should knowingly seek matrimonial relations when thus afflicted. We quote from Dr. C.A. Huff the following: 10. "WHAT IS IT, THEN, THAT USUALLY CAUSES distress to many women, whether a bride or a long-time wife?" The answer is, Simply those conditions of the organs in which they are not properly prepared, by anticipation and desire, to receive a foreign body. The modest one craves only refined and platonic love at first, and if husbands, new and old, would only realize this plain truth, wife-torturing would cease and the happiness of each one of all human pairs vastly increase. 11. THE CONDITIONS OF THE FEMALE organs depend upon the state of the mind just as much as in the case of the husband. The male, however, being more sensual, is more quickly roused. She is far less often or early ready. In its unexcited state the vagina is lax, its walls are closed together, and their surfaces covered by but little lubricating secretion. The chaster one of the pair has no desire that this sacred vestibule to the great arcana of procreation shall be immediately and roughly invaded. This, then, is the time for all approaches by the husband to be of the most delicate, considerate, and refined description possible. The quietest and softest demeanor, with gentle and re-assuring words, are all that should be attempted at first. The wedding day has probably been one of fatigue, and it is foolish to go farther. 12. FOR MORE THAN ONE NIGHT it will be wise, indeed, if the wife's confidence shall be as much wooed and won by patient, delicate, and prolonged courting, as before the marriage engagement. How long should this period of waiting be can only be decided by the circumstances of any case. The bride will ultimately deny no favor which is sought with full deference to her modesty, and in connection with which bestiality is not exhibited. Her nature is that of delicacy; her affection is of a refined character; if the love and conduct offered to her are a careful effort to adapt roughness and strength to her refinement and weakness, her admiration and responsive love will be excited to the utmost. 13. WHEN THAT MOMENT ARRIVES when the bride finds she can repose perfect confidence in the kindness of her husband, that his love is not purely animal, and that no violence will be attempted, the power of her affection for him will surely assert itself; the mind will act on those organs which nature has endowed to fulfil the law of her being, the walls of the vagina will expand, and the glands at the entrance will be fully lubricated by a secretion of mucous which renders congress a matter of comparative ease. 14. WHEN THIS RESPONSIVE ENLARGEMENT and lubrication are fully realized, it is made plain why the haste and force so common to first and subsequent coition, is, as it has been justly called, nothing but "legalized rape." Young husband, Prove your manhood, not by yielding to unbridled lust and cruelty, but by the exhibition of true power in _self-control_ and patience with the helpless being confided to your care. Prolong the delightful season of courting into and _through_ wedded life and rich shall be your reward. 15. A WANT OF DESIRE may often prevail, and may be caused by loss of sleep, study, constant thought, mental disturbance, anxiety, self-abuse, excessive use of tobacco or alcoholic drink, etc. Overwork may cause debility; a man may not have an erection for months, yet it may not be a sign of debility, sexual lethargy or impotence. Get the mind and the physical constitution in proper condition, and most all these difficulties will disappear. Good athletic exercise by walking, riding, or playing croquet, or any other amusement, will greatly improve the condition. A good rest, however, will be necessary to fully restore the mind and the body, then the natural condition of the sexual organs will be resumed. 16. HAVING TWINS.--Having twins is undoubtedly hereditary and descends from generation to generation, and persons who have twins are generally those who have great sexual vigor. It is generally the result of a second cohabitation immediately following the first, but some parents have twins who cohabit but once during several days. 17. PROPER INTERCOURSE.--The right relation of a newly-married couple will rather increase than diminish love. To thus offer up the maiden on the altar of love and affection only swells her flood of joy and bliss; whereas, on the other hand, sensuality humbles, debases, pollutes, and never elevates. Young husbands should wait for an _invitation to the banquet_ and they will be amply paid by the very pleasure sought. Invitation or permission delights, and possession by force degrades. The right-minded bridegroom will postpone the exercise of his nuptial rights for a few days, and allow his young wife to become rested from the preparation and fatigue of the wedding, and become accustomed to the changes in her new relations of life. 18. RIGHTLY BEGINNING SEXUAL LIFE.--Intercourse promotes all the functions of the body and mind, but rampant just and sexual abuses soon destroy the natural pleasures of intercourse, and unhappiness will be the result. Remember that _intercourse_ should not become the polluted purpose of marriage. To be sure, rational enjoyment benefits and stimulates love, but the pleasure of each other's society, standing together on all questions of mutual benefit, working hand in hand and shoulder to shoulder in the battle of life, raising a family of beautiful children, sharing each other's joys and sorrows, are the things that bring to every couple the best, purest, and noblest enjoyment that God has bestowed upon man. [Illustration: A TURKISH HAREM.] * * * * * SEXUAL PROPRIETIES AND IMPROPRIETIES. 1. To have offspring is not to be regarded as a luxury, but as a great primary necessity of health and happiness, of which every fully-developed man and woman should have a fair share, while it cannot be denied that the ignorance of the necessity of sexual intercourse to the health and virtue of both man and woman is the most fundamental error in medical and moral philosophy. 2. In a state of pure nature, where man would have his sexual instincts under full and natural restraint, there would be little, if any, licentiousness, and children would be the result of natural desire, and not the accidents of lust. 3. This is an age of sensuality; unnatural passions cultivated and indulged. Young people in the course of their engagement often sow the seed of serious excesses. This habit of embracing, sitting on the lover's lap, leaning on his breast, long and uninterrupted periods of secluded companionship, have become so common that it is amazing how a young lady can safely arrive at the wedding day. While this conduct may safely terminate with the wedding day, yet it cultivates the tendency which often results in excessive indulgencies after the honey-moon is over. 4. SEPARATE BEDS.--Many writers have vigorously championed as a reform the practice of separate beds for husband and wife. While we would not recommend such separation, it is no doubt very much better for both husband and wife, in case the wife is pregnant. Where people are reasonably temperate, no such ordinary precautions as separate sleeping places may be necessary. But in case of pregnancy it will add rest to the mother and add vigor to the unborn child. Sleeping together, however, is natural and cultivates true affection, and it is physiologically true that in very cold weather life is prolonged by husband and wife sleeping together. 5. THE AUTHORITY OF THE WIFE.--Let the wife judge whether she desires a separate couch or not. She has the superior right to control her own person. In such diseases as consumption, or other severe or lingering diseases, separate beds should always be insisted upon. 6. THE TIME FOR INDULGENCE.--The health of the generative functions depends upon exercise, just the same as any other vital organ. Intercourse should be absolutely avoided just before or after meals, or just after mental excitement or physical exercise. No wife should indulge her husband when he is under the influence of alcoholic stimulants, for idiocy and other serious maladies are liable to be visited upon the offspring. 7. RESTRAINT DURING PREGNANCY.--There is no question but what moderate indulgence during the first few months of pregnancy does not result in serious harm; but people who excessively satisfy their ill-governed passions are liable to pay a serious penalty. 8. MISCARRIAGE.--If a woman is liable to abortion or miscarriage, absolute abstinence is the only remedy. No sexual indulgence during pregnancy can be safely tolerated. 9. It is better for people not to marry until they are of proper age. It is a physiological fact that men seldom reach the full maturity or their virile power before the age of twenty-five, and the female rarely attains the full vigor of her sexual powers before the age of twenty. 10. ILLICIT PLEASURES.--The indulgence of illicit pleasures, says Dr. S. Pancoast, sooner or later is sure to entail the most loathsome diseases on their votaries. Among these diseases are Gonorrhoea, Syphilis, Spermatorrhoea (waste of semen by daily and nightly involuntary emissions), Satyriasis (a species of sexual madness, or a sexual diabolism, causing men to commit rape and other beastly acts and outrages, not only on women and children, but men and animals, as sodomy, pederasty, etc.), Nymphomania (causing women to assail every man they meet, and supplicate and excite him to gratify their lustful passions, or who resort to means of sexual pollutions, which is impossible to describe without shuddering), together with spinal diseases and many disorders of the most distressing and disgusting character filling the bones with rottenness, and eating away the flesh by gangrenous ulcers, until the patient dies, a horrible mass of putridity and corruption. 11. SENSUALITY.--Sensuality is not love, but an unbridled desire which kills the soul. Sensuality will drive away the roses in the cheeks of womanhood, undermine health and produce a brazen countenance that can be read by all men. The harlot may commit her sins in the dark, but her countenance reveals her character and her immorality is an open secret. 12. SEXUAL TEMPERANCE.--All excesses and absurdities of every kind should be carefully avoided. Many of the female disorders which often revenge themselves in the cessation of all sexual pleasure are largely due to the excessive practice of sexual indulgence. 13. FREQUENCY.--Some writers claim that intercourse should never occur except for the purpose of childbearing but such restraint is not natural and consequently not conducive to health. There are many conditions in which the health of the mother and offspring must be respected. It is now held that it is nearer a crime than a virtue to prostitute woman to the degradation of breeding animals by compelling her to bring into life more offspring than can be born healthy, or be properly cared for and educated. 14. In this work we shall attempt to specify no rule, but simply give advice as to the health and happiness of both man and wife. A man should not gratify his own desires at the expense of his wife's health, comfort or inclination. Many men no doubt harass their wives and force many burdens upon their slender constitutions. But it is a great sin and no true husband will demand unreasonable recognition. The wife when physically able, however, should bear with her husband. Man is naturally sensitive on this subject, and it takes but little to alienate his affections and bring discover into the family. 15. The best writers lay down the rule for the government of the marriage-bed, that sexual indulgence should only occur about once in a week or ten days, and this of course applies only to those who enjoy a fair degree of health. But it is a hygienic and physiological fact that those who indulge only once a month receive a far greater degree of the intensity of enjoyment than those who indulge their passions more frequently. Much pleasure is lost by excesses where much might be gained by temperance giving rest to the organs for the accumulation of nervous force. [Illustration] * * * * * HOW TO PERPETUATE THE HONEY-MOON. 1. CONTINUE YOUR COURTSHIP.--Like causes produce like effects. 2. NEGLECT OF YOUR COMPANION.--Do not assume a right to neglect your companion more after marriage than you did before. 3. SECRETS.--Have no secrets that you keep from your companion. A third party is always disturbing. 4. AVOID THE APPEARANCE OF EVIL.--In matrimonial matters it is often that the mere appearance contains all the evil. Love, as soon as it rises above calculation and becomes love, is exacting. It gives all, and demands all. 5. ONCE MARRIED, NEVER OPEN YOUR MIND TO ANY CHANGE. If you keep the door of your purpose closed, evil or even desirable changes cannot make headway without help. 6. KEEP STEP IN MENTAL DEVELOPMENT.--A tree that grows for forty years may take all the sunlight from a tree that stops growing at twenty. 7. KEEP A LIVELY INTEREST IN THE BUSINESS OF THE HOME.--Two that do not pull together are weaker than either alone. 8. GAUGE YOUR EXPENSES BY YOUR REVENUES.--Love must eat. The sheriff often levies on Cupid long before he takes away the old furniture. 9. START FROM WHERE YOUR PARENTS STARTED RATHER THAN FROM WHERE THEY NOW ARE.--Hollow and showy boarding often furnishes the too strong temptation, while the quietness of a humble home would cement the hearts beyond risk. 10. AVOID DEBT.--Spend your own money, but earn it first, then it will not be necessary to blame any one for spending other people's. 11. DO NOT BOTH GET ANGRY AT THE SAME TIME.--Remember, it takes two to quarrel. 12. DO NOT ALLOW YOURSELF EVER TO COME TO AN OPEN RUPTURE.--Things unsaid need less repentance. 13. STUDY TO CONFORM YOUR TASTES AND HABITS TO THE TASTES AND HABITS OF YOUR COMPANION.--If two walk together, they must agree. * * * * * HOW TO BE A GOOD WIFE. 1. REVERENCE YOUR HUSBAND.--He sustains by God's order a position of dignity as head of a family, head of the woman. Any breaking down of this order indicates a mistake in the union, or a digression from duty. 2. LOVE HIM.--A wife loves as naturally as the sun shines. Love is your best weapon. You conquered him with that in the first place. You can reconquer by the same means. 3. DO NOT CONCEAL YOUR LOVE FROM HIM.--If he is crowded with care, and too busy to seem to heed your love, you need to give all the greater attention to securing his knowledge of your love. If you intermit he will settle down into a hard, cold life with increased rapidity. Your example will keep the light on his conviction. The more he neglects the fire on the hearth, the more carefully must you feed and guard it. It must not be allowed to go out. Once out you must sit ever in darkness and in the cold. 4. CULTIVATE THE MODESTY AND DELICACY OF YOUR YOUTH.--The relations and familiarity of wedded life may seem to tone down the sensitive and retiring instincts of girlhood, but nothing can compensate for the loss of these. However, much men may admire the public performance of gifted women, they do not desire that boldness and dash in a wife. The holy blush of a maiden's modesty is more powerful in hallowing and governing a home than the heaviest armament that ever a warrior bore. 5. CULTIVATE PERSONAL ATTRACTIVENESS.--This means the storing of your mind with a knowledge of passing events, and with a good idea of the world's general advance. If you read nothing, and make no effort to make yourself attractive, you will soon sink down into a dull hack of stupidity. If your husband never hears from you any words of wisdom, or of common information, he will soon hear nothing from you. Dress and gossips soon wear out. If your memory is weak, so that it hardly seems worth while to read, that is additional reason for reading. [Illustration: TALKING BEFORE MARRIAGE.] 6. CULTIVATE PHYSICAL ATTRACTIVENESS.--When you were encouraging the attentions of him whom you now call husband, you did not neglect any item of dress or appearance that could help you. Your hair was always in perfect training. You never greeted him with a ragged or untidy dress or soiled hands. It is true that your "market is made," but you cannot afford to have it "broken." Cleanliness and good taste will attract now as they did formerly. Keep yourself at your best. Make the most of physical endowments. Neatness and order break the power of poverty. 7. STUDY YOUR HUSBAND'S CHARACTER.--He has his peculiarities. He has no right to many of them, and you need to know them; thus you can avoid many hours of friction. The good pilot steers around the sunken rocks that lie in the channel. The engineer may remove them, not the pilot. You are more pilot than engineer. Consult his tastes. It is more important to your home, that you should please him than anybody else. 8. PRACTICE ECONOMY.--Many families are cast out of peace into grumbling and discord by being compelled to fight against poverty. When there are no great distresses to be endured or accounted for, complaint and fault-finding are not so often evoked. Keep your husband free from the annoyance of disappointed creditors, and he will be more apt to keep free from annoying you. To toil hard for bread, to fight the wolf from the door, to resist impatient creditors, to struggle against complaining pride at home, is too much to ask of one man. A crust that is your own is a feast, while a feast that is purloined from unwilling creditors if a famine. * * * * * HOW TO BE A GOOD HUSBAND. 1. SHOW YOUR LOVE.--All life manifests itself. As certainly as a live tree will put forth leaves in the spring, so certainly will a living love show itself. Many a noble man toils early and late to earn bread and position for his wife. He hesitates at no weariness for her sake. He justly thinks that such industry and providence give a better expression of his love than he could by caressing her and letting the grocery bills go unpaid. He fills the cellar and pantry. He drives and pushes his business. He never dreams that he is actually starving his wife to death. He may soon have a woman left to superintend his home, but his wife is dying. She must be kept alive by the same process that called her into being. Recall and repeat the little attentions and delicate compliments that once made you so agreeable, and that fanned her love into a consuming flame. It is not beneath the dignity of the skillful physician to study all the little symptoms, and order all the little round of attentions that check the waste of strength and brace the staggering constitution. It is good work for a husband to cherish his wife. [Illustration: TALKING AFTER MARRIAGE.] 2. CONSULT WITH YOUR WIFE.--She is apt to be as right as you are, and frequently able to add much to your stock of wisdom. In any event she appreciates your attentions. 3. STUDY TO KEEP HER YOUNG.--It can be done. It is not work, but worry, that wears. Keep a brave, true heart between her and all harm. 4. HELP TO BEAR HER BURDENS.--Bear one another's burdens, and so fulfill the law of love. Love seeks opportunities to do for the loved object. She has the constant care of your children. She is ordained by the Lord to stand guard over them. Not a disease can appear in the community without her taking the alarm. Not a disease can come over the threshold without her instantly springing into the mortal combat. If there is a deficiency anywhere it comes out of her pleasure. Her burdens are everywhere. Look for them, that you may lighten them. 5. MAKE YOURSELF HELPFUL BY THOUGHTFULNESS.--Remember to bring into the house your best smile and sunshine. It is good for you, and it cheers up the home. There is hardly a nook in the house that has not been carefully hunted through to drive out everything that might annoy you. The dinner which suits, or ought to suit you, has not come on the table of itself. It represents much thoughtfulness and work. You can do no more manly thing than find some way of expressing, in word or look, your appreciation of it. 6. EXPRESS YOUR WILL, NOT BY COMMANDS, BUT BY SUGGESTIONS.--It is God's order that you should be the head of the family. You are clothed with authority. But this does not authorize you to be stern and harsh, as an officer in the army. Your authority is the dignity of love. When it is not clothed in love it ceases to have the substance of authority. A simple suggestion that may embody a wish, an opinion or an argument, becomes one who reigns over such a kingdom as yours. 7. SEEK TO REFINE YOUR NATURE.--It is no slander to say that many men have wives much more refined than themselves. This is natural in the inequalities of life. Other qualities may compensate for any defect here. But you need have no defect in refinement. Preserve the gentleness and refinement of your wife as a rich legacy for your children, and in so doing you will lift yourself to higher levels. 8. BE A GENTLEMAN AS WELL AS A HUSBAND.--The signs and bronze and callouses of toil are no indications that you are not a gentleman. The soul of gentlemanliness is a kindly feeling toward others, that prompts one to secure their comfort. That is why the thoughtful peasant lover is always so gentlemanly, and in his love much above himself. 9. STAY AT HOME.--Habitual absence during the evenings is sure to bring sorrow. If your duty or business calls you you have the promise that you will be kept in all your ways. But if you go out to mingle with other society, and leave your wife at home alone, or with the children and servants, know that there is no good in store for you. She has claims upon you that you can not afford to allow to go to protest. Reverse the case. You sit down alone after having waited all day for your wife's return, and think of her as reveling in gay society, and see if you can keep out all the doubts as to what takes her away. If your home is not as attractive as you want it, you are a principal partner. Set yourself about the work of making it attractive. 10. TAKE YOUR WIFE WITH YOU INTO SOCIETY.--Seclusion begets morbidness. She needs some of the life that comes from contact with society. She must see how other people appear and act. It often requires an exertion for her to go out of her home, but it is good for her and for you. She will bring back more sunshine. It is wise to rest sometimes. When the Arab stops for his dinner he unpacks his camel. Treat your wife with as much consideration. [Illustration] [Illustration: TIRED OF LIFE.] * * * * * CAUSE OF FAMILY TROUBLES. 1. MUCH BETTER TO BE ALONE.--He who made man said it is not good for him to be alone; but it is much better to be alone, than it is to be in some kinds of company. Many couples who felt unhappy when they were apart, have been utterly miserable when together; and scores who have been ready to go through fire and water to get married, have been willing to run the risk of fire and brimstone to get divorced. It is by no means certain that because persons are wretched before marriage they will be happy after it. The wretchedness of many homes, and the prevalence of immorality and divorce is a sad commentary on the evils which result from unwise marriages. 2. UNAVOIDABLE EVILS.--There are plenty of unavoidable evils in this world, and it is mournful to think of the multitudes who are preparing themselves for needless disappointments, and who yet have no fear, and are unwilling to be instructed, cautioned or warned. To them the experience of mature life is of little account compared with the wisdom of ardent and enthusiastic youth. 3. MATRIMONIAL INFELICITY.--One great cause of matrimonial infelicity is the hasty marriages of persons who have no adequate knowledge of each other's characters. Two strangers become acquainted, and are attracted to each other, and without taking half the trouble to investigate or inquire that a prudent man would take before buying a saddle horse, they are married. In a few weeks or months it is perhaps found that one of the parties was married already, or possibly that the man is drunken or vicious, or the woman anything but what she should be. Then begins the bitter part of the experience: shame, disgrace, scandal, separation, sin and divorce, all come as the natural results of a rash and foolish marriage. A little time spent in honest, candid, and careful preliminary inquiry and investigations would have saved the trouble. 4. THE CLIMAX.--It has been said that a man is never utterly ruined until he has married a bad woman. So the climax of woman's miseries and sorrows may be said to come only when she is bound with that bond which should be her chiefest blessing and her highest joy, but which may prove her deepest sorrow and her bitterest curse. 5. THE FOLLY OF FOLLIES.--There are some lessons which people are very slow to learn, and yet which are based upon the simple principles of common-sense. A young lady casts her eye upon a young man. She says, "I mean to have that man." She plies her arts, engages his affections, marries him, and secures for herself a life of sorrow and disappointment, ending perhaps in a broken up home or an early grave. Any prudent, intelligent person of mature age, might have warned or cautioned her; but she sought no advice, and accepted no admonition. A young man may pursue a similar course with equally disastrous results. 6. HAP-HAZARD.--Many marriages are undoubtedly arranged by what may be termed the accident of locality. Persons live near each other, become acquainted, and engage themselves to those whom they never would have selected as their companions in life if they had wider opportunities of acquaintance. Within the borders of their limited circle they make a selection which may be wise or may be unwise. They have no means of judging, they allow no one else to judge for them. The results are sometimes happy and sometimes unhappy in the extreme. It is well to act cautiously in doing what can be done but once. It is not a pleasant experience for a person to find out a mistake when it is too late to rectify it. 7. WE ALL CHANGE.--When two persons of opposite sex are often thrown together they are very naturally attracted to each other, and are liable to imbibe the opinion that they are better fitted for life-long companionship than any other two persons in the world. This may be the case, or it may not be. There are a thousand chances against such a conclusion to one in favor of it. But even if at the present moment these two persons were fitted to be associated, no one can tell whether the case will be the same five or ten years hence. Men change; women change; they are not the same they were ten years ago; they are not the same they will be ten years hence. 8. THE SAFE RULE.--Do not be in a hurry; take your time and consider well before you allow your devotion to rule you. Study first your character, then study the character of her whom you desire to marry. Love works mysteriously, and if it will bear careful and cool investigation, it will no doubt thrive under adversity. When people marry they unite their destinies for the better or the worse. Marriage is a contract for life and will never bear a hasty conclusion. _Never be in a hurry_! * * * * * JEALOUSY--ITS CAUSE AND CURE. Trifles, light as air Are to the jealous confirmations strong, As proofs of holy writ.--SHAKESPEARE. Nor Jealousy Was understood, the injur'd lover's hell.--MILTON O, beware, my lord, of jealousy; It is the green-eyed monster which doth mock The meat it feeds on.--SHAKESPEARE. 1. DEFINITION.--Jealousy is an accidental passion, for which the faculty indeed is unborn. In its nobler form and in its nobler motives it arises from love, and in its lower form it arises from the deepest and darkest Pit of Satan. 2. HOW DEVELOPED.--Jealousy arises either from weakness, which from a sense of its own want of lovable qualities is not convinced of being sure of its cause, or from distrust, which thinks the beloved person capable of infidelity. Sometimes all these motives may act together. 3. NOBLEST JEALOUSY.--The noblest jealousy, if the term noble is appropriate, is a sort of ambition or pride of the loving person who feels it is an insult that another one should assume it as possible to supplant his love, or it is the highest degree of devotion which sees a declaration of its object in the foreign invasion, as it were, of his own altar. Jealousy is always a sign that a little more wisdom might adorn the individual without harm. 4. THE LOWEST JEALOUSY.--The lowest species of jealousy is a sort of avarice of envy which, without being capable of love, at least wishes to possess the object of its jealousy alone by the one party assuming a sort of property right over the other. This jealousy, which might be called the Satanic, is generally to be found with old withered "husbands," whom the devil has prompted to marry young women and who forthwith dream night and day of cuck-old's horns. These Argus-eyed keepers are no longer capable of any feeling that could be called love, they are rather as a rule heartless house-tyrants, and are in constant dread that some one may admire or appreciate his unfortunate slave. 5. WANT OF LORE.--The general conclusion will be that jealousy is more the result of wrong conditions which cause uncongenial unions, and which through moral corruption artificially create distrust than a necessary accompaniment of love. [Illustration: SEEKING THE LIFE OF A RIVAL.] 6. RESULT OF POOR OPINION.--Jealousy is a passion with which those are most afflicted who are the least worthy of love. An innocent maiden who enters marriage will not dream of getting jealous; but all her innocence cannot secure her against the jealousy of her husband if he has been a libertine. Those are wont to be the most jealous who have the consciousness that they themselves are most deserving of jealousy. Most men in consequence of their present education and corruption have so poor an opinion not only of the male, but even of the female sex, that they believe every woman at every moment capable of what they themselves have looked for among all and have found among the most unfortunate, the prostitutes. No libertine can believe in the purity of woman; it is contrary to nature. A libertine therefore cannot believe in the loyalty of a faithful wife. 7. WHEN JUSTIFIABLE.--There may be occasions where jealousy is justifiable. If a woman's confidence has been shaken in her husband, or a husband's confidence has been shaken in his wife by certain signs or conduct, which have no other meaning but that of infidelity, then there is just cause for jealousy. There must, however, be certain proof as evidence of the wife's or husband's immoral conduct. Imaginations or any foolish absurdities should have no consideration whatever, and let everyone have confidence until his or her faith has been shaken by the revelation of absolute facts. 8. CAUTION AND ADVICE.--No couple should allow their associations to develop into an engagement and marriage if either one has any inclination to jealousy. It shows invariably a want of sufficient confidence, and that want of confidence, instead of being diminished after marriage, is liable to increase, until by the aid of the imagination and wrong interpretation the home is made a hell and divorce a necessity. Let it be remembered, there can be no true love without perfect and absolute confidence, jealousy is always the sign of weakness or madness. Avoid a jealous disposition, for it is an open acknowledgment of a lack of faith. [Illustration] * * * * * THE IMPROVEMENT OF OFFSPRING. Why Bring Into the World Idiots, Fools, Criminals and Lunatics? 1. THE RIGHT WAY.--When mankind will properly love AND marry and then rightly generate, carry, nurse and educate their children, will they in deed and in truth carry out the holy and happy purpose of their Creator. See those miserable and depraved scape-goats of humanity, the demented simpletons, the half-crazy, unbalanced multitudes which infest our earth, and fill our prisons with criminals and our poor-houses with paupers. Oh! the boundless capabilities and perfections of our God-like nature and, alas! its deformities! All is the result of the ignorance or indifference of parents. As long as children are the accidents of lust instead of the premeditated objects of love, so long will the offspring deteriorate and the world be cursed with deformities, monstrosities, unhumanities and cranks. 2. EACH AFTER ITS KIND.--"Like parents like children." "In their own image beget" they them. In what other can they? "How can a corrupt tree bring forth good fruit?" How can animal propensities in parents generate other than depraved children, or moral purity beget beings other than as holy by nature as those at whose hands they received existence and constitution? 3. AS ARE THE PARENTS, physically, mentally and morally when they stamp their own image and likeness upon progeny, so will be the constitution of that progeny. 4. "JUST AS THE TWIG IS BENT THE TREE'S INCLINED."--Yet the bramble cannot be bent to bear delicious peaches, nor the sycamore to bear grain. Education is something, _but parentage_ is _everything_; because it "_dyes in the wool_" and thereby exerts an influence on character almost infinitely more powerful than all other conditions put together. 5. HEALTHY AND BEAUTIFUL CHILDREN.--Thoughtless mortal! Before you allow the first goings forth of love, learn what the parental conditions in you mean, and you will confer a great boon upon the prospective bone of your bone, and flesh of your flesh! If it is in your power to be the parent of beautiful, healthy, moral and talented children instead of diseased and depraved, is it not your imperious duty then, to impart to them that physical power, moral perfection, and intellectual capability, which shall ennoble their lives and make them good people and good citizens? 6. PAUSE AND TREMBLE.--Prospective parents! Will you trifle with the dearest interests of your children? Will you in matters thus momentous, head-long rush "Where angels dare not tread," Seeking only mere animal indulgence?--Well might cherubim shrink from assuming responsibilities thus momentous Yet, how many parents tread this holy ground completely unprepared, and almost as thoughtlessly and Ignorantly as brutes--entailing even loathsome diseases and sensual propensities upon the fruit of their own bodies. Whereas they are bound, by obligations the most imperious to bestow on them a good physical organization, along with a pure, moral, and strong intellectual constitution, or else not to become parents! Especially since it is easier to generate human angels than devils incarnate. 7. HEREDITARY DESCENT.--This great law of things, "Hereditary Descent," fully proves and illustrates in any required number and variety or cases, showing that progeny inherits the constitutional natures and characters, mental and physical, of parents, including pre-dispositions to consumption, insanity, all sorts of disease, etc., as well as longevity, strength, stature, looks, disposition, talents,--all that is constitutional. From what other source do or can they come? Indeed, who can doubt a truth as palpable as that children inherit some, and if some, therefore all, the physical and mental nature and constitutor of parents, thus becoming almost their fac-similes? 8. ILLUSTRATIONS.--A whaleman was severely hurt by a harpooned and desperate whale turning upon the small boat, and, by his monstrous jaws, smashing it to pieces, one of which, striking him in his right side, crippled him for life. When sufficiently recovered, he married, according to previous engagement, and his daughter, born in due time, and closely resembling him in looks, constitution and character, has a weak and sore place corresponding in location with that of the injury of her father. Tubercles have been found in the lungs of infants at birth, born of consumptive parents,--a proof, clear and demonstrative, that children inherit the several states of parental physiology existing at the time they received their physiological constitution. The same is true of the transmission of those diseases consequent on the violation of the law of chastity, and the same conclusion established thereby. 9. PARENT'S PARTICIPATION.--Each parent furnishing at indispensable portion of the materials of life, and somehow or other, contributes parentally to the formation of the constitutional character of their joint product, appears far more reasonable, than to ascribe, as many do, the whole to either some to paternity, others to maternity. Still this decision go which way it may, does not affect the great fact that children inherit both the physiology and the mentality existing in parents at the time they received being and constitution. 10. ILLEGITIMATES OR BASTARDS also furnish strong proof of the correctness of this our leading doctrine. They are generally lively, sprightly, witty, frolicksome, knowing, quiet of perception, apt to learn, full of passion, quick-tempered, impulsive throughout, hasty, indiscreet, given to excesses, yet abound in good feeling, and are well calculated to enjoy life, though in general sadly deficient in some essential moral elements. 11. CHARACTER OF ILLEGITIMATES.--Wherein, then, consists this difference? First, in "novelty lending an enchantment" rarely experienced in sated wedlock, as well as in, power of passion sufficient to break through all restraint, external and internal; and hence their high wrought organization. They are usually wary and on the alert, and their parents drank "stolen waters." They are commonly wanting in moral balance, or else delinquent in some important moral aspect; nor would they have ever been born unless this had been the case, for the time being at least with their parents. Behold in these, and many other respects easily cited, how striking the coincidence between their characters on the one hand, and, on the other, those parental conditions necessarily attendant on their origin. 12. CHILDREN'S CONDITION depends upon parents' condition at the time of the sexual embrace. Let parents recall, as nearly as may be their circumstances and states of body and mind at this period, and place them by the side of the physical and mental constitutions of their children, and then say whether this law is not a great practical truth, and if so, its importance is as the happiness and misery it is capable of affecting! The application of this mighty engine of good or evil to mankind, to the promotion of human advancement, is the great question which should profoundly interest all parents. 13. THE VITAL PERIOD.--The physical condition of parents at the vital period of transmission of life should be a perfect condition of health in both body and mind, and a vigorous condition of all the animal organs and functions. 14. MUSCULAR PREPARATION.--Especially should parents cultivate their muscular system preparatory to the perfection of this function, and of their children; because, to impart strength and stamina to offspring they must of necessity both possess a good muscular organization, and also bring it into vigorous requisition at this period. For this reason, if for no other, let those of sedentary habits cultivate muscular energy preparatory to this time of need. 15. THE SEED.--So exceedingly delicate are the seeds of life, that, unless planted in a place of perfect security, they must all be destroyed and our race itself extinguished. And what place is as secure as that chosen, where they can be reached only with the utmost difficulty, and than only as the peril of even life itself? Imperfect seed sown in poor ground means a sickly harvest. 16. HEALTHY PEOPLE--MOST CHILDREN.--The most healthy classes have the most numerous families; but that, as luxury enervates society, it diminishes the population, by enfeebling parents, nature preferring none rather than those too weakly to live and be happy, and thereby rendering that union unfruitful which is too feeble to produce offspring sufficiently strong to enjoy life. Debility and disease often cause barrenness. Nature seems to rebel against sickly offspring. 17. WHY CHILDREN DIE.--Inquire whether one or both the parents of those numerous children that die around us, have not weak lungs, or a debilitated stomach, or a diseased liver, or feeble muscles, or else use them but little, or disordered nerves, or some other debility or form of disease. The prevalence of summer complaints, colic, cholera infantum, and other affections of these vital organs of children is truly alarming, sweeping them into their graves by the million. Shall other animals rear nearly all their young, and shall man, constitutionally by far the strongest of them all, lose half or more of his? is this the order of nature? No, but their death-worm is born in and with them, and by parental agency. 18. GRAVE-YARD STATISTICS.--Take grave-yard statistics in August, and then say, whether most of the deaths of children are not caused by indigestion, or feebleness of the bowels, liver, etc., or complaints growing out of them? Rather, take family statistics from broken-hearted parents! And yet, in general, those very parents who thus suffer more than words can tell, were the first and main transgressors, because they entailed those dyspeptic, heart, and other kindred affections so common among American parents upon their own children, and thereby almost as bad as killed them by inches; thus depriving them of the joys of life, and themselves of their greatest earthly treasure! 19. ALL CHILDREN MAY DIE.--Children may indeed die whose parents are healthy, but they almost must whose parents are essentially ailing in one or more of their vital organs; because, since they inherit this organ debilitated or diseased, any additional cause of sickness attacks this part first, and when it gives out, all go by the board together. 20. PARENTS MUST LEARN AND OBEY.--How infinitely more virtuous and happy would your children be if you should be healthy in body, and happy in mind, so as to beget in them a constitutionally healthy and vigorous physiology, along with a serene and happy frame of mind! Words are utterly powerless in answer, and so is everything but a lifetime of consequent happiness or misery! Learn and obey, then, the laws of life and health, that you may both reap the rich reward yourself, and also shower down upon your children after you, blessings many and most exalted. Avoid excesses of all kinds, be temperate, take good care of the body and avoid exposures and disease, and your children will be models of health and beauty. 21. THE RIGHT CONDITION.--The great practical inference is, that those parents who desire intellectual and moral children, must love each other; because, this love, besides perpetually calling forth and cultivating their higher faculties, awakens them to the highest pitch of exalted action in that climax, concentration, and consummation of love which propagates their existing qualities, the mental endowment of offspring being proportionate to the purity and intensity of parental love. 22. THE EFFECTS.--The children of affectionate parents receive existence and constitution when love has rendered the mentality of their parents both more elevated and more active than it is by nature, of course the children of loving parents are both more intellectual and moral by nature than their parents. Now, if these children and their companions also love one another, this same law which renders the second generation better than the first, will of course render the third still better than the second, and thus of all succeeding generations. 23. ANIMAL IMPULSE.--You may preach and pray till doomsday--may send out missionaries, may circulate tracts and Bibles, and multiply revivals and all the means of grace, with little avail; because, as long as mankind go on, as now, to propagate by animal impulse, so long must their offspring be animal, sensual, devilish! But only induce parents cordially to love each other, and you thereby render their children constitutionally talented and virtuous. Oh! parents, by as much as you prefer the luxuries of concord to the torments of discord, and children that are sweet dispositioned and highly intellectual to those that are rough wrathful, and depraved, be entreated to "_love one another_." [Illustration: JUST HOME FROM SCHOOL.] * * * * * TOO MANY CHILDREN. 1. LESSENING PAUPERISM.--Many of the agencies for lessening pauperism are afraid of tracing back its growth to the frequency of births under wretched conditions. One begins to question whether after all sweet charity or dignified philanthropy has not acted with an unwise reticence. Among the problems which defy practical handling this is the most complicated. The pauperism which arises from marriage is the result of the worst elements of character legalized. In America, where the boundaries of wedlock are practically boundless, it is not desirable, even were it possible, that the state should regulate marriage much further than it now does; therefore must the sociologist turn for aid to society in his struggle with pauperism. 2. RIGHT PHYSICAL AND SPIRITUAL CONDITIONS OF BIRTH.--Society should insist upon the right spiritual and physical conditions for birth. It should be considered more than "a pity" when another child is born into a home too poor to receive it. The underlying selfishness of such an event should be recognized, for it brings motherhood under wrong conditions of health and money. Instead of each birth being the result of mature consideration and hallowed loves children are too often born as animals are born. To be sure the child has a father whom he can call by name. Better that there had never been a child. 3. WRONG RESULTS.--No one hesitates to declare that if is want of self-respect and morality which brings wrong results outside of marriage, but it is also the want of them which begets evil inside the marriage relation. Though there is nothing more difficult than to find the equilibrium between self-respect and self-sacrifice, yet on success in finding it depends individual and national preservation. The fact of being wife and mother or husband and father should imply dignity and joyousness, no matter how humble the home. 4. DIFFERENCE OF OPINION AMONGST PHYSICIANS.--In regard to teaching, the difficulties are great. As soon as one advances beyond the simplest subjects of hygiene, one is met with the difference of opinions among physicians. When each one has a different way of making a mustard plaster, no wonder that each has his own notions about everything else. One doctor recommends frequent births, another advises against them. 5. DIFFERENT NATURES.--If physiological facts are taught to a large class, there are sure to be some in it whose impressionable natures are excited by too much plain speaking, while there are others who need the most open teaching in order to gain any benefit. Talks to a few persons generally are wiser than popular lectures. Especially are talks needed by mothers and unmothered girls who come from everywhere to the city. 6. BOYS AND YOUNG MEN.--It is not women alone who require the shelter of organizations and instruction, but boys and young men. There is no double standard of morality, though the methods of advocating it depend upon the sex which is to be instructed. Men are more concerned with the practical basis of morality than with its sentiment, and with the pecuniary aspects of domestic life than with its physical and mental suffering. We all may need medicine for moral ills, yet the very intangibleness of purity makes us slow to formulate rules for its growth. Under the guidance of the wise in spirit and knowledge, much can be done to create a higher standard of marriage and to proportion the number of births according to the health and income of parents. 7. FOR THE SAKE OF THE STATE.--If the home exists primarily for the sake of the individual, it exists secondarily for the sake of the state. Therefore, any home into which are continually born the inefficient children of inefficient parents, not only is a discomfort in itself, but it also furnishes members for the armies of the unemployed, which are tinkering and hindering legislation and demanding by the brute force of numbers that the state shall support them. 8. OPINIONS FROM HIGH AUTHORITIES.--In the statements and arguments made in the above we have not relied upon our own opinions and convictions, but have consulted the best authorities, and we hereby quote some of the highest authorities upon this subject. 9. REV. LEONARD DAWSON.--"How rapidly conjugal prudence might lift a nation out of pauperism was seen in France.--Let them therefore hold the maxim that the production of offspring with forethought and providence is rational nature. It was immoral to bring children into the world whom they could not reasonably hope to feed, clothe and educate." 10. MRS. FAWCETT.--"Nothing will permanently offset pauperism while the present reckless increase of population continues." 11. DR. GEORGE NAPHEYS.--"Having too many children unquestionably has its disastrous effects on both mother and children as known to every intelligent physician. Two-thirds of all cases of womb disease, says Dr. Tilt, are traceable to child-bearing in feeble women. There are also women to whom pregnancy is a nine months' torture, and others to whom it is nearly certain to prove fatal. Such a condition cannot be discovered before marriage--The detestable crime of abortion is appallingly rife in our day. It is abroad in our land to an extent which would have shocked the dissolute women of pagan RomeS--This wholesale, fashionable murder, how are we to stop it? Hundreds of vile men and women in our large cities subsist by this slaughter of the innocent." 12. REV. H.R. HAWEIS.--"Until it is thought a disgrace in every rank of society, from top to bottom of social scale, to bring into the world more children than you are able to provide for, the poor man's home, at least, must often be a purgatory--his children dinnerless, his wife a beggar--himself too often drunk--here, then, are the real remedies: first, control the family growth according to the family means of support." 13. MONTAGUE COOKSON.--"The limitation of the number of the family--is as much the duty of married persons as the observance of chastity is the duty of those that are unmarried." 14. JOHN STUART MILL.--"Every one has aright to live. We will suppose this granted. But no one has a right to bring children into life to be supported by other people. Whoever means to stand upon the first of these rights must renounce all pretension to the last. Little improvement can be expected in morality until the production of a large family is regarded in the same light as drunkenness or any other physical excess." 15. DR. T.D. NICHOLLS.--"In the present social state, men and women should refrain from having children unless they see a reasonable prospect of giving them suitable nurture and education." 16. REV. M.J. SAVAGE.--"Some means ought to be provided for checking the birth of sickly children." 17. DR. STOCKHAM.--"Thoughtful minds must acknowledge the great wrong done when children are begotten under adverse conditions. Women must learn the laws of life so as to protect themselves, and not be the means of bringing sin-cursed, diseased children into the world. The remedy is in the prevention of pregnancy, not in producing abortion." * * * * * SMALL FAMILIES AND THE IMPROVEMENT OF THE RACE. 1. MARRIED PEOPLE MUST DECIDE FOR THEMSELVES.--It is the fashion of those who marry nowadays to have few children, often none. Of course this is a matter which married people must decide for themselves. As is stated in an earlier chapter, sometimes this policy is the wisest that can be pursued. 2. Diseased people who are likely to beget only a sickly offspring, may follow this course, and so may thieves, rascals, vagabonds, insane and drunken persons, and all those who are likely to bring into the world beings that ought not to be here. But why so many well-to-do folks should pursue a policy adapted only to paupers and criminals, is not easy to explain. Why marry at all if not to found a family that shall live to bless and make glad the earth after father and mother are gone? It is not wise to rear too many children, nor is it wise to have too few. Properly brought up, they will make home a delight, and parents happy. [Illustration: A WELL NOURISHED CHILD.] 3. POPULATION LIMITED.--Galton, in his great work on hereditary genius, observes that "the time may hereafter arrive in far distant years, when the population of this earth shall be kept as strictly within bounds of number and suitability of race, as the sheep of a well-ordered moor, or the plants in an orchard-house; in the meantime let us do what we can to encourage the multiplication of the races best fitted to invent and conform to a high and generous civilization." 4. SHALL SICKLY PEOPLE RAISE CHILDREN?--The question whether sickly people should marry and propagate their kind, is briefly alluded to in an early chapter of this work. Where father and mother are both consumptive the chances are that the children will inherit physical weakness, which will result in the same disease, unless great pains are taken to give them a good physical education, and even then the probabilities are that they will find life a burden hardly worth living. 5. NO REAL BLESSING.--Where one parent is consumptive and the other vigorous, the chances are just half as great. If there is a scrofulous or consumptive taint in the blood, beware! Sickly children are no comfort to their parents, no real blessing. If such people marry, they had better, in most cases, avoid parentage. 6. WELFARE OF MANKIND.--The advancement of the welfare of mankind is a most intricate problem: all ought to refrain from marriage who cannot avoid abject poverty for their children; for poverty is not only a great evil, but tends to its own increase by leading to recklessness in marriage. On the other hand, as Mr. Galton has remarked, if the prudent avoid marriage, while the reckless marry, the inferior members will tend to supplant the better members of society. 7. PREVENTIVES.--Remember that the thousands of preventives which are advertised in papers, private circulars, etc., are not only inefficient, unreliable and worthless, but positively dangerous, and the annual mortality of females in this country from this cause alone is truly horrifying. Study nature, and nature's laws alone will guide you safely in the path of health and happiness. 8. NATURE'S REMEDY.--Nature in her wise economy has prepared for overproduction, for during the period of pregnancy and nursing, and also most of the last half of each menstrual month, woman is naturally sterile; but this condition may become irregular and uncertain on account of stimulating drinks or immoral excesses. * * * * * THE GENERATIVE ORGANS. [Illustration: THE MALE GENERATIVE ORGANS AND THEIR STRUCTURE AND ADAPTATION.] 1. The reproductive organs in man are the penis and testicles and their appendages. 2. The penis deposits the seminal life germ of the male. It is designed to fulfill the seed planting mission of human life. 3. In the accompanying illustration all the parts are named. 4. URETHRA.--The urethra performs the important mission of emptying the bladder, and is rendered very much larger by the passion, and the semen is propelled along through it by little layers of muscles on each side meeting above and below. It is this canal that is inflamed by the disease known as gonorrhoea. 5. PROSTATE GLAND.--The prostate gland is located just before the bladder. It swells in men who have previously overtaxed it, thus preventing all sexual intercourse, and becomes very troublesome to void urine. This is a very common trouble in old age. 6. THE PENAL GLAND.--The penal gland, located at the end of the penis, becomes unduly enlarged by excessive action and has the consistency of India rubber. It is always enlarged by erection. It is this gland at the end that draws the semen forward. It is one of the most essential and wonderful constructed glands of the human body. 7. FEMALE MAGNETISM.--When the male organ comes in contact with female magnetism, the natural and proper excitement takes place. When excited without this female magnetism it becomes one of the most serious injuries to the human body. The male organ was made for a high and holy purpose, and woe be to him who pollutes his manhood by practicing the secret vice. He pays the penalty in after years either by the entire loss of sexual power, or by the afflictions of various urinary diseases. 8. NATURE PAYS all her debts, and when there is an abuse of organ, penalties must follow. If the hand is thrust into the fire it will be burnt. * * * * * THE FEMALE SEXUAL ORGANS. 1. The generative or reproductive organs of the human female are usually divided into the internal and external. Those regarded as internal are concealed from view and protected within the body. Those that can be readily perceived are termed external. The entrance of the vagina may be stated as the line of demarcation of the two divisions. [Illustration: ANATOMY OR STRUCTURE OF THE FEMALE ORGANS OF GENERATION.] 2. HYMEN OR VAGINAL VALVE.--This is a thin membrane of half moon shape stretched across the opening of the vagina. It usually contains before marriage one or more small openings for the passage of the menses. This membrane has been known to cause much distress in many females at the first menstrual flow. The trouble resulting from the openings in the hymen not being large enough to let the flow through and consequently blocking up the vaginal canal, and filling the entire internal sexual organs with blood; causing paroxysms and hysterics and other alarming symptoms. In such cases the hymen must be ruptured that a proper discharge may take place at once. [Illustration: Impregnated Egg. In the first formation of Embryo.] 3. UNYIELDING HYMEN.--The hymen is usually ruptured by the first sexual intercourse, but sometimes it is so unyielding as to require the aid of a knife before coition can take place. 4. THE PRESENCE OF THE HYMEN was formerly considered a test of virginity, but this theory is no longer held by competent authorities, as disease or accidents or other circumstances may cause its rupture. 5. THE OVARIES.--The ovaries are little glands for the purpose of forming the female ova or egg. They are not fully developed until the period of puberty, and usually are about the size of a large chestnut. The are located in the broad ligaments between the uterus and the Fallopian tubes. During pregnancy the ovaries change position; they are brought farther into the abdominal cavity as the uterus expands. 6. OFFICE OF THE OVARY.--The ovary is to the female what the testicle is to the male. It is the germ vitalizing organ and the most essential part of the generative apparatus. The ovary is not only an organ for the formation of the ova, but is also designed for their separation when they reach maturity. 7. FALLOPION TUBES.--These are the ducts that lead from the ovaries to the uterus. They are entirely detached from the glands or ovaries, and are developed on both sides of the body. 8. OFFICE OF THE FALLOPIAN TUBES.--The Fallopian tubes have a double office: receiving the ova from the ovaries and conducting it into the uterus, as well as receiving the spermatic fluid of the male and conveying it from the uterus in the direction of the ovaries, the tubes being the seat of impregnation. [Illustration: OVUM.] 9. STERILITY IN FEMALES.--Sterility in the female is sometimes caused by a morbid adhesion of the tube to a portion of the ovary. By what power the mouth of the tube is directed toward a particular portion of an ovary, from which the ovum is about to be discharged, remains entirely unknown, as does also the precise nature of the cause which effects this movement. [Illustration: Ripe Ovum from the Ovary.] * * * * * THE MYSTERIES OF THE FORMATION OF LIFE. 1. SCIENTIFIC THEORIES.--Darwin, Huxley, Haeckel, Tyndall, Meyer, and other renowned scientists, have tried to find the _missing link_ between man and animal; they have also exhausted their genius in trying to fathom the mysteries of the beginning of life, or find where the animal and mineral kingdoms unite to form life; but they have added to the vast accumulation of theories only, and the world is but little wiser on this mysterious subject. 2. PHYSIOLOGY.--Physiology has demonstrated what physiological changes take place in the germination and formation of life, and how nature expresses the intentions of reproduction by giving animals distinctive organs with certain secretions for this purpose, etc. All the different stages of development can be easily determined, but how and why life takes place under such special condition and under no other, is an unsolved mystery. 3. OVARIES.--The ovaries are the essential parts of the generative system of the human female in which ova are matured. There are two ovaries, one on each side of the uterus, and connected with it by the Fallopian tubes. They are egg-shaped, about an inch in diameter, and furnish the germs or ovules. These germs or ovules are very small, measuring about 1/120 of an inch in diameter. 4. DEVELOPMENT.--The ovaries develop with the growth of the female, so that finally at the period of puberty they ripen and liberate an ovum or germ vesicle, which is carried into the uterine cavity of the Fallopian tubes. By the aid of the microscope we find that these ova are composed of granular substance, in which is found a miniature yolk surrounded by a transparent membrane called the zona pellucida. This yolk contains a germinal vesicle in which can be discovered a nucleus, called the germinal spot. The process of the growth of the ovaries is very gradual, and their function of ripening and discharging one ovum monthly into the Fallopian tubes and uterus, is not completed until between the twelfth and fifteenth years. 5. WHAT SCIENCE KNOWS.--After the sexual embrace we know that the sperm is lifted within the genital passages or portion of the vagina and mouth of the uterus. The time between the deposit of the semen and fecundation varies according to circumstances. If the sperm-cell travels to the ovarium it generally takes from three to five days to make the journey. As Dr. Pierce says: The transportation is aided by the ciliary processes (little hairs) of the mucous surface of the vaginal and uterine walls, as well as by its own vibratile movements. The action of the cilia, under the stimulus of the sperm, seems to be from without, inward. Even if a minute particle of sperm, less than a drop, be left upon the margin of the external genitals of the female, it is sufficient in amount to impregnate, and can be carried, by help of these cilia, to the ovaries. 6. CONCEPTION.--After intercourse at the proper time the liability to conception is very great. If the organs are in a healthy condition, conception must necessarily follow, and no amount of prudence and the most rigid precautions often fail to prevent pregnancy. 7. ONLY ONE ABSOLUTELY SAFE METHOD.--There is only one absolutely safe method to prevent conception, entirely free from danger and injury to health, and one that is in the reach of all; that is to refrain from union altogether. [Illustration: A EUGENIC BABY.] * * * * * CONCEPTION--ITS LIMITATIONS. 1. A COMMON QUESTION.--The question is often asked, "Can Conception be prevented at all times?" Let us say right here that even if such an interference with nature's laws were possible it is inadmissible, and never to be justified except in cases of deformity or disease. 2. FALSE CLAIMS OF IMPOSTERS.--During the past few years a great deal has been written on the subject, claiming that new remedies had been discovered for the prevention of conception, etc., but these are all money making devices to deceive the public, and enrich the pockets of miserable and unprincipled imposters. 3. THE TRUTH OF THE MATTER.--Dr. Pancoast, an eminent authority, says: "The truth is, there is no medicine taken internally capable of preventing conception, and the person who asserts to the contrary, not only speaks falsely, but is both a knave and a fool." 4. FOOLISH DREAD OF CHILDREN.--What is more deplorable and pitiable than an old couple childless? Young people dislike the care and confinement of children and prefer society and social entertainments and thereby do great injustice and injury to their health. Having children under proper circumstances never ruins the health and happiness of any woman. In fact, womanhood is incomplete without them. She may have a dozen or more, and still have better health than before marriage. It is having them too close together, and when she is not in a fit state, that her health gives way. 5. SELF-DENIAL AND FORBEARANCE.--If the husband respects his wife he will come to her relief by exercising self-denial and forbearance, but sometimes before the mother has recovered from the effects of bearing, nursing and rearing one child, ere she has regained proper tone and vigor of body and mind, she is unexpectedly overtaken, surprised by the manifestation of symptoms which again indicate pregnancy. Children thus begotten cannot become hardy and long-lived. But the love that parents may feel for their posterity, by the wishes for their success, by the hopes for their usefulness, by every consideration for their future well-being, let them exercise caution and forbearance until the wife becomes sufficiently healthy and enduring to bequeath her own rugged, vital stamina to the child she bears in love. 6. A WRONG TO THE MOTHER AND CHILD.--Sometimes the mother is diseased; the outlet from the womb, as a result of laceration by a previous child-birth, is frequently enlarged, thus allowing conception to take place very readily, and hence she has children in rapid succession. Besides the wrong to the mother in having children in such rapid succession, it is a great injustice to the babe in the womb and the one at the breast that they should follow each other so quickly that one is conceived while the other is nursing. One takes the vitality of the other; neither has sufficient nourishment, and both are started in life stunted and incomplete. 7. FEEBLE AND DISEASED PARENTS.--If the parties of a marriage are both feeble and so adapted to each other that their children are deformed, insane or idiots, then to beget offspring would be a flagrant wrong; if the mother's health is in such a condition as to forbid the right of laying the burden of motherhood upon her, then medical aid may safely come to her relief. 8. "THE DESIRABILITY AND PRACTICABILITY of limiting offspring," says Dr. Stockham, are the subject of frequent inquiry. Fewer and better children are desired by right-minded parents. Many men and women, wise in other things of the world, permit generation as a chance result of copulation, without thought of physical or mental conditions to be transmitted to the child. Coition, the one important act of all others, carrying with it the most vital results, is usually committed for selfish gratification. Many a drunkard owes his lifelong appetite for alcohol to the fact that the inception of his life could be traced to a night of dissipation on the part of his father. Physical degeneracy and mental derangements are too often caused by the parents producing offspring while laboring under great mental strain or bodily fatigue. Drunkenness and licentiousness are frequently the heritage of posterity. Future generations demand that such results be averted by better prenatal influences. The world is groaning under the curse of chance parenthood. It is due to posterity that procreation be brought under the control of reason and conscience. 9. "IT HAS BEEN FEARED THAT A KNOWLEDGE of means to control offspring would, if generally diffused, be abused by women; that they would to so great an extent escape motherhood as to bring about social disaster. This fear is not well founded. The maternal instinct is inherent and sovereign in woman. Even the prenatal influences of a murderous intent on the part of parents scarcely ever eradicate it. With this natural desire for children, we believe few woman would abuse the knowledge of privilege of controlling offspring. Although women shrink from forced maternity, and from the bearing of children under the great burden of suffering, as well as other adverse conditions, it is rare to find a woman who is not greatly disappointed if she does not, some time in her life, wear the crown of motherhood. "An eminent lady teacher, in talking to her pupils once said, 'The greatest calamity that can befall a woman is never to have a child. The next greatest calamity is to have one only.' From my professional experience I am happy to testify that more women seek to overcome causes of sterility than to obtain knowledge of limiting the size of the family or means to destroy the embryo. Also, if consultation for the latter is sought, it is usually at the instigation of the husband. Believing in the rights of unborn children, and in the maternal instinct, I am consequently convinced that no knowledge should be withheld that will secure proper conditions for the best parenthood." 10. THE CASE OF THE JUKE FAMILY.--We submit the following case of the Juke family, mostly of New York state, as related by Dr. R.L. Dugdale, when a member of the prison Association, and let the reader judge for himself: "It was traced out by painstaking research that from one woman called Margaret, who, like Topsy, merely 'growed' without pedigree as a pauper in a village of the upper Hudson, about eighty-five years ago, there descended 673 children, grandchildren and great grandchildren, of whom 200 were criminals of the dangerous class, 280 adult paupers, and 50 prostitutes, while 300 children of her lineage died prematurely. The last fact proves to what extent in this family nature was kind to the rest of humanity in saving it from a still larger aggregation or undesirable and costly members, for it is estimated that the expense to the State of the descendants of Maggie was over a million dollars, and the State itself did something also towards preventing a greater expense by the restrain exercised upon the criminals, paupers, and idiots of the family during a considerable portion of their lives." 11. MODERATION.--Continence, self-control, a willingness to deny himself--that is what is required from the husband. But a thousand voices reach us from suffering women in all parts of the land that this will not suffice; that men refuse thus to restrain themselves; that it leads to a loss of domestic happiness and to illegal amour, or it is injurious physically and morally; that, in short, such advice is useless because impracticable. 12. NATURE'S METHOD.--To such we reply that nature herself has provided to some extent, against overproduction. It is well known that women, when nursing, rarely become pregnant, and for this reason, if for no other, women should nurse their own children, and continue the period until the child is at least nine months or a year old. However, the nursing, if continued too long, weakens both the mother and the child. 13. ANOTHER PROVISION OF NATURE.--For a certain period between her monthly illness, every woman is sterile. Conception may be avoided by refraining from coition except for this particular number of days, and there will be no evasion of natural intercourse, no resort to disgusting practices, and nothing degrading. * * * * * PRENATAL INFLUENCES. 1. DEFINITION.--By prenatal influences we mean those temporary operations of the mind or physical conditions of the parents previous to birth, which stamp their impress upon the new life. 2. THREE PERIODS.--We may consider this subject as one which naturally divides itself into three periods: the preparation which precedes conception, the mental, moral and physical conditions at the time of conjunction, and the environment and condition of the mother during the period of gestation. 3. PROMINENT AUTHORITIES.--A.E. Newton says: "Numerous facts indicate that offspring may be affected and their tendencies shaped by a great variety of influences, among which moods and influences more or less transient may be included." Dr. Stall says: "Prenatal influences are both subtle and potent, and no amount of wealth or learning or influence can secure exemption from them." Dr. John Cowan says upon this subject: "The fundamental principles of genius in reproduction are that, through the rightly directed wills of the father and mother, preceding and during antenatal life, the child's form or body, character of mind and purity of soul are formed and established. That in its plastic state, during antenatal life, like clay in the hands of the potter, it can be molded into absolutely any form of body and soul the parents may knowingly desire." 4. LIKE PARENTS, LIKE CHILDREN.--It is folly to expect strong and vigorous children from weak and sickly parents, or virtuous offspring from impure ancestry. Dr. James Foster Scott tells us that purity is, in fact, the crown of all real manliness; and the vigorous and robust, who by repression of evil have preserved their sexual potency, make the best husbands and fathers, and they are the direct benefactors for the race by begetting progeny who are not predisposed to sexual vitiation and bodily and mental degeneracy. 5. BLOOD WILL TELL.--Thus we see that prenatal influences greatly modify, if they do not wholly control, inherited tendencies. Is it common sense to suppose that a child, begotten when the parents are exhausted from mental or physical overwork, can be as perfect as when the parents are overflowing with the buoyancy of life and health? The practical farmer would not allow a domestic animal to come into his flock or herd under imperfect physical conditions. He understands that while "blood will tell," the temporary conditions of the animals will also tell in the perfections or imperfections of the offspring. 6. HEALTH A LEGACY.--It is no small legacy to be endowed with perfect health. In begetting children comparatively few people seem to think that any care of concern is necessary to insure against ill-health or poverty of mind. How strange our carelessness and unconcern when these are the groundwork of all comfort and success! How few faces and forms we see which give sign of perfect health. It is just as reasonable to suppose that men and women can squander their fortune and still have it left to bequeath to their children, as that parents can violate organic laws and still retain their own strength and activity. 7. RESPONSIBILITY OF PARENTS.--Selden H. Tascott says: "Ungoverned passions in the parents may unloose the furies of unrestrained madness in the minds of their children. Even untempered religious enthusiasm may beget a fanaticism that can not be restrained within the limits of reason." In view of the preceding statements, what a responsibility rests upon the parents! No step in the process of parentage is unimportant. From the lovers first thought of marriage to the birth of the child, every step of the way should be paved with the snow-white blossoms of pure thought. Kindly words and deeds should bind the prospective parents more closely together. Not mine and thine, but ours, should be the bond of sympathy. Each should be chaste in thought and word and deed as was Sir Galahad, who went in search of the Holy Grail, saying: "My strength is as the strength of ten, Because my heart is pure." [Illustration: DR. HALL'S SYRINGE. No. 1 Gives a Whirling Spray and No. 2 Also Whirling Spray. Price of No. 1 is $1.50 and of No. 2, $3.00. To readers of this book the publishers will send No. 1 for $1.20 and No. 2 for $2.25 postpaid. Dr. Hall's is larger and made of highest grade red rubber and its action is very effective.] * * * * * VAGINAL CLEANLINESS. 1. The above syringes are highly recommended by physicians as vaginal cleansers. They will be found a great relief in health or sickness, and in many cases cure barrenness or other diseases of the womb. 2. CLEANLINESS.--Cleanliness is next to godliness. Without cleanliness the human body is more or less defiled and repulsive. A hint to the wise is sufficient. The vagina should be cleansed with the same faithfulness as any other portion of the body. 3. TEMPERATURE OF THE WATER.--Those not accustomed to use vaginal injections would do well to use water milk-warm at the commencement; after this the temperature may be varied according to circumstances. In case of local inflammation use hot water. The indiscriminate use of cold water injections will be found rather injurious than beneficial, and a woman in feeble health will always find warm water invigorating and preferable. 4. LEUCORRHOEA.--In case of persistent leucorrhoea use the temperature of water from seventy-two to eighty-five degrees Fahrenheit. 5. THE CLEANSER will greatly stimulate the health and spirits of any woman who uses it. Pure water injections have a stimulating effect, and it seems to invigorate the entire body. 6. SALT AND WATER INJECTIONS.--This will cure mild cases of leucorrhoea. Add a teaspoonful of salt to a pint and a half of water at the proper temperature. Injections may be repeated daily if deemed necessary. 7. SOAP AND WATER.--Soap and water is a very simple domestic remedy, and will many times afford relief in many diseases of the womb. It seems it thoroughly cleanses the parts. A little borax or vinegar may be used the same as salt water injections. (See No. 6.) 8. HOLES IN THE TUBES.--Most of the holes in the tubes of syringes are too small. See that they are sufficiently large to produce thorough cleansing. 9. INJECTIONS DURING THE MONTHLY FLOW.--Of course it is not proper to arrest the flow, and the injections will stimulate a healthy action of the organs. The injections may be used daily throughout the monthly flow with much comfort and benefit. If the flow is scanty and painful the injections may be as warm as they can be comfortably borne. If the flowing is immoderate, then cool water may be used. A woman will soon learn her own condition and can act accordingly. 10. BLOOM AND GRACE OF YOUTH.--The regular bathing of the body will greatly improve woman's beauty. Remember that a perfect complexion depends upon the healthy action of all the organs. Vaginal injections are just as important as the bath. A beautiful woman must not only be cleanly, but robust and healthy. There can be no perfect beauty without good health. [Illustration] [Illustration: Trying On a New Dress.] * * * * * IMPOTENCE AND STERILITY. 1. Actual impotence during the period of manhood is a very rare complaint, and nature very unwillingly, and only after the absolute neglect of sanitary laws, gives up the power of reproduction. 2. Not only sensual women, but all without exception, feel deeply hurt, and are repelled by the husband whom they may previously have loved dearly, when, after entering the married state, they find that he is impotent. The more inexperienced and innocent they were at the time of marriage, the longer it often is before they find that something is lacking in the husband; but, once knowing this, the wife infallibly has a feeling of contempt and aversion for him though there are many happy families where this defect exists. It is often very uncertain who is the weak one, and no cause for separation should be sought. 3. Unhappy marriages, barrenness, divorces, and perchance an occasional suicide, may be prevented by the experienced physician, who can generally give correct information, comfort, and consolation, when consulted on these delicate matters. 4. When a single man fears that he is unable to fulfill the duties of marriage, he should not marry until his fear is dispelled. The suspicion of such a fear strongly tends to bring about the very weakness which he dreads. Go to a good physician (not to one of those quacks whose advertisements you see in the papers; they are invariably unreliable), and state the case fully and freely. 5. Diseases, malformation, etc., may cause impotence. In case of malformation there is usually no remedy, but in case of disease it is usually within the reach of a skillful physician. 6. Self-abuse and spermatorrhoea produce usually only temporary impotence and can generally be relieved by carrying out the instructions given elsewhere in this book. 7. Excessive indulgences often enfeeble the powers and often result in impotence. Dissipated single men, professional libertines, and married men who are immoderate, often pay the penalty of their violations of the laws of nature, by losing their vital power. In such cases of excess there may be some temporary relief, but as age advances the effects of such indiscretion will become more and more manifest. 8. The condition of sterility in man may arise either from a condition of the secretion which deprives it of its fecundating powers or it may spring from a malformation which prevents it reaching the point where fecundation takes place. The former condition is most common in old age, and is a sequence of venereal disease, or from a change in the structure or functions of the glands. The latter has its origin in a stricture, or in an injury, or in that condition technically known as hypospadias, or in debility. 9. It can be safely said that neither self-indulgence nor spermatorrhoea often leads to permanent sterility. 10. It is sometimes, however, possible, even where there is sterility in the male, providing the secretion is not entirely devoid of life properties on part of the husband, to have children, but these are exceptions. 11. No man need hesitate about matrimony on account of sterility, unless that condition arises from a permanent and absolute degeneration of his functions. 12. Impotence from mental and moral causes often takes place. Persons of highly nervous organization may suffer incapacity in their sexual organs. The remedy for these difficulties is rest and change of occupation. 13. REMEDIES IN CASE OF IMPOTENCE ON ACCOUNT OF FORMER PRIVATE DISEASES, OR MASTURBATION, OR OTHER CAUSES.--First build up the body by taking some good stimulating tonics. The general health is the most essential feature to be considered, in order to secure restoration of the sexual powers. Constipation must be carefully avoided. If the kidneys do not work in good order, some remedy for their restoration must be taken. Take plenty of out-door excercise avoid horseback riding or heavy exhaustive work. 14. FOOD AND DRINKS WHICH WEAKEN DESIRE.--All kinds of food which cause dyspepsia or bring on constipation, diarrhea, or irritate the bowels, alcoholic beverages, or any indigestible compound, has the tendency to weaken the sexual power. Drunkards and tipplers suffer early loss of vitality. Beer drinking has a tendency to irritate the stomach and to that extent affects the private organs. 15. COFFEE.--Coffee drank excessively causes a debilitating effect upon the sexual organs. The moderate use of coffee can be recommended, yet an excessive habit of drinking very strong coffee will sometimes wholly destroy vitality. 16. TOBACCO.--It is a hygienic and physiological fact that tobacco produces sexual debility and those who suffer any weakness on that source should carefully avoid the weed in all its forms. 17. DRUGS WHICH STIMULATE DESIRE.--There are certain medicines which act locally on the membranes and organs of the male, and the papers are full of advertisements of "Lost Manhood Restored", etc., but in every case they are worthless or dangerous drugs and certain to lead to some painful malady or death. All these patent medicines should be carefully avoided. People who are troubled with any of these ailments should not attempt to doctor themselves by taking drugs, but a competent physician should be consulted. Eating rye, corn, or graham bread, oatmeal, cracked wheat, plenty of fruit, etc. is a splendid medicine. If that is not sufficient, then a physician should be consulted. 18. DRUGS WHICH MODERATE DESIRE.--Among one of the most common domestic remedies is camphor. This has stood the test for ages. Small doses or half a grain in most instances diminishes the sensibility of the organs of sex. In some cases it produces irritation of the bladder. In that case it should be at once discontinued. On the whole a physician had better be consulted. The safest drug among domestic remedies is a strong tea made out of hops. Saltpeter, or nitrate of potash, taken in moderate quantities are very good remedies. [Illustration] 19. STRICTLY SPEAKING there is a distinction made between; _impotence_ and _sterility._ _Impotence_ is a loss of power to engage in the sexual act and is common to men. It may be imperfection in the male organ or a lack of sufficient sexual vigor to produce and maintain erection. _Sterility_ is a total loss of capacity in the reproduction of the species, and is common to women. There are, however, very few causes of barrenness that cannot be removed when the patient is perfectly developed. Sterility, in a female, most frequently depends upon a weakness or irritability either in the ovaries or the womb, and anything having a strengthening effect upon either organ will remove the disability. (See page 249.) 20. "OVER-INDULGENCE in intercourse," says Dr. Hoff, "is sometimes the cause of barrenness; this is usually puzzling to the interested parties, inasmuch as the practices which, in their opinion, should be the source of a numerous progeny, have the very opposite effect. By greatly moderating their ardor, this defect may be remedied." 21. "NAPOLEON AND JOSEPHINE.--A certain adaptation between the male and female has been regarded as necessary to conception, consisting of some mysterious influence which one sex exerts over the other, neither one, however, being essentially impotent or sterile. The man may impregnate one woman and not another, and the woman will conceive by one man and not by another. In the marriage of Napoleon Bonaparte and Josephine no children were born, but after he had separated from the Empress and wedded Maria Louisa of Austria, an heir soon came. Yet Josephine had children by Beauharnais, her previous husband. But as all is not known as to the physical condition of Josephine during her second marriage, it cannot be assumed that mere lack of adaptability was the cause of unfruitfulness between them. There may have been some cause that history has not recorded, or unknown to the state of medical science of those days. There are doubtless many cases of apparently causeless unfruitfulness in marriage that even physicians, with a knowledge of all apparent conditions in the parties cannot explain; but when, as elsewhere related in this volume, impregnation by artificial means is successfully practised, it is useless to attribute barrenness to purely psychological and adaptative influences." * * * * * PRODUCING BOYS OR GIRLS AT WILL. 1. CAN THE SEXES BE PRODUCED AT WILL?--This question has been asked in all ages of the world. Many theories have been advanced, but science has at last replied with some authority. The following are the best known authorities which this age of science has produced. 2. THE AGRICULTURAL THEORY.--The agricultural theory as it may be called, because adopted by farmers, is that impregnation occurring within four days of the close of the female monthlies produces a girl, because the ovum is yet immature; but that when it occurs after the fourth day from its close, gives a boy, because this egg is now mature; whereas after about the eighth day this egg dissolves and passes off, so that impregnation is thereby rendered impossible, till just before the mother's next monthly.--_Sexual Science._ 3. QUEEN BEES LAY FEMALE EGGS FIRST, and male after wards. So with hens; the first eggs laid after the tread give females, the last males. Mares shown the stallion late in their periods drop horse colts rather than fillies.--_Napheys._ 4. IF YOU WISH FEMALES, give the male at the first sign of heat; if males, at its end.--_Prof. Thury._ 5. ON TWENTY-TWO SUCCESSIVE OCCASIONS I desired to have heifers, and succeeded in every case. I have made in all twenty-nine experiments, after this method, and succeeded in every one, in producing the sex I desired.--_A Swiss Breeder._ 6. THIS THURY PLAN has been tried on the farms of the Emperor of the French with unvarying success. 7. CONCEPTION IN THE FIRST HALF of the time between the menstrual periods produces females, and males in the latter.--_London Lancet._ 8. INTERCOURSE in from two to six days after cessation of the menses produces girls, in from nine to twelve, boys.--_Medical Reporter._ THE MOST MALE POWER and passion creates boys; female girls. This law probably causes those agricultural facts just cited thus: Conception right after menstruation give girls, because the female is then the most impassioned; later, boys, because her wanting sexual warmth leaves him the most vigorous. Mere sexual excitement, a wild, fierce, furious rush of passion, is not only not sexual vigor, but in its inverse ratio; and a genuine insane fervor caused by weakness; just as a like nervous excitability indicates weak nerves instead of strong. Sexual power is deliberate, not wild; cool, not impetuous; while all false excitement diminishes effectiveness.--_Fowler._ [Illustration: HEALTHY CHILDREN.] * * * * * ABORTION OR MISCARRIAGE. 1. ABORTION OR MISCARRIAGE is the expulsion of the child from the womb previous to six months; after that it is called premature birth. 2. CAUSES.--It may be due to a criminal act of taking medicine for the express purpose of producing miscarriage or it may be caused by certain medicines, severe sickness or nervousness, syphilis, imperfect semen, lack of room in the pelvis and abdomen, lifting, straining, violent cold, sudden mental excitement, excessive sexual intercourse, dancing, tight lacing, the use of strong purgative medicines, bodily fatigue, late suppers, and fashionable amusements. 3. SYMPTOMS.--A falling or weakness and uneasiness in the region of the loins, thighs and womb, pain in the small of the back, vomiting and sickness of the stomach, chilliness with a discharge of blood accompanied with pain in the lower portions of the abdomen. These may take place in a single hour, or it may continue for several days. If before the fourth month, there is not so much danger, but the flow of blood is generally greater. If miscarriage is the result of an accident, it generally takes place without much warning, and the service of a physician should at once be secured. 4. HOME TREATMENT.--A simple application of cold water externally applied will produce relief, or cold cloths of ice, if convenient, applied to the lower portions of the abdomen. Perfect quiet, however, is the most essential thing for the patient. She should lie on her back and take internally a teaspoonful of paregoric every two hours; drink freely of lemonade or other cooling drinks, and for nourishment subsist chiefly on chicken broth, toast, water gruel, fresh fruits, etc. The principal homeopathic remedies for this disease are ergot and cimicifuga, given in drop-doses of the tinctures. 5. INJURIOUS EFFECTS.--Miscarriage is a very serious difficulty, and the health and the constitution may be permanently impaired. Any one prone to miscarriage should adopt every measure possible to strengthen and build up the system; avoid going up stairs or doing much heavy lifting or hard work. 6. PREVENTION.--Practice the laws of sexual abstinence, take frequent sitz-baths, live on oatmeal, graham bread, and other nourishing diet. Avoid highly seasoned food, rich gravies, late suppers and the like. [Illustration] [Illustration: AN INDIAN FAMILY. THE SAVAGE INDIAN TEACHES US LESSONS OF CIVILIZATION.] * * * * * THE MURDER OF THE INNOCENTS. 1. MANY CAUSES.--Many causes have operated to produce a corruption of the public morals so deplorable; prominent among which may be mentioned the facility with which divorces may be obtained in some of the States, the constant promulgation of false ideas of marriage and its duties by means of books, lectures, etc., and the distribution through the mails of impure publications. But an influence not less powerful than any of these is the growing devotion of fashion and luxury of this age, and the idea which practically obtains to so great an extent that pleasure, instead of the health or morals, is the great object of life. 2. A MONSTROUS CRIME.--The abiding interest we feel in the preservation of the morals of our country, constrains us to raise our voice against the daily increasing practice of infanticide, especially before birth. The notoriety that monstrous crime has obtained of late, and the hecatombs of infants that are annually sacrificed to Moloch, to gratify an unlawful passion, are a sufficient justification for our alluding to a painful and delicate subject, which should "not even be named," only to correct and admonish the wrong-doers. 3. LOCALITIES IN WHICH IT IS MOST PREVALENT.--We may observe that the crying sin of infanticide is most prevalent In those localities where the system of moral education has been longest neglected. This inhuman crime might be compared to the murder of the innocents, except that the criminals, in this case, exceed in enormity the cruelty of Herod. 4. SHEDDING INNOCENT BLOOD.--If it is a sin to take away the life even of an enemy; if the crime of shedding innocent blood cries to heaven for vengeance; in what language can we characterize the double guilt of those whose souls are stained with the innocent blood of their own unborn, unregenerated offspring? 5. THE GREATNESS OF THE CRIME.--The murder of an infant before its birth, is, in the sight of God and the law, as great a crime as the killing of a child after birth. 6. LEGAL RESPONSIBILITY.--Every State of the Union has made this offense one of the most serious crimes. The law has no mercy for the offenders that violate the sacred law of human life. It is murder of the most cowardly character and woe to him who brings this curse upon his head, to haunt him all the days of his or her life, and to curse him at the day of his death. 7. THE PRODUCT OF LUST.--Lust pure and simple. The only difference between a marriage of this character and prostitution is, that society, rotten to its heart, pulpits afraid to cry aloud against crime and vice, and the church conformed to the world, have made such a profanation of marriage respectable. To put it in other words, when two people determine to live together as husband and wife, and evade the consequences and responsibilities of marriage, they are simply engaged in prostitution without the infamy which attaches to that vice and crime. 8. OUTRAGEOUS VIOLATION OF ALL LAW.--The violation of all law, both natural and revealed, is the cool and villainous contract by which people entering into the marital relation engage in defiance of the laws of God and the laws of the commonwealth, that they shall be unencumbered with a family of children. "Disguise the matter as you will," says Dr. Pomeroy, "yet the fact remains that the first and specific object of marriage is the rearing of a family." "Be fruitful and multiply and replenish the earth," is God's first word to Adam after his creation. 9. THE NATIONAL SIN.--The prevention of offspring is preeminently the sin of America. It is fast becoming the national sin of America, and if it is not checked, it will sooner or later be an irremediable calamity. The sin has its roots in a low and perverted idea of marriage, and is fostered by false standards of modesty. 10. THE SIN OF HEROD.--Do these same white-walled sepulchres of hell know that they are committing the damning sin of Herod in the slaughter of the innocents, and are accessories before the fact to the crime of murder? Do women in all circles of society, when practicing these terrible crimes realize the real danger? Do they understand that it is undermining their health, and their constitution, and that their destiny, if persisted in, is a premature grave just as sure as the sun rises in the heavens? Let all beware and let the first and only purpose be, to live a life guiltless before God and man. 11. THE CRIME OF ABORTION.--From the moment of conception a new life commences; a new individual exists; another child is added to the family. The mother who deliberately sets about to destroy this life, either by want of care, or by taking drugs, or using instruments, commits as great a crime, and is just as guilty as if she strangled her new-born infant or as if she snatched from her own breast her six months' darling and dashed out its brains against the wall. Its blood is upon her head, and as sure as there is a God and a judgment, that blood will be required of her. The crime she commits is murder, child murder--the slaughter of a speechless, helpless being, whom it is her duty, beyond all things else, to cherish and preserve. 12. DANGEROUS DISEASES.--We appeal to all such with earnest and with threatening words. If they have no feeling for the fruit of their womb, if maternal sentiment is so callous in their breasts, let them know that such produced abortions are the constant cause of violent and, dangerous womb diseases, and frequently of early death; that they bring on mental weakness, and often insanity; that they are the most certain means to destroy domestic happiness which can be adopted. Better, far better, to bear a child every year for twenty years than to resort to such a wicked and injurious step; better to die, if need be, of the pangs of child-birth, than to live with such a weight of sin on the conscience. * * * * * THE UNWELCOME CHILD.[Footnote: This is the title of a pamphlet written by Henry C. Wright. We have taken some extracts from it.] 1. TOO OFTEN THE HUSBAND thinks only of his personal gratification; he insists upon what he calls his rights(?); forces on his wife an _unwelcome child_, and thereby often alienates her affections, if he does not drive her to abortion. Dr Stockham reports the following case: "A woman once consulted me who was the mother of five children, all born within ten years. These were puny, scrofulous, nervous and irritable. She herself was a fit subject for doctors and drugs. Every organ in her body seemed diseased, and every function perverted. She was dragging out a miserable existence. Like other physicians, I had prescribed in vain for her many maladies. One day she chanced to inquire how she could safely prevent conception. This led me to ask how great was the danger. She said: 'Unless my husband is absent from home, few nights have been exempt since we were married, except it may be three or four immediately after confinement.' "'And yet your husband loves you?' "'O, yes, he is kind and provides for his family. Perhaps I might love him but for this. While now--(will God forgive me?)--_I detest, I loathe him_, and if I knew how to support myself and children, I would leave him.' "'Can you talk with him upon this subject?' "'I think I can.' "'Then there is hope, for many women cannot do that. Tell him I will give you treatment to improve your health and if he will wait until you can respond, _take time for the act, have it entirely mutual from first to last_, the demand will not come so frequent.' "'Do you think so?' "'The experience of many proves the truth of this statement.' "Hopefully she went home, and in six months I had the satisfaction of knowing my patient was restored to health, and a single coition in a month gave the husband more satisfaction than the many had done previously, that the creative power was under control, and that my lady could proudly say 'I love,' where previously she said 'I hate.' "If husbands will listen, a few simple instructions will appeal to their _common sense_, and none can imagine the gain to themselves, to their wives and children, and their children's children. Then it may not be said of the babes that the 'Death borders on their birth, and their cradle stands in the grave.'" 2. WIVES! BE FRANK AND TRUE to your husbands on the subject of maternity, and the relation that leads to it. Interchange thoughts and feelings with them as to what nature allows or demands in regard to these. Can maternity be natural when it is undesigned by the father or undesired by the mother? Can a maternity be natural, healthful, ennobling to the mother, to the child, to the father, and to the home, when no loving, tender, anxious forethought presides over thee relation in which it originated?--when the mother's nature loathed and repelled it, and the father's only thought was his own selfish gratification; the feelings and conditions of the mother, and the health, character and destiny of the child that may result being ignored by him. Wives! let there be a perfect and loving understanding between you and your husbands on these matters, and great will be your reward. 3. A WOMAN WRITES:--"There are few, vary few, wives and mothers who could not reveal a sad, dark picture in their own experience in their relations to their husbands and their children. Maternity, and the relation in which it originates, are thrust upon them by their husbands, often without regard to their spiritual or physical conditions, and often in contempt of their earnest and urgent entreaties. No joy comes to their heart at the conception and birth of their children, except that which arises from the consciousness that they have survived the sufferings wantonly and selfishly inflicted upon them." 4. HUSBAND, WHEN MATERNITY is imposed on your wife without her consent, and contrary to her appeal, how will her mind necessarily be affected towards her child? It was conceived in dread and in bitterness of spirit. Every stage of its foetal development is watched with feeling of settled repugnance. In every step of its ante-natal progress the child meets only with grief and indignation in the mother. She would crush out its life, if she could. She loathed its conception; she loathed it in every stage of its ante-natal development. Instead of fixing her mind on devising ways and means for the healthful and happy organization and development of her child before it is born, and for its post natal comfort and support, her soul may be intent on its destruction, and her thoughts devise plans to kill it. In this, how often is she aided by others! There are those, and they are called men and women, whose profession is to devise ways to kill children before they are born. Those who do this would not hesitate (but for the consequences) to kill them after they are born, for the state of mind that would justify and instigate _ante-natal_ child-murder would justify and instigate _post-natal_ child-murder. Yet, public sentiment consigns the murderer of post-natal children to the dungeon or the gallows, while the murderers of antenatal children are often allowed to pass in society as honest and honorable men and women. 5. THE FOLLOWING IS AN EXTRACT from a letter written by one who has proudly and nobly filled the station of a wife and mother, and whose children and grandchildren surround her and crown her life with tenderest love and respect: "It has often been a matter of wonder to me that men should, so heedlessly, and so injuriously to themselves, their wives and children, and their homes, demand at once, as soon as they get legal possession of their wives, the gratification of a passion, which, when indulged merely for the sake of the gratification of the moment, must end in the destruction of all that is beautiful, noble and divine in man or woman. I have often felt that I would give the world for a friendship with man that should show no impurity in its bearing, and for a conjugal relation that would, at all times, heartily and practically recognize the right of the wife to decide for herself when she should enter into the relation that leads to maternity." 6. TIMELY ADVICE.--Here let me say that on no subject should a man and woman, as they are being attracted into conjugal relations, be more open and truthful with each other than on this. No woman, who would save herself and the man she loves from a desecrated and wretched home, should enter into the physical relations of marriage with a man until she understands what he expects of her as to the function of maternity, and the relation that leads to it. If a woman is made aware that the man who would win her as a wife regards her and the marriage relation only as the means of a legalized gratification of his passions, and she sees fit to live with him as a wife, with such a prospect before her, she must take the consequences of a course so degrading and so shameless. If she sees fit to make an offering of her body and soul on the altar of her husband's sensuality, she must do it; but she has a right to know to what base uses her womanhood is to be put, and it is due to her, as well as to himself, that he should tell beforehand precisely what he wants and expects of her. Too frequently, man shrinks from all allusion, during courtship, to his expectations in regard to future passional relations. He fears to speak of them, lest he should shock and repel the woman he would win as a wife. Being conscious, it may be, of an intention to use power he may acquire over her person for his own gratification, he shuns all interchange of views with her, lest she should divine the hidden sensualism of his soul, and his intention to victimize her person to it the moment he shall get the license. A woman had better die at once than enter into or continue in marriage with a man whose highest conception of the relation is, that it is a means of licensed animal indulgence. In such a relation, body and soul are sacrificed. 7. ONE DISTINCTIVE CHARACTERISTIC of a true and noble husband is a feeling of manly pride in the physical elements of his manhood. His physical manhood, as well as his soul, is dear to the heart of his wife, because through this he can give the fullest expression of his manly power. How can you, my friend, secure for your person the loving care and respect of your wife? There is but one way: so manifest yourself to her, in the hours of your most endearing intimacies, that all your manly power shall be associated only with all that is generous, just and noble in you, and with purity, freedom and happiness in her. Make her feel that all which constitutes you a man, and qualifies you to be her husband and the father of her children, belongs to her, and is sacredly consecrated to the perfection and happiness of her nature. Do this, and the happiness of your home is made complete Your _body_ will be lovingly and reverently cared for, because the wife of your bosom feels that it is the sacred symbol through which a noble, manly love is ever speaking to her, to cheer and sustain her. 8. WOMAN IS EVER PROUD, and justly so, of the manly passion of her husband, when she knows it is controlled by a love for her, whose manifestations have regard only to her elevation and happiness. The power which, when bent only on selfish indulgence, becomes a source of more shame, degradation, disease and wretchedness, to women and to children than all other things put together, does but ennoble her, add grace and glory to her being, and concentrate and vitalize the love that encircles her as a wife when it is controlled by wisdom and consecrated to her highest growth and happiness, and that of her children. It lends enchantment to her person, and gives a fascination to her smiles, her words and her caresses, which ever breathe of purity and of heaven, and make her all lovely as a wife and mother to her husband and the father of her child. _Manly passion is to the conjugal love of the wife like the sun to the rose-bud, that opens its petals, and causes them to give out their sweetest fragrance and to display their most delicate tints; or like the frost, which chills and kills it ere it blossoms in its richness and beauty._ 9. A DIADEM OF BEAUTY.--Maternity, when it exists at the call of the wife, and is gratefully received, but binds her heart more tenderly and devotedly to her husband. As the father of her child, he stands before her invested with new beauty and dignity. In receiving from him the germ of a new life, she receives that which she feels is to add new beauty and glory to her as a woman--a new grace and attraction to her as a wife. She loves and honors him, because he has crowned her with the glory of a mother. Maternity, to her, instead of being repulsive, is a diadem of beauty, a crown of rejoicing; and deep, tender, and self-forgetting are her love and reverence for him who has placed it on her brow. How noble, how august, how beautiful is maternity when thus bestowed and received! 10. CONCLUSION.--Would you, then, secure the love and trust of your wife, and become an object of her ever-growing tenderness and reverence? Assure her, by all your manifestations, and your perfect respect for the functions of her nature, that your passion shall be in subjection of her wishes. It is not enough that you have secured in her heart respect for your spiritual and intellectual manhood. To maintain your self-respect in your relations with her, to perfect your growth and happiness as a husband, you must cause your _physical_ nature to be tenderly cherished and reverenced by her in all the sacred intimacies of home. No matter how much she reverences your intellectual or your social power, if by reason of your uncalled-for passional manifestations you have made your physical manhood disagreeable, how can you, in her presence, preserve a sense of manly pride and dignity as a husband? [Illustration] * * * * * HEALTH AND DISEASE. Heredity and the Transmission of Diseases. 1. BAD HABITS.--It is known that the girl who marries the man with bad habits, is, in a measure, responsible for the evil tendencies which these habits have created in the children; and young people are constantly warned of the danger in marrying when they know they come from families troubled with chronic diseases or insanity. To be sure the warnings have had little effect thus far in preventing such marriages, and it is doubtful whether they will, unless the prophecy of an extremist writing for one of our periodicals comes to pass--that the time is not far distant when such marriages will be a crime punishable by law. 2. TENDENCY IN THE RIGHT DIRECTION.--That there is a tendency in the right direction must be admitted, and is perhaps most clearly shown in some of the articles on prison reform. Many of them strongly urge the necessity of preventive work as the truest economy, and some go so far as to say that if the present human knowledge of the laws of heredity were acted upon for a generation, reformatory measures would be rendered unnecessary. 3. SERIOUS CONSEQUENCES.--The mother who has ruined her health by late hours, highly-spiced food, and general carelessness in regard to hygienic laws, and the father who is the slave of questionable habits, will be very sure to have children either mentally or morally inferior to what they might otherwise have had a right to expect. But the prenatal influences may be such that evils arising from such may be modified to a great degree. 4. FORMATION OF CHARACTER.--I believe that pre-natal influences may do as much in the formation of character as all the education that can come after, and that the mother may, in a measure, "will" what that influence shall be, and that, as knowledge on the subject increases, it will be more and more under their control. In that, as in everything else, things that would be possible with one mother would not be with another, and measures that would be successful with one would produce opposite results from the other. 5. INHERITING DISEASE. Consumption--that dread foe of modern life--is the most frequently encountered of all affections as the result of inherited predispositions. Indeed, some of the most eminent physicians have believed it is never produced in any other way. Heart disease, disease of the throat, excessive obesity, affections of the skin, asthma, disorders of the brain and nervous system, gout, rheumatism and cancer, are all hereditary. A tendency to bleed frequently, profusely and uncontrollably, from trifling wounds, is often met with as a family affection. 6. MENTAL DERANGEMENTS.--Almost all forms of mental derangements are hereditary--one of the parents or near relation being afflicted. Physical or bodily weakness is often hereditary, such as scrofula, gout, rheumatism, rickets, consumption, apoplexy, hernia, urinary calculi, hemorrhoids or piles, cataract, etc. In fact, all physical weakness, if ingrafted in either parent, is transmitted from parents to offspring, and is often more strongly marked in the latter than in the former. 7. MARKS AND DEFORMITIES.--Marks and deformities are all transmissible from parents to offspring, equally with diseases and peculiar proclivities. Among such blemishes may be mentioned moles, hair-lips, deficient or supernumerary fingers, toes, and other characteristics. It is also asserted that dogs and cats that have accidentally lost their tails, bring forth young similarly deformed. Blumenbach tells of a man who had lost his little finger, having children with the same deformity. 8. CAUTION.--Taking facts like these into consideration, how very important is it for persons, before selecting partners for life, to deliberately weigh every element and circumstances of this nature, if they would insure a felicitous union, and not entail upon their posterity disease, misery and despair. Alas! in too many instances matrimony is made a matter of money, while all earthly joys are sacrificed upon the accursed altars of lust and mammon. [Illustration: Outdoor Sports Good Training For Morals As Well As Health.] * * * * * PREPARATION FOR MATERNITY. 1. WOMAN BEFORE MARRIAGE.--It is not too much to say that the life of women before marriage ought to be adjusted with more reference to their duties as mothers than to any other one earthly object. It is the continuance of the race which is the chief purpose of marriage. The passion of amativeness is probably, on the whole, the most powerful of all human impulses. Its purpose, however, is rather to subserve the object of continuing the species, than merely its own gratification. 2. EXERCISE.--Girls should be brought up to live much in the open air, always with abundant clothing against wet and cold. They should be encouraged to take much active exercise; as much, if they; want to, as boys. It is as good for little girls to run and jump, to ramble in the woods, to go boating, to ride and drive, to play and "have fun" generally, as for little boys. 3. PRESERVE THE SIGHT.--Children should be carefully prevented from using their eyes to read or write, or in any equivalent exertion, either before breakfast, by dim daylight, or by artificial light. Even school studies should be such that they can be dealt with by daylight. Lessons that cannot be learned without lamp-light study are almost certainly excessive. This precaution should ordinarily be maintained until the age of puberty is reached. 4. BATHING.--Bathing should be enforced according to constitutions, not by an invariable rule, except the invariable rule of keeping clean. Not necessarily every day, nor necessarily in cold water; though those conditions are doubtless often right in case of abundant physical health and strength. 5. WRONG HABITS.--The habit of daily natural evacuations should be solicitously formed and maintained. Words or figures could never express the discomforts and wretchedness which wrong habits in this particular have locked down upon innumerable women for years and even for life. 6. DRESS.--Dress should be warm, loose, comely, and modest rather than showy; but it should be good enough to Satisfy a child's desires after a good appearance, if they are reasonable. Children, indeed, should have all their reasonable desires granted as far as possible; for nothing makes them reasonable so rapidly and so surely as to treat them reasonably. 7. TIGHT LACING.--Great harm is often done to maidens for want of knowledge in them, or wisdom and care in their parents. The extremes of fashions are very prone to violate not only taste, but physiology. Such cases are tight lacing, low necked dresses, thin shoes, heavy skirts. And yet, if the ladies only knew, the most attractive costumes are not the extremes of fashion, but those which conform to fashion enough to avoid oddity, which preserve decorum and healthfulness, whether or no; and here is the great secret of successful dress--vary fashion so as to suit the style of the individual. 8. COURTSHIP AND MARRIAGE.--Last of all, parental care in the use of whatever influence can be exerted in the matter of courtship and marriage. Maidens, as well as youths, must, after all, choose for themselves. It is their own lives which they take in their hands as they enter the marriage state, and not their parents; and as the consequences affect them primarily it is the plainest justice that with the responsibility should be joined the right of choice. The parental influence, then, must be indirect and advisory. Indirect, through the whole bringing up of their daughter; for if they have trained her aright, she will be incapable of enduring a fool, still more a knave. 9. A YOUNG WOMAN AND A YOUNG MAN HAD BETTER NOT BE ALONE TOGETHER VERY MUCH UNTIL THEY ARE MARRIED.--This will be found to prevent a good many troubles. It is not meant to imply that either sex, or any member of it, is worse than another, or bad at all, or anything but human. It is simply the prescription of a safe general rule. It is no more an imputation than the rule that people had better not be left without oversight in presence of large sums of other folks' money. The close personal proximity of the sexes is greatly undesirable before marriage. Kisses and caresses are most properly the monopoly of wives. Such indulgences have a direct and powerful physiological effect. Nay, they often lead to the most fatal results. 10. IGNORANCE BEFORE MARRIAGE.--At some time before marriage those who are to enter into it ought to be made acquainted with some of the plainest common-sense limitations which should govern their new relations to each other. Ignorance in such matters has caused an infinite amount of disgust, pain and unhappiness. It is not necessary to specify particulars here; see other portions of this work. [Illustration: A HEALTHY MOTHER.] * * * * * IMPREGNATION. 1. CONCEPTION OR IMPREGNATION.--Conception or impregnation takes place by the union of the male sperm and female sperm. Whether this is accomplished in the ovaries, the oviducts or the uterus, is still a question of discussion and investigation by physiologists. 2. PASSING OFF THE OVUM.--"With many women," says Dr. Stockham in her Tokology, "the ovum passes off within twenty-four or forty-eight hours after menstruation begins. Some, by careful observation, are able to know with certainty when this takes place. It is often accompanied with malaise, nervousness, headache or actual uterine pain. A minute substance like the white of an egg, with a fleck of blood in it, can frequently be seen upon the clothing. Ladies who have noticed this phenomenon testify to its recurring very regularly upon the same day after menstruation. Some delicate women have observed it as late as the fourteenth day." 3. CALCULATIONS.--Conception is more liable to take place either immediately before or immediately after the period, and, on that account it is usual when calculating the date at which to expect labor, to count from the day of disappearance of the last period. The easiest way to make a calculation is to count back three months from the date of the last period and add seven days; thus we might say that the date was the 18th of July; counting back brings us to the 18th of April, and adding the seven days will bring us to the 25th day of April, the expected time. 4. EVIDENCE OF CONCEPTION.--Very many medical authorities, distinguished in this line, have stated their belief that women never pass more than two or three days at the most beyond the forty weeks conceded to pregnancy--that is two hundred and eighty days or ten lunar months, or nine calendar months and a week. About two hundred and eighty days will represent the average duration of pregnancy, counting from the last day of the last period. Now it must be borne in mind, that there are many disturbing elements which might cause the young married woman to miss a time. During the first month of pregnancy there is no sign by which the condition may be positively known. The missing of a period, especially in a person who has, been regular for some time, may lead one to suspect it; but there are many attendant causes in married life, the little annoyances of household duties, embarrassments, and the enforced gayety which naturally surrounds the bride, and these should all be taken into consideration in the discussion as to whether or not she is pregnant. But then, again, there are some rare cases who have menstruated throughout their pregnancy, and also cases where menstruation was never established and pregnancy occurred. Nevertheless, the non-appearance of the period, with other signs, may be taken as presumptive evidence. 5. "ARTIFICIAL IMPREGNATION".--It may not be generally known that union is not essential to impregnation; it is possible for conception to occur without congress. All that is necessary is that seminal animalcules enter the womb and unite there with the egg or ovum. It is not essential that the semen be introduced through the medium of the male organ, as it has been demonstrated repeatedly that by means of a syringe and freshly obtained and healthy semen, impregnation can be made to follow by its careful introduction. There are physicians in France who make a specialty of "Artificial Impregnation," as it is called, and produce children to otherwise childless couples, being successful in many instances in supplying them as they are desired. * * * * * SIGNS AND SYMPTOMS OF PREGNANCY. 1. THE FIRST SIGN.--The first sign that leads a lady to suspect that she is pregnant is her ceasing-to-be-unwell. This, provided she has just before been in good health, is a strong symptom of pregnancy; but still there must be others to corroborate it. 2. ABNORMAL CONDITION.--Occasionally, women menstruate during the entire time of gestation. This, without doubt, is an abnormal condition, and should be remedied, as disastrous consequences may result. Also, women have been known to bear children who have never menstruated. The cases are rare of pregnancy taking place where menstruation has never occurred, yet it frequently happens that women never menstruate from one pregnancy to another. In these cases this symptom is ruled out for diagnotic purposes. 3. MAY PROCEED FROM OTHER CAUSES.--But a ceasing-to-be-unwell may proceed from other causes than that of pregnancy such as disease or disorder of the womb or of other organs of the body--especially of the lungs--it is not by itself alone entirely to be depended upon; although, as a single sign, it is, especially if the patient be healthy, one of the most reliable of all the other signs of pregnancy. [Illustration: EMBRYO OF TWENTY DAYS, LAID OPEN: _b_, the Back; _a a a_ Covering, and pinned to Back.] 4. MORNING SICKNESS.--If this does not arise from a disordered stomach, it is a trustworthy sign of pregnancy. A lady who has once had morning-sickness can always for the future distinguish it from each and from every other sickness; it is a peculiar sickness, which no other sickness can simulate. Moreover, it is emphatically a morning-sickness--the patient being, as a rule, for the rest of the day entirely free from sickness or from the feeling of sickness. 5. A THIRD SYMPTOM.--A third symptom is shooting, throbbing and lancinating pains in, and enlargement of the breasts, with soreness of the nipples, occurring about the second month. In some instances, after the first few months, a small quantity of watery fluid or a little milk, may be squeezed out or them. This latter symptom, in a first pregnancy, is valuable, and can generally be relied on as fairly conclusive of pregnancy. Milk in the breast, however small it may be in quantity, especially in a first pregnancy, is a reliable sign, indeed, we might say, a certain sign, of pregnancy. 6. A DARK BROWN AREOLA OR MARK around the nipple is one of the distinguishing signs of pregnancy--more especially of a first pregnancy. Women who have had large families, seldom, even when they are not pregnant, lose this mark entirely; but when they are pregnant it is more intensely dark--the darkest brown--especially if they be brunettes. 7. QUICKENING.--Quickening is one of the most important signs of pregnancy, and one of the most valuable, as at the moment it occurs, as a rule, the motion of the child is first felt, whilst, at the same time, there is a sudden increase in the size of the abdomen. Quickening is a proof that nearly half the time of pregnancy has passed. If there be liability to miscarry, quickening makes matters more safe, as there is less likelihood of a miscarriage after than before it. A lady at this time frequently feels faint or actually faints away; she is often giddy, or sick, or nervous, and in some instances even hysterically; although, in rare cases, some women do not even know the precise time when they quicken. 8. INCREASED SIZE AND HARDNESS OF THE ABDOMEN.--This is very characteristic of pregnancy. When a lady is not pregnant the abdomen is soft and flaccid; when she is pregnant, and after she has quickened, the abdomen; over the region of the womb, is hard and resisting. [Illustration: EMBRYO AT THIRTY DAYS _a_, the Head; _b_, the Eyes; _d_ the Neck; _e_, the Chest; _f_, the Abdomen.] 9. EXCITABILITY OF MIND.--Excitability of mind is very common in pregnancy, more especially if the patient be delicate; indeed, excitability is a sign of debility, and requires plenty of good nourishment, but few stimulants. 10. ERUPTIONS ON THE SKIN.--Principally on the face, neck, or throat, are tell-tales of pregnancy, and to an experienced matron, publish the fact that an acquaintance thus marked is pregnant. 11. THE FOETAL HEART.--In the fifth month there is a sign which, if detected, furnishes indubitable evidence of conception, and that is the sound of the child's heart. If the ear be placed on the abdomen, over the womb, the beating of the foetal heart can sometimes be heard quite plainly, and by the use of an instrument called the stethoscope, the sounds can be still more plainly heard. This is a very valuable sign, inasmuch as the presence of the child is not only ascertained, but also its position, and whether there are twins or more. [Illustration: Baby Elizabeth, Brought Into the World by the "Twilight Sleep" Method. It Robs Child Bearing of Most of Its Terrors.] * * * * * DISEASES OF PREGNANCY. 1. COSTIVE STATE OF THE BOWELS.--A costive state of the bowels is common in pregnancy; a mild laxative is therefore occasionally necessary. The mildest must be selected, as a strong purgative is highly improper, and even dangerous. Calomel and all other preparations of mercury are to be especially avoided, as a mercurial medicine is apt to weaken the system, and sometimes even to produce a miscarriage. Let me again urge the importance of a lady, during the whole period of pregnancy, being particular as to the state of her bowels, as costiveness is a fruitful cause of painful, tedious and hard labors. 2. LAXATIVES.--The best laxatives are caster oil, salad oil, compound rhubarb pills, honey, stewed prunes, stewed rhubarb, Muscatel raisins, figs, grapes, roasted apples, baked pears, stewed Normandy pippins, coffee, brown-bread and treacle. Scotch oatmeal made with new milk or water, or with equal parts of milk and water. 3. PILLS.--When the motions are hard, and when the bowels are easily acted upon, two, or three, or four pills made of Castile soap will frequently answer the purpose; and if they will, are far better than any other ordinary laxative. The following is a good form. Take of: Castile Soap, five scruples; Oil of Caraway, six drops; To make twenty-four pills. Two, or three, or four to be taken at bedtime, occasionally. 4. HONEY.--A teaspoonful of honey, either eaten at breakfast or dissolved in a cup of tea, will frequently, comfortably and effectually, open the bowels, and will supersede the necessity of taking laxative medicine. 5. NATURE'S MEDICINES.--Now, Nature's medicines--exercise in the open air, occupation, and household duties--on the contrary, not only at the time open the bowels, but keep up a proper action for the future; her--their inestimable superiority. 6. WARM WATER INJECTIONS.--An excellent remedy for costiveness of pregnancy is an enema, either of warm water, or of Castile soap and water, which the patient, by means of a self-injecting enema-apparatus, may administer to herself. The quantity of warm water to be used, is from half a pint to a pint; the proper heat is the temperature of new milk; the time for administering it is early in the morning, twice or three times a week. 7. MUSCULAR PAINS OF THE ABDOMEN.--The best remedy is an abdominal belt constructed for pregnancy, and adjusted with proper straps and buckles to accomodate the gradually increasing size of the womb. This plan often affords great comfort and relief; indeed, such a belt is indispensably necessary. 8. DIARRHEA.--Although the bowels in pregnancy are generally costive, they are sometimes in an opposite state, and are relaxed. Now, this relaxation is frequently owing to there having been prolonged constipation, and Nature is trying to relieve herself by purging. Do not check it, but allow it to have its course, and take a little rhubarb or magnesia. The diet should be simple, plain, and nourishing, and should consist of beef tea, chicken broth, arrow-root, and of well-made and well-boiled oatmeal gruel. Butcher's meat, for a few days, should not be eaten; and stimulants of all kinds must be avoided. 9. FIDGETS.--A pregnant lady sometimes suffers severely from "fidgets"; it generally affects her feet and legs, especially at night, so as to entirely destroy her sleep; she cannot lie still; she every few minutes moves, tosses and tumbles about--first on one side, then on the other. The causes of "fidgets" are a heated state of the blood; an irritable condition of the nervous system, prevailing at that particular time; and want of occupution. The treatment of "fidgets" consists of: sleeping in a well-ventilated apartment, with either window or door open; a thorough ablution of the whole body every morning, and a good washing with tepid water of the face, neck, chest, arms and hands every night; shunning hot and close rooms; taking plenty of out-door exercise; living on a bland, nourishing, put not rich diet; avoiding meat at night, and substituting in lieu thereof, either a cupful of arrow-root made with milk, or of well-boiled oatmeal gruel. 10. EXERCISE.--If a lady, during the night, have the "fidgets," she should get out of bed; take a short walk up and down the room, being well protected by a dressing-gown; empty her bladders turn, her pillow, so as to have the cold side next the head; and then lie down again; and the chances are that she will now fall asleep. If during the day she have the "fidgets," a ride in an open carriage; or a stroll in the garden, or in the fields; or a little housewifery, will do her good, and there is nothing like fresh air, exercise, and occupation to drive away "the fidgets." 11. HEARTBURN.--Heartburn is a common and often a distressing symptom of pregnancy. The acid producing the heartburn is frequently much increased by an overloaded stomach. An abstemious diet ought to be strictly observed. Great attention should be paid to the quality of the food. Greens, pastry, hot buttered toast, melted butter, and everything that is rich and gross, ought to be carefully avoided. Either a teaspoonful of heavy calcined magnesia, or half a teaspoonful of carbonate of soda--the former to be preferred if there be constipation--should occasionally be taken in a wine-glassful of warm water. If these do not relieve--the above directions as to diet having been strictly attended to--the following mixture ought to be tried. Take of: Carbonate of Ammonia, half a drachm; Bicarbonate of Soda, a drachm and a half; Water, eight ounces; To make a mixture: Two tablespoonfuls to be taken twice or three times a day, until relief be obtained. 12. WIND IN THE STOMACH AND BOWELS.--This is a frequent reason why a pregnant lady cannot sleep at night. The two most frequent causes of flatulence are, first, the want of walking exercise during the day, and second, the eating of a hearty meal just before going to bed at night. The remedies are, of course, in each instance, self-evident. 13. SWOLLEN LEGS FROM ENLARGED VEINS (VARICOSE VEINS.)--The veins are frequently much enlarged and distended, causing the legs to be greatly swollen and very painful, preventing the patient from taking proper walking exercise. Swollen legs are owing to the pressure of the womb upon the blood-vessels above. Women who have had large families are more liable than others to varicose veins. If a lady marry late in life, or if she be very heavy in pregnancy carrying the child low down she is more likely to have distention of the veins. The best plan will be for her to wear during the day an elastic stocking, which ought to be made on purpose for her, in order that it may properly fit the leg and foot. 14. STRETCHING OF THE SKIN OF THE ABDOMEN. This is frequently, in a first pregnancy, distressing, from the soreness it causes. The best remedy is to rub the abdomen, every night and morning, with warm camphorated oil, and to wear a belt during the day and a broad flannel bandage at night, both of which should be put on moderately but comfortably tight. The belt must be secured in its situation by means of properly adjusted straps. 15. BEFORE THE APPROACH OF LABOR.--The patient, before the approach of labor, ought to take particular care to have the bowels gently opened, as during that state a costive state greatly increases her sufferings, and lengthens the period of her labor. A gentle action is all that is necessary; a violent one would do more harm than good. 16. SWOLLEN AND PAINFUL BREASTS. The breasts are, at times, during pregnancy, much swollen and very painful; and, now and then, they; cause the patient great uneasiness, as she fancies that she is going to have either some dreadful tumor or a gathering of the bosom. There need, in such a case, be no apprehension. The swelling and the pain are the consequences of the pregnancy, and will in due time subside without any unpleasant result. For treatment she cannot do better than rub them well, every night and morning, with equal parts of Eau de Cologne and olive oil, and wear a piece of new flannel over them; taking care to cover the nipples with soft linen, as the friction of the flannel might irritate them. 17. BOWEL COMPLAINTS. Bowel complaints, during pregnancy, are not unfrequent. A dose either of rhubarb and magnesia, or of castor oil, are the best remedies, and are generally, in the way of medicine, all that is necessary. 18. CRAMPS. Cramps of the legs and of the thighs during the latter period, and especially at night, are apt to attend pregnancy, and are caused by the womb pressing upon the nerves which extend to the lower extremities. Treatment. Tightly tie a handkerchief, folded like a neckerchief, round the limb a little above the part affected, and let it remain on for a few minutes. Friction by means of the hand either with opodeldoc or with laudanum, taking care not to drink the lotion by mistake, will also give relief. 19. THE WHITES. The whites during pregnancy, especially during the latter months, and particularly if the lady have had many children, are frequently troublesome, and are, in a measure, occasioned by the pressure of the womb on the parts below, causing irritation. The best way, therefore, to obviate such pressure is for the patient to lie down a great part of each day either on a bed or a sofa. She ought to retire early to rest: she should sleep on a hair mattress and in a well ventilated apartment, and should not overload her bed with clothes. A thick, heavy quilt at these times, and indeed at all times, is particularly objectionable; the perspiration cannot pass readily through it as through blankets, and thus she is weakened. She ought to live on plain, wholesome, nourishing food; and she must abstain from beer and wine and spirits. The bowels ought to be gently opened by means of a Seidlitz powder, which should occasionally be taken early in the morning. [Illustration: A PRECIOUS FLOWER.] 20. IRRITATION AND ITCHING OF THE EXTERNAL PARTS.--This is a most troublesome affection, and may occur at any time, but more especially during the latter period of the pregnancy. Let her diet be simple and nourishing; let her avoid stimulants of all kinds. Let her take a sitz-bath of warm water, considerably salted. Let her sit in the bath with the body thoroughly covered. 21. HOT AND INFLAMED.--The external parts, and the passage to the womb (vagina), in these cases, are not only irritable and itching, but are sometimes hot and inflamed, and are covered either with small pimples, or with a whitish exudation of the nature of aphtha (thrush), somewhat similar to the thrush on the mouth of an infant; then, the addition of glycerine to the lotion is a great improvement and usually gives much relief. 22. BILIOUSNESS[Footnote: Some of these valuable suggestions are taken from "Parturition Without Pain," by Dr. M.L. Holbrook.] is defined by some one as piggishness. Generally it may be regarded as _overfed_. The elements of the bile are in the blood in excess of the power of the liver to eliminate them. This may be caused either from the superabundance of the materials from which the bile is made or by inaction of the organ itself. Being thus retained the system is _clogged_. It is the result of either too much food in quantity or too rich in quality. Especially is it caused by the excessive use of _fats and sweets_. The simplest remedy is the best. A plain, light diet with plenty of acid fruits, avoiding fats and sweets, will ameliorate or remove it. Don't force the appetite. Let hunger demand food. In the morning the sensitiveness of the stomach may be relieved by taking before rising a cup of hot water, hot milk, hot lemonade, rice or barley water, selecting according to preference. For this purpose many find coffee made from browned wheat or corn the best drink. Depend for a time upon liquid food that can be taken up by absorbents. The juice of lemons and other acid fruits is usually grateful, and assists in assimilating any excess in nutriment. These may be diluted according to taste. With many, an egg lemonade proves relishing and acceptable. 23. DERANGED APPETITE.--Where the appetite fails, let the patient go without eating for a little while, say for two or three meals. If, however, the strength begins to go, try the offering of some unexpected delicacy; or give small quantities of nourishing food, as directed in case of morning sickness. 24. PILES.--For cases of significance consult a physician. As with constipation, so with piles, its frequent result, fruit diet, exercise, and sitz-bath regimen will do much to prevent the trouble. Frequent local applications of a cold compress, and even of ice, and tepid water injections, are of great service. Walking or standing aggravate this complaint. Lying down alleviates it. Dr. Shaw says, "There is nothing in the world that will produce so great relief in piles as fasting. If the fit is severe, live a whole day, or even two, if necessary, upon pure soft cold water alone. Give then very lightly of vegetable food." 25. TOOTHACHE.--There is a sort of proverb that a woman loses one tooth every time she has a child. Neuralgic toothache during pregnancy is, at any rate, extremely common, and often has to be endured. It is generally thought not best to have teeth extracted during pregnancy, as the shock to the nervous system has sometimes caused miscarriage. To wash out the mouth morning and night with cold or lukewarm water and salt is often of use. If the teeth are decayed, consult a good dentist in the early stages of pregnancy, and have the offending teeth properly dressed. Good dentists, in the present state of the science, extract very few teeth, but save them. 26. SALIVATION.--Excessive secretion of the saliva has usually been reckoned substantially incurable. Fasting, cold water treatment, exercise and fruit diet may be relied on to prevent, cure or alleviate it, where this is possible, as it frequently is. 27. HEADACHE.--This is, perhaps, almost as common in cases of pregnancy as "morning sickness." It may be from determination of blood to the head, from constipation or indigestion, constitutional "sick headache," from neuralgia, from a cold, from rheumatism. Correct living will prevent much headache trouble; and where this does not answer the purpose, rubbing and making magnetic passes over the head by the hand of some healthy magnetic person will often prove of great service. 28. LIVER-SPOTS.--These, on the face, must probably be endured, as no trustworthy way of driving them off is known. 29. JAUNDICE.--See the doctor. 30. PAIN ON THE RIGHT SIDE.--This is liable to occur from about the fifth to the eighth month, and is attributed to the pressure of the enlarging womb upon the liver. Proper living is most likely to alleviate it. Wearing a wet girdle in daytime or a wet compress at night, sitz-baths, and friction with the wet hand may also be tried. If the pain is severe a mustard poultice may be used. Exercise should be carefully moderated if found to increase the pain. If there is fever and inflammation with it, consult a physician. It is usually not dangerous, but uncomfortable only. 31. PALPITATION OF THE HEART.--To be prevented by healthy living and calm, good humor. Lying down will often gradually relieve it, so will a compress wet with water, as hot as can be borne, placed over the heart and renewed as often as it gets cool. 32. FAINTING.--Most likely to be caused by "quickening," or else by tight dress, bad air, over-exertion, or other unhealthy living. It is not often dangerous. Lay the patient in an easy posture, the head rather low than high, and where cool air may blow across the face; loosen the dress if tight; sprinkle cold water on the face and hands. 33. SLEEPLESSNESS.--Most likely to be caused by incorrect living, and to be prevented and cured by the opposite. A glass or two of cold water drank deliberately on going to bed often helps one to go to sleep; so does bathing the face and hands and the feet in cold water. A short nap in the latter part of the forenoon can sometimes be had, and is of use. Such a nap ought not to be too long, or it leaves a heavy feeling; it should be sought with the mind in a calm state, in a well-ventilated though darkened room, and with the clothing removed, as at night. A similar nap in the afternoon is not so good, but is better than nothing. The tepid sitz-bath on going to bed will often produce sleep, and so will gentle percussion given by an attendant with palms of the hand over the back for a few minutes on retiring. To secure sound sleep do not read, write or severely tax the mind in the evening. * * * * * MORNING SICKNESS. 1. A pregnant woman is especially liable to suffer many forms of dyspepsia, nervous troubles, sleeplessness, etc. 2. MORNING SICKNESS is the most common and is the result of an irritation in the womb, caused by some derangement, and it is greatly irritated by the habit of indulging in sexual gratification during pregnancy. If people would imitate the lower animals and reserve the vital forces of the mother for the benefit of her unborn child, it would be a great boon to humanity. Morning sickness may begin the next day after conception, but it usually appears from two to three weeks after the beginning of pregnancy and continues with more or less severity from two to four months. 3. HOME TREATMENT FOR MORNING SICKNESS.--Avoid all highly seasoned and rich food. Also avoid strong tea and coffee. Eat especially light and simple suppers at five o'clock and no later than six. Some simple broths, such as will be found in the cooking department of this book will be very nourishing and soothing. Coffee made from brown wheat or corn is an excellent remedy to use. The juice of lemons reduced with water will sometimes prove very effectual. A good lemonade with an egg well stirred is very nourishing and toning to the stomach. 4. HOT FOMENTATION on the stomach and liver is excellent, and warm and hot water injections are highly beneficial. 5. A little powdered magnesia at bed time, taken in a little milk, will often give almost permanent relief. 6. Avoid corsets or any other pressure upon the stomach. All garments must be worn loosely. In many cases this will entirely prevent all stomach disturbances. * * * * * RELATION OF HUSBAND AND WIFE DURING PREGNANCY. 1. MISCARRIAGE.--If the wife is subject to miscarriage every precaution should be employed to prevent its happening again. Under such exceptional circumstances the husband should sleep apart the first five months of pregnancy; after that length of time, the ordinary relation may be assumed. If miscarriage has taken place, intercourse should be avoided for a month or six weeks at least after the accident. 2. IMPREGNATION.--Impregnation is the only mission of intercourse, and after that has taken place, intercourse can subserve no other purpose than sensual gratification. 3. WOMAN MUST JUDGE.--Every man should recognize the fact that woman is the sole umpire as to when, how frequent, and under what circumstances, connection should take place. Her desires should not be ignored, for her likes and dislikes are--as seen in another part of this book--easily impressed upon the unborn child. If she is strong and healthy there is no reason why passion should not be gratified with moderation and caution during the whole period of pregnancy, but she must be the sole judge and her desires supreme. 4. VOLUNTARY INSTANCES.--No voluntary instances occur through the entire animal kingdom. All females repel with force and fierceness the approaches of the male. The human family is the only exception. A man that loves his wife, however, will respect her under all circumstances and recognize her condition and yield to her wishes. * * * * * A PRIVATE WORD TO THE EXPECTANT MOTHER. Elizabeth Cady Stanton, in a lecture to ladies, thus strongly states her views regarding maternity and painless childbirth: "We must educate our daughters to think that motherhood is grand, and that God never cursed it. And this curse, if it be a curse, may be rolled off, as man has rolled away the curse of labor; as the curse has been rolled from the descendants of Ham. My mission is to preach this new gospel. If you suffer, it is not because you are cursed of God, but because you violate His laws. What an incubus it would take from woman could she be educated to know that the pains of maternity are no curse upon her kind. We know that among the Indians the squaws do not suffer in childbirth. They will step aside from the ranks, even on the march, and return in a short time to them with the new-born child. What an absurdity then, to suppose that only enlightened Christian women are cursed. But one word of fact is worth a volume of philosophy; let me give you some of my own experience. I am the mother of seven children. My girlhood was spent mostly in the open air. I early imbibed the idea that a girl was just as good as a boy, and I carried it out. I would walk five miles before breakfast or ride ten on horseback. After I was married I wore my clothing sensibly. Their weight hung entirely on my shoulders. I never compressed my body out of its natural shape. When my first four children were born, I suffered very little. I then made up my mind that it was totally unnecessary for me to suffer at all; so I dressed lightly, walked every day, lived as much as possible in the open air, ate no condiments or spices, kept quiet, listened to music, looked at pictures, and took proper care of myself. The night before the birth of the child I walked three miles. The child was born without a particle of pain. I bathed it and dressed it, and it weighed ten and one-half pounds. That same day I dined with the family. Everybody said I would surely die, but I never had a relapse or a moment's inconvenience from it. I know this is not being delicate and refined, but if you would be vigorous and healthy, in spite of the diseases of your ancestors, and your own disregard of nature's laws, try it." * * * * * SHALL PREGNANT WOMEN WORK? 1. OVER-WORKED MOTHERS.--Children born of over-worked mothers, are liable to a be dwarfed and puny race. However, their chances are better than those of the children of inactive, dependent, indolent mothers who have neither brain nor muscle to transmit to son or daughter. The truth seems to be that excessive labor, with either body or mind, is alike injurious to both men and women; and herein lies the sting of that old curse. This paragraph suggests all that need be said on the question whether pregnant women should or should not labor. 2. FOOLISHLY IDLE.--At least it is certain that they should not be foolishly idle; and on the other hand, it is equally certain that they should be relieved from painful laborious occupations that exhaust and unfit them for happiness. Pleasant and useful physical and intellectual occupation, however, will not only do no harm, but positive good. 3. THE BEST MAN AND THE BEST WOMAN.--The best man is he who can rear the best child, and the best woman is she who can rear the best child. We very properly extol to the skies Harriet Hosmer, the artist, for cutting in marble the statue of a Zenobia; how much more should we sing praises to the man and the woman who bring into the world a noble boy or girl. The one is a piece of lifeless beauty, the other a piece of life Including all beauty, all possibilities. [Illustration] * * * * * WORDS FOR YOUNG MOTHERS. The act of nursing is sometimes painful to the mother, especially before the habit is fully established. The discomfort is greatly increased if the skin that covers the nipples is tender and delicate. The suction pulls it off leaving them in a state in which the necessary pressure of the child's lips cause intense agony. This can be prevented in a great measure, says Elizabeth Robinson Scovil, in _Ladies' Home Journal_, if not entirely, by bathing the nipples twice a day for six weeks before the confinement with powdered alum dissolved in alcohol; or salt dissolved in brandy. If there is any symptom of the skin cracking when the child begins; to nurse, they should be painted with a mixture of tannin and glycerine. This must be washed off before the baby touches them and renewed when it leaves them. If they are very painful, the doctor will probably order morphia added to the mixture. A rubber nipple shield to be put on at the time of nursing, is a great relief. If the nipples are retracted or drawn inward, they can be drawn out painlessly by filling a pint bottle with boiling water, emptying it and quickly applying the mouth over the nipple. As the air in the bottle cools, it condenses, leaving a vacuum and the nipple is pushed out by the air behind it. When the milk accumulates or "cakes" in the breast in hard patches, they should be rubbed very gently, from the base upwards, with warm camphorated oil. The rubbing should be the lightest, most delicate stroking, avoiding pressure. If lumps appear at the base of the breast and it is red swollen and painful, cloths wrung out of cold water should be applied and the doctor sent for. While the breast is full and hard all over, not much apprehension need be felt. It is when lumps appear that the physician should be notified, that he may, if possible, prevent the formation of abscesses. While a woman is nursing she should eat plenty of nourishing food--milk, oatmeal, cracked wheat, and good juicy, fresh meat, boiled, roasted, or broiled, but not fried. Between each meal, before going to bed, and once during the night, she should take a cup of cocoa, gruel made with milk; good beef tea, mutton broth, or any warm, nutritive drink. Tea and coffee are to be avoided. It is important to keep the digestion in order and the bowels should be carefully regulated as a means to this end. If necessary, any of the laxative mineral waters can be used for this purpose, or a teaspoonful of compound licorice powder taken at night. Powerful cathartic medicines should be avoided because of their effect upon the baby. The child should be weaned at nine months old, unless this time comes in very hot weather, or the infant is so delicate that a change of food would be injurious. If the mother is not strong her nurseling will sometimes thrive better upon artificial food than on its natural nourishment. By gradually lengthening the interval between the nursing and feeding the child, when it is hungry, the weaning can be accomplished without much trouble. A young mother should wear warm underclothing, thick stockings and a flannel jacket over her night dress, unless she is in the habit of wearing an under vest. If the body is not protected by warm clothing there is an undue demand upon the nervous energy to keep up the vital heat, and nerve force is wasted by the attempt to compel the system to do what ought to be done for it by outside means. [Illustration] * * * * * HOW TO HAVE BEAUTIFUL CHILDREN. 1. PARENTAL INFLUENCE.--The art of having handsome children has been a question that has interested the people of all ages and of all nationalities. There is no longer a question as to the influence that parents may and do exert upon their offspring, and it is shown in other parts of this book that beauty depends largely on the condition of health at the time of conception. It is therefore of no little moment that parents should guard carefully their own health as well as that of their children, that they may develop a vigorous constitution. There cannot be beauty without good health. 2. MARRYING TOO EARLY.--We know that marriage at too early an age, or too late in life, is apt to produce imperfectly developed children, both mentally and physically. The causes are self-evident: A couple marrying too young, they lack maturity and consequently will impart weakness to their offspring; while on the other hand persons marrying late in life fail to find that normal condition which is conducive to the health and vigor of offspring. 3. CROSSING OF TEMPERAMENTS AND NATIONALITIES.--The Crossing of temperaments and nationalities beautifies offspring. If young persons of different nationalities marry, their children under proper hygienic laws are generally handsome and healthy. For instance, an American and German or an Irish and German uniting in marriage, produces better looking children than those marrying in the same nationality. Persons of different temperaments uniting in marriage, always produces a good effect upon offspring. 4. THE PROPER TIME.--To obtain the best results, conception should take place only when both parties are in the best physical condition. If either parent is in any way indisposed at the time of conception the results will be seen in the health of the child. Many children brought in the world with diseases or other infirmities stamped upon their feeble frames show the indiscretion and ignorance of parents. 5. DURING PREGNANCY.--During pregnancy the mother should take time for self improvement and cultivate an interest for admiring beautiful pictures or engravings which represent cheerful and beautiful figures. Secure a few good books illustrating art, with some fine representations of statues and other attractive pictures. The purchase of several illustrated an journals might answer the purpose. 6. WHAT TO AVOID.--Pregnant mothers should avoid thinking of ugly people, or those marked by any deformity or disease; avoid injury, fright and disease of any kind. Also avoid ungraceful position and awkward attitude, but cultivate grace and beauty in herself. Avoid difficulty with neighbors or other trouble. 7. GOOD CARE.--She should keep herself in good physical condition, and the system well nourished, as a want of food always injures the child. 8. THE IMPROVEMENT OF THE MIND.--The mother should read suitable articles in newspapers or good books, keep her mind occupied. If she cultivates a desire for intellectual improvement, the same desire will be more or less manifested in the growth and development of the child. 9. LIKE PRODUCES LIKE, everywhere and always--in general forms and in particular features--in mental qualities and in bodily conditions--in tendencies of thought and in habits of action. Let this grand truth be deeply impressed upon the hearts of all who desire or expect to become parents. 10. HEREDITY.--Male children generally inherit the peculiar traits and diseases of the mother and female children those of the father. 11. ADVICE.--Therefore it is urged that during the period of utero-gestation, especial pains should be taken to render the life of the female as harmonious as possible, that her surroundings should all be of a nature calculated to inspire the mind with thoughts of physical and mental beauties and perfections, and that she should be guarded against all influences, of whatever character, having a deteriorative tendency. [Illustration] [Illustration: THE BEAUTIFUL BUTTERFLY.] * * * * * EDUCATION OF THE CHILD IN THE WOMB. "A lady once interviewed a prominent college president and asked him when the education of a child should begin. 'Twenty-five years before it is born,' was the prompt reply." No better answer was ever given to that question Every mother may well consider it. 1. THE UNBORN CHILD AFFECTED BY THE THOUGHTS AND THE SURROUNDINGS OF THE MOTHER.--That the child is affected in the womb of the mother, through the influences apparently connected with objects by which she is surrounded, appears to have been well known in ancient days, as well as at the present time. 2. EVIDENCES.--Many evidences are found in ancient history, especially among the refined nations, showing that certain expedients were resorted to by which their females, during the period of utero-gestation, were surrounded by the superior refinements of the age, with the hope of thus making upon them impressions which should have the effect of communicating certain desired qualities to the offspring. For this reason apartments were adorned with statuary and paintings, and special pains were taken not only to convey favorable impressions, but also to guard against unfavorable ones being made, upon the mind of the pregnant woman. 3. HANKERING AFTER GIN.--A certain mother while pregnant, longed for gin, which could not be gotten; and her child cried incessantly for six weeks till gin was given it, which it eagerly clutched and drank with ravenous greediness, stopped crying, and became healthy. 4. BEGIN TO EDUCATE CHILDREN AT CONCEPTION, and continue during their entire carriage. Yet maternal study, of little account before the sixth, after it, is most promotive of talents; which, next to goodness are the father's joy and the mother's pride. What pains are taken after they are born, to render them prodigies of learning, by the best of schools and teachers from their third year; whereas their mother's study, three months before their birth, would improve their intellects infinitely more. 5. MOTHERS, DOES GOD THUS PUT the endowment of your darlings into your moulding power? Then tremble in view of its necessary responsibilities, and learn how to wield them for their and your temporal and eternal happiness. [Illustration] 6. QUALITIES OF THE MIND.--The Qualities of the mind are perhaps as much liable to hereditary transmission as bodily configuration. Memory, intelligence, judgment, imagination, passions, diseases, and what is usually called genius, are often very markedly traced in the offspring.--I have known mental impressions forcibly impressed upon the offspring at the time of conception, as concomitant of some peculiar eccentricity, idiosyncrasy, morbidness, waywardness, irritability, or proclivity of either one or both parents. 7. THE PLASTIC BRAIN.--The plastic brain of the foetus is prompt to receive all impressions. It retains them, and they become the characteristics of the child and the man. Low spirits, violent passions, irritability, frivolity, in the pregnant woman, leave indelible marks on the unborn child. 8. FORMATION OF CHARACTER.--I believe that pre-natal influences may do as much in the formation of character as all the education that can come after, and that mothers may, in a measure, "will," what that influence shall be, and that, as knowledge on the subject increases, it will be more and more under their control. In that, as in everything else, things that would be possible with one mother would not be with another, and measures that would be successful with one would produce opposite results from the other. 9. A HISTORICAL ILLUSTRATION.--A woman rode side by side with her soldier husband, and witnessed the drilling of troops for battle. The scene inspired her with a deep longing to see a battle and share in the excitements of the conquerors. This was but a few months before her boy was born, and his name was Napoleon. 10. A MUSICIAN.--The following was reported by Dr. F.W. Moffatt, in the mother's own language, "When I was first pregnant, I wished my offspring to be a musician, so, during the period of that pregnancy, settled my whole mind on music, and attended every musical entertainment I possibly could. I had my husband, who has a violin, to play for me by the hour. When the child was born, it was a girl, which grew and prospered, and finally became an expert musician." 11. MURDEROUS INTENT.--The mother of a young man, who was hung not long ago, was heard to say: "I tried to get rid of him before he was born; and, oh, how I wish now that I had succeeded!" She added that it was the only time she had attempted anything of the sort; but, because of home troubles, she became desperate, and resolved that her burdens should not be made any greater. Does it not seem probable that the murderous intent, even though of short duration, was communicated to the mind of the child, and resulted in the crime for which he was hung? 12. THE ASSASSIN OF GARFIELD.--Guiteau's father was a man of integrity and conquerable intellectual ability. His children were born in quick succession, and the mother was obliged to work very hard. Before this child was born, she resorted to every means, though unsuccessful, to produce abortion. The world knows the result. Guiteau's whole life was full of contradictions. There was little self-controlling power in him; no common sense, and not a vestige or remorse or shame. In his wild imagination, he believed himself capable of doing the greatest work and of filling the loftiest station in life. Who will dare question that this mother's effort to destroy him while in embryo was the main cause in bringing him to the level of the brutes? 13. CAUTION.--Any attempt, on the part of the mother, to destroy her child before birth, is liable, if unsuccessful, to produce murderous tendencies. Even harboring murderous thoughts, whether toward her own child or not, might be followed by similar results. "The great King of kings Hath in the table of His law commanded That thou shall do no murder. Wilt thou, then, Spurn at His edict, and fulfill a man's? Take heed, for He holds vengeance in His hand To hurl upon their heads that break his law." --RICHARD III., _Act I._ [Illustration: The Embryo In Sixty Days.] * * * * * HOW TO CALCULATE THE TIME OF EXPECTED LABOR. 1. The table on the opposite page has been very accurately compiled, and will be very helpful to those who desire the exact time. 2. The duration of pregnancy is from 278 to 280 days, or nearly forty weeks. The count should be made from the beginning of the last menstruation, and add eight days on account of the possibility of it occurring within that period. The heavier the child the longer is the duration; the younger the woman the longer time it often requires. The duration is longer in married than in unmarried women; the duration is liable to be longer if the child is a female. 3. MOVEMENT.--The first movement is generally felt on the 135th day after impregnation. 4. GROWTH OF THE EMBRYO.--About the twentieth day the embryo resembles the appearance of an ant or lettuce seed; the 30th day the embryo is as large as a common horse fly; the 40th day the form resembles that of a person; in sixty days the limbs begin to form, and in four months the embryo takes the name of foetus. 5. Children born after seven or eight months can survive and develop to maturity. [Illustration: DURATION OF PREGNANCY.] DIRECTIONS.--Find in the upper horizontal line the date on which the last menstruation ceased; the figure beneath gives the date of expected confinement (280 days). Jan. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Oct. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Jan. 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Oct. 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 Nov. Feb. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Nov. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Feb. 16 17 18 19 20 21 22 23 24 25 26 27 28 Nov. 23 24 25 26 27 28 29 30 1 2 3 4 5 6 7 Dec. Mar. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Dec. 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Mar. 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Dec. 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 Jan. Apr. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Jan. 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 Apr. 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan. 21 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 Feb. May 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Feb. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 May 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Feb. 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 Mar. June 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Mar. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 June 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Mar. 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 Apr. July 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Apr. 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 July 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Apr. 22 23 24 25 26 27 28 29 30 31 1 2 3 4 5 May Aug. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 May 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Aug. 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 May 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 June Sep. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 June 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Sep. 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 June 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 July Oct. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 July 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Oct. 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 July 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 Aug. Nov. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Aug. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Nov. 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Aug. 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 Sep. Dec. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Sep. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Dec. 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Sep. 23 24 25 26 27 28 29 30 31 1 2 3 4 5 6 7 Oct. [Illustration: If menstruation ceased Oct. 31, the confinement will take place July 18.] * * * * * THE SIGNS AND SYMPTOMS OF LABOR. 1. Although the majority of patients, a day or two before the labor comes on, are more bright and cheerful, some few are more anxious, fanciful, fidgety and reckless. 2. A few days, sometimes a few hours, before labor commences, the child "falls" as it is called; that is to say, there is a subsidence--a dropping--of the womb lower down the abdomen. This is the reason why she feels lighter and more comfortable, and more inclined to take exercise, and why she can breathe more freely. 3. The only inconvenience of the dropping of the womb is, that the womb presses more on the bladder, and sometimes causes an irritability of that organ, inducing a frequent desire to make water. The wearing the obstetric belt, as so particularly enjoined in previous pages, will greatly mitigate this inconvenience. 4. The subsidence--the dropping--of the womb may then be considered one of the earliest of the precursory symptoms of child-birth, and as the herald of the coming event. 5. She has, at this time, an increased moisture of the vagina--the passage leading to the womb--and of the external parts. She has, at length, slight pains, and then she has a "show," as it is called; which is the coming away of a mucous plug which, during pregnancy, had hermetically sealed up the mouth of the womb. The "show" is generally tinged with a little blood. When a "show" takes place, she may rest assured that labor has actually commenced. One of the early symptoms of labor is a frequent desire to relieve the bladder. 6. She ought not, on any account, unless it be ordered by the medical man, to take any stimulant as a remedy for the shivering. In case of shivering or chills, a cup either of hot lea or of hot gruel will be the best remedy for the shivering; and an extra blanket or two should be thrown over her, and be well tucked around her, in order to thoroughly exclude the air from the body. The extra clothing, as soon as she is warm and perspiring, should be gradually removed, as she ought not to be kept very hot, or it will weaken her, and will thus retard her labor. 7. She must not, on any account, force down--as her female friends or as a "pottering" old nurse may advise--to "grinding pains"; if sue does, it will rather retard than forward her labor. 8. During this stage, she had better walk about or sit down, and not confine herself to bed; indeed, there is no necessity for her, unless she particularly desire it, to remain in her chamber. 9. After an uncertain length of time, the pains alter in character. From being "grinding" they become "bearing down," and more regular and frequent, and the skin becomes both hot and perspiring. These may be considered the true labor-pains. The patient ought to bear in mind then that "true labor-pains" are situated in the back, and loins; they come on at regular intervals, rise gradually up to a certain pitch of intensity, and abate as gradually; it is a dull, heavy, deep sort of pain, producing occasionally a low moan from the patient; not sharp or twinging, which would elicit a very different expression of suffering from her. 10. Labor--and truly it maybe called, "labor." The fiat has gone forth that in "sorrow thou shalt bring forth children." Young, in his "Night Thoughts," beautifully expresses the common lot of women to suffer: "'Tis the common lot; in this shape, or in that, has fate entailed The mother's throes on all of women born, Not more the children than sure heirs of pain." [Illustration] [Illustration: LOVE OF HOME.] * * * * * SPECIAL SAFEGUARDS IN CONFINEMENT. 1. Before the confinement takes place everything should be carefully arranged and prepared. The physician should be spoken to and be given the time as near as can be calculated. The arrangement of the bed, bed clothing, the dress for the mother and the expected babe should be arranged for convenient and immediate use. 2. A bottle of sweet oil, or vaseline, or some pure lard should be in readiness. Arrangements should be made for washing all soiled garments, and nothing by way of soiled rags or clothing should be allowed to accumulate. 3. A rubber blanket, or oil or waterproof cloth should be in readiness to place underneath the bottom sheet to be used during labor. 4. As soon as labor pains have begun a fire should be built and hot water kept ready for immediate use. The room should be kept well ventilated and comfortably warm. 5. No people should be allowed in or about the room except the nurse, the physician, and probably members of the family when called upon to perform some duty. 6. During labor no solid food should be taken; a little milk, broth or soup may be given, provided there is an appetite. Malt or spirituous liquors should be carefully avoided. A little wine, however, may be taken in case of great exhaustion. Lemonade, toast, rice water, and tea may be given when desired. Warm tea is considered an excellent drink for the patient at this time. 7. When the pains become regular and intermit, it is time that the physician is sent for. On the physician's arrival he will always take charge of the case and give necessary instructions. 8. In nearly all cases the head of the child is presented first. The first pains are generally grinding and irregular, and felt mostly in the groins and within, but as labor progresses the pains are felt in the abdomen, and as the head advances there is severe pain in the back and hips and a disposition to bear down, but no pressure should be placed upon the abdomen of the patient; it is often the cause of serious accidents. Nature will take care of itself. 9. Conversation should be of a cheerful character, and all allusions to accidents of other child births should be carefully avoided. 10. ABSENCE OF PHYSICIAN.--In case the child should be born in the absence of the physician, when the head is born receive it in the hand and support it until the shoulders have been expelled, and steady the whole body until the child is born. Support the child with both hands and lay it as far from the mother as possible without stretching the cord. Remove the mucus from the nostrils and mouth, wrap the babe in warm flannel, make the mother comfortable, give her a drink, and allow the child to remain until the pulsations in the cord have entirely ceased. After the pulsations have entirely ceased then sever the cord. Use a dull pair of scissors, cutting it about two inches from the child's navel, and generally no time is necessary, and when the physician comes he will give it prompt attention. 11. If the child does not breathe at its arrival, says Dr. Stockham in her celebrated Tokology, a little slapping on the breast and body will often produce respiration, and if this is not efficient, dash cold water on the face and chest; if this fails then close the nostrils with two fingers, breathe into the mouth and then expel the air from the lungs by gentle pressure upon the chest. Continue this as long as any hope of life remains. 12. AFTER-BIRTH.--Usually contractions occur and the after-birth is readily expelled; if not, clothes wrung out in hot water laid upon the bowels will often cause the contraction of the uterus, and the expulsion of the after-birth. 13. If the cord bleeds severely inject cold water into it. This in many cases removes the after-birth. 14. After the birth of the child give the patient a bath, if the patient is not too exhausted, change the soiled quilts and clothing, fix up everything neat and clean and let the patient rest. 15 Let the patient drink weak tea, gruel, cold or hot water, whichever she chooses. 16. After the birth of the baby, the mother should be kept perfectly quiet for the first 24 hours and not allowed to talk or see anyone except her nearest relations, however well she may seem. She should not get out of bed for ten days or two weeks, nor sit up in bed for nine days. The more care taken of her at this time, the more rapid will be her recovery when she does get about. She should go up and down stairs slowly, carefully, and as seldom as possible for six weeks. She should not stand more than is unavoidable during that time, but sit with her feet up and lie down when she has time to rest. She should not work a sewing machine with a treadle for at least six weeks, and avoid any unusual strain or over-exertion. "An ounce of prevention IS worth a pound of cure," and carefulness will be well repaid by a perfect restoration to health. [Illustration] [Illustration: MY PRICELESS JEWEL. What will be his fate in life?] * * * * * WHERE DID THE BABY COME FROM? Where did you come from, baby dear? Out of the everywhere into here. Where did you get the eyes so blue? Out of the sky, as I came through. Where did you get that little tear? I found it waiting when I got here. What makes your forehead so smooth and high? A soft hand stroked it as I went by. What makes your cheek like a warm, white rose? I saw something better than anyone knows. Whence that three-cornered smile of bliss? Three angels gave me at once a kiss. Where did you get this pretty ear? God spoke, and it came out to hear. Where did you get those arms and hands? Love made itself into hooks and bands. Feet whence did you come, you darling things? From the same box as the cherub's wings. How did they all come just to be you? God thought of me, and so I grew. But how did you come to us, you dear? God thought about you, and so I am here. --GEORGE MACDONALD. * * * * * CHILD BEARING WITHOUT PAIN. HOW TO DRESS, DIET AND EXERCISE IN PREGNANCY. 1. AILMENTS.--Those ailments to which pregnant women are liable are mostly inconveniences rather than diseases, although they may be aggravated to a degree of danger. No patent nostrums or prescriptions are necessary. If there is any serious difficulty the family physician should be consulted. 2. COMFORT.--Wealth and luxuries are not a necessity. Comfort will make the surroundings pleasant. Drudgery, overwork and exposure are the three things that tend to make women miserable while in the state of pregnancy, and invariably produce irritable, fretful and feeble children. Dr. Stockham says in her admirable work "Tokology:" "The woman who indulges in the excessive gayety of fashionable life, as well as the overworked woman, deprives her child of vitality. She attends parties in a dress that is unphysiological in warmth, distribution and adjustment, in rooms badly ventilated; partakes of a supper of indigestible compounds, and remains into the 'wee, sma' hours,' her nervous system taxed to the utmost." 3. EXERCISE.--A goodly amount of moderate exercise is a necessity, and a large amount of work may be accomplished if prudence is properly exercised. It is overwork, and the want of sufficient rest and sleep that produces serious results. 4. DRESSES.--A pregnant woman should make her dresses of light material and avoid surplus trimmings. Do not wear anything that produces any unnecessary weight. Let the clothing be light but sufficient in quantity to produce comfort in all kinds of weather. 5. GARMENTS.--It is well understood that the mother must breathe for two, and in order to dress healthily the garments should be worn loose, so as to give plenty of room for respiration. Tight clothes only cause disease, or produce frailty or malformation in the offspring. 6. SHOES.--Wear a large shoe in pregnancy; the feet may swell and untold discomfort may be the result. Get a good large shoe with a large sole. Give the feet plenty of room. Many women suffer from defects in vision, indigestion, backache, loss of voice, headache, etc., simply as the result of the reflex action of the pressure of tight shoes. 7. LACING.--Many women lace themselves to the first period of their gestation in order to meet their society engagements. All of this is vitally wrong and does great injury to the unborn child as well as to inflict many ills and pains upon the mother. 8. CORSETS.--Corsets should be carefully avoided, for the corset more than any other one thing is responsible for making woman the victim of more woes and diseases than all other causes put together. About one-half the children born in this country die before they are five years of age, and no doubt this terrible mortality is largely due to this instrument of torture known as the _modern corset._ Tight lacing is the cause of infantile mortality. It slowly but surely takes the lives of tens of thousands, and so effectually weakens and diseases, so as to cause the untimely death of millions more. 9. BATHING.--Next to godliness is cleanliness. A pregnant woman should take a sponge or towel-bath two or three times a week. It stimulates and invigorates the entire body. No more than two or three minutes are required. It should be done in a warm room, and the body rubbed thoroughly after each bathing. 10. THE HOT SITZ-BATH.--This bath is one of the most desirable and healthful baths for pregnant women. It will relieve pain or acute inflammation, and will be a general tonic in keeping the system in a good condition. This may be taken in the middle of the forenoon or just before retiring, and if taken just before retiring will produce invigorating sleep, will quiet the nerves, cure headache, weariness, etc. It is a good plan to take this bath every night before retiring in case of any disorders. A woman who keeps this tip during the period of gestation will have a very easy labor and a strong, vigorous babe. 11. HOT FOMENTATIONS.--Applying flannel cloths wrung out of simple or medicated hot water is a great relief for acute suffering, such as neuralgia, rheumatic pain, biliousness, constipation, torpid liver, colic, flatulency, etc. 12. THE HOT WATER-BAG.--The hot water-bag serves the same purpose as hot fomentations, and is much more convenient. No one should go through the period of gestation without a hot water-bag. 13. THE COLD COMPRESS.--This is a very desirable and effectual domestic remedy. Take a towel wrung from cold water and apply it to the affected parts; then cover well with several thicknesses of flannel. This is excellent in cases of sore throat, hoarseness, bronchitis, inflammation of the lungs, croup, etc. It is also excellent for indigestion, constipation or distress of the bowels accompanied by heat. 14. DIET.--The pregnant woman should eat nutritious, but not stimulating or heating food, and eat at the regular time. Avoid drinking much while eating. 15. AVOID salt, pepper and sweets as much as possible. 16. EAT all kinds of grains, vegetables and fruits, and avoid salted meat, but eat chicken, steak, fish, oysters, etc. 17. THE WOMAN WHO EATS INDISCRIMINATELY anything and everything the same as any other person, will have a very painful labor and suffer many ills that could easily be avoided by more attention being paid to the diet. With a little study and observation a woman will soon learn what to eat and what to avoid. [Illustration: _Nature Versus Corsets Illustrated_ A. The ribs of large curve; the lungs large and roomy; the liver, stomach and bowels in their normal position; all with abundant room. B. The ribs bent almost to angles; the lungs contracted; the liver, stomach and intestines forced down into the pelvis, crowding the womb seriously.] 18. The above cuts are given on page 113; we repeat them here for the benefit of expectant mothers who may be ignorant of the evil effects of the corset. Displacement of the womb, interior irritation and inflammation, miscarriage and sterility, are some of the many injuries of tight lacing. There are many others, in fact their name is legion, and every woman who has habitually worn a corset and continues to wear it during the early period of gestation must suffer severely during childbirth. [Illustration: _"The House We Live In" for nine months: showing the ample room provided by Nature when uncontracted by inherited inferiority of form or artificial dressing._] [Illustration: _A Contracted Pelvis. Deformity and Insufficient Space._] 19. THIS IS WHAT DR. STOCKHAM says: "If women had _common sense_, instead of _fashion sense_, the corset would not exist. There are not words in the English language to express my convictions upon this subject. The corset more than any other one thing is responsible for woman's being the victim of disease and doctors.... "What is the effect upon the child? One-half of the children born in this country die before they are five years of age. Who can tell how much this state of things is due to the enervation of maternal life forces by the one instrument of torture? "I am a temperance woman. No one can realize more than I the devastation and ruin alcohol in its many tempting forms has brought to the human family. Still I solemnly believe that in weakness and deterioration of health, the corset has more to answer for than intoxicating drinks." When asked how far advanced a woman should be in pregnancy before she laid aside her corset, Dr. Stockham said with emphasis: "_The corset should not be worn for two hundred years before pregnancy takes place._ Ladies, it will take that time at least to overcome the ill-effect of tight garments which you think so essential." 20. PAINLESS PREGNANCY AND CHILD-BIRTH.--"Some excellent popular volumes," says Dr. Haff, "have been largely devoted to directions how to secure a comfortable period of pregnancy and painless delivery. After much conning of these worthy efforts to impress a little common sense upon the sisterhood, we are convinced that all may be summed up under the simple heads of: (1) An unconfined and lightly burdened waist; (2) Moderate but persistent outdoor exercise, of which walking is the best form; (3) A plain unstimulating, chiefly fruit and vegetable diet; (4) Little or no intercourse during the time. "These are hygienic rules of benefit under any ordinary conditions; yet they are violated by almost every pregnant lady. If they are followed, biliousness, indigestion, constipation, swollen limbs, morning sickness and nausea--all will absent themselves or be much lessened. In pregnancy more than at any other time, corsets are injurious. The waist and abdomen must be allowed to expand freely with the growth of the child. The great process of _evolution_ must have room." 21. IN ADDITION, we can do no better than quote the following recapitulation by Dr. Stockham in her famous Tokology: "To give a woman the greatest immunity from suffering during pregnancy, prepare her for a safe and comparatively easy delivery, and insure a speedy recovery, all hygienic conditions must be observed. "The dress must give: "1. Freedom of movement; "2. No pressure upon any part of the body; "3. No more weight than is essential for warmth, and both weight and warmth evenly distributed. "These requirements necessitate looseness, lightness and warmth, which can be obtained from the union underclothes, a princess skirt and dress, with a shoe that allows full development and use of the foot. While decoration and elegance are desirable, they should not sacrifice comfort and convenience. 22. "LET THE DIET BE LIGHT, plain and nutritious. Avoid fats and sweets, relying mainly upon fruits and grain that contain little of the mineral salts. By this diet bilious and inflammatory conditions are overcome, the development of bone in the foetus lessened, and muscles necessary in labor nourished and strengthened. 23. "EXERCISE should be sufficient and of such a character as will bring into action gently every muscle of the body; but must particularly develop the muscles of the trunk, abdomen and groin, that are specially called into action in labor. Exercise, taken faithfully and systematically, more than any other means assists assimilative processes and stimulates the organs of excretion to healthy action. 24. "BATHING MUST BE FREQUENT and regular. Unless in special conditions the best results are obtained from tepid or cold bathing, which invigorates the system and overcomes nervousness. The sitz-bath is the best therapeutic and hygienic measure within the reach of the pregnant woman. "Therefore, to establish conditions which will overcome many previous infractions of law, _dress_ naturally and physiologically; _live_ much of the time _out of doors_; have _abundance_ of _fresh air_ in the house; let _exercise_ be _sufficient_ and _systematic_; pursue a _diet of fruit_, rice and vegetables; _regular rest_ must be faithfully taken; _abstain_ from the sexual relation. To those who will commit themselves to this course of life, patiently and persistently carrying it out through the period of gestation, the possibilities of attaining a healthy, natural, painless parturition will be remarkably increased. 25. "IF THE FIRST EXPERIMENT should not result in a painless labor, it without doubt will prove the beginning of sound health. Persisted in through years of married life, the ultimate result will be more and more closely approximated, while there will be less danger of diseases after childbirth and better and more vigorous children will be produced. "Then pregnancy by every true woman will be desired, and instead of being a period of disease, suffering and direful forebodings, will become a period of health, exalted pleasure and holiest anticipations. Motherhood will be deemed the choicest of earth's blessings; women will rejoice in a glad maternity and for any self-denial will be compensated by healthy, happy, buoyant, grateful children." [Illustration] [Illustration: SWAT THE FLIES AND SAVE THE BABIES. LIFE CYCLE OF A FLY EGG STAGE 1 DAY MAGGOT STAGE 5 DAYS PUPA STAGE 5 DAYS 14 DAYS LATER IT BEGINS TO LAY EGGS] [Illustration: JOAN OF ARC.] * * * * * SOLEMN LESSONS FOR PARENTS. 1. EXCESSIVE PLEASURES AND PAINS.--A woman during her time of pregnancy should of all women be most carefully tended, and kept from violent and excessive pleasures and pains; and at that time she should cultivate gentleness, benevolence and kindness. 2. HEREDITARY EFFECTS.--Those who are born to become insane do not necessarily spring from insane parents, or from any ancestry having any apparent taint of lunacy in their blood, but they do receive from their progenitors certain impressions upon their mental and moral, as well as their physical beings, which impressions, like an iron mould, fix and shape their subsequent destinies. Hysteria in the mother may develop insanity in the child, while drunkenness in the father may impel epilepsy, or mania, in the son. Ungoverned passions in the parents may unloose the furies of unrestrained madness in the minds of their children, and the bad treatment of the wife may produce sickly or weak-minded children. 3. The influence of predominant passion may be transmitted from the parent to the child, just as surely a similarity of looks. It has been truly said that "the faculties which predominate in power and activity in the parents, when the organic existence of the child commences, determine its future mental disposition." A bad mental condition of the mother may produce serious defects upon her unborn child. 4. The singular effects produced on the unborn child by the sudden mental emotions of the mother are remarkable examples of a kind of electrotyping on the sensitive surfaces of living forms. It is doubtless true that the mind's action in such cases may increase or diminish the molecular deposits in the several portions of the system. The precise place which each separate particle assumes in the new organic structure may be determined by the influence of thought or feeling. Perfect love and perfect harmony should exist between wife and husband during this vital period. 5. AN ILLUSTRATION.--If a sudden and powerful emotion of a woman's mind exerts such an influence upon her stomach as to excite vomiting, and upon her heart as almost to arrest its motion and induce fainting, can we believe that it will have no effect upon her womb and the fragile being contained within it? Facts and reason then, alike demonstrate the reality of the influence, and much practical advantage would result to both parent and child, were the conditions and extent of its operations better understood. 6. Pregnant women should not be exposed to causes likely to distress or otherwise strongly impress their minds. A consistent life with worthy objects constantly kept in mind should be the aim and purpose of every expectant mother. * * * * * TEN HEALTH RULES FOR BABIES CUT DEATH RATE IN TWO. Ninety-four babies out of every thousand born in New York died last year. Only thirty-eight babies died in Montclair, N.J., out of every thousand born during the same period. Much credit for this low rate of infant mortality in the latter city is given the Montclair Day Nursery which prescribes the following decade of baby health rules: 1. Give a baby pure milk and watch its feeding very closely. 2. Keep everything connected with a baby absolutely clean. Cleanliness in the house accounts for a baby's health. Untidy babies are usually sick babies. 3. Never let a baby get chilled. Keep its hands and feet warm. 4. Regulate a baby's day by the clock. Everything about its wants should be attended to on schedule time. 5. Diminish a baby's food the minute signs of illness appear. Most babies are overfed anyway. 6. Weigh a baby every week until it is a year old. Its weight is an index of its health. 7. Every mother should get daily out-door exercise. It means better health for her babies. 8. Every baby should be "mothered" more and mauled less. Babies thrive on cuddling but they can get along on a lot less kissing. 9. Don't amuse or play with your baby too much. Its regular daily routine is all the stimulation its little brain needs at first. 10. Don't let too many different people take care of the baby. Even members of the same family make a baby nervous if they fuss around him too much. [Illustration] [Illustration: MAN WITH SCALES AND INFANT.] * * * * * THE CARE OF NEW-BORN INFANTS. 1. The first thing to be done ordinarily is to give the little stranger a bath by using soap and warm water. To remove the white material that usually covers the child use olive oil, goose oil or lard, and apply it with a soft piece of worn flannel, and when the child is entirely clean rub all off with a fresh piece of flannel. 2. Many physicians in the United States recommend a thorough oiling of the child with pure lard or olive oil, and then rub dry as above stated. By these means water is avoided, and with it much risk of taking cold. 3. The application of brandy or liquor is entirely unnecessary, and generally does more injury than good. 4. If an infant should breathe feebly, or exhibit other signs of great feebleness, it should not be washed at once, but allowed to remain quiet and undisturbed, warmly wrapped up until the vital actions have acquired a fair degree of activity. 5. DRESSING THE NAVEL.--There is nothing better for dressing the navel than absorbent antiseptic cotton. There needs be no grease or oil upon the cotton. After the separation of the cord the navel should be dressed with a little cosmoline, still using the absorbent cotton. The navel string usually separates in a week's time; it may be delayed for twice this length of time, this will make no material difference, and the rule is to allow it to drop off of its own accord. 6. THE CLOTHING OF THE INFANT.--The clothing of the infant should be light, soft and perfectly loose. A soft flannel band is necessary only until the navel is healed. Afterwards discard bands entirely if you wish your babe to be happy and well. Make the dresses "Mother Hubbard" Put on first a soft woolen shirt, then prepare the flannel skirts to hang from the neck like a slip. Make one kind with sleeves and one just like it without sleeves, then white muslin skirts (if they are desired), all the same way. Then baby is ready for any weather. In intense heat simply put on the one flannel slip with sleeves, leaving off the shirt. In Spring and Fall the shirt and skirt with no sleeves. In Cold weather shirt and both skirts. These garments can be all put on at once, thus making the process of dressing very quick and easy. These are the most approved modern styles for dressing infants, and with long cashmere stockings pinned to the diapers the little feet are free to kick with no old-fashioned pinning blanket to torture the naturally active, healthy child, and retard its development. If tight bands are an injury to grown people, then in the name of pity emancipate the poor little infant from their torture! 7. THE DIAPER.--Diapers should be of soft linen, and great care should be exercised not to pin them too tightly. Never dry them, but always wash them thoroughly before being used again. 8. The band need not be worn after the navel has healed so that it requires no dressing, as it serves no purpose save to keep in place the dressing of the navel. The child's body should be kept thoroughly warm around the chest, bowels and feet. Give the heart and lungs plenty of room to heave. 9. The proper time for shortening the clothes is about three months in Summer and six months in Winter. 10. INFANT BATHING.--The first week of a child's life it should not be entirely stripped and washed. It is too exhausting. After a child is over a week old it should be bathed every day; after a child is three weeks old it may be put in the water and supported with one hand while it is being washed with the other. Never, however, allow it to remain too long in the water. From ten to twenty minutes is the limit. Use Pears' soap or castile soap, and with a sponge wipe quickly, or use a soft towel. [Illustration] * * * * * NURSING. 1. The new-born infant requires only the mother's milk. The true mother will nurse her child if it is a possibility. The infant will thrive better and have many more chances for life. 2. The mother's milk is the natural food, and nothing can fully take its place. It needs no feeding for the first few days as it was commonly deemed necessary a few years ago. The secretions in the mother's breast are sufficient. 3. Artificial Food. Tokology says: "The best artificial food is cream reduced and sweetened with sugar of mill. Analysis shows that human milk contains more cream and sugar and less casein than the milk of animals." 4. Milk should form the basis of all preparations of food. If the milk is too strong, indigestion will follow, and the child will lose instead of gaining strength. WEANING.--The weaning of the child depends much upon the strength and condition of the mother. If it does not occur in hot weather, from nine to twelve months is as long as any child should be nursed. FOOD IN WEANING.--Infants cry a great deal during weaning, but a few days of patient perseverance will overcome all difficulties. Give the child purely a milk diet, Graham bread, milk crackers and milk, or a little milk thickened with boiled rice, a little jelly, apple sauce, etc., may be safely used. Cracked wheat, oatmeal, wheat germ, or anything of that kind thoroughly cooked and served with a little cream and sugar, is an excellent food. MILK DRAWN FROM THE BREASTS.--If the mother suffers considerably from the milk gathering in the breast after weaning the child, withdraw it by taking a bottle that holds about a pint or a quart, putting a piece of cloth wrung out in warm water around the bottle, then fill it with boiling water, pour the water out and apply the bottle to the breast, and the bottle cooling will form a vacuum and will withdraw the milk into the bottle. This is one of the best methods now in use. RETURN OF THE MENSES.--If the menses return while the mother is nursing, the child should at once be weaned, for the mother's milk no longer contains sufficient nourishment. In case the mother should become pregnant while the child is nursing it should at once be weaned, or serious results will follow to the health of the child. A mother's milk is no longer sufficiently rich to nourish the child or keep it in good health. CARE OF THE BOTTLE.--If the child is fed on the bottle great care should be taken in keeping it absolutely clean. Never use white rubber nipples. A plain form of bottle with a black rubber nipple is preferable. CHILDREN should not be permitted to come to the table until two years of age. CHAFING.--One of the best remedies is powdered lycopodium; apply it every time the babe is cleaned; but first wash with pure castile soap; Pears' soap is also good. A preparation of oxide of zinc is also highly recommended. Chafing sometimes results from an acid condition of the stomach; in that case give a few doses of castoria. COLIC.--If an infant is seriously troubled with colic, there is nothing better than camomile or catnip tea. Procure the leaves and make tea and give it as warm as the babe can bear. * * * * * FEEDING INFANTS. 1. The best food for infants is mother's milk; next best is cow's milk. Cow's milk contains about three times as much curd and one-half as much sugar, and it should be reduced with two parts of water. 2. In feeding cow's milk there is too little cream and too little sugar, and there is no doubt no better preparation than Mellin's food to mix it with (according to directions). 3. Children being fed on food lacking fat generally have their teeth come late; their muscles will be flabby and bones soft. Children will be too fat when their food contains too much sugar. Sugar always makes their flesh soft and flabby. 4. During the first two months the baby should be fed every two hours during the day, and two or three times during the night, but no more. Ten or eleven feedings for twenty-four hours are all a child will bear and remain healthy. At three months the child may be fed every three hours instead of every two. 5. Children can be taught regular habits by being fed and put to sleep at the same time every day and evening. Nervous diseases are caused by irregular hours of sleep and diet, and the use of soothing medicines. 6. A child five or six months old should not be fed during the night from nine in the evening until six or seven in the morning, as overfeeding causes most of the wakefulness and nervousness of children during the night. 7. If a child vomits soon after taking the bottle, and there is an appearance of undigested food in the stool, it is a sign of overfeeding. If a large part of the bottle has been vomited, avoid the next bottle at regular time and pass over one bottle. If the child is nursing the same principles apply. 8. If a child empties its bottle and sucks vigorously its fingers after the bottle is emptied, it is very evident that the child is not fed enough, and should have its food gradually increased. 9. Give the baby a little cold water several times a day. * * * * * INFANTILE CONVULSIONS. DEFINITION.--An infantile convulsion corresponds to a chill in an adult, and is the most common brain affection among children. CAUSES.--Anything that irritates the nervous system may cause convulsions in the child, as teething, indigestible food, worms, dropsy of the brain, hereditary constitution, or they may be the accompanying symptom in nearly all the acute diseases of children, or when the eruption is suppressed in eruptive diseases. SYMPTOMS.--In case of convulsions of a child parents usually become frightened, and very rarely do the things that should be done in order to afford relief. The child, previous to the fit, is usually irritable, and the twitching of the muscles of the face may be noticed, or it may come on suddenly without warning. The child becomes insensible, clenches its hands tightly, lips turn blue, and the eyes become fixed, usually frothing from the mouth with head turned back. The convulsion generally lasts two or three minutes; sometimes, however, as long as ten or fifteen minutes, but rarely. REMEDY.--Give the child a warm bath and rub gently. Clothes wrung out of cold water and applied to the lower and back part of the head and plenty of fresh air will usually relieve the convulsion. Be sure and loosen the clothing around the child's neck. After the convulsion is over, give the child a few doses of potassic bromide, and an injection of castor oil if the abdomen is swollen. Potassic bromide should be kept in the house, to use in case of necessity. [Illustration] [Illustration: POOR CHILDREN FROM TENEMENT.] * * * * * PAINS AND ILLS IN NURSING. 1. SORE NIPPLES.--If a lady, during the latter few months of her pregnancy, where to adopt "means to harden the nipples," sore nipples during the period of suckling would not be so prevalent as they are. 2. CAUSE.--A sore nipple is frequently produced by the injudicious custom of allowing the child to have the nipple almost constantly in his mouth. Another frequent cause of a sore nipple is from the babe having the canker. Another cause of a sore nipple is from the mother, after the babe has been sucking, putting up the nipple wet. She, therefore, ought always to dry the nipple, not by rubbing, but by dabbing it with a soft cambric or lawn handkerchief, or with a piece of soft linen rag one or the other of which ought always to be at hand every time directly after the child has done sucking, and just before applying any of the following powders or lotions to the nipple. 3. REMEDIES.--One of the best remedies for a sore nipple is the following powder: Take of Borax, one drachm; Powdered Starch, seven drachms. Mix. A pinch of the powder to be frequently applied to the nipple. If the above does not cure, try Glycerine by applying it each time after nursing. 4. GATHERED BREAST.--A healthy woman with a well-developed breast and a good nipple, scarcely, if ever, has a gathered bosom; it is the delicate, the ill-developed breasted and worse-developed nippled lady who usually suffers from this painful complaint. And why? The evil can generally be traced to girlhood. If she be brought up luxuriously, her health and her breasts are sure to be weakened, and thus to suffer, more especially if the development of the bosoms and nipples has been arrested and interfered with by tight stays and corsets. Why, the nipple is by them drawn in, and retained on the level with the breast countersunk as though it were of no consequence to her future well-being, as though it were a thing of nought. 5. TIGHT LACERS.--Tight lacers will have to pay the penalties of which they little dream. Oh, the monstrous folly of such proceedings! When will mothers awake from their lethargy? It is high time that they did so! From the mother having "no nipple," the effects of tight lacing, many a home has been made childless, the babe not being able to procure its proper nourishment, and dying in consequence! It is a frightful state of things! But fashion, unfortunately, blinds the eyes and deafens the ears of its votaries! 6. BAD BREAST.--A gathered bosom, or "bad breast," as it is sometimes called, is more likely to occur after a first confinement and during the first month. Great care, therefore, ought to be taken to avoid such a misfortune. A gathered breast is frequently owing to the carelessness of a mother in not covering her bosoms during the time she is suckling. Too much attention cannot be paid to keeping the breasts comfortably warm. This, during the act of nursing, should be done by throwing either a shawl or a square of flannel over the neck, shoulders, and bosoms. 7. ANOTHER CAUSE.--Another cause of gathered breasts arises from a mother sitting up in bed to suckle her babe. He ought to be accustomed to take the bosom while she is lying down; if this habit is not at first instituted, it will be difficult to adopt it afterwards. Good habits may be taught a child from earliest babyhood. 8. FAINTNESS.--When a nursing mother feels faint, she ought immediately to lie down and take a little nourishment; a cup of tea with the yolk of an egg beaten up in it, or a cup of warm milk, or some beef-tea, any of which will answer the purpose extremely well. Brandy, or any other spirit we would not recommend, as it would only cause, as soon as the immediate effects of the stimulant had gone off, a greater depression to ensue; not only so, but the frequent taking of brandy might become a habit a necessity which would be a calamity deeply to be deplored! 9. STRONG PURGATIVES.--Strong purgatives during this period are highly improper, as they are apt to give pain to the infant, as well as to injure the mother. If it be absolutely necessary to give physic, the mildest, such as a dose of castor oil, should be chosen. 10. HABITUALLY COSTIVE.--When a lady who is nursing is habitually costive, she ought to eat brown instead of white bread. This will, in the majority of cases, enable her to do without an aperient. The brown bread may be made with flour finely ground all one way; or by mixing one part of bran and three parts of fine wheaten flour together, and then making it in the usual way into bread. Treacle instead of butter, on the brown bread increases its efficacy as an aperient; and raw should be substituted for lump sugar in her tea. 11. TO PREVENT CONSTIPATION.--Stewed prunes, or stewed French plums, or stewed Normandy pippins, are excellent remedies to prevent constipation. The patient ought to eat, every morning, a dozen or fifteen of them. The best way to stew either prunes or French plums, is the following: Put a pound of either prunes or French plums, and two tablespoonfuls of raw sugar, into a brown jar; cover them with water; put them into a slow oven, and stew them for three or four hours. Both stewed rhubarb and stewed pears often act as mild and gentle aperients. Muscatel raisins, eaten at dessert, will oftentimes without medicine relieve the bowels. 12. COLD WATER--A tumblerful of cold water, taken early every morning, sometimes effectually relieves the bowels; indeed, few people know the value of cold water as an aperient it is one of the best we possess, and, unlike drug aperients, can never by any possibility do any harm. An injection of warm water is one of the best ways to relieve the bowels. 13. WELL-COOKED VEGETABLES.--Although a nursing mother ought, more especially if she be costive, to take a variety of well-cooked vegetables, such as potatoes, asparagus, cauliflower, French beans, spinach, stewed celery and turnips; she should avoid eating greens, cabbages, and pickles, as they would be likely to affect the babe, and might cause him to suffer from gripings, from pain, and "looseness" of the bowels. 14. SUPERSEDE THE NECESSITY OF TAKING PHYSIC.--Let me again--for it cannot be too urgently insisted upon--strongly advise a nursing mother to use every means in the way of diet, etc., to supersede the necessity of taking physic (opening medicine), as the repetition of aperients injures, and that severely, both herself and child. Moreover, the more opening medicine she swallows, the more she requires; so that if she once gets into the habit of regularly taking physic, the bowels will not act without them. What a miserable existence to be always swallowing physic! [Illustration: HEALTHY YOUTH AND RIPE OLD AGE.] * * * * * HOME LESSONS IN NURSING SICK CHILDREN. 1. MISMANAGEMENT.--Every doctor knows that a large share of the ills to which infancy is subject are directly traceable to mismanagement. Troubles of the digestive system are, for the most part due to errors, either in the selection of the food or in the preparation of it. 2. RESPIRATORY DISEASES.--Respiratory diseases or the diseases of the throat and lungs have their origin, as a rule, in want of care and judgment in matters of clothing, bathing and exposure to cold and drafts. A child should always be dressed to suit the existing temperature of the weather. 3. NERVOUS DISEASES.--Nervous diseases are often aggravated if not caused by over-stimulation of the brain, by irregular hours of sleep, or by the use of "soothing" medicines, or eating indigestible food. 4. SKIN AFFECTIONS.--Skin affections are generally due to want of proper care of the skin, to improper clothing or feeding, or to indiscriminate association with nurses and Children, who are the carriers of contagious diseases. 5. PERMANENT INJURY.--Permanent injury is often caused by lifting the child by one hand, allowing it to fall, permitting it to play with sharp instruments, etc. 6. RULES AND PRINCIPLES.--Every mother should understand the rules and principles of home nursing. Children are very tender plants and the want of proper knowledge is often very disastrous if not fatal. Study carefully and follow the principles and rules which are laid down in the different parts of this work on nursing and cooking for the sick. 7. WHAT A MOTHER SHOULD KNOW: I. INFANT FEEDING.--The care of milk, milk sterilization, care of bottles, preparation of commonly employed infant foods, the general principles of infant feeding, with rules as to quality and frequency. II. BATHING.--The daily bath; the use of hot, cold and mustard baths. III. HYGIENE OF THE SKIN. Care of the mouth, eyes and ears. Ventilation, temperature, cleanliness, care of napkins, etc. IV. TRAINING OF CHILDREN in proper bodily habits. Simple means of treatment in sickness, etc. 8. THE CRY OF THE SICK CHILD.--The cry of the child is a language by which the character of its suffering to some extent may be ascertained. The manner in which the cry is uttered, or the pitch and tone is generally a symptom of a certain kind of disease. 9. STOMACHACHE.--The cry of the child in suffering with pain of the stomach is loud, excitable and spasmodic. The legs are drawn up and as the pain ceases, they are relaxed and the child sobs itself to sleep, and rests until awakened again by pain. 10. LUNG TROUBLE.--When a child is suffering with an affection of the lungs or throat, it never cries loudly or continuously. A distress in breathing causes a sort of subdued cry and low moaning. If there is a slight cough it is generally a sign that there is some complication with the lungs. 11. DISEASE OF THE BRAIN.--In disease of the brain the cry is always sharp, short and piercing. Drowsiness generally follows each spasm of pain. 12. FEVERS.--Children rarely cry when suffering with fever unless they are disturbed. They should be handled very gently and spoken to in a very quiet and tender tone of voice. 13. THE CHAMBER OF THE SICK ROOM.--The room of the sick child should be kept scrupulously clean. No noise should disturb the quiet and rest of the child. If the weather is mild, plenty of fresh air should be admitted; the temperature should be kept at about 70 degrees. A thermometer should be kept in the room, and the air should be changed several times during the day. This may be done with safety to the child by covering it up with woolen blankets to protect it from draft, while the windows and doors are opened. Fresh air often does more to restore the sick child than the doctor's medicine. Take the best room in the house. If necessary take the parlor, always make the room pleasant for the sick. 14. VISITORS.--Carefully avoid the conversation of visitors or the loud and boisterous playing of children in the house. If there is much noise about the house that cannot be avoided, it is a good plan to put cotton in the ears of the patient. 15. LIGHT IN THE ROOM.--Light has a tendency to produce nervous irritability, consequently it is best to exclude as much daylight as possible and keep the room in a sort of twilight until the child begins to improve. Be careful to avoid any odor coming from a burning lamp in the night. When the child begins to recover, give it plenty of sunlight. After the child begins to get better let in all the sunlight the windows will admit. Take a south room for the sick bed. 16. SICKNESS IN SUMMER.--If the weather is very hot it is a good plan to dampen the floors with cold water, or set several dishes of water in the room, but be careful to keep the patient out of the draft, and avoid any sudden change of temperature. 17. BATHING.--Bathe every sick child in warm water once a day unless prohibited by the doctor. If the child has a spasm or any attack of a serious nervous character in absence of the doctor, place him in a hot bath at once. Hot water is one of the finest agencies for the cure of nervous diseases. [Illustration] 18. SCARLET FEVER AND MEASLES.--Bathe the child in warm water to bring out the rash, and put in about a dessertspoonsful of mustard into each bath. 19. DRINKS.--If a child is suffering with fevers, let it have all the water it wants. Toast-water will be found nourishing. When the stomach of the child is in an irritable condition, nourishments containing milk or any other fluid should be given very sparingly. Barley-water and rice-water are very soothing to an irritable stomach. 20. FOOD.--Mellin's Food and milk is very nourishing if the child will take it. Oatmeal gruel, white of eggs, etc. are excellent and nourishing articles. See "How to cook for the Sick." 21. EATING FRUIT.--Let children who are recovering from sickness eat moderately of good fresh fruit. Never let a child, whether well or sick, eat the skins of any kind of fruit. The outer covering of fruit was not made to eat, and often has poisonous matter very injurious to health upon its surface. Contagious and infectious diseases are often communicated in that way. 22. SUDDEN STARTINGS with the thumbs drawn into the palms, portend trouble with the brain, and often end in convulsions, which are far more serious in infants than in children. Convulsions in children often result from a suppression of urine. If you have occasion to believe that such is the case, get the patient to sweating as soon as possible. Give it a hot bath, after which cover it up in bed and put bags of hot salt over the lower part of the abdomen. 23. SYMPTOMS OF INDIGESTION.--If the baby shows symptoms of indigestion, do not begin giving it medicine. It is wiser to decrease the quantity and quality of the food and let the little one omit one meal entirely, that his stomach may rest. Avoid all starchy foods, as the organs of digestion are not sufficiently developed to receive them. A TABLE FOR FEEDING A BABY ON MODIFIED MILK. 2d week: Top Milk 1-1/2 oz. Milk Sugar 4 teaspoons Barley Gruel 10 oz. Cream 2-3/4 oz. Lime Water 2 oz. 1-1/2 oz. at feeding 10 times a day 3d week: Top Milk 6 oz. Milk Sugar 5-1/2 teaspoons Barley Gruel 18 oz. Lime Water 4 oz. 2 oz. at feeding 10 times a day 4th to 8th week: Top Milk 9 oz. Milk Sugar 8 teaspoons Barley Gruel to make a quart Lime Water 4 oz. 3 oz. at feeding 8 times a day 9th to 12th week: Top Milk 11 oz. Milk Sugar 7-1/2 teaspoons Barley Gruel to make a quart Lime Water 4 oz. 3 oz. at feeding 8 times a day 4th month: Top Milk 13 oz. Milk Sugar 7 teaspoons Barley Gruel to make a quart Lime Water 4 oz. 3 to 4 oz. at feeding 7 times a day 5th to 7th month: Top Milk 15 oz. Milk Sugar 6-1/2 teaspoons Barley Gruel to make a quart Lime Water 4 oz. 4 to 5 oz. at feeding 6 times a day 7th to 9th month: Top Milk 17 oz. Milk Sugar 6 teaspoons Barley Gruel to make a quart Lime Water 4 oz. 6 to 7 oz. at feeding 6 times a day Top Milk--Let your quart of milk stand until the cream has risen, then pour off number of ounces required. Sugar of Milk may be purchased at your local druggist's. Gruel is prepared by cooking one level tablespoon of any good barley flour in a pint of water with a pinch of salt. When partly cooled add to the milk. NURSING. Period: 1st and 2d day Nursing in 24 hours: 4 Interval by day: 6 hrs. Night nursings 10 p.m. to 6 a.m.: 1 Period: 3 days to 4 weeks Nursing in 24 hours: 10 Interval by day: 2 hrs. Night nursings 10 p.m. to 6 a.m.: 1 Period: 4 weeks to 2 mo. Nursing in 24 hours: 8 Interval by day: 2-1/2 hrs. Night nursings 10 p.m. to 6 a.m.: 1 Period: 2 to 5 mo. Nursing in 24 hours: 7 Interval by day: 3 hrs. Night nursings 10 p.m. to 6 a.m.: 1 Period: 5 to 12 mo. Nursing in 24 hours: 6 Interval by day: 3 hrs. Night nursings 10 p.m. to 6 a.m.: 0 SCHEDULE FOR FEEDING HEALTHY INFANTS DURING FIRST YEAR Age: 2d to 7th day Interval between meals by day: 2 hours Night feedings 10 p.m. to 7 a.m.: 1 No. of feedings in 24 hours: 10 Quantity for one feeding: 1 to 1-1/2 ounces Quantity in 24 hours: 10 to 15 ounces Age: 2d and 3d week Interval between meals by day: 2 hours Night feedings 10 p.m. to 7 a.m.: 1 No. of feedings in 24 hours: 10 Quantity for one feeding: 1-1/2 to 3 ounces Quantity in 24 hours: 15 to 30 ounces Age: 4th and 5th weeks Interval between meals by day: 2-1/2 hours Night feedings 10 p.m. to 7 a.m.: 1 No. of feedings in 24 hours: 8 Quantity for one feeding: 2-1/2 to 4 ounces Quantity in 24 hours: 20 to 32 ounces Age: 6th to 9th week Interval between meals by day: 2-1/2 hours Night feedings 10 p.m. to 7 a.m.: 1 No. of feedings in 24 hours: 8 Quantity for one feeding: 3 to 5 ounces Quantity in 24 hours: 24 to 40 ounces Age: 9th week to 5th mo. Interval between meals by day: 3 hours Night feedings 10 p.m. to 7 a.m.: 1 No. of feedings in 24 hours: 7 Quantity for one feeding: 4 to 6 ounces Quantity in 24 hours: 28 to 42 ounces Age: 5th to 9th month Interval between meals by day: 3 hours Night feedings 10 p.m. to 7 a.m.: 0 No. of feedings in 24 hours: 6 Quantity for one feeding: 5 to 7-1/2 ounces Quantity in 24 hours: 30 to 45 ounces Age: 9th to 12th month Interval between meals by day: 4 hours Night feedings 10 p.m. to 7 a.m.: 0 No. of feedings in 24 hours: 5 Quantity for one feeding: 7 to 9 ounces Quantity in 24 hours: 35 to 45 ounces [Illustration: A delicate child should never be put into the bath, but bathed on the lap and kept warmly covered.] * * * * * HOW TO KEEP A BABY WELL. 1. The mother's milk is the natural food, and nothing can fully take its place. 2. The infant's stomach does not readily accommodate itself to changes in diet; therefore, regularity in quality, quantity and temperature is extremely necessary. 3. Not until a child is a year old should it be allowed any food except that of milk, and possibly a little cracker or bread, thoroughly soaked and softened. 4. Meat should never be given to very young children. The best artificial food is cream, reduced and sweetened with sugar and milk. No rule can be given for its reduction. Observation and experience must teach that, because every child's stomach is governed by a rule of its own. 5. A child can be safely weaned at one year of age, and sometimes less. It depends entirely upon the season, and upon the health of the child. 6. A child should never be weaned during the warm weather, in June, July or August. 7. When a child is weaned it may be given, in connection with the milk diet, some such nourishment as broth, gruel, egg, or some prepared food. 8. A child should never be allowed to come to the table until two years of age. 9. A child should never eat much starchy food until four years old. 10. A child should have all the water it desires to drink, but it is decidedly the best to boil the water first, and allow it to cool. All the impurities and disease germs are thereby destroyed. This one thing alone will add greatly to the health and vigor of the child. 11. Where there is a tendency to bowel disorder, a little gum arabic, rice, or barley may be boiled with the drinking water. 12. If the child uses a bottle it should be kept absolutely clean. It is best to have two or three bottles, so that one will always be perfectly clean and fresh. 13. The nipple should be of black or pure rubber, and not of the white or vulcanized rubber; it should fit over the top of the bottle. No tubes should ever be used; it is impossible to keep them clean. 14. When the rubber becomes coated, a little coarse salt will clean it. 15. Babies should be fed at regular times. They should also be put to sleep at regular hours. Regularity is one of the best safeguards to health. 16. Milk for babies and children should be from healthy cows. Milk from different cows varies, and it is always better for a child to have milk from the same cow. A farrow cow's milk is preferable, especially if the child is not very strong. 17. Many of the prepared foods advertised for children are of little benefit. A few may be good, but what is good for one child may not be for another. So it must be simply a matter of experiment if any of the advertised foods are used. 18. It is a physiological fact that an infant is always healthier and better to sleep alone. It gets better air and is not liable to suffocation. 19. A healthy child should never be fed in less than two hours from the last time they finished before, gradually lengthening the time as it grows older. At 4 months 3-1/2 or 4 hours; at 5 months a healthy child will be better if given nothing in the night except, perhaps, a little water. 20. Give an infant a little water several times a day. 21. A delicate child the first year should be oiled after each bath. The oiling may often take the place of the bath, in case of a cold. 22. In oiling a babe, use pure olive oil, and wipe off thoroughly after each application. For nourishing a weak child use also olive oil. 23. For colds, coughs, croup, etc., use goose oil externally and give a teaspoonful at bed-time. [Illustration: FOUND UPON THE DOORSTEP.] * * * * * HOW TO PRESERVE THE HEALTH AND LIFE OF YOUR INFANT DURING HOT WEATHER. _BATHING._ 1. Bathe infants daily in tepid water and even twice a day in hot weather. If delicate they should be sponged instead of immersing them in water, but cleanliness is absolutely necessary for the health of infants. _CLOTHING._ 2. Put no bands in their clothing, but make all garments to hang loosely from the shoulders, and have all their clothing _scrupulously clean_; even the diaper should not be re-used without rinsing. _SLEEP ALONE._ 3. The child should in all cases sleep by itself on a cot or in a crib and retire at a regular hour. A child _always_ early taught to go to sleep without rocking or nursing is the healthier and happier for it. Begin _at birth_ and this will be easily accomplished. _CORDIALS AND SOOTHING SYRUPS._ 4. Never give cordials, soothing syrups, sleeping drops etc., without the advice of a physician. A child that frets and does not sleep is either hungry or ill. _If ill it needs a physician._ Never give candy or cake to quiet a small child, they are sure to produce disorders of the stomach, diarrhoea or some other trouble. _FRESH AIR._ 5. Children should have plenty of fresh air summer as well as winter. Avoid the severe hot sun and the heated kitchen for infants in summer. Heat is the great destroyer of infants. _CLEAN HOUSES._ 6. Keep your house clean and cool and well aired night and day. Your cellars cleared of all rubbish and white-washed every spring, your drains cleaned with strong solution of copperas or chloride of lime, poured down them once a week. Keep your gutters and yards clean and insist upon your neighbors doing the same. _EVACUATIONS OF A CHILD._ The healthy motion varies from light orange yellow to greenish yellow, in number, two to four times daily. Smell should never be offensive. Slimy mucous-like jelly passages indicate worms. Pale green, offensive, acrid motions indicate disordered stomach. Dark green indicate acid secretions and a more serious trouble. Fetid dark brown stools are present in chronic diarrhoea Putty-like pasty passages are due to aridity curdling the milk or to torpid liver. [Illustration] _BREAST MILK._ 7. Breast milk is the only proper food for infants until after the second summer. If the supply is small keep what you have and feed the child in connection with it, for if the babe is ill this breast milk may be all that will save its life. _STERILIZED MILK._ 8. Milk is the best food. Goat's milk best, cows milk next. If the child thrives on this _nothing else_ should be given during the hot weather, until the front teeth are cut. Get fresh cow's milk twice a day if the child requires food in the night, pour it into a glass fruit jar with one-third pure water for a child under three months old, afterwards the proportion of water may be less and less, also a trifle of sugar may be added. Then place the jar in a kettle or pan of cold water, like the bottom of an oatmeal kettle. Leave the cover of the jar loose. Place it on the stove and let the water come to a boil and boil ten minutes, screw down the cover tight and boil ten minutes more, then remove from the fire, and allow it to cool in the water slowly so as not to break the jar. When partly cool put on the ice or in a cool place, and keep tightly covered except when the milk is poured out for use. The glass jar must be kept perfectly clean and washed and scalded carefully before use. A tablespoonful of lime water to a bottle of milk will aid indigestion. Discard the bottle as soon as possible and use a cup which you know is clean, whereas a bottle must be kept in water constantly when not in use, or the sour milk will make the child sick. Use no tube for it is exceedingly hard to keep it clean, and if pure milk cannot be had, condensed milk is admirable and does not need to be sterilized as the above. _DIET._ 9. Never give babies under two years old such food if grown persons eat. Their chief diet should be milk, wheat bread and milk, oatmeal, possibly a little rare boiled egg, but always and chiefly milk. Germ wheat is also excellent. [Illustration] _EXERCISE._ 10. Children should have exercise in the house as well as outdoors, but should not be jolted and jumped and jarred in rough play, not rudely rocked in the cradle, nor carelessly trundled over bumps in their carriages. They should not be held too much in the arms, but allowed to crawl and kick upon the floor and develop their limbs and muscles. A child should not be lifted by its arms nor dragged along by one hand after it learns to take a few feeble steps, but when they do learn to walk steadily it is the best of all exercise, especially in the open air. Let the children as they grow older romp and play in the open air all they wish, girls as well as boys. Give the girls an even chance for health, while they are young at least, and don't mind about their complexion. [Illustration] * * * * * INFANT TEETHING. 1. REMARKABLE INSTANCES.--There are instances where babies have been born with teeth, and, on the other hand, there are cases of persons who have never had any teeth at all; and others that had double teeth all around in both upper and lower jaws, but these are rare instances, and may be termed as a sort of freaks of nature. 2. INFANT TEETHING.--The first teeth generally make their appearance after the third month, and during the period of teething the child is fretful and restless, causing sometimes constitutional disturbances, such as diarrhoea, indigestion, etc. Usually, however, no serious results follow, and no unnecessary anxiety need be felt, unless the weather is extremely warm, then there is some danger of summer complaint setting in and seriously complicating matters. 3. THE NUMBER OF TEETH.--Teeth are generally cut in pairs and make their appearance first in the front and going backwards until all are complete. It generally takes about two years for a temporary set of children's teeth. A child two or three years old should have twenty teeth. After the age of seven they generally begin to loosen and fall out and permanent teeth take their place. 4. LANCING THE GUMS.--This is very rarely necessary. There are extreme cases when the condition of the mouth and health of the child demand a physician's lance, but this should not he resorted to, unless it is absolutely necessary. When the gums are very much swollen and the tooth is nearly through, the pains may be relieved by the mother taking a thimble and pressing it down upon the tooth, the sharp edges of the tooth will cut through the swollen flesh, and instant relief will follow. A child in a few hours or a day will be perfectly happy after a very severe and trying time of sickness. 5. PERMANENT TEETH.--The teeth are firmly inserted in sockets of the upper and lower jaw. The permanent teeth which follow the temporary teeth, when complete, are sixteen in each jaw, or thirty-two in all. 6. NAMES OF TEETH.--There are four incisors (front teeth), four cuspids (eye teeth), four bicuspids (grinders), and four molars (large grinders), in each jaw. Each tooth is divided into the crown, body, and root. The crown is the grinding surface; the body--the part projecting from the jaw--is the seat of sensation and nutrition; the root is that portion of the tooth which is inserted in the alveolus. The teeth are composed of dentine (ivory) and enamel. The ivory forms the greater portion of the body and root, while the enamel covers the exposed surface. The small white cords communicating with the teeth are the nerves. [Illustration] [Illustration] * * * * * HOME TREATMENT FOR THE DISEASES OF INFANTS AND CHILDREN. 1. Out of every 1000 persons that died during the year of 1912, 175 did not reach one year of age, and 244 died under five years of age. What a fearful responsibility therefore rests upon the parents who permit these hundreds of thousands of children to die annually. This terrible mortality among children is undoubtedly largely the result of ignorance as regarding to the proper care and treatment of sick children. 2. For very small children it is always best to use homoeopathic remedies. _COLIC._ 1. Babies often suffer severely with colic. It is not considered dangerous, but causes considerable suffering. 2. Severe colic is usually the result of derangement of the liver in the mother, or of her insufficient or improper nourishment, and it occurs more frequently when the child is from two to five months old. 3. Let the mother eat chiefly barley, wheat and bread, rolled wheat, graham bread, fish, milk, eggs and fruit. The latter may be freely eaten, avoiding that which is very sour. 4. A rubber bag or bottle filled with hot water put into a crib, will keep the child, once quieted, asleep for hours. If a child is suffering from colic, it should be thoroughly warmed and kept warm. 5. Avoid giving opiates of any kind, such as cordials, Mrs. Winslow's Soothing Syrup, "Mother's Friend," and various other patent medicines. They injure the stomach and health of the child, instead of benefiting it. 6. REMEDIES.--A few tablespoonfuls of hot water will often allay a severe attack of the colic. Catnip tea is also a good remedy. A drop of essence of peppermint in 6 or 7 teaspoonfuls of hot water will give relief. If the stools are green and the child is very restless, give chamomilla. If the child is suffering from constipation, and undigested curds of milk appear in its faeces, and the child starts suddenly in its sleep, give nux vomica. An injection of a few spoonfuls of hot water into the rectum with a little asafoetida is an effective remedy, and will be good for an adult. _CONSTIPATION._ 1. This is a very frequent ailment of infants. The first thing necessary is for the mother to regulate her diet. 2. If the child is nursed regularly and held out at the same time of each day, it will seldom be troubled with this complaint. Give plenty of _water_. Regularity of habit is the remedy. If this method fails, use a soap suppository. Make it by paring a piece of white castile soap round. It should be made about the size of a lead pencil, pointed at the end. 3. Avoid giving a baby drugs. Let the physician administer them if necessary. _DIARRHOEA._ Great care should be exercised by parents in checking the diarrhoea of children. Many times serious diseases are brought on by parents being too hasty in checking this disorder of the bowels. It is an infant's first method of removing obstructions and overcoming derangements of the system. _SUMMER COMPLAINT._ 1. Summer complaint is an irritation and inflammation of the lining membranes of the intestines. This may often be caused by teething, eating indigestible food, etc. 2. If the discharges are only frequent and yellow and not accompanied with pain, there is no cause for anxiety; but if the discharges are green, soon becoming gray, brown and sometimes frothy, having a mixture of phlegm, and sometimes containing food undigested, a physician had better be summoned. 3. For mild attacks the following treatment may be given: 1) Keep the child perfectly quiet and keep the room well aired. 2) Put a drop of tincture of camphor on a teaspoonful of sugar, mix thoroughly; then add 6 teaspoonfuls of hot water and give a teaspoonful of the mixture every ten minutes. This is indicated where the discharges are watery, and where there is vomiting and coldness of the feet and hands. Chamomilla is also an excellent remedy. Ipecac and nux vomica may also be given. In giving homoeopathic remedies, give 5 or 6 pellets every 2 or 3 hours. 3) The diet should be wholesome and nourishing. _FOR TEETHING._ If a child is suffering with swollen gums, is feverish, restless, and starts in its sleep, give nux vomica. WORMS. _PIN WORMS._ Pin worms and round worms are the most common in children. They are generally found in the lower bowels. SYMPTOMS.--Restlessness, itching about the anus in the fore part of the evening, and worms in the faeces. TREATMENT.--Give with a syringe an injection of a tablespoonful of linseed oil. Cleanliness is also very necessary. _ROUND WORMS._ A round worm is from six to sixteen inches in length, resembling the common earth worm. It inhabits generally the small intestines, but it sometimes enters the stomach and is thrown up by vomiting. SYMPTOMS.--Distress, indigestion, swelling of the abdomen, grinding of the teeth, restlessness, and sometimes convulsions. TREATMENT.--One teaspoonful of powdered wormseed mixed with a sufficient quantity of molasses, or spread on bread and butter. Or, one grain of santonine every four hours for two or three days, followed by a brisk cathartic. Wormwood tea is also highly recommended. SWAIM'S VERMIFUGE. 2 ounces wormseed, 1-1/2 ounces valerian, 1-1/2 ounces rhubarb, 1-1/2 ounces pink-root, 1-1/2 ounces white agaric. Boil in sufficient water to yield 3 quarts of decoction, and add to it 30 drops of oil of tansy and 45 drops of oil of cloves, dissolved in a quart of rectified spirits. Dose, 1 teaspoonful at night. _ANOTHER EXCELLENT VERMIFUGE._ Oil of wormseed, 1 ounce, Oil of anise, 1 ounce, Castor oil, 1 ounce, Tinct. of myrrh, 2 drops, Oil of turpentine, 10 drops. Mix thoroughly. Always shake well before using. Give 10 to 15 drops in cold coffee, once or twice a day. [Illustration] HOW TO TREAT CROUP SPASMODIC AND TRUE. _SPASMODIC CROUP._ DEFINITION.--A spasmodic closure of the glottis which interferes with respiration. Comes on suddenly and usually at night, without much warning. It is a purely nervous disease and may be caused by reflex nervous irritation from undigested food in the stomach or bowels, irritation of the gums in dentition, or from brain disorders. SYMPTOMS.--Child awakens suddenly at night with suspended respiration or very difficult breathing. After a few respirations it cries out and then falls asleep quietly, or the attack may last an hour or so, when the face will become pale, veins in the neck become turgid and feet and hands contract spasmodically. In mild cases the attacks will only occur once during the night, but may recur on the following night. HOME TREATMENT.--During the paroxysm dashing cold water in the face is a common remedy. To terminate the spasm and prevent its return give teaspoonful doses of powdered alum. The syrup of squills is an old and tried remedy; give in 15 to 30 drop doses and repeat every 10 minutes till vomiting occurs. Seek out the cause if possible and remove it. It commonly lies in some derangement of the digestive organs. _TRUE CROUP._ DEFINITION.--This disease consists of an inflammation of the mucous membrane of the upper air passages, particularly of the larynx with the formation of a false membrane that obstructs the breathing. The disease is most common in children between the ages of two and seven years, but it may occur at any age. SYMPTOMS.--Usually there are symptoms of a cold for three or four days previous to the attack. Marked hoarseness is observed in the evening with a ringing metallic cough and some difficulty in breathing, which increases and becomes somewhat paroxysmal till the face which was at first flushed becomes pallid and ashy in hue. The efforts at breathing become very great, and unless the child gets speedy relief it will die of suffocation. HOME TREATMENT.--Patient should be kept in a moist warm atmosphere, and cold water applied to the neck early in the attack. As soon as the breathing seems difficult give a half to one teaspoonful of powdered alum in honey to produce vomiting and apply the remedies suggested in the treatment of diphtheria, as the two diseases are thought by many to be identical. When the breathing becomes labored and face becomes pallid, the condition is very serious and a physician should be called without delay. _SCARLET FEVER._ DEFINITION.--An eruptive contagious disease, brought about by direct exposure to those having the disease, or by contact with clothing, dishes, or other articles, used about the sick room. The clothing may be disinfected by heating to a temperature of 230 [degrees] Fahrenheit or by dipping in boiling water before washing. Dogs and cats will also carry the disease and should be kept from the house, and particularly from the sick room. SYMPTOMS.--Chilly sensations or a decided chill, fever, headache, furred tongue, vomiting, sore throat, rapid pulse, hot dry skin and more or less stupor. In from 6 to 18 hours a fine red rash appears about the ears, neck and shoulders, which rapidly spreads to the entire surface of the body. After a few days, a scurf or branny scales will begin to form on the skin. These scales are the principal source of contagion. HOME TREATMENT. 1. Isolate the patient from other members of the family to prevent the spread of the disease. 2. Keep the patient in bed and give a fluid diet of milk gruel, beef tea, etc., with plenty of cold water to drink. 3. Control the fever by sponging the body with tepid water, and relieve the pain in the throat by cold compresses, applied externally. 4. As soon as the skin shows a tendency to become scaly, apply goose grease or clean lard with a little boracic acid powder dusted in it, or better, perhaps, carbolized vaseline to relieve the itching and prevent the scales from being scattered about, and subjecting others to the contagion. REGULAR TREATMENT.--A few drops of aconite every three hours to regulate the pulse, and if the skin be pale and circulation feeble, with tardy eruption, administer one to ten drops of tincture of belladonna, according to the age of the patient. At the end of third week, if eyes look puffy and feet swell, there is danger of Acute Bright's disease, and a physician should be consulted. If the case does not progress well under the home remedies suggested, a physician should be called at once. _WHOOPING COUGH._ DEFINITION.--This is a contagious disease which is known by a peculiar whooping sound in the cough. Considerable mucus is thrown off after each attack of spasmodic coughing. SYMPTOMS.--It usually commences with the symptoms of a common cold in the head, some chilliness, feverishness, restlessness, headache, a feeling of tightness across the chest, violent paroxysms of coughing, sometimes almost threatening suffocation, and accompanied with vomiting. HOME TREATMENT.--Patient should eat plain food and avoid cold drafts and damp air, but keep in the open air as much as possible. A strong tea made of the tops of red clover is highly recommended. A strong tea made of chestnut leaves, sweetened with sugar, is also very good. 1 teaspoonful of powdered alum, 1 teaspoonful of syrup. Mix in a tumbler of water, and give the child one teaspoonful every two or three hours. A kerosene lamp kept burning in the bed chamber at night is said to lessen the cough and shorten the course of the disease. _MUMPS._ DEFINITION.--This is a contagious disease causing the inflammation of the salivary glands, and is generally a disease of childhood and youth. SYMPTOMS.--A slight fever, stiffness of the neck and lower jaw, swelling and soreness of the gland. It usually develops in four or five days and then begins to disappear. HOME TREATMENT.--Apply to the swelling a hot poultice of cornmeal and bread and milk. A hop poultice is also excellent. Take a good dose of physic and rest carefully. A warm general bath, or mustard foot bath, is very good. Avoid exposure or cold drafts. If a bad cold is taken, serious results may follow. _MEASLES._ DEFINITION.--It is an eruptive, contagious disease, preceded by cough and other catarrhal symptoms for about four or five days. The eruption comes rapidly in small red spots, which are slightly raised. SYMPTOMS.--A feeling of weakness, loss of appetite, some fever, cold in the head, frequent sneezing, watery eyes, dry cough and a hot skin. The disease takes effect nine or ten days after exposure. HOME TREATMENT.--Measles is not a dangerous disease in the child, but in an adult it is often very serious. In childhood very little medicine is necessary, but exposure must be carefully avoided, and the patient kept in bed, in a moderately warm room. The diet should be light and nourishing. Keep the room dark. If the eruption does not come out promptly, apply hot baths. COMMON TREATMENT.--Two teaspoonfuls of spirits of nitre, one teaspoonful paregoric, one wineglassful of camphor water. Mix thoroughly, and give a teaspoonful in half a teacupful of water every two hours. To relieve the cough, if troublesome, flax seed tea, or infusion of slippery-elm bark, with a little lemon juice to render more palatable, will be of benefit. _CHICKEN POX._ DEFINITION.--This is a contagious, eruptive disease, which resembles to some extent small-pox. The pointed vesicles or pimples have a depression in the center in chicken-pox, and in small pox they do not. SYMPTOMS.--Nine to seventeen days elapse after the exposure, before symptoms appear. Slight fever, a sense of sickness, the appearance of scattered pimples, some itching and heat. The pimples rapidly change into little blisters, filled with a watery fluid. After five or six days they disappear. HOME TREATMENT.--Milk diet, and avoid all kinds of meat. Keep the bowels open, and avoid all exposure to cold. Large vesicles on the face should be punctured early and irritation by rubbing should be avoided. _HOME TREATMENT OF DIPHTHERIA._ DEFINITION.--Acute, specific, constitutional disease, with local manifestations in the throat, mouth, nose, larynx, wind-pipe, and glands of the neck. The disease is infectious but not very contagious under the proper precautions. It is a disease of childhood, though adults sometimes contract it. Many of the best physicians of the day consider true or membranous croup to be due to this diphtheritic membranous disease thus located in the larynx or trachea. SYMPTOMS.--Symptoms vary according to the severity of the attack. Chills, fever, headache, languor, loss of appetite, stiffness of neck, with tenderness about the angles of the jaw, soreness of the throat, pain in the ear, aching of the limbs, loss of strength, coated tongue, swelling of the neck, and offensive breath; lymphatic glands on side of neck enlarged and tender. The throat is first to be seen red and swollen, then covered with grayish white patches, which spread, and a false membrane is found on the mucous membrane. If the nose is attacked, there will be an offensive discharge, and the child will breathe through the mouth. If the larynx or throat are involved, the voice will become hoarse, and a croupy cough, with difficult breathing, shows that the air passage to the lungs is being obstructed by the false membrane. HOME TREATMENT.--Isolate the patient, to prevent the spread of the disease. Diet should be of the most nutritious character, as milk, eggs, broths, and oysters. Give at intervals of every two or three hours. If patient refuses to swallow, from the pain caused by the effort, a nutrition injection must be resorted to. Inhalations of steam and hot water, and allowing the patient to suck pellets of ice, will give relief. Sponges dipped in hot water, and applied to the angles of the jaw, are beneficial. Inhalations of lime, made by slaking freshly burnt lime in a vessel, and directing the vapor to the child's mouth, by means of a newspaper, or similar contrivance. Flour of sulphur, blown into the back of the mouth and throat by means of a goose quill, has been highly recommended. Frequent gargling of the throat and mouth, with a solution of lactic acid, strong enough to taste sour, will help to keep the parts clean, and correct the foul breath. If there is great prostration, with the nasal passage affected, or hoarseness and difficult breathing, a physician should be called at once. [Illustration] * * * * * DISEASES OF WOMEN. _DISORDERS OF THE MENSES._ 1. SUPPRESSION OF, OR SCANTY MENSES. HOME TREATMENT.--Attention to the diet, and exercise in the open air to promote the general health. Some bitter tonic, taken with fifteen grains of dialyzed iron, well diluted, after meals, if patient is pale and debilitated. A hot foot bath is often all that is necessary. 2. PROFUSE MENSTRUATION. HOME TREATMENT.--Avoid highly seasoned food, and the use of spirituous liquors; also excessive fatigue, either physical or mental. To check the flow, patient should be kept quiet, and allowed to sip cinnamon tea during the period. 3. PAINFUL MENSTRUATION. HOME TREATMENT.--Often brought on by colds. Treat by warm hip baths, hot drinks (avoiding spirituous liquors), and heat applied to the back and extremities. A teaspoonful of the fluid extract of viburnum will sometimes act like a charm. _HOW TO CURE SWELLED AND SORE BREASTS._ Take and boil a quantity of chamomile, and apply the hot fomentations. This dissolves the knot, and reduces the swelling and soreness. _LEUCORRHEA OR WHITES._ HOME TREATMENT.--This disorder, if not arising from some abnormal condition of the pelvic organs, can easily be cured by patient taking the proper amount of exercise and good nutritious food, avoiding tea and coffee. An injection every evening of one teaspoonful of Pond's Extract in a cup of hot water, after first cleansing the vagina well with a quart of warm water, is a simple but effective remedy. _INFLAMMATION OF THE WOMB._ HOME TREATMENT.--When in the acute form this disease is ushered in by a chill, followed by fever, and pain in the region of the womb. Patient should be placed in bed, and a brisk purgative given, hot poultices applied to the abdomen, and the feet and hands kept warm. If the symptoms do not subside, a physician should be consulted. _HYSTERIA._ DEFINITION.--A functional disorder of the nervous system of which it is impossible to speak definitely; characterized by disturbance of the reason, will, imagination, and emotions, with sometimes convulsive attacks that resemble epilepsy. SYMPTOMS.--Fits of laughter, and tears without apparent cause; emotions easily excited; mind often melancholy and depressed; tenderness along the spine; disturbances, of digestion, with hysterical convulsions, and other nervous phenomena. HOME TREATMENT.--Some healthy and pleasant employment should be urged upon women afflicted with this disease. Men are also subject to it, though not so frequently. Avoid excessive fatigue and mental worry; also stimulants and opiates. Plenty of good food and fresh air will do more good than drugs. * * * * * FALLING OF THE WOMB. CAUSES.--The displacement of the womb usually is the result of too much childbearing, miscarriages, abortions, or the taking of strong medicines to bring about menstruation. It may also be the result in getting up too quickly from the childbed. There are, however, other causes, such as a general breaking down of the health. SYMPTOMS.--If the womb has fallen forward it presses against the bladder, causing the patient to urinate frequently. If the womb has fallen back, it presses against the rectum, and constipation is the result with often severe pain at stool. If the womb descends into the vagina there is a feeling of heaviness. All forms of displacement produce pain in the back, with an irregular and scanty menstrual flow and a dull and exhausted feeling. HOME TREATMENT.--Improve the general health. Take some preparation of cod-liver oil, hot injections (of a teaspoonful of powdered alum with a pint of water), a daily sitz-bath, and a regular morning bath three times a week will be found very beneficial. There, however, can be no remedy unless the womb is first replaced to the proper position. This must be done by a competent physician who should frequently be consulted. [Illustration] * * * * * MENSTRUATION. 1. ITS IMPORTANCE.--Menstruation plays a momentous part in the female economy; indeed, unless it be in every way properly and duly performed, it is neither possible that a lady can be well, nor is it at all probable that she will conceive. The large number of barren, of delicate, and of hysterical women there are in America arises mainly from menstruation not being duly and properly performed. 2. THE BOUNDARY-LINE.--Menstruation--"the periods"--the appearance of the catamenia or the menses--is then one of the most important epochs in a girl's life. It is the boundary-line, the landmark between childhood and womanhood; it is the threshold, so to speak, of a woman's life. Her body now develops and expands, and her mental capacity enlarges and improves. 3. THE COMMENCEMENT OF MENSTRUATION.--A good beginning at this time is peculiarly necessary, or a girl's health is sure to suffer and different organs of the body--her lungs, for instance, may become imperiled. A healthy continuation, at regular periods, is also much needed, or conception, when she is married, may not occur. Great attention and skillful management is required to ward off many formidable diseases, which at the close of menstruation--at "the change of life"--are more likely than at any time to be developed. If she marry when very young, marriage weakens her system, and prevents a full development of her body. Moreover, such an one is, during the progress of her labor, prone to convulsions--which is a very serious childbed complication. 4. EARLY MARRIAGES.--Statistics prove that twenty per cent--20 in every 100--of females who marry are under age, and that such early marriages are often followed by serious, and sometimes even by fatal consequences to mother, to progeny, or to both. Parents ought, therefore, to persuade their daughters not to marry until they are of age--twenty-one; they should point out to them the risk and danger likely to ensue if their advice be not followed; they should Impress upon their minds the old adage: "Early wed, Early dead." 5. TIME TO MARRY.--Parents who have the real interest and happiness of their daughters at heart, ought, in consonance with the laws of physiology, to discountenance marriage before twenty; and the nearer the girls arrive at the age of twenty-five before the consummation of this important rite, the greater the probability that, physically and morally, they will be protected against those risks which precocious marriages bring in their train. 6. FEEBLE PARENTS.--Feeble parents have generally feeble children; diseased parents, diseased children; nervous parents, nervous children;--"like begets like." It is sad to reflect, that the innocent have to suffer, not only for the guilty, but for the thoughtless and inconsiderate. Disease and debility are thus propagated from one generation to another and the American race becomes woefully deteriorated. 7. TIME.--Menstruation in this country usually commences at the ages of from thirteen to sixteen, sometimes earlier; occasionally as early as eleven or twelve; at other times later, and not until a girl be seventeen or eighteen years of age. Menstruation in large towns is supposed to commence at an earlier period than in the country, and earlier in luxurious than in simple life. 8. CHARACTER.--The menstrual fluid is not exactly blood, although, both in appearance and properties, it much resembles it; yet it never in the healthy state clots as blood does. It is a secretion of the womb, and, when healthy, ought to be of a bright red color in appearance very much like the blood from a recently cut finger. The menstrual fluid ought not, as before observed, clot. If it does, a lady, during "her periods," suffers intense pain; moreover, she seldom conceives until the clotting has ceased. 9. MENSTRUATION DURING NURSING.--Some ladies, though comparatively few, menstruate during nursing; when they do, it may be considered not as the rule, but as the exception. It is said in such instances, that they are more likely to conceive; and no doubt they are, as menstruation is an indication of a proneness to conception. Many persons have an idea that when a woman, during lactation, menstruates, her milk is both sweeter and purer. Such is an error. Menstruation during nursing is more likely to weaken the mother, and consequently to deteriorate her milk, and thus make it less sweet and less pure. 10. VIOLENT EXERCISE.--During "the monthly periods" violent exercise is injurious; iced drinks and acid beverages are improper; and bathing in the sea, and bathing the feet in cold water, and cold baths are dangerous; indeed, at such times as these, no risks should be run, and no experiments should, for the moment, be permitted, otherwise serious consequences will, in all probability, ensue. 11. THE PALE, COLORLESS-COMPLEXIONED.--The pale, colorless-complexioned, helpless, listless, and almost lifeless young ladies who are so constantly seen in society, usually owe their miserable state of health to absent, to deficient, or to profuse menstruation. Their breathing is short--they are soon "out of breath," if they attempt to take exercise--to walk, for instance, either up stairs or up a hill, or even for half a mile on level ground, their breath is nearly exhausted--they pant as though they had been running quickly. They are ready, after the slightest exertion or fatigue, and after the least worry or excitement, to feel faint, and sometimes even to actually swoon away. Now such cases may, if judiciously treated, be generally soon cured. It therefore behooves mothers to seek medical aid early for their girls, and that before irreparable mischief has been done to the constitution. 12. POVERTY OF BLOOD.--In a pale, delicate girl or wife, who is laboring under what is popularly called poverty of blood, the menstrual fluid is sometimes very scant, at others very copious, but is, in either case, usually very pale--almost as colorless as water, the patient being very nervous and even hysterical. Now, these are signs of great debility; but, fortunately for such an one, a medical man is, in the majority of cases, in possession of remedies that will soon make her all right again. 13. NO RIGHT TO MARRY.--A delicate girl has no right until she be made strong, to marry. If she should marry, she will frequently, when in labor, not have strength, unless she has help, to bring a child into the world; which, provided she be healthy and well-formed, ought not to be. How graphically the Bible tells of delicate women not having strength to bring children into the world: "For the children are come to the birth, and there is not strength to bring forth."--2 Kings XIX, 3. 14. TOO SPARING.--Menstruation at another time is too sparing; this is a frequent cause of sterility. Medical aid, in the majority of cases, will be able to remedy the defect, and, by doing so, will probably be the means of bringing the womb into a healthy state, and thus predispose to conception. [Illustration] [Illustration] * * * * * CELEBRATED PRESCRIPTIONS FOR ALL DISEASES AND HOW TO USE THEM. VINEGAR FOR HIVES. After trying many remedies in a severe case of hives, Mr. Swain found vinegar lotion gave instant relief, and subsequent trials in other cases have been equally successful. One part of water to two parts of vinegar is the strength most suitable. THROAT TROUBLE. A teaspoonful of salt, in a cup of hot water makes a safe and excellent gargle in most throat troubles. FOR SWEATING FEET, WITH BAD ODOR. Wash the feet in warm water with borax, and if this don't cure, use a solution of permanganate to destroy the fetor; about five grains to each ounce of water. AMENORRHOEA. The following is recommended as a reliable emmenagogue in many cases of functional amenorrhoea: Bichloride of mercury, Arsenite of sodium, aa gr. iij. Sulphate of strychnine, gr. iss. Carbonate of potassium, Sulphate of iron, aa gr. xlv. Mix and divide into sixty pills. Sig. One pill after each meal. SICK HEADACHE. Take a spoonful of finely powdered charcoal in a small glass of warm water to relieve a sick headache. It absorbs the gasses produced by the fermentation of undigested food. AN EXCELLENT EYE WASH. Acetate of zinc, 20 grains. Acetate of morphia, 5 grains. Rose water, 4 ounces. Mix. FOR FILMS AND CATARACTS OF THE EYES. Blood Root Pulverized, 1 ounce. Hog's lard, 3 ounces. Mix, simmer for 20 minutes, then strain; when cold put a little in the eyes twice or three times a day. FOR BURNS AND SORES. Pitch Burgundy, 2 pounds. Bees' Wax, 1 pound. Hog's lard, one pound. Mix all together and simmer over a slow fire until the whole are well mixed together; then stir it until cold. Apply on muslin to the parts affected. FOR CHAPPED HANDS. Olive oil, 6 ounces. Camphor beat fine, 1/2 ounce. Mix, dissolve by gentle heat over slow fire and when cold apply to the hand freely. INTOXICATION. A man who is helplessly intoxicated may almost immediately restore the faculties and powers of locomotion by taking half a teaspoonful of chloride of ammonium in a goblet of water. A wineglassful of strong vinegar will have the same effect and is frequently resorted to by drunken soldiers. NERVOUS DISABILITY, HEADACHE, NEURALGIA, NERVOUSNESS. Fluid extract of scullcap, 1 ounce. Fluid extract American valerian, 1 ounce. Fluid extract catnip, 1 ounce. Mix all. Dose, from 15 to 30 drops every two hours, in water; most valuable. A valuable tonic in all conditions of debility and want of appetite. Comp. tincture of cinchona in teaspoonful doses in a little water, half hour before meals. ANOTHER EXCELLENT TONIC Tincture of gentian, 1 ounce. Tincture of Columba, 1 ounce. Tincture of Collinsonia, 1 ounce. Mix all. Dose, one tablespoonful in one tablespoonful of water before meals. REMEDY FOR CHAPPED HANDS. When doing housework, if your hands become chapped or red, mix corn meal and vinegar into a stiff paste and apply to the hands two or three times a day, after washing them in hot water, then let dry without wiping, and rub with glycerine. At night use cold cream, and wear gloves. BLEEDING. Very hot water is a prompt checker of bleeding, besides if it is clean, as it should be, it aids in sterilizing our wound. TREATMENT FOR CRAMP. Wherever friction can be conveniently applied, heat will be generated by it, and the muscle again reduced to a natural condition; but if the pains proceed from the contraction of some muscle located internally, burnt brandy is an excellent remedy. A severe attack which will not yield to this simple treatment may be conquered by administering a small dose of laudanum or ether, best given under medical supervision. TREATMENT FOR COLIC Castor oil, given as soon as the symptoms of colic manifest themselves, has frequently afforded relief. At any rate, the irritating substances must be expelled from the alimentary canal before the pains will subside. All local remedies will be ineffectual, and consequently the purgative should be given in large doses until a copious vacuation is produced. [Illustration: THE DOCTOR'S VISIT.] TREATMENT FOR HEARTBURN. If soda, taken in small quantities after meals, does not relieve the distress, one may rest assured that the fluid is an alkali and requires an acid treatment. Proceed, after eating, to squeeze ten drops of lemon-juice into a small quantity of water, and swallow it. The habit of daily life should be made to conform to the laws of health, or local treatment will prove futile. BILIOUSNESS. For biliousness, squeeze the juice of a lime or small lemon into half a glass of cold water, then stir in a little baking soda and drink while it foams. This receipt will also relieve sick headache if taken at the beginning. TURPENTINE APPLICATIONS. Mix turpentine and lard in equal parts. Warmed and rubbed on the chest, it is a safe, reliable and mild counter irritant and revulsent in minor lung complications. TREATMENT FOR MUMPS. It is very important that the face and neck be kept warm. Avoid catching cold, and regulate the stomach and bowels; because when aggravated, this disease is communicated to other glands, and assumes there a serious form. Rest and quiet, with a good condition of the general health, will throw off this disease without further inconvenience. TREATMENT FOR FELON. All medication, such as poulticing, anointing, and the applications of lotions, is but useless waste of time. The surgeon's knife should be used as early as possible, for it will be required sooner or later and the more promptly it can be applied, the less danger is there from the disease, and the more agony is spared to the unfortunate victim. TREATMENT FOR STABS. A wound made by thrusting a dagger or other oblong instrument into the flesh, is best treated, if no artery has been severed, by applying lint scraped from a linen cloth, which serves as an obstruction, allowing and assisting coagulation. Meanwhile cold water should be applied to the parts adjoining the wound. TREATMENT FOR MASHED NAILS. If the injured member be plunged into very hot water the nail will become pliable and adapt itself to the new condition of things, thus alleviating agony to some extent. A small hole may be bored on the nail with a pointed instrument, so adroitly as not to cause pain, yet so successfully as to relieve pressure on the sensitive tissues. Free applications of arnica or iodine will have an excellent effect. TREATMENT FOR FOREIGN BODY IN THE EYE. When any foreign body enters the eye, close it instantly, and keep it still until you have an opportunity to ask the assistance of some one; then have the upper lid folded over a pencil and the exposed surfaces closely searched; if the body be invisible, catch the everted lid by the lashes, and drawing it down over the lower lid, suddenly release it, and it will resume its natural position. Unsuccessful in this attempt, you may be pretty well assured that the object has become lodged in the tissues, and will require the assistance of a skilled operator to remove it. CUTS. A drop or two of creosote on a cut will stop its bleeding. TREATMENT FOR POISON OAK--POISON IVY--POISON SUMACH.--Mr. Charles Morris, of Philadelphia, who has studied the subject closely, uses, as a sovereign remedy, frequent bathing of the affected parts in water as hot as can be borne. If used immediately after exposure, it may prevent the eruption appearing. If later, it allays the itching, and gradually dries up the swellings, though they are very stubborn after they have once appeared. But an application every few hours keeps down the intolerable itching, which is the most annoying feature of sumach poisoning. In addition to this, the ordinary astringent ointments are useful, as is also that sovereign lotion, "lead-water and laudanum." Mr. Morris adds to these a preventive prescription of "wide-open eyes." BITES AND STINGS OF INSECTS.--Wash with a solution of ammonia water. BITES OF MAD DOGS.--Apply caustic potash at once to the wound, and give enough whiskey to cause sleep. BURNS.--Make a paste of common baking soda and water, and apply it promptly to the burn. It will quickly check the pain and inflammation. COLD ON CHEST.--A flannel rag wrung out in boiling water and sprinkled with turpentine, laid on the chest, gives the greatest relief. COUGH.--Boil one ounce of flaxseed in a pint of water, strain, and add a little honey, one ounce of rock candy, and the juice of three lemons. Mix and boil well. Drink as hot as possible. SPRAINED ANKLE OR WRIST.--Wash the ankle very frequently with cold salt and water, which is far better than warm vinegar or decoction of herbs. Keep the foot as cool as possible to prevent inflammation, and sit with it elevated on a high cushion. Live on low diet, and take every morning some cooling medicine, such as Epsom salts. It cures in a few days. CHILBLAINS, SPRAINS, ETC.--One raw egg well beaten, half a pint of vinegar, one ounce spirits of turpentine, a quarter of an ounce of spirits of wine, a quarter of an ounce of camphor. These ingredients to be beaten together, then put in a bottle and shaken for ten minutes, after which, to be corked down tightly to exclude the air. In half an hour it is fit for use. To be well rubbed in, two, three, or four times a day. For rheumatism in the head, to be rubbed at the back of the neck and behind the ears. In chilblains this remedy is to be used before they are broken. HOW TO REMOVE SUPERFLUOUS HAIR.--Sulphuret of Arsenic, one ounce; Quicklime, one ounce; Prepared Lard, one ounce; White Wax, one ounce. Melt the Wax, add the Lard. When nearly cold, stir in the other ingredients. Apply to the superfluous hair, allowing it to remain on from five to ten minutes; use a table-knife to shave off the hair; then wash with soap and warm water. DYSPEPSIA CURE.--Powdered Rhubarb, two drachms: Bicarbonate of Sodium, six drachms; Fluid Extract of Gentian, three drachms; Peppermint Water, seven and a half ounces. Mix them. Dose, a teaspoonful half an hour before meals. FOR NEURALGIA.--Tincture of Belladonna, one ounce; Tincture of Camphor, one ounce; Tincture of Arnica, one ounce; Tincture of Opium, one ounce. Mix them. Apply over the seat of the pain, and give ten to twenty drops in sweetened water every two hours. FOR COUGHS, COLDS, ETC.--Syrup of Morphia, three ounces; Syrup of Tar, three and a half ounces; Chloroform, one troy ounce; Glycerine, one troy ounce. Mix them. Dose, a teaspoonful three or four times a day. TO CURE HIVES.--Compound syrup of Squill, U.S., three ounces; Syrup of Ipecac, U.S., one ounce. Mix them. Dose, a teaspoonful. TO CURE SICK HEADACHE.--Gather sumach leaves in the summer, and spread them in the sun a few days to dry. Then powder them fine, and smoke, morning and evening for two weeks, also whenever there are symptoms of approaching headache. Use a new clay pipe. If these directions are adhered to, this medicine will surely effect a permanent cure. WHOOPING COUGH.--Dissolve a scruple of salt of tartar in a gill of water; add to it ten grains of cochineal; sweeten it with sugar. Give to an infant a quarter teaspoonful four times a day; two years old, one-half teaspoonful; from four years, a tablespoonful. Great care is required in the administration of medicines to infants. We can assure paternal inquirers that the foregoing may be depended upon. CUT OR BRUISE.--Apply the moist surface of the inside coating or skin of the shell of a raw egg. It will adhere of itself, leave no scar, and heal without pain. DISINFECTANT.--Chloride of lime should be scattered at least once a week under sinks and wherever sewer gas is likely to penetrate. [Illustration: THE YOUNG DOCTOR.] COSTIVENESS.--Common charcoal is highly recommended for costiveness. It may be taken in tea- or tablespoonful, or even larger doses, according to the exigencies of the case, mixed with molasses, repeating it as often as necessary. Bathe the bowels with pepper and vinegar. Or take two ounces of rhubarb, add one ounce of rust of iron, infuse in one quart of wine. Half a wineglassful every morning. Or take pulverized blood root, one drachm, pulverized rhubarb, one drachm, castile soap, two scruples. Mix and roll into thirty-two pills. Take one, morning and night. By following these directions it may perhaps save you from a severe attack of the piles, or some other kindred disease. TO CURE DEAFNESS.--Obtain pure pickerel oil, and apply four drops morning and evening to the ear. Great care should be taken to obtain oil that is perfectly pure. DEAFNESS.--Take three drops of sheep's gall, warm and drop it into the ear on going to bed. The ear must be syringed with warm soap and water in the morning. The gall must be applied for three successive nights. It is only efficacious when the deafness is produced by cold. The most convenient way of warming the gall is by holding it in a silver spoon over the flame of a light. The above remedy has been frequently tried with perfect success. GOUT.--This is Col. Birch's recipe for rheumatic gout or acute rheumatism, commonly called in England the "Chelsea Pensioner." Half an ounce of nitre (saltpetre), half an ounce of sulphur, half an ounce of flour of mustard, half an ounce of Turkey rhubarb, quarter of an ounce of powdered guaicum. Mix, and take a teaspoonful every other night for three nights, and omit three nights, in a wineglassful of cold water which has been previously well boiled. RINGWORM.--The head is to be washed twice a day with soft soap and warm soft water; when dried the places to be rubbed with a piece of linen rag dipped in ammonia from gas tar; the patient should take a little sulphur and molasses, or some other genuine aperient, every morning; brushes and combs should be washed every day, and the ammonia kept tightly corked. PILES.--Hamamelis, both internally or as an injection in rectum. Bathe the parts with cold water or with astringent lotions, as alum water, especially in bleeding piles. Ointment of gallic acid and calomel is of repute. The best treatment of all is, suppositories of iodoform, ergotine, of tannic acid, which can be made at any drug store. CHICKEN POX.--No medicine is usually needed, except a tea made from pleurisy root, to make the child sweat. Milk diet is the best; avoidance of animal food; careful attention to the bowels; keep cool and avoid exposure to cold. SCARLET FEVER.--Cold water compress on the throat. Fats and oils rubbed on hands and feet. The temperature of the room should be about 68 degrees Fahr., and all draughts avoided. Mustard baths for retrocession of the rash and to bring it out. Diet: ripe fruit, toast, gruel, beef, tea and milk. Stimulants are useful to counteract depression of the vital forces. FALSE MEASLES OR ROSE RASH.--It requires no treatment except hygienic. Keep the bowels open. Nourishing diet, and if there is itching, moisten the skin with five per cent. solution of aconite or solution of starch and water. BILIOUS ATTACKS.--Drop doses of muriatic acid in a wine glass of water every four hours, or the following prescription: Bicarbonate of soda, one drachm; Aromatic spirits of ammonia, two drachms; Peppermint water, four ounces. Dose: Take a teaspoonful every four hours. DIARRHOEA.--The following prescription is generally all that will be necessary: acetate of lead, eight grains; gum arabic, two drachms; acetate of morphia, one grain; and cinnamon water, eight ounces. Take a teaspoonful every three hours. Be careful not to eat too much food. Some consider, the best treatment is to fast, and it is a good suggestion. Patients should keep quiet and have the room of a warm and even temperature. VOMITING.--Ice dissolved in the mouth, often cures vomiting when all remedies fail. Much depends on the diet of persons liable to such attacts; this should be easily digestible food, taken often and in small quantities. Vomiting can often be arrested by applying a mustard paste over the region of the stomach. It is not necessary to allow it to remain until the parts are blistered, but it may be removed when the part becomes thoroughly red, and reapplied if required after the redness has disappeared. One of the secrets to relieve vomiting is to give the stomach perfect rest, not allowing the patient even a glass of water, as long as the tendency remains to throw it up again. NERVOUS HEADACHE.--Extract hyoscymus five grains, pulverized camphor five grains. Mix. Make four pills, one to be taken when the pain is most severe in nervous headache. Or three drops tincture nux vomica in a spoonful of water, two or three times a day. BLEEDING FROM THE NOSE.--from whatever cause--may generally be stopped by putting a plug of lint into the nostril; if this does not do, apply a cold lotion to the forehead; raise the head and place both arms over the head, so that it will rest on both hands; dip the lint plug, slightly moistened, in some powdered gum arabic, and plug the nostrils again; or dip the plug into equal parts of gum arabic and alum. An easier and simpler method is to place a piece of writing paper on the gums of the upper jaw, under the upper lip, and let it remain there for a few minutes. BOILS.--These should be brought to a head by warm poultices of camomile flowers, or boiled white lily root, or onion root, by fermentation with hot water, or by stimulating plasters. When ripe they should be destroyed by a needle or lancet. But this should not be attempted until they are thoroughly proved. BUNIONS may be checked in their early development by binding the joint with adhesive plaster, and keeping it on as long as any uneasiness is felt. The bandaging should be perfect, and it might be well to extend it round the foot An inflamed bunion should be poulticed, and larger shoes be worn. Iodine 12 grains, lard or spermaceti ointment half an ounce, makes a capital ointment for bunions. It should be rubbed on gently twice or three times a day. FELONS.--One table-spoonful of red lead, and one tablespoonful of castile soap, and mix them with as much weak lye as will make it soft enough to spread like a salve, and apply it on the first appearance of the felon, and it will cure in ten or twelve days. CARE FOR WARTS.--The easiest way to get rid of warts, is to pare off the thickened skin which covers the prominent wart; cut it off by successive layers and shave it until you come to the surface of the skin, and till you draw blood in two or three places. Then rub the part thoroughly over with lunar caustic, and one effective operation of this kind will generally destroy the wart; if not, you cut off the black spot which has been occasioned by the caustic, and apply it again; or you may apply acetic acid, and thus you will get rid of it. Care must be taken in applying these acids, not to rub them on the skin around the wart. WENS.--Take the yoke of some eggs, beat up, and add as much fine salt as will dissolve, and apply a plaster to the wen every ten hours. It cures without pain or any other inconvenience. * * * * * HOW TO CURE APOPLEXY, BAD BREATH AND QUINSY. 1. APOPLEXY.--Apoplexy occurs only in the corpulent or obese, and those of gross or high living. _Treatment_--Raise the head to a nearly upright position; loosen all tight clothes, strings, etc., and apply cold water to the head and warm water and warm cloths to the feet. Have the apartment cool and well ventilated. Give nothing by the mouth until the breathing is relieved, and then only draughts of cold water. 2. BAD BREATH.--Bad or foul breath will be removed by taking a teaspoonful of the following mixture after each meal: One ounce chloride of soda, one ounce liquor of potassa, one and one-half ounces phosphate of soda, and three ounces of water. 3. QUINSY.--This is an inflammation of the tonsils, or common inflammatory sore throat; commences with a slight feverish attack, with considerable pain and swelling of the tonsils, causing some difficulty in swallowing; as the attack advances, these symptoms become more intense, there is headache, thirst, a painful sense of tension, and acute darting pains in the ears. The attack is generally brought on by exposure to cold, and lasts from five to seven days, when it subsides naturally, or an abscess may form in tonsils and burst, or the tonsils may remain enlarged, the inflammation subsiding. _Home Treatment._--The patient should remain in a warm room, the diet chiefly milk and good broths, some cooling laxative and diaphoretic medicine may be given; but the greatest relief will be found in the frequent inhalation of the steam of hot water through an inhaler, or in the old-fashioned way through the spout of a teapot. * * * * * SENSIBLE RULES FOR THE NURSE. "Remember to be extremely neat in dress; a few drops of hartshorn in the water used for _daily_ bathing will remove the disagreeable odors of warmth and perspiration. "Never speak of the symptoms of your patient in his presence, unless questioned by the doctor, whose orders you are always to obey _implicitly_. "Remember never to be a gossip or tattler, and always to hold sacred the knowledge which, to a certain extent, you must obtain of the private affairs of your patient and the household in which you nurse. "Never contradict your patient, nor argue with him, nor let him see that you are annoyed about anything. "Never _whisper_ in the sick room. If your patient be well enough, and wishes you to talk to him, speak in a low, distinct voice, on cheerful subjects. Don't relate painful hospital experiences, nor give details of the maladies of former patients, and remember never to startle him with accounts of dreadful crimes or accidents that you have read in the newspapers. "_Write_ down the orders that the physician gives you as to time for giving the medicines, food, etc. "Keep the room bright (unless the doctor orders it darkened). "Let the air of the room be as pure as possible, and keep everything in order, but without being fussy and bustling. "The only way to remove dust in a sick room is to wipe everything with a damp cloth. "Remember to carry out all vessels covered. Empty and wash them immediately, and keep some disinfectant in them. "Remember that to leave the patient's untasted food by his side, from meal to meal, in hopes that he will eat it in the interval, is simply to prevent him from taking any food at all. "Medicines, beef tea or stimulants, should never be kept where the patient can see them or smell them. "Light-colored clothing should be worn by those who have the care of the sick, in preference to dark-colored apparel; particularly if the disease is of a contagious nature. Experiments have shown that black and other dark colors will absorb more readily the subtle effluvia that emanates from sick persons than white or light colors." * * * * * LONGEVITY. The following table exhibits very recent mortality statistics, showing the average duration of life among persons of various classes: Employment. Years. Judges 65 Farmers 64 Bank Officers 64 Coopers 58 Public Officers 57 Clergymen 56 Shipwrights 55 Hatters 54 Lawyers 54 Rope Makers 54 Blacksmiths 51 Merchants 51 Calico Printers 51 Physicians 51 Butchers 50 Carpenters 49 Masons 48 Traders 46 Tailors 44 Jewelers 44 Manufacturers 43 Bakers 43 Painters 43 Shoemakers 43 Mechanics 43 Editors 40 Musicians 39 Printers 38 Machinists 36 Teachers 34 Clerks 34 Operatives 32 "It will be easily seen, by these figures, how a quiet or tranquil life affects longevity. The phlegmatic man will live longer, all other things being equal, than the sanguine, nervous individual. Marriage is favorable to longevity, and it has also been ascertained that women live longer than men." [Illustration: HOT WATER THROAT BAG.] [Illustration: HOT WATER BAG.] * * * * * HOW TO APPLY AND USE HOT WATER IN ALL DISEASES. 1. THE HOT WATER THROAT BAG. The hot water throat bag is made from fine white rubber fastened to the head by a rubber band (see illustration), and is an unfailing remedy for catarrh, hay fever, cold, toothache, headache, earache, neuralgia, etc. 2. THE HOT WATER BOTTLE. No well regulated house should be without a hot water bottle. It is excellent in the application of hot water for inflammations, colic, headache, congestion, cold feet, rheumatism, sprains, etc., etc. It is an excellent warming pan and an excellent feet and hand warmer when riding. These hot water bags in any variety can be purchased at any drug store. 3. Boiling water may be used in the bags and the heat will be retained many hours. They are soft and pliable and pleasant to the touch, and can be adjusted to any part of the body. 4. Hot water is good for constipation, torpid liver and relieves colic and flatulence, and is of special value. 5. _Caution._ When hot water bags or any hot fomentation is removed, replace dry flannel and bathe parts in tepid water and rub till dry. 6. By inflammations it is best to use hot water and then cold water. It seems to give more immediate relief. Hot water is a much better remedy than drugs, paragoric, Dover's powder or morphine. Always avoid the use of strong poisonous drugs when possible. 7. Those who suffer from cold feet there is no better remedy than to bathe the feet in cold water before retiring and then place a hot water bottle in the bed at the feet. A few weeks of such treatment results in relief if not cure of the most obstinate case. HOW TO USE COLD WATER. Use a compress of cold water for acute or chronic inflammation, such as sore throat, bronchitis, croup, inflammation of the lungs, etc. If there is a hot and aching pain in the back apply a compress of cold water on the same, or it may simply be placed across the back or around the body. The most depends upon the condition of the patient. [Illustration] [Illustration] * * * * * PRACTICAL RULES FOR BATHING. 1. Bathe at least once a week all over, thoroughly. No one can preserve his health by neglecting personal cleanliness. Remember, "Cleanliness is akin to Godliness." 2. Only mild soap should be used in bathing the body. 3. Wipe quickly and dry the body thoroughly with a moderately coarse towel. Rub the skin vigorously. 4. Many people have contracted severe and fatal diseases by neglecting to take proper care of the body after bathing. 5. If you get up a good reaction by thorough rubbing in a mild temperature, the effect is always good. 6. Never go into a cold room, or allow cold air to enter the room until you are dressed. 7. Bathing in cold rooms and in cold water is positively injurious, unless the person possesses a very strong and vigorous constitution, and then there is great danger of laying the foundation of some serious disease. 8. Never bathe within two hours after eating. It injures digestion. 9. Never bathe when the body or mind is much exhausted. It is liable to check the healthful circulation. 10. A good time for bathing is just before retiring. The morning hour is a good time also, if a warm room and warm water can be secured. 11. Never bathe a fresh wound or broken skin with cold water; the wound absorbs water, and causes swelling and irritation. 12. A person not robust should be very careful in bathing; great care should be exercised to avoid any chilling effects. * * * * * ALL THE DIFFERENT KINDS OF BATHS, AND HOW TO PREPARE THEM. THE SULPHUR BATH. For the itch, ringworm, itching, and for other slight irritations, bathe in water containing a little sulphur. THE SALT BATH. To open the pores of the skin, put a little common salt into the water. Borax, baking soda or lime used in the same way are excellent for cooling and cleansing the skin. A very small quantity in a bowl of water is sufficient. THE VAPOR BATH. 1. For catarrh, bronchitis, pleurisy, inflammation of the lungs, rheumatism, fever, affections of the bowels and kidneys, and skin diseases, the vapor-bath is an excellent remedy. 2. APPARATUS.--Use a small alcohol lamp, and place over it a small dish containing water. Light the lamp and allow the water to boil. Place a cane bottom chair over the lamp, and seat the patient on it. Wrap blankets or quilts around the chair and around the patient, closing it tightly about the neck. After free perspiration is produced the patient should be wrapped in warm blankets, and placed in bed, so as to continue the perspiration for some time. 3. A convenient alcohol lamp may be made by taking a tin box, placing a tube in it, and putting in a common lamp wick. Any tinner can make one in a few minutes, at a trifling cost. THE HOT-AIR BATH. 1. Place the alcohol lamp under the chair, without the dish of water. Then place the patient on the chair, as in the vapor bath, and let him remain until a gentle and free perspiration is produced. This bath may be taken from time to time, as may be deemed necessary. 2. While remaining in the hot-air bath the patient may drink freely of cold or tepid water. 3. As soon as the bath is over the patient should be washed with hot water and soap. 4. The hot-air bath is excellent for colds, skin diseases, and the gout. THE SPONGE BATH. 1. Have a large basin of water of the temperature of 85 or 95 degrees. As soon as the patient rises rub the body over with a soft, dry towel until it becomes warm. 2. Now sponge the body with water and a little soap, at the same time keeping the body well covered, except such portions as are necessarily exposed. Then dry the skin carefully with a soft, warm towel. Rub the skin well for two or three minutes, until every part becomes red and perfectly dry. 3. Sulphur, lime or salt, and sometimes mustard, may be used in any of the sponge baths, according to the disease. THE FOOT BATH. 1. The foot bath, in coughs, colds, asthma, headaches and fevers, is excellent. One or two tablespoonfuls of ground mustard added to a gallon of hot water, is very beneficial. 2. Heat the water as hot as the patient can endure it, and gradually increase the temperature by pouring in additional quantities of hot water during the bath. THE SITZ BATH. A tub is arranged so that the patient can sit down in it while bathing. Fill the tub about one-half full of water. This is an excellent remedy for piles, constipation, headache, gravel, and for acute and inflammatory affections generally. THE ACID BATH. Place a little vinegar in water, and heat to the usual temperature. This is an excellent remedy for the disorders of the liver. A SURE CURE FOR PRICKLY HEAT. 1. Prickly heat is caused by hot weather, by excess of flesh, by rough flannels, by sudden changes of temperature, or by over-fatigue. 2. TREATMENT--Bathe two or three times a day with warm water, in which a moderate quantity of bran and common soda has been stirred. After wiping the skin dry, dust the affected parts with common cornstarch. * * * * * DIGESTIBILITY OF FOOD. ARTICLE OF FOOD; CONDITION; HOURS REQUIRED Rice; Boiled; 1.00 Eggs, whipped; Raw; 1.30 Trout, salmon, fresh; Boiled; 1.30 Apples, sweet and mellow; Raw; 1.30 Venison steak; Broiled; 1.35 Tapioca; Boiled; 2.00 Barley; Boiled; 2.00 Milk; Boiled; 2.00 Bullock's liver, fresh; Broiled; 2.00 Fresh eggs; Raw; 2.00 Codfish, cured and dry; Boiled; 2.00 Milk; Raw; 2.15 Wild turkey; Roasted; 2.15 Domestic turkey; Roasted; 2.30; Goose; Roasted; 2.30 Suckling pig; Roasted; 2.30 Fresh Lamb; Broiled; 2.30 Hash, meat and vegetables; Warmed; 2.30 Beans and pod; Boiled; 2.30 Parsnips; Boiled; 2.30 Irish potatoes; Roasted; 2.30 Chicken; Fricassee; 2.45 Custard; Baked; 2.45 Salt beef; Boiled; 2.45 Sour and hard apples; Raw; 2.50 Fresh oysters; Raw; 2.55 Fresh eggs; Soft Boiled; 3.00 Beef, fresh, lean and rare; Roasted; 3.00 Beef steak; Broiled; 3.00 Pork, recently salted; Stewed; 3.00 Fresh mutton; Boiled; 3.00 Soup, beans; Boiled; 3.00 Soup, chicken; Boiled; 3.00 Apple dumpling; Boiled; 3.00 Fresh oysters; Roasted; 3.15 Pork steak; Broiled; 3.15 Fresh mutton; Roasted; 3.15 Corn bread; Baked; 3.15 Carrots; Boiled; 3.15 Fresh sausage; Broiled; 3.20 Fresh flounder; Fried; 3.30 Fresh catfish; Fried; 3.30 Fresh oysters; Stewed; 3.30 Butter; Melted; 3.30 Old, strong cheese; Raw; 3.30 Mutton soup; Boiled; 3.30 Oyster soup; Boiled; 3.30 Fresh wheat bread; Baked; 3.30 Flat turnips; Boiled; 3.30 Irish potatoes; Boiled; 3.30 Fresh eggs; Hard boiled; 3.30 Fresh eggs; Fried; 3.30 Green corn and beans; Boiled; 3.45 Beets, Boiled; 3.45 Fresh, lean beef; Fried; 4.00 Fresh veal; Broiled; 4.00 Domestic fowls; Roasted; 4.00 Ducks, Roasted; 4.00 Beef soup, vegetables and bread Boiled; 4.00 Pork, recently salted; Boiled; 4.30 Fresh veal; Fried; 4.30 Cabbage, with vinegar; Boiled; 4.30 Pork, fat and lean; Roasted; 5.30 * * * * * HOW TO COOK FOR THE SICK. Useful Dietetic Recipes. GRUELS. 1. OATMEAL GRUEL.--Stir two tablespoonfuls of coarse oatmeal into a quart of boiling water, and let it simmer two hours. Strain, if preferred. 2. BEEF TEA AND OATMEAL.--Beat two tablespoonfuls of fine oatmeal, with two tablespoonfuls of cold water until very smooth, then add a pint of hot beef tea. Boil together six or eight minutes, stirring constantly. Strain through a fine sieve. 3. MILK GRUEL.--Into a pint of scalding milk stir two tablespoonfuls of fine oatmeal. Add a pint of boiling water, and boil until the meal is thoroughly cooked. 4. MILK PORRIDGE.--Place over the fire equal parts of milk and water. Just before it boils, add a small quantity (a tablespoonful to a pint of water) of graham flour or cornmeal, previously mixed with water, and boil three minutes. 5. SAGO GRUEL.--Take two tablespoonfuls of sago and place them in a small saucepan, moisten gradually with a little cold water. Set the preparation on a slow fire, and keep stirring till it becomes rather stiff and clear. Add a little grated nutmeg and sugar to taste; if preferred, half a pat of butter may also be added with the sugar. 6. CREAM GRUEL.--Put a pint and a half of water on the stove in a saucepan. Take one tablespoon of flour and the same of cornmeal, mix this with cold water, and as soon as the water in the saucepan boils, stir it in slowly. Let it boil slowly about twenty minutes, stirring constantly then add a little salt and a gill of sweet cream. Do not let it boil after putting in the cream, but turn into a bowl and cover tightly. Serve in a pretty cup and saucer. DRINKS. 1. APPLE WATER.--Cut two large apples into slices and pour a quart of boiling water on them, or on roasted apples; strain in two or three hours and sweeten slightly. 2. ORANGEADE.--Take the thin peel of two oranges and of one lemon; add water and sugar the same as for hot lemonade. When cold add the juice of four or five oranges and one lemon and strain off. 3. HOT LEMONADE.--Take two thin slices and the juice of one lemon; mix with two tablespoonfuls of granulated sugar, and add one-half pint of boiling water. 4. FLAXSEED LEMONADE.--Two tablespoonfuls of whole flaxseed to a pint of boiling water, let it steep three hours, strain when cool and add the juice of two lemons and two tablespoonfuls of honey. If too thick, put in cold water. Splendid for colds and suppression of urine. 5. JELLY WATER.--Sour jellies dissolved in water make a pleasant drink for fever patients. 6. TOAST WATER.--Toast several thin pieces of bread a slice deep brown, but do not blacken or burn. Break into small pieces and put into a jar. Pour over the pieces a quart of boiling water; cover the jar and let it stand an hour before using. Strain if desired. 7. WHITE OF EGG AND MILK.--The white of an egg beaten to a stiff froth, and stirred very quickly into a glass of milk, is a very nourishing food for persons whose digestion is weak, also for children who cannot digest milk alone. 8. EGG COCOA.--One-half teaspoon cocoa with enough hot water to make a paste. Take one egg, beat white and yolk separately. Stir into a cup of milk heated to nearly boiling. Sweeten if desired. Very nourishing. 9. EGG LEMONADE.--White of one egg, one tablespoonful pulverized sugar, juice of one lemon and one goblet of water. Beat together. Very grateful in inflammation of of lungs, stomach or bowels. 10. BEEF TEA.--For every quart of tea desired use one pound of fresh beef, from which all fat, bones and sinews have been carefully removed; cut the beef into pieces a quarter of an inch thick and mix with a pint of cold water. Let it stand an hour, then pour into a glass fruit can and place in a vessel of water; let it heat on the stove another hour, but do not let it boil. Strain before using. JELLIES. 1. SAGO JELLY.--Simmer gently in a pint of water two tablespoonfuls of sago until it thickens, frequently stirring. A little sugar may be added if desired. 2. CHICKEN JELLY.--Take half a raw chicken, tie in a coarse cloth and pound, till well mashed, bones and meat together. Place the mass in a covered dish with water sufficient to cover it well. Allow it to simmer slowly till the liquor is reduced about one-half and the meat is thoroughly cooked. Press through a fine sieve or cloth, and salt to taste. Place on the stove to simmer about five minutes When cold remove all particles of grease. 3. MULLED JELLY.--Take one tablespoonful of currant or grape jelly; beat it with the white of one egg and a little loaf sugar; pour on it one-half pint of boiling water and break in a slice of dry toast or two crackers. 4. BREAD JELLY.--Pour boiling water over bread crumbs place the mixture on the fire and let it boil until it is perfectly smooth. Take it off, and after pouring off the water, flavor with something agreeable, as a little raspberry or currant jelly water. Pour into a mold until required for use. 5. LEMON JELLY.--Moisten two tablespoonfuls of cornstarch, stir into one pint boiling water; add the juice of two lemons and one-half cup of sugar. Grate in a little of the rind. Put in molds to cool. MISCELLANEOUS. 1. TO COOK RICE.--Take two cups of rice and one and one-half pints of milk. Place in a covered dish and steam in a kettle of boiling water until it is cooked through, pour into cups and let it stand until cold. Serve with cream. 2. RICE OMELET.--Two cups boiled rice, one cup sweet milk, two eggs. Stir together with egg beater, and put into a hot buttered skillet. Cook slowly ten minutes, stirring frequently. 3. BROWNED RICE.--Parch or brown rice slowly. Steep in milk for two hours. The rice or the milk only is excellent in summer complaint. 4. STEWED OYSTERS.--Take one pint of milk, one cup of water, a teaspoon of salt; when boiling put in one pint of bulk oysters. Stir occasionally and remove from the stove before it boils. An oyster should not be shriveled in cooking. 5. BROILED OYSTERS.--Put large oysters on a wire toaster Hold over hot coals until heated through. Serve on toast moistened with cream. Very grateful in convalescence. 6. OYSTER TOAST.--Pour stewed oysters over graham or bread toasted. Excellent for breakfast. 7. GRAHAM CRISPS.--Mix graham flour and cold water into a very stiff dough. Knead, roll very thin, and bake quickly in a hot oven. Excellent food for dyspeptics. 8. APPLE SNOW.--Take seven apples, not very sweet ones, and bake till soft and brown. Then remove the skins and cores; when cool, beat them smooth and fine; add one-half cup of granulated sugar and the white of one egg. Beat till the mixture will hold on your spoon. Serve with soft custard. 9. EGGS ON TOAST.--Soften brown bread toast with hot water, put on a platter and cover with poached or scrambled eggs. 10. BOILED EGGS.--An egg should never be boiled. Place in boiling water and set back on the stove for from seven to ten minutes. A little experience will enable anyone to do it successfully. 11. CRACKED WHEAT PUDDING.--In a deep two-quart pudding dish put layers of cold, cooked, cracked wheat, and tart apples sliced thin, with four tablespoonfuls of sugar. Raisins can be added if preferred. Fill the dish, having the wheat last, add a cup of cold water. Bake two hours. 12. PIE FOR DYSPEPTICS.--Four tablespoonfuls of oatmeal, one pint of water; let stand for a few hours, or until the meal is swelled. Then add two large apples, pared and sliced, a little salt, one cup of sugar, one tablespoonful of flour. Mix all well together and bake in a buttered dish; makes a most delicious pie, which can be eaten with safety by the sick or well. 13. APPLE TAPIOCA PUDDING.--Soak a teacup of tapioca in a quart of warm water three hours. Cut in thin slices six tart apples, stir them lightly with the tapioca, add half cup sugar. Bake three hours. To be eaten with whipped cream. Good either warm or cold. 14. GRAHAM MUFFINS.--Take one pint of new milk, one pint graham or entire wheat flour; stir together and add one beaten egg. Can be baked in any kind of gem pans or muffin rings. Salt must not be used with any bread that is made light with egg. 15. STRAWBERRY DESSERT.--Place alternate layers of hot cooked cracked wheat and strawberries in a deep dish; when cold, turn out on platter; cut in slices and serve with cream and sugar, or strawberry juice. Wet the molds with cold water before using. This, molded in small cups, makes a dainty dish for the sick. Wheatlet can be used in the same way. 16. FRUIT BLANC MANGE.--One quart of juice of strawberries, cherries, grapes or other juicy fruit; one cup water. When boiling, add two tablespoonfuls sugar and four tablespoonfuls cornstarch wet in cold water; let boil five or six minutes, then mold in small cups. Serve without sauce, or with cream or boiled custard. Lemon juice can be used the same, only requiring more water. This is a very valuable dish for convalescents and pregnant women, when the stomach rejects solid food. [Illustration] * * * * * SAVE THE GIRLS. 1. PUBLIC BALLS.--The church should turn its face like flint against the public ball. Its influence is evil, and nothing but evil. It is a well known fact that in all cities and large towns the ball room is the recruiting office for prostitution. 2. THOUGHTLESS YOUNG WOMEN.--In cities public balls are given every night, and many thoughtless young women, mostly the daughters of small tradesmen and mechanics, or clerks or laborers, are induced to attend "just for fun." Scarcely one in a hundred of the girls attending these balls preserve their purity. They meet the most desperate characters, professional gamblers, criminals and the lowest debauchees. Such an assembly and such influence cannot mean anything but ruin for an innocent girl. 3. VILE WOMEN.--The public ball is always a resort of vile women who picture to innocent girls the ease and luxury of a harlot's life, and offer them all manner of temptations to abandon the paths of virtue. The public ball is the resort of the libertine and the adulterer, and whose object is to work the ruin of every innocent girl that may fall into their clutches. 4. THE QUESTION.--Why does society wonder at the increase of prostitution, when the public balls and promiscuous dancing is so largely endorsed and encouraged? 5. WORKING GIRLS.--Thousands of innocent working girls enter innocently and unsuspectingly into the paths which lead them to the house of evil, or who wander the streets as miserable outcasts all through the influence of the dance. The low theatre and dance halls and other places of unselected gatherings are the milestones which mark the working girl's downward path from virtue to vice, from modesty to shame. 6. THE SALESWOMAN, the seamstress, the factory girl or any other virtuous girl had better, far better, die than take the first step in the path of impropriety and danger. Better, a thousand times better, better for this life, better for the life to come, an existence of humble, virtuous industry than a single departure from virtue, even though it were paid with a fortune. 7. TEMPTATIONS.--There is not a young girl but what is more or less tempted by some unprincipled wretch who may have the reputation of a genteel society man. It behooves parents to guard carefully the morals of their daughters, and be vigilant and cautious in permitting them to accept the society of young men. Parents who desire to save their daughters from a fate which is worse than death, should endeavor by every means in their power to keep them from falling into traps cunningly devised by some cunning lover. There are many good young men, but not all are safe friends to an innocent, confiding young girl. 8. PROSTITUTION.--Some girls inherit their vicious tendency; others fall because of misplaced affections; many sin through a love of dress, which is fostered by society and by the surroundings amidst which they may be placed; many, very many, embrace a life of shame to escape poverty While each of these different phases of prostitution require a different remedy, we need better men, better women, better laws and better protection for the young girls. [Illustration: A RUSSIAN SPINNING GIRL.] 9. A STARTLING FACT.--Startling as it may seem to some, it is a fact in our large cities that there are many girls raised by parents with no other aim than to make them harlots. At a tender age they are sold by fathers and mothers into an existence which is worse than slavery itself. It is not uncommon to see girls at the tender age of thirteen or fourteen--mere children--hardened courtesans, lost to all sense of shame and decency. They are reared in ignorance, surrounded by demoralizing influences, cut off from the blessings of church and Sabbath school, see nothing but licentiousness, intemperance and crime. These young girls are lost forever. They are beyond the reach of the moralist or preacher and have no comprehension of modesty and purity. Virtue to them is a stranger, and has been from the cradle. 10. A GREAT WRONG.--Parents too poor to clothe themselves bring children into the world, children for whom they have no bread, consequently the girl easily falls a victim in early womanhood to the heartless libertine. The boy with no other schooling but that of the streets soon masters all the qualifications for a professional criminal. If there could be a law forbidding people to marry who have no visible means of supporting a family, or if they should marry, if their children could be taken from them and properly educated by the State, it would cost the country less and be a great step in advancing our civilization. 11. THE FIRST STEP.--Thousands of fallen women could have been saved from lives of degradation and deaths of shame had they received more toleration and loving forgiveness in their first steps of error. Many women naturally pure and virtuous have fallen to the lowest depths because discarded by friends, frowned upon by society, and sneered at by the world, after they had taken a single mis-step. Society forgives man, but woman never. 12. IN THE BEGINNING of every girl's downward career there is necessarily a hesitation. She naturally ponders over what course to take, dreading to meet friends and looking into the future with horror. That moment is the vital turning point in her career; a kind word of forgiveness, a mother's embrace a father's welcome may save her. The bloodhounds, known as the seducer, the libertine, the procurer, are upon her track; she is trembling on the frightful brink of the abyss. Extend a helping hand and save her! 13. FATHER, if your daughter goes astray, do not drive her from your home. Mother, if your child errs, do not close your heart against her. Sisters and brothers and friends, do not force her into the pathway of shame, but rather strive to win her back into the Eden of virtue, an in nine cases out of ten you will succeed. 14. SOCIETY EVILS.--The dance, the theater, the wine-cup, the race-course, the idle frivolity and luxury of summer watering places, all have a tendency to demoralize the young. 15. BAD SOCIETY.--Much of our modern society admits libertines and seducers to the drawing-room, while it excludes their helpless and degraded victims, consequently it is not strange that there are skeletons in many closets, matrimonial infelicity and wayward girls. 16. "'KNOW THYSELF,'" says Dr. Saur, "is an important maxim for us all, and especially is it true for girls. "All are born with the desire to become attractive girls especially want to grow up, not only attractive, but beautiful. Some girls think that bright eyes, pretty hair and fine clothes alone make them beautiful. This is not so. Real beauty depends upon good health, good manners and a pure mind. "As the happiness of our girls depends upon their health, it behoves us all to guide the girls in such a way as to bring forward the best of results. 17. "THERE IS NO ONE who stands so near the girl as the mother. From early childhood she occupies the first place in the little one's confidence she laughs, plays, and corrects, when necessary, the faults of her darling. She should be equally ready to guide in the important laws of life and health upon which rest her future. Teach your daughters that in all things the 'creative principle' has its source in life itself. It originates from Divine life, and when they know that it may be consecrated to wise and useful purposes, they are never apt to grow up with base thoughts or form bad habits. Their lives become a happiness to themselves and a blessing to humanity. 18. TEACH WISELY.--"Teach your daughters that _all life_ originates from a seed a germ. Knowing this law, you need have no fears that base or unworthy thoughts of the reproductive function can ever enter their minds. The growth, development and ripening of human seed becomes a beautiful and sacred mystery. The tree, the rose and all plant life are equally as mysterious and beautiful in their reproductive life. Does not this alone prove to us, conclusively, that there is a Divinity in the background governing, controlling and influencing our lives? Nature has no secrets, and why should we? None at all. The only care we should experience is in teaching wisely. "Yes lead them wisely teach them that the seed, the germ of a new life, is maturing within them. Teach them that between the ages of eleven and fourteen this maturing process has certain physical signs. The breasts grow round and full, the whole body, even the voice, undergoes a change. It is right that they should be taught the natural law of life in reproduction and the physiological structure of their being. Again we repeat that these lessons should be taught by the mother, and in a tender, delicate and confidential way. Become, oh, mother, your daughter's companion, and she will not go elsewhere for this knowledge which must come to all in time, but possibly too late and through sources that would prove more harm than good. 19. THE ORGANS OF CREATIVE LIFE in women are: Ovaries, Fallopian tubes, uterus, vagina and mammary glands. The _ovaries_ and _Fallopian tubes_ have already been described under "The Female Generative Organs." "The _uterus_ is a pear-shaped muscular organ, situated in the lower portion of the pelvis, between the bladder and the rectum. It is less than three inches in length and two inches in width and one in thickness. "The _vagina_ is a membranous canal which joins the internal outlet with the womb, which projects slightly into it. The opening into the vagina is nearly oval, and in those who have never indulged in sexual intercourse or in handling the sexual organs is more or less closed by a membrane termed the _hymen_. The presence of this membrane was formerly considered as undoubted evidence of virginity; its absence, a lack of chastity. "The _mammary glands_ are accessory to the generative organs. They secrete milk, which the All-wise Gatherer provided for the nourishment of the child after birth. 20. "MENSTRUATION, which appears about the age of thirteen years, is the flow from the uterus that occurs every month as the seed-germ ripens in the ovaries. God made the sexual organs so that the race should not die out. He gave them to us so that we may reproduce life, and thus fill the highest position in the created universe. The purpose for which they are made is high and holy and honorable, and if they are used only for this purpose and they must not be used at all until they are fully matured they will be a source of greatest blessing to us all. [Illustration: THE TWO PATHS--WHAT WILL THE GIRL BECOME? AT 13: BAD LITERATURE AT 20: FLIRTING & COQUETTERY AT 26: FAST LIFE & DISSIPATION AT 40: AN OUTCAST AT 13: STUDY & OBEDIENCE AT 20: VIRTUE & DEVOTION AT 26: A LOVING MOTHER AT 60: AN HONORED GRANDMOTHER] 21. "A CAREFUL STUDY of this organ, of its location, of its arteries and nerves, will convince the growing girl that her body should never submit to corsets and tight lacing in response to the demands of fashion, even though nature has so bountifully provided for the safety of this important organ. By constant pressure the vagina and womb may be compressed into one-third their natural length or crowded into an unnatural position. We can readily see, then, the effect of lacing or tight clothing. Under these circumstances the ligaments lose their elasticity, and as a result we have prolapsus or falling of the womb. 22. "I AM MORE ANXIOUS for growing girls than for any other earthly object. These girls are to be the mothers of future generations; upon them hangs the destiny of the world in coming time, and if they can be made to understand what is right and what is wrong with regard to their own bodies now, while they are young, the children they will give birth to and the men and women who shall call them mother will be of a higher type and belong to a nobler class than those of the present day. 23. "ALL WOMEN CANNOT have good features, but they can look well, and it is possible to a great extent to correct deformity and develop much of the figure. The first step to good looks is good health, and the first element of health is cleanliness. Keep clean wash freely, bathe regularly. All the skin wants is leave to act, and it takes care of itself. 24. "GIRLS SOMETIMES GET THE IDEA that it is nice to be 'weak' and 'delicate,' but they cannot get a more false idea! God meant women to be strong and able-bodied, and only by being so can they be happy and capable of imparting happiness to others. It is only by being strong and healthy that they can be perfect in their sexual nature; and It is only by being perfect in this part of their being that you can become a noble, grand and beautiful woman. 25. "UP TO THE AGE of puberty, if the girl has grown naturally, waist, hips and shoulders are about the same in width, the shoulders being, perhaps, a trifle the broadest. Up to this time the sexual organs have grown but little. Now they take a sudden start and need more room. Nature aids the girls; the tissues and muscles increase in size and the pelvis bones enlarge. The limbs grow plump, the girl stops growing tall and becomes round and full. Unsuspected strength comes to her; tasks that were once hard to perform are now easy; her voice becomes sweeter and stronger. The mind develops more rapidly even than the body; her brain is more active and quicker; subjects that once were dull and dry have unwonted interest; lessons are more easily learned; the eyes sparkle with intelligence, indicating increased mental power; her manner denotes the consciousness of new power; toys of childhood are laid away; womanly thoughts and pursuits fill her mind; budding childhood has become blooming womanhood. Now, if ever, must be laid the foundation of physical vigor and of a healthy body. Girls should realize the significance of this fact. Do not get the idea that men admire a weakly, puny, delicate, small-waisted, languid, doll-like creature, a libel on true womanhood. Girls admire men with broad chests, square shoulders, erect form, keen bright eyes, hard muscles and undoubted vigor. Men also turn naturally to healthy, robust, well-developed girls, and to win their admiration girls must meet their ideals. A good form, a sound mind and a healthy body are within the reach of nine out of ten of our girls by proper care and training. Physical bankruptcy may claim the same proportion if care and training are neglected. 26. "A WOMAN FIVE FEET TALL should measure two feet around the waist and thirty-three inches around the hips. A waist less than this proportion indicates compression either by lacing or tight clothing. Exercise in the open air, take long walks and vigorous exercise, using care not to overdo it. Housework will prove a panacea for many of the ills which flesh is heir to. One hour's exercise at the wash-tub is of far more value, from a physical standpoint, than hours at the piano. Boating is most excellent exercise and within the reach of many. Care in dressing is also important, and, fortunately, fashion is coming to the rescue here. It is essential that no garments be suspended from the waist. Let the shoulders bear the weight of all the clothing, so that the organs of the body may be left free and unimpeded. 27. "SLEEP SHOULD BE HAD regularly and abundantly. Avoid late hours, undue excitement, evil associations; partake of plain, nutritious food, and health will be your reward. There is one way of destroying health, which, fortunately, is not as common among girls as boys, and which must be mentioned ere this chapter closes. Self-abuse is practised among growing girls to such an extent as to arouse serious alarm. Many a girl has been led to handle and play with her sexual organs through the advice of some girl who has obtained temporary pleasure in that way; or, perchance, chafing has been followed by rubbing until the organs have become congested with blood, and in this accidental manner the girl discovered what seems to her a source of pleasure, but which, alas, is a source of misery, and even death. 28. "AS IN THE BOY, SO IN THE GIRL, self-abuse causes an undue amount of blood to flow to those organs, thus depriving other parts of the body of its nourishment, the weakest part first showing the effect of want of sustenance. All that has been said upon this loathsome subject in the preceding chapter for boys might well be repeated here, but space forbids. Read that chapter again, and know that the same signs that betray the boy will make known the girl addicted to the vice. The bloodless lips, the dull, heavy eye surrounded with dark rings, the nerveless hand, the blanched cheek, the short breath, the old, faded look, the weakened memory and silly irritability tell the story all too plainly. The same evil result follows, ending perhaps in death, or worse, in insanity. Aside from the injury the girl does herself by yielding to this habit, there is one other reason which appeals to the conscience, and that is, self-abuse is an offence against moral law it is putting to a vile, selfish use the organs which were given for a high, sacred purpose. 29. "LET THEM ALONE, except to care for them when care is needed, and they may prove the greatest blessing you have ever known. They were given you that you might become a mother, the highest office to which God has ever called one of His creatures. Do not debase yourself and become lower than the beasts of the field. If this habit has fastened itself upon any one of our readers, stop it now. Do not allow yourself to think about it, give up all evil associations, seek pure companions, and go to your mother, older sister, or physician for advice. 30. "AND YOU, MOTHER, knowing the danger that besets your daughters at this critical period, are you justified in keeping silent? Can you be held guiltless if your daughter ruins body and mind because you were too modest to tell her the laws of her being? There is no love that is dearer to your daughter than yours, no advice that is more respected than yours, no one whose warning would be more potent. Fail not in your duty. As motherhood has been your sweetest joy, so help your daughter to make it hers." [Illustration: YOUNG GARFIELD DRIVING TEAM ON THE CANAL.] * * * * * SAVE THE BOYS. PLAIN WORDS TO PARENTS. 1. With a shy look, approaching his mother when she was alone, the boy of fifteen said, "There are some things I want to ask you. I hear the boys speak of them at school, and I don't understand, and a fellow doesn't like to ask any one but his mother." 2. Drawing him down to her, in the darkness that was closing about them, the mother spoke to her son and the son to his mother freely of things which everybody must know sooner or later, and which no boy should learn from "anyone but his mother" or father. 3. If you do not answer such a natural question your boy will turn for answer to others, and learn things, perhaps, which your cheeks may well blush to have him know. 4. Our boys and girls are growing faster than we think. The world moves; we can no longer put off our children with the old nurses' tales; even MacDonald's beautiful statement, "Out of the everywhere into the there", does not satisfy them when they reverse his question and ask, "Where did I come from?" 5. They must be answered. If we put them off, they may be tempted to go elsewhere for information, and hear half-truths, or whole truths so distorted, so mingled with what is low and impure that, struggle against it as they may in later years, their minds will always retain these early impressions. 6. It is not so hard if you begin early. The very flowers are object lessons. The wonderful mystery of life is wrapped in one flower, with its stamens, pistils and ovaries. Every child knows how an egg came in the nest, and takes it as a matter of course; why not go one step farther with them and teach the wonder, the beauty, the holiness that surrounds maternity anywhere? Why, centuries ago the Romans honored, and taught their boys to honor, the women in whose safety was bound up the future of their existence as a nation! Why should we do less? 7. Your sons and mine, your daughters and mine, need to be wisely taught and guarded just along these lines, if your sons and mine, your daughters and mine, are to grow up into a pure, healthy, Christian manhood and womanhood. [Illustration] 8.[_Footnote: This quotation is an appeal to mothers by Mrs. P.B. Saur, M.D._] "How grand is the boy who has kept himself undefiled! His complexion clear, his muscles firm, his movements vigorous, his manner frank, his courage undaunted, his brain active, his will firm, his self-control perfect, his body and mind unfolding day by day. His life should be one song of praise and thanksgiving. If you want your boy to be such a one, train him, my dear woman, _to-day_, and his _to-morrow_ will take care of itself. 9. "Think you that good seed sown will bring forth bitter fruit? A thousand times, No! As we sow, so shall we reap. Train your boys in morality, temperance and virtue. Teach them to embrace good and shun evil. Teach them the true from the false; the light from the dark. Teach them that when they take a thing that is not their own, they commit a sin. Teach them that _sin means disobedience of God's laws of every kind_. 10. "God made every organ of our body with the intention that it should perform a certain work. If we wish to see, we use our eyes; if we want to hear, our ears are called into use. In fact, nature teaches us the proper use of _all our organs_. I say to you, mother, and oh, so earnestly: 'Go teach your boy that which you may never be ashamed to do, about these organs that make him _specially a boy_.' 11. "Teach him they are called _sexual organs_; that they are not impure, but of special importance, and made by God for a definite purpose. Teach him that there are impurities taken from the system in fluid form called urine, and that it passes through the sexual organs, but that nature takes care of that. Teach him that these organs are given as a sacred trust, that in maturer years he may be the means of giving life to those who shall live forever. 12. "Impress upon him that if these organs are abused, or if they are put to any use besides that for which God made them and He did not intend they should be used at all until man is fully grown they will bring disease and ruin upon those who abuse and disobey the laws which God has made to govern them. If he has ever learned to handle his _sexual organs_, or to touch them in any way except to keep them clean, not to do it again. If he does he will not grow up happy, healthy and strong. 13. "Teach him that when he handles or excites the sexual organs all parts of the body suffer, because they are connected by nerves that run throughout the system; this is why it is called 'self-abuse.' The whole body is abused when this part of the body is handled or excited in any manner whatever. Teach them to shun all children who indulge in this loathsome habit, or all children who talk about these things. The sin is terrible, and is, in fact, worse than lying or stealing. For, although these are wicked and will ruin their souls, yet this habit of self-abuse will ruin both soul and body. 14. "If the sexual organs are handled, it brings too much blood to these parts, and this produces a diseased condition; it also causes disease in other organs of the body, because they are left with a less amount of blood than they ought to have. The sexual organs, too, are very closely connected with the spine and the brain by means of the nerves, and if they are handled, or if you keep thinking about them, these nerves get excited and become exhausted, and this makes the back ache, the brain heavy and the whole body weak. 15. "It lays the foundation for consumption, paralysis and heart disease. It weakens the memory, makes a boy careless, negligent and listless. It even makes many lose their minds; others, when grown, commit suicide. How often mothers see their little boys handling themselves, and let it pass, because they think the boy will outgrow the habit, and do not realize the strong hold it has upon them. I say to you who love your boys 'Watch!' 16. "Don't think it does no harm to your boy because he does not suffer now, for the effects of this vice come on so slowly that the victim is often very near death before you realize that he has done himself harm. The boy with no knowledge of the consequences, and with no one to warn him, finds momentary pleasure in its practice, and so contracts a habit which grows upon him, undermining his health, poisoning his mind, arresting his development, and laying the foundation for future misery. 17. "Do not read this book and forget it, for it contains earnest and living truths. Do not let false modesty stand in your way, but from this time on keep this thought in mind 'the saving of your boy.' Follow its teachings and you will bless God as long as you live. Read it to your neighbors, who, like yourself, have growing boys, and urge them for the sake of humanity to heed its advice. 18. "Right here we want to emphasize the importance of _cleanliness_. We verily believe that oftentimes these habits originate in a burning and irritating sensation about the organs, caused by a want of thorough washing. 19. "It is worthy of note that many eminent physicians now advocate the custom of circumcision, claiming that the removal of a little of the foreskin induces cleanliness, thus preventing the irritation and excitement which come from the gathering of the whiteish matter under the foreskin at the beginning of the glands. This irritation being removed, the boy is less apt to tamper with his sexual organs. The argument seems a good one, especially when we call to mind the high physical state of those people who have practiced the custom. 20. "Happy is the mother who can feel she has done her duty, in this direction, while her boy is still a child. For those mothers, though, whose little boys have now grown to boyhood with the evil still upon them, and _you_, through ignorance, permitted it, we would say, 'Begin at once; it is never too late.' If he has not lost all will power, he can be saved. Let him go in confidence to a reputable physician and follow his advice. Simple diet, plentiful exercise in open air and congenial employment will do much. Do not let the mind dwell upon evil thoughts, shun evil companions, avoid vulgar stories, sensational novels, and keep the thoughts pure. 21. "Let him interest himself in social and benevolent affairs, participate in Sunday-school work, farmers' clubs, or any organizations which tend to elevate and inspire noble sentiment. Let us remember that 'a perfect man is the noblest work of God.' God has given us a life which is to last forever, and the little time we spend on earth is as nothing to the ages which we are to spend in the world beyond; so our earthly life is a very important part of our existence, for it is here that the foundation is laid for either happiness or misery in the future. It is here that we decide our destiny, and our efforts to know and obey God's laws in our bodies as well as in our souls will not only bring blessings to us in this life, but never-ending happiness throughout eternity." 22. A QUESTION. How can a father chew and smoke tobacco, drink and swear, use vulgar language, tell obscene stories, and raise a family of pure, clean-minded children? LET THE ECHO ANSWER. [Illustration: "SUFFER LITTLE CHILDREN, AND FORBID THEM NOT, TO COME UNTO ME: FOR OF SUCH IS THE KINGDOM OF HEAVEN-"--_MATT. 19:14_] * * * * * THE INHUMANITIES OF PARENTS. 1. Not long ago a Presbyterian minister in Western New York whipped his three-year-old boy to death for refusing to say his prayers. The little fingers were broken; the tender flesh was bruised and actually mangled; strong men wept when they looked on the lifeless body. Think of a strong man from one hundred and fifty to two hundred pounds in weight, pouncing upon a little child, like a Tiger upon a Lamb, and with his strong arm inflicting physical blows on the delicate tissues of a child's body. See its frail and trembling flesh quiver and its tender nervous organization shaking with terror and fear. 2. How often is this the case in the punishment of children all over this broad land! Death is not often the immediate consequence of this brutality as in the above stated case, but the punishment is often as unjust, and the physical constitution of children is often ruined and the mind by fright seriously injured. 3. Everyone knows the sudden sense of pain, and sometimes dizziness and nausea follow, as the results of an accidental hitting of the ankle, knee or elbow against a hard substance, and involuntary tears are brought to the eyes; but what is such a pain as this compared with the pains of a dozen or more quick blows on the body of a little helpless child from the strong arm of a parent in a passion? Add to this overwhelming terror of fright, the strangulating effects of sighing and shrieking, and you have a complete picture of child-torture. 4. Who has not often seen a child receive, within an hour or two of the first whipping, a second one, for some small ebullition of nervous irritability, which was simply inevitable from its spent and worn condition? 5. Would not all mankind cry out at the inhumanity of one who, as things are to-day, should propose the substitution of pricking or cutting or burning for whipping? It would, however, be easy to show that small jabs or pricks or cuts are more human than the blows many children receive. Why may not lying be as legitimately cured by blisters made with hot coals as by black and blue spots made with a ruler or whip? The principle is the same; and if the principle is right, why not multiply methods? 6. How many loving mothers will, without any thought of cruelty, inflict half a dozen quick blows on the little hand of her child and when she could no more take a pin and make the same number of thrusts into the tender flesh, than she could bind the baby on a rack. Yet the pin-thrust would hurt far less, and would probably make a deeper impression on the child's mind. [Illustration] 7. We do not intend to be understood that a child must have everything that it desires and every whim and wish to receive special recognition by the parents. Children can soon be made to understand the necessity of obedience, and punishment can easily be brought about by teaching them self-denial. Deny them the use of a certain plaything, deny them the privilege of visiting certain of their little friends, deny them the privilege of the table, etc., and these self-denials can be applied according to the age and condition of the child, with firmness and without any yielding. Children will soon learn obedience if they see the parents are sincere. Lessons of home government can be learned by the children at home as well as they can learn lessons at school. 8. The trouble is, many parents need more government, more training and more discipline than the little ones under their control. 9. Scores of times during the day a child is told in a short, authoritative way to do or not to do certain little things, which we ask at the hands of elder persons as favors. When we speak to an elder person, we say, would you be so kind as to close the door, when the same person making the request of a child will say, _"Shut the door."_ _"Bring me the chair."_ _"Stop that noise."_ _"Sit down there."_ Whereas, if the same kindness was used towards the child it would soon learn to imitate the example. 10. On the other hand, let a child ask for anything without saying "please," receive anything without saying "thank you," it suffers a rebuke and a look of scorn at once. Often a child insists on having a book, chair or apple to the inconveniencing of an elder, and what an outcry is raised: "Such rudeness;" "Such an ill-mannered child;" "His parents must have neglected him strangely." Not at all: The parents may have been steadily telling him a great many times every day not to do these precise things which you dislike. But they themselves have been all the time doing those very things before him, and there is no proverb that strikes a truer balance between two things than the old one which weighs example over against precept. 11. It is a bad policy to be rude to children. A child will win and be won, and in a long run the chances are that the child will have better manners than its parents. Give them a good example and take pains in teaching them lessons of obedience and propriety, and there will be little difficulty in raising a family of beautiful and well-behaved children. 12. Never correct a child in the presence of others; it is a rudeness to the child that will soon destroy its self-respect. It is the way criminals are made and should always and everywhere be condemned. 13. But there are no words to say what we are or what we deserve if we do this to the little children whom we have dared for our own pleasure to bring into the perils of this life, and whose whole future may be blighted by the mistakes of our careless hands. There are thousands of young men and women to-day groaning under the penalties and burdens of life, who owe their misfortunes, their shipwreck and ruin to the ignorance or indifference of parents. 14. Parents of course love their children, but with that love there is a responsibility that cannot be shirked. The government and training of children is a study that demands a parent's time and attention often much more than the claims of business. 15. Parents, study the problems that come up every day in your home. Remember, your future happiness, and the future welfare of your children, depend upon it. 16. CRIMINALS AND HEREDITY. Wm. M.F. Round was for many years in charge of the House of Refuge on Randall's Island, New York, and his opportunities for observation in the work among criminals surely make him a competent judge, and he says in his letter to the New York Observer: "Among this large number of young offenders I can state with entire confidence that not one per cent. were children born of criminal parents; and with equal confidence I am able to say that the common cause of their delinquency was found in bad parental training, in bad companionship, and in lack of wholesome restraint from evil associations and influences. It was this knowledge that led to the establishing of the House of Refuge nearly three-quarters of a century ago." 17. BAD TRAINING. Thus it is seen from one of the best authorities in the United States that criminals are made either by the indifference or the neglect of parents, or both, or by too much training without proper judgment and knowledge. Give your children a good example, and never tell a child to do something and then become indifferent as to whether they do it or not. A child should never be told twice to do the same thing. Teach the child in childhood obedience and never vary from that rule. Do it kindly but firmly. 18. IF YOUR CHILDREN DO NOT OBEY OR RESPECT YOU in their childhood and youth, how can you expect to govern them when older and shape their character for future usefulness and good citizenship? 19. THE FUNDAMENTAL RULE. Never tell a child twice to do the same thing. Command the respect of your children, and there will be no question as to obedience. * * * * * CHASTITY AND PURITY OF CHARACTER. [Illustration] 1. CHASTITY is the purest and brightest jewel in human character. Dr. Pierce in his widely known _Medical Adviser_ says: For the full and perfect development of mankind, both mental and physical, chastity is necessary. The health demands abstinence from unlawful intercourse. Therefore children should be instructed to avoid all impure works of fiction, which tend to inflame the mind and excite the passions. Only in total abstinence from illicit pleasures is there safety, morals, and health, while integrity, peace and happiness are the conscious rewards of virtue. Impurity travels downward with intemperance, obscenity and corrupting diseases, to degradation and death. A dissolute, licentious, free-and-easy life is filled with the dregs of human suffering, iniquity and despair. The penalties which follow a violation of the law of chastity are found to be severe and swiftly retributive. 2. THE UNION of the sexes in holy Matrimony is a law of nature, finding sanction in both morals and legislation. Even some of the lower animals unite in this union for life and instinctively observe the law of conjugal fidelity with a consistency which might put to blush other animals more highly endowed. It seems important to discuss this subject and understand our social evils, as well as the intense passional desires of the sexes, which must be controlled, or they lead to ruin. 3. SEXUAL PROPENSITIES are possessed by all, and these must be held in abeyance, until they are needed for legitimate purposes. Hence parents ought to understand the value to their children of mental and physical labor, to elevate and strengthen the intellectual and moral faculties, to develop the muscular system and direct the energies of the blood into healthful channels. Vigorous employment of mind and body engrosses the vital energies and diverts them from undue excitement of the sexual desires. _Give your young people plenty of outdoor amusement; less of dancing and more of croquet and lawn tennis. Stimulate the methods of pure thoughts in innocent amusement, and your sons and daughters will mature to manhood and womanhood pure and chaste in character._ 4. IGNORANCE DOES NOT MEAN INNOCENCE.--It is a current idea, especially among our good common people, that the child should be kept in ignorance regarding the mystery of his own body and how he was created or came into the world. This is a great mistake. Parents must know that the sources of social impurity are great, and the child is a hundred times more liable to have his young mind poisoned if entirely ignorant of the functions of his nature than if judiciously enlightened on these important truths by the parent. The parent must give him weapons of defense against the putrid corruption he is sure to meet outside the parental roof. The child cannot get through the A, B, C period of school without it. 5. CONFLICTING VIEWS.--There is a great difference of opinion regarding the age at which the child should be taught the mysteries of nature: some maintain that he cannot comprehend the subject before the age of puberty; others say "they will find it out soon enough, it is not best to have them over-wise while they are so young. Wait a while." That is just the point (_they will find it out_), and we ask in all candor, is it not better that they learn it from the pure loving mother, untarnished from any insinuating remark, than that they should learn it from some foul-mouthed libertine on the street, or some giddy girl at school? Mothers! fathers! which think you is the most sensible and fraught with the least danger to your darling boy or girl? 6. DELAY IS FRAUGHT WITH DANGER.--Knowledge on a subject so vitally connected with moral health must not be deferred. It is safe to say that no child, no boy at least in these days of excitement and unrest, reaches the age of ten years without getting some idea of nature's laws regarding parenthood. And ninety-nine chances to one, those ideas will be vile and pernicious unless they come from a wise, loving and pure parent. Now, we entreat you, parents, mothers! do not wait; begin before a false notion has had chance to find lodgment in the childish mind. But remember this is a lesson of life, it cannot be told in one chapter, it is as important as the lessons of love and duty. 7. THE FIRST LESSONS.--Should you be asked by your four or five-year old, "Mamma, where did you get me?" Instead of saying, "The doctor brought you," or "God made you and a stork brought you from Babyland on his back," tell him the truth as you would about any ordinary question. One mother's explanation was something like this: "My dear, you were not made any more than apples are made, or the little chickens are made. Your dolly was made, but it has no life like you have. God has provided that all living things such as plants, trees, little chickens, little kittens, little babies, etc., should grow from seeds or little tiny eggs. Apples grow, little chickens grow, little babies grow. Apple and peach trees grow from seeds that are planted in the ground, and the apples and peaches grow on the trees. Baby chickens grow inside the eggs that are kept warm by the mother hen for a certain time. Baby boys and girls do not grow inside an egg, but they start to grow inside of a snug warm nest, from an egg that is so small you cannot see it with just your eye." This was not given at once, but from time to time as the child asked questions and in the simplest language, with many illustrations from plant and animal life. It may have occupied months, but in time the lesson was fully understood. 8. THE SECOND LESSON.--The second lesson came with the question, "But _where_ is the nest?" The ice is now broken, as it were; it was an easy matter for the mother to say, "The nest in which you grew, dear, was close to your mother's heart inside her body. All things that do not grow inside the egg itself, and which are kept warm by the mother's body, begin to grow from the egg in a nest inside the mother's body." It may be that this mother had access to illustrations of the babe in the womb which were shown and explained to the child, a boy. He was pleased and satisfied with the explanations. It meant nothing out of the ordinary any more than a primary lesson on the circulatory system did, it was knowledge on nature in its purity and simplicity taught by mother, and hence caused no surprise. The subject of the male and female generative organs came later; the greatest pains and care was taken to make it clear, the little boy was taught that the _sexual organs_ were made for a high and holy purpose, that their office at present is only to carry off impurities from the system in the fluid form called urine, and that he must never handle his _sexual organs_ nor touch them in any way except to keep them clean, and if he does this, he will grow up a bright, happy and healthy boy. But if he excites or _abuses_ them, he will become puny, sickly and unhappy. All this was explained in language pure and simple. There is now in the boy a sturdy base of character building along the line of virtue and purity through knowledge. 9. SILLY DIRTY TRASH.--But I hear some mother say "Such silly dirty trash to tell a child!" It is not dirty nor silly; it is nature's untarnished truth. God has ordained that children should thus be brought into the world, do you call the works of God silly? Remember, kind mother, and don't forget it, if you fail to teach your children, boys or girls, these important lessons early in life, they will learn them from other sources, perhaps long ere you dream of it, and ninety-nine times out of one hundred they will get improper, perverted, impure and vile ideas of these important truths; besides you nave lost their confidence and you will never regain it in these matters. They will never come to mamma for information on these subjects. And, think you, that your son and daughter, later in life will make you their confidant as they ought? Will your beautiful daughter hand the first letters she receives from her lover to mamma to read, and seek her counsel and advice when she replies to them? Will she ask mamma whether it is ever proper to sit in her lover's lap? I think not; you have blighted her confidence and alienated her affections. You have kept knowledge from her that she had a right to know; you even failed to teach her the important truths of menstruation. Troubled and excited at the first menstrual flow, she dashed her feet in cold water hoping to stop the flow. You know the results she is now twenty-five but is suffering from it to this day. You, her mother, over fastidious, _so very nice_ you would never mention "_such silly trash_" but by your consummate foolishness and mock modesty you have ruined your daughter's health, and though in later years she may forgive you, yet she can never love and respect you as she ought. 10. "KNOWLEDGE THE PRESERVER OF PURITY."--Laura E. Scammon, writing on this subject, in the Arena of November, 1893, says: "When questions arise that can not be answered by observation, reply to each as simply and directly as you answer questions upon other subjects, giving scientific names and facts, and such explanations as are suited to the comprehension of the child. Treat nature and her laws always with serious, respectful attention. Treat the holy mysteries of parenthood reverently, never losing sight of the great law upon which are founded all others the law of love. Say it and sing it, play it and pray it into the soul of your child, that _love is lord of all_." 11. CONCLUSION OF THE WHOLE MATTER.--Observation and common sense should teach every parent that lack of knowledge on these subjects and proper counsel and advice in later years is the main cause of so many charming girls being seduced and led astray, and so many bright promising boys wrecked by _self-abuse or social impurity_. Make your children your confidants early in life, especially in these things, have frequent talks with them on nature, and you will never, other things being equal, mourn over a ruined daughter or a wreckless, debased son. * * * * * EXCITING THE PASSIONS IN CHILDREN. 1. CONVERSATION BEFORE CHILDREN.--The conduct and conversation of adults before children and youth, how often have I blushed with shame, and kindled with indignation at the conversation of parents, and especially of mothers, to their children: "John, go and kiss Harriet, for she is your sweet-heart." Well may shame make him hesitate and hang his head. "Why, John, I did not think you so great a coward. Afraid of the girls, are you? That will never do. Come, go along, and hug and kiss her. There, that's a man. I guess you will love the girls yet." Continually is he teased about the girls and being in love, till he really selects a sweet-heart. 2. THE LOSS OF MAIDEN PURITY AND NATURAL DELICACY.--I will not lift the veil, nor expose the conduct of children among themselves. And all this because adults have filled their heads with those impurities which surfeit their own. What could more effectually wear off that natural delicacy, that maiden purity and bashfulness, which form the main barriers against the influx of vitiated Amativeness? How often do those whose modesty has been worn smooth, even take pleasure in thus saying and doing things to raise the blush on the cheek of youth and innocence, merely to witness the effect of this improper illusion upon them; little realizing that they are thereby breaking down the barriers of their virtue, and prematurely kindling the fires of animal passion! 3. BALLS. PARTIES AND AMUSEMENTS.--The entire machinery of balls and parties, of dances and other amusements of young people, tend to excite and inflame this passion. Thinking it a fine thing to get in love, they court and form attachments long before either their mental or physical powers are matured. Of course, these young loves, these green-house exotics, must be broken off, and their miserable subjects left burning up with the fierce fires of a flaming passion, which, if left alone, would have slumbered on for years, till they were prepared for its proper management and exercise. 4. SOWING THE SEEDS FOR FUTURE RUIN.--Nor is it merely the conversation of adults that does all this mischief; their manners also increase it. Young men take the hands of girls from six to thirteen years old, kiss them, press them, and play with them so as, in a great variety of ways, to excite their innocent passions, combined, I grant, with friendship and refinement--for all this is genteely done. They intend no harm, and parents dream of none: and yet their embryo love is awakened, to be again still more easily excited. Maiden ladies, and even married women, often express similar feelings towards lads, not perhaps positively improper in themselves, yet injurious in their ultimate effects. 5. READING NOVELS.--How often have I seen girls not twelve years old, as hungry for a story or novel as they should be for their dinners! A sickly sentimentalism is thus formed, and their minds are sullied with impure desires. Every fashionable young lady must of course read every new novel, though nearly all of them contain exceptionable allusions, perhaps delicately covered over with a thin gauze of fashionable refinement; yet, on that very account, the more objectionable. If this work contained one improper allusion to their ten, many of those fastidious ladies who now eagerly devour the vulgarities of Dumas, and the double-entendres of Bulwer, and even converse with gentlemen about their contents, would discountenance or condemn it as improper. _Shame on novel-reading women_; for they cannot have pure minds or unsullied feelings, but Cupid and the beaux, and waking of dreams of love, are fast consuming their health and virtue. 6. THEATER-GOING.--Theaters and theatrical dancing, also inflame the passions, and are "the wide gate" of "the broad road" of moral impurity. Fashionable music is another, especially the verses set to it, being mostly love-sick ditties, or sentimental odes, breathing this tender passion in its most melting and bewitching strains. Improper prints often do immense injury in this respect, as do also balls, parties, annuals, newspaper articles, exceptional works, etc. 7. THE CONCLUSION OF THE WHOLE MATTER.--Stop for one moment and think for yourself and you will be convinced that the sentiment herein announced is for your good and the benefit of all mankind. [Illustration] [Illustration] * * * * * PUBERTY, VIRILITY AND HYGIENIC LAWS. 1. WHAT IS PUBERTY?--The definition is explained in another portion of this book, but it should be understood that it is not a prompt or immediate change; it is a slow extending growth and may extend for many years. The ripening of physical powers do not take place when the first signs of puberty appear. 2. PROPER AGE.--The proper age for puberty should vary from twelve to eighteen years. As a general rule, in the more vigorous and the more addicted to athletic exercise or out-door life, this change is slower in making its approach. 3. HYGIENIC ATTENTION.--Youths at this period should receive special private attention. They should be taught the purpose of the sexual organs and the proper hygienic laws that govern them, and they should also be taught to rise in the morning and not to lie in bed after waking up, because it is largely owing to this habit that the secret vice is contracted. One of the common causes of premature excitement in many boys is a tight foreskin. It may cause much evil and ought always to be remedied. Ill-fitting garments often cause much irritation in children and produce unnatural passions. It is best to have boys sleep in separate beds and not have them sleep together if it can be avoided. 4. PROPER INFLUENCE.--Every boy and girl should be carefully trained to look with disgust on everything that is indecent in word or action. Let them be taught a sense of shame in doing shameful things, and teach them that modesty is honorable, and that immodesty is indecent and dishonorable. Careful training at the proper age may save many a boy or girl from ruin. 5. SEXUAL PASSIONS.--The sexual passions may be a fire from heaven, or a subtle flame from hell. It depends upon the government and proper control. The noblest and most unselfish emotions take their arise in the passion of sex. Its sweet influence, its elevating ties, its vibrations and harmony, all combine to make up the noble and courageous traits of man. 6. WHEN PASSIONS BEGIN.--It is thought by some that passions begin at the age of puberty, but the passions may be produced as early as five or ten years. All depends upon the training or the want of it. Self-abuse is not an uncommon evil at the age of eight or ten. A company of bad boys often teach an innocent child that which will develop his ruin. A boy may feel a sense of pleasure at eight and produce a slight discharge, but not of semen. Thus it is seen that parents may by neglect do their child the greatest injury. 7. FALSE MODESTY.--Let there be no false modesty on part of the parents. Give the child the necessary advice and instructions as soon as necessary. 8. THE MAN UNSEXED, by Mutilation or Masturbation. Eunuchs are proverbial for tenor cruelty and crafty and unsympathizing dispositions. Their mental powers are feeble and their physical strength is inferior. They lack courage and physical endurance. When a child is operated upon before the age of puberty, the voice retains its childish treble, the limbs their soft and rounded outlines, and the neck acquires a feminine fulness; no beard makes its appearance. In ancient times and up to this time in Oriental nations eunuchs are found. They are generally slaves who have suffered mutilation at a tender age. It is a scientific fact that where boys have been taught the practice of masturbation in their early years, say from eight to fourteen years of age, if they survive at all they often have their powers reduced to a similar condition of a eunuch. They generally however suffer a greater disadvantage. Their health will be more or less injured. In the eunuch the power of sexual intercourse is not entirely lost, but of course there is sterility, and little if any satisfaction, and the same thing may be true of the victim of self-abuse. 9. SIGNS OF VIRILITY.--As the young man develops in strength and years the sexual appetite will manifest itself. The secretion of the male known as the seed or semen depends for the life-transmitting power upon little minute bodies called spermatozoa. These are very active and numerous in a healthy secretion, being many hundreds in a single drop and a single one of them is capable to bring about conception in a female. Dr. Napheys in his "Transmission of Life," says: "The secreted fluid has been frozen and kept at a temperature of zero for four days, yet when it was thawed these animalcules, as they are supposed to be, were as active as ever. They are not, however, always present, and when present may be of variable activity. In young men, just past puberty, and in aged men, they are often scarce and languid in motion." At the proper age the secretion is supposed to be the most active, generally at the age of twenty-five, and decreases as age increases. 10. HYGIENIC RULE.--The man at mid-life should guard carefully his passions and the husband his virile powers, and as the years progress, steadily wean himself more from his desire, for his passions will become weaker with age and any excitement in middle life may soon debilitate and destroy his virile powers. 11. FOLLIES OF YOUTH.--Dr. Napheys says: "Not many men can fritter away a decade or two of years in dissipation and excess, and ever hope to make up their losses by rigid surveillance in later years." "The sins of youth are expiated in age," is a proverb which daily examples illustrate. In proportion as puberty is precocious, will decadence be premature; the excesses of middle life draw heavily on the fortune of later years. "The mill of the gods grinds slow, but it grinds exceedingly fine," and though nature may be a tardy creditor, she is found at last to be an inexorable one. * * * * * OUR SECRET SINS. 1. PASSIONS.--Every healthful man has sexual desires and he might as well refuse to satisfy his hunger as to deny their existence. The Creator has given us various appetites intended they should be indulged, and has provided the means. 2. REASON.--While it is true that a healthy man has strongly developed sexual passions, yet, God has crowned man with reason, and with a proper exercise of this wonderful faculty of the human mind no lascivious thoughts need to control the passions. A pure heart will develop pure thoughts and bring out a good life. 3. RIOTING IN VISIONS.--Dr. Lewis says: "Rioting in visions of nude women may exhaust one as much as an excess in actual intercourse. There are multitudes who would never spend the night with an abandoned female, but who rarely meet a young girl that their imaginations are not busy with her person. This species of indulgence is well-nigh universal; and it is the source of all other forms the fountain from which the external vices spring, and the nursery of masturbation." 4. COMMITTING ADULTERY IN THE HEART.--A young man who allows his mind to dwell upon the vision of nude women will soon become a victim of ruinous passion, and either fall under the influence of lewd women or resort to self-abuse. The man who has no control over his mind and allows impure thoughts to be associated with the name of every female that may be suggested to his mind, is but committing adultery in his heart, just as guilty at heart as though he had committed the deed. 5. UNCHASTITY.--So far as the record is preserved, unchastity has contributed above all other causes, more to the ruin and exhaustion and demoralization of the race than all other wickedness. And we shall not be likely to vanquish the monster, even in ourselves, unless we make the thoughts our point of attack. So long as they are sensual we are indulging in sexual abuse, and are almost sure, when temptation is presented, to commit the overt acts of sin. If we cannot succeed within, we may pray in vain for help to resist the tempter outwardly. A young man who will indulge in obscene language will be guilty of a worse deed if opportunity is offered. 6. BAD DRESSING.--If women knew how much mischief they do men they would change some of their habits of dress. The dress of their busts, the padding in different parts, are so contrived as to call away attention from the soul and fix it on the bosom and hips. And then, many, even educated women, are careful to avoid serious subjects in our presence one minute before a gentleman enters the room they may be engaged in thoughtful discussion, but the moment he appears their whole style changes; they assume light fascinating ways, laugh sweet little bits of laughs, and turn their heads this way and that, all which forbids serious thinking and gives men over to imagination. 7. THE LUSTFUL EYE.--How many men there are who lecherously stare at every woman in whose presence they happen to be. These monsters stare at women as though they were naked in a cage on exhibition. A man whose whole manner is full of animal passion is not worthy of the respect of refined women. They have no thoughts, no ideas, no sentiments, nothing to interest them but the bodies of women whom they behold. The moral character of young women has no significance or weight in their eyes. This kind of men are a curse to society and a danger to the community. No young lady is safe in their company. 8. REBUKING SENSUALISM.--If the young women would exercise an honorable independence and heap contempt upon the young men that allow their imagination to take such liberties, a different state of things would soon follow. Men of that type of character should have no recognition in the presence of ladies. 9. EARLY MARRIAGES.--There can be no doubt that early marriages are bad for both parties. For children of such a marriage always lack vitality. The ancient Germans did not marry until the twenty-fourth or twenty-fifth year, previous to which they observed the most rigid chastity, and in consequence they acquired a size and strength that excited the astonishment of Europe. The present incomparable vigor of that race, both physically and mentally, is due in a great measure to their long established aversion to marrying young. The results of too early marriages are in brief, stunted growth and impaired strength on the part of the male; delicate if not utterly bad health in the female; the premature old age or death of one or both, and a puny, sickly offspring. 10. SIGNS OF EXCESSES.--Dr. Dio Lewis says: "Some of the most common effects of sexual excess are backache, lassitude, giddiness, dimness of sight, noises in the ears, numbness of the fingers, and paralysis. The drain is universal, but the more sensitive organs and tissues suffer most. So the nervous system gives way and continues the principal sufferer throughout. A large part of the premature loss of sight and hearing, dizziness, numbness and pricking in the hands and feet, and other kindred developments, are justly chargeable to unbridled venery. Not unfrequently you see men whose head or back or nerve testifies of such reckless expenditure." 11. NON-COMPLETED INTERCOURSE.--Withdrawal before the emission occurs is injurious to both parties. The soiling of the conjugal bed by the shameful manoeuvres is to be deplored. 12. THE EXTENT OF THE PRACTICE.--One cannot tell to what extent this vice is practiced, except by observing its consequences, even among people who fear to commit the slightest sin, to such a degree is the public conscience perverted upon this point. Still, many husbands know that nature often renders nugatory the most subtle calculations, and reconquers the rights which they have striven to frustrate. No matter; they persevere none the less, and by the force of habit they poison the most blissful moments of life, with no surety of averting the result that they fear. So who knows if the too often feeble and weakened infants are not the fruit of these in themselves incomplete procreations, and disturbed by preoccupations foreign to the natural act. 13. HEALTH OF WOMEN.--Furthermore, the moral relations existing between the married couple undergo unfortunate changes; this affection, founded upon reciprocal esteem, is little by little effaced by the repetition of an act which pollutes the marriage bed. If the good harmony of families and the reciprocal relations are seriously menaced by the invasion of these detestable practices, the health of women, as we have already intimated, is fearfully injured. 14. CROWNING SIN OF THE AGE.--Then there is the crime of abortion which is so prevalent in these days. It is the crowning sin of the age, though in a broader sense it includes all those sins that are committed to limit the size of the family. "It lies at the root of our spiritual life," says Rev. B.D. Sinclair, "and though secret in its nature, paralyzes Christian life and neutralizes every effort for righteousness which the church puts forth." 15. SEXUAL EXHAUSTION.--Every sexual excitement is exhaustive in proportion to its intensity and continuance. If a man sits by the side of a woman, fondles and kisses her three or four hours, and allows his imagination to run riot with sexual visions, he will be five times as much exhausted as he would by the act culminating in emission. It is the sexual excitement more than the emission which exhausts. As shown in another part of this work, thoughts of sexual intimacies, long continued, lead to the worst effects. To a man, whose imagination is filled with erotic fancies the emission comes as a merciful interruption to the burning, harassing and wearing excitement which so constantly goads him. 16. THE DESIRE OF GOOD.--The desire of good for its own sake--this is Love. The desire of good for bodily pleasure--this is Lust. Man is a moral being, and as such should always act in the animal sphere according to the spiritual law. Hence, to break the law of the highest creative action for the mere gratification of animal instinct is to perform the act of sin and to produce the corruption of nature. 17. CAUSE OF PROSTITUTION.--Dr. Dio Lewis says: "Occasionally we meet a diseased female with excessive animal passion, but such a case is very rare. The average woman has so little sexual desire that if licentiousness depended upon her, uninfluenced by her desire to please man or secure his support, there would be very little sexual excess. Man is strong he has all the money and all the facilities for business and pleasure; and woman is not long in learning the road to his favor. Many prostitutes who take no pleasure in their unclean intimacies not only endure a disgusting life for the favor and means thus gained, but affect intense passion in their sexual contacts because they have learned that such exhibitions gratify men." 18. HUSBAND'S BRUTALITY.--Husbands! It is your licentiousness that drives your wives to a deed so abhorrent to their every wifely, womanly and maternal instinct a deed which ruins the health of their bodies, prostitutes their souls, and makes marriage, maternity and womanhood itself degrading and loathsome. No terms can sufficiently characterize the cruelty, meanness and disgusting selfishness of your conduct when you impose on them a maternity so detested as to drive them to the desperation of killing their unborn children and often themselves. 19. WHAT DRUNKARDS BEQUEATH TO THEIR OFFSPRING.--Organic imperfections unfit the brain for sane action, and habit confirms the insane condition; the man's brain has become unsound. Then comes in the law of hereditary descent, by which the brain of a man's children is fashioned after his own not as it was originally, but as it has become, in consequence of frequent functional disturbance. Hence, of all appetites, the inherited appetite for drunkenness is the most direful. Natural laws contemplate no exceptions, and sins against them are never pardoned. 20. THE REPORTS OF HOSPITALS.--The reports of hospitals for lunatics almost universally assign intemperance as one of the causes which predispose a man's offspring to insanity. This is even more strikingly manifested in the case of congenital idiocy. They come generally from a class of families which seem to have degenerated physically to a low degree. They are puny and sickly. 21. SECRET DISEASES.--See the weakly, sickly and diseased children who are born only to suffer and die, all because of the private disease of the father before his marriage. Oh, let the truth be told that the young men of our land may learn the lessons of purity of life. Let them learn that in morality there is perfect protection and happiness. [Illustration: GETTING A DIVORCE.] [Illustration: THE DEGENERATE TURK.] * * * * * PHYSICAL AND MORAL DEGENERACY. 1. MORAL PRINCIPLE.--"Edgar Allen Poe, Lord Byron, and Robert Burns," says Dr. Geo. F. Hall, "were men of marvelous strength intellectually. But measured by the true rule of high moral principle, they were very weak. Superior endowment in a single direction--physical, mental, or spiritual--is not of itself sufficient to make one strong in all that that heroic word means. 2. INSANE ASYLUM.--many a good man spiritually has gone to an untimely grave because of impaired physical powers. Many a good man spiritually has gone to the insane asylum because of bodily and mental weaknesses. Many a good man spiritually has fallen from virtue in an evil moment because of a weakened will, or a too demanding fleshly passion, or, worse than either, too lax views on the subject of personal chastity." 3. BOYS LEARNING VICES.--some ignorant and timid people argue that boys and young men in reading a work of this character will learn vices concerning which they had never so much as dreamed of before. This is, however, certain, that vices cannot be condemned unless they are mentioned; and if the condemnation is strong enough it surely will be a source of strength and of security. If light and education, on these important subjects, does injury, then all knowledge likewise must do more wrong than good. Knowledge is power, and the only hope of the race is enlightenment on all subjects pertaining to their being. 4. MORAL MANHOOD.--it is clearly visible that the American manhood is rotting down--decaying at the center. The present generation shows many men of a small body and weak principles, and men and women of this kind are becoming more and more prevalent. Dissipation and indiscretions of all kind are working ruin. Purity of life and temperate habits are being too generally disregarded. 5. YOUNG WOMEN.--the vast majority of graduates from the schools and colleges of our land to-day, and two-thirds of the membership of our churches, and three-fourths of the charitable workers, are females. Everywhere girls are carrying off most of the prizes in competitive examinations, because women, as a sex, naturally maintain a better character, take better care of their bodies, and are less addicted to bad and injurious habits. While all this is true in reference to females, you will find that the male sex furnishes almost the entire number of criminals. The saloons, gambling dens, the brothels, and bad literature are drawing down all that the public schools can build up. Seventy per cent. Of the young men of this land do not darken the church door. They are not interested in moral improvement or moral education. Eighty-five per cent. Leave school under 15 years of age; prefer the loafer's honors to the benefit of school. 6. PROMOTION.--the world is full of good places for good young men, and all the positions of trust now occupied by the present generation will soon be filled by the competent young men of the coming generation; and he that keeps his record clean, lives a pure life, and avoids excesses or dissipations of all kinds, and fortifies his life with good habits, is the young man who will be heard from, and a thousand places will be open for his services. 7. PERSONAL PURITY.--Dr. George F. Hall says: "why not pay careful attention to man in all his elements of strength, physical, mental, and moral? Why not make personal purity a fixed principle in the manhood of the present and coming generation, and thus insure the best men the world has ever seen? It can be done. Let every reader of these lines resolve that he will be one to help do it." [Illustration: Charles Dickens' chair and desk.] * * * * * IMMORALITY, DISEASE AND DEATH. 1. THE POLICY OF SILENCE.--there is no greater delusion than to suppose that vast number of boys know nothing about practices of sin. Some parents are afraid that unclean thoughts may be suggested by these very defences. The danger is slight. Such cases are barely possible, but when the untold thousands are thought of on the other side, who have been demoralized from childhood through ignorance, and who are to-day suffering the result of these vicious practices, the policy of silence stands condemned, and intelligent knowledge abundantly justified. The emphatic words of scripture are true in this respect also, "the people are destroyed for lack of knowledge." 2. LIVING ILLUSTRATION.--without fear of truthful contradiction, we affirm that the homes, public assemblies, and streets of all our large cities abound to-day with living illustrations and proofs of the widespread existence of this physical and moral scourge. An enervated and stunted manhood, a badly developed physique, a marked absence of manly and womanly strength and beauty, are painfully common everywhere. Boys and girls, young men and women, exist by thousands, of whom it may be said, they were badly born and ill-developed. Many of them are, to some extent, bearing the penalty of the [transcriber's note: the text appears to read "sins" but it is unclear] and excesses of their parents, especially their fathers, whilst the great majority are reaping the fruits of their own immorality in a dwarfed and ill-formed body, and effeminate appearance, weak and enervated mind. 3. EFFEMINATE AND SICKLY YOUNG MEN.--the purposeless and aimless life of any number of effeminate and sickly young men, is to be distinctly attributed to these sins. The large class of mentally impotent "ne'er-do-wells" are being constantly recruited and added to by those who practice what the celebrated Erichson calls "that hideous sin engendered by vice, and practiced in solitude"--the sin, be it observed, which is the common cause of physical and mental weakness, and of the fearfully impoverishing night-emissions, or as they are commonly called, "wet-dreams." 4. WEAKNESS, DISEASE, DEFORMITY, AND DEATH.--Through self-pollution and fornication the land is being corrupted with weakness, disease, deformity, and death. We regret to say that we cannot speak with confidence concerning the moral character of the Jew; but we have people amongst us who have deservedly a high character for the tone of their moral life--we refer to the members of the Society of Friends. The average of life amongst these reaches no less than fifty-six years; and, whilst some allowance must be made for the fact that amongst the Friends the poor have not a large representation, these figures show conclusively the soundness of this position. 5. SOWING THEIR WILD OATS.--It is monstrous to suppose that healthy children should die just as they are coming to manhood. The fact that thousands of young people do reach the age of sixteen or eighteen, and then decline and die, should arouse parents to ask the question: Why? Certainly it would not be difficult to tell the reason in thousands of instances, and yet the habit and practice of the deadly sin of self-pollution is actually ignored; it is even spoken of as a boyish folly not to be mentioned, and young men literally burning up with lust are mildly spoken of as "sowing their wild oats." Thus the cemetery is being filled with masses of the youth of America who, as in Egypt of old, fill up the graves of uncleanness and lust. Some time since a prominent Christian man was taking exception to my addressing men on this subject; observe this! one of his own sons was at that very time near the lunatic asylum through these disgusting sins. What folly and madness this is! 6. DEATH TO TRUE MANHOOD.--The question for each one is, "In what way are you going to divert the courses of the streams of energy which pertain to youthful vigor and manhood?" To be destitute of that which may be described as raw material in the human frame, means that no really vigorous manhood can have place; to burn up the juices of the system in the fires of lust is madness and wanton folly, but it can be done. To divert the currents of life and energy from blood and brain, from memory and muscle, in order to secrete it for the shambles of prostitution, is death to true manhood; but remember, it can be done! The generous liquid life may inspire the brain and blood with noble impulse and vital force, or it may be sinned away and drained out of the system until the jaded brain, the faded cheek, the enervated young manhood, the gray hair, narrow chest, weak voice, and the enfeebled mind show another victim in the long catalogue of the degraded through lust. 7. THE SISTERHOOD OF SHAME AND DEATH.--Whenever we pass the sisterhood of death, and hear the undertone of song, which is one of the harlot's methods of advertising, let us recall the words, that these represent the "pestilence which walketh in darkness, the destruction that wasteth at noonday." The allusion, of course, is to the fact that the great majority of these harlots are full of loathsome physical and moral disease; with the face and form of an angel, these women "bite like a serpent and sting like an adder;" their traffic is not for life, but inevitably for shame, disease, and death. Betrayed and seduced themselves, they in their turn betray and curse others. 8. WARNING OTHERS.--Have you never been struck with the argument of the Apostle, who, warning others from the corrupt example of the fleshy Esau, said, "Lest there be any fornicator or profane person as Esau, who for one mess of meat sold his own birthright. For ye know that even afterward, when he desired to inherit the blessing, he was rejected, he found no place for repentance, though he sought it diligently with tears." Terrible and striking words are these. His birthright sold for a mess of meat. The fearful costs of sin--yes, that is the thought, particularly the sin of fornication! Engrave that word upon your memories and hearts--"One mess of meat." 9. THE HARLOT'S MESS OF MEAT.--Remember it, young men, when you are tempted to this sin. For a few minutes' sensual pleasure, for a mess of harlot's meat, young men are paying out the love of the son and brother; they are deceiving, lying, and cheating for a mess of meat; for a mess, not seldom of putrid flesh, men have paid down purity and prayer, manliness and godliness; for a mess of meat some perhaps have donned their best attire, and assumed the manners of the gentleman, and then, like an infernal hypocrite flogged the steps of maiden or harlot to satisfy their degrading lust; for a mess of meat young men have deceived father and mother, and shrunk from the embrace of love of the pure-minded sister. For the harlot's mess of meat some listening to me have spent scores of hours of invaluable time. They have wearied the body, diseased and demoralized the mind. The pocket has been emptied, theft committed, lies unnumbered told, to play the part of the harlot's mate--perchance a six-foot fool, dragged into the filth and mire of the harlot's house. You called her your friend, when, but for her mess of meat, you would have passed her like dirt in the street. 10. SEEING LIFE.--You consorted with her for your mutual shame and death, and then called it "seeing life." Had your mother met you, you would have shrunk away like a craven cur. Had your sister interviewed you, she had blushed to bear your name; or had she been seen by you in company with some other whoremaster, for similar commerce, you would have wished that she had been dead. Now what think you of this "seeing life?" And it is for this that tens of thousands of strong men in our large cities are selling their birthright. 11. THE DEVIL'S DECOYS.--Some may be ready to affirm that physical and moral penalties do not appear to overtake all men; that many men known to be given to intemperance and sensuality are strong, well, and live to a good age. Let us not make any mistake concerning these; they are exceptions to the rule; the appearance of health in them is but the grossness of sensuality. You have only carefully to look into the faces of these men to see that their countenances, eyes, and speech betray them. They are simply the devil's decoys. 12. GROSSNESS OF SENSUALITY.--The poor degraded harlot draws in the victims like a heavily charged lodestone; these men are found in large numbers throughout the entire community; they would make fine men were they not weighted with the grossness of sensuality; as it is, they frequent the race-course, the card-table, the drinking-saloon, the music-hall, and the low theaters, which abound in our cities and towns; the great majority of these are men of means and leisure. Idleness is their curse, their opportunity for sin; you may know them as the loungers over refreshment-bars, as the retailers of the latest filthy joke, or as the vendors of some disgusting scandal; indeed, it is appalling the number of these lepers found both in our business and social circles. [Illustration: PALESTINE WATER CARRIERS.] * * * * * POISONOUS LITERATURE AND BAD PICTURES. 1. OBSCENE LITERATURE.--No other source contributes so much to sexual immorality as obscene literature. The mass of stories published in the great weeklies and the cheap novels are mischievous. When the devil determines to take charge of a young soul, be often employs a very ingenious method. He slyly hands a little novel filled with "voluptuous forms," "reclining on bosoms," "languishing eyes," etc. 2. MORAL FORCES.--The world is full of such literature. It is easily accessible, for it is cheap, and the young will procure it, and therefore become easy prey to its baneful influence and effects. It weakens the moral forces of the young, and they thereby fall an easy prey before the subtle schemes of the libertine. 3. BAD BOOKS.--Bad books play not a small part in the corruption of the youth. A bad book is as bad as an evil companion. In some respects it is even worse than a living teacher of vice, since it may cling to an individual at all times. It will follow him and poison his mind with the venom of evil. The influence of bad books in making bad boys and men is little appreciated. Few are aware how much evil seed is being sown among the young everywhere through the medium of vile books. 4. SENSATIONAL STORY BOOKS.--Much of the evil literature which is sold in nickel and dime novels, and which constitutes the principal part of the contents of such papers as the "Police Gazette," the "Police News," and a large proportion of the sensational story books which flood the land. You might better place a coal of fire or a live viper in your bosom, than allow yourself to read such a book. The thoughts that are implanted in the mind in youth will often stick there through life, in spite of all efforts to dislodge them. 5. PAPERS AND MAGAZINES.--Many of the papers and magazines sold at our news stands, and eagerly sought after by young men and boys, are better suited for the parlors of a house of ill-fame than for the eyes of pure-minded youth. A newsdealer who will distribute such vile sheets ought to be dealt with as an educator in vice and crime, an agent of evil, and a recruiting officer of hell and perdition. 6. SENTIMENTAL LITERATURE OF LOW FICTION.--Sentimental literature, whether impure in its subject matter or not, has a direct tendency in the direction of impurity. The stimulation of the emotional nature, the instilling of sentimental ideas into the minds of the young, has a tendency to turn the thoughts into a channel which leads in the direction of the formation of vicious habits. 7. IMPRESSIONS LEFT BY READING QUESTIONABLE LITERATURE.--It is painful to see strong intelligent men and youths reading bad books, or feasting their eyes on filthy pictures, for the practice is sure to affect their personal purity. Impressions will be left which cannot fail to breed a legion of impure thoughts, and in many instances criminal deeds. Thousands of elevator boys, clerks, students, traveling men, and others, patronize the questionable literature counter to an alarming extent. 8. THE NUDE IN ART.--For years there has been a great craze after the nude in art, and the realistic in literature. Many art galleries abound in pictures and statuary which cannot fail to fan the fires of sensualism, unless the thoughts of the visitor are trained to the strictest purity. Why should artists and sculptors persist in shocking the finer sensibilities of old and young of both sexes by crowding upon their view representations of naked human forms in attitudes of luxurious abandon? Public taste may demand it. But let those who have the power endeavor to reform public taste. 9. WIDELY DIFFUSED.--Good men have ever lamented the pernicious influence of a depraved and perverted literature. But such literature has never been so systematically and widely diffused as at the present time. This is owing to two causes, its cheapness and the facility of conveyance. 10. INFLAME THE PASSIONS.--A very large proportion of the works thus put in circulation are of the worst character, tending to corrupt the principles, to inflame the passions, to excite impure desire, and spread a blight over all the powers of the soul. Brothels are recruited from this more than any other source. Those who search the trunks of convicted criminals are almost sure to find in them one of more of these works; and few prisoners who can read at all fail to enumerate among the causes which led them into crime the unhealthy stimulus of this depraved and poisonous literature. [Illustration] [Illustration] * * * * * STARTLING SINS. 1. NAMELESS CRIMES.--The nameless crimes identified with the hushed-up Sodomite cases; the revolting condition of the school of Sodomy; the revelations of the Divorce Court concerning the condition of what is called national nobility, and upper classes, as well as the unclean spirit which attaches to "society papers," has revealed a condition which is perfectly disgusting. 2. UNFAITHFULNESS.--Unfaithfulness amongst husbands and wives in the upper classes is common and adultery rife everywhere; mistresses are kept in all directions; thousands of these rich men have at least two, and not seldom three establishments. 3. A FRIGHTFUL INCREASE.--Facts which have come to light during the past ten years show a frightful increase in every form of licentiousness; the widely extended area over which whoredom and degrading lust have thrown the glamor of their fascinating toils is simply appalling. 4. MORAL CARNAGE.--We speak against the fearful moral carnage; would to God that some unmistakable manifestation of the wrath of God should come in and put a stop to this huge seed-plot of national demoralization! We are reaping in this disgusting center the harvest of corruption which has come from the toleration and encouragements given by the legislature, the police, and the magistrates to immorality, vice and sin; the awful fact is that we are in the midst of the foul and foetid harvest of lust. Aided by some of the most exalted personages in the land, assisted by thousands of educated and wealthy whoremongers and adulterers, we are reaping also, in individual physical ugliness and deformity, that which has been sown; the puny, ill-formed and mentally weak youths and maidens, men and women, to be seen in large numbers in our principal towns and cities, represent the widespread nature of the curse, which has, in a marked manner, impaired the physique, the morality, and the intelligence of the nation. 5. DAILY PRESS.--The daily press has not had the moral courage to say one word; the quality of demoralizing novels such as have been produced from the impure brain and unclean imaginations; the subtle, clever and fascinating undermining of the white-winged angel of purity by modern sophists, whose purient and vicious volumes were written to throw a halo of charm and beauty about the brilliant courtesan and the splendid adulteress; the mixing up of lust and love; the making of corrupt passion to stand in the garb of a deep, lasting, and holy affection--these are some of the hidious seedlings which, hidden amid the glamor and fascination of the seeming "angel of light," have to so large an extent corrupted the morality of the country. 6. NIGHTLY EXHIBITIONS.--Some of you know what the nightly exhibitions in these garlanded temples of whorish incentive are. There is the variety theatre with its disgusting ballet dancing, and its shamelessly indecent photographs exhibited in every direction. What a clear gain to morality it would be if the accursed houses were burnt down, and forbidden by law ever to be re-built or re-opened; the whole scene is designed to act upon and stimulate the lusts and evil passions of corrupt men and women. 7. CONFIDENCE AND EXPOSURE.--I hear some of you say, cannot some influence be brought to bear upon this plague-spot? Will the legislature or congress do nothing? Is the law and moral right to continue to be trodden under foot? Are the magistrates and the police powerless? The truth is, the harlots and whoremongers are master of the situation; the moral sense of the legislators, the magistrates, and the police is so low that anything like confidence is at present out of the question. 8. THE SISTERHOOD OF SHAME AND DEATH.--It is enough to make angels weep to see a great mass of America's wealthy and better-class sons full of zeal and on fire with interest in the surging hundreds of the sisterhood of shame and death. Many of these men act as if they were--if they do not believe they are--dogs. No poor hunted dog in the streets was ever tracked by a yelping crowd of curs more than is the fresh girl or chance of a maid in the accursed streets of our large cities. Price is no object, nor parentage, nor home; it is the truth to affirm that hundreds and thousands of well-dressed and educated men come in order to the gratification of their lusts, and to this end they frequent this whole district; they have reached this stage, they are being burned up in this fire of lust; men of whom God says, "Having eyes full of adultery and that cannot cease sin." 9. LAW MAKERS.--Now should any member of the legislature rise up and testify against this "earthly hell," and speak in defence of the moral manhood and womanhood of the nation, he would be greeted as a fanatic, and laughed down amid derisive cheers; such has been the experience again and again. Therefore attack this great stronghold which for the past thirty years has warred and is warring against our social manhood and womanhood, and constantly undermining the moral life of the nation; against this citadel of licentiousness, this metropolitan centre of crime, and vice, and sin, direct your full blast of righteous and manly indignation. 10. TEMPLES OF LUST.--Here stand the foul and splendid temples of lust, intemperance, and passion, into whose vortex tens of thousands of our sons and daughters are constantly being drawn. Let it be remembered that this whole area represents the most costly conditions, and proves beyond Question that an enormous proportion of the wealthy manhood of the nation, and we as citizens sustain, partake, and share in this carnival of death. Is it any wonder that the robust type of godly manhood which used to be found in the legislature is sadly wanting now, or that the wretched caricatures of manhood which find form and place in such papers as "Truth" and the "World" are accepted as representing "modern society?" 11. PURITANIC MANHOOD.--It is a melancholy fact that, by reason of uncleanness, we have almost lost regard for the type of puritanic manhood which in the past held aloft the standard of a chaste and holy life; such men in this day are spoken of as "too slow" as "weak-kneed," and "goody-goody" men. Let me recall that word, the fast and indecently-dressed "things," the animals of easy virtue, the "respectable" courtesans that flirt, chaff, gamble, and waltz with well-known high-class licentious lepers--such is the ideal of womanhood which a large proportion of our large city society accepts, fawns upon, and favors. [Illustration] 12. SHAMEFUL CONDITIONS.--Perhaps one of the most inhuman and shameful conditions of modern fashionable society, both in England and America, is that which wealthy men and women who are married destroy their own children in the embryo stage of being, and become murderers thereby. This is done to prevent what should become one of our chief glories, viz., large and well-developed [Transcriber's note: the text appears to read "home" but it is unclear] and family life. * * * * * THE PROSTITUTION OF MEN. CAUSE AND REMEDY. 1. EXPOSED YOUTH.--Generally even in the beginning of the period when sexual uneasiness begins to show itself in the boy, he is exposed in schools, institutes, and elsewhere to the temptations of secret vice, which is transmitted from youth to youth, like a contagious corruption, and which in thousands destroys the first germs of virility. Countless numbers of boys are addicted to these vices for years. That they do not in the beginning of nascent puberty proceed to sexual intercourse with women, is generally due to youthful timidity, which dares not reveal its desire, or from want of experience for finding opportunities. The desire is there, for the heart is already corrupted. 2. BOYHOOD TIMIDITY OVERCOME.--Too often a common boy's timidity is overcome by chance or by seduction, which is rarely lacking in great cities where prostitution is flourishing, and thus numbers of boys immediately after the transition period of youth, in accordance with the previous secret practice, accustom themselves to the association with prostitute women, and there young manhood and morals are soon lost forever. 3. MARRIAGE-BED RESOLUTIONS.--Most men of the educated classes enter the marriage-bed with the consciousness of leaving behind them a whole army of prostitutes or seduced women, in whose arms they cooled their passions and spent the vigor of their youth. But with such a past the married man does not at the same time leave behind him its influence on his inclinations. The habit of having a feminine being at his disposal for every rising appetite, and the desire for change inordinately indulged for years, generally make themselves felt again as soon as the honeymoon is over. Marriage will not make a morally corrupt man all at once a good man and a model husband. 4. THE INJUSTICE OF MAN.--Now, although many men are in a certain sense "not worthy to unloose the latchet of the shoes" of the commonest woman, much less to "unfasten her girdle," yet they make the most extravagant demands on the feminine sex. Even the greatest debauchee, who has spent his vigor in the arms of a hundred courtesans, will cry out fraud and treachery if he does not receive his newly married bride as an untouched virgin. Even the most dissolute husband will look on his wife as deserving of death if his daily infidelity is only once reciprocated. 5. UNJUST DEMANDS.--The greater the injustice a husband does to his wife, the less he is willing to submit to from her; the oftener he becomes unfaithful to her, the stricter he is in demanding faithfulness from her. We see that despotism nowhere denies its own nature: the more a despot deceives and abuses his people, the more submissiveness and faithfulness he demands of them. 6. SUFFERING WOMEN.--Who can be astonished at the many unhappy marriages, if he knows how unworthy most men are of their wives? Their virtues they rarely can appreciate, and their vices they generally call out by their own. Thousands of women suffer from the results of a mode of life of which they, having remained pure in their thought, have no conception whatever; and many an unsuspecting wife nurses her husband with tenderest care in sicknesses which are nothing more than the consequences of his amours with other women. 7. AN INHUMAN CRIMINAL.--When at last, after long years of delusion and endurance, the scales drop from the eyes of the wife, and revenge or despair drives her into a hostile position towards her lord and master, she is an inhuman criminal, and the hue and cry against the fickleness of women and the falsity of their nature is endless. Oh, the injustice of society and the injustice of cruel man. Is there no relief for helpless women that are bound by the ties of marriage to men who are nothing but rotten corruption? 8. VULGAR DESIRE.--The habit of regarding the end and aim of woman only from the most vulgar side--not to respect in her the noble human being, but to see in her only the instrument of sensual desire--is carried so far among men that they will allow it to force into the background considerations among themselves, which they otherwise pretend to rank very high. 9. THE ONLY REMEDY.--But when the feeling of women has once been driven to indignation with respect to the position which they occupy, it is to be hoped that they will compel men to be pure before marriage, and they will remain loyal after marriage. 10. WORSE THAN SAVAGES.--With all our civilization we are put to shame even by the savages. The savages know of no fastidiousness of the sexual instinct and of no brothels. We are, indeed, likewise savages, but in quite a different sense. Proof of this is especially furnished by our youth. But that our students, and young men in general, usually pass through the school of corruption and drag the filth of the road which they have traversed before marriage along with them throughout life, is not their fault so much as the fault of prejudices and of our political and social conditions that prohibits a proper education, and the placing of the right kind of literature on these subjects into the hands of young people. [Illustration] 11. REASON AND REMEDY.--Keep the youth pure by a thorough system of plain unrestricted training. The seeds of immorality are sown in youth, and the secret vice eats out their young manhood often before the age of puberty. They develop a bad character as they grow older. Young girls are ruined, and licentiousness and prostitution flourish. Keep the boys pure and the harlot would soon lose her vocation. Elevate the morals of the boys, and you will have pure men and moral husbands. [Illustration: SUICIDE LAKE.] * * * * * THE ROAD TO SHAME. 1. INSULT TO MOTHER OR SISTER.--Young men, it can never tinder any circumstances be right for you to do to a woman that, which, if another man did to your mother or sister, you could never forgive! The very thought is revolting. Let us suppose a man guilty of this shameful sin, and I apprehend that each of us would feel ready to shoot the villain. We are not justifying the shooting, but appealing to your instinctive sense of right, in order to show the enormity of this fearful crime, and to fasten strong conviction in your mind against this sin. 2. A RUINED SISTER.--What would you think of a man, no matter what his wealth, culture, or gentlemanly bearing, who should lay himself out for the seduction and shame of your beloved sister? Her very name now reminds you of the purest affection: think of her, if you can bear it, ruined in character, and soon to become an unhappy mother. To whom can you introduce her? What can you say concerning her? How can her own brothers and sisters associate with her? and, mark! all this personal and relative misery caused by this genteel villain's degrading passion. 3. YOUNG MAN LOST.--Another terrible result of this sin is the practical overthrow of natural affection which it effects. A young man comes from his father's house to Chicago. Either through his own lust or through the corrupt companions that he finds in the house of business where he resides, he becomes the companion of lewd women. The immediate result is a bad conscience, a sense of shame, and a breach in the affections of home. Letters are less frequent, careless, and brief. He cannot manifest true love now. He begins to shrink from his sister and mother, and well he may. 4. THE HARLOT'S INFLUENCE.--He has spent the strength of his affection and love for home. In their stead the wretched harlot has filled him with unholy lust. His brain and heart refuse to yield him the love of the son and brother. His hand can not write as aforetime, or at best, his expressions become a hypocritical pretence. Fallen into the degradation of the fornicator, he has changed a mother's love and sister's affection for the cursed fellowship of the woman "whose house is the way to hell." (Prov. VII. 27.) 5. THE WAY OF DEATH.--Observe, that directly the law of God is broken, and wherever promiscuous intercourse between the sexes takes place, gonorrhoea, syphilis, and every other form of venereal disease is seen in hideous variety. It is only true to say that thousands of both sexes are slain annually by these horrible diseases. What must be the moral enormity of a sin, which, when committed, produces in vast numbers of cases such frightful physical and moral destruction as that which is here portrayed? 6. A HARLOT'S WOES.--Would to God that something might be done to rescue fallen women from their low estate. We speak of them as "fallen women". Fallen, indeed, they are, but surely not more deserving of the application of that term than the "fallen men" who are their partners and paramours. It is easy to use the words "a fallen woman," but who can apprehend all that is involved in the expression, seeing that every purpose for which God created woman is prostituted and destroyed? She is now neither maiden, wife, nor mother; the sweet names of sister and betrothed can have no legitimate application in her case. 7. THE PENALTIES FOR LOST VIRTUE.--Can the harlot be welcomed where either children, brothers, sisters, wife, or husband are found? Surely, no. Home is a sphere alien to the harlot's estate. See such an one wherever you may--she is a fallen outcast from woman's high estate. Her existence--for she does not live--now culminates in one dread issue, viz., prostitution. She sleeps, but awakes a harlot. She rises in the late morning hours, but her object is prostitution; she washes, dresses, and braids her hair, but it is with one foul purpose before her. To this end she eats, drinks, and is clothed. To this end her house is hidden and the blinds are drawn. 8. LOST FOREVER.--To this end she applies the unnatural cosmetique, and covers herself with sweet perfumes, which vainly try to hide her disease and shame. To this end she decks herself with dashing finery and tawdry trappings, and with bold, unwomanly mien essays the streets of the great city. To this end she is loud and coarse and impudent. To this end she is the prostituted "lady," with simpering words, and smiles, and glamour of refined deceit. To this end an angel face, a devil in disguise. There is one foul and ghastly purpose towards which all her energies now tend. So low has she fallen, so lost is she to all the design of woman, that she exists for one foul purpose only, viz., to excite, stimulate, and gratify the lusts of degraded, ungodly men. Verily, the word "prostitute" has an awful meaning. What plummet can sound the depths of a woman's fall who has become a harlot? 9. SOUND THE ALARM.--Remember, young man, you can never rise above the degradation of the companionship of lewd women. Your virtue once lost is lost forever. Remember, young woman, your wealth or riches is your good name and good character--you have nothing else. Give a man your virtue and he will forsake you, and you will be forsaken by all the world. Remember that purity of purpose brings nobility of character, and an honorable life is the joy and security of mankind. [Illustration: THE GREAT PHILANTHROPIST.] * * * * * THE CURSE OF MANHOOD. 1. MORAL LEPERS.--We cannot but denounce, in the strongest terms, the profligacy of many married men. Not content with the moderation permitted in the divine appointed relationship of marriage, they become adulterers, in order to gratify their accursed lust. The man in them is trodden down by the sensual beast which reigns supreme. These are the moral outlaws that make light of this scandalous social iniquity, and by their damnable example encourage young men to sin. 2. A SAD CONDITION.--It is constantly affirmed by prostitutes, that amongst married men are found their chief supporters. Evidence from such a quarter must be received with considerable caution. Nevertheless, we believe that there is much truth in this statement. Here, again, we lay the ax to the root of the tree; the married man who dares affirm that there is a particle of physical necessity for this sin, is a liar, and the truth is not in him. Whether these men be princes, peers, legislators, professional men, mechanics, or workmen, they are moral pests, a scandal to the social state, and a curse to the nation. 3. EXCESSES.--Many married men exhaust themselves by these excesses; they become irritable, liable to cold, to rheumatic affections, and nervous depression. They find themselves weary when they rise in the morning. Unfitted for close application to business, they become dilatory and careless, often lapsing into entire lack of energy, and not seldom into the love of intoxicating stimulants. Numbers of husbands and wives entering upon these experiences lose the charm of health, the cheerfulness of life and converse. Home duties become irksome to the wife; the brightness, vivacity, and bloom natural to her earlier years, decline; she is spoken of as highly nervous, poorly, and weak, when the whole truth is that she is suffering from physical exhaustion which she cannot bear. Her features become angular, her hair prematurely gray, she rapidly settles down into the nervous invalid, constantly needing medical aid, and, if possible, change of air. 4. IGNORANCE.--These conditions are brought about in many cases through ignorance on the part of those who are married. Multitudes of men have neither read, heard, nor known the truth of this question. We sympathize with our fellow-men in this, that we have been left in practical ignorance concerning the exceeding value and legitimate uses of these functions of our being. Some know, that, had they known these things in the early days of their married life, it would have proved to them knowledge of exceeding value. If this counsel is followed, thousands of homes will scarcely know the need of the physician's presence. 5. ANIMAL PASSION.--Commonsense teaches that children who are begotten in the heat of animal passion, are likely to be licentious when they grow up. Many parents through excesses of eating and drinking, become inflamed with wine and strong drink. They are sensualists, and consequently, morally diseased. Now, if in such conditions men beget their children, who can affect surprise if they develop licentious tendencies? Are not such parents largely to blame? Are they not criminals in a high degree? Have they not fouled their own nest, and transmitted to their children predisposition to moral evil? 6. FAST YOUNG MEN.--Many of our "fast young men" have been thus corrupted, even as the children of the intemperate are proved to have been. Certainly no one can deny that many of our "well-bred" young men are little better than "high-class dogs" so lawless are they, and ready for the arena of licentiousness. 7. THE PURE-MINDED WIFE.--Happily, as tens of thousands of husbands can testify, the pure-minded wife and mother is not carried away, as men are liable to be, with the force of animal passion. Were it not so, the tendencies to licentiousness in many sons would be stronger than they are. In the vast majority of cases suggestion is never made except by the husband, and it is a matter of deepest gratitude and consideration, that the true wife may become a real helpmeet in restraining this desire in the husband. 8. YOUNG WIFE AND CHILDREN.--We often hear it stated that a young wife has her children quickly. This cannot happen to the majority of women without injury to health and jeopardy to life. The law which rendered it imperative for the land to lie fallow in order to rest and gain renewed strength, is only another illustration of the unity which pervades physical conditions everywhere. It should be known that if a mother nurses her own babe, and the child is not weaned until it is nine or ten months old, the mother, except in rare cases, will not become enceinte again, though cohabitation with the husband takes place. 9. SELFISH AND UNNATURAL CONDUCT.--It is natural and rational that a mother should feed her own children; in the selfish and unnatural conduct of many mothers, who, to avoid the self-denial and patience which are required, hand the little one over to the wet-nurse, or to be brought up by hand, is found in many cases the cause and reason of the unnatural haste of child-bearing. Mothers need to be taught that the laws of nature cannot be broken without penalty. For every woman whose health has been weakened through nursing her child, a hundred have lost strength and health through marital excesses. The haste of having children is the costly penalty which women pay for shirking the mother's duty to the child. 10. LAW OF GOD.--So graciously has the law of God been arranged in regard to the mother's strength, that, if it be obeyed, there will be, as a rule, an interval of at least from eighteen months to two years between the birth of one child and that of another. Every married man should abstain during certain natural seasons. In this periodical recurrance God has instituted to every husband the law of restraint, and insisted upon self-control. 11. TO YOUNG PEOPLE WHO ARE MARRIED.--Be exceedingly careful of license and excess in your intercourse with one another. Do not needlessly expose, by undress, the body. Let not the purity of love degenerate into unholy lust! See to it that you walk according to the divine Word. "Dwelling together as being heirs of the grace of life, that your prayers be not hindered." 12. LOST POWERS.--Many young men after their union showed a marked difference. They lost much of their natural vivacity, energy, and strength of voice. Their powers of application, as business men, students, and ministers, had declined, as also their enterprise, fervor, and kindliness. They had become irritable, dull, pale, and complaining. Many cases of rheumatic fever have been induced through impoverishment, caused by excesses on the part of young married men. 13. MIDDLE AGE.--After middle age the sap of a man's life declines in quantity. A man who intends close application to the ministry, to scientific or literary pursuits, where great demands are made upon the brain, must restrain this passion. The supplies for the brain and nervous system are absorbed, and the seed diverted through sexual excesses in the marriage relationship, by fornication, or by any other form of immorality, the man's power must decline: that to this very cause may be attributed the failure and breakdown of so many men of middle age. 14. INTOXICATING DRINKS.--By all means avoid intoxicating drinks. Immorality and alcoholic stimulants, as we have shown, are intimately related to one another. Wine and strong drink inflame the blood, and heat the passions. Attacking the brain, they warp the judgment, and weaken the power of restraint. Avoid what is called good living: it is madness to allow the pleasures of the table to corrupt and corrode the human body. We are not designed for gourmands, much less for educated pigs. Cold water bathing, water as a beverage, simple and wholesome food, regularity of sleep, plenty of exercise; games such as cricket, football, tennis, boating, or bicycling, are among the best possible preventives against lust and animal passion. 15. BEWARE OF IDLENESS.--Indolent leisure means an unoccupied mind. When young men lounge along the streets, in this condition they become an easy prey to the sisterhood of shame and death. Bear in mind that evil thoughts precede evil actions. The hand of the worst thief will not steal until the thief within operates upon the hand without. The members of the body which are capable of becoming instruments of sin, are not involuntary actors. Lustful desires must proceed from brain and heart, ere the fire that consumes burns in the member. [Illustration: YOUNG LINCOLN STARTING TO SCHOOL.] * * * * * A PRIVATE TALK TO YOUNG MEN. 1. The most valuable and useful organs of the body are those which are capable of the greatest dishonor, abuse and corruption. What a snare the wonderful organism of the eye may become when used to read corrupt books or look upon licentious scenes at the theatre, or when used to meet the fascinating gaze of the harlot! What an instrument for depraving the whole man may be found in the matchless powers of the brain, the hand, the ear, the mouth, or the tongue! What potent instruments may these become in accomplishing the ruin of the whole being for time and eternity! 2. In like manner the organ concerning the uses of which I am to speak, has been, and continues to be, made one of the chief instruments of man's immorality, shame, disease, and death. How important to know what the legitimate uses of this member of the body are, and how great the dignity conferred upon us in the possession of this gift. On the human side this gift may be truly said to bring men nearer to the high and solemn relationship of the Creator than any other which they possess. 3. I first deal with the destructive sin of self-abuse. There can be little doubt that vast numbers of boys are guilty of this practice. In many cases the degrading habit has been taught by others, e.g., by elder boys at school, where association largely results in mutual corruption. With others, the means of sensual gratification is found out by personal action; whilst in other cases fallen and depraved men have not hesitated to debauch the minds of mere children by teaching them this debasing practice. 4. Thousands of youths and young men have only to use the looking-glass to see the portrait of one guilty of this loathsome sin. The effects are plainly discernible in the boy's appearance. The face and hands become pale and bloodless. The eye is destitute of its natural fire and lustre. The flesh is soft and flabby, the muscles limp and lacking healthy firmness. In cases where the habit has become confirmed, and where the system has been drained of this vital force, it is seen in positive ugliness, in a pale and cadaverous appearance, slovenly gait, slouching walk, and an impaired memory. 5. It is obvious that if the most vital physical force of a boy's life is being spent through this degrading habit--a habit, be it observed, of rapid growth, great strength, and difficult to break--he must develop badly. In thousands of cases the result is seen in a low stature, contracted chest, weak lungs, and liability to sore throat. Tendency to cold, indigestion, depression, drowsiness, and idleness, are results distinctly traceable to this deadly practice. Pallor of countenance, nervous and rheumatic affections, loss of memory, epilepsy, paralysis, and insanity find their principal predisposing cause in the same shameful waste of life. The want of moral force and strength of mind often observable in youths and young men is largely induced by this destructive and deadly sin. 6. Large numbers of youths pass from an exhausted boyhood into the weakness, intermittent fevers, and consumption, which are said to carry off so many. If the deaths were attributed primarily to loss of strength occasioned by self-pollution, it would be much nearer the truth. It is monstrous to suppose that a boy who comes from healthy parents should decline and die. Without a shade of doubt the chief cause of decay and death amongst youths and young men, is to be traced to this baneful habit. 7. It is a well-known fact that any man who desires to excel and retain his excellence as an accurate shot, an oarsman, a pedestrian, a pugilist, a first-class cricketer, bicyclist, student, artist, or literary man, must abstain from self-pollution and fornication. Thousands of school boys and students lose their positions in the class, and are plucked at the time of their examination by reason of failure of memory, through lack of nerve and vital force, caused mainly by draining the physical frame of the seed which is the vigor of the life. 8. It is only true to say that thousands of young men in the early stages of a licentious career would rather lose a right hand than have their mothers or sisters know what manner of men they are. From the side of the mothers and sisters it may also be affirmed that, were they aware of the real character of those brothers and sons, they would wish that they had never been born. 9. Let it be remembered that sexual desire is not in itself dishonorable or sinful, any more than hunger, thirst, or any other lawful and natural desire is. It is the gratification by unlawful means of this appetite which renders it so corrupting and iniquitous. 10. Leisure means the opportunity to commit sin. Unclean pictures are sought after and feasted upon, paragraphs relating to cases of divorce and seduction are eagerly read, papers and books of an immoral character and tendency greedily devoured, low and disgusting conversation indulged in and repeated. 11. The practical and manly counsel to every youth and young man is, entire abstinence from indulgence of the sexual faculty until such time as the marriage relationship is entered upon. Neither is there, nor can there be, any exception to this rule. 12. No man can affirm that self-denial ever injured him. On the contrary, self-restraint has been liberty, strength and blessing. Beware of the deceitful streams of temporary gratification, whose eddying current drifts towards license, shame, disease and death. Remember, how quickly moral power declines, how rapidly the edge of the fatal maelstrom is reached, how near the vortex, how terrible the penalty, how fearful the sentence of everlasting punishment. 13. Be a young man of principle, honor, and preserve your powers. How can you look an innocent girl in the face when you are degrading your manhood with the vilest practice? Keep your mind and life pure and nobility will be your crown. * * * * * REMEDIES FOR THE SOCIAL EVIL. 1. MAN RESPONSIBLE.--Every great social reform must begin with the male sex. They must either lead, or give it its support. Prostitution is a sin wholly of their own making. All the misery, all the lust, as well as all the blighting consequences, are chargeable wholly to the uncontrolled sexual passion of the male. To reform sinful women, _reform the men_. Teach them that the physiological truth means permanent moral, physical and mental benefit, while seductive indulgence blights and ruins. 2. CONTAGIOUS DISEASES.--A man or woman cannot long live an impure life without sooner or later contracting disease which brings to every sufferer not only moral degradation, but often serious and vital injuries and many times death itself becomes the only relief. 3. SHOULD IT BE REGULATED BY LAW?--Dr. G.J. Ziegler, of Philadelphia, in several medical articles says that the act of sexual connection should be made in itself the solemnization of marriage, and that when any such single act can be proven against an unmarried man, by an unmarried woman, the latter be at once invested with all the legal privileges of a wife. By bestowing this power on women very few men would risk the dangers of the society of a dissolute and scheming woman who might exercise the right to force him to a marriage and ruin his reputation and life. The strongest objection of this would be that it would increase the temptation to destroy the purity of married women, for they could be approached without danger of being forced into another marriage. But this objection could easily be harmonized with a good system of well regulated laws. Many means have been tried to mitigate the social evils, but with little encouragement. In the city of Paris a system of registration has been inaugurated and houses of prostitution are under the supervision of the police, yet prostitution has not been in any degree diminished. Similar methods have been tried in other European towns, but without satisfactory results. 4. MORAL INFLUENCE.--Let it be an imperative to every clergyman, to every educator, to every statesman and to every philanthropist, to every father and to every mother, to impart that moral influence which may guide and direct the youth of the land into the natural channels of morality, chastity and health. Then, and not till then, shall we see righteous laws and rightly enforced for the mitigation and extermination of the modern house of prostitution. [Illustration: A TURKISH CIGARETTE GIRL.] * * * * * THE SELFISH SLAVES OF DOSES OF DISEASE AND DEATH. 1. MOST DEVILISH INTOXICATION.--What is the most devilish, subtle alluring, unconquerable, hopeless and deadly form of intoxication, with which science struggles and to which it often succumbs; which eludes the restrictive grasp of legislation; lurks behind lace curtains, hides in luxurious boudoirs, haunts the solitude of the study, and with waxen face, furtive eyes and palsied step totters to the secret recesses of its self-indulgence? It is the drunkenness of drugs, and woe be unto him that crosseth the threshold of its dream-curtained portal, for though gifted with the strength of Samson, the courage of Richard and the genius of Archimedes, he shall never return, and of him it is written that forever he leaves hope behind. 2. THE MATERIAL SATAN.--The material Satan in this sensuous syndicate of soul and body-destroying drugs is opium, and next in order of hellish potency come cocaine and chloral. 3. GUM OPIUM.--Gum opium, from which the sulphate of morphine is made, is the dried juice of the poppy, and is obtained principally in the orient. Taken in moderate doses it acts specially upon the nervous system, deadens sensibility, and the mind becomes inactive. When used habitually and excessively it becomes a tonic, which stimulates the whole nervous system, producing intense mental exaltation and delusive visions. When the effects wear off, proportionate lassitude follows, which begets an insatiate and insane craving for the drug. Under the repeated strain of the continually increasing doses, which have to be taken to renew the desired effect, the nervous system finally becomes exhausted, and mind and body are utterly and hopelessly wrecked. 4. COCAINE.--Cocaine is extracted from the leaves of the Peruvian cocoa tree, and exerts a decided influence upon the nervous system, somewhat akin to that of coffee. It increases the heart action and is said to be such an exhilarant that the natives of the Andes are enabled to make extra-ordinary forced marches by chewing the leaves containing it. Its after effects are more depressing even than those of opium, and insanity more frequently results from its use. 5. CHLORAL.--The name which is derived from the first two syllables of chlorine and alcohol, is made by passing dry chlorine gas in a continuous stream through absolute alcohol for six or eight weeks. It is a hypnotic or sleep-producing drug, and in moderate doses acts on the caliber of the blood vessels of the brain, producing a soothing effect, especially in cases of passive congestion. Some patent medicines contain chloral, bromide and hyoseamus, and they have a large sale, being bought by persons of wealth, who do not know what they are composed of and recklessly take them for the effect they produce. 6. VICTIMS RAPIDLY INCREASING.--"From my experience," said a leading and conservative druggist, "I infer that the number of what are termed opium, cocaine, and chloral "fiends" is rapidly increasing, and is greater by two or three hundred percent than a year ago, with twice as many women as men represented. I should say that one person out of every fifty is a victim of this frightful habit, which claims its doomed votaries from the extremes of social life, those who have the most and the least to live for, the upper classes and the cyprian, professional men of the finest intelligence, fifty per cent. of whom are doctors and walk into the pit with eyes wide open. And lawyers and other professional men must be added to this fated vice." 7. DESTROYS THE MORAL FIBER.--"It is a habit which utterly destroys the moral fiber of its slaves, and makes unmitigated liars and thieves and forgers of them, and even murder might be added to the list of crimes, were no other road left open to the gratification of its insatiate and insane appetite. I do not know of a single case in which it has been mastered, but I do know of many where the end has been unspeakable misery, disgrace, suffering, insanity and death." 8. SHAMEFUL DEATH.--To particularize further would be profitless so far as the beginners are concerned, but would to heaven that those not within the shadow of this shameful death would take warning from those who are. There are no social or periodical drunkards in this sort of intoxication. The vice is not only solitary, unsocial and utterly selfish, but incessant and increasing in its demands. 9. APPETITE STRONGER THAN FOR LIQUOR.--This appetite is far stronger and more uncontrollable than that for liquor, and we can spot its victim as readily as though he were an ordinary bummer. He has a pallid complexion, a shifting, shuffling manner and can't look you in the face. If you manage to catch his eye for an instant you will observe that its pupil is contracted to an almost invisible point. It is no exaggeration to say that he would barter his very soul for that which indulgence has made him too poor to purchase, and where artifice fails he will grovel in abject agony of supplication for a few grains. At the same time he resorts to all kinds of miserable and transparent shifts, to conceal his degradation. He never buys for himself, but always for some fictitious person, and often resorts to purchasing from distant points. 10. OPIUM SMOKING.--"Opium smoking," said another representative druggist, "is almost entirely confined to the Chinese and they seem to thrive on it. Very few others hit the pipe that we know of." 11. MALT AND ALCOHOLIC DRUNKENNESS.--Alcoholic stimulants have a record of woe second to nothing. Its victims are annually marching to drunkards' graves by the thousands. Drunkards may be divided into three classes: First, the accidental or social drunkard; second, the periodical or spasmodic drunkard; and third, the sot. 12. THE ACCIDENTAL OR SOCIAL DRUNKARD is yet on safe ground. He has not acquired the dangerous craving for liquor. It is only on special occasions that he yields to excessive indulgence; sometimes in meeting a friend, or at some political blow-out. On extreme occasions he will indulge until he becomes a helpless victim, and usually as he grows older occasions will increase, and step by step he will be lead nearer to the precipice of ruin. 13. THE PERIODICAL OR SPASMODIC DRUNKARD, with whom it is always the unexpected which occurs, and who at intervals exacts from his accumulated capital the usury of as prolonged a spree as his nerves and stomach will stand. Science is inclined to charitably label this specimen of man a sort of a physiologic puzzle, to be as much pitied as blamed. Given the benefit of every doubt, when he starts off on one of his hilarious tangents, he becomes a howling nuisance; if he has a family, keeps them continually on the ragged edge of apprehension, and is unanimously pronounced a "holy terror" by his friends. His life and future is an uncertainty. He is unreliable and cannot be long trusted. Total reformation is the only hope, but it rarely is accomplished. 14. THE SOT.--A blunt term that needs no defining, for even the children comprehend the hopeless degradation it implies. Laws to restrain and punish him are framed; societies to protect and reform him are organized, and mostly in vain. He is prone in life's very gutter; bloated, reeking and polluted with the doggery's slops and filth. He can fall but a few feet lower, and not until he stumbles into an unmarked, unhonored grave, where kind mother earth and the merciful mantle of oblivion will cover and conceal the awful wreck he made of God's own image. To the casual observer, the large majority of the community, these three phases, at whose vagaries many laugh, and over whose consequences millions mourn, comprehend intoxication and its results, from the filling of the cup to its shattering fall from the nerveless hand, and this is the end of the matter. Would to God that it were! for at that it would be bad enough. But it is not, for wife, children and friends must suffer and drink the cup of trouble and sorrow to its dregs. * * * * * OBJECT LESSONS OF THE EFFECTS OF ALCOHOL AND CIGARETTE SMOKING. By Prof. George Henkle, who personally made the post-mortem examinations and drew the following illustrations from the diseased organs just as they appeared when first taken from the bodies of the unfortunate victims. [Illustration: THE STOMACH of an habitual drinker of alcoholic stimulants, showing the ulcerated condition of the mucous membrane, incapacitating this important organ for digestive functions.] [Illustration: THE STOMACH (interior view) of a healthy person with the first section of the small intestines.] [Illustration: THE LIVER of a drunkard who died of Cirrhosis of the liver, also called granular liver, or "gin drinker's liver." The organ is much shrunken and presents rough, uneven edges, with carbuncular non-suppurative sores. In this self-inflicted disease the tissues of the liver undergo a cicatrical retraction which strangulates and partly destroys the parenchyma of the liver.] [Illustration: THE LIVER IN HEALTH.] [Illustration: THE KIDNEY of a man who died a drunkard, showing in upper portion the sores so often found on kidneys of hard drinkers, and in the lower portion, the obstruction formed in the internal arrangement of this organ. Alcohol is a great enemy to the kidneys, and after this poison has once set in on its destructive course in these organs no remedial agents are known to exist to stop the already established disease.] [Illustration: THE KIDNEY in health, with the lower section removed, to show the filtering apparatus (Malphigian pyramids). Natural size.] [Illustration: THE LUNGS AND HEART of a boy who died from the effects of cigarette smoking, showing the nicotine sediments in lungs and shrunken condition of the heart.] [Illustration: THE LUNGS AND HEART IN HEALTH.] [Illustration: A section of the diseased Lung of a cigarette smoker, highly magnified.] * * * * * THE DESTRUCTIVE EFFECTS OF CIGARETTE SMOKING. Cigarettes have been analyzed, and the most physicians and chemists were surprised to find how much opium is put into them. A tobacconist himself says that "the extent to which drugs are used in cigarettes is appalling." "Havana flavoring" for this same purpose is sold everywhere by the thousand barrels. This flavoring is made from the tonka-bean, which contains a deadly poison. The wrappers, warranted to be rice paper, are sometimes made of common paper, and sometimes of the filthy scrapings of ragpickers bleached white with arsenic. What a thing for human lungs. The habit burns up good health, good resolutions, good manners, good memories, good faculties, and often honesty and truthfulness as well. Cases of epilepsy, insanity and death are frequently reported as the result of smoking cigarettes, while such physicians as Dr. Lewis Sayre, Dr. Hammond, and Sir Morell Mackenzie of England, name heart trouble, blindness, cancer and other diseases as occasioned by it. Leading physicians of America unanimously condemn cigarette smoking as "one of the vilest and most destructive evils that ever befell the youth of any country," declaring that "its direct tendency is a deterioration of the race." Look at the pale, wilted complexion of a boy who indulges to excessive cigarette smoking. It takes no physician to diagnose his case, and death will surely mark for his own every boy and young man who will follow up the habit. It is no longer a matter of guess. It is a scientific fact which the microscope in every case verifies. [Illustration: _Illustrating the shrunken condition of one of the Lungs of an excessive smoker_] [Illustration: INNOCENT YOUTH.] * * * * * The Dangerous Vices. Few persons are aware of the extent to which masturbation or self-pollution is practiced by the young of both sexes in civilized society. SYMPTOMS. The hollow, sunken eye, the blanched cheek, the withered hands, and emaciated frame, and the listless life, have other sources than the ordinary illnesses of all large communities. When a child, after having given proofs of memory and intelligence, experiences daily more and more difficulty in retaining and understanding what is taught him, it is not only from unwillingness and idleness, as is commonly supposed, but from a disease eating out life itself, brought on by a self-abuse of the private organs. Besides the slow and progressive derangement of his or her health, the diminished energy of application, the languid movement, the stooping gait, the desertion of social games, the solitary walk, late rising, livid and sunken eye, and many other symptoms, will fix the attention of every intelligent and competent guardian of youth that something is wrong. [Illustration: GUARD WELL THE CRADLE. EDUCATION CANNOT BEGIN TOO YOUNG.] MARRIED PEOPLE. Nor are many persons sufficiently aware of the ruinous extent to which the amative propensity is indulged by married persons. The matrimonial ceremony does, indeed, sanctify the act of sexual intercourse, but it can by no means atone for nor obviate the consequences of its abuse. Excessive indulgence in the married relation is, perhaps, as much owing to the force of habit, as to the force of the sexual appetite. EXTREME YOUTH. More lamentable still is the effect of inordinate sexual excitement of the young and unmarried. It is not very uncommon to find a confirmed onanist, or, rather, masturbator, who has not yet arrived at the period of puberty. Many cases are related in which young boys and girls, from eight to ten years of age, were taught the method of self-pollution by their older playmates, and had made serious encroachments on the fund of constitutional vitality even before any considerable degree of sexual appetite was developed. FORCE OF HABIT. Here, again, the fault was not in the power of passion, but in the force of habit. Parents and guardians of youth can not be too mindful of the character and habits of those with whom they allow young persons and children under their charge to associate intimately, and especially careful should they be with whom they allow them to sleep. SIN OF IGNORANCE. It is customary to designate self-pollution as among the "vices." I think misfortune is the more appropriate term. It is true, that in the physiological sense, it is one of the very worst "transgressions of the law." But in the moral sense it is generally the sin of ignorance in the commencement, and in the end the passive submission to a morbid and almost resistless impulse. QUACKS. The time has come when the rising generation must be thoroughly instructed in this matter. That quack specific "ignorance" has been experimented with quite too long already. The true method of insuring all persons, young or old, against the abuses of any part, organ, function, or faculty of the wondrous machinery of life, is to teach them its use. "Train a child in the way it should go" or be sure it will, amid the ten thousand surrounding temptations, find out a way in which it should not go. Keeping a child in ignorant innocence is, I aver, no part of the "training" which has been taught by a wiser than Solomon. Boys and girls do know, will know, and must know, that between them are important anatomical differences and interesting physiological relations. Teach them, I repeat, their use, or expect their abuse. Hardly a young person in the world would ever become addicted to self-pollution if he or she understood clearly the consequences; if he or she knew at the outset that the practice was directly destroying the bodily stamina, vitiating the moral tone, and enfeebling the intellect. No one would pursue the disgusting habit if he or she was fully aware that it was blasting all prospects of health and happiness in the approaching period of manhood and womanhood. GENERAL SYMPTOMS OF THE SECRET HABIT. The effects of either self-pollution or excessive sexual indulgence, appear in many forms. It would seem as if God had written an instinctive law of remonstrance, in the innate moral sense, against this filthy vice. All who give themselves up to the excesses of this debasing indulgence, carry about with them, continually, a consciousness of their defilement, and cherish a secret suspicion that others look upon them as debased beings. They feel none of that manly confidence and gallant spirit, and chaste delight in the presence of virtuous females, which stimulate young men to pursue the course of ennobling refinement, and mature them for the social relations and enjoyments of life. This shamefacedness, or unhappy quailing of the countenance, on meeting the look of others, often follows them through life, in some instances even after they have entirely abandoned the habit, and became married men and respectable members of society. In some cases, the only complaint the patient will make on consulting you, is that he is suffering under a kind of continued fever. He will probably present a hot, dry skin, with something of a hectic appearance. Though all the ordinary means of arresting such symptoms have been tried, he is none the better. The sleep seems to be irregular and unrefreshing--restlessness during the early part of the night, and in the advanced stages of the disease, profuse sweats before morning. There is also frequent starting in the sleep, from disturbing dreams. The characteristic feature is, that your patient almost always dreams of sexual intercourse. This is one of the earliest, as well as most constant symptoms. When it occurs most frequently, it is apt to be accompanied with pain. A gleety discharge from the urethra may also be frequently discovered, especially if the patient examine when at stool or after urinating. Other common symptoms are nervous headache, giddiness, ringing in the ears, and a dull pain in the back part of the head. It is frequently the case that the patient suffers a stiffness in the neck, darting pains in the forehead, and also weak eyes are among the common symptoms. One very frequent, and perhaps early symptom (especially in young females) is solitariness--a disposition to seclude themselves from society. Although they may be tolerably cheerful when in company, they prefer rather to be alone. The countenance has often a gloomy and worn-down expression. The patient's friends frequently notice a great change. Large livid spots under the eyes is a common feature. Sudden flashes of heat may be noticed passing over the patient's face. He is liable also to palpitations. The pulse is very variable, generally too slow. Extreme emaciation, without any other assignable cause for it, may be set down as another very common symptom. If the evil has gone on for several years, there will be a general unhealthy appearance, of a character so marked as to enable an experienced observer at once to detect the cause. In the case of onanists especially there is a peculiar rank odor emitted from the body, by which they may be readily distinguished. One striking peculiarity of all these patients is, that they cannot look a man in the face! Cowardice is constitutional with them. HOME TREATMENT OF THE SECRET HABIT. 1. The first condition of recovery is a prompt and permanent abandonment of the ruinous habit. Without a faithful adherence to this prohibitory law on the part of the patient all medication on the part of the physician will assuredly fail. The patient must plainly understand that future prospects, character, health, and life itself, depend on an unfaltering resistance to the morbid solicitation; with the assurance, however, that a due perseverance will eventually render, what now seems like a resistless and overwhelming propensity, not only controllable but perfectly loathsome and undesirable. 2. Keep the mind employed by interesting the patient in the various topics of the day, and social features of the community. 3. Plenty of bodily out of door exercise, hoeing in the garden, walking, or working on the farm; of course not too heavy work must be indulged in. 4. If the patient is weak and very much emaciated, cod liver oil is an excellent remedy. 5. DIET. The patient should live principally on brown bread, oat meal, graham crackers, wheat meal, cracked or boiled wheat, or hominy, and food of that character. No meats should be indulged in whatever; milk diet if used by the patient is an excellent remedy. Plenty of fruit should be indulged in; dried toast and baked apples make an excellent supper. The patient should eat early in the evening, never late at night. 6. Avoid all tea, coffee, or alcoholic stimulants of any kind. 7. "Early to bed and early to rise," should be the motto of every victim of this vice. A patient should take a cold bath every morning after rising. A cold water injection in moderate quantities before retiring has cured many patients. 8. If the above remedies are not sufficient, a family physician should be consulted. 9. Never let children sleep together, if possible, to avoid it. Discourage the children of neighbors and friends from sleeping with your children. 10. Have your children rise early. It is the lying in bed in the morning that plays the mischief. [Illustration: Healthy Semen, Greatly Magnified.] [Illustration: The Semen of a Victim of Masturbation.] * * * * * NOCTURNAL EMISSIONS. Involuntary emissions of semen during amorous dreams at night is not at all uncommon among healthy men. When this occurs from one to three or four times a month, no anxiety or concern need be felt. When the emissions take place without dreams, manifested only by stained spots in the morning on the linen, or take place at stool and are entirely beyond control, then the patient should at once seek for remedies or consult a competent physician. When blood stains are produced, then medical aid must be sought at once. HOME TREATMENT FOR NOCTURNAL EMISSIONS. Sleep in a hard bed, and rise early and take a sponge bath in cold water every morning. Eat light suppers and refrain from eating late in the evening. Empty the bladder thoroughly before retiring, bathe the spine and hips with a sponge dipped in cold water. _Never sleep lying on the back._ Avoid all highly seasoned food and read good books, and keep the mind well employed. Take regular and vigorous outdoor exercise every day. Avoid all coffee, tea, wine, beer and all alcoholic liquors. Don't use tobacco, and keep the bowels free. [Illustration: Healthy Testicle.] [Illustration: A Testicle wasted by Masturbation.] PRESCRIPTION.--Ask your druggist to put you up a good Iron Tonic and take it regularly according to his directions. BEWARE OF ADVERTISING QUACKS. Beware of these advertising schemes that advertise a speedy cure for "Loss of Youth," "Lost Vitality," "A Cure for Impotency," "Renewing of Old Age," etc. Do not allow these circulating pamphlets and circulars to concern you the least. If you have a few _Nocturnal Emissions_, remember it is only a mark of vitality and health, and not a sign of a deathly disease, as many of these advertising quacks would lead you to believe. Use your private organs only for what your Creator intended they should be used, and there will be no occasion for you to be frightened by the deception of quacks. [Illustration: THE TWO PATHS--What Will The Boy Become? At 15: STUDY & CLEANLINESS At 25: PURITY & ECONOMY At 36: HONORABLE SUCCESS At 60: VENERABLE OLD AGE At 15: CIGARETTES & SELF-ABUSE At 25: IMPURITY & DISSIPATION At 36: VICE & DEGENERACY At 60: MORAL-PHYSICAL WRECK] * * * * * LOST MANHOOD RESTORED. 1. RESOLUTE DESISTENCE.--The first step towards the restoration of lost manhood is a resolute desistence from these terrible sins. Each time the temptation is overcome, the power to resist becomes stronger, and the fierce fire declines. Each time the sin is committed, its hateful power strengthens, and the fire of lust is increased. Remember, that you cannot commit these sins, and maintain health and strength. 2. AVOID BEING ALONE.--Avoid being alone when the temptation comes upon you to commit self-abuse. Change your thoughts at once; "keep the heart diligently, for out of it are the issues of life." 3. AVOID EVIL COMPANIONS.--Avoid evil companions, lewd conversation, bad pictures, corrupt and vicious novels, books, and papers. Abstain from all intoxicating drinks. These inflame the blood, excite the passions, and stimulate sensuality; weakening the power of the brain, they always impair the power of self-restraint. Smoking is very undesirable. Keep away from the moral pesthouses. Remember that these houses are the great resort of fallen and depraved men and women. The music, singing, and dancing are simply a blind to cover the intemperance and lust, which hold high carnival in these guilded hells. This, be it remembered, is equally true of the great majority of the theatres. 4. AVOID STRONG TEA, OR COFFEE.--Take freely of cocoa, milk, and bread and milk, or oatmeal porridge. Meats, such as beef and mutton, use moderately. We would strongly recommend to young men of full habit, vegetarian diet. Fruits in their season, partake liberally; also fresh vegetables. Brown bread and toast, as also rice, and similar puddings, are always suitable. Avoid rich pastry and new bread. 5. THREE MEALS A DAY ARE ABUNDANT.--Avoid suppers, and be careful, if troubled with nightly emissions, not to take any liquid, not even water, after seven o'clock in the evening, at latest. This will diminish the secretions of the body, when asleep, and the consequent emissions, which in the early hours of the morning usually follow the taking of any kind of drink. Do not be anxious or troubled by an occasional emission, say, for example, once a fortnight. 6. REST ON A HARD MATTRESS.--Keep the body cool when asleep; heat arising from a load of bed-clothes, is most undesirable. Turn down the counterpane, and let the air have free course through the blankets. 7. RELIEVE THE SYSTEM.--As much as possible relieve the system of urine before going to sleep. On rising, bathe if practicable. If you cannot bear cold water, take the least possible chill off the water (cold water, however, is best). If bathing is not practicable, wash the body with cold water, and keep scrupulously clean. The reaction caused by cold water, is most desirable. Rub the body dry with a rough towel. Drink a good draught of cold water. 8. EXERCISE.--Get fifteen minutes' brisk walk, if possible before breakfast. If any sense of faintness exists, eat a crust of bread, or biscuit. Be regular in your meals, and do not fear to make a hearty breakfast. This lays a good foundation for the day. Take daily good, but not violent exercise. Walk until you can distinctly feel the tendency to perspiration. This will keep the pores of the skin open and in healthy condition. 9. MEDICINES.--Take the medicines, if used, regularly and carefully. Bromide of Potassium is a most valuable remedy in allaying lustful and heated passions and appetites. Unless there is actual venereal disease, medicine should be very little resorted to. 10. AVOID THE STREETS AT NIGHT.--Beware of corrupt companions. Fast young men and women should be shunned everywhere. Cultivate a taste for good reading and evening studies. Home life with its gentle restraints, pure friendships, and healthful discipline, should be highly valued. There is no liberty like that of a well-regulated home. To large numbers of young men in business houses, home life is impracticable. 11. BE OF GOOD CHEER AND COURAGE.--Recovery will be gradual, and not sudden; vital force is developed slowly from within. The object aimed at by medicine and counsel, is to aid and increase nervous and physical vigor, and give tone to the demoralized system. Do not pay the slightest heed to the exaggerated statements of the wretched quack doctors, who advertise everywhere. Avoid them as you would a pestilence. Their great object is, through exciting your fears, to get you into their clutches, in order to oppress you with heavy and unjust payments. Be careful, not to indulge in fancies, or morbid thoughts and feelings. Be hopeful, and play the part of a man determined to overcome. * * * * * MANHOOD WRECKED AND RESCUED. 1. THE NOBLEST FUNCTIONS OF MANHOOD.--The noblest functions of manhood are brought into action in the office of the parent. It is here that man assumes the prerogative of a God and becomes a creator. How essential that every function of his physical system should be perfect, and every faculty of his mind free from that which would degrade; yet how many drag their purity through the filth of masturbation, revel in the orgies of the debauchee, and worship at the shrine of the prostitute, until, like a tree blighted by the livid lightning, they stand with all their outward form of men, but without life. 2. THRESHOLD OF HONOR.--Think of a man like that; in whom the passions and vices have burned themselves out, putting on the airs of a saint and claiming to have reformed. Aye, reformed, when there is no longer sweetness in the indulgence of lust. Think of such loathsome bestiality, dragging its slimy body across the threshold of honor and nobility and asking a pure woman, with the love-light of heaven in her eyes, to pass her days with him; to accept him as her lord; to be satisfied with the burnt-out, shriveled forces of manhood left; to sacrifice her purity that he may be redeemed, and to respect in a husband what she would despise in the brute. 3. STOP.--If you are, then, on the highway to this state of degradation, stop. If already you have sounded the depths of lost manhood, then turn, and from the fountain of life regain your power, before you perpetrate the terrible crime of marriage, thus wrecking a woman's life and perhaps bringing into the world children who will live only to suffer and curse the day on which they were born and the father who begat them. 4. SEXUAL IMPOTENCY.--Sexual impotency means sexual starvation, and drives many wives to ruin, while a similar lack among wives drives husbands to libertinism. Nothing so enhances the happiness of married couples as this full, life-abounding, sexual vigor in the husband, thoroughly reciprocated by the wife, yet completely controlled by both. 5. TWO CLASSES OF SUFFERERS.--There are two classes of sufferers. First, those who have only practiced self-abuse and are suffering from emissions. Second, those who by overindulgence in marital relations, or by dissipation with women, have ruined their forces. 6. THE REMEDY.--For self-abuse: When the young man has practiced self-abuse for some time, he finds, upon quitting the habit, that he has nightly emissions. He becomes alarmed, reads every sensational advertisement in the papers, and at once comes to the conclusion that he must take something. _Drugs are not necessary._ 7. STOP THE CAUSE.--The one thing needful, above all others, is to stop the cause. I have found that young men are invariably mistaken as to what is the cause. When asked as to the first cause of their trouble, they invariably say it was self-abuse, etc., but it is not. _It is the thought._ This precedes the handling, and, like every other cause, must be removed in order to have right results. 8. STOP THE THOUGHT.--But remember, _stop the thought_! You must not look after every woman with lustful thoughts, nor go courting girls who will allow you to hug, caress and kiss them, thus rousing your passions almost to a climax. Do not keep the company of those whose only conversation is of a lewd and depraved character, but keep the company of those ladies who awaken your higher sentiments and nobler impulses, who appeal to the intellect and rouse your aspiration, in whose presence you would no more feel your passions aroused than in the presence of your own mother. 9. YOU WILL GET WELL.--Remember you will get well. Don't fear. Fear destroys strength and therefore increases the trouble. Many get downhearted, discouraged, despairing--the very worst thing that can happen, doing as much harm, and in many cases more, than their former dissipation. Brooding kills; hope enlivens. Then sing with joy that the savior of knowledge has vanquished the death-dealing ignorance of the past; that the glorious strength of manhood has awakened and cast from you forever the grinning skeleton of vice. Be your better self, proud that your thoughts in the day-time are as pure as you could wish your dreams to be at night. 10. HELPS.--Do not use tobacco or liquor. They inflame the passions and irritate the nervous system; they only gratify base appetites and never rouse the higher feelings. Highly spiced food should be eschewed, not chewed. Meat should be eaten sparingly, and never at the last meal. 11. DON'T EAT TOO MUCH.--If not engaged in hard physical labor, try eating two meals a day. Never neglect the calls of nature, and if possible have a passage from the bowels every night before retiring. When this is not done the feces often drop into the rectum during sleep, producing heat which extends to the sexual organs, causing the lascivious dreams and emission. This will be noticed especially in the morning, when the feces usually distend the rectum and the person nearly always awakes with sexual passions aroused. If necessary, use injections into the rectum of from one to two quarts of water, blood heat, two or three times a week. Be sure to keep clean and see to it that no matter collects under the foreskin. Wash off the organ every night and take a quick, cold hand-bath every morning. Have something to do. Never be idle. Idleness always worships at the shrine of passion. 12. THE WORST TIME OF ALL.--Many are ruined by allowing their thoughts to run riot in the morning. Owing to the passions being roused as stated above, the young man lies half awake and half dozing, rousing his passions and reveling in lascivious thought for hours perhaps, thus completely sapping the fountains of purity, establishing habits of vice that will bind him with iron bands, and doing his physical system more injury than if he had practiced self-abuse, and had the emission in a few minutes. Jump out of bed at once on waking, and never allow the thought to master you. 13. A HAND BATH.--A hand bath in cold water every morning will diminish those rampant sexual cravings, that crazy, burning, lustful desire so sensualizing to men by millions; lessen prostitution by toning down that passion which alone patronizes it, and relieve wives by the millions of those excessive conjugal demands which ruin their sexual health; besides souring their tempers, and then demanding millions of money for resultant doctor bills. 14. WILL GET WELL.--Feel no more concern about yourself. Say to yourself, "I shall and will get well under this treatment," as you certainly will. Pluck is half the battle. Mind acts and reads directly on the sexual organs. Determining to get well gets you well; whilst all fear that you will become worse makes you worse. All worrying over your case as if it were hopeless, all moody and despondent feelings, tear the life right out of these organs, whilst hopefulness puts new life into them. [Illustration] [Illustration: INNOCENT CHILDHOOD.] * * * * * THE CURSE AND CONSEQUENCE OF SECRET DISEASES. 1. THE SINS OF THE FATHERS ARE VISITED ON THE CHILDREN.--If persons who contract secret diseases were the only sufferers, there would be less pity and less concern manifested by the public and medical profession. 2. There are many secret diseases which leave an hereditary taint, and innocent children and grandchildren are compelled to suffer as well as those who committed the immoral act. 3. GONORRHOEA (Clap) is liable to leave the parts sensitive and irritable, and the miseries of spermatorrhoea, impotence, chronic rheumatism, stricture and other serious ailments may follow. 4. SYPHILIS (Pox).--Statistics prove that over 30 per cent. of the children born alive perish within the first year. Outside of this frightful mortality, how many children are born, inheriting eruptions of the skin, foul ulcerations swelling of the bones, weak eyes or blindness, scrofula, idiocy, stunted growth, and finally insanity, all on account of the father's early vices. The weaknesses and afflictions of parents are by natural laws visited upon their children. 5. The mother often takes the disease from her husband, and she becomes an innocent sufferer to the dreaded disease. However, some other name generally is applied to the disease, and with perfect confidence in her husband she suffers pain all her life, ignorant of the true cause. Her children have diseases of the eyes, skin, glands and bones, and the doctor will apply the term scrofula, when the result is nothing more or less than inherited syphilis. Let every man remember, the vengeance to a vital law knows only justice, not mercy, and a single moment of illicit pleasure will bring many curses upon him, and drain out the life of his innocent children, and bring a double burden of disease and sorrow to his wife. 6. If any man who has been once diseased is determined to marry, he should have his constitution tested thoroughly and see that every seed of the malady in the system has been destroyed. He should bathe daily in natural sulphur waters, as, for instance, the hot springs in Arkansas, or the sulphur springs in Florida, or those springs known as specific remedies for syphilic diseases. As long as the eruptions on the skin appear by bathing in sulphur water there is danger, and if the eruptions cease and do not appear, it is very fair evidence that the disease has left the system, yet it is not an infallible test. 7. How many bright and intelligent young men have met their doom and blighted the innocent lives of others, all on account of the secret follies and vices of men. 8. PROTECTION.--Girls, you, who are too poor and too honest to disguise aught in your character, with your sweet soul shining through every act of your lives, beware of the men who smile upon you. Study human nature, and try and select a virtuous companion. 10. SYPHILITIC POISON INERADICABLE.--Many of our best and ablest physicians assert that syphilitic poison, once infected, there can be no total disinfection during life; some of the virus remains in the system, though it may seem latent. Boards of State Charities in discussing the causes of the existence of whole classes of defectives hold to the opinion given above. The Massachusetts board in its report has these strong words on the subject: "The worst is that, though years may have passed since its active stage, it permeates the very seed of life and causes strange affections or abnormalities in the offspring, or it tends to lessen their vital force, to disturb or to repress their growth, to lower their standard of mental and bodily vigor, and to render life puny and short." 11. A SERPENT'S TOOTH.--"_The direct blood-poisoning, caused by the absorption into the system of the virus (syphilis) is more hideous and terrible in its effect than that of a serpent's tooth._ This may kill outright, and there's an end; but that, stingless and painless, slowly and surely permeates and vitiates the whole system of which it becomes part and parcel, like myriads of trichinae, and can never be utterly cast out, even by salivation. "Woe to the family and to the people in whose veins the poison courses! "It would seem that nothing could end the curse except utter extermination. That, however, would imply a purpose of eternal vengeance, involving the innocent with the guilty." This disease compared with small-pox is as an ulcer upon a finger to an ulcer in the vitals. Small-pox does not vitiate the blood of a people; this disease does. Its existence in a primary form implies moral turpitude. 12. CASES CITED.--Many cases might be cited. We give but one. A man who had contracted the disease reformed his ways and was apparently cured. He married, and although living a moral life was compelled to witness in his little girl's eye-balls, her gums, and her breath the result of his past sins. No suffering, no expense, no effort would have been too great could he but be assured that his offspring might be freed from these results. 13. PREVENTION BETTER THAN CURE.--Here is a case where the old adage, "An ounce of prevention is worth a pound of cure," may be aptly applied. Our desire would be to herald to all young men in stentorian tones the advice, "Avoid as a deadly enemy any approaches or probable pitfalls of the disease. Let prevention be your motto and then you need not look for a cure." 14. HELP PROFFERED.--Realizing the sad fact that many are afflicted with this disease we would put forth our utmost powers to help even these, and hence give on the following pages some of the best methods of cure. HOW TO CURE GONORRHOEA (Clap). CAUSES, IMPURE CONNECTIONS, ETC. SYMPTOMS.--As the disease first commences to manifest itself, the patient notices a slight itching at the point of the male organ, which is shortly followed by a tingling or smarting sensation, especially on making water. This is on account of the inflammation, which now gradually extends backward, until the whole canal is involved. The orifice of the urethra is now noticed to be swollen and reddened, and on inspection a slight discharge will be found to be present. And if the penis is pressed between the finger and thumb, matter or pus exudes. As the inflammatory stage commences, the formation of pus is increased, which changes from a thin to a thick yellow color, accompanied by a severe scalding on making water. The inflammation increases up to the fifth day, often causing such pain, on urinating, that the patient is tortured severely. When the disease reaches its height, the erections become somewhat painful, when the discharge may be streaked with blood. HOME TREATMENT. First, see that the bowels are loose--if not, a cathartic should be given. If the digestive powers are impaired, they should be corrected and the general health looked after. If the system is in a good condition, give internally five drops of gelseminum every two hours. The first thing to be thought of is to pluck the disease in its bud, which is best done by injections. The best of these are: tinct. hydrastis, one drachm; pure water, four ounces; to be used three times a day after urinating. Zinc, sulphate, ten grains; pure water, eight ounces; to be used after urinating every morning and night. Equal parts of red wine and pure water are often used, and are of high repute, as also one grain of permanganate of potash to four ounces of water. If the above remedies are ineffectual, a competent physician should be consulted. GENERAL TREATMENT.--One of the best injections for a speedy cure is: Hydrastis, 1 oz. Water, 5 oz. Mix and with a small syringe inject into the penis four or five times a day after urinating, until relieved, and diminish the number of injections as the disease disappears. No medicine per mouth need be given, unless the patient is in poor health. SYPHILIS (POX). 1. This is the worst of all diseases except cancer--no tissue of the body escapes the ravages of this dreadful disease--bone, muscle, teeth, skin and every part of the body are destroyed by its deforming and corroding influence. 2. SYMPTOMS.--About eight days after the exposure a little redness and then a pimple, which soon becomes an open sore, makes its appearance, on or about the end of the penis in males or on the external or inner parts of the uterus of females. Pimples and sores soon multiply, and after a time little hard lumps appear in the groin, which soon develop into a blue tumor called _bubo._ Copper colored spots may appear in the face, hair fall out, etc. Canker and ulcerations in the mouth and various parts of the body soon develop. 3. TREATMENT.--Secure the very best physician your means will allow without delay. 4. LOCAL TREATMENT OF BUBOES.--To prevent suppuration, treatment must be instituted as soon as they appear. Compresses, wet in a solution composed of half an ounce of muriate of ammonia, three drachms of the fluid extract of belladonna, and a pint of water, are beneficial, and should be continuously applied. The tumor may be scattered by painting it once a day with tincture of iodine. 5. FOR ERUPTIONS.--The treatment of these should be mainly constitutional. Perfect cleanliness should be observed, and the sulphur, spirit vapor, or alkaline bath freely used. Good diet and the persistent use of alteratives will generally prove successful in removing this complication. RECIPE FOR SYPHILIS. Bin-iodide of mercury, 1 gr. Extract of licorice, 32 gr. Make into 16 pills. Take one morning and night. _LOTION._ Bichloride of mercury, 15 gr. Lime water, 1 pt. Shake well, and wash affected parts night and morning. FOR ERUPTIONS ON TONGUE. Cyanide of silver, 1/2 gr. Powdered iridis, 2 gr. Divide into 10 parts. To be rubbed on tongue once a day. FOR ERUPTIONS IN SYPHILIS. A 5 per cent. ointment of carbolic acid, in a good preparation. BUBO. TREATMENT. Warm poultice of linseed meal, Mercurial plaster, Lead ointment. GLEET (CHRONIC CLAP). 1. SYMPTOMS.--When gonorrhoea is not cured at the end of twenty-one or twenty-eight days, at which time all discharge should have ceased, we have a condition known as chronic clap, which is nothing more or less than gleet. At this time most of the symptoms have abated, and the principal one needing medical attention is the discharge, which is generally thin, and often only noticed in the morning on arising, when a scab will be noticed, glutinating the lips of the external orifice. Or, on pressing with the thumb and finger from behind, forward, a thin, white discharge can be noticed. 2. HOME TREATMENT.--The diet of patients affected with this disease is all-important, and should have careful attention. The things that should be avoided are highly spiced and stimulating foods and drinks, as all forms of alcohol, or those containing acids. Indulgence in impure thoughts is often sufficient to keep a discharge, on account of the excitement it produces to the sensitive organs, thus inducing erections, which always do harm. 3. GENERAL TREATMENT.--The best injection is: Nitrate of silver, 1/4 grain Pure water, 1 oz. Inject three or four times a day after urinating. STRICTURE OF THE URETHRA. SYMPTOMS.--The patient experiences difficulty in voiding the urine, several ineffectual efforts being made before it will flow. The stream is diminished in size, of a flattened or spiral form, or divided in two or more parts, and does not flow with the usual force. TREATMENT.--It is purely a surgical case and a competent surgeon must be consulted. PHIMOSIS. 1. CAUSE.--Is a morbid condition of the penis, in which the glans penis cannot be uncovered, either on account of a congenital smallness of the orifice of the foreskin, or it may be due to the acute stage of gonorrhoea, or caused by the presence of soft chancre. 2. SYMPTOMS.--It is hardly necessary to give a description of the symptoms occurring in this condition, for it will be easily diagnosed, and its appearances are so indicative that all that is necessary is to study into its cause and treat the disease with reference to that. TREATMENT.--If caused from acute gonorrhoea, it should be treated first by hot fomentations, to subdue the swelling, when the glans penis can be uncovered. If the result of the formation of chancre under the skin, they should be treated by a surgeon, for it may result in the sloughing off of the end of the penis, unless properly treated. [Illustration: ILLUSTRATING MAGNETIC INFLUENCES. ANIMAL MAGNETISM IS SUPPOSED TO RADIATE FROM AND ENCIRCLE EVERY HUMAN BEING.] * * * * * ANIMAL MAGNETISM. WHAT IT IS AND HOW TO USE IT. 1. MAGNETISM EXISTING BETWEEN THE BODIES OF MANKIND.--It is rational to believe that there is a magnetism existing between the bodies of mankind, which may have either a beneficial or a damaging effect upon our health, according to the conditions which are produced, or the nature of the individuals who are brought in contact with each other. As an illustration of this point we might consider that, all nature is governed by the laws of attraction and repulsion, or in other words, by positive and negative forces. These subtle forces or laws in nature which we call attraction or repulsion, are governed by the affinity--or sameness--or the lack of affinity--or sameness--which exists between what may be termed the combination of atoms or molecules which goes to make up organic structure. 2. LAW OF ATTRACTION.--Where this affinity--or sameness--exists between the different things, there is what we term the law of attraction, or what may be termed the disposition to unite together. Where there is no affinity existing between the nature of the different particles of matter, there is what may be termed the law of repulsion, which has a tendency to destroy the harmony which would otherwise take place. 3. MAGNETISM OF THE MIND.--Now, what is true of the magnet and steel, is also true--from the sameness of their nature--of two bodies. And what is true of the body in this sense, is also true of the sameness or magnetism of the mind. Hence, _by the laying on of hands_, or by the association of the minds of individuals, we reach the same result as when a combination is produced in any department of nature. Where this sameness of affinity exists, there will be a blending of forces, which has a tendency to build up vitality. 4. A PROOF.--As a proof of this position, how often have you found the society of strangers to be so repulsive to your feelings, that you have no disposition to associate. Others seem to bring with them a soothing influence that draws you closer to them. All these involuntary likes and dislikes are but the results of the _animal magnetism_ that we are constantly throwing off from our bodies,--although seemingly imperceptible to our internal senses.--The dog can scent his master, and determine the course which he pursues, no doubt from similar influences. 5. HOME HARMONY.--Many of the infirmities that afflict humanity are largely due to a want of an understanding of its principles, and the right applications of the same. I believe that if this law of magnetism was more fully understood and acted upon, there would be a far greater harmony in the domestic circle; the health of parents and children might often be preserved where now sickness and discord so frequently prevail. 6. THE LAW OF MAGNETISM.--When two bodies are brought into contact with each other, the weak must naturally draw from the strong until both have become equal. And as long as this equality exists there will be perfect harmony between individuals, because of the reciprocation which exists in their nature. 7. SURVIVAL OF THE FITTEST.--But if one should gain the advantage of the other in magnetic attraction, the chances are that through the law of development, or what has been termed the "Survival of the Fittest"--the stronger will rob the weaker until one becomes robust and healthy, while the other grows weaker and weaker day by day. This frequently occurs with children sleeping together, also between husband and wife. 8. SLEEPING WITH INVALIDS.--Healthy, hearty, vigorous persons sleeping with a diseased person is always at a disadvantage. The consumptive patient will draw from the strong, until the consumptive person becomes the strong patient and the strong person will become the consumptive. There are many cases on record to prove this statement. A well person should never sleep with an invalid if he desires to keep his health unimpaired, for the weak will take from the strong, until the strong becomes the weak and the weak the strong. Many a husband has died from a lingering disease which saved his wife from an early grave. He took the disease from his wife because he was the stronger, and she became better and he perished. 9. HUSBAND AND WIFE.--It is not always wise that husband and wife should sleep together, nor that children--whose temperament does not harmonize--should be compelled to sleep in the same bed. By the same law it is wrong for the young to sleep with old persons. Some have slept in the same bed with persons, when in the morning they have gotten up seemingly more tired than when they went to bed. At other times with different persons, they have lain awake two-thirds of the night in pleasant conversation and have gotten up in the morning without scarcely realizing that they had been to sleep at all, yet have felt perfectly rested and refreshed. 10. MAGNETIC HEALING, OR WHAT HAS BEEN KNOWN AS THE LAYING ON OF HANDS.--A nervous prostration is a negative condition beneath the natural, by the laying on of hands a person in a good, healthy condition is capable of communicating to the necessity of the weak. For the negative condition of the patient will as naturally draw from the strong, as the loadstone draws from the magnet, until both become equally charged. And as fevers are a positive condition of the system "beyond the natural," the normal condition of the healer will, by the laying on of the hands, absorb these positive atoms, until the fever of the patient becomes reduced or cured. As a proof of this the magnetic healer often finds himself or herself prostrated after treating the weak, and excited or feverish after treating a feverish patient. [Illustration: WELL MATED.] * * * * * HOW TO READ CHARACTER. HOW TO TELL DISPOSITION AND CHARACTER BY THE NOSE. 1. LARGE NOSES.--Bonaparte chose large-nosed men for his generals, and the opinion prevails that large noses indicate long heads and strong minds. Not that great noses cause great minds, but that the motive or powerful temperament cause both. 2. FLAT NOSES.--Flat noses indicate flatness of mind and character, by indicating a poor, low organic structure. 3. BROAD NOSES.--Broad noses indicate large passage-ways to the lungs, and this, large lungs and vital organs and this, great strength of constitution, and hearty animal passions along with selfishness; for broad noses, broad shoulders, broad heads, and large animal organs go together. But when the nose is narrow at the base, the nostrils are small, because the lungs are small and need but small avenues for air; and this indicates a predisposition to consumptive complaints, along with an active brain and nervous system, and a passionate fondness for literary pursuits. 4. SHARP NOSES.--Sharp noses indicate a quick, clear, penetrating, searching, knowing, sagacious mind, and also a scold; indicate warmth of love, hate, generosity, moral sentiment--indeed, positiveness in everything. 5. BLUNT NOSES.--Blunt noses indicate and accompany obtuse intellects and perceptions, sluggish feelings, and a soulless character. 6. ROMAN NOSES.--The Roman nose indicates a martial spirit, love of debate, resistance, and strong passions, while hollow, pug noses indicate a tame, easy, inert, sly character, and straight, finely-formed Grecian noses harmonious characters. Seek their acquaintance. DISPOSITION AND CHARACTER BY STATURE. 1. TALL PERSONS.--Tall persons have high heads, and are aspiring, aim high, and seek conspicuousness, while short ones have flat heads, and seek the lower forms of worldly pleasures. Tall persons are rarely mean, though often grasping; but very penurious persons are often broad-built. 2. SMALL PERSONS.--Small persons generally have exquisite mentalities, yet less power--the more precious the article, the smaller the package in which it is done up,--while great men are rarely dwarfs, though great size often co-exists with sluggishness. DISPOSITION AND CHARACTER BY THE WALK. 1. AWKWARD.--Those whose motions are awkward yet easy, possess much efficiency and positiveness of character, yet lack polish; and just in proportion as they become refined in mind will their movements be correspondingly improved. A short and quick step indicates a brisk and active but rather contracted mind, whereas those who take long steps generally have long heads; yet if the step is slow, they will make comparatively little progress, while those whose step is long and quick will accomplish proportionately much, and pass most of their competitors on the highway of life. 2. A DRAGGING STEP.--Those who sluff or drag their heels, drag and drawl in everything; while those who walk with a springing, bouncing step, abound in mental snap and spring. Those whose walk is mincing, affected, and artificial, rarely, if ever, accomplish much; whereas those who walk carelessly, that is, naturally, are just what they appear to be, and put on nothing for outside show. 3. THE DIFFERENT MODES OF WALKING.--In short, every individual has his own peculiar mode of moving, which exactly accords with his mental character; so that, as far as you can see such modes, you can decipher such outlines of character. THE DISPOSITION AND CHARACTER BY LAUGHING. 1. LAUGHTER EXPRESSIVE OF CHARACTER.--Laughter is very expressive of character. Those who laugh very heartily have much cordiality and whole-souledness of character, except that those who laugh heartily at trifles have much feeling, yet little sense. Those whose giggles are rapid but light, have much intensity of feeling, yet lack power; whereas those who combine rapidity with force in laughing, combine them in character. 2. VULGAR LAUGH.--Vulgar persons always laugh vulgarly, and refined persons show refinement in their laugh. Those who ha, ha right out, unreservedly, have no cunning, and are open-hearted in everything; while those who suppress laughter, and try to control their countenances in it, are more or less secretive. Those who laugh with their mouths closed are non-committal; while those who throw it wide open are unguarded and unequivocal in character. 3. SUPPRESSED LAUGHTER.--Those who, suppressing laughter for a while, burst forth volcano-like, have strong characteristics, but are well-governed, yet violent when they give way to their feelings. Then there is the intellectual laugh, the love laugh, the horse laugh, the philoprogenitive laugh, the friendly laugh, and many other kinds of laugh, each indicative of corresponding mental developments. DISPOSITION AND CHARACTER BY THE MODE OF SHAKING HANDS. THEIR EXPRESSION OF CHARACTER.--Thus, those who give a tame and loose hand, and shake lightly, have a cold, if not heartless and selfish disposition, rarely sacrificing much for others, are probably conservatives, and lack warmth and soul. But those who grasp firmly, and shake heartily, have a corresponding whole-souledness of character, are hospitable, and will sacrifice business to friends; while those who bow low when they shake hands, add deference to friendship, and are easily led, for good or bad, by friends. [Illustration: AN EASY-GOING DISPOSITION.] THE DISPOSITION AND CHARACTER BY THE MOUTH AND EYES. 1. DIFFERENT FORMS OF MOUTHS.--Every mouth differs from every other, and indicates a coincident character. Large mouths express a corresponding quantity of mentality, while small ones indicate a lesser amount. A coarsely-formed mouth indicates power, while one finely-formed indicates exquisite susceptibilities. Hence small, delicately formed mouths indicate only common minds, with very fine feelings and much perfection of character. 2. CHARACTERISTICS.--Whenever the muscles about the mouth are distinct, the character is correspondingly positive, and the reverse. Those who open their mouths wide and frequently, thereby evince an open soul, while closed mouths, unless to hide deformed teeth, are proportionately secretive. 3. EYES.--Those who keep their eyes half shut are peek-a-boos and eaves-droppers. 4. EXPRESSIONS OF THE EYE.--The mere expression of the eye conveys precise ideas of the existing and predominant states of the mentality and physiology. As long as the constitution remains unimpaired, the eye is clear and bright, but becomes languid and soulless in proportion as the brain has been enfeebled. Wild, erratic persons have a half-crazed expression of eye, while calmness, benignancy, intelligence, purity, sweetness, love, lasciviousness, anger, and all the other mental affections, express themselves quite as distinctly by the eye as voice, or any other mode. 6. COLOR OF THE EYES.--Some inherit fineness from one parent, and coarseness from the other, while the color of the eye generally corresponds with that of the skin, and expresses character. Light eyes indicate warmth of feeling, and dark eyes power. 6. GARMENTS.--Those, who keep their coats buttoned up, fancy high-necked and closed dresses, etc., are equally non-communicative, but those who like open, free, flowing garments, are equally open-hearted and communicative. THE DISPOSITION AND CHARACTER BY THE COLOR OF THE HAIR. 1. DIFFERENT COLORS.--Coarseness and fineness of texture in nature indicate coarse and fine-grained feelings and characters, and since black signifies power, and red ardor, therefore coarse black hair and skin signify great power of character of some kind, along with considerable tendency to the sensual; yet fine black hair and skin indicate strength of character, along with purity and goodness. 2. COARSE HAIR.--Coarse black hair and skin, and coarse red hair and whiskers, indicate powerful animal passions, together with corresponding strength of character; while fine or light, or auburn hair indicates quick susceptibilities, together with refinement and good taste. 3. FINE HAIR.--Fine dark or brown hair indicates the combination of exquisite susceptibilities with great strength of character, while auburn hair, with a florid countenance, indicates the highest order of sentiment and intensity of feeling, along with corresponding purity of character, combined with the highest capacities for enjoyment and suffering. 4. CURLY HAIR.--Curly hair or beard indicates a crisp, excitable, and variable disposition, and much diversity of character--now blowing hot, now cold--along with intense love and hate, gushing, glowing emotions, brilliancy, and variety of talent. So look out for ringlets; they betoken April weather--treat them gently, lovingly, and you will have the brightest, clearest sunshine, and the sweetest balmiest breezes. 5. STRAIGHT HAIR.--Straight, even, smooth, and glossy hair indicate strength, harmony, and evenness of character, and hearty, whole-souled affections, as well as a clear head and superior talents; while straight, stiff, black hair and beard indicate a coarse, strong, rigid, straight-forward character. 6. ABUNDANCE OF HAIR.--Abundance of hair and beard signifies virility and a great amount of character; while a thin beard signifies sterility and a thinly settled upper story, with rooms to let, so that the beard is very significant of character. 7. FIERY RED HAIR indicates a quick and fiery disposition. Persons with such hair generally have intense feelings--love and hate intensely--yet treat them kindly, and you have the warmest friends, but ruffle them, and you raise a hurricane on short notice. This is doubly true of auburn curls. It takes but little kindness, however, to produce a calm and render them as fair as a Summer morning. Red-headed people in general are not given to hold a grudge. They are generally of a very forgiving disposition. SECRETIVE DISPOSITIONS. 1. A man that naturally wears his hat upon the top or back of the head is frank and outspoken; will easily confide and have many confidential friends, and is less liable to keep a secret. He will never do you any harm. 2. If a man wears his hat well down on the forehead, shading the eyes more or less, will always keep his own counsel. He will not confide a secret, and if criminally inclined will be a very dangerous character. 3. If a lady naturally inclines to high-necked dresses and collars, she will keep her secrets to herself if she has any. In courtship or love she is an uncertainty, as she will not reveal sentiments of her heart. The secretive girl, however, usually makes a good housekeeper and rarely gets mixed into neighborhood difficulties. As a wife she will not be the most affectionate, nor will she trouble her husband with many of her trials or difficulties. * * * * * TWILIGHT SLEEP. Some years ago two German Physicians, Kroenig and Grauss, of the University of Baden, startled the world by announcing: "Dammerschlaf" or "Twilight Sleep," a treatment which rendered childbirth almost painless and free from dangerous complications. A woman's clinic was established at Freiburg where a combination of scopolamine and morphine was given. The muscular activity of the pelvic organs was not lessened, the length of labor was shortened, and instruments were rarely necessary. ABBOTT'S H-M-C is another sedative composed of hyoseine, morphine, and cactoid. It is less dangerous than the other remedy, and accomplishes the same result, hence is greatly preferred. THE UTMOST CAUTION is necessary in the administration of either of these drugs, and the most competent medical supervision is essential to their success. CAUTIONS.--The patient should not be left a moment without medical supervision. The lying in chamber should be darkened, and kept as quiet as possible. * * * * * PAINLESS CHILDBIRTH. WHY SHOULD A WOMAN SUFFER?--Childbirth is a natural function, as natural as eating, sleeping or walking. If the laws of nature are complied with it loses most, if not all, of its terrors. The facts show that Indian women, and those of other uncivilized races have children without experiencing pain, and with none of the so common modern complications. WHAT IS THE REASON?--They live a natural, out of doors life, free from the evils and restrictions of present day civilization in dress and habits of life. A NORMAL LIFE.--The expectant mother should therefore live a perfectly rational life, keeping the stomach and intestines especially healthy and active, and hence the general physical condition good. An abundance of fresh air, hearty exercise, and childbirth will pass over without any abnormal consequences. * * * * * THE DISEASES OF WOMEN. THE WOMAN'S PLACE IS IN THE HOME.--For centuries the world has stuck to this rule. Because the woman has been considered less fit for the struggles of the active workaday world, she has been kept at home, shut in from the air and sunshine, deprived of healthy exercise, and obliged to live a life of confinement and inactivity. WHAT IS THE RESULT?--In connection with menstruation, pregnancy and child bearing a long list of diseases peculiar to woman have arisen, most of which through proper food and exercise could be avoided. In matters so vital to posterity false modesty and ignorance can no longer be tolerated. CHLOROSIS OR ANAEMIA. _Home Treatment_: Plenty of good food and fresh air will do much to restore the blood. Keep the bowels free. Satisfactory results have been brought about by a systematic use of iron as a tonic. DISORDERS OF THE MENSES. RETENTION OF MENSTRUATION. _Treatment_: When due to the condition of the blood, recommend good food, fresh air, and sunshine to improve circulation. If the result of cold and exposure means and appliances for restoring the circulation must be adopted. In either case the bowels should be kept open by injections. VICARIOUS MENSTRUATION. _Treatment_: No attempt should be made to stop the hemorrhage during the monthly period. The discharge is usually light although it occasionally causes great weakness. This disorder is caused by the suppression of the menses, and must be treated accordingly between periods. CESSATION OF THE MENSES. Commonly called "Change of Life." _Treatment_: At this dangerous and trying period in a woman's life she must adopt the utmost regularity in the habits of her existence. Hot baths, taken just before retiring, will relieve the uncomfortable feeling so common at this time of life. DISORDERS OF THE WOMB. CANCER OF THE WOMB. _Treatment_: Call at once a competent physician. DISPLACEMENT OF THE WOMB. _Treatment_: Evacuate the bowels and the bladder by means of injections, and the catheter. Place the fingers in the vagina, locate the mouth of the womb, insert finger into it, and gently pull the organ into its natural position. DROPSY OF THE WOMB. _Treatment_: Use tonics freely together with vapor baths, and frequent hot hip baths. FALLING OF THE WOMB. _Treatment_: Build up the physical condition by an abundance of good food, fresh air and sunshine, with moderate exercise. Astringent injections and vaginal suppositories of oak bark, myrrh, and cocoa-butter will usually bring relief. INFLAMMATION OF THE WOMB. _Treatment_: Apply stimulating liniment to the abdomen. Keep body warm and moist especially at extremities. Add 10-15 drops of carbolic acid to one quart of warm water and use as a vaginal douche. Keep bowels open. Furnish light, nourishing diet, and give tonics. NEURALGIA OF THE WOMB. _Treatment_: Keep feet warm and give injections to the bowels of lobelia, lady slipper, and skullcap. Rub the abdomen with liniment. Absolute quiet, above all else, will bring relief. DISEASES OF THE VAGINA. VAGINITIS, OR INFLAMMATION OF THE VAGINA. _Treatment_: Complete rest. Use distilled sweet clover with a slight infusion of lady slipper warm, three times a day as a vaginal injection. PROLAPSUS OF THE VAGINA. _Treatment_: When the walls of the vagina become folded upon themselves through abortion, rupture during delivery, excessive indulgence, masturbation, etc. it is called prolapsus. Use an astringent suppository or injection. SPASM OF THE VAGINA. _Treatment_: This is nothing more than a nervous condition causing the muscles of the vagina to spasm thus closing the passage, and rendering conception almost impossible. Outdoor exercise, light but nourishing diet, and general attention to the nervous system will bring prompt relief. Intercourse, if attempted, should be quiet and unfrequent. An effort should be made to keep the thoughts on other subjects. DISEASES OF THE EXTERNAL FEMALE GENITALS. INFLAMMATION AND ABSCESS. _Treatment_: Wash the parts often with warm water, distilled witch hazel, and strong infusion of lobelia. Keep the bowels free. In severe cases apply poultices of ground flaxseed, sprinkled over with golden seal and lobelia. After poultices are removed, cleanse parts with warm water, containing a little tincture of myrrh. PRURITIS. _Treatment_: A very mortifying and uncomfortable affliction, accompanied by an almost uncontrollable desire to scratch the parts. The itching is due to uncleanliness, excessive masturbation, violent intercourse, inflammation of the bladder, stomach or liver trouble etc. Bathe the affected parts well with borax water, and apply a wash of equal parts witch hazel, and an infusion of lobelia. Use mild laxatives to keep the bowels open. DISEASES OF THE OVARIES. DROPSY OF THE OVARIES. _Treatment_: An accumulation of fluid in the membranous sack about the ovaries. An operation is necessary and is almost always successful. INFLAMMATION OF THE OVARIES. _Treatment_: In mild cases rub abdomen with liniment and apply hot water bottles. Perfect quiet is essential to an early recovery. TUMORS OF THE OVARIES. _Treatment_: A surgical operation is the only means of cure. * * * * * REMEDIES FOR DISEASES OF WOMEN. AFTER PAINS: Salophen in fifteen grain doses. If necessary take another dose in two hours. Should the pains reappear the next day, repeat the dosage. AMENORRHEA: Tincture chloride of iron, three drams; tincture cantharides, one dram; tincture guaiac ammon., one-half dram; tincture aloe, one-half ounce; syrup enough to make six ounces. Dose: Tablespoonful after meals. CANCER OF THE WOMB: Make a solution and use in douches: Picric acid, two one-half dram; water one and one-half pint; the patient must lie flat on back while fluid runs up into the vagina, hips must be raised; retain the fluid as long as possible. Later on make a cotton tampon, saturated with chloral hydrate, one-half dram; cocaine hydrochloride, one and one-half grain; dissolve in five drams of water. Use injection and tampon morning and night. DYSMENORRHEA: Asafoetida, forty grains; ext. Valerian, twenty grains; ext. Cannabis Indica, five grains; make twenty pills. Dose: One pill after meals. Use the following ointment for the pain in the back: Ext. Hyoscyamus, thirty grains; ext. Belladonna, thirty grains; Adipis, one ounce. Apply locally night and morning. EMMENAGOGUE: Ergotin, twenty grains; ext. cotton root bark, twenty grains; Purified Aloes, twenty grains; Dried Ferrous sulphate, twenty grains; ext. Savine, ten grains. Make twenty pills. Dose: One pill four times a day. ENDOMETRITIS: Ext. Viburnum Prun, forty grains; ext. Hamamelis, twenty grains; Ergotin, ten grains; ext. Nux Vomica, two grains; Hydrastin, one grain. Make twenty pills. Dose: One pill morning and night. FIBROID TUMORS: Chromium Sulphate, four-grain tablets. Dose: One tablet after meals. FISSURE OF NIPPLES: Apply Iodoform, one dram; carbolic acid, twenty grains; white Petrolatum, one ounce. Apply at night; requires thorough washing next morning. HELONIAS COMPOSITION: Helonias, fifteen grains; Squaw wine, sixty grains; Viburnum Opulus, fifteen grains; Caulophyllum, fifteen grains; syrup, two ounces. Dose: Teaspoonful every two hours. LEUCORRHOEA: Ext. Hyoscyamus, one dram; ext. Hamamelis, one dram; tannic acid, one dram; ext. Helonias, one-half dram; Salicylic acid, one dram; Alum, three drams; boric acid, five drams. Dissolve flat teaspoonful in half cup of water, soak a cotton tampon and place way up in the vagina. As a tonic take: Tincture Cinchona comp., two ounces; tincture gentian comp., two ounces. Dose: Dessertspoonful after meals. MENOPAUSE: Ammonium bromide, two drams; Potassium bromide, four drams; aromatii spirits amoniae, six drams; camphor water enough to make six ounces. Dose: One dessertspoonful, three times a day. MENORRHAGIA: Gallic acid, fifty grains; Ergotin, twenty grains; Hydrastin, ten grains. Make twenty pills. Dose: One pill after meals. Another prescription: Calcium chloride, two and one-half drams; syrup, fifteen drams; water, six ounces. Dose: One tablespoonful morning and night. MENSTRUAL IRREGULARITIES: Extracts of cramp bark, forty grains; blue cohosh, ten grains; Squaw wine, forty grains; pokeberry, twenty grains; strychnine, one grain. Make forty pills. Dose: One pill four times a day until relieved. MENSTRUATION, PROFUSE: Extracts of white ash bark, two drams; black haw, two drams; cramp bark, two drams; unicorn root, one dram; Squaw wine, one dram; blue cohosh, one dram. Steep 24 hours in one-half pint of water, add one-half pint of alcohol. Dose: Tablespoonful three times a day. NEURALGIA OF WOMB: Fl. ext. henbane, two drams; Fl. ext. Indian hemp, one dram; Fl. ext. snake root, four drams; spirits of camphor, two drams; compound spirits of ether, three ounces. Dose: One teaspoonful in water three times a day. Medicated hot sitz bath. OVARIAN CONGESTION: Black haw, sixty grains; Golden seal, sixty grains; Jamaica dogwood, thirty grains; syrup and water, four ounces. Dose: One teaspoonful three or four times a day. OVARIAN SEDATIVE: Lupulin, ten grains; ergotin, five grains; scutellarin, ten grains; zinc bromide, two grains. Make twenty pills. Dose: One pill after meals. VAGINISMUS: Strontium bromide, two drams; potassium bromide, two drams; ammonium bromide, two drams; water to make ten ounces. Dose: Tablespoonful morning and night. Make a suppository and insert night: Cocaine hydrochlorate, two grains; ext. Belladonna, one and one-half grains; Strontium bromide, four grains; Oil Theobromat, two drams. Use every night one such suppository, placed high up in the vagina until all signs of the difficulty are gone. VAGINITIS: Resorcine, forty grains; Salicylic acid, eight grains; Betanaphtholis, one grain; add enough water to make it eight ounces. Dose: Add to this mixture one tablespoonful to a quart of warm water and douche vagina in above stated manner. Use also suppository as in Vaginismus. VULVA ITCHING: Apply externally morning and night the following salve: Boric acid, thirty grains; Oxide of zinc, sixty grains. Powdered starch, sixty grains; Petrolatum, one ounce. Apply on cotton and to affected parts. ULCERATIONS OF VAGINA OR WOMB: Insert a suppository each one made of Boric acid, five grains; Powdered alum, five grains. Or the following composition; Black haw, two grains; golden seal, two grains; add enough cocoa butter to make one suppository. Insert and keep in over night after a hot medicated vaginal douche is taken. UTERINE ASTRINGENT: Alum, three drams; zinc sulphate, two drams; morphine sulphate, one grain; tannic acid, two drams; Boric acid, six drams. Mix and use of it one tablespoonful dissolved in pint of warm water. Inject slowly into vagina in recumbent position, retain the douche fluid as long as possible. Later on insert when retiring a vaginal suppository. UTERINE HEMORRHAGES: Take Stypticin tablets according to printed direction on the package. UTERINE TONIC: Helonin, three grains; Caulophyllin, three grains; Macrotin, three grains; Hyoscyamine, three grains. Make twenty pills. Dose: One pill after meals. UTERINE TONIC AND STIMULANT: Take Elixir of Helonias, which can be bought in drug stores, or get the following tinctures and make it at home: Partridge berry, ninety-six grains; unicorn root, forty-eight grains; Blue cohosh, forty-eight grains; cramp bark, forty-eight grains. Steep these for 24 hours in one-half pint of water, add one-half pint of alcohol, then strain and bottle. Dose: One teaspoonful three times a day. WHITES: Dried alum, one-half ounce; Borax, two ounces; boric acid, four ounces; Thymol, ten grains; Eucalyptol, ten grains; Oil of peppermint, two drams. Dissolve, one teaspoonful of the mixture in a pint of hot water and use as a douche morning and night. WOMB SPASMS: Cramp bark, one ounce; skullcap, one ounce; skunk cabbage, four drams. Steep 24 hours in one-half pint of water, add one-half pint of alcohol. Dose: One tablespoonful three times a day. * * * * * [Transcriber's Note: The following "Alphabetical Index" is as it appears in the original book. It is not in alphabetical order.] ALPHABETICAL INDEX. A Abstention, 137 Abstinence, 52 Abuse After Marriage, 202 Abortion or Miscarriage, 253 Abortion, Causes and Symptoms, 253 Abortion, Home Treatment, 254 Abortion, Prevention of, 254 Abortion, The Sin of Herod, 257 Abortion, The Violation of all Law, 256 Absence of Physician, 300 Abraham a Polygamist, 133 A Broken Heart, 159 Aboriginal, Australian, 162 Admired and Beloved, 28 Advantages of Wedlock, 135 Advice to Newly Married Couples, 201 Advice to Married and Unmarried, 181 Advice to Bridegroom, 201 Advice to Young Mothers, 286 Advice to Young Married People, 435 Advice to Young Men, 437 Adultery in the Heart, 409 After Birth, 300 Affectionate Parents, 227 Amenorrhoea, 355 Amativeness or Connubial Love, 122 Animal Passions, 434 Animal Impulse, 227 Apoplexy, 365 Artificial Impregnation, 270 Arms, Beautiful, 131 Assassin of Garfield, 294 Asking an Honest Question, 61 Associates, Influence of, 11 Authority of the Wife, 267 B Bad Company, The Result of, 13 Bad Society, 381 Bad Dressing, 409 Bad Books, 421 Bad Breath, 365 Bathing, Rules for, 371-373 Bath, The, 83 Barber's Shampoos, 107 Bad Breast, 322 Bastards or Illegitimates, 224 Beginning of Life, 5 Begin at Right Place, 7 Begin Well, 17 Beauty and Style, 27 Beauty a Dangerous Gift, 27 Beautiful Women, Beware of, 27 Beauty in Dress, 89 Beauty, 91-92 Beauty Which Perishes Not, 92 Beauty, Sensible Hints to, 95 Beautiful Arms, 131 "Be Ye Fruitful and Multiply", 201 Beautiful Children, How to Have, 288 Birth, Conditions of, 229 Biliousness, 279, 357, 363 Bites and Stings of Insects, 359 Bloom and Grace of Youth, 97 Black-heads, and Flesh Worms, 112 Blue Feelings, 159 Bleeding, 364 Both Puzzled, 77 Bodily Symmetry, 100, 105 Boils, 364 Breath, The, 86 Broad Hips, 130 Breach of Confidence, 191 Bride, The, 199 "Bridal Tour", 200 Breasts, Swelled and Sore, 348 Burns, 13, 355, 359 Busts, Full, 130 Bunions, 364 Bubo Treatment, 468 C Care of the Person, 84 Care of the Hair, 107 Cause of Family Troubles, 217 Calamities of Lust, 416-419 Causes of Sterility, 251 Causes of Divorce, 258-262 Care of New-Born Infant, 315 Cataracts of the Eyes, 355 Causes of Prostitution, 412 Celibacy, Disadvantages of, 138 Chinese Marriage System, 133 Children, Healthy and Beautiful, 222-227 Children, Idiots, Criminals and Lunatics, 222 Children's Condition Depends on Parents, 225 Children, All, May Die, 226 Children, Too Many, 229 Children, Foolish Dread of, 241 Character Lost, 9 Character, Formation of, 11 Character, Essence, 12 Character Exhibits Itself, 15 Character, Beauty of, 18 Child, An Honored, 19 Character, School of, 23 Child, The, is Father of the Man, 24 Character, Female, Influence of, 30 Children, Fond of, 62 Character, Influence of Good, 73 Character is Property, 74 Child Bearing without Pain, 304, 479 Chickenpox, 346, 363 Chapped Hands, 355, 356 Chilblains, 359 Child Training, 396 Chastity and Purity, 400 Character, How to Read, 473 Civilization, 18 Circumcision, 394 Cigarette Smoking, Effects of, 445, 450 Clap--Gonorrhoea, 464 Clap--Gonorrhoea Treatment, 466 Corsets, 101-103 Corset, Egyptian, 104 Coloring for Eyelashes and Eyebrows, 108 Confidence, 122 Connubial Love, 122 Concubinage and Polygamy, 133 Courtship and Marriage, 148 Court Scientifically, 166 Consummation of Marriage, 202 Conception, 239 Conception, Its Limitations, 240 Conceptions and Accidents of Lust, 256 Courtship and Marriage, 267 Control, Self, 12 Coarseness, 24 Correspondence, 36 Conversation, 79 Conception or Impregnation, 269 Conception, The Proper Time for, 289 Colic, 318, 338, 356 Convulsions, Infantile, 319 Constipation, To Prevent, 323, 339 Coughs, Colds, etc., 360 Cold Water for Diseases, 369 Cook for the Sick, How to, 375 Cramps, 277, 356 Croup, How to Treat, 343 Crimping Hair, 109 Criminals and Heredity, 399 Crowning Sin of the Age, 411 Cuts, 358, 360 Cultivate Modesty, 210 Cultivate Personal Attractiveness, 210 Cultivate Physical Attractiveness, 211 Curse of Manhood, The, 433 D Day Dreaming, 26 Dangerous Diseases, 257 Danger in Lack of Knowledge, 403 Deformities, 98 Development of the Individual, 98 Desertion and Divorce, 187 Desire, Stimulated by Drugs, 250 Desire Moderated by Drugs, 250 Deformities, 264 Desire, Want of, 205 Deafness, How to Cure, 362 Devil's Decoys, The, 419 Disadvantages of Celibacy, 138 Diseased, Parents, 144 Disrupted Love, 159 Divorces, 166 Distress during Consummation, 202 Diseases, Heredity and Transmission of, 263 Diseases of Pregnancy, 274 Diseases of Infants and Children, 338 Diarrhoea, 340, 363 Diphtheria, 346 Diseases of Women and Treatment, 349, 480-485 Disinfectant, 360 Digestibility of Food, 374 Dietetic Recipes, 375 Diseases of Women, 483 Dictionary of Medical Terms, 486 Drink, 16 Dress, 88 Dress Affects Our Manners, 90 Drugs which Stimulate Desire, 250 Drugs which Moderate Desire, 250 Drug Habit, The, 441 Dude of the 17th Century, 87 Duration of Pregnancy, 296 Dyspepsia Cure, 360 E Early Marriages, 351, 410 Education of Child in the Womb, 292 Effects of Cigarette Smoking, 445-450 Egyptian Dancer, An, 20 Eruptions on the Skin, 272 Etiquette, Rules on, 49 Etiquette of Calls, 56 Etiquette in Your Speech, 57 Etiquette of Dress and Habits, 58 Etiquette on the Street, 59 Etiquette Between Sexes, 60 Eugenic Baby Party, 75 Eunuchs, 407 Evidence of Conception, 269 Expectant Mother, The, 284 Exciting the Passions in Children, 404 Exposed Youth, 427 Excesses by Married Men, 434 Eye Wash, 355 F Fame, 18 Family Group, Blessing the, 19 Family Government, 76 False Beautifiers, 129 False Appearance, 131 Family Troubles, Cause of, 217 Families, Small, 232 Fallopian Tubes, 237 Fake Medical Advice, 240, 250 Fainting, 281 Falling of the Womb, 350 Fast Young Men, 435 Female Character, Influence of, 30 Female Beauty, 129 Feet, Small, 130 Female Organs, Conditions of, 204 Female Magnetism, 235 Female Sexual Organs, 235 Feeding Infants, 319 Fevers, 327 Feet with Bad Odor, 354 Felon, 358, 364 Female Organs of Creative Life, 385 First Love, 185 First Conjugal Approach, 203 Flirting, 166, 168 Flirting and Its Dangers, 190 Form, Male and Female, 98 Former Customs, 162 Fondling and Caressing, 168 Folly of Follies, 217 Foetal Heart, 273 Follies of Youth, 468 Free Lovers, 133 Frequency of Intercourse, 208 Full Busts, 130 G Garden of Eden, 133 Gathered Breast, 322 Generosity, 126 Generative Organs, Male, 234 Generative Organs, Female, 236 Girls, Save the, 380 Gland, The Penal, 235 Gland, The Prostate, 235 Gladstone, 8 Gleet, Symptoms and Treatment of, 468 Good Character, 73 Gout, 362 Gonorrhoea (Clap), 464 Gonorrhoea (Clap), Remedy for, 466 Grace, 28 Gray Hair, 110 Grave-Yard Statistics, 226 Grossness of Sensuality, 419 H Hawaiian Islands and Marriage, 163 Harlot's Woes, A, 431 Habits, 17 Hair and Beard, 85 Hand in Hand, 92 Hair, The Care of, 107-111 Hate-Spats, 154 Hap-Hazard Marriages, 218 Hair, How to Remove, 360 Harlot's Mess of Meat, The, 418 Harlot's Influence, 431 Health a Duty, 7 Helps to Beauty, 95 Heart, A Broken, 159 Healthy Wives and Mothers, 183 Hereditary Descent, 224 Healthy People--Most Children, 226 Heartburn, 276, 357 Headache, 280, 355, 360, 363 Health Rules for Babies, 314 History of Marriage, 132 Hints on Courtship and Marriage, 148-153 Hints in Choosing a Partner, 162 Hives, 354, 360 Home Ties, 6, 22 Home, The Best Regulated, 14 Honesty or Knavery, 17 Home Power, 23 Home Makes the Man, 23 Home the Best of Schools, 25 Homely Men, 128 Honeymoon, How to Perpetuate, 209 Home Treatment, Diseases of Children, 338 Home Treatment of the Secret Habit, 455 How to Write Letters, 34-47 How to Write Love Letters, 37 How to Write Social Letters, 39 How to Determine Perfect Human Figure, 99 How to be a Good Wife, 210 How to be a Good Husband, 212 How to Calculate Time of Labor, 295 How to Keep a Baby Well, 330-335 How to Cook for the Sick, 375 How Many Girls are Ruined, 190 How to Overcome "Secret Habit", 389 How to Tell a Victim of the "Secret Habit", 451 How to Tell Children the Story of Life, 390-395, 401-403 Hot Water for all Diseases, 368 Husband, Whom to Choose for a, 144 Husband's Brutality, 412 Hymen or Vaginal Valve, 202, 203, 236 Hysteria, 349 I Ignorance, 24 Illicit Pleasures, 207 Illegitimates or Bastards, 224 Illegitimates, Character of, 225 Impulse, 14 Impolite, 70 Improper Liberties, 168 Improvement of the Race, 232 Impotence and Sterility 248 Impotence, Lack of Sexual Vigor, 251 Improper Liberties During Courtship, 267 Impregnation or Conception, 269, 283 Impregnation Artificial, 270 Immorality, Disease and Death, 416 Independence, The Growth of, 6 Influences, 18 Integrity, 19 Influence, The Mother's, 21 Influence of Women, 30 Intelligence, 126-131 Intercourse, Proper, 205 Indulgence, The Time for, 207 Intercourse, Frequency of, 208 Intercourse During Pregnancy, 207, 283 Infanticide, 255 Infantile Convulsions, 319 Indigestion, 328 Infant Teething, 336 Inflammation of Womb, 349 Inhumanities of Parents, 396 Itching of External Parts, 279 J Jealousy, 156 Jealousy--Its Cause and Cure, 219 Juke Family, The, 243 K Kalmuck Tartar and Marriage, 163 Keep the Boys Pure, 429 Kindness, 28 Kissing, 168 Knowledge is Safety, 3 L Ladies' Society, 61 Lady's Dress in Days of Greece, 100 Lacing, 104 Large Men, 126 Lack of Knowledge, 267 Letter Writing, 34-47 Letters, Social, 39 Leucorrhoea, 247, 349 Lessons for Parents, 312 Life Methods, 18 Licentiousness, Beginning of, 151 Limitation of Offspring, 242 Liver-Spots, 281 Love Letters, 37 Love, 114-117 Love, Power and Peculiarities of, 118 Love, Turkish Way of Making, 120 Love and Common Sense, 123 Love-Spats, 154 Love for the Dead, 160 Loss of Desire, 205 Longevity, 367 Loss of Maiden Purity, 404 Low Fiction, 421 Lost Manhood Restored, 459 Lung Trouble, 326 Lustful Eyes, 410 M Marriage Excesses, 208 Matrimonial Infelicity, 217 Male Sexual Organs, 234 Maternity a Diadem of Beauty, 262 Marks and Deformities, 264 Maternity, Preparation for, 266 Marrying Too Early, 288 Marry, Time to, 351 Man Unsexed, 407 Marriage Bed Resolutions, 427 Man's Lost Powers, 436 Man, The Ideal, 14 Masculine Attention, 62 Maternal Love, 24 Manners, Table, 63 Male Form, 98 Marriage, History of, 132 Marriage, 134 Marriages, Too Early, 136-144 Maids, Old, 140-143 Marry, When and Whom to, 144 Marrying First Cousins, 146 Marriage, Hints on, 148 Marriages, Unhappy, 151 Matrimonial Pointers, 171 Marriage Securities, 174 Marrying for Wealth, 181 Marriage, Time for, 191 Marriage and Motherhood, 192 Marriage, Consummation of, 202 Manhood Wrecked and Rescued, 461 Magnetism, 470-472 Men Haters, 62 Membership in Society, 66 Mental Derangements, 264 Menstruation During Pregnancy, 270 Menstruation During Nursing, 352 Measles, 328, 345, 363 Menstruation, 351, 385 Men Demand Purity, 427 Miscarriage, 207, 253, 283 Miscarriage, Causes and Symptoms, 253 Miscarriage Home Treatment, 254 Miscarriage Prevention, 254 Middle Age, 436 Mistakes Often Fatal, 7 Mistakes of Parents, 185 Moderation, 243 Morning Sickness and Remedy, 271, 282 Modified Milk, 329 Moral Degeneracy, 414 Moral Manhood, 414 Moral Lepers, 433 Moral Principle, 16 Mother's Influence, 21 Mother, A Devoted, 22 Mohammedanism, 133 Mormonism, 133 Monogamy (Single Wife), 134 Motherhood, 150 Morganic Marriages, 162 Murder of the Innocents, 255 Mumps, 345, 358 N Name, A Good, 18 Name, An Empty or an Evil, 20 Nature's Remedy, 233 Natural Waist, 105 Newly Married Couples, Advice to, 201 Neuralgia, 356, 360 Need of Early Instruction, 380 Non-Completed Intercourse, 411 Nocturnal Emissions and Home Treatment, 459 Nurseries, 24 Nuptial Chamber, 202-204 Nursing, 321 Nursing Sick Children, 325 Nude in Art, The, 422 O Obscene Literature, 421 Offspring, The Improvement of, 222 Old Maids, 140-143 Ornaments, 94 Our Secret Sins, 409 Ovaries, 237-238 Over-indulgence, 251 Over-Worked Mothers, 285 P Parents Must Obey, 226 Parents, Feeble and Diseased, 241 Palpitation of the Heart, 281 Pains and Ills in Nursing, 321 Parents Must Teach Children, 391 Passions in Children, 404 Passionate Men, 127 Parents, Diseased, 144 Parents' Participation, 224 Penal Gland, 235 Personal Purity, 31, 415 Penmanship, 34 Personality of Others, 70 Person, Care of the, 81 Perfect Human Figure, 99 Penalties for lost Virtue, 432 Physical and Moral Degeneracy, 414 Physical Deformities, 98 Physical Perfection, 99 Physical Relations of Marriage, 192 Phimosis, Symptoms and Treatment, 469 Piles, 280, 362 Pimples or Facial Eruptions, 111 Plea for Purity, A, 380 Plain Words to Parents, 390 Pleasures, Illicit, 207 Population Limited, 232 Poison Ivy, 359 Poison Sumach, 359 Policy of Silence in Sex Matters, 416 Pollution, Sinks of, 12 Pollution, Sow, 15 Politeness, 70 Polygamy, 133-162 Popping the Question, 195 Poisonous Literature, 421 Pox-Syphilis, 464 Pox-Symptoms and Treatment, 467 Prevention of Conception, 233, 239, 240-241 Prevention, Nature's Method, 243 Prenatal Influences, 244 Prostate Gland, 235 Producing Boys or Girls at Will, 252 Preparation for Maternity, 266 Pregnancy Signs and Symptoms, 270 Pregnancy, Diseases of, 274 Pregnancy, Duration of, 296 Prescription for Diseases, 355 Prickly Heat, Cure for, 373 Principle Moral, 10 Prisons, 19 Practical Rules on Table Manners, 63 Prostitution, 137,381 Proposing, A Romantic Way, 198 Proper Intercourse, 205 Pregnancy, Restraint During, 207 Preparation for Parenthood, 225 Prostitution of Men, 427 Private Talk to Young Men, 437 Puberty, Virility and Hygienic Laws, 406 Purity, 62 Puberty, 144 Puritanic Manhood, 425 Pure Minded Wife, 435 Q Quacks and Methods Exposed, 250, 453, 457 Quickening, 271 Quinsy, 365 R Reputation, Value of, 9 Reputation, Selling out Their, 19 Religion in Women, 131 Restraint During Pregnancy, 207 Revelation for Women, 247 Remedies for Sterility, 249 Remedies for Diseases, 355 Recruiting Office for Prostitution, 380 Remedy for "Secret Habit", 394 Rebuking Sensualism, 410 Remedies for the Social Evil, 440 Remedies for Diseases of Women, 483-485 Rival the Boys, 27 Ring Worm, 362 Rights of Lovers, 168 Right of Children to be Born Right, 464 Roman Ladies, 29 Road to Shame, The, 430 Rules on Etiquette, 49-64 Rules on Table Manners, 63 Ruin and Seduction, 152 Rules for the Nurse, 366 Ruined Sister, A, 431 S Save the Girls, 380 Save the Boys, 390 Scientific Theories of Life, 238 Scarlet Fever, 328, 343, 363 Schedule for Feeding Babies, 329 Sexual Passions, 407 Sexual Exhaustion, 411 Secret Diseases, 413 Seeing Life, 419 Sexual Impotency, The Remedy, 461 Secret Diseases, 464 Seed of Life, 225 Sexual Organs, Male, 234 Sexual Organs, Female, 235 Seducer, The, 190 Self Abuse or "Secret Habit", 389 Sex Instruction for Children, 380, 390, 400 Sexual Propensities, 400 Self-Control, 12 Self-Denial, Practice, 15 Selfishness, 24 Self-Forgetfulness, 72 Sensible Helps to Beauty, 95-114 Sexual Excitement, 126 Sexual Vigor, 127 Seduction and Ruin, 152 Seducer, A, 168 Sensuality and Unnatural Passion, 202-208 Sexual Life, Rightly Beginning, 205 Sexual Proprieties and Improprieties, 206 Separate Beds, 206 Sexual Control, 208-241 Shall Sickly People Raise Children, 233 Shall Pregnant Women Work, 285 Shy People, 72 Signs and Symptoms of Labor, 297 Signs of Virility, 408 Signs of Excesses, 410 Sisterhood of Shame, The, 418, 425 Slaves of Injurious Drugs, 441 Sleeplessness, 281 Small Families, 232 Small and Weakly Men, 126 Sore Nipples, 321 Society Evils, 384 Society, Govern, 24 Social Letters, 39 Social Duties, 65 Society, Membership in, 66 Soiled Garments, 85 Soft Men, 27 Solomon and Polygamy, 133 Society Rules and Customs, 191 Sowing Wild Oats, 417 Social Evil, 410 Speech, Improved by Reading, 57 Special Safeguards in Confinement, 299 Sprains, 359 Startling Sins, 423 Sterility in Females, 237 Sterility, 248 Sterility, Remedies for, 249 Sterility common to women, 251 Stomachache, 326 Stabs, 358 Story of Life for Children, 401 Stranger, Silken Enticements of, 28 Style of Beauty, 91 Summer Complaint, 340 Success or Failure, 276 Swollen Legs During Pregnancy, 276 Symptoms of the "Secret Habit", 451 Syphilitic Poison, 465 Syphilis (Pox), 464, 467 Syphilis (Pox) Treatment of, 468 Syphilis, Recipe for, 468 Syringes, Whirling Spray, 246 T Table Manners, 63 Tables for Feeding a Baby, 329 Teeth, 85 Test of Virginity, 202, 237 Teething, 336, 310 Teach Sex Truths to Children, 401, 416 Temples of Lust, 425 Thinking only of Dress, 81 Throat Troubles, 354 Tight Lacing, 104 Time to Marry, 351 Too Many Children, 229 Toothache, 280 True Kind of Beauty, 129 Twins, 205 Twilight Sleep, 479 U Unwelcome Child, 258 Union of the Sexes, The, 400 Unchastity, 409 Unfaithfulness, 423 Unjust Demands, 428 Underclothing, 85 Uniformed Men, 128 Unhappy Marriages, 151 Urethra, 231 Urethra, Stricture of--Symptoms and Treatment, 469 V Vaginal Cleanliness, 246 Vice or Virtue, 6 Virtues, Root of all the, 12 Virtue, A New, 19 Virginity, Test of, 202, 237 Vile Women, 382 Vomiting, 363 Vulgar Desire, 428 Vulgar, Society of the, 11 W Warning, 6 Waist, Natural, 105 Wasp Waists, 181 Warts, Cure for, 364 Wealth, 73 Wedlock, Advantages of, 135 Wedding Rings, 167 Wedding, The Proper Time, 199 Weaning, 318 Wens, 364 What Women Love in Men, 126 What Men Love in Women, 129 When and Whom to Marry, 311 Why Children Die, 226 When Conception Takes Place, 269 Whites, The, 277 What a Mother Should Know, 326 Whooping Cough, 344, 360 Why Girls Go Astray, 381 What is Puberty, 406 When Passion Begins, 407 Wife, How to be a Good, 210 Words, Power of, 15 Woman, The Best Educator, 25 Women, Young, 26 Women, Influence of, 30 Woman Haters, 61 Woman the Perfect Type of Beauty, 92 Woman's Love, 116 Women who Makes Best Wives, 178 Worms and Remedy, 341 Womb, inflammation of, 349 Womb Falling of, 350 Y Young Mothers, Advice to, 286 Young Man's Personal Appearance, 86 Youth, Bloom and Grace of, 97 Youthful Sexual Excitement, 126 [Transcriber's Note: Most probable typos in the original paper book have been retained as printed, e.g. saguine, excercise, diagnotic, attacts. However, two occurrences of "Prostrate" have been changed to "Prostate" when referring to the prostate gland.] 
23609	----	Transcriber's note: A few typographical errors have been corrected: they are listed at the end of the text. * * * * * [Illustration: GUARDIAN ANGEL] * * * * * SEARCHLIGHTS ON HEALTH LIGHT ON DARK CORNERS * * * * * A COMPLETE SEXUAL SCIENCE AND A Guide to Purity and Physical Manhood ADVICE TO MAIDEN, WIFE, AND MOTHER LOVE, COURTSHIP, AND MARRIAGE. * * * * * BY PROF. B. G. JEFFERIS, M.D., PH.D., AND J. L. NICHOLS, A.M. * * * * * J. L. NICHOLS & CO. Naperville, Ill. Memphis, Tenn. Atlanta, Ga. SOLD ONLY BY SUBSCRIPTION. AGENTS WANTED * * * * * "Vice has no friend like the prejudice which claims to be virtue."--_Lord Lytton_. * * * * * "When the judgment's weak, the prejudice is strong."--_Kate O'Hare_. * * * * * "It is the first right of every child to be well born." * * * * * Entered according to Act of Congress, in the year 1894 By J. L. NICHOLS, In the Office of the Librarian of Congress, at Washington, D. C. * * * * * Copyrighted 1895. * * * * * Copyrighted. 1896, by J. L. Nichols & Co. * * * * * Copyrighted, 1904, by J. L. Nichols & Co. * * * * * OVER 500,000 COPIES SOLD. * * * * * {3} He stumbleth not, because he seeth the Light. [Illustration: "Search Me, Oh Thou Great Creator."] * * * * * Knowledge is Safety. 1. The old maxim, that "Knowledge is power," is a true one, but there is still a greater truth: "KNOWLEDGE IS SAFETY." Safety amid physical ills that beset mankind, and safety amid the moral pitfalls that surround so many young people, is the great crying demand of the age. {4} 2. CRITICISM.--While the aim of this work, though novel and to some extent is daring, it is chaste, practical and to the point, and will be a boon and a blessing to thousands who consult its pages. The world is full of ignorance, and the ignorant will always criticise, because they live to suffer ills, for they know no better. New light is fast falling upon the dark corners, and the eyes of many are being opened. 3. RESEARCHES OF SCIENCE.--The researches of science in the past few years have thrown light on many facts relating to the physiology of man and woman, and the diseases to which they are subject, and consequently many reformations have taken place in the treatment and prevention of diseases peculiar to the sexes. 4. LOCK AND KEY.--Any information bearing upon the diseases of mankind should not be kept under lock and key. The physician is frequently called upon to speak in plain language to his patients upon some private and startling disease contracted on account of ignorance. The better plan, however, is to so educate and enlighten old and young upon the important subjects of health, so that the necessity to call a physician may occur less frequently. 5. PROGRESSION.--A large, respectable, though diminishing class in every community, maintain that nothing that relates exclusively to either sex should become the subject of popular medical instruction. But such an opinion is radically wrong; ignorance is no more the mother of purity than it is of religion. Enlightenment can never work injustice to him who investigates. 6. AN EXAMPLE.--The men and women who study and practice medicine are not the worse, but the better for such knowledge; so it would be to the community in general if all would be properly instructed on the laws of health which relate to the sexes. 7. CRIME AND DEGRADATION.--Had every person a sound understanding on the relation of the sexes, one of the most fertile sources of crime and degradation would be removed. Physicians know too well what sad consequences are constantly occurring from a lack of proper knowledge on these important subjects. 8. A CONSISTENT CONSIDERATION.--Let the reader of this work study its pages carefully and be able to give safe counsel and advice to others, and remember that purity of purpose and purity of character are the brightest jewels in the crown of immortality. * * * * * {5} The Beginning of Life. [Illustration: Beginning Right.] 1. THE BEGINNING.--There is a charm in opening manhood which has commended itself to the imagination in every age. The undefined hopes and promises of the future--the dawning strength of intellect--the vigorous flow of passion--the very exchange of home ties and protected joys for free and manly pleasures, give to this period an interest and excitement unfelt, perhaps, at any other. {6} 2. THE GROWTH OF INDEPENDENCE.--Hitherto life has been to boys, as to girls, a dependent existence--a sucker from the parent growth--a home discipline of authority and guidance and communicated impulse. But henceforth it is a transplanted growth of its own--a new and free power of activity in which the mainspring is no longer authority or law from without, but principle or opinion within. The shoot which has been nourished under the shelter of the parent stem, and bent according to its inclination, is transferred to the open world, where of its own impulse and character it must take root, and grow into strength, or sink into weakness and vice. 3. HOME TIES.--The thought of home must excite a pang even in the first moments of freedom. Its glad shelter--its kindly guidance--its very restraints, how dear and tender must they seem in parting! How brightly must they shine in the retrospect as the youth turns from them to the hardened and unfamiliar face of the world! With what a sweet, sadly-cheering pathos they must linger in the memory! And then what chance and hazard is there in his newly-gotten freedom! What instincts of warning in its very novelty and dim inexperience! What possibilities of failure as well as of success in the unknown future as it stretches before him! 4. VICE OR VIRTUE.--Certainly there is a grave importance as well as a pleasant charm in the beginning of life. There is awe as well as excitement in it when rightly viewed. The possibilities that lie in it of noble or ignoble work--of happy self-sacrifice or ruinous self-indulgence--the capacities in the right use of which it may rise to heights of beautiful virtue, in the abuse of which it may sink to the depths of debasing vice--make the crisis one of fear as well as of hope, of sadness as well as of joy. 5. SUCCESS OR FAILURE.--It is wistful as well as pleasing to think of the young passing year by year into the world, and engaging with its duties, its interests, and temptations. Of the throng that struggle at the gates of entrance, how many may reach their anticipated goal? Carry the mind forward a few years, and some have climbed the hills of difficulty and gained the eminence on which they wished to stand--some, although they may not have done this, have kept their truth unhurt, their integrity unspoiled; but others have turned back, or have perished by the way, or fallen in weakness of will, no more to rise again; victims of their own sin. 6. WARNING.--As we place ourselves with the young at the opening gates of life, and think of the end from the {7} beginning, it is a deep concern more than anything else that fills us. Words of earnest argument and warning counsel rather than of congratulation rise to our lips. 7. MISTAKES ARE OFTEN FATAL.--Begin well, and the habit of doing well will become quite as easy as the habit of doing badly. "Well begun is half ended," says the proverb; "and a good beginning is half the battle." Many promising young men have irretrievably injured themselves by a first false step at the commencement of life; while others, of much less promising talents, have succeeded simply by beginning well, and going onward. The good, practical beginning is, to a certain extent, a pledge, a promise, and an assurance of the ultimate prosperous issue. There is many a poor creature, now crawling through life, miserable himself and the cause of sorrow to others, who might have lifted up his head and prospered, if, instead of merely satisfying himself with resolutions of well-doing, he had actually gone to work and made a good, practical beginning. 8. BEGIN AT THE RIGHT PLACE.--Too many are, however, impatient of results. They are not satisfied to begin where their fathers did, but where they left off. They think to enjoy the fruits of industry without working for them. They cannot wait for the results of labor and application, but forestall them by too early indulgence. * * * * * [Illustration: SOLID COMFORT AND GOOD HEALTH.] Health a Duty. Perhaps nothing will so much hasten the time when body and mind will both be adequately cared for, as a diffusion of the belief that the preservation of health is a duty. Few seem conscious that there is such a thing as physical morality. Men's habitual words and acts imply that they are at liberty to treat their bodies as they please. Disorder entailed by disobedience to nature's dictates they regard as grievances, not as the effects of a conduct more or less flagitious. Though the evil consequences inflicted on their descendents and on future generations are often as great as those caused by crime, they do not think themselves in any degree criminal. It is true that in the case of drunkenness the viciousness of a bodily transgression is recognized; but none appear to infer that if this bodily transgression is vicious, so, too, is {8} every bodily transgression. The fact is, all breaches of the law of health are physical sins. When this is generally seen, then, and perhaps not till then, will the physical training of the young receive all the attention it deserves. Purity of life and thought should be taught in the home. It is the only safeguard of the young. Let parents wake up on this important subject. * * * * * {9} Value of Reputation. 1. WHO SHALL ESTIMATE THE COST.--Who shall estimate the cost of a priceless reputation--that impress which gives this human dross its currency--without which we stand despised, debased, depreciated? Who shall repair it injured? Who can redeem it lost? Oh, well and truly does the great philosopher of poetry esteem the world's wealth as "trash" in the comparison. Without it gold has no value; birth, no distinction; station, no dignity; beauty, no charm; age, no reverence; without it every treasure impoverishes, every grace deforms, every dignity degrades, and all the arts, the decorations and accomplishments of life stand, like the beacon-blaze upon a rock, warning the world that its approach is dangerous; that its contact is death. 2. THE WRETCH WITHOUT IT.--The wretch without it is under eternal quarantine; no friend to greet; no home to harbor him, the voyage of his life becomes a joyless peril; and in the midst of all ambition can achieve, or avarice amass, or rapacity plunder, he tosses on the surge, a buoyant pestilence. But let me not degrade into selfishness of individual safety or individual exposure this individual principle; it testifies a higher, a more ennobling origin. 3. ITS DIVINITY.--Oh, Divine, oh, delightful legacy of a spotless reputation: Rich is the inheritance it leaves; pious the example it testifies; pure, precious and imperishable, the hope which it inspires; can there be conceived a more atrocious injury than to filch from its possessor this inestimable benefit to rob society of its charm, and solitude of its solace; not only to out-law life, but attain death, converting the very grave, the refuge of the sufferer, into the gate of infamy and of shame. 4. LOST CHARACTER.--We can conceive few crimes beyond it. He who plunders my property takes from me that which can be repaired by time; but what period can repair a ruined reputation? He who maims my person effects that which medicine may remedy; but what herb has sovereignty over the wounds of slander? He who ridicules my poverty or reproaches my profession, upbraids me with that which industry may retrieve, and integrity may purify; but what riches shall redeem the bankrupt fame? What power shall blanch the sullied show of character? There can be no injury more deadly. There can be no crime more cruel. It is without remedy. It is without antidote. It is without evasion. * * * * * {11} Influence of Associates. If you always live with those who are lame, you will yourself learn to limp.--FROM THE LATIN. If men wish to be held in esteem, they must associate with those who are estimable.--LA BRUYERE. [Illustration: GATHERING WILD FLOWERS.] 1. BY WHAT MEN ARE KNOWN.--An author is known by his writings, a mother by her daughter, a fool by his words, and all men by their companions. 2. FORMATION OF A GOOD CHARACTER.--Intercourse with persons of decided virtue and excellence is of great importance in the formation of a good character. The force of example is powerful; we are creatures of imitation, and, by a necessary influence, our tempers and habits are very much formed on the model of those with whom we familiarly associate. Better be alone than in bad company. Evil communications corrupt good manners. Ill qualities are catching as well as diseases; and the mind is at least as much, if not a great deal more, liable to infection, than the body. Go with mean people, and you think life is mean. 3. GOOD EXAMPLE.--How natural is it for a child to look up to those around him for an example of imitation, and how readily does he copy all that he sees done, good or bad. The importance of a good example on which the young may exercise this powerful and active element of their nature, is a matter of the utmost moment. 4. A TRUE MAXIM.--It is a trite, but true maxim, that "a man is known by the company he keeps." He naturally assimilates by the force of imitation, to the habits and manners of those by whom he is surrounded. We know persons who walk much with the lame, who have learned to walk with a hitch or limp like their lame friends. Vice stalks in the streets unabashed, and children copy it. 5. LIVE WITH THE CULPABLE.--Live with the culpable, and you will be very likely to die with the criminal. Bad company is like a nail driven into a post, which after the first or second blow, may be drawn out with little difficulty; but being once driven in up to the head, the pinchers cannot take hold to draw it out, which can only be done by the destruction of the wood. You may be ever so pure, you cannot associate with bad companions without falling into bad odor. 6. SOCIETY OF THE VULGAR.--Do you love the society of the vulgar? Then you are already debased in your sentiments. Do you seek to be with the profane? In your heart you are like them. Are jesters and buffoons your choice friends? {12} He who loves to laugh at folly, is himself a fool. Do you love and seek the society of the wise and good? Is this your habit? Had you rather take the lowest seat among these than the highest seat among others? Then you have already learned to be good. You may not make very much progress, but even a good beginning is not to be despised. 7. SINKS OF POLLUTION.--Strive for mental excellence, and strict integrity, and you never will be found in the sinks of pollution, and on the benches of retailers and gamblers. Once habituate yourself to a virtuous course, once secure a love of good society, and no punishment would be greater than by accident to be obliged for half a day to associate with the low and vulgar. Try to frequent the company of your betters. 8. PROCURE NO FRIEND IN HASTE.--Nor, if once secured, in haste abandon them. Be slow in choosing an associate, and slower to change him; slight no man for poverty, nor esteem any one for his wealth. Good friends should not be easily forgotten, nor used as suits of apparel, which, when we have worn them threadbare, we cast them off, and call for new. When once you profess yourself a friend, endeavor to be always such. He can never have any true friends that will be often changing them. 9. HAVE THE COURAGE TO CUT THE MOST AGREEABLE ACQUAINTANCE.--Do this when you are convinced that he lacks principle; a friend should bear with a friend's infirmities, but not with his vices. He that does a base thing in zeal for his friend, burns the golden thread that ties their hearts together. * * * * * Self-Control. "Honor and profit do not always lie in the same sack."--GEORGE HERBERT. "The government of one's self is the only true freedom for the individual."--FREDERICK PERTHES. "It is length of patience, and endurance, and forebearance, that so much of what is called good in mankind and womankind is shown."--ARTHUR HELPS. * * * * * 1. ESSENCE OF CHARACTER.--Self-control is only courage under another form. It may also be regarded as the primary essence of character. It is in virtue of this quality that Shakespeare defines man as a being "looking before and after." It forms the chief distinction between man and the mere animal; and, indeed, there can be no true manhood without it. [Illustration: THE RESULT OF BAD COMPANY.] 2. ROOT OF ALL THE VIRTUES.--Self-control is at the root {14} of all the virtues. Let a man give the reins to his impulses and passions, and from that moment he yields up his moral freedom. He is carried along the current of life, and becomes the slave of his strongest desire for the time being. 3. RESIST INSTINCTIVE IMPULSE.--To be morally free--to be more than an animal--man must be able to resist instinctive impulse, and this can only be done by exercise of self-control. Thus it is this power which constitutes the real distinction between a physical and a moral life, and that forms the primary basis of individual character. 4. A STRONG MAN RULETH HIS OWN SPIRIT.--In the Bible praise is given, not to a strong man who "taketh a city," but to the stronger man who "ruleth his own spirit." This stronger man is he who, by discipline, exercises a constant control over his thoughts, his speech, and his acts. Nine-tenths of the vicious desires that degrade society, and which, when indulged, swell into the crimes that disgrace it, would shrink into insignificance before the advance of valiant self-discipline, self-respect, and self-control. By the watchful exercise of these virtues, purity of heart and mind become habitual, and the character is built up in chastity, virtue, and temperance. 5. THE BEST SUPPORT.--The best support of character will always be found in habit, which, according as the will is directed rightly or wrongly, as the case may be, will prove either a benignant ruler, or a cruel despot. We may be its willing subject on the one hand, or its servile slave on the other. It may help us on the road to good, or it may hurry us on the road to ruin. 6. THE IDEAL MAN.--"In the supremacy of self-control," says Herbert Spencer, "consists one of the perfections of the ideal man. Not to be impulsive, not to be spurred hither and thither by each desire that in turn comes uppermost, but to be self-restrained, self-balanced, governed by the joint decision of the feelings in council assembled, before whom every action shall have been fully debated, and calmly determined--that it is which education, moral education at least, strives to produce." 7. THE BEST REGULATED HOME.--The best regulated home is always that in which the discipline is the most perfect, and yet where it is the least felt. Moral discipline acts with the force of a law of nature. Those subject to it yield themselves to it unconsciously; and though it shapes and forms the whole character, until the life becomes crystallized in habit, the influence thus exercised is for the most part unseen, and almost unfelt. {15} 8. PRACTICE SELF-DENIAL.--If a man would get through life honorably and peaceably, he must necessarily learn to practice self-denial in small things as well as in great. Men have to bear as well as to forbear. The temper has to be held in subjection to the judgment; and the little demons of ill-humor, petulance, and sarcasm, kept resolutely at a distance. If once they find an entrance to the mind, they are apt to return, and to establish for themselves a permanent occupation there. 9. POWER OF WORDS.--It is necessary to one's personal happiness, to exercise control over one's words as well as acts: for there are words that strike even harder than blows; and men may "speak daggers," though they use none. The stinging repartee that rises to the lips, and which, if uttered, might cover an adversary with confusion, how difficult it is to resist saying it! "Heaven, keep us," says Miss Bremer, in her 'Home', "from the destroying power of words! There are words that sever hearts more than sharp swords do; there are words the point of which sting the heart through the course of a whole life." 10. CHARACTER EXHIBITS ITSELF.--Character exhibits itself in self-control of speech as much as in anything else. The wise and forbearant man will restrain his desire to say a smart or severe thing at the expense of another's feeling; while the fool blurts out what he thinks, and will sacrifice his friend rather than his joke. "The mouth of a wise man," said Solomon, "is in his heart: the heart of a fool is in his mouth." 11. BURNS.--No one knew the value of self-control better than the poet Burns, and no one could teach it more eloquently to others, but when it came to practice, Burns was as weak as the weakest. He could not deny himself the pleasure of uttering a harsh and clever sarcasm at another's expense. One of his biographers observed of him, that it was no extravagant arithmetic to say that for every ten jokes he made himself a hundred enemies. But this was not all. Poor Burns exercised no control over his appetites, but freely gave them the rein: "Thus thoughtless follies laid him low, And stained his name." [Illustration: LOST SELF-CONTROL.] 12. SOW POLLUTION.--Nor had he the self-denial to resist giving publicity to compositions originally intended for the delight of the tap-room, but which continued secretly to sow pollution broadcast in the minds of youth. Indeed, notwithstanding the many exquisite poems of this writer, it is not saying too much that his immoral writings have done far more harm than his purer writings have done good; and {16} it would be better that all his writings should be destroyed and forgotten, provided his indecent songs could be destroyed with them. 13. MORAL PRINCIPLE.--Many of our young men lack moral principle. They cannot look upon a beautiful girl with a pure heart and pure thoughts. They have not manifested or practiced that self-control which develops true manhood, and brings into subordination evil thoughts, evil passions, and evil practices. Men who have no self-control will find life a failure, both in a social and in a business sense. The world despises an insignificant person who lacks backbone and character. Stand upon your manhood and womanhood; honor your convictions, and dare to do right. 14. STRONG DRINK.--There is the habit of strong drink. It is only the lack of self-control that brings men into the depths of degradation; on account of the cup, the habit of taking drink occasionally in its milder forms--of playing with a small appetite that only needs sufficient playing with to make you a demon or a dolt. You think you are safe; I know you are not safe, if you drink at all; and when you get offended with the good friends that warn you of your danger, you are a fool. I know that the grave swallows daily, by scores, drunkards, every one of whom thought he was safe while he was forming his appetite. But this is old talk. A young man in this age who forms the habit of drinking, or puts himself in danger of forming the habit, is usually so weak that it doesn't pay to save him. * * * * * {17} Habit. It is almost as difficult to make a man unlearn his Errors as his Knowledge.--COLTON. There are habits contracted by bad example, or bad management, before we have judgment to discern their approaches, or because the eye of Reason is laid asleep, or has not compass of view sufficient to look around on every quarter.--TUCKER. * * * * * 1. HABIT.--Our real strength in life depends upon habits formed in early life. The young man who sows his wild oats and indulges in the social cup, is fastening chains upon himself that never can be broken. The innocent youth by solitary practice of self-abuse will fasten upon himself a habit which will wreck his physical constitution and bring suffering and misery and ruin. Young man and young woman, beware of bad habits formed in early life. 2. A BUNDLE OF HABITS.--Man, it has been said, is a bundle of habits; and habit is second nature. Metastasio entertained so strong an opinion as to the power of repetition in act and thought, that he said, "All is habit in mankind, even virtue itself." Evil habits must be conquered, or they will conquer us and destroy our peace and happiness. 3. VICIOUS HABITS.--Vicious habits, when opposed, offer the most vigorous resistence on the first attack. At each successive encounter this resistence grows fainter and fainter, until finally it ceases altogether and the victory is achieved. Habit is man's best friend and worst enemy; it can exalt him to the highest pinnacle of virtue, honor and happiness, or sink him to the lowest depths of vice, shame and misery. 4. HONESTY, OR KNAVERY.--We may form habits of honesty, or knavery; truth, or falsehood; of industry, or idleness; frugality, or extravagance; of patience, or impatience; self-denial, or self-indulgence; of kindness, cruelty, politeness, rudeness, prudence, perseverance, circumspection. In short, there is not a virtue, nor a vice; not an act of body, nor of mind, to which we may not be chained down by this despotic power. 5. BEGIN WELL.--It is a great point for young men to begin well; for it is the beginning of life that that system of conduct is adopted which soon assumes the force of habit. Begin well, and the habit of doing well will become quite easy, as easy as the habit of doing badly. Pitch upon that course of life which is the most excellent, and habit will render it the most delightful. * * * * * {18} A Good Name. 1. THE LONGING FOR A GOOD NAME.--The longing for a good name is one of those laws of nature that were passed for the soul and written down within to urge toward a life of action, and away from small or wicked action. So large is this passion that it is set forth in poetic thought, as having a temple grand as that of Jupiter or Minerva, and up whose marble steps all noble minds struggle--the temple of Fame. 2. CIVILIZATION.--Civilization is the ocean of which the millions of individuals are the rivers and torrents. These rivers and torrents swell with those rains of money and home and fame and happiness, and then fall and run almost dry, but the ocean of civilization has gathered up all these waters, and holds them in sparkling beauty for all subsequent use. Civilization is a fertile delta made by the drifting souls of men. 3. FAME.--The word "fame" never signifies simply notoriety. The meaning of the direct term may be seen from its negation or opposite, for only the meanest of men are called infamous. They are utterly without fame, utterly nameless; but if fame implied only notoriety then infamous would possess no marked significance. Fame is an undertaker that pays but little attention to the living, but who bedizens the dead, furnishes out their funerals and follows them to the grave. 4. LIFE-MOTIVE.--So in studying that life-motive which is called a "good name," we must ask the large human race to tell us the high merit of this spiritual longing. We must read the words of the sage, who said long centuries ago that "a good name was rather chosen than great riches." Other sages have said as much. Solon said that "He that will sell his good name will sell the State." Socrates said, "Fame is the perfume of heroic deeds." Our Shakspeare said, "He lives in fame who died in virtue's cause." 5. INFLUENCES OF OUR AGE.--Our age is deeply influenced by the motives called property and home and pleasure, but it is a question whether the generation in action to-day and the generation on the threshold of this intense life are conscious fully of the worth of an honorable name. 6. BEAUTY OF CHARACTER.--We do not know whether with us all a good name is less sweet than it was with our fathers, but this is painfully evident, that our times do not sufficiently behold the beauty of character--their sense does not {19} detect quickly enough or love deeply enough this aroma of heroic deeds. 7. SELLING OUT THEIR REPUTATION.--It is amazing what multitudes there are who are willing to sell out their reputation, and amazing at what a low price they will make the painful exchange. Some king remarked that he would not tell a lie for any reward less than an empire. It is not uncommon in our world for a man to sell out all his honor and hopes for a score or a half score of dollars. 8. PRISONS OVERFLOWING.--Our prisons are all full to overflowing of those who took no thought of honor. They have not waited for an empire to be offered them before they would violate the sacred rights of man, but many of them have even murdered for a cause that would not have justified even an exchange of words. 9. INTEGRITY THE PRIDE OF THE GOVERNMENT.--If integrity were made the pride of the government, the love of it would soon spring up among the people. If all fraudulent men should go straight to jail, pitilessly, and if all the most rigid characters were sought out for all political and commercial offices, there would soon come a popular honesty just as there has come a love of reading or of art. It is with character as with any new article--the difficulty lies in its first introduction. 10. A NEW VIRTUE.--May a new virtue come into favor, all our high rewards, those from the ballot-box, those from employers, the rewards of society, the rewards of the press, should be offered only to the worthy. A few years of rewarding the worthy would result in a wonderful zeal in the young to build up, not physical property, but mental and spiritual worth. [Illustration: AN ARAB PRINCESS.] 11. BLESSING THE FAMILY GROUP.--No young man or young woman can by industry and care reach an eminence in study or art or character, without blessing the entire family group. We have all seen that the father and mother feel that all life's care and labor were at last perfectly rewarded in the success of their child. But had the child been reckless or indolent, all this domestic joy--the joy of a large group--would have been blighted forever. 12. AN HONORED CHILD.--There have been triumphs at old Rome, where victors marched along with many a chariot, many an elephant, and many spoils of the East; and in all times money has been lavished in the efforts of States to tell their pleasure in the name of some general; but more numerous and wide-spread and beyond expression, by chariot or cannon or drum, have been those triumphal {20} hours, when some son or daughter has returned to the parental hearth beautiful in the wreaths of some confessed excellence, bearing a good name. 13. RICH CRIMINALS.--We looked at the utter wretchedness of the men who threw away reputation, and would rather be rich criminals in exile than be loved friends and persons at home. 14. AN EMPTY, OR AN EVIL NAME.--Young and old cannot afford to bear the burden of an empty or an evil name. A good name is a motive of life. It is a reason for that great encampment we call an existence. While you are building the home of to-morrow, build up also that kind of soul that can sleep sweetly on home's pillow, and can feel that God is not near as an avenger of wrong, but as the Father not only of the verdure and the seasons, but of you. Live a pure life and bear a good name, and your reward will be sure and great. * * * * * {21} The Mother's Influence. Mother, O mother, my heart calls for you, Many a Summer the grass has grown green, Blossomed and faded, our faces between; Yet with strong yearning and passionate pain, Long I to-night for your presence again.--_Elizabeth Akers Allen._ A mother is a mother still, The holiest thing alive.--_Coleridge._ There is none, In all this cold and hollow world, no fount Of deep, strong, deathless love, save that within A mother's heart.--_Mrs. Hemans._ And all my mother came into mine eyes, And gave me up to tears.--_Shakespeare._ * * * * * [Illustration: A PRAYERFUL AND DEVOTED MOTHER.] 1. HER INFLUENCE.--It is true to nature, although it be expressed in a figurative form, that a mother is both the morning and the evening star of life. The light of her eye is always the first to rise, and often the last to set upon man's day of trial. She wields a power more decisive far than syllogisms in argument or courts of last appeal in authority. 2. HER LOVE.--Mother! ecstatic sound so twined round our hearts that they must cease to throb ere we forget it; 'tis our first love; 'tis part of religion. Nature has set the mother upon such a pinnacle that our infant eyes and arms are first uplifted to it; we cling to it in manhood; we almost worship it in old age. 3. HER TENDERNESS.--Alas! how little do we appreciate a mother's tenderness while living. How heedless are we in youth of all her anxieties and kindness! But when she is dead and gone, when the cares and coldness of the world come withering to our hearts, when we experience for ourselves how hard it is to find true sympathy, how few to love us, how few will befriend us in misfortune, then it is that we think of the mother we have lost. 4. HER CONTROLLING POWER.--The mother can take man's whole nature under her control. She becomes what she has been called, "The Divinity of Infancy." Her smile is its sunshine, her word its mildest law, until sin and the world have steeled the heart. {22} 5. THE LAST TIE.--The young man who has forsaken the advice and influence of his mother has broken the last cable and severed the last tie that binds him to an honorable and upright life. He has forsaken his best friend, and every hope for his future welfare may be abandoned, for he is lost forever. If he is faithless to mother, he will have but little respect for wife and children. 6. HOME TIES.--The young man or young woman who love their home and love their mother can be safely trusted under almost any and all circumstances, and their life will not be a blank, for they seek what is good. Their hearts will be ennobled, and God will bless them. * * * * * {23} Home Power. "The mill-streams that turn the clappers of the world arise in solitary places."--HELPS. "Lord! with what care hast Thou begirt us round! Parents first season us. Then schoolmasters Deliver us to laws. They send us bound To rules of reason."--GEORGE HERBERT. * * * * * [Illustration: HOME AMUSEMENT.] 1. SCHOOL OF CHARACTER.--Home is the first and most important school of character. It is there that every human being receives his best moral training, or his worst, for it is there that he imbibes those principles of conduct which endure through manhood, and cease only with life. 2. HOME MAKES THE MAN.--It is a common saying, "Manners make the man;" and there is a second, that "Mind makes the man;" but truer than either is a third, that "Home makes the man." For the home-training includes not only manners and mind, but character. It is mainly in the home that the heart is opened, the habits are formed, the intellect is awakened, and character moulded for good or for evil. {24} 3. GOVERN SOCIETY.--From that source, be it pure or impure, issue the principles and maxims that govern society. Law itself is but the reflex of homes. The tiniest bits of opinion sown in the minds of children in private life afterwards issue forth to the world, and become its public opinion; for nations are gathered out of nurseries, and they who hold the leading-strings of children may even exercise a greater power than those who wield the reins of government. 4. THE CHILD IS FATHER OF THE MAN.--The child's character is the nucleus of the man's; all after-education is but superposition; the form of the crystal remains the same. Thus the saying of the poet holds true in a large degree, "The child is father of the man;" or as Milton puts it, "The childhood shows the man, as morning shows the day." Those impulses to conduct which last the longest and are rooted the deepest, always have their origin near our birth. It is then that the germs of virtues or vices, of feelings or sentiments, are first implanted which determine the character of life. 5. NURSERIES.--Thus homes, which are nurseries of children who grow up into men and women, will be good or bad according to the power that governs them. Where the spirit of love and duty pervades the home, where head and heart bear rule wisely there, where the daily life is honest and virtuous, where the government is sensible, kind, and loving, then may we expect from such a home an issue of healthy, useful, and happy beings, capable as they gain the requisite strength, of following the footsteps of their parents, of walking uprightly, governing themselves wisely, and contributing to the welfare of those about them. 6. IGNORANCE, COARSENESS, AND SELFISHNESS.--On the other hand, if surrounded by ignorance, coarseness, and selfishness, they will unconsciously assume the same character, and grow up to adult years rude, uncultivated, and all the more dangerous to society if placed amidst the manifold temptations of what is called civilized life. "Give your child to be educated by a slave," said an ancient Greek, "and, instead of one slave, you will then have two." 7. MATERNAL LOVE.--Maternal love is the visible providence of our race. Its influence is constant and universal. It begins with the education of the human being at the outstart of life, and is prolonged by virtue of the powerful influence which every good mother exercises over her children through life. When launched into the world, each to take part in its labors, anxieties, and trials, they still turn {25} to their mother for consolation, if not for counsel, in their time of trouble and difficulty. The pure and good thoughts she has implanted in their minds when children continue to grow up into good acts long after she is dead; and when there is nothing but a memory of her left, her children rise up and call her blessed. 8. WOMAN, ABOVE ALL OTHER EDUCATORS, educates humanly. Man is the brain, but woman is the heart of humanity; he its judgment, she its feeling; he its strength, she its grace, ornament, and solace. Even the understanding of the best woman seems to work mainly through her affections. And thus, though man may direct the intellect, woman cultivates the feelings, which mainly determine the character. While he fills the memory, she occupies the heart. She makes us love what he can make us only believe, and it is chiefly through her that we are enabled to arrive at virtue. 9. THE POOREST DWELLING, presided over by a virtuous, thrifty, cheerful, and cleanly woman, may thus be the abode of comfort, virtue, and happiness; it may be the scene of every ennobling relation in family life; it may be endeared to man by many delightful associations; furnishing a sanctuary for the heart, a refuge from the storms of life, a sweet resting-place after labor, a consolation in misfortune, a pride in prosperity, and a joy at all times. 10. THE GOOD HOME IS THUS THE BEST OF SCHOOLS, not only in youth but in age. There young and old best learn cheerfulness, patience, self-control, and the spirit of service and of duty. The home is the true school of courtesy, of which woman is always the best practical instructor. "Without woman," says the Provencal proverb, "men were but ill-licked cubs." Philanthropy radiates from the home as from a centre. "To love the little platoon we belong to in society," said Burke, "is the germ of all public affections." The wisest and best have not been ashamed to own it to be their greatest joy and happiness to sit "behind the heads of children" in the inviolable circle of home. [Illustration] {26} To Young Women. [Illustration: MEDITATION.] 1. TO BE A WOMAN, in the truest and highest sense of the word, is to be the best thing beneath the skies. To be a woman is something more than to live eighteen or twenty years; something more than to grow to the physical stature of women; something more than to wear flounces, exhibit dry goods, sport jewelry, catch the gaze of lewd-eyed men; {27} something more than to be a belle, a wife, or a mother. Put all these qualifications together and they do but little toward making a true woman. 2. BEAUTY AND STYLE are not the surest passports to womanhood--some of the noblest specimens of womanhood that the world has ever seen have presented the plainest and most unprepossessing appearance. A woman's worth is to be estimated by the real goodness of her heart, the greatness of her soul, and the purity and sweetness of her character; and a woman with a kindly disposition and well-balanced temper is both lovely and attractive, be her face ever so plain, and her figure ever so homely; she makes the best of wives and the truest of mothers. 3. BEAUTY IS A DANGEROUS GIFT.--It is even so. Like wealth, it has ruined its thousands. Thousands of the most beautiful women are destitute of common sense and common humanity. No gift from heaven is so general and so widely abused by woman as the gift of beauty. In about nine cases in ten it makes her silly, senseless, thoughtless, giddy, vain, proud, frivolous, selfish, low and mean. I think I have seen more girls spoiled by beauty than by any other one thing. "She is beautiful, and she knows it," is as much as to say that she is spoiled. A beautiful girl is very likely to believe she was made to be looked at; and so she sets herself up for a show at every window, in every door, on every corner of the street, in every company at which opportunity offers for an exhibition of herself. 4. BEWARE OF BEAUTIFUL WOMEN.--These facts have long since taught sensible men to beware of beautiful women--to sound them carefully before they give them their confidence. Beauty is shallow--only skin deep; fleeting--only for a few years' reign; dangerous--tempting to vanity and lightness of mind; deceitful--dazzling often to bewilder; weak--reigning only to ruin; gross--leading often to sensual pleasure. And yet we say it need not be so. Beauty is lovely and ought to be innocently possessed. It has charms which ought to be used for good purposes. It is a delightful gift, which ought to be received with gratitude and worn with grace and meekness. It should always minister to inward beauty. Every woman of beautiful form and features should cultivate a beautiful mind and heart. 5. RIVAL THE BOYS.--We want the girls to rival the boys in all that is good, and refined, and ennobling. We want them to rival the boys, as they well can, in learning, in understanding, in virtues; in all noble qualities of mind and heart, but not in any of those things that have caused them, justly or unjustly, to be described as savages. We want {28} the girls to be gentle--not weak, but gentle, and kind and affectionate. We want to be sure, that wherever a girl is, there should be a sweet, subduing and harmonizing influence of purity, and truth, and love, pervading and hallowing, from center to circumference, the entire circle in which she moves. If the boys are savages, we want her to be their civilizer. We want her to tame them, to subdue their ferocity, to soften their manners, and to teach them all needful lessons of order, sobriety, and meekness, and patience, and goodness. 6. KINDNESS.--Kindness is the ornament of man--it is the chief glory of woman--it is, indeed, woman's true prerogative--her sceptre and her crown. It is the sword with which she conquers, and the charm with which she captivates. 7. ADMIRED AND BELOVED.--Young lady, would you be admired and beloved? Would you be an ornament to your sex, and a blessing to your race? Cultivate this heavenly virtue. Wealth may surround you with its blandishments, and beauty, and learning, or talents, may give you admirers, but love and kindness alone can captivate the heart. Whether you live in a cottage or a palace, these graces can surround you with perpetual sunshine, making you, and all around you, happy. 8. INWARD GRACE.--Seek ye then, fair daughters, the possession of that inward grace, whose essence shall permeate and vitalize the affections, adorn the countenance, make mellifluous the voice, and impart a hallowed beauty even to your motions. Not merely that you may be loved, would I urge this, but that you may, in truth, be lovely--that loveliness which fades not with time, nor is marred or alienated by disease, but which neither chance nor change can in any way despoil. 9. SILKEN ENTICEMENTS OF THE STRANGER.--We urge you, gentle maiden, to beware of the silken enticements of the stranger, until your love is confirmed by protracted acquaintance. Shun the idler, though his coffers overflow with pelf. Avoid the irreverent--the scoffer of hallowed things; and him who "looks upon the wine while it is red;" him too, "who hath a high look and a proud heart," and who "privily slandereth his neighbor." Do not heed the specious prattle about "first love," and so place, irrevocably, the seal upon your future destiny, before you have sounded, in silence and secrecy, the deep fountains of your own heart. Wait, rather, until your own character and that of him who would woo you, is more fully developed. Surely, if this "first love" cannot endure a short probation, fortified by "the {29} pleasures of hope," how can it be expected to survive years of intimacy, scenes of trial, distracting cares, wasting sickness, and all the homely routine of practical life? Yet it is these that constitute life, and the love that cannot abide them is false and must die. * * * * * {30} Influence of Female Character. [Illustration: ROMAN LADIES.] 1. MORAL EFFECT.--It is in its moral effect on the mind and the heart of man, that the influence of woman is most powerful and important. In the diversity of tastes, habits, inclinations, and pursuits of the two sexes, is found a most beneficent provision for controlling the force and extravagance of human passion. The objects which most strongly seize and stimulate the mind of man, rarely act at the same time and with equal power on the mind of woman. She is naturally better, purer, and more chaste in thought and language. 2. FEMALE CHARACTER.--But the influence of female character on the virtue of men, is not seen merely in restraining and softening the violence of human passion. To her is mainly committed the task of pouring into the opening mind of infancy its first impressions of duty, and of stamping on its susceptible heart the first image of its God. Who will not confess the influence of a mother in forming the heart of a child? What man is there who can not trace the origin of many of the best maxims of his life to the lips of her who gave him birth? How wide, how lasting, how sacred is that part of a woman's influence. 3. VIRTUE OF A COMMUNITY.--There is yet another mode, by which woman may exert a powerful influence on the virtue of a community. It rests with her in a pre-eminent degree, to give tone and elevation to the moral character of the age, by deciding the degree of virtue that shall be necessary to afford a passport to her society. If all the favor of woman were given only to the good, if it were known that the charms and attractions of beauty, and wisdom, and wit, were reserved only for the pure; if, in one word, something of a similar rigor were exerted to exclude the profligate and abandoned of society, as is shown to those who have fallen from virtue,--how much would be done to re-enforce the motives to moral purity among us, and impress on the minds of all a reverence for the sanctity and obligations of virtue. 4. THE INFLUENCE OF WOMAN ON THE MORAL SENTIMENTS.--The influence of woman on the moral sentiments of society is intimately connected with her influence on its religious character; for religion and a pure and elevated morality must ever stand in the relation to each other of effect and cause. The heart of a woman is formed for the abode of sacred truth; and for the reasons alike honorable to her character and to that of society. From the nature of humanity this must be so, or the race would soon degenerate, and moral contagion eat out the heart of society. The purity of home is the safeguard to American manhood. * * * * * {31} Personal Purity. "Self-reverence, self-knowledge, self-control, These three alone lead life to sovereign power."--TENNYSON. * * * * * [Illustration] 1. WORDS OF THE GREAT TEACHER.--Mark the words of the Great Teacher: "If thy right hand or foot cause thee to fall, cut it off and cast it from thee. If thy right eye cause thee to fall, pluck it out. It is better for thee to enter into life maimed and halt, than having two eyes to be cast into hell-fire, where the worm dieth not, and the fire is not quenched." 2. A MELANCHOLY FACT.--It is a melancholy fact, in human experience, that the noblest gifts which men possess are constantly prostituted to other purposes than those for which they are designed. The most valuable and useful organs of the body are those which are capable of the greatest dishonor, abuse, and corruption. What a snare the wonderful organism of the eye may become, when used to read corrupt books, or to look upon licentious pictures, or vulgar theater scenes, or when used to meet the fascinating gaze of the harlot! What an instrument for depraving the whole man may be found in the matchless powers of the brain, the hand, the mouth, or the tongue! What potent instruments may these become in accomplishing the ruin of the whole being, for time and eternity! {32} 3. ABSTINENCE.--Some can testify with thankfulness that they never knew the sins of gambling, drunkenness, fornication, or adultery. In all these cases abstinence has been, and continues to be, liberty. Restraint is the noblest freedom. No man can affirm that self-denial ever injured him; on the contrary, self-restraint has been liberty, strength and blessing. Solemnly ask young men to remember this when temptation and passion strive as a floodtide to move them from the anchorage and peace of self-restraint. Beware of the deceitful stream of temporary gratification, whose eddying current drifts towards license, shame, disease and death. Remember how quickly moral power declines, how rapidly the edge of the fatal maelstrom is reached, how near the vortex, how terrible the penalty, how fearful the sentence of everlasting punishment! 4. FRANK DISCUSSION.--The time has arrived for a full and frank discussion of those things which affect the personal purity. Thousands are suffering to-day from various weaknesses, the causes of which they have never learned. Manly vigor is not increasing with that rapidity which a Christian age demands. Means of dissipation are on the increase. It is high time, therefore, that every lover of the race should call a halt, and inquire into the condition of things. Excessive modesty on this subject is not virtue. Timidity in presenting unpleasant but important truths has permitted untold damage in every age. 5. MAN IS A CARELESS BEING.--He is very much inclined to sinful things. He more often does that which is wrong than that which is right, because it is easier, and, for the moment, perhaps, more satisfying to the flesh. The Creator is often blamed for man's weaknesses and inconsistencies. This is wrong. God did not intend that we should be mere machines, but free moral agents. We are privileged to choose between good and evil. Hence, if we perseveringly choose the latter, and make a miserable failure of life, we should blame only ourselves. 6. THE PULPIT.--Would that every pulpit in the land might join hands with the medical profession and cry out with no uncertain sound against the mighty evils herein stigmatized! It would work a revolution for which coming society could never cease to be grateful. 7. STRIVE TO ATTAIN A HIGHER LIFE.--Strive to attain unto a higher and better life. Beware of all excesses, of whatever nature, and guard your personal purity with sacred determination. Let every aspiration be upward, and be strong in every good resolution. Seek the light, for in light there is life, while in darkness there is decay and death. {33} [Illustration: CONFIDENCE THAT SOMETIMES MAKES TROUBLE.] * * * * * {34} How to Write All Kinds of Letters. [Illustration] 1. From the President in his cabinet to the laborer in the street; from the lady in her parlor to the servant in her kitchen; from the millionaire to the beggar; from the emigrant to the settler; from every country and under every combination of circumstances, letter writing in all its forms and varieties is most important to the advancement, welfare and happiness of the human family. 2. EDUCATION.---The art of conveying thought through the medium of written language is so valuable and so necessary, a thorough knowledge of the practice must be desirable to every one. For merely to write a good letter requires the exercise of much of the education and talent of any writer. 3. A GOOD LETTER.--A good letter must be correct in every mechanical detail, finished in style, interesting in substance, and intelligible in construction. Few there are who do not need write them; yet a letter perfect in detail is rarer than any other specimen of composition. 4. PENMANSHIP.--It is folly to suppose that the faculty for writing a good hand is confined to any particular persons. There is no one who can write at all, but what can write well, if only the necessary pains are practiced. Practice makes perfect. Secure a few copy books and write an hour each day. You will soon write a good hand. {35} 5. WRITE PLAINLY.--Every word of even the most trifling document should be written in such clear characters that it would be impossible to mistake it for another word, or the writer may find himself in the position of the Eastern merchant who, writing to the Indies for five thousand mangoes, received by the next vessel five hundred monkies, with a promise of more in the next cargo. 6. HASTE.--Hurry is no excuse for bad writing, because any one of sense knows that everything hurried is liable to be ruined. Dispatch may be acquired, but hurry will ruin everything. If, however, you must write slowly to write well, then be careful not to hurry at all, for the few moments you will gain by rapid writing will never compensate you for the disgrace of sending an ill-written letter. 7. NEATNESS.--Neatness is also of great importance. A fair white sheet with handsomely written words will be more welcome to any reader than a blotted, bedaubed page covered with erasures and dirt, even if the matter in each be of equal value and interest. Erasures, blots, interlineations always spoil the beauty of any letter. 8. BAD SPELLING.--When those who from faulty education, or forgetfulness are doubtful about the correct spelling of any word, it is best to keep a dictionary at hand, and refer to it upon such occasions. It is far better to spend a few moments in seeking for a doubtful word, than to dispatch an ill-spelled letter, and the search will probably impress the spelling upon the mind for a future occasion. 9. CARELESSNESS.--Incorrect spelling will expose the most important or interesting letter to the severest sarcasm and ridicule. However perfect in all other respects, no epistle that is badly spelled will be regarded as the work of an educated gentleman or lady. Carelessness will never be considered, and to be ignorant of spelling is to expose an imperfect education at once. 10. AN EXCELLENT PRACTICE.--After writing a letter, read it over carefully, correct all the errors and re-write it. If you desire to become a good letter writer, improve your penmanship, improve your language and grammar, re-writing once or twice every letter that you have occasion to write, whether on social or business subjects. 11. PUNCTUATION.--A good rule for punctuation is to punctuate where the sense requires it, after writing a letter and reading it over carefully you will see where the punctuation marks are required, you can readily determine where the sense requires it, so that your letter will convey the desired meaning. {36} [Illustration] 12. CORRESPONDENCE.--There is no better school or better source for self-improvement than a pleasant correspondence between friends. It is not at all difficult to secure a good list of correspondents if desired. The young people who take advantage of such opportunities for self-improvement will be much more popular in the community and in society. Letter writing cultivates the habit of study; it cultivates the mind, the heart, and stimulates self-improvement in general. 13. FOLDING.--Another bad practice with those unaccustomed to corresponding is to fold the sheet of writing in such a fantastic manner as to cause the receiver much annoyance in opening it. To the sender it may appear a very ingenious performance, but to the receiver it is only a source of vexation and annoyance, and may prevent the communication receiving the attention it would otherwise merit. 14. SIMPLE STYLE.--The style of letter writing should be simple and unaffected, not raised on stilts and indulging in pedantic displays which are mostly regarded as cloaks of ignorance. Repeated literary quotations, involved sentences, long-sounding words and scraps of Latin, French and other languages are, generally speaking, out of place, and should not be indulged in. 15. THE RESULT.--A well written letter has opened the way to prosperity for many a one, has led to many a happy marriage and constant friendship, and has secured many a good service in time of need; for it is in some measure a photograph of the writer, and may inspire love or hatred, regard or aversion in the reader, just as the glimpse of a portrait often determine us, in our estimate, of the worth of the person represented. Therefore, one of the roads to fortune runs through the ink bottle, and if we want to attain a certain end in love, friendship or business, we must trace out the route correctly with the pen in our hand. {37} [Illustration] HOW TO WRITE A LOVE LETTER. 1. LOVE.--There is no greater or more profound reality than love. Why that reality should be obscured by mere sentimentalism, with all its train of absurdities is incomprehensible. There is no nobler possession than the love of another. There is no higher gift from one human being to another than love. The gift and the possession are true sanctifiers of life, and should be worn as precious jewels without affectation and without bashfulness. For this reason there is nothing to be ashamed of in a love letter, provided it be sincere. 2. FORFEITS.--No man need consider that he forfeits dignity if he speaks with his whole heart: no woman need fear she forfeits her womanly attributes if she responds as her heart bids her respond. "Perfect love casteth out fear" is as true now as when the maxim was first given to the world. 3. TELLING THEIR LOVE.--The generality of the sex is love to be loved: how are they to know the fact that they {38} are loved unless they are told? To write a sensible love letter requires more talent than to solve, with your pen, a profound problem in philosophy. Lovers must not then expect much from each other's epistles. 4. CONFIDENTIAL.--Ladies and gentlemen who correspond with each other should never be guilty of exposing any of the contents of any letters written expressing confidence, attachment or love. The man who confides in a lady and honors her with his confidence should be treated with perfect security and respect, and those who delight in showing their confidential letters to others are unworthy, heartless and unsafe companions. 5. RETURN OF LETTERS.--If letters were written under circumstances which no longer exist and all confidential relations are at an end, then all letters should be promptly returned. 6. HOW TO BEGIN A LOVE LETTER.--How to begin a love letter has been no doubt the problem of lovers and suitors of all ages and nations. Fancy the youth of Young America with lifted pen, thinking how he shall address his beloved. Much depends upon this letter. What shall he say, and how shall he say it, is the great question. Perseverance, however, will solve the problem and determine results. 7. FORMS OF BEGINNING A LOVE LETTER.--Never say, "My Dearest Nellie," "My Adored Nellie," or "My Darling Nellie," until Nellie has first called you "My Dear," or has given you to understand that such familiar terms are permissible. As a rule a gentleman will never err if he says "Dear Miss Nellie," and if the letters are cordially reciprocated the "Miss" may in time be omitted, or other familiar terms used instead. In addressing a widow "Dear Madam," or, "My Dear Madam," will be a proper form until sufficient intimacy will justify the use of other terms. 8. RESPECT.--A lady must always be treated with respectful delicacy, and a gentleman should never use the term "Dear" or "My Dear" under any circumstances unless he knows it is perfectly acceptable or a long and friendly acquaintance justifies it. 9. HOW TO FINISH A LETTER.--A letter will be suggested by the remarks on how to begin one. "Yours respectfully," "Yours truly," "Yours sincerely," "Yours affectionately," "Yours ever affectionately," "Yours most affectionately," "Ever yours," "Ever your own," or "Yours," are all appropriate, each depending upon the beginning of the letter. It is difficult to see any phrase which could be added to them which would carry more meaning than they {39} contain. People can sign themselves "adorers" and such like, but they do so at the peril of good taste. It is not good that men or women "worship" each other--if they succeed in preserving reciprocal love and esteem they will have cause for great contentment. 10. PERMISSION.--No young man should ever write to a young lady any letter, formal or informal, unless he has first sought her permission to do so. 11. SPECIAL FORMS.--We give various forms or models of love letters to be _studied, not copied_. We have given no replies to the forms given, as every letter written will naturally suggest an answer. A careful study will be a great help to many who have not enjoyed the advantages of a literary education. [Illustration] _FORMS OF SOCIAL LETTERS._ * * * * * _1.--From a Young Lady to a Clergyman Asking a Recommendation._ Nantwich, May 18th, 1894. Reverend and Dear Sir: Having seen an advertisment for a school mistress in the Daily Times, I have been recommended to offer myself as a candidate. Will you kindly favor me {40} with a testimonial as to my character, ability and conduct while at Boston Normal School? Should you consider that I am fitted for the position, you would confer a great favor on me if you would interest yourself in my behalf. I remain, Reverend Sir, Your most obedient and humble servant, LAURA B. NICHOLS. _2.--Applying for a Position as a Teacher of Music._ Scotland, Conn., January 21st, 1894. Madam: Seeing your advertisement in The Clarion of to-day, I write to offer my services as a teacher of music in your family. I am a graduate of the Peabody Institute, of Baltimore, where I was thoroughly instructed in instrumental and vocal music. I refer by permission to Mrs. A. J. Davis, 1922 Walnut Street; Mrs. Franklin Hill, 2021 Spring Garden Street, and Mrs. William Murray, 1819 Spruce Street, in whose families I have given lessons. Hoping that you may see fit to employ me, I am, Very respectfully yours, NELLIE REYNOLDS. _3.--Applying for a Situation as a Cook._ Charlton Place, September 8th, 1894. Madam: Having seen your advertisement for a cook in today's Times, I beg to offer myself for your place. I am a thorough cook. I can make clear soups, entrees, jellies, and all kinds of made dishes. I can bake, and am also used to a dairy. My wages are $4 per week, and I can give good reference from my last place, in which I lived for two years. I am thirty-three years of age. I remain, Madam, Yours very respectfully, MARY MOONEY. _4.--Recommending a School Teacher._ Ottawa, Ill., February 10th, 1894. Col. Geo. H. Haight, President Board of Trustees, etc. Dear Sir: I take pleasure in recommending to your favorable consideration the application of Miss Hannah Alexander for the position of teacher in the public school at Weymouth. {41} Miss Alexander is a graduate of the Davidson Seminary, and for the past year has taught a school in this place. My children have been among her pupils, and their progress has been entirely satisfactory to me. Miss Alexander is a strict disciplinarian, an excellent teacher, and is thoroughly competent to conduct the school for which she applies. Trusting that you may see fit to bestow upon her the appointment she seeks, I am, Yours very respectfully, ALICE MILLER. _5.--A Business Introduction._ Chicago., Ill., May 1st, 1894. J. W. Brown, Earlville, Ill. My Dear Sir: This will introduce to you Mr. William Channing, of this city, who visits Earlville on a matter of business, which he will explain to you in person. You can rely upon his statements, as he is a gentleman of high character, and should you be able to render him any assistance, it would be greatly appreciated by Yours truly, HAIGHT LARABEE. _6.--Introducing One Lady to Another._ Dundee, Tenn., May 5th, 1894. Dear Mary: Allow me to introduce to you my ever dear friend, Miss Nellie Reynolds, the bearer of this letter. You have heard me speak of her so often that you will know at once who she is. As I am sure you will be mutually pleased with each other, I have asked her to inform you of her presence in your city. Any attention you may show her will be highly appreciated by Yours affectionately, LIZZIE EICHER. _7.--To a Lady, Apologizing for a Broken Engagement._ Albany, N. Y., May 10th, 1894. My Dear Miss Lee: Permit me to explain my failure to keep my appointment with you this evening. I was on my way to your house, with the assurance of a pleasant evening, when unfortunately I was very unexpectedly called from home on very important business. I regret my disappointment, but hope that the future may afford us many pleasant meetings. Sincerely your friend, IRVING GOODRICH. {42} _8.--Form of an Excuse for a Pupil._ Thursday Morning, April 4th. Mr. Bunnel: You will please excuse William for non-attendance at school yesterday, as I was compelled to keep him at home to attend to a matter of business. MRS. A. SMITH. _9.--Form of Letter Accompanying a Present._ Louisville, July 6, 1894. My Dearest Nelly: Many happy returns of the day. So fearful was I that it would escape your memory, that I thought I would send you this little trinket by way of reminder. I beg you to accept it and wear it for the sake of the giver. With love and best wishes. Believe me ever, your sincere friend, CAROLINE COLLINS. _10.--Returning Thanks for the Present._ Louisville, July 6, 1894. Dear Mrs. Collins: I am very much obliged to you for the handsome bracelet you have sent me. How kind and thoughtful it was of you to remember me on my birthday. I am sure I have every cause to bless the day, and did I forget it, I have many kind friends to remind me of it. Again thanking you for your present, which is far too beautiful for me, and also for your kind wishes. Believe me, your most grateful BERTHA SMITH. _11.--Congratulating a Friend Upon His Marriage._ Menton, N.Y., May 24th, 1894. My Dear Everett: I have to-day received the invitation to your wedding, and as I cannot be present at that happy event to offer my congratulations in person, I write. I am heartily glad you are going to be married, and congratulate you upon the wisdom of your choice. You have won a noble as well as a beautiful woman, and one whose love will make you a happy man to your life's end. May God grant that trouble may not come near you, but should it be your lot, you will have a wife to whom you can look with confidence for comfort, and whose good sense and devotion to you will be your sure and unfailing support. That you may both be very happy, and that your happiness may increase with your years, is the prayer of Your Friend, FRANK HOWARD. {43} [Illustration: Declaration of Affection] Any extravagant flattery should be avoided, both as tending to disgust those to whom it is addressed, as well as to degrade the writers, and to create suspicion as to their sincerity. The sentiments should spring from the tenderness of the heart, and, when faithfully and delicately expressed, will never be read without exciting sympathy or emotion in all hearts not absolutely deadened by insensibility. {44} [Illustration] _FORMS OF LOVE LETTERS._ _12.--An Ardent Declaration._. Naperville, Ill., June 10th, 1894. My Dearest Laura: I can no longer restrain myself from writing to you, dearest and best of girls, what I have often been on the point of saying to you. I love you so much that I cannot find words in which to express my feelings. I have loved you from the very first day we met, and always shall. Do you blame me because I write so freely? I should be unworthy of you if I did not tell you the whole truth. Oh, Laura, can you love me in return? I am sure I shall not be able to bear it if your answer is unfavorable. I will study your every wish if you will give me the right to do so. May I hope? Send just one kind word to your sincere friend, HARRY SMITH. _13.--A Lover's Good-bye Before Starting on a Journey._ Pearl St., New York, March 11th, 1894. My Dearest Nellie: I am off to-morrow, and yet not altogether, for I leave my heart behind in your gentle keeping. You need not place a guard over it, however, for it is as impossible that it should stay away, as for a bit of steel {45} to rush from a magnet. The simile is eminently correct, for you, my dear girl, are a magnet, and my heart is as true to you as steel. I shall make my absence as brief as possible. Not a day, not an hour, not a minute, shall I waste either in going or returning. Oh, this business; but I won't complain, for we must have something for our hive besides honey--something that rhymes with it--and that we must have it, I must bestir myself. You will find me a faithful correspondent. Like the spider, I shall drop a line by (almost) every post; and mind, you must give me letter for letter. I can't give you credit. Your returns must be prompt and punctual. Passionately yours, LEWIS SHUMAN. To Miss Nellie Carter, No. ---- Fifth Avenue, New York. _14.--From an Absent Lover._ Chicago, Ill., Sept. 10, 1894. My Dearest Kate: This sheet of paper, though I should cover it with loving words, could never tell you truly how I long to see you again. Time does not run on with me now at the same pace as with other people; the hours seem days, the days weeks, while I am absent from you, and I have no faith in the accuracy of clocks and almanacs. Ah! if there were truth in clairvoyance, wouldn't I be with you at this moment! I wonder if you are as impatient to see me as I am to fly to you? Sometimes it seems as if I must leave business and everything else to the Fates, and take the first train to Dawson. However, the hours do move, though they don't appear to, and in a few more weeks we shall meet again. Let me hear from you as frequently as possible in the meantime. Tell me of your health, your amusements and your affections. Remember that every word you write will be a comfort to me. Unchangeably yours, WILLIAM MILLER. To Miss Kate Martin, Dawson, N. D. _15.--A Declaration of Love at First Sight_. Waterford, Maine, May 8th, 1894. Dear Miss Searles: Although I have been in your society but once, the impression you have made upon me is so deep and powerful that I cannot forbear writing to you, in defiance of all rules of etiquette. Affection is sometimes of slow growth: {46} but sometimes it springs up in a moment. In half an hour after I was introduced to you my heart was no longer my own. I have not the assurance to suppose that I have been fortunate enough to create any interest in yours; but will you allow me to cultivate your acquaintance in the hope of being able to win your regard in the course of time? Petitioning for a few lines in reply, I remain, dear Miss Searles, Yours devotedly, E. C. NICKS. Miss E. Searles, Waterford, Maine. _16.--Proposing Marriage._ Wednesday, October 20th, 1894. Dearest Etta: The delightful hours I have passed in your society have left an impression on my mind that is altogether indelible, and cannot be effaced even by time itself. The frequent opportunities I have possessed, of observing the thousand acts of amiability and kindness which mark the daily tenor of your life, have ripened my feelings of affectionate regard into a passion at once ardent and sincere, until I have at length associated my hopes of future happiness with the idea of you as a life partner, in them. Believe me, dearest Etta, this is no puerile fancy, but the matured results of a long and warmly cherished admiration of your many charms of person and mind. It is love--pure, devoted love, and I feel confident that your knowledge of my character will lead you to ascribe my motives to their true source. May I then implore you to consult your own heart, and should this avowal of my fervent and honorable passion for you be crowned with your acceptance and approval, to grant me permission to refer the matter to your parents. Anxiously awaiting your answer, I am, dearest Etta, Your sincere and faithful lover, GEO. COURTRIGHT. To Miss Etta Jay, Malden, Ill. {47} _17.--From a Gentleman to a Widow._ Philadelphia, May 10th, 1894. My Dear Mrs. Freeman: I am sure you are too clear-sighted not to have observed the profound impression which your amiable qualities, intelligence and personal attractions have made upon my heart, and as you have not repelled my attentions nor manifested displeasure when I ventured to hint at the deep interest I felt in your welfare and happiness, I cannot help hoping that you will receive an explicit expression of my attachments, kindly and favorably. I wish it were in my power to clothe the feelings I entertain for you in such words as should make my pleadings irresistible; but, after all, what could I say, more than you are very dear to me, and that the most earnest desire of my soul is to have the privilege of calling you my wife? Do you, can you love me? You will not, I am certain, keep me in suspense, for you are too good and kind to trifle for a moment with sincerity like mine. Awaiting your answer, I remain with respectful affection, Ever yours, HENRY MURRAY. Mrs. Julia Freeman, Philadelphia. _18.--From a Lady to an Inconstant Lover._ Dear Harry: It is with great reluctance that I enter upon a subject which has given me great pain, and upon which silence has become impossible if I would preserve my self-respect. You cannot but be aware that I have just reason for saying that you have much displeased me. You have apparently forgotten what is due to me, circumstanced as we are, thus far at least. You cannot suppose that I can tamely see you disregard my feelings, by conduct toward other ladies from which I should naturally have the right to expect you to abstain. I am not so vulgar a person as to be jealous. When there is cause to infer changed feelings, or unfaithfulness to promises of constancy, jealousy is not the remedy. What the remedy is I need not say--we both of us have it in our hands. I am sure you will agree with me that we must come to some understanding by which the future shall be governed. Neither you nor I can bear a divided allegiance. Believe me that I write more in sorrow than in anger. You have made me very unhappy, and perhaps thoughtlessly. But it will take much to reassure me of your unaltered regard. Yours truly, EMMA. * * * * * {48} [Illustration: MODESTY. ACT NATURAL AND SPEAK WELL OF ALL PEOPLE.] * * * * * {49} Hints and Helps on Good Behavior at all Times and at all Places. [Illustration: THE HUMAN FACE, LIKE A FLOWER, SPEAKS FOR ITSELF.] 1. It takes acquaintance to found a noble esteem, but politeness prepares the way. Indeed, as Montaigne says, Courtesy begets esteem at sight. Urbanity is half of affability, and affability is a charm worth possessing. 2. A pleasing demeanor is often the scales by which the pagan weighs the Christian. It is not virtue, but virtue inspires it. There are circumstances in which it takes a great and strong soul to pass under the little yoke of courtesy, but it is a passport to a greater soul standard. 3. Matthew Arnold says, "Conduct is three-fourths of character," and Christian benignity draws the line for conduct. A high sense of rectitude, a lowly soul, with a pure and kind {50} heart are elements of nobility which will work out in the life of a human being at home--everywhere. "Private refinement makes public gentility." 4. If you would conciliate the favor of men, rule your resentment. Remember that if you permit revenge or malice to occupy your soul, you are ruined. 5. Cultivate a happy temper; banish the blues; a cheerful saguine spirit begets cheer and hope. 6. Be trustworthy and be trustful. 7. Do not place a light estimate upon the arts of good reading and good expression; they will yield perpetual interest. 8. Study to keep versed in world events as well as in local occurrences, but abhor gossip, and above all scandal. 9. Banish a self-conscience spirit--the source of much awkwardness--with a constant aim to make others happy. Remember that it is incumbent upon gentlemen and ladies alike to be neat in habits. 10. The following is said to be a correct posture for walking. Head erect--not too rigid--chin in, shoulders back. Permit no unnecessary motion about the thighs. Do not lean over to one side in walking, standing or sitting; the practice is not only ungraceful, but it is deforming and therefore unhealthful. 11. Beware of affectation and of Beau Brummel airs. 12. If the hands are allowed to swing in walking, the arc should be limited, and the lady will manage them much more gracefully, if they almost touch the clothing. 13. A lady should not stand with her hands behind her. We could almost say, forget the hands except to keep them clean, including the nails, cordial and helpful. One hand may rest easily in the other. Study repose of attitude here as well as in the rest of the body. 14. Gestures are for emphasis in public speaking; do not point elsewhere, as a rule. 15. Greet your acquaintances as you meet them with a slight bow and smile, as you speak. 16. Look the person to whom you speak in the eye. Never under any circumstances wink at another or communicate by furtive looks. 17. Should you chance to be the rejected suitor of a lady, bear in mind your own self-respect, as well as the inexorable laws {51} of society, and bow politely when you meet her. Reflect that you do not stand before all woman-kind as you do at her bar. Do not resent the bitterness of flirtation. No lady or gentleman will flirt. Remember ever that painful prediscovery is better than later disappointment. Let such experience spur you to higher exertion. 18. Discretion should be exercised in introducing persons. Of two gentlemen who are introduced, if one is superior in rank or age, he is the one to whom the introduction should be made. Of two social equals, if one be a stranger in the place, his name should be mentioned first. 19. In general the simpler the introduction the better. 20. Before introducing a gentleman to a lady, remember that she is entitled to hold you responsible for the acquaintance. The lady is the one to whom the gentleman is presented, which may be done thus: "Miss A, permit me to introduce to you my friend, Mr. B."; or, "Miss A., allow me to introduce Mr. B." If mutual and near friends of yours, say simply, "Miss A., Mr. B." 21. Receive the introduction with a slight bow and the acknowledgment, "Miss A., I am happy to make your acquaintance"; or, "Mr. B., I am pleased to meet you." There is no reason why such stereotyped expressions should always be used, but something similar is expected. Do not extend the hand usually. 22. A true lady will avoid familiarity in her deportment towards gentlemen. A young lady should not permit her gentlemen friends to address her by her home name, and the reverse is true. Use the title Miss and Mr. respectively. 23. Ladies should be frank and cordial towards their lady friends, but never gushing. 24. Should you meet a friend twice or oftener, at short intervals, it is polite to bow slightly each time after the first. 25. A lady on meeting a gentleman with whom she has slight acquaintance will make a medium bow--neither too decided nor too slight or stiff. 26. For a gentleman to take a young lady's arm, is to intimate that she is feeble, and young ladies resent the mode. 27. If a young lady desires to visit any public place where she expects to meet a gentleman acquaintance, she should have a chaperon to accompany her, a person of mature years when possible, and never a giddy girl. 28. A lady should not ask a gentleman to walk with her. * * * * * {52} [Illustration] A COMPLETE ETIQUETTE IN A FEW PRACTICAL RULES. _1. If you desire to be respected, keep clean. The finest attire and decorations will add nothing to the appearance or beauty of an untidy person._ _2. Clean clothing, clean skin, clean hands, including the nails, and clean, white teeth, are a requisite passport for good society._ _3. A bad breath should be carefully remedied, whether it proceeds from the stomach or from decayed teeth._ _4. To pick the nose, finger about the ears, or scratch the head or any other part of the person, in company, is decidedly vulgar._ _5. When you call at any private residence, do not neglect to clean your shoes thoroughly._ _6. A gentleman should always remove his hat in the presence of ladies, except out of doors, and then he should lift or touch his hat in salutation. On meeting a lady a well-bred gentleman will always lift his hat._ _7. An invitation to a lecture, concert, or other entertainment, may be either verbal or written, but should always be made at least twenty-four hours before the time._ {53} _8. On entering a hall or church the gentleman should precede the lady in walking up the aisle, or walk by her side, if the aisle is broad enough._ _9. A gentleman should always precede a lady upstairs, and follow her downstairs._ _10. Visitors should always observe the customs of the church with reference to standing, sitting, or kneeling during the services._ _11. On leaving a hall or church at the close of entertainment or services, the gentleman should precede the lady._ _12. A gentleman walking with a lady should carry the parcels, and never allow the lady to be burdened with anything of the kind._ _13. A gentleman meeting a lady on the street and wishing to speak to her, should never detain her, but may turn around and walk in the same direction she is going, until the conversation is completed._ _14. If a lady is traveling with a gentleman, simply as a friend, she should place the amount of her expenses in his hands, or insist on paying the bills herself._ _15. Never offer a lady costly gifts unless you are engaged to her, for it looks as if you were trying to purchase her goodwill; and when you make a present to a lady use no ceremony whatever._ [Illustration: Children should early be taught the lesson of Propriety and Good Manners.] _16. Never carry on a private conversation in company. If secrecy is necessary, withdraw from the company._ _17. Never sit with your back to another without asking to be excused._ _18. It is as unbecoming for a gentleman to sit with legs crossed as it is for a lady._ _19. Never thrum with your fingers, rub your hands, yawn, or sigh aloud in company._ _20. Loud laughter, loud talking, or other boisterous manifestations should be checked in the society of others, especially on the street and in public places._ {54} _21. When you are asked to sing or play in company, do so without being urged, or refuse in a way that shall be final; and when music is being rendered in company, show politeness to the musician by giving attention. It is very impolite to keep up a conversation. If you do not enjoy the music, keep silent._ _22. Contentions, contradictions, etc., in society should be carefully avoided._ _23. Pulling out your watch in company, unless asked the time of day, is a mark of the demi-bred. It looks as if you were tired of the company and the time dragged heavily._ _24. You should never decline to be introduced to any one or all of the guests present at a party to which you have been invited._ _25. A gentleman who escorts a lady to a party, or who has a lady placed under his care, is under particular obligations to attend to her wants and see that she has proper attention. He should introduce her to others, and endeavor to make the evening pleasant. He should escort her to the supper table and provide for her wants._ _26. To take small children or dogs with you on a visit of ceremony is altogether vulgar, though in visiting familiar friends, children are not objectionable._ * * * * * {55} [Illustration: AN EGYPTIAN BRIDE'S WEDDING OUTFIT.] {56} ETIQUETTE OF CALLS. [Illustration] In the matter of making calls it is the correct thing: For the caller who arrived first to leave first. To return a first call within a week and in person. To call promptly and in person after a first invitation. For the mother or chaperon to invite a gentleman to call. To call within a week after any entertainment to which one has been invited. You should call upon an acquaintance who has recently returned from a prolonged absence. It is proper to make the first call upon people in a higher social position, if one is asked to do so. It is proper to call, after an engagement has been announced, or a marriage has taken place, in the family. For the older residents in the city or street to call upon the newcomers to their neighborhood is a long recognized custom. It is proper, after a removal from one part of the city to another, to send out cards with one's new address upon them. To ascertain what are the prescribed hours for calling in the place where one is living, or making a visit, and to adhere to those hours is a duty that must not be overlooked. A gentleman should ask for the lady of the house as well as the young ladies, and leave cards for her as well as for the head of the family. {57} [Illustration: _Improve Your Speech by Reading._] * * * * * ETIQUETTE IN YOUR SPEECH. Don't say Miss or Mister without the person's name. Don't say pants for trousers. Don't say gents for gentlemen. Don't say female for woman. Don't say elegant to mean everything that pleases you. Don't say genteel for well-bred. Don't say ain't for isn't. Don't say I done it for I did it. Don't say he is older than me; say older than I. Don't say she does not see any; say she does not see at all. Don't say not as I know; say not that I know. Don't say he calculates to get off; say he expects to get off. Don't say he don't; say he doesn't. Don't say she is some better; say she is somewhat better. Don't say where are you stopping? say where are you staying? Don't say you was; say you were. Don't say I say, says I, but simply say I said. Don't sign your letters yours etc., but yours truly. Don't say lay for lie; lay expresses action; lie expresses rest. Don't say them bonnets; say those bonnets. Don't say party for person. Don't say it looks beautifully, but say it looks beautiful. {58} Don't say feller, winder, to-morrer, for fellow, window, tomorrow. Don't use slangy words; they are vulgar. Don't use profane words; they are sinful and foolish. Don't say it was her, when you mean it was she. Don't say not at once for at once. Don't say he gave me a recommend, but say he gave me a recommendation. Don't say the two first for the first two. Don't say he learnt me French; say he taught me French. Don't say lit the fire; say lighted the fire. Don't say the man which you saw; say the man whom you saw. Don't say who done it; say who did it. Don't say if I was rich I would buy a carriage; say if I were rich. Don't say if I am not mistaken you are in the wrong; say if I mistake not. Don't say who may you be; say who are you? Don't say go lay down; say go lie down. Don't say he is taller than me; say taller than I. Don't say I shall call upon him; say I shall call on him. Don't say I bought a new pair of shoes; say I bought a pair of new shoes. Don't say I had rather not; say I would rather not. Don't say two spoonsful; say two spoonfuls. * * * * * ETIQUETTE OF DRESS AND HABITS. Don't let one day pass without a thorough cleansing of your person. Don't sit down to your evening meal before a complete toilet if you have company. Don't cleanse your nails, your nose or your ears in public. Don't use hair dye, hair oil or pomades. Don't wear evening dress in daytime. Don't wear jewelry of a gaudy character; genuine jewelry modestly worn is not out of place. Don't overdress yourself or walk affectedly. Don't wear slippers or dressing-gown or smoking-jacket out of your own house. Don't sink your hands in your trousers' pockets. Don't whistle in public places, nor inside of houses either. Don't use your fingers or fists to beat a tattoo upon floor, desk or window panes. Don't examine other people's papers or letters scattered on their desk. {59} Don't bring a smell of spirits or tobacco into the presence of ladies. Never use either in the presence of ladies. Don't drink spirits; millions have tried it to their sorrow. * * * * * ETIQUETTE ON THE STREET. 1. Your conduct on the street should always be modest and dignified. Ladies should carefully avoid all loud and boisterous conversation or laughter and all undue liveliness in public. 2. When walking on the street do not permit yourself to be absent-minded, as to fail to recognize a friend; do not go along reading a book or newspaper. 3. In walking with a lady on the street give her the inner side of the walk, unless the outside is the safer part; in which case she is entitled to it. 4. Your arm should not be given to any lady except your wife or a near relative, or a very old lady, during the day, unless her comfort or safety requires it. At night the arm should always be offered; also in ascending the steps of a public building. 5. In crossing the street a lady should gracefully raise her dress a little above her ankle with one hand. To raise the dress with both hands is vulgar, except in places where the mud is very deep. 6. A gentleman meeting a lady acquaintance on the street should not presume to join her in her walk without first asking her permission. 7. If you have anything to say to a lady whom you may happen to meet in the street, however intimate you may be, do not stop her, but turn round and walk in company with her; you can take leave at the end of the street. 8. A lady should not venture out upon the street alone after dark. By so doing she compromises her dignity, and exposes herself to indignity at the hands of the rougher class. 9. Never offer to shake hands with a lady in the street if you have on dark or soiled gloves, as you may soil hers. 10. A lady does not form acquaintances upon the street, or seek to attract the attention of the other sex or of persons of her own sex. Her conduct is always modest and unassuming. Neither does a lady demand services or favors from a gentleman. She accepts them graciously, always {60} expressing her thanks. A gentleman will not stand on the street corners, or in hotel doorways, or store windows and gaze impertinently at ladies as they pass by. This is the exclusive business of loafers. 11. In walking with a lady who has your arm, should you have to cross the street, do not disengage your arm and go around upon the outside, unless the lady's comfort renders it necessary. In walking with a lady, where it is necessary for you to proceed singly, always go before her. * * * * * ETIQUETTE BETWEEN SEXES. 1. A lady should be a lady, and a gentleman a gentleman under any and all circumstances. 2. FEMALE INDIFFERENCE TO MAN.--There is nothing that affects the nature and pleasure of man so much as a proper and friendly recognition from a lady, and as women are more or less dependent upon man's good-will, either for gain or pleasure, it surely stands to their interest to be reasonably pleasant and courteous in his presence or society. Indifference is always a poor investment, whether in society or business. 3. GALLANTRY AND LADYISM should be a prominent feature in the education of young people. Politeness to ladies cultivates the intellect and refines the soul, and he who can be easy and entertaining in the society of ladies has mastered one of the greatest accomplishments. There is nothing taught in school, academy or college, that contributes so much to the happiness of man as a full development of his social and moral qualities. 4. LADYLIKE ETIQUETTE.--No woman can afford to treat men rudely. A lady must have a high intellectual and moral ideal and hold herself above reproach. She must remember that the art of pleasing and entertaining gentlemen is infinitely more ornamental than laces, ribbons or diamonds. Dress and glitter may please man, but it will never benefit him. 5. CULTIVATE DEFICIENCIES.--Men and women poorly sexed treat each other with more or less indifference, whereas a hearty sexuality inspires both to a right estimation of the faculties and qualities of each other. Those who are deficient should seek society and overcome their deficiencies. While some naturally inherit faculties as entertainers, others are compelled to acquire them by cultivation. {61} [Illustration: ASKING AN HONEST QUESTION.] 6. LADIES' SOCIETY.--He who seeks ladies' society should seek an education and should have a pure heart and a pure mind. Read good, pure and wholesome literature and study human nature, and you will always be a favorite in the society circle. 7. WOMAN HATERS.--Some men with little refinement and strong sensual feelings virtually insult and thereby disgust and repel every female they meet. They look upon woman with an inherent vulgarity, and doubt the virtue and integrity of all alike. But it is because they are generally {62} insincere and impure themselves, and with such a nature culture and refinement are out of the question, there must be a revolution. 8. MEN HATERS.--Women who look upon all men as odious, corrupt or hateful, are no doubt so themselves, though they may be clad in silk and sparkle with diamonds and be as pretty as a lily; but their hypocrisy will out, and they can never win the heart of a faithful, conscientious and well balanced man. A good woman has broad ideas and great sympathy. She respects all men until they are proven unworthy. 9. FOND OF CHILDREN.--The man who is naturally fond of children will make a good husband and a good father. So it behooves the young man, to notice children and cultivate the art of pleasing them. It will be a source of interest, education and permanent benefit to all. 10. EXCESSIVE LUXURY.--Although the association with ladies is an expensive luxury, yet it is not an expensive education. It elevates, refines, sanctifies and purifies, and improves the whole man. A young man who has a pure and genuine respect for ladies, will not only make a good husband, but a good citizen as well. 11. MASCULINE ATTENTION.--No woman is entitled to any more attention than her loveliness and ladylike conduct will command. Those who are most pleasing will receive the most attention, and those who desire more should aspire to acquire more by cultivating those graces and virtues which ennoble woman, but no lady should lower or distort her own true ideal, or smother and crucify her conscience, in order to please any living man. A good man will admire a good woman, and deceptions cannot long be concealed. Her show of dry goods or glitter of jewels cannot long cover up her imperfections or deceptions. 12. PURITY.--Purity of purpose will solve all social problems. Let all stand on this exalted sexual platform, and teach every man just how to treat the female sex, and every woman how to behave towards the masculine; and it will incomparably adorn the manners of both, make both happy in each other, and mutually develop each other's sexuality and humanity. [Illustration] {63} Practical Rules on Table Manners. [Illustration] 1. Help ladies with a due appreciation; do not overload the plate of any person you serve. Never pour gravy on a plate without permission. It spoils the meat for some persons. 2. Never put anything by force upon any one's plate. It is extremely ill-bred, though extremely common, to press one to eat of anything. 3. If at dinner you are requested to help any one to sauce or gravy, do not pour it over the meat or vegetables, but on one side of them. Never load down a person's plate with anything. 4. As soon as you are helped, begin to eat, or at least begin to occupy yourself with what you have before you. Do not wait till your neighbors are served--a custom that was long ago abandoned. 5. Should you, however, find yourself at a table where they have the old-fashioned steel forks, eat with your knife, as the others do, and do not let it be seen that you have any objection to doing so. 6. Bread should be broken. To butter a large piece of bread and then bite it, as children do, is something the knowing never do. {64} 7. In eating game or poultry do not touch the bones with your fingers. To take a bone in the fingers for the purpose of picking it, is looked upon as being very inelegant. 8. Never use your own knife or fork to help another. Use rather the knife or fork of the person you help. 9. Never send your knife or fork, or either of them, on your plate when you send for second supply. 10. Never turn your elbows out when you use your knife and fork. Keep them close to your sides. 11. Whenever you use your fingers to convey anything to your mouth or to remove anything from the mouth, let it be the fingers of the left hand. 12. Tea, coffee, chocolate and the like are drank from the cup and never from the saucer. 13. In masticating your food, keep your mouth shut; otherwise you will make a noise that will be very offensive to those around you. 14. Don't attempt to talk with a full mouth. One thing at a time is as much as any man can do well. 15. Should you find a worm or insect in your food, say nothing about it. 16. If a dish is distasteful to you, decline it, and without comment. 17. Never put bones or bits of fruit on the table cloth. Put them on the side of your plate. 18. Do not hesitate to take the last piece on the dish, simply because it is the last. To do so is to directly express the fear that you would exhaust the supply. 19. If you would be what you would like to be--abroad, take care that you _are_ what you would like to be--at home. 20. Avoid picking your teeth at the table if possible; but if you must, do it, if you can, where you are not observed. 21. If an accident of any kind soever should occur during dinner, the cause being who or what it may, you should not seem to note it. 22. Should you be so unfortunate as to overturn or to break anything, you should make no apology. You might let your regret appear in your face, but it would not be proper to put it in words. * * * * * {65} Social Duties. Man in Society is like a flower, Blown in its native bed. 'Tis there alone His faculties expanded in full bloom Shine out, there only reach their proper use.--COWPER. The primal duties shine aloft like stars; The charities that soothe, and heal, and bless, Are scatter'd at the feet of man like flowers.--WORDSWORTH. * * * * * {66} [Illustration: GIVING A PARLOR RECITATION.] 1. MEMBERSHIP IN SOCIETY.--Many fail to get hold of the idea that they are members of society. They seem to suppose that the social machinery of the world is self-operating. They cast their first ballot with an emotion of pride, perhaps, but are sure to pay their first tax with a groan. They see political organizations in active existence; the parish, and the church, and other important bodies that embrace in some form of society all men, are successfully operated; and yet these young men have no part or lot in the matter. They do not think of giving a day's time to society. 2. BEGIN EARLY.--One of the first things a young man should do is to see that he is acting his part in society. The earlier this is begun the better. I think that the opponents of secret societies in colleges have failed to estimate the benefit which it must be to every member to be obliged to contribute to the support of his particular organization, and to assume personal care and responsibility as a member. If these societies have a tendency to teach the lessons of which I speak, they are a blessed thing. 3. DO YOUR PART.--Do your part, and be a man among men. Assume your portion of social responsibility, and see that you discharge it well. If you do not do this, then you are mean, and society has the right to despise you just as much as it chooses to do so. You are, to use a word more emphatic than agreeable, a sneak, and have not a claim upon your neighbors for a single polite word. 4. A WHINING COMPLAINER.--Society, as it is called, is far more apt to pay its dues to the individual than the individual to society. Have you, young man, who are at home whining over the fact that you cannot get into society, done anything to give you a claim to social recognition? Are you able to make any return for social recognition and social privileges? Do you know anything? What kind of coin do you propose to pay in the discharge of the obligation which comes upon you with social recognition? In other words, as a return for what you wish to have society do for you, what can you do for society? This is a very important question--more important to you than to society. The question is, whether you will be a member of society by right, or by courtesy. If you have so mean a spirit as to be content to be a beneficiary of society--to receive favors and to confer none--you have no business in the society to which you aspire. You are an exacting, conceited fellow. 5. WHAT ARE YOU GOOD FOR?--Are you a good beau, and are you willing to make yourself useful in waiting on the {67} ladies on all occasions? Have you a good set of teeth, which you are willing to show whenever the wit of the company gets off a good thing? Are you a true, straightforward, manly fellow, with whose healthful and uncorrupted nature it is good for society to come in contact? In short, do you possess anything of any social value? If you do, and are willing to impart it, society will yield itself to your touch. If you have nothing, then society, as such, owes you nothing. Christian philanthropy may put its arm around you, as a lonely young man, about to spoil for want of something, but it is very sad and humiliating for a young man to be brought to that. There are people who devote themselves to nursing young men, and doing them good. If they invite you to tea, go by all means, and try your hand. If, in the course of the evening, you can prove to them that your society is desirable, you have won a point. Don't be patronized. 6. THE MORBID CONDITION.--Young men, you are apt to get into a morbid state of mind, which declines them to social intercourse. They become devoted to business with such exclusiveness, that all social intercourse is irksome. They go out to tea as if they were going to jail, and drag themselves to a party as to an execution. This disposition is thoroughly morbid, and to be overcome by going where you are invited, always, and with a sacrifice of feeling. 7. THE COMMON BLUNDER.--Don't shrink from contact with anything but bad morals. Men who affect your unhealthy minds with antipathy, will prove themselves very frequently to be your best friends and most delightful companions. Because a man seems uncongenial to you, who are squeamish and foolish, you have no right to shun him. We become charitable by knowing men. We learn to love those whom we have despised by rubbing against them. Do you not remember some instance of meeting a man or woman whom you had never previously known or cared to know--an individual, perhaps, against whom you have entertained the strongest prejudices--but to whom you became bound by a lifelong friendship through the influence of a three days' intercourse? Yet, if you had not thus met, you would have carried through life the idea that it would be impossible for you to give your fellowship to such an individual. 8. THE FOOLISHNESS OF MAN.--God has introduced into human character infinite variety, and for you to say that you do not love and will not associate with a man because he is unlike you, is not only foolish but wrong. You are to remember that in the precise manner and decree in which {68} a man differs from you, do you differ from him; and that from his standpoint you are naturally as repulsive to him, as he, from your standpoint, is to you. So, leave all this talk of congeniality to silly girls and transcendental dreamers. [Illustration: GATHERING ORANGES IN THE SUNNY SOUTH.] 9. DO BUSINESS IN YOUR WAY AND BE HONEST.--Do your business in your own way, and concede to every man the privilege which you claim for yourself. The more you mix with men, the less you will be disposed to quarrel, and the more charitable and liberal will you become. The fact that you do not understand a man, is quite as likely to be your fault as his. There are a good many chances in favor of the conclusion that, if you fail to like an individual whose acquaintance you make it is through your own ignorance and illiberality. So I say, meet every man honestly; seek to know him; and you will find that in those points in which he differs from you rests his power to instruct you, enlarge you, and do you good. Keep your heart open for everybody, and be sure that you shall have your reward. You shall find a jewel under the most uncouth exterior; and associated with homeliest manners and oddest ways and ugliest faces, you will find rare virtues, fragrant little humanities, and inspiring heroisms. 10. WITHOUT SOCIETY, WITHOUT INFLUENCE.--Again: you can have no influence unless you are social. An unsocial man is as devoid of influence as an ice-peak is of verdure. It is through social contact and absolute social value alone that you can accomplish any great social good. It is through the invisible lines which you are able to attach to the minds with which you are brought into association alone that you can tow society, with its deeply freighted interests, to the great haven of your hope. 11. THE REVENGE OF SOCIETY.--The revenge which society takes upon the man who isolates himself, is as terrible as it is inevitable. The pride which sits alone will have the privilege of sitting alone in its sublime disgust till it drops into the grave. The world sweeps by the man, carelessly, remorselessly, contemptuously. He has no hold upon society, because he is no part of it. 12. THE CONCLUSION OF THE WHOLE MATTER.--You cannot move men until you are one of them. They will not follow you until they have heard your voice, shaken your hand, and fully learned your principles and your sympathies. It makes no difference how much you know, or how much you are capable of doing. You may pile accomplishment upon acquisition mountain high; but if you fail to be a social man, demonstrating to society that your lot is with the rest, a {69} little child with a song in its mouth, and a kiss for all and a pair of innocent hands to lay upon the knees, shall lead more hearts and change the direction of more lives than you. * * * * * {70} Politeness. 1. BEAUTIFUL BEHAVIOR.--Politeness has been described as the art of showing, by external signs, the internal regard we have for others. But one may be perfectly polite to another without necessarily paying a special regard for him. Good manners are neither more nor less than beautiful behavior. It has been well said that "a beautiful form is better than a beautiful face, and a beautiful behavior is better than a beautiful form; it gives a higher pleasure than statues or pictures--it is the finest of the fine arts." 2. TRUE POLITENESS.--The truest politeness comes of sincerity. It must be the outcome of the heart, or it will make no lasting impression; for no amount of polish can dispense with truthfulness. The natural character must be allowed to appear, freed of its angularities and asperities. Though politeness, in its best form, should resemble water--"best when clearest, most simple, and without taste"--yet genius in a man will always cover many defects of manner, and much will be excused to the strong and the original. Without genuineness and individuality, human life would lose much of its interest and variety, as well as its manliness and robustness of character. 3. PERSONALITY OF OTHERS.--True politeness especially exhibits itself in regard for the personality of others. A man will respect the individuality of another if he wishes to be respected himself. He will have due regard for his views and opinions, even though they differ from his own. The well-mannered man pays a compliment to another, and sometimes even secures his respect by patiently listening to him. He is simply tolerant and forbearant, and refrains from judging harshly; and harsh judgments of others will almost invariably provoke harsh judgments of ourselves. 4. THE IMPOLITE.--The impolite, impulsive man will, however, sometimes rather lose his friend than his joke. He may surely be pronounced a very foolish person who secures another's hatred at the price of a moment's gratification. It was a saying of Burnel, the engineer--himself one of the kindest-natured of men--that "spite and ill-nature are among the most expensive luxuries in life." Dr. Johnson once said: "Sir, a man has no more right to say a rude thing to another than to knock him down." 5. FEELINGS OF OTHERS.--Want of respect for the feelings of others usually originates in selfishness, and issues in {71} hardness and repulsiveness of manner. It may not proceed from malignity so much, as from want of sympathy, and want of delicacy--a want of that perception of, and attention to, those little and apparently trifling things, by which pleasure is given or pain occasioned to others. Indeed, it may be said that in self-sacrifice in the ordinary intercourse of life, mainly consists the difference between being well and ill bred. Without some degree of self-restraint in society a man may be found almost insufferable. No one has pleasure in holding intercourse with such a person, and he is a constant source of annoyance to those about him. 6. DISREGARD OF OTHERS.--Men may show their disregard to others in various impolite ways, as, for instance, by neglect of propriety in dress, by the absence of cleanliness, or by indulging in repulsive habits. The slovenly, dirty person, by rendering himself physically disagreeable, sets the tastes and feelings of others at defiance, and is rude and uncivil, only under another form. 7. THE BEST SCHOOL OF POLITENESS.--The first and best school of politeness, as of character, is always the home, where woman is the teacher. The manners of society at large are but the reflex of the manners of our collective homes, neither better nor worse. Yet, with all the disadvantages of ungenial homes, men may practice self-culture of manner as of intellect, and learn by good examples to cultivate a graceful and agreeable behavior towards others. Most men are like so many gems in the rough, which need polishing by contact with other and better natures, to bring out their full beauty and lustre. Some have but one side polished, sufficient only to show the delicate graining of the interior; but to bring out the full qualities of the gem, needs the discipline of experience, and contact with the best examples of character in the intercourse of daily life. 8. CAPTIOUSNESS OF MANNER.--While captiousness of manner, and the habit of disputing and contradicting every thing said, is chilling and repulsive, the opposite habit of assenting to, and sympathizing with, every statement made, or emotion expressed, is almost equally disagreeable. It is unmanly, and is felt to be dishonest. "It may seem difficult," says Richard Sharp, "to steer always between bluntness and plain dealing, between merited praises and lavishing indiscriminate flattery; but it is very easy--good humor, kindheartedness, and perfect simplicity, being all that are requisite to do what is right in the right way." At the same time many are impolite, not because they mean to be so, but because they are awkward, and perhaps know no better. {72} 9. SHY PEOPLE.--Again many persons are thought to be stiff, reserved, and proud, when they are only shy. Shyness is characteristic of most people of the Teutonic race. From all that can be learned of Shakespeare, it is to be inferred that he was an exceedingly shy man. The manner in which his plays were sent into the world--for it is not known that he edited or authorized the publication of a single one of them,--and the dates at which they respectively appeared, are mere matters of conjecture. 10. SELF-FORGETFULNESS.--True politeness is best evinced by self-forgetfulness, or self-denial in the interest of others. Mr. Garfield, our martyred president, was a gentleman of royal type. His friend, Col. Rockwell, says of him: "In the midst of his suffering he never forgets others. For instance, to-day he said to me, 'Rockwell, there is a poor soldier's widow who came to me before this thing occurred, and I promised her, she should be provided for. I want you to see that the matter is attended to at once.' He is the most docile patient I ever saw." 11. ITS BRIGHT SIDE.--We have thus far spoken of shyness as a defect. But there is another way of looking at it; for even shyness has its bright side, and contains an element of good. Shy men and shy races are ungraceful and undemonstrative, because, as regards society at large, they are comparatively unsociable. They do not possess those elegancies of manner acquired by free intercourse, which distinguish the social races, because their tendency is to shun society rather than to seek it. They are shy in the presence of strangers, and shy even in their own families. They hide their affections under a robe of reserve, and when they do give way to their feelings, it is only in some very hidden inner chamber. And yet, the feelings are there, and not the less healthy and genuine, though they are not made the subject of exhibition to others. 12. WORTHY OF CULTIVATION.--While, therefore, grace of manner, politeness of behavior, elegance of demeanor, and all the arts that contribute to make life pleasant and beautiful, are worthy of cultivation, it must not be at the expense of the more solid and enduring qualities of honesty, sincerity, and truthfulness. The fountain of beauty must be in the heart more than in the eye, and if it does not tend to produce beautiful life and noble practice, it will prove of comparatively little avail. Politeness of manner is not worth much, unless it is accompanied by polite actions. [Illustration] {73} Influence of Good Character. "Unless above himself he can Erect himself, how poor a thing is man!"--DANIEL. "Character is moral order seen through the medium of an individual nature--Men of character are the conscience of the society to which they belong."--EMERSON. The purest treasure mortal times afford, Is--spotless reputation; that away, Men are but gilded loam, or painted clay. A jewel in a ten-times-barr'd-up chest Is--a bold Spirit in a loyal breast.--SHAKSPEARE. 1. REPUTATION.--The two most precious things this side the grave are our reputation and our life. But it is to be lamented that the most contemptible whisper may deprive us of the one, and the weakest weapon of the other. A wise man, therefore, will be more anxious to deserve a fair name than to possess it, and this will teach him so to live, as not to be afraid to die. 2. CHARACTER.--Character is one of the greatest motive powers in the world. In its noblest embodiments, it exemplifies human nature in its highest forms, for it exhibits man at his best. 3. THE HEART THAT RULES IN LIFE.--Although genius always commands admiration, character most secures respect. The former is more the product of brain power, the latter of heart power; and in the long run it is the heart that rules in life. Men of genius stand to society in the relation of its intellect as men of character of its conscience: and while the former are admired, the latter are followed. 4. THE HIGHEST IDEAL OF LIFE AND CHARACTER.--Commonplace though it may appear, this doing of one's duty embodies the highest ideal of life and character. There may be nothing heroic about it; but the common lot of men is not heroic. And though the abiding sense of duty upholds man in his highest attitudes, it also equally sustains him in the transaction of the ordinary affairs of every-day existence. Man's life is "centered in the sphere of common duties." The most influential of all the virtues are those which are the most in request for daily use. They wear the best, and last the longest. 5. WEALTH.--Wealth in the hands of men of weak purpose, or deficient self-control, or of ill regulated passions, is {74} only a temptation and a snare--the source, it may be, of infinite mischief to themselves, and often to others. On the contrary, a condition of comparative poverty is compatible with character in its highest form. A man may possess only his industry, his frugality, his integrity, and yet stand high in the rank of true manhood. The advice which Burns' father gave him was the best: "He bade me act a manly part, though I had ne'er a farthing, For without an honest, manly heart no man was worth regarding." 6. CHARACTER IS PROPERTY.--It is the noblest of possessions. It is an estate in the general good-will and respect of men; they who invest in it--though they may not become rich in this world's goods--will find their reward in esteem and reputation fairly and honorably won. And it is right that in life good qualities should tell--that industry, virtue, and goodness should rank the highest--and that the really best men should be foremost. 7. SIMPLE HONESTY OF PURPOSE.--This in a man goes a long way in life, if founded on a just estimate of himself and a steady obedience to the rule he knows and feels to be right. It holds a man straight, gives him strength and sustenance, and forms a mainspring of vigorous action. No man is bound to be rich or great--no, nor to be wise--but every man is bound to be honest and virtuous. [Illustration] {76} Family Government. [Illustration: HEAVENLY MUSIC.] 1. GENTLENESS MUST CHARACTERIZE EVERY ACT OF AUTHORITY.--The storm of excitement that may make the child start, bears no relation to actual obedience. The inner firmness, that sees and feels a moral conviction and expects obedience, is only disguised and defeated by bluster. The more calm and direct it is, the greater certainty it has of dominion. 2. FOR THE GOVERNMENT OF SMALL CHILDREN.--For the government of small children speak only in the authority of love, yet authority, loving and to be obeyed. The most important lesson to impart is obedience to authority as authority. The question of salvation with most children will be settled as soon as they learn to obey parental authority. It establishes a habit and order of mind that is ready to accept divine authority. This precludes skepticism and disobedience, and induces that childlike trust and spirit set forth as a necessary state of salvation. Children that are never made to obey are left to drift into the sea of passion where the pressure for surrender only tends to drive them at greater speed from the haven of safety. 3. HABITS OF SELF-DENIAL.--Form in the child habits of self-denial. Pampering never matures good character. 4. EMPHASIZE INTEGRITY.--Keep the moral tissues tough in integrity; then it will hold a hook of obligations when once set in a sure place. There is nothing more vital. Shape all your experiments to preserve the integrity. Do not so reward it that it becomes mercenary. Turning State's evidence is a dangerous experiment in morals. Prevent deceit from succeeding. 5. GUARD MODESTY.--To be brazen is to imperil some of the best elements of character. Modesty may be strengthened into a becoming confidence, but brazen facedness can seldom be toned down into decency. It requires the miracle of grace. 6. PROTECT PURITY.--Teach your children to loathe impurity. Study the character of their playmates. Watch their books. Keep them from corruption at all cost. The groups of youth in the school and in society, and in business places, seed with improprieties of word and thought. Never relax your vigilance along this exposed border. [Illustration: BOTH PUZZLED.] 7. THREATEN THE LEAST POSSIBLE.--In family government threaten the least possible. Some parents rattle off their commands with penalties so profusely that there is a steady {78} roar of hostilities about the child's head. These threats are forgotten by the parent and unheeded by the child. All government is at an end. 8. DO NOT ENFORCE TOO MANY COMMANDS.--Leave a few things within the range of the child's knowledge that are not forbidden. Keep your word good, but do not have too much of it out to be redeemed. 9. PUNISH AS LITTLE AS POSSIBLE.--Sometimes punishment is necessary, but the less it is resorted to the better. 10. NEVER PUNISH IN A PASSION.--Wrath only becomes cruelty. There is no moral power in it. When you seem to be angry you can do no good. 11. BRUTISH VIOLENCE ONLY MULTIPLIES OFFENDERS.--Striking and beating the body seldom reaches the soul. Fear and hatred beget rebellion. 12. PUNISH PRIVATELY.--Avoid punishments that break down self-respect. Striking the body produces shame and indignation. It is enough for the other children to know that discipline is being administered. 13. NEVER STOP SHORT OF SUCCESS.--When the child is not conquered the punishment has been worse than wasted. Reach the point where neither wrath nor sullenness remain. By firm persistency and persuasion require an open look of recognition and peace. It is only evil to stir up the devil unless he is cast out. Ordinarily one complete victory will last a child for a lifetime. But if the child relapses, repeat the dose with proper accompaniments. 14. DO NOT REQUIRE CHILDREN TO COMPLAIN OF THEMSELVES FOR PARDON.--It begets either sycophants or liars. It is the part of the government to detect offences. It reverses the order of matters to shirk this duty. 15. GRADE AUTHORITY UP TO LIBERTY.--The growing child must have experiments of freedom. Lead him gently into the family. Counsel with him. Let him plan as he can. By and by he has the confidence of courage without the danger of exposures. 16. RESPECT.--Parents must respect each other. Undermining either undermines both. Always govern in the spirit of love. [Illustration] {79} CONVERSATION. [Illustration] Some men are very entertaining for a first interview, but after that they are exhausted, and run out; on a second meeting we shall find them very flat and monotonous; like hand-organs, we have heard all their tunes.--COULTON. He who sedulously attends, pointedly asks, calmly speaks, coolly answers, and ceases when he has no more to say, is in possession of some of the best requisites of man.--LAVATER. Beauty is never so lovely as when adorned with the smile, and conversation never sits easier upon us than when we know and then discharge ourselves in a symphony of Laughter, which may not improperly be called the Chorus of Conversation.--STEELE. The first ingredient in Conversation is Truth, the next Good Sense, the third Good Humor, and the fourth Wit.--SIR WILLIAM TEMPLE. {80} Home Lessons in Conversation. Say nothing unpleasant when it can be avoided. Avoid satire and sarcasm. Never repeat a word that was not intended for repetition. Cultivate the supreme wisdom, which consists less in saying what ought to be said than in not saying what ought not to be said. Often cultivate "flashes of silence." It is the larger half of the conversation to listen well. Listen to others patiently, especially the poor. Sharp sayings are an evidence of low breeding. Shun faultfindings and faultfinders. Never utter an uncomplimentary word against anyone. Compliments delicately hinted and sincerely intended are a grace in conversation. Commendation of gifts and cleverness properly put are in good taste, but praise of beauty is offensive. Repeating kind expressions is proper. Compliments given in a joke may be gratefully received in earnest. The manner and tone are important parts of a compliment. Avoid egotism. Don't talk of yourself, or of your friends or your deeds. Give no sign that you appreciate your own merits. Do not become a distributer of the small talk of a community. The smiles of your auditors do not mean respect. Avoid giving the impression of one filled with "suppressed egotism." Never mention your own peculiarities; for culture destroys vanity. Avoid exaggeration. Do not be too positive. Do not talk of display oratory. Do not try to lead in conversation, looking around to enforce silence. Lay aside affected silly etiquette for the natural dictates of the heart. Direct the conversation where others can join with you and impart to you useful information. Avoid oddity. Eccentricity is shallow vanity. Be modest. Be what you wish to seem. Avoid repeating a brilliant or clever saying. {82} [Illustration: THINKING ONLY OF DRESS.] If you find bashfulness or embarrassment coming upon you, do or say something at once. The commonest matter gently stated is better than an embarrassing silence. Sometimes changing your position, or looking into a book for a moment may relieve your embarrassment, and dispel any settling stiffness. Avoid telling many stories, or repeating a story more than once in the same company. Never treat any one as if you simply wanted him to tell stories. People laugh and despise such a one. Never tell a coarse story. No wit or preface can make it excusable. Tell a story, if at all, only as an illustration, and not for itself. Tell it accurately. Be careful in asking questions for the purpose of starting conversation or drawing out a person, not to be rude or intrusive. Never take liberties by staring, or by any rudeness. Never infringe upon any established regulations among strangers. Do not always prove yourself to be the one in the right. The right will appear. You need only give it a chance. Avoid argument in conversation. It is discourteous to your host. Cultivate paradoxes in conversation with your peers. They add interest to common-place matters. To strike the harmless faith of ordinary people in any public idol is waste, but such a movement with those able to reply is better. Never discourse upon your ailments. Never use words of the meaning or pronunciation of which you are uncertain. Avoid discussing your own or other people's domestic concerns. Never prompt a slow speaker, as if you had all the ability. In conversing with a foreigner who may be learning our language, it is excusable to help him in some delicate way. Never give advice unasked. Do not manifest impatience. Do not interrupt another when speaking. Do not find fault, though you may gently criticise. Do not appear to notice inaccuracies of speech in others. Do not always commence a conversation by allusion to the weather. Do not, when narrating an incident, continually say, "you see," "you know." {83} Do not allow yourself to lose temper or speak excitedly. Do not introduce professional or other topics that the company generally cannot take an interest in. Do not talk very loud. A firm, clear, distinct, yet mild, gentle, and musical voice has great power. Do not be absent-minded, requiring the speaker to repeat what has been said that you may understand. Do not try to force yourself into the confidence of others. Do not use profanity, vulgar terms, words of double meaning, or language that will bring the blush to anyone. Do not allow yourself to speak ill of the absent one if it can be avoided. The day may come when some friend will be needed to defend you in your absence. Do not speak with contempt and ridicule of a locality which you may be visiting. Find something to truthfully praise and commend; thus make yourself agreeable. Do not make a pretense of gentility, nor parade the fact that you are a descendant of any notable family. You must pass for just what you are, and must stand on your own merit. Do not contradict. In making a correction say, "I beg your pardon, but I had the impression that it was so and so." Be careful in contradicting, as you may be wrong yourself. Do not be unduly familiar; you will merit contempt if you are. Neither should you be dogmatic in your assertions, arrogating to yourself such consequences in your opinions. Do not be too lavish in your praise of various members of your own family when speaking to strangers; the person to whom you are speaking may know some faults that you do not. Do not feel it incumbent upon yourself to carry your point in conversation. Should the person with whom you are conversing feel the same, your talk may lead into violent argument. Do not try to pry into the private affairs of others by asking what their profits are, what things cost, whether Melissa ever had a beau, and why Amarette never got married? All such questions are extremely impertinent and are likely to meet with rebuke. Do not whisper in company; do not engage in private conversation; do not speak a foreign language which the general company present may not understand, unless it is understood that the foreigner is unable to speak your own language. * * * * * {84} THE TOILET OR The Care of the Person. * * * * * IMPORTANT RULES. [Illustration: Widower Jones and Widow Smith.] 1. GOOD APPEARANCE.--The first care of all persons should be for their personal appearance. Those who are slovenly or careless in their habits are unfit for refined society, and cannot possibly make a good appearance in it. A well-bred person will always cultivate habits of the most scrupulous neatness. A gentleman or lady is always well dressed. The garment may be plain or of coarse material, or even worn "thin and shiny," but if it is carefully brushed and neat it can be worn with dignity. {85} 2. PERSONAL CLEANLINESS.--Personal appearance depends greatly on the careful toilet and scrupulous attention to dress. The first point which marks the gentleman or lady in appearance is rigid cleanliness. This remark supplies to the body and everything which covers it. A clean skin--only to be secured by frequent baths--is indispensable. 3. THE TEETH.--The teeth should receive the utmost attention. Many a young man has been disgusted with a lady by seeing her unclean and discolored teeth. It takes but a few moments, and if necessary secure some simple tooth powder or rub the teeth thoroughly every day with a linen handkerchief, and it will give the teeth and mouth a beautiful and clean appearance. 4. THE HAIR AND BEARD.--The hair should be thoroughly brushed and well kept, and the beard of men properly trimmed. Men should not let their hair grow long and shaggy. 5. UNDERCLOTHING.--The matter of cleanliness extends to all articles of clothing, underwear as well as the outer clothing. Cleanliness is a mark of true utility. The clothes need not necessarily be of a rich and expensive quality, but they can all be kept clean. Some persons have an odor about them that is very offensive, simply on account of their underclothing being worn too long without washing. This odor of course cannot be detected by the person who wears the soiled garments, but other persons easily detect it and are offended by it. 6. THE BATH.--No person should think for a moment that they can be popular in society without regular bathing. A bath should be taken at least once a week, and if the feet perspire they should be washed several times a week, as the case may require. It is not unfrequent that young men are seen with dirty ears and neck. This is unpardonable and boorish, and shows gross neglect. Occasionally a young lady will be called upon unexpectedly when her neck and smiling face are not emblems of cleanliness. Every lady owes it to herself to be fascinating; every gentleman is bound, for his own sake, to be presentable; but beyond this there is the obligation to society, to one's friends, and to those with whom we may be brought in contact. 7. SOILED GARMENTS.--A young man's garments may not be expensive, yet there is no excuse for wearing a soiled collar and a soiled shirt, or carrying a soiled handkerchief. No one should appear as though he had slept in a stable, shaggy hair, soiled clothing or garments indifferently put on and carelessly buttoned. A young man's vest should always be kept buttoned in the presence of ladies. {86} 8. THE BREATH.--Care should be taken to remedy an offensive breath without delay. Nothing renders one so unpleasant to one's acquaintance, or is such a source of misery to one's self. The evil may be from some derangement of the stomach or some defective condition of the teeth, or catarrhal affection of the throat and nose. See remedies in other portions of the book. * * * * * A YOUNG MAN'S PERSONAL APPEARANCE. Dress changes the manners.--VOLTAIRE. Whose garments wither, shall receive faded smiles.--SHERIDAN KNOWLES. Men of sense follow fashion so far that they are neither conspicuous for their excess nor peculiar by their opposition to it.--ANONYMOUS. 1. A well-dressed man does not require so much an extensive as a varied wardrobe. He does not need a different suit for every season and every occasion, but if he is careful to select clothes that are simple and not striking or conspicuous, he may use the garment over and over again without their being noticed, provided they are suitable to the season and the occasion. 2. A clean shirt, collar and cuffs always make a young man look neat and tidy, even if his clothes are not of the latest pattern and are somewhat threadbare. 3. Propriety is outraged when a man of sixty dresses like a youth of sixteen. It is bad manners for a gentleman to use perfumes to a noticeable extent. Avoid affecting singularity in dress. Expensive clothes are no sign of a gentleman. [Illustration: The Dude of the 17th Century.] 4. When dressed for company, strive to appear easy and natural. Nothing is more distressing to a sensitive person, or more ridiculous to one gifted with refinement, than to see a lady laboring under the consciousness of a fine gown; or a gentleman who is stiff, awkward and ungainly in a brand-new coat. 5. Avoid what is called the "ruffianly style of dress" or the slouchy appearance of a half-unbottoned vest, and suspenderless pantaloons. That sort of affectation is, if possible, even more disgusting than the painfully elaborate frippery of the dandy or dude. Keep your clothes well brushed and keep them cleaned. Slight spots can be removed with a little sponge and soap and water. 6. A gentleman should never wear a high hat unless he has on a frock coat or a dress suit. 7. A man's jewelry should be good and simple. Brass or false jewelry, like other forms of falsehood, is vulgar. Wearing many cheap decorations is a serious fault. {87} 8. If a man wears a ring it should be on the third finger of the left hand. This is the only piece of jewelry a man is allowed to wear that does not serve a purpose. 9. Wearing imitations of diamonds is always in very bad taste. 10. Every man looks better in a full beard it he keeps it well trimmed. If a man shaves he should shave at least every other day, unless he is in the country. 11. The finger-nails should be kept cut, and the teeth should be cleaned every morning, and kept clear from tartar. A man who does not keep his teeth clean does not look like a gentleman when he shows them. * * * * * {88} Dress. We sacrifice to dress, till household joys And comforts cease. Dress drains our cellar dry, And keeps our larder lean. Puts out our fires, And introduces hunger, frost and woe, Where peace and hospitality might reign.--COWPER. * * * * * [Illustration] 1. GOD IS A LOVER OF DRESS.--We cannot but feel that God is a lover of dress. He has put on robes of beauty and glory upon all his works. Every flower is dressed in richness; every field blushes beneath a mantle of beauty; every star is veiled in brightness; every bird is clothed in the {89} habiliments of the most exquisite taste. The cattle upon the thousand hills are dressed by the hand divine. Who, studying God in his works, can doubt, that he will smile upon the evidence of correct taste manifested by his children in clothing the forms he has made them? 2. LOVE OF DRESS.--To love dress is not to be a slave of fashion; to love dress only is the test of such homage. To transact the business of charity in a silken dress, and to go in a carriage to the work, injures neither the work nor the worker. The slave of fashion is one who assumes the livery of a princess, and then omits the errand of the good human soul; dresses in elegance, and goes upon no good errand, and thinks and does nothing of value to mankind. 3. BEAUTY IN DRESS.--Beauty in dress is a good thing, rail at it who may. But it is a lower beauty, for which a higher beauty should not be sacrificed. They love dresses too much who give it their first thought, their best time, or all their money; who for it neglect the culture of their mind or heart, or the claims of others on their service; who care more for their dress than their disposition; who are troubled more by an unfashionable bonnet than a neglected duty. 4. SIMPLICITY OF DRESS.--Female lovliness never appears to so good advantage as when set off by simplicity of dress. No artist ever decks his angels with towering feathers and gaudy jewelry; and our dear human angels--if they would make good their title to that name--should carefully avoid ornaments, which properly belong to Indian squaws and African princesses. These tinselries may serve to give effect on the stage, or upon the ball room floor, but in daily life there is no substitute for the charm of simplicity. A vulgar taste is not to be disguised by gold or diamonds. The absence of a true taste and refinement of delicacy cannot be compensated for by the possession of the most princely fortune. Mind measures gold, but gold cannot measure mind. Through dress the mind may be read, as through the delicate tissue the lettered page. A modest woman will dress modestly; a really refined and intelligent woman will bear the marks of careful selection and faultless taste. 5. PEOPLE OF SENSE.--A coat that has the mark of use upon it, is a recommendation to the people of sense, and a hat with too much nap, and too high lustre, a derogatory circumstance. The best coats in our streets are worn on the backs of penniless fops, broken down merchants, clerks with pitiful salaries, and men that do not pay up. The heaviest gold chains dangle from the fobs of gamblers and gentlemen of very limited means; costly ornaments on {90} ladies, indicate to the eyes that are well opened, the fact of a silly lover or husband cramped for funds. 6. PLAIN AND NEAT.--When a pretty woman goes by in plain and neat apparel, it is the presumption that she has fair expectations, and a husband that can show a balance in his favor. For women are like books,--too much gilding makes men suspicious, that the binding is the most important part. The body is the shell of the soul, and the dress is the husk of the body; but the husk generally tells what the kernel is. As a fashionably dressed young lady passed some gentlemen, one of them raised his hat, whereupon another, struck by the fine appearance of the lady, made some inquiries concerning her, and was answered thus: "She makes a pretty ornament in her father's house, but otherwise is of no use." 7. THE RICHEST DRESS.--The richest dress is always worn on the soul. The adornments that will not perish, and that all men most admire, shine from the heart through this life. God has made it our highest, holiest duty, to dress the soul he has given us. It is wicked to waste it in frivolity. It is a beautiful, undying, precious thing. If every young woman would think of her soul when she looks in the glass, would hear the cry of her naked mind when she dallies away her precious hours at her toilet, would listen to the sad moaning of her hollow heart, as it wails through her idle, useless life, something would be done for the elevation of womanhood. 8. DRESSING UP.--Compare a well-dressed body with a well-dressed mind. Compare a taste for dress with a taste for knowledge, culture, virtue, and piety. Dress up an ignorant young woman in the "height of fashion"; put on plumes and flowers, diamonds and gewgaws; paint her face, girt up her waist, and I ask you, if this side of a painted and feathered savage you can find anything more unpleasant to behold. And yet such young women we meet by the hundred every day on the street and in all our public places. It is awful to think of. 9. DRESS AFFECTS OUR MANNERS.--A man who is badly dressed, feels chilly, sweaty, and prickly. He stammers, and does not always tell the truth. He means to, perhaps, but he can't. He is half distracted about his pantaloons, which are much to short, and are constantly hitching up; or his frayed jacket and crumpled linen harrow his soul, and quite unman him. He treads on the train of a lady's dress, and says, "Thank you", sits down on his hat, and wishes the "desert were his dwelling place." * * * * * {91} Beauty. "She walks in beauty, like the night Of cloudless climes and starry skies: And all that's best of dark and bright Meet her in aspect and in her eyes; Thus mellowed to that tender light Which heaven to gaudy day denies."--BYRON. [Illustration] 1. THE HIGHEST STYLE OF BEAUTY.--The highest style of beauty to be found in nature pertains to the human form, as animated and lighted up by the intelligence within. It is the expression of the soul that constitutes this superior beauty. It is that which looks out of the eye, which sits in calm majesty on the brow, lurks on the lip, smiles on the cheek, is set forth in the chiselled lines and features of the countenance, in the general contour of figure and form, in the movement, and gesture, and tone; it is this looking out of the invisible spirit that dwells within, this manifestation of the higher nature, that we admire and love; this constitutes to us the beauty of our species. {92} 2. BEAUTY WHICH PERISHES NOT.--There is a beauty which perishes not. It is such as the angels wear. It forms the washed white robes of the saints. It wreathes the countenance of every doer of good. It adorns every honest face. It shines in the virtuous life. It molds the hands of charity. It sweetens the voice of sympathy. It sparkles on the brow of wisdom. It flashes in the eye of love. It breathes in the spirit of piety. It is the beauty of the heaven of heavens. It is that which may grow by the hand of culture in every human soul. It is the flower of the spirit which blossoms on the tree of life. Every soul may plant and nurture it in its own garden, in its own Eden. 3. WE MAY ALL BE BEAUTIFUL.--This is the capacity of beauty that God has given to the human soul, and this the beauty placed within the reach of all. We may all be beautiful. Though our forms may be uncomely and our features not the prettiest, our spirits may be beautiful. And this inward beauty always shines through. A beautiful heart will flash out in the eye. A lovely soul will glow in the face. A sweet spirit will tune the voice, wreathe the countenance in charms. Oh, there is a power in interior beauty that melts the hardest heart! 4. WOMAN THE MOST PERFECT TYPE OF BEAUTY.--Woman, by common consent, we regard as the most perfect type of beauty on earth. To her we ascribe the highest charms belonging to this wonderful element so profusely mingled in all God's works. Her form is molded and finished in exquisite delicacy of perfection. The earth gives us no form more perfect, no features more symmetrical, no style more chaste, no movements more graceful, no finish more complete; so that our artists ever have and ever will regard the woman-form of humanity as the most perfect earthly type of beauty. This form is most perfect and symmetrical in the youth of womanhood; so that the youthful woman is earth's queen of beauty. This is true, not only by the common consent of mankind, but also by the strictest rules of scientific criticism. [Illustration: A REJECTED LOVER.] 5. FADELESS BEAUTY.--There cannot be a picture without its bright spots; and the steady contemplation of what is bright in others, has a reflex influence upon the beholder. It reproduces what it reflects. Nay, it seems to leave an impress even upon the countenance. The feature, from having a dark, sinister aspect, becomes open, serene, and sunny. A countenance so impressed, has neither the vacant stare of the idiot, nor the crafty, penetrating look of the basilisk, but the clear, placid aspect of truth and goodness. The woman {94} who has such a face is beautiful. She has a beauty which changes not with the features, which fades not with years. It is beauty of expression. It is the only kind of beauty which can be relied upon for a permanent influence with the other sex. The violet will soon cease to smile. Flowers must fade. The love that has nothing but beauty to sustain it, soon withers away. 6. A PRETTY WOMAN PLEASES THE EYE, a good woman, the heart. The one is a jewel, the other a treasure. Invincible fidelity, good humor, and complacency of temper, outlive all the charms of a fine face, and make the decay of it invisible. That is true beauty which has not only a substance, but a spirit; a beauty that we must intimately know to justly appreciate. 7. THE WOMAN YOU LOVE BEST.--Beauty, dear reader, is probably the woman you love best, but we trust it is the beauty of soul and character, which sits in calm majesty on the brow, lurks on the lip, and will outlive what is called a fine face. 8. THE WEARING OF ORNAMENTS.--Beauty needs not the foreign aid of ornament, but is when unadorned adorned the most, is a trite observation; but with a little qualification it is worthy of general acceptance. Aside from the dress itself, ornaments should be very sparingly used--at any rate, the danger lies in over-loading oneself, and not in using too few. A young girl, and especially one of a light and airy style of beauty, should never wear gems. A simple flower in her hair or on her bosom is all that good taste will permit. When jewels or other ornaments are worn, they should be placed where you desire the eye of the spectator to rest, leaving the parts to which you do not want attention called as plain and negative as possible. There is no surer sign of vulgarity than a profusion of heavy jewelry carried about upon the person. [Illustration] {95} Sensible Helps to Beauty. [Illustration] 1. FOR SCRAWNY NECK.--Take off your tight collars, feather boas and such heating things. Wash neck and chest with hot water, then rub in sweet oil all that you can work in. Apply this every night before you retire and leave the skin damp with it while you sleep. 2. FOR RED HANDS.--Keep your feet warm by soaking them often in hot water, and keep your hands out of the water as much as possible. Rub your hands with the skin of a lemon and it will whiten them. If your skin will bear glycerine after you have washed, pour into the palm a little glycerine and lemon juice mixed, and rub over the hands and wipe off. 3. NECK AND FACE.--Do not bathe the neck and face just before or after being out of doors. It tends to wrinkle the skin. 4. SCOWLS.--Never allow yourself to scowl, even if the sun be in your eyes. That scowl will soon leave its trace and no beauty will outlive it. {96} 5. WRINKLED FOREHEAD.--If you wrinkle your forehead when you talk or read, visit an oculist and have your eyes tested, and then wear glasses to fit them. 6. OLD LOOKS.--Sometimes your face looks old because it is tired. Then apply the following wash and it will make you look younger: Put three drops of ammonia, a little borax, a tablespoonful of bay rum, and a few drops of camphor into warm water and apply to your face. Avoid getting it into your eyes. 7. THE BEST COSMETIC.--Squeeze the juice of a lemon into a pint of sweet milk. Wash the face with it every night and in the morning wash off with warm rain water. This will produce a very beautiful effect upon the skin. 8. SPOTS ON THE FACE.--Moles and many other discolorations may be removed from the face by a preparation composed of one part chemically pure carbolic acid and two parts pure glycerine. Touch the spots with a camel's-hair pencil, being careful that the preparation does not come in contact with the adjacent skin. Five minutes after touching, bathe with soft water and apply a little vaseline. It may be necessary to repeat the operation, but if persisted in, the blemishes will be entirely removed. 9. WRINKLES.--This prescription is said to cure wrinkles: Take one ounce of white wax and melt it to a gentle heat. Add two ounces of the juice of lily bulbs, two ounces of honey, two drams of rose water, and a drop or two of ottar of roses. Apply twice a day, rubbing the wrinkles the wrong way. Always use tepid water for washing the face. 10. THE HAIR.--The hair must be kept free from dust or it will fall out. One of the best things for cleaning it, is a raw egg rubbed into the roots and then washed out in several waters. The egg furnishes material for the hair to grow on, while keeping the scalp perfectly clean. Apply once a month. 11. LOSS OF HAIR.--When through sickness or headache the hair falls out, the following tonic may be applied with good effect: Use one ounce of glycerine, one ounce of bay rum, one pint of strong sage tea, and apply every other night, rubbing well into the scalp. * * * * * {97} How to Keep the Bloom and Grace of Youth. THE SECRET OF ITS PRESERVATION. [Illustration: MRS. WM. MCKINLEY.] 1. The question most often asked by women is regarding the art of retaining, with advancing years, the bloom and grace of youth. This secret is not learned through the analysis of chemical compounds, but by a thorough study of nature's laws peculiar to their sex. It is useless for women with wrinkled faces, dimmed eyes and blemished skins to seek for external applications of beautifying balms and lotions to bring the glow of life and health into the face, and yet there are truths, simple yet wonderful, whereby the bloom of early life can be restored and retained, as should be the heritage of all God's children, sending the light of beauty into every woman's face. The secret: 2. Do not bathe in hard water; soften it with a few drops of ammonia, or a little borax. 3. Do not bathe the face while it is very warm, and never use very cold water. 4. Do not attempt to remove dust with cold water; give your face a hot bath, using plenty of good soap, then give it a thorough rinsing with warm water. 5. Do not rub your face with a coarse towel. 6. Do not believe you can remove wrinkles by filling in the crevices with powder. Give your face a Russian bath every night; that is, bathe it with water so hot that you wonder how you can bear it, and then, a minute after, with moderately cold water, that will make your face glow with warmth; dry it with a soft towel. * * * * * {98} Form and Deformity. [Illustration: MALE. FEMALE. Showing the Difference in Form and Proportion.] 1. PHYSICAL DEFORMITIES.--Masquerading is a modern accomplishment. Girls wear tight shoes, burdensome skirts, corsets, etc., all of which prove so fatal to their health. At the age of seventeen or eighteen, our "young ladies" are sorry specimens of feminality; and palpitators, cosmetics and all the modern paraphernalia are required to make them appear fresh and blooming. Man is equally at fault. A devotee to all the absurd devices of fashion, he practically asserts that "dress makes the man." But physical deformities are of far less importance than moral imperfections. 2. DEVELOPMENT OF THE INDIVIDUAL.--It is not possible for human beings to attain their full stature of humanity, except by loving long and perfectly. Behold that venerable man! he is mature in judgment, perfect in every action and expression, and saintly in goodness. You almost worship as you behold. What rendered him thus perfect? What {99} rounded off his natural asperities, and moulded up his virtues? Love, mainly. It permeated every pore, and seasoned every fibre of his being, as could nothing else. Mark that matronly woman. In the bosom of her family she is more than a queen and goddess combined. All her looks and actions express the outflowing of some or all of the human virtues. To know her is to love her. She became thus perfect, not in a day or year, but by a long series of appropriate means. Then by what? Chiefly in and by love, which is specially adapted thus to develop this maturity. 3. PHYSICAL STATURE.--Men and women generally increase in stature until the twenty-fifth year, and it is safe to assume, that perfection of function is not established until maturity of bodily development is completed. The physical contour of these representations plainly exhibits the difference in structure, and also implies difference of function. Solidity and strength are represented by the organization of the male, grace and beauty by that of the female. His broad shoulders represent physical power and the right of dominion, while her bosom is the symbol of love and nutrition. HOW TO DETERMINE A PERFECT HUMAN FIGURE. [Illustration: Lady's Dress in the days of Greece.] The proportions of the perfect human figure are strictly mathematical. The whole figure is six times the length of the foot. Whether the form be slender or plump, this rule holds good. Any deviation from it is a departure from the highest beauty of proportion. The Greeks made all their statues according to this rule. The face, from the highest point of the forehead, where the hair begins, to the end of the chin, is one-tenth of the whole stature. The hand, from the wrist to the end of the middle finger, is the same. The chest is a fourth, and from the nipples to the top of the head is the same. From the top of the chest to the highest point of the forehead is a seventh. If the length of the face, from the roots of the hair to the chin, be divided into three equal parts, the first division determines the point where the eyebrows meet, and the second the place of the nostrils. The navel is the central point of the human body, and if a man should lie on his back with his arms and legs extended, the periphery of the circle which might be described around him, with the navel for its center, would touch the extremities of his hands and feet. The height from the feet to the top of the head is the same as the {100} distance from the extremity of one hand to the extremity of the other when the arms are extended. The Venus de Medici is considered the most perfect model of the female forms, and has been the admiration of the world for ages. Alexander Walker, after minutely describing this celebrated statue, says: "All these admirable characteristics of the female form, the mere existence of which in woman must, one is temped to imagine, be, even to herself, a source of ineffable pleasure, these constitute a being worthy, as the personification of beauty, of occupying the temples of Greece; present an object finer, alas, than Nature even seems capable of producing; and offer to all nations and ages a theme of admiration and delight." Well might Thomson say: So stands the statue that enchants the world, So, bending, tries to vail the matchless boast-- The mingled beauties of exulting Greece. We beg our readers to observe the form of the waist (evidently innocent of corsets and tight dresses) of this model woman, and also that of the Greek Slave in the accompanying outlines. These forms are such as unperverted nature and the highest art alike require. To compress the waist, and thereby change its form, pushing the ribs inward, displacing the vital organs, and preventing the due expansion of the lungs, is as destructive to beauty as it is to health. {101} THE HISTORY, MYSTERY, BENEFITS AND INJURIES OF THE CORSET. [Illustration: The Corset in the 18th Century.] 1. The origin of the corset is lost in remote antiquity. The figures of the early Egyptian women show clearly an artificial shape of the waist produced by some style of corset. A similar style of dress must also have prevailed among the ancient Jewish maidens; for Isaiah, in calling upon the women to put away their personal adornments, says: "Instead of a girdle there shall be a rent, and instead of a stomacher (corset) a girdle of sackcloth." 2. Homer also tells us of the cestus or girdle of Venus, which was borrowed by the haughty Juno with a view to increasing her personal attractions, that Jupiter might be a more tractable and orderly husband. 3. Coming down to the later times, we find the corset was used in France and England as early as the 12th century. 4. The most extensive and extreme use of the corset occurred in the 16th century, during the reign of Catherine de Medici of France and Queen Elizabeth of England. With Catherine de Medici a thirteen-inch waist measurement was considered the standard of fashion, while a thick waist was an abomination. No lady could consider her figure of proper shape unless she could span her waist with her two hands. To produce this result a strong rigid corset was worn night and day until the waist was laced down to the required size. Then over this corset was placed the steel apparatus shown in the illustration on next page. This corset-cover reached from the hip to the throat, and {102} produced a rigid figure over which the dress would fit with perfect smoothness. 5. During the 18th century corsets were largely made from a species of leather known as "Bend," which was not unlike that used for shoe soles, and measured nearly a quarter of an inch in thickness. One of the most popular corsets of the time was the corset and stomacher shown in the accompanying illustration. [Illustration: Steel Corset worn in Catherine's time.] 6. About the time of the French Revolution a reaction set in against tight lacing, and for a time there was a return to the early classical Greek costume. This style of dress prevailed, with various modifications, until about 1810, when corsets and tight lacing again returned with threefold fury. Buchan, a prominent writer of this period, says that it was by no means uncommon to see "a mother lay her daughter down upon the carpet, and, placing her foot upon her back, break half a dozen laces in tightening her stays." 7. It is reserved to our own time to demonstrate that corsets and tight lacing do not necessarily go hand in hand. Distortion and feebleness are not beauty. A proper proportion should exist between the size of the waist and the breadth of the shoulders and hips, and if the waist is diminished below this proportion, it suggests disproportion and invalidism rather than grace and beauty. 8. The perfect corset is one which possesses just that degree of rigidity which will prevent it from wrinkling, but will at the same time allow freedom in the bending and twisting of the body. Corsets boned with whalebone, horn or steel are necessarily stiff, rigid and uncomfortable. After a few days' wear the bones or steels become bent and set in position, or, as more frequently happens, they break and cause injury or discomfort to the wearer. 9. About seven years ago an article was discovered for the stiffening of corsets, which has revolutionized the corset industry of the world. This article is manufactured from {103} the natural fibers of the Mexican Ixtle plant, and is known as Coraline. It consists of straight, stiff fibers like bristles bound together into a cord by being wound with two strands of thread passing in opposite directions. This produces an elastic fiber intermediate in stiffness between twine and whalebone. It cannot break, but it possesses all the stiffness and flexibility necessary to hold the corset in shape and prevent its wrinkling. We congratulate the ladies of to-day upon the advantages they enjoy over their sisters of two centuries ago, in the forms and the graceful and easy curves of the corsets now made as compared with those of former times. [Illustration: Forms of Corsets in the time of Elizabeth of England.] {104} TIGHT-LACING. [Illustration: EGYPTIAN CORSET.] [Illustration: THE NATURAL WAIST. THE EFFECTS OF LACING.] It destroys natural beauty and creates an unpleasant and irritable temper. A tight-laced chest and a good disposition cannot go together. The human form has been molded by nature, the best shape is undoubtedly that which she has given it. To endeavor to render it more elegant by artificial means is to change it; to make it much smaller below and much larger above is to destroy its beauty; to keep it cased up in a kind of domestic cuirass is not only to deform it, but to expose the internal parts to serious injury. Under such compression as is commonly practiced by ladies, the {105} development of the bones, which are still tender, does not take place conformably to the intention of nature, because nutrition is necessarily stopped, and they consequently become twisted and deformed. Those who wear these appliances of tight-lacing often complain that they cannot sit upright without them--are sometimes, indeed, compelled to wear them during all the twenty-four hours; a fact which proves to what extent such articles weaken the muscles of the trunk. The injury does not fall merely on the internal structure of the body, but also on its beauty, and on the temper and feelings with which that beauty is associated. Beauty is in reality but another name for expression of countenance, which is the index of sound health, intelligence, good feelings and peace of mind. All are aware that uneasy feelings, existing habitually in the breast speedily exhibit their signature on the countenance, and that bitter thoughts or a bad temper spoil the human expression of its comeliness and grace. * * * * * {107} The Care of the Hair. [Illustration: NATURAL HAIR.] 1. THE COLOR OF THE HAIR.--The color of the hair corresponds with that of the skin--being dark or black, with a dark complexion, and red or yellow with a fair skin. When a white skin is seen in conjunction with black hair, as among the women of Syria and Barbary, the apparent exception arises from protection from the sun's rays, and opposite colors are often found among people of one prevailing feature. Thus red-haired Jews are not uncommon, though the nation in general have dark complexion and hair. 2. THE IMPERISHABLE NATURE OF HAIR.--The imperishable nature of hair arises from the combination of salt and metals in its composition. In old tombs and on mummies it has been found in a perfect state, after a lapse of over two thousand years. There are many curious accounts proving the indestructibility of the human hair. 3. TUBULAR.--In the human family the hairs are tubular, the tubes being intersected by partitions, resembling in some degree the cellular tissue of plants. Their hollowness prevents incumbrance from weight, while their power of resistance is increased by having their traverse sections rounded in form. 4. CAUTIONS.--It is ascertained that a full head of hair, beard and whiskers, are a prevention against colds and consumptions. Occasionally, however, it is found necessary to remove the hair from the head, in cases of fever or disease, to stay the inflammatory symptoms, and to relieve the brain. The head should invariably be kept cool. Close night-caps are unhealthy, and smoking-caps and coverings for the head within doors are alike detrimental to the free growth of the hair, weakening it, and causing it to fall out. HOW TO BEAUTIFY AND PRESERVE THE HAIR. 1. TO BEAUTIFY THE HAIR.--Keep the head clean, the pores of the skin open, and the whole circulatory system in a healthy condition, and you will have no need of bear's grease (alias hog's lard). Where there is a tendency in the hair to fall off on account of the weakness or sluggishness of the circulation, or an unhealthy state of the skin, cold water and friction with a tolerably stiff brush are probably the best remedial agents. 2. BARBER'S SHAMPOOS.--Are very beneficial if properly prepared. They should not be made too strong. Avoid strong shampoos of any kind. Great caution should be exercised in this matter. {108} 3. CARE OF THE HAIR.--To keep the hair healthy, keep the head clean. Brush the scalp well with a stiff brush, while dry. Then wash with castile soap, and rub into the roots, bay rum, brandy or camphor water. This done twice a month will prove beneficial. Brush the scalp thoroughly twice a week. Dampen the hair with soft water at the toilet, and do not use oil. 4. HAIR WASH.--Take one ounce of borax, half an ounce of camphor powder--these ingredients fine--and dissolve them in one quart of boiling water. When cool, the solution will be ready for use. Dampen the hair frequently. This wash is said not only to cleanse and beautify, but to strengthen the hair, preserve the color and prevent baldness. ANOTHER EXCELLENT WASH.--The best wash we know for cleansing and softening the hair is an egg beaten up and rubbed well into the hair, and afterwards washed out with several washes of warm water. 5. THE ONLY SENSIBLE AND SAFE HAIR OIL.--The following is considered a most valuable preparation: Take of extract of yellow Peruvian bark, fifteen grains; extract of rhatany root, eight grains; extract of burdoch root and oil of nutmegs (fixed), of each two drachms; camphor (dissolve with spirits of wine), fifteen grains; beef marrow, two ounces; best olive oil, one ounce; citron juice, half a drachm; aromatic essential oil, as much as sufficient to render it fragrant; mix and make into an ointment. Two drachms of bergamot, and a few drops of attar of roses would suffice. 6. HAIR WASH.--A good hair wash is soap and water, and the oftener it is applied the freer the surface of the head will be from scurf. The hair-brush should also be kept in requisition morning and evening. 7. TO REMOVE SUPERFLUOUS HAIR.--With those who dislike the use of arsenic, the following is used for removing superfluous hair from the skin: Lime, one ounce; carbonate of potash, two ounces; charcoal powder, one drachm. For use, make it into a paste with a little warm water, and apply it to the part, previously shaved close. As soon as it has become thoroughly dry, it may be washed off with a little warm water. 8. COLORING FOR EYELASHES AND EYEBROWS.--In eyelashes the chief element of beauty consists in their being long and glossy; the eyebrows should be finely arched and clearly divided from each other. The most innocent darkener of the brow is the expressed juice of the elderberry, or a burnt clove. {109} [Illustration: DISCUSSING THE FASHIONS.] 9. CRIMPING HAIR.--To make the hair stay in crimps, take five cents worth of gum arabic and add to it just enough boiling water to dissolve it. When dissolved, add enough alcohol to make it rather thin. Let this stand all night and then bottle it to prevent the alcohol from evaporating. This put on the hair at night, after it is done up in papers or pins, will make it stay in crimp the hottest day, and is perfectly harmless. 10. TO CURL THE HAIR.--There is no preparation that will make naturally straight hair assume a permanent curl. The following will keep the hair in curl for a short time: Take borax, two ounces; gum arabic, one drachm; and hot {110} water, not boiling, one quart; stir, and, as soon as the ingredients are dissolved, add three tablespoonfuls of strong spirits of camphor. On retiring to rest, wet the hair with the above liquid, and roll in twists of paper as usual. Do not disturb the hair until morning, when untwist and form into ringlets. 11. FOR FALLING OR LOOSENING OF THE HAIR.--Take: Alcohol, a half pint. Salt, as much as will dissolve. Glycerine, a tablespoonful. Flour of sulphur, teaspoonful. Mix. Rub on the scalp every morning. 12. TO DARKEN THE HAIR WITHOUT BAD EFFECTS.--Take: Blue vitriol (powdered), one drachm. Alcohol, one ounce. Essence of roses, ten drops. Rain-water, a half-pint. Shake together until they are thoroughly dissolved. 13. GRAY HAIR.--There are no known means by which the hair can be prevented from turning gray, and none which can restore it to its original hue, except through the process of dyeing. The numerous "hair color restorers" which are advertised are chemical preparations which act in the manner of a dye or as a paint, and are nearly always dependent for their power on the presence of lead. This mineral, applied to the skin, for a long time, will lead to the most disastrous maladies--lead-palsy, lead colic, and other symptoms of poisoning. It should, therefore, never be used for this purpose. [Illustration] * * * * * {111} How to Cure Pimples or Other Facial Eruptions. [Illustration] 1. It requires self-denial to get rid of pimples, for persons troubled with them will persist in eating fat meats and other articles of food calculated to produce them. Avoid the use of rich gravies, or pastry, or anything of the kind in excess. Take all the out-door exercise yon can and never indulge in a late supper. Retire at a reasonable hour, and rise early in the morning. Sulphur to purify the blood may be taken three times a week--a thimbleful in a glass of milk before breakfast. It takes some time for the sulphur to do its work, therefore persevere in its use till the humors, or pimples, or blotches, disappear. Avoid getting wet while taking the sulphur. 2. TRY THIS RECIPE: Wash the face twice a day in warm water, and rub dry with a coarse towel. Then with a soft towel rub in a lotion made of two ounces of white brandy, one ounce of cologne, and one-half ounce of liquor potassa. {112} Persons subject to skin eruptions should avoid very salty or fat food. A dose of Epsom salts occasionally might prove beneficial. 3. Wash the face in a dilution of carbolic acid, allowing one teaspoonful to a pint of water. This is an excellent and purifying lotion, and may be used on the most delicate skins. Be careful about letting this wash get into the eyes. 4. Oil of sweet almonds, one ounce; fluid potash, one drachm. Shake well together, and then add rose water, one ounce; pure water, six ounces. Mix. Rub the pimples or blotches for some minutes with a rough towel, and then dab them with the lotion. 5. Dissolve one ounce of borax, and sponge the face with it every night. When there are insects, rub on flower of sulphur dry after washing, rub well and wipe dry; use plenty of castile soap. 6. Dilute corrosive sublimate with oil of almonds. A few days' application will remove them. * * * * * BLACK-HEADS AND FLESH WORMS. [Illustration: A Regular Flesh Worm Greatly Magnified.] * * * * * [Illustration: A HEALTHY COMPLEXION.] This is a minute little creature, scientifically called _Demodex folliculorum_, hardly visible to the naked eye, with comparatively large fore body, a more slender hind body and eight little stumpy processes that do duty as legs. No specialized head is visible, although of course there is a mouth orifice. These creatures live on the sweat glands or pores of the human face, and owing to the appearance that they give to the infested pores, they are usually known as "black-heads." It is not at all uncommon to see an otherwise pretty face disfigured by these ugly creatures, although the insects themselves are nearly transparent white. The black appearance is really due the accumulation of dirt which gets under the edges of the skin of the enlarged sweat glands and cannot be removed in the ordinary way by washing, because the abnormal, hardened secretion of the gland itself becomes stained. These insects are so lowly organized that it is almost impossible to satisfactorily deal with them. {113} and they sometimes cause the continual festering of the skin which they inhabit. REMEDY.--Press them out with a hollow key or with the thumb and fingers, and apply a mixture of sulphur and cream every evening. Wash every morning with the best toilet soap, or wash the face with hot water with a soft flannel at bedtime. * * * * * {114} Love. But there's nothing half so sweet in life As love's young dream.--MOORE. All love is sweet, Given or returned. Common as light is love, And its familiar voice wearies not ever.--SHELLEY. Doubt thou the stars are fire, Doubt that the sun doth move; Doubt truth to be a liar, But never doubt I love.--SHAKESPEARE. Let those love now who never loved before, Let those that always loved now love the more.--PARNELL. [Illustration: LOVE'S YOUNG DREAM.] 1. LOVE BLENDS YOUNG HEARTS.--Love blends young hearts in blissful unity, and, for the time, so ignores past ties and affections, as to make willing separation of the son from his father's house, and the daughter from all the sweet endearments of her childhood's home, to go out together, and rear for themselves an altar, around which shall cluster all the cares and delights, the anxieties and sympathies, of the family relationship; this love, if pure, unselfish, and discreet, constitutes the chief usefulness and happiness of human life. 2. WITHOUT LOVE.--Without love there would be no organized households, and, consequently, none of that earnest endeavor for competence and respectability, which is the mainspring to human effort; none of those sweet, softening, restraining and elevating influences of domestic life, which can alone fill the earth with the glory of the Lord and make glad the city of Zion. This love is indeed heaven upon earth; but above would not be heaven without it; where there is not love, there is fear; but, "love casteth out fear." And yet we naturally do offend what we most love. 3. LOVE IS THE SUN OF LIFE.--Most beautiful in morning and evening, but warmest and steadiest at noon. It is the sun of the soul. Life without love is worse than death; a world without a sun. The love which does not lead to labor will soon die out, and the thankfulness which does not embody itself in sacrifices is already changing to gratitude. Love is not ripened in one day, nor in many, nor even in a human lifetime. It is the oneness of soul with soul in appreciation and perfect trust. To be blessed it must rest in that faith in the Divine which underlies every other motion. To be true, it must be eternal as God himself. 4. LOVE IS DEPENDENT.--Remember that love is dependent upon forms; courtesy of etiquette guards and protects courtesy of heart. How many hearts have been lost irrevocably, and how many averted eyes and cold looks have been gained from what seemed, perhaps, but a trifling negligence of forms? {116} [Illustration: LOVE MAKING IN THE EARLY COLONIAL DAYS.] 5. RADICAL DIFFERENCES.--Men and women should not be judged by the same rules. There are many radical differences in their affectional natures. Man is the creature of interest and ambition. His nature leads him forth into the struggle and bustle of the world. Love is but the embellishment of his early life, or a song piped in the intervals of the acts. He seeks for fame, for fortune, for space in the world's thoughts, and dominion over his fellow-men. But a woman's whole life is a history of the affections. The heart is her world; it is there her ambition strives for empire; it is there her ambition seeks for hidden treasures. She sends forth her sympathies on adventure; she embarks her whole soul in the traffic of affection; and if shipwrecked her case is hopeless, for it is bankruptcy of the heart. 6. WOMAN'S LOVE.--Woman's love is stronger than death; it rises superior to adversity, and towers in sublime beauty above the niggardly selfishness of the world. Misfortune cannot suppress it; enmity cannot alienate it; temptation cannot enslave it. It is the guardian angel of the nursery and the sick bed; it gives an affectionate concord to the partnership of life and interest, circumstances cannot modify it; it ever remains the same to sweeten existence, to purify the cup of life, on the rugged pathway to the grave, and melt to moral pliability the brittle nature of man. It is the ministering spirit of home, hovering in soothing caresses over the cradle, and the death-bed of the household, and filling up the urn of all its sacred memories. 7. A LADY'S COMPLEXION.--He who loves a lady's complexion, form and features, loves not her true self, but her soul's old clothes. The love that has nothing but beauty to sustain it, soon withers and dies. The love that is fed with presents always requires feeding. Love, and love only, is the loan for love. Love is of the nature of a burning glass, which, kept still in one place, fireth; changed often, it doth nothing. The purest joy we can experience in one we love, is to see that person a source of happiness to others. When you are with the person loved, you have no sense of being bored. This humble and trivial circumstance is the great test--the only sure and abiding test of love. 8. TWO SOULS COME TOGETHER.--When two souls come together, each seeking to magnify the other, each in subordinate sense worshiping the other, each help the other; the two flying together so that each wing-beat of the one helps each wing-beat of the other--when two souls come together thus, they are lovers. They who unitedly move themselves away from grossness and from earth, toward the throne of crystaline and the pavement golden, are, indeed, true lovers. {118} [Illustration: CUPID'S CAPTURED VICTIM.] The Power and Peculiarities of Love. * * * * * LOVE IS A TONIC AND A REMEDY FOR DISEASE, MAKES PEOPLE LOOK YOUNGER, CREATES INDUSTRY, ETC. * * * * * "All thoughts, all passions, all desires, Whatever stirs this mortal frame, Are ministers of Love, And feed his sacred flame." 1. It is a physological fact long demonstrated that persons possessing a loving disposition borrow less of the cares of life, and also live much longer than persons with a strong, narrow and selfish nature. Persons who love scenery, love domestic animals, show great attachment for all friends; love their home dearly and find interest and enchantment in almost everything have qualities of mind and heart which indicate good health and a happy disposition. 2. Persons who love music and are constantly humming or whistling a tune, are persons that need not be feared, they are kind-hearted and with few exceptions possess a loving disposition. Very few good musicians become criminals. 3. Parents that cultivate a love among then children will find that the same feeling will soon be manifested in their children's disposition. Sunshine in the hearts of the parents will blossom in the lives of the children. The parent who continually cherishes a feeling of dislike and rebellion in his soul, cultivating moral hatred against his fellow-man, will soon find the same things manifested by his son. As the son resembles his father in looks so he will to a certain extent resemble him in character. Love in the heart of the parent will beget kindness and affection in the heart of a child. Continuous scolding and fretting in the home will soon make love a stranger. {119} [Illustration: THE TURKISH WAY OF MAKING LOVE] 4. If you desire to cultivate love, create harmony in all your feelings and faculties. Remember that all that is pure, holy and virtuous in love flows from the deepest fountain of the human soul. Poison the fountain and you change virtue to vice, and happiness to misery. 5. Love strengthens health, and disappointment cultivates disease. A person in love will invariably enjoy the best of health. Ninety-nine per cent. of our strong constitutioned men, now in physical ruin, have wrecked themselves on the breakers of an unnatural love. Nothing but right love and a right marriage will restore them to health. 6. All men feel much better for going a courting, providing they court purely. Nothing tears the life out of man more than lust, vulgar thoughts and immoral conduct. The libertine or harlot has changed love, God's purest gift to man, into lust. They cannot acquire love in its purity again, the sacred flame has vanished forever. Love is pure, and cannot be found in the heart of a seducer. 7. A woman is never so bright and full of health as when deeply in love. Many sickly and frail women are snatched from the clutches of some deadly disease and restored to health by falling in love. 8. It is a long established fact that married persons are healthier than unmarried persons; thus it proves that health and happiness belong to the home. Health depends upon mind. Love places the mind into a delightful state and quickens every human function, makes the blood circulate and weaves threads of joy into cables of domestic love. [Illustration: PREPARING TO ENTERTAIN HER LOVER.] 9. An old but true proverb: "A true man loving one woman will speak well of all women. A true woman loving one man will speak well of all men. A good wife praises all men, but praises her husband most. A good man praises all women, but praises his wife most." 10. Persons deeply in love become peculiarly pleasant, winning and tender. It is said that a musician can never excel or an artist do his best until he has been deeply in love. A good orator, a great statesman or great men in general are greater and better for having once been thoroughly in love. A man who truly loves his wife and home is always a safe man to trust. 11. Love makes people look younger in years. People in unhappy homes look older and more worn and fatigued. A woman at thirty, well courted and well married, looks five or ten years younger than a woman of the same age unhappily married. Old maids and bachelors always look older {120} than they are. A flirting widow always looks younger than an old maid of like age. 12. Love renders women industrious and frugal, and a loving husband spends lavishly on a loved wife and children, though miserly towards others. 13. Love cultivates self-respect and produces beauty. Beauty in walk and beauty in looks; a girl in love is at her best; it brings out the finest traits of her character, she walks more erect and is more generous and forgiving; her voice is sweeter and she makes happy all about her. She works better, sings better and is better. 14. Now in conclusion, a love marriage is the best life insurance policy; it pays dividends every day, while every other insurance policy merely promises to pay after death. Remember that statistics demonstrate that married people outlive old maids and old bachelors by a goodly number of years and enjoy healthier and happier lives. * * * * * {122} Amativeness or Connubial Love. [Illustration: CONFIDENCE.] 1. MULTIPLYING THE RACE.--Some means for multiplying our race is necessary to prevent its extinction by death. Propagation and death appertain to man's earthly existence. If the Deity had seen fit to bring every member of the human family into being by a direct act of creative power, without the agency of parents, the present wise and benevolent arrangements of husbands and wives, parents and children, friends and neighbors, would have been superseded, and all opportunities for exercising parental and connubial love, in which so much enjoyment is taken, cut off. But the domestic feelings and relations, as now arranged, must strike every philosophical observer as inimitably beautiful and perfect--as the offspring of infinite Wisdom and Goodness combined. 2. AMATIVENESS AND ITS COMBINATIONS constitute their origin, counterpart, and main medium of manifestation. Its primary function is connubial love. From it, mainly, spring those feelings which exist between the sexes as such and {123} result in marriage and offspring. Combined with the higher sentiments, it gives rise to all those reciprocal kind feelings and nameless courtesies which each sex manifests towards the other; refining and elevating both, promoting gentility and politeness, and greatly increasing social and general happiness. 3. RENDERS MEN MORE POLITE TO WOMEN.--So far from being in the least gross or indelicate, its proper exercise is pure, chaste, virtuous, and even an ingredient in good manners. It is this which renders men always more polite towards women than to one another, and more refined in their society, and which makes women more kind, grateful, genteel and tender towards men than women. It makes mothers love their sons more than their daughters, and fathers more attached to their daughters. Man's endearing recollections of his mother or wife form his most powerful incentives to virtue, study, and good deeds, as well as restraints upon his vicious inclinations; and, in proportion as a young man is dutiful and affectionate to his mother, will he be fond of his wife; for, this faculty is the parent of both. 4. ALL SHOULD CULTIVATE THE FACULTY OF AMATIVENESS OR CONNUBIAL LORE.--Study the personal charms and mental accomplishments of the other sex by ardent admirers of beautiful forms, and study graceful movements and elegant manners, and remember, much depends upon the tones and accents of the voice. Never be gruff if you desire to be winning. Seek and enjoy and reciprocate fond looks and feelings. Before you can create favorable impressions you must first be honest and sincere and natural, and your conquest will be sure and certain. * * * * * Love and Common-Sense. 1. Do you love her because she goes to the altar with her head full of book learning, her hands of no earthly use, save for the piano and brush; because she has no conception of the duties and responsibilities of a wife; because she hates housework, hates its everlasting routine and ever recurring duties; because she hates children and will adopt every means to evade motherhood; because she loves her ease, loves to have her will supreme, loves, oh how well, to be free to go and come, to let the days slip idly by, to be absolved from all responsibility, to live without labor, without care? Will you love her selfish, shirking, calculating nature after twenty years of close companionship? 2. Do you love him because he is a man, and therefore, no matter how weak mentally, morally or physically he may {124} be, he has vested in him the power to save you from the ignominy of an old maid's existence? Because you would rather be Mrs. Nobody, than make the effort to be Miss Somebody? because you have a great empty place in your head and heart that nothing but a man can fill? because you feel you cannot live without him? God grant the time may never come when you cannot live with him. [Illustration: AN EARNEST CALLER.] 3. Do you love her because she is a thoroughly womanly woman; for her tender sympathetic nature; for the jewels of her life, which are absolute purity of mind and heart; for the sweet sincerity of her disposition; for her loving, charitable thought; for her strength of character? because she is pitiful to the sinful, tender to the sorrowful, capable, self-reliant, modest, true-hearted? in brief, because she is the embodiment of all womanly virtues? 4. Do you love him because he is a manly man; because the living and operating principle of his life is a tender reverence for all women; because his love is the overflow of the best part of his nature; because he has never soiled his soul with an unholy act or his lips with an oath; because mentally he is a man among men; because physically he stands head and shoulders above the masses; because morally he is far beyond suspicion, in his thought, word or deed; because his earnest manly consecrated life is a mighty power on God's side? 5. But there always has been and always will be unhappy marriages until men learn what husbandhood means; how to care for that tenderly matured, delicately constituted being, that he takes into his care and keeping. That if her wonderful adjusted organism is overtaxed and overburdened, her happiness, which is largely dependent upon her health, is destroyed. 6. Until men give the women they marry the undivided love of their heart; until constancy is the key-note of a life which speaks eloquently of clean thoughts and clean hearts. 7. Until men and women recognize that self-control in a man, and modesty in a woman, will bring a mutual respect that years of wedded life will only strengthen. Until they recognize that love is the purest and holiest of all things known to humanity, will marriage continue to bring unhappiness and discontent, instead of that comfort and restful peace which all loyal souls have a right to expect and enjoy. 8. Be sensible and marry a sensible, honest and industrious companion, and happiness through life will be your reward. {126} [Illustration] What Women Love in Men. 1. Women naturally love courage, force and firmness in men. The ideal man in a woman's eye must be heroic and brave. Woman naturally despises a coward, and she has little or no respect for a bashful man. 2. Woman naturally loves her lord and master. Women who desperately object to be overruled, nevertheless admire men who overrule them, and few women would have any respect for a man whom they could completely rule and control. 3. Man is naturally the protector of woman; as the male wild animal of the forest protects the female, so it is natural for man to protect his wife and children, and therefore woman admires those qualities in a man which make him a protector. 4. LARGE MEN.--Women naturally love men of strength, size and fine physique, a tall, large and strong man rather than a short, small and weak man. A woman always pities a weakly man, but rarely ever has any love for him. 5. SMALL AND WEAKLY MEN.--All men would be of good size in frame and flesh, were it not for the infirmities visited upon them by the indiscretion of parents and ancestors of generations before. 6. YOUTHFUL SEXUAL EXCITEMENT.--There are many children born healthy and vigorous who destroy the full vigor of their generative organs in youth by self-abuse, and if they survive and marry, their children will have small bones, small frames and sickly constitutions. It is therefore not strange that instinct should lead women to admire men not touched with these symptoms of physical debility. 7. GENEROSITY.--Woman generally loves a generous man. Religion absorbs a great amount of money in temples, churches, ministerial salaries, etc., and ambition and appetite absorb countless millions, yet woman receives more gifts from man than all these combined: she {127} loves a generous giver. _Generosity and Gallantry_ are the jewels which she most admires. A woman receiving presents from a man implies that she will pay him back in love, and the woman who accepts a man's presents, and does not respect him, commits a wrong which is rarely ever forgiven. 8. INTELLIGENCE.--Above all other qualities in man, woman admires his intelligence. Intelligence is man's woman-captivating card. This character in woman is illustrated by an English army officer, as told by O. S. Fowler, betrothed in marriage to a beautiful, loving heiress, summoned to India, who wrote back to her: "I have lost an eye, a leg, an arm, and been so badly marred and begrimmed besides, that you never could love this poor, maimed soldier. Yet, I love you too well to make your life wretched by requiring you to keep your marriage-vow with me, from which I hereby release you. Find among English peers one physically more perfect, whom you can love better." She answered, as all genuine women must answer: "Your noble mind, your splendid talents, your martial prowess which maimed you, are what I love. As long as you retain sufficient body to contain the casket of your soul, which alone is what I admire, I love you all the same, and long to make you mine forever." 9. SOFT MEN.--All women despise soft and silly men more than all other defects in their character. Woman never can love a man whose conversation is flat and insipid. Every man seeking woman's appreciation or love should always endeavor to show his intelligence and manifest an interest in books and daily papers. He should read books and inform himself so that he can talk intelligently upon the various topics of the day. Even an ignorant woman always loves superior intelligence. 10. SEXUAL VIGOR.--Women love sexual vigor in men. This is human nature. Weakly and delicate fathers have weak and puny children, though the mother may be strong and robust. A weak mother often bears strong children, if the father is physically and sexually vigorous. Consumption is often inherited from fathers, because they furnish the body, yet more women die with it because of female obstructions. Hence women love passion in men, because it endows their offspring with strong functional vigor. 11. PASSIONATE MEN.--The less passion any woman possesses, the more she prizes a strong passionate man. This is a natural consequence, for if she married one equally {128} passionless, their children would be poorly endowed or they would have none; she therefore admires him who makes up the deficiency. Hence very amorous men prefer quiet, modest and reserved women. 12. HOMELY MEN are admired by women if they are large, strong and vigorous and possess a good degree of intelligence. Looks are trifles compared with the other qualities which man may possess. 13. YOUNG MAN, If you desire to win the love and admiration of young ladies, first, be intelligent; read books and papers; remember what you read, so you can talk about it. Second, be generous and do not show a stingy and penurious disposition when in the company of ladies. Third, be sensible, original, and have opinions of your own and do not agree with everything that someone else says, or agree with everything that a lady may say. Ladies naturally admire genteel and intelligent discussions and conversations when there is someone to talk with who has an opinion of his own. Woman despises a man who has no opinion of his own; she hates a trifling disposition and admires leadership, original ideas, and looks up to man as a leader. Women despise all men whom they can manage, overrule, cow-down and subdue. 14. BE SELF-SUPPORTING.--The young man who gives evidence of thrift is always in demand. Be enthusiastic and drive with success all that you undertake. A young man, sober, honest and industrious, holding a responsible position or having a business of his own, is a prize that some bright and beautiful young lady would like to draw. Woman admires a certainty. 15. UNIFORMED MEN.--It is a well known fact that women love uniformed men. The soldier figures as a hero in about every tale of fiction and it is said by good authority that a man in uniform has three more chances to marry than the man without uniform. The correct reason is, the soldier's profession is bravery, and he is dressed and trained for that purpose, and it is that which makes him admired by ladies rather than the uniform which he wears. His profession is also that of a protector. * * * * * {129} [Illustration] KATE SHELLEY The Heroine of Honey Creek, who July 6, 1881, crept across the trembling bridge in the darkness of a terrific storm, and stopped the approaching Passenger Train. * * * * * What Men Love in Women. 1. FEMALE BEAUTY.--Men love beautiful women, for woman's beauty is the highest type of all beauty. A handsome woman needs no diamonds, no silks or satins; her brilliant face outshines diamonds and her form is beautiful in calico. 2. FALSE BEAUTIFIERS.--Man's love of female beauty surpasses all other love, and whatever artificial means are used to beautify, to a certain extent are falsehoods which lead to distrust or dislike. Artificial beauty is always an imitation, and never can come into competition with the genuine. No art can successfully imitate nature. 3. TRUE KIND OF BEAUTY.--Facial beauty is only skin-deep. A beautiful form, a graceful figure, graceful movements and a kind heart are the strongest charms in the perfection of female beauty. A brilliant face always outshines what may be called a pretty face, for intelligence is that queenly grace which crowns woman's influence over men. Good looks and good and pure conduct awaken a man's love for women. A girl must therefore be charming as well {130} as beautiful, for a charming girl will never become a charmless wife. 4. A GOOD FEMALE BODY.--No weakly, poor-bodied woman can draw a man's love like a strong, well developed body. A round, plump figure with an overflow of animal life is the woman most commonly sought, for nature in man craves for the strong qualities in women, as the health and life of offspring depend upon the physical qualities of wife and mother. A good body and vigorous health, therefore, become indispensable to female beauty. 5. BROAD HIPS.--A woman with a large pelvis gives her a superior and significant appearance, while a narrow pelvis always indicate weak sexuality. The other portions of the body however must be in harmony with the size and breadth of the hips. 6. FULL BUSTS.--In the female beauty of physical development there is nothing that can equal full breasts. It is an indication of good health and good maternal qualities. As a face looks bad without a nose, so the female breast, when narrow and flat, produces a bad effect. The female breasts are the means on which a new-born child depends for its life and growth, hence it is an essential human instinct for men to admire those physical proportions in women which indicate perfect motherhood. Cotton and all other false forms simply show the value of natural ones. All false forms are easily detected, because large natural ones will generally quiver and move at every step, while the artificial ones will manifest no expression of life. As woman looks so much better with artificial paddings and puffings than she does without, therefore modern society should waive all objections to their use. A full breast has been man's admiration through all climes and ages, and whether this breast-loving instinct is right or wrong, sensible or sensual, it is a fact well known to all, that it is a great disappointment to a husband and father to see his child brought up on a bottle. Men love full breasts, because it promotes maternity. If, however, the breasts are abnormally large, it indicates maternal deficiency the same as any disproportion or extreme. 7. SMALL FEET.--Small feet and small ankles are very attractive, because they are in harmony with a perfect female form, and men admire perfection. Small feet and ankles indicate modesty and reserve, while large feet and ankles indicate coarseness, physical power, authority, predominance. Feet and ankles however must be in harmony with the body, as small feet and small ankles on a large woman would be out of proportion and consequently not beautiful. {131} 8. BEAUTIFUL ARMS.--As the arm is always in proportion with the other portions of the body, consequently a well-shaped arm, small hands and small wrists, with full muscular development, is a charm and beauty not inferior to the face itself, and those who have well-shaped arms may be proud of them, because they generally keep company with a fine bust and a fine figure. 9. INTELLIGENCE.--A mother must naturally possess intelligence, in order to rear her children intelligently, consequently it is natural for man to chiefly admire mental qualities in women, for utility and practicability depend upon intelligence. Therefore a man generally loves those charms in women which prepare her for the duties of companionship. If a woman desires to be loved, she must cultivate her intellectual gifts, be interesting and entertaining in society, and practical and helpful in the home, for these are some of the qualifications which make up the highest type of beauty. 10. PIETY AND RELIGION IN WOMEN.--Men who love home and the companionship of their wives, love truth, honor and honesty. It is this higher moral development that naturally leads them to admire women of moral and religious natures. It is therefore not strange that immoral men love moral and church-loving wives. Man naturally admires the qualities which tend to the correct government of the home. Men want good and pure children, and it is natural to select women who insure domestic contentment and happiness. A bad man, of course, does not deserve a good wife, yet he will do his utmost to get one. 11. FALSE APPEARANCE.--Men love reserved, coy and discreet women much more than blunt, shrewd and boisterous. Falsehood, false hair, false curls, false forms, false bosoms, false colors, false cheeks, and all that is false, men naturally dislike, for in themselves they are a poor foundation on which to form family ties, consequently duplicity and hypocrisy in women is very much disliked by men, but a frank, honest, conscientious soul is always lovable and lovely and will not become an old maid, except as a matter of choice and not of necessity. [Illustration] {132} History of Marriage. [Illustration] 1. "It is not good for man to be alone," was the Divine judgment, and so God created for him an helpmate; therefore sex is as Divine as the soul. {133} 2. POLYGAMY.--Polygamy has existed in all ages. It is and always has been the result of moral degradation and wantonness. 3. THE GARDEN OF EDEN.--The Garden of Eden was no harem. Primeval nature knew no community of love; there was only the union of two souls, and the twain were made one flesh. If God had intended man to be a polygamist he would have created for him two or more wives; but he only created one wife for the first man. He also directed Noah to take into the ark two of each sort--a male and female--another evidence that God believed in pairs only. 4. ABRAHAM no doubt was a polygamist, and the general history of patriarchal life shows that the plurality of wives and concubinage were national customs, and not the institutions authorized by God. 5. EGYPTIAN HISTORY.--Egyptian history, in the first ostensible form we have, shows that concubinage and polygamy were in common practice. 6. SOLOMON.--It is not strange that Solomon, with his thousand wives, exclaimed: "All is vanity and vexation of spirit." Polygamy is not the natural state of man. 7. CONCUBINAGE AND POLYGAMY continued till the fifth century, when the degraded condition of woman became to some extent matters of some concern and recognition. Before this woman was regarded simply as an instrument of procreation, or a mistress of the household, to gratify the passions of man. 8. THE CHINESE marriage system was, and is, practically polygamous, for from their earliest traditions we learn, although a man could have but one wife, he was permitted to have as many concubines as he desired. 9. MOHAMMEDANISM.--Of the 150,000,000 Mohammedans all are polygamists. Their religion appeals to the luxury of animal propensities, and the voluptuous character of the Orientals has penetrated western Europe and Africa. 10. MORMONISM.--The Mormon Church, founded by Joseph Smith, practiced polygamy until the beginning of 1893, when the church formally declared and resigned polygamy as a part or present doctrine of their religious institution. Yet all Mormons are polygamists at heart. It is a part of their religion; national law alone restrains them. 11. FREE LOVERS.--There is located at Lenox, Madison County, New York, an organization popularly known as Free Lovers. The members advocate a system of complex marriage, a sort of promiscuity, with a freedom of love for {134} any and all. Man offers woman support and love, woman enjoying freedom, self-respect, health, personal and mental competency, gives herself to man in the boundless sincerity of an unselfish union. In their system, love is made synonymous with sexuality, and there is no doubt but what woman is only a plaything to gratify animal caprice. 12. MONOGAMY (SINGLE WIFE), is a law of nature evident from the fact that it fulfills the three essential conditions of man, viz.: the development of the individual, the welfare of society and reproduction. In no nation with a system of polygamy do we find a code of political and moral rights, and the condition of woman is that of a slave. In polygamous countries nothing is added to the education and civilization. The natural tendency is sensualism, and sensualism tends to mental starvation. 13. CHRISTIAN CIVILIZATION has lifted woman from slavery to liberty. Wherever Christian civilization prevails there are legal marriages, pure homes and education. May God bless the purity of the home. * * * * * Marriage. "Thus grief still treads upon the heel of pleasure, Married in haste we may repent at leisure."--SHAKSPEARE. The parties are wedded. The priest or clergyman has pronounced as one those hearts that before beat in unison with each other. The assembled guests congratulate the happy pair. The fair bride has left her dear mother bedewed with tears and sobbing just as if her heart would break, and as if the happy bridegroom was leading her away captive against her will. They enter the carriage. It drives off on the wedding tour, and his arms encircles the yielding waist of her now all his own, while her head reclines on the breast of the man of her choice. If she be young and has married an old man, she will be sad. If she has married for a home, or position, or wealth, a pang will shoot across her fair bosom. If she has married without due consideration or on too light an acquaintance, it will be her sorrow before long. But, if loving and beloved, she has united her destiny with a worthy man, she will rejoice, and on her journey feel a glow of satisfaction and delight unfelt before and which will be often renewed, and daily prove as the living waters from some perennial spring. * * * * * {135} The Advantages of Wedlock. 'Tis sweet to hear the watch-dog's honest bark, Bay deep-mouthed welcome as we draw near home; 'Tis sweet to know there is an eye will mark Our coming, and look brighter when we come.--BYRON, DON JUAN. [Illustration] 1. Marriage is the natural state of man and woman. Matrimony greatly contributes to the wealth and health of man. 2. Circumstances may compel a man not to select a companion until late in life. Many may have parents or relatives, dependent brothers and sisters to care for, yet family {136} ties are cultivated, notwithstanding the home is without a wife. 3. In Christian countries the laws of marriage have greatly added to the health of man. Marriage in barbarous countries, where little or no marriage ceremonies are required, benefits man but little. There can be no true domestic blessedness without loyalty and love for the select and married companion. All the licentiousness and lust of a libertine, whether civilized or uncivilized, bring him only unrest and premature decay. 4. A man, however, may be married and not mated, and consequently reap trouble and unhappiness. A young couple should first carefully learn each other by making the courtship a matter of business, and sufficiently long that the disposition and temper of each may be thoroughly exposed and understood. 5. First see that there is love; secondly, that there is adaptation; thirdly, see that there are no physical defects; and if these conditions are properly considered, cupid will go with you. 6. The happiest place on all earth is home. A loving wife and lovely children are jewels without price, as Payne says: "'Mid pleasures and palaces though we may roam, Be it ever so humble, there's no place like home." 7. Reciprocated love produces a general exhilaration of the system. The elasticity of the muscles is increased, the circulation is quickened, and every bodily function is stimulated to renewed activity by a happy marriage. 8. The consummation desired by all who experience this affection, is the union of souls in a true marriage. Whatever of beauty or romance there may have been in the lover's dream, is enhanced and spiritualized in the intimate communion of married life. The crown of wifehood and maternity is purer, more divine than that of the maiden. Passion is lost--emotions predominate. [Illustration: AN ALGERIAN BRIDE.] 9. TOO EARLY MARRIAGES.--Too early marriage is always bad for the female. If a young girl marries, her system is weakened and a full development of her body is prevented, and the dangers of confinement are considerably increased. 10. Boys who marry young derive but little enjoyment from the connubial state. They are liable to excesses and thereby lose much of the vitality and power of strength and physical endurance. 11. LONG LIFE.--Statistics show that married men live longer than bachelors. Child-bearing for women is conducive to longevity. {137} 12. COMPLEXION.--Marriage purifies the complexion, removes blotches from the skin, invigorates the body, fills up the tones of the voice, gives elasticity and firmness to the step, and brings health and contentment to old age. 13. TEMPTATIONS REMOVED.--Marriage sanctifies a home, while adultery and libertinism produce unrest, distrust and misery. It must be remembered that a married man can practice the most absolute continence and enjoy a far better state of health than the licentious man. The comforts of companionship develop purity and give rest to the soul. 14. TOTAL ABSTENTION.--It is no doubt difficult for some men to fully abstain from sexual intercourse and be entirely chaste in mind. The great majority of men experience frequent strong sexual desire. Abstention is very apt to produce in their minds voluptuous images and untamable desires which require an iron will to banish or control. The hermit in his seclusion, or the monk in his retreat, are often flushed with these passions and trials. It is, however, natural; for remove these passions and man would be no longer a man. It is evident that the natural state of man is that of marriage; and he who avoids that state is not in harmony with the laws of his being. 15. PROSTITUTION.--Men who inherit strong passions easily argue themselves into the belief, either to practice {138} masturbation or visit places of prostitution, on the ground that their health demands it. Though medical investigation has proven it repeatedly to be false, yet many believe it. The consummation of marriage involves the mightiest issues of life and is the most holy and sacred right recognized by man, and it is the Balm of Gilead for many ills. Masturbation or prostitution soon blight the brightest prospects a young man may have. Manhood is morality and purity of purpose, not sensuality. * * * * * Disadvantages of Celibacy. [Illustration: Disadvantages of Celibacy. Keeping Bachelor's Hall. The Old Bachelor Sewing on His Buttons.] 1. To live the life of a bachelor has many advantages and many disadvantages. The man who commits neither fornication, adultery nor secret vice, and is pure in mind, surely has all the moral virtues that make a good man and a good citizen, whether married or unmarried. 2. If a good pure-minded man does not marry, he will suffer no serious loss of vital power; there will be no tendency to spermatorrhoea or congestion, nor will he be afflicted with any one of those ills which certain vicious writers and quacks would lead many people to believe. Celibacy is perfectly consistent with mental vigor and physical strength. Regularity in the habits of life will always have its good effects on the human body. 3. The average life of a married man is much longer than that of a bachelor. There is quite an alarming odds in the United States in favor of a man with a family. It is claimed that the married man lives on an average from five to twenty years longer than a bachelor. The married man lives a more regular life. He has his meals more regularly and is better nursed in sickness, and in every way a happier and more contented man. The happiness of wife and children will always add comfort and length of days to the man who is happily married. 4. It is a fact well answered by statistics that there is more crime committed, more vices practiced, and more immorality among single men than among married men. Let the young man be pure in heart like Bunyan's Pilgrim, and he can pass the deadly dens, the roaring lions, and overcome the ravenous fires of passion, unscathed. The vices of single men support the most flagrant of evils of modern society, hence let every young man beware and keep his body clean and pure. His future happiness largely depends upon his chastity while a single man. * * * * * {140} Old Maids. [Illustration: "WE SHALL NEVER MARRY."] 1. MODERN ORIGIN.--The prejudice which certainly still exists in the average mind against unmarried women must be of comparatively modern origin. From the earliest ages, in ancient Greece, and Rome particularly, the highest {141} honors were paid them. They were the ministers of the old religions, and regarded with superstitious awe. 2. MATRIMONY.--Since the reformation, especially during the last century, and in our own land, matrimony has been so much esteemed, notably by women, that it has come to be regarded as in some sort discreditable for them to remain single. Old maids are mentioned on every hand with mingled pity and disdain, arising no doubt from the belief, conscious or unconscious, that they would not be what they are if they could help it. Few persons have a good word for them as a class. We are constantly hearing of lovely maidens, charming wives, buxom widows, but almost never of attractive old maids. 3. DISCARDING PREJUDICE.--The real old maid is like any other woman. She has faults necessarily, though not those commonly conceived of. She is often plump, pretty, amiable, interesting, intellectual, cultured, warm-hearted, benevolent, and has ardent friends of both sexes. These constantly wonder why she has not married, for they feel that she must have had many opportunities. Some of them may know why; she may have made them her confidantes. She usually has a sentimental, romantic, frequently a sad and pathetic past, of which she does not speak unless in the sacredness of intimacy. 4. NOT QUARRELSOME.--She is not dissatisfied, querulous nor envious. On the contrary, she is, for the most part, singularly content, patient and serene,--more so than many wives who have household duties and domestic cares to tire and trouble them. 5. REMAIN SINGLE FROM NECESSITY.--It is a stupid, as well as a heinous mistake, that women who remain single do so from necessity. Almost any woman can get a husband if she is so minded, as daily observation attests. When we see the multitudes of wives who have no visible signs of matrimonial recommendation, why should we think that old maids have been totally neglected? We may meet those who do not look inviting. But we meet any number of wives who are even less inviting. [Illustration: "WE HAVE CHANGED OUR MINDS."] 6. FIRST OFFER.--The appearance and outgiving of many wives denote that they have accepted the first offer; the appearance and outgiving of many old maids that they have declined repeated offers. It is undeniable, that wives, in the mass, have no more charm than old maids have, in the mass. But, as the majority of women are married, they are no more criticised nor commented on, in the bulk, than the whole sex are. They are spoken of individually as pretty or {143} plain, bright or dull, pleasant or unpleasant; while old maids are judged as a species, and almost always unfavorable. 7. BECOMES A WIFE.--Many an old maid, so-called, unexpectedly to her associates becomes a wife, some man of taste, discernment and sympathy having induced her to change her state. Probably no other man of his kind has proposed before, which accounts for her singleness. After her marriage hundreds of persons who had sneered at her condition find her charming, thus showing the extent of their prejudice against feminine celibacy. Old maids in general, it is fair to presume, do not wait for opportunities, but for proposers of an acceptable sort. They may have, indeed they are likely to have, those, but not to meet these. 8. NO LONGER MARRY FOR SUPPORT.--The time has changed and women have changed with it. They have grown more sensible, more independent in disposition as well as circumstances. They no longer marry for support; they have proved their capacity to support themselves, and self-support has developed them in every way. Assured that they can get on comfortably and contentedly alone they are better adapted by the assurance for consortship. They have rapidly increased from this and cognate causes, and have so improved in person, mind and character that an old maid of to-day is wholly different from an old maid of forty years ago. [Illustration: CONVINCING HIS WIFE.] {144} When and Whom to Marry. 1. EARLY MARRIAGES.--Women too early married always remain small in stature, weak, pale, emaciated, and more or less miserable. We have no natural nor moral right to perpetuate unhealthy constitutions, therefore women should not marry too young and take upon themselves the responsibility, by producing a weak and feeble generation of children. It is better not to consummate a marriage until a full development of body and mind has taken place. A young woman of twenty-one to twenty-five, and a young man of twenty-three to twenty-eight, are considered the right age in order to produce an intelligent and healthy offspring. "First make the tree good, then shall the fruit be good also." 2. If marriage is delayed too long in either sex, say from thirty to forty-five, the offspring will often be puny and more liable to insanity, idiocy, and other maladies. 3. PUBERTY.--This is the period when childhood passes from immaturity of the sexual functions to maturity. Woman attains this state a year or two sooner than man. In the hotter climates the period of puberty is from twelve to fifteen years of age, while in cold climates, such as Russia, the United States, and Canada, puberty is frequently delayed until the seventeenth year. 4. DISEASED PARENTS.--We do the race a serious wrong in multiplying the number of hereditary invalids. Whole families of children have fallen heir to lives of misery and suffering by the indiscretion and poor judgment of parents. No young man in the vigor of health should think for a moment of marrying a girl who has the impress of consumption or other disease already stamped upon her feeble constitution. It only multiplies his own suffering, and brings no material happiness to his invalid wife. On the other hand, no healthy, vigorous young woman ought to unite her destiny with a man, no matter how much she adored him, who is not healthy and able to brave the hardships of life. If a young man or young woman with feeble body cannot find permanent relief either by medicine or change of climate, no thoughts of marriage should be entertained. Courting a patient may be pleasant, but a hard thing in married life to enjoy. The young lady who supposes that any young man wishes to marry her for the sake of nursing her through life makes a very grave mistake. [Illustration: THE BASHFUL YOUNG COUPLE. "A faint heart never won a fair lady."] 5. WHOM TO CHOOSE FOR A HUSBAND.--The choice of a husband requires the coolest judgment and the most {146} vigilant sagacity. A true union based on organic law is happiness, but let all remember that oil and water will not mix; the lion will not lie down with the lamb, nor can ill-assorted marriages be productive of aught but discord. "Let the woman take An elder than herself, so wears she to him-- So sways she, rules in her husband's heart." Look carefully at the disposition.--See that your intended spouse is kind-hearted, generous, and willing to respect the opinions of others, though not in sympathy with them. Don't marry a selfish tyrant who thinks only of himself. 6. BE CAREFUL.--Don't marry an intemperate man with a view of reforming him. Thousands have tried it and failed. Misery, sorrow and a very hell on earth have been the consequences of too many such generous undertakings. 7. THE TRUE AND ONLY TEST which any man should look for in woman is modesty in demeanor before marriage, absence both of assumed ignorance and disagreeable familiarity, and a pure and religious frame of mind. Where these are present, he need not doubt that he has a faithful and a chaste wife. 8. MARRYING FIRST COUSINS is dangerous to offspring. The observation is universal, the children of married first cousins are too often idiots, insane, clump-footed, crippled, blind, or variously diseased. First cousins are always sure to impart all the hereditary disease in both families to their children. If both are healthy there is less danger. 9. DO NOT CHOOSE ONE TOO GOOD, or too far above you, lest the inferior dissatisfying the superior, breed those discords which are worse than the trials of a single life. Don't be too particular; for you might go farther and fare worse. As far as you yourself are faulty, you should put up with faults. Don't cheat a consort by getting one much better than you can give. We are not in heaven yet, and must put up with their imperfections, and instead of grumbling at them, be glad they are no worse; remembering that a faulty one is a great deal better than none, if he loves you. 10. MARRYING FOR MONEY.--Those who seek only the society of those who can boast of wealth will nine times out of ten suffer disappointment. Wealth cannot manufacture true love nor money buy domestic happiness. Marry because you love each other, and God will bless your home. A cottage with a loving wife is worth more than a royal palace with a discontented and unloving queen. {147} 11. DIFFERENCE IN AGE.--It is generally admitted that the husband should be a few years older than the wife. The question seems to be how much difference. Up to twenty-two those who propose marriage should be about the same age; however, other things being equal, a difference of fifteen years after the younger is twenty-five, need not prevent a marriage. A man of forty-five may marry a woman of twenty-five much more safely than one of thirty a girl below nineteen, because her mental sexuality is not as mature as his, and again her natural coyness requires more delicate and affectionate treatment than he is likely to bestow. A girl of twenty or under should seldom if ever marry a man of thirty or over, because the love of an elderly man for a girl is more parental than conjugal; while hers for him is like that of a daughter to a father. He may pet, flatter and indulge her as he would a grown-up daughter, yet all this is not genuine masculine and feminine love, nor can she exert over him the influence every man requires from his wife. 12. THE BEST TIME.--All things considered, we advise the male reader to keep his desires in check till he is at least twenty-five, and the female not to enter the pale of wedlock until she has attained the age of twenty. After those periods, marriage is the proper sphere of action, and one in which nearly every individual is called by nature to play his proper part. 13. SELECT CAREFULLY.--While character, health, accomplishments and social position should be considered, yet one must not overlook mental construction and physical conformation. The rule always to be followed in choosing a life partner is _identity of taste and diversity of temperament_. Another essential is that they be physically adapted to each other. For example: The pelvis--that part of the anatomy containing all the internal organs of gestation--is not only essential to beauty and symmetry, but is a matter of vital importance to her who contemplates matrimony, and its usual consequences. Therefore, the woman with a very narrow and contracted pelvis should never choose a man of giant physical development lest they cannot duly realize the most important of the enjoyments of the marriage state, while the birth of large infants will impose upon her intense labor pains, or even cost her her life. {148} * * * * * CHOOSE INTELLECTUALLY--LOVE AFTERWARD. [Illustration: Explaining the Necessity for a New Bonnet.] 1. LOVE.--Let it ever be remembered that love is one of the most sacred elements of our nature, and the most dangerous with which to tamper. It is a very beautiful and delicately contrived faculty, producing the most delightful results, but easily thrown out of repair--like a tender plant, the delicate fibers of which incline gradually to entwine themselves around its beloved one, uniting two willing hearts by a thousand endearing ties, and making of "twain one flesh"; but they are easily torn asunder, and then adieu to the joys of connubial bliss! {149} 2. COURTING BY THE QUARTER.--This courting by the quarter, "here a little and there a little," is one of the greatest evils of the day. This getting a little in love with Julia, and then a little with Eliza, and a little more with Mary,--this fashionable flirtation and coquetry of both sexes--is ruinous to the domestic affections; besides, effectually preventing the formation of true connubial love. I consider this dissipation of the affections one of the greatest sins against Heaven, ourselves, and the one trifled with, that can be committed. 3. FRITTERING AWAY AFFECTIONS.--Young men commence courting long before they think of marrying, and where they entertain no thoughts of marriage. They fritter away their own affections, and pride themselves on their conquests over the female heart; triumphing in having so nicely fooled them. They pursue this sinful course so far as to drive their pitiable victims, one after another, from respectable society, who, becoming disgraced, retaliate by heaping upon them all the indignities and impositions which the fertile imagination of woman can invent or execute. 4. COURTING WITHOUT INTENDING TO MARRY.--Nearly all this wide-spread crime and suffering connected with public and private licentiousness and prostitution, has its origin in these unmeaning courtships--this premature love--this blighting of the affections, and every young man who courts without intending to marry, is throwing himself or his sweetheart into _this hell upon earth_. And most of the blame rests on young men, because they take the liberty of paying their addresses to the ladies and discontinuing them, at pleasure, and thereby mainly cause this vice. 5. SETTING THEIR CAPS.--True, young ladies sometimes "set their caps," sometimes court very hard by their bewitching smiles and affectionate manners; by the natural language of love, or that backward reclining and affectionate roll of the head which expresses it; by their soft and persuasive accents; by their low dresses, artificial forms, and many other unnatural and affected ways and means of attracting attention and exciting love; but women never court till they have been in love and experienced its interruption, till their first and most tender fibres of love have been frostbitten by disappointment. It is surely a sad condition of society. [Illustration: "HASTY FAMILIARITY IS FRAUGHT WITH MANY DANGERS."] 6. TRAMPLING THE AFFECTIONS OF WOMEN.--But man is a self-privileged character. He may not only violate the laws of his own social nature with impunity, but he may even trample upon the affections of woman. He may even carry {151} this sinful indulgence to almost any length, and yet be caressed and smiled tenderly upon by woman; aye, even by virtuous woman. He may call out, only to blast the glowing affections of one young lady after another, and yet his addresses be cordially welcomed by others. Surely a gentleman is at perfect liberty to pay his addresses, not only to a lady, but even to the ladies, although he does not once entertain the thought of marrying his sweet-heart, or, rather his victim. O, man, how depraved! O, woman, how strangely blind to your own rights and interests! 7. AN INFALLIBLE SIGN.--An infallible sign that a young man's intentions are improper, is his trying to excite your passions. If he loves you, he will never appeal to that feeling, because he respects you too much for that. And the woman who allows a man to take advantage of her just to compel him to marry her, is lost and heartless in the last degree, and utterly destitute of moral principle as well as virtue. A woman's riches is her virtue, that gone she has lost all. 8. THE BEGINNING OF LICENTIOUSNESS.--Man it seldom drives from society. Do what he may, woman, aye, virtuous and even pious woman rarely excludes him from her list of visitors. But where is the point of propriety?--immoral transgression should exclude either sex from respectable society. Is it that one false step which now constitutes the boundary between virtue and vice? Or rather, the discovery of that false step? Certainly not! but it is all that leads to, and precedes and induces it. It is this courting without marrying. This is the beginning of licentiousness, as well as its main, procuring cause, and therefore infinitely worse than its consummation merely. 9. SEARING THE SOCIAL AFFECTIONS.--He has seared his social affections so deeply, so thoroughly, so effectually, that when, at last, he wishes to marry, he is incapable of loving. He marries, but is necessarily cold-hearted towards his wife, which of course renders her wretched, if not jealous, and reverses the faculties of both towards each other; making both most miserable for life. This induces contention and mutual recrimination, if not unfaithfulness, and imbitters the marriage relations through life; and well it may. 10. UNHAPPY MARRIAGES.--This very cause, besides inducing most of that unblushing public and private prostitution already alluded to, renders a large proportion of the marriages of the present day unhappy. Good people mourn over the result, but do not once dream of its cause. They even pray for moral reform, yet do the very things that increase the evil. {152} [Illustration: AFTER THE ENGAGEMENT.] 11. WEEPING OVER HER FALLEN SON.--Do you see yonder godly mother, weeping over her fallen son, and remonstrating with him in tones of a mother's tenderness and importunity? That very mother prevented that very son marrying the girl he dearly loved, because she was poor, and this interruption of his love was the direct and procuring cause of his ruin; for, if she had allowed him to marry this beloved one, he never would have thought of giving his "strength unto strange women." True, the mother ruined her son ignorantly, but none the less effectually. 12. SEDUCTION AND RUIN.--That son next courts another virtuous fair one, engages her affections, and ruins her, or else leaves her broken-hearted, so that she is the more easily ruined by others, and thus prepares the way for her becoming an inmate of a house "whose steps take hold on hell." His heart is now indifferent, he is ready for anything. 13. THE RIGHT PRINCIPLE.--I say then, with emphasis, that no man should ever pay his addresses to any woman, until he has made his selection, not even to aid him in making that choice. He should first make his selection intellectually, and love afterward. He should go about the matter coolly and with judgment, just as he would undertake any other important matter. No man or woman, when blinded by love, is in a fit state to judge advantageously as to what he or she requires, or who is adapted to his or her wants. 14. CHOOSING FIRST AND LOVING AFTERWARDS.--I know, indeed, that this doctrine of choosing first and loving afterward, of excluding love from the councils, and of choosing by and with the consent of the intellect and moral sentiments, is entirely at variance with the feelings of the young and the customs of society; but, for its correctness, I appeal to the common-sense--not to the experience, for so few try this plan. Is not this the only proper method, and the one most likely to result happily? Try it. 15. THE YOUNG WOMAN'S CAUTION.--And, especially, let no young lady ever once think of bestowing her affections till she is certain they will not be broken off--that is, until the match is fully agreed upon; but rather let her keep her heart whole till she bestows it for life. This requisition is as much more important, and its violation as much more disastrous to woman than to man, as her social faculties are stronger than his. 16. A BURNT CHILD DREADS THE FIRE.--As a "burnt child dreads the fire," and the more it is burnt, the greater the dread: so your affections, once interrupted, will recoil from a second love, and distrust all mankind. No! you cannot be too choice of your love--that pivot on which turn your destinies for life and future happiness. * * * * * {154} Love-Spats. For aught that ever I could read, Could ever hear by tale or history, The course of true love never did ran smooth."--SHAKESPEARE. "Heaven has no rage like love to hatred turned, Nor hell a fury like a woman scorned."--CONGREVE. "Thunderstorms clear the atmosphere and promote vegetation; then why not Love-spats promote love, as they certainly often do? They are almost universal, and in the nature of our differences cannot be helped. The more two love, the more they are aggrieved by each other's faults; of which these spats are but the correction. Love-spats instead of being universal, they are consequent on imperfect love, and only aggravate, never correct errors. Sexual storms never improve, whereas love obviates faults by praising the opposite virtues. Every view of them, practical and philosophical, condemns them as being to love what poison is to health, both before and after marriage. They are nothing but married discords. Every law of mind and love condemns them. Shun them as you would deadly vipers, and prevent them by forestallment."--O. S. Fowler. * * * * * 1. THE TRUE FACTS.--Notwithstanding some of the above quotations, to the contrary, trouble and disagreement between lovers embitters both love and life. Contention is always dangerous, and will beget alienation if not final separation. 2. CONFIRMED AFFECTIONS.--Where affections are once thoroughly confirmed, each one should be very careful in taking offense, and avoid all disagreements as far as possible, but if disagreements continually develop with more or less friction and irritation, it is better for the crisis to come and a final separation take place. For peace is better than disunited love. [Illustration: CUPID'S REBELLION] 3. HATE-SPATS.--Hate-spats, though experienced by most lovers, yet, few realize how fatal they are to subsequent affections. Love-spats develop into hate-spats, and their effects upon the affections are blighting and should not under any circumstances be tolerated. Either agree, or agree to disagree. If there cannot be harmony before the ties of marriage are assumed, then there cannot be harmony {156} after. Married life will be continually marred by a series of "hate-spats" that sooner or later will destroy all happiness, unless the couple are reasonably well mated. 4. MORE FATAL THE OFTENER THEY OCCUR.--As O. S. Fowler says: "'The poison of asps is under their lips.' The first spat is like a deep gash cut into a beautiful face, rendering it ghastly, and leaving a fearful scar, which neither time nor cosmetics can ever efface; including that pain so fatal to love, and blotting that sacred love-page with memory's most hideous and imperishable visages. Cannot many now unhappy remember them as the beginning of that alienation which embittered your subsequent affectional cup, and spoiled your lives? With what inherent repulsion do you look back upon them? Their memory is horrid, and effect on love most destructive." 5. FATAL CONDITIONS.--What are all lovers' "spats" but disappointment in its very worst form? They necessarily and always produce all its terrible consequences. The finer feelings and sensibilities will soon become destroyed and nothing but hatred will remain. 6. EXTREME SORROW.--After a serious "spat" there generally follows a period of tender sorrow, and a feeling of humiliation and submission. Mutual promises are consequently made that such a condition of things shall never happen again, etc. But be sure and remember, that every subsequent difficulty will require stronger efforts to repair the breach. Let it be understood that these compromises are dangerous, and every new difficulty increases their fatality. Even the strongest will endure but few, nor survive many. 7. DISTRUST AND WANT OF CONFIDENCE.--Most difficulties arise from distrust or lack of confidence or common-sense. When two lovers eye each other like two curs, each watching, lest the other should gain some new advantage, then this shows a lack of common-sense, and the young couple should get sensible or separate. 8. JEALOUSY.--When one of the lovers, once so tender, now all at once so cold and hardened; once so coy and familiar, now suddenly so reserved, distant, hard and austere, is always a sure case of jealousy. A jealous person is first talkative, very affectionate, and then all at once changes and becomes cold, reserved and repulsive, apparently without cause. If a person is jealous before marriage, this characteristic will be increased rather than diminished by marriage. {157} 9. CONFESSION.--If you make up by confession, the confessor feels mean and disgraced; or if both confess and forgive, both feel humbled; since forgiveness implies inferiority and pity; from which whatever is manly and womanly shrinks. Still even this is better than continued "spats." 10. PREVENTION.--If you can get along well in your courtship you will invariably make a happy couple if you should unite your destinies in marriage. Learn not to give nor take offence. You must remember that all humanity is imperfect at best. We all have our faults, and must keep them in subordination. Those who truly love each other will have but few difficulties in their courtship or in married life. 11. REMEDIES.--Establishing a perfect love in the beginning constitutes a preventive. Fear that they are not truly loved usually paves the way for "spats." Let all who make any pretension guard against all beginnings of this reversal, and strangle these "hate-spats" the moment they arise. "Let not the sun go down upon thy wrath," not even an hour, but let the next sentence after they begin quench them forever. And let those who cannot court without "spats," stop; for those who spat before marriage, must quarrel after. [Illustration: "Let not the sun go down upon thy wrath."] [Illustration] * * * * * {159} A Broken Heart. [Illustration: A BROKEN HEART] 1. WOUNDED LOVE.--Tis true that love wields a magic, sovereign, absolute, and tyrannical power over both the body and the mind when it is given control. It often, in case of disappointment, works havoc and deals death blows to its victims, and leaves many in that morbid mental condition which no life-tonics simply can restore. Wounded love may be the result of hasty and indiscreet conduct of young people; or the outgrowth of lust, or the result of domestic infidelity and discord. 2. FATAL EFFECTS.--Our cemeteries receive within the cold shadows of the grave thousands and thousands of victims that annually die from the results of "broken hearts." It is no doubt a fact that love troubles cause more disorders of the heart than everything else combined. 3. DISRUPTED LOVE.--It has long been known that dogs, birds, and even horses, when separated from their companions or friends, have pined away and died; so it is not strange that man with his higher intuitive ideas of affection should suffer from love when suddenly disrupted. 4. CRUCIFYING LOVE.--Painful love feelings strike right to the heart, and the breaking up of love that cannot be consummated in marriage is sometimes allowed to crucify the affections. There is no doubt that the suffering from disappointed love is often deeper and more intense than meeting death itself. 5. HEALING.--The paralyzing and agonizing consequences of ruptured love can only be remedied by diversion and society. Bring the mind into a state of patriotic independence with a full determination to blot out the past. Those who cannot bring into subordination the pangs of disappointment in love are not strong characters, and invariably will suffer disappointments in almost every department of life. Disappointment in love means rising above it, and conquering it, or demoralization, mental, physical and sexual. 6. LOVE RUNS MAD.--Love comes unbidden. A blind ungovernable impulse seems to hold sway in the passions of the affections. Love is blind and seems to completely subdue and conquer. It often comes like a clap of thunder from a clear sky, and when it falls it falls flat, leaving only the ruins of a tornado behind. 7. BAD, DISMAL, AND BLUE FEELINGS.--Despondency breathes disease, and those who yield to it can neither work, eat nor sleep; they only suffer. The spell-bound, fascinated, magnetized affections seem to deaden self-control and no {160} doubt many suffering from love-sickness are totally helpless; they are beside themselves, irritational and wild. Men and women of genius, influence and education, all seem to suffer alike, but they do not yield alike to the subduing influence; some pine away and die; others rise above it, and are the stronger and better for having been afflicted. 8. RISE ABOVE IT.--Cheer up! If you cannot think pleasurably over your misfortune, forget it. You must do this or perish. Your power and influence is too much to blight by foolish and melancholicy pining. Your own sense, your self-respect, your self-love, your love for others, command you not to spoil yourself by crying over "spilt milk." [Illustration: MARRIAGE ON A DEATHBED.] 9. RETRIEVE YOUR PAST LOSS.--Do sun, moon, and stars indeed rise and set in your loved one? Are there not "as good fish in the sea as ever were caught?" and can you not catch them? Are there not other hearts on earth just as loving and lovely, and in every way as congenial? If circumstances had first turned you upon another, you would have felt about that one as now about this. Love depends far less on the party loved than on the loving one. Or is this the way either to retrieve your past loss, or provide for the future? Is it not both unwise and self-destructive; and in every way calculated to render your case, present and prospective, still more hopeless? 10. FIND SOMETHING TO DO.--Idle hands are Satan's workshop. Employ your mind; find something to do; something in which you can find self-improvement; something that will fit you better to be admired by someone else, read, and improve your mind; get into society, throw your whole soul into some new enterprise, and you will conquer with glory and come out of the fire purified and made more worthy. 11. LOVE AGAIN.--As love was the cause of your suffering, so love again will restore you, and you will love better and more consistently. Do not allow yourself to become soured and detest and shun association. Rebuild your dilapidated sexuality by cultivating a general appreciation of the excellence, especially of the mental and moral qualities of the opposite sex. Conquer your prejudices, and vow not to allow anyone to annoy or disturb your calmness. 12. LOVE FOR THE DEAD.--A most affectionate woman, who continues to love her affianced though long dead, instead of becoming soured or deadened, manifests all the richness and sweetness of the fully-developed woman thoroughly in love, along with a softened, mellow, twilight sadness which touches every heart, yet throws a peculiar lustre and beauty over her manners and entire character. She must mourn, {161} but not forever. It is not her duty to herself or to her Creator. 13. A SURE REMEDY.--Come in contact with the other sex. You are infused with your lover's magnetism, which must remain till displaced by another's. Go to parties and picnics; be free, familiar, offhand, even forward; try your knack at fascinating another, and yield to fascinations yourself. But be honest, command respect, and make yourself attractive and worthy. * * * * * {162} Former Customs and Peculiarities Among Men. 1. POLYGAMY.--There is a wide difference as regards the relations of the sexes in different parts of the world. In some parts polygamy has prevailed from time immemorial. Most savage people are polygamists, and the Turks, though slowly departing from the practice, still allow themselves a plurality of wives. 2. RULE REVERSED.--In Thibet the rule is reversed, and the females are provided with two or more husbands. It is said that in many instances a whole family of brothers have but one wife. The custom has at least one advantageous feature, viz.: the possibility of leaving an unprotected widow and a number of fatherless children is entirely obviated. 3. THE MORGANATIC MARRIAGE is a modification of polygamy. It sometimes occurs among the royalty of Europe, and is regarded as perfectly legitimate, but the morganatic wife is of lower rank than her royal husband, and her children do not inherit his rank or fortune. The Queen only is the consort of the sovereign, and entitled to share his rank. 4. DIFFERENT MANNERS OF OBTAINING WIVES.--Among the uncivilized almost any envied possession is taken by brute force or superior strength. The same is true in obtaining a wife. The strong take precedence of the weak. It is said that among the North American Indians it was the custom for men to wrestle for the choice of women. A weak man could seldom retain a wife that a strong man coveted. The law of contest was not confined to individuals alone. Women were frequently the cause of whole tribes arraying themselves against each other in battle. The effort to excel in physical power was a great incentive to bodily development, and since the best of the men were preferred by the most superior women, the custom was a good one in this, that the race was improved. 5. THE ABORIGINAL AUSTRALIAN employed low cunning and heartless cruelty in obtaining his wife. Laying in ambush, with club in hand, he would watch for the coveted woman, {163} and, unawares, spring upon her. If simply disabled he carried her off as his possession, but if the blow had been hard enough to kill, he abandoned her to watch for another victim. There is here no effort to attract or please, no contest of strength; his courtship, if courtship it can be called, would compare very unfavorably with any among the brute creation. 6. THE KALMUCK TARTAR races for his bride on horseback, she having a certain start previously agreed upon. The _nuptial knot_ consists in catching her, but we are told that the result of the race all depends upon whether the girl wants to be caught or not. 7. SANDWICH ISLANDERS.--Marriage among the early natives of these islands was merely a matter of mutual inclination. There was no ceremony at all, the men and women united and separated as they felt disposed. 8. THE FEUDAL LORD, in various parts of Europe, when any of his dependents or followers married, exercised the right of assuming the bridegroom's proper place in the marriage couch for the first night. Seldom was there any escape from this abominable practice. Sometimes the husband, if wealthy, succeeded in buying off the petty sovereign from exercising his privilege. 9. THE SPARTANS had the custom of encouraging intercourse between their best men and women for the sake of a superior progeny, without any reference to a marriage ceremony. Records show that the ancient Roman husband has been known to invite a friend, in whom he may have admired some physical or mental trait, to share the favors of his wife, that the peculiar qualities that he admired might be repeated in the offspring. [Illustration] {164} [Illustration: The Peasant Father Blessing His Daughter at Her Engagement.] * * * * * {165} [Illustration] Hasty marriage seldom proveth well.--_Shakespere, Henry VI._ The reason why so few marriages are happy is, because young ladies spend their time in making nets, not in making cages.--_Swift, Thoughts on Various Subjects._ * * * * * Sensible Hints in Choosing a Partner. 1. There are many fatal errors and many love-making failures in courtship. Natural laws govern all nature and reduce all they govern to eternal right; therefore love naturally, not artificially. Don't love a somebody or a nobody simply because they have money. 2. COURT SCIENTIFICALLY.--If you court at all, court scientifically. Bungle whatever else you will, but do not bungle courtship. A failure in this may mean more than a loss of wealth or public honors; it may mean ruin, or a life often worse than death. The world is full of wretched and mismated people. BEGIN RIGHT and all will be right; begin wrong and all will end wrong. When you court, make a business of it and study your interest the same as you would study any other business proposition. 3. DIVORCES.--There is not a divorce on our court records that is not the result of some fundamental error in courtship. The purity or the power of love may be corrupted the same as any other faculty, and when a man makes up his mind to marry and shuts his eyes and grabs in the dark for a companion, he dishonors the woman he captures and commits a crime against God and society. In this enlightened age there should be comparatively few mistakes made in the selection of a suitable partner. Sufficient time should be taken to study each other's character and disposition. Association will soon reveal adaptability. 4. FALSE LOVE.--Many a poor, blind and infatuated novice thinks he is desperately in love, when there is not the least genuine affection in his nature. It is all a momentary {166} passion, a sort of puppy love; his vows and pledges are soon violated, and in wedlock he will become indifferent and cold to his wife and children, and he will go through life without ambition, encouragement or success. He will be a failure. True love speaks for itself, and the casual observer can read its proclamations. True love does not speak in a whisper. It always makes itself heard. The follies of flirting develop into many unhappy marriages, and blight many a life. A man happily married has superior advantages both socially and financially. 5. FLIRTING JUST FOR FUN.--Who is the flirt, what is his reputation, motive, or character? Every young man and woman must have a reputation; if it is not good it is bad, there is no middle ground. Young people who are running in the streets after dark, boisterous and noisy in their conversation, gossiping and giggling, flirting with first one and then another, will soon settle their matrimonial prospects among good society. Modesty is a priceless jewel. No sensible young man with a future will marry a flirt. 6. THE ARCH-DECEIVER.--They who win the affection simply for their own amusement are committing a great sin for which there is no adequate punishment. How can you shipwreck the innocent life of that confiding maiden, how can you forget her happy looks as she drank in your expressions of love, how can you forget her melting eyes and glowing cheeks, her tender tone reciprocating your pretended love? Remember that God is infinitely just, and "the soul that sinneth shall surely die." You may dash into business, seek pleasure in the club room, and visit gambling hells, but "Thou art the man" will ever stare you in the face. Her pale, sad cheeks, her hollow eyes will never cease to haunt you. Men should promote happiness, and not cause misery. Let the savage Indians torture captives to death by the slow flaming fagot, but let civilized man respect the tenderness and love of confiding women. Torturing the opposite sex is double-distilled barbarity. Young men agonizing young ladies, is the cold-blooded cruelty of devils, not men. 7. THE RULE TO FOLLOW.--Do not continually pay your attentions to the same lady if you have no desire to win her affections. Occasionally escorting her to church, concert, picnic, party, etc., is perfectly proper; but to give her your special attention, and extend invitations to her for all places of amusements where you care to attend, is an implied promise that you prefer her company above all others, and she has a right to believe that your attentions are serious. {167} [Illustration: THE WEDDING RING.] 8. EVERY GIRL SHOULD SEAL HER HEART against all manifested affections, unless they are accompanied by a proposal. Woman's love is her all, and her heart should be as flint until she finds one who is worthy of her confidence. Young woman, never bestow your affections until by some word or deed at least you are fully justified in recognizing sincerity and faith in him who is paying you special attention. Better not be engaged until twenty-two. You are {168} then more competent to judge the honesty and falsity of man. Nature has thrown a wall of maidenly modesty around you. Preserve that and not let your affections be trifled with while too young by any youthful flirt who is in search of hearts to conquer. 9. FEMALE FLIRTATION.--The young man who loves a young woman has paid her the highest compliment in the possession of man. Perpetrate almost any sin, inflict any other torture, but spare him the agony of disappointment. It is a crime that can never be forgiven, and a debt that never can be paid. 10. LOYALTY.--Young persons with serious intentions, or those who are engaged should be thoroughly loyal to each other. If they seek freedom with others the flame of jealousy is likely to be kindled and love is often turned to hatred, and the severest anger of the soul is aroused. Loyalty, faithfulness, confidence, are the three jewels to be cherished in courtship. Don't be a flirt. 11. KISSING, FONDLING, AND CARESSING BETWEEN LOVERS.--This should never be tolerated under any circumstances, unless there is an engagement to justify it, and then only in a sensible and limited way. The girl who allows a young man the privilege of kissing her or putting his arms around her waist before engagement will at once fall in the estimation of the man she has thus gratified and desired to please. Privileges always injure, but never benefit. [Illustration: SAYING "NO" WHEN MEANING "YES."] 12. IMPROPER LIBERTIES DURING COURTSHIP KILL LOVE.--Any improper liberties which are permitted by young ladies, whether engaged or not, will change love into sensuality, and her affections will become obnoxious, if not repellent. Men by nature love virtue, and for a life companion naturally shun an amorous woman. Young folks, as you love moral purity and virtue, never reciprocate love until you have required the right of betrothal. Remember that those who are thoroughly in love will respect the honor and virtue of each other. The purity of woman is doubly attractive, and sensuality in her becomes doubly offensive and repellent. It is contrary to the laws of nature for a man to love a harlot. 13. A SEDUCER.--The punishment of the seducer is best given by O. S. Fowler, in his "Creative Science." The sin and punishment rest on all you who call out only to blight a trusting, innocent, loving virgin's affections, and then discard her. You deserve to be horsewhipped by her father, cowhided by her brothers, branded villain by her mother, cursed by herself, and sent to the whipping-post and dungeon. {169} 14. CAUTION.--A young lady should never encourage the attentions of a young man, who shows no interest in his sisters. If a young man is indifferent to his sisters he will become indifferent to his wife as soon as the honey moon is over. There are few if any exceptions to this rule. The brother who will not be kind and loving in his mother's home will make a very poor husband. 15. THE OLD RULE: "Never marry a man that does not make his mother a Christmas present every Christmas," is a good one. The young lady makes no mistake in uniting her destinies with the man that loves his mother and respects his sisters and brothers. * * * * * {170} SAFE HINTS. [Illustration: A CHINESE BRIDE AND GROOM.] 1. Marry in your own position in life. If there is any difference in social position, it is better that the husband should be the superior. A woman does not like to look down upon her husband, and to be obliged to do so is a poor guarantee for their happiness. 2. It is best to marry persons of your own faith and religious convictions, unless one is willing to adopt those of the other. Difference of faith is apt to divide families, and to produce great trouble in after life. A pious woman should beware of marrying an irreligious man. {171} 3. Don't be afraid of marrying a poor man or woman. Good health, cheerful disposition, stout hearts and industrious hands will bring happiness and comfort. 4. Bright red hair should marry jet black, and jet black auburn or bright red, etc. And the more red-faced and bearded or impulsive a man, the more dark, calm, cool and quiet should his wife be; and vice versa. The florid should not marry the florid, but those who are dark, in proportion as they themselves are light. 5. Red-whiskered men should marry brunettes, but no blondes; the color of the whiskers being more determinate of the temperament than that of the hair. 6. The color of the eyes is still more important. Gray eyes must marry some other color, almost any other except gray; and so of blue, dark, hazel, etc. 7. Those very fleshy should not marry those equally so, but those too spare and slim; and this is doubly true of females. A spare man is much better adapted to a fleshy woman than a round-favored man. Two who are short, thick-set and stocky, should not unite in marriage, but should choose those differently constituted; but on no account one of their own make. And, in general, those predisposed to corpulence are therefore less inclined to marriage. 8. Those with little hair or beard should marry those whose hair is naturally abundant; still those who once had plenty, but who have lost it, may marry those who are either bald or have but little; for in this, as in all other cases, all depends on what one is by nature, little on present states. 9. Those whose motive-temperament decidedly predominates, who are bony, only moderately fleshy, quite prominent-featured, Roman-nosed and muscular, should not marry those similarly formed. 10. Small, nervous men must not marry little, nervous or sanguine women, lest both they and their children have quite too much of the hot-headed and impulsive, and die suddenly. [Illustration: Light, Life, Health and Beauty.] 11. Two very beautiful persons rarely do or should marry; nor two extra homely. The fact is a little singular that very handsome women, who of course can have their pick, rarely marry good-looking men, but generally give preference to those who are homely; because that {173} exquisiteness in which beauty originates naturally blends with that power which accompanies huge noses and disproportionate features. 12. Rapid movers, speakers, laughers, etc., should marry those who are calm and deliberate, and impulsives those who are stoical; while those who are medium may marry those who are either or neither, as they prefer. 13. Noses indicate characters by indicating the organisms and temperaments. Accordingly, those noses especially marked either way should marry those having opposite nasal characteristics. Roman noses are adapted to those which turn up, and pug noses to those turning down; while straight noses may marry either. 14. Men who love to command must be especially careful not to marry imperious, women's-rights woman; while those who willingly "obey order;" need just such. Some men require a wife who shall take their part; yet all who do not need strong-willed women, should be careful how they marry them. 15. A sensible woman should not marry an obstinate but injudicious, unintelligent man; because she cannot long endure to see and help him blindly follow his poor, but spurn her good, plans. 16. The reserved or secretive should marry the frank. A cunning man cannot endure the least artifice in a wife. Those who are non-committal must marry those who are demonstrative; else, however much they may love, neither will feel sure as to the other's affections, and each will distrust the other, while their children will be deceitful. 17. A timid woman should never marry a hesitating man, lest, like frightened children, each keep perpetually re-alarming the other by imaginary fears. 18. An industrious, thrifty, hard-working man should marry a woman tolerably saving and industrious. As the "almighty dollar" is now the great motor-wheel of humanity, and that to which most husbands devote their entire lives, to delve alone is uphill work. [Illustration] {174} Marriage Securities. [Illustration: WE MUST PART.] 1. SEEK EACH OTHER'S HAPPINESS.--A selfish marriage that seeks only its own happiness defeats itself. Happiness is a fire that will not burn long on one stick. {175} 2. DO NOT MARRY SUDDENLY.--It can always be done till it is done, if it is a proper thing to do. 3. MARRY IN YOUR OWN GRADE IN SOCIETY.--It is painful to be always apologizing for any one. It is more painful to be apologized for. 4. DO NOT MARRY DOWNWARD.--It is hard enough to advance in the quality of life without being loaded with clay heavier than your own. It will be sufficiently difficult to keep your children up to your best level without having to correct a bias in their blood. 5. DO NOT SELL YOURSELF.--It matters not whether the price be money or position. 6. DO NOT THROW YOURSELF AWAY.--You will not receive too much, even if you are paid full price. 7. SEEK THE ADVICE OF YOUR PARENTS.--Your parents are your best friends. They will make more sacrifice for you than any other mortals. They are elevated above selfishness concerning you. If they differ from you concerning your choice, it is because they must. 8. DO NOT MARRY TO PLEASE ANY THIRD PARTY.--You must do the living and enduring. 9. DO NOT MARRY TO SPITE ANYBODY.--It would add wretchedness to folly. 10. DO NOT MARRY BECAUSE SOMEONE ELSE MAY SEEK THE SAME HAND.--One glove may not fit all hands equally well. 11. DO NOT MARRY TO GET RID OF ANYBODY.--The coward who shot himself to escape from being drafted was insane. 12. DO NOT MARRY MERELY FOR THE IMPULSE OF LOVE.--Love is a principle as well as an emotion. So far as it is a sentiment it is a blind guide. It does not wait to test the presence of exalted character in its object before breaking out into a flame. Shavings make a hot fire, but hard coal is better for the Winter. 13. DO NOT MARRY WITHOUT LOVE.--A body without a soul soon becomes offensive. 14. TEST CAREFULLY THE EFFECT OF PROTRACTED ASSOCIATION.--If familiarity breeds contempt before marriage it will afterward. 15. TEST CAREFULLY THE EFFECT OF PROTRACTED SEPARATION.--True love will defy both time and space. 16. CONSIDER CAREFULLY the right of your children under the laws of heredity. It is doubtful whether you have a right to increase the number of invalids and cripples. 17. DO NOT MARRY SIMPLY BECAUSE YOU HAVE PROMISED TO DO SO.--If a seam opens between you now it will widen into {176} a gulf. It is less offensive to retract a mistaken promise than to perjure your soul before the altar. Your intended spouse has a right to absolute integrity. [Illustration: GOING TO BE MARRIED.] 18. MARRY CHARACTER.--It is not so much what one has as what one is. 19. DO NOT MARRY THE WRONG OBJECT.--Themistocles said he would rather marry his daughter to a man without {177} money than to money without a man. It is well to have both. It is fatal to have neither. 20. DEMAND A JUST RETURN.--You give virtue and purity, and gentleness and integrity. You have a right to demand the same in return. Duty requires it. 21. REQUIRE BRAINS.--Culture is good, but will not be transmitted. Brain power may be. 22. STUDY PAST RELATIONSHIP.--The good daughter and sister makes a good wife. The good son and brother makes a good husband. 23. NEVER MARRY AS A MISSIONARY DEED.--If one needs saving from bad habits he is not suitable for you. 24. MARRIAGE IS A SURE AND SPECIFIC REMEDY for all the ills known as seminal losses. As right eating cures a sick stomach and right breathing diseased lungs, so the right use of the sexual organs will bring relief and restoration. Many men who have been sufferers from indiscretions of youth, have married, and were soon cured of spermatorrhoea and other complications which accompanied it. 25. A GOOD, LONG COURTSHIP will often cure many difficulties or ills of the sexual organs. O. S. Fowler says: "See each other often spend many pleasant hours together," have many walks and talks, think of each other while absent, write many love letters, be inspired to many love feelings and acts towards each other, and exercise your sexuality in a thousand forms ten thousand times, every one of which tones up and thereby recuperates this very element now dilapidated. When you have courted long enough to marry, you will be sufficiently restored to be reimproved by it. Come, UP AND AT IT.--Dress up, spruce up, and be on the alert. Don't wait too long to get one much more perfect than you are; but settle on some one soon. Remember that your unsexed state renders you over-dainty, and easily disgusted. So contemplate only their lovable qualities. 26. PURITY OF PURPOSE.--Court with a pure and loyal purpose, and when thoroughly convinced that the disposition of other difficulties are in the way of a happy marriage life, then _honorably_ discuss it and honorably treat each other in the settlement. 27. DO NOT TRIFLE with the feelings or affections of each other. It is a sin that will curse you all the days of your life. * * * * * {178} Women Who Make the Best Wives. 1. CONSCIOUS OF THE DUTIES OF HER SEX.--A woman conscious of the duties of her sex, one who unflinchingly discharges the duties allotted to her by nature, would no doubt make a good wife. 2. GOOD WIVES AND MOTHERS.--The good wives and mothers are the women who believe in the sisterhood of women as well as in the brotherhood of men. The highest exponent of this type seeks to make her home something more than an abode where children are fed, clothed and taught the catechism. The State has taken her children into politics by making their education a function of politicians. The good wife and homemaker says to her children, "Where thou goest, I will go." She puts off her own inclinations to ease and selfishness. She studies the men who propose to educate her children; she exhorts mothers to sit beside fathers on the school-board; she will even herself accept such thankless office in the interests of the helpless youth of the schools who need a mother's as well as a father's and a teacher's care in this field of politics. 3. A BUSY WOMAN.--As to whether a busy woman, that is, a woman who labors for mankind in the world outside her home,--whether such an one can also be a good housekeeper, and care for her children, and make a real "Home, Sweet Home!" with all the comforts by way of variation, why! I am ready, as the result of years practical experience as a busy woman, to assert that women of affairs can also be women of true domestic tastes and habits. 4. BRAINY ENOUGH.--What kind of women make the best wives? The woman who is brainy enough to be a companion, wise enough to be a counsellor, skilled enough in the domestic virtues to be a good housekeeper, and loving enough to guide in true paths the children with whom the home may be blessed. 5. FOUND THE RIGHT HUSBAND.--The best wife is the woman who has found the right husband, a husband who understands her. A man will have the best wife when he rates that wife as queen among women. Of all women she should always be to him the dearest. This sort of man will not only praise the dishes made by his wife, but will actually eat them. [Illustration: PUNISHMENT OF WIFE BEATERS IN NEW ENGLAND IN THE EARLY DAYS.] 6. BANK ACCOUNT.--He will allow his life-companion a bank account, and will exact no itemized bill at the end of the month. Above all, he will pay the Easter bonnet bill without a word, never bring a friend to dinner without first telephoning home,--short, he will comprehend that the {180} woman who makes the best wife is the woman whom, by his indulgence of her ways and whims, he makes the best wife. So after all, good husbands have the most to do with making good wives. 7. BEST HOME MAKER.--A woman to be the best home maker needs to be devoid of intensive "nerves." She must be neat and systematic, but not too neat, lest she destroy the comfort she endeavors to create. She must be distinctly amiable, while firm. She should have no "career," or desire for a career, if she would fill to perfection the home sphere. She must be affectionate, sympathetic and patient, and fully appreciative of the worth and dignity of her sphere. 8. KNOW NOTHING WHATSOEVER ABOUT COOKING OR SEWING OR HOUSEKEEPING.--I am inclined to make my answer to this question somewhat concise, after the manner of a text without the sermon. Like this: To be the "best wife" depends upon three things: first, an abiding faith with God; second, duty lovingly discharged as daughter, wife and mother; third, self-improvement, mentally, physically, spiritually. With this as a text and as a glittering generality, let me touch upon one or two practical essentials. In the course of every week it is my privilege to meet hundreds of young women,--prospective wives. I am astonished to find that many of these know nothing whatsoever about cooking or sewing or housekeeping. Now, if a woman cannot broil a beefsteak, nor boil the coffee when it is necessary, if she cannot mend the linen, nor patch a coat, if she cannot make a bed, order the dinner, create a lamp-shade, ventilate the house, nor do anything practical in the way of making home actually a home, how can she expect to make even a good wife, not to speak of a better or best wife? I need not continue this sermon. Wise girls will understand. 9. THE BEST KEEPER OF HOME.--As to who is the best keeper of this transition home, memory pictures to me a woman grown white under the old slavery, still bound by it, in that little-out-of-the-way Kansas town, but never so bound that she could not put aside household tasks, at any time, for social intercourse, for religious conversation, for correspondence, for reading, and, above all, for making everyone who came near her feel that her home was the expression of herself, a place for rest, study, and the cultivation of affection. She did not exist for her walls, her carpets, her furniture; they existed for her and all who came to her. She considered herself the equal of all; and everyone else thought her the superior of all. * * * * * {181} Adaptation, Conjugal Affection, and Fatal Errors. * * * * * ADVICE TO THE MARRIED AND UNMARRIED. 1. MARRYING FOR WEALTH.--Those who marry for wealth often get what they marry and nothing else; for rich girls, besides being generally destitute of both industry and economy, are generally extravagant in their expenditures, and require servants enough to dissipate a fortune. They generally have insatiable wants, yet feel that they deserve to be indulged in everything, because they placed their husbands under obligation to them by bringing them a dowry. And then the mere idea of living on the money of a wife, and of being supported by her, is enough to tantalize any man of an independent spirit. 2. SELF-SUPPORT.--What spirited husband would not prefer to support both himself and wife, rather than submit to this perpetual bondage of obligation. To live upon a father, or take a patrimony from him, is quite bad enough; but to run in debt to a wife, and owe her a living, is a little too aggravating for endurance, especially if there be not perfect cordiality between the two, which cannot be the case in money matches. Better live wifeless, or anything else, rather than marry for money. 3. MONEY-SEEKERS.--Shame on sordid wife-seekers, or, rather, money-seekers; for it is not a wife that they seek, but only filthy lucre! They violate all their other faculties simply to gratify miserly desire. Verily such "have their reward"! 4. THE PENITENT HOUR.--And to you, young ladies, let me say with great emphasis, that those who court and marry you because you are rich, will make you rue the day of your pecuniary espousals. They care not for you, but only your money, and when they get that, will be liable to neglect or abuse you, and probably squander it, leaving you destitute and abandoning you to your fate. 5. INDUSTRY THE SIGN OF NOBILITY.--Marry a working, industrious young lady, whose constitution is strong, flesh solid, and health unimpaired by confinement, bad habits, or late hours. Give me a plain, home-spun farmer's daughter, and you may have all the rich and fashionable belles of our cities and villages. [Illustration: AN ILL-MATED COUPLE.] 6. WASP WAISTS.--Marrying small waists is attended with consequences scarcely less disastrous than marrying {183} rich and fashionable girls. An amply developed chest is a sure indication of a naturally vigorous constitution and a strong hold on life; while small waists indicate small and feeble vital organs, a delicate constitution, sickly offspring, and a short life. Beware of them, therefore, unless you wish your heart broken by the early death of your wife and children. 7. MARRYING TALKERS.--In marrying a wit or a talker merely, though the brilliant scintillations of the former, or the garrulity of the latter, may amuse or delight you for the time being, yet you will derive no permanent satisfaction from these qualities, for there will be no common bond of kindred feeling to assimilate your souls and hold each spell-bound at the shrine of the other's intellectual or moral excellence. 8. THE SECOND WIFE.--Many men, especially in choosing a second wife, are governed by her own qualifications as a housekeeper mainly, and marry industry and economy. Though these traits of character are excellent, yet a good housekeeper may be far from being a good wife. A good housekeeper, but a poor wife, may indeed prepare you a good dinner, and keep her house and children neat and tidy, yet this is but a part of the office of a wife; who, besides all her household duties, has those of a far higher order to perform. She should soothe you with her sympathies, divert your troubled mind, and make the whole family happy by the gentleness of her manners, and the native goodness of her heart. A husband should also likewise do his part. 9. DO NOT MARRY A MAN WITH A LOW, FLAT HEAD; for, however fascinating, genteel, polite, tender, plausible or winning he may be, you will repent the day of your espousal. 10. HEALTHY WIVES AND MOTHERS.--Let girls romp, and let them range hill and dale in search of flowers, berries, or any other object of amusement or attraction; let them bathe often, skip the rope, and take a smart ride on horseback; often interspersing these amusements with a turn of sweeping or washing, in order thereby to develop their vital organs, and thus lay a substantial physical foundation for becoming good wives and mothers. The wildest romps usually make the best wives, while quiet, still, demure, sedate and sedentary girls are not worth having. 11. SMALL STATURE.--In passing, I will just remark, that good size is important in wives and mothers. A small stature is objectionable in a woman, because little women {184} usually have too much activity for their strength, and, consequently, feeble constitutions; hence they die young, and besides, being nervous, suffer extremely as mothers. 12. HARD TIMES AND MATRIMONY.--Many persons, particularly young men, refuse to marry, especially "these hard times," because they cannot support a wife in the style they wish. To this I reply, that a good wife will care less for the style in which she is supported, than for you. She will cheerfully conform to your necessities, and be happy with you in a log-cabin. She will even help you support yourself. To support a good wife, even if she have children, is really less expensive than to board alone, besides being one of the surest means of acquiring property. 13. MARRYING FOR A HOME.--Do not, however, marry for a home merely, unless you wish to become even more destitute with one than without one; for, it is on the same footing with "marrying for money." Marry a man for his merit, and you take no chances. 14. MARRY TO PLEASE NO ONE BUT YOURSELF.--Marriage is a matter exclusively your own; because you alone must abide its consequences. No person, not even a parent, has the least right to interfere or dictate in this matter. I never knew a marriage, made to please another, to turn out any otherwise than most unhappily. 15. DO NOT MARRY TO PLEASE YOUR PARENTS. Parents cannot love for their children any more than they can eat or sleep, or breathe, or die and go to heaven for them. They may give wholesome advice merely, but should leave the entire decision to the unbiased judgment of the parties themselves, who mainly are to experience the consequences of their choice. Besides, such is human nature, that to oppose lovers, or to speak against the person beloved, only increases their desire and determination to marry. 16. RUN-AWAY MATCHES.--Many a run-away match would never have taken place but for opposition or interference. Parents are mostly to be blamed for these elopements. Their children marry partly out of spite and to be contrary. Their very natures tell them that this interference is unjust--as it really is--and this excites combativeness, firmness, and self-esteem, in combination with the social faculties, to powerful and even blind resistance--which turmoil of the faculties hastens the match. Let the affections of a daughter be once slightly enlisted in your favor, and then let the "old folks" start an opposition, and you may feel sure of your prize. If she did not love you before, she will now, that you are persecuted. {185} 17. DISINHERITANCE.--Never disinherit, or threaten to disinherit, a child for marrying against your will. If you wish a daughter not to marry a certain man, oppose her, and she will be sure to marry him; so also in reference to a son. 18. PROPER TRAINING.--The secret is, however, all in a nutshell. Let the father properly train his daughter, and she will bring her first love-letter to him, and give him an opportunity to cherish a suitable affection, and to nip an improper one in the germ, before it has time to do any harm. 19. THE FATAL MISTAKES OF PARENTS.--_There is, however, one way of effectually preventing an improper match, and that is, not to allow your children to associate with any whom you are unwilling they should marry. How cruel as well as unjust, to allow a daughter to associate with a young man till the affections of both are riveted, and then forbid her marrying him. Forbid all association or consent cheerfully to the marriage._ 20. AN INTEMPERATE LOVER.--Do not flatter yourselves, young women, that you can wean even an occasional wine drinker from his cups by love and persuasion. Ardent spirit at first, kindles up the fires of love into the fierce flames at burning licentiousness, which burn out every element of love and destroy every vestige of pure affection. It over-excites the passions, and thereby finally destroys it,--producing at first, unbridled libertinism, and then an utter barrenness of love; besides reversing the other faculties of the drinker against his own consort, and those of the wife against her drinking husband. * * * * * FIRST LOVE, DESERTION AND DIVORCE. 1. FIRST LOVE.--This is the most important direction of all. The first love experiences a tenderness, a purity and unreservedness, an exquisiteness, a devotedness, and a poetry belonging to no subsequent attachment. "Love, like life, has no second spring." Though a second attachment may be accompanied by high moral feeling, and to a devotedness to the object loved; yet, let love be checked or blighted in its first pure emotion, and the beauty of its spring is irrecoverably withered and lost. This does not mean the simple love of children in the first attachment they call love, but rather the mature intelligent love of those of suitable age. [Illustration: CONSIDERING THE QUESTION.] {187} 2. FREE FROM TEMPTATIONS.--As long as his heart is bound up in its first bundle of love and devotedness--as long as his affections remain reciprocated and uninterrupted--so long temptations cannot take effect. His heart is callous to the charms of others, and the very idea of bestowing his affections upon another is abhorrent. Much more so is animal indulgence, which is morally impossible. 3. SECOND LOVE NOT CONSTANT.--But let this first love be broken off, and the flood-gates of passion are raised. Temptations now flow in upon him. He casts a lustful eye upon every passing female, and indulges unchaste imaginations and feelings. Although his conscientiousness or intellect may prevent actual indulgence, yet temptations now take effect, and render him liable to err; whereas before they had no power to awaken improper thoughts or feelings. Thus many young men find their ruin. 4. LEGAL MARRIAGE.--What would any woman give for merely a nominal or legal husband, just to live with and provide for her, but who entertained not one spark of love for her, or whose affections were bestowed upon another? How absurd, how preposterous the doctrine that the obligations of marriage derive their sacredness from legal enactments and injunctions! How it literally profanes this holy of holies, and drags down this heaven-born institution from its original, divine elevation, to the level of a merely human device. Who will dare to advocate the human institution of marriage without the warm heart of a devoted and loving companion! 5. LEGISLATION.--But no human legislation can so guard this institution but that it may be broken in spirit, though, perhaps, acceded to in form; for, it is the heart which this institution requires. There must be true and devoted affection, or marriage is a farce and a failure. 6. THE MARRIAGE CEREMONY AND THE LAW GOVERNING MARRIAGE are for the protection of the individual, yet a man and woman may be married by law and yet unmarried in spirit. The law may tie together, and no marriage be consummated. Marriage therefore is Divine, and "whom God hath joined together let no man put asunder." A right marriage means a right state of the heart. A careful study of this work will be a great help to both the unmarried and the married. 7. DESERTION AND DIVORCE.--For a young man to court a young woman, and excite her love till her affections are riveted, and then (from sinister motives, such as, to marry one richer, or more handsome), to leave her, and try {188} elsewhere, is the very same crime as to divorce her from all that she holds dear on earth--to root up and pull out her imbedded affections, and to tear her from her rightful husband. First love is always constant. The second love brings uncertainty--too often desertions before marriage and divorces after marriage. 8. THE COQUET.--The young woman to play the coquet, and sport with the sincere affections of an honest and devoted young man, is one of the highest crimes that human nature can commit. Better murder him in body too, as she does in soul and morals, and it is the result of previous disappointment, never the outcome of a sincere first love. 9. ONE MARRIAGE. One evidence that second marriages are contrary to the laws of our social nature, is the fact that almost all step-parents and step-children disagree. Now, what law has been broken, to induce this penalty? The law of marriage; and this is one of the ways in which the breach punishes itself. It is much more in accordance with our natural feelings, especially those of mothers, that children should be brought up by their own parent. 10. SECOND MARRIAGE.--Another proof of this point is, that second marriage is more a matter of business. "I'll give you a home, if you'll take care of my children." "It's a bargain," is the way most second matches are made. There is little of the poetry of first-love, and little of the coyness and shrinking diffidence which characterize the first attachment. Still these remarks apply almost equally to a second attachment, as to second marriage. 11. THE CONCLUSION OF THE WHOLE MATTER.--Let this portion be read and pondered, and also the one entitled, "Marry your First Love if possible," which assigns the cause, and points out the only remedy, of licentiousness. As long as the main cause of this vice exists, and is aggravated by purse-proud, high-born, aristocratic parents and friends, and even by the virtuous and religious, just so long, and exactly in the same ratio will this blighting Sirocco blast the fairest flowers of female innocence and lovliness, and blight our noblest specimens of manliness. No sin of our land is greater. [Illustration] {189} [Illustration: CUPID'S CHARM.] * * * * * {190} Flirting and Its Dangers. [Illustration: HOW MANY YOUNG GIRLS ARE RUINED.] 1. NO EXCUSE.--In this country there is no excuse for the young man who seeks the society of the loose and the dissolute. There is at all times and everywhere open to him a society of persons of the opposite sex of his own age and of pure thoughts and lives, whose conversation will refine him and drive from his bosom ignoble and impure thoughts. 2. THE DANGERS.--The young man who may take pleasure in the fact that he is the hero of half a dozen or more {191} engagements and love episodes, little realizes that such constant excitement often causes not only dangerously frequent and long-continued nocturnal emissions, but most painful affections of the testicles. Those who show too great familiarity with the other sex, who entertain lascivious thoughts, continually exciting the sexual desires, always suffer a weakening of power and sometimes the actual diseases of degeneration, chronic inflammation of the gland, spermatorrhoea, impotence, and the like.--Young man, beware; your punishment for trifling with the affections of others may cost you a life of affliction. 3. REMEDY.--Do not violate the social laws. Do not trifle with the affections of your nature. Do not give others countless anguish, and also do not run the chances of injuring yourself and others for life. The society of refined and pure women is one of the strongest safeguards a young man can have, and he who seeks it will not only find satisfaction, but happiness. Simple friendship and kind affections for each other will ennoble and benefit. 4. THE TIME FOR MARRIAGE.--When a young man's means permit him to marry, he should then look intelligently for her with whom he expects to pass the remainder of his life in perfect loyalty, and in sincerity and singleness of heart. Seek her to whom he is ready to swear to be ever true. 5. BREACH OF CONFIDENCE.--Nothing is more certain, says Dr. Naphey, to undermine domestic felicity, and sap the foundation of marital happiness, than marital infidelity. The risks of disease which a married man runs in impure intercourse are far more serious, because they not only involve himself, but his wife and his children. He should know that there is nothing which a woman will not forgive sooner than such a breach of confidence. He is exposed to the plots and is pretty certain sooner or later to fall into the snares of those atrocious parties who subsist on blackmail. And should he escape these complications, he still must lose self-respect, and carry about with him the burden of a guilty conscience and a broken vow. 6. SOCIETY RULES AND CUSTOMS.--A young man can enjoy the society of ladies without being a "flirt." He can escort ladies to parties, public places of interest, social gatherings, etc., without showing special devotion to any one special young lady. When he finds the choice of his heart, then he will be justified to manifest it, and publicly proclaim it by paying her the compliment, exclusive attention. To keep a lady's company six months is a public announcement of an engagement. * * * * * {192} A Word to Maidens. 1. NO YOUNG LADY who is not willing to assume the responsibility of a true wife, and be crowned with the sacred diadem of motherhood, should ever think of getting married. We have too many young ladies to-day who despise maternity, who openly vow that they will never be burdened with children, and yet enter matrimony at the first opportunity. What is the result? Let echo answer, What? Unless a young lady believes that motherhood is noble, is honorable, is divine, and she is willing to carry out that sacred function of her nature, she had a thousand times better refuse every proposal, and enter some honorable occupation and wisely die an old maid by choice. 2. ON THE OTHER HAND, YOUNG LADY, never enter into the physical relations of marriage with a man until you have conversed with him freely and fully on these relations. Learn distinctly his views and feelings and expectations in regard to that purest and most ennobling of all the functions of your nature, and the most sacred of all intimacies of conjugal love. Your self-respect, your beauty, your glory, your heaven, as a wife, will be more directly involved in his feelings and views and practices, in regard to that relation, than in all other things. As you would not become a weak, miserable, imbecile, unlovable and degraded wife and mother, in the very prime of your life, come to a perfect understanding with your chosen one, ere you commit your person to his keeping in the sacred intimacies of home. Beware of that man who, under pretence of delicacy, modesty, and propriety, shuns conversation with you on this relation, and on the hallowed function of maternity. 3. TALK WITH YOUR INTENDED frankly and openly. Remember, concealment and mystery in him, towards you, on all other subjects pertaining to conjugal union might be overlooked, but if he conceals his views here, rest assured it bodes no good to your purity and happiness as a wife and mother. You can have no more certain assurance that you are to be victimized, your soul and body offered up, _slain_, on the altar of his sensualism, than his unwillingness to converse with you on subjects so vital to your happiness. Unless he is willing to hold his manhood in abeyance to the calls of your nature and to your conditions, and consecrate its passions and its powers to the elevation and happiness of his wife and children, your maiden soul had better return to God unadorned with the diadem of conjugal and maternal love than that you should become the wife of such a man and the mother of his children. {193} [Illustration: ROMAN LOVE MAKING.] * * * * * {194} POPPING THE QUESTION. [Illustration: Uniformed Men are always Popular with the Ladies.] 1. MAKING THE DECLARATION.--There are few emergencies in business and few events in life that bring to man the trying ordeal of "proposing to a lady." We should be glad to help the bashful lover in his hours of perplexity, embarrassment and hesitation, but unfortunately we cannot pop the question for him, nor give him a formula by which {195} he may do it. Different circumstances and different surroundings compel every lover to be original in his form or mode of proposing. 2. BASHFULNESS.--If a young man is very bashful, he should write his sentiments in a clear, frank manner on a neat white sheet of note paper, enclose it in a plain white envelope and find some way to convey it to the lady's hand. 3. THE ANSWER.--If the beloved one's heart is touched, and she is in sympathy with the lover, the answer should be frankly and unequivocally given. If the negative answer is necessary, it should be done in the kindest and most sympathetic language, yet definite, positive and to the point, and the gentleman should at once withdraw his suit and continue friendly but not familiar. 4. SAYING "NO" FOR "YES."--If girls are foolish enough to say "No" when they mean "Yes," they must suffer the consequences which often follow. A man of intelligence and self-respect will not ask a lady twice. It is begging for recognition and lowers his dignity, should he do so. A lady is supposed to know her heart sufficiently to consider the question to her satisfaction before giving an answer. 5. CONFUSION OF WORDS AND MISUNDERSTANDING.--Sometimes a man's happiness, has depended on his manner of popping the question. Many a time the girl has said "No" because the question was so worded that the affirmative did not come from the mouth naturally; and two lives that gravitated toward each other with all their inward force have been thrown suddenly apart, because the electric keys were not carefully touched. 6. SCRIPTURAL DECLARATION.--The church is not the proper place to conduct a courtship, yet the following is suggestive and ingenious. A young gentleman, familiar with the Scriptures, happening to sit in a pew adjoining a young lady for whom he conceived a violent attachment, made his proposal in this way: He politely handed his neighbor a Bible open, with a pin stuck in the following text: Second Epistle of John, verse 5: "And I beseech thee, lady, not as though I wrote a new commandment unto thee, but that we had from the beginning, that we love one another." [Illustration: SEALING THE ENGAGEMENT. From the Most Celebrated Painting in the German Department at the World's Fair.] She returned it, pointing to the second chapter of Ruth, verse 10: "Then she fell on her face, and bowed herself to the ground, and said unto him. Why have I found grace in {197} thine eyes that thou shouldest take knowledge of me, seeing I am a stranger?" He returned the book, pointing to the 13th verse of the Third Epistle of John: "Having many things to write unto you, I would not write to you with paper and ink, but trust to come unto you and speak face to face, that your joy may be full." From the above interview a marriage took place the ensuing month in the same church. 7. HOW JENNY WAS WON. On a sunny Summer morning, Early as the dew was dry, Up the hill I went a berrying; Need I tell you--tell you why? Farmer Davis had a daughter, And it happened that I knew, On each sunny morning, Jenny Up the hill went berrying too. Lonely work is picking berries, So I joined her on the hill: "Jenny, dear," said I, "your basket's Quite too large for one to fill." So we stayed--we two--to fill it, Jenny talking--I was still.-- Leading where the hill was steepest, Picking berries up the hill. "This is up-hill work," said Jenny; "So is life," said I; "shall we Climb it each alone, or, Jenny, Will you come and climb with me?" Redder than the blushing berries Jenny's cheek a moment grew, While without delay she answered, "I will come and climb with you." {198} 8. A ROMANTIC WAY FOR PROPOSING.--In Peru they have a romantic way of popping the question. The suitor appears on the appointed evening, with a gaily dressed troubadour, under the balcony of his beloved. The singer steps before her flower-bedecked window, and sings her beauties in the name of her lover. He compares her size to that of a pear-tree, her lips to two blushing rose-buds, and her womanly form to that of a dove. With assumed harshness the lady asks her lover: "Who are you, and what do you want?" He answers with ardent confidence: "Thy love I do adore, The stars live in the harmony of love, and why should not we, too, love each other?" Then the proud beauty gives herself away: she takes her flower-wreath from her hair and throws it down to her lover, promising to be his forever. [Illustration: A PERUVIAN BEAUTY.] * * * * * {199} The Wedding. [Illustration: THE BRIDE.] 1. THE PROPER TIME.--Much has been printed in various volumes regarding the time of the year, the influence of the seasons, etc., as determining the proper time to set for the wedding day. Circumstances must govern these things. To be sure, it is best to avoid extremes of heat and cold. Very hot weather is debilitating, and below zero is uncomfortable. 2. THE LADY SHOULD SELECT THE DAY.--There is one element in the time that is of great importance, physically, especially to the lady. It is the day of the month, and it is hoped that every lady who contemplates marriage is informed upon the great facts of ovulation. By reading page {200} 245 she will understand that it is to her advantage to select a wedding day about fifteen or eighteen days after the close of menstruation in the month chosen, since it is not best that the first child should be conceived during the excitement or irritation of first attempts at congress; besides modest brides naturally do not wish to become large with child before the season of congratulation and visiting on their return from the "wedding tour" is over. Again, it is asserted by many of the best writers on this subject, that the mental condition of either parent at the time of intercourse will be stamped upon the embryo; hence it is not only best, but wise, that the first-born should not be conceived until several months after marriage, when the husband and wife have nicely settled in their new home, and become calm in their experience of each other's society. 3. THE "BRIDAL TOUR" is considered by many newly-married couples as a necessary introduction to a life of connubial joy. There is, in our opinion, nothing in the custom to recommend it. After the excitement and overwork before and accompanying a wedding, the period immediately following should be one of _rest_. Again, the money expended on the ceremony and a tour of the principal cities, etc., might, in most cases, be applied to a multitude of after-life comforts of far more lasting value and importance. To be sure, it is not pleasant for the bride, should she remain at home, to pass through the ordeal of criticism and vulgar comments of acquaintances and friends, and hence, to escape this, the young couple feel like getting away for a time. Undoubtedly the best plan for the great majority, after this most eventful ceremony, is to enter their future home at once, and there to remain in comparative privacy until the novelty of the situation is worn off. 4. IF THE CONVENTIONAL TOUR is taken, the husband should remember that his bride cannot stand the same amount of tramping around and sight-seeing that he can. The female organs of generation are so easily affected by excessive exercise of the limbs which support them, that at this critical period it would be a foolish and costly experience to drag a lady hurriedly around the country on an extensive and protracted round of sight-seeing or visiting. Unless good common-sense is displayed in the manner of spending the "honey-moon," it will prove very untrue to its name. In many cases it lays the foundation for the wife's first and life-long "backache." * * * * * {201} Advice to Newly Married Couples. [Illustration: THE HONEY-MOON.] 1. "BE YE FRUITFUL AND MULTIPLY" is a Bible commandment which the children of men habitually obey. However they may disagree on other subjects, all are in accord on this; the barbarous, the civilized, the high, the low, the fierce, the gentle--all unite in the desire which finds its accomplishment in the reproduction of their kind. Who {202} shall quarrel with the Divinely implanted instinct, or declare it to be vulgar or unmentionable? It is during the period of the honeymoon that the intensity of this desire, coupled with the greatest curiosity, is at its height, and the unbridled license often given the passions at this time is attended with the most dangerous consequences. 2. CONSUMMATION OF MARRIAGE.--The first time that the husband and wife cohabit together after the ceremony has been performed is called the consummation of marriage. Many grave errors have been committed by people in this, when one or both of the contracting parties were not physically or sexually in a condition to carry out the marriage relation. A marriage, however, is complete without this in the eyes of the law, as it is a maxim taken from the Roman civil statutes that consent, not cohabitation, is the binding element in the ceremony. Yet, in most States of the U.S., and in some other countries; marriage is legally declared void and of no effect where it is not possible to consummate the marriage relation. A divorce may be obtained provided the injured party begins the suit. 3. TEST OF VIRGINITY.--The consummation of marriage with a virgin is not necessarily attended with a flow of blood, and the absence of this sign is not the slightest presumption against her former chastity. The true test of virginity is modesty void of any disagreeable familiarity. A sincere Christian faith is one of the best recommendations. 4. LET EVERY MAN REMEMBER that the legal right of marriage does not carry with it the moral right to injure for life the loving companion he has chosen. Ignorance may be the cause, but every man before he marries should know something of the physiology and the laws of health, and we here give some information which is of very great importance to every newly-married man. 5. SENSUALITY.--Lust crucifies love. The young sensual husband is generally at fault. Passion sways and the duty to bride and wife is nor thought of, and so a modest young wife is often actually forced and assaulted by the unsympathetic haste of her husband. An amorous man in that way soon destroys his own love, and thus is laid the foundation for many difficulties that soon develop trouble and disturb the happiness of both. 6. ABUSE AFTER MARRIAGE.--Usually marriage is consummated within a day or two after the ceremony, but this is {203} gross injustice to the bride. In most cases she is nervous, timid, and exhausted by the duties of preparation for the wedding, and in no way in a condition, either in body or mind, for the vital change which the married relation bring upon her. Many a young husband often lays the foundation of many diseases of the womb and of the nervous system in gratifying his unchecked passions without a proper regard for his wife's exhausted condition. 7. THE FIRST CONJUGAL APPROACHES are usually painful to the new wife, and no enjoyment to her follows. Great caution and kindness should be exercised. A young couple rushing together in their animal passion soon produce a nervous and irritating condition which ere long brings apathy, indifference, if not dislike. True love and a high regard for each other will temper passion into moderation. 8. WERE THE ABOVE INJUNCTIONS HEEDED fully and literally it would be folly to say more, but this would be omitting all account of the bridegroom's new position, the power of his passion, and the timidity of the fair creature who is wondering what fate has in store for her trembling modesty. To be sure, there are some women who are possessed of more forward natures and stronger desires than others. In such cases there may be less trouble. 9. A COMMON ERROR.--The young husband may have read in some treatise on physiology that the hymen in a virgin is the great obstacle to be overcome. He is apt to conclude that this is all, that some force will be needed to break it down, and that therefore an amount of urgency even to the degree of inflicting considerable pain is justifiable. This is usually wrong. It rarely constitutes any obstruction, and, even when its rupturing may be necessary, it alone seldom causes suffering. There are sometimes certain deformities of the vagina, but no woman should knowingly seek matrimonial relations when thus afflicted. We quote from Dr. C. A. Huff the following: 10. "WHAT IS IT, THEN, THAT USUALLY CAUSES distress to many women, whether a bride or a long-time wife?" The answer is, Simply those conditions of the organs in which they are not properly prepared, by anticipation and desire, to receive a foreign body. The modest one craves only refined and platonic love at first, and if husbands, new and old, would only realize this plain truth, wife-torturing would cease and the happiness of each one of all human pairs vastly increase. {204} 11. THE CONDITIONS OF THE FEMALE organs depend upon the state of the mind just as much as in the case of the husband. The male, however, being more sensual, is more quickly roused. She is far less often or early ready. In its unexcited state the vagina is lax, its walls are closed together, and their surfaces covered by but little lubricating secretion. The chaster one of the pair has no desire that this sacred vestibule to the great arcana of procreation shall be immediately and roughly invaded. This, then, is the time for all approaches by the husband to be of the most delicate, considerate, and refined description possible. The quietest and softest demeanor, with gentle and re-assuring words, are all that should be attempted at first. The wedding day has probably been one of fatigue, and it is foolish to go farther. 12. FOR MORE THAN ONE NIGHT it will be wise, indeed, if the wife's confidence shall be as much wooed and won by patient, delicate, and prolonged courting, as before the marriage engagement. How long should this period of waiting be can only be decided by the circumstances of any case. The bride will ultimately deny no favor which is sought with full deference to her modesty, and in connection with which bestiality is not exhibited. Her nature is that of delicacy; her affection is of a refined character; if the love and conduct offered to her are a careful effort to adapt roughness and strength to her refinement and weakness, her admiration and responsive love will be excited to the utmost. 13. WHEN THAT MOMENT ARRIVES when the bride finds she can repose perfect confidence in the kindness of her husband, that his love is not purely animal, and that no violence will be attempted, the power of her affection for him will surely assert itself; the mind will act on those organs which nature has endowed to fulfil the law of her being, the walls of the vagina will expand, and the glands at the entrance will be fully lubricated by a secretion of mucous which renders congress a matter of comparative ease. 14. WHEN THIS RESPONSIVE ENLARGEMENT and lubrication are fully realized, it is made plain why the haste and force so common to first and subsequent coition is, as it has been justly called, nothing but "legalized rape." Young husband! Prove your manhood, not by yielding to unbridled lust and cruelty, but by the exhibition of true power in _self-control_ and patience with the helpless being confided to your care! Prolong the delightful season of courting into and _through_ wedded life, and rich shall be your reward. {205} 15. A WANT OF DESIRE may often prevail, and may be caused by loss of sleep, study, constant thought, mental disturbance, anxiety, self-abuse, excessive use of tobacco or alcoholic drink, etc. Overwork may cause debility; a man may not have an erection for months, yet it may not be a sign of debility, sexual lethargy or impotence. Get the mind and the physical constitution in proper condition, and most all these difficulties will disappear. Good athletic exercise by walking, riding, or playing croquet, or any other amusement, will greatly improve the condition. A good rest, however, will be necessary to fully restore the mind and the body, then the natural condition of the sexual organs will be resumed. 16. HAVING TWINS.--Having twins is undoubtedly hereditary and descends from generation to generation, and persons who have twins are generally those who have great sexual vigor. It is generally the result of a second cohabitation immediately following the first, but some parents have twins who cohabit but once during several days. 17. PROPER INTERCOURSE.--The right relation of a newly-married couple will rather increase than diminish love. To thus offer up the maiden on the altar of love and affection only swells her flood of joy and bliss; whereas, on the other hand, sensuality humbles, debases, pollutes, and never elevates. Young husbands should wait for an _invitation to the banquet_, and they will be amply paid by the very pleasure sought. Invitation or permission delights, and possession by force degrades. The right-minded bridegroom will postpone the exercise of his nuptial rights for a few days, and allow his young wife to become rested from the preparation and fatigue of the wedding, and become accustomed to the changes in her new relations of life. 18. RIGHTLY BEGINNING SEXUAL LIFE.--Intercourse promotes all the functions of the body and mind, but rampant lust and sexual abuses soon destroy the natural pleasures of intercourse, and unhappiness will be the result. Remember that _intercourse_ should not become the polluted purpose of marriage. To be sure, rational enjoyment benefits and stimulates love, but the pleasure of each other's society, standing together on all questions of mutual benefit, working hand in hand and shoulder to shoulder in the battle of life, raising a family of beautiful children, sharing each other's joys and sorrows, are the things that bring to every couple the best, purest, and noblest enjoyment that God has bestowed upon man. {206} [Illustration: A TURKISH HAREM.] Sexual Proprieties and Improprieties. 1. To have offspring is not to be regarded as a luxury, but as a great primary necessity of health and happiness, of which every fully-developed man and woman should have a fair share, while it cannot be denied that the ignorance of the necessity of sexual intercourse to the health and virtue of both man and woman is the most fundamental error in medical and moral philosophy. 2. In a state of pure nature, where man would have his sexual instincts under full and natural restraint, there would be little, if any, licentiousness, and children would be the result of natural desire, and not the accidents of lust. 3. This is an age of sensuality; unnatural passions are cultivated and indulged. Young people in the course of their engagement often sow the seed of serious excesses. This habit of embracing, sitting on the lover's lap, leaning on his breast, long and uninterrupted periods of secluded companionship, have become so common that it is amazing how a young lady can safely arrive at the wedding day. While this conduct may safely terminate with the wedding day, yet it cultivates the tendency which often results in excessive indulgencies after the honey-moon is over. 4. SEPARATE BEDS.--Many writers have vigorously championed as a reform the practice of separate beds for husband and wife. While we would not recommend such separation, it is no doubt very much better for both husband and wife, in case the wife is pregnant. Where people are reasonably temperate, no such ordinary precautions as {207} separate sleeping places may be necessary. But in case of pregnancy it will add rest to the mother and add vigor to the unborn child. Sleeping together, however, is natural and cultivates true affection, and it is physiologically true that in very cold weather life is prolonged by husband and wife sleeping together. 5. THE AUTHORITY OF THE WIFE.--Let the wife judge whether she desires a separate couch or not. She has the superior right to control her own person. In such diseases as consumption, or other severe or lingering diseases, separate beds should always be insisted upon. 6. THE TIME FOR INDULGENCE.--The health of the generative functions depends upon exercise, just the same as any other vital organ. Intercourse should be absolutely avoided just before or after meals, or just after mental excitement or physical exercise. No wife should indulge her husband when he is under the influence of alcoholic stimulants, for idiocy and other serious maladies are liable to be visited upon the offspring. 7. RESTRAINT DURING PREGNANCY.--There is no question but what moderate indulgence during the first few months of pregnancy does not result in serious harm; but people who excessively satisfy their ill-governed passions are liable to pay a serious penalty. 8. MISCARRIAGE.--If a woman is liable to abortion or miscarriage, absolute abstinence is the only remedy. No sexual indulgence during pregnancy can be safely tolerated. 9. It is better for people not to marry until they are of proper age. It is a physiological fact that men seldom reach the full maturity of their virile power before the age of twenty-five, and the female rarely attains the full vigor of her sexual powers before the age of twenty. 10. ILLICIT PLEASURES.--The indulgence of illicit pleasures, says Dr. S. Pancoast, sooner or later is sure to entail the most loathsome diseases on their votaries. Among these diseases are Gonorrhoea, Syphilis, Spermatorrhoea (waste of semen by daily and nightly involuntary emissions), Satyriasis (a species of sexual madness, or a sexual diabolism, causing men to commit rape and other beastly acts and outrages, not only on women and children, but men and animals, as sodomy, pederasty, etc.), Nymphomania (causing women to assail every man they meet, and supplicate and excite him to gratify their lustful passions, or who resort to means of sexual pollutions, which is impossible to describe without shuddering), together with spinal diseases and many disorders of the most distressing and disgusting character, {208} filling the bones with rottenness, and eating away the flesh by gangrenous ulcers, until the patient dies, a horrible mass of putridity and corruption. 11. SENSUALITY.--Sensuality is not love, but an unbridled desire which kills the soul. Sensuality will drive away the roses in the cheeks of womanhood, undermine health and produce a brazen countenance that can be read by all men. The harlot may commit her sins in the dark, but her countenance reveals her character and her immorality is an open secret. 12. SEXUAL TEMPERANCE.--All excesses and absurdities of every kind should be carefully avoided. Many of the female disorders which often revenge themselves in the cessation of all sexual pleasure are largely due to the excessive practice of sexual indulgence. 13. FREQUENCY.--Some writers claim that intercourse should never occur except for the purpose of childbearing; but such restraint is not natural and consequently not conducive to health. There are many conditions in which the health of the mother and offspring must be respected. It is now held that it is nearer a crime than a virtue to prostitute woman to the degradation of breeding animals by compelling her to bring into life more offspring than can be born healthy, or be properly cared for and educated. 14. In this work we shall attempt to specify no rule, but simply give advice as to the health and happiness of both man and wife. A man should not gratify his own desires at the expense of his wife's health, comfort or inclination. Many men no doubt harass their wives and force many burdens upon their slender constitutions. But it is a great sin and no true husband will demand unreasonable recognition. The wife when physically able, however, should bear with her husband. Man is naturally sensitive on this subject, and it takes but little to alienate his affections and bring discord into the family. 15. The best writers lay down the rule for the government of the marriage-bed, that sexual indulgence should only occur about once in a week or ten days, and this of course applies only to those who enjoy a fair degree of health. But it is a hygienic and physiological fact that those who indulge only once a month receive a far greater degree of the intensity of enjoyment than those who indulge their passions more frequently. Much pleasure is lost by excesses where much might be gained by temperance, giving rest to the organs for the accumulation of nervous force. {209} [Illustration] How to Perpetuate the Honey-Moon. 1. CONTINUE YOUR COURTSHIP.--Like causes produce like effects. 2. NEGLECT OF YOUR COMPANION.--Do not assume a right to neglect your companion more after marriage than you did before. 3. SECRETS.--Have no secrets that you keep from your companion. A third party is always disturbing. 4. AVOID THE APPEARANCE OF EVIL.--In matrimonial matters it is often that the mere appearance contains all the evil. Love, as soon as it rises above calculation and becomes love, is exacting. It gives all, and demands all. 5. ONCE MARRIED, NEVER OPEN YOUR MIND TO ANY CHANGE.--If you keep the door of your purpose closed, evil or even desirable changes cannot make headway without help. 6. KEEP STEP IN MENTAL DEVELOPMENT.--A tree that grows for forty years may take all the sunlight from a tree that stops growing at twenty. 7. KEEP A LIVELY INTEREST IN THE BUSINESS OF THE HOME.--Two that do not pull together are weaker than either alone. 8. GAUGE YOUR EXPENSES BY YOUR REVENUES.--Love must eat. The sheriff often levies on Cupid long before he takes away the old furniture. 9. START FROM WHERE YOUR PARENTS STARTED RATHER THAN FROM WHERE THEY NOW ARE.--Hollow and showy boarding often furnishes the too strong temptation, while the quietness of a humble home would cement the hearts beyond risk. {210} 10. AVOID DEBT.--Spend your own money, but earn it first, then it will not be necessary to blame any one for spending other people's. 11. DO NOT BOTH GET ANGRY AT THE SAME TIME.--Remember, it takes two to quarrel. 12. DO NOT ALLOW YOURSELF EVER TO COME TO AN OPEN RUPTURE.--Things unsaid need less repentance. 13. STUDY TO CONFORM YOUR TASTES AND HABITS TO THE TASTES AND HABITS OF YOUR COMPANION.--If two walk together, they must agree. * * * * * How to Be a Good Wife. 1. REVERENCE YOUR HUSBAND.--He sustains by God's order a position of dignity as head of a family, head of the woman. Any breaking down of this order indicates a mistake in the union, or a digression from duty. 2. LOVE HIM.--A wife loves as naturally as the sun shines. Love is your best weapon. You conquered him with that in the first place. You can reconquer by the same means. 3. DO NOT CONCEAL YOUR LOVE FROM HIM.--If he is crowded with care, and too busy to seem to heed your love, you need to give all the greater attention to securing his knowledge of your love. If you intermit he will settle down into a hard, cold life with increased rapidity. Your example will keep the light on his conviction. The more he neglects the fire on the hearth, the more carefully must you feed and guard it. It must not be allowed to go out. Once out you must sit ever in darkness and in the cold. 4. CULTIVATE THE MODESTY AND DELICACY OF YOUR YOUTH.--The relations and familiarity of wedded life may seem to tone down the sensitive and retiring instincts of girlhood, but nothing can compensate for the loss of these. However, much men may admire the public performance of gifted women, they do not desire that boldness and dash in a wife. The holy blush of a maiden's modesty is more powerful in hallowing and governing a home than the heaviest armament that ever a warrior bore. 5. CULTIVATE PERSONAL ATTRACTIVENESS.--This means the storing of your mind with a knowledge of passing events, and with a good idea of the world's general advance. If you read nothing, and make no effort to make yourself attractive, you will soon sink down into a dull hack of stupidity. If {211} your husband never hears from you any words of wisdom, or of common information, he will soon hear nothing from you. Dress and gossips soon wear out. If your memory is weak, so that it hardly seems worth while to read, that is additional reason for reading. [Illustration: TALKING BEFORE MARRIAGE.] 6. CULTIVATE PHYSICAL ATTRACTIVENESS.--When you were encouraging the attentions of him whom you now call husband, you did not neglect any item of dress or appearance {212} that could help you. Your hair was always in perfect training. You never greeted him with a ragged or untidy dress or soiled hands. It is true that your "market is made," but you cannot afford to have it "broken." Cleanliness and good taste will attract now as they did formerly. Keep yourself at your best. Make the most of physical endowments. Neatness and order break the power of poverty. 7. STUDY YOUR HUSBAND'S CHARACTER.--He has his peculiarities. He has no right to many of them, and you need to know them; thus you can avoid many hours of friction. The good pilot steers around the sunken rocks that lie in the channel. The engineer may remove them, not the pilot. You are more pilot than engineer. Consult his tastes. It is more important to your home, that you should please him than anybody else. 8. PRACTICE ECONOMY.--Many families are cast out of peace into grumbling and discord by being compelled to fight against poverty. When there are no great distresses to be endured or accounted for, complaint and fault-finding are not so often evoked. Keep your husband free from the annoyance of disappointed creditors, and he will be more apt to keep free from annoying you. To toil hard for bread, to fight the wolf from the door, to resist impatient creditors, to struggle against complaining pride at home, is too much to ask of one man. A crust that is your own is a feast, while a feast that is purloined from unwilling creditors is a famine. * * * * * How to Be a Good Husband. 1. SHOW YOUR LOVE.--All life manifests itself. As certainly as a live tree will put forth leaves in the spring, so certainly will a living love show itself. Many a noble man toils early and late to earn bread and position for his wife. He hesitates at no weariness for her sake. He justly thinks that such industry and providence give a better expression of his love than he could by caressing her and letting the grocery bills go unpaid. He fills the cellar and pantry. He drives and pushes his business. He never dreams that he is actually starving his wife to death. He may soon have a woman left to superintend his home, but his wife is dying. She must be kept alive by the same process that called her into being. Recall and repeat the little attentions and delicate compliments that once made you so agreeable, and that fanned her love into a consuming flame. It is not beneath the dignity of the skillful physician to study all the {214} little symptoms, and order all the little round of attentions that check the waste of strength and brace the staggering constitution. It is good work for a husband to cherish his wife. [Illustration: TALKING AFTER MARRIAGE.] 2. CONSULT WITH YOUR WIFE.--She is apt to be as right as you are, and frequently able to add much to your stock of wisdom. In any event she appreciates your attentions. 3. STUDY TO KEEP HER YOUNG.--It can be done. It is not work, but worry, that wears. Keep a brave, true heart between her and all harm. 4. HELP TO BEAR HER BURDENS.--Bear one another's burdens, and so fulfill the law of love. Love seeks opportunities to do for the loved object. She has the constant care of your children. She is ordained by the Lord to stand guard over them. Not a disease can appear in the community without her taking the alarm. Not a disease can come over the threshold without her instantly springing into the mortal combat. If there is a deficiency anywhere, it comes out of her pleasure. Her burdens are everywhere. Look for them, that you may lighten them. 5. MAKE YOURSELF HELPFUL BY THOUGHTFULNESS.--Remember to bring into the house your best smile and sunshine. It is good for you, and it cheers up the home. There is hardly a nook in the house that has not been carefully hunted through to drive out everything that might annoy you. The dinner which suits, or ought to suit you, has not come on the table of itself. It represents much thoughtfulness and work. You can do no more manly thing than find some way of expressing, in word or look, your appreciation of it. 6. EXPRESS YOUR WILL, NOT BY COMMANDS, BUT BY SUGGESTIONS.--It is God's order that you should be the head of the family. You are clothed with authority. But this does not authorize you to be stern and harsh, as an officer in the army. Your authority is the dignity of love. When it is not clothed in love it ceases to have the substance of authority. A simple suggestion that may embody a wish, an opinion or an argument, becomes one who reigns over such a kingdom as yours. 7. SEEK TO REFINE YOUR NATURE.--It is no slander to say that many men have wives much more refined than themselves. This is natural in the inequalities of life. Other qualities may compensate for any defect here. But you need have no defect in refinement. Preserve the gentleness and refinement of your wife as a rich legacy for your children, and in so doing you will lift yourself to higher levels. {215} 8. BE A GENTLEMAN AS WELL AS A HUSBAND.--The signs and bronze and callouses of toil are no indications that you are not a gentleman. The soul of gentlemanliness is a kindly feeling toward others, that prompts one to secure their comfort. That is why the thoughtful peasant lover is always so gentlemanly, and in his love much above himself. 9. STAY AT HOME.--Habitual absence during the evenings is sure to bring sorrow. If your duty or business calls you, you have the promise that you will be kept in all your ways. But if you go out to mingle with other society, and leave your wife at home alone, or with the children and servants, know that there is no good in store for you. She has claims upon you that you can not afford to allow to go to protest. Reverse the case. You sit down alone after having waited all day for your wife's return, and think of her as reveling in gay society, and see if you can keep out all the doubts as to what takes her away. If your home is not as attractive as you want it, you are a principal partner. Set yourself about the work of making it attractive. 10. TAKE YOUR WIFE WITH YOU INTO SOCIETY.--Seclusion begets morbidness. She needs some of the life that comes from contact with society. She must see how other people appear and act. It often requires an exertion for her to go out of her home, but it is good for her and for you. She will bring back more sunshine. It is wise to rest sometimes. When the Arab stops for his dinner he unpacks his camel. Treat your wife with as much consideration. [Illustration] {217} Cause of Family Troubles. [Illustration: TIRED OF LIFE.] 1. MUCH BETTER TO BE ALONE.--He who made man said it is not good for him to be alone; but it is much better to be alone, than it is to be in some kinds of company. Many couples who felt unhappy when they were apart, have been utterly miserable when together; and scores who have been ready to go through fire and water to get married, have been willing to run the risk of fire and brimstone to get divorced. It is by no means certain that because persons are wretched before marriage they will be happy after it. The wretchedness of many homes, and the prevalence of immorality and divorce is a sad commentary on the evils which result from unwise marriages. 2. UNAVOIDABLE EVILS.--There are plenty of unavoidable evils in this world, and it is mournful to think of the multitudes who are preparing themselves for needless disappointments, and who yet have no fear, and are unwilling to be instructed, cautioned or warned. To them the experience of mature life is of little account compared with the wisdom of ardent and enthusiastic youth. 3. MATRIMONIAL INFELICITY.--One great cause of matrimonial infelicity is the hasty marriages of persons who have no adequate knowledge of each other's characters. Two strangers become acquainted, and are attracted to each other, and without taking half the trouble to investigate or inquire that a prudent man would take before buying a saddle horse, they are married. In a few weeks or months it is perhaps found that one of the parties was married already, or possibly that the man is drunken or vicious, or the woman anything but what she should be. Then begins the bitter part of the experience: shame, disgrace, scandal, separation, sin and divorce, all come as the natural results of a rash and foolish marriage. A little time spent in honest, candid, and careful preliminary inquiry and investigation, would have saved the trouble. 4. THE CLIMAX.--It has been said that a man is never utterly ruined until he has married a bad woman. So the climax of woman's miseries and sorrows may be said to come only when she is bound with that bond which should be her chiefest blessing and her highest joy, but which may prove her deepest sorrow and her bitterest curse. 5. THE FOLLY OF FOLLIES.--There are some lessons which people are very slow to learn, and yet which are based upon {218} the simple principles of common-sense. A young lady casts her eye upon a young man. She says, "I mean to have that man." She plies her arts, engages his affections, marries him, and secures for herself a life of sorrow and disappointment, ending perhaps in a broken up home or an early grave. Any prudent, intelligent person of mature age, might have warned or cautioned her; but she sought no advice, and accepted no admonition. A young man may pursue a similar course with equally disastrous results. 6. HAP-HAZARD.--Many marriages are undoubtedly arranged by what may be termed the accident of locality. Persons live near each other, become acquainted, and engage themselves to those whom they never would have selected as their companions in life if they had wider opportunities of acquaintance. Within the borders of their limited circle they make a selection which may be wise or may be unwise. They have no means of judging, they allow no one else to judge for them. The results are sometimes happy and sometimes unhappy in the extreme. It is well to act cautiously in doing what can be done but once. It is not a pleasant experience for a person to find out a mistake when it is too late to rectify it. 7. WE ALL CHANGE.--When two persons of opposite sex are often thrown together they are very naturally attracted to each other, and are liable to imbibe the opinion that they are better fitted for life-long companionship than any other two persons in the world. This may be the case, or it may not be. There are a thousand chances against such a conclusion to one in favor of it. But even if at the present moment these two persons were fitted to be associated, no one can tell whether the case will be the same five or ten years hence. Men change; women change; they are not the same they were ten years ago; they are not the same they will be ten years hence. 8. THE SAFE RULE.--Do not be in a hurry; take your time, and consider well before you allow your devotion to rule you. Study first your character, then study the character of her whom you desire to marry. Love works mysteriously, and if it will bear careful and cool investigation, it will no doubt thrive under adversity. When people marry they unite their destinies for the better or the worse. Marriage is a contract for life and will never bear a hasty conclusion. _Never be in a hurry!_ * * * * * {219} Jealousy--Its Cause and Cure. * * * * * Trifles, light as air Are to the jealous confirmations strong, As proofs of holy writ.--SHAKESPEARE. Nor Jealousy Was understood, the injur'd lover's hell.--MILTON. O, beware, my lord, of jealousy; It is the green-eyed monster which doth mock The meat it feeds on.--SHAKESPEARE. * * * * * 1. DEFINITION.--Jealousy is an accidental passion, for which the faculty indeed is unborn. In its nobler form and in its nobler motives it arises from love, and in its lower form it arises from the deepest and darkest Pit of Satan. 2. HOW DEVELOPED.--Jealousy arises either from weakness, which from a sense of its own want of lovable qualities is not convinced of being sure of its cause, or from distrust, which thinks the beloved person capable of infidelity. Sometimes all these motives may act together. 3. NOBLEST JEALOUSY.--The noblest jealousy, if the term noble is appropriate, is a sort of ambition or pride of the loving person who feels it is an insult that another one should assume it as possible to supplant his love, or it is the highest degree of devotion which sees a declaration of its object in the foreign invasion, as it were, of his own altar. Jealousy is always a sign that a little more wisdom might adorn the individual without harm. 4. THE LOWEST JEALOUSY.--The lowest species of jealousy is a sort of avarice of envy which, without being capable of love, at least wishes to possess the object of its jealousy alone by the one party assuming a sort of property right over the other. This jealousy, which might be called the Satanic, is generally to be found with old withered "husbands," whom the devil has prompted to marry young women and who forthwith dream night and day of cuck-old's horns. These Argus-eyed keepers are no longer capable of any feeling that could be called love, they are rather as a rule heartless house-tyrants, and are in constant dread that some one may admire or appreciate his unfortunate slave. 5. WANT OF LOVE.--The general conclusion will be that jealousy is more the result of wrong conditions which cause uncongenial unions, and which through moral corruption, artificially create distrust, than a necessary accompaniment of love. [Illustration: SEEKING THE LIFE OF A RIVAL.] {221} 6. RESULT OF POOR OPINION.--Jealousy is a passion with which those are most afflicted who are the least worthy of love. An innocent maiden who enters marriage will not dream of getting jealous; but all her innocence cannot secure her against the jealousy of her husband if he has been a libertine. Those are wont to be the most jealous who have the consciousness that they themselves are most deserving of jealousy. Most men in consequence of their present education and corruption have so poor an opinion not only of the male, but even of the female sex, that they believe every woman at every moment capable of what they themselves have looked for among all and have found among the most unfortunate, the prostitutes. No libertine can believe in the purity of woman; it is contrary to nature. A libertine therefore cannot believe in the loyalty of a faithful wife. 7. WHEN JUSTIFIABLE.--There may be occasions where jealousy is justifiable. If a woman's confidence has been shaken in her husband, or a husband's confidence has been shaken in his wife by certain signs or conduct, which have no other meaning but that of infidelity, then there is just cause for jealousy. There must, however, be certain proof as evidence of the wife's or husband's immoral conduct. Imaginations or any foolish absurdities should have no consideration whatever, and let everyone have confidence until his or her faith has been shaken by the revelation of absolute facts. 8. CAUTION AND ADVICE.--No couple should allow their associations to develop into an engagement and marriage if either one has any inclination to jealousy. It shows invariably a want of sufficient confidence, and that want of confidence, instead of being diminished after marriage, is liable to increase, until by the aid of the imagination and wrong interpretation the home is made a hell and divorce a necessity. Let it be remembered, there can be no true love without perfect and absolute confidence. Jealousy is always the sign of weakness or madness. Avoid a jealous disposition, for it is an open acknowledgment of a lack of faith. [Illustration] {222} The Improvement of Offspring. * * * * * Why Bring Into the World Idiots, Fools, Criminals and Lunatics? [Illustration: The Mother's Good Night Prayer.] 1. THE RIGHT WAY.--When mankind will properly love and marry and then rightly generate, carry, nurse and educate their children, will they in deed and in truth carry out {223} the holy and happy purpose of their Creator. See those miserable and depraved scape-goats of humanity, the demented simpletons, the half-crazy, unbalanced multitudes which infest our earth, and fill our prisons with criminals and our poor-houses with paupers. Oh! the boundless capabilities and perfections of our God-like nature and, alas! its deformities! All is the result of the ignorance or indifference of parents. As long as children are the accidents of lust instead of the premeditated objects of love, so long will the offspring deteriorate and the world be cursed with deformities, monstrosities, unhumanities and cranks. 2. EACH AFTER ITS KIND.--"Like parents like children." "In their own image beget" they them. In what other can they? "How can a corrupt tree bring forth good fruit?" How can animal propensities in parents generate other than depraved children, or moral purity beget beings other than as holy by nature as those at whose hands they received existence and constitution? 3. AS ARE THE PARENTS, physically, mentally and morally when they stamp their own image and likeness upon progeny, so will be the constitution of that progeny. 4. "JUST AS THE TWIG IS BENT THE TREE'S INCLINED."--Yet the bramble cannot be bent to bear delicious peaches, nor the sycamore to bear grain. Education is something, but _parentage_ is _everything_; because it "_dyes in the wool_," and thereby exerts an influence on character almost infinitely more powerful than all other conditions put together. 5. HEALTHY AND BEAUTIFUL CHILDREN.--Thoughtless mortal! Before you allow the first goings forth of love, learn what the parental conditions in you mean, and you will confer a great boon upon the prospective bone of your bone, and flesh of your flesh! If it is in your power to be the parent of beautiful, healthy, moral and talented children instead of diseased and depraved, is it not your imperious duty then, to impart to them that physical power, moral perfection, and intellectual capability, which shall ennoble their lives and make them good people and good citizens? 6. PAUSE AND TREMBLE.--Prospective parents! Will you trifle with the dearest interests of your children? Will you in matters thus momentous, head-long rush "Where angels dare not tread?" Seeking only mere animal indulgence?--Well might cherubim shrink from assuming responsibilities thus momentous! Yet, how many parents tread this holy ground completely unprepared, and almost as thoughtlessly and ignorantly as brutes--entailing even loathsome diseases and {224} sensual propensities upon the fruit of their own bodies. Whereas they are bound, by obligations the most imperious, to bestow on them a good physical organization, along with a pure, moral, and strong intellectual constitution, or else not to become parents! Especially since it is easier to generate human angels than devils incarnate. 7. HEREDITARY DESCENT.--This great law of things, "Hereditary Descent," fully proves and illustrates in any required number and variety of cases, showing that progeny inherits the constitutional natures and characters, mental and physical, of parents, including pre-dispositions to consumption, insanity, all sorts of disease, etc., as well as longevity, strength, stature, looks, disposition, talents,--all that is constitutional. From what other source do or can they come? Indeed, who can doubt a truth as palpable as that children inherit some, and if some, therefore all, the physical and mental nature and constitution of parents, thus becoming almost their fac-similes? 8. ILLUSTRATIONS.--A whaleman was severely hurt by a harpooned and desperate whale turning upon the small boat, and, by his monstrous jaws, smashing it to pieces, one of which, striking him in his right side, crippled him for life. When sufficiently recovered, he married, according to previous engagement, and his daughter, born in due time, and closely resembling him in looks, constitution and character, has a weak and sore place corresponding in location with that of the injury of her father. Tubercles have been found in the lungs of infants at birth, born of consumptive parents,--a proof, clear and demonstrative, that children inherit the several states of parental physiology existing at the time they received their physiological constitution. The same is true of the transmission of those diseases consequent on the violation of the law of chastity, and the same conclusion established thereby. 9. PARENT'S PARTICIPATION.--Each parent furnishing an indispensable portion of the materials of life, and somehow or other, contributes parentally to the formation of the constitutional character of their joint product, appears far more reasonable, than to ascribe, as many do, the whole to either, some to paternity, others to maternity. Still this decision go which way it may, does not affect the great fact that children inherit both the physiology and the mentality existing in parents at the time they received being and constitution. 10. ILLEGITIMATES OR BASTARDS also furnish strong proof of the correctness of this our leading doctrine. They are generally lively, sprightly, witty, frolicsome, knowing, {225} quick of perception, apt to learn, full of passion, quick-tempered, impulsive throughout, hasty, indiscreet, given to excesses, yet abound in good feeling, and are well calculated to enjoy life, though in general sadly deficient in some essential moral elements. 11. CHARACTER OF ILLEGITIMATES.--Wherein, then, consists this difference? First, in "novelty lending an enchantment" rarely experienced in sated wedlock, as well as in power of passion sufficient to break through all restraint, external and internal; and hence their high wrought organization. They are usually wary and on the alert, and their parents drank "stolen waters." They are commonly wanting in moral balance, or else delinquent in some important moral aspect; nor would they have ever been born unless this had been the case, for the time being at least, with their parents. Behold in these, and many other respects easily cited, how striking the coincidence between their characters on the one hand, and, on the other, those parental conditions necessarily attendant on their origin. 12. CHILDREN'S CONDITION depends upon parents' condition at the time of the sexual embrace. Let parents recall, as nearly as may be their circumstances and states of body and mind at this period, and place them by the side of the physical and mental constitutions of their children, and then say whether this law is not a great practical truth, and if so, its importance is as the happiness and misery it is capable of affecting! The application of this mighty engine of good or evil to mankind, to the promotion of human advancement, is the great question which should profoundly interest all parents. 13. THE VITAL PERIOD.--The physical condition of parents at the vital period of transmission of life should be a perfect condition of health in both body and mind, and a rigorous condition of all the animal organs and functions. 14. MUSCULAR PREPARATION.--Especially should parents cultivate their muscular system preparatory to the perfection of this function, and of their children; because, to impart strength and stamina to offspring they must of necessity both possess a good muscular organization, and also bring it into vigorous requisition at this period. For this reason, if for no other, let those of sedentary habits cultivate muscular energy preparatory to this time of need. 15. THE SEED.--So exceedingly delicate are the seeds of life, that, unless planted in a place of perfect security, they must all be destroyed, and our race itself extinguished. And what place is as secure as that chosen, where they can {226} be reached only with the utmost difficulty, and than only at the peril of even life itself? Imperfect seed sown in poor ground means a sickly harvest. 16. HEALTHY PEOPLE--MOST CHILDREN.--The most healthy classes have the most numerous families; but that, as luxury enervates society, it diminishes the population, by enfeebling parents, nature preferring none rather than those too weakly to live and be happy, and thereby rendering that union unfruitful which is too feeble to produce offspring sufficiently strong to enjoy life. Debility and disease often cause barrenness. Nature seems to rebel against sickly offspring. 17. WHY CHILDREN DIE.--Inquire whether one or both the parents of those numerous children that die around us, have not weak lungs, or a debilitated stomach, or a diseased liver, or feeble muscles, or else use them but little, or disordered nerves, or some other debility or form of disease. The prevalence of summer complaints, colic, cholera infantum, and other affections of these vital organs of children is truly alarming, sweeping them into their graves by the million. Shall other animals rear nearly all their young, and shall man, constitutionally by far the strongest of them all, lose half or more of his? Is this the order of nature? No, but their death-worm is born in and with them, and by parental agency. 18. GRAVE-YARD STATISTICS.--Take grave-yard statistics in August, and then say, whether most of the deaths of children are not caused by indigestion, or feebleness of the bowels, liver, etc., or complaints growing out of them? Rather, take family statistics from broken-hearted parents! And yet, in general, those very parents who thus suffer more than words can tell, were the first and main transgressors, because they entailed those dyspeptic, heart, and other kindred affections so common among American parents upon their own children, and thereby almost as bad as killed them by inches; thus depriving them of the joys of life, and themselves of their greatest earthly treasure! 19. ALL CHILDREN MAY DIE.--Children may indeed die whose parents are healthy, but they almost must whose parents are essentially ailing in one or more of their vital organs; because, since they inherit this organ debilitated or diseased, any additional cause of sickness attacks this part first, and when it gives out, all go by the board together. 20. PARENTS MUST LEARN AND OBEY.--How infinitely more virtuous and happy would your children be if you should be healthy in body, and happy in mind, so as to beget in {227} them a constitutionally healthy and vigorous physiology, along with a serene and happy frame of mind! Words are utterly powerless in answer, and so is everything but a lifetime of consequent happiness or misery! Learn and obey, then, the laws of life and health, that you may both reap the rich reward yourself, and also shower down upon your children after you, blessings many and most exalted. Avoid excesses of all kinds, be temperate, take good care of the body and avoid exposures and disease, and your children will be models of health and beauty. 21. THE RIGHT CONDITION.--The great practical inference is, that those parents who desire intellectual and moral children, must love each other; because, this love, besides perpetually calling forth and cultivating their higher faculties, awakens them to the highest pitch of exalted action in that climax, concentration, and consummation of love which propagates their existing qualities, the mental endowment of offspring being proportionate to the purity and intensity of parental love. 22. THE EFFECTS.--The children of affectionate parents receive existence and constitution when love has rendered the mentality of their parents both more elevated and more active than it is by nature, of course the children of loving parents are both more intellectual and moral by nature than their parents. Now, if these children and their companions also love one another, this same law which renders the second generation better than the first, will of course render the third still better than the second, and thus of all succeeding generations. 23. ANIMAL IMPULSE.--You may preach and pray till doomsday--may send out missionaries, may circulate tracts and Bibles, and multiply revivals and all the means of grace, with little avail; because, as long as mankind go on, as now, to propagate by animal impulse, so long must their offspring be animal, sensual, devilish! But only induce parents cordially to love each other, and you thereby render their children constitutionally talented and virtuous. Oh! parents, by as much as you prefer the luxuries of concord to the torments of discord, and children that are sweet dispositioned and highly intellectual to those that are rough, wrathful, and depraved, be entreated to "_love one another_." [Illustration] * * * * * {229} Too Many Children. [Illustration: JUST HOME FROM SCHOOL.] 1. LESSENING PAUPERISM.--Many of the agencies for lessening pauperism are afraid of tracing back its growth to the frequency of births under wretched conditions. One begins to question whether after all sweet charity or dignified philanthropy has not acted with an unwise reticence. Among the problems which defy practical handling this is the most complicated. The pauperism which arises from marriage is the result of the worst elements of character legalized. In America, where the boundaries of wedlock are practically boundless, it is not desirable, even were it possible, that the state should regulate marriage much further than it now does; therefore must the sociologist turn for aid to society in his struggle with pauperism. 2. RIGHT PHYSICAL AND SPIRITUAL CONDITIONS OF BIRTH.--Society should insist upon the right spiritual and physical conditions for birth. It should be considered more than "a pity" when another child is born into a home too poor to receive it. The underlying selfishness of such an event should be recognized, for it brings motherhood under wrong conditions of health and money. Instead of each birth being the result of mature consideration and hallowed love, children are too often born as animals are born. To be sure the child has a father whom he can call by name. Better that there had never been a child. 3. WRONG RESULTS.--No one hesitates to declare that it is want of self-respect and morality which brings wrong results outside of marriage, but it is also the want of them which begets evil inside the marriage relation. Though there is nothing more difficult than to find the equilibrium between self-respect and self-sacrifice, yet on success in finding it depends individual and national preservation. The fact of being wife and mother or husband and father should imply dignity and joyousness, no matter how humble the home. 4. DIFFERENCE OF OPINION AMONGST PHYSICIANS.--In regard to teaching, the difficulties are great. As soon as one advances beyond the simplest subjects of hygiene, one is met with the difference of opinions among physicians. When each one has a different way of making a mustard plaster, no wonder that each has his own notions about everything else. One doctor recommends frequent births, another advises against them. 5. DIFFERENT NATURES.--If physiological facts are taught to a large class, there are sure to be some in it whose impressionable natures are excited by too much plain {230} speaking, while there are others who need the most open teaching in order to gain any benefit. Talks to a few persons generally are wiser than popular lectures. Especially are talks needed by mothers and unmothered girls who come from everywhere to the city. 6. BOYS AND YOUNG MEN.--It is not women alone who require the shelter of organizations and instruction, but boys and young men. There is no double standard of morality, though the methods of advocating it depend upon the sex which is to be instructed. Men are more concerned with the practical basis of morality than with its sentiment, and with the pecuniary aspects of domestic life than with its physical and mental suffering. We all may need medicine for moral ills, yet the very intangibleness of purity makes us slow to formulate rules for its growth. Under the guidance of the wise in spirit and knowledge, much can be done to create a higher standard of marriage and to proportion the number of births according to the health and income of parents. 7. FOR THE SAKE OF THE STATE.--If the home exists primarily for the sake of the individual, it exists secondarily for the sake of the state. Therefore, any home into which are continually born the inefficient children of inefficient parents, not only is a discomfort in itself, but it also furnishes members for the armies of the unemployed, which are tinkering and hindering legislation and demanding by the brute force of numbers that the state shall support them. 8. OPINIONS FROM HIGH AUTHORITIES.--In the statements and arguments made in the above we have not relied upon our own opinions and convictions, but have consulted the best authorities, and we hereby quote some of the highest authorities upon this subject. 9. REV. LEONARD DAWSON.--"How rapidly conjugal prudence might lift a nation out of pauperism was seen in France.--Let them therefore hold the maxim that the production of offspring with forethought and providence is rational nature. It was immoral to bring children into the world whom they could not reasonably hope to feed, clothe and educate." 10. MRS. FAWCETT.--"Nothing will permanently offset pauperism while the present reckless increase of population continues." 11. DR. GEORGE NAPHEYS.--"Having too many children unquestionably has its disastrous effects on both mother and {231} children as known to every intelligent physician. Two-thirds of all cases of womb disease, says Dr. Tilt, are traceable to child-bearing in feeble women. There are also women to whom pregnancy is a nine months' torture, and others to whom it is nearly certain to prove fatal. Such a condition cannot be discovered before marriage--The detestable crime of abortion is appallingly rife in our day. It is abroad in our land to an extent which would have shocked the dissolute women of pagan Rome--This wholesale, fashionable murder, how are we to stop it? Hundreds of vile men and women in our large cities subsist by this slaughter of the innocent." 12. REV. H. R. HAWEIS.--"Until it is thought a disgrace in every rank of society, from top to bottom of social scale, to bring into the world more children than you are able to provide for, the poor man's home, at least, must often be a purgatory--his children dinnerless, his wife a beggar--himself too often drunk--here, then, are the real remedies: first, control the family growth according to the family means of support." 13. MONTAGUE COOKSON.--"The limitation of the number of the family--is as much the duty of married persons as the observance of chastity is the duty of those that are unmarried." 14. JOHN STUART MILL.--"Every one has aright to live. We will suppose this granted. But no one has a right to bring children into life to be supported by other people. Whoever means to stand upon the first of these rights must renounce all pretension to the last. Little improvement can be expected in morality until the production of a large family is regarded in the same light as drunkenness or any other physical excess." 15. DR. T. D. NICHOLLS.--"In the present social state, men and women should refrain from having children unless they see a reasonable prospect of giving them suitable nurture and education." 16. REV. M. J. SAVAGE.--"Some means ought to be provided for checking the birth of sickly children." 17. DR. STOCKHAM.--"Thoughtful minds must acknowledge the great wrong done when children are begotten under adverse conditions. Women must learn the laws of life so as to protect themselves, and not be the means of bringing sin-cursed, diseased children into the world. The remedy is in the prevention of pregnancy, not in producing abortion." * * * * * {232} Small Families and the Improvement of the Race. 1. MARRIED PEOPLE MUST DECIDE FOR THEMSELVES.--It is the fashion of those who marry nowadays to have few children, often none. Of course this is a matter which married people must decide for themselves. As is stated in an earlier chapter, sometimes this policy is the wisest that can be pursued. [Illustration] 2. DISEASED PEOPLE.--Diseased people who are likely to beget only a sickly offspring, may follow this course, and so may thieves, rascals, vagabonds, insane and drunken persons, and all those who are likely to bring into the world beings that ought not to be here. But why so many well-to-do folks should pursue a policy adapted only to paupers and criminals, is not easy to explain. Why marry at all if not to found a family that shall live to bless and make glad the earth after father and mother are gone? It is not wise to rear too many children, nor is it wise to have too few. Properly brought up, they will make home a delight and parents happy. 3. POPULATION LIMITED.--Galton, in his great work on hereditary genius, observes that "the time may hereafter arrive in far distant years, when the population of this earth shall be kept as strictly within bounds of number and suitability of race, as the sheep of a well-ordered moor, or the plants in an orchard-house; in the meantime, let us do what we can to encourage the multiplication of the races best {233} fitted to invent and conform to a high and generous civilization." 4. SHALL SICKLY PEOPLE RAISE CHILDREN?--The question whether sickly people should marry and propagate their kind, is briefly alluded to in an early chapter of this work. Where father and mother are both consumptive the chances are that the children will inherit physical weakness, which will result in the same disease, unless great pains are taken to give them a good physical education, and even then the probabilities are that they will find life a burden hardly worth living. 5. NO REAL BLESSING.--Where one parent is consumptive and the other vigorous, the chances are just half as great. If there is a scrofulous or consumptive taint in the blood, beware! Sickly children are no comfort to their parents, no real blessing. If such people marry, they had better, in most cases, avoid parentage. 6. WELFARE OF MANKIND.--The advancement of the welfare of mankind is a most intricate problem: all ought to refrain from marriage who cannot avoid abject poverty for their children; for poverty is not only a great evil, but tends to its own increase by leading to recklessness in marriage. On the other hand, as Mr. Galton has remarked, if the prudent avoid marriage, while the reckless marry, the inferior members will tend to supplant the better members of society. 7. PREVENTIVES.--Remember that the thousands of preventives which are advertised in papers, private circulars, etc., are not only inefficient, unreliable and worthless, but positively dangerous, and the annual mortality of females in this country from this cause alone is truly horrifying. Study nature, and nature's laws alone will guide you safely in the path of health and happiness. 8. NATURE'S REMEDY.--Nature in her wise economy has prepared for overproduction, for during the period of pregnancy and nursing, and also most of the last half of each menstrual month, woman is naturally sterile; but this condition may become irregular and uncertain on account of stimulating drinks or immoral excesses. [Illustration] {234} The Generative Organs. [Illustration] THE MALE GENERATIVE ORGANS AND THEIR STRUCTURE AND ADAPTATION. 1. The reproductive organs in man are the penis and testicles and their appendages. 2. The penis deposits the seminal life germ of the male. It is designed to fulfill the seed planting mission of human life. 3. In the accompanying illustration all the parts are named. 4. URETHRA.--The urethra performs the important mission of emptying the bladder, and is rendered very much larger by the passion, and the semen is propelled along through it by little layers of muscles on each side meeting {235} above and below. It is this canal that is inflamed by the disease known as gonorrhoea. 5. PROSTRATE GLAND.--The prostrate gland is located just before the bladder. It swells in men who have previously overtaxed it, thus preventing all sexual intercourse, and becomes very troublesome to void urine. This is a very common trouble in old age. 6. THE PENAL GLAND.--The penal gland, located at the end of the penis, becomes unduly enlarged by excessive action and has the consistency of India rubber. It is always enlarged by erection. It is this gland at the end that draws the semen forward. It is one of the most essential and wonderful constructed glands of the human body. 7. FEMALE MAGNETISM.--When the male organ comes in contact with female magnetism, the natural and proper excitement takes place. When excited without this female magnetism it becomes one of the most serious injuries to the human body. The male organ was made for a high and holy purpose, and woe be to him who pollutes his manhood by practicing the secret vice. He pays the penalty in after years either by the entire loss of sexual power, or by the afflictions of various urinary diseases. 8. NATURE PAYS all her debts, and when there is an abuse of organ, penalties must follow. If the hand is thrust into the fire it will be burnt. * * * * * THE FEMALE SEXUAL ORGANS. * * * * * [Illustration: ANATOMY OR STRUCTURE OF THE FEMALE ORGANS OF GENERATION.] 1. The generative or reproductive organs of the human female are usually divided into the internal and external. Those regarded as internal are concealed from view and protected within the body. Those that can be readily perceived are termed external. The entrance of the vagina may be stated as the line of demarcation of the two divisions. {236} [Illustration: Impregnated Egg. In the first formation of Embryo.] 2. HYMEN OR VAGINAL VALVE.--This is a thin membrane of half moon shape stretched across the opening of the vagina. It usually contains before marriage one or more small openings for the passage of the menses. This membrane has been known to cause much distress in many females at the first menstrual flow. The trouble resulting from the openings in the hymen not being large enough to let the flow through and consequently blocking up the vaginal canal, and filling the entire {237} internal sexual organs with blood; causing paroxysms and hysterics and other alarming symptoms. In such cases the hymen must be ruptured that a proper discharge may take place at once. 3. UNYIELDING HYMEN.--The hymen is usually ruptured by the first sexual intercourse, but sometimes it is so unyielding as to require the aid of a knife before coition can take place. 4. THE PRESENCE OF THE HYMEN was formerly considered a test of virginity, but this theory is no longer held by competent authorities, as disease or accidents or other circumstances may cause its rupture. 5. THE OVARIES.--The ovaries are little glands for the purpose of forming the female ova or egg. They are not fully developed until the period of puberty, and usually are about the size of a large chestnut. The are located in the broad ligaments between the uterus and the Fallopian tubes. During pregnancy the ovaries change position; they are brought farther into the abdominal cavity as the uterus expands. 6. OFFICE OF THE OVARY.--The ovary is to the female what the testicle is to the male. It is the germ vitalizing organ and the most essential part of the generative apparatus. The ovary is not only an organ for the formation of the ova, but is also designed for their separation when they reach maturity. 7. FALLOPIAN TUBES.--These are the ducts that lead from the ovaries to the uterus. They are entirely detached from the glands or ovaries, and are developed on both sides of the body. 8. OFFICE OF THE FALLOPIAN TUBES.--The Fallopian tubes have a double office: receiving the ova from the ovaries and conducting it into the uterus, as well as receiving the spermatic fluid of the male and conveying it from the uterus in the direction of the ovaries, the tubes being the seat of impregnation. [Illustration: OVUM.] 9. STERILITY IN FEMALES.--Sterility in the female is sometimes caused by a morbid adhesion of the tube to a portion of the ovary. By what power the mouth of the tube is directed toward a particular portion of an ovary from which the ovum is about to be discharged, remains entirely unknown, as does also the precise nature of the cause which effects this movement. * * * * * {238} THE MYSTERIES OF THE FORMATION OF LIFE. [Illustration: Ripe Ovum from the Ovary.] 1. SCIENTIFIC THEORIES.--Darwin, Huxley, Haeckel, Tyndall, Meyer, and other renowned scientists, have tried to find the _missing link_ between man and animal; they have also exhausted their genius in trying to fathom the mysteries of the beginning of life, or find where the animal and mineral kingdoms unite to form life; but they have added to the vast accumulation of theories only, and the world is but little wiser on this mysterious subject. 2. PHYSIOLOGY.--Physiology has demonstrated what physiological changes take place in the germination and formation of life, and how nature expresses the intentions of reproduction by giving animals distinctive organs with certain secretions for this purpose, etc. All the different stages of development can be easily determined, but how and why life takes place under such special condition and under no other, is an unsolved mystery. 3. OVARIES.--The ovaries are the essential parts of the generative system of the human female in which ova are matured. There are two ovaries, one on each side of the uterus, and connected with it by the Fallopian tubes. They are egg-shaped, about an inch in diameter, and furnish the {239} germs or ovules. These germs or ovules are very small, measuring about 1/120 of an inch in diameter. 4. DEVELOPMENT.--The ovaries develop with the growth of the female, so that finally at the period of puberty they ripen and liberate an ovum or germ vesicle, which is carried into the uterine cavity of the Fallopian tubes. By the aid of the microscope we find that these ova are composed of granular substance, in which is found a miniature yolk surrounded by a transparent membrane called the zona pellucida. This yolk contains a germinal vesicle in which can be discovered a nucleus, called the germinal spot. The process of the growth of the ovaries is very gradual, and their function of ripening and discharging one ovum monthly into the Fallopian tubes and uterus, is not completed until between the twelfth and fifteenth years. 5. WHAT SCIENCE KNOWS.--After the sexual embrace we know that the sperm is lifted within the genital passages or portion of the vagina and mouth of the uterus. The time between the deposit of the semen and fecundation varies according to circumstances. If the sperm-cell travels to the ovarium it generally takes from three to five days to make the journey. As Dr. Pierce says: "The transportation is aided by the ciliary processes (little hairs) of the mucous surface of the vaginal and uterine walls, as well as by its own vibratile movements. The action of the cilia, under the stimulus of the sperm, seems to be from without, inward. Even if a minute particle of sperm, less than a drop, be left upon the margin of the external genitals of the female, it is sufficient in amount to impregnate, and can be carried, by help of these cilia, to the ovaries." 6. CONCEPTION.--After intercourse at the proper time the liability to conception is very great. If the organs are in a healthy condition, conception must necessarily follow, and no amount of prudence and the most rigid precautions often fail to prevent pregnancy. 7. ONLY ONE ABSOLUTELY SAFE METHOD.--There is only one absolutely safe method to prevent conception, entirely free from danger and injury to health, and one that is in the reach of all; that is to refrain from union altogether. [Illustration] {240} PREVENTION OF CONCEPTION. [Illustration: THE PATIENT MOTHER.] 1. The question is always asked, "Can Conception be prevented at all times?" Certainly, this is possible; but such an interference with nature's laws is inadmissible, and perhaps never to be justified in any case whatever, except in cases of deformity or disease. 2. If the parties of a marriage are both feeble and so adapted to each other that their children are deformed, insane or idiots, then to beget offspring would be a flagrant wrong; if the mother's health is in such a condition as to forbid the right of laying the burden of motherhood upon her, then medical aid may safely come to her relief. If the man, however, respects his wife, he ought to come to her relief without the counsel of a physician. {241} 3. FORBEARANCE.--Often before the mother has recovered from the effects of bearing, nursing and rearing one child, ere she has regained proper tone and vigor of body and mind, she is unexpectedly overtaken, surprised by the manifestation of symptoms which again indicate pregnancy. Children thus begotten cannot become hardy and long-lived. By the love that parents may feel for their posterity, by the wishes for their success, by the hopes for their usefulness, by every consideration for their future well-being, let them exercise precaution and forbearance until the wife becomes sufficiently healthy and enduring to bequeath her own rugged, vital stamina to the child she bears in love. 4. IMPOSTORS.--During the past few years hundreds of books and pamphlets have been written on the subject, claiming that new remedies had been discovered for the prevention of conception, etc., but these are all money making devices to deceive the public, and enrich the pockets of miserable and unprincipled impostors. 5. THE FOLLIES OF PREVENTION.--Dr. Pancoast, an eminent authority, says: "The truth is, there is no medicine taken internally capable of preventing conception, and the person who asserts to the contrary, not only speaks falsely, but is both a knave and a fool. It is true enough that remedies may be taken to produce abortion after conception occurs; but those who prescribe and those who resort to such desperate expedients, can only be placed in the category of lunatics and assassins!" 6. PATENT MEDICINES.--If nature does not promptly respond, there are many patent medicines which when taken at the time the monthly flow is to begin, will produce the desired result. Let women beware; for it is only a question of a few years when their constitution, complexion, and health will be a sorry evidence of their folly. The woman who continually takes a drug to prevent conception, cannot retain her natural complexion; her eyes will become dull, her cheeks flabby, and she will show various evidences of poor health, and her sexual organs will soon become permanently impaired and hopelessly diseased. 7. FOOLISH DREAD OF CHILDREN.--What is more deplorable and pitiable than an old couple childless. Young people dislike the care and confinement of children and prefer society and social entertainments and thereby do great injustice and injury to their health and fit themselves in later years to visit infirmities and diseases upon their children. The vigilant and rigid measures which have to be resorted to in order to prevent conception for a period of years unfits many a wife for the production of healthy children. {242} 8. HAVING CHILDREN under proper circumstances never ruins the health and happiness of any woman. In fact, womanhood is incomplete without them. She may have a dozen or more, and still have better health than before marriage. It is having them too close together, and when she is not in a fit state, that her health gives way. Sometimes the mother is diseased; the outlet from the womb, as a result of laceration by a previous child-birth, is frequently enlarged, thus allowing conception to take place very readily, and hence she has children in rapid succession. Besides the wrong to the mother in having children in such rapid succession, it is a great injustice to the babe in the womb and the one at the breast that they should follow each other so quickly that one is conceived while the other is nursing. One takes the vitality of the other; neither has sufficient nourishment, and both are started in life stunted and incomplete. 9. "THE DESIRABILITY AND PRACTICABILITY of limiting offspring," says Dr. Stockham, "are the subject of frequent inquiry. Fewer and better children are desired by right-minded parents. Many men and women, wise in other things of the world, permit generation as a chance result of copulation, without thought of physical or mental conditions to be transmitted to the child. Coition, the one important act of all others, carrying with it the most vital results, is usually committed for selfish gratification. Many a drunkard owes his life-long appetite for alcohol to the fact that the inception of his life could be traced to a night of dissipation on the part of his father. Physical degeneracy and mental derangements are too often caused by the parents producing offspring while laboring under great mental strain or bodily fatigue. Drunkenness and licentiousness are frequently the heritage of posterity. Future generations demand that such results be averted by better pre-natal influences. The world is groaning under the curse of chance parenthood. It is due to posterity that procreation be brought under the control of reason and conscience. 10. "IT HAS BEEN FEARED THAT A KNOWLEDGE of means to prevent conception would, if generally diffused, be abused by women; that they would to so great an extent escape motherhood as to bring about social disaster. This fear is not well founded. The maternal instinct is inherent and sovereign in woman. Even the pre-natal influences of a murderous intent on the part of parents scarcely ever {243} eradicate it. With this natural desire for children, we believe few women would abuse the knowledge or privilege of controlling conception. Although women shrink from forced maternity, and from the bearing of children under the great burden of suffering, as well as other adverse conditions, it is rare to find a woman who is not greatly disappointed if she does not, some time in her life, wear the crown of motherhood. "An eminent lady teacher, in talking to her pupils, once said: 'The greatest calamity that can befall a woman is never to have a child. The next greatest calamity is to have one only.' From my professional experience I am happy to testify that more women seek to overcome causes of sterility than to obtain knowledge of limiting the size of the family or means to destroy the embryo. Also, if consultation for the latter is sought, it is usually at the instigation of the husband. Believing in the rights of unborn children, and in the maternal instinct, I am consequently convinced that no knowledge should be withheld that will secure proper conditions for the best parenthood. 11. "MANY OF THE MEANS USED TO PREVENT conception are injurious, and often lay the foundation for a train of physical ailments. Probably no one means is more serious in its results than the practice of withdrawal, or the discharge of the semen externally to the vagina. The act is incomplete and unnatural, and is followed by results similar to and as disastrous as those consequent upon _masturbation_. In the male it may result in impotence, in the female in sterility. In both sexes many nervous symptoms are produced, such as headache, defective vision, dyspepsia, insomnia, loss of memory, etc. Very many cases of uterine diseases can be attributed solely to this practice. The objection to the use of the syringe is that if the sperm has passed into the uterus the fluid cannot reach it. A cold fluid may, in some instances, produce contractions to throw it off, but cannot be relied upon." 12. IS IT EVER RIGHT TO PREVENT CONCEPTION? We submit the following case of the _Juke_ family, mostly of New York State, as related by R. L. Dugdale, when a member of the Prison Association, and let the reader judge for himself: "It was traced out by painstaking research that from one woman called Margaret, who, like Topsy, merely 'growed' without pedigree as a pauper in a village on the upper Hudson, about eighty-five years ago, there descended 673 {244} children, grandchildren, and great-grandchildren, of whom 200 were criminals of the dangerous class, 280 adult paupers, and fifty prostitutes, while 300 children of her lineage died prematurely. The last fact proves to what extent in this family nature was kind to the rest of humanity in saving it from a still larger aggregation of undesirable and costly members, for it is estimated that the expense to the State of the descendants of Maggie was over a million dollars, and the State itself did something also towards preventing a greater expense by the restrain exercised upon the criminals, paupers, and idiots of the family during a considerable portion of their lives." 13. THE LEGAL ASPECT.--By the Revised Statutes of the United States it is provided "that no obscene, * * * or lascivious book, picture, or any article or thing designed or intended for the prevention of conception or producing of abortion shall be carried in the mail, and any person who shall knowingly deposit or cause to be deposited for mailing or delivery any of the hereinbefore mentioned things shall be guilty of misdemeanor," etc. In New Jersey, Oregon, South Carolina, Texas and District of Columbia we find no local law against abortion. Nine states, viz.: New Hampshire, Connecticut, New York, Indiana, Wisconsin, Dakotas, Wyoming and California punish the woman upon whom the abortion is attempted; while Massachusetts, New York, Ohio, Indiana, Michigan, Nebraska, Kansas and California punish the advertising or furnishing of means for the prevention of conception; and Ohio makes it a crime to even have such means in one's possession. There is exception made in favor of every case where the early birth of the infant is necessary to save the life of the mother. It will be noticed that the common law punishes the furnishing or advertising of means for the prevention of conception, and hence regards it as a crime. There is, however, no ban of the civil law on Nature's law as laid down by Nature's God and discovered by medical science, which we here make known. 14. IS NATURE'S METHOD RELIABLE?--Dr. Cowan says: "Sexual excitement hastens the premature ripening and meeting of the germ cell with the sperm cell, and impregnation may result, although intercourse occurs only in the specified two weeks' absence of the egg from the uterus." This is just possible under certain peculiar circumstances of diseased conditions, or after long separation of husband and wife. However, it seldom happens, and married people in normal health, temperate in the sexual relation, desirous of controlling the size of their family, can usually depend upon this law. {245} 15. MODERATION.--Continence, self-control, a willingness to deny himself--that is what is required from the husband. But a thousand voices reach us from suffering women in all parts of the land that this will not suffice; that men refuse thus to restrain themselves; that it leads to a loss of domestic happiness and to illegal amour, or it is injurious physically and morally; that, in short, such advice is useless because impracticable. 16. NATURE'S METHOD.--To such we reply that Nature herself has provided, to some extent, against over-production, and that it is well to avail ourselves of her provision. It is well known that women, when nursing, rarely become pregnant, and for this reason, if for no other, women should nurse their own children, and continue the period until the child is at least nine months or a year old. However, the nursing, if continued too long, weakens both the mother and the child, and, moreover, ceases to accomplish the end for which we now recommend it. 17. ANOTHER PROVISION OF NATURE.--For a certain period between her monthly illness, every woman is sterile. Conception may be avoided by refraining from coition except for this particular number of days, and there will be no evasion of natural intercourse, no resort to disgusting practices, and nothing degrading. The following facts have been established, without a doubt: The Graafian Vesicle, containing the egg in the ovary, enlarges during menstruation and bursts open to let the egg escape usually on the first day after the flow ceases, and seldom, if ever, later than the fourth day. It then takes from two to six days for the egg to pass down through the Fallopian tube into the womb, where it remains from two to six days, when, if not impregnated, it passes down through the vagina from the body. After the egg has passed from the body, conception is not possible until after the next menstrual flow. The period, therefore, from after the sixteenth to within three days of the following menstrual discharge is one of almost absolute safety. We say within three days of the next menstruation, because the male seminal fluid may be retained there till the egg leaves the ovary, and in that way impregnation might follow. Impregnation would, however, rarely occur if the period was extended to from the twelfth day after menstruation close up to one day before it began again. The above is the only physiological method (and it is no secret to a great many people) by which conception can be limited, without the employment of such means as involve danger and serious evils. 18. WARNING.--Let women be warned in the most emphatic manner against the employment of the secret methods constantly advertised by quacks. Such means are the almost certain cause of painful uterine diseases and of shortened life. They are productive of more misery by far than over-production itself. {246} [Illustration: [1]New Revelation for Women.] VAGINAL CLEANLINESS. 1. The above Syringe has a patent tube known as the vaginal cleanser. This keeps the sides of the vagina apart and permits the water to thoroughly clean and cleanse the organ. It will be found a great relief in both health and sickness, and in many cases cure barrenness and other diseases of the womb. It can be used the same as any other syringe. The tube can be procured at almost any drug store and applied to either bulb or fountain syringe. Many women are barren on account of an acid secretion in the vagina. The cleanser is almost a certain remedy and cure. 2. CLEANLINESS.--Cleanliness is next to godliness. Without cleanliness the human body is more or less defiled and repulsive. A hint to the wise is sufficient. The vagina should be cleansed with the same faithfulness as any other portion of the body. 3. TEMPERATURE OF THE WATER.--Those not accustomed to use vaginal injections would do well to use water milk-warm at the commencement; after this the temperature may be varied according to circumstances. In case of local inflammation use hot water. The indiscriminate use of cold water injections will be found rather injurious than beneficial, and a woman in feeble health will always find warm water invigorating and preferable. {247} 4. LEUCORRHOEA.--In case of persistent leucorrhoea use the temperature of water from seventy-two to eighty-five degrees Fahrenheit. 5. THE CLEANSER will greatly stimulate the health and spirits of any woman who uses it. Pure water injections have a stimulating effect, and it seems to invigorate the entire body. 6. SALT AND WATER INJECTIONS.--This will cure mild cases of leucorrhoea. Add a teaspoonful of salt to a pint and a half of water at the proper temperature. Injections may be repeated daily if deemed necessary. 7. SOAP AND WATER.--Soap and water is a very simple domestic remedy, and will many times afford relief in many diseases of the womb. It seems it thoroughly cleanses the parts. A little borax or vinegar may be used the same as salt water injections. (See No. 6.) 8. STERILE WOMEN desiring offspring should seek sexual union soon after the appearance of the menses, and not use the vaginal cleanser till several days later. Those not desiring offspring should avoid copulation until the ovum has passed the generative tract. 9. HOLES IN THE TUBES.--Most of the holes in the tubes of syringes are too small. See that they are sufficiently large to produce thorough cleansing. 10. INJECTIONS DURING THE MONTHLY FLOW.--Of course it is not proper to arrest the flow, and the injections will stimulate a healthy action of the organs. The injections may be used daily throughout the monthly flow with much comfort and benefit. If the flow is scanty and painful the injections may be as warm as they can be comfortably borne. If the flowing is immoderate, then cool water may be used. A woman will soon learn her own condition and can act accordingly. 11. BLOOM AND GRACE OF YOUTH.--The regular bathing of the body will greatly improve woman's beauty. Remember that a perfect complexion depends upon the healthy action of all the organs. Vaginal injections are just as important as the bath. A beautiful woman must not only be cleanly, but robust and healthy. There can be no perfect beauty without good health. [Illustration] {248} IMPOTENCE AND STERILITY. [Illustration: Trying On a New Dress.] 1. Actual impotence during the period of manhood is a very rare complaint, and nature very unwillingly, and only after the absolute neglect of sanitary laws, gives up the power of reproduction. 2. Not only sensual women, but all without exception, feel deeply hurt, and are repelled by the husband whom they may previously have loved dearly, when, after entering the married state, they find that he is impotent. The more inexperienced and innocent they were at the time of marriage, the longer it often is before they find that something is lacking in the husband; but, once knowing this, the wife infallibly has a feeling of contempt and aversion for him; though there are many happy families where this defect exists. It is often very uncertain who is the weak one, and no cause for separation should be sought. 3. Unhappy marriages, barrenness, divorces, and perchance an occasional suicide, may be prevented by the experienced physician, who can generally give correct information, comfort, and consolation, when consulted on these delicate matters. 4. When a single man fears that he is unable to fulfill the duties of marriage, he should not marry until his fear is dispelled. The suspicion of such a fear strongly tends to bring about the very weakness which he dreads. Go to a good physician (not to one of those quacks whose {249} advertisements you see in the papers; they are invariably unreliable), and state the case fully and freely. 5. Diseases, malformation, etc., may cause impotence. In case of malformation there is usually no remedy, but in case of disease it is usually within the reach of a skillful physician. 6. Self-abuse and spermatorrhoea produce usually only temporary impotence and can generally be relieved by carrying out the instructions given elsewhere in this book. 7. Excessive indulgences often enfeeble the powers and often result in impotence. Dissipated single men, professional libertines, and married men who are immoderate, often pay the penalty of their violations of the laws of nature, by losing their vital power. In such cases of excess there may be some temporary relief, but as age advances the effects of such indiscretion will become more and more manifest. 8. The condition of sterility in man may arise either from a condition of the secretion which deprives it of its fecundating powers or it may spring from a malformation which prevents it reaching the point where fecundation takes place. The former condition is most common in old age, and is a sequence of venereal disease, or from a change in the structure or functions of the glands. The latter has its origin in a stricture, or in an injury, or in that condition technically known as hypospadias, or in debility. 9. It can be safely said that neither self-indulgence nor spermatorrhoea often leads to permanent sterility. 10. It is sometimes, however, possible, even where there is sterility in the male, providing the secretion is not entirely devoid of life properties on part of the husband, to have children, but these are exceptions. 11. No man need hesitate about matrimony on account of sterility, unless that condition arises from a permanent and absolute degeneration of his functions. 12. Impotence from mental and moral causes often takes place. Persons of highly nervous organization may suffer incapacity in their sexual organs. The remedy for these difficulties is rest and change of occupation. 13. REMEDIES IN CASE OF IMPOTENCE ON ACCOUNT OF FORMER PRIVATE DISEASES, OR MASTURBATION, OR OTHER CAUSES.--First build up the body by taking some good stimulating tonics. The general health is the most essential feature to be considered, in order to secure restoration of the sexual powers. Constipation must be carefully avoided. If the {250} kidneys do not work in good order, some remedy for their restoration must be taken. Take plenty of out-door exercise, avoid horseback riding or heavy exhaustive work. 14. FOOD AND DRINKS WHICH WEAKEN DESIRE.--All kinds of food which cause dyspepsia or bring on constipation, diarrhoea, or irritate the bowels, alcoholic beverages, or any indigestible compound, has the tendency to weaken the sexual power. Drunkards and tipplers suffer early loss of vitality. Beer drinking has a tendency to irritate the stomach and to that extent affects the private organs. 15. COFFEE.--Coffee drank excessively causes a debilitating effect upon the sexual organs. The moderate use of coffee can be recommended, yet an excessive habit of drinking very strong coffee will sometimes wholly destroy vitality. 16. TOBACCO.--It is a hygienic and physiological fact that tobacco produces sexual debility and those who suffer any weakness from that source should carefully avoid the weed in all its forms. 17. DRUGS WHICH STIMULATE DESIRE.--There are certain medicines which act locally on the membranes and organs of the male, and the papers are full of advertisements of "Lost Manhood Restored", etc., but in every case they are worthless or dangerous drugs and certain to lead to some painful malady or death. All these patent medicines should be carefully avoided. People who are troubled with any of these ailments should not attempt to doctor themselves by taking drugs, but a competent physician should be consulted. Eating rye, corn, or graham bread, oatmeal, cracked wheat, plenty of fruit, etc. is a splendid medicine. If that is not sufficient, then a physician should be consulted. 18. DRUGS WHICH MODERATE DESIRE.--Among one of the most common domestic remedies is camphor. This has stood the test for ages. Small doses of half a grain in most instances diminishes the sensibility of the organs of sex. In some cases it produces irritation of the bladder. In that case it should be at once discontinued. On the whole a physician had better be consulted. The safest drug among domestic remedies is a strong tea made out of hops. Saltpeter, or nitrate of potash, taken in moderate quantities, are very good remedies. {251} 19. STRICTLY SPEAKING there is a distinction made between _impotence_ and _sterility_. _Impotence_ is a loss of power to engage in the sexual act and is common to men. It may be imperfection in the male organ or a lack of sufficient sexual vigor to produce and maintain erection. _Sterility_ is a total loss of capacity in the reproduction of the species, and is common to women. There are, however, very few causes of barrenness that cannot be removed when the patient is perfectly developed. Sterility, in a female, most frequently depends upon a weakness or irritability either in the ovaries or the womb, and anything having a strengthening effect upon either organ will remove the disability. (See page 249.) 20. "OVER-INDULGENCE in intercourse," says Dr. Hoff, "is sometimes the cause of barrenness; this is usually puzzling to the interested parties, inasmuch as the practices which, in their opinion, should be the source of a numerous progeny, have the very opposite effect. By greatly moderating their ardor, this defect may be remedied." 21. "NAPOLEON AND JOSEPHINE.--A certain adaptation between the male and female has been regarded as necessary to conception, consisting of some mysterious influence which one sex exerts over the other, neither one, however, being essentially impotent or sterile. The man may impregnate one woman and not another, and the woman will conceive by one man and not by another. In the marriage of Napoleon Bonaparte and Josephine no children were born, but after he had separated from the Empress and wedded Maria Louisa of Austria, an heir soon came. Yet Josephine had children by Beauharnais, her previous husband. But as all is not known as to the physical condition of Josephine during her second marriage, it cannot be assumed that mere lack of adaptability was the cause of unfruitfulness between them. There may have been some cause that history has not recorded, or unknown to the state of medical science of those days. There are doubtless many cases of apparently causeless unfruitfulness in marriage that even physicians, with a knowledge of all apparent conditions in the parties, cannot explain; but when, as elsewhere related in this volume, impregnation by artificial means is successfully practised, it is useless to attribute barrenness to purely psychological and adaptative influences." * * * * * {252} Producing Boys or Girls at Will. 1. CAN THE SEXES BE PRODUCED AT WILL?--This question has been asked in all ages of the world. Many theories have been advanced, but science has at last replied with some authority. The following are the best known authorities which this age of science has produced. 2. THE AGRICULTURAL THEORY.--The agricultural theory, as it may be called, because adopted by farmers, is that impregnation occurring within four days of the close of the female monthlies produces a girl, because the ovum is yet immature; but that when it occurs after the fourth day from its close, gives a boy, because this egg is now mature; whereas after about the eighth day this egg dissolves and passes off, so that impregnation is thereby rendered impossible, till just before the mother's next monthly.--_Sexual Science._ 3. QUEEN BEES LAY FEMALE EGGS FIRST, and male afterwards. So with hens; the first eggs laid after the tread give females, the last males. Mares shown the stallion late in their periods drop horse colts rather than fillies.--_Napheys._ 4. IF YOU WISH FEMALES, give the male at the first sign of heat; if males, at its end.--_Prof. Thury._ 5. ON TWENTY-TWO SUCCESSIVE OCCASIONS I desired to have heifers, and succeeded in every case. I have made in all twenty-nine experiments, after this method, and succeeded in every one, in producing the sex I desired.--_A Swiss Breeder._ 6. THIS THURY PLAN has been tried on the farms of the Emperor of the French with unvarying success. 7. CONCEPTION IN THE FIRST HALF of the time between the menstrual periods produces females, and males is the latter.--_London Lancet._ 8. INTERCOURSE in from two to six days after cessation of the menses produces girls, in from nine to twelve, boys.--_Medical Reporter._ 9. THE MOST MALE POWER and passion creates boys; female girls. This law probably causes those agricultural facts just cited thus: Conception right after menstruation give girls, because the female is then the most impassioned; later, boys, because her wanting sexual warmth leaves him the most vigorous. Mere sexual excitement, a wild, fierce, furious rush of passion, is not only not sexual vigor, but in its inverse ratio; and a genuine insane fervor caused by weakness; just as a like nervous excitability indicates weak nerves instead of strong. Sexual power is deliberate, not wild; cool, not impetuous; while all false excitement diminishes effectiveness.--_Fowler._ * * * * * {253} ABORTION OR MISCARRIAGE. [Illustration: HEALTHY CHILDREN.] 1. ABORTION OR MISCARRIAGE is the expulsion of the child from the womb previous to six months; after that it is called premature birth. 2. CAUSES.--It may be due to a criminal act of taking medicine for the express purpose of producing miscarriage or it may be caused by certain medicines, severe sickness or nervousness, syphilis, imperfect semen, lack of room in the pelvis and abdomen, lifting, straining, violent cold, sudden mental excitement, excessive sexual intercourse, dancing, tight lacing, the use of strong purgative medicines, bodily fatigue, late suppers, and fashionable amusements. 3. SYMPTOMS.--A falling or weakness and uneasiness in the region of the loins, thighs and womb, pain in the small {254} of the back, vomiting and sickness of the stomach, chilliness with a discharge of blood accompanied with pain in the lower portions of the abdomen. These may take place in a single hour, or it may continue for several days. If before the fourth month, there is not so much danger, but the flow of blood is generally greater. If miscarriage is the result of an accident, it generally takes place without much warning, and the service of a physician should at once be secured. 4. HOME TREATMENT.--A simple application of cold water externally applied will produce relief, or cold cloths of ice, if convenient, applied to the lower portions of the abdomen. Perfect quiet, however, is the most essential thing for the patient. She should lie on her back and take internally a teaspoonful of paregoric every two hours; drink freely of lemonade or other cooling drinks, and for nourishment subsist chiefly on chicken broth, toast, water gruel, fresh fruits, etc. The principal homeopathic remedies for this disease are ergot and cimicifuga, given in drop-doses of the tinctures. 5. INJURIOUS EFFECTS.--Miscarriage is a very serious difficulty, and the health and the constitution may be permanently impaired. Any one prone to miscarriage should adopt every measure possible to strengthen and build up the system; avoid going up stairs or doing much heavy lifting or hard work. 6. PREVENTION.--Practice the laws of sexual abstinence, take frequent sitz-baths, live on oatmeal, graham bread, and other nourishing diet. Avoid highly seasoned food, rich gravies, late suppers and the like. [Illustration] {255} The Murder of the Innocents. [Illustration: AN INDIAN FAMILY. The Savage Indian Teaches Us Lessons of Civilization.] 1. MANY CAUSES.--Many causes have operated to produce a corruption of the public morals so deplorable; prominent among which may be mentioned the facility with which divorces may be obtained in some of the States, the constant promulgation of false ideas of marriage and its duties by means of books, lectures, etc., and the distribution through the mails of impure publications. But an influence not less powerful than any of these is the growing devotion of fashion and luxury of this age, and the idea which practically obtains to so great an extent that pleasure, instead of the health or morals, is the great object of life. 2. A MONSTROUS CRIME.--The abiding interest we feel in the preservation of the morals of our country, constrains us to raise our voice against the daily increasing practice of {256} infanticide, especially before birth. The notoriety this monstrous crime has obtained of late, and the hecatombs of infants that are annually sacrificed to Moloch, to gratify an unlawful passion, are a sufficient justification for our alluding to a painful and delicate subject, which should "not even be named," only to correct and admonish the wrong-doers. 3. LOCALITIES IN WHICH IT IS MOST PREVALENT.--We may observe that the crying sin of infanticide is most prevalent in those localities where the system of moral education has been longest neglected. This inhuman crime might be compared to the murder of the innocents, except that the criminals, in this case, exceed in enormity the cruelty of Herod. 4. SHEDDING INNOCENT BLOOD.--If it is a sin to take away the life even of an enemy; if the crime of shedding innocent blood cries to heaven for vengeance; in what language can we characterize the double guilt of those whose souls are stained with the innocent blood of their own unborn, unregenerated offspring? 5. THE GREATNESS OF THE CRIME.--The murder of an infant before its birth, is, in the sight of God and the law, as great a crime as the killing of a child after birth. 6. LEGAL RESPONSIBILITY.--Every State of the Union has made this offense one of the most serious crimes. The law has no mercy for the offenders that violate the sacred law of human life. It is murder of the most cowardly character and woe to him who brings this curse upon his head, to haunt him all the days of his or her life, and to curse him at the day of his death. 7. THE PRODUCT OF LUST.--Lust pure and simple. The only difference between a marriage of this character and prostitution is, that society, rotten to its heart, pulpits afraid to cry aloud against crime and vice, and the church conformed to the world, have made such a profanation of marriage respectable. To put it in other words, when two people determine to live together as husband and wife, and evade the consequences and responsibilities of marriage, they are simply engaged in prostitution without the infamy which attaches to that vice and crime. 8. OUTRAGEOUS VIOLATION OF ALL LAW.--The violation of all law, both natural and revealed, is the cool and villainous contract by which people entering into the marital relation engage in defiance of the laws of God and the laws of the commonwealth, that they shall be unincumbered with a family of children. "Disguise the matter as you will," says Dr. Pomeroy, "yet the fact remains that the first and {257} specific object of marriage is the rearing of a family." "Be fruitful and multiply and replenish the earth," is God's first word to Adam after his creation. 9. THE NATIONAL SIN.--The prevention of offspring is preeminently the sin of America. It is fast becoming the national sin of America, and if it is not checked, it will sooner or later be an irremediable calamity. The sin has its roots in a low and perverted idea of marriage, and is fostered by false standards of modesty. 10. THE SIN OF HEROD.--Do these same white-walled sepulchres of hell know that they are committing the damning sin of Herod in the slaughter of the innocents, and are accessories before the fact to the crime of murder? Do women in all circles of society, when practicing these terrible crimes realize the real danger? Do they understand that it is undermining their health, and their constitution, and that their destiny, if persisted in, is a premature grave just as sure as the sun rises in the heavens? Let all beware, and let the first and only purpose be, to live a life guiltless before God and man. 11. THE CRIME OF ABORTION.--From the moment of conception a new life commences; a new individual exists; another child is added to the family. The mother who deliberately sets about to destroy this life, either by want of care, or by taking drugs, or using instruments, commits as great a crime, and is just as guilty as if she strangled her new-born infant or as if she snatched from her own breast her six months' darling and dashed out its brains against the wall. Its blood is upon her head, and as sure as there is a God and a judgment, that blood will be required of her. The crime she commits is murder, child murder--the slaughter of a speechless, helpless being, whom it is her duty, beyond all things else, to cherish and preserve. 12. DANGEROUS DISEASES.--We appeal to all such with earnest and with threatening words. If they have no feeling for the fruit of their womb, if maternal sentiment is so callous in their breasts, let them know that such produced abortions are the constant cause of violent and dangerous womb diseases, and frequently of early death; that they bring on mental weakness, and often insanity; that they are the most certain means to destroy domestic happiness which can be adopted. Better, far better, to bear a child every year for twenty years than to resort to such a wicked and injurious step; better to die, if need be, in the pangs of child-birth, than to live with such a weight of sin on the conscience. * * * * * {258} The Unwelcome Child.[2] 1. TOO OFTEN THE HUSBAND thinks only of his personal gratification; he insists upon what he calls his rights (?); forces on his wife an _unwelcome child_, and thereby often alienates her affections, if he does not drive her to abortion. Dr Stockham reports the following case: "A woman once consulted me who was the mother of five children, all born within ten years. These were puny, scrofulous, nervous and irritable. She herself was a fit subject for doctors and drugs. Every organ in her body seemed diseased, and every function perverted. She was dragging out a miserable existence. Like other physicians, I had prescribed in vain for her many maladies. One day she chanced to inquire how she could safely prevent conception. This led me to ask how great was the danger. She said: 'Unless my husband is absent from home, few nights have been exempt since we were married, except it may be three or four immediately after confinement.' "'And yet your husband loves you?' "'O, yes, he is kind and provides for his family. Perhaps I might love him but for this. While now--(will God forgive me?)--_I detest, I loathe him_, and if I knew how to support myself and children, I would leave him.' "'Can you talk with him upon this subject?' "'I think I can.' "' Then there is hope, for many women cannot do that. Tell him I will give you treatment to improve your health, and if he will wait until you can respond, _take time for the act, have it entirely mutual from first to last_, the demand will not come so frequent.' "'Do you think so?' "'The experience of many proves the truth of this statement.' "Hopefully she went home, and in six months I had the satisfaction of knowing my patient was restored to health, and a single coition in a month gave the husband more satisfaction than the many had done previously, that the creative power was under control, and that my lady could proudly say 'I love,' where previously she said 'I hate.' "If husbands will listen, a few simple instructions will {259} appeal to their _common sense_, and none can imagine the gain to themselves, to their wives and children, and their children's children. Then it may not be said of the babes that the 'Death borders on their birth, and their cradle stands in the grave.'" 2. WIVES! BE FRANK AND TRUE to your husbands on the subject of maternity, and the relation that leads to it. Interchange thoughts and feelings with them as to what nature allows or demands in regard to these. Can maternity be natural when it is undesigned by the father or undesired by the mother? Can a maternity be natural, healthful, ennobling to the mother, to the child, to the father, and to the home, when no loving, tender, anxious forethought presides over the relation in which it originated?--when the mother's nature loathed and repelled it, and the father's only thought was his own selfish gratification; the feelings and conditions of the mother, and the health, character and destiny of the child that may result being ignored by him. Wives! let there be a perfect and loving understanding between you and your husbands on these matters, and great will be your reward. 3. A WOMAN WRITES:--"There are few, very few, wives and mothers who could not reveal a sad, dark picture in their own experience in their relations to their husbands and their children. Maternity, and the relation in which it originates, are thrust upon them by their husbands, often without regard to their spiritual or physical conditions, and often in contempt of their earnest and urgent entreaties. No joy comes to their heart at the conception and birth of their children, except that which arises from the consciousness that they have survived the sufferings wantonly and selfishly inflicted upon them." 4. HUSBAND, WHEN MATERNITY is imposed on your wife without her consent, and contrary to her appeal, how will her mind necessarily be affected towards her child? It was conceived in dread and in bitterness of spirit. Every stage of its foetal development is watched with feeling of settled repugnance. In every step of its ante-natal progress the child meets only with grief and indignation in the mother. She would crush out its life, if she could. She loathed its conception; she loathed it in every stage of its ante-natal development. Instead of fixing her mind on devising ways and means for the healthful and happy organization and {260} development of her child before it is born, and for its postnatal comfort and support, her soul may be intent on its destruction, and her thoughts devise plans to kill it. In this, how often is she aided by others! There are those, and they are called men and women, whose profession is to devise ways to kill children before they are born. Those who do this would not hesitate (but for the consequences) to kill them after they are born, for the state of mind that would justify and instigate _ante-natal_ child-murder would justify and instigate _post-natal_ child-murder. Yet, public sentiment consigns the murderer of post-natal children to the dungeon or the gallows, while the murderers of ante-natal children are often allowed to pass in society as honest and honorable men and women. 5. THE FOLLOWING IS AN EXTRACT from a letter written by one who has proudly and nobly filled the station of a wife and mother, and whose children and grandchildren surround her and crown her life with tenderest love and respect: "It has often been a matter of wonder to me that men should, so heedlessly, and so injuriously to themselves, their wives and children, and their homes, demand at once, as soon as they get legal possession of their wives, the gratification of a passion, which, when indulged merely for the sake of the gratification of the moment, must end in the destruction of all that is beautiful, noble and divine in man or woman. I have often felt that I would give the world for a friendship with man that should show no impurity in its bearing, and for a conjugal relation that would, at all times, heartily and practically recognize the right of the wife to decide for herself when she should enter into the relation that leads to maternity." 6. TIMELY ADVICE.--Here let me say that on no subject should a man and woman, as they are being attracted into conjugal relations, be more open and truthful with each other than on this. No woman, who would save herself and the man she loves from a desecrated and wretched home, should enter into the physical relations of marriage with a man until she understands what he expects of her as to the function of maternity, and the relation that leads to it. If a woman is made aware that the man who would win her as a wife regards her and the marriage relation only as the means of a legalized gratification of his passions, and she sees fit to live with him as a wife, with such a prospect before her, she must take the consequences of a course so {261} degrading and so shameless. If she sees fit to make an offering of her body and soul on the altar of her husband's sensuality, she must do it; but she has a right to know to what base uses her womanhood is to be put, and it is due to her, as well as to himself, that he should tell beforehand precisely what he wants and expects of her. Too frequently, man shrinks from all allusion, during courtship, to his expectations in regard to future passional relations. He fears to speak of them, lest he should shock and repel the woman he would win as a wife. Being conscious, it may be, of an intention to use power he may acquire over her person for his own gratification, he shuns all interchange of views with her, lest she should divine the hidden sensualism of his soul, and his intention to victimize her person to it the moment he shall get the license. A woman had better die at once than enter into or continue in marriage with a man whose highest conception of the relation is, that it is a means of licensed animal indulgence. In such a relation, body and soul are sacrificed. 7. ONE DISTINCTIVE CHARACTERISTIC of a true and noble husband is a feeling of manly pride in the physical elements of his manhood. His physical manhood, as well as his soul, is dear to the heart of his wife, because through this he can give the fullest expression of his manly power. How can you, my friend, secure for your person the loving care and respect of your wife? There is but one way: so manifest yourself to her, in the hours of your most endearing intimacies, that all your manly power shall be associated only with all that is generous, just and noble in you, and with purity, freedom and happiness in her. Make her feel that all which constitutes you a man, and qualifies you to be her husband and the father of her children, belongs to her, and is sacredly consecrated to the perfection and happiness of her nature. Do this, and the happiness of your home is made complete. Your _body_ will be lovingly and reverently cared for, because the wife of your bosom feels that it is the sacred symbol through which a noble, manly love is ever speaking to her, to cheer and sustain her. 8. WOMAN IS EVER PROUD, and justly so, of the manly passion of her husband, when she knows it is controlled by a love for her, whose manifestations have regard only to her elevation and happiness. The power which, when bent only on selfish indulgence, becomes a source of more shame, degradation, disease and wretchedness, to {262} women and to children than all other things put together, does but ennoble her, add grace and glory to her being, and concentrate and vitalize the love that encircles her as a wife when it is controlled by wisdom and consecrated to her highest growth and happiness, and that of her children. It lends enchantment to her person, and gives a fascination to her smiles, her words and her caresses, which ever breathe of purity and of heaven, and make her all lovely as a wife and mother to her husband and the father of her child. _Manly passion is to the conjugal love of the wife like the sun to the rose-bud, that opens its petals, and causes them to give out their sweetest fragrance and to display their most delicate tints; or like the frost, which chills and kills it ere it blossoms in its richness and beauty._ 9. A DIADEM OF BEAUTY.--Maternity, when it exists at the call of the wife, and is gratefully received, but binds her heart more tenderly and devotedly to her husband. As the father of her child, he stands before her invested with new beauty and dignity. In receiving from him the germ of a new life, she receives that which she feels is to add new beauty and glory to her as a woman--a new grace and attraction to her as a wife. She loves and honors him, because he has crowned her with the glory of a mother. Maternity, to her, instead of being repulsive, is a diadem of beauty, a crown of rejoicing; and deep, tender, and self-forgetting are her love and reverence for him who has placed it on her brow. How noble, how august, how beautiful is maternity when thus bestowed and received! 10. CONCLUSION.--Would you, then, secure the love and trust of your wife, and become an object of her ever-growing tenderness and reverence? Assure her, by all your manifestations, and your perfect respect for the functions of her nature, that your passion shall be in subjection of her wishes. It is not enough that you have secured in her heart respect for your spiritual and intellectual manhood. To maintain your self-respect in your relations with her, to perfect your growth and happiness as a husband, you must cause your _physical_ nature to be tenderly cherished and reverenced by her in all the sacred intimacies of home. No matter how much she reverences your intellectual or your social power, if by reason of your uncalled-for passional manifestations you have made your physical manhood disagreeable, how can you, in her presence, preserve a sense of manly pride and dignity as a husband? * * * * * {263} Heredity and the Transmission of Diseases. [Illustration: HEALTH AND DISEASE.] 1. BAD HABITS.--It is known that the girl who marries the man with bad habits, is, in a measure, responsible for the evil tendencies which these habits have created in the children; and young people are constantly warned of the danger in marrying when they know they come from families troubled with chronic diseases or insanity. To be sure the warnings have had little effect thus far in preventing such marriages, and it is doubtful whether they will, unless the prophecy of an extremist writing for one of our periodicals comes to pass--that the time is not far distant when such marriages will be a crime punishable by law. {264} 2. TENDENCY IN THE RIGHT DIRECTION.--That there is a tendency in the right direction must be admitted, and is perhaps most clearly shown in some of the articles on prison reform. Many of them strongly urge the necessity of preventive work as the truest economy, and some go so far as to say that if the present human knowledge of the laws of heredity were acted upon for a generation, reformatory measures would be rendered unnecessary. 3. SERIOUS CONSEQUENCES.--The mother who has ruined her health by late hours, highly-spiced food, and general carelessness in regard to hygienic laws, and the father who is the slave of questionable habits, will be very sure to have children either mentally or morally inferior to what they might otherwise have had a right to expect. But the prenatal influences may be such that evils arising from such may be modified to a great degree. 4. FORMATION OF CHARACTER.--I believe that pre-natal influences may do as much in the formation of character as all the education that can come after, and that the mother may, in a measure, "will" what that influence shall be, and that, as knowledge on the subject increases, it will be more and more under their control. In that, as in everything else, things that would be possible with one mother would not be with another, and measures that would be successful with one would produce opposite results from the other. 5. INHERITING DISEASE. Consumption--that dread foe of modern life--is the most frequently encountered of all affections as the result of inherited predispositions. Indeed, some of the most eminent physicians have believed it is never produced in any other way. Heart disease, disease of the throat, excessive obesity, affections of the skin, asthma, disorders of the brain and nervous system, gout, rheumatism and cancer, are all hereditary. A tendency to bleed frequently, profusely and uncontrollably, from trifling wounds, is often met with as a family affection. 6. MENTAL DERANGEMENTS.--Almost all forms of mental derangements are hereditary--one of the parents or near relation being afflicted. Physical or bodily weakness is often hereditary, such as scrofula, gout, rheumatism, rickets, consumption, apoplexy, hernia, urinary calculi, hemorrhoids or piles, cataract, etc. In fact, all physical weakness, if ingrafted in either parent, is transmitted from parents to offspring, and is often more strongly marked in the latter than in the former. 7. MARKS AND DEFORMITIES.--Marks and deformities are all transmissible from parents to offspring, equally with {265} diseases and peculiar proclivities. Among such blemishes may be mentioned moles, hair-lips, deficient or supernumerary fingers, toes, and other characteristics. It is also asserted that dogs and cats that have accidentally lost their tails, bring forth young similarly deformed. Blumenbach tells of a man who had lost his little finger, having children with the same deformity. 8. CAUTION.--Taking facts like these into consideration, how very important is it for persons, before selecting partners for life, to deliberately weigh every element and circumstances of this nature, if they would insure a felicitous union, and not entail upon their posterity disease, misery and despair. Alas! in too many instances matrimony is made a matter of money, while all earthly joys are sacrificed upon the accursed altars of lust and mammon. [Illustration] {266} Preparation for Maternity. 1. WOMAN BEFORE MARRIAGE.--It is not too much to say that the life of women before marriage ought to be adjusted with more reference to their duties as mothers than to any other one earthly object. It is the continuance of the race which is the chief purpose of marriage. The passion of amativeness is probably, on the whole, the most powerful of all human impulses. Its purpose, however, is rather to subserve the object of continuing the species, than merely its own gratification. 2. EXERCISE.--Girls should be brought up to live much in the open air, always with abundant clothing against wet and cold. They should be encouraged to take much active exercise; as much, if they want to, as boys. It is as good for little girls to run and jump, to ramble in the woods, to go boating, to ride and drive, to play and "have fun" generally, as for little boys. 3. PRESERVE THE SIGHT.--Children should be carefully prevented from using their eyes to read or write, or in any equivalent exertion, either before breakfast, by dim daylight, or by artificial light. Even school studies should be such that they can be dealt with by daylight. Lessons that cannot be learned without lamp-light study are almost certainly excessive. This precaution should ordinarily be maintained until the age of puberty is reached. 4. BATHING.--Bathing should be enforced according to constitutions, not by an invariable rule, except the invariable rule of keeping clean. Not necessarily every day, nor necessarily in cold water; though those conditions are doubtless often right in case of abundant physical health and strength. 5. WRONG HABITS.--The habit of daily natural evacuations should be solicitously formed and maintained. Words or figures could never express the discomforts and wretchedness which wrong habits in this particular have locked down upon innumerable women for years and even for life. 6. DRESS.--Dress should be warm, loose, comely, and modest rather than showy; but it should be good enough to satisfy a child's desires after a good appearance, if they are reasonable. Children, indeed, should have all their reasonable desires granted as far as possible; for nothing makes them reasonable so rapidly and so surely as to treat them reasonably. {267} 7. TIGHT LACING.--Great harm is often done to maidens for want of knowledge in them, or wisdom and care in their parents. The extremes of fashions are very prone to violate not only taste, but physiology. Such cases are tight lacing, low necked dresses, thin shoes, heavy skirts. And yet, if the ladies only knew, the most attractive costumes are not the extremes of fashion, but those which conform to fashion enough to avoid oddity, which preserve decorum and healthfulness, whether or no; and here is the great secret of successful dress--vary fashion so as to suit the style of the individual. 8. COURTSHIP AND MARRIAGE.--Last of all, parental care in the use of whatever influence can be exerted in the matter of courtship and marriage. Maidens, as well as youths, must, after all, choose for themselves. It is their own lives which they take in their hands as they enter the marriage state, and not their parents'; and as the consequences affect them primarily it is the plainest justice that with the responsibility should be joined the right of choice. The parental influence, then, must be indirect and advisory. Indirect, through the whole bringing up of their daughter; for if they have trained her aright, she will be incapable of enduring a fool, still more a knave. 9. A YOUNG WOMAN AND A YOUNG MAN HAD BETTER NOT BE ALONE TOGETHER VERY MUCH UNTIL THEY ARE MARRIED.--This will be found to prevent a good many troubles. It is not meant to imply that either sex, or any member of it, is worse than another, or bad at all, or anything but human. It is simply the prescription of a safe general rule. It is no more an imputation than the rule that people had better not be left without oversight in presence of large sums of other folks' money. The close personal proximity of the sexes is greatly undesirable before marriage. Kisses and caresses are most properly the monopoly of wives. Such indulgences have a direct and powerful physiological effect. Nay, they often lead to the most fatal results. 10. IGNORANCE BEFORE MARRIAGE.--At some time before marriage those who are to enter into it ought to be made acquainted with some of the plainest common-sense limitations which should govern their new relations to each other. Ignorance in such matters has caused an infinite amount of disgust, pain, and unhappiness. It is not necessary to specify particulars here: see other portions of this work. * * * * * {269} Impregnation. [Illustration: A HEALTHY MOTHER.] 1. CONCEPTION OR IMPREGNATION.--Conception or impregnation takes place by the union of the male sperm and female sperm. Whether this is accomplished in the ovaries, the oviducts or the uterus, is still a question of discussion and investigation by physiologists. 2. PASSING OFF THE OVUM.--"With many woman," says Dr. Stockham in her Tokology, "the ovum passes off within twenty-four or forty-eight hours after menstruation begins. Some, by careful observation, are able to know with certainty when this takes place. It is often accompanied with malaise, nervousness, headache or actual uterine pain. A minute substance like the white of an egg; with a fleck of blood in it, can frequently be seen upon the clothing. Ladies who have noticed this phenomenon testify to its recurring very regularly upon the same day after menstruation. Some delicate women have observed it as late as the fourteenth day." 3. CALCULATIONS.--Conception is more liable to take place either immediately before or immediately after the period, and, on that account it is usual when calculating the date at which to expect labor, to count from the day of disappearance of the last period. The easiest way to make a calculation is to count back three months from the date of the last period and add seven days; thus we might say that the date was the 18th of July; counting back brings us to the 18th of April, and adding the seven days will bring us to the 25th day of April, the expected time. 4. EVIDENCE OF CONCEPTION.--Very many medical authorities, distinguished in this line, have stated their belief that women never pass more than two or three days at the most beyond the forty weeks conceded to pregnancy--that is two hundred and eighty days or ten lunar months, or nine calendar months and a week. About two hundred and eighty days will represent the average duration of pregnancy, counting from the last day of the last period. Now it must be borne in mind, that there are many disturbing elements which might cause the young married woman to miss a time. During the first month of pregnancy there is no sign by which the condition may be positively known. The missing of a period, especially in a person who has been regular for some time, may lead one to suspect it; but there are many attendant causes in married life, the little annoyances of household duties, embarrassments, and the enforced gayety which naturally surrounds the bride, and {270} these should all be taken into consideration in the discussion as to whether or not she is pregnant. But then, again, there are some rare cases who have menstruated throughout their pregnancy; and also cases where menstruation was never established and pregnancy occurred. Nevertheless, the non-appearance of the period, with other signs, may be taken as presumptive evidence. 5. "ARTIFICIAL IMPREGNATION.--It may not be generally known that union is not essential to impregnation; it is possible for conception to occur without congress. All that is necessary is that seminal animalcules enter the womb and unite there with the egg or ovum. It is not essential that the semen be introduced through the medium of the male organ, as it has been demonstrated repeatedly that by means of a syringe and freshly obtained and healthy semen, impregnation can be made to follow by its careful introduction. There are physicians in France who make a specialty of "Artificial Impregnation," as it is called, and produce children to otherwise childless couples, being successful in many instances in supplying them as they are desired." * * * * * Signs and Symptoms of Pregnancy. 1. THE FIRST SIGN.--The first sign that leads a lady to suspect that she is pregnant is her ceasing-to-be-unwell. This, provided she has just before been in good health, is a strong symptom of pregnancy; but still there must be others to corroborate it. 2. ABNORMAL CONDITION.--Occasionally, women menstruate during the entire time of gestation. This, without doubt, is an abnormal condition, and should be remedied, as disastrous consequences may result. Also, women have been known to bear children who have never menstruated. The cases are rare of pregnancy taking place where menstruation has never occurred, yet it frequently happens that women never menstruate from one pregnancy to another. In these cases this symptom is ruled out for diagnotic purposes. 3. MAY PROCEED FROM OTHER CAUSES.--But a ceasing-to-be-unwell may proceed from other causes than that of pregnancy, such as disease or disorder of the womb or of other {271} organs of the body--especially of the lungs--it is not by itself alone entirely to be depended upon; although, as a single sign, it is, especially if the patient be healthy, one of the most reliable of all the other signs of pregnancy. 4. MORNING SICKNESS.--If this does not arise from a disordered stomach, it is a trustworthy sign of pregnancy. A lady who has once had morning-sickness can always for the future distinguish it from each and from every other sickness; it is a peculiar sickness, which no other sickness can simulate. Moreover, it is emphatically a morning-sickness--the patient being, as a rule, for the rest of the day entirely free from sickness or from the feeling of sickness. [Illustration: Embryo of Twenty Days, Laid Open. _b_, the Back: _a_ _a_ _a_, Covering, and pinned to Back.] 5. A THIRD SYMPTOM.--A third symptom is shooting, throbbing and lancinating pains in, and enlargement of the breasts, with soreness of the nipples, occurring about the second month. In some instances, after the first few months, a small quantity of watery fluid or a little milk, may be squeezed out of them. This latter symptom, in a first pregnancy, is valuable, and can generally be relied on as fairly conclusive of pregnancy. Milk in the breast, however small it may be in quantity, especially in a first pregnancy, is a reliable sign, indeed, we might say, a certain sign, of pregnancy. 6. A DARK BROWN AREOLA OR MARK around the nipple is one of the distinguishing signs of pregnancy--more especially of a first pregnancy. Women who have had large families, seldom, even when they are not pregnant, lose this mark entirely; but when they are pregnant it is more intensely dark--the darkest brown--especially if they be brunettes. 7. QUICKENING.--Quickening is one of the most important signs of pregnancy, and one of the most valuable, as at the moment it occurs, as a rule, the motion of the child is first felt, whilst, at the same time, there is a sudden increase in the size of the abdomen. Quickening is a proof that nearly half the time of pregnancy has passed. If there be a {272} liability to miscarry, quickening makes matters more safe, as there is less likelihood of a miscarriage after than before it. A lady at this time frequently feels faint or actually faints away; she is often giddy, or sick, or nervous, and in some instances even hysterically; although, in rare cases, some women do not even know the precise time when they quicken. 8. INCREASED SIZE AND HARDNESS OF THE ABDOMEN.--This is very characteristic of pregnancy. When a lady is not pregnant the abdomen is soft and flaccid; when she is pregnant, and after she has quickened, the abdomen; over the region of the womb, is hard and resisting. [Illustration: Embryo at Thirty Days. _a_, the Head; _b_, the Eyes; _d_, the Neck; _e_, the Chest; _f_, the Abdomen.] 9. EXCITABILITY OF MIND.--Excitability of mind is very common in pregnancy, more especially if the patient be delicate; indeed, excitability is a sign of debility, and requires plenty of good nourishment, but few stimulants. 10. ERUPTIONS ON THE SKIN.--Principally on the face, neck, or throat, are tell-tales of pregnancy, and to an experienced matron, publish the fact that an acquaintance thus marked is pregnant. {273} 11. THE FOETAL HEART.--In the fifth month there is a sign which, if detected, furnishes indubitable evidence of conception, and that is the sound of the child's heart. If the ear be placed on the abdomen, over the womb, the beating of the foetal heart can sometimes be heard quite plainly, and by the use of an instrument called the stethoscope, the sounds can be still more plainly heard. This is a very valuable sign, inasmuch as the presence of the child is not only ascertained, but also its position, and whether there are twins or more. [Illustration: OUR KING.] {274} [Illustration] Diseases of Pregnancy. 1. COSTIVE STATE OF THE BOWELS.--A costive state of the bowels is common in pregnancy; a mild laxative is therefore occasionally necessary. The mildest must be selected, as a strong purgative is highly improper, and even dangerous. Calomel and all other preparations of mercury are to be especially avoided, as a mercurial medicine is apt to weaken the system, and sometimes even to produce a miscarriage. Let me again urge the importance of a lady, during the whole period of pregnancy, being particular as to the state of her bowels, as costiveness is a fruitful cause of painful, tedious and hard labors. 2. LAXATIVES.--The best laxatives are castor oil, salad oil, compound rhubarb pills, honey, stewed prunes, stewed rhubarb, Muscatel raisins, figs, grapes, roasted apples, baked pears, stewed Normandy pippins, coffee, brown-bread and treacle. Scotch oatmeal made with new milk or water, or with equal parts of milk and water. 3. PILLS.--When the motions are hard, and when the bowels are easily acted upon, two, or three, or four pills made of Castile soap will frequently answer the purpose; and if they will, are far better than any other ordinary laxative. The following is a good form. Take of: Castile Soap, five scruples; Oil of Caraway, six drops; To make twenty-four pills. Two, or three, or four to be taken at bedtime, occasionally. 4. HONEY.--A teaspoonful of honey, either eaten at breakfast or dissolved in a cup of tea, will frequently, comfortably and effectually, open the bowels, and will supersede the necessity of taking laxative medicine. 5. NATURE'S MEDICINES.--Now, Nature's medicines--exercise in the open air, occupation, and household duties--on the contrary, not only at the time open the bowels, but keep up a proper action for the future; hence their inestimable superiority. {275} 6. WARM WATER INJECTIONS.--An excellent remedy for costiveness of pregnancy is an enema, either of warm water, or of Castile soap and water, which the patient, by means of a self-injecting enema-apparatus, may administer to herself. The quantity of warm water to be used, is from half a pint to a pint; the proper heat is the temperature of new milk; the time for administering it is early in the morning, twice or three times a week. 7. MUSCULAR PAINS OF THE ABDOMEN.--The best remedy is an abdominal belt constructed for pregnancy, and adjusted with proper straps and buckles to accomodate the gradually increasing size of the womb. This plan often affords great comfort and relief; indeed, such a belt is indispensably necessary. 8. DIARRHOEA.--Although the bowels in pregnancy are generally costive, they are sometimes in an opposite state, and are relaxed. Now, this relaxation is frequently owing to there having been prolonged constipation, and Nature is trying to relieve herself by purging. Do not check it, but allow it to have its course, and take a little rhubarb or magnesia. The diet should be simple, plain, and nourishing, and should consist of beef tea, chicken broth, arrowroot, and of well-made and well-boiled oatmeal gruel. Butcher's meat, for a few days, should not be eaten; and stimulants of all kinds must be avoided. 9. FIDGETS.--A pregnant lady sometimes suffers severely from "fidgets"; it generally affects her feet and legs, especially at night, so as to entirely destroy her sleep; she cannot lie still; she every few minutes moves, tosses and tumbles about--first on one side, then on the other. The causes of "fidgets" are a heated state of the blood; an irritable condition of the nervous system, prevailing at that particular time; and want of occupation. The treatment of "fidgets" consists of: sleeping in a well-ventilated apartment, with either window or door open; a thorough ablution of the whole body every morning, and a good washing with tepid water of the face, neck, chest, arms and hands every night; shunning hot and close rooms; taking plenty of out-door exercise; living on a bland, nourishing, but not rich diet; avoiding meat at night, and substituting in lieu thereof, either a cupful of arrow-root made with milk, or of well-boiled oatmeal gruel. 10. EXERCISE.--If a lady, during the night, have the "fidgets," she should get out of bed; take a short walk up and down the room, being well protected by a dressing-gown; empty her bladder; turn her pillow, so as to have {276} the cold side next the head; and then lie down again; and the chances are that she will now fall asleep. If during the day she have the "fidgets," a ride in an open carriage; or a stroll in the garden, or in the fields; or a little housewifery, will do her good, and there is nothing like fresh air, exercise, and occupation to drive away "the fidgets." 11. HEARTBURN.--Heartburn is a common and often a distressing symptom of pregnancy. The acid producing the heartburn is frequently much increased by an overloaded stomach. An abstemious diet ought to be strictly observed. Great attention should be paid to the quality of the food. Greens, pastry, hot buttered toast, melted butter, and everything that is rich and gross, ought to be carefully avoided. Either a teaspoonful of heavy calcined magnesia, or half a teaspoonful of carbonate of soda--the former to be preferred if there be constipation--should occasionally be taken in a wine-glassful of warm water. If these do not relieve--the above directions as to diet having been strictly attended to--the following mixture ought to be tried. Take of: Carbonate of Ammonia, half a drachm; Bicarbonate of Soda, a drachm and a half; Water, eight ounces; To make a mixture: Two tablespoonfuls to be taken twice or three times a day, until relief be obtained. 12. WIND IN THE STOMACH AND BOWELS.--This is a frequent reason why a pregnant lady cannot sleep at night. The two most frequent causes of flatulence are, first, the want of walking exercise during the day, and second, the eating of a hearty meal just before going to bed at night. The remedies are, of course, in each instance, self-evident. 13. SWOLLEN LEGS FROM ENLARGED VEINS (VARICOSE VEINS.)--The veins are frequently much enlarged and distended, causing the legs to be greatly swollen and very painful, preventing the patient from taking proper walking exercise. Swollen legs are owing to the pressure of the womb upon the blood-vessels above. Women who have had large families are more liable than others to varicose veins. If a lady marry late in life, or if she be very heavy in pregnancy--carrying the child low down--she is more likely to have distention of the veins. The best plan will be for her to wear during the day an elastic stocking, which ought to be made on purpose for her, in order that it may properly fit the leg and foot. 14. STRETCHING OF THE SKIN OF THE ABDOMEN.--This is frequently, in a first pregnancy, distressing, from the {277} soreness it causes. The best remedy is to rub the abdomen, every night and morning, with warm camphorated oil, and to wear a belt during the day and a broad flannel bandage at night, both of which should be put on moderately but comfortably tight. The belt must be secured in its situation by means of properly adjusted straps. 15. BEFORE THE APPROACH OF LABOR.--The patient, before the approach of labor, ought to take particular care to have the bowels gently opened, as during that state a costive state greatly increases her sufferings, and lengthens the period of her labor. A gentle action is all that is necessary; a violent one would do more harm than good. 16. SWOLLEN AND PAINFUL BREASTS.--The breasts are, at times, during pregnancy, much swollen and very painful and, now and then, they cause the patient great uneasiness as she fancies that she is going to have either some dreadful tumor or a gathering of the bosom. There need, in such a case, be no apprehension. The swelling and the pain are the consequences of the pregnancy, and will in due time subside without any unpleasant result. For treatment she cannot do better than rub them well, every night and morning, with equal parts of Eau de Cologne and olive oil, and wear a piece of new flannel over them; taking care to cover the nipples with soft linen, as the friction of the flannel might irritate them. 17. BOWEL COMPLAINTS.--Bowel complaints, during pregnancy, are not unfrequent. A dose either of rhubarb and magnesia, or of castor oil, are the best remedies, and are generally, in the way of medicine, all that is necessary. 17. CRAMPS.--Cramps of the legs and of the thighs during the latter period, and especially at night, are apt to attend pregnancy, and are caused by the womb pressing upon the nerves which extend to the lower extremities. Treatment.--Tightly tie a handkerchief, folded like a neckerchief, round the limb a little above the part affected, and let it remain on for a few minutes. Friction by means of the hand either with opodeldoc or with laudanum, taking care not to drink the lotion by mistake, will also give relief. [Illustration: A PRECIOUS FLOWER.] 19. THE WHITES.--The whites during pregnancy, especially during the latter months, and particularly if the lady have had many children, are frequently troublesome, and are, in a measure, occasioned by the pressure of the womb on the parts below, causing irritation. The best way, therefore, to obviate such pressure is for the patient to lie down a great part of each day either on a bed or a sofa. She ought to retire early to rest; she should sleep on a hard {279} mattress and in a well-ventilated apartment, and should not overload her bed with clothes. A thick, heavy quilt at these times, and indeed at all times, is particularly objectionable; the perspiration cannot pass readily through it as through blankets, and thus she is weakened. She ought to live on plain, wholesome, nourishing food; and she must abstain from beer and wine and spirits. The bowels ought to be gently opened by means of a Seidlitz powder, which should occasionally be taken early in the morning. 20. IRRITATION AND ITCHING OF THE EXTERNAL PARTS.--This a most troublesome affection, and may occur at any time, but more especially during the latter period of the pregnancy. Let her diet be simple and nourishing; let her avoid stimulants of all kinds. Let her take a sitz-bath of warm water, considerably salted. Let her sit in the bath with the body thoroughly covered. 21. HOT AND INFLAMED.--The external parts, and the passage to the womb (vagina), in these cases, are not only irritable and itching, but are sometimes hot and inflamed, and are covered either with small pimples, or with a whitish exudation of the nature of aphtha (thrush), somewhat similar to the thrush on the mouth of an infant; then, the addition of glycerine to the lotion is a great improvement and usually gives much relief. 22. [3]BILIOUSNESS is defined by some one as piggishness. Generally it may be regarded as _overfed_. The elements of the bile are in the blood in excess of the power of the liver to eliminate them. This may be caused either from the superabundance of the materials from which the bile is made or by inaction of the organ itself. Being thus retained the system is _clogged_. It is the result of either too much food in quantity or too rich in quality. Especially is it caused by the excessive use of _fats and sweets_. The simplest remedy is the best. A plain, light diet with plenty of acid fruits, avoiding fats and sweets, will ameliorate or remove it. Don't force the appetite. Let hunger demand food. In the morning the sensitiveness of the stomach may be relieved by taking before rising a cup of hot water, hot milk, hot lemonade, rice or barley water, selecting according to preference. For this purpose many find coffee made from browned wheat or corn the best drink. Depend for a time upon liquid food that can be taken up by absorbents. The juice of lemons and other acid fruits is usually grateful, and {280} assists in assimilating any excess in nutriment. These may be diluted according to taste. With many, an egg lemonade proves relishing and acceptable. 23. DERANGED APPETITE.--Where the appetite fails, let the patient go without eating for a little while, say for two or three meals. If, however, the strength begins to go, try the offering of some unexpected delicacy; or give small quantities of nourishing food, as directed in case of morning sickness. 24. PILES.--For cases of significance consult a physician. As with constipation, so with piles, its frequent result, fruit diet, exercise, and sitz-bath regimen will do much to prevent the trouble. Frequent local applications of a cold compress, and even of ice, and tepid water injections, are of great service. Walking or standing aggravate this complaint. Lying down alleviates it. Dr. Shaw says, "There is nothing in the world that will produce so great relief in piles as fasting. If the fit is severe, live a whole day, or even two, if necessary, upon pure soft cold water alone. Give then very lightly of vegetable food." 25. TOOTHACHE.--There is a sort of proverb that a woman loses one tooth every time she has a child. Neuralgic toothache during pregnancy is, at any rate, extremely common, and often has to be endured. It is generally thought not best to have teeth extracted during pregnancy, as the shock to the nervous system has sometimes caused miscarriage. To wash out the mouth morning and night with cold or lukewarm water and salt is often of use. If the teeth are decayed, consult a good dentist in the early stages of pregnancy, and have the offending teeth properly dressed. Good dentists, in the present state of the science, extract very few teeth, but save them. 26. SALIVATION.--Excessive secretion of the saliva has usually been reckoned substantially incurable. Fasting, cold water treatment, exercise and fruit diet may be relied on to prevent, cure or alleviate it, where this is possible, as it frequently is. 27. HEADACHE.--This is, perhaps, almost as common in cases of pregnancy as "morning sickness." It may be from determination of blood to the head, from constipation or indigestion, constitutional "sick headache," from neuralgia, from a cold, from rheumatism. Correct living will prevent much headache trouble; and where this does not answer the purpose, rubbing and making magnetic passes over the {281} head by the hand of some healthy magnetic person will often prove of great service. 28. LIVER-SPOTS.--These, on the face, must probably be endured, as no trustworthy way of driving them off is known. 29. JAUNDICE.--See the doctor. 30. PAIN ON THE RIGHT SIDE.--This is liable to occur from about the fifth to the eighth month, and is attributed to the pressure of the enlarging womb upon the liver. Proper living is most likely to alleviate it. Wearing a wet girdle in daytime or a wet compress at night, sitz-baths, and friction with the wet hand may also be tried. If the pain is severe a mustard poultice may be used. Exercise should be carefully moderated if found to increase the pain. If there is fever and inflammation with it, consult a physician. It is usually not dangerous, but uncomfortable only. 31. PALPITATION OF THE HEART.--To be prevented by healthy living and calm, good humor. Lying down will often gradually relieve it, so will a compress wet with water, as hot as can be borne, placed over the heart and renewed as often as it gets cool. 32. FAINTING.--Most likely to be caused by "quickening," or else by tight dress, bad air, over-exertion, or other unhealthy living. It is not often dangerous. Lay the patient in an easy posture, the head rather low than high, and where cool air may blow across the face; loosen the dress if tight; sprinkle cold water on the face and hands. 33. SLEEPLESSNESS.--Most likely to be caused by incorrect living, and to be prevented and cured by the opposite. A glass or two of cold water drank deliberately on going to bed often helps one to go to sleep; so does bathing the face and hands and the feet in cold water. A short nap in the latter part of the forenoon can sometimes be had, and is of use. Such a nap ought not to be too long, or it leaves a heavy feeling; it should be sought with the mind in a calm state, in a well-ventilated though darkened room, and with the clothing removed, as at night. A similar nap in the afternoon is not so good, but is better than nothing. The tepid sitz-bath on going to bed will often produce sleep, and so will gentle percussion given by an attendant with palms of the hand over the back for a few minutes on retiring. To secure sound sleep do not read, write or severely tax the mind in the evening. {282} [Illustration] MORNING SICKNESS. 1. A pregnant woman is especially liable to suffer many forms of dyspepsia, nervous troubles, sleeplessness, etc. 2. MORNING SICKNESS is the most common and is the result of an irritation in the womb, caused by some derangement, and it is greatly irritated by the habit of indulging in sexual gratification during pregnancy. If people would imitate the lower animals and reserve the vital forces of the mother for the benefit of her unborn child, it would be a great boon to humanity. Morning sickness may begin the next day after conception, but it usually appears from two to three weeks after the beginning of pregnancy and continues with more or less severity from two to four months. 3. HOME TREATMENT FOR MORNING SICKNESS.--Avoid all highly seasoned and rich food. Also avoid strong tea and coffee. Eat especially light and simple suppers at five o'clock and no later than six. Some simple broths, such as will be found in the cooking department of this book will be very nourishing and soothing. Coffee made from brown wheat or corn is an excellent remedy to use. The juice of lemons reduced with water will sometimes prove very effectual. A good lemonade with an egg well stirred is very nourishing and toning to the stomach. 4. HOT FOMENTATION on the stomach and liver is excellent, and warm and hot water injections are highly beneficial. 5. A little powdered magnesia at bed time, taken in a little milk, will often give almost permanent relief. 6. Avoid corsets or any other pressure upon the stomach. All garments must be worn loosely. In many cases this will entirely prevent all stomach disturbances. * * * * * {283} Relation of Husband and Wife During Pregnancy. 1. MISCARRIAGE.--If the wife is subject to miscarriage every precaution should be employed to prevent its happening again. Under such exceptional circumstances the husband should sleep apart the first five months of pregnancy; after that length of time, the ordinary relation may be assumed. If miscarriage has taken place, intercourse should be avoided for a month or six weeks at least after the accident. 2. IMPREGNATION--Impregnation is the only mission of intercourse, and after that has taken place, intercourse can subserve no other purpose than sensual gratification. 3. WOMAN MUST JUDGE.--Every man should recognize the fact that woman is the sole umpire as to when, how frequent, and under what circumstances, connection should take place. Her desires should not be ignored, for her likes and dislikes are--as seen in another part of this book--easily impressed upon the unborn child. If she is strong and healthy there is no reason why passion should not be gratified with moderation and caution during the whole period of pregnancy, but she must be the sole judge and her desires supreme. 4. VOLUNTARY INSTANCES.--No voluntary instances occur through the entire animal kingdom. All females repel with force and fierceness the approaches of the male. The human family is the only exception. A man that loves his wife, however, will respect her under all circumstances and recognize her condition and yield to her wishes. [Illustration] {284} A Private Word to the Expectant Mother [Illustration] Elizabeth Cady Stanton, in a lecture to ladies, thus strongly states her views regarding maternity and painless childbirth: "We must educate our daughters to think that motherhood is grand, and that God never cursed it. And this curse, if it be a curse, may be rolled off, as man has rolled away the curse of labor; as the curse has been rolled from the descendants of Ham. My mission is to preach this new gospel. If you suffer, it is not because you are cursed of God, but because you violate His laws. What an incubus it would take from woman could she be educated to know that the pains of maternity are no curse upon her kind. We know that among the Indians the squaws do not suffer in childbirth. They will step aside from the ranks, even on the march, and return in a short time to them with the newborn child. What an absurdity then, to suppose that only enlightened Christian women are cursed. But one word of fact is worth a volume of philosophy; let me give you some of my own experience. I am the mother of seven children. My girlhood was spent mostly in the open air. I early imbibed the idea that a girl was just as good as a boy, and I carried it out. I would walk five miles before breakfast or {285} ride ten on horseback. After I was married I wore my clothing sensibly. Their weight hung entirely on my shoulders. I never compressed my body out of its natural shape. When my first four children were born, I suffered very little. I then made up my mind that it was totally unnecessary for me to suffer at all; so I dressed lightly, walked every day, lived as much as possible in the open air, ate no condiments or spices, kept quiet, listened to music, looked at pictures, and took proper care of myself. The night before the birth of the child I walked three miles. The child was born without a particle of pain. I bathed it and dressed it, and it weighed ten and one-half pounds. That same day I dined with the family. Everybody said I would surely die, but I never had a relapse or a moment's inconvenience from it. I know this is not being delicate and refined, but if you would be vigorous and healthy, in spite of the diseases of your ancestors, and your own disregard of nature's laws, try it." * * * * * Shall Pregnant Women Work? 1. OVER-WORKED MOTHERS.--Children born of over-worked mothers, are liable to be a dwarfed and puny race. However, their chances are better than those of the children of inactive, dependent, indolent mothers who have neither brain nor muscle to transmit to son or daughter. The truth seems to be that excessive labor, with either body or mind, is alike injurious to both men and women, and herein lies the sting of that old curse. This paragraph suggests all that need be said on the question whether pregnant women should or should not labor. 2. FOOLISHLY IDLE.--At least it is certain that they should not be foolishly idle; and on the other hand, it is equally certain that they should be relieved from painful laborious occupations that exhaust and unfit them for happiness. Pleasant and useful physical and intellectual occupation, however, will not only do no harm, but positive good. 3. THE BEST MAN AND THE BEST WOMAN.--The best man is he who can rear the best child, and the best woman is she who can rear the best child. We very properly extol to the skies Harriet Hosmer, the artist, for cutting in marble the statue of a Zenobia, how much more should we sing praises to the man and the woman who bring into the world a noble boy or girl. The one is a piece of lifeless beauty, the other a piece of life including all beauty, all possibilities. * * * * * {286} Words for Young Mothers. [Illustration] The act of nursing is sometimes painful to the mother, especially before the habit is fully established. The discomfort is greatly increased if the skin that covers the nipples is tender and delicate. The suction pulls it off, leaving them in a state in which the necessary pressure of the child's lips cause intense agony. This can be prevented in a great measure, says Elizabeth Robinson Scovil, in _Ladies' Home Journal_, if not entirely, by bathing the nipples twice a day for six weeks before the confinement with powdered alum dissolved in alcohol; or salt dissolved in brandy. If there is any symptom of the skin cracking when the child begins to nurse, they should be painted with a mixture of tannin and glycerine. This must be washed off before the baby touches them and renewed when it leaves them. If they are {287} very painful, the doctor will probably order morphia added to the mixture. A rubber nipple shield to be put on at the time of nursing, is a great relief. If the nipples are retracted or drawn inward, they can be drawn out painlessly by filling a pint bottle with boiling water, emptying it and quickly applying the mouth over the nipple. As the air in the bottle cools, it condenses, leaving a vacuum and the nipple is pushed out by the air behind it. When the milk accumulates or "cakes" in the breast in hard patches, they should be rubbed very gently, from the base upwards, with warm camphorated oil. The rubbing should be the lightest, most delicate stroking, avoiding pressure. If lumps appear at the base of the breast and it is red, swollen and painful, cloths wrung out of cold water should be applied and the doctor sent for. While the breast is full and hard all over, not much apprehension need be felt. It is when lumps appear that the physician should be notified, that he may, if possible, prevent the formation of abscesses. While a woman is nursing she should eat plenty of nourishing food--milk, oatmeal, cracked wheat, and good juicy, fresh meat, boiled, roasted, or broiled, but not fried. Between each meal, before going to bed, and once during the night, she should take a cup of cocoa, gruel made with milk, good beef tea, mutton broth, or any warm, nutritive drink. Tea and coffee are to be avoided. It is important to keep the digestion in order and the bowels should be carefully regulated as a means to this end. If necessary, any of the laxative mineral waters can be used for this purpose, or a teaspoonful of compound licorice powder taken at night. Powerful cathartic medicines should be avoided because of their effect upon the baby. The child should be weaned at nine months old, unless this time comes in very hot weather, or the infant is so delicate that a change of food would be injurious. If the mother is not strong her nurseling will sometimes thrive better upon artificial food than on its natural nourishment. By gradually lengthening the interval between the nursing and feeding the child, when it is hungry, the weaning can be accomplished without much trouble. A young mother should wear warm underclothing, thick stockings and a flannel jacket over her night dress, unless she is in the habit of wearing an under vest. If the body is not protected by warm clothing there is an undue demand upon the nervous energy to keep up the vital heat, and nerve force is wasted by the attempt to compel the system to do what ought to be done for it by outside means. [Illustration] {288} How to Have Beautiful Children. [Illustration] 1. PARENTAL INFLUENCE.--The art of having handsome children has been a question that has interested the people of all ages and of all nationalities. There is no longer a question as to the influence that parents may and do exert upon their offspring, and it is shown in other parts of this book that beauty depends largely on the condition of health at the time of conception. It is therefore of no little moment that parents should guard carefully their own health as well as that of their children, that they may develop a vigorous constitution. There cannot be beauty without good health. 2. MARRYING TOO EARLY.--We know that marriage at too early an age, or too late in life, is apt to produce imperfectly {289} developed children, both mentally and physically. The causes are self-evident: A couple marrying too young, they lack maturity and consequently will impart weakness to their offspring; while on the other hand persons marrying late in life fail to find that normal condition which is conducive to the health and vigor of offspring. 3. CROSSING OF TEMPERAMENTS AND NATIONALITIES.--The crossing of temperaments and nationalities beautifies offspring. If young persons of different nationalities marry, their children under proper hygienic laws are generally handsome and healthy. For instance, an American and German or an Irish and German uniting in marriage, produces better looking children than those marrying in the same nationality. Persons of different temperaments uniting in marriage, always produces a good effect upon offspring. 4. THE PROPER TIME.--To obtain the best results, conception should take place only when both parties are in the best physical condition. If either parent is in any way indisposed at the time of conception the results will be seen in the health of the child. Many children brought in the world with diseases or other infirmities stamped upon their feeble frames show the indiscretion and ignorance of parents. 5. DURING PREGNANCY.--During pregnancy the mother should take time for self improvement and cultivate an interest for admiring beautiful pictures or engravings which represent cheerful and beautiful figures. Secure a few good books illustrating art, with some fine representations of statues and other attractive pictures. The purchase of several illustrated art journals might answer the purpose. 6. WHAT TO AVOID.--Pregnant mothers should avoid thinking of ugly people, or those marked by any deformity or disease; avoid injury, fright and disease of any kind. Also avoid ungraceful position and awkward attitude, but cultivate grace and beauty in herself. Avoid difficulty with neighbors or other trouble. 7. GOOD CARE.--She should keep herself in good physical condition, and the system well nourished, as a want of food always injures the child. 8. THE IMPROVEMENT OF THE MIND.--The mother should read suitable articles in newspapers or good books, keep her mind occupied. If she cultivates a desire for intellectual improvement, the same desire will be more or less manifested in the growth and development of the child. {290} 9. LIKE PRODUCES LIKE, everywhere and always--in general forms and in particular features--in mental qualities and in bodily conditions--in tendencies of thought and in habits of action. Let this grand truth be deeply impressed upon the hearts of all who desire or expect to become parents. 10. HEREDITY.--Male children generally inherit the peculiar traits and diseases of the mother and female children those of the father. 11. ADVICE.--"Therefore it is urged that during the period of utero-gestation, especial pains should be taken to render the life of the female as harmonious as possible, that her surroundings should all be of a nature calculated to inspire the mind with thoughts of physical and mental beauties and perfections, and that she should be guarded against all influences, of whatever character, having a deteriorating tendency." [Illustration] {292} Education of the Child in the Womb. "A lady once interviewed a prominent college president and asked him when the education of a child should begin. 'Twenty-five years before it is born,' was the prompt reply." No better answer was ever given to that question. Every mother may well consider it. [Illustration: THE BEAUTIFUL BUTTERFLY.] 1. THE UNBORN CHILD AFFECTED BY THE THOUGHTS AND THE SURROUNDINGS OF THE MOTHER.--That the child is affected in the womb of the mother, through the influences apparently connected with objects by which she is surrounded, appears to have been well known in ancient days, as well as at the present time. 2. EVIDENCES.--Many evidences are found in ancient history, especially among the refined nations, showing that certain expedients were resorted to by which their females, during the period of utero-gestation, were surrounded by the superior refinements of the age, with the hope of thus making upon them impressions which should have the effect of communicating certain desired qualities to the offspring. For this reason apartments were adorned with statuary and paintings, and special pains were taken not only to convey favorable impressions, but also to guard against unfavorable ones being made, upon the mind of the pregnant woman. 3. HANKERING AFTER GIN.--A certain mother while pregnant, longed for gin, which could not be gotten; and her child cried incessantly for six weeks till gin was given it, which it eagerly clutched and drank with ravenous greediness, stopped crying, and became healthy. 4. BEGIN TO EDUCATE CHILDREN AT CONCEPTION, and continue during their entire carriage. Yet maternal study, of little account before the sixth, after it, is most promotive of talents; which, next to goodness are the father's joy and the mother's pride. What pains are taken after they are born, to render them prodigies of learning, by the best of schools and teachers from their third year; whereas their mother's study, three months before their birth, would improve their intellects infinitely more. 5. MOTHERS, DOES GOD THUS PUT the endowment of your darlings into your moulding power? Then tremble in view of its necessary responsibilities, and learn how to wield them for their and your temporal and eternal happiness. {293} 6. QUALITIES OF THE MIND.--The qualities of the mind are perhaps as much liable to hereditary transmission as bodily configuration. [Illustration] Memory, intelligence, judgment, imagination, passions, diseases, and what is usually called genius, are often very markedly traced in the offspring.--I have known mental impressions forcibly impressed upon the offspring at the time of conception, as concomitant of some peculiar eccentricity, idiosyncracy, morbidness, waywardness, irritability, or proclivity of either one or both parents. 7. THE PLASTIC BRAIN.--The plastic brain of the foetus is prompt to receive all impressions. It retains them, and they become the characteristics of the child and the man. Low spirits, violent passions, irritability, frivolity, in the pregnant woman, leave indelible marks on the unborn child. 8. FORMATION OF CHARACTER.--I believe that pre-natal influences may do as much in the formation of character as all the education that can come after, and that mothers may, in a measure, "will," what that influence shall be, and that, as knowledge on the subject increases, it will be more and more under their control. In that, as in everything else, things that would be possible with one mother would not be with another, and measures that would be successful with one would produce opposite results from the other. 9. A HISTORICAL ILLUSTRATION.--A woman rode side by side with her soldier husband, and witnessed the drilling of troops for battle. The scene inspired her with a deep longing to see a battle and share in the excitements of the {294} conquerors. This was but a few months before her boy was born, and his name was Napoleon. 10. A MUSICIAN.--The following was reported by Dr. F. W. Moffatt, in the mother's own language: "When I was first pregnant, I wished my offspring to be a musician, so, during the period of that pregnancy, settled my whole mind on music, and attended every musical entertainment I possibly could. I had my husband, who has a violin, to play for me by the hour. When the child was born, it was a girl, which grew and prospered, and finally became an expert musician." 11. MURDEROUS INTENT.--The mother of a young man, who was hung not long ago, was heard to say: "I tried to get rid of him before he was born; and, oh, how I wish now that I had succeeded!" She added that it was the only time she had attempted anything of the sort; but, because of home troubles, she became desperate, and resolved that her burdens should not be made any greater. Does it not seem probable that the murderous intent, even though of short duration, was communicated to the mind of the child, and resulted in the crime for which he was hung? 12. THE ASSASSIN OF GARFIELD.--Guiteau's father was a man of integrity and considerable intellectual ability. His children were born in quick succession, and the mother was obliged to work very hard. Before this child was born, she resorted to every means, though unsuccessful, to produce abortion. The world knows the result. Guiteau's whole life was full of contradictions. There was little self-controlling power in him; no common sense, and not a vestige of remorse or shame. In his wild imagination, he believed himself capable of doing the greatest work, and of filling the loftiest station in life. Who will dare question that this mother's effort to destroy him while in embryo was the main cause in bringing him to the level of the brutes? 13. CAUTION.--Any attempt, on the part of the mother, to destroy her child before birth, is liable, if unsuccessful, to produce murderous tendencies. Even harboring murderous thoughts, whether toward her own child or not, might be followed by similar results. "The great King of kings Hath in the table of His law commanded That thou shalt do no murder. Wilt thou, then, Spurn at His edict, and fulfill a man's? Take heed, for He holds vengeance in His hand To hurl upon their heads that break his law."--RICHARD III., _Act 1._ * * * * * {295} How to Calculate the Time of Expected Labor. [Illustration: The Embryo In Sixty Days.] 1. The table on the opposite page has been very accurately compiled, and will be very helpful to those who desire the exact time. 2. The duration of pregnancy is from 278 to 280 days, or nearly forty weeks. The count should be made from the beginning of the last menstruation, and add eight days on account of the possibility of it occurring within that period The heavier the child the longer is the duration; the younger the woman the longer time it often requires. The duration is longer in married than in unmarried women; the duration is liable to be longer if the child is a female. 3. MOVEMENT.--The first movement is generally felt on the 135th day after impregnation. 4. GROWTH OF THE EMBRYO.--About the twentieth day the embryo resembles the appearance of an ant or lettuce seed; the 30th day the embryo is as large as a common horse fly; the 40th day the form resembles that of a person; in sixty days the limbs begin to form, and in four months the embryo takes the name of foetus. 5. Children born after seven or eight months can survive and develop to maturity. * * * * * {296} DURATION OF PREGNANCY. DIRECTIONS.--Find in the upper horizontal line the date on which the last menstruation ceased; the figure beneath gives the date of expected confinement (280 days). ________________________________________________________________ |Jan. | 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 | |Oct. | 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 | | | | |Feb. | 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 | |Nov. | 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 | | | | |Mar. | 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 | |Dec. | 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 | | | | |Apr. | 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 | |Jan. | 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 | | | | |May | 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 | |Feb. | 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 | | | | |June | 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 | |Mar. | 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 | | | | |July | 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 | |Apr. | 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 | | | | |Aug. | 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 | |May | 8 9 10 11 12 13 14 15 16 17 18 19 21 21 22 23 24 25 26 | | | | |Sept.| 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 | |June | 8 9 10 11 12 13 14 15 16 17 18 19 21 21 22 23 24 25 26 | | | | |Oct. | 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 | |July | 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 | | | | |Nov. | 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 | |Aug. | 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 | | | | |Dec. | 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 | |Sep. | 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 | ________________________________________________________________ _________________________________________________ Jan. | 20 21 22 23 24 25 26 27 28 29 30 31 | | Oct. | 27 28 29 30 31 1 2 3 4 5 6 7 |Nov. | | | | Feb. | 20 21 22 23 24 25 26 27 28 | | Nov. | 27 28 29 30 1 2 3 4 5 |Dec. | | | | Mar. | 20 21 22 23 24 25 26 27 28 19 30 31 | | Dec. | 25 26 27 28 29 30 31 1 2 3 4 5 |Jan. | | | | Apr. | 20 21 22 23 24 25 26 27 28 29 30 31 | | Jan. | 25 26 27 28 29 30 31 1 2 3 4 5 |Feb. | | | | May | 20 21 22 23 24 25 26 27 28 29 30 31 | | Feb. | 24 25 26 27 28 1 2 3 4 5 6 7 |Mar. | | | | June | 20 21 22 23 24 25 26 27 28 29 30 | | Mar. | 27 28 29 30 31 1 2 3 4 5 6 |Apr. | | | | July | 20 21 22 23 24 25 26 27 28 29 30 | | Apr. | 26 27 28 29 30 1 2 3 4 5 6 |May | | | | Aug. | 20 21 22 23 24 25 26 27 28 29 30 31 | | May | 27 28 29 30 31 1 2 3 4 5 6 7 |June | | | | Sept.| 20 21 22 23 24 25 26 27 28 29 30 | | June | 27 28 29 30 1 2 3 4 5 6 7 |July | | | | Oct. | 20 21 22 23 24 25 26 27 28 29 30 31 | | July | 27 28 29 30 31 1 2 3 4 5 6 7 |Aug. | | | | Nov. | 20 21 22 23 24 25 26 27 28 29 30 | | Aug. | 27 28 29 30 31 1 2 3 4 5 6 |Sep. | | | | Dec. | 20 21 22 23 24 25 26 27 23 29 30 31 | | Sep. | 26 27 28 29 30 1 2 3 4 5 6 7 |Oct. | _________________________________________________| [Illustration: _"The House We Live In" for nine months: showing the ample room provided by Nature when uncontracted by inherited inferiority of form or artificial dressing._] [Illustration: _A Contracted Pelvis. Deformity and Insufficient Space._] {297} 19. THIS IS WHAT DR. STOCKHAM says: "If women had _common sense_, instead of _fashion sense_, the corset would not exist. There are not words in the English language to express my convictions upon this subject. The corset more than any other one thing is responsible for woman's being the victim of disease and doctors.... "What is the effect upon the child? One-half of the children born in this country die before they are five years of age. Who can tell how much this state of things is due to the enervation of maternal life forces by the one instrument of torture? "I am a temperance woman. No one can realize more than I the devastation and ruin alcohol in its many tempting forms has brought to the human family. Still I solemnly believe that in weakness and deterioration of health, the corset has more to answer for than intoxicating drinks." When asked how far advanced a woman should be in pregnancy before she laid aside her corset, Dr. Stockham said with emphasis: "_The corset should not be worn for two hundred years before pregnancy takes place._ Ladies, it will take that time at least to overcome the ill-effect of tight garments which you think so essential." 20. PAINLESS PREGNANCY AND CHILD-BIRTH.--"Some excellent popular volumes," says Dr. Haff, "have been largely devoted to directions how to secure a comfortable period of pregnancy and painless delivery. After much conning of these worthy efforts to impress a little common sense upon the sisterhood, we are convinced that all may be summed up under the simple heads of: (1) An unconfined and lightly burdened waist; (2) Moderate but persistent outdoor exercise, of which walking is the best form; (3) A plain, unstimulating, chiefly fruit and vegetable diet; (4) Little or no intercourse during the time. "These are hygienic rules of benefit under any ordinary conditions; yet they are violated by almost every pregnant lady. If they are followed, biliousness, indigestion, constipation, swollen limbs, morning sickness and nausea--all will absent themselves or be much lessened. In pregnancy, more than at any other time, corsets are injurious. The waist and abdomen must be allowed to expand freely with the growth of the child. The great process of _evolution_ must have room." 21. IN ADDITION, we can do no better than quote the following recapitulation by Dr. Stockham in her famous {298} Tokology: "To give a woman the greatest immunity from suffering during pregnancy, prepare her for a safe and comparatively easy delivery, and insure a speedy recovery, all hygienic conditions must be observed. "The dress must give: "1. Freedom of movement; "2. No pressure upon any part of the body; "3. No more weight than is essential for warmth, and both weight and warmth evenly distributed. "These requirements necessitate looseness, lightness and warmth, which can be obtained from the union underclothes, a princess skirt and dress, with a shoe that allows full development and use of the foot. While decoration and elegance are desirable, they should not sacrifice comfort and convenience. 22. "LET THE DIET BE LIGHT, plain and nutritious. Avoid fats and sweets, relying mainly upon fruits and grain that contain little of the mineral salts. By this diet bilious and inflammatory conditions are overcome, the development of bone in the foetus lessened, and muscles necessary in labor nourished and strengthened. 23. "EXERCISE should be sufficient and of such a character as will bring into action gently every muscle of the body; but must particularly develop the muscles of the trunk, abdomen and groin, that are specially called into action in labor. Exercise, taken faithfully and systematically, more than any other means assists assimilative processes and stimulates the organs of excretion to healthy action. 24. "BATHING MUST BE FREQUENT and regular. Unless in special conditions the best results are obtained from tepid or cold bathing, which invigorates the system and overcomes nervousness. The sitz-bath is the best therapeutic and hygienic measure within the reach of the pregnant woman. "Therefore, to establish conditions which will overcome many previous infractions of law, _dress_ naturally and physiologically; _live_ much of the time _out of doors_; have _abundance_ of _fresh air_ in the house; let _exercise_ be _sufficient_ and _systematic_; pursue a _diet of fruit_, rice and vegetables; _regular rest_ must be faithfully taken; _abstain_ from the sexual relation. To those who will commit themselves to this course of life, patiently and persistently carrying it out through the period of gestation, the possibilities of attaining a healthy, natural, painless parturition will be remarkably increased. {299} 25. "IF THE FIRST EXPERIMENT should not result in a painless labor, it without doubt will prove the beginning of sound health. Persisted in through years of married life, the ultimate result will be more and more closely approximated, while there will be less danger of diseases after childbirth and better and more vigorous children will be produced. "Then pregnancy by every true woman will be desired, and instead of being a period of disease, suffering and direful forebodings, will become a period of health, exalted pleasure and holiest anticipations. Motherhood will be deemed the choicest of earth's blessings; women will rejoice in a glad maternity and for any self-denial will be compensated by healthy, happy, buoyant, grateful children." [Illustration] {300} [Illustration: A HAPPY MOTHER.] {301} Solemn Lessons for Parents. [Illustration: JOAN OF ARC.] 1. EXCESSIVE PLEASURES AND PAINS.--A woman during her time of pregnancy should of all women be most carefully tended, and kept from violent and excessive pleasures and pains; and at that time she should cultivate gentleness, benevolence and kindness. {302} 2. HEREDITARY EFFECTS.--Those who are born to become insane do not necessarily spring from insane parents, or from any ancestry having any apparent taint of lunacy in their blood, but they do receive from their progenitors certain impressions upon their mental and moral, as well as their physical beings, which impressions, like an iron mould, fix and shape their subsequent destinies. Hysteria in the mother may develop insanity in the child, while drunkenness in the father may impel epilepsy, or mania, in the son. Ungoverned passions in the parents may unloose the furies of unrestrained madness in the minds of their children, and the bad treatment of the wife may produce sickly or weak-minded children. 3. THE INFLUENCE OF PREDOMINANT PASSION may be transmitted from the parent to the child, just as surely as similarity of looks. It has been truly said that "the faculties which predominate in power and activity in the parents, when the organic existence of the child commences, determine its future mental disposition." A bad mental condition of the mother may produce serious defects upon her unborn child. 4. THE SINGULAR EFFECTS produced on the unborn child by the sudden mental emotions of the mother are remarkable examples of a kind of electrotyping on the sensitive surfaces of living forms. It is doubtless true that the mind's action in such cases may increase or diminish the molecular deposits in the several portions of the system. The precise place which each separate particle assumes in the new organic structure may be determined by the influence of thought or feeling. Perfect love and perfect harmony should exist between wife and husband during this vital period. 5. AN ILLUSTRATION.--If a sudden and powerful emotion of a woman's mind exerts such an influence upon her stomach as to excite vomiting, and upon her heart as almost to arrest its motion and induce fainting, can we believe that it will have no effect upon her womb and the fragile being contained within it? Facts and reason then, alike demonstrate the reality of the influence, and much practical advantage would result to both parent and child, were the conditions and extent of its operations better understood. 6. PREGNANT WOMEN should not be exposed to causes likely to distress or otherwise strongly impress their minds. A consistent life with worthy objects constantly kept in mind should be the aim and purpose of every expectant mother. {303} CASES CITED. We selected only a few cases to illustrate the above statement. Thousands of cases occur every year that might be cited to illustrate these principles. A mother cannot be too careful, and she should have the hearty co-operation and assistance of her husband. We quote the following cases from Dr. Pancoast's Medical Guide, who is no doubt one of the best authorities on the subject. 1. A woman bitten on the vulva by a dog, bore a child having a similar wound on the glans penis. The boy suffered from epilepsy, and when the fit came on, or during sleep, was frequently heard to cry out, "The dog bites me!" 2. A pregnant woman who was suddenly alarmed from seeing her husband come home with one side of his face swollen and distorted by a blow, bore a girl with a purple swelling upon the same side of the face. 3. A woman, who was forced to be present at the opening of a calf by a butcher, bore a child with all its bowels protruding from the abdomen. She was aware at the time of something going on within the womb. 4. A pregnant woman fell into a violent passion at not being able to procure a particular piece of meat of a butcher; she bled at the nose, and wiping the blood from her lips, bore a child wanting a lip. 5. A woman absent from home became alarmed by seeing a great fire in the direction of her own house, bore a child with a distinct mark of the flame upon its forehead. 6. A woman who had borne healthy children, became frightened by a beggar with a wooden leg and a stumped arm, who threatened to embrace her. Her next child had one stump leg and two stump arms. 7. A woman frightened in her first pregnancy by the sight of a child with a hare lip, had a child with a deformity of the same kind. Her second child had a deep slit, and the third a mark of a similar character or modified hare lips. In this instance the morbid mind of the mother affected several successive issues of her body. 8. A pregnant woman became frightened at a lizard jumping into her bosom. She bore a child with a fleshy excrescence exactly resembling a lizard, growing from the breast, adhering by the head and neck. * * * * * {304} The Care of New-Born Infants. [Illustration] 1. The first thing to be done ordinarily is to give the little stranger a bath by using soap and warm water. To remove the white material that usually covers the child use olive oil, goose oil or lard, and apply it with a soft piece of worn flannel, and when the child is entirely clean rub all off with a fresh piece of flannel. 2. Many physicians in the United States recommend a thorough oiling of the child with pure lard or olive oil, and then rub dry as above stated. By these means water is avoided, and with it much risk of taking cold. 3. The application of brandy or liquor is entirely unnecessary, and generally does more injury than good. {305} 4. If an infant should breathe feebly, or exhibit other signs of great feebleness, it should not be washed at once, but allowed to remain quiet and undisturbed, warmly wrapped up until the vital actions have acquired a fair degree of activity. 5. DRESSING THE NAVEL.--There is nothing better for dressing the navel than absorbent antiseptic cotton. There needs be no grease or oil upon the cotton. After the separation of the cord the navel should be dressed with a little cosmoline, still using the absorbent cotton. The navel string usually separates in a week's time; it may be delayed for twice this length of time, this will make no material difference, and the rule is to allow it to drop off of its own accord. 6. THE CLOTHING OF THE INFANT.--The clothing of the infant should be light, soft and _perfectly_ loose. A soft flannel band is necessary _only_ until the navel is healed. Afterwards discard bands entirely if you wish your babe to be happy and well. Make the dresses "Mother Hubbard"--Put on first a soft woolen shirt, then prepare the flannel skirts to hang from the neck like a slip. Make one kind with sleeves and one just like it without sleeves, then white muslin skirts (if they are desired), all the same way. Then baby is ready for any weather. In intense heat simply put on the one flannel slip with sleeves, leaving off the shirt. In Spring and Fall the shirt and skirt with no sleeves. In cold weather shirt and both skirts. These garments can be all put on at once, thus making the process of dressing very quick and easy. These are the most approved modern styles for dressing infants, and with long cashmere stockings pinned to the diapers the little feet are free to kick with no old-fashioned pinning blanket to torture the naturally active, healthy child, and retard its development. If tight bands are an injury to grown people, then in the name of pity emancipate the poor little infant from their torture! 7. THE DIAPER.--Diapers should be of soft linen, and great care should be exercised not to pin them too tightly. Never dry them, but always wash them thoroughly before being used again. 8. The band need not be worn after the navel has healed so that it requires no dressing, as it serves no purpose save to keep in place the dressing of the navel. The child's body should be kept thoroughly warm around the chest, bowels and feet. Give the heart and lungs plenty of room to heave. 9. The proper time for shortening the clothes is about three months in Summer and six months in Winter. {306} 10. INFANT BATHING.--The first week of a child's life it should not be entirely stripped and washed. It is too exhausting. After a child is over a week old it should be bathed every day; after a child is three weeks old it may be put in the water and supported with one hand while it is being washed with the other. Never, however, allow it to remain too long in the water. From ten to twenty minutes is the limit. Use Pears' soap or castile soap, and with a sponge wipe quickly, or use a soft towel. * * * * * NURSING. [Illustration] 1. The new-born infant requires only the mother's milk. The true mother will nurse her child if it is a possibility. The infant will thrive better and have many more chances for life. 2. The mother's milk is the natural food, and nothing can fully take its place. It needs no feeding for the first few days as it was commonly deemed necessary a few years ago. The secretions in the mother's breast are sufficient. 3. ARTIFICIAL FOOD.--Tokology says: "The best artificial food is cream reduced and sweetened with sugar of milk. Analysis shows that human milk contains more cream and sugar and less casein than the milk of animals. {307} 4. Milk should form the basis of all preparations of food. If the milk is too strong, indigestion will follow, and the child will lose instead of gaining strength. WEANING.--The weaning of the child depends much upon the strength and condition of the mother. If it does not occur in hot weather, from nine to twelve months is as long as any child should be nursed. FOOD IN WEANING.--Infants cry a great deal during weaning, but a few days of patient perseverance will overcome all difficulties. Give the child purely a milk diet, Graham bread, milk crackers and milk, or a little milk thickened with boiled rice, a little jelly, apple sauce, etc., may be safely used. Cracked wheat, oatmeal, wheat germ, or anything of that kind thoroughly cooked and served with a little cream and sugar, is an excellent food. MILK DRAWN FROM THE BREASTS.--If the mother suffers considerably from the milk gathering in the breast after weaning the child, withdraw it by taking a bottle that holds about a pint or a quart, putting a piece of cloth wrung out in warm water around the bottle, then fill it with boiling water, pour the water out and apply the bottle to the breast, and the bottle cooling will form a vacuum and will withdraw the milk into the bottle. This is one of the best methods now in use. RETURN OF THE MENSES.--If the menses return while the mother is nursing, the child should at once be weaned, for the mother's milk no longer contains sufficient nourishment. In case the mother should become pregnant while the child is nursing it should at once be weaned, or serious results will follow to the health of the child. A mother's milk is no longer sufficiently rich to nourish the child or keep it in good health. CARE OF THE BOTTLE.--If the child is fed on the bottle, great care should be taken in keeping it absolutely clean. Never use white rubber nipples. A plain form of bottle with a black rubber nipple is preferable. CHILDREN should not be permitted to come to the table until two years of age. CHAFING.--One of the best remedies is powdered lycopodium; apply it every time the babe is cleaned; but first wash with pure castile soap; Pears' soap is also good. A preparation of oxide of zinc is also highly recommended. Chafing sometimes results from an acid condition of the stomach; in that case give a few doses of castoria. COLIC.--If an infant is seriously troubled with colic, there is nothing better than camomile or catnip tea. Procure the leaves and make tea and give it as warm as the babe can bear. * * * * * {308} FEEDING INFANTS. 1. The best food for infants is mother's milk; next best is cow's milk. Cow's milk contains about three times as much curd and one-half as much sugar, and it should be reduced with two parts of water. 2. In feeding cow's milk there is too little cream and too little sugar, and there is no doubt no better preparation than Mellin's food to mix it with (according to directions). 3. Children being fed on food lacking fat generally have their teeth come late; their muscles will be flabby and bones soft. Children will be too fat when their food contains too much sugar. Sugar always makes their flesh soft and flabby. 4. During the first two months the baby should be fed every two hours during the day, and two or three times during the night, but no more. Ten or eleven feedings for twenty-four hours are all a child will bear and remain healthy. At three months the child may be fed every three hours instead of every two. 5. Children can be taught regular habits by being fed and put to sleep at the same time every day and evening. Nervous diseases are caused by irregular hours of sleep and diet, and the use of soothing medicines. 6. A child five or six months old should not be fed during the night--from nine in the evening until six or seven in the morning, as overfeeding causes most of the wakefulness and nervousness of children during the night. 7. If a child vomits soon after taking the bottle, and there is an appearance of undigested food in the stool, it is a sign of overfeeding. If a large part of the bottle has been vomited, avoid the next bottle at regular time and pass over one bottle. If the child is nursing the same principles apply. 8. If a child empties its bottle and sucks vigorously its fingers after the bottle is emptied, it is very evident that the child is not fed enough, and should have its food gradually increased. 9. Give the baby a little cold water several times a day. * * * * * INFANTILE CONVULSIONS. DEFINITION.--An infantile convulsion corresponds to a chill in an adult, and is the most common brain affection among children. CAUSES.--Anything that irritates the nervous system may cause convulsions in the child, as teething, indigestible food, worms, dropsy of the brain, hereditary constitution, or they may be the accompanying symptom in nearly all the {309} acute diseases of children, or when the eruption is suppressed in eruptive diseases. SYMPTOMS.--In case of convulsions of a child parents usually become frightened, and very rarely do the things that should be done in order to afford relief. The child, previous to the fit, is usually irritable, and the twitching of the muscles of the face may be noticed, or it may come on suddenly without warning. The child becomes insensible, clenches its hands tightly, lips turn blue, and the eyes become fixed, usually frothing from the mouth with head turned back. The convulsion generally lasts two or three minutes; sometimes, however, as long as ten or fifteen minutes, but rarely. REMEDY.--Give the child a warm bath and rub gently. Clothes wrung out of cold water and applied to the lower and back part of the head and plenty of fresh air will usually relieve the convulsion. Be sure and loosen the clothing around the child's neck. After the convulsion is over, give the child a few doses of potassic bromide, and an injection of castor oil if the abdomen is swollen. Potassic bromide should be kept in the house, to use in case of necessity. [Illustration] {310} Pains and Ills in Nursing. [Illustration: The City Hospital.--A Homeless and Friendless Mother.] 1. SORE NIPPLES.--If a lady, during the latter few months of her pregnancy, were to adopt "means to harden the nipples," sore nipples during the period of suckling would not be so prevalent as they are. 2. CAUSE.--A sore nipple is frequently produced by the injudicious custom of allowing the child to have the nipple {311} almost constantly in his mouth. Another frequent cause of a sore nipple is from the babe having the canker. Another cause of a sore nipple is from the mother, after the babe has been sucking, putting up the nipple wet. She, therefore, ought always to dry the nipple, not by rubbing, but by dabbing it with a soft cambric or lawn handkerchief, or with a piece of soft linen rag--one or the other of which ought always to be at hand--every time directly after the child has done sucking, and just before applying any of the following powders or lotions to the nipple. 3. REMEDIES.--One of the best remedies for a sore nipple is the following powder: Take of--Borax, one drachm; Powdered Starch, seven drachms. Mix.--A pinch of the powder to be frequently applied to the nipple. If the above does not cure, try Glycerine by applying it each time after nursing. 4. GATHERED BREAST.--A healthy-woman with a well-developed breast and a good nipple, scarcely, if ever, has a gathered bosom; it is the delicate, the ill-developed breasted and worse-developed nippled lady who usually suffers from this painful complaint. And why? The evil can generally be traced to girlhood. If she be brought up luxuriously, her health and her breasts are sure to be weakened, and thus to suffer, more especially if the development of the bosoms and nipples has been arrested and interfered with by tight stays and corsets. Why, the nipple is by them drawn in, and retained on the level with the breast--countersunk--as though it were of no consequence to her future well-being, as though it were a thing of nought. 5. TIGHT LACERS.--Tight lacers will have to pay the penalties of which they little dream. Oh, the monstrous folly of such proceedings! When will mothers awake from their lethargy? It is high time that they did so! From the mother having "no nipple," the effects of tight lacing, many a home has been made childless, the babe not being able to procure its proper nourishment, and dying in consequence! It is a frightful state of things! But fashion, unfortunately, blinds the eyes and deafens the ears of its votaries! 6. BAD BREAST.--A gathered bosom, or "bad breast," as it is sometimes called, is more likely to occur after a first confinement and during the first month. Great care, therefore, ought to be taken to avoid such a misfortune. A gathered breast is frequently owing to the carelessness of a {312} mother in not covering her bosoms during the time she is suckling. Too much attention cannot be paid to keeping the breasts comfortably warm. This, during the act of nursing, should be done by throwing either a shawl or a square of flannel over the neck, shoulders, and bosoms. 7. ANOTHER CAUSE.--Another cause of gathered breasts arises from a mother sitting up in bed to suckle her babe. He ought to be accustomed to take the bosom while she is lying down; if this habit is not at first instituted, it will be difficult to adopt it afterwards. Good habits may be taught a child from earliest babyhood. 8. FAINTNESS.--When a nursing mother feels faint, she ought immediately to lie down and take a little nourishment; a cup of tea with the yolk of an egg beaten up in it, or a cup of warm milk, or some beef-tea, any of which will answer the purpose extremely well. Brandy, or any other spirit we would not recommend, as it would only cause, as soon as the immediate effects of the stimulant had gone off, a greater depression to ensue; not only so, but the frequent taking of brandy might become a habit--a necessity--which would be a calamity deeply to be deplored! 9. STRONG PURGATIVES.--Strong purgatives during this period are highly improper, as they are apt to give pain to the infant, as well as to injure the mother. If it be absolutely necessary to give physic, the mildest, such as a dose of castor oil, should be chosen. 10. HABITUALLY COSTIVE.--When a lady who is nursing is habitually costive, she ought to eat brown instead of white bread. This will, in the majority of cases, enable her to do without an aperient. The brown bread may be made with flour finely ground all one way; or by mixing one part of bran and three parts of fine wheaten flour together, and then making it in the usual way into bread. Treacle instead of butter, on the brown bread increases its efficacy as an aperient; and raw should be substituted for lump sugar in her tea. 11. TO PREVENT CONSTIPATION.--Stewed prunes, or stewed French plums, or stewed Normandy pippins, are excellent remedies to prevent constipation. The patient ought to eat, every morning, a dozen or fifteen of them. The best way to stew either prunes or French plums, is the following:--Put a pound of either prunes or French plums, and two tablespoonfuls of raw sugar, into a brown jar; cover them with water; put them into a slow oven, and stew them for three or four hours. Both stewed rhubarb and stewed {313} pears often act as mild and gentle aperients. Muscatel raisins, eaten at dessert, will oftentimes without medicine relieve the bowels. 12. COLD WATER.--A tumblerful of cold water, taken early every morning, sometimes effectually relieves the bowels; indeed, few people know the value of cold water as an aperient--it is one of the best we possess, and, unlike drug aperients, can never by any possibility do any harm. An injection of warm water is one of the best ways to relieve the bowels. 13. WELL-COOKED VEGETABLES.--Although a nursing mother ought, more especially if she be costive, to take a variety of well-cooked vegetables, such as potatoes, asparagus, cauliflower, French beans, spinach, stewed celery and turnips; she should avoid eating greens, cabbages, and pickles, as they would be likely to affect the babe, and might cause him to suffer from gripings, from pain, and "looseness" of the bowels. 14. SUPERSEDE THE NECESSITY OF TAKING PHYSIC.--Let me again--for it cannot be too urgently insisted upon--strongly advise a nursing mother to use every means in the way of diet, etc., to supersede the necessity of taking physic (opening medicine), as the repetition of aperients injures, and that severely, both herself and child. Moreover, the more opening medicine she swallows, the more she requires; so that if she once gets into the habit of regularly taking physic, the bowels will not act without them. What a miserable existence to be always swallowing physic! [Illustration] {314} Home Lessons in Nursing Sick Children. [Illustration: HEALTHY YOUTH AND RIPE OLD AGE.] 1. MISMANAGEMENT.--Every doctor knows that a large share of the ills to which infancy is subject are directly traceable to mismanagement. Troubles of the digestive system are, for the most part due to errors, either in the selection of the food or in the preparation of it. 2. RESPIRATORY DISEASES.--Respiratory diseases or the diseases of the throat and lungs have their origin, as a rule, in want of care and judgment in matters of clothing, bathing and exposure to cold and drafts. A child should always be dressed to suit the existing temperature of the weather. {315} 3. NERVOUS DISEASES.--Nervous diseases are often aggravated if not caused by over-stimulation of the brain, by irregular hours of sleep, or by the use of "soothing" medicines, or eating indigestible food. 4. SKIN AFFECTIONS.--Skin affections are generally due to want of proper care of the skin, to improper clothing or feeding, or to indiscriminate association with nurses and children, who are the carriers of contagious diseases. 5. PERMANENT INJURY.--Permanent injury is often caused by lifting the child by one hand, allowing it to fall, permitting it to play with sharp instruments, etc. 6. RULES AND PRINCIPLES.--Every mother should understand the rules and principles of home nursing. Children are very tender plants and the want of proper knowledge is often very disastrous if not fatal. Study carefully and follow the principles and rules which are laid down in the different parts of this work on nursing and cooking for the sick. 7. WHAT A MOTHER SHOULD KNOW: I. INFANT FEEDING.--The care of milk, milk sterilization, care of bottles, preparation of commonly employed infant foods, the general principles of infant feeding, with rules as to quality and frequency. II. BATHING.--The daily bath; the use of hot, cold and mustard baths. III. HYGIENE OF THE SKIN. Care of the mouth, eyes and ears. Ventilation, temperature, cleanliness, care of napkins, etc. IV. TRAINING OF CHILDREN in proper bodily habits. Simple means of treatment in sickness, etc. 8. THE CRY OF THE SICK CHILD.--The cry of the child is a language by which the character of its suffering to some extent may be ascertained. The manner in which the cry is uttered, or the pitch and tone is generally a symptom of a certain kind of disease. 9. STOMACHACHE.--The cry of the child in suffering with pain of the stomach is loud, excitable and spasmodic. The legs are drawn up and as the pain ceases, they are relaxed and the child sobs itself to sleep, and rests until awakened again by pain. 10. LUNG TROUBLE.--When a child is suffering with an affection of the lungs or throat, it never cries loudly or continuously. A distress in breathing causes a sort of subdued cry and low moaning. If there is a slight cough it is generally a sign that there is some complication with the lungs. {316} 11. DISEASE OF THE BRAIN.--In disease of the brain the cry is always sharp, short and piercing. Drowsiness generally follows each spasm of pain. 12. FEVERS.--Children rarely cry when suffering with fever unless they are disturbed. They should be handled very gently and spoken to in a very quiet and tender tone of voice. 13. THE CHAMBER OF THE SICK ROOM.--The room of the sick child should be kept scrupulously clean. No noise should disturb the quiet and rest of the child. If the weather is mild, plenty of fresh air should be admitted; the temperature should be kept at about 70 degrees. A thermometer should be kept in the room, and the air should be changed several times during the day. This may be done with safety to the child by covering it up with woolen blankets to protect it from draft, while the windows and doors are opened. Fresh air often does more to restore the sick child than the doctor's medicine. Take the best room in the house. If necessary take the parlor, always make the room pleasant for the sick. 14. VISITORS.--Carefully avoid the conversation of visitors or the loud and boisterous playing of children in the house. If there is much noise about the house that cannot be avoided, it is a good plan to put cotton in the ears of the patient. 15. LIGHT IN THE ROOM.--Light has a tendency to produce nervous irritability, consequently it is best to exclude as much daylight as possible and keep the room in a sort of twilight until the child begins to improve. Be careful to avoid any odor coming from a burning lamp in the night. When the child begins to recover, give it plenty of sunlight. After the child begins to get better let in all the sunlight the windows will admit. Take a south room for the sick bed. 16. SICKNESS IN SUMMER.--If the weather is very hot it is a good plan to dampen the floors with cold water, or set several dishes of water in the room, but be careful to keep the patient out of the draft, and avoid any sudden change of temperature. 17. BATHING.--Bathe every sick child in warm water once a day unless prohibited by the doctor. If the child has a spasm or any attack of a serious nervous character in absence of the doctor, place him in a hot bath at once. Hot water is one of the finest agencies for the cure of nervous diseases. {317} [Illustration] 18. SCARLET FEVER AND MEASLES.--Bathe the child in warm water to bring out the rash, and put in about a dessertspoonful of mustard into each bath. 19. DRINKS.--If a child is suffering with fevers, let it have all the water it wants. Toast-water will be found nourishing. When the stomach of the child is in an irritable condition, nourishments containing milk or any other fluid should be given very sparingly. Barley-water and rice-water are very soothing to an irritable stomach. 20. FOOD.--Mellin's Food and milk is very nourishing if the child will take it. Oatmeal gruel, white of eggs, etc. are excellent and nourishing articles. See "How to cook for the Sick." 21. EATING FRUIT.--Let children who are recovering from sickness eat moderately of good fresh fruit. Never let a child, whether well or sick, eat the skins of any kind of fruit. The outer covering of fruit was not made to eat, and often has poisonous matter very injurious to health upon its surface. Contagious and infectious diseases are often communicated in that way. 22. SUDDEN STARTINGS with the thumbs drawn into the palms, portend trouble with the brain, and often end in convulsions, which are far more serious in infants than in children. Convulsions in children often result from a suppression of urine. If you have occasion to believe that such is the case, get the patient to sweating as soon as possible. Give it a hot bath, after which cover it up in bed and put bags of hot salt over the lower part of the abdomen. 23. SYMPTOMS OF INDIGESTION.--If the baby shows symptoms of indigestion, do not begin giving it medicine. It is wiser to decrease the quantity and quality of the food and let the little one omit one meal entirely, that his stomach may rest. Avoid all starchy foods, as the organs of digestion are not sufficiently developed to receive them. * * * * * {318} A Practical Rule for Feeding a Baby on Cow's Milk. Cow's milk is steadily growing in favor as an artificial food. Country milk should be used instead of milk purchased in town or city. RULE--Take the upper half of milk that has stood an hour of two, dilute, not hardly as much as a third, with sweetened water, and if there is a tendency to sour stomach, put in a teaspoonful of lime water to every quart. The milk and water should both be boiled separately. If the baby is constipated, it is best to heat the milk over boiling water and not allow it to boil. INFANT FOOD FOR 24 HOURS. Age of Child. Milk. Water. Total. 2 to 10 days 1-1/4 gills 3-1/4 gills 4-1/2 gills 10 to 20 days 1-3/4 gills 4-1/4 gills 6 gills 20 to 30 days 2-1/2 gills 6 gills 8-1/2 gills 1 to 1-1/2 months 3 gills 6-3/4 gills 9-3/4 gills 1-1/2 to 2 months 3-1/2 gills 7 gills 10-1/2 gills 2 to 2-1/2 months 4 gills 7-1/2 gills 11-1/2 gills 2-1/2 to 3 months 4-1/2 gills 7-1/2 gills 12 gills 3 to 3-1/2 months 5 gills 7-1/2 gills 12-1/2 gills 3-1/2 to 4 months 5-1/2 gills 7-1/2 gills 13 gills 4 to 4-1/2 months 6 gills 7-1/2 gills 13-1/2 gills 4-1/2 to 5 months 6-1/2 gills 7-1/2 gills 14 gills 5 to 6 months 7 gills 7 gills 14 gills 6-1/2 to 7 months 7-1/2 gills 6-1/2 gills 14 gills 7 to 8 months 8 gills 6 gills 14 gills 8 to 9 months 8-1/4 gills 6 gills 14-1/4 gills 9 to 10 months 8-1/2 gills 6 gills 14-1/2 gills 10 to 11 months 8-3/4 gills 6 gills 14-3/4 gills 11 to 12 months 9 gills 5-1/2 gills 14-1/2 gills 12 to 15 months 9-1/4 gills 5-1/4 gills 14-1/2 gills 15 to 18 months 9-1/2 gills 5 gills 14-1/2 gills 18 and more months 10 gills 5 gills 15 gills * * * * * {319} HOW TO KEEP A BABY WELL. [Illustration: A delicate child should never be put into the bath, but bathed on the lap and kept warmly covered.] 1. The mother's milk is the natural food, and nothing can fully take its place. 2. The infant's stomach does not readily accommodate itself to changes in diet; therefore, regularity in quality, quantity and temperature is extremely necessary. 3. Not until a child is a year old should it be allowed any food except that of milk, and possibly a little cracker or bread, thoroughly soaked and softened. 4. Meat should never be given to very young children. The best artificial food is cream, reduced and sweetened with sugar and milk. No rule can be given for its reduction. Observation and experience must teach that, because every child's stomach is governed by a rule of its own. 5. A child can be safely weaned at one year of age, and sometimes less. It depends entirely upon the season, and upon the health of the child. 6. A child should never be weaned during the warm weather, in June, July or August. 7. When a child is weaned it may be given, in connection {320} with the milk diet, some such nourishment as broth, gruel, egg, or some prepared food. 8. A child should never be allowed to come to the table until two years of age. 9. A child should never eat much starchy food until four years old. 10. A child should have all the water it desires to drink, but it is decidedly the best to boil the water first, and allow it to cool. All the impurities and disease germs are thereby destroyed. This one thing alone will add greatly to the health and vigor of the child. 11. Where there is a tendency to bowel disorder, a little gum arabic, rice, or barley may be boiled with the drinking water. 12. If the child uses a bottle it should be kept absolutely clean. It is best to have two or three bottles, so that one will always be perfectly clean and fresh. 13. The nipple should be of black or pure rubber, and not of the white or vulcanized rubber; it should fit over the top of the bottle. No tubes should ever be used; it is impossible to keep them clean. 14. When the rubber becomes coated, a little coarse salt will clean it. 15. Babies should be fed at regular times. They should also be put to sleep at regular hours. Regularity is one of the best safeguards to health. 16. Milk for babies and children should be from healthy cows. Milk from different cows varies, and it is always better for a child to have milk from the same cow. A farrow cow's milk is preferable, especially if the child is not very strong. 17. Many of the prepared foods advertised for children are of little benefit. A few may be good, but what is good for one child may not be for another. So it must be simply a matter of experiment if any of the advertised foods are used. 18. It is a physiological fact that an infant is always healthier and better to sleep alone. It gets better air and is not liable to suffocation. 19. A healthy child should never be fed in less than two hours from the last time they finished before, gradually lengthening the time as it grows older. At 4 months 3½ or 4 hours; at 5 months a healthy child will be better if given nothing in the night except, perhaps, a little water. 20. Give an infant a little water several times a day. 21. A delicate child the first year should be oiled after each bath. The oiling may often take the place of the bath, in case of a cold. 22. In oiling a babe, use pure olive oil, and wipe off thoroughly after each application. For nourishing a weak child use also olive oil. 23. For colds, coughs, croup, etc., use goose oil externally and give a teaspoonful at bed-time. * * * * * {321} HOW TO PRESERVE THE HEALTH AND LIFE OF YOUR INFANT DURING HOT WEATHER. [Illustration: FOUND UPON THE DOOR STEP.] _BATHING._ 1. Bathe infants daily in tepid water and even twice a day in hot weather. If delicate they should be sponged instead of immersing them in water, but cleanliness is absolutely necessary for the health of infants. _CLOTHING._ 2. Put no bands in their clothing, but make all garments to hang loosely from the shoulders, and have all their clothing _scrupulously clean_; even the diaper should not be re-used without rinsing. {322} _SLEEP ALONE._ 3. The child should in all cases sleep by itself on a cot or in a crib and retire at a regular hour. A child _always_ early taught to go to sleep without rocking or nursing is the healthier and happier for it. Begin _at birth_ and this will be easily accomplished. _CORDIALS AND SOOTHING SYRUPS._ 4. Never give cordials, soothing syrups, sleeping drops, etc., without the advice of a physician. A child that frets and does not sleep is either hungry or ill. _If ill it needs a physician._ Never give candy or cake to quiet a small child, they are sure to produce disorders of the stomach, diarrhoea or some other trouble. _FRESH AIR._ 5. Children should have plenty of fresh air summer as well as winter. Avoid the severe hot sun and the heated kitchen for infants in summer. Heat is the great destroyer of infants. In excessive hot weather feed them with chips of ice occasionally, if you have it. _CLEAN HOUSES._ 6. Keep your house clean and cool and well aired night and day. Your cellars cleared of all rubbish and whitewashed every spring, your drains cleaned with strong solution of copperas or chloride of lime, poured down them once a week. Keep your gutters and yards clean and insist upon your neighbors doing the same. _EVACUATIONS OF A CHILD._ The healthy motion varies from light orange yellow to greenish yellow, in number, two to four times daily. Smell should never be offensive. Slimy mucous-like jelly passages indicate worms. Pale green, offensive, acrid motions indicate disordered stomach. Dark green indicate acid secretions and a more serious trouble. Fetid dark brown stools are present in chronic diarrhoea. Putty-like pasty passages are due to acidity curdling the milk or to torpid liver. {323} [Illustration] _BREAST MILK._ 7. Breast milk is the only proper food for infants, until after the second summer. If the supply is small keep what you have and feed the child in connection with it, for if the babe is ill this breast milk may be all that will save its life. _STERILIZED MILK._ 8. Milk is the best food. Goat's milk best, cows milk next. If the child thrives on this _nothing else_ should be given during the hot weather, until the front teeth are cut. Get fresh cow's milk twice a day if the child requires food in the night, pour it into a glass fruit jar with one-third pure water for a child under three months old, afterwards the proportion of water may be less and less, also a trifle of sugar may be added. Then place the jar in a kettle or pan of cold water, like the bottom of an oatmeal kettle. Leave the cover of the jar loose. Place it on the stove and let the water come to a boil and boil ten minutes, screw down the cover tight and boil ten minutes more, then remove from the fire, and allow it to cool in the water slowly so as not to break the jar. When partly cool put on the ice or in a cool place, and keep tightly covered except when the milk is poured out for use. The glass jar must be kept perfectly clean and washed {324} and scalded carefully before use. A tablespoonful of lime water to a bottle of milk will aid indigestion. Discard the bottle as soon as possible and use a cup which you know is clean, whereas a bottle must be kept in water constantly when not in use, or the sour milk will make the child sick. Use no tube for it is exceedingly hard to keep it clean, and if pure milk cannot be had, condensed milk is admirable and does not need to be sterilized as the above. _DIET._ 9. Never give babies under two years old such food as grown persons eat. Their chief diet should be milk, wheat bread and milk, oatmeal, possibly a little rare boiled egg, but always and chiefly milk. Germ wheat is also excellent. _EXERCISE._ 10. Children should have exercise in the house as well as outdoors, but should not be jolted and jumped and jarred in rough play, not rudely rocked in the cradle, nor carelessly trundled over bumps in their carriages. They should not be held too much in the arms, but allowed to crawl and kick upon the floor and develop their limbs and muscles. A child should not be lifted by its arms, nor dragged along by one hand after it learns to take a few feeble steps, but when they do learn to walk steadily it is the best of all exercise, especially in the open air. Let the children as they grow older romp and play in the open air all they wish, girls as well as boys. Give the girls an even chance for health, while they are young at least, and don't mind about their complexion. [Illustration] {325} Infant Teething. [Illustration] 1. REMARKABLE INSTANCES.--There are instances where babies have been born with teeth, and, on the other hand, there are cases of persons who have never had any teeth at all; and others that had double teeth all around in both upper and lower jaws, but these are rare instances, and may be termed as a sort of freaks of nature. 2. INFANT TEETHING.--The first teeth generally make their appearance after the third month, and during the period of teething the child is fretful and restless, causing sometimes constitutional disturbances, such as diarrhoea, indigestion, etc. Usually, however, no serious results follow, and no unnecessary anxiety need be felt, unless the weather is extremely warm, then there is some danger of summer complaint setting in and seriously complicating matters. 3. THE NUMBER OF TEETH.--Teeth are generally cut in pairs and make their appearance first in the front and going backwards until all are complete. It generally takes about {326} two years for a temporary set of children's teeth. A child two or three years old should have twenty teeth. After the age of seven they generally begin to loosen and fall out and permanent teeth take their place. 4. LANCING THE GUMS.--This is very rarely necessary. There are extreme cases when the condition of the mouth and health of the child demand a physician's lance but this should not be resorted to, unless it is absolutely necessary. When the gums are very much swollen and the tooth is nearly through, the pains may be relieved by the mother taking a thimble and pressing it down upon the tooth, the sharp edges of the tooth will cut through the swollen flesh, and instant relief will follow. A child in a few hours or a day will be perfectly happy after a very severe and trying time of sickness. 5. PERMANENT TEETH.--The teeth are firmly inserted in sockets of the upper and lower jaw. The permanent teeth which follow the temporary teeth, when complete, are sixteen in each jaw, or thirty-two in all. 6. NAMES OF TEETH.--There are four incisors (front teeth), four cuspids (eye teeth), four bicuspids (grinders), and four molars (large grinders), in each jaw. Each tooth is divided into the crown, body, and root. The crown is the grinding surface; the body--the part projecting from the jaw--is the seat of sensation and nutrition; the root is that portion of the tooth which is inserted in the alveolus. The teeth are composed of dentine (ivory) and enamel. The ivory forms the greater portion of the body and root, while the enamel covers the exposed surface. The small white cords communicating with the teeth are the nerves. [Illustration] {327} HOME TREATMENT FOR THE DISEASES OF INFANTS AND CHILDREN. [Illustration] 1. Out of the 984,000 persons that died during the year of 1890, 227,264 did not reach one year of age, and 400,647 died under five years of age. What a fearful responsibility therefore rests upon the parents who permit these hundreds of thousands of children to die annually. This terrible mortality among children is undoubtedly largely the result of ignorance as regarding to the proper care and treatment of sick children. 2. For very small children it is always best to use homoeopathic remedies. _COLIC._ 1. Babies often suffer severely with colic. It is not considered dangerous, but causes considerable suffering. 2. Severe colic is usually the result of derangement of the liver in the mother, or of her insufficient or improper nourishment, and it occurs more frequently when the child is from two to five months old. {328} 3. Let the mother eat chiefly barley, wheat and bread, rolled wheat, graham bread, fish, milk, eggs and fruit. The latter may be freely eaten, avoiding that which is very sour. 4. A rubber bag or bottle filled with hot water put into a crib, will keep the child, once quieted, asleep for hours. If a child is suffering from colic, it should be thoroughly warmed and kept warm. 5. Avoid giving opiates of any kind, such as cordials, Mrs. Winslow's Soothing Syrup, "Mother's Friend," and various other patent medicines. They injure the stomach and health of the child, instead of benefiting it. 6. REMEDIES.--A few tablespoonfuls of hot water will often allay a severe attack of the colic. Catnip tea is also a good remedy. A drop of essence of peppermint in 6 or 7 teaspoonfuls of hot water will give relief. If the stools are green and the child is very restless, give chamomilla. If the child is suffering from constipation, and undigested curds of milk appear in its fæces, and the child starts suddenly in its sleep, give nux vomica. An injection of a few spoonfuls of hot water into the rectum with a little asafoetida is an effective remedy, and will be good for an adult. _CONSTIPATION._ 1. This is a very frequent ailment of infants. The first thing necessary is for the mother to regulate her diet. 2. If the child is nursed regularly and held out at the same time of each day, it will seldom be troubled with this complaint. Give plenty of _water_. Regularity of habit is the remedy. If this method fails, use a soap suppository. Make it by paring a piece of white castile soap round. It should be made about the size of a lead pencil, pointed at the end. 3. Avoid giving a baby drugs. Let the physician administer them if necessary. {329} _DIARRHOEA._ Great care should be exercised by parents in checking the diarrhoea of children. Many times serious diseases are brought on by parents being too hasty in checking this disorder of the bowels. It is an infant's first method of removing obstructions and overcoming derangements of the system. _SUMMER COMPLAINT._ 1. Summer complaint is an irritation and inflammation of the lining membranes of the intestines. This may often be caused by teething, eating indigestible food, etc. 2. If the discharges are only frequent and yellow and not accompanied with pain, there is no cause for anxiety; but if the discharges are green, soon becoming gray, brown and sometimes frothy, having a mixture of phlegm, and sometimes containing food undigested, a physician had better be summoned. 3. For mild attacks the following treatment may be given: 1) Keep the child perfectly quiet and keep the room well aired. 2) Put a drop of tincture of camphor on a teaspoonful of sugar, mix thoroughly; then add 6 teaspoonfuls of hot water and give a teaspoonful of the mixture every ten minutes. This is indicated where the discharges are watery, and where there is vomiting and coldness of the feet and hands. Chamomilla is also an excellent remedy. Ipecac and nux vomica may also be given. In giving homoeopathic remedies, give 5 or 6 pellets every 2 or 3 hours. 3) The diet should be wholesome and nourishing. _FOR TEETHING._ If a child is suffering with swollen gums, is feverish, restless, and starts in its sleep, give nux vomica. {330} WORMS. _PIN WORMS._ Pin worms and round worms are the most common in children. They are generally found in the lower bowels. SYMPTOMS.--Restlessness, itching about the anus in the fore part of the evening, and worms in the fæces. TREATMENT.--Give with a syringe an injection of a tablespoonful of linseed oil. Cleanliness is also very necessary. _ROUND WORMS._ A round worm is from six to sixteen inches in length, resembling the common earth worm. It inhabits generally the small intestines, but it sometimes enters the stomach and is thrown up by vomiting. SYMPTOMS.--Distress, indigestion, swelling of the abdomen, grinding of the teeth, restlessness, and sometimes convulsions. TREATMENT.--One teaspoonful of powdered wormseed mixed with a sufficient quantity of molasses, or spread on bread and butter. Or, one grain of santonine every four hours for two or three days, followed by a brisk cathartic. Wormwood tea is also highly recommended. SWAIM'S VERMIFUGE. 2 ounces wormseed, 1½ ounces valerian, 1½ ounces rhubarb, 1½ ounces pink-root, 1½ ounces white agaric. Boil in sufficient water to yield 3 quarts of decoction, and add to it 30 drops of oil of tansy and 45 drops of oil of cloves, dissolved in a quart of rectified spirits. Dose, 1 teaspoonful at night. _ANOTHER EXCELLENT VERMIFUGE._ Oil of wormseed, 1 ounce, Oil of anise, 1 ounce, Castor oil, 1 ounce, Tinct. of myrrh, 2 drops, Oil of turpentine, 10 drops. Mix thoroughly. Always shake well before using. Give 10 to 15 drops in cold coffee, once or twice a day. * * * * * {331} HOW TO TREAT CROUP SPASMODIC AND TRUE. _SPASMODIC CROUP._ [Illustration] DEFINITION.--A spasmodic closure of the glottis which interferes with respiration. Comes on suddenly and usually at night, without much warning. It is a purely nervous disease and may be caused by reflex nervous irritation from undigested food in the stomach or bowels, irritation of the gums in dentition, or from brain disorders. SYMPTOMS.--Child awakens suddenly at night with suspended respiration or very difficult breathing. After a few respirations it cries out and then falls asleep quietly, or the attack may last an hour or so, when the face will become pale, veins in the neck become turgid and feet and hands contract spasmodically. In mild cases the attacks will only occur once during the night, but may recur on the following night. HOME TREATMENT.--During the paroxysm dashing cold water in the face is a common remedy. To terminate the spasm and prevent its return give teaspoonful doses of {332} powdered alum. The syrup of squills is an old and tried remedy; give in 15 to 30 drop doses and repeat every 10 minutes till vomiting occurs. Seek out the cause if possible and remove it. It commonly lies in some derangement of the digestive organs. _TRUE CROUP._ DEFINITION.--This disease consists of an inflammation of the mucous membrane of the upper air passages, particularly of the larynx with the formation of a false membrane that obstructs the breathing. The disease is most common in children between the ages of two and seven years, but it may occur at any age. SYMPTOMS.--Usually there are symptoms of a cold for three or four days previous to the attack. Marked hoarseness is observed in the evening with a ringing metallic cough and some difficulty in breathing, which increases and becomes somewhat paroxysmal till the face which was at first flushed becomes pallid and ashy in hue. The efforts at breathing become very great, and unless the child gets speedy relief it will die of suffocation. HOME TREATMENT.--Patient should be kept in a moist warm atmosphere, and cold water applied to the neck early in the attack. As soon as the breathing seems difficult give a half to one teaspoonful of powdered alum in honey to produce vomiting and apply the remedies suggested in the treatment of diphtheria, as the two diseases are thought by many to be identical. When the breathing becomes labored and face becomes pallid, the condition is very serious and a physician should be called without delay. _SCARLET FEVER._ DEFINITION.--An eruptive contagious disease, brought about by direct exposure to those having the disease, or by contact with clothing, dishes, or other articles, used about the sick room. The clothing may be disinfected by heating to a temperature of 230° Fahrenheit or by dipping in boiling water before washing. {333} Dogs and cats will also carry the disease and should be kept from the house, and particularly from the sick room. SYMPTOMS.--Chilly sensations or a decided chill, fever, headache, furred tongue, vomiting, sore throat, rapid pulse, hot dry skin and more or less stupor. In from 6 to 18 hours a fine red rash appears about the ears, neck and shoulders, which rapidly spreads to the entire surface of the body. After a few days, a scurf or branny scales will begin to form on the skin. These scales are the principal source of contagion. HOME TREATMENT. 1. Isolate the patient from other members of the family to prevent the spread of the disease. 2. Keep the patient in bed and give a fluid diet of milk gruel, beef tea, etc., with plenty of cold water to drink. 3. Control the fever by sponging the body with tepid water, and relieve the pain in the throat by cold compresses, applied externally. 4. As soon as the skin shows a tendency to become scaly, apply goose grease or clean lard with a little boracic acid powder dusted in it, or better, perhaps, carbolized vaseline to relieve the itching and prevent the scales from being scattered about, and subjecting others to the contagion. REGULAR TREATMENT.--A few drops of aconite every three hours to regulate the pulse, and if the skin be pale and circulation feeble, with tardy eruption, administer one to ten drops of tincture of belladonna, according to the age of the patient. At the end of third week, if eyes look puffy and feet swell, there is danger of Acute Bright's disease, and a physician should be consulted. If the case does not progress well under the home remedies suggested, a physician should be called at once. _WHOOPING COUGH._ DEFINITION.--This is a contagious disease which is known by a peculiar whooping sound in the cough. Considerable mucus is thrown off after each attack of spasmodic coughing. SYMPTOMS.--It usually commences with the symptoms of a common cold in the head, some chilliness, feverishness, {334} restlessness, headache, a feeling of tightness across the chest, violent paroxysms of coughing, sometimes almost threatening suffocation, and accompanied with vomiting. HOME TREATMENT.--Patient should eat plain food and avoid cold drafts and damp air, but keep in the open air as much as possible. A strong tea made of the tops of red clover is highly recommended. A strong tea made of chestnut leaves, sweetened with sugar, is also very good. 1 teaspoonful of powdered alum. 1 teaspoonful of syrup. Mix in a tumbler of water, and give the child one teaspoonful every two or three hours. A kerosene lamp kept burning in the bed chamber at night is said to lessen the cough and shorten the course of the disease. _MUMPS._ DEFINITION.--This is a contagious disease causing the inflammation of the salivary glands, and is generally a disease of childhood and youth. SYMPTOMS.--A slight fever, stiffness of the neck and lower jaw, swelling and soreness of the gland. It usually develops in four or five days and then begins to disappear. HOME TREATMENT.--Apply to the swelling a hot poultice of cornmeal and bread and milk. A hop poultice is also excellent. Take a good dose of physic and rest carefully. A warm general bath, or mustard foot bath, is very good. Avoid exposure or cold drafts. If a bad cold is taken, serious results may follow. _MEASLES._ DEFINITION.--It is an eruptive, contagious disease, preceded by cough and other catarrhal symptoms for about four or five days. The eruption comes rapidly in small red spots, which are slightly raised. SYMPTOMS.--A feeling of weakness, loss of appetite, some fever, cold in the head, frequent sneezing, watery eyes, dry cough and a hot skin. The disease takes effect nine or ten days after exposure. {335} HOME TREATMENT.--Measles is not a dangerous disease in the child, but in an adult it is often very serious. In childhood very little medicine is necessary, but exposure must be carefully avoided, and the patient kept in bed, in a moderately warm room. The diet should be light and nourishing. Keep the room dark. If the eruption does not come out promptly, apply hot baths. COMMON TREATMENT.--Two teaspoonfuls of spirits of nitre, one teaspoonful paregoric, one wineglassful of camphor water. Mix thoroughly, and give a teaspoonful in half a tea-cupful of water every two hours. To relieve the cough, if troublesome, flax seed tea, or infusion of slippery-elm bark, with a little lemon juice to render more palatable, will be of benefit. _CHICKEN POX._ DEFINITION.--This is a contagious, eruptive disease, which resembles to some extent small-pox. The pointed vesicles or pimples have a depression in the center in chicken-pox, and in small pox they do not. SYMPTOMS.--Nine to seventeen days elapse after the exposure, before symptoms appear. Slight fever, a sense of sickness, the appearance of scattered pimples, some itching and heat. The pimples rapidly change into little blisters, filled with a watery fluid. After five or six days they disappear. HOME TREATMENT.--Milk diet, and avoid all kinds of meat. Keep the bowels open, and avoid all exposure to cold. Large vesicles on the face should be punctured early, and irritation by rubbing should be avoided. _HOME TREATMENT OF DIPHTHERIA._ DEFINITION.--Acute, specific, constitutional disease, with local manifestations in the throat, mouth, nose, larynx, windpipe, and glands of the neck. The disease is infectious, but not very contagious under the proper precautions. It is a disease of childhood, though adults sometimes contract it. Many of the best physicians of the day consider true or membranous croup to be due to this diphtheritic membranous disease thus located in the larynx or trachea. {336} SYMPTOMS.--Symptoms vary according to the severity of the attack. Chills, fever, headache, languor, loss of appetite, stiffness of neck, with tenderness about the angles of the jaw, soreness of the throat, pain in the ear, aching of the limbs, loss of strength, coated tongue, swelling of the neck, and offensive breath; lymphatic glands on side of neck enlarged and tender. The throat is first to be seen red and swollen, then covered with grayish white patches, which spread, and a false membrane is found on the mucous membrane. If the nose is attacked, there will be an offensive discharge, and the child will breathe through the mouth. If the larynx or throat are involved, the voice will become hoarse, and a croupy cough, with difficult breathing, shows that the air passage to the lungs is being obstructed by the false membrane. HOME TREATMENT.--Isolate the patient, to prevent the spread of the disease. Diet should be of the most nutritious character, as milk, eggs, broths, and oysters. Give at intervals of every two or three hours. If patient refuses to swallow, from the pain caused by the effort, a nutrition injection must be resorted to. Inhalations of steam and hot water, and allowing the patient to suck pellets of ice, will give relief. Sponges dipped in hot water, and applied to the angles of the jaw, are beneficial. Inhalations of lime, made by slaking freshly burnt lime in a vessel, and directing the vapor to the child's mouth, by means of a newspaper, or similar contrivance. Flour of sulphur, blown into the back of the mouth and throat by means of a goose quill, has been highly recommended. Frequent gargling of the throat and mouth, with a solution of lactic acid, strong enough to taste sour, will help to keep the parts clean, and correct the foul breath. If there is great prostration, with the nasal passage affected, or hoarseness and difficult breathing, a physician should be called at once. * * * * * {337} DISEASES OF WOMEN. _DISORDERS OF THE MENSES._ 1. SUPPRESSION OF, OR SCANTY MENSES. [Illustration] HOME TREATMENT.--Attention to the diet, and exercise in the open air to promote the general health. Some bitter tonic, taken with fifteen grains of dialyzed iron, well diluted, after meals, if patient is pale and debilitated. A hot foot bath is often all that is necessary. 2. PROFUSE MENSTRUATION. HOME TREATMENT.--Avoid highly seasoned food, and the use of spirituous liquors; also excessive fatigue, either physical or mental. To check the flow, patient should be kept quiet, and allowed to sip cinnamon tea during the period. 3. PAINFUL MENSTRUATION. HOME TREATMENT.--Often brought on by colds. Treat by warm hip baths, hot drinks (avoiding spirituous liquors), and heat applied to the back and extremities. A teaspoonful of the fluid extract of viburnum will sometimes act like a charm. _HOW TO CURE SWELLED AND SORE BREASTS._ Take and boil a quantity of chamomile, and apply the hot fomentations. This dissolves the knot, and reduce the swelling and soreness. {338} _LEUCORRHEA OR WHITES._ HOME TREATMENT.--This disorder, if not arising from some abnormal condition of the pelvic organs, can easily be cured by patient taking the proper amount of exercise and good nutritious food, avoiding tea and coffee. An injection every evening of one teaspoonful of Pond's Extract in a cup of hot water, after first cleansing the vagina well with a quart of warm water, is a simple but effective remedy. _INFLAMMATION OF THE WOMB._ HOME TREATMENT.--When in the acute form this disease is ushered in by a chill, followed by fever, and pain in the region of the womb. Patient should be placed in bed, and a brisk purgative given, hot poultices applied to the abdomen, and the feet and hands kept warm. If the symptoms do not subside, a physician should be consulted. _HYSTERIA._ DEFINITION.--A functional disorder of the nervous system of which it is impossible to speak definitely; characterized by disturbance of the reason, will, imagination, and emotions, with sometimes convulsive attacks that resemble epilepsy. SYMPTOMS.--Fits of laughter, and tears without apparent cause; emotions easily excited; mind often melancholy and depressed; tenderness along the spine; disturbances of digestion, with hysterical convulsions, and other nervous phenomena. HOME TREATMENT.--Some healthy and pleasant employment should be urged upon women afflicted with this disease. Men are also subject to it, though not so frequently. Avoid excessive fatigue and mental worry; also stimulants and opiates. Plenty of good food and fresh air will do more good than drugs. * * * * * {339} Falling of the Womb. CAUSES.--The displacement of the womb usually is the result of too much childbearing, miscarriages, abortions, or the taking of strong medicines to bring about menstruation. It may also be the result in getting up too quickly from the childbed. There are, however, other causes, such as a general breaking down of the health. SYMPTOMS.--If the womb has fallen forward it presses against the bladder, causing the patient to urinate frequently. If the womb has fallen back, it presses against the rectum, and constipation is the result with often severe pain at stool. If the womb descends into the vagina there is a feeling of heaviness. All forms of displacement produce pain in the back, with an irregular and scanty menstrual flow and a dull and exhausted feeling. HOME TREATMENT.--Improve the general health. Take some preparation of cod-liver oil, hot injections (of a teaspoonful of powdered alum with a pint of water), a daily sitz-bath, and a regular morning bath three times a week will be found very beneficial. There, however, can be no remedy unless the womb is first replaced to the proper position. This must be done by a competent physician who should frequently be consulted. [Illustration] {340} Menstruation. 1. ITS IMPORTANCE.--Menstruation plays a momentous part in the female economy; indeed, unless it be in every way properly and duly performed, it is neither possible that a lady can be well, nor is it at all probable that she will conceive. The large number of barren, of delicate, and of hysterical women there are in America arises mainly from menstruation not being duly and properly performed. 2. THE BOUNDARY-LINE.--Menstruation--"the periods"--the appearance of the catamenia or the menses--is then one of the most important epochs in a girl's life. It is the boundary-line, the landmark between childhood and womanhood; it is the threshold, so to speak, of a woman's life. Her body now develops and expands, and her mental capacity enlarges and improves. 3. THE COMMENCEMENT OF MENSTRUATION.--A good beginning at this time is peculiarly necessary, or a girl's health is sure to suffer, and different organs of the body--her lungs, for instance, may become imperiled. A healthy continuation, at regular periods, is also much needed, or conception, when she is married, may not occur. Great attention and skillful management is required to ward off many formidable diseases, which at the close of menstruation--at "the change of life"--are more likely than at any time to be developed. If she marry when very young, marriage weakens her system, and prevents a full development of her body. Moreover, such an one is, during the progress of her labor, prone to convulsions--which is a very serious childbed complication. 4. EARLY MARRIAGES.--Statistics prove that twenty per cent--20 in every 100--of females who marry are under age, and that such early marriages are often followed by serious, and sometimes even by fatal consequences to mother, to progeny, or to both. Parents ought, therefore, to persuade their daughters not to marry until they are of age--twenty-one; they should point out to them the risk and danger likely to ensue if their advice be not followed; they should impress upon their minds the old adage: "Early wed, Early dead." 5. TIME TO MARRY.--Parents who have the real interest and happiness of their daughters at heart, ought, in consonance with the laws of physiology, to discountenance marriage before twenty; and the nearer the girls arrive at {341} the age of twenty-five before the consummation of this important rite, the greater the probability that, physically and morally, they will be protected against those risks which precocious marriages bring in their train. 6. FEEBLE PARENTS.--Feeble parents have generally feeble children; diseased parents, diseased children; nervous parents, nervous children;--"like begets like." It is sad to reflect, that the innocent have to suffer, not only for the guilty, but for the thoughtless and inconsiderate. Disease and debility are thus propagated from one generation to another and the American race becomes woefully deteriorated. 7. TIME.--Menstruation in this country usually commences at the ages of from thirteen to sixteen, sometimes earlier; occasionally as early as eleven or twelve; at other times later, and not until a girl be seventeen or eighteen years of age. Menstruation in large towns is supposed to commence at an earlier period than in the country, and earlier in luxurious than in simple life. 8. CHARACTER.--The menstrual fluid is not exactly blood, although, both in appearance and properties, it much resembles it; yet it never in the healthy state clots as blood does. It is a secretion of the womb, and, when healthy, ought to be of a bright red color, in appearance very much like the blood from a recently cut finger. The menstrual fluid ought not, as before observed, clot. If it does, a lady, during "her periods," suffers intense pain; moreover, she seldom conceives until the clotting has ceased. 9. MENSTRUATION DURING NURSING.--Some ladies, though comparatively few, menstruate during nursing; when they do, it may be considered not as the rule, but as the exception. It is said in such instances, that they are more likely to conceive; and no doubt they are, as menstruation is an indication of a proneness to conception. Many persons have an idea that when a woman, during lactation, menstruates, her milk is both sweeter and purer. Such is an error. Menstruation during nursing is more likely to weaken the mother, and consequently to deteriorate her milk, and thus make it less sweet and less pure. 10. VIOLENT EXERCISE.--During "the monthly periods" violent exercise is injurious; iced drinks and acid beverages are improper; and bathing in the sea, and bathing the feet in cold water, and cold baths are dangerous; indeed, at such times as these, no risks should be run, and no experiments should, for the moment, be permitted, otherwise serious consequences will, in all probability, ensue. {342} 11. THE PALE, COLORLESS-COMPLEXIONED.--The pale, colorless-complexioned, helpless, listless, and almost lifeless young ladies who are so constantly seen in society, usually owe their miserable state of health to absent, to deficient, or to profuse menstruation. Their breathing is short--they are soon "out of breath," if they attempt to take exercise--to walk, for instance, either up stairs or up a hill, or even for half a mile on level ground, their breath is nearly exhausted--they pant as though they had been running quickly. They are ready, after the slightest exertion or fatigue, and after the least worry or excitement, to feel faint, and sometimes even to actually swoon away. Now such cases may, if judiciously treated, be generally soon cured. It therefore behooves mothers to seek medical aid early for their girls, and that before irreparable mischief has been done to the constitution. 12. POVERTY OF BLOOD.--In a pale, delicate girl or wife, who is laboring under what is popularly called poverty of blood, the menstrual fluid is sometimes very scant, at others very copious, but is, in either case, usually very pale--almost as colorless as water, the patient being very nervous and even hysterical. Now, these are signs of great debility; but, fortunately for such an one, a medical man is, in the majority of cases, in possession of remedies that will soon make her all right again. 13. NO RIGHT TO MARRY.--A delicate girl has no right until she be made strong, to marry. If she should marry, she will frequently, when in labor, not have strength, unless she has help, to bring a child into the world; which, provided she be healthy and well-formed, ought not to be. How graphically the Bible tells of delicate women not having strength to bring children into the world: "For the children are come to the birth, and there is not strength to bring forth."--2 Kings XIX, 3. 14. TOO SPARING.--Menstruation at another time is too sparing; this is a frequent cause of sterility. Medical aid, in the majority of cases, will be able to remedy the defect, and, by doing so, will probably be the means of bringing the womb into a healthy state, and thus predispose to conception. [Illustration] {343} Celebrated Prescriptions for All Diseases and How to Use Them. [Illustration] VINEGAR FOR HIVES. After trying many remedies in a severe case of hives, Mr. Swain found vinegar lotion gave instant relief, and subsequent trials in other cases have been equally successful. One part of water to two parts of vinegar is the strength most suitable. THROAT TROUBLE. A teaspoonful of salt, in a cup of hot water, makes a safe and excellent gargle in most throat troubles. FOR SWEATING FEET, WITH BAD ODOR. Wash the feet in warm water with borax, and if this don't cure, use a solution of permanganate to destroy the fetor; about five grains to each ounce of water. {344} AMENORRHOEA. The following is recommended as a reliable emmenagogue in many cases of functional amenorrhoea: Bichloride of mercury, Arsenite of sodium, aa gr. iij. Sulphate of strychnine, gr. iss. Carbonate of potassium, Sulphate of iron, aa gr. xlv. Mix and divide into sixty pills. Sig. One pill after each meal. SICK HEADACHE. Take a spoonful of finely powdered charcoal in a small glass of warm water to relieve a sick headache. It absorbs the gasses produced by the fermentation of undigested food. AN EXCELLENT EYE WASH. Acetate of zinc, 20 grains. Acetate of morphia, 5 grains. Rose water, 4 ounces. Mix. FOR FILMS AND CATARACTS OF THE EYES. Blood Root Pulverized, 1 ounce. Hog's lard, 3 ounces. Mix, simmer for 20 minutes, then strain; when cold put a little in the eyes twice or three times a day. FOR BURNS AND SORES. Pitch Burgundy, 2 pounds. Bees' Wax, 1 pound. Hog's lard, one pound. Mix all together and simmer over a slow fire until the whole are well mixed together; then stir it until cold. Apply on muslin to the parts affected. FOR CHAPPED HANDS. Olive oil, 6 ounces. Camphor beat fine, ½ ounce. Mix, dissolve by gentle heat over slow fire and when cold apply to the hand freely. INTOXICATION. A man who is helplessly intoxicated may almost immediately restore the faculties and powers of locomotion by taking half a teaspoonful of chloride of ammonium in a goblet of water. A wineglassful of strong vinegar will have the same effect and is frequently resorted to by drunken soldiers. {345} NERVOUS DISABILITY. HEADACHE. NEURALGIA. NERVOUSNESS. Fluid extract of scullcap, 1 ounce. Fluid extract American valerian, 1 ounce. Fluid extract catnip, 1 ounce. Mix all. Dose, from 15 to 30 drops every two hours, in water; most valuable. A valuable tonic in all conditions of debility and want of appetite. Comp. tincture of cinchona in teaspoonful doses in a little water, half hour before meals. ANOTHER EXCELLENT TONIC. Tincture of gentian, 1 ounce. Tincture of Columba, 1 ounce. Tincture of collinsonia, 1 ounce. Mix all. Dose, one tablespoonful in one tablespoonful of water before meals. REMEDY FOR CHAPPED HANDS. When doing housework, if your hands become chapped or red, mix corn meal and vinegar into a stiff paste and apply to the hand two or three times a day, after washing them in hot water, then let dry without wiping, and rub with glycerine. At night use cold cream, and wear gloves. BLEEDING. Very hot water is a prompt checker of bleeding, besides, if it is clean, as it should be, it aids in sterilizing our wound. TREATMENT FOR CRAMP. Wherever friction can be conveniently applied, heat will be generated by it, and the muscle again reduced to a natural condition; but if the pains proceed from the contraction of some muscle located internally, burnt brandy is an excellent remedy. A severe attack which will not yield to this simple treatment may be conquered by administering a small dose of laudanum or ether, best given under medical supervision. TREATMENT FOR COLIC. Castor oil, given as soon as the symptoms of colic manifest themselves, has frequently afforded relief. At any rate, the irritating substances may be expelled from the alimentary canal before the pains will subside. All local remedies will be ineffectual, and consequently the purgative should be given in large doses until a copious vacuation is produced. {346} [Illustration: THE DOCTOR'S VISIT.] TREATMENT FOR HEARTBURN. If soda, taken in small quantities after meals, does not relieve the distress, one may rest assured that the fluid is an alkali and requires an acid treatment. Proceed, after eating, to squeeze ten drops of lemon-juice into a small quantity of water, and swallow it. The habit of daily life should be made to conform to the laws of health, or local treatment will prove futile. BILIOUSNESS. For biliousness, squeeze the juice of a lime or small lemon into half a glass of cold water, then stir in a little baking soda and drink while it foams. This receipt will also relieve sick headache if taken at the beginning. TURPENTINE APPLICATIONS. Mix turpentine and lard in equal parts. Warmed and rubbed on the chest, it is a safe, reliable and mild counter irritant and revulsent in minor lung complications. {347} TREATMENT FOR MUMPS. It is very important that the face and neck be kept warm. Avoid catching cold, and regulate the stomach and bowels, because, when aggravated, this disease is communicated to other glands, and assumes there a serious form. Rest and quiet, with a good condition of the general health, will throw off this disease without further inconvenience. TREATMENT FOR FELON. All medication, such as poulticing, anointing, and the applications of lotions, is but useless waste of time. The surgeon's knife should be used as early as possible, for it will be required sooner or later, and the more promptly it can be applied, the less danger is there from the disease, and the more agony is spared to the unfortunate victim. TREATMENT FOR STABS. A wound made by thrusting a dagger or other oblong instrument into the flesh, is best treated, if no artery has been severed, by applying lint scraped from a linen cloth, which serves as an obstruction, allowing and assisting coagulation. Meanwhile cold water should be applied to the parts adjoining the wound. TREATMENT FOR MASHED NAILS. If the injured member be plunged into very hot water, the nail will become pliable and adapt itself to the new condition of things, thus alleviating agony to some extent. A small hole may be bored on the nail with a pointed instrument, so adroitly so as not to cause pain, yet so successfully as to relieve pressure on the sensitive tissues. Free applications of arnica or iodine will have an excellent effect. TREATMENT FOR FOREIGN BODY IN THE EYE. When any foreign body enters the eye, close it instantly, and keep it still until you have an opportunity to ask the assistance of some one; then have the upper lid folded over a pencil and the exposed surfaces closely searched; if the body be invisible, catch the everted lid by the lashes, and drawing it down over the lower lid, suddenly release it, and it will resume its natural position. Unsuccessful in this attempt, you may be pretty well assured that the object has become lodged in the tissues, and will require the assistance of a skilled operator to remove it. CUTS. A drop or two of creosote on a cut will stop its bleeding. {348} * * * * * TREATMENT FOR POISON OAK--POISON IVY--POISON SUMACH.--Mr. Charles Morris, of Philadelphia, who has studied the subject closely, uses, as a sovereign remedy, frequent bathing of the affected parts in water as hot as can be borne. If used immediately after exposure, it may prevent the eruption appearing. If later, it allays the itching, and gradually dries up the swellings, though, they are very stubborn after they have once appeared. But an application every few hours keeps down the intolerable itching, which is the most annoying feature of sumach poisoning. In addition to this, the ordinary astringent ointments are useful, as is also that sovereign lotion, "lead-water and laudanum." Mr. Morris adds to these a preventive prescription of "wide-open eyes." BITES AND STINGS OF INSECTS.--Wash with a solution of ammonia water. BITES OF MAD DOGS.--Apply caustic potash at once to the wound, and give enough whiskey to cause sleep. BURNS.--Make a paste of common baking soda and water, and apply it promptly to the burn. It will quickly check the pain and inflammation. COLD ON CHEST.--A flannel rag wrung out in boiling water and sprinkled with turpentine, laid on the chest, gives the greatest relief. COUGH.--Boil one ounce of flaxseed in a pint of water, strain, and add a little honey, one ounce of rock candy, and the juice of three lemons. Mix and boil well. Drink as hot as possible. SPRAINED ANKLE OR WRIST.--Wash the ankle very frequently with cold salt and water, which is far better than warm vinegar or decoction of herbs. Keep the foot as cool as possible to prevent inflammation, and sit with it elevated on a high cushion. Live on low diet, and take every morning some cooling medicine, such as Epsom salts. It cures in a few days. CHILBLAINS, SPRAINS, ETC.--One raw egg well beaten, half a pint of vinegar, one ounce spirits of turpentine, a quarter of an ounce of spirits of wine, a quarter of an ounce of camphor. These ingredients to be beaten together, then put in a bottle and shaken for ten minutes, after which, to be corked down tightly to exclude the air. In half an hour it is fit for use. To be well rubbed in, two, three, or four times a day. For rheumatism in the head, to be rubbed at the back of the neck and behind the ears. In chilblains this remedy is to be used before they are broken. {349} HOW TO REMOVE SUPERFLUOUS HAIR.--Sulphuret of Arsenic, one ounce; Quicklime, one ounce; Prepared Lard, one ounce; White Wax, one ounce. Melt the Wax, add the Lard. When nearly cold, stir in the other ingredients. Apply to the superfluous hair, allowing it to remain on from five to ten minutes; use a table-knife to shave off the hair; then wash with soap and warm water. DYSPEPSIA CURE.--Powdered Rhubarb, two drachms; Bicarbonate of Sodium, six drachms; Fluid Extract of Gentian, three drachms; Peppermint Water, seven and a half ounces. Mix them. Dose, a teaspoonful half an hour before meals. FOR NEURALGIA.--Tincture of Belladonna, one ounce; Tincture of Camphor, one ounce; Tincture of Arnica, one ounce; Tincture of Opium, one ounce. Mix them. Apply over the seat of the pain, and give ten to twenty drops in sweetened water every two hours. FOR COUGHS, COLDS, ETC.--Syrup of Morphia, three ounces; Syrup of Tar, three and a half ounces; Chloroform, one troy ounce; Glycerine, one troy ounce. Mix them. Dose, a teaspoonful three or four times a day. TO CURE HIVES.--Compound syrup of Squill, U. S., three ounces; Syrup of Ipecac, U. S., one ounce. Mix them. Dose, a teaspoonful. TO CURE SICK HEADACHE.--Gather sumach leaves in the summer, and spread them in the sun a few days to dry. Then powder them fine, and smoke, morning and evening for two weeks, also whenever there are symptoms of approaching headache. Use a new clay pipe. If these directions are adhered to, this medicine will surely effect a permanent cure. WHOOPING COUGH.--Dissolve a scruple of salt of tartar in a gill of water; add to it ten grains of cochineal; sweeten it with sugar. Give to an infant a quarter teaspoonful four times a day; two years old, one-half teaspoonful; from four years, a tablespoonful. Great care is required in the administration of medicines to infants. We can assure paternal inquirers that the foregoing may be depended upon. CUT OR BRUISE.--Apply the moist surface of the inside coating or skin of the shell of a raw egg. It will adhere of itself, leave no scar, and heal without pain. DISINFECTANT.--Chloride of lime should be scattered at least once a week under sinks and wherever sewer gas is likely to penetrate. [Illustration: THE YOUNG DOCTOR.] {362} COSTIVENESS.--Common charcoal is highly recommended for costiveness. It may be taken in tea- or tablespoonful, or even larger doses, according to the exigencies of the case, mixed with molasses, repeating it as often as necessary. Bathe the bowels with pepper and vinegar. Or take two ounces of rhubarb, add one ounce of rust of iron, infuse in one quart of wine. Half a wineglassful every morning. Or take pulverized blood root, one drachm, pulverized rhubarb, one drachm, castile soap, two scruples. Mix. and roll into thirty-two pills. Take one, morning and night. By following these directions it may perhaps save you from a severe attack of the piles, or some other kindred disease. TO CURE DEAFNESS.--Obtain pure pickerel oil, and apply four drops morning and evening to the ear. Great care should be taken to obtain oil that is perfectly pure. DEAFNESS.--Take three drops of sheep's gall, warm, and drop it into the ear on going to bed. The ear must be syringed with warm soap and water in the morning. The gall must be applied for three successive nights. It is only efficacious when the deafness is produced by cold. The most convenient way of warming the gall is by holding it in a silver spoon over the flame of a light. The above remedy has been frequently tried with perfect success. GOUT.--This is Col. Birch's recipe for rheumatic gout or acute rheumatism, commonly called in England the "Chelsea Pensioner." Half an ounce of nitre (saltpetre), half an ounce of sulphur, half an ounce of flour of mustard, half an ounce of Turkey rhubarb, quarter of an ounce of powdered guaicum. Mix, and take a teaspoonful every other night for three nights, and omit three nights, in a wine-glassful of cold water which has been previously well boiled. RINGWORM.--The head is to be washed twice a day with soft soap and warm soft water; when dried the places to be rubbed with a piece of linen rag dipped in ammonia from gas tar; the patient should take a little sulphur and molasses, or some other genuine aperient, every morning; brushes and combs should be washed every day, and the ammonia kept tightly corked. PILES.--Hamamelis, both internally or as an injection in rectum. Bathe the parts with cold water or with astringent lotions, as alum water, especially in bleeding piles. Ointment of gallic acid and calomel is of repute. The best treatment of all is, suppositories of iodoform, ergotine, or tannic acid, which can be made at any drug store. {363} CHICKEN POX.--No medicine is usually needed, except a tea made from pleurisy root, to make the child sweat. Milk diet is the best; avoidance of animal food; careful attention to the bowels; keep cool and avoid exposure to cold. SCARLET FEVER.--Cold water compress on the throat. Fats and oils rubbed on hands and feet. The temperature of the room should be about 68 degrees Fahr., and all draughts avoided. Mustard baths for retrocession of the rash and to bring it out. Diet: ripe fruit, toast, gruel, beef tea and milk. Stimulants are useful to counteract depression of the vital forces. FALSE MEASLES OR ROSE RASH.--It requires no treatment except hygienic. Keep the bowels open. Nourishing diet, and if there is itching, moisten the skin with five per cent. solution of aconite or solution of starch and water. BILIOUS ATTACKS.--Drop doses of muriatic acid in a wine glass of water every four hours, or the following prescription. Bicarbonate of soda, one drachm; Aromatic spirits of ammonia, two drachms; Peppermint water, four ounces. Dose: Take a teaspoonful every four hours. DIARRHOEA.--The following prescription is generally all that will be necessary: acetate of lead, eight grains; gum arabic, two drachms; acetate of morphia, one grain; and cinnamon water, eight ounces. Take a teaspoonful every three hours. Be careful not to eat too much food. Some consider, the best treatment is to fast, and it is a good suggestion. Patients should keep quiet and have the room of a warm and even temperature. VOMITING.--Ice dissolved in the mouth, often cures vomiting when all remedies fail. Much depends on the diet of persons liable to such attacks; this should be easily digestible food, taken often and in small quantities. Vomiting can often be arrested by applying a mustard paste over the region of the stomach. It is not necessary to allow it to remain until the parts are blistered, but it may be removed when the part becomes thoroughly red, and reapplied if required after the redness has disappeared. One of the secrets to relieve vomiting is to give the stomach perfect rest, not allowing the patient even a glass of water, as long as the tendency remains to throw it up again. NERVOUS HEADACHE.--Extract hyoscymus five grains, pulverized camphor five grains. Mix. Make four pills, one to be taken when the pain is most severe in nervous headache. Or three drops tincture nux vomica in a spoonful of water, two or three times a day. {364} BLEEDING FROM THE NOSE,--from whatever cause--may generally be stopped by putting a plug of lint into the nostril; if this does not do, apply a cold lotion to the forehead; raise the head and place both arms over the head, so that it will rest on both hands; dip the lint plug, slightly moistened, in some powdered gum arabic, and plug the nostrils again; or dip the plug into equal parts of gum arabic and alum. An easier and simpler method is to place a piece of writing paper on the gums of the upper jaw, under the upper lip, and let it remain there for a few minutes. BOILS.--These should be brought to a head by warm poultices of camomile flowers, or boiled white lily root, or onion root, by fermentation with hot water, or by stimulating plasters. When ripe they should be destroyed by a needle or lancet. But this should not be attempted until they are thoroughly proved. BUNIONS may be checked in their early development by binding the joint with adhesive plaster, and keeping it on as long as any uneasiness is felt. The bandaging should be perfect, and it might be well to extend it round the foot. An inflamed bunion should be poulticed, and larger shoes be worn. Iodine 12 grains, lard or spermaceti ointment half an ounce, makes a capital ointment for bunions. It should be rubbed on gently twice or three times a day. FELONS.--One table-spoonful of red lead, and one table-spoonful of castile soap, and mix them with as much weak lye as will make it soft enough to spread like a salve, and apply it on the first appearance of the felon, and it will cure in ten or twelve days. CURE FOR WARTS.--The easiest way to get rid of warts, is to pare off the thickened skin which covers the prominent wart; cut it off by successive layers and shave it until you come to the surface of the skin, and till you draw blood in two or three places. Then rub the part thoroughly over with lunar caustic, and one effective operation of this kind will generally destroy the wart; if not, you cut off the black spot which has been occasioned by the caustic, and apply it again; or you may apply acetic acid, and thus you will get rid of it. Care must be taken in applying these acids, not to rub them on the skin around the wart. WENS.--Take the yoke of some eggs, beat up, and add as much fine salt as will dissolve, and apply a plaster to the wen every ten hours. It cures without pain or any other inconvenience. * * * * * {365} HOW TO CURE Apoplexy, Bad Breath and Quinsy. 1. APOPLEXY.--Apoplexy occurs only in the corpulent or obese, and those of gross or high living. _Treatment._--Raise the head to a nearly upright position; loosen all tight clothes, strings, etc., and apply cold water to the head and warm water and warm cloths to the feet. Have the apartment cool and well ventilated. Give nothing by the mouth until the breathing is relieved, and then only draughts of cold water. 2. BAD BREATH.--Bad or foul breath will be removed by taking a teaspoonful of the following mixture after each meal: One ounce chloride of soda, one ounce liquor of potassa, one and one-half ounces phosphate of soda, and three ounces of water. 3. QUINSY.--This is an inflammation of the tonsils, or common inflammatory sore throat; commences with a slight feverish attack, with considerable pain and swelling of the tonsils, causing some difficulty in swallowing; as the attack advances, these symptoms become more intense, there is headache, thirst, a painful sense of tension, and acute darting pains in the ears. The attack is generally brought on by exposure to cold, and lasts from five to seven days, when it subsides naturally, or an abscess may form in tonsils and burst, or the tonsils may remain enlarged, the inflammation subsiding. _Home Treatment._--The patient should remain in a warm room, the diet chiefly milk and good broths, some cooling laxative and diaphoretic medicine may be given; but the greatest relief will be found in the frequent inhalation of the steam of hot water through an inhaler, or in the old-fashioned way through the spout of a teapot. * * * * * {366} Sensible Rules for the Nurse. "Remember to be extremely neat in dress; a few drops of hartshorn in the water used for _daily_ bathing will remove the disagreeable odors of warmth and perspiration. "Never speak of the symptoms of your patient in his presence, unless questioned by the doctor, whose orders you are always to obey _implicitly_. "Remember never to be a gossip or tattler, and always to hold sacred the knowledge which, to a certain extent, you must obtain of the private affairs of your patient and the household in which you nurse. "Never contradict your patient, nor argue with him, nor let him see that you are annoyed about anything. "Never _whisper_ in the sick room. If your patient be well enough, and wishes you to talk to him, speak in a low, distinct voice, on cheerful subjects. Don't relate painful hospital experiences, nor give details of the maladies of former patients, and remember never to startle him with accounts of dreadful crimes or accidents that you have read in the newspapers. "_Write_ down the orders that the physician gives you as to time for giving the medicines, food, etc. "Keep the room bright (unless the doctor orders it darkened). "Let the air of the room be as pure as possible, and keep everything in order, but without being fussy and bustling. "The only way to remove dust in a sick room is to wipe everything with a damp cloth. "Remember to carry out all vessels covered. Empty and wash them immediately, and keep some disinfectant in them. "Remember that to leave the patient's untasted food by his side, from meal to meal, in hopes that he will eat it in the interval, is simply to prevent him from taking any food at all. "Medicines, beef tea or stimulants, should never be kept where the patient can see them or smell them. "Light-colored clothing should be worn by those who have the care of the sick, in preference to dark-colored apparel; particularly if the disease is of a contagious nature. Experiments have shown that black and other dark colors will absorb more readily the subtle effluvia that emanates from sick persons than white or light colors." * * * * * {367} Longevity. The following table exhibits very recent mortality statistics, showing the average duration of life among persons of various classes: _Employment_ _Years_. Judges 65 Farmers 64 Bank Officers 64 Coopers 58 Public Officers 57 Clergymen 56 Shipwrights 55 Hatters 54 Lawyers 54 Rope Makers 54 Blacksmiths 51 Merchants 51 Calico Printers 51 Physicians 51 Butchers 50 Carpenters 49 Masons 48 Traders 46 Tailors 44 Jewelers 44 Manufacturers 43 Bakers 43 Painters 43 Shoemakers 43 Mechanics 43 Editors 40 Musicians 39 Printers 38 Machinists 36 Teachers 34 Clerks 34 Operatives 32 "It will be easily seen, by these figures, how a quiet or tranquil life affects longevity. The phlegmatic man will live longer, all other things being equal, than the sanguine, nervous individual. Marriage is favorable to longevity, and it has also been ascertained that women live longer than men." {368} [Illustration: HOT WATER THROAT BAG. HOT WATER BAG.] HOW TO APPLY AND USE HOT WATER IN ALL DISEASES. 1. THE HOT WATER THROAT BAG. The hot water throat bag is made from fine white rubber fastened to the head by a rubber band (see illustration), and is an unfailing remedy for catarrh, hay fever, cold, toothache, headache, earache, neuralgia, etc. 2. THE HOT WATER BOTTLE. No well regulated house should be without a hot water bottle. It is excellent in the application of hot water for inflammations, colic, headache, congestion, cold feet, rheumatism, sprains, etc., etc. It is an excellent warming pan and an excellent feet and hand warmer when riding. These hot water bags in any variety can be purchased at any drug store. 3. Boiling water may be used in the bags and the heat will be retained many hours. They are soft and pliable and pleasant to the touch, and can be adjusted to any part of the body. 4. Hot water is good for constipation, torpid liver, and relieves colic and flatulence, and is of special value. 5. _Caution_. When hot water bags or any hot fomentation {369} is removed, replace dry flannel and bathe parts in tepid water and rub till dry. 6. By inflammations it is best to use hot water and then cold water. It seems to give more immediate relief. Hot water is a much better remedy than drugs, paragoric, Dover's powder or morphine. Always avoid the use of strong poisonous drugs when possible. 7. Those who suffer from cold feet there is no better remedy than to bathe the feet in cold water before retiring and then place a hot water bottle in the bed at the feet. A few weeks of such treatment results in relief if not cure of the most obstinate case. * * * * * HOW TO USE COLD WATER. Use a compress of cold water for acute or chronic inflammation, such as sore throat, bronchitis, croup, inflammation of the lungs, etc. If there is a hot and aching pain in the back apply a compress of cold water on the same, or it may simply be placed across the back or around the body. The most depends upon the condition of the patient. [Illustration] {370} Practical Rules for Bathing. [Illustration] 1. Bathe at least once a week all over, thoroughly. No one can preserve his health by neglecting personal cleanliness. Remember, "Cleanliness is akin to Godliness." 2. Only mild soap should be used in bathing the body. 3. Wipe quickly and dry the body thoroughly with a moderately coarse towel. Rub the skin vigorously. {371} 4. Many people have contracted severe and fatal diseases by neglecting to take proper care of the body after bathing. 5. If you get up a good reaction by thorough rubbing in a mild temperature, the effect is always good. 6. Never go into a cold room, or allow cold air to enter the room until you are dressed. 7. Bathing in cold rooms and in cold water is positively injurious, unless the person possesses a very strong and vigorous constitution, and then there is great danger of laying the foundation of some serious disease. 8. Never bathe within two hours after eating. It injures digestion. 9. Never bathe when the body or mind is much exhausted. It is liable to check the healthful circulation. 10. A good time for bathing is just before retiring. The morning hour is a good time also, if a warm room and warm water can be secured. 11. Never bathe a fresh wound or broken skin with cold water; the wound absorbs water, and causes swelling and irritation. 12. A person not robust should be very careful in bathing; great care should be exercised to avoid any chilling effects. [Illustration] {372} All the Different Kinds of Baths, and How to Prepare Them. THE SULPHUR BATH. For the itch, ringworm, itching, and for other slight skin irritations, bathe in water containing a little sulphur. THE SALT BATH. To open the pores of the skin, put a little common salt into the water. Borax, baking soda or lime used in the same way are excellent for cooling and cleansing the skin. A very small quantity in a bowl of water is sufficient. THE VAPOR BATH. 1. For catarrh, bronchitis, pleurisy, inflammation of the lungs, rheumatism, fever, affections of the bowels and kidneys, and skin diseases, the vapor-bath is an excellent remedy. 2. APPARATUS.--Use a small alcohol lamp, and place over it a small dish containing water. Light the lamp and allow the water to boil. Place a cane-bottom chair over the lamp, and seat the patient on it. Wrap blankets or quilts around the chair and around the patient, closing it tightly about the neck. After free perspiration is produced the patient should be wrapped in warm blankets, and placed in bed, so as to continue the perspiration for some time. 3. A convenient alcohol lamp may be made by taking a tin box, placing a tube in it, and putting in a common lamp wick. Any tinner can make one in a few minutes, at a trifling cost. THE HOT-AIR BATH. 1. Place the alcohol lamp under the chair, without the dish of water. Then place the patient on the chair, as in the vapor bath, and let him remain until a gentle and free perspiration is produced. This bath may be taken from time to time, as may be deemed necessary. 2. While remaining in the hot-air bath the patient may drink freely of cold or tepid water. 3. As soon as the bath is over the patient should be washed with hot water and soap. 4. The hot-air bath is excellent for colds, skin diseases, and the gout. {373} THE SPONGE BATH. 1. Have a large basin of water of the temperature of 88 or 95 degrees. As soon as the patient rises rub the body over with a soft, dry towel until it becomes warm. 2. Now sponge the body with water and a little soap, at the same time keeping the body well covered, except such portions as are necessarily exposed. Then dry the skin carefully with a soft, warm towel. Rub the skin well for two or three minutes, until every part becomes red and perfectly dry. 3. Sulphur, lime or salt, and sometimes mustard, may be used in any of the sponge baths, according to the disease. THE FOOT BATH. 1. The foot bath, in coughs, colds, asthma, headaches and fevers, is excellent. One or two tablespoonfuls of ground mustard added to a gallon of hot water, is very beneficial. 2. Heat the water as hot as the patient can endure it, and gradually increase the temperature by pouring in additional quantities of hot water during the bath. THE SITZ BATH. A tub is arranged so that the patient can sit down in it while bathing. Fill the tub about one-half full of water. This is an excellent remedy for piles, constipation, headache, gravel, and for acute and inflammatory affections generally. THE ACID BATH. Place a little vinegar in water, and heat to the usual temperature. This is an excellent remedy for the disorders of the liver. * * * * * A Sure Cure for Prickly Heat. 1. Prickly heat is caused by hot weather, by excess of flesh, by rough flannels, by sudden changes of temperature, or by over-fatigue. 2. TREATMENT--Bathe two or three times a day with warm water, in which a moderate quantity of bran and common soda has been stirred. After wiping the skin dry, dust the affected parts with common cornstarch. * * * * * {374} Digestibility of Food. Article of Food. Condition. Hours Required. Rice Boiled 1.00 Eggs, whipped Raw 1.30 Trout, salmon, fresh Boiled 1.30 Apples, sweet and mellow Raw 1.30 Venison steak Broiled 1.35 Tapioca Boiled 2.00 Barley " 2.00 Milk " 2.00 Bullock's liver, fresh Broiled 2.00 Fresh eggs Raw 2.00 Codfish, cured and dry Boiled 2.00 Milk Raw 2.15 Wild turkey Roasted 2.15 Domestic turkey " 2.30 Goose " 2.30 Sucking pig " 2.30 Fresh lamb Broiled 2.30 Hash, meat and vegetables Warmed 2.30 Beans and pod Boiled 2.30 Parsnips " 2.30 Irish potatoes Roasted 2.30 Chicken Fricassee 2.45 Custard Baked 2.45 Salt beef Boiled 2.45 Sour and hard apples Raw 2.50 Fresh oysters " 2.55 Fresh eggs Soft boiled 3.00 Beef, fresh, lean and rare Roasted 3.00 Beef steak Broiled 3.00 Pork, recently salted Stewed 3.00 Fresh mutton Boiled 3.00 Soup, beans " 3.00 Soup, chicken " 3.00 Apple dumpling " 3.00 Fresh oysters Roasted 3.15 Pork steak Broiled 3.15 Fresh mutton Roasted 3.15 Corn bread Baked 3.15 Carrots Boiled 3.15 Fresh sausage Broiled 3.20 Fresh flounder Fried 3.30 Fresh catfish " 3.30 Fresh oysters Stewed 3.30 Butter Melted 3.30 Old, strong cheese Raw 3.30 Mutton soup Boiled 3.30 Oyster soup " 3.30 Fresh wheat bread Baked 3.30 Flat turnips Boiled 3.30 Irish potatoes " 3.30 Fresh eggs Hard boiled 3.30 " " Fried 3.30 Green corn and beans Boiled 3.45 Beets " 3.45 Fresh, lean beef Fried 4.00 Fresh veal Broiled 4.00 Domestic fowls Roasted 4.00 Ducks " 4.00 Beef soup, vegetables and bread Boiled 4.00 Pork, recently salted " 4.30 Fresh veal Fried 4.30 Cabbage, with vinegar Boiled 4.30 Pork, fat and lean Roasted 5.30 * * * * * {375} How to Cook for the Sick. Useful Dietetic Recipes. * * * * * GRUELS. 1. OATMEAL GRUEL.--Stir two tablespoonfuls of coarse oatmeal into a quart of boiling water, and let it simmer two hours. Strain, if preferred. 2. BEEF TEA AND OATMEAL.--Beat two tablespoonfuls of fine oatmeal, with two tablespoonfuls of cold water until very smooth, then add a pint of hot beef tea. Boil together six or eight minutes, stirring constantly. Strain through a fine sieve. 3. MILK GRUEL.--Into a pint of scalding milk stir two tablespoonfuls of fine oatmeal. Add a pint of boiling water, and boil until the meal is thoroughly cooked. 4. MILK PORRIDGE.--Place over the fire equal parts of milk and water. Just before it boils, add a small quantity (a tablespoonful to a pint of water) of graham flour or cornmeal, previously mixed with water, and boil three minutes. 5. SAGO GRUEL.--Take two tablespoonfuls of sago and place them in a small saucepan, moisten gradually with a little cold water. Set the preparation on a slow fire, and keep stirring till it becomes rather stiff and clear. Add a little grated nutmeg and sugar to taste; if preferred, half a pat of butter may also be added with the sugar. 6. CREAM GRUEL.--Put a pint and a half of water on the stove in a saucepan. Take one tablespoon of flour and the same of cornmeal; mix this with cold water, and as soon as the water in the saucepan boils, stir it in slowly. Let it boil slowly about twenty minutes, stirring constantly; then add a little salt and a gill of sweet cream. Do not let it boil after putting in the cream, but turn into a bowl and cover tightly. Serve in a pretty cup and saucer. {376} DRINKS. 1. APPLE WATER.--Cut two large apples into slices and pour a quart of boiling water on them, or on roasted apples: strain in two or three hours and sweeten slightly. 2. ORANGEADE.--Take the thin peel of two oranges and of one lemon; add water and sugar the same as for hot lemonade. When cold add the juice of four or five oranges and one lemon and strain off. 3. HOT LEMONADE.--Take two thin slices and the juice of one lemon; mix with two tablespoonfuls of granulated sugar, and add one-half pint of boiling water. 4. FLAXSEED LEMONADE.--Two tablespoonfuls of whole flaxseed to a pint of boiling water, let it steep three hours, strain when cool and add the juice of two lemons and two tablespoonfuls of honey. If too thick, put in cold water. Splendid for colds and suppression of urine. 5. JELLY WATER.--Sour jellies dissolved in water make a pleasant drink for fever patients. 6. TOAST WATER.--Toast several thin pieces of bread a nice deep brown, but do not blacken or burn. Break into small pieces and put into a jar. Pour over the pieces a quart of boiling water; cover the jar and let it stand an hour before using. Strain if desired. 7. WHITE OF EGG AND MILK.--The white of an egg beaten to a stiff froth, and stirred very quickly into a glass of milk, is a very nourishing food for persons whose digestion is weak, also for children who cannot digest milk alone. 8. EGG COCOA.--One-half teaspoon cocoa with enough hot water to make a paste. Take one egg, beat white and yolk separately. Stir into a cup of milk heated to nearly boiling. Sweeten if desired. Very nourishing. 9. EGG LEMONADE.--White of one egg, one tablespoonful pulverized sugar, juice of one lemon and one goblet of water. Beat together. Very grateful in inflammation of lungs, stomach or bowels. 10. BEEF TEA.--For every quart of tea desired use one pound of fresh beef, from which all fat, bones and sinews have been carefully removed; cut the beef into pieces a quarter of an inch thick and mix with a pint of cold water. Let it stand an hour, then pour into a glass fruit can and place in a vessel of water; let it heat on the stove another hour, but do not let it boil. Strain before using. {377} JELLIES. 1. SAGO JELLY.--Simmer gently in a pint of water two tablespoonfuls of sago until it thickens, frequently stirring. A little sugar may be added if desired. 2. CHICKEN JELLY.--Take half a raw chicken, tie in a coarse cloth and pound, till well mashed, bones and meat together. Place the mass in a covered dish with water sufficient to cover it well. Allow it to simmer slowly till the liquor is reduced about one-half and the meat is thoroughly cooked. Press through a fine sieve or cloth, and salt to taste. Place on the stove to simmer about five minutes. When cold remove all particles of grease. 3. MULLED JELLY.--Take one tablespoonful of currant or grape jelly; beat it with the white of one egg and a little loaf sugar; pour on it one-half pint of boiling water and break in a slice of dry toast or two crackers. 4. BREAD JELLY.--Pour boiling water over bread crumbs; place the mixture on the fire and let it boil until it is perfectly smooth. Take it off, and after pouring off the water, flavor with something agreeable, as a little raspberry or currant jelly water. Pour into a mold until required for use. 5. LEMON JELLY.--Moisten two tablespoonfuls of cornstarch, stir into one pint boiling water; add the juice of two lemons and one-half cup of sugar. Grate in a little of the rind. Put in molds to cool. MISCELLANEOUS. 1. TO COOK RICE.--Take two cups of rice and one and one-half pints of milk. Place in a covered dish and steam in a kettle of boiling water until it is cooked through, pour into cups and let it stand until cold. Serve with cream. 2. RICE OMELET.--Two cups boiled rice, one cup sweet milk, two eggs. Stir together with egg beater, and put into a hot buttered skillet. Cook slowly ten minutes, stirring frequently. 3. BROWNED RICE.--Parch or brown rice slowly. Steep in milk for two hours. The rice or the milk only is excellent in summer complaint. 4. STEWED OYSTERS.--Take one pint of milk, one cup of water, a teaspoon of salt: when boiling put in one pint of {378} bulk oysters. Stir occasionally and remove from the stove before it boils. An oyster should not be shriveled in cooking. 5. BROILED OYSTERS.--Put large oysters on a wire toaster. Hold over hot coals until heated through. Serve on toast moistened with cream. Very grateful in convalescence. 6. OYSTER TOAST.--Pour stewed oysters over graham gems or bread toasted. Excellent for breakfast. 7. GRAHAM CRISPS.--Mix graham flour and cold water into a very stiff dough. Knead, roll very thin, and bake quickly in a hot oven. Excellent food for dyspeptics. 8. APPLE SNOW.--Take seven apples, not very sweet ones, and bake till soft and brown. Then remove the skins and cores; when cool, beat them smooth and fine; add one-half cup of granulated sugar and the white of one egg. Beat till the mixture will hold on your spoon. Serve with soft custard. 9. EGGS ON TOAST.--Soften brown bread toast with hot water, put on a platter and cover with poached or scrambled eggs. 10. BOILED EGGS.--An egg should never be boiled. Place in boiling water and set back on the stove for from seven to ten minutes. A little experience will enable anyone to do it successfully. 11. CRACKED WHEAT PUDDING.--In a deep two-quart pudding dish put layers of cold, cooked, cracked wheat, and tart apples sliced thin, with four tablespoonfuls of sugar. Raisins can be added if preferred. Fill the dish, having the wheat last, add a cup of cold water. Bake two hours. 12. PIE FOR DYSPEPTICS.--Four tablespoonfuls of oatmeal, one pint of water; let stand for a few hours, or until the meal is swelled. Then add two large apples, pared and sliced, a little salt, one cup of sugar, one tablespoonful of flour. Mix all well together and bake in a buttered dish; makes a most delicious pie, which can be eaten with safety by the sick or well. 13. APPLE TAPIOCA PUDDING.--Soak a teacup of tapioca in a quart of warm water three hours. Cut in thin slices six tart apples, stir them lightly with the tapioca, add half cup sugar. Bake three hours. To be eaten with whipped cream. Good either warm or cold. {379} 14. GRAHAM MUFFINS.--Take one pint of new milk, one pint graham or entire wheat flour; stir together and add one beaten egg. Can be baked in any kind of gem pans or muffin rings. Salt must not be used with any bread that is made light with egg. 15. STRAWBERRY DESSERT.--Place alternate layers of hot cooked cracked wheat and strawberries in a deep dish; when cold, turn out on platter; cut in slices and serve with cream and sugar, or strawberry juice. Wet the molds with cold water before using. This, molded in small cups, makes a dainty dish for the sick. Wheatlet can be used in the same way. 16. FRUIT BLANC MANGE.--One quart of juice of strawberries, cherries, grapes or other juicy fruit; one cup water. When boiling, add two tablespoonfuls sugar and four tablespoonfuls cornstarch wet in cold water; let boil five or six minutes, then mold in small cups. Serve without sauce, or with cream or boiled custard. Lemon juice can be used the same, only requiring more water. This is a very valuable dish for convalescents and pregnant women, where the stomach rejects solid food. [Illustration] {380} Save the Girls. [Illustration: GOOD ADVICE FROM GRANDPA.] 1. PUBLIC BALLS.--The church should turn its face like flint against the public ball. Its influence is evil, and nothing but evil. It is a well known fact that in all cities and large towns the ball room is the recruiting office for prostitution. 2. THOUGHTLESS YOUNG WOMEN.--In cities public balls are given every night, and many thoughtless young women, {381} mostly the daughters of small tradesmen and mechanics, or clerks or laborers, are induced to attend "just for fun." Scarcely one in a hundred of the girls attending these balls preserve their purity. They meet the most desperate characters, professional gamblers, criminals and the lowest debauchees. Such an assembly and such influence cannot mean anything but ruin for an innocent girl. 3. VILE WOMEN.--The public ball is always a resort of vile women who picture to innocent girls the ease and luxury of a harlot's life, and offer them all manner of temptations to abandon the paths of virtue. The public ball is the resort of the libertine and the adulterer, and whose object is to work the ruin of every innocent girl that may fall into their clutches. 4. THE QUESTION.--Why does society wonder at the increase of prostitution, when the public balls and promiscuous dancing is so largely endorsed and encouraged? 5. WORKING GIRLS.--Thousands of innocent working girls enter innocently and unsuspectingly into the paths which lead them to the house of evil, or who wander the streets as miserable outcasts all through the influence of the dance. The low theatre and dance halls and other places of unselected gatherings are the milestones which mark the working girl's downward path from virtue to vice, from modesty to shame. 6. THE SALESWOMAN, the seamstress, the factory girl or any other virtuous girl had better, far better, die than take the first step in the path of impropriety and danger. Better, a thousand times better, better for this life, better for the life to come, an existence of humble, virtuous industry than a single departure from virtue, even though it were paid with a fortune. 7. TEMPTATIONS.--There is not a young girl but what is more or less tempted by some unprincipled wretch who may have the reputation of a genteel society man. It behooves parents to guard carefully the morals of their daughters, and be vigilant and cautious in permitting them to accept the society of young men. Parents who desire to save their daughters from a fate which is worse than death, should endeavor by every means in their power to keep them from falling into traps cunningly devised by some cunning lover. There are many good young men, but not all are safe friends to an innocent, confiding young girl. 8. PROSTITUTION.--Some girls inherit their vicious tendency; others fall because of misplaced affections; many sin through a love of dress, which is fostered by society and {382} by the surroundings amidst which they may be placed; many, very many, embrace a life of shame to escape poverty. While each of these different phases of prostitution require a different remedy, we need better men, better women, better laws and better protection for the young girls. [Illustration: A RUSSIAN SPINNING GIRL.] 9. A STARTLING FACT.--Startling as it may seem to some, it is a fact in our large cities that there are many girls raised {383} by parents with no other aim than to make them harlots. At a tender age they are sold by fathers and mothers into an existence which is worse than slavery itself. It is not uncommon to see girls at the tender age of thirteen or fourteen--mere children--hardened courtesans, lost to all sense of shame and decency. They are reared in ignorance, surrounded by demoralizing influences, cut off from the blessings of church and Sabbath school, see nothing but licentiousness, intemperance and crime. These young girls are lost forever. They are beyond the reach of the moralist or preacher and have no comprehension of modesty and purity. Virtue to them is a stranger, and has been from the cradle. 10. A GREAT WRONG.--Parents too poor to clothe themselves bring children into the world, children for whom they have no bread, consequently the girl easily falls a victim in early womanhood to the heartless libertine. The boy with no other schooling but that of the streets soon masters all the qualifications for a professional criminal. If there could be a law forbidding people to marry who have no visible means of supporting a family, or if they should marry, if their children could be taken from them and properly educated by the State, it would cost the country less and be a great step in advancing our civilization. 11. THE FIRST STEP.--Thousands of fallen women could have been saved from lives of degradation and deaths of shame had they received more toleration and loving forgiveness in their first steps of error. Many women naturally pure and virtuous have fallen to the lowest depths because discarded by friends, frowned upon by society, and sneered at by the world, after they had taken a single mis-step. Society forgives man, but woman never. 12. IN THE BEGINNING of every girl's downward career there is necessarily a hesitation. She naturally ponders over what course to take, dreading to meet friends and looking into the future with horror. That moment is the vital turning point in her career; a kind word of forgiveness, a mother's embrace a father's welcome may save her. The bloodhounds, known as the seducer, the libertine, the procurer, are upon her track; she is trembling on the frightful brink of the abyss. Extend a helping hand and save her! 13. FATHER, if your daughter goes astray, do not drive her from your home. Mother, if your child errs, do not close your heart against her. Sisters and brothers and friends, do not force her into the pathway of shame, but rather strive to win her back into the Eden of virtue, and in nine cases out of ten you will succeed. {384} 14. SOCIETY EVILS.--The dance, the theater, the wine-cup, the race-course, the idle frivolity and luxury of summer watering places, all have a tendency to demoralize the young. 15. BAD SOCIETY.--Much of our modern society admits libertines and seducers to the drawing-room, while it excludes their helpless and degraded victims, consequently it is not strange that there are skeletons in many closets, matrimonial infelicity and wayward girls. 16. "'KNOW THYSELF,' says Dr. Saur, "is an important maxim for us all, and especially is it true for girls. "All are born with the desire to become attractive--girls especially want to grow up, not only attractive, but beautiful. Some girls think that bright eyes, pretty hair and fine clothes alone make them beautiful. This is not so. Real beauty depends upon good health, good manners and a pure mind. "As the happiness of our girls depends upon their health, it behoves us all to guide the girls in such a way as to bring forward the best of results. 17. "THERE IS NO ONE who stands so near the girl as the mother. From early childhood she occupies the first place in the little one's confidence--she laughs, plays, and corrects, when necessary, the faults of her darling. She should be equally ready to guide in the important laws of life and health upon which rest her future. Teach your daughters that in all things the 'creative principle' has its source in life itself. It originates from Divine life, and when they know that it may be consecrated to wise and useful purposes, they are never apt to grow up with base thoughts or form bad habits. Their lives become a happiness to themselves and a blessing to humanity. 18. TEACH WISELY.--"Teach your daughters that _all life_ originates from a seed--a germ. Knowing this law, you need have no fears that base or unworthy thoughts of the reproductive function can ever enter their minds. The growth, development and ripening of human seed becomes a beautiful and sacred mystery. The tree, the rose and all plant life are equally as mysterious and beautiful in their reproductive life. Does not this alone prove to us, conclusively, that there is a Divinity in the background governing, controlling and influencing our lives? Nature has no secrets, and why should we? None at all. The only care we should experience is in teaching wisely. {385} "Yes--lead them wisely--teach them that the seed, the germ of a new life, is maturing within them. Teach them that between the ages of eleven and fourteen this maturing process has certain physical signs. The breasts grow round and full, the whole body, even the voice, undergoes a change. It is right that they should be taught the natural law of life in reproduction and the physiological structure of their being. Again we repeat that these lessons should be taught by the mother, and in a tender, delicate and confidential way. Become, oh, mother, your daughter's companion, and she will not go elsewhere for this knowledge--which must come to all in time, but possibly too late and through sources that would prove more harm than good. 19. THE ORGANS OF CREATIVE LIFE in women are: Ovaries, Fallopian tubes, uterus, vagina and mammary glands. The _ovaries_ and _Fallopian tubes_ have already been described under "The Female Generative Organs." "The _uterus_ is a pear-shaped muscular organ, situated in the lower portion of the pelvis, between the bladder and the rectum. It is less than three inches in length and two inches in width and one in thickness. "The _vagina_ is a membranous canal which joins the internal outlet with the womb, which projects slightly into it. The opening into the vagina is nearly oval, and in those who have never indulged in sexual intercourse or in handling the sexual organs is more or less closed by a membrane termed the _hymen_. The presence of this membrane was formerly considered as undoubted evidence of virginity; its absence, a lack of chastity. "The _mammary glands_ are accessory to the generative organs. They secrete milk, which the All-wise Father provided for the nourishment of the child after birth. 20. "MENSTRUATION, which appears about the age of thirteen years, is the flow from the uterus that occurs every month as the seed-germ ripens in the ovaries. God made the sexual organs so that the race should not die out. He gave them to us so that we may reproduce life, and thus fill the highest position in the created universe. The purpose for which they are made is high and holy and honorable, and if they are used only for this purpose--and they must not be used at all until they are fully matured--they will be a source of greatest blessing to us all. [Illustration: HOPEFUL YOUTH.] 21. "A CAREFUL STUDY of this organ, of its location, of its arteries and nerves, will convince the growing girl that {387} her body should never submit to corsets and tight lacing in response to the demands of fashion, even though nature has so bountifully provided for the safety of this important organ. By constant pressure the vagina and womb may be compressed into one-third their natural length or crowded into an unnatural position. We can readily see, then, the effect of lacing or tight clothing. Under these circumstances the ligaments lose their elasticity, and as a result we have prolapsus or falling of the womb. 22. "I AM MORE ANXIOUS for growing girls than for any other earthly object. These girls are to be the mothers of future generations; upon them hangs the destiny of the world in coming time, and if they can be made to understand what is right and what is wrong with regard to their own bodies now, while they are young, the children they will give birth to and the men and women who shall call them mother will be of a higher type and belong to a nobler class than those of the present day. 23. "ALL WOMEN CANNOT have good features, but they can look well, and it is possible to a great extent to correct deformity and develop much of the figure. The first step to good looks is good health, and the first element of health is cleanliness. Keep clean--wash freely, bathe regularly. All the skin wants is leave to act, and it takes care of itself. 24. "GIRLS SOMETIMES GET THE IDEA that it is nice to be 'weak' and 'delicate,' but they cannot get a more false idea! God meant women to be strong and able-bodied, and only by being so can they be happy and capable of imparting happiness to others. It is only by being strong and healthy that they can be perfect in their sexual nature; and it is only by being perfect in this part of their being that you can become a noble, grand and beautiful woman. 25. "UP TO THE AGE of puberty, if the girl has grown naturally, waist, hips and shoulders are about the same in width, the shoulders being, perhaps, a trifle the broadest. Up to this time the sexual organs have grown but little. Now they take a sudden start and need more room. Nature aids the girls; the tissues and muscles increase in size and the pelvis bones enlarge. The limbs grow plump, the girl stops growing tall and becomes round and full. Unsuspected strength comes to her; tasks that were once hard to perform are now easy; her voice becomes sweeter and stronger. The mind develops more rapidly even than the body; her brain is more active and quicker; subjects that once were {388} dull and dry have unwonted interest; lessons are more easily learned; the eyes sparkle with intelligence, indicating increased mental power; her manner denotes the consciousness of new power; toys of childhood are laid away; womanly thoughts and pursuits fill her mind; budding childhood has become blooming womanhood. Now, if ever, must be laid the foundation of physical vigor and of a healthy body. Girls should realize the significance of this fact. Do not get the idea that men admire a weakly, puny, delicate, small-waisted, languid, doll-like creature, a libel on true womanhood. Girls admire men with broad chests, square shoulders, erect form, keen bright eyes, hard muscles and undoubted vigor. Men also turn naturally to healthy, robust, well-developed girls, and to win their admiration girls must meet their ideals. A good form, a sound mind and a healthy body are within the reach of nine out of ten of our girls by proper care and training. Physical bankruptcy may claim the same proportion if care and training are neglected. 26. "A WOMAN FIVE FEET TALL should measure two feet around the waist and thirty-three inches around the hips. A waist less than this proportion indicates compression either by lacing or tight clothing. Exercise in the open air, take long walks and vigorous exercise, using care not to overdo it. Housework will prove a panacea for many of the ills which flesh is heir to. One hour's exercise at the wash-*tub is of far more value, from a physical standpoint, than hours at the piano. Boating is most excellent exercise and within the reach of many. Care in dressing is also important, and, fortunately, fashion is coming to the rescue here. It is essential that no garments be suspended from the waist. Let the shoulders bear the weight of all the clothing, so that the organs of the body may be left free and unimpeded. 27. "SLEEP SHOULD BE HAD regularly and abundantly. Avoid late hours, undue excitement, evil associations; partake of plain, nutritious food, and health will be your reward. There is one way of destroying health, which, fortunately, is not as common among girls as boys, and which must be mentioned ere this chapter closes. Self-abuse is practised among growing girls to such an extent as to arouse serious alarm. Many a girl has been led to handle and play with her sexual organs through the advice of some girl who has obtained temporary pleasure in that {389} way; or, perchance, chafing has been followed by rubbing until the organs have become congested with blood, and in this accidental manner the girl discovered what seems to her a source of pleasure, but which, alas, is a source of misery, and even death. 28. "AS IN THE BOY, SO IN THE GIRL, self-abuse causes an undue amount of blood to flow to those organs, thus depriving other parts of the body of its nourishment, the weakest part first showing the effect of want of sustenance. All that has been said upon this loathsome subject in the preceding chapter for boys might well be repeated here, but space forbids. Read that chapter again, and know that the same signs that betray the boy will make known the girl addicted to the vice. The bloodless lips, the dull, heavy eye surrounded with dark rings, the nerveless hand, the blanched cheek, the short breath, the old, faded look, the weakened memory and silly irritability tell the story all too plainly. The same evil result follows, ending perhaps in death, or worse, in insanity. Aside from the injury the girl does herself by yielding to this habit, there is one other reason which appeals to the conscience, and that is, self-abuse is an offence against moral law--it is putting to a vile, selfish use the organs which were given for a high, sacred purpose. 29. "LET THEM ALONE, except to care for them when care is needed, and they may prove the greatest blessing you have ever known. They were given you that you might become a mother, the highest office to which God has ever called one of His creatures. Do not debase yourself and become lower than the beasts of the field. If this habit has fastened itself upon any one of our readers, stop it now. Do not allow yourself to think about it, give up all evil associations, seek pure companions, and go to your mother, older sister, or physician for advice. 30. "AND YOU, MOTHER, knowing the danger that besets your daughters at this critical period, are you justified in keeping silent? Can you be held guiltless if your daughter ruins body and mind because you were _too modest_ to tell her the laws of her being? There is no love that is dearer to your daughter than _yours_, no advice that is more respected than _yours_, no one whose warning would be more potent. Fail not in your duty. As motherhood has been your sweetest joy, so help your daughter to make it hers." * * * * * {390} Save the Boys. PLAIN WORDS TO PARENTS. [Illustration: YOUNG GARFIELD DRIVING TEAM ON THE CANAL.] 1. With a shy look, approaching his mother when she was alone, the boy of fifteen said, "There are some things I want to ask you. I hear the boys speak of them at school, and I don't understand, and a fellow doesn't like to ask any one but his mother." 2. Drawing him down to her, in the darkness that was closing about them, the mother spoke to her son and the son to his mother freely of things which everybody must know sooner or later, and which no boy should learn from "anyone but his mother" or father. 3. If you do not answer such a natural question, your boy will turn for answer to others, and learn things, perhaps, which your cheeks may well blush to have him know. 4. Our boys and girls are growing faster than we think. The world moves; we can no longer put off our children {391} with the old nurses' tales; even MacDonald's beautiful statement, "Out of the everywhere into the there", does not satisfy them when they reverse his question and ask, "Where did I come from?" 5. They must be answered. If we put them off, they may be tempted to go elsewhere for information, and hear half-truths, or whole truths so distorted, so mingled with what is low and impure that, struggle against it as they may in later years, their minds will always retain these early impressions. 6. It is not so hard if you begin early. The very flowers are object lessons. The wonderful mystery of life is wrapped in one flower, with its stamens, pistils and ovaries. Every child knows how an egg came in the nest, and takes it as a matter of course; why not go one step farther with them and teach the wonder, the beauty, the holiness that surrounds maternity anywhere? Why, centuries ago the Romans honored, and taught their boys to honor, the women in whose safety was bound up the future of their existence as a nation! Why should we do less? 7. Your sons and mine, your daughters and mine, need to be wisely taught and guarded just along these lines, if your sons and mine, your daughters and mine, are to grow up into a pure, healthy, Christian manhood and womanhood. [Illustration] {392} 8. [4]"How grand is the boy who has kept himself undefiled! His complexion clear, his muscles firm, his movements vigorous, his manner frank, his courage undaunted, his brain active, his will firm, his self-control perfect, his body and mind unfolding day by day. His life should be one song of praise and thanksgiving. If you want your boy to be such a one, train him, my dear woman, _to-day_, and his _to-morrow_ will take care of itself. 9. "Think you that good seed sown will bring forth bitter fruit? A thousand times, No! As we sow, so shall we reap. Train your boys in morality, temperance and virtue. Teach them to embrace good and shun evil. Teach them the true from the false; the light from the dark. Teach them that when they take a thing that is not their own, they commit a sin. Teach them that _sin means disobedience of God's laws of every kind_. 10. "God made every organ of our body with the intention that it should perform a certain work. If we wish to see, we use our eyes; if we want to hear, our ears are called into use. In fact, nature teaches us the proper use of _all our organs_. I say to you, mother, and oh, so earnestly: 'Go teach your boy that which you may never be ashamed to do, about these organs that make him _specially a boy_.' 11. "Teach him they are called _sexual organs_; that they are not impure, but of special importance, and made by God for a definite purpose. Teach him that there are impurities taken from the system in fluid form called urine, and that it passes through the sexual organs, but that nature takes care of that. Teach him that these organs are given as a sacred trust, that in maturer years he may be the means of giving life to those who shall live forever. 12. "Impress upon him that if these organs are abused, or if they are put to any use besides that for which God made them--and He did not intend they should be used at all until man is fully grown--they will bring disease and ruin upon those who abuse and disobey the laws which God has made to govern them. If he has ever learned to handle his _sexual organs_, or to touch them in any way except to keep them clean, not to do it again. If he does he will not grow up happy, healthy and strong. 13. "Teach him that when he handles or excites the {393} sexual organs all parts of the body suffer, because they are connected by nerves that run throughout the system; this is why it is called 'self-abuse.' The whole body is abused when this part of the body is handled or excited in any manner whatever. Teach them to shun all children who indulge in this loathsome habit, or all children who talk about these things. The sin is terrible, and is, in fact, worse than lying or stealing. For, although these are wicked and will ruin their souls, yet this habit of self-abuse will ruin both soul and body. 14. "If the sexual organs are handled, it brings too much blood to these parts, and this produces a diseased condition; it also causes disease in other organs of the body, because they are left with a less amount of blood than they ought to have. The sexual organs, too, are very closely connected with the spine and the brain by means of the nerves, and if they are handled, or if you keep thinking about them, these nerves get excited and become exhausted, and this makes the back ache, the brain heavy and the whole body weak. 15. "It lays the foundation for consumption, paralysis and heart disease. It weakens the memory, makes a boy careless, negligent and listless. It even makes many lose their minds; others, when grown, commit suicide. How often mothers see their little boys handling themselves, and let it pass, because they think the boy will outgrow the habit, and do not realize the strong hold it has upon them. I say to you who love your boys--'Watch!' 16. "Don't think it does no harm to your boy because he does not suffer now, for the effects of this vice come on so slowly that the victim is often very near death before you realize that he has done himself harm. The boy with no knowledge of the consequences, and with no one to warn him, finds momentary pleasure in its practice, and so contracts a habit which grows upon him, undermining his health, poisoning his mind, arresting his development, and laying the foundation for future misery. 17. "Do not read this book and forget it, for it contains earnest and living truths. Do not let false modesty stand in your way, but from this time on keep this thought in mind--'the saving of your boy.' Follow its teachings and you will bless God as long as you live. Read it to your neighbors, who, like yourself, have growing boys, and urge them for the sake of humanity to heed its advice. {394} 18. "Right here we want to emphasize the importance of _cleanliness_. We verily believe that oftentimes these habits originate in a burning and irritating sensation about the organs, caused by a want of thorough washing. 19. "It is worthy of note that many eminent physicians now advocate the custom of circumcision, claiming that the removal of a little of the foreskin induces cleanliness, thus preventing the irritation and excitement which come from the gathering of the whiteish matter under the foreskin at the beginning of the glands. This irritation being removed, the boy is less apt to tamper with his sexual organs. The argument seems a good one, especially when we call to mind the high physical state of those people who have practiced the custom. 20. "Happy is the mother who can feel she has done her duty, in this direction, while her boy is still a child. For those mothers, though, whose little boys have now grown to boyhood with the evil still upon them, and _you_, through ignorance, permitted it, we would say, 'Begin at once; it is never too late.' If he has not lost all will power, he can be saved. Let him go in confidence to a reputable physician and follow his advice. Simple diet, plentiful exercise in open air and congenial employment will do much. Do not let the mind dwell upon evil thoughts, shun evil companions, avoid vulgar stories, sensational novels, and keep the thoughts pure. 21. "Let him interest himself in social and benevolent affairs, participate in Sunday-school work, farmers' clubs, or any organizations which tend to elevate and inspire noble sentiment. Let us remember that 'a perfect man is the noblest work of God.' God has given us a life which is to last forever, and the little time we spend on earth is as nothing to the ages which we are to spend in the world beyond; so our earthly life is a very important part of our existence, for it is here that the foundation is laid for either happiness or misery in the future. It is here that we decide our destiny, and our efforts to know and obey God's laws in our bodies as well as in our souls will not only bring blessings to us in this life, but never-ending happiness throughout eternity." 22. A QUESTION.--How can a father chew and smoke tobacco, drink and swear, use vulgar language, tell obscene stories, and raise a family of pure, clean-minded children? LET THE ECHO ANSWER. * * * * * {396} The Inhumanities of Parents. [Illustration: AN OLD ADAGE: "HE WHO LOVES CHILDREN WILL DO YOU NO HARM."] 1. Not long ago a Presbyterian minister in Western New York whipped his three-year-old boy to death for refusing to say his prayers. The little fingers were broken; the tender flesh was bruised and actually mangled; strong men wept when they looked on the lifeless body. Think of a strong man from one hundred and fifty to two hundred pounds in weight, pouncing upon a little child, like a Tiger upon a Lamb, and with his strong arm inflicting physical blows on the delicate tissues of a child's body. See its frail and trembling flesh quiver and its tender nervous organization shaking with terror and fear. 2. How often is this the case in the punishment of children all over this broad land! Death is not often the immediate consequence of this brutality as in the above stated case, but the punishment is often as unjust, and the physical constitution of children is often ruined and the mind by fright seriously injured. 3. Everyone knows the sudden sense of pain, and sometimes dizziness and nausea follow, as the results of an accidental hitting of the ankle, knee or elbow against a hard substance, and involuntary tears are brought to the eyes; but what is such a pain as this compared with the pains of a dozen or more quick blows on the body of a little helpless child from the strong arm of a parent in a passion? Add to this overwhelming terror of fright, the strangulating effects of sighing and shrieking, and you have a complete picture of child-torture. 4. Who has not often seen a child receive, within an hour or two of the first whipping, a second one, for some small ebullition of nervous irritability, which was simply inevitable from its spent and worn condition? 5. Would not all mankind cry out at the inhumanity of one who, as things are to-day, should propose the substitution of pricking or cutting or burning for whipping? It would, however, be easy to show that small jabs or pricks or cuts are more human than the blows many children receive. Why may not lying be as legitimately cured by blisters made with hot coals as by black and blue spots made with a ruler or whip? The principle is the same; and if the principle is right, why not multiply methods? 6. How many loving mothers will, without any thought of cruelty, inflict half a dozen quick blows on the little hand of her child, and when she could no more take a pin and make {397} the same number of thrusts into the tender flesh, than she could bind the baby on a rack. Yet the pin-thrust would hurt far less, and would probably make a deeper impression on the child's mind. [Illustration] 7. We do not intend to be understood that a child must have everything that it desires and every whim and wish to receive special recognition by the parents. Children can soon be made to understand the necessity of obedience, and punishment can easily be brought about by teaching them self-denial. Deny them the use of a certain plaything, deny {398} them the privilege of visiting certain of their little friends, deny them the privilege of the table, etc., and these self-denials can be applied according to the age and condition of the child, with firmness and without any yielding. Children will soon learn obedience if they see the parents are sincere. Lessons of home government can be learned by the children at home as well as they can learn lessons at school. 8. The trouble is, many parents need more government, more training and more discipline than the little ones under their control. 9. Scores of times during the day a child is told in a short, authoritative way to do or not to do certain little things, which we ask at the hands of elder persons as favors. When we speak to an elder person, we say, would you be so kind as to close the door, when the same person making the request of a child will say, "_Shut the door._" "_Bring me the chair._" "_Stop that noise._" "_Sit down there._" Whereas, if the same kindness was used towards the child it would soon learn to imitate the example. 10. On the other hand, let a child ask for anything without saying "please," receive anything without saying "thank you," it suffers a rebuke and a look of scorn at once. Often a child insists on having a book, chair or apple to the inconveniencing of an elder, and what an outcry is raised: "Such rudeness;" "Such an ill-mannered child;" "His parents must have neglected him strangely." Not at all: The parents may have been steadily telling him a great many times every day not to do these precise things which you dislike. But they themselves have been all the time doing those very things before him, and there is no proverb that strikes a truer balance between two things than the old one which weighs example over against precept. 11. It is a bad policy to be rude to children. A child will win and be won, and in a long run the chances are that the child will have better manners than its parents. Give them a good example and take pains in teaching them lessons of obedience and propriety, and there will be little difficulty in raising a family of beautiful and well-behaved children. 12. Never correct a child in the presence of others; it is a rudeness to the child that will soon destroy its self-respect. It is the way criminals are made and should always and everywhere be condemned. 13. But there are no words to say what we are or what we deserve, if we do this to the little children whom we {399} have dared for our own pleasure to bring into the perils of this life, and whose whole future may be blighted by the mistakes of our careless hands. There are thousands of young men and women to-day groaning under the penalties and burdens of life, who owe their misfortunes, their shipwreck and ruin to the ignorance or indifference of parents. 14. Parents of course love their children, but with that love there is a responsibility that cannot be shirked. The government and training of children is a study that demands a parent's time and attention often much more than the claims of business. 15. Parents, study the problems that come up every day in your home. Remember, your future happiness, and the future welfare of your children, depend upon it. 16. CRIMINALS AND HEREDITY.--Wm. M. F. Round was for many years in charge of the House of Refuge on Randall's Island, New York, and his opportunities for observation in the work among criminals surely make him a competent judge, and he says in his letter to the New York Observer: "Among this large number of young offenders I can state with entire confidence that not one per cent. were children born of criminal parents; and with equal confidence I am able to say that the common cause of their delinquency was found in bad parental training, in bad companionship, and in lack of wholesome restraint from evil associations and influences. It was this knowledge that led to the establishing of the House of Refuge nearly three-quarters of a century ago." 17. BAD TRAINING.--Thus it is seen from one of the best authorities in the United States that criminals are made either by the indifference or the neglect of parents, or both, or by too much training without proper judgment and knowledge. Give your children a good example, and never tell a child to do something and then become indifferent as to whether they do it or not. A child should never be told twice to do the same thing. Teach the child in childhood obedience and never vary from that rule. Do it kindly but firmly. 18. IF YOUR CHILDREN DO NOT OBEY OR RESPECT YOU in their childhood and youth, how can you expect to govern them when older and shape their character for future usefulness and good citizenship? 19. THE FUNDAMENTAL RULE.--Never tell a child twice to do the same thing. Command the respect of your children, and there will be no question as to obedience. * * * * * {400} Chastity and Purity of Character. 1. CHASTITY is the purest and brightest jewel in human character. Dr. Pierce in his widely known _Medical Adviser_ says: For the full and perfect development of mankind, both mental and physical, chastity is necessary. The health demands abstinence from unlawful intercourse. Therefore children should be instructed to avoid all impure works of fiction, which tend to inflame the mind and excite the passions. Only in total abstinence from illicit pleasures is there safety, morals, and health, while integrity, peace and happiness are the conscious rewards of virtue. Impurity travels downward with intemperance, obscenity and corrupting diseases, to degradation and death. A dissolute, licentious, free-and-easy life is filled with the dregs of human suffering, iniquity and despair. The penalties which follow a violation of the law of chastity are found to be severe and swiftly retributive. [Illustration] 2. THE UNION of the sexes in holy Matrimony is a law of nature, finding sanction in both morals and legislation. Even some of the lower animals unite in this union for life and instinctively observe the law of conjugal fidelity with a consistency which might put to blush other animals more highly endowed. It seems important to discuss this subject and understand our social evils, as well as the intense passional desires of the sexes, which must be controlled, or they lead to ruin. 3. SEXUAL PROPENSITIES are possessed by all, and these must be held in abeyance, until they are needed for legitimate purposes. Hence parents ought to understand the value to their children of mental and physical labor, to elevate and strengthen the intellectual and moral faculties, to develop the muscular system and direct the energies of the blood into healthful channels. Vigorous employment of mind and body engrosses the vital energies and diverts them from undue excitement of the sexual desires. _Give your young people plenty of outdoor amusement; less of dancing and more of croquet and lawn tennis. Stimulate the methods of pure thoughts in innocent amusement, and your sons and daughters will mature to manhood and womanhood pure and chaste in character._ {401} 4. IGNORANCE DOES NOT MEAN INNOCENCE.--It is a current idea, especially among our good common people, that the child should be kept in ignorance regarding the mystery of his own body and how he was created or came into the world. This is a great mistake. Parents must know that the sources of social impurity are great, and the child is a hundred times more liable to have his young mind poisoned if entirely ignorant of the functions of his nature than if judiciously enlightened on these important truths by the parent. The parent must give him weapons of defense against the putrid corruption he is sure to meet outside the parental roof. The child cannot get through the A, B, C period of school without it. 5. CONFLICTING VIEWS.--There is a great difference of opinion regarding the age at which the child should be taught the mysteries of nature: some maintain that he cannot comprehend the subject before the age of puberty; others say "they will find it out soon enough, it is not best to have them over-wise while they are so young. Wait a while." That is just the point (_they will find it out_), and we ask in all candor, is it not better that they learn it from the pure loving mother, untarnished from any insinuating remark, than that they should learn it from some foul-mouthed libertine on the street, or some giddy girl at school? Mothers! fathers! which think you is the most sensible and fraught with the least danger to your darling boy or girl? 6. DELAY IS FRAUGHT WITH DANGER.--Knowledge on a subject so vitally connected with moral health must not be deferred. It is safe to say that no child, no boy at least in these days of excitement and unrest, reaches the age of ten years without getting some idea of nature's laws regarding parenthood. And ninety-nine chances to one, those ideas will be vile and pernicious unless they come from a wise, loving and pure parent. Now, we entreat you, parents, mothers! do not wait; begin before a false notion has had chance to find lodgment in the childish mind. But remember this is a lesson of life, it cannot be told in one chapter; it is as important as the lessons of love and duty. 7. THE FIRST LESSONS.--Should you be asked by your four or five-year old, "Mamma, where did you get me?" Instead of saying, "The doctor brought you," or "God made you and a stork brought you from Babyland on his back," tell him the truth as you would about any ordinary question. One mother's explanation was something like this: "My dear, you were not made any more than apples are made, or the little chickens are made. Your dolly was {402} made, but it has no life like you have. God has provided that all living things such as plants, trees, little chickens, little kittens, little babies, etc., should grow from seeds or little tiny eggs. Apples grow, little chickens grow, little babies grow. Apple and peach trees grow from seeds that are planted in the ground, and the apples and peaches grow on the trees. Baby chickens grow inside the eggs that are kept warm by the mother hen for a certain time. Baby boys and girls do not grow inside an egg, but they start to grow inside of a snug warm nest, from an egg that is so small you cannot see it with just your eye." This was not given at once, but from time to time as the child asked questions and in the simplest language, with many illustrations from plant and animal life. It may have occupied months, but in time the lesson was fully understood. 8. THE SECOND LESSON.--The second lesson came with the question, "But _where_ is the nest?" The ice is now broken, as it were; it was an easy matter for the mother to say, "The nest in which you grew, dear, was close to your mother's heart inside her body. All things that do not grow inside the egg itself, and which are kept warm by the mother's body, begin to grow from the egg in a nest inside the mother's body." It may be that this mother had access to illustrations of the babe in the womb which were shown and explained to the child, a boy. He was pleased and satisfied with the explanations. It meant nothing out of the ordinary any more than a primary lesson on the circulatory system did, it was knowledge on nature in its purity and simplicity taught by mother, and hence caused no surprise. The subject of the male and female generative organs came later; the greatest pains and care was taken to make it clear, the little boy was taught that the _sexual organs_ were made for a high and holy purpose, that their office at present is only to carry off impurities from the system in the fluid form called urine, and that he must never handle his _sexual organs_ nor touch them in any way except to keep them clean, and if he does this, he will grow up a bright, happy and healthy boy. But if he excites or _abuses_ them, he will become puny, sickly and unhappy. All this was explained in language pure and simple. There is now in the boy a sturdy base of character building along the line of virtue and purity through knowledge. 9. SILLY DIRTY TRASH.--But I hear some mother say "Such silly dirty trash to tell a child!" It is not dirty nor silly; it is nature's untarnished truth. God has ordained that children should thus be brought into the world, do you call the works of God silly? Remember, kind mother, and {403} don't forget it, if you fail to teach your children, boys or girls, these important lessons early in life, they will learn them from other sources, perhaps long ere you dream of it, and ninety-nine times out of one hundred they will get improper, perverted, impure and vile ideas of these important truths; besides you have lost their confidence and you will never regain it in these matters. They will never come to mamma for information on these subjects. And, think you, that your son and daughter, later in life will make you their confidant as they ought? Will your beautiful daughter hand the first letters she receives from her lover to mamma to read, and seek her counsel and advice when she replies to them? Will she ask mamma whether it is ever proper to sit in her lover's lap? I think not; you have blighted her confidence and alienated her affections. You have kept knowledge from her that she had a right to know; you even failed to teach her the important truths of menstruation. Troubled and excited at the first menstrual flow, she dashed her feet in cold water hoping to stop the flow. You know the results--she is now twenty-five but is suffering from it to this day. You, her mother, over fastidious, _so very nice_ you would never mention "_such silly trash_," but by your consummate foolishness and mock modesty you have ruined your daughter's health, and though in later years she may forgive you, yet she can never love and respect you as she ought. 10. "KNOWLEDGE THE PRESERVER OF PURITY."--Laura E. Scammon, writing on this subject, in the _Arena_ of November, 1893, says: "When questions arise that can not be answered by observation, reply to each as simply and directly as you answer questions upon other subjects, giving scientific names and facts, and such explanations as are suited to the comprehension of the child. Treat nature and her laws always with serious, respectful attention. Treat the holy mysteries of parenthood reverently, never losing sight of the great law upon which are founded all others--the law of love. Say it and sing it, play it and pray it into the soul of your child, that _love is lord of all_." 11. CONCLUSION OF THE WHOLE MATTER.--Observation and common sense should teach every parent that lack of knowledge on these subjects and proper counsel and advice in later years is the main cause of so many charming girls being seduced and led astray, and so many bright promising boys wrecked by _self-abuse_ or _social impurity_. Make your children your confidants early in life, especially in these things, have frequent talks with them on nature, and you will never, other things being equal, mourn over a ruined daughter or a wreckless, debased son. * * * * * {404} Exciting the Passions in Children. 1. CONVERSATION BEFORE CHILDREN.--The conduct and conversation of adults before children and youth, how often have I blushed with shame, and kindled with indignation at the conversation of parents, and especially of mothers, to their children: "John, go and kiss Harriet, for she is your sweet-heart." Well may shame make him hesitate and hang his head. "Why, John, I did not think you so great a coward. Afraid of the girls, are you? That will never do. Come, go along, and hug and kiss her. There, that's a man. I guess you will love the girls yet." Continually is he teased about the girls and being in love, till he really selects a sweet-heart. 2. THE LOSS OF MAIDEN PURITY AND NATURAL DELICACY.--I will not lift the veil, nor expose the conduct of children among themselves. And all this because adults have filled their heads with those impurities which surfeit their own. What could more effectually wear off that natural delicacy, that maiden purity and bashfulness, which form the main barriers against the influx of vitiated Amativeness? How often do those whose modesty has been worn smooth, even take pleasure in thus saying and doing things to raise the blush on the cheek of youth and innocence, merely to witness the effect of this improper illusion upon them; little realizing that they are thereby breaking down the barriers of their virtue, and prematurely kindling the fires of animal passion! 3. BALLS, PARTIES AND AMUSEMENTS.--The entire machinery of balls and parties, of dances and other amusements of young people, tend to excite and inflame this passion. Thinking it a fine thing to get in love, they court and form attachments long before either their mental or physical powers are matured. Of course, these young loves, these green-house exotics, must be broken off, and their miserable subjects left burning up with the fierce fires of a flaming passion, which, if left alone, would have slumbered on for years, till they were prepared for its proper management and exercise. 4. SOWING THE SEEDS FOR FUTURE RUIN.--Nor is it merely the conversation of adults that does all this mischief; their manners also increase it. Young men take the hands of girls from six to thirteen years old, kiss them, press them, and play with them so as, in a great variety of ways, to excite their innocent passions, combined, I grant, with friendship and refinement--for all this is genteely done. They {405} intend no harm, and parents dream of none: and yet their embryo love is awakened, to be again still more easily excited. Maiden ladies, and even married women, often express similar feelings towards lads, not perhaps positively improper in themselves, yet injurious in their ultimate effects. 5. READING NOVELS.--How often have I seen girls not twelve years old, as hungry for a story or novel as they should be for their dinners! A sickly sentimentalism is thus formed, and their minds are sullied with impure desires. Every fashionable young lady must of course read every new novel, though nearly all of them contain exceptionable allusions, perhaps delicately covered over with a thin gauze of fashionable refinement; yet, on that very account, the more objectionable. If this work contained one improper allusion to their ten, many of those fastidious ladies who now eagerly devour the vulgarities of Dumas, and the double-entendres of Bulwer, and even converse with gentlemen about their contents, would discountenance or condemn it as improper. _Shame on novel-reading women_; for they cannot have pure minds or unsullied feelings but Cupid and the beaux, and waking of dreams of love, are fast consuming their health and virtue. 6. THEATER-GOING.--Theaters and theatrical dancing, also inflame the passions, and are "the wide gate" of "the broad road" of moral impurity. Fashionable music is another, especially the verses set to it, being mostly love-sick ditties, or sentimental odes, breathing this tender passion in its most melting and bewitching strains. Improper prints often do immense injury in this respect, as do also balls, parties, annuals, newspaper articles, exceptional works, etc. 7. THE CONCLUSION OF THE WHOLE MATTER.--Stop for one moment and think for yourself and you will be convinced that the sentiment herein announced is for your good and the benefit of all mankind. [Illustration] {406} Puberty, Virility and Hygienic Laws. [Illustration] 1. WHAT IS PUBERTY?--The definition is explained in another portion of this book, but it should be understood that it is not a prompt or immediate change; it is a slow extending growth and may extend for many years. The ripening of physical powers do not take place when the first signs of puberty appear. 2. PROPER AGE.--The proper age for puberty should vary from twelve to eighteen years. As a general rule, in the more vigorous and the more addicted to athletic exercise or out-door life, this change is slower in making its approach. 3. HYGIENIC ATTENTION.--Youths at this period should receive special private attention. They should be taught the purpose of the sexual organs and the proper hygienic laws that govern them, and they should also be taught to rise in the morning and not to lie in bed after waking up, because it is largely owing to this habit that the secret vice is contracted. One of the common causes of premature excitement in many boys is a tight foreskin. It may cause much evil and ought always to be remedied. Ill-fitting garments often cause much irritation in children and produce unnatural passions. It is best to have boys sleep in separate beds and not have them sleep together if it can be avoided. {407} 4. PROPER INFLUENCE.--Every boy and girl should be carefully trained to look with disgust on everything that is indecent in word or action. Let them be taught a sense of shame in doing shameful things, and teach them that modesty is honorable, and that immodesty is indecent and dishonorable. Careful training at the proper age may save many a boy or girl from ruin. 5. SEXUAL PASSIONS.--The sexual passions may be a fire from heaven, or a subtle flame from hell. It depends upon the government and proper control. The noblest and most unselfish emotions take their arise in the passion of sex. Its sweet influence, its elevating ties, its vibrations and harmony, all combine to make up the noble and courageous traits of man. 6. WHEN PASSIONS BEGIN.--It is thought by some that passions begin at the age of puberty, but the passions may be produced as early as five or ten years. All depends upon the training or the want of it. Self-abuse is not an uncommon evil at the age of eight or ten. A company of bad boys often teach an innocent child that which will develop his ruin. A boy may feel a sense of pleasure at eight and produce a slight discharge, but not of semen. Thus it is seen that parents may by neglect do their child the greatest injury. 7. FALSE MODESTY.--Let there be no false modesty on part of the parents. Give the child the necessary advice and instructions as soon as necessary. 8. THE MAN UNSEXED, by Mutilation or Masturbation. Eunuchs are proverbial for their cruelty and crafty and unsympathizing dispositions. Their mental powers are feeble and their physical strength is inferior. They lack courage and physical endurance. When a child is operated upon before the age of puberty, the voice retains its childish treble, the limbs their soft and rounded outlines, and the neck acquires a feminine fulness; no beard makes its appearance. In ancient times and up to this time in Oriental nations eunuchs are found. They are generally slaves who have suffered mutilation at a tender age. It is a scientific fact that where boys have been taught the practice of masturbation in their early years, say from eight to fourteen years of age, if they survive at all they often have their powers reduced to a similar condition of a eunuch. They generally however suffer a greater disadvantage. Their health will be more or less injured. In the eunuch the power of sexual intercourse is not entirely lost but of course there is sterility and little if any satisfaction, and the same thing may be true of the victim of self-abuse. {408} 9. SIGNS OF VIRILITY.--As the young man develops in strength and years the sexual appetite will manifest itself. The secretion of the male known as the seed or semen depends for the life-transmitting power upon little minute bodies called spermatozoa. These are very active and numerous in a healthy secretion, being many hundreds in a single drop and a single one of them is capable to bring about conception in a female. Dr. Napheys in his "Transmission of Life," says: "The secreted fluid has been frozen and kept at a temperature of zero for four days, yet when it was thawed these animalcules, as they are supposed to be, were as active as ever. They are not, however, always present, and when present may be of variable activity. In young men, just past puberty, and in aged men, they are often scarce and languid in motion." At the proper age the secretion is supposed to be the most active, generally at the age of twenty-five, and decreases as age increases. 10. HYGIENIC RULE.--The man at mid-life should guard carefully his passions and the husband his virile powers, and as the years progress, steadily wean himself more from his desire, for his passions will become weaker with age and any excitement in middle life may soon debilitate and destroy his virile powers. 11. FOLLIES OF YOUTH.--Dr. Napheys says: "Not many men can fritter away a decade or two of years in dissipation and excess, and ever hope to make up their losses by rigid surveillance in later years." "The sins of youth are expiated in age," is a proverb which daily examples illustrate. In proportion as puberty is precocious, will decadence be premature; the excesses of middle life draw heavily on the fortune of later years. "The mill of the gods grinds slow, but it grinds exceedingly fine," and though nature may be a tardy creditor, she is found at last to be an inexorable one. * * * * * {409} Our Secret Sins. 1. PASSIONS.--Every healthful man has sexual desires, and he might as well refuse to satisfy his hunger as to deny their existence. The Creator has given us various appetites, intended they should be indulged, and has provided the means. 2. REASON.--While it is true that a healthy man has strongly developed sexual passions, yet, God has crowned man with reason, and with a proper exercise of this wonderful faculty of the human mind no lascivious thoughts need to control the passions. A pure heart will develop pure thoughts and bring out a good life. 3. RIOTING IN VISIONS.--Dr. Lewis says: "Rioting in visions of nude women may exhaust one as much as an excess in actual intercourse. There are multitudes who would never spend the night with an abandoned female, but who rarely meet a young girl that their imaginations are not busy with her person. This species of indulgence is well-nigh universal; and it is the source of all other forms--the fountain from which the external vices spring, and the nursery of masturbation." 4. COMMITTING ADULTERY IN THE HEART.--A young man who allows his mind to dwell upon the vision of nude women will soon become a victim of ruinous passion, and either fall under the influence of lewd women or resort to self-abuse. The man who has no control over his mind and allows impure thoughts to be associated with the name of every female that may be suggested to his mind, is but committing adultery in his heart, just as guilty at heart as though he had committed the deed. 5. UNCHASTITY.--So far as the record is preserved, unchastity has contributed above all other causes, more to the ruin and exhaustion and demoralization of the race than all other wickedness. And we shall not be likely to vanquish the monster, even in ourselves, unless we make the thoughts our point of attack. So long as they are sensual we are indulging in sexual abuse, and are almost sure, when temptation is presented, to commit the overt acts of sin. If we cannot succeed within, we may pray in vain for help to resist the tempter outwardly. A young man who will indulge in obscene language will be guilty of a worse deed if opportunity is offered. 6. BAD DRESSING.--If women knew how much mischief they do men they would change some of their habits of {410} dress. The dress of their busts, the padding in different parts, are so contrived as to call away attention from the soul and fix it on the bosom and hips. And then, many, even educated women, are careful to avoid serious subjects in our presence--one minute before a gentleman enters the room they may be engaged in thoughtful discussion, but the moment he appears their whole style changes; they assume light fascinating ways, laugh sweet little bits of laughs, and turn their heads this way and that, all which forbids serious thinking and gives men over to imagination. 7. THE LUSTFUL EYE.--How many men there are who lecherously stare at every woman in whose presence they happen to be. These monsters stare at women as though they were naked in a cage on exhibition. A man whose whole manner is full of animal passion is not worthy of the respect of refined women. They have no thoughts, no ideas, no sentiments, nothing to interest them but the bodies of women whom they behold. The moral character of young women has no significance or weight in their eyes. This kind of men are a curse to society and a danger to the community. No young lady is safe in their company. 8. REBUKING SENSUALISM.--If the young women would exercise an honorable independence and heap contempt upon the young men that allow their imagination to take such liberties, a different state of things would soon follow. Men of that type of character should have no recognition in the presence of ladies. 9. EARLY MARRIAGES.--There can be no doubt that early marriages are bad for both parties. For children of such a marriage always lack vitality. The ancient Germans did not marry until the twenty-fourth or twenty-fifth year, previous to which they observed the most rigid chastity, and in consequence they acquired a size and strength that excited the astonishment of Europe. The present incomparable vigor of that race, both physically and mentally, is due in a great measure to their long established aversion to marrying young. The results of too early marriages are in brief, stunted growth and impaired strength on the part of the male; delicate if not utterly bad health in the female; the premature old age or death of one or both, and a puny, sickly offspring. 10. SIGNS OF EXCESSES.--Dr. Dio Lewis says: "Some of the most common effects of sexual excess are backache, lassitude, giddiness, dimness of sight, noises in the ears, numbness of the fingers, and paralysis. The drain is universal, but the more sensitive organs and tissues suffer {411} most. So the nervous system gives way and continues the principal sufferer throughout. A large part of the premature loss of sight and hearing, dizziness, numbness and pricking in the hands and feet, and other kindred developments, are justly chargeable to unbridled venery. Not unfrequently you see men whose head or back or nerve testifies of such reckless expenditure." 11. NON-COMPLETED INTERCOURSE.--Withdrawal before the emission occurs is injurious to both parties. The soiling of the conjugal bed by the shameful manoeuvres is to be deplored. 12. THE EXTENT OF THE PRACTICE.--One cannot tell to what extent this vice is practiced, except by observing its consequences, even among people who fear to commit the slightest sin, to such a degree is the public conscience perverted upon this point. Still, many husbands know that nature often renders nugatory the most subtle calculations, and reconquers the rights which they have striven to frustrate. No matter; they persevere none the less, and by the force of habit they poison the most blissful moments of life, with no surety of averting the result that they fear. So who knows if the too often feeble and weakened infants are not the fruit of these in themselves incomplete procreations, and disturbed by preoccupations foreign to the natural act. 13. HEALTH OF WOMEN.--Furthermore, the moral relations existing between the married couple undergo unfortunate changes; this affection, founded upon reciprocal esteem, is little by little effaced by the repetition of an act which pollutes the marriage bed. If the good harmony of families and the reciprocal relations are seriously menaced by the invasion of these detestable practices, the health of women, as we have already intimated, is fearfully injured. 14. THE PRACTICE OF ABORTION.--Then we have the practice of abortion reduced in modern times to a science, and almost to a distinct profession. A large part of the business is carried on by the means of medicines advertised in obscure but intelligible terms as embryo-destroyers or preventives of conception. Every large city has its professional abortionist. Many ordinary physicians destroy embryos to order, and the skill to do this terrible deed has even descended among the common people. 15. SEXUAL EXHAUSTION.--Every sexual excitement is exhaustive in proportion to its intensity and continuance. If a man sits by the side of a woman, fondles and kisses her three or four hours, and allows his imagination to run riot with sexual visions, he will be five times as much exhausted {412} as he would by the act culminating in emission. It is the sexual excitement more than the emission which exhausts. As shown in another part of this work, thoughts of sexual intimacies, long continued, lead to the worst effects. To a man, whose imagination is filled with erotic fancies the emission comes as a merciful interruption to the burning, harassing and wearing excitement which so constantly goads him. 16. THE DESIRE OF GOOD.--The desire of good for its own sake--this is Love. The desire of good for bodily pleasure--this is Lust. Man is a moral being, and as such should always act in the animal sphere according to the spiritual law. Hence, to break the law of the highest creative action for the mere gratification of animal instinct is to perform the act of sin and to produce the corruption of nature. 17. CAUSE OF PROSTITUTION.--Dr. Dio Lewis says: "Occasionally we meet a diseased female with excessive animal passion, but such a case is very rare. The average woman has so little sexual desire that if licentiousness depended upon her, uninfluenced by her desire to please man or secure his support, there would be very little sexual excess. Man is strong--he has all the money and all the facilities for business and pleasure; and woman is not long in learning the road to his favor. Many prostitutes who take no pleasure in their unclean intimacies not only endure a disgusting life for the favor and means thus gained, but affect intense passion in their sexual contacts because they have learned that such exhibitions gratify men." 18. HUSBAND'S BRUTALITY.--Husbands! It is your licentiousness that drives your wives to a deed so abhorrent to their every wifely, womanly and maternal instinct--a deed which ruins the health of their bodies, prostitutes their souls, and makes marriage, maternity and womanhood itself degrading and loathsome. No terms can sufficiently characterize the cruelty, meanness and disgusting selfishness of your conduct when you impose on them a maternity so detested as to drive them to the desperation of killing their unborn children and often themselves. 19. WHAT DRUNKARDS BEQUEATH TO THEIR OFFSPRING.--Organic imperfections unfit the brain for sane action, and habit confirms the insane condition; the man's brain has become unsound. Then comes in the law of hereditary descent, by which the brain of a man's children is fashioned after his own--not as it was originally, but as it has become, in consequence of frequent functional disturbance. Hence, of all appetites, the inherited appetite for drunkenness is {413} the most direful. Natural laws contemplate no exceptions, and sins against them are never pardoned. 20. THE REPORTS OF HOSPITALS.--The reports of hospitals for lunatics almost universally assign intemperance as one of the causes which predispose a man's offspring to insanity. This is even more strikingly manifested in the case of congenital idiocy. They come generally from a class of families which seem to have degenerated physically to a low degree. They are puny and sickly. 21. SECRET DISEASES.--See the weakly, sickly and diseased children who are born only to suffer and die, all because of the private disease of the father before his marriage. Oh, let the truth be told that the young men of our land may learn the lessons of purity of life. Let them learn that in morality there is perfect protection and happiness. [Illustration: GETTING A DIVORCE] {414} Physical and Moral Degeneracy. [Illustration: THE DEGENERATE TURK.] 1. MORAL PRINCIPLE.--"Edgar Allen Poe, Lord Byron, and Robert Burns," says Dr. Geo. F. Hall, "were men of marvelous strength intellectually. But measured by the true rule of high moral principle, they were very weak. Superior endowment in a single direction--physical, mental, or spiritual--is not of itself sufficient to make one strong in all that that heroic word means. 2. INSANE ASYLUM.--Many a good man spiritually has gone to an untimely grave because of impaired physical powers. Many a good man spiritually has gone to the insane asylum because of bodily and mental weaknesses. Many a good man spiritually has fallen from virtue in an evil moment because of a weakened will, or, a too demanding fleshly passion, or, worse than either, too lax views on the subject of personal chastity." 3. BOYS LEARNING VICES.--Some ignorant and timid people argue that boys and young men in reading a work of this character will learn vices concerning which they had {415} never so much as dreamed of before. This is, however, certain, that vices cannot be condemned unless they are mentioned; and if the condemnation is strong enough it surely will be a source of strength and of security. If light and education, on these important subjects, does injury, then all knowledge likewise must do more wrong than good. Knowledge is power, and the only hope of the race is enlightenment on all subjects pertaining to their being. 4. MORAL MANHOOD.--It is clearly visible that the American manhood is rotting down--decaying at the center. The present generation shows many men of a small body and weak principles, and men and women of this kind are becoming more and more prevalent. Dissipation and indiscretions of all kind are working ruin. Purity of life and temperate habits are being too generally disregarded. 5. YOUNG WOMEN.--The vast majority of graduates from the schools and colleges of our land to-day, and two-thirds of the membership of our churches, and three-fourths of the charitable workers, are females. Everywhere girls are carrying off most of the prizes in competitive examinations, because women, as a sex, naturally maintain a better character, take better care of their bodies, and are less addicted to bad and injurious habits. While all this is true in reference to females, you will find that the male sex furnishes almost the entire number of criminals. The saloons, gambling dens, the brothels, and bad literature are drawing down all that the public schools can build up. Seventy per cent. of the young men of this land do not darken the church door. They are not interested in moral improvement or moral education. Eighty-five per cent. leave school under 15 years of age; prefer the loafer's honors to the benefit of school. 6. PROMOTION.--The world is full of good places for good young men, and all the positions of trust now occupied by the present generation will soon be filled by the competent young men of the coming generation; and he that keeps his record clean, lives a pure life, and avoids excesses or dissipations of all kinds, and fortifies his life with good habits, is the young man who will be heard from, and a thousand places will be open for his services. 7. PERSONAL PURITY.--Dr. George F. Hall says: "Why not pay careful attention to man in all his elements of strength, physical, mental, and moral? Why not make personal purity a fixed principle in the manhood of the present and coming generations, and thus insure the best men the world has ever seen? It can be done. Let every reader of these lines resolve that he will be one to help do it." * * * * * {416} Immorality, Disease and Death. [Illustration: Charles Dickens' Chair and Desk.] 1. THE POLICY OF SILENCE.--There is no greater delusion than to suppose that vast number of boys know nothing about practices of sin. Some parents are afraid that unclean thoughts may be suggested by these very defences. The danger is slight. Such cases are barely possible, but when the untold thousands are thought of on the other side, who have been demoralized from childhood through ignorance, and who are to-day suffering the result of these vicious practices, the policy of silence stands condemned, and intelligent knowledge abundantly justified. The emphatic words of Scripture are true in this respect also, "The people are destroyed for lack of knowledge." 2. LIVING ILLUSTRATIONS.--Without fear of truthful contradiction we affirm that the homes, public assemblies, and streets of all our large cities abound to-day with living illustrations and proofs of the widespread existence of this physical and moral scourge. An enervated and stunted manhood, a badly developed physique, a marked absence of manly and womanly strength and beauty, are painfully common everywhere. Boys and girls, young men and women, exist by thousands, of whom it may be said, they were badly born and ill-developed. Many of these are, to some extent, bearing the penalty of the sins and excesses of their parents, especially their fathers, whilst the great majority are reaping the fruits of their own immorality in a dwarfed and ill-formed body, and effeminate appearance, weak and enervated mind. {417} 3. EFFEMINATE AND SICKLY YOUNG MEN.--The purposeless and aimless life of any number of effeminate and sickly young men, is to be distinctly attributed to these sins. The large class of mentally impotent "ne'er-do-wells" are being constantly recruited and added to by those who practice what the celebrated Erichson calls "that hideous sin engendered by vice, and practiced in solitude"--the sin, be it observed, which is the common cause of physical and mental weakness, and of the fearfully impoverishing night-emissions, or as they are commonly called, "wet-dreams." 4. WEAKNESS, DISEASE, DEFORMITY, AND DEATH.--Through self-pollution and fornication the land is being corrupted with weakness, disease, deformity, and death. We regret to say that we cannot speak with confidence concerning the moral character of the Jew; but we have people amongst us who have deservedly a high character for the tone of their moral life--we refer to the members of the Society of Friends. The average of life amongst these reaches no less than fifty-six years; and, whilst some allowance must be made for the fact that amongst the Friends the poor have not a large representation, these figures show conclusively the soundness of this position, 5. SOWING THEIR WILD OATS.--It is monstrous to suppose that healthy children should die just as they are coming to manhood. The fact that thousands of young people do reach the age of sixteen or eighteen, and then decline and die, should arouse parents to ask the question: Why? Certainly it would not be difficult to tell the reason in thousands of instances, and yet the habit and practice of the deadly sin of self-pollution is actually ignored; it is even spoken of as a boyish folly not to be mentioned, and young men literally burning up with lust are mildly spoken of as "sowing their wild oats." Thus the cemetery is being filled with masses of the youth of America who, as in Egypt of old, fill up the graves of uncleanness and lust. Some time since a prominent Christian man was taking exception to my addressing men on this subject; observe this! one of his own sons was at that very time near the lunatic asylum through these disgusting sins. What folly and madness this is! 6. DEATH TO TRUE MANHOOD.--The question for each one is, "In what way are you going to divert the courses of the streams of energy which pertain to youthful vigor and manhood?" To be destitute of that which may be described as raw material in the human frame, means that no really vigorous manhood can have place; to burn up the juices of the system in the fires of lust is madness and wanton folly, {418} but it can be done. To divert the currents of life and energy from blood and brain, from memory and muscle, in order to secrete it for the shambles of prostitution, is death to true manhood; but remember, it can be done! The generous liquid life may inspire the brain and blood with noble impulse and vital force, or it may be sinned away and drained out of the system until the jaded brain, the faded cheek, the enervated young manhood, the gray hair, narrow chest, weak voice, and the enfeebled mind show another victim in the long catalogue of the degraded through lust. 7. THE SISTERHOOD OF SHAME AND DEATH.--Whenever we pass the sisterhood of death, and hear the undertone of song, which is one of the harlot's methods of advertising, let us recall the words, that these represent the "pestilence which walketh in darkness, the destruction that wasteth at noonday." The allusion, of course, is to the fact that the great majority of these harlots are full of loathsome physical and moral disease; with the face and form of an angel, these women "bite like a serpent and sting like an adder;" their traffic is not for life, but inevitably for shame, disease, and death. Betrayed and seduced themselves, they in their turn betray and curse others. 8. WARNING OTHERS.--Have you never been struck with the argument of the Apostle, who, warning others from the corrupt example of the fleshy Esau, said, "Lest there be any fornicator or profane person as Esau, who for one mess of meat sold his own birthright. For ye know that even afterward, when he desired to inherit the blessing, he was rejected, he found no place for repentance, though he sought it diligently with tears." Terrible and striking words are these. His birthright sold for a mess of meat. The fearful costs of sin--yes, that is the thought, particularly the sin of fornication! Engrave that word upon your memories and hearts--"One mess of meat." 9. THE HARLOT'S MESS OF MEAT.--Remember it, young men, when you are tempted to this sin. For a few minutes' sensual pleasure, for a mess of harlot's meat, young men are paying out the love of the son and brother; they are deceiving, lying, and cheating for a mess of meat; for a mess, not seldom of putrid flesh, men have paid down purity and prayer, manliness and godliness; for a mess of meat some perhaps have donned their best attire, and assumed the manners of the gentleman, and then, like an infernal hypocrite, dogged the steps of maiden or harlot to satisfy their degrading lust; for a mess of meat young men have deceived father and mother, and shrunk from the embrace of {419} love of the pure-minded sister. For the harlot's mess of meat some listening to me have spent scores of hours of invaluable time. They have wearied the body, diseased and demoralized the mind. The pocket has been emptied, theft committed, lies unnumbered told, to play the part of the harlot's mate--perchance a six-foot fool, dragged into the filth and mire of the harlot's house. You called her your friend, when, but for her mess of meat, you would have passed her like dirt in the street. 10. SEEING LIFE.--You consorted with her for your mutual shame and death, and then called it "seeing life." Had your mother met you, you would have shrunk away like a craven cur. Had your sister interviewed you, she had blushed to bear your name; or had she been seen by you in company with some other whoremaster, for similar commerce, you would have wished that she had been dead. Now what think you of this "seeing life?" And it is for this that tens of thousands of strong men in our large cities are selling their birthright. 11. THE DEVIL'S DECOYS.--Some may be ready to affirm that physical and moral penalties do not appear to overtake all men; that many men known to be given to intemperance and sensuality are strong, well, and live to a good age. Let us not make any mistake concerning these; they are exceptions to the rule; the appearance of health in them is but the grossness of sensuality. You have only carefully to look into the faces of these men to see that their countenances, eyes, and speech betray them. They are simply the devil's decoys. 12. GROSSNESS OF SENSUALITY.--The poor degraded harlot draws in the victims like a heavily charged lodestone; these men are found in large numbers throughout the entire community; they would make fine men were they not weighted with the grossness of sensuality; as it is, they frequent the race-course, the card-table, the drinking-saloon, the music-hall, and the low theaters, which abound in our cities and towns; the great majority of these are men of means and leisure. Idleness is their curse, their opportunity for sin; you may know them as the loungers over refreshment-bars, as the retailers of the latest filthy joke, or as the vendors of some disgusting scandal; indeed, it is appalling the number of these lepers found both in our business and social circles. * * * * * {421} Poisonous Literature and Bad Pictures. [Illustration: PALESTINE WATER CARRIERS.] 1. OBSCENE LITERATURE.--No other source contributes so much to sexual immorality as obscene literature. The mass of stories published in the great weeklies and the cheap novels are mischievous. When the devil determines to take charge of a young soul, he often employs a very ingenious method. He slyly hands a little novel filled with "voluptuous forms," "reclining on bosoms," "languishing eyes," etc. 2. MORAL FORCES.--The world is full of such literature. It is easily accessible, for it is cheap, and the young will procure it, and therefore become easy prey to its baneful influence and effects. It weakens the moral forces of the young, and they thereby fall an easy prey before the subtle schemes of the libertine. 3. BAD BOOKS.--Bad books play not a small part in the corruption of the youth. A bad book is as bad as an evil companion. In some respects it is even worse than a living teacher of vice, since it may cling to an individual at all times. It will follow him and poison his mind with the venom of evil. The influence of bad books in making bad boys and men is little appreciated. Few are aware how much evil seed is being sown among the young everywhere through the medium of vile books. 4. SENSATIONAL STORY BOOKS.--Much of the evil literature which is sold in nickel and dime novels, and which constitutes the principal part of the contents of such papers as the "Police Gazette," the "Police News," and a large proportion of the sensational story books which flood the land. You might better place a coal of fire or a live viper in your bosom, than allow yourself to read such a book. The thoughts that are implanted in the mind in youth will often stick there through life, in spite of all efforts to dislodge them. 5. PAPERS AND MAGAZINES.--Many of the papers and magazines sold at our news stands, and eagerly sought after by young men and boys, are better suited for the parlors of a house of ill-fame than for the eyes of pure-minded youth. A newsdealer who will distribute such vile sheets ought to be dealt with as an educator in vice and crime, an agent of evil, and a recruiting officer of hell and perdition. 6. SENTIMENTAL LITERATURE OF LOW FICTION.--Sentimental literature, whether impure in its subject matter or not, has {422} a direct tendency in the direction of impurity. The stimulation of the emotional nature, the instilling of sentimental ideas into the minds of the young, has a tendency to turn the thoughts into a channel which leads in the direction of the formation of vicious habits. 7. IMPRESSIONS LEFT BY READING QUESTIONABLE LITERATURE.--It is painful to see strong intelligent men and youths reading bad books, or feasting their eyes on filthy pictures, for the practice is sure to affect their personal purity. Impressions will be left which cannot fail to breed a legion of impure thoughts, and in many instances criminal deeds. Thousands of elevator boys, clerks, students, traveling men, and others, patronize the questionable literature counter to an alarming extent. 8. THE NUDE IN ART.--For years there has been a great craze after the nude in art, and the realistic in literature. Many art galleries abound in pictures and statuary which cannot fail to fan the fires of sensualism, unless the thoughts of the visitor are trained to the strictest purity. Why should artists and sculptors persist in shocking the finer sensibilities of old and young of both sexes by crowding upon their view representations of naked human forms in attitudes of luxurious abandon? Public taste may demand it. But let those who have the power endeavor to reform public taste. 9. WIDELY DIFFUSED.--Good men have ever lamented the pernicious influence of a depraved and perverted literature. But such literature has never been so systematically and widely diffused as at the present time. This is owing to two causes, its cheapness and the facility of conveyance. 10. INFLAME THE PASSIONS.--A very large proportion of the works thus put in circulation are of the worst character, tending to corrupt the principles, to inflame the passions, to excite impure desire, and spread a blight over all the powers of the soul. Brothels are recruited from this more than any other source. Those who search the trunks of convicted criminals are almost sure to find in them one or more of these works; and few prisoners who can read at all fail to enumerate among the causes which led them into crime the unhealthy stimulus of this depraved and poisonous literature. [Illustration] {423} Startling Sins. [Illustration] 1. NAMELESS CRIMES.--The nameless crimes identified with the hushed-up Sodomite cases; the revolting condition of the school of Sodomy; the revelations of the Divorce Court concerning the condition of what is called national nobility, and upper classes, as well as the unclean spirit which attaches to "society papers," has revealed a condition which is perfectly disgusting. 2. UNFAITHFULNESS.--Unfaithfulness amongst husbands and wives in the upper classes is common and adultery rife everywhere; mistresses are kept in all directions; thousands of these rich men have at least two, and not seldom three establishments. 3. A FRIGHTFUL INCREASE.--Facts which have come to light during the past ten years show a frightful increase in every form of licentiousness; the widely extended area over which whoredom and degrading lust have thrown the glamor of their fascinating toils is simply appalling. {424} 4. MORAL CARNAGE.--We speak against the fearful moral carnage; would to God that some unmistakable manifestation of the wrath of God should come in and put a stop to this huge seed-plot of national demoralization! We are reaping in this disgusting centre the harvest of corruption which has come from the toleration and encouragements given by the legislature, the police, and the magistrates to immorality, vice, and sin; the awful fact is, that we are in the midst of the foul and foetid harvest of lust. Aided by some of the most exalted personages in the land, assisted by thousands of educated and wealthy whoremongers and adulterers, we are reaping also, in individual physical ugliness and deformity, that which has been sown; the puny, ill-formed and mentally weak youths and maidens, men and women, to be seen in large numbers in our principal towns and cities, represent the widespread nature of the curse which has, in a marked manner, impaired the physique, the morality, and the intelligence of the nation. 5. DAILY PRESS.--The daily press has not had the moral courage to say one word; the quality of demoralizing novels such as have been produced from the impure brain and unclean imaginations; the subtle, clever, and fascinating undermining of the white-winged angel of purity by modern sophists, whose prurient and vicious volumes were written to throw a halo of charm and beauty about the brilliant courtesan and the splendid adulteress; the mixing up of lust and love; the making of corrupt passion to stand in the garb of a deep, lasting, and holy affection--these are some of the hideous seedlings which, hidden amid the glamor and fascination of the seeming "angel of light," have to so large an extent corrupted the morality of the country. 6. NIGHTLY EXHIBITIONS.--Some of you know what the nightly exhibitions in these garlanded temples of whorish incentive are. There is the variety theatre, with its disgusting ballet dancing, and its shamelessly indecent photographs exhibited in every direction. What a clear gain to morality it would be if the accursed houses were burnt down, and forbidden by law ever to be re-built or re-opened; the whole scene is designed to act upon and stimulate the lusts and evil passions of corrupt men and women. 7. CONFIDENCE AND EXPOSURE.--I hear some of you say, cannot some influence be brought to bear upon this plague-spot? Will the legislature or congress do nothing? Is the law and moral right to continue to be trodden under foot? Are the magistrates and the police powerless? The truth is the harlots and whoremongers are master of the situation; the moral sense of the legislators, the magistrates, and the {425} police is so low that anything like confidence is at present out of the question. 8. THE SISTERHOOD OF SHAME AND DEATH.--It is enough to make angels weep to see a great mass of America's wealthy and better-class sons full of zeal and on fire with interest in the surging hundreds of the sisterhood of shame and death. Many of these men act as if they were--if they do not believe they are--dogs. No poor hunted dog in the streets was ever tracked by a yelping crowd of curs more than is the fresh girl or chance of a maid in the accursed streets of our large cities. Price is no object, nor parentage, nor home; it is the truth to affirm that hundreds and thousands of well-dressed and educated men come in order to the gratification of their lusts, and to this end they frequent this whole district; they have reached this stage, they are being burned up in this fire of lust; men of whom God says, "Having eyes full of adultery and that cannot cease sin." 9. LAW MAKERS.--Now should any member of the legislature rise up and testify against this "earthly hell," and speak in defence of the moral manhood and womanhood of the nation, he would be greeted as a fanatic, and laughed down amid derisive cheers; such has been the experience again and again. Therefore attack this great stronghold which for the past thirty years has warred and is warring against our social manhood and womanhood, and constantly undermining the moral life of the nation; against this citadel of licentiousness, this metropolitan centre of crime, and vice, and sin, direct your full blast of righteous and manly indignation. [Illustration] 10. TEMPLES OF LUST.--Here stand the foul and splendid temples of lust, intemperance, and passion, into whose vortex tens of thousands of our sons and daughters are constantly being drawn. Let it be remembered that this whole area represents the most costly conditions, and proves beyond question that an enormous proportion of the wealthy manhood of the nation, and we as citizens sustain, partake, and share in this carnival of death. Is it any wonder that the robust type of godly manhood which used to be found in the legislature, is sadly wanting now, or that the wretched caricatures of manhood which find form and place in such papers as "Truth" and the "World" are accepted as representing "modern society?" 11. PURITANIC MANHOOD.--It is a melancholy fact that by reason of uncleanness, we have almost lost regard for the type of puritanic manhood which in the past held aloft the standard of a chaste and holy life; such men in this day are spoken of as "too slow" as "weak-kneed," and {426} "goody-goody" men. Let me recall that word, the fast and indecently-dressed "things," the animals of easy virtue, the "respectable" courtesans that flirt, chaff, gamble, and waltz with well-known high-class licentious lepers--such is the ideal of womanhood which a large proportion of our large city society accepts, fawns upon, and favors. 12. SHAMEFUL CONDITIONS.--Perhaps one of the most inhuman and shameful conditions of modern fashionable society, both in England and America, is that which wealthy men and women who are married destroy their own children in the embryo stage of being, and become murderers thereby. This is done to prevent what should be one of our chief glories, viz., large and well-developed home and family life. * * * * * {427} The Prostitution of Men. CAUSE AND REMEDY. 1. EXPOSED YOUTH.--Generally even in the beginning of the period when sexual uneasiness begins to show itself in the boy, he is exposed in schools, institutes, and elsewhere to the temptations of secret vice, which is transmitted from youth to youth, like a contagious corruption, and which in thousands destroys the first germs of virility. Countless numbers of boys are addicted to these vices for years. That they do not in the beginning of nascent puberty proceed to sexual intercourse with women, is generally due to youthful timidity, which dares not reveal its desire, or from want of experience for finding opportunities. The desire is there, for the heart is already corrupted. 2. BOYHOOD TIMIDITY OVERCOME.--Too often a common boy's timidity is overcome by chance or by seduction, which is rarely lacking in great cities where prostitution is flourishing, and thus numbers of boys immediately after the transition period of youth, in accordance with the previous secret practice, accustom themselves to the association with prostitute women, and there young manhood and morals are soon lost forever. 3. MARRIAGE-BED RESOLUTIONS.--Most men of the educated classes enter the marriage-bed with the consciousness of leaving behind them a whole army of prostitutes or seduced women, in whose arms they cooled their passions and spent the vigor of their youth. But with such a past the married man does not at the same time leave behind him its influence on his inclinations. The habit of having a feminine being at his disposal for every rising appetite, and the desire for change inordinately indulged for years, generally make themselves felt again as soon as the honeymoon is over. Marriage will not make a morally corrupt man all at once a good man and a model husband. 4. THE INJUSTICE OF MAN.--Now, although many men are in a certain sense "not worthy to unloose the latchet of the shoes" of the commonest woman, much less to "unfasten her girdle," yet they make the most extravagant demands on the feminine sex. Even the greatest debauchee, who has spent his vigor in the arms of a hundred courtesans, will cry out fraud and treachery if he does not receive his newly married bride as an untouched virgin. Even the most dissolute husband will look on his wife as deserving of death if his daily infidelity is only once reciprocated. {428} 5. UNJUST DEMANDS.--The greater the injustice a husband does to his wife, the less he is willing to submit to from her; the oftener he becomes unfaithful to her, the stricter he is in demanding faithfulness from her. We see that despotism nowhere denies its own nature: the more a despot deceives and abuses his people, the more submissiveness and faithfulness he demands of them. 6. SUFFERING WOMEN.--Who can be astonished at the many unhappy marriages, if he knows how unworthy most men are of their wives? Their virtues they rarely can appreciate, and their vices they generally call out by their own. Thousands of women suffer from the results of a mode of life of which they, having remained pure in their thought, have no conception whatever; and many an unsuspecting wife nurses her husband with tenderest care in sicknesses which are nothing more than the consequences of his amours with other women. 7. AN INHUMAN CRIMINAL.--When at last, after long years of delusion and endurance, the scales drop from the eyes of the wife, and revenge or despair drives her into a hostile position towards her lord and master, she is an inhuman criminal, and the hue and cry against the fickleness of women and the falsity of their nature is endless. Oh, the injustice of society and the injustice of cruel man. Is there no relief for helpless women that are bound by the ties of marriage to men who are nothing but rotten corruption? 8. VULGAR DESIRE.--The habit of regarding the end and aim of woman only from the most vulgar side--not to respect in her the noble human being, but to see in her only the instrument of sensual desire--is carried so far among men that they will allow it to force into the background considerations among themselves, which they otherwise pretend to rank very high. [Illustration] 9. THE ONLY REMEDY.--But when the feeling of women has once been driven to indignation with respect to the position which they occupy, it is to be hoped that they will compel men to be pure before marriage, and they will remain loyal after marriage. 10. WORSE THAN SAVAGES.--With all our civilization we are put to shame even by the savages. The savages know of no fastidiousness of the sexual instinct and of no brothels. We are, indeed, likewise savages, but in quite a different sense. Proof of this is especially furnished by our youth. But that our students, and young men in general, usually pass through the school of corruption and drag the filth of the road which they have traversed before marriage along {429} with them throughout life, is not their fault so much as the fault of prejudices and of our political and social conditions that prohibits a proper education, and the placing of the right kind of literature on these subjects into the hands of young people. 11. REASON AND REMEDY.--Keep the youth pure by a thorough system of plain unrestricted training. The seeds of immorality are sown in youth, and the secret vice eats out their young manhood often before the age of puberty. They develop a bad character as they grow older. Young girls are ruined, and licentiousness and prostitution flourish. Keep the boys pure and the harlot would soon lose her vocation. Elevate the morals of the boys, and you will have pure men and moral husbands. * * * * * {430} The Road to Shame. [Illustration: SUICIDE LAKE.] 1. INSULT TO MOTHER OR SISTER.--Young men, it can never under any circumstances be right for you to do to a woman that, which, if another man did to your mother or sister, you could never forgive! The very thought is revolting. Let us suppose a man guilty of this shameful sin, and I apprehend that each of us would feel ready to shoot the villain. We are not justifying the shooting, but appealing to your instinctive sense of right, in order to show the enormity of this fearful crime, and to fasten strong conviction in your mind against this sin. {431} 2. A RUINED SISTER.--What would you think of a man, no matter what his wealth, culture, or gentlemanly bearing, who should lay himself out for the seduction and shame of your beloved sister? Her very name now reminds you of the purest affection: think of her, if you can bear it, ruined in character, and soon to become an unhappy mother. To whom can you introduce her? What can you say concerning her? How can her own brothers and sisters associate with her? and, mark! all this personal and relative misery caused by this genteel villain's degrading passion. 3. YOUNG MAN LOST.--Another terrible result of this sin is the practical overthrow of natural affection which it effects. A young man comes from his father's house to Chicago. Either through his own lust or through the corrupt companions that he finds in the house of business where he resides, he becomes the companion of lewd women. The immediate result is a bad conscience, a sense of shame, and a breach in the affections of home. Letters are less frequent, careless, and brief. He cannot manifest true love now. He begins to shrink from his sister and mother, and well he may. 4. THE HARLOT'S INFLUENCE.--He has spent the strength of his affection and love for home. In their stead the wretched harlot has filled him with unholy lust. His brain and heart refuse to yield him the love of the son and brother. His hand can not write as aforetime, or at best, his expressions become a hypocritical pretence. Fallen into the degradation of the fornicator, he has changed a mother's love and sister's affection for the cursed fellowship of the woman "whose house is the way to hell." (Prov. VII. 27.) 5. THE WAY OF DEATH.--Observe, that directly the law of God is broken, and wherever promiscuous intercourse between the sexes takes place, gonorrhoea, syphilis, and every other form of venereal disease is seen in hideous variety. It is only true to say that thousands of both sexes are slain annually by these horrible diseases. What must be the moral enormity of a sin, which, when committed, produces in vast numbers of cases such frightful physical and moral destruction as that which is here portrayed? 6. A HARLOT'S WOES.--Would to God that something might be done to rescue fallen women from their low estate. We speak of them as "fallen women". Fallen, indeed, they are, but surely not more deserving of the application of that term than the "fallen men" who are their partners and paramours. It is easy to use the words, "a fallen woman", but who can apprehend all that is involved in the {432} expression, seeing that every purpose for which God created woman is prostituted and destroyed? She is now neither maiden, wife, nor mother; the sweet names of sister and betrothed can have no legitimate application in her case. 7. THE PENALTIES FOR LOST VIRTUE.--Can the harlot be welcomed where either children, brothers, sisters, wife, or husband are found? Surely, no. Home is a sphere alien to the harlot's estate. See such an one wherever you may--she is a fallen outcast from woman's high estate. Her existence--for she does not live--now culminates in one dread issue, viz., prostitution. She sleeps, but awakes a harlot. She rises in the late morning hours, but her object is prostitution; she washes, dresses, and braids her hair, but it is with one foul purpose before her. To this end she eats, drinks, and is clothed. To this end her house is hidden and the blinds are drawn. 8. LOST FOREVER.--To this end she applies the unnatural cosmetique, and covers herself with sweet perfumes, which vainly try to hide her disease and shame. To this end she decks herself with dashing finery and tawdry trappings, and with bold, unwomanly mien essays the streets of the great city. To this end she is loud and coarse and impudent. To this end she is the prostituted "lady," with simpering words, and smiles, and glamour of refined deceit. To this end an angel face, a devil in disguise. There is one foul and ghastly purpose towards which all her energies now tend. So low has she fallen, so lost is she to all the design of woman, that she exists for one foul purpose only, viz., to excite, stimulate, and gratify the lusts of degraded, ungodly men. Verily, the word "prostitute" has an awful meaning. What plummet can sound the depths of a woman's fall who has become a harlot? 9. SOUND THE ALARM.--Remember, young man, you can never rise above the degradation of the companionship of lewd women. Your virtue once lost is lost forever. Remember, young woman, your wealth or riches is your good name and good character--you have nothing else. Give a man your virtue and he will forsake you, and you will be forsaken by all the world. Remember that purity of purpose brings nobility of character, and an honorable life is the joy and security of mankind. * * * * * {433} The Curse of Manhood. [Illustration: THE GREAT PHILANTHROPIST.] 1. MORAL LEPERS.--We cannot but denounce in the strongest terms, the profligacy of many married men. Not content with the moderation permitted in the divine appointed relationship of marriage, they become adulterers, in order to gratify their accursed lust. The man in them is trodden down by the sensual beast which reigns supreme. These are the moral outlaws that make light of this scandalous social iniquity, and by their damnable example encourage young men to sin. 2. A SAD CONDITION.--It is constantly affirmed by prostitutes, that amongst married men are found their chief supporters. Evidence from such a quarter must be received with considerable caution. Nevertheless, we believe that there is much truth in this statement. Here, again, we lay {434} the ax to the root of the tree; the married man who dares affirm that there is a particle of physical necessity for this sin, is a liar, and the truth is not in him. Whether these men be princes, peers, legislators, professional men, mechanics, or workmen, they are moral pests, a scandal to the social state, and a curse to the nation. 3. EXCESSES.--Many married men exhaust themselves by these excesses; they become irritable, liable to cold, to rheumatic affections, and nervous depression. They find themselves weary when they rise in the morning. Unfitted for close application to business, they become dilatory and careless, often lapsing into entire lack of energy, and not seldom into the love of intoxicating stimulants. Numbers of husbands and wives entering upon these experiences lose the charm of health, the cheerfulness of life and converse. Home duties become irksome to the wife; the brightness, vivacity, and bloom natural to her earlier years, decline; she is spoken of as highly nervous, poorly, and weak, when the whole truth is that she is suffering from physical exhaustion which she cannot bear. Her features become angular, her hair prematurely gray, she rapidly settles down into the nervous invalid, constantly needing medical aid, and, if possible, change of air. 4. IGNORANCE.--These conditions are brought about in many cases through ignorance on the part of those who are married. Multitudes of men have neither read, heard, nor known the truth of this question. We sympathize with our fellow-men in this, that we have been left in practical ignorance concerning the exceeding value and legitimate uses of these functions of our being. Some know, that, had they known these things in the early days of their married life, it would have proved to them knowledge of exceeding value. If this counsel is followed, thousands of homes will scarcely know the need of the physician's presence. 5. ANIMAL PASSION.--Common-sense teaches that children who are begotten in the heat of animal passion, are likely to be licentious when they grow up. Many parents through excesses of eating and drinking, become inflamed with wine and strong drink., They are sensualists, and consequently, morally diseased. Now, if in such conditions men beget their children, who can affect surprise if they develop licentious tendencies? Are not such parents largely to blame? Are they not criminals in a high degree? Have they not fouled their own nest, and transmitted to their children predisposition to moral evil? 6. FAST YOUNG MEN.--Many of our "fast young men" have been thus corrupted, even as the children of the {435} intemperate are proved to have been. Certainly no one can deny that many of our "well-bred" young men are little better than "high-class dogs" so lawless are they, and ready for the arena of licentiousness. 7. THE PURE-MINDED WIFE.--Happily, as tens of thousands of husbands can testify, the pure-minded wife and mother is not carried away, as men are liable to be, with the force of animal passion. Were it not so, the tendencies to licentiousness in many sons would be stronger than they are. In the vast majority of cases suggestion is never made except by the husband, and it is a matter of deepest gratitude and consideration, that the true wife may become a real helpmeet in restraining this desire in the husband. 8. YOUNG WIFE AND CHILDREN.--We often hear it stated that a young wife has her children quickly. This cannot happen to the majority of women without injury to health and jeopardy to life. The law which rendered it imperative for the land to lie fallow in order to rest and gain renewed strength, is only another illustration of the unity which pervades physical conditions everywhere. It should be known that if a mother nurses her own babe, and the child is not weaned until it is nine or ten months old, the mother, except in rare cases, will not become enceinte again, though cohabitation with the husband takes place. 9. SELFISH AND UNNATURAL CONDUCT.--It is natural and rational that a mother should feed her own children; in the selfish and unnatural conduct of many mothers, who, to avoid the self-denial and patience which are required, hand the little one over to the wet-nurse, or to be brought up by hand, is found in many cases the cause and reason of the unnatural haste of child-bearing. Mothers need to be taught that the laws of nature cannot be broken without penalty. For every woman whose health has been weakened through nursing her child, a hundred have lost strength and health through marital excesses. The haste of having children is the costly penalty which women pay for shirking the mother's duty to the child. 10. LAW OF GOD.--So graciously has the law of God been arranged in regard to the mother's strength, that, if it be obeyed, there will be, as a rule, an interval of at least from eighteen months to two years between the birth of one child and that of another. Every married man should abstain during certain natural seasons. In this periodical recurrence God has instituted to every husband the law of restraint, and insisted upon self-control. 11. TO YOUNG PEOPLE WHO ARE MARRIED.--Be exceedingly careful of license and excess in your intercourse with {436} one another. Do not needlessly expose, by undress, the body. Let not the purity of love degenerate into unholy lust. See to it that you walk according to the divine Word, "Dwelling together as being heirs of the grace of life, that your prayers be not hindered." 12. LOST POWERS.--Many young men after their union showed a marked difference. They lost much of their natural vivacity, energy, and strength of voice. Their powers of application, as business men, students, and ministers, had declined, as also their enterprise, fervor, and kindliness. They had become irritable, dull, pale, and complaining. Many cases of rheumatic fever have been induced through impoverishment, caused by excesses on the part of young married men. 13. MIDDLE AGE.--After middle age the sap of a man's life declines in quantity. A man who intends close application to the ministry, to scientific or literary pursuits, where great demands are made upon the brain, must restrain this passion. The supplies for the brain and nervous system are absorbed, and the seed diverted through sexual excesses in the marriage relationship, by fornication, or by any other form of immorality, the man's power must decline: that to this very cause may be attributed the failure and breakdown of so many men of middle age. 14. INTOXICATING DRINKS.--By all means avoid intoxicating drinks. Immorality and alcoholic stimulants, as we have shown, are intimately related to one another. Wine and strong drink inflame the blood, and heat the passions. Attacking the brain, they warp the judgment, and weaken the power of restraint. Avoid what is called good living; it is madness to allow the pleasures of the table to corrupt and corrode the human body. We are not designed for gourmands, much less for educated pigs. Cold water bathing, water as a beverage, simple and wholesome food, regularity of sleep, plenty of exercise; games such as cricket, football, tennis, boating, or bicycling, are among the best possible preventives against lust and animal passion. 15. BEWARE OF IDLENESS.--Indolent leisure means an unoccupied mind. When young men lounge along the streets, in this condition they become an easy prey to the sisterhood of shame and death. Bear in mind that evil thoughts precede evil actions. The hand of the worst thief will not steal until the thief within operates upon the hand without. The members of the body which are capable of becoming instruments of sin, are not involuntary actors. Lustful desires must proceed from brain and heart, ere the fire that consumes burns in the member. * * * * * {437} A Private Talk to Young Men. [Illustration: Young Lincoln Starting to School.] 1. The most valuable and useful organs of the body are those which are capable of the greatest dishonor, abuse and corruption. What a snare the wonderful organism of the eye may become when used to read corrupt books or look upon licentious scenes at the theatre, or when used to meet the fascinating gaze of the harlot! What an instrument for depraving the whole man may be found in the matchless powers of the brain, the hand, the ear, the mouth, or the tongue! What potent instruments may these become in accomplishing the ruin of the whole being for time and eternity! 2. In like manner the organ concerning the uses of which I am to speak, has been, and continues to be, made one of the chief instruments of man's immorality, shame, disease, and death. How important to know what the legitimate uses of this member of the body are, and how great the {438} dignity conferred upon us in the possession of this gift. On the human side this gift may be truly said to bring men nearer to the high and solemn relationship of the Creator than any other which they possess. 3. I first deal with the destructive sin of self-abuse. There can be little doubt that vast numbers of boys are guilty of this practice. In many cases the degrading habit has been taught by others, e.g., by elder boys at school, where association largely results in mutual corruption. With others, the means of sensual gratification is found out by personal action; whilst in other cases fallen and depraved men have not hesitated to debauch the minds of mere children by teaching them this debasing practice. 4. Thousands of youths and young men have only to use the looking-glass to see the portrait of one guilty of this loathsome sin. The effects are plainly discernible in the boy's appearance. The face and hands become pale and bloodless. The eye is destitute of its natural fire and lustre. The flesh is soft and flabby, the muscles limp and lacking healthy firmness. In cases where the habit has become confirmed, and where the system has been drained of this vital force, it is seen in positive ugliness, in a pale and cadaverous appearance, slovenly gait, slouching walk, and an impaired memory. 5. It is obvious that if the most vital physical force of a boy's life is being spent through this degrading habit--a habit, be it observed, of rapid growth, great strength, and difficult to break--he must develop badly. In thousands of cases the result is seen in a low stature, contracted chest, weak lungs, and liability to sore throat. Tendency to cold, indigestion, depression, drowsiness, and idleness, are results distinctly traceable to this deadly practice. Pallor of countenance, nervous and rheumatic affections, loss of memory, epilepsy, paralysis, and insanity find their principal predisposing cause in the same shameful waste of life. The want of moral force and strength of mind often observable is youths and young men is largely induced by this destructive and deadly sin. 6. Large numbers of youths pass from an exhausted boyhood into the weakness, intermittent fevers, and consumption, which are said to carry off so many. If the deaths were attributed primarily to loss of strength occasioned by self-pollution, it would be much nearer the truth. It is monstrous to suppose that a boy who comes from healthy parents should decline and die. Without a shade of doubt the chief cause of decay and death amongst youths and young men, is to be traced to this baneful habit. {439} 7. It is a well-known fact that any man who desires to excel and retain his excellence as an accurate shot, an oarsman, a pedestrian, a pugilist, a first-class cricketer, bicyclist, student, artist, or literary man, must abstain from self-pollution and fornication. Thousands of school boys and students lose their positions in the class, and are plucked at the time of their examination by reason of failure of memory, through lack of nerve and vital force, caused mainly by draining the physical frame of the seed which is the vigor of the life. 8. It is only true to say that thousands of young men in the early stages of a licentious career would rather lose a right hand than have their mothers or sisters know what manner of men they are. From the side of the mothers and sisters it may also be affirmed that, were they aware of the real character of those brothers and sons, they would wish that they had never been born. 9. Let it be remembered that sexual desire is not in itself dishonorable or sinful, any more than hunger, thirst, or any other lawful and natural desire is. It is the gratification by unlawful means of this appetite which renders it so corrupting and iniquitous. 10. Leisure means the opportunity to commit sin. Unclean pictures are sought after and feasted upon, paragraphs relating to cases of divorce and seduction are eagerly read, papers and books of an immoral character and tendency greedily devoured, low and disgusting conversation indulged in and repeated. 11. The practical and manly counsel to every youth and young man is, entire abstinence from indulgence of the sexual faculty until such time as the marriage relationship is entered upon. Neither is there, nor can there be, any exception to this rule. 12. No man can affirm that self-denial ever injured him. On the contrary, self-restraint has been liberty, strength and blessing. Beware of the deceitful streams of temporary gratification, whose eddying current drifts towards license, shame, disease and death. Remember, how quickly moral power declines, how rapidly the edge of the fatal maelstrom is reached, how near the vortex, how terrible the penalty, how fearful the sentence of everlasting punishment. 13. Be a young man of principle, honor, and preserve your powers. How can you look an innocent girl in the face when you are degrading your manhood with the vilest practice? Keep your mind and life pure, and nobility will be your crown. * * * * * {440} Remedies for the Social Evil. 1. MAN RESPONSIBLE.--Every great social reform must begin with the male sex. They must either lead, or give it its support. Prostitution is a sin wholly of their own making. All the misery, all the lust, as well as all the blighting consequences, are chargeable wholly to the uncontrolled sexual passion of the male. To reform sinful women, _reform the men_. Teach them that the physiological truth means permanent moral, physical and mental benefit, while seductive indulgence blights and ruins. 2. CONTAGIOUS DISEASES.--A man or woman cannot long live an impure life without sooner or later contracting disease which brings to every sufferer not only moral degradation, but often serious and vital injuries and many times death itself becomes the only relief. 3. SHOULD IT BE REGULATED BY LAW?--Dr. G. J. Ziegler, of Philadelphia, in several medical articles says that the act of sexual connection should be made in itself the solemnization of marriage, and that when any such single act can be proven against an unmarried man, by an unmarried woman, the latter be at once invested with all the legal privileges of a wife. By bestowing this power on women very few men would risk the dangers of the society of a dissolute and scheming woman who might exercise the right to force him to a marriage and ruin his reputation and life. The strongest objection of this would be that it would increase the temptation to destroy the purity of married women, for they could be approached without danger of being forced into another marriage. But this objection could easily be harmonized with a good system of well regulated laws. Many means have been tried to mitigate the social evils, but with little encouragement. In the city of Paris a system of registration has been inaugurated and houses of prostitution are under the supervision of the police, yet prostitution has not been in any degree diminished. Similar methods have been tried in other European towns, but without satisfactory results. 4. MORAL INFLUENCE.--Let it be an imperative to every clergyman, to every educator, to every statesman and to every philanthropist, to every father and to every mother, to impart that moral influence which may guide and direct the youth of the land into the natural channels of morality, chastity and health. Then, and not till then, shall we see righteous laws and rightly enforced for the mitigation and extermination of the modern house of prostitution. * * * * * {441} The Selfish Slaves of Doses of Disease and Death. [Illustration: A TURKISH CIGARETTE GIRL.] 1. MOST DEVILISH INTOXICATION.--What is the most devilish, subtle alluring, unconquerable, hopeless and deadly form of intoxication, with which science struggles and to which it often succumbs; which eludes the restrictive grasp of legislation; lurks behind lace curtains, hides in luxurious boudoirs, haunts the solitude of the study, and with waxen {442} face, furtive eyes and palsied step totters to the secret recesses of its self-indulgence? It is the drunkenness of drugs, and woe be unto him that crosseth the threshold of its dream-curtained portal, for though gifted with the strength of Samson, the courage of Richard and the genius of Archimedes, he shall never return, and of him it is written that forever he leaves hope behind. 2. THE MATERIAL SATAN.--The material Satan in this sensuous syndicate of soul and body-destroying drugs is opium, and next in order of hellish potency come cocaine and chloral. 3. GUM OPIUM.--Gum opium, from which the sulphate of morphine is made, is the dried juice of the poppy, and is obtained principally in the orient. Taken in moderate doses it acts specially upon the nervous system, deadens sensibility, and the mind becomes inactive. When used habitually and excessively it becomes a tonic, which stimulates the whole nervous system, producing intense mental exaltation and delusive visions. When the effects wear off, proportionate lassitude follows, which begets an insatiate and insane craving for the drug. Under the repeated strain of the continually increasing doses, which have to be taken to renew the desired effect, the nervous system finally becomes exhausted, and mind and body are utterly and hopelessly wrecked. 4. COCAINE.--Cocaine is extracted from the leaves of the Peruvian cocoa tree, and exerts a decided influence upon the nervous system, somewhat akin to that of coffee. It increases the heart action and is said to be such an exhilarant that the natives of the Andes are enabled to make extraordinary forced marches by chewing the leaves containing it. Its after effects are more depressing even than those of opium, and insanity more frequently results from its use. 5. CHLORAL.--The name which is derived from the first two syllables of chlorine and alcohol, is made by passing dry chlorine gas in a continuous stream through absolute alcohol for six or eight weeks. It is a hypnotic or sleep-producing drug, and in moderate doses acts on the caliber of the blood vessels of the brain, producing a soothing effect, especially in cases of passive congestion. Some patent medicines contain chloral, bromide and hyoscymus, and they have a large sale, being bought by persons of wealth, who do not know what they are composed of and recklessly take them for the effect they produce. 6. VICTIMS RAPIDLY INCREASING.--"From my experience," said a leading and conservative druggist, "I infer that the {443} number of what are termed opium, cocaine, and chloral "fiends" is rapidly increasing, and is greater by two or three hundred per cent than a year ago, with twice as many women as men represented. I should say that one person out of every fifty is a victim of this frightful habit, which claims its doomed votaries from the extremes of social life, those who have the most and the least to live for, the upper classes and the cyprian, professional men of the finest intelligence, fifty per cent of whom are doctors and walk into the pit with eyes wide open. And lawyers and other professional men must be added to this fated vice." 7. DESTROYS THE MORAL FIBER.--"It is a habit which utterly destroys the moral fiber of its slaves, and makes unmitigated liars and thieves and forgers of them, and even murder might be added to the list of crimes, were no other road left open to the gratification of its insatiate and insane appetite. I do not know of a single case in which it has been mastered, but I do know of many where the end has been unspeakable misery, disgrace, suffering, insanity and death." 8. SHAMEFUL DEATH.--To particularize further would be profitless so far as the beginners are concerned, but would to heaven that those not within the shadow of this shameful death would take warning from those who are. There are no social or periodical drunkards in this sort of intoxication. The vice is not only solitary, unsocial and utterly selfish, but incessant and increasing in its demands. 9. APPETITE STRONGER THAN FOR LIQUOR.--This appetite is far stronger and more uncontrollable than that for liquor, and we can spot its victim as readily as though he were an ordinary bummer. He has a pallid complexion, a shifting, shuffling manner and can't look you in the face. If you manage to catch his eye for an instant you will observe that its pupil is contracted to an almost invisible point. It is no exaggeration to say that he would barter his very soul for that which indulgence has made him too poor to purchase, and where artifice fails he will grovel in abject agony of supplication for a few grains. At the same time he resorts to all kinds of miserable and transparent shifts, to conceal his degradation. He never buys for himself, but always for some fictitious person, and often resorts to purchasing from distant points. 10. OPIUM SMOKING.--"Opium smoking," said another representative druggist, "is almost entirely confined to the Chinese and they seem to thrive on it. Very few others hit the pipe that we know of." {444} 11. MALT AND ALCOHOLIC DRUNKENNESS.--Alcoholic stimulants have a record of woe second to nothing. Its victims are annually marching to drunkards' graves by the thousands. Drunkards may be divided into three classes: First, the accidental or social drunkard; second, the periodical or spasmodic drunkard; and third, the sot. 12. THE ACCIDENTAL OR SOCIAL DRUNKARD is yet on safe ground. He has not acquired the dangerous craving for liquor. It is only on special occasions that he yields to excessive indulgence; sometimes in meeting a friend, or at some political blow-out. On extreme occasions he will indulge until he becomes a helpless victim, and usually as he grows older occasions will increase, and step by step he will be lead nearer to the precipice of ruin. 13. THE PERIODICAL OR SPASMODIC DRUNKARD, with whom it is always the unexpected which occurs, and who at intervals exacts from his accumulated capital the usury of as prolonged a spree as his nerves and stomach will stand. Science is inclined to charitably label this specimen of man a sort of a physiologic puzzle, to be as much pitied as blamed. Given the benefit of every doubt, when he starts off on one of his hilarious tangents, he becomes a howling nuisance; if he has a family, keeps them continually on the ragged edge of apprehension, and is unanimously pronounced a "holy terror" by his friends. His life and future is an uncertainty. He is unreliable and cannot be long trusted. Total reformation is the only hope, but it rarely is accomplished. 14. THE SOT.--A blunt term that needs no defining, for even the children comprehend the hopeless degradation it implies. Laws to restrain and punish him are framed; societies to protect and reform him are organized, and mostly in vain. He is prone in life's very gutter; bloated, reeking and polluted with the doggery's slops and filth. He can fall but a few feet lower, and not until he stumbles into an unmarked, unhonored grave, where kind mother earth and the merciful mantle of oblivion will cover and conceal the awful wreck he made of God's own image. To the casual observer, the large majority of the community, these three phases, at whose vagaries many laugh, and over whose consequences millions mourn, comprehend intoxication and its results, from the filling of the cup to its shattering fall from the nerveless hand, and this is the end of the matter. Would to God that it were! for at that it would be bad enough. But it is not, for wife, children and friends must suffer and drink the cup of trouble and sorrow to its dregs. * * * * * {445} OBJECT LESSONS OF THE EFFECTS OF ALCOHOL AND CIGARETTE SMOKING. By PROF. GEORGE HENKLE, who personally made the postmortem examinations and drew the following illustrations from the diseased organs just as they appeared when first taken from the bodies of the unfortunate victims. [Illustration: THE STOMACH of an habitual drinker of alcoholic stimulants, showing the ulcerated condition of the mucous membrane, incapacitating this important organ for digestive functions.] [Illustration: THE STOMACH (interior view) of a healthy person with the first section of the small intestines.] {446} [Illustration: THE LIVER of a drunkard who died of Cirrhosis of the liver, also called granular liver, or "gin drinker's liver." The organ is much shrunken and presents rough, uneven edges, with carbuncular non-suppurative sores. In this self-inflicted disease the tissues of the liver undergo a cicatrical retraction which strangulates and partly destroys the parenchyma of the liver.] [Illustration: THE LIVER IN HEALTH.] {447} [Illustration: THE KIDNEY of a man who died a drunkard, showing in upper portion the sores so often found on kidneys of hard drinkers, and in the lower portion, the obstruction formed in the internal arrangement of this organ. Alcohol is a great enemy to the kidneys, and after this poison has once set in on its destructive course in these organs no remedial agents are known to exist to stop the already established disease.] [Illustration: THE KIDNEY in health, with the lower section removed, to show the filtering apparatus (Malphigian pyramids). Natural size.] {448} [Illustration: THE LUNGS AND HEART of a boy who died from the effects of cigarette smoking, showing the nicotine sediments in lungs and shrunken condition of the heart.] [Illustration: THE LUNGS AND HEART IN HEALTH.] [Illustration: A section of the diseased Lung of a cigarette smoker, highly magnified.] THE DESTRUCTIVE EFFECTS OF CIGARETTE SMOKING. [Illustration: _Illustrating the shrunken condition of one of the Lungs of an excessive smoker_] {449} Cigarettes have been analyzed, and the most physicians and chemists were surprised to find how much opium is put into them. A tobacconist himself says that "the extent to which drugs are used in cigarettes is appalling." "Havana flavoring" for this same purpose is sold everywhere by the thousand barrels. This flavoring is made from the tonka-bean, which contains a deadly poison. The wrappers, warranted to be rice paper, are sometimes made of common paper, and sometimes of the filthy scrapings of ragpickers bleached white with arsenic. What a thing for human lungs. The habit burns up good health, good resolutions, good manners, good memories, good faculties, and often honesty and truthfulness as well. Cases of epilepsy, insanity and death are frequently reported as the result of smoking cigarettes, while such physicians as Dr. Lewis Sayre, Dr. Hammond, and Sir Morell Mackenzie of England, name heart trouble, blindness, cancer and other diseases as occasioned by it. Leading physicians of America unanimously condemn {450} cigarette smoking as "one of the vilest and most destructive evils that ever befell the youth of any country," declaring that "its direct tendency is a deterioration of the race." Look at the pale, wilted complexion of a boy who indulges in excessive cigarette smoking. It takes no physician to diagnose his case, and death will surely mark for his own every boy and young man who will follow up the habit. It is no longer a matter of guess. It is a scientific fact which the microscope in every case verifies. * * * * * {451} The Dangerous Vices. [Illustration: INNOCENT YOUTH.] Few persons are aware of the extent to which masturbation or self-pollution is practiced by the young of both sexes in civilized society. SYMPTOMS. The hollow, sunken eye, the blanched cheek, the withered hands, and emaciated frame, and the listless life, have other sources than the ordinary illnesses of all large communities. When a child, after having given proofs of memory and intelligence, experiences daily more and more difficulty in retaining and understanding what is taught him, it is not only from unwillingness and idleness, as is commonly supposed, but from a disease eating out life itself, brought on by a self-abuse of the private organs. Besides the slow and progressive derangement of his or her health, the diminished energy of application, the languid movement, the stooping gait, the desertion of social games, the solitary walk, late rising, livid and sunken eye, and many other symptoms, will fix the attention of every intelligent and competent guardian of youth that something is wrong. {453} MARRIED PEOPLE. Nor are many persons sufficiently aware of the ruinous extent to which the amative propensity is indulged by married persons. The matrimonial ceremony does, indeed, sanctify the act of sexual intercourse, but it can by no means atone for nor obviate the consequences of its abuse. Excessive indulgence in the married relation is, perhaps, as much owing to the force of habit, as to the force of the sexual appetite. [Illustration: GUARD WELL THE CRADLE. EDUCATION CANNOT BEGIN TOO YOUNG.] EXTREME YOUTH. More lamentable still is the effect of inordinate sexual excitement of the young and unmarried. It is not very uncommon to find a confirmed onanist, or, rather, masturbator, who has not yet arrived at the period of puberty. Many cases are related in which young boys and girls, from eight to ten years of age, were taught the method of self-pollution by their older playmates, and had made serious encroachments on the fund of constitutional vitality even before any considerable degree of sexual appetite was developed. FORCE OF HABIT. Here, again, the fault was not in the power of passion, but in the force of habit. Parents and guardians of youth can not be too mindful of the character and habits of those with whom they allow young persons and children under their charge to associate intimately, and especially careful should they be with whom they allow them to sleep. SIN OF IGNORANCE. It is customary to designate self-pollution as among the "vices." I think misfortune is the more appropriate term. It is true, that in the physiological sense, it is one of the very worst "transgressions of the law." But in the moral sense it is generally the sin of ignorance in the commencement, and in the end the passive submission to a morbid and almost resistless impulse. QUACKS. The time has come when the rising generation must be thoroughly instructed in this matter. That quack specific "ignorance" has been experimented with quite too long already. The true method of insuring all persons, young or old, against the abuses of any part, organ, function, or faculty of the wondrous machinery of life, is to teach them its use. "Train a child in the way it should go" or be sure it {454} will, amid the ten thousand surrounding temptations, find out a way in which it should not go. Keeping a child in ignorant innocence is, I aver, no part of the "training" which has been taught by a wiser than Solomon. Boys and girls do know, will know, and must know, that between them are important anatomical differences and interesting physiological relations. Teach them, I repeat, their use, or expect their abuse. Hardly a young person in the world would ever become addicted to self-pollution if he or she understood clearly the consequences; if he or she knew at the outset that the practice was directly destroying the bodily stamina, vitiating the moral tone, and enfeebling the intellect. No one would pursue the disgusting habit if he or she was fully aware that it was blasting all prospects of health and happiness in the approaching period of manhood and womanhood. GENERAL SYMPTOMS OF THE SECRET HABIT. The effects of either self-pollution or excessive sexual indulgence, appear in many forms. It would seem as if God had written an instinctive law of remonstrance, in the innate moral sense, against this filthy vice. All who give themselves up to the excesses of this debasing indulgence, carry about with them, continually, a consciousness of their defilement, and cherish a secret suspicion that others look upon them as debased beings. They feel none of that manly confidence and gallant spirit, and chaste delight in the presence of virtuous females, which stimulate young men to pursue the course of ennobling refinement, and mature them for the social relations and enjoyments of life. This shamefacedness, or unhappy quailing of the countenance, on meeting the look of others, often follows them through life, in some instances even after they have entirely abandoned the habit, and became married men and respectable members of society. In some cases, the only complaint the patient will make on consulting you, is that he is suffering under a kind of continued fever. He will probably present a hot, dry skin, with something of a hectic appearance. Though all the ordinary means of arresting such symptoms have been tried, he is none the better. The sleep seems to be irregular and unrefreshing--restlessness during the early part of the night, and in the advanced stages of the disease, profuse sweats before morning. There is also frequent starting in the sleep, from {455} disturbing dreams. The characteristic feature is, that your patient almost always dreams of sexual intercourse. This is one of the earliest, as well as most constant symptoms. When it occurs most frequently, it is apt to be accompanied with pain. A gleety discharge from the urethra may also be frequently discovered, especially if the patient examine when at stool or after urinating. Other common symptoms are nervous headache, giddiness, ringing in the ears, and a dull pain in the back part of the head. It is frequently the case that the patient suffers a stiffness in the neck, darting pains in the forehead, and also weak eyes are among the common symptoms. One very frequent, and perhaps early symptom (especially in young females) is solitariness--a disposition to seclude themselves from society. Although they may be tolerably cheerful when in company, they prefer rather to be alone. The countenance has often a gloomy and worn-down expression. The patient's friends frequently notice a great change. Large livid spots under the eyes is a common feature. Sudden flashes of heat may be noticed passing over the patient's face. He is liable also to palpitations. The pulse is very variable, generally too slow. Extreme emaciation, without any other assignable cause for it, may be set down as another very common symptom. If the evil has gone on for several years, there will be a general unhealthy appearance, of a character so marked as to enable an experienced observer at once to detect the cause. In the case of onanists especially there is a peculiar rank odor emitted from the body, by which they may be readily distinguished. One striking peculiarity of all these patients is, that they cannot look a man in the face! Cowardice is constitutional with them. * * * * * HOME TREATMENT OF THE SECRET HABIT. 1. The first condition of recovery is a prompt and permanent abandonment of the ruinous habit. Without a faithful adherence to this prohibitory law on the part of the patient all medication on the part of the physician will assuredly fail. The patient must plainly understand that future prospects, character, health, and life itself, depend on an unfaltering resistance to the morbid solicitation; with the assurance, however, that a due perseverance will eventually render what now seems like a resistless and overwhelming {456} propensity, not only controllable but perfectly loathsome and undesirable. 2. Keep the mind employed by interesting the patient in the various topics of the day, and social features of the community. 3. Plenty of bodily out of door exercise, hoeing in the garden, walking, or working on the farm; of course not too heavy work must be indulged in. 4. If the patient is weak and very much emaciated, cod liver oil is an excellent remedy. 5. DIET. The patient should live principally on brown bread, oat meal, graham crackers, wheat meal, cracked or boiled wheat, or hominy, and food of that character. No meats should be indulged in whatever; milk diet if used by the patient is an excellent remedy. Plenty of fruit should be indulged in; dried toast and baked apples make an excellent supper. The patient should eat early in the evening, never late at night. 6. Avoid all tea, coffee, or alcoholic stimulants of any kind. 7. "Early to bed and early to rise," should be the motto of every victim of this vice. A patient should take a cold bath every morning after rising. A cold water injection in moderate quantities before retiring has cured many patients. 8. If the above remedies are not sufficient, a family physician should be consulted. 9. Never let children sleep together, if possible, to avoid it. Discourage the children of neighbors and friends from sleeping with your children. 10. Have your children rise early. It is the lying in bed in the morning that plays the mischief. [Illustration: (l) Healthy Semen, Greatly Magnified. (r) The Semen of a Victim of Masturbation.] {457} NOCTURNAL EMISSIONS Involuntary emissions of semen during amorous dreams at night is not at all uncommon among healthy men. When this occurs from one to three or four times a month, no anxiety or concern need be felt. When the emissions take place without dreams, manifested only by stained spots in the morning on the linen, or take place at stool and are entirely beyond control, then the patient should at once seek for remedies or consult a competent physician. When blood stains are produced, then medical aid must be sought at once. HOME TREATMENT FOR NOCTURNAL EMISSIONS. Sleep in a hard bed, and rise early and take a sponge bath in cold water every morning. Eat light suppers and refrain from eating late in the evening. Empty the bladder thoroughly before retiring, bathe the spine and hips with a sponge dipped in cold water. _Never sleep lying on the back._ Avoid all highly seasoned food and read good books, and keep the mind well employed. Take regular and vigorous outdoor exercise every day. [Illustration: Healthy Testicle.] [Illustration: A Testicle wasted by Masturbation.] Avoid all coffee, tea, wine, beer and all alcoholic liquors. Don't use tobacco, and keep the bowels free. PRESCRIPTION.--Ask your druggist to put you up a good Iron Tonic and take it regularly according to his directions. BEWARE OF ADVERTISING QUACKS. Beware of these advertising schemes that advertise a speedy cure for "Loss of Youth," "Lost Vitality," "A Cure for Impotency," "Renewing of Old Age," etc. Do not allow these circulating pamphlets and circulars to concern you the least. If you have a few _Nocturnal Emissions_, remember it is only a mark of vitality and health, and not a sign of a deathly disease, as many of these advertising quacks would lead you to believe. Use your private organs only for what your Creator intended they should be used, and there will be no occasion for you to be frightened by the deception of quacks. {458} [Illustration: THE TWO PATHS: WHAT WILL THE BOY BECOME?] {459} Lost Manhood Restored. 1. RESOLUTE DESISTENCE.--The first step towards the restoration of lost manhood is a resolute desistence from these terrible sins. Each time the temptation is overcome, the power to resist becomes stronger, and the fierce fire declines. Each time the sin is committed, its hateful power strengthens, and the fire of lust is increased. Remember, that you cannot commit these sins, and maintain health and strength. 2. AVOID BEING ALONE.--Avoid being alone when the temptation comes upon you to commit self-abuse. Change your thoughts at once; "keep the heart diligently, for out of it are the issues of life." 3. AVOID EVIL COMPANIONS.--Avoid evil companions, lewd conversation, bad pictures, corrupt and vicious novels, books, and papers. Abstain from all intoxicating drinks. These inflame the blood, excite the passions, and stimulate sensuality; weakening the power of the brain, they always impair the power of self-restraint. Smoking is very undesirable. Keep away from the moral pesthouses. Remember that these houses are the great resort of fallen and depraved men and women. The music, singing, and dancing are simply a blind to cover the intemperance and lust, which hold high carnival in these guilded hells. This, be it remembered, is equally true of the great majority of the theatres. 4. AVOID STRONG TEA, OR COFFEE.--Take freely of cocoa, milk, and bread and milk, or oatmeal porridge. Meats, such as beef and mutton, use moderately. We would strongly recommend to young men of full habit, vegetarian diet. Fruits in their season, partake liberally; also fresh vegetables. Brown bread and toast, as also rice, and similar puddings, are always suitable. Avoid rich pastry and new bread. 5. THREE MEALS A DAY ARE ABUNDANT.--Avoid suppers, and be careful, if troubled with nightly emissions, not to take any liquid, not even water, after seven o'clock in the evening, at latest. This will diminish the secretions of the body, when asleep, and the consequent emissions, which in the early hours or the morning usually follow the taking of any kind of drink. Do not be anxious or troubled by an occasional emission, say, for example, once a fortnight. 6. REST ON A HARD MATTRESS.--Keep the body cool when asleep; heat arising from a load of bed-clothes is most {460} undesirable. Turn down the counterpane, and let the air have free course through the blankets. 7. RELIEVE THE SYSTEM.--As much as possible relieve the system of urine before going to sleep. On rising, bathe if practicable. If you cannot bear cold water, take the least possible chill off the water (cold water, however, is best). If bathing is not practicable, wash the body with cold water, and keep scrupulously clean. The reaction caused by cold water, is most desirable. Rub the body dry with a rough towel. Drink a good draught of cold water. 8. EXERCISE.--Get fifteen minutes' brisk walk, if possible before breakfast. If any sense of faintness exists, eat a crust of bread, or biscuit. Be regular in your meals, and do not fear to make a hearty breakfast. This lays a good foundation for the day. Take daily good, but not violent exercise. Walk until you can distinctly feel the tendency to perspiration. This will keep the pores of the skin open and in healthy condition. 9. MEDICINES.--Take the medicines, if used, regularly and carefully. Bromide of Potassium is a most valuable remedy in allaying lustful and heated passions and appetites. Unless there is actual venereal disease, medicine should be very little resorted to. 10. AVOID THE STREETS AT NIGHT.--Beware of corrupt companions. Fast young men and women should be shunned everywhere. Cultivate a taste for good reading and evening studies. Home life with its gentle restraints, pure friendships, and healthful discipline, should be highly valued. There is no liberty like that of a well-regulated home. To large numbers of young men in business houses, home life is impracticable. 11. BE OF GOOD CHEER AND COURAGE.--Recovery will be gradual, and not sudden; vital force is developed slowly from within. The object aimed at by medicine and counsel is to aid and increase nervous and physical vigor, and give tone to the demoralized system. Do not pay the slightest heed to the exaggerated statements of the wretched quack doctors, who advertise everywhere. Avoid them as you would a pestilence. Their great object is, through exciting your fears, to get you into their clutches, in order to oppress you with heavy and unjust payments. Be careful, not to indulge in fancies, or morbid thoughts and feelings. Be hopeful, and play the part of a man determined to overcome. * * * * * {461} Manhood Wrecked and Rescued. 1. THE NOBLEST FUNCTIONS OF MANHOOD.--The noblest functions of manhood are brought into action in the office of the parent. It is here that man assumes the prerogative of a God and becomes a creator. How essential that every function of his physical system should be perfect, and every faculty of his mind free from that which would degrade; yet how many drag their purity through the filth of masturbation, revel in the orgies of the debauchee, and worship at the shrine of the prostitute, until, like a tree blighted by the livid lightning, they stand with all their outward form of men, but without life. 2. THRESHOLD OF HONOR.--Think of a man like that; in whom the passions and vices have burned themselves out, putting on the airs of a saint and claiming to have reformed! Aye, reformed, when there is no longer sweetness in the indulgence of lust. Think of such loathsome bestiality, dragging its slimy body across the threshold of honor and nobility and asking a pure woman, with the love-light of heaven in her eyes, to pass her days with him; to accept him as her lord; to be satisfied with the burnt-out, shriveled forces of manhood left; to sacrifice her purity that he may be redeemed, and to respect in a husband what she would despise in the brute. 3. STOP.--If you are, then, on the highway to this state of degradation, stop. If already you have sounded the depths of lost manhood, then turn, and from the fountain of life regain your power, before you perpetrate the terrible crime of marriage, thus wrecking a woman's life and perhaps bringing into the world children who will live only to suffer and curse the day on which they were born and the father who begat them. 4. SEXUAL IMPOTENCY.--Sexual impotency means sexual starvation, and drives many wives to ruin, while a similar lack among wives drives husbands to libertinism. Nothing so enhances the happiness of married couples as this full, life-abounding, sexual vigor in the husband, thoroughly reciprocated by the wife, yet completely controlled by both. 5. TWO CLASSES OF SUFFERERS.--There are two classes of sufferers. First, those who have only practiced self-abuse and are suffering from emissions. Second, those who by overindulgence in marital relations, or by dissipation with women, have ruined their forces. 6. THE REMEDY.--For self-abuse: When the young man has practiced self-abuse for some time, he finds, upon {462} quitting the habit, that he has nightly emissions. He becomes alarmed, reads every sensational advertisement in the papers, and at once comes to the conclusion that he must take something. _Drugs are not necessary._ 7. STOP THE CAUSE.--The one thing needful, above all others, is to stop the cause. I have found that young men are invariably mistaken as to what is the cause. When asked as to the first cause of their trouble, they invariably say it was self-abuse, etc., but it is not. _It is the thought._ This precedes the handling, and, like every other cause, must be removed in order to have right results. 8. STOP THE THOUGHT.--But remember, _stop the thought_! You must not look after every woman with lustful thoughts, nor go courting girls who will allow you to hug, caress and kiss them, thus rousing your passions almost to a climax. Do not keep the company of those whose only conversation is of a lewd and depraved character, but keep the company of those ladies who awaken your higher sentiments and nobler impulses, who appeal to the intellect and rouse your aspiration, in whose presence you would no more feel your passions aroused than in the presence of your own mother. 9. YOU WILL GET WELL.--Remember you will get well. Don't fear. Fear destroys strength and therefore increases the trouble. Many get downhearted, discouraged, despairing--the very worst thing that can happen, doing as much harm, and in many cases more, than their former dissipation. Brooding kills; hope enlivens. Then sing with joy that the savior of knowledge has vanquished the death-dealing ignorance of the past; that the glorious strength of manhood has awakened and cast from you forever the grinning skeleton of vice. Be your better self, proud that your thoughts in the day-time are as pure as you could wish your dreams to be at night. 10. HELPS.--Do not use tobacco or liquor. They inflame the passions and irritate the nervous system; they only gratify base appetites and never rouse the higher feelings. Highly spiced food should be eschewed, not chewed. Meat should be eaten sparingly, and never at the last meal. 11. DON'T EAT TOO MUCH.--If not engaged in hard physical labor, try eating two meals a day. Never neglect the calls of nature, and if possible have a passage from the bowels every night before retiring. When this is not done the feces often drop into the rectum during sleep, producing heat which extends to the sexual organs, causing the lascivious dreams and emission. This will be noticed especially in the morning, when the feces usually distend {463} the rectum and the person nearly always awakes with sexual passions aroused. If necessary, use injections into the rectum of from one to two quarts of water, blood heat, two or three times a week. Be sure to keep clean and see to it that no matter collects under the foreskin. Wash off the organ every night and take a quick, cold hand-bath every morning. Have something to do. Never be idle. Idleness always worships at the shrine of passion. 12. THE WORST TIME OF ALL.--Many are ruined by allowing their thoughts to run riot in the morning. Owing to the passions being roused as stated above, the young man lies half awake and half dozing, rousing his passions and reveling in lascivious thought for hours perhaps, thus completely sapping the fountains of purity, establishing habits of vice that will bind him with iron bands, and doing his physical system more injury than if he had practiced self-abuse, and had the emission in a few minutes. Jump out of bed at once on waking, and never allow the thought to master you. 13. A HAND BATH.--A hand bath in cold water every morning will diminish those rampant sexual cravings, that crazy, burning, lustful desire so sensualizing to men by millions; lessen prostitution by toning down that passion which alone patronizes it, and relieve wives by the millions of those excessive conjugal demands which ruin their sexual health; besides souring their tempers, and then demanding millions of money for resultant doctor bills. 14. WILL GET WELL.--Feel no more concern about your self. Say to yourself, "I shall and will get well under this treatment," as you certainly will. Pluck is half the battle. Mind acts and reads directly on the sexual organs. Determining to get well gets you well; whilst all fear that you will become worse makes you worse. All worrying over your case as if it were hopeless, all moody and despondent feelings, tear the life right out of these organs whilst hopefulness puts new life into them. [Illustration] {464} The Curse and Consequence of Secret Diseases. [Illustration: INNOCENT CHILDHOOD.] 1. THE SINS OF THE FATHERS ARE VISITED ON THE CHILDREN.--If persons who contract secret diseases were the only sufferers, there would be less pity and less concern manifested by the public and medical profession. 2. There are many secret diseases which leave an hereditary taint, and innocent children and grandchildren are compelled to suffer as well as those who committed the immoral act. 3. GONORRHOEA (Clap) is liable to leave the parts sensitive and irritable, and the miseries of spermatorrhoea, impotence, chronic rheumatism, stricture and other serious ailments may follow. 4. SYPHILIS (Pox).--Statistics prove that over 30 per cent. of the children born alive perish within the first year. Outside of this frightful mortality, how many children are born, inheriting eruptions of the skin, foul ulcerations, {465} swelling of the bones, weak eyes or blindness, scrofula, idiocy, stunted growth, and finally insanity, all on account of the father's early vices. The weaknesses and afflictions of parents are by natural laws visited upon their children. 5. The mother often takes the disease from her husband, and she becomes an innocent sufferer to the dreaded disease. However, some other name generally is applied to the disease, and with perfect confidence in her husband she suffers pain all her life, ignorant of the true cause. Her children have diseases of the eyes, skin, glands and bones, and the doctor will apply the term scrofula, when the result is nothing more or less than inherited syphilis. Let every man remember, the vengeance to a vital law knows only justice, not mercy, and a single moment of illicit pleasure will bring many curses upon him, and drain out the life of his innocent children, and bring a double burden of disease and sorrow to his wife. 6. If any man who has been once diseased is determined to marry, he should have his constitution tested thoroughly and see that every seed of the malady in the system has been destroyed. He should bathe daily in natural sulphur waters, as, for instance, the hot springs in Arkansas, or the sulphur springs in Florida, or those springs known as specific remedies for syphilic diseases. As long as the eruptions on the skin appear by bathing in sulphur water there is danger, and if the eruptions cease and do not appear, it is very fair evidence that the disease has left the system, yet it is not an infallible test. 7. How many bright and intelligent young men have met their doom and blighted the innocent lives of others, all on account of the secret follies and vices of men. 8. PROTECTION.--Girls, you, who are too poor and too honest to disguise aught in your character, with your sweet soul shining through every act of your lives, beware of the men who smile upon you. Study human nature, and try and select a virtuous companion. _Transcriber's note: there is no 9. in the original._ 10. SYPHILITIC POISON INERADICABLE.--Many of our best and ablest physicians assert that syphilitic poison, once infected, there can be no total disinfection during life; some of the virus remains in the system, though it may seem latent. Boards of State Charities in discussing the causes of the existence of whole classes of defectives hold to the opinion given above. The Massachusetts board in its report has these strong words on the subject: "The worst is that, though years may have passed since its active stage, it permeates the very seed of life and {466} causes strange affections or abnormalities in the offspring, or it tends to lessen their vital force, to disturb or to repress their growth, to lower their standard of mental and bodily vigor, and to render life puny and short. 11. A SERPENT'S TOOTH.--"_The direct blood-poisoning, caused by the absorption into the system of the virus (syphilis) is more hideous and terrible in its effect than that of a serpent's tooth._ This may kill outright, and there's an end; but that, stingless and painless, slowly and surely permeates and vitiates the whole system of which it becomes part and parcel, like myriads of trichinæ, and can never be utterly cast out, even by salivation. "Woe to the family and to the people in whose veins the poison courses! "It would seem that nothing could end the curse except utter extermination. That, however, would imply a purpose of eternal vengeance, involving the innocent with the guilty." This disease compared with small-pox is as an ulcer upon a finger to an ulcer in the vitals. Small-pox does not vitiate the blood of a people; this disease does. Its existence in a primary form implies moral turpitude. 12. CASES CITED.--Many cases might be cited. We give but one. A man who had contracted the disease reformed his ways and was apparently cured. He married, and although living a moral life was compelled to witness in his little girl's eye-balls, her gums, and her breath the result of his past sins. No suffering, no expense, no effort would have been too great could he but be assured that his offspring might be freed from these results. 13. PREVENTION BETTER THAN CURE.--Here is a case where the old adage, "An ounce of prevention is worth a pound of cure," may be aptly applied. Our desire would be to herald to all young men in stentorian tones the advice, "Avoid as a deadly enemy any approaches or probable pitfalls of the disease. Let prevention be your motto and then you need not look for a cure." 14. HELP PROFFERED.--Realizing the sad fact that many are afflicted with this disease we would put forth our utmost powers to help even these, and hence give on the following pages some of the best methods of cure. HOW TO CURE GONORRHOEA (Clap). CAUSES, IMPURE CONNECTIONS, ETC. SYMPTOMS.--As the disease first commences to manifest itself, the patient notices a slight itching at the point of the the {467} male organ, which is shortly followed by a tingling or smarting sensation, especially on making water. This is on account of the inflammation, which now gradually extends backward, until the whole canal is involved. The orifice of the urethra is now noticed to be swollen and reddened, and on inspection a slight discharge will be found to be present. And if the penis is pressed between the finger and thumb, matter or pus exudes. As the inflammatory stage commences, the formation of pus is increased, which changes from a thin to a thick yellow color, accompanied by a severe scalding on making water. The inflammation increases up to the fifth day, often causing such pain, on urinating, that the patient is tortured severely. When the disease reaches its height, the erections become somewhat painful, when the discharge may be streaked with blood. HOME TREATMENT. First, see that the bowels are loose--if not, a cathartic should be given. If the digestive powers are impaired, they should be corrected and the general health looked after. If the system is in a good condition, give internally five drops of gelseminum every two hours. The first thing to be thought of is to pluck the disease in its bud, which is best done by injections. The best of these are: tinct. hydrastis, one drachm; pure water, four ounces; to be used three times a day after urinating. Zinc, sulphate, ten grains; pure water, eight ounces; to be used after urinating every morning and night. Equal parts of red wine and pure water are often used, and are of high repute, as also one grain of permanganate of potash to four ounces of water. If the above remedies are ineffectual, a competent physician should be consulted. General Treatment.--One of the best injections for a speedy cure is: Hydrastis, 1 oz. Water, 5 oz. Mix and with a small syringe inject into the penis four or five times a day after urinating, until relieved, and diminish the number of injections as the disease disappears. No medicine per mouth need be given, unless the patient is in poor health. SYPHILIS (Pox). 1. This is the worst of all diseases except cancer--no tissue of the body escapes the ravages of this dreadful {468} disease--bone, muscle, teeth, skin and every part of the body are destroyed by its deforming and corroding influence. 2. SYMPTOMS.--About eight days after the exposure a little redness and then a pimple, which soon becomes an open sore, makes its appearance, on or about the end of the penis in males or on the external or inner parts of the uterus of females. Pimples and sores soon multiply, and after a time little hard lumps appear in the groin, which soon develop into a blue tumor called _bubo_. Copper colored spots may appear in the face, hair fall out, etc. Canker and ulcerations in the mouth and various parts of the body soon develop. 3. TREATMENT.--Secure the very best physician your means will allow without delay. 4. LOCAL TREATMENT OF BUBOES.--To prevent suppuration, treatment must be instituted as soon as they appear. Compresses, wet in a solution composed of half an ounce of muriate of ammonia, three drachms of the fluid extract of belladonna, and a pint of water, are beneficial, and should be continuously applied. The tumor may be scattered by painting it once a day with tincture of iodine. 5. FOR ERUPTIONS.--The treatment of these should be mainly constitutional. Perfect cleanliness should be observed, and the sulphur, spirit vapor, or alkaline bath freely used. Good diet and the persistent use of alteratives will generally prove successful in removing this complication. RECIPE FOR SYPHILIS.-- Bin-iodide of mercury, 1 gr. Extract of licorice, 32 gr. Make into 16 pills. Take one morning and night. _LOTION._-- Bichloride of mercury, 15 gr. Lime water, 1 pt. Shake well, and wash affected parts night and morning. FOR ERUPTIONS ON TONGUE.-- Cyanide of silver, ½ gr. Powdered iridis, 2 gr. Divide into 10 parts. To be rubbed on tongue once a day. FOR ERUPTIONS IN SYPHILIS.--A 5 per cent. ointment of carbolic acid in a good preparation. BUBO. TREATMENT.-- Warm poultice of linseed meal, Mercurial plaster, Lead ointment. GLEET (Chronic Clap). 1. SYMPTOMS.--When gonorrhoea is not cured at the end of twenty-one or twenty-eight days, at which time all {469} discharge should have ceased, we have a condition known as chronic clap, which is nothing more or less than gleet. At this time most of the symptoms have abated, and the principal one needing medical attention is the discharge, which is generally thin, and often only noticed in the morning on arising, when a scab will be noticed, glutinating the lips of the external orifice. Or, on pressing with the thumb and finger from behind, forward, a thin, white discharge can be noticed. 2. HOME TREATMENT.--The diet of patients affected with this disease is all-important, and should have careful attention. The things that should be avoided are highly spiced and stimulating foods and drinks, as all forms of alcohol, or those containing acids. Indulgence in impure thoughts is often sufficient to keep a discharge, on account of the excitement it produces to the sensitive organs, thus inducing erections, which always do harm. 3. GENERAL TREATMENT.--The best injection is: Nitrate of silver, ¼ grain. Pure water, 1 oz. Inject three or four times a day after urinating. STRICTURE OF THE URETHRA. SYMPTOMS.--The patient experiences difficulty in voiding the urine, several ineffectual efforts being made before it will flow. The stream is diminished in size, of a flattened or spiral form, or divided in two or more parts, and does not flow with the usual force. TREATMENT.--It is purely a surgical case and a competent surgeon must be consulted. PHIMOSIS. 1. CAUSE.--Is a morbid condition of the penis, in which the glans penis cannot be uncovered, either on account of a congenital smallness of the orifice of the foreskin, or it may be due to the acute stage of gonorrhoea, or caused by the presence of soft chancre. 2. SYMPTOMS.--It is hardly necessary to give a description of the symptoms occurring in this condition, for it will be easily diagnosed, and its appearances are so indicative that all that is necessary is to study into its cause and treat the disease with reference to that. TREATMENT.--If caused from acute gonorrhoea, it should be treated first by hot fomentations, to subdue the swelling, when the glans penis can be uncovered. If the result of the formation of chancre under the skin, they should be treated by a surgeon, for it may result in the sloughing off of the end of the penis, unless properly treated. * * * * * {470} Animal Magnetism. WHAT IT IS AND HOW TO USE IT. [Illustration: ILLUSTRATING MAGNETIC INFLUENCES. ANIMAL MAGNETISM IS SUPPOSED TO RADIATE FROM AND ENCIRCLE EVERY HUMAN BEING.] 1. MAGNETISM EXISTING BETWEEN THE BODIES OF MANKIND.--It is rational to believe that there is a magnetism existing between the bodies of mankind, which may have either a beneficial or a damaging effect upon our health, according to the conditions which are produced, or the nature of the individuals who are brought in contact with each other. As an illustration of this point we might consider that, all nature is governed by the laws of attraction and repulsion, or in other words, by positive and negative forces. These subtle forces or laws in nature which we call attraction or {471} repulsion, are governed by the affinity--or sameness--or the lack of affinity--or sameness--which exists between what may be termed the combination of atoms or molecules which goes to make up organic structure. 2. LAW OF ATTRACTION.--Where this affinity--or sameness--exists between the different things, there is what we term the law of attraction, or what may be termed the disposition to unite together. Where there is no affinity existing between the nature of the different particles of matter, there is what may be termed the law of repulsion, which has a tendency to destroy the harmony which would otherwise take place. 3. MAGNETISM OF THE MIND.--Now, what is true of the magnet and steel, is also true--from the sameness of their nature--of two bodies. And what is true of the body in this sense, is also true of the sameness or magnetism of the mind. Hence, _by the laying on of hands_, or by the association of the minds of individuals, we reach the same result as when a combination is produced in any department of nature. Where this sameness of affinity exists, there will be a blending of forces, which has a tendency to build up vitality. 4. A PROOF.--As a proof of this position, how often have you found the society of strangers to be so repulsive to your feelings, that you have no disposition to associate. Others seem to bring with them a soothing influence that draws you closer to them. All these involuntary likes and dislikes are but the results of the _animal magnetism_ that we are constantly throwing off from our bodies,--although seemingly imperceptible to our internal senses.--The dog can scent his master, and determine the course which he pursues, no doubt from similar influences. 5. HOME HARMONY.--Many of the infirmities that afflict humanity are largely due to a want of an understanding of its principles, and the right applications of the same. I believe that if this law of magnetism was more fully understood and acted upon, there would be a far greater harmony in the domestic circle; the health of parents and children might often be preserved where now sickness and discord so frequently prevail. 6. THE LAW OF MAGNETISM.--When two bodies are brought into contact with each other, the weak must naturally draw from the strong until both have become equal. And as long as this equality exists there will be perfect harmony between individuals, because of the reciprocation which exists in their nature. {472} 7. SURVIVAL OF THE FITTEST.--But if one should gain the advantage of the other in magnetic attraction, the chances are that through the law of development, or what has been termed the "Survival of the Fittest"--the stronger will rob the weaker until one becomes robust and healthy, while the other grows weaker and weaker day by day. This frequently occurs with children sleeping together, also between husband and wife. 8. SLEEPING WITH INVALIDS.--Healthy, hearty, vigorous persons sleeping with a diseased person is always at a disadvantage. The consumptive patient will draw from the strong, until the consumptive person becomes the strong patient and the strong person will become the consumptive. There are many cases on record to prove this statement. A well person should never sleep with an invalid if he desires to keep his health unimpaired, for the weak will take from the strong, until the strong becomes the weak and the weak the strong. Many a husband has died from a lingering disease which saved his wife from an early grave. He took the disease from his wife because he was the stronger, and she became better and he perished. 9. HUSBAND AND WIFE.--It is not always wise that husband and wife should sleep together, nor that children--whose temperament does not harmonize--should be compelled to sleep in the same bed. By the same law it is wrong for the young to sleep with old persons. Some have slept in the same bed with persons, when in the morning they have gotten up seemingly more tired than when they went to bed. At other times with different persons, they have lain awake two-thirds of the night in pleasant conversation and have gotten up in the morning without scarcely realizing that they had been to sleep at all, yet have felt perfectly rested and refreshed. 10. MAGNETIC HEALING, OR WHAT HAS BEEN KNOWN AS THE LAYING ON OF HANDS.--A nervous prostration is a negative condition beneath the natural, by the laying on of hands a person in a good, healthy condition is capable of communicating to the necessity of the weak. For the negative condition of the patient will as naturally draw from the strong, as the loadstone draws from the magnet, until both become equally charged. And as fevers are a positive condition of the system "beyond the natural," the normal condition of the healer will, by the laying on of the hands, absorb these positive atoms, until the fever of the patient becomes reduced or cured. As a proof of this the magnetic healer often finds himself or herself prostrated after treating the weak; and excited or feverish after treating a feverish patient. * * * * * {473} How to Read Character. HOW TO TELL DISPOSITION AND CHARACTER BY THE NOSE. [Illustration: WELL MATED.] 1. LARGE NOSES.--Bonaparte chose large-nosed men for his generals, and the opinion prevails that large noses indicate long heads and strong minds. Not that great noses cause great minds, but that the motive or powerful temperament cause both. 2. FLAT NOSES.--Flat noses indicate flatness of mind and character, by indicating a poor, low organic structure. 3. BROAD NOSES.--Broad noses indicate large passageways to the lungs, and this, large lungs and vital organs, and this, great strength of constitution, and hearty animal {474} passions along with selfishness; for broad noses, broad shoulders, broad heads, and large animal organs go together. But when the nose is narrow at the base, the nostrils are small, because the lungs are small and need but small avenues for air; and this indicates a predisposition to consumptive complaints, along with an active brain and nervous system, and a passionate fondness for literary pursuits. 4. SHARP NOSES.--Sharp noses indicate a quick, clear, penetrating, searching, knowing, sagacious mind, and also a scold; indicate warmth of love, hate, generosity, moral sentiment--indeed, positiveness in everything. 5. BLUNT NOSES.--Blunt noses indicate and accompany obtuse intellects and perceptions, sluggish feelings, and a soulless character. 6. ROMAN NOSES.--The Roman nose indicates a martial spirit, love of debate, resistance, and strong passions, while hollow, pug noses indicate a tame, easy, inert, sly character, and straight, finely-formed Grecian noses harmonious characters. Seek their acquaintance. DISPOSITION AND CHARACTER BY STATURE. 1. TALL PERSONS.--Tall persons have high heads, and are aspiring, aim high, and seek conspicuousness, while short ones have flat heads, and seek the lower forms of worldly pleasures. Tall persons are rarely mean, though often grasping; but very penurious persons are often broad-built. 2. SMALL PERSONS.--Small persons generally have exquisite mentalities, yet less power--the more precious the article, the smaller the package in which it is done up,--while great men are rarely dwarfs, though great size often co-exists with sluggishness. DISPOSITION AND CHARACTER BY THE WALK. 1. AWKWARD.--Those whose motions are awkward yet easy, possess much efficiency and positiveness of character, yet lack polish; and just in proportion as they become refined in mind will their movements be correspondingly improved. A short and quick step indicates a brisk and active but rather contracted mind, whereas those who take long steps generally have long heads; yet if the step is slow, they will make comparatively little progress, while those whose step is long and quick will accomplish proportionately much, and pass most of their competitors on the highway of life. {475} 2. A DRAGGING STEP.--Those who sluff or drag their heels, drag and drawl in everything; while those who walk with a springing, bouncing step, abound in mental snap and spring. Those whose walk is mincing, affected, and artificial, rarely, if ever, accomplish much; whereas those who walk carelessly, that is, naturally, are just what they appear to be, and put on nothing for outside show. 3. THE DIFFERENT MODES OF WALKING.--In short, every individual has his own peculiar mode of moving, which exactly accords with his mental character; so that, as far as you can see such modes, you can decipher such outlines of character. THE DISPOSITION AND CHARACTER BY LAUGHING. 1. LAUGHTER EXPRESSIVE OF CHARACTER.--Laughter is very expressive of character. Those who laugh very heartily have much cordiality and whole-souledness of character, except that those who laugh heartily at trifles have much feeling, yet little sense. Those whose giggles are rapid but light, have much intensity of feeling, yet lack power; whereas those who combine rapidity with force in laughing, combine them in character. 2. VULGAR LAUGH.--Vulgar persons always laugh vulgarly, and refined persons show refinement in their laugh. Those who ha, ha right out, unreservedly, have no cunning, and are open-hearted in everything; while those who suppress laughter, and try to control their countenances in it, are more or less secretive. Those who laugh with their mouths closed are non-committal; while those who throw it wide open are unguarded and unequivocal in character. 3. SUPPRESSED LAUGHTER.--Those who, suppressing laughter for a while, burst forth volcano-like, have strong characteristics, but are well-governed, yet violent when they give way to their feelings. Then there is the intellectual laugh, the love laugh, the horse laugh, the philoprogenitive laugh, the friendly laugh, and many other kinds of laugh, each indicative of corresponding mental developments. DISPOSITION AND CHARACTER BY THE MODE OF SHAKING HANDS. THEIR EXPRESSION OF CHARACTER.--Thus, those who give a tame and loose hand, and shake lightly, have a cold, if not heartless and selfish disposition, rarely sacrificing much for others, are probably conservatives, and lack warmth and {476} soul. But those who grasp firmly, and shake heartily, have a corresponding whole-souledness of character, are hospitable, and will sacrifice business to friends; while those who bow low when they shake hands, add deference to friendship, and are easily led, for good or bad, by friends. [Illustration: AN EASY-GOING DISPOSITION.] THE DISPOSITION AND CHARACTER BY THE MOUTH AND EYES. 1. DIFFERENT FORMS OF MOUTHS.--Every mouth differs from every other, and indicates a coincident character. Large mouths express a corresponding quantity of mentality, while small ones indicate a lesser amount. A coarsely-formed mouth indicates power, while one finely-formed indicates exquisite susceptibilities. Hence small, delicately formed mouths indicate only common minds, with very fine feelings and much perfection of character. 2. CHARACTERISTICS.--Whenever the muscles about the mouth are distinct, the character is correspondingly positive, and the reverse. Those who open their mouths wide and frequently, thereby evince an open soul, while closed {477} mouths, unless to hide deformed teeth, are proportionately secretive. 3. EYES.--Those who keep their eyes half shut are peek-a-boos and eaves-droppers. 4. EXPRESSIONS OF THE EYE.--The mere expression of the eye conveys precise ideas of the existing and predominant states of the mentality and physiology. As long as the constitution remains unimpaired, the eye is clear and bright, but becomes languid and soulless in proportion as the brain has been enfeebled. Wild, erratic persons have a half-crazed expression of eye, while calmness, benignancy, intelligence, purity, sweetness, love, lasciviousness, anger, and all the other mental affections, express themselves quite as distinctly by the eye as voice, or any other mode. 5. COLOR OF THE EYES.--Some inherit fineness from one parent, and coarseness from the other, while the color of the eye generally corresponds with that of the skin, and expresses character. Light eyes indicate warmth of feeling, and dark eyes power. 6. GARMENTS.--Those, who keep their coats buttoned up, fancy high-necked and closed dresses, etc., are equally non-communicative, but those who like open, free, flowing garments, are equally open-hearted and communicative. THE DISPOSITION AND CHARACTER BY THE COLOR OF THE HAIR. 1. DIFFERENT COLORS.--Coarseness and fineness of texture in nature indicate coarse and fine-grained feelings and characters, and since black signifies power, and red ardor, therefore coarse black hair and skin signify great power of character of some kind, along with considerable tendency to the sensual; yet fine black hair and skin indicate strength of character, along with purity and goodness. 2. COARSE HAIR.--Coarse black hair and skin, and coarse red hair and whiskers, indicate powerful animal passions, together with corresponding strength of character; while fine or light, or auburn hair indicates quick susceptibilities, together with refinement and good taste. 3. FINE HAIR.--Fine dark or brown hair indicates the combination of exquisite susceptibilities with great strength of character, while auburn hair, with a florid countenance, indicates the highest order of sentiment and intensity of feeling, along with corresponding purity of character, combined with the highest capacities for enjoyment and suffering. {478} 4. CURLY HAIR.--Curly hair or beard indicates a crisp, excitable, and variable disposition, and much diversity of character--now blowing hot, now cold--along with intense love and hate, gushing, glowing emotions, brilliancy, and variety of talent. So look out for ringlets; they betoken April weather--treat them gently, lovingly, and you will have the brightest, clearest sunshine, and the sweetest, balmiest breezes. 5. STRAIGHT HAIR.--Straight, even, smooth, and glossy hair indicate strength, harmony, and evenness of character, and hearty, whole-souled affections, as well as a clear head and superior talents; while straight, stiff, black hair and beard indicate a coarse, strong, rigid, straight-forward character. 6. ABUNDANCE OF HAIR.--Abundance of hair and beard signifies virility and a great amount of character; while a thin beard signifies sterility and a thinly settled upper story, with rooms to let, so that the beard is very significant of character. 7. FIERY RED HAIR indicates a quick and fiery disposition. Persons with such hair generally have intense feelings--love and hate intensely--yet treat them kindly, and you have the warmest friends, but ruffle them, and you raise a hurricane on short notice. This is doubly true of auburn curls. It takes but little kindness, however, to produce a calm and render them as fair as a Summer morning. Red-headed people in general are not given to hold a grudge. They are generally of a very forgiving disposition. SECRETIVE DISPOSITIONS. 1. A man that naturally wears his hat upon the top or back of the head is frank and outspoken; will easily confide and have many confidential friends, and is less liable to keep a secret. He will never do you any harm. 2. If a man wears his hat well down on the forehead, shading the eyes more or less, will always keep his own counsel. He will not confide a secret, and if criminally inclined will be a very dangerous character. 3. If a lady naturally inclines to high-necked dresses and collars, she will keep her secrets to herself if she has any. In courtship or love she is an uncertainty, as she will not reveal sentiments of her heart. The secretive girl, however, usually makes a good housekeeper and rarely gets mixed into neighborhood difficulties. As a wife she will not be the most affectionate, nor will she trouble her husband with many of her trials or difficulties. * * * * * {479} Dictionary of Medical Terms. _Found in this and other works._ ABDOMEN--The largest cavity of the body, containing the liver, stomach, intestines, etc. ABNORMAL--Unhealthy, unnatural. ABORTION--A premature birth, or miscarriage. ABSCESS--A cavity containing pus. ACETIC--Sour, acid. ACIDITY--Sourness. ACRID--Irritating, biting. ACUTE--Of short duration. ADIPOSE--Fatty. ALBUMEN--An animal substance resembling white of egg. ALIMENTARY CANAL--The entire passage through which food passes; the whole intestines from mouth to anus. ALTERATIVE--Medicines which gradually restore healthy action. AMENORRHOEA--Suppression of the menses. AMORPHOUS--Irregular. AN�MIA--Bloodlessness. AN�STHETICS--Medicines depriving of sensation and suffering. ANATOMY--Physical structure. ANODYNE--A remedy used for the relief of pain. ANTE-NATAL--Before birth. ANTEVERSION--Bending forward. ANTIDOTE--A medicine counteracting poison. ANTI-EMETIC--That which will stop vomiting. ANTISEPTIC--That which will prevent putrefaction. ANUS--Circular opening or outlet of the bowels. AORTA--The great artery of the heart. APHTHA--Thrush; infant sore mouth. AQUA--Water. AREOLA--Circle around the nipple. ASTRINGENT--Binding; contracting. AURICLE--A cavity of the heart. AXILLA--The armpit. AZOTE--Nitrogen. BACTERIA--Infusoria; microscopical insects. BICUSPID--A two-pointed tooth. BILE--Secretion from the liver. {480} BRONCHITIS--Inflammation of the bronchial tubes which lead into the lungs. CALCULUS--A stone found in the bladder, gall-ducts and kidneys. CALLOUS--A hard bony substance or growth. CAPILLARIES--Hair-like vessels that convey the blood from the arteries to the veins. CARBONIC ACID--The gas which is expired from the lungs. CARDIAC--Relating to the heart. CATARRH--Flow of mucus. CATHARTIC--An active purgative. CAUSTIC--A corroding or destroying substance. CELLULAR--Composed of cells. CERVIX--Neck. CERVIX UTERI--Neck of the womb. CHRONIC--Of long standing. CLAVICLE--The collar bone. COCCYX--Terminal bone of the spine. CONDIMENT--That which gives relish to food. CONGESTION--Overfullness of blood vessels. CONTUSION--A bruise. CUTICLE--The outer skin. DENTITION--Act of cutting teeth. DIAGNOSIS--Scientific determination of diseases. DIARRHOEA--Looseness of the bowels. DISINFECTANT--That which cleanses or purifies. DIAPHRAGM--Breathing muscle between chest and abdomen. DUODENUM--The first part of the small intestines. DYSPEPSIA--Difficult digestion. DYSURIA--Difficult or painful urination. EMETIC--Medicines which produce vomiting. ENAMEL--Covering of the teeth. ENEMA--An injection by the rectum. ENTERITIS--Inflammation of the intestines. EPIDEMIC--Generally prevailing. EPIDERMIS--Outer skin. EPIGASTRIUM--Region of the pit of the stomach. EPILEPSY--Convulsions. EUSTACHIAN TUBE--A tube leading from the side of the throat to the internal ear. EVACUATION--Discharging by stool. EXCRETION--That which is thrown off. EXPECTORANT--Tending to produce free discharge from the lungs or throat. FALLOPIAN TUBES--Tubes from ovaries to uterus. {481} F�CES--Discharge from the bowels. FOETUS--The child in the womb after the fifth month. FIBULA--The smallest bone of the leg below the knee. FISTULA--An ulcer. FLATULENCE--Gas in the stomach or bowels. FLOODING--Uterine hemorrhage. FLUOR ALBUS--White flow; leucorrhoea; whites. FLUX--Diarrhoea, or other excessive discharge. FOMENTATION--Warm or hot application to the body. FRIABLE--Easily crumbled or broken. FRICTION--Rubbing with the dry hand or dry coarse cloth. FUMIGATE--To smoke a room, or any article needing to be cleansed. FUNCTION--The office or duty of any organ. FUNDAMENT--The anus. FUNGUS--Spongy flesh in wounds; proud flesh. FUSION--To melt by heat. GALL--Bile. GALL-STONES--Hard biliary concretions found in the gall bladder. GANGRENE--The first stage of mortification. GARGLE--A liquid preparation for washing the throat. GASTRIC--Of the stomach. GASTRITIS--Inflammation of the stomach. GELATINOUS--Like jelly. GENITALS--The sexual organs. GENU--The knee. GENUS--Family of plants; a group. GERM--The vital principal, or life spark. GESTATION--Period of growth of child in the womb. GLEET--Chronic gonorrhoea. GLOTTIS--The opening of the windpipe. GONORRHOEA--An infectious discharge from the genital organs. GOUT--Painful inflammation of the joints of the toes. GRAVEL--Crystalline sand-like particles in the urine. GUTTURAL--Relating to the throat. HECTIC--A fever which occurs generally at night. HEMORRHAGE--A discharge of blood. HEMORRHOIDS--Piles; tumors in the anus. HEPATIC--Pertaining to the liver. HEREDITARY--Transmitted from parents. HERNIA--Rupture which permits a part of the bowels to protrude. HYGIENE--Preserving health by diet and other precautions. {482} HYPER�MIA--Excess of blood in any part. HYSTERITIS--Inflammation of the uterus. IMPREGNATION--The act of producing. INCISION--The cutting with instruments. INCONTINENCE--Not being able to hold the natural secretions. INFLUENZA--A disease affecting the nostrils and throat. INFUSION--The liquor in which plants have been steeped, and their medicinal virtues extracted. INHALATION--Drawing in the breath. INJECTION--Any preparation introduced into the rectum or other cavity by syringe. INSPIRATION--The act of drawing air into the lungs. INSOMNIA--Sleeplessness. INVOLUNTARY--Against the will. INTROVERSION--Turned within. JAUNDICE--A disease caused by the inactivity of the liver or ducts leading from it. JUGULAR--Belonging to the throat. KIDNEYS--Two organs which secrete the urine. LABIA--The lips of the vagina. LARYNGITIS--Inflammation of the throat. LARYNX--The upper part of the throat. LASSITUDE--Weakness; a feeling of stupor. LAXATIVE--Remedy increasing action of the bowels. LEUCORRHOEA--Whites; fluor albis. LIVID--A dark colored spot on the surface. LOIN--Lower part of the back. LOTION--A preparation to wash a sore. LUMBAGO--Rheumatism of the loins. MALARIA--Foul marsh air. MALIGNANT--A disease of a very serious character. MALFORMATION--Irregular, unnatural formation. MASTICATION--The act of chewing. MASTURBATION--Excitement, by the hand, of the genital organs. MATRIX--The womb. MECONIUM--The first passage of babes after birth. MEMBRANE--A thin lining or covering. MENOPAUSE--Change of life. MENSTRUATION--Monthly discharge of blood from the uterus. MIDWIFERY--Art of assisting at childbirth. MUCUS--A fluid secreted or poured out by the mucous membrane, serving to protect it. NARCOTIC--A medicine relieving pain and producing sleep. NEPHRITIS--Inflammation of the kidneys. NEURALGIA--Pain in nerves. {483} NORMAL--In a natural condition. NUTRITIOUS--A substance which feeds the body. OBESITY--Excess of fat or flesh. OBSTETRICS--The science of midwifery. OCULUS--The eye. OESOPHAGUS--The tube leading from the throat to the stomach. OPTIC NERVE--The nerve which enters the back part of the eye. ORGANIC--Having organs. OS--Mouth; used as mouth of womb. OSTALGIA--Pain in the bone. OTITIS--Inflammation of the ear. OVUM--An egg. OXALIC ACID--An acid found in sorrel, very poisonous. PALATE--The roof of the mouth. PALLIATIVE--To afford relief only. PALPITATION--Unnatural beating of the heart. PARALYSIS--Loss of motion. PARTURITION--Childbirth. PATHOLOGICAL--Morbid, diseased. PELVIS--The bony cavity at lower part of trunk. PERICARDIUM--Sac containing the heart. PERIN�UM--The floor of the pelvis, or space between and including the anus and vulva. PERITONITIS--Inflammation of lining membrane of bowels. PLACENTA--After-birth. PLEURA--Membrane covering the lungs. PLEURISY--Inflammation of the pleura. PREGNANCY--Being with child. PROGNOSIS--Prediction of termination of a disease. PROLAPSUS--Falling; protrusion. PROLAPSUS UTERI--Falling of the womb. PROSTRATION--Without strength. PRURITIS--A skin trouble causing intense itching. PUBERTY--Full growth. PUBES--External part of the organs of generation covered with hair. PUERPERAL--Belonging to childbirth. PULMONARY--Pertaining to the lungs. PULMONITIS--Inflammation of the lungs. PUS--Unhealthy matter. PUTRID--Rotten, decomposed. PYLORUS--Lower opening of the stomach. RECTUM--The lower portion of the intestines. REGIMEN--Regulated habits and food. {484} RETCHING--An effort to vomit. RETINA--Inner coat of the eye. RETROVERSION--Falling backward. RIGOR--Chilliness, convulsive shuddering. SACRUM--Bone of the pelvis. SALIVA--Fluid of the mouth. SALIVATION--Unnatural flow of saliva. SANATIVE--Health-producing. SCIATIC--Pertaining to the hip. SCROFULA--A constitutional tendency to disease of the glands. SCROTUM--The sac which encloses the testicles. SEDATIVE--Quieting, soothing. SEMEN--Secretion of the testes. SITZ-BATH--Bath in a sitting position. STERILITY--Barrenness. STIMULANT--A medicine calculated to excite an increased and healthy action. STYPTIC--A substance to stop bleeding. SUDORIFIC--Inducing sweat. TAMPAN--A plug to arrest hemorrhage. TONIC--A medicine which increases the strength of the system. TESTICLE--Gland that secretes the semen. THERAPEUTIC--Treatment of disease. TISSUE--The peculiar structure of a part. TONSILS--Glands on each side of the throat. TRACHEA--Windpipe. Triturate--To rub into a powder. TUMOR--A morbid enlargement of a part. ULCERATION--The forming of an ulcer. UMBILICUS--The navel. URETER--Duct leading from kidney to the bladder. URETHRA--Duct leading from the bladder. UTERUS--The womb. VAGINA--The passage from the womb to the vulva. VARICOSE VEINS--Veins dilated with accumulation of dark colored blood. VASCULAR--Relating to the blood vessels. VENA CAVA--The large vein communicating with the heart. VENOUS--Pertaining to the veins. VENTRICLE--One of the lower chambers of the heart. VIABLE--Capable of life. VULVA--Outer lips of the vagina. WOMB--That organ of the woman which conceives and nourishes the offspring. ZYMOTIC--Caused by fermentation. * * * * * {485} Alphabetical Index. A broken heart, Page. 159-161 Abortion, or miscarriage, 253, 254 Adaptation, conjugal, affection, etc, 181-185 Advantages of wedlock, 135-137 Advice to the married and unmarried, 181-188 Advice to the newly married couples, 201-205 A good name, 18-20 Amenorrhoea, 355 Animal magnetism, 470 A perfect human figure, how to determine, 99 A plea for the girls, 380-389 Apoplexy, how to cure, 365 Associates, influence of, 11 Bad company, result of, 11 Bad breath and quinsy, how to cure, 365 Babies, how to keep well, 330-331 Bathing, practical rules for, 370, 371 Baths, all the different kinds of, 372, 373 Beauty, a dangerous gift, 27 Beauty, 91-94 Beauty, sensible helps to, 95, 96 Beautiful children, how to have, 288-290 Beginning of life, 5 Beware of idleness, 436 Beware of advertising quacks, 457 Biliousness, 357 Blackheads and flesh worms, 112 Bleeding, to check, 356 Bleeding, from the nose, 364 Boils, 364 Boys, save them, 390-394 Bruises or cuts, 360 Bunions, 364 Burns and sores, 355 Care of the hair, 107-110 Care of the new born infants, 315 Cases cited, 314 Cause of family troubles, 217, 218 Celebrated prescriptions and how to use them, 354-364 Celibacy, disadvantages of, 138 Character, exhibits itself, 15 Character, how to read, 473-478 Child in the womb, education of, 292-294 Child bearing without pain, 304-310 Chilblains, sprains, etc, 359 Children, too many, 229-231 Chapped hands, 355 Chicken pox, 346 Choosing a partner, sensible hints in, 165-169 Chastity and purity of character, 400-403 Cigarette smoking, the destructive effects of, 449-450 Cooking for the sick, 375-379 Confinement, special safeguards in, 299-301 Correspondence, 36 Conversation, 79-83 Conversation, home lessons, 80-83 Corset, benefit and injury, 101-103 Costiveness, 362 Courtship and marriage, hints and helps, 144-152 Conjugal affections and fatal errors, 181-185 Conception, prevention of, 240-245 Colic, 338 Constipation, how to cure, 339 Coughs and colds, 360 Croup, spasmodic and true, 342 Cramps and colic, remedies for, 356 Dangerous vices, 451-456 Deafness, cure for, 362 Dictionary of medical terms, 479-484 Diarrhoea, 363 Diphtheria, home treatment of, 346 Disinfectant, 360 Diseases of women, 348-350 Disposition, an easy going, ??? Diseases of infants and children, home treatment for, 338-347 Diseases, transmission of, 263-265 Diseases of pregnancy, 274-281 Doses, of disease and death, 441-444 Dress, 88-90 Dress, diet, and exercise during pregnancy, 304-310 Duration of pregnancy, 295 Dyspepsia, cure of, 360 Education of child in the womb, 292-294 Eruption of the skin, 111, 112 Etiquette, rules on, 49-54 Etiquette of calls, 56 Etiquette in your speech, 57 Etiquette of dress and habit, 58 Etiquette on the street, 59 Etiquette between sexes, 60 Expectant mother cautioned 284 Exciting the passions in children, 404, 405 Eye wash, 355 Falling of the womb, 350 Family troubles, cause of, 217 Family, government, 76-78 Facial eruptions, how to cure, 111-112 Feeding a baby on cow's milk, 329 Felons, how to treat, 364 Female character, influence of, 30 {486} First love, desertion, etc., 185 Films and cataracts of the eyes, 355 Flirting and its dangers, 190, 191 Fleshworms, etc., 112 Form and deformity, 98-103 Foreign bodies in the eye, to remove, 358 Former customs among men, 162-163 Formation of life, mystery of, 238, 239 Food, digestibility of, 374 Friends, procure none in haste, 12 Generative organs--Male and female, 234-237 Good behavior, at all times and places, 49 Good character, influence of, 73, 74 Gout, cure for, 362 Guard modesty, 210 Habit, 17 Hair, the care of, 107-110 Headache, sick, cure for, 355, 360 Health, a duty, 7 Heartburn, 357 Heredity and transmission of diseases, 263-265 Hints and helps on good behavior, 49 Hints in choosing a partner, 165-169 Hives, cure for, 354 Home power, 23-25 Honeymoon, how to perpetuate, 209 Home lessons in nursing sick children, 325-328 Home treatment of the secret habit, 455-456 Hot water, how to use in all diseases, 368-369 How to keep the bloom and grace of youth, 97 How to be a good wife, 210-212 How to be a good husband, 212-215 How to feed infants, 329 How to keep a baby well, 330-335 How to apply and use hot water in all diseases, 368, 369 How to mesmerize, ??? How the mind speaks through the nerves and muscles, ??? How to cook for the sick, 375-379 Human magnetism, effects of, ??? Human figure, a perfect, 99-100 Hygienic laws, 406-408 Ignorance, coarseness, etc., 24 Illustrations, ??? Immorality, disease and death, 416-419 Impotence and sterility, 248-251 Improvement of offspring, 222-227 Impregnation, 269 Impregnation, artificial, 270 Infant teething, 336, 337 Infants, feeding, 319 Infants, care of, 315-320 Influence of good character, 73-74 Inhumanities of parents, 396-399 Intoxication, 355 Infants, care of during hot weather, 332-335 Infantile convulsions, 319, 320 Influence of associates, 11 Influence of female character, 30 Indigestion, symptoms of, 328 Inward graces, 28 Jealousy, its cause and cure, 219-221 Kidneys, the object lessons, 447 Knowledge is safety, 3 Labor, time of expected, 295-298 Labor, signs and symptoms of, 297, 298 Leucorrhoea, 349 Lessons of caution to young women, 380 Letters, how to write, 34-47 Letters, social forms of, 39-43 Life, beginning of, 5 Liver and kidneys of a drunkard, 446, 447 Lock and key, 4 Longevity, 367 Love, 114-120 Love letters, forms of, 44-47 Love power, the peculiarities of, 118 Love, connubial, 122 Love and common sense, 123, 124 Love spats, 154-157 Lost manhood restored, 459, 460 Lungs and heart of a cigarette smoker, 448, 449 Maidens, a word to, 192 Male and female generative organs explained, 234-237 Manhood wrecked and rescued, 461-463 Man, a careless being, 32 Mashed nails, 358 Men, prostitution of, 427-429 Maternity, preparation for, 266, 267 Marriage, history of, 132-134 Marriage securities, 174-177 Matrimonial pointers, 170-173 Menstruation, 351-353 Mother's influence, 21 Morning sickness, 282 Mumps and measles, 345 Murder of the innocents, 255-257 {487} Nervous, disability, remedy for, 356 Nervous headache, 356 Neuralgia, 356, 360 Newly married couples, advice to, 201-205 New revelation for women, 246, 247 Nocturnal emissions, 457 Nursing, pains and ills of, 321-324 Nursing sick children, 325-328 Object lessons of the effects of alcohol and cigarette smoking, 445-450 Offspring, improvement of, 222-227 Old maids, 140-143 Our secret sins, 409-413 Ovum, ripe from the ovary, 238 Pains and ills in nursing, 321-324 Person, care of, 84 Personal appearance, 86 Personal purity, 31, 32 Physical and moral degeneracy, 414, 415 Piles, cure of, 362 Pimples, how to cure, 111 Plain words to parents, 312 Poisonous literature and bad pictures, 421, 422 Poisons, remedies for, 359 Popping the question, 194-198 Politeness, 70-72 Prescriptions, celebrated, 354-364 Prevention of conception, 240-245 Preparation for maternity, 266, 267 Pregnancy, signs and symptoms of, 270-273 Pregnancy, diseases of, 274-281 Pregnancy, relation of husband and wife during, 283 Prisons overflowing, 19 Private talk to young men, 437-439 Private word to the expectant mother, 284 Producing boys or girls at will, 252 Prostitution, cause and cure, 427-429 Puberty, virility and hygienic laws, 406-408 Quacks, 453 Quinsy, 365 Relation of husband and wife during pregnancy, 283 Road to shame, the, 430-432 Ringworm, 362 Rose rash, 363 Safeguards during confinement, 299-301 Safe hints, 170-173 Save the boys, 390-394 Save the girls, 380-389 Scriptural declaration, 195 Scarlet fever, 363 Scarlet fever and measles, 328 Secret sins, symptoms of, 451-455 Secret diseases, curse and consequence, 464-465 Self control, 12 Sensible hints in choosing a partner, 165-169 Sensible rules for the nurse, 366 Sexual propriety, etc., 206-208 Shall pregnant women work, 285 Shame, the road to, 430-432 Signs and symptoms of labor, 297, 298 Signs and symptoms of pregnancy, 270-273 Sin of ignorance, 453 Slave of injurious drugs, 441-444 Small families and the improvement of the race, 232-233 Social duties, 65-69 Solemn lessons for parents, 312-314 Social evil, remedies for, 440 Sprained ankle or wrist, 359 Stomach, the object lessons, 445 Startling sins, 423-426 Strong drink, 16 Sterilized milk, 334 Superfluous hair, 360 Sweating feet, cure for, 354 Table manners, practical rules on, 63, 64 The beginning of life, 5 The curse of manhood, 433-436 The last tie, 22 The ideal man, 14 The mother's influence, 21-22 The toilet, 84-87 The history and mystery of the corset, 101-103 The inhumanities of parents, 396 The road to shame, 430, 432 Throat trouble, 354 Tight lacing, effects of, 104, 105 Time of expected labor, how to calculate, 295 Toilet, the, 84-87 Too many children, 229-231 To young women, 26-28 Turpentine, applications, 357 Unwelcome child, 258-262 Value of reputation, 9 Virility, 406 Vice or virtue, 6 Vomiting, 363 Waists, natural and unnatural, 105 Warts and wens, 364 Water as medicine, 368 Wedlock, advantages of, 135-137 Wedding, 199, 200 What women love in men, 126-128 What men love in women, 129-131 When and whom to marry, 144-152 Where did the baby come from, 303 Whooping cough, 344 Women, new revelations for, 246, 247 Women who make the best wives, 178-180 Words for young mothers, 286, 287 Worms, round and pin, 341 * * * * * Notes [1] Above syringe will be sent by publishers, postpaid, for $1.20. The cleanser alone for 60c. [2] This is the title of a pamphlet written by Henry C. Wright. We have taken some extracts from it. [3] Some of these valuable suggestions are taken from "Parturition Without Pain," by Dr. M. L. Holbrook. [4] This quotation is an appeal to mothers by Mrs. P. B. Saur, M.D. * * * * * Corrections made to printed original. p. 6. s. 5. "victims of their own sin.": 'or' (for 'of') in original. p. 16. s. 9. "It is necessary to one's personal happiness,": 'neccessary' in original. p. 50. s. 10. "not too rigid": 'rigd' in original. p. 50. s. 17. "Should you chance": 'yon' in original. The same error in "unless you are engaged", p. 53. s. 15. p. 129. s. 13. "the love and admiration of young ladies": 'admiraton' in original. p. 135. "a glow of satisfaction and delight": 'satsfaction' in original. p. 165. s. 2. "do not bungle courtship": 'no' (for 'not') in original. p. 177. "rather ... to a man without money than to money without a man": garbled to 'with a man' in original. p. 237. s. 7. "Fallopian Tubes.": 'Fallopion' in original. p. 239. s. 5. "sufficient in amount to impregnate": 'amouut' in original. p. 250. s. 13. "Take plenty of out-door exercise": 'excercise' in original. p. 285. s. 1. "to be a dwarfed and puny race": 'to a be' in original. p. 300. s. 10. "no tying is necessary": 'no time is neeessary' in original. p. 306. s. 18. "The above cuts are given on page 105": incorrectly '113' in original. p. 321. s. 1. "were to adopt": 'where' (for 'were') in original. p. 376. s. 9. "inflammation of lungs": 'of of' (over line-break) in original. p. 425. s. 9. "moral manhood and womanhood": 'womahood' in original. p. 428. s. 10. "Proof of this is especially furnished": 'if' (for 'is') in original. p. 440. s. 2. "sooner or later contracting disease": 'dis-disease' (over line-break) in original. p. 442. s. 5. "chloral, bromide and hyoscymus": 'hyoseamus' in original, 'hyoscymus' is his spelling on p. 363 (it should really be 'hyoscyamus'). p. 469. "STRICTURE OF THE URETHRA.": 'URETHA' in original. p. 472. s. 7. "one becomes robust and healthy": 'heatlhy' in original. The following index entries in the original do not seem to match anything in the text: Disposition, an easy going, 491 How to mesmerize, 468 How the mind speaks through the nerves and muscles, 494, 495 Human magnetism, effects of, 503-506 Illustrations, 1 
39044	----	Advice to the people _ADVICE_ __to the__ _PEOPLE_ in __General__, __with__ Regard to their __Health__: But more particularly calculated for those, who, by their Distance from regular Physicians, or other very experienced Practitioners, are the most unlikely to be seasonably provided with the best Advice and Assistance, in acute Diseases, or upon any sudden inward or outward Accident. _WITH_ A Table of the most cheap, yet effectual Remedies, and the plainest Directions for preparing them readily. Translated from the _French_ Edition of Dr. __Tissot's__ _Avis au Peuple_, &c. Printed at _Lyons_; with all his own Notes; a few of his medical Editor's at _Lyons_; and several occasional Notes, adapted to this _English_ Translation, By J. _Kirkpatrick_, M. D. _In the Multitude of the People is the Honour of a King; and for the Want of People cometh the Destruction of the Prince._ Proverbs xiv, 28. ----------------------------------------------------------------- __LONDON:__ Printed for T. _Becket_ and P. A. _De Hondt_, at _Tully's_ Head, near _Surry-Street_, in the _Strand_. M DCC LXV. _the Translator's_ PREFACE. Though the great Utility of those medical Directions, with which the following Treatise is thoroughly replenished, will be sufficiently evident to every plain and sensible Peruser of it; and the extraordinary Reception of it on the Continent is recited in the very worthy Author's Preface; yet something, it should seem, may be pertinently added, with Regard to this Translation of it, by a Person who has been strictly attentive to the Original: a Work, whose Purpose was truly necessary and benevolent; as the Execution of it, altogether, is very happily accomplished. It will be self evident, I apprehend, to every excellent Physician, that a radical Knowledge of the Principles, and much Experience in the Exercise, of their Profession, were necessary to accommodate such a Work to the Comprehension of those, for whom it was more particularly calculated. Such Gentlemen must observe, that the certain Axiom of _Nature's curing Diseases_, which is equally true in our Day, as it was in that of _Hippocrates_, so habitually animates this Treatise, as not to require the least particular Reference. This _Hippocratic_ Truth as certain (though much less subject to general Observation) as that Disease, or Age, is finally prevalent over all sublunary Life, the most attentive Physicians discern the soonest, the most ingenuous readily confess: and hence springs that wholesome Zeal and Severity, with which Dr. _Tissot_ encounters such Prejudices of poor illiterate Persons, as either oppose, or very ignorantly precipitate, her Operations, in her Attainment of Health. These Prejudices indeed may seem, from this Work, to be still greater, and perhaps grosser too, in _Swisserland_ than among ourselves; though it is certain there is but too much Room for the Application of his salutary Cautions and Directions, even in this Capital; and doubtless abundantly more at great Distances from it. It may be very justly supposed, for _one_ Instance, that in most of those Cases in the Small Pocks, in which the Mother undertakes the Cure of her Child, or confides it to a Nurse, that Saffron, in a greater or less Quantity, and Sack or Mountain Whey, are generally still used in the Sickening before Eruption; to accelerate that very Eruption, whose gradual Appearance, about the fourth Day, from that of Seizure inclusive, is so favourable and promising to the Patient; and the Precipitation of which is often so highly pernicious to them. Most of, or rather all, his other Cautions and Corrections seem equally necessary here, as often as the Sick are similarly circumstanced, under the different acute Diseases in which he enjoins them. Without the least Detraction however from this excellent Physician, it may be admitted that a few others, in many other Countries, might have sufficient Abilities and Experience for the Production of a like Work, on the same good Plan. This, we find, Dr. _Hirzel_, principal Physician of _Zurich_, had in Meditation, when the present Treatise appeared, which he thought had so thoroughly fulfilled his own Intention, that it prevented his attempting to execute it. But the great Difficulty consisted in discovering a Physician, who, with equal Abilities, Reputation and Practice, should be qualified with that _much rarer_ Qualification of caring so much more for the Health of those, who could never pay him for it, than for his own Profit or Ease, as to determine him to project and to accomplish so necessary, and yet so self-denying, a Work. For as the Simplicity he proposed in the Style and Manner of it, by condescending, in the plainest Terms, to the humblest Capacities, obliged him to depress himself, by writing rather beneath the former Treatises, which had acquired him the Reputation of medical Erudition, Reasoning and Elegance; we find that the Love of Fame itself, so stimulating even to many ingenuous Minds, was as impotent as that of Wealth, to seduce him from so benign, so generous a Purpose. Though, upon Reflection, it is by no Means strange to see wise Men found their Happiness, which all [however variously and even oppositely] pursue, rather in Conscience, than on Applause; and this naturally reminds us of that celebrated Expression of _Cato_, or some other excellent Ancient, "that he had rather _be_ good, than _be reputed_ so." However singular such a Determination may now appear, the Number of reputable medical Translators into different Languages, which this original Work has employed on the Continent, makes it evident, that real Merit will, sooner or later, have a pretty general Influence; and induce many to imitate that Example, which they either could not, or did not, propose. As the truly modest Author has professedly disclaimed all Applause on the Performance, and contented himself with hoping an Exemption from Censure, through his Readers' Reflection on the peculiar Circumstances and Address of it; well may his best, his faithfullest Translators, whose Merit and Pains must be of a very secondary Degree to his own, be satisfied with a similar Exemption: especially when joined to the Pleasure, that must result from a Consciousness of having endeavoured to extend the Benefits of their Author's Treatise, to Multitudes of their own Country and Language. For my own Particular, when after reading the Introduction to the Work, and much of the Sequel, I had determined to translate it; to be as just as possible to the Author, and to his _English_ Readers, I determined not to interpolate any Sentiment of my own into the Text, nor to omit one Sentence of the Original, which, besides its being _Detraction_ in its literal Sense, I thought might imply it in its worst, its figurative one; for which there was no Room. To conform as fully as possible to the Plainness and Perspicuity he proposed, I have been pretty often obliged in the anatomical Names of some Parts, and sometimes of the Symptoms, as well as in some pretty familiar, though not entirely popular Words, to explain all such by the most common Words I have heard used for them; as after mentioning the _Diaphragm_, to add, or _Midriff_--the _Trachæa_--or _Windpipe_--_acrimonious_, or _very sharp_, and so of many others. This may a little, though but a little, have extended the Translation beyond the Original; as the great Affinity between the _French_ and _Latin_, and between the former and many _Latin_ Words borrowed from the _Greek_, generally makes the same anatomical or medical Term, that is technical with us, vernacular or common with them. But this unavoidable Tautology, which may be irksome to many Ears, those medical Readers, for whom it was not intended, will readily forgive, from a Consideration of the general Address of the Work: while they reflect that meer Style, if thoroughly intelligible, is least essential to those Books, which wholly consist of very useful, and generally interesting, Matter. As many of the Notes of the Editor of _Lyons_, as I have retained in this Version (having translated from the Edition of _Lyons_) are subscribed _E. L._ I have dispensed with several, some, as evidently less within Dr. _Tissot's_ Plan, from tending to theorize, however justly or practically, where he must have had his own Reasons for omitting to theorize: a few others, as manifestly needless, from what the Author had either premised, or speedily subjoined, on the very same Circumstance: besides a very few, from their local Confinement to the Practice at _Lyons_, which lies in a Climate somewhat more different from our own than that of _Lausanne_. It is probable nevertheless, I have retained a few more than were necessary in a professed Translation of the original Work: but wherever I have done this, I have generally subjoined my Motive for it; of whatever Consequence that may appear to the Reader. I have retained all the Author's own Notes, with his Name annexed to them; or if ever the Annotator was uncertain to me, I have declared whose Note I supposed it to be. Such as I have added from my own Experience or Observation are subscribed _K_, to distinguish them from the others; and that the Demerit of any of them may neither be imputed to the learned Author, nor to his Editor. Their principal Recommendation, or Apology is, that whatever Facts I have mentioned are certainly true. I have endeavoured to be temperate in their Number and Length, and to imitate that strict Pertinence, which prevails throughout the Author's Work. If any may have ever condescended to consider my Way of writing, they will conceive this Restraint has cost me at least as much Pains, as a further Indulgence of my own Conceptions could have done. The few Prescriptions I have included in some of them, have been so conducted, as not to give the Reader the least Confusion with Respect to those, which the Author has given in his Table of Remedies, and which are referred to by numerical Figures, throughout the Course of his Book. The moderate Number of Dr. _Tissot's_ Prescriptions, in his Table of Remedies, amounting but to seventy-one, and the apparent Simplicity of many of them, may possibly disgust some Admirers of pompous and compound Prescription. But his Reserve, in this important Respect, has been thoroughly consistent with his Notion of Nature's curing Diseases; which suggested to him the first, the essential Necessity of cautioning his Readers against doing, giving, or applying any thing, that might oppose her healing Operations (a most capital Purpose of his Work) which important Point being gained, the mildest, simplest and least hazardous Remedies would often prove sufficient Assistants to her. Nevertheless, under more severe and tedious Conflicts, he is not wanting to direct the most potent and efficacious ones. The Circumstances of the poor Subjects of his medical Consideration, became also a very natural Object to him, and was in no wise unworthy the Regard of the humane Translator of _Bilguer on Amputations_, or rather _against_ the crying Abuse of them; an excellent Work, that does real Honour to them both; and which can be disapproved by none, who do not prefer the frequently unnecessary Mutilation of the afflicted, to the Consumption of their own Time, or the Contraction of their Employment. Some Persons may imagine that a Treatise of this Kind, composed for the Benefit of labouring People in _Swisserland_, may be little applicable to those of the _British_ Islands: and this, in a very few Particulars, and in a small Degree, may reasonably be admitted. But as we find their common Prejudices are often the very same; as the _Swiss_ are the Inhabitants of a colder Climate than _France_, and generally, as Dr. _Tissot_ often observes, accustomed to drink (like ourselves) more strong Drink than the _French_ Peasantry; and to indulge more in eating Flesh too, which the Religion of _Berne_, like our own, does not restrain; the Application of his Advice to them will pretty generally hold good here. Where he forbids them Wine and Flesh, all Butchers Meat, and in most Cases all Flesh, and all strong Drink should be prohibited here: especially when we consider, that all his Directions are confined to the Treatment of acute Diseases, of which the very young, the youthful, and frequently even the robust are more generally the Subjects. Besides, in some few of the _English_ Translator's Notes, he has taken the Liberty of moderating the Coolers, or the Quantities of them (which may be well adapted to the great Heats and violent _Swiss_ Summers he talks of) according to the Temperature of our own Climate, and the general Habitudes of our own People. It may be observed too, that from the same Motive, I have sometimes assumed the Liberty of dissenting from the Text in a very few Notes, as for Instance, on the Article of Pastry, which perhaps is generally better here than in _Swisserland_ (where it may be no better than the coarse vile Trash that is hawked about and sold to meer Children) as I have frequently, in preparing for Inoculation, admitted the best Pastry (but not of Meat) into the limited Diet of the Subjects of Inoculation, and constantly without the least ill Consequence. Thus also in Note [70] Page 287, 288, I have presumed to affirm the Fact, that a strong spirituous Infusion of the Bark has succeeded more speedily in some Intermittents, in particular Habits, than the Bark in Substance. This I humbly conceive may be owing to such a _Menstruum's_ extracting the Resin of the Bark more effectually (and so conveying it into the Blood) than the Juices of the Stomach and of the alimentary Canal did, or could. For it is very conceivable that the _Crasis_, the Consistence, of the fibrous Blood may sometimes be affected with a morbid Laxity or Weakness, as well as the general System of the muscular Fibres. These and any other like Freedoms, I am certain the Author's Candour will abundantly pardon; since I have never dissented for Dissention's Sake, to the best of my Recollection; and have the Honour of harmonizing very generally in Judgment with him. If _one_ useful Hint or Observation occurs throughout my Notes, his Benevolence will exult in that essential Adherence to his Plan, which suggested it to me: While an invariable ecchoing Assentation throughout such Notes, when there really was any salutary Room for doubting, or for adding (with Respect to ourselves) would discover a Servility, that must have disgusted a liberal manly Writer. One common good Purpose certainly springs from the generous Source, and replenishes the many Canals into which it is derived; all the Variety and little Deviations of which may be considered as more expansive Distributions of its Benefits. Since the natural Feelings of Humanity generally dispose us, but especially the more tender and compassionate Sex, to advise Remedies to the poor Sick; such a Knowledge of their real Disease, as would prevent their Patrons, Neighbours and Assistants from advising a wrong Regimen, or an improper or ill-timed Medicine, is truly essential to relieving them: and such we seriously think the present Work is capable of imparting, to all commonly sensible and considerate Perusers of it. A Vein of unaffected Probity, of manly Sense, and of great Philanthropy, concur to sustain the Work: And whenever the Prejudices of the Ignorant require a forcible Eradication; or the crude Temerity and Impudence of Knaves and Impostors cry out for their own Extermination, a happy Mixture of strong Argument, just Ridicule, and honest Severity, give a poignant and pleasant Seasoning to the Work, which renders it occasionally entertaining, as it is continually instructive. A general Reader may be sometimes diverted with such Customs and Notions of the _Swiss_ Peasants, as are occasionally mentioned here: and possibly our meerest Rustics may laugh at the brave simple _Swiss_, on his introducing a Sheep into the Chamber of a very sick Person, to save the Life of the Patient, by catching its own Death. But the humblest Peasantry of both Nations are agreed in such a Number of their absurd unhealthy Prejudices, in the Treatment of Diseases, that it really seemed necessary to offer our own the Cautions and Counsels of this principal Physician, in a very respectable Protestant Republick, in Order to prevent their Continuance. Nor is it unreasonable to presume, that under such a Form of Government, if honestly administered upon its justest Principles, the People may be rather more tenderly regarded, than under the Pomp and Rage of Despotism, or the Oppression of some Aristocracies. Besides the different Conditions of [1] Persons, to whom our Author recommends the Patronage and Execution of his Scheme, in his Introduction, it is conceived this Book must be serviceable to many young Country Practitioners, and to great Numbers of Apothecaries, by furnishing them with such exact and striking Descriptions of each acute Disease and its Symptoms, as may prevent their mistaking it for any other; a Deception which has certainly often been injurious, and sometimes even fatal: for it is dreadful but to contemplate the Destruction or Misery, with which Temerity and Ignorance, so frequently combined, overwhelm the Sick. Thus more Success and Reputation, with the Enjoyment of a better Conscience, would crown their Endeavours, by a more general Recovery of, or Relief to, their Patients. To effect this, to improve every Opportunity of eschewing medical Evil, and of doing medical Good, was the Author's avowed Intention; which he informs us in his Preface, he has heard, from some intelligent and charitable Persons, his Treatise had effected, even in some violent Diseases. That the same good Consequences may every where attend the numerous Translations of it, must be the fervent Wish of all, except the Quacks and Impostors he so justly characterizes in his thirty-third Chapter! and particularly of all, who may be distinguishably qualified, like himself, to, --_Look through Nature up to Nature's GOD!_ [1] Of all these the Schoolmasters, _with us_, may seem the most reasonably exempted from this Duty. The AUTHOR's _DEDICATION._ _To the most Illustrious, the most Noble and Magnificent Lords, the Lords President and Counsellors of the Chamber of Health, of the City and Republick of_ Berne. _Most honourable Lords_, When I first published the following Work, my utmost Partiality to it was not sufficient to allow me the Confidence of addressing it to Your Lordships. But Your continual Attention to all the Objects, which have any Relation to that important Part of the Administration of the State, which has been so wisely committed to Your Care, has induced You to take Notice of it. You have been pleased to judge it might prove useful, and that an Attempt must be laudable, which tends to the Extermination of erroneous and inveterate Prejudices, those cruel Tyrants, that are continually opposing the Happiness of the People, even under that Form and Constitution of Government, which is the best adapted to establish and to increase it. Your Lordships Approbation, and the splendid Marks of [2] Benevolence, with which You have honoured me, have afforded me a juster Discernment of the Importance of this Treatise, and have inclined me to hope, _most Illustrious, most Noble, and Magnificent Lords_, that You will permit this new Edition of it to appear under the Sanction of your Auspices; that while the Publick is assured of Your general Goodness and Beneficence, it may also be informed of my profoundly grateful Sense of them, on the same Occasion. [2] See the Author's Preface, immediately following this Dedication. May the present Endeavour then, in fully corresponding to my Wishes, effectually realize Your Lordships utmost Expectations from it; while You condescend to accept this small Oblation, as a very unequal Expression of that profound Respect, with which I have the Honour to be, _Most Illustrious, Most Noble, and Magnificent Lords,_ _Your most humble_ _And most_ _Obedient Servant_, _TISSOT._ _Lausanne_, _Dec. 3, 1762._ THE AUTHOR's _PREFACE._ _If Vanity too often disposes many to speak of themselves, there are some Occasions, on which a total Silence might be supposed to result from a still higher Degree of it: And the very general Reception of the *Advice to the People* has been such, that there would be Room to suspect me of that most shocking Kind of Pride, which receives Applause with Indifference (as deeming its own Merit Superior to the greatest) if I did not appear to be strongly impressed with a just Sense of that great Favour of the Publick, which has been so very obliging, and is so highly agreable, to me._ _Unfeignedly affected with the unhappy Situation of the poor Sick in Country Places in *Swisserland*, where they are lost from a Scarcity of the best Assistance, and from a fatal Superfluity of the worst, my sole Purpose in writing this Treatise has been to serve, and to comfort them. I had intended it only for a small Extent of Country, with a moderate Number of Inhabitants; and was greatly surprized to find, that within five or six Months after its Publication, it was become one of the most extensively published Books in *Europe*; and one of those Treatises, on a scientific Subject, which has been perused by the greatest Number of Readers of all Ranks and Conditions. To consider such Success with Indifference, were to have been unworthy of it, which Demerit, at least on this Account, I cannot justly be charged with; since Indifference has not been my Case, who have felt, as I ought, this Gratification of Self-love; and which, under just and prudent Restrictions, may perhaps be even politically cherished; as the Delight naturally arising from having been approved, is a Source of that laudable Emulation, which has sometimes produced the most essential good Consequences to Society itself. For my own particular, I can truly aver, that my Satisfaction has been exquisitely heightened on this Occasion, as a Lover of my Species: since judging from the Success of this Work (a Success which has exceeded my utmost Expectations) of the Effects that may reasonably be expected from it, I am happily conscious of that Satisfaction, or even Joy, which every truly honest Man must receive, from rendering essential good Offices to others. Besides which, I have enjoyed, in its utmost Extent, that Satisfaction which every grateful Man must receive from the Approbation and Beneficence of his Sovereign, when I was distinguished with the precious Medal, which the illustrious Chamber of Health of the Republick of Berne honoured me with, a few Months after the Publication of this Treatise; together with a Letter still more estimable, as it assured me of the extraordinary Satisfaction the Republick had testified on the Impression of it; a Circumstance, which I could not avoid this publick Acknowledgement of, without the greatest Vanity and Ingratitude. This has also been a very influencing Motive with me, to exert my utmost Abilities in perfecting this new Edition, in which I have made many Alterations, that render it greatly preferable to the first; and of which Amendments I shall give a brief Account, after saying somewhat of the Editions, which have appeared elsewhere._ _The first is that, which Messrs. *Heidegger*, the Booksellers published in the *German* Language at *Zurich*, about a Year since. I should have been highly delighted with the meer Approbation of *__M. Hirzel__*, first Physician of the Canton of *Zurich, &c.* whose superior and universal Talents; whose profound Knowledge in the Theory of Physick; and the Extent and Success of whose Practice have justly elevated him among the small Number of extraordinary Men of our own Times; he having lately obtained the Esteem and the Thanks of all *Europe,* for the History of one of her [3] Sages. But I little expected the Honour this Gentleman has done me, in translating the *Advice to the People* into his own Language. Highly sensible nevertheless as I am of this Honour, I must always reflect with Regret, that he has consumed that important Time, in rendering my Directions intelligible to his Countrymen, which he might have employed much more usefully, in obliging the World with his own._ _He has enriched his Translation with an excellent Preface, which is chiefly employed in a just and beautiful Portrait and Contrast of the true, and of the false Physician; with which I should have done myself the Pleasure to have adorned the present [4] Edition; if the Size of this Volume, already too large, had not proved an Obstacle to so considerable an Addition; and if the Manner, in which *Mr.* *__Hirzel__* speaks of its Author, had permitted me with Decency to publish his Preface. I have been informed by some Letters, that there have been two other *German* Translation of it; but I am not informed by whom. However, *__M. Hirzel's__* Preface, his own Notes, and some Additions with which I have furnished him, renders his Edition preferable to the first in *French*, and to the other *German* Translations already made._ [3] _Le Socrate rustique_, a Work, which every Person should read. [4] This Preface is indeed premised to this _French_ Edition, but a Translation of it was omitted, to avoid extending the Bulk and Price of the Work. Dr. _Tissot_ must then have been ignorant of this Addition, when first published at _Lyons_. _The Second Edition is that, which the younger *__Didot__*, the Bookseller, published towards the End of the Winter at *Paris*. He had requested me to furnish him with some Additions to it, which I could not readily comply with._ _The Third Edition is a *Dutch* Translation of it, which will be very speedily published by *__M. Renier Aremberg__*, Bookseller at *Rotterdam*. He had begun the Translation from my first Edition; but having wrote to know whether I had not some Additions to make, I desired him to wait for the Publication of this. I have the good Fortune to be very happy in my Translators; it being *__M. Bikker__*, a celebrated Physician at *Rotterdam* (so very advantagiously known in other Countries, by his beautiful *Dissertation on Human Nature*, throughout which Genius and Knowledge proceed Hand in Hand) who will present his Countrymen with the *Advice to the People*, in their own Language: and who will improve it with such Notes, as are necessary for a safe and proper Application of its Contents, in a Climate, different from that in which it was wrote. I have also heard, there has been an *Italian* Translation of it._ _After this Account of the foreign Editions, I return to the present one, which is the second of the original *French* Treatise. I shall not affirm it is greatly corrected, with Respect to fundamental Points: for as I had advanced nothing in the first, that was not established on Truth and Demonstration, there was no Room for Correction, with Regard to any essential Matters. Nevertheless, in this I have made, 1, a great Number of small Alterations in the Diction, and added several Words, to render the Work still more simple and perspicuous. 2, The typographical Execution of this is considerably improved in the Type, the Paper and Ink, the Spelling, Pointing, and Arrangement of the Work. 3, I have made some considerable Additions, which are of three Kinds. Not a few of them are new Articles on some of the Subjects formerly treated of; such as the Articles concerning Tarts and other Pastry Ware; the Addition concerning the Regimen for Persons, in a State of Recovery from Diseases; the Preparation for the Small Pocks; a long Note on the Jesuits Bark; another on acid Spirits; one on the Extract of Hemlock: besides some new Matter which I have inserted; such as an Article with Regard to proper Drinks; one on the Convulsions of Infants; one on Chilblains; another on Punctures from Thorns; one upon the Reason of the Confidence reposed in Quacks, and the thirty-first Chapter entirely: in which I have extended the Consideration of some former Articles, that seemed to me a little too succinct and short. There are some Alterations of this last, this additional, Kind, interspersed almost throughout the whole Substance of this Edition; but especially in the two Chapters relating to Women and Children._ _The Objects of the XXXI Chapter are such as require immediate Assistance, viz. Swoonings, Hæmorrhages, that is, large spontaneous Bleedings; the Attacks of Convulsions, and of Suffocations; the Consequences of Fright and Terror; Disorders occasioned by unwholesome or deadly Vapours; the Effects of Poison, and the sudden Invasions of excessive Pain._ _The Omission of this Chapter was a very material Defect in the original Plan of this Work. The Editor of it at Paris was very sensible of this Chasm, or Blank, as it may be called, and has filled it up very properly: and if I have not made Use of his Supplement, instead of enlarging myself upon the Articles of which he has treated, it has only been from a Purpose of rendering the whole Work more uniform; and to avoid that odd Diversity, which seems scarcely to be avoided in a Treatise composed by two Persons. Besides which, that Gentleman has said nothing of the Articles, which employ the greatest Part of that Chapter, *viz.* the Swoonings, the Consequences of great Fear, and the noxious Vapours._ _Before I conclude, I ought to justify myself, as well as possible, to a great Number of very respectable Persons both here and abroad, (to whom I can refuse nothing without great Chagrine and Reluctance) for my not having made such Additions as they desired of me. This however was impossible, as the Objects, in which they concurred, were some chronical Distempers, that are entirely out of the Plan, to which I was strictly attached, for many Reasons. The first is, that it was my original Purpose to oppose the Errors incurred in Country Places, in the Treatment of acute Diseases; and to display the best Method of conducting such, as do not admit of waiting for the Arrival of distant Succour; or of removing the Patients to Cities, or large Towns. It is but too true indeed, that chronical Diseases are also liable to improper Treatment in small Country Places: but then there are both Time and Convenience to convey the Patients within the Reach of better Advice; or for procuring them the Attendance of the best Advisers, at their own Places of Residence. Besides which, such Distempers are considerably less common than those to which I had restrained my Views: and they will become still less frequent, whenever acute Diseases, of which they are frequently the Consequences, shall be more rationally and safely conducted._ _The second Reason, which, if alone, would have been a sufficient one, is, that it is impossible to subject the Treatment of chronical Distempers to the Capacity and Conduct of Persons, who are not Physicians. Each acute Distemper generally arises from one Cause; and the Treatment of it is simple and uniform; since those Symptoms, which manifest the Malady, point out its Cause and Treatment. But the Case is very differently circumstanced in tedious and languid Diseases; each of which may depend on so many and various Causes (and it is only the real, the true Cause, which ought to determine us in selecting its proper Remedies) that though the Distemper and its Appellation are evidently known, a meer By-stander may be very remote from penetrating into its true Cause; and consequently be incapable of chusing the best Medicines for it. It is this precise and distinguishing Discernment of the real particular Cause *[or of the contingent Concurrence of more than one]* that necessarily requires the Presence of Persons conversant in the Study and the Practice of all the Parts of Physick; and which Knowledge it is impossible for People, who are Strangers to such Studies, to arrive at. Moreover, their frequent Complexness; the Variety of their Symptoms; the different Stages of these tedious Diseases [not exactly attended to even by many competent Physicians] the Difficulty of ascertaining the different Doses of Medicines, whose Activity may make the smallest Error highly dangerous, &c. &c. are really such trying Circumstances, as render the fittest Treatment of these Diseases sufficiently difficult and embarrassing to the most experienced Physicians, and unattainable by those who are not Physicians._ _A third Reason is, that, even supposing all these Circumstances might be made so plain and easy, as to be comprehended by every Reader, they would require a Work of an excessive Length; and thence be disproportioned to the Faculties of those, for whom it was intended. One single chronical Disease might require as large a Volume as the present one._ _But finally, were I to acknowledge, that this Compliance was both necessary and practicable, I declare I find it exceeds my Abilities; and that I am also far from having sufficient Leisure for the Execution of it. It is my Wish that others would attempt it, and may succeed in accomplishing it; but I hope these truly worthy Persons, who have honoured me by proposing the Achievement of it to myself, will perceive the Reasons for my not complying with it, in all their Force; and not ascribe a Refusal, which arises from the very Nature of the thing, either to Obstinacy, or to any Want of an Inclination to oblige them._ _I have been informed my Citations, or rather References, have puzzled some Readers. It was difficult to foresee this, but is easy to prevent it for the future. The Work contains Citations only of two Sorts; one, that points to the Remedies prescribed; and the other, which refers to some Passage in the Book itself, that serves to illustrate those Passages in which I cite. Neither of these References could have been omitted. The first is marked thus, *Nº.* with the proper Figure to it, as 1, 2, &c. This signifies, that the Medicine I direct is described in the Table of Remedies, according to the Number annexed to that Character. Thus when we find directed, in any Page of the Book, the warm Infusion *Nº. 1*; in some other, the Ptisan *Nº. 2*; or in a third, the Almond Milk, or Emulsion *Nº. 4*, it signifies, that such Prescriptions will be found at the Numbers 1, 2, and 4; and this Table is printed at the End of the Book._ _If, instead of forming this Table, and thus referring to the Prescriptions by their Numbers, I had repeated each Prescription as often as I directed it, this Treatise must have been doubled in Bulk, and insufferably tiresome to peruse. I must repeat here, what I have already said in the former Edition, that the [5] Prices of the Medicines, or of a great Number of them, are those at which the Apothecaries may afford them, without any Loss, to a Peasant in humble Circumstances. But it should be remembered, they are not set down at the full Prices which they may handily demand; since that would be unjust for some to insist on them at. Besides, there is no Kind of Tax in *Swisserland*, and I have no Right to impose one._ [5] The Reasons for omitting the Prices _here_, may be seen Page 23 of this Translation. _The Citations of the second Kind are very plain and simple. The whole Work is divided into numbered Paragraphs distinguished by the Mark §. And not to swell it with needless Repetitions, when in one Place I might have even pertinently repeated something already observed, instead of such Repetition at Length, I have only referred to the Paragraph, where it had been observed. Thus, for Example when we read Page 81, § 50 --*When the Disease is so circumstanced as we have described*, § 46,-- this imports that, not to repeat the Description already given, I refer the Reader to that last § for it._ _The Use of these Citations is not the least Innovation, and extremely commodious and easy: but were there only a single Reader likely to be puzzled by them, I ought not to omit this Explanation of them, as I can expect to be generally useful, only in Proportion as I am clear: and it must be obvious, that a Desire of being extensively useful is the sole Motive of this Work. I have long since had the Happiness of knowing, that some charitable and intelligent Persons have applied the Directions it contains, with extraordinary Success, even in violent Diseases: And I shall arrive at the Height of my Wishes, if I continue to be informed, that it contributes to alleviate the Sufferings, and to prolong the Days, of my rational Fellow Creatures._ _N. B._ A Small Blank occurring conveniently here in the Impression, the Translator of this Work has employed it to insert the following proper Remark, _viz._ Whenever the Tea or Infusion of the Lime-tree is directed in the Body of the Book, which it often is, the _Flowers_ are always meant, and not the _Leaves_; though by an Error of the Press, or perhaps rather by an Oversight of the Transcribers of this Version, it is printed _Leaves_ instead of _Flowers_ P. 392, as noted and corrected in the _Errata_. These Flowers are easily procurable here, meerly for gathering, in most Country Places in _July_, as few Walks, Vistas, &c. are without these Trees, planted for the pleasant Shade they afford, and to keep off the Dust in Summer, though the Leaf drops rather too early for this Purpose. Their Flowers have an agreeable Flavour, which is communicated to Water by Infusion, and rises with it in Distillation. They were, to the best of my Recollection, an Ingredient in the antiepileptic Water of _Langius_, omitted in our late Dispensatories of the College. They are an Ingredient in the antiepileptic Powder, in the List of Medicines in the present Practice of the _Hotel Dieu_ at _Paris_: and we think were in a former Prescription of our _Pulvis de Gutteta_, or Powder against Convulsions. Indeed they are considered, by many medical Writers, as a Specific in all Kinds of Spasms and Pains; and __Hoffman__ affirms, he knew a very tedious Epilepsy cured by the Use of an Infusion of these Flowers. I also take this Opportunity of adding, that as this Translation is intended for the Attention and the Benefit of the Bulk of the Inhabitants of the _British_ Empire, I have been careful not to admit any Gallicisms into it; as such might render it either less intelligible, or less agreeable to its Readers. If but a single one occurs, I either have printed it, or did intend it should be printed, distinguishably in Italics. _K._ __Introduction.__ The Decrease of the Number of Inhabitants, in most of the States of Europe, is a Fact, which impresses every reflecting Person, and is become such a general Complaint, as is but too well established on plain Calculations. This Decrease is most remarkable in Country Places. It is owing to many Causes; and I shall think myself happy, if I can contribute to remove one of the greatest of them, which is the pernicious Manner of treating sick People in Country Places. This is my sole Object, tho' I may be excused perhaps for pointing out the other concurring Causes, which may be all included within these two general Affirmations; That greater Numbers than usual emigrate from the Country; and that the People increase less every where. There are many Sorts of Emigration. Some leave their Country to enlist in the Service of different States by Sea and Land; or to be differently employ'd abroad, some as Traders, others as Domestics, _&c._ Military Service, by Land or Sea, prevents Population in various Respects. In the first Place, the Numbers going abroad are always less, often _much_ less, than those who return. General Battles, with all the Hazards and Fatigues of War; detached Encounters, bad Provisions, Excess in drinking and eating, Diseases that are the Consequences of Debauches, the Disorders that are peculiar to the Country; epidemical, pestilential or contagious Distempers, caused by the unwholsome Air of Flanders, Holland, Italy and Hungary; long Cruises, Voyages to the East or West Indies, to Guinea, &c. destroy a great Number of Men. The Article of Desertion also, the Consequences of which they dread on returning home, disposes many to abandon their Country for ever. Others, on quitting the Service, take up with such Establishments, as it has occasionally thrown in their Way; and which necessarily prevent their Return. But in the second Place, supposing they were all to come back, their Country suffers equally from their Absence; as this very generally happens during that Period of Life, when they are best adapted for Propagation; since that Qualification on their Return is impaired by Age, by Infirmities and Debauches: and even when they do marry, the Children often perish as Victims to the Excesses and Irregularities of their Fathers: they are weak, languishing, distempered, and either die young, or live incapable of being useful to Society. Besides, that the prevailing Habit of Libertinage, which many have contracted, prevents several of them from marrying at all. But notwithstanding all these inconvenient Consequences are real and notorious; yet as the Number of those, who leave their Country on these Accounts, is limited, and indeed rather inconsiderable, if compared with the Number of Inhabitants which must remain at home: as it may be affirmed too, that this relinquishing of their Country, may have been even necessary at some Times, and may become so again, if the Causes of Depopulation should cease, this kind of Emigration is doubtless the least grievous of any, and the last which may require a strict Consideration. But that abandoning of their Country, or _Expatriation_, as it may be termed, the Object of which is a Change of the Emigrants Condition, is more to be considered, being more numerous. It is attended with many and peculiar Inconveniencies, and is unhappily become an epidemical Evil, the Ravages of which are still increasing; and that from one simple ridiculous Source, which is this; that the Success of one Individual determines a hundred to run the same Risque, ninety and nine of whom may probably be disappointed. They are struck with the apparent Success of one, and are ignorant of the Miscarriage of others. Suppose a hundred Persons might have set out ten Years ago, to _seek their Fortune_, as the saying is, at the End of six Months they are all forgotten, except by their Relations; but if one should return the same Year, with more Money than his own Fortune, more than he set out with; or if one of them has got a moderate Place with little Work, the whole Country rings with it, as a Subject of general Entertainment. A Croud of young People are seduced by this and sally forth, because not one reflects, that of the ninety nine, who set out with the hundredth Person, one half has perished, many are miserable, and the Remainder come back, without having gained any thing, but an Incapacity to employ themselves usefully at home, and in their former Occupations: and having deprived their Country of a great many Cultivaters, who, from the Produce of the Lands, would have attracted considerable Sums of Money, and many comfortable Advantages to it. In short, the very small Proportion who succeed, are continually talked of; the Croud that sink are perpetually forgot. This is a very great and real Evil, and how shall it be prevented? It would be sufficient perhaps to publish the extraordinary Risque, which may be easily demonstrated: It would require nothing more than to keep an exact yearly Register of all these Adventurers, and, at the Expiration of six, eight, or ten Years, to publish the List, with the Fate, of every Emigrant. I am greatly deceived, or at the End of a certain Number of Years, we should not see such Multitudes forsake their native Soil, in which they might live comfortably by working, to go in Search of Establishments in others; the Uncertainty of which, such Lists would demonstrate to them; and also prove, how preferable their Condition in their own Country would have been, to that they have been reduced to. People would no longer set out, but on almost certain Advantages: fewer would undoubtedly emigrate, more of whom, from that very Circumstance, must succeed. Meeting with fewer of their Country-men abroad, these fortunate few would oftner return. By this Means more Inhabitants would remain in the Country, more would return again, and bring with them more Money to it. The State would be more populous, more rich and happy; as the Happiness of a People, who live on a fruitful Soil, depends essentially on a great Number of Inhabitants, with a moderate Quantity of pecuniary Riches. But the Population of the Country is not only necessarily lessened, in Consequence of the Numbers that leave it; but even those who remain increase less, than an equal Number formerly did. Or, which amounts to the same Thing, among the same Number of Persons, there are fewer Marriages than formerly; and the same Number of Marriages produce fewer Christenings. I do not enter upon a Detail of the Proofs, since merely looking about us must furnish a sufficient Conviction of the Truth of them. What then are the Causes of this? There are two capital ones, Luxury and Debauchery, which are Enemies to Population on many Accounts. Luxury compells the wealthy Man, who would make a Figure; and the Man of a moderate Income, but who is his equal in every other Respect, and who _will_ imitate him, to be afraid of a numerous Family; the Education of which must greatly contract that Expence he had devoted to Parade and Ostentation: And besides, if he must divide his Estate among a great many Children, each of them would have but a little, and be unable to keep up the State and the Train of the Father's. Since Merit is unjustly estimated by exterior Shew and Expence, one must of Course endeavour to attain for himself, and to leave his Children in, a Situation capable of supporting that Expence. Hence the fewer Marriages of People who are not opulent, and the fewer Children among People who marry. Luxury is further prejudicial to the Increase of the People, in another Respect. The irregular Manner of Life which it introduces, depresses Health; it ruins the Constitutions, and thus sensibly affects Procreation. The preceding Generation counted some Families with more than twenty Children: the living one less than twenty Cousins. Very unfortunately this Way of thinking and acting, so preventive of Increase, has extended itself even into Villages: and they are no longer convinced there, that the Number of Children makes the Riches of the Countryman. Perhaps the next Generation will scarcely be acquainted with the Relation of Brotherhood. A third Inconvenience of Luxury is, that the Rich retreat from the Country to live in Cities; and by multiplying their Domestics there, they drain the former. This augmented Train is prejudicial to the Country, by depriving it of Cultivaters, and by diminishing Population. These Domestics, being seldom sufficiently employed, contract the Habit of Laziness; and they prove incapable of returning to that Country Labour, for which Nature intended them. Being deprived of this Resource they scarcely ever marry, either from apprehending the Charge of Children, or from their becoming Libertines; and sometimes, because many Masters will not employ married Servants. Or should any of them marry, it is often in the Decline of Life, whence the State must have the fewer Citizens. Idleness of itself weakens them, and disposes them to those Debauches, which enfeeble them still more. They never have more than a few Children, and these sickly; such as have not Strength to cultivate the Ground; or who, being brought up in Cities, have an Aversion to the Country. Even those among them who are more prudent, who preserve their Morals, and make some Savings, being accustomed to a City Life, and dreading the Labour of a Country one (of the Regulation of which they are also ignorant) chuse to become little Merchants, or Tradesmen; and this must be a Drawback from Population, as any Number of Labourers beget more Children than an equal Number of Citizens; and also by Reason, that out of any given Number, more Children die in Cities, than in the Country. The same Evils also prevail, with Regard to female Servants. After ten or twelve Years Servitude, the Maid-Servants in Cities cannot acquit themselves as good Country Servants: and such of them as chuse this Condition, quickly fail under that Kind or Quantity of Work, for which they are no longer constituted. Should we see a Woman married in the Country, a Year after leaving Town, it is easy to observe, how much that Way of living in the Country has broke her. Frequently their first Child-bed, in which Term they have not all the Attendance their Delicacy demands, proves the Loss of their Health; they remain in a State of Languor, of Feebleness, and of Decay: they have no more Children; and this renders their Husbands unuseful towards the Population of the State. Abortions, Infants carried out of their Country after a concealed Pregnancy, and the Impossibility of their getting Husbands afterwards, are frequently the Effects of their Libertinage. It is to be apprehended too these bad Effects are rather increasing with us; since, either for want of sufficient Numbers, or from oeconomical Views, it has become a Custom, instead of Women Servants, to employ Children, whose Manners and whole Constitutions are not yet formed; and who are ruined in the same Manner, by their Residence in Town, by their Laziness, by bad Examples, and bad Company. Doubtless much remains still unsaid on these important Heads; but besides my Intention not to swell this Treatise immoderately, and the many Avocations, which prevent me from launching too far into what may be less within the Bounds of Medicine, I should be fearful of digressing too far from my Subject. What I have hitherto said however, I think cannot be impertinent to it; since in giving Advice to the People, with Regard to their Health, it was necessary to display to them the Causes that impaired it: though what I might be able to add further on this Head, would probably be thought more remote from the Subject. I shall add then but a single Hint on the Occasion. Is it not practicable, in Order to remedy those Evils which we cannot prevent, to select some particular Part or Canton of the Country, wherein we should endeavour by Rewards, _1st._ Irremoveably to fix all the Inhabitants. _2dly._ To encourage them by other Rewards to a plentiful and legitimate Increase. They should not be permitted to go out of it, which must prevent them from being exposed to the Evils I have mentioned. They should by no means intermarry with any Strangers, who might introduce such Disorders among them. Thus very probably this Canton, after a certain Time, would become even over-peopled, and might send out Colonies to the others. One Cause, still more considerable than those we have already mention'd, has, to this very Moment, prevented the Increase of the People in France. This is the Decay of Agriculture. The Inhabitants of the Country, to avoid serving in the Militia; to elude the Days-Service impos'd by their Lords, and the Taxes; and being attracted to the City by the Hopes of Interest, by Laziness and Libertinage, have left the Country nearly deserted. Those who remain behind, either not being encouraged to work, or not being sufficient for what there is to do, content themselves with cultivating just as much as is absolutely necessary for their Subsistence. They have either lived single, or married but late; or perhaps, after the Example of the Inhabitants of the Cities, they have refused to fulfil their Duty to Nature, to the State, and to a Wife. The Country deprived of Tillers, by this Expatriation and Inactivity, has yielded nothing; and the Depopulation of the State has daily increased, from the reciprocal and necessary Proportion between Subsistence and Population, and because Agriculture alone can increase Subsistence. A single Comparison will sufficiently evince the Truth and the Importance of these Principles, to those who have not seen them already divulged and demonstrated in the Works of the [6] Friend of Man. [6] The Marquis of Mirabeau. "An old Roman, who was always ready to return to the Cultivation of his Field, subsisted himself and his Family from one Acre of Land. A Savage, who neither sows nor cultivates, consumes, in his single Person, as much Game as requires fifty Acres to feed them. Consequently _Tullus Hostilius_, on a thousand Acres, might have five thousand Subjects: while a Savage Chief, limited to the same Extent of Territory, could scarcely have twenty: such an immense Disproportion does Agriculture furnish, in Favour of Population. Observe these two great Extremes. A State becomes dispeopled or peopled in that Proportion, by which it recedes from one of these Methods, and approaches to the other." Indeed it is evident, that wherever there is an Augmentation of Subsistence, an Increase of Population will soon follow; which again will still further facilitate the Increase of Provisions. In a State thus circumstanced Men will abound, who, after they have furnished sufficient Numbers for the Service of War, of Commerce, of Religion, and for Arts and Professions of every kind, will further also furnish a Source for Colonies, who will extend the Name and the Prosperity of their Nation to distant Regions. There will ensue a Plenty of Commodities, the Superfluity of which will be exported to other Countries, to exchange for other Commodities, that are not produced at home; and the Balance, being received in Money, will make the Nation rich, respectable by its Neighbours, and happy. Agriculture, vigorously pursued, is equal to the Production of all these Benefits; and the present Age will enjoy the Glory of restoring it, by favouring and encouraging Cultivaters, and by forming Societies for the Promotion of Agriculture. I proceed at length to the fourth Cause of Depopulation, which is the Manner of treating sick People in the Country. This has often affected me with the deepest Concern. I have been a Witness, that Maladies, which, in themselves, would have been gentle, have proved mortal from a pernicious Treatment: I am convinced that this Cause alone makes as great a Havock as the former; and certainly it requires the utmost Attention of Physicians, whose Duty it is to labour for the Preservation of Mankind. While we are employing our assiduous Cares on the more polished and fashionable Part of them in Cities, the larger and more useful Moiety perish in the Country; either by particular, or by highly epidemical, Diseases, which, within a few Years past, have appeared in different Villages, and made no small Ravages. This afflicting Consideration has determined me to publish this little Work, which is solely intended for those Patients, who, by their Distance from Physicians, are deprived of their Assistance. I shall not give a Detail of my Plan, which is very simple, in this Part; but content myself with affirming, I have used my utmost Care to render it the most useful I possibly could: and I dare hope, that if I have not fully displayed its utmost Advantages, I have at least sufficiently shewn those pernicious Methods of treating Diseases, that should incontestably be avoided. I am thoroughly convinced, the Design might be accomplished more compleatly than I have done it; but those who are so capable of, do not attempt, it: I happen to be less timid; and I hope that thinking Persons will rather take it in good part of me, to have published a Book, the composing of which is rather disagreeable from its very Facility; from the minute Details, which however are indispensable; and from the Impossibility of discussing any Part of it (consistently with the Plan) to the Bottom of the Subject; or of displaying any new and useful Prospect. It may be compared, in some Respects, to the Works of a spiritual Guide, who was to write a Catechism for little Children. At the same time I am not ignorant there have already been a few Books calculated for Country Patients, who are remote from Succour: but some of these, tho' published with a very good Purpose, produce a bad Effect. Of this kind are all Collections of Receipts or Remedies, without the least Description of the Disease; and of Course without just Directions for the Exhibition, or Application, of them. Such, for Example, is the famous Collection of Madam _Fouquet_, and some more in the same manner. Some others approach towards my Plan; but many of them have taken in too many Distempers, whence they are become too voluminous. Besides, they have not dwelt sufficiently upon the Signs of the Diseases; upon their Causes; the general Regimen in them, and the Mismanagement of them. Their Receipts are not generally as simple, and as easy to prepare, as they ought to be. In short, the greater Part of their Writers seem, as they advanced, to have grown tired of their melancholy Task, and to have hurried them out too expeditiously. There are but two of them, which I must name with Respect, and which being proposed on a Plan very like my own, are executed in a superior Manner, that merits the highest Acknowlegements of the Publick. One of these Writers is M. _Rosen_, first Physician of the Kingdom of _Sweden_; who, some Years since, employed his just Reputation to render the best Services to his Country Men. He has made them retrench from the Almanacs those ridiculous Tales; those extraordinary Adventures; those pernicious astrological Injunctions, which there, as well as here, answer no End, but that of keeping up Ignorance, Credulity, Superstition, and the falsest Prejudices on the interesting Articles of Health, of Diseases, and of Remedies. He has also taken Care to publish simple plain Treatises on the most popular Distempers; which he has substituted in the Place of the former Heap of Absurdities. These concise Works however, which appear annually in their Almanacs, are not yet translated from the _Swedish_, so that I was unqualified to make any Extracts from them. The other is the Baron _Van Swieten_, first Physician to their Imperial Majesties, who, about two Years since, has effected for the Use of the Army, what I now attempt for sick People in the Country. Though my Work was greatly advanced, when I first saw his, I have taken some Passages from it: and had our Plans been exactly alike, I should imagine I had done the Publick more Service by endeavouring to extend the Reading of his Book, than by publishing a new one. Nevertheless, as he is silent on many Articles, of which I have treated diffusively; as he has treated of many Distempers, which did not come within my Plan; and has said nothing of some others which I could not omit; our two Works, without entering into the Particulars of the superior Merit of the Baron's, are very different, with Regard to the Subject of the Diseases; tho' in such as we have both considered, I account it an Honour to me to find, we have almost constantly proceeded upon the same Principles. The present Work is by no means addressed to such Physicians, as are thoroughly accomplished in their Profession; yet possibly, besides my particular medical Friends, some others may read it. I beg the Favour of all such fully to consider the Intention, the Spirit, of the Author, and not to censure him, as a Physician, from the Composition of this Book. I even advise them here rather to forbear perusing it; as a Production, that can teach them nothing. Such as read, in order to criticize, will find a much greater Scope for exercising that Talent on the other Pamphlets I have published. It were certainly unjust that a Performance, whose sole abstracted Object is the Health and Service of my Countrymen, should subject me to any disagreeable Consequences: and a Writer may fairly plead an Exemption from any Severity of Censure, who has had the Courage to execute a Work, which cannot pretend to a Panegyric. Having premised thus much in general, I must enter into some Detail of those Means, that seem the most likely to me, to facilitate the beneficial Consequences, which, I hope, may result to others, from my present Endeavours. I shall afterwards give an Explanation of some Terms which I could not avoid using, and which, perhaps, are not generally understood. The Title of _Advice to the People_, was not suggested to me by an Illusion, which might persuade me, this Book would become a Piece of Furniture, as it were, in the House of every Peasant. Nineteen out of twenty will probably never know of its Existence. Many may be unable to read, and still more unable to understand, it, plain and simple as it is. I have principally calculated it for the Perusal of intelligent and charitable Persons, who live in the Country; and who seem to have, as it were, a Call from Providence, to assist their less intelligent poor Neighbours with their Advice. It is obvious, that the first Gentlemen I have my Eye upon, are the Clergy. There is not a single Village, a Hamlet, nor even the House of an Alien in the Country, that has not a Right to the good Offices of some one of this Order; And I assure myself there are a great Number of them, who, heartily affected with the Distress of their ailing Flocks, have wished many hundred Times, that it were in their Power to give their Parishioners some bodily Help, at the very Time they were disposing them to prepare for Death; or so far to delay the Fatality of the Distemper, that the Sick might have an Opportunity of living more religiously afterwards. I shall think myself happy, if such truly respectable Ecclesiastics shall find any Resources in this Performance, that may conduce to the Accomplishment of their beneficent Intentions. Their Regard, their Love for their People; their frequent Invitations to visit their principal Neighbours; their Duty to root out all unreasonable Prejudices, and Superstition; their Charity, their Learning; the Facility, with which their general Knowlege in Physics, qualifies them to comprehend thoroughly all the medical Truths, and Contents of this Piece, are so many Arguments to convince me, that they will have the greatest Influence to procure that Reformation, in the Administration of Physick to poor Country People, which is so necessary, so desirable, an Object. In the next Place, I dare assure myself of the Concurrence of Gentlemen of Quality and Opulence, in their different Parishes and Estates, whose Advice is highly regarded by their Inferiors; who are so powerfully adapted to discourage a wrong, and to promote a right Practice, of which they will easily discern all the Advantages. The many Instances I have seen of their entering, with great Facility, into all the Plan and Conduct of a Cure; their Readiness and even Earnestness to comfort the Sick in their Villages; and the Generosity with which they prevent their Necessities, induce me to hope, from judging of these I have not the Pleasure to know, by those whom I have, that they will eagerly embrace an Opportunity of promoting a new Method of doing good in their Neighbourhood. Real Charity will apprehend the great Probability there is of doing Mischief, tho' with the best Intention, for want of a proper Knowledge of material Circumstances; and the very Fear of that Mischief may sometimes suspend the Exercise of such Charity; notwithstanding it must seize, with the most humane Avidity, every Light that can contribute to its own beneficent Exertion. Thirdly, Persons who are rich, or at least in easy Circumstances, whom their Disposition, their Employments, or the Nature of their Property, fixes in the Country, where they are happy in doing good, must be delighted to have some proper Directions for the Conduct and Effectuation of their charitable Intentions. In every Village, where there are any Persons, of these three Conditions, they are always readily apprized of the Distempers in it, by their poor Neighbours coming to intreat a little Soup, Venice Treacle, Wines, Biscuits, or any thing they imagine necessary for their sick Folks. In Consequence of some Questions to the Bystanders, or of a Visit to the sick Person, they will judge at least of _what kind_ the Disease is; and by their prudent Advice they may be able to prevent a Multitude of Evils. They will give them some Nitre instead of Venice Treacle; Barley, or sweet Whey, in lieu of Soup. They will advise them to have Recourse to Glysters, or Bathings of their Feet, rather than to Wine; and order them Gruel rather than Biscuits. A man would scarcely believe, 'till after the Expiration of a few Years, how much Good might be effected by such proper Regards, so easily comprehended, and often repeated. At first indeed there may be some Difficulty in eradicating old Prejudices, and inveterately bad Customs; but whenever these were removed, good Habits would strike forth full as strong Roots, and I hope that no Person would be inclined to destroy them. It may be unnecessary to declare, that I have more Expectation from the Care and Goodness of the Ladies, than from those of their Spouses, their Fathers, or Brothers. A more active Charity, a more durable Patience, a more domestic Life; a Sagacity, which I have greatly admired in many Ladies both in Town and Country, that disposes them to observe, with great Exactness; and to unravel, as it were, the secret Causes of the Symptoms, with a Facility that would do Honour to very good Practioners, and with a Talent adapted to engage the Confidence of the Patient:--All these, I say, are so many characteristical Marks of their Vocation in this important and amicable Duty; nor are there a few, who fulfil it with a Zeal, that merits the highest Commendation, and renders them excellent Models for the Imitation of others. Those who are intrusted with the Education of Youth, may also be supposed sufficiently intelligent to take some Part in this Work; and I am satisfied that much Good might result from their undertaking it. I heartily wish, they would not only study to _distinguish the Distemper_ (in which the principal, but by no means an insuperable Difficulty consists; and to which I hope I have considerably put them in the Way) but I would have them learn also the Manner of applying Remedies. Many of them have; I have known some who bleed, and who have given Glysters very expertly. This however all may easily learn; and perhaps it would not be imprudent, if the Art of bleeding well and safely were reckoned a necessary Qualification, when they are examined for their Employment. These Faculties, that of estimating the Degree of a Fever, and how to apply and to dress Blisters, may be of great Use within the Neighbourhood of their Residence. Their Schools, which are not frequently over-crouded, employ but a few of their daily Hours; the greater part of them have no Land to cultivate; and to what better Use can they apply their Leisure, than to the Assistance and Comfort of the Sick? The moderate Price of their Service may be so ascertained, as to incommode no Person; and this little Emolument might render their own Situation the more agreeable: besides which, these little Avocations might prevent their being drawn aside sometimes, by Reason of their Facility and frequent Leisure, so as to contract a Habit of drinking too often. Another Benefit would also accrue from accustoming them to this kind of Practice, which is, that being habituated to the Care of sick People, and having frequent Occasions to write, they would be the better qualify'd, in difficult Cases, to advise with those, who were thought further necessary to be consulted. Doubtless, even among Labourers, there may be many, for some such I have known, who being endued with good natural Sense and Judgment, and abounding with Benevolence, will read this Book with Attention, and eagerly extend the Maxims and the Methods it recommends. And finally I hope that many Surgeons, who are spread about the Country, and who practice Physic in their Neighbourhood, will peruse it; will carefully enter into the Principles established in it, and will conform to its Directions; tho' a little different perhaps from such as they may have hitherto practiced. They will perceive a Man may learn at any Age, and of any Person; and it may be hoped they will not think it too much Trouble to reform some of their Notions in a Science, which is not properly within their Profession (and to the Study of which they were never instituted) by those of a Person, who is solely employed in it, and who has had many Assistances of which they are deprived. Midwives may also find their Attendance more efficacious, as soon as they are thoroughly disposed to be better informed. It were heartily to be wished, that the greater Part of them had been better instructed in the Art they profess. The Instances of Mischief that might have been avoided, by their being better qualify'd, are frequent enough to make us wish there may be no Repetition of them, which it may be possible to prevent. Nothing seems impossible, when Persons in Authority are zealously inclined to prevent every such Evil; and it is time they should be properly informed of one so essentially hurtful to Society. The Prescriptions I have given consist of the most simple Remedies, and I have adjoined the Manner of preparing them so fully, that I hope no Person can be at any Loss in that Respect. At the same time, that no one may imagine they are the less useful and efficacious for their Simplicity, I declare, they are the same I order in the City for the most opulent Patients. This Simplicity is founded in Nature: the Mixture, or rather the Confusion, of a Multitude of Drugs is ridiculous. If they have the very same Virtues, for what Purpose are they blended? It were more judicious to confine ourselves to that, which is the most effectual. If their Virtues are different, the Effect of one destroys, or lessens, the Effect of the other; and the Medicine ceases to prove a Remedy. I have given no Direction, which is not very practicable and easy to execute; nevertheless it will be discernible, that some few are not calculated for the Multitude, which I readily grant. However I have given them, because I did not lose Sight of some Persons; who, tho' not strictly of the Multitude, or Peasantry, do live in the Country, and cannot always procure a Physician as soon, or for as long a Time, as they gladly would. A great Number of the Remedies are entirely of the Country Growth, and may be prepared there; but there are others, which must be had from the Apothecaries. I have set down the Price [7] at which I am persuaded all the Country Apothecaries will retail them to a Peasant, who is not esteemed a rich one. I have marked the Price, not from any Apprehension of their being imposed on in the Purchase, for this I do not apprehend; but, that seeing the Cheapness of the Prescription, they may not be afraid to buy it. The necessary Dose of the Medicine, for each Disease, may generally be purchased for less Money than would be expended on Meat, Wine, Biscuits, and other improper things. But should the Price of the Medicine, however moderate, exceed the Circumstances of the Sick, doubtless the Common Purse, or the Poors-Box will defray it: moreover there are in many Country Places Noblemens Houses, some of whom charitably contribute an annual Sum towards buying of Medicines for poor Patients. Without adding to which Sum, I would only intreat the Favour of each of them to alter the Objects of it, and to allow their sick Neighbours the Remedies and the Regimen directed here, instead of such as they formerly distributed among them. [7] This oeconomical Information was doubtless very proper, where our judicious and humane Author published it; but notwithstanding his excellent Motives for giving it, we think it less necessary here, where many Country Gentlemen furnish themselves with larger or smaller Medicine Chests, for the Benefit of their poor sick Neighbours; and in a Country, where the settled parochial Poor are provided with Medicines, as well as other Necessaries, at a parochial Expence. Besides, tho' we would not suppose our Country Apothecaries less considerate or kind than others, we acknowledge our Apprehension, that in such Valuation of their Drugs (some of which often vary in their Price) might dispose a few of them, rather to discountenance the Extension of a Work, so well intended and executed as Dr. _Tissot's_; a Work, which may not be wholly unuseful to some of the most judicious among them, and will be really necessary for the rest. _K._ It may still be objected, that many Country Places are very distant from large Towns; from which Circumstance a poor Peasant is incapable of procuring himself a seasonable and necessary Supply in his Illness. I readily admit, that, in Fact, there are many Villages very remote from such Places as Apothecaries reside in. Yet, if we except a few among the Mountains, there are but very few of them above three or four Leagues from some little Town, where there always lives some Surgeon, or some Vender of Drugs. Perhaps however, even at this Time, indeed, there may not be many thus provided; but they will take care to furnish themselves with such Materials, as soon as they have a good Prospect of selling them, which may constitute a small, but new, Branch of Commerce for them. I have carefully set down the Time, for which each Medicine will keep, without spoiling. There is a very frequent Occasion for some particular ones, and of such the School-masters may lay in a Stock. I also imagine, if they heartily enter into my Views, they will furnish themselves with such Implements, as may be necessary in the Course of their Attendance. If any of them were unable to provide themselves with a sufficient Number of good Lancets, an _Apparatus_ for Cupping, and a Glyster Syringe (for want of which last a Pipe and Bladder may be occasionally substituted) the Parish might purchase them, and the same Instruments might do for the succeeding School-master. It is hardly to be expected, that all Persons in that Employment would be able, or even inclined, to learn the Way of using them with Address; but one Person who did, might be sufficient for whatever Occasions should occur in this Way in some contiguous Villages; with very little Neglect of their Functions among their Scholars. Daily Instances of Persons, who come from different Parts to consult me, without being capable of answering the Questions I ask them, and the like Complaints of many other Physicians on the same Account, engaged me to write the last Chapter of this Work. I shall conclude this Introduction with some Remarks, necessary to facilitate the Knowledge of a few Terms, which were unavoidable in the Course of it. The Pulse commonly beats in a Person in good Health, from the Age of eighteen or twenty to about sixty six Years, between sixty and seventy Times in a Minute. It sometimes comes short of this in old Persons, and in very young Children it beats quicker: until the Age of three or four Years the Difference amounts at least to a third; after which it diminishes by Degrees. An intelligent Person, who shall often touch and attend to his own Pulse, and frequently to other Peoples, will be able to judge, with sufficient Exactness, of the Degree of a Fever in a sick Person. If the Strokes are but one third above their Number in a healthy State, the Fever is not very violent: which it is, as often as it amounts to half as many more as in Health. It is very highly dangerous, and may be generally pronounced mortal, when there are two Strokes in the Time of one. We must not however judge of the Pulse, solely by its Quickness, but by its Strength or Weakness; its Hardness or Softness; and the Regularity or Irregularity of it. There is no Occasion to define the strong and the feeble Pulse. The Strength of it generally affords a good Prognostic, and, supposing it too strong, it may easily be lowered. The weak Pulse is often very menacing. If the Pulse, in meeting the Touch, excites the Notion of a dry Stroke, as though the Artery consisted of Wood, or of some Metal, we term it _hard_; the opposite to which is called _soft_, and generally promises better. If it be strong and yet soft, even though it be quick, it may be considered as a very hopeful Circumstance. But if it is strong and hard, that commonly is a Token of an Inflammation, and indicates Bleeding and the cooling Regimen. Should it be, at the same time, small, quick and hard, the Danger is indeed very pressing. We call that Pulse regular, a continued Succession of whole Strokes are made in equal Intervals of Time; and in which Intervals, not a single Stroke is wanting (since if that is its State, it is called an intermitting Pulse.) The Beats or Pulsations are also supposed to resemble each other so exactly in Quality too, that one is not strong, and the next alternately feeble. As long as the State of the Pulse is promising; Respiration or Breathing is free; the Brain does not seem to be greatly affected; while the Patient takes his Medicines, and they are attended with the Consequence that was expected; and he both preserves his Strength pretty well, and continues sensible of his Situation, we may reasonably hope for his Cure. As often as all, or the greater Number of these characterizing Circumstances are wanting, he is in very considerable Danger. The Stoppage of Perspiration is often mentioned in the Course of this Work. We call the Discharge of that Fluid which continually passes off through the Pores of the Skin, _Transpiration_; and which, though invisible, is very considerable. For if a Person in Health eats and drinks to the Weight of eight Pounds daily, he does not discharge four of them by Stool and Urine together, the Remainder passing off by insensible Transpiration. It may easily be conceived, that if so considerable a Discharge is stopt, or considerably lessened; and if this Fluid, which ought to transpire through the Skin, should be transfered to any inward Part, it must occasion some dangerous Complaint. In fact this is one of the most frequent Causes of Diseases. To conclude very briefly--All the Directions in the following Treatise are solely designed for such Patients, as cannot have the Attendance of a Physician. I am far from supporting, they ought to do instead of one, even in those Diseases, of which I have treated in the fullest Manner; and the Moment a Physician arrives, they ought to be laid aside. The Confidence reposed in him should be entire, or there should be none. The Success of the Event is founded in that. It is his Province to judge of the Disease, to select Medicines against it; and it is easy to foresee the Inconveniences that may follow, from proposing to him to consult with any others, preferably to those he may chuse to consult with; only because they have succeeded in the Treatment of another Patient, whose Case they suppose to have been nearly the same with the present Case. This were much the same, as to order a Shoemaker to make a Shoe for one Foot by the Pattern of another Shoe, rather than by the Measure he has just taken. _N. B._ Though a great Part of this judicious Introduction is less applicable to the political Circumstances of the British Empire, than to those of the Government for which it was calculated; we think the good Sense and the unaffected Patriotism which animate it, will supersede any Apology for our translating it. The serious Truth is this, that a thorough Attention to Population seems never to have been more expedient for ourselves, than after so bloody and expensive, though such a glorious and successful War: while our enterprizing Neighbours, who will never be our Friends, are so earnest to recruit their Numbers; to increase their Agriculture; and to force a Vent for their Manufactures, which cannot be considerably effected, without a sensible Detriment to our own. Besides which, the unavoidable Drain from the People here, towards an effectual Cultivation, Improvement, and Security of our Conquests, demands a further Consideration. _K._ _ADVICE_ _TO THE_ _PEOPLE_, With Respect to their _HEALTH._ *__Chapter I.__* _Of the most usual Causes of popular Maladies._ __Sect.__ 1. The most frequent Causes of Diseases commonly incident to Country People are, 1. Excessive Labour, continued for a very considerable Time. Sometimes they sink down at once in a State of Exhaustion and Faintness, from which they seldom recover: but they are oftener attacked with some inflammatory Disease; as a Quinsey, a Pleurisy, or an Inflammation of the Breast. There are two Methods of preventing these Evils: one is, to avoid the Cause which produces them; but this is frequently impossible. Another is, when such excessive Labour has been unavoidable, to allay their Fatigue, by a free Use of some temperate refreshing Drink; especially by sweet Whey, by Butter-milk, or by [8] Water, to a Quart of which a Wine-glass of Vinegar may be added; or, instead of that, the expressed Juice of Grapes not fully ripe, or even of Goosberries or Cherries: which wholesome and agreeable Liquors are refreshing and cordial. I shall treat, a little lower, of inflammatory Disorders. The Inanition or Emptiness, though accompanied with Symptoms different from the former, have yet some Affinity to them with Respect to their Cause, which is a kind of general Exsiccation or Dryness. I have known some cured from this Cause by Whey, succeeded by tepid Baths, and afterwards by Cow's Milk: for in such Cases hot Medicines and high Nourishment are fatal. [8] This supposes they are not greatly heated, as well as fatigued, by their Labour or Exercise, in which Circumstance free and sudden Draughts of cooling Liquors might be very pernicious: and it evidently also supposes these Drinks to be thus given, rather in Summer, than in very cold Weather, as the Juice of the unripe Grapes, and the other fresh Fruits sufficiently ascertain the Season of the Year. We think the Addition of Vinegar to their Water will scarcely ever be necessary in this or the adjoining Island, on such Occasions. The Caution recommended in this Note is abundantly enforced by Dr. _Tissot_, § 4: but considering the Persons, to whom this Work is more particularly addressed, we were willing to prevent every Possibility of a Mistake, in so necessary, and sometimes so vital a Point. _K._ § 2. There is another Kind of Exhaustion or Emptiness, which may be termed real Emptiness, and is the Consequence of great Poverty, the Want of sufficient Nourishment, bad Food, unwholesome Drink, and excessive Labour. In Cases thus circumstanced, good Soups and a little Wine are very proper. Such happen however very seldom in this Country: I believe they are frequent in some others, especially in many Provinces of _France_. § 3. A second and very common Source of Disorders arises, from Peoples' lying down and reposing, when very hot, in a cold Place. This at once stops Perspiration, the Matter of which being thrown upon some internal Part, proves the Cause of many violent Diseases, particularly of Quinseys, Inflammations of the Breast, Pleurisies, and inflammatory Cholics. These Evils, from this Cause, may always be avoided by avoiding the Cause, which is one of those that destroy a great Number of People. However, when it has occurred, as soon as the first Symptoms of the Malady are perceiveable, which sometimes does not happen till several Days after, the Patient should immediately be bled; his Legs should be put into Water moderately hot, and he should drink plentifully of the tepid Infusion marked No. 1. Such Assistances frequently prevent the Increase of these Disorders; which, on the contrary, are greatly aggravated, if hot Medicines are given to sweat the Patient. § 4. A third Cause is drinking cold Water, when a Person is extremely hot. This acts in the same Manner with the second; but its Consequences are commonly more sudden and violent. I have seen most terrible Examples of it, in Quinseys, Inflammations of the Breast, Cholics, Inflammations of the Liver, and all the Parts of the Belly, with prodigious Swellings, Vomitings, Suppressions of Urine, and inexpressible Anguish. The most available Remedies in such Cases, from this Cause, are, a plentiful Bleeding at the Onset, a very copious Drinking of warm Water, to which one fifth Part of Whey should be added; or of the Ptisan No. 2, or of an Emulsion of Almonds, all taken warm. Fomentations of warm Water should also be applied to the Throat, the Breast and Belly, with Glysters of the same, and a little Milk. In this Case, as well as in the preceding one, (§ 3.) a _Semicupium_, or Half-bath of warm Water has sometimes been attended with immediate Relief. It seems really astonishing, that labouring People should so often habituate themselves to this pernicious Custom, which they know to be so very dangerous to their very Beasts. There are none of them, who will not prevent their Horses from drinking while they are hot, especially if they are just going to put them up. Each of them knows, that if he lets them drink in that State, they might possibly burst with it; nevertheless he is not afraid of incurring the like Danger himself. However, this is not the only Case, in which the Peasant seems to have more Attention to the Health of his Cattle, than to his own. § 5. The fourth Cause, which indeed affects every Body, but more particularly the Labourer, is, the Inconstancy of the Weather. We shift all at once, many times a Day, from Hot to Cold, and from Cold to Hot, in a more remarkable Manner, and more suddenly, than in most other Countries. This makes Distempers from Defluxion and Cold so common with us: and it should make us careful to go rather a little more warmly cloathed, than the Season may seem to require; to have Recourse to our Winter-cloathing early in Autumn, and not to part with it too early in the Spring. Prudent Labourers, who strip while they are at Work, take care to put on their Cloaths in the Evening when they return home. [9] Those, who from Negligence, are satisfied with hanging them upon their Country Tools, frequently experience, on their Return, the very unhappy Effects of it. There are some, tho' not many Places, where the Air itself is unwholsome, more from its particular Quality, than from its Changes of Temperature, as at _Villeneuve_, and still more at _Noville_, and in some other Villages situated among the Marshes which border on the _Rhone_. These Countries are particularly subject to intermitting Fevers; of which I shall treat briefly hereafter. [9] This good Advice is enforced in a Note, by the Editor of _Lyons_, who observes, it should be still more closely attended to, in Places, where Rivers, Woods or Mountains retain, as it were, a considerable Humidity; and where the Evenings are, in every Season, cold and moist.--It is a very proper Caution too in our own variable Climate, and in many of our Colonies in North _America_. _K._ § 6. Such sudden Changes are often attended with great Showers of Rain, and even cold Rain, in the Middle of a very hot Day; when the Labourer who was bathed, as it were, in a hot Sweat, is at once moistened in cold Water; which occasions the same Distempers, as the sudden Transition from Heat to Cold, and requires the same Remedies. If the Sun or a hot Air succeed immediately to such a Shower, the Evil is considerably lighter: but if the Cold continues, many are often greatly incommoded by it. A Traveller is sometimes thoroughly and unavoidably wet with Mud; the ill Consequence of which is often inconsiderable, provided he changes his Cloaths immediately, when he sets up. I have known fatal Pleurisies ensue from omitting this Caution. Whenever the Body or the Limbs are wet, nothing can be more useful than bathing them in warm Water. If the Legs only have been wet, it may be sufficient to bath them. I have radically, thoroughly, cured Persons subject to violent Cholics, as often as their Feet were wet, by persuading them to pursue this Advice. The Bath proves still more effectual, if a little Soap be dissolved in it. § 7. A fifth Cause, which is seldom attended to, probably indeed because it produces less violent Consequences, and yet is certainly hurtful, is the common Custom in all Villages, of having their Ditches or Dunghills directly under their Windows. Corrupted Vapours are continually exhaling from them, which in Time cannot fail of being prejudicial, and must contribute to produce putrid diseases. Those who are accustomed to the Smell, become insensible of it: but the Cause, nevertheless, does not cease to be unwholesomly active; and such as are unused to it perceive the Impression in all its Force. § 8. There are some Villages, in which, after the Curtain Lines are erased, watery marshy Places remain in the Room of them. The Effect of this is still more dangerous, because that putrify'd Water, which stagnates during the hot Season, suffers its Vapours to exhale more easily, and more abundantly, than that in the Curtain Lines did. Having set out for _Pully le Grand_, in 1759, on Account of an epidemical putrid Fever which raged there, I was sensible, on traversing the Village, of the Infection from those Marshes; nor could I doubt of their being the Cause of this Disease, as well as of another like it, which had prevailed there five Years before. In other Respects the Village is wholesomly situated. It were to be wished such Accidents were obviated by avoiding these stagnated Places; or, at least, by removing them and the Dunghils, as far as possible from the Spot, where we live and lodge. § 9. To this Cause may also be added the Neglect of the Peasants to air their Lodgings. It is well known that too close an Air occasions the most perplexing malignant Fevers; and the poor Country People respire no other in their own Houses. Their Lodgings, which are very small, and which notwithstanding inclose, (both Day and Night) the Father, Mother, and seven or eight Children, besides some Animals, are never kept open during six Months in the Year, and very seldom during the other six. I have found the Air so bad in many of these Houses, that I am persuaded, if their Inhabitants did not often go out into the free open Air, they must all perish in a little Time. It is easy, however, to prevent all the Evils arising from this Source, by opening the Windows daily: so very practicable a Precaution must be followed with the happiest Consequences. § 10. I consider Drunkenness as a sixth Cause, not indeed as producing epidemical Diseases, but which destroys, as it were, by Retail, at all times, and every where. The poor Wretches, who abandon themselves to it, are subject to frequent Inflammations of the Breast, and to Pleurisies, which often carry them off in the Flower of their Age. If they sometimes escape through these violent Maladies, they sink, a long Time before the ordinary Approach of old Age, into all its Infirmities, and especially into an Asthma, which terminates in a Dropsy of the Breast. Their Bodies, worn out by Excess, do not comply and concur, as they ought, with the Force or Operation of Remedies; and Diseases of Weakness, resulting from this Cause, are almost always incurable. It seems happy enough, that Society loses nothing in parting with these Subjects, who are a Dishonour to it; and whose brutal Souls are, in some Measure, dead, long before their Carcases. § 11. The Provisions of the common People are also frequently one Cause of popular Maladies. This happens 1st, whenever the Corn, not well ripened, or not well got in, in bad [10] _Harvests_, has contracted an unwholesome Quality. Fortunately however this is seldom the Case; and the Danger attending the Use of it, may be lessened by some Precautions, such as those of washing and drying the Grain completely; of mixing a little Wine with the Dough, in kneading it; by allowing it a little more Time to swell or rise, and by baking it a little more. 2dly, The fairer and better saved Part of the Wheat is sometimes damaged in the Farmers House; either because he does not take due Care of it, or because he has no convenient Place to preserve it, only from one Summer to the next. It has often happened to me, on entering one of these bad Houses, to be struck with the Smell of Wheat that has been spoiled. Nevertheless, there are known and easy Methods to provide against this by a little Care; though I shall not enter into a Detail of them. It is sufficient to make the People sensible, that since their chief Sustenance consists of Corn, their Health must necessarily be impaired by what is bad. 3dly, That Wheat, which is good, is often made into bad Bread, by not letting it rise sufficiently; by baking it too little, and by keeping it too long. All these Errors have their troublesome Consequences on those who eat it; but in a greater Degree on Children and Valetudinarians, or weakly People. [10] Thus I have ventured to translate _Etés_ (_Summers_) to apply it to this and the neighbouring Islands. Their Harvests in _Swisserland_ perhaps are earlier, and may occur in _August_, and that of some particular Grain, probably still earlier. _K._ Tarts or Cakes may be considered as an Abuse of Bread, and this in some Villages is increased to a very pernicious Height. The Dough is almost constantly bad, and often unleavened, ill baked, greasy, and stuffed with either fat or sour Ingredients, which compound one of the most indigestible Aliments imaginable. Women and Children consume the most of this Food, and are the very Subjects for whom it is the most improper: little Children especially, who live sometimes for many successive Days on these Tarts, are, for the greater Part, unable to digest them perfectly. Hence they receive a [11] Source of Obstructions in the Bowels of the Belly, and of a slimy Viscidity or Thickishness, throughout the Mass of Humours, which throws them into various Diseases from Weakness; slow Fevers, a Hectic, the Rickets, the King's Evil, and Feebleness; for the miserable Remainder of their Days. Probably indeed there is nothing more unwholesome than Dough not sufficiently leavened, ill-baked, greasy, and soured by the Addition of Fruits. Besides, if we consider these Tarts in an oeconomical View, they must be found inconvenient also for the Peasant on that Account. [11] The Abuse just mentioned can scarcely be intended to forbid the moderate Use of good Pastry, the Dough of which is well raised and well baked, the Flower and other Ingredients sound, and the Paste not overcharged with Butter, even though it were sweet and fresh. But the Abuse of Alum and other pernicious Materials introduced by our Bakers, may too justly be considered as one horrible Source of those Diseases of Children, &c. which our humane and judicious Author mentions here. What he adds, concerning the Pastries being rendered still more unwholesome by the sour Fruits sometimes baked in it, is true with Respect to those Children and others, who are liable to Complaints from Acidities abounding in the Bowels; and for all those who are ricketty or scrophulous, from a cold and viscid State of their Humours. But as to healthy sanguine Children, who are advanced and lively, and others of a sanguine or bilious Temperament, we are not to suppose a moderate Variety of this Food injurious to them; when we consider, that the Sharpness and Crudity of the Fruit is considerably corrected by the long Application of Fire; and that they are the Produce of Summer, when bilious Diseases are most frequent. This suggests however no bad Hint against making them immoderately sweet. _K._ Some other Causes of Maladies may also be referred to the Article of Food, tho' less grievous and less frequent, into a full Detail of which it is very difficult to enter: I shall therefore conclude that Article with this general Remark; that it is the Care which Peasants usually take in eating slowly, and in chewing very well, that very greatly lessens the Dangers from a bad Regimen: and I am convinced they constitute one of the greatest Causes of that Health they enjoy. We may further add indeed the Exercise which the Peasant uses, his long abiding in the open Air, where he passes three fourths of his Life; besides (which are also considerable Advantages) his happy Custom of going soon to Bed, and of rising very early. It were to be wished, that in these Respects, and perhaps on many other Accounts, the Inhabitants of the Country were effectually proposed as Models for reforming the Citizens. § 12. We should not omit, in enumerating the Causes of Maladies among Country People, the Construction of their Houses, a great many of which either lean, as it were, close to a higher Ground, or are sunk a little in the Earth. Each of these Situations subjects them to considerable Humidity; which is certain greatly to incommode the Inhabitants, and to spoil their Provisions, if they have any Quantity in Store; which, as we have observed, is another, and not the least important, Source of their Diseases. A hardy Labourer is not immediately sensible of the bad Influence of this moist and marshy Habitation; but they operate at the long Run, and I have abundantly observed their most evident bad Effects, especially on Women in Child-bed, on Children, and in Persons recovering of a preceding Disease. It would be easy to prevent this Inconvenience, by raising the Ground on which the House stood, some, or several, Inches above the Level of the adjacent Soil, by a Bed of Gravel, of small Flints, pounded Bricks, Coals, or such other Materials; and by avoiding to build immediately close to, or, as it were, under a much higher Soil. This Object, perhaps, may well deserve the Attention of the Publick; and I earnestly advise as many as do build, to observe the necessary Precautions on this Head. Another, which would cost still less Trouble, is to give the Front of their Houses an Exposure to the South-East. This Exposure, supposing all other Circumstances of the Building and its Situation to be alike, is both the most wholesome and advantageous. I have seen it, notwithstanding, very often neglected, without the least Reason being assigned for not preferring it. These Admonitions may possibly be thought of little Consequence by three fourths of the People. I take the Liberty of reminding them, however, that they are more important than they may be supposed; and so many Causes concur to the Destruction of Men, that none of the Means should be neglected, which may contribute to their Preservation. § 13. The Country People in _Swisserland_ drink, either 1, pure Water, 2, some Wine, 3, Perry, made from wild Pears, or sometimes Cyder from Apples, and, 4, a small Liquor which they call _Piquette_, that is Water, which has fermented with the Cake or Husks of the Grapes, after their Juice has been expressed. Water however is their most general Drink; Wine rarely falling in their Way, but when they are employed by rich Folks; or when they can spare Money enough for a Debauch. Fruit Wines and the [12] _Piquettes_ are not used in all Parts of the Country; they are not made in all Years; and keep but for some Months. [12] This Word's occurring in the plural Number will probably imply, the _Swiss_ make more than one Species of this small Drink, by pouring Water on the Cake or Remainder of their other Fruits, after they have been expressed; as our People in the Cyder, and perhaps in the Perry, Counties, make what they call _Cyderkin_, _Perkin_, _&c._ It should seem too from this Section, that the laborious Countrymen in _Swisserland_ drink no Malt Liquor, though the Ingredients may be supposed to grow in their Climate. Now Beer, of different Strength, making the greater Part of our most common Drink, it may be proper to observe here, that when it is not strong and heady, but a middling well-brewed Small-beer, neither too new, nor hard or sour, it is full as wholesome a Drink for laborious People in Health as any other, and perhaps generally preferable to Water for such; which may be too thin and light for those who are unaccustomed to it; and more dangerous too, when the labouring Man is very hot, as well as thirsty. The holding a Mouthful of any weak cold Liquor in the Mouth without swallowing 'till it becomes warm, there, and spurting it out before a Draught is taken down would be prudent; and in Case of great Heat, to take the requisite Quantity rather at two Draughts, with a little Interval between them, than to swallow the Whole precipitately at one, would be more safe, and equally refreshing, though perhaps less grateful. _K._ Our Waters in general, are pretty good; so that we have little Occasion to trouble ourselves about purifying them; and they are well known in those Provinces where they are chiefly and necessarily used. [13] The pernicious Methods taken to improve or meliorate, as it is falsely called, bad Wines, are not as yet sufficiently practiced among us, for me to treat of them here: and as our Wines are not hurtful, of themselves, they become hurtful only from their Quantity. The Consumption of made Wines and _Piquettes_ is but inconsiderable, and I have not hitherto known of any ill Effects from them, so that our Liquors cannot be considered as Causes of Distempers in our Country; but in Proportion to our Abuse of them by Excess. The Case is differently circumstanced in some [14] other Countries; and it is the Province of Physicians who reside in them, to point out to their Country-Men the Methods of preserving their Health; as well as the proper and necessary Remedies in their Sickness. [13] The bad Quality of Water is another common Cause of Country Diseases; either where the Waters are unwholesome, from the Soils in which they are found, as when they flow through, or settle, on Banks of Shells; or where they become such, from the Neighbourhood of, or Drainings from Dunghills and Marshes. When Water is unclear and turbid, it is generally sufficient to let it settle in order to clear itself, by dropping its Sediment. But if that is not effected, or if it be slimy or muddy, it need only be poured into a large Vessel, half filled with fine Sand, or, for want of that, with Chalk; and then to shake and stir it about heartily for some Minutes. When this Agitation is over, the Sand, in falling to the Bottom of the Vessel, will attract some of the Foulness suspended in the Water. Or, which is still better, and very easy to do, two large Vessels may be set near together, one of which should be placed considerably higher than the other. The highest should be half filled with Sand. Into this the turbid, or slimy muddy Water is to be poured; whence it will filter itself through the Body of Sand, and pass off clear by an Opening or Orifice made at the Bottom of the Vessel; and fall from thence into the lower one, which serves as a Reservoir. When the Water is impregnated with Particles from the Beds of Selenites, or of any Spar (which Water we call hard, because Soap will not easily dissolve in it, and Puls and other farinaceous Substances grow hard instead of soft, after boiling in it) such Water should be exposed to the Sun, or boiled with the Addition of some Puls, or leguminous Vegetables, or Bread toasted, or untoasted. When Water is in its putrid State, it may be kept till it recovers its natural sweet one: but if this cannot be waited for, a little Sea Salt should be dissolved in it, or some Vinegar may be added, in which some grateful aromatic Plant has been infused. It frequently happens, that the publick Wells are corrupted by foul Mud at the Bottom, and by different Animals which tumble in and putrify there. Drinking Snow-water should be avoided, when the Snow is but lately fallen, as it seems to be the Cause of those swelling wenny Throats in the Inhabitants of some Mountains; and of endemic Cholics in many Persons. As Water is so continually used, great Care should be taken to have what is good. Bad Water, like bad Air, is one of the most general Causes of Diseases; that which produces the greater Number of them, the most grieveous ones; and often introduces such as are epidemical. _E. L. i.e._ the Editor of Lyons. [14] Many Persons, With a Design to preserve their Wines, add Shot to them, or Preparations of Lead, Alum, &c. The Government should forbid, under the most severe Penalties, all such Adulterations, as tend to introduce the most painful Cholics, Obstruction, and a long Train of Evils, which it sometimes proves difficult to trace to this peculiar Cause; while they shorten the lives of, or cruelly torment, such over credulous Purchasers, as lay in a Stock of bad Wines, or drink of them, without distinction, from every Wine Merchant or Tavern. _E. L._ _This Note, from the Editor at_ Lyons, _we have sufficient Reason for retaining here. K._ __Chapter II.__ _Of the Causes which aggravate the Diseases of the People. General Considerations._ __Sect.__ 14. The Causes already enumerated in the first Chapter occasion Diseases; and the bad Regimen, or Conduct of the People, on the Invasion of them, render them still more perplexing, and very often mortal. There is a prevailing Prejudice among them, which is every Year attended with the Death of some Hundreds in this Country, and it is this--That all Distempers are cured by Sweat; and that to procure Sweat, they must take Abundance of hot and heating things, and keep themselves very hot. This is a Mistake in both Respects, very fatal to the Population of the State; and it cannot be too much inculcated into Country People; that by thus endeavouring to force Sweating, at the very Beginning of a Disease, they are with great Probability, taking Pains to kill themselves. I have seen some Cases, in which the continual Care to provoke this Sweating, has as manifestly killed the Patient, as if a Ball had been shot through his Brains; as such a precipitate and untimely Discharge carries off the thinner Part of the Blood, leaving the Mass more dry, more viscid and inflamed. Now as in all acute Diseases (if we except a very few, and those too much less frequent) the Blood is already too thick; such a Discharge must evidently increase the Disorder, by co-operating with its Cause. Instead of forcing out the watery, the thinner Part of the Blood, we should rather endeavour to increase it. There is not a single Peasant perhaps, who does not say, when he has a Pleurisy, or an Inflammation of his Breast, that his Blood is too thick, and that it cannot circulate. On seeing it in the Bason after Bleeding, he finds it _black, dry, burnt_; these are his very Words. How strange is it then, that common Sense should not assure him, that, far from forcing out the _Serum_, the watery Part, of such a Blood by sweating, there is a Necessity to increase it? § 15. But supposing it were as certain, as it is erroneous, that Sweating was beneficial at the Beginning of Diseases, the Means which they use to excite it would not prove the less fatal. The first Endeavour is, to stifle the Patient with the Heat of a close Apartment, and a Load of Covering. Extraordinary Care is taken to prevent a Breath of fresh Air's squeezing into the Room; from which Circumstance, the Air already in it is speedily and extremely corrupted: and such a Degree of Heat is procured by the Weight of the Patient's Bed-cloaths, that these two Causes alone are sufficient to excite a most ardent Fever, and an Inflammation of the Breast, even in a healthy Man. More than once have I found myself seized with a Difficulty of breathing, on entering such Chambers, from which I have been immediately relieved, on obliging them to open all the Windows. Persons of Education must find a Pleasure, I conceive, in making People understand, on these Occasions, which are so frequent, that the Air being more indispensably necessary to us, if possible, than Water is to a Fish, our Health must immediately suffer, whenever that ceases to be pure; in assuring them also, that nothing corrupts it sooner than those Vapours, which continually steam from the Bodies of many Persons inclosed within a little Chamber, from which the Air is excluded. The Absurdity of such Conduct is a self-evident Certainty. Let in a little fresh Air on these miserable Patients, and lessen the oppressing Burthen of their Coverings, and you generally see upon the Spot, their Fever and Oppression, their Anguish and Raving, to abate. § 16. The second Method taken to raise a Sweat in these Patients is, to give them nothing but hot things, especially Venice Treacle, Wine, or some [15] _Faltranc_, the greater Part of the Ingredients of which are dangerous, whenever there is an evident Fever; besides Saffron, which is still more pernicious. In all feverish Disorders we should gently cool, and keep the Belly moderately open; while the Medicines just mentioned both heat and bind; and hence we may easily judge of their inevitable ill Consequences. A healthy Person would certainly be seized with an inflammatory Fever, on taking the same Quantity of Wine, of Venice Treacle, or of _Faltranc_, which the Peasant takes now and then, when he is attacked by one of these Disorders. How then should a sick Person escape dying by them? Die indeed he _generally_ does, and sometimes with astonishing Speed. I have published some dreadful Instances of such Fatality some Years since, in another Treatise. In fact they still daily occur, and unhappily every Person may observe some of them in his own Neighbourhood. [15] This Word, which must be of German, not of French Extraction, strictly signifies, _Drink for a Fall_, as we say _Pulvis ad Casum_, &c. Powder for a Fall, or a supposed inward Bruise. Dr. _Tissot_ informs me, it is otherwise called the vulnerary Herbs, or the Swiss Tea; and that it is an injudicious _Farrago_ or Medley of Herbs and Flowers, blended with Bitters, with stimulating, harsh and astringent Ingredients, being employed indiscriminately in all their Distempers by the Country People in _Swisserland_. _K._ § 17. But I shall be told perhaps, that Diseases are often carried off by Sweat, and that we ought to be guided by Experience. To this I answer, it is very true, that Sweating cures some particular Disorders, as it were, at their very Onset, for Instance, those Stitches that are called spurious or false Pleurisies, some rheumatic Pains, and some Colds or Defluxions. But this only happens when the Disorders depend solely and simply on stopt or abated Perspiration, to which such Pain instantly succeeds; where immediately, before the Fever has thickened the Blood, and inflamed the Humours; and where before any internal Infarction, any Load, is formed, some warm Drinks are given, such as _Faltranc_ and Honey; which, by restoring Transpiration, remove the very Cause of the Disorder. Nevertheless, even in such a Case, great Care should be had not to raise too violent a Commotion in the Blood, which would rather restrain, than promote, Sweat, to effect which Elder-flowers are in my Opinion preferable to _Faltranc_. Sweating is also of Service in Diseases, when their Causes are extinguished, as it were, by plentiful Dilution: then indeed it relieves, by drawing off, with itself, some Part of the distempered Humours; after which their grosser Parts have passed off by Stool and by Urine: besides which, the Sweat has also served to carry off that extraordinary Quantity of Water, we were obliged to convey into the Blood, and which was become superfluous there. Under such Circumstances, and at such a Juncture, it is of the utmost Importance indeed, not to check the Sweat, whether by Choice, or for Want of Care. There might often be as much Danger in doing this, as there would have been in endeavouring to force a Sweat, immediately upon the Invasion of the Disorder; since the arresting of this Discharge, under the preceding Circumstances, might frequently occasion a more dangerous Distemper, by repelling the Humour on some inward vital Part. As much Care therefore should be taken not to check, imprudently, that Evacuation by the Skin, which naturally occurs towards the Conclusion of Diseases, as not to force it at their Beginning; the former being almost constantly beneficial, the latter as constantly pernicious. Besides, were it even necessary, it might be very dangerous to force it violently; since by heating the Patients greatly, a vehement Fever is excited; they become scorched up in a Manner, and the Skin proves extremely dry. Warm Water, in short, is the best of Sudorifics. If the Sick are sweated very plentifully for a Day or two, which may make them easier for some Hours; these Sweats soon terminate, and cannot be excited again by the same Medicines. The Dose thence is doubled, the Inflammation is increased, and the Patient expires in terrible Anguish, with all the Marks of a general Inflammation. His Death is ascribed to his Want of Sweating; when it really was the Consequence of his Sweating too much at first; and of his taking Wine and hot Sudorifics. An able Swiss Physician had long since assured his Countrymen, that Wine was fatal to them in Fevers; I take leave to repeat it again and again, and wish it may not be with as little Success. Our Country Folks, who in Health, naturally dislike red Wine, prefer it when Sick; which is wrong, as it binds them up more than white Wine. It does not promote Urine as well; but increases the Force of the circulating Arteries, and the Thickness of the Blood, which were already too considerable. § 18. Their Diseases are also further aggravated by the Food that is generally given them. They must undoubtedly prove weak, in Consequence of their being sick; and the ridiculous Fear of the Patients' dying of Weakness, disposes their Friends to force them to eat; which, increasing their Disorder, renders the Fever mortal. This Fear is absolutely chimerical; never yet did a Person in a Fever die merely from Weakness. They may be supported, even for some Weeks, by Water only; and are stronger at the End of that Time, than if they had taken more solid Nourishment; since, far from strengthening them, their Food increases their Disease, and thence increases their Weakness. § 19. From the first Invasion of a Fever, Digestion ceases. Whatever solid Food is taken corrupts, and proves a Source of Putridity, which adds nothing to the Strength of the Sick, but greatly to that of the Distemper. There are in fact a thousand Examples to prove, that it becomes a real Poison: and we may sensibly perceive these poor Creatures, who are thus compelled to eat, lose their Strength, and fall into Anxiety and Ravings, in Proportion as they swallow. § 20. They are also further injured by the Quality, as well as the Quantity, of their Food. They are forced to sup strong Gravey Soups, Eggs, Biscuits, and even Flesh, if they have but just Strength and Resolution to chew it. It seems absolutely impossible for them to survive all this Trash. Should a Man in perfect Health be compelled to eat stinking Meat, rotten Eggs, stale sour Broth, he is attacked with as violent Symptoms, as if he had taken real Poison, which, in Effect, he has. He is seized with Vomiting, Anguish, a violent Purging, and a Fever, with Raving, and eruptive Spots, which we call the Purple Fever. Now when the very same Articles of Food, in their soundest State, are given to a Person in a Fever, the Heat, and the morbid Matter already in his Stomach, quickly putrify them; and after a few Hours produce all the abovementioned Effects. Let any Man judge then, if the least Service can be expected from them. § 21. It is a Truth established by the first of Physicians, above two thousand Years past, and still further ratified by his Successors, that as long as a sick Person has a bad Humour or Ferment in his Stomach, his Weakness increases, in Proportion to the Food he receives. For this being corrupted by the infected Matter it meets there, proves incapable of nourishing, and becomes a conjunct or additional Cause of the Distemper. The most observing Persons constantly remark, that whenever a feverish Patient sups, what is commonly called some good Broth, the Fever gathers Strength and the Patient Weakness. The giving such a Soup or Broth, though of the freshest soundest Meat, to a Man who has a high Fever, or putrid Humours in his Stomach, is to do him exactly the same service, as if you had given him, two or three Hours later, stale putrid Soup. § 22. I must also affirm, that this fatal Prejudice, of keeping up the Patients' Strength by Food, is still too much propagated, even among those very Persons, whose Talents and whose Education might be expected to exempt them from any such gross Error. It were happy for Mankind, and the Duration of their Lives would generally be more extended, if they could be thoroughly persuaded of this medical, and so very demonstrable, Truth;--That the only things which can strengthen sick Persons are those, which are able to weaken their Disease; but their Obstinacy in this Respect is inconceivable: it is another Evil superadded to that of the Disease, and sometimes the more grievous one. Out of twenty sick Persons, who are lost in the Country, more than two Thirds might often have been cured, if being only lodged in a Place defended from the Injuries of the Air, they were supplied with Abundance of good Water. But that most mistaken Care and Regimen I have been treating of, scarcely suffers one of the twenty to survive them. § 23. What further increases our Horror at this enormous Propensity to heat, dry up, and cram the sick is, that it is totally opposite to what Nature herself indicates in such Circumstances. The burning Heat of which they complain; the Dryness of the Lips, Tongue and Throat; the flaming high Colour of their Urine; the great Longing they have for cooling things; the Pleasure and sensible Benefit they enjoy from fresh Air, are so many Signs, or rather Proofs, which cry out with a loud Voice, that we ought to attemperate and cool them moderately, by all means. Their foul Tongues, which shew the Stomach to be in the like Condition; their Loathing, their Propensity to vomit, their utter Aversion to all solid Food, and especially to Flesh; the disagreeable Stench of their Breath; their Discharge of fetid Wind upwards and downwards, and frequently the extraordinary Offensiveness of their Excrements, demonstrate, that their Bowels are full of putrid Contents, which must corrupt all the Aliments superadded to them; and that the only thing, which can prudently be done, is to dilute and attemper them by plentiful Draughts of refreshing cooling Drinks, which may promote an easy Discharge of them. I affirm it again, and I heartily wish it may be thoroughly attended to, that as long as there is any Taste of Bitterness, or of Putrescence; as long as there is a _Nausea_ or Loathing, a bad Breath, Heat and Feverishness with fetid Stools, and little and high-coloured Urine; so long all flesh, and Flesh-Soup, Eggs, and all kind of Food composed of them, or of any of them, and all Venice Treacle, Wine, and all heating things are so many absolute Poisons. § 24. I may possibly be censured as extravagant and excessive on these Heads by the Publick, and even by some Physicians: but the true and enlightened Physicians, those who attend to the Effects of every Particular, will find on the contrary, that far from exceeding in this Respect, I have rather feebly expressed their own Judgment, in which they agree with that of all the good ones, who have existed within more than two thousand Years; that very Judgment which Reason approves, and continual Experience confirms. The Prejudices I have been contending against have cost _Europe_ some Millions of Lives. § 25. Neither should it be omitted, that even when a Patient has very fortunately escaped Death, notwithstanding all this Care to obtain it, the Mischief is not ended; the Consequences of the high Aliments and heating Medicines being, to leave behind the Seed, the Principle, of some low and chronical Disease; which increasing insensibly, bursts out at length, and finally procures him the Death he has even wished for, to put an End to his tedious Sufferings. § 26. I must also take Notice of another dangerous common Practice; which is that of purging, or vomiting a Patient, at the very Beginning of a Distemper. Infinite Mischiefs are occasioned by it. There are some Cases indeed, in which evacuating Medicines, at the Beginning of a Disease, are convenient and even necessary. Such Cases shall be particularly mentioned in some other Chapters: but as long as we are unacquainted with them, it should be considered as a general Rule, that they are hurtful at the Beginning; this being true very often; and always, when the Diseases are strictly inflammatory. § 27. It is hoped by their Assistance, at that Time, to remove the Load and Oppression of the Stomach, the Cause of a Disposition to vomit, of a dry Mouth, of Thirst, and of much Uneasiness; and to lessen the Leaven or Ferment of the Fever. But in this Hope they are very often deceived; since the Causes of these Symptoms are seldom of a Nature to yield to these Evacuations. By the extraordinary Viscidity or Thickness of the Humours, that foul the Tongue, we should form our Notions of those, which line the Stomach and the Bowels. It may be washed, gargled and even scraped to very little good Purpose. It does not happen, until the Patient has drank for many Days, and the Heat, the Fever and the great Siziness of the Humours are abated, that this Filth can he thoroughly removed, which by Degrees separates of itself. The State of the Stomach being conformable to that of the Tongue, no Method can effectually scour and clean it at the Beginning: but by giving refreshing and diluting Remedies plentifully, it gradually frees itself; and the Propensity to vomit, with its other Effects and Uneasinesses, go off naturally, and without Purges. § 28. Neither are these Evacuations only negatively wrong, merely from doing no Good; for considerable Evil positively ensues from the Application of those acrid irritating Medicines, which increase the Pain and Inflammation; drawing the Humours upon those Parts that were already overloaded with them; which by no means expel the Cause of the Disease, that not being at this time fitted for Expulsion, as not sufficiently concocted or ripe: and yet which, at the same Time, discharge the thinnest Part of the Blood, whence the Remainder becomes more thick; in short which carry off the useful, and leave the hurtful Humours behind. § 29. The Vomit especially, being given in an inflammatory Disease, and even without any Distinction in all acute ones, before the Humours have been diminished by Bleeding, and diluted by plentiful small Drinks, is productive of the greatest Evils; of Inflammations of the Stomach, of the Lungs and Liver, of Suffocations and Frenzies. Purges sometimes occasion a general Inflammation of the Guts, which [16] terminates in Death. Some Instances of each of these terrible Consequences have I seen, from blundering Temerity, Imprudence and Ignorance. The Effect of such Medicines, in these Circumstances, are much the same with those we might reasonably expect, from the Application of Salt and Pepper to a dry, inflamed and foul Tongue, in Order to moisten and clean it. [16] It is pretty common to _hear_ of Persons recovering from Inflammations of the Bowels, or Guts, which our Author more justly and ingenuously considers as general Passports to Death: for it is difficult to conceive, that a real and _considerable_ Inflammation of such thin, membranous, irritable Parts, lined with such putrescent Humours and Contents, and in so hot and close a Situation, could be restored to a sound and healthy State _so often_ as Rumour affirms it. This makes it so important a Point, to avert every Tendency to an Inflammation of these feculent Parts, as to justify a Bleeding directed, solely, from this Precaution, and which might have been no otherwise indicated by a Disease, attended with any Symptom, that threatened such an Inflammation. But when a Person recovers, there can be no anatomical Search for such Inflammations, or its Effects, the real or imaginary Cure of which may well amaze the Patient, and must greatly redound to the Honour of his Prescriber; so that there may be Policy sometimes in giving a moderate Disease a very bad Name. _K._ § 30. Every Person of sound plain Sense is capable of perceiving the Truth of whatever I have advanced in this Chapter: and there would be some Degree of Prudence, even in those who do not perceive the real good Tendency of my Advice, not to defy nor oppose it too hardily. The Question relates to a very important Object; and in a Matter quite foreign to themselves, they undoubtedly owe some Deference to the Judgment of Persons, who have made it the Study and Business of their whole Lives. It is not to myself that I hope for their Attention, but to the greatest Physicians, whose feeble Instrument and Eccho I am. What Interest have any of us in forbidding sick People to eat, to be stifled, or to drink such heating things as heighten their Fever? What Advantage can accrue to us from opposing the fatal Torrent, which sweeps them off? What Arguments can persuade People, that some thousand Men of Genius, of Knowledge, and of Experience, who pass their Lives among a Croud and Succession of Patients; who are entirely employed to take Care of them, and to observe all that passes, have been only amusing and deceiving themselves, on the Effects of Food, of Regimen and of Remedies? Can it enter into any sensible Head, that a Nurse, who advises Soup, an Egg, or a Biscuit, deserves a Patient's Confidence, better than a Physician who forbids them? Nothing can be more disagreeable to the latter, than his being obliged to dispute continually in Behalf of the poor Patients; and to be in constant Terror, lest this mortally officious Attendance, by giving such Food as augments all the Causes of the Disease, should defeat the Efficacy of all the Remedies he administers to remove it; and should fester and aggravate the Wound, in Proportion to the Pains he takes to dress it. The more such absurd People love a Patient, the more they urge him to eat, which, in Effect, verifies the Proverb of _killing one with Kindness_. __Chapter III.__ _Of the Means that ought to be used, at the Beginning of Diseases; and of the Diet in acute Diseases._ __Sect.__ 31. I have clearly shewn the great Dangers of the Regimen, or Diet, and of the principal Medicines too generally made Use of by the Bulk of the People, on these Occasions. I must now point out the actual Method they may pursue, without any Risque, on the Invasion of some acute Diseases, and the general Diet which agrees with them all. As many as are desirous of reaping any Benefit from this Treatise, should attend particularly to this Chapter; since, throughout the other Parts of it, in Order to avoid Repetitions, I shall say nothing of the Diet, except the particular Distemper shall require a different one, from that of which I am now to give an exact Detail. And whenever I shall say in general, that a Patient is to be put upon a Regimen, it will signify, that he is to be treated according to the Method prescribed in this Chapter; and all such Directions are to be observed, with Regard to Air, Food, Drink and Glysters; except when I expressly order something else, as different Ptisans, Glysters, &c. § 32. The greater Part of Diseases (by which I always understand acute and feverish ones) often give some Notice of their Approach a few Weeks, and, very commonly, some Days before their actual Invasion; such as a light Lassitude, or Weariness, Stiffness or Numbness; less Activity than usual, less Appetite, a small Load or Heaviness at Stomach; some Complaint in the Head; a profounder Degree of Sleep, yet less composed, and less refreshing than usual; less Gayety and Liveliness; sometimes a light Oppression of the Breast, a less regular Pulse; a Propensity to be Cold; an Aptness to sweat; and sometimes a Suppression of a former Disposition to sweat. At such a Term it may be practicable to prevent, or at least considerably to mitigate, the most perplexing Disorders, by carefully observing the four following Points. 1. To omit all violent Work or Labour, but yet not so, as to discontinue a gentle easy Degree of Exercise. 2. To bring the Complainant to content himself without any, or with very little, solid Food; and especially to renounce all Flesh, Flesh-broth, Eggs and Wine. 3. To drink plentifully, that is to say, at least three Pints, or even four Pints daily, by small Glasses at a Time, from half hour to half hour, of the Ptisans Nº. 1 and 2, or even of warm Water, to each Quart of which may be added half a Glass of Vinegar. No Person can be destitute of this very attainable Assistance. But should there be a Want even of Vinegar, a few Grains of common [17] Salt may be added to a Quart of warm Water for Drink. Those who have Honey will do well to add two or three Spoonfuls of it to the Water. A light Infusion of Elder Flowers, or of those of the Linden, the Lime-tree, may also be advantageously used, and even well settled and clear sweet Whey. [17] This Direction of our Author's, which may surprize some, probably arises from his preferring a small Quantity of the marine Acid to no Acid at all: For though a great Proportion of Salt, in saving and seasoning Flesh and other Food, generally excites Thirst, yet a little of it seems to have rather a different Effect, by gently stimulating the salivary Glands: And we find that Nature very seldom leaves the great diluting Element wholly void of this quickening, antiputrescent Principle. _K._ 4. Let the Person, affected with such previous Complaints, receive Glysters of warm Water, or the Glyster Nº. 5. By pursuing these Precautions some grievous Disorders have often been happily rooted out: and although they should not prove so thoroughly efficacious, as to prevent their Appearance, they may at least be rendered more gentle, and much less dangerous. § 33. Very unhappily People have taken the directly contrary Method. From the Moment these previous, these forerunning Complaints are perceived, they allow themselves to eat nothing but gross Meat, Eggs, or strong Meat-Soups. They leave off Garden-Stuff and Fruits, which would be so proper for them; and they drink heartily (under a Notion of strengthening the Stomach and expelling Wind) of Wine and other Liquors, which strengthen nothing but the Fever, and expel what Degree of Health might still remain. Hence all the Evacuations are restrained; the Humours causing and nourishing the Diseases are not at all attempered, diluted, nor rendered proper for Evacuation. Nay, on the very contrary, they become more sharp, and more difficult to be discharged: while a sufficient Quantity of diluting refreshing Liquor, asswages and separates all Matters foreign to the Blood, which it purifies; and, at the Expiration of some Days, all that was noxious in it is carried off by Stool, by Urine, or by Sweat. § 34. When the Distemper is further advanced, and the Patient is already seized with that Coldness or Shuddering, in a greater or less Degree, which ushers in all Disease; and which is commonly attended with an universal Oppression, and Pains over all the Surface of the Body; the Patient, thus circumstanced, should be put to Bed, if he cannot keep up; or should sit down as quietly as possible, with a little more Covering than usual: he should drink every Quarter of an Hour a small Glass of the Ptisan, Nº. 1 or 2, warm; or, if that is not at Hand, of some one of those Liquids I have recommended § 32. § 35. These Patients earnestly covet a great Load of covering, during the Cold or Shivering; but we should be very careful to lighten them as soon as it abates; so that when the succeeding Heat begins, they may have no more than their usual Weight of Covering. It were to be wished _perhaps_, they had rather less. The Country People lie upon a Feather-bed, and under a downy Coverlet, or Quilt, that is commonly extremely heavy; and the Heat which is heightened and retained by Feathers, is particularly troublesome to Persons in a Fever. Nevertheless, as it is what they are accustomed to, this Custom may be complied with for one Season of the Year: but during our Heats, or whenever the Fever is very violent, they should lie on a Pallet (which will be infinitely better for them) and should throw away their Coverings of Down, so as to remain covered only with Sheets, or something else, less injurious than Feather-Coverings. A Person could scarcely believe, who had not been, as I have, a Witness of it, how much Comfort a Patient is sensible of, in being eased of his former Coverings. The Distemper immediately puts on a different Appearance. § 36. As soon as the Heat after the _Rigor_, or Coldness and Shuddering, approaches, and the Fever is manifestly advanced, we should provide for the Patient's _Regimen_. And 1, Care should be taken that the Air, in the Room where he lies, should not be too hot, the mildest Degree of Warmth being very sufficient; that there be as little Noise as possible, and that no Person speak to the Sick, without a Necessity for it. No external Circumstance heightens the Fever more, nor inclines the Patient more to a _Delirium_ or Raving, than the Persons in the Chamber, and especially about the Bed. They lessen the Spring, the elastic and refreshing Power, of the Air; they prevent a Succession of fresh Air; and the Variety of Objects occupies the Brain too much. Whenever the Patient has been at Stool, or has made Urine, these Excrements should be removed immediately. The Windows should certainly be opened Night and Morning, at least for a Quarter of an Hour each Time; when also a Door should be opened, to promote an entire Renovation or Change of the Air in the Room. Nevertheless, as the Patient should not be exposed at any Time to a Stream or Current of Air, the Curtains of his Bed should be drawn on such Occasions; and, if he lay without any, Chairs, with Blankets or Cloaths hung upon them, should be substituted in the Place of Curtains, and surround the Bed; while the Windows continued open, in Order to defend the Patient from the Force of the rushing Air. If the Season, however, be rigidly cold, it will be sufficient to keep the Windows open, but for a few Minutes, each Time. In Summer, at least one Window should be set open Day and Night. The pouring a little Vinegar upon a red-hot Shovel also greatly conduces to restore the Spring, and correct the Putridity, of the Air. In our greatest Heats, when that in the Room seems nearly scorching, and the sick Person is sensibly and greatly incommoded by it, the Floor may be sprinkled now and then; and Branches of Willow or Ash-trees dipt a little in Pails of Water may be placed within the Room. § 37. 2. With Respect to the Patient's Nourishment, he must entirely abstain from all Food; but he may always be allowed, and have daily prepared, the following Sustenance, which is one of the wholesomest, and indisputably the simplest one. Take half a Pound of Bread, a Morsel of the freshest Butter about the Size only of a Hazel Nut (which may even be omitted too) three Pints and one quarter of a Pint of Water. Boil them 'till the Bread be entirely reduced to a thin Consistence. Then strain it, and give the Patient one eighth Part of it every three, or every four, Hours; but still more rarely, if the Fever be vehemently high. Those who have Groats, Barley, Oatmeal, or Rice, may boil and prepare them in the same Manner, with some Grains of Salt. § 38. The Sick may also be sometimes indulged, in lieu of these different Spoon-Meats, with raw Fruits in Summer, or in Winter with Apples baked or boiled, or Plumbs and Cherries dried and boiled. Persons of Knowledge and Experience will be very little, or rather not at all, surprized to see various Kinds of Fruit directed in acute Diseases; the Benefit of which they may here have frequently seen. Such Advice can only disgust those, who remain still obstinately attached to old Prejudices. But could they prevail on themselves to reflect a little, they must perceive, that these Fruits which allay Thirst; which cool and abate the Fever; which correct and attemper the putrid and heated Bile; which gently dispose the Belly to be rather open, and promote the Secretion and Discharge of the Urine, must prove the properest Nourishment for Persons in acute Fevers. Hence we see, as it were by a strong Admonition from Nature herself, they express an ardent Longing for them; and I have known several, who would not have recovered, but for their eating secretly large Quantities of those Fruits they so passionately desired, and were refused. As many however, as are not convinced by my Reasoning in this Respect, may at least make a Tryal of my Advice, on my Affirmation and Experience; when I have no doubt but their own will speedily convince them of the real Benefit received from this Sort of Nourishment. It will then be evident, that we may safely and boldly allow, in all continual Fevers, Cherries red and black, Strawberries, the best cured Raisins, Raspberries, and Mulberries; provided that all of them be perfectly ripe. Apples, Pears and Plumbs are less melting and diluting, less succulent, and rather less proper. Some kinds of Pears however are extremely juicy, and even watery almost, such as the Dean or Valentia Pear, different Kinds of the Buree Pear; the St. Germain, the Virgoleuse; the green sugary Pear, and the Summer Royal, which may all be allowed; as well as a little Juice of very ripe Plumbs, with the Addition of Water to it. This last I have known to asswage Thirst in a Fever, beyond any other Liquor. Care should be taken, at the same Time, that the Sick should never be indulged in a great Quantity of any of them at once, which would overload the Stomach, and be injurious to them; but if they are given a little at a Time and often, nothing can be more salutary. Those whose Circumstances will afford them China Oranges, or Lemons, may be regaled with the Pulp and Juice as successfully; but without eating any of their Peel, which is hot and inflaming. § 39. 3. Their Drink should be such as allays Thirst, and abates the Fever; such as dilutes, relaxes, and promotes the Evacuations by Stool, Urine and Perspiration. All these which I have recommended in the preceding Chapters, jointly and severally possess these Qualities. A Glass or a Glass and a half of the Juice of such Fruits as I have just mentioned, may also be added to three full Pints of Water. § 40. The Sick should drink at least twice or thrice that Quantity daily, often, and a little at once, between three or four Ounces, every Quarter of an Hour. The Coldness of the Drink should just be taken off. § 41. 4. If the Patient has not two Motions in the 24 Hours; if the Urine be in small Quantity and high coloured; if he rave, the Fever rage, the Pain of the Head and of the Loins be considerable, with a Pain in the Belly, and a Propensity to vomit, the Glyster Nº. 5 should be given at least once a Day. The People have generally an Aversion to this kind of Remedy; notwithstanding there is not any more useful in feverish Disorders, especially in those I have just recounted; and one Glyster commonly gives more Relief, than if the Patient had drank four or five Times the Quantity of his Drinks. The Use of Glysters, in different Diseases, will be properly ascertained in the different Chapters, which treat of them. But it may be observed in this Place, that they are never to be given at the very Time the Patient is in a Sweat, which seems to relieve him. § 42. 5. As long as the Patient has sufficient Strength for it, he should sit up out of Bed one Hour daily, and longer if he can bear it; but at least half an Hour. It has a Tendency to lessen the Fever, the Head-ach, and a Light-headiness, or Raving. But he should not be raised, while he has a hopeful Sweating; though such Sweats hardly ever occur, but at the Conclusion of Diseases, and after the Sick has had several other Evacuations. § 43. 6. His Bed should be made daily while he sits up; and the Sheets of the Bed, as well as the Patient's Linen, should be changed every two Days, if it can be done with Safety. An unhappy Prejudice has established a contrary, and a really dangerous, Practice. The People about the Patient dread the very Thought of his rising out of Bed; they let him continue there in nasty Linen loaden with putrid Steams and Humours; which contribute, not only to keep up the Distemper, but even to heighten it into some Degree of Malignity. I do again repeat it here, that nothing conduces more to continue the Fever and Raving, than confining the Sick constantly to Bed, and witholding him from changing his foul Linen: by relieving him from both of which Circumstances I have, without the Assistance of any other Remedy, put a Stop to a continual Delirium of twelve Days uninterrupted Duration. It is usually said, the Patient is too weak, but this is a very weak Reason. He must be in very nearly a dying Condition, not to be able to bear these small Commotions, which, in the very Moment when he permits them, increase his Strength, and immediately after abate his Complaints. One Advantage the Sick gain by sitting up a little out of Bed, is the increased Quantity of their Urine, with greater Facility in passing it. Some have been observed to make none at all, if they did not rise out of Bed. A very considerable Number of acute Diseases have been radically, effectually, cured by this Method, which mitigates them all. Where it is not used, as an Assistance at least, Medicines are very often of no Advantage. It were to be wished the Patient and his Friends were made to understand, that Distempers were not to be expelled at once with rough and precipitate Usage; that they must have their certain Career or Course; and that the Use of the violent Methods and Medicines they chuse to employ, might indeed abridge the Course of them, by killing the Patient; yet never otherwise shortened the Disease; but, on the contrary, rendered it more perplexing, tedious and obstinate; and often entailed such unhappy Consequences on the Sufferer, as left him feeble and languid for the rest of his Life. § 44. But it is not sufficient to treat, and, as it were, to conduct the Distemper properly. The Term of Recovery from a Disease requires considerable Vigilance and Attention, as it is always a State of Feebleness, and, thence, of Depression and Faintness. The same Kind of Prejudice which destroys the Sick, by compelling them to eat, during the Violence of the Disease, is extended also into the Stage of Convalescence, or Recovery; and either renders it troublesome and tedious; or produces fatal Relapses, and often chronical Distempers. In Proportion to the Abatement, and in the Decline, of the Fever, the Quantity of Nourishment may be gradually increased: but as long as there are any Remains of it, their Qualities should be those I have already recommended. Whenever the Fever is compleatly terminated, some different Foods may be entered upon; so that the Patient may venture upon a little white Meat, provided it be tender; some [18] Fish; a little Flesh-Soup, a few Eggs at times, with Wine property diluted. It must be observed at the same Time, that those very proper Aliments which restore the Strength, when taken moderately, delay the perfect Cure, if they exceed in Quantity, tho' but a little; because the Action of the Stomach being extremely weakened by the Disease and the Remedies, is capable only, as yet, of a small Degree of Digestion; and if the Quantity of its Extents exceed its Powers, they do not digest, but become putrid. Frequent Returns of the Fever supervene; a continual Faintishness; Head-achs; a heavy Drowsiness without a Power of Sleeping comfortably; flying Pains and Heats in the Arms and Legs; Inquietude; Peevishness; Propensity to Vomit; Looseness; Obstructions, and sometimes a slow Fever, with a Collection of Humours, that comes to Suppuration. All these bad Consequences are prevented, by the recovering Sick contenting themselves, for some Time, with a very moderate Share of proper Food. We are not nourished in Proportion to the Quantity we swallow, but to that we digest. A Person on the mending Hand, who eats moderately, digests it and grows strong from it. He who swallows abundantly does not digest it, and instead of being nourished and strengthened, he withers insensibly away. [18] The most allowable of these are Whitings, Flounders, Plaice, Dabbs, or Gudgeons; especially such of the last as are taken out of clear current Streams with gravelly Bottoms. Salmon, Eels, Carp, all the Skate kind, Haddock, and the like, should not be permitted, before the Sick return to their usual Diet when in Health. _K._ § 45. We may reduce, within the few following Rules, all that is most especially to be observed, in Order to procure a compleat, a perfect Termination of acute Diseases; and to prevent their leaving behind them any Impediments to Health. 1. Let these who are recovering, as well as those who are actually sick, take very little Nourishment at a time, and take it often. 2. Let them take but one sort of Food at each Meal, and not change their Food too often. 3. Let them chew whatever solid Victuals they eat, very carefully. 4. Let them diminish their Quantity of Drink. The best for them in general is Water, [19] with a fourth or third Part of white Wine. Too great a Quantity of Liquids at this time prevents the Stomach from recovering its Tone and Strength; impairs Digestion; keeps up Weakness; increases the Tendency to a Swelling of the Legs; sometimes even occasions a slow Fever; and throws back the Person recovering into a languid State. [19] We have known many who had an Aversion to Water, and with whom, on that very Account, it might probably agree less, find Water very grateful, in which a thoroughly baked and hot, not burnt, Slice of Bread had been infused, untill it attained the Colour of fine clear Small-beer, or light Amber coloured Beer, and we never saw any Inconvenience result from it. Doubtless pure, untoasted elemental Water may be preferable for those who like, and have been accustomed to it. _K._ 5. Let them go abroad as often as they are able, whether on Foot, in a Carriage, or on Horseback. This last Exercise is the healthiest of all, and three fourths of the labouring People in this Country, who have it in their Power to procure it without Expense, are in the wrong to neglect it. They, who would practice it, should mount before their principal Meal, which should be about Noon, and never ride after it. Exercise taken before a Meal strengthens the Organs of Digestion, which is promoted by it. If the Exercise is taken soon after the Meal, it impairs it. 6. As People in this State are seldom quite as well towards Night, in the Evening they should take very little Food. Their Sleep will be the less disturbed for this, and repair them the more, and sooner. 7. They should not remain in Bed above seven, or eight Hours. 8. The Swelling of the Legs and Ancles, which happens to most Persons at this time, is not dangerous, and generally disappears of itself; if they live soberly and regularly, and take moderate Exercise. 9. It is not necessary, in this State, that they should go constantly every Day to Stool; though they should not be without one above two or three. If their Costiveness exceeds this Term, they should receive a Glyster the third Day, and even sooner, if they are heated by it, if they feel puffed up, are restless, and have any Pains in the Head. 10. Should they, after some time, still continue very weak; if their Stomach is disordered; if they have, from time to time, a little irregular Fever, they should take three Doses daily of the Prescription Nº. 14. which fortifies the Digestions, recovers the strength, and drives away the Fever. 11. They must by no means return to their Labour too soon. This erroneous Habit daily prevents many Peasants from ever getting perfectly well, and recovering their former Strength. From not having been able to confine themselves to Repose and Indolence for some Days, they never become as hearty hardy Workmen as they had been: and this premature hasty Labour makes them lose in the Consequence, every following Week of their Lives, more time than they ever gained, by their over-early resuming of their Labour. I see every Day weakly Labourers, Vineroons, and other Workmen, who date the Commencement of their Weakness from that of some acute Disease, which, for want of proper Management through the Term of their Recovery, was never perfectly cured. A Repose of seven or eight Days, more than they allowed themselves, would have prevented all these Infirmities; notwithstanding it is very difficult to make them sensible of this. The Bulk, the Body of the People, in this and in many other Cases, look no further than the present Day; and never extend their Views to the following one. They are for making no Sacrifice to Futurity; which nevertheless must be done, to render it favourable to us. __Chapter IV.__ _Of an Inflammation of the Breast._ __Sect.__ 46. The Inflammation of the Breast, or Peripneumony, or a Fluxion upon the Breast, is an Inflammation of the Lungs, and most commonly of one only, and consequently on one Side. The Signs by which it is evident, are a Shivering, of more or less Duration, during which the Person affected is sometimes very restless and in great Anguish, an essential and inseparable symptom; and which has helped me more than once to distinguish this Disease certainly, at the very Instant of its Invasion. Besides this, a considerable Degree of Heat succeeds the Shivering, which Heat, for a few ensuing Hours, is often blended as it were, with some Returns of Chilliness. The Pulse is quick, pretty strong, moderately full, hard and regular, when the Distemper is not very violent; but small, soft and irregular, when it is very dangerous. There is also a Sensation of Pain, but rather light and tolerable, in one Side of the Breast; sometimes a kind of straitning or Pressure on the Heart; at other times Pains through the whole Body, especially along the Reins; and some Degree of Oppression, at least very often; for sometimes it is but very inconsiderable. The Patient finds a Necessity of lying almost continually upon his Back, being able to lie but very rarely upon either of his Sides. Sometimes his Cough is dry, and then attended with the most Pain; at other times it is accompanied with a Spitting or Hawking up, blended with more or less Blood, and sometimes with pure sheer Blood. There is also some Pain, or at least a Sensation of Weight and Heaviness in the Head: and frequently a Propensity to rave. The Face is almost continually flushed and red: though sometimes there is a Degree of Paleness and an Air of Astonishment, at the Beginning of the Disease, which portend no little Danger. The Lips, the Tongue, the Palate, the Skin are all dry; the Breath hot; the Urine little and high coloured in the first Stage: but more plentiful, less flaming, and letting fall much Sediment afterwards. There is a frequent Thirst, and sometimes an Inclination to vomit; which imposing on the ignorant Assistants, have often inclined them to give the Patient a Vomit, which is mortal, especially at this Juncture. The Heat becomes universal. The Symptoms are heightened almost every Night, during which the Cough is more exasperated, and the Spitting or Expectoration in less Quantity. The best Expectoration is of a middling Consistence, neither too thin, nor too hard and tough, like those which are brought up at the Termination of a Cold; but rather more yellow, and mixed with a little Blood, which gradually becomes still less, and commonly disappears entirely, before the seventh Day. Sometimes the Inflammation ascends along the Wind-pipe, and in some Measure suffocates the Patient, paining him considerably in Swallowing, which makes him think he has a sore Throat. § 47. Whenever the Disease is very violent at first, or increases to be such, the Patient cannot draw his Breath, but when he sits up. The Pulse becomes very small and very quick; the Countenance livid, the Tongue black; the Eyes stare wildly; and he suffers inexpressible Anguish, attended with incessant Restlessness and Agitation in his Bed. One of his Arms is sometimes affected with a sort of Palsy; he raves without Intermission; can neither thoroughly wake nor sleep. The Skin of his Breast and of his Neck is covered (especially in close sultry Weather, and when the Distemper is extremely violent) with livid Spots, more or less remarkable, which should be called _petechial_ ones, but are improperly termed the _pourpre_, or purple. The natural Strength becomes exhausted; the Difficulty of breathing increases every Moment; he sinks into a Lethargy, and soon dies a terrible Death in Country Places, by the very Effects of the inflaming Medicines they employ on such Occasions. It has been known in Fact, that the Use of them has raised the Distemper to such a Height, that the very Heart has been rent open, which the Dissection of the Body has demonstrated. § 48. If the Disease rushes on at once, with a sudden and violent Attack; if the Horror, the Cold and Shivering last many Hours, and are followed with a nearly scorching Degree of Heat; if the Brain is affected from the very Onset; if the Patient has a small Purging, attended with a _Tenesinus_, or straining to Stool, often termed a _Needy_; if he abhors the Bed; if he either sweat excessively, or if his Skin be extremely dry; if his natural Manner and Look are considerably changed; and if he spits up with much Difficulty, the Disease is extremely dangerous. § 49. He must directly, from the first Seizure in this State, be put upon a Regimen, and his Drink must never be given cold. It should either be the Barley Water Nº. 2, the Almond Emulsion Nº. 4, or that of Nº. 7. The Juices of the Plants, which enter into the last of these Drinks, are excellent Remedies in this Case; as they powerfully attenuate, or melt down, the viscid thick Blood, which causes the Inflammation. The Advantage of Bleeding: As long as the Fever keeps up extremely violent; while the Patient does not expectorate sufficiently; continues raving; has a violent Head-ach, or raises up pure Blood, the Glyster Nº. 5 must be given thrice, or at least twice, in twenty four Hours. However the principal Remedy is Bleeding. As soon as ever the preceding cold Assault is over, twelve Ounces of Blood must be taken away at once; and, if the Patient be young and strong, fourteen or even sixteen. This plentiful Bleeding gives him more Ease, than if twenty four Ounces had been drawn, at three different Times. § 50. When the Disease is circumstanced as described (§ 46) that first Bleeding makes the Patient easy for some Hours; but the Complaint returns; and to obviate its Violence, as much as possible, we must, except things promise extremely well, repeat the Bleeding four Hours after the first, taking again twelve Ounces of Blood, which pretty often proves sufficient. But if, about the Expiration of eight or ten Hours, it appears to kindle up again, it must be repeated a third, or even a fourth Time. Yet, with the Assistance of other proper Remedies, I have seldom been obliged to bleed a fourth Time, and have sometimes found the two first Bleedings sufficient. If the Disease has been of several Days Duration, when I have first been called; if the Fever is still very high; if there be a Difficulty of Breathing; if the Patient does not expectorate at all, or brings up too much Blood; without being too solicitous about the Day of the Disease, the Patient should be bled, though it were on the tenth. [20] § 51. In this, and in all other inflammatory Diseases, the Blood is in a very thick viscid State: and almost immediately on its being drawn, a white tough Skin, somewhat like Leather, is formed on its Top, which most People have seen, and which is called the _pleuritic Crust_. It is thought a promising Appearance, when at each Bleeding it seems less hard, and less thick, than it was at the preceding ones: and this is very generally true, if the Sick feels himself, at the same Time, sensibly better: but whoever shall attend _solely_ to the Appearance of the Blood, will find himself often deceived. It will happen, even in the most violent Inflammation of the Breast, that this Crust is not formed, which is supposed to be a very unpromising Sign. There are also, in this Respect, many odd Appearances, which arise from the smallest Circumstances; so that we must not regulate the Repetitions of our bleeding, solely by this Crust: and in general we must not be over credulous in supposing, that the Appearances in the Blood, received into the Bason, can enable us to determine, with Certainty, of its real State in the Body. [20] We should however, with the greater Circumspection (of how much the longer standing the Disease has been, and by how much the more difficult the viscous Humours are to be melted down and dislodged) attend to the Coction of the Matter of Expectoration; which Nature does not often easily effect, and which she effects the more imperfectly and slowly, the weaker he is. Her last Efforts have often been attended with such high Paroxysms, as have imposed even upon very competent Physicians, and have made them open a Vein a few Hours before the Patients' Death, from their Pulses being strong, hard and frequent. Excessive Weakness is the Sign, by which we may discover such unavailing Efforts to be the last. _E. L._ § 52. When the sick Person is in the Condition described (§ 47) the Bleeding is not only unattended with Ease; but sometimes it is also pernicious, by the sudden Weakness to which it reduces him. Generally in such a Case all Medicines and Means are insignificant: and it is a very bad Sign in this Disease, when this Discharge is not attended with Ease and Benefit to the Sick; or when there are some Circumstances, which oblige us to be sparing of it. § 53. The Patient's Legs should every Day, for one half Hour, be put into a Bath of warm Water, wrapping him up closely; that the Cold may not check that Perspiration, which the Bath promotes. § 54. Every two Hours he should take two Spoonfuls of the Mixture Nº. 8, which promotes all the Discharges, and chiefly that of Expectoration. § 55. When the Oppression and Straitness are considerable, and the Cough dry, the Patient may receive the Vapour of boiling Water, to which a little Vinegar has been added. There are two ways of effecting this; either by placing below his Face, after setting him up, a Vessel filled with such boiling hot Water, and covering the Patient's Head and the Vessel with a Linen Cloth, that may inclose the Steam; or else by holding before his Mouth a Spunge dipped in the same boiling Liquor. This last Method is the least effectual, but it fatigues the Patient considerably less. When this bad Symptom is extremely pressing, Vinegar alone should be used without Water; and the Vapour of it has often saved Patients, who seemed to have one Foot in the Grave: but it should be continued for several Hours. § 56. The outward Remedies directed in Nº. 9. are also applied with Success to the Breast, and to the Throat. § 57. When the Fever is extremely high, the Sick should take every Hour, a Spoonful of the Mixture Nº. 10. in a Cup of the Ptisan [21] but without diminishing on this Account the usual Quantity of his other Drinks, which may be taken immediately after it. [21] The Use of Acids, in Inflammations of the Breast, requires no little Consideration. Whenever the sick Person has an Aversion to them; when the Tongue is moist, the Stomach is heavy and disordered, and the Habit and Temperament of the Patient is mild and soft; when the Cough is very sharp without great Thirst, we ought to abstain from them. But when the Inflammation is joined to a dry Tongue, to great Thirst, Heat and Fever, they are of great Service. Slices of China Oranges sprinkled with Sugar may be given first; a light Limonade may be allowed afterwards; and at last small Doses of the Mixture, Nº. 10. if it becomes necessary. _E. L._--I have chosen to retain this Note of the Editor of _Lyons_, from having frequently seen the Inefficacy, and sometimes, I have even thought, the ill Effects of Acids in Peripneumonies and Pleurisies, in a Country far South of _Swisserland_; and where these Diseases are very frequent, acute and fatal. On the other hand I shall add the Substance of what Dr. _Tissot_ says on this Head in a Note to his Table of Remedies, wherein he affirms, that he has given in this Disease very large Doses of them, rising gradually from small ones, and always with great Success; intreating other Physicians to order this Acid (the Spirit of Sulphur) in the same large Doses which he directs in this Chapter, and assuring himself of their thanks, for its good Consequences--Now the only ill Effect I can surmize here, from shewing this Diversity of Opinion in these two learned Physicians, and my own Doubts, is, that the Subjects of this Disease in Country Places may prove somewhat confused and irresolute by it, in their Conduct in such Cases. But as all of us certainly concur in the great Intention of doing all possible Good, by the extensive Publication of this Treatise, I shall take leave to observe that in this Disease, and in Pleurisies, more solid Benefit has been received in _Carolina_, _Virginia_, &c. from the Use of the _Seneka_ Rattle-snake Root, than from any other Medicine whatever. Bleeding indeed is necessarily premised to it; but it has often saved the Necessity of many repeated Bleedings. This Medicine, which is termed in Latin, the _Polygala Virginiana_, is certainly rather of a saponaceous attenuating Quality, and betrays not any Marks of Acidity, being rather moderately acrid. There will be Occasion to mention it more particularly in the subsequent Chapter, as such a Liberty can need no Apology to any philosophical Physician. _K._ § 58. As long as the Patient shall grow worse, or only continue equally bad, the same Medicines are to be repeated. But if on the third Day (tho' it rarely happens so soon) or fourth, or fifth, the Disease takes a more favourable Turn; if the Exasperation returns with less Violence; the Cough be less severe; the Matter coughed up less bloody: if Respiration becomes easier; the Head be less affected; the Tongue not quite so dry; if the high Colour of the Urine abates, and its Quantity be increased, it may be sufficient then to keep the Patient carefully to his Regimen, and to give him a Glyster every Evening. The Exasperation that occurs the fourth Day is often the highest. § 59. This Distemper is most commonly terminated and carried off by Expectoration, and often by Urine, which on the seventh, the ninth, or the eleventh Day, and sometimes on the Days between them, begins to let fall a plentiful Sediment, or Settling, of a pale red Colour, and sometimes real _Pus_ or ripe Matter. These Discharges are succeeded by Sweats, which are as serviceable then, as they were injurious at the Beginning of the Disease. § 60. Some Hours before these Evacuations appear, there come on, and not seldom, some very alarming Symptoms, such as great Anguish; Palpitations, some Irregularity in the Pulse; an increased Oppression; convulsive Motions (this being what is called the _Crisis_, the Height, or Turn of the Distemper) but they are no ways dangerous, provided they do not occasion any improper Treatment. These Symptoms depend on the morbid and purulent Matter, which, being dislodged, circulates with the Humours, and irritates different Parts, until the Discharge of it has fairly begun; after which all such Symptoms disappear, and Sleep generally ensues. However I cannot too strongly insist on the Necessity of great Prudence in such Circumstances. Sometimes it is the Weakness of the Patient, and at other times Convulsions, or some other Symptoms, that terrify the By-standers. If, which is most generally the Case, the absurd Practice of directing particular Remedies for such Accidents takes place, such as spirituous Cordials, Venice Treacle, Confections, Castor and Rue; the Consequence is, that Nature being disturbed in her Operations, the _Crisis_ or Turn is not effected; the Matter which should be discharged by Stool, by Urine, or by Sweat, is not discharged out of the Body; but is thrown upon some internal or external part of it. Should it be on some inward part, the Patient either dies at once; or another Distemper succeeds, more troublesome and incurable than the first. Should it be expelled to some outward part, the Danger indeed is less; and as soon as ever such a Tumour appears, ripening Pultices should be apply'd to bring it to a Head, after which it should immediately be opened. § 61. In order to prevent such unhappy Consequences, great Care must be taken, whenever such terrifying Symptoms come on, [about the Time of the _Crisis_] to make no Change in the Diet, nor in the Treatment of the Patient; except in giving him the loosening Glyster Nº. 5; and applying every two Hours a Flannel, squeezed out of warm Water, which may cover all the Belly, and in a Manner go round the Body behind the Reins. The Quantity of his Drink may also be increased a little; and that of his Nourishment lessened, as long as this high and violent State continues. § 62. I have not spoken of Vomits or Purges, as being directly contrary to the Nature of this Disease. Anodynes, or Opiates, to procure Sleep are also, in general, very improper. In a few Cases, however, they may possibly be useful; but these Cases are so very difficult to be sufficiently distinguished, that Opiates should never be admitted in this Disease, without the Presence and Advice of a Physician. I have seen many Patients, who have been thrown into an incurable Hectic, by taking them improperly. When the Disease is not received in a mortal Degree, nor has been injudiciously treated, and proceeds in a benign regular Manner, the Patient may be called very well and safe by the fourteenth Day; when he may, if he has an Appetite, be put upon the Diet of People who are recovering. But if he still retains an Aversion to Food; if his Mouth is foul and furred, and he is sensible of some Heaviness in his Head, he should take the purging Potion Nº. 11. § 63. Bleedings from the Nose occur sometimes naturally in this Disease, even after repeated Bleedings by Art; these are very benign and favourable, and are commonly attended with more Ease and Relief than artificial Bleedings. Such voluntary Discharges may sometimes be expected, when the Patient is sensibly mended in many Respects after the Use of the Lancet; and yet complains of a great Pain in his Head, accompanied with quick sparkling Eyes, and a Redness of the Nose. Nothing should be done to stop these voluntary Bleedings, since it would be very dangerous: For when Nature has fulfilled her Intention by them, they cease of themselves. At other times, but more rarely, the Distemper is carried off by a natural Purging, attended with moderate Pain, and the Discharge of bilious Matter. § 64. If the Expectoration, or hawking up of Matter, stops very suddenly, and is not speedily attended with some other Evacuation; the Oppression and Anguish of the Patient immediately return, and the Danger is great and pressing. If the Distemper, at this Juncture, is not of many Days standing; if the Patient is a strong Person; if he has not as yet been plentifully bled; if there be still some Blood mixed with the Humour he expectorates; or if the Pulse be strong and hard, he should be bled immediately in the Arm; and constantly receive the Steam of hot Water and Vinegar by the Mouth, and drink plentifully of the Ptisan Nº. 2, something hotter than ordinary. But if his Circumstances, after this Suppression, are different from these just mentioned; instead of bleeding him, two Blisters should be applied to the Legs; and he should drink plentifully of the Ptisan Nº. 12. The Causes which oftenest produce this Suppression of his Expectoration are, 1, a sharp and sudden cold Air. 2, too hot a one. 3, over hot Medicines. 4, excessive Sweating. 5, a Purge prematurely and injudiciously timed. and 6, some immoderate Passion of the Mind. § 65. When the Sick has not been sufficiently bled, or not soon enough; and even sometimes, which I have seen, when he has been greatly weakened by excessive Bleeding; so that the Discharges by Stool, Urine, Expectoration and Perspiration, have not been sufficiently made; when these Discharges have been confused by some other Cause; or the Disease has been injudiciously treated; then the Vessels that have been inflamed, do not unload themselves of the Humours, which stuff up and oppress them: but there happens in the Substance of the affected Lung, the same Circumstance we see daily occur on the Surface of the Body. If an inflammatory Tumour or Swelling does not disperse itself, and disappears insensibly, it forms an Imposthume or Abscess. Thus exactly also in the inflamed Lung, if the Inflammation is not dissipated, it forms an Abscess, which, in that part, is called a _Vomica:_ and the Matter of that Abscess, like the external ones, remains often long inclosed in its Sac or Bag, without bursting open its Membrane or Case, and discharging the Matter it contains. § 66. If the Inflammation was not very deeply seated in the inward Substance of the diseased Lung; but was extended to its Surface, that is, very near the Ribs, the Sac will burst on the Surface of the Lung; and the Matter contained in it must be discharged into the Cavity, or Hollowness of the Breast, between the Lung, the Ribs, and the Diaphragm or Midriff, which is the Membrane that divides the Breast and the Belly. But when the Inflammation is considerably deeper, the Imposthume bursts withinside of the Lung itself. If its Orifice, or Opening is so small, that but little can get out at once; if the Quantity of all the Matter be inconsiderable, and the Patient is at the same Time pretty strong, he coughs up the Matter, and is very sensibly relieved. But if this _Vomica_ be large, or if its Orifice is wide, and it throws out a great Quantity of Matter at once; or if the Patient is very weak, he dies the Moment it bursts, and that sometimes when it is least expected. I have seen one Patient so circumstanced expire, as he was conveying a Spoonful of Soup to his Mouth; and another, while he was wiping his Nose. There was no present Symptom in either of these Cases, whence a Physician might suppose them likelier to die at that Instant, than for some Hours before. The _Pus_, or Matter, is commonly discharged through the Mouth after Death, and the Bodies very soon become putrified. § 67. We call that _Vomica_ which is not burst, an _occult_ or hidden, and that which is, an evident or open one. It is of considerable Importance to treat exactly and clearly of this Topic; as a great Number of Country People die of these Imposthumes, even without a Suspicion of the Cause of their Death. I had an Instance of it some Days since, in the School-master of a Village. He had an occult and very considerable _Vomica_ in the left Lung, which was the Consequence of an Inflammation of the Breast, that had been treated improperly at the Beginning. He seemed to me not likely to live twenty four Hours; and really died in the Night, after inexpressible Anguish. § 68. Whatever Distemper is included within the Breast of a living Patient, is neither an Object of the Sight or Touch whence these _Vomicas_, these inward Tumours, are so often unknown, and indeed unsuspected. The Evacuations that were necessary for the Cure, or sometimes for the Prevention, of them, have not taken place, during the first fourteen Days. At the End of this Term, the Patient, far from being cured, is not very considerably relieved; but, on the contrary, the Fever continues to be pretty high, with a Pulse continually quick; in general soft and weak; though sometimes pretty hard, and often fluctuating, or, as it were, waving. His Breathing is still difficult and oppressed; with small cold Shudderings from Time to Time; an Exasperation of the Fever; flushed Cheeks, dry Lips, and Thirst. The Increase of these Symptoms declare, that _Pus_ or Matter is thoroughly formed: the Cough then becomes more continual; being exasperated with the least Motion; or as soon as ever the Patient has taken any Nourishment. He can repose only on the Side affected. It often happens indeed, that he cannot lie down at all; but is obliged to be set up all Day; sometimes even without daring to lean a little upon his Loins, for fear of increasing the Cough and Oppression. He is unable to sleep; has a continual Fever, and his Pulse frequently intermits. The Fever is not only heightened every Evening; but the smallest Quantity of Food, the gentlest Motion, a little Coughing, the lightest Agitation of the Mind, a little more than usual Heat in the Chamber, Soup either a little too strong, or a little too salt, increase the Quickness of his Pulse the Moment they occur, or are given. He is quite restless, has some short Attacks of the most terrible Anguish, accompanied and succeeded by Sweatings on his Breast, and from his whole Countenance. He sweats sometimes the whole Night; his Urine is reddish, now frothy, and at other times oily, as it were. Sudden Flushings, hot as Flames, rise into his whole Visage. The greater Number of the Sick are commonly sensible of a most disagreeable Taste in their Mouth; some of old strong Cheese; others of rotten Eggs; and others again of stinking Meat, and fall greatly away. The Thirst of some is unquenchable; their Mouths and Lips are parched; their Voice weak and hoarse; their Eyes hollow, with a kind of Wildness in their Looks. They have a general Disgust to all Food; and if they should ask for some particular Nourishment without seeing it, they reject it the Moment it is brought them; and their Strength at length seems wholly exhausted. Besides these Symptoms, a little Inflation, or _Bloatedness_, as it were, is sometimes observed on the Breast, towards the Side affected; with an almost insensible Change of Colour. If the _Vomica_ be situated at the Bottom of the affected Lobe of the Lungs, and in its internal Part, that is, nearly in the Middle of the Breast, some _Puffiness_ or light Swelling may be perceived in some Bodies, by gently pressing the Pit of the Stomach; especially when the Patient coughs. In short, according to the Observations of a German Physician, if one strike the open Hand on the Breast, covered only with a Shirt, it retains in the Spot, which is directly opposite to the _Vomica_, a flat heavy Sound, as if one struck a Piece of Flesh; while in striking on the other Side it gives a clear loud Sound, as from a Drum. I still doubt however, whether this Observation will generally hold true; and it would be hazardous to affirm there is no Abscess in a Breast, which does not return this heavy Sound. § 69. When a _Vomica_ is formed, as long as it is not emptied, all the Symptoms I have already enumerated increase, and the _Vomica_ grows in Size: the whole Side of the Lung affected sometimes becomes a Bag or Sac of Matter. The sound Side is compressed; and the Patient dies after dreadful Anguish, with the Lung full of _Pus_, and without having ever brought up any. To avoid such fatal Consequences, it is necessary to procure the Rupture and Discharge of this inward Abscess, as soon as we are certain of its Existence: And as it is safer it should break within the Lobe affected, from whence it may be discharged by hawking up; than that it should burst and void itself into the Cavity of the Breast, for Reasons I shall give hereafter, we must endeavour, that this Rupture may be effected within the internal Substance of the Lungs. § 70. The most effectual Methods to procure this are, 1. To make the Patient continually receive, by his Mouth, the Vapour of warm Water. 2. When by this Means that part of the Sac or Abscess is softened, where we could wish the Rupture of it to happen, the Patient is to swallow a large Quantity of the most emollient Liquid; such as Barley Water, Almond Milk, light Veal Broth, or Milk and Water. By this Means the Stomach is kept always full: so that the Resistance to the Lungs being considerable on that Side, the Abscess and its Contents will naturally be pressed towards the Side of the Wind-pipe, as it will meet with less Resistance there. This fulness of the Stomach will also incline the Patient to cough, which may concur to produce a good Event. Hence, 3, we should endeavour to make the Patient cough, by making him smell to some Vinegar, or even snuff up a little; or by injecting into his Throat, by the Means of a small Syringe or Pipe, such as Children make out of short Pieces of Elder-Boughs, a little Water or Vinegar. 4. He should be advised to bawl out aloud, to read loud, or to laugh heartily; all which Means contribute to burst open the Abscess, as well as those two following ones. 5. Let him take every two Hours a Soup-Ladle of the Potion Nº. 8. 6. He should be put into a Cart, or some other Carriage; but not before he has drank plentifully of such Liquors as I have just mentioned: after which the Shaking and Jolting in the Carriage have sometimes immediately procured that Rupture, or breaking of the Bag or Abscess, we wished for. § 71. Some Years since I saw a Country Maid Servant, who was left in a languishing Condition after an Inflammation of the Breast; without any Person's suspecting her Ailment. This Woman being put into a Cart, that was sent for a Load of Hay; one of the Wheels run violently against a Tree: she swooned away, and at the same Time brought up a great Quantity of digested Matter. She continued to bring up more; during which I was informed of her Case, and of the Accident, which effectually cured her. A _Swiss_ Officer, who served in _Piedmont_, had been in a languid State of Health for some Months; and returned home to set himself down as easily as he could, without conceiving any considerable Hopes of Recovery. Upon entering into his own Country, by the Way of _Mount Bernard_; and being obliged to go some Paces on Foot, he fell down; and remained in a Swoon above a Quarter of an Hour: during which Time he threw up a large Quantity of Matter, and found himself that very Moment very greatly relieved. I ordered him a proper Diet, and suitable Medicines: his Health became perfectly established; and the Preservation of his Life was principally owing to this lucky Fall. Many Persons afflicted with a _Vomica_, faint away the very Instant it breaks. Some sharp Vinegar should be directly held to their Nose. This small Assistance is generally sufficient, where the bursting of it is not attended with such Appearances as shew it to be mortal, in which Case every Application is insignificant. § 72. If the sick Person was not extremely weak before the Bursting of the Abscess; if the Matter was white, and well conditioned; if the Fever abates after it; if the Anguish, Oppression and Sweats terminate; if the Cough is less violent; if the Patient is sensibly easier in his Situation or Posture; if he recovers his Sleep and Appetite; if his usual Strength returns; if the Quantity he expectorates, or brings up, becomes daily and gradually less; and if his Urine is apparently better, we may have Room to hope, that by the Assistance of these Remedies I shall immediately direct, he may be radically, compleatly cured. § 73. But if on the contrary; when his Strength is exhausted before the bursting of the Abscess; when the Matter is too thin and transparent, brown, green, yellow, bloody and of an Offensive Smell; if the Pulse continues quick and weak; if the Patient's Appetite, Strength and Sleep do not improve, there remains no hope of a Cure, and the best Medicines are ineffectual: Nevertheless we ought to make some Tryal of them. § 74. They consist of the following Medicines and Regulations. 1. Give every four Hours a little Barley or Rice Cream. 2. If the Matter brought up is thick and glewy, so that it is very difficult to be loosened and discharged, give every two Hours a Soup-ladle of the Potion Nº. 8; and between the giving these two, let the Patient take every half Hour a Cup of the Drink Nº. 13. 3. When the Consistence of the Matter is such, that there is no Occasion for these Medicines to promote the Discharge of it, they must be omitted; tho' the same Sort and Quantity of Food are to be continued; but with the Addition of an equal Quantity of Milk; or, which would be still more beneficial, instead of this Mixture, we should give an equal Quantity of sweet Milk, taken from a good Cow, which, in such a Case, may compose the whole Nourishment of the Patient. 4. He should take four Times a Day, beginning early in the Morning, and at the Distance of two Hours, a Dose of the Powder Nº. 14, diluted in a little Water, or made into a _Bolus_, or Morsel, with a little Syrup or Honey. His common Drink should be Almond Emulsion, commonly called Almond Milk, or Barley Water, or fresh Water with a fourth part Milk. 5. He should air and exercise every Day on Horseback, or in a Carriage, according as his Strength and his Circumstances will allow him. But of all Sorts of Exercise, that upon a trotting Horse is, beyond all Comparison, the very best, and the easiest to be procured by every Body; provided the Disease be not too far advanced; since in such a Situation, any Exercise, that was only a little violent, might prove pernicious. § 75. The Multitude, who are generally illiterate, seldom consider any thing as a Remedy, except they swallow it. They have but little Confidence in _Regimen_, or any Assistance in the Way of Diet, and consider Riding on Horseback as wholly useless to them. This is a dangerous Mistake, of which I should be glad to undeceive them: since this Assistance, which appears so insignificant to them, is probably the most effectual of any: it is that in Fact, without which they can scarcely expect a Cure, in the highest Degrees of this Disease: it is that, which perhaps alone may recover them, provided they take no improper Food. In brief it is considered, and with Reason, as the real Specific for this Disease. § 76. The Influence of the Air is of more Importance in this Disorder, than in any others; for which Reason great Care should be taken to procure the best, in the Patient's Chamber. For this Purpose it should often be ventilated, or have an Admission of fresh Air, and be sweetened from Time to Time, tho' very lightly, with a little good Vinegar; and in the Season it should be plentifully supplied with agreeable Herbs, Flowers and Fruits. Should the Sick be unfortunately situated, and confined in an unwholsome Air, there can be but little Prospect of curing him, without altering it. § 77. Out of many Persons affected with these Disorders, some have been cured by taking nothing whatsoever but Butter-milk; others by Melons and Cucumbers only; and others again by Summer Fruits of every Sort. Nevertheless, as such Cases are singular, and have been but few, I advise the Patient to observe the Method I have directed here, as the surest. § 78. It is sufficient if he have a Stool once in two, or even in three, Days. Hence, there is no Reason for him, in this Case, to accustom himself to Glysters: they might excite a Looseness, which may be very dangerous. § 79. When the Discharge of the Matter from the Breast diminishes, and the Patient is perceivably mended in every Respect, it is a Proof that the Wound in the Abscess is deterged, or clean, and that it is disposed to heal up gradually. If the Suppuration, or Discharge, continues in great Quantity; if it seems but of an indifferent Consistence; if the Fever returns every Evening, it may be apprehended, that the Wound, instead of healing, may degenerate into an Ulcer, which must prove a most embarrassing Consequence. Under such a Circumstance, the Patient would fall into a confirmed Hectic, and die after some Months Sickness. § 80. I am not acquainted with any better Remedy, in such a dangerous Case, than a Perseverance in these already directed, and especially in moderate Exercise on Horseback. In some of them indeed Recourse may be had to the sweet Vapours of some vulnerary Herbs in hot Water, with a little Oil of Turpentine, as directed Nº. 15. I have seen them succeed; but the safest Way is to consult a Physician, who may examine and consider, if there is not some particular Circumstance combined with the Disease, that proves an Obstacle to the Cure of it. If the Cough prevents the Patient from Sleeping, he may take in the Evening two or three Table Spoonfuls of the Prescription Nº. 16, in a Glass of Almond Milk or Barley Water. § 81. The very same Causes which suddenly suppress the Expectoration, in an Inflammation of the Breast, may also check the Expectoration from a _Vomica_ already begun: in which Circumstance the Patient is speedily afflicted with an Oppression and Anguish, a Fever and evident Feebleness. We should immediately endeavour to remove this Stoppage, by the Vapour of hot Water; by giving a Spoonful of the Mixture Nº. 3 every Hour; by a large Quantity of the Ptisan Nº. 12, and by a proper Degree of Motion or Exercise. As soon as ever the Expectoration returns, the Fever and the other Symptoms disappear. I have seen this Suppression in strong Habits quickly followed with an Inflammation about the Seat of the _Vomica_, which has obliged me to bleed, after which the Expectoration immediately returned. § 82. It happens sometimes, that the _Vomica_ is entirely cleansed; the Expectoration is entirely finished, or drained off, the Patient seems well, and thinks himself compleatly cured: but soon after, the Uneasiness, Oppression, Cough and Fever are renewed, because the Membrane or Bag of the _Vomica_ fills again: again it empties itself, the Patient expectorates for some Days, and seems to recover. After some Time however, the same Scene is repeated; and this Vicissitude, or Succession, of moderate and of bad Health, often continues for some Months and even some Years. This happens when the _Vomica_ is emptied, and is gradually deterged; so that its Membranes, or Sides touch or approach each other; but without cicatrizing or healing firmly; and then there drops or leaks in very gradually fresh Matter. For a few Days this seems no ways to incommode the Patient; but as soon as a certain Quantity is accumulated, he is visited again with some of the former Symptoms, 'till another Evacuation ensues. People thus circumstanced, in this Disease, sometimes appear to enjoy a tolerable Share of Health. It may be considered as a kind of internal Issue, which empties and cleanses itself from Time to Time; pretty frequently in some Constitutions, more slowly in others; and under which some may attain a good middling Age. When it arrives however at a very considerable Duration, it proves incurable. In its earliest State, it gives way sometimes to a Milk-diet, to riding on Horseback; and to the Medicine Nº. 14. § 83. Some may be surprized, that in treating of an Abscess of the Lungs, and of the Hectic, which is a Consequence of it, I say nothing of those Remedies, commonly termed _Balsamics_, and so frequently employed in them, for Instance, Turpentines, Balsam of Peru, of Mecca, Frankincense, Mastich, Myrrh, Storax and Balsam of Sulphur. I shall however say briefly here (because it is equally my Design to destroy the Prejudice of the People, in favour of improper Medicines, and to establish the Reputation of good ones) that I never in such Cases made use of these Medicines; because I am convinced, that their Operation is generally hurtful in such Cases; because I see them daily productive of real Mischief; that they protract the Cure, and often change a slight Disorder into an incurable Disease. They are incapable of perfect Digestion, they obstruct the finest Vessels of the Lungs, whose Obstructions we should endeavour to remove; and evidently occasion, except their Dose be extremely small, Heat and Oppression. I have very often seen to a Demonstration, that Pills compounded of Myrrh, Turpentine and Balsam of Peru, have, an Hour after they were swallowed, occasioned a Tumult and Agitation in the Pulse, high Flushings, Thirst and Oppression. In short it is demonstrable to every unprejudiced Person, that these Remedies, as they have been called, are truly prejudicial in this Case; and I heartily wish People may be disabused with Respect to them, and that they may lose that Reputation so unhappily ascribed to them. I know that many Persons, very capable in other Respects, daily make use of them in these Distempers: such however cannot fail of disusing them, as soon as they shall have observed their Effects, abstracted from the Virtues of the other Medicines to which they add them, and which mitigate the Danger of them. I saw a Patient, whom a foreign Surgeon, who lived at _Orbe_, attempted to cure of a Hectic with melted Bacon, which aggravated the Disease. This Advice seemed, and certainly was, absurd; nevertheless the Balsamics ordered in such Cases are probably not more digestible than fat Bacon. The Powder Nº. 14 possesses whatever these Balsamics pretend to: it is attended with none of the Inconveniencies they produce; and has all the good Qualities ascribed to them. Notwithstanding which, it must not be given while the Inflammation exists; nor when it may revive again; and no other Aliment should be mixed with the Milk. The famous Medicine called the _Antihectic_, (_Antihecticum Poterii_) has not, any more than these Balsamics, the Virtues ascribed to it in such Cases. I very often give it in some obstinate Coughs to Infants with their Milk, and then it is very useful: but I have seldom seen it attended with considerable Effects in grown Persons; and in the present Cases I should be fearful of its doing Mischief. § 84. If the _Vomica_, instead of breaking within the Substance of the Lungs affected, should break without it, the Pus must be received into the Cavity of the Breast. We know when that has happened, by the Sensation or Feeling of the Patient; who perceives an uncommon, a singular kind of Movement, pretty generally accompanied with a Fainting. The Oppression and Anguish cease at once; the Fever abates; the Cough however commonly continues, tho' with less Violence, and without any Expectoration. But this seeming Amendment is of a short Duration, since from the daily Augmentation of the Matter, and its becoming more acrid or sharp, the Lungs become oppressed, irritated and eroded. The Difficulty of Breathing, Heat, Thirst, Wakefulness, Distaste, and Deafness, return, with many other Symptoms unnecessary to be enumerated, and especially with frequent Sinkings and Weakness. The Patient should be confined to his _Regimen_, to retard the Increase of the Disease as much as possible; notwithstanding no other effectual Remedy remains, except that of opening the Breast between two of the Ribs, to discharge the Matter, and to stop the Disorder it occasions. This is called the Operation for the _Empyema_. I shall not describe it here, as it should not be undertaken but by Persons of Capacity and Experience, for whom this Treatise was not intended. I would only observe, it is less painful than terrifying; and that if it is delayed too long, it proves useless, and the Patient dies miserably. § 85. We may daily see external Inflammations turn gangrenous, or mortify. The same Thing occurs in the Lungs, when the Fever is excessive, the Inflammation either in its own Nature, extremely violent, or raised to such a Height by hot Medicines. Intolerable Anguish, extreme Weakness, frequent Faintings, Coldness of the Extremities, a livid and foetid thin Humour brought up instead of concocted Spitting, and sometimes blackish Stripes on the Breast, sufficiently distinguish this miserable State. I have smelt in one Case of this Kind, where the Patient had been attacked with this Disease (after a forced March on Foot, having taken some Wine with Spices to force a Sweat) his Breath so horribly stinking, that his Wife had many Sinkings from attending him. When I saw him, I could discern neither Pulse nor Intellect, and ordered him nothing. He died an Hour afterwards, about the Beginning of the third Hour. § 86. An Inflammation may also become hard, when it forms what we call a _Scirrhus_, which is a very hard Tumour, indolent, or unpainful. This is known to occur, when the disease has not terminated in any of those Manners I have represented; and where, tho' the Fever and the other Symptoms disappear, the Respiration, or Breathing, remains always a little oppressed; the Patient still retains a troublesome Sensation in one Side of his Breast; and has from Time to Time a dry Cough, which increases after Exercise, and after eating. This Malady is but seldom cured; though some Persons attacked with it last many Years, without any other considerable Complaint. They should avoid all Occasions of over-heating themselves; which might readily produce a new Inflammation about this Tumour, the Consequences of which would be highly dangerous. § 87. The best Remedies against this Disorder, and from which I have seen some good Effects, are the medicated Whey Nº. 17, and the Pills Nº. 18. The Patient may take twenty Pills, and a Pint and a half of the Whey every Morning for a long Continuance; and receive inwardly, now and then, the Vapour of hot Water. § 88. Each Lung, in a perfect State of Health, touches the _Pleura_, the Membrane, that lines the Inside of the Breast; though it is not connected to it. But it often happens, after an Inflammation of the Breast, after the Pleurisy, and in some other Cases, that these two Parts adhere closely to each other, and are never afterwards separated. However this is scarcely to be considered as a Disease; and remains commonly unknown, as the Health is not impaired by it, and nothing is ever prescribed to remove it. Nevertheless I have seen a few Cases, in which this Adhesion was manifestly prejudicial. __Chapter V.__ _Of the Pleurisy._ __Sect.__ 89. The Pleurisy, which is chiefly known by these four Symptoms, a strong Fever, a Difficulty of Breathing, a Cough, and an acute Pain about the Breast; the Pleurisy, I say, is not a different Malady from the Peripneumony, or Inflammation of the Breast, the Subject of the preceding Chapter; so that I have very little to say of it, particularly, or apart. § 90. The Cause of this Disease then is exactly the same with that of the former, that is, an Inflammation of the Lungs; but an Inflammation, that seems rather a little more external. The only considerable Difference in the Symptoms is, that the Pleurisy is accompanied with a most acute Pain under the Ribs, and which is commonly termed a _Stitch_. This Pain is felt indifferently over every Part of the Breast; though more commonly about the Sides, under the more fleshy Parts of the Breast, and oftenest on the right Side. The Pain is greatly increased whenever the Patient coughs or draws in the Air in breathing; and hence a Fear of increasing it, by making some Patients forbear to cough or respire, as much as they possibly can; and that aggravates the Disease, by stopping the Course of the Blood in the Lungs, which are soon overcharged with it. Hence the Inflammation of this Bowel becomes general; the Blood mounts up to the Head; the Countenance looks deeply red, or as it were livid; the Patient becomes nearly suffocated, and falls into the State described § 47. Sometimes the Pain is so extremely violent, that if the Cough is very urgent at the same Time, and the Sick cannot suppress or restrain it, they are seized with Convulsions, of which I have seen many Instances, but these occur almost always to Women; though they are much less subject than Men to this Disease, and indeed to all inflammatory ones. It may be proper however to observe here, that if Women should be attacked with it, during their monthly Discharges, that Circumstance should not prevent the repeated and necessary Bleedings, nor occasion any Alteration in the Treatment of the Disease. And hence it appears, that the Pleurisy is really an Inflammation of the Lungs, accompanied with acute Pain. § 91. I am sensible that sometimes an Inflammation of the Lungs is communicated also to that Membrane, which lines the Inside of the Breast; and which is called the _Pleura_; and from thence to the Muscles, the fleshy Parts, over and between the Ribs. This however is not very frequently the Case. § 92. Spring is commonly the Season most productive of Pleurisies: in general there are few in Summer: notwithstanding that in the Year 1762, there were a great many during the hottest Season, which then was excessively so. The Disease usually begins with a violent Shivering, succeeded by considerable Heat, with a Cough, an Oppression, and sometimes with a sensible Straitning, or Contraction, as it were, all over the Breast; and also with a Head-ach, a Redness of the Cheeks, and with Reachings to vomit. The Stitch does not always happen at the very first Onset; often not 'till after several Hours from the first Complaint; sometimes not before the second, or even the third Day. Sometimes the Patient feels two Stitches, in different Parts of the Side; though it seldom happens that they are equally sharp, and the lightest soon ceases. Sometimes also the Stitch shifts its Place, which promises well, if the Part first attacked by it continues perfectly free from Pain: but it has a bad Appearance, if, while the first is present, another also supervenes, and both continue. The Pulse is usually very hard in this Distemper; but in the dreadful Cases described § 47 and 90, it becomes soft and small. There often occur at, or very quickly after, the Invasion, such an Expectoration, or hawking up, as happens in an Inflammation of the Breast; at other Times there is not the least Appearance of it, whence such are named dry Pleurisies, which happen pretty often. Sometimes the Sick cough but little, or not at all. They often lie more at Ease upon the Side affected, than on the sound one. The Progress of this Disease advances exactly like that described in the preceding Chapter: for how can they differ considerably? and the Treatment of both is the same. Large Hæmorrhages, or Bleedings from the Nose, frequently happen, to the great Relief of the Patient; but sometimes such Discharges consist of a kind of corrupted Blood, when the Patient is very ill, and these portend Death. § 93. This Distemper is often produced by drinking cold Water, while a Person is hot; from which Cause it is sometimes so violent, as to kill the Patient in three Hours. A young Man was found dead at the Side of the Spring, from which he had quenched his Thirst: neither indeed is it uncommon for Pleurisies to prove mortal within three Days. Sometimes the Stitch disappears, whence the Patient complains less; but at the same Time his Countenance changes; he grows pale and sad; his Eyes look dull and heavy, and his Pulse grows feeble. This signifies a Translation of the Disease to the Brain, a Case which is almost constantly fatal. There is no Disease in which the critical Symptoms are more violent, and more strongly marked, than in this. It is proper this should be known, as it may prevent or lessen our excessive Terror. A perfect Cure supervenes sometimes, at the very Moment when Death was expected. § 94. This Malady is one of the most common and the most destroying kind, as well from its own violent Nature, as through the pernicious Treatment of it in Country Places. That Prejudice, which insists on curing all Diseases by Sweating, entirely regulates their Conduct in treating a Pleurisy; and as soon as a Person is afflicted with a Stitch, all the hot Medicines are immediately set to Work. This mortal Error destroys more People than Gunpowder; and it is by so much the more hurtful, as the Distemper is of the most violent kind; and because, as there is commonly not a Moment to be lost, the whole depends on the Method immediately recurred to. § 95. The proper Manner of treating this Disease, is exactly the same in all Respects, with that of the Peripneumony; because, I again affirm, it is the very same Disease. Hence the Bleedings, the softening and diluting Drinks, the Steams, the Glysters, the Potion Nº. 8, and the emollient Poultices are the real Remedies. These last perhaps are still more effectual in the Pleurisy; and therefore they should be continually applied over the very Stitch. The first Bleeding, especially if there has been a considerable Discharge, almost constantly abates the Stitch, and often entirely removes it: though it more commonly returns, after an Intermission of some Hours, either in the same Spot, or sometimes in another. This shifting of it is rather favourable, especially if the Pain, that was first felt under the Breast, shifts into the Shoulders, to the Back, the Shoulder-blade, or the Nape of the Neck. When the Stitch is not at all abated, or only a little; or if, after having abated, it returns as violently as at first, and especially if it returns in the same Spot, and the Height of the other Symptoms continue, Bleeding must be repeated. But if a sensible Abatement of the Stitch continues; and if, though it returns, it should be in a smaller Degree, and by Intervals, or in these Places I have mentioned above; if the Quickness, or the Hardness of the Pulse, and all the other Symptoms are sensibly diminished, this repeated Bleeding may sometimes be omitted. Nevertheless, in a very strong Subject, it seems rather prudent not to omit it, since in such Circumstances it can do no Mischief; and a considerable Hazard may sometimes be incurred by the Omission. In very high and dangerous Pleurisies a frequent Repetition of bleeding is necessary; except some Impediment to it should arise from the particular Constitution of the Patient, or from his Age, or some other Circumstances. If, from the Beginning of the Disease, the Pulse is but a little quicker and harder than in a healthy State; if it is not manifestly strong; if the Head-ach and the Stitch are so moderate as to prove supportable; if the Cough is not too violent; if there is no sensible Oppression or Straitness, and the Patient expectorate, or cough up, Bleeding may be omitted. With Respect to the administering of other Remedies, the same Directions are to be exactly followed, which have been already given in the preceding Chapter, to which the Reader is referred from § 53 to 66. § 96. When the Disease is not very acute and pressing, I have often cured it in a very few Days by a single Bleeding, and a large Quantity of a Tea or Infusion of Elder-flowers, sweetened with Honey. It is in some Cases of this kind, that we often find the Water _Faltranc_ succeed, with the Addition of some Honey, and even of Oil: though the Drink I have just directed is considerably preferable. That Drink which is compounded of equal Quantities of Wine and Water, with the Addition of much Venice Treacle, annually destroys a great Number of People in the Country. § 97. In those dry Pleurisies, in which the Stitch, the Fever, and the Head-ach are strong and violent; and where the Pulse is very hard and very full, with an excessive Dryness of the Skin and of the Tongue, Bleeding should be frequently repeated, and at small Intervals from each other. This Method frequently cures the Disease effectually, without using any other Evacuation. § 98. The Pleurisy terminates, like any other inward Inflammation, either by some Evacuation; by an Abscess; in a Mortification; or in a Scirrhosity or hard Tumour; and it often leaves Adhesions in the Breast. The Gangrene or Mortification sometimes appears on the third Day, without having been preceded by very vehement Pains. In such Cases the dead Body often looks very black, especially in the Parts near the Seat of the Disease: and in such the more superstitious ascribe it to some supernatural Cause; or draw some unhappy Presage from it, with Respect to those who are yet unattacked by it. This Appearance however is purely a natural Consequence, quite simple, and cannot be otherwise; and the hot Regimen and Medicines are the most prevailing Causes of it. I have seen it thus circumstanced in a Man in the Flower of his Age, who had taken Venice Treacle in Cherry Water, and the Ingredients of _Faltranc_ infused in Wine. § 99. _Vomicas_ are sometimes the Consequences of Pleurisies; but their particular Situation disposes them more to break [22] outwardly; which is the most frequent Cause of an _Empyema_ § 84. "To prevent this, it is highly proper to apply, at the first Invasion of the Disease, to the Spot where the Pain chiefly rages, a small Plaister, which may exactly fit it; since if the Pleurisy should terminate in an Abscess or Imposthume, the purulent Matter will be determined to that Side. [22] That is, into the Cavity of the Breast, rather than within the Substance of the Lungs. "As soon then as it is foreseen that an Abscess is forming (see § 68) we should erode, by a light Caustic, the Place where it is expected; and as soon as it is removed, Care should be taken to promote Suppuration there. By this Means we may entertain a reasonable Hope, that the Mass of Matter will incline its Course to that Spot, where it will meet with the least Resistance, and be discharged from thence. For this Heap of Matter is often accumulated between the _Pleura_, and the Parts which adhere to it." This is the Advice of a very [23] great Physician; but I must inform the Reader, there are many Cases, in which it can be of no Service; neither ought it to be attempted, but by Persons of undoubted Abilities. [23] This is, undoubtedly, Baron _Van Swieten_, with whom he had premised, he agreed considerably, in all the Diseases they had both treated of. _K._ With Regard to the Scirrhosity, or Hardness, and to the Circumstances of Adhesions, I can add nothing to what I have said in § 86 and 87. § 100. It has been observed that some Persons, who have been once attacked by this Disease, are often liable to Relapses of it, especially such as drink hard. I knew one Man, who reckoned up his Pleurisies by Dozens. A few Bleedings, at certain proper Intervals, might prevent these frequent Returns of it; which, joined to their excessive Drinking, make them languid and stupid, in the very Flower of their Age. They generally fall into some Species of an Asthma, and from that into a Dropsy, which proves the melancholy, though not an improper, Conclusion of their Lives. Such as can confine themselves to some proper Precautions, may also prevent these frequent Returns of this Disease, even without bleeding; by a temperate Regimen; by abstaining from Time to Time, from eating Flesh and drinking Wine; at which Times they should drink Whey, or some of those Diet-Drinks Nº. 1, 2, 4; and by bathing their Legs sometimes in warm Water; especially in those Seasons, when this Disease is the most likely to return. § 101. Two Medicines greatly esteemed in this Disease among the Peasantry, and even extolled by some Physicians, are the Blood of a wild He Goat, and the [24] Soot in an Egg. I do not contest the Cure or Recovery of many Persons, who have taken these Remedies; notwithstanding it is not less true, that both of them, as well as the Egg in which the Soot is taken, are dangerous: For which Reason it is prudent, at least, never to make use of them; as there is great Probability, they may do a little Mischief; and a Certainty that they can do no Good. The _Genipi_, or [25] Wormwood of the Alps, has also acquired great Reputation in this Disease, and occasioned many Disputes between some very zealous Ecclesiastics, and a justly celebrated Physician. It seems not difficult however to ascertain the proper Use of it. This Plant is a powerful Bitter; it heats and excites Sweat: it seems clear, that, from such Consequences, it should never be employed in a Pleurisy, while the Vessels are full, the Pulse hard, the Fever high, and the Blood inflamed. In all such Circumstances it must aggravate the Disease; but towards the Conclusion of it, when the Vessels are considerably emptied, the Blood is diluted, and the Fever abated, it may then be recurred to; but with a constant Recollection that it is hot, and not to be employed without Reflection and Prudence. [26] [24] This, with great Probability, means that small black Substance often visible in a rotten Egg, which is undoubtedly of a violent, or even poisonous Quality. Dr. _Tissot_ terms it expressly--_la suie dans un Oeuf_. K. [25] Dr. _Lewis_, who has not taken Notice of this Species of Wormwood in his Improvement of _Quincy's_ Dispensatory, has mentioned it in his late _Materia Medica_. K. [26] This being a proper Place for directing the Seneka Rattle Snake Root, I shall observe, that the best Way of exhibiting it is in Decoction, by gradually simmering and boiling two Ounces of it in gross Powder, in two Pints and a half of Water, to a Pint and a quarter; and then giving three Spoonfuls of it to a grown Person, every six Hours. If the Stitch should continue, or return, after taking it, Bleeding, which should be premised to it, must be occasionally repeated; though it seldom proves necessary, after a few Doses of it. It greatly promotes Expectoration, keeps the Body gently open, and sometimes operates by Urine and by Sweat; very seldom proving at all emetic in Decoction. The Regimen of Drinks directed here in Pleurisies are to be given as usual. Dr. _Tennant_, the Introducer of this valuable Medicine, confided solely in it, in Bastard Peripneumonies, without Bleeding, Blistering, or any other Medicines. _K._ __Chapter VI.__ _Of the Diseases of the Throat._ __Sect.__ 102. The Throat is subject to many Diseases: One of the most frequent and the most dangerous, is that Inflammation of it, commonly termed a Quinsey. This in Effect is a Distemper of the same Nature with an Inflammation of the Breast; but as it occurs in a different Part, the Symptoms, of Course, are very different. They also vary, not a very little, according to the different Parts of the Throat which are inflamed. § 103. The general Symptoms of an Inflammation of the Throat are, the Shivering, the subsequent Heat, the Fever, the Head-ach, red high-coloured Urine, a considerable Difficulty, and sometimes even an Impossibility, of swallowing any thing whatever. But if the nearer Parts to the _Glottis_, that is, of the Entrance into the Windpipe, or Conduit through which we breathe, are attacked, Breathing becomes excessively difficult; the Patient is sensible of extreme Anguish, and great Approaches to Suffocation; the Disease is then extended to the _Glottis_, to the Body of the Wind-pipe, and even to the Substance of the Lungs, whence it becomes speedily fatal. The Inflammation of the other Parts is attended with less Danger; and this Danger becomes still less, as the Disease is more extended to the outward and superficial Parts. When the Inflammation is general, and seizes all the internal Parts of the Throat, and particularly the Tonsils or Almonds, as they are called, the _Uvula_, or Process of the Palate, and the _Basis_, or remotest deepest Part of the Tongue, it is one of the most dangerous and dreadful Maladies. The Face is then swelled up and inflamed; the whole Inside of the Throat is in the same Condition; the Patient can get nothing down; he breathes with a Pain and Anguish, which concur, with a Stuffing or Obstruction in his Brains, to throw him into a kind of furious _Delirium_, or Raving. His Tongue is bloated up, and is extended out of his Mouth; his Nostrils are dilated, as tho' it were to assist him in his Breathing; the whole Neck, even to the Beginning of the Breast, is excessively tumified or swelled up; the Pulse is very quick, very weak, and often intermits; the miserable Patient is deprived of all his Strength, and commonly dies the second or third Day. Very fortunately this Kind, or Degree of it, which I have often seen in _Languedoc_, happens very rarely in _Swisserland_, where the Disease is less violent; and where I have only seen People die of it, in Consequence of its being perniciously treated; or by Reason of some accidental Circumstances, which were foreign to the Disease itself. Of the Multitude of Patients I have attended in this Disorder, I have known but one to fail under it, whose Case I shall mention towards the Close of this Chapter. § 104. Sometimes the Disease shifts from the internal to the external Parts: the Skin of the Neck and Breast grows very red, and becomes painful, but the Patient finds himself better. At other Times the Disorder quits the Throat; but is transferred to the Brain, or upon the Lungs. Both these Translations of it are mortal, when the best Advice and Assistance cannot be immediately procured; and it must be acknowledged, that even the best are often ineffectual. § 105. The most usual kind of this Disease is that which affects only the Tonsils (the Almonds) and the Palate; or rather its Process, _commonly called_ the Palate. It generally first invades one of the Tonsils, which becomes enlarged, red and painful, and does not allow the afflicted to swallow, but with great Pain. Sometimes the Disorder is confined to one Side; but most commonly it is extended to the _Uvula_, (the Palate) from whence it is extended to the other Tonsil. If it be of a mild kind, the Tonsil first affected is generally better, when the second is attacked. Whenever they are both affected at once, the Pain and the Anguish of the Patient are very considerable; he cannot swallow, but with great Difficulty and Complaint; and the Torment of this is so vehement, that I have seen Women affected with Convulsions, as often as they endeavoured to swallow their Spittle, or any other Liquid. They continue, even for several Hours sometimes, unable to take any thing whatever; all the upper inward Part of the Mouth, the Bottom of the Palate, and the descending Part of the Tongue become lightly red, or inflamed. A considerable Proportion of Persons under this Disease swallow Liquids more difficultly than Solids; by Reason that Liquids require a greater Action of some Part of the Muscles, in order to their being properly directed into their Conduit or Chanel. The Deglutition (the Swallowing) of the Spittle is attended with still more Uneasiness than that of other Liquids, because it is a little more thick and viscid, and flows down with less Ease. This Difficulty of swallowing, joined to the Quantity thence accumulated, produces that almost continual hawking up, which oppresses some Patients so much the more, as the Inside of their Cheeks, their whole Tongue, and their Lips are often galled, and even flead as it were. This also prevents their Sleeping, which however seems no considerable Evil; Sleep being _sometimes_ but of little Service in Diseases attended with a Fever; and I have often seen those, who thought their Throats almost entirely well in the Evening, and yet found them very bad after some Hours Sleep. The Fever, in this Species of the Disease, is sometimes, very high; and the Shivering often endures for many Hours. It is succeeded by considerable Heat, and a violent Head-ach, which yet is sometimes attended with a Drowsiness. The Fever is commonly pretty high in the Evening, though sometimes but inconsiderable, and by the Morning perhaps there is none at all. A light Invasion of this Disease of the Throat often precedes the Shivering; though most commonly it does not become manifest 'till after it, and at the same Time when the Heat comes on. The Neck is sometimes a little inflated, or puffed up; and many of the Sick complain of a pretty smart Pain in the Ear of that Side, which is most affected. I have but very seldom observed that they had it in both. § 106. The Inflammation either disappears by Degrees, or an Abscess is formed in the Part which was chiefly affected. It has never happened, at least within my Knowledge, that this Sort of the Disease, prudently treated, has ever terminated either in a Mortification, or a Scirrhus: but I have been a Witness to either of these supervening, when Sweating was extorted in the Beginning of it, by hot Medicines. It is also very rare to meet with those highly dangerous Translations of this Disease upon the Lungs, such as are described in that Species of it from § 103, 104. It is true indeed it does not occur more frequently, even in that Species, whenever the Disease is thrown out upon the more external Parts. § 107. The Treatment of the Quinsey, as well as of all other inflammatory Diseases, is the same with that of an Inflammation of the Breast. The Sick is immediately to be put upon a Regimen; and in that Sort described § 103, Bleeding must be repeated four or five Times within a few Hours; and sometimes there is a Necessity to recur still oftner to it. When it assaults the Patient in the most vehement Degree, all Medicines, all Means, are very generally ineffectual; they should be tried however. We should give as much as can be taken of the Drinks Nº. 2 and 4. But as the Quantity they are able to swallow is often very inconsiderable; the Glyster Nº. 5 should be repeated every three Hours; and their Legs should be put into a Bath of warm Water, thrice a Day. § 108. Cupping Glasses, with Scarification, applied about the Neck, after bleeding twice or thrice, have often been experienced to be highly useful. In the most desperate Cases, when the Neck is excessively swelled, one or two deep Incisions made with a Razor, on this external Tumour, have sometimes saved a Patient's Life. § 109. In that kind, and those Circumstances, of this Disease described § 105 we must have very frequent Recourse to Bleeding; and it should never be omitted, when the Pulse is very perceivably hard and full. It is of the utmost Consequence to do it instantaneously; since it is the only Means to prevent the Abscess, which forms very readily, if Bleeding has been neglected, only for a few Hours. Sometimes it is necessary to repeat it a second Time, but very rarely a third. This Disease is frequently so gentle and mild, as to be cured without Bleeding, by the Means of much good Management. But as many as are not Masters of their own Time, nor in such an easy Situation, as to be properly attended, ought, without the least Hesitation, to be bled directly, which is sometimes sufficient to remove the Complaint; especially if, after Bleeding, the Patient drinks plentifully of the Ptisan Nº. 2. In this light Degree of the Disease, it may suffice to bathe the Legs, and to receive a Glyster, once a Day each; the first to be used in the Morning, and the last in the Evening. Besides the general Remedies against Inflammations, a few particular ones, calculated precisely for this Disease, may be applied in each kind or Degree of it. The best are, first the emollient Poultices, Nº. 9, laid over the whole Neck. [27] Some have highly extolled the Application of Swallows Nests in this Disease; and though I make no Objection to it, I think it certainly less efficacious than any of those which I direct. [27] The _English_ avail themselves considerably, in this Disease, of a Mixture of equal Parts of Sallad Oil, and Spirit of Sal Ammoniac; or of Oil and Spirit of Hartshorn, as a Liniment and Application round the Neck. This Remedy corresponds with many Indications; and deserves, perhaps, the first Place amongst local Applications against the inflammatory Quinsey. _E. L._ 2. Of the Gargarisms (Nº. 19) a great Variety may be prepared, of pretty much the same Properties, and of equal Efficacy. Those I direct here are what have succeeded best with me and they are very simple. [28] [28] Dr. _Pringle_ is apprehensive of some ill Effects from Acids in Gargarisms [_which is probably from their supposed repelling Property_] and prefers a Decoction of Figs in Milk and Water, to which he adds a small Quantity of Spirit of Sal Ammoniac. _E. L._ 3. The Steam of hot Water, as directed § 55, should be repeated five or six Times a Day; a Poultice should be constantly kept on, and often renewed; and the Patient should often gargle. There are some Persons, besides Children, who cannot gargle themselves: and in fact the Pain occasioned by it makes it the more difficult. In such a Case, instead of gargling, the same Gargarism (Nº. 19) may be injected with a small Syringe. The Injection reaches further than Gargling, and often causes the Patient to hawk up a considerable Quantity of glarey Matter (which has grown still thicker towards the Bottom of the Throat) to his sensible Relief. This Injection should be often repeated. The little hollowed Pipes of Elder Wood, which all the Children in the Country can make, may be conveniently employed for this Purpose. The Patient should breathe out, rather than inspire, during the Injection. § 110. Whenever the Disease terminates without Suppuration, the Fever, the Head-ach, the Heat in the Throat, and the Pain in swallowing, begin to abate from the fourth Day, some times from the third, often only from the fifth; and from such Period that Abatement increases at a great Rate; so that at the End of two, three, or four Days, on the sixth, seventh, or eighth, the Patient is entirely well. Some few however continue to feel a light Degree of Pain, and that only on one Side, four or five Days longer, but without a Fever, or any considerable Uneasiness. § 111. Sometimes the Fever and the other Symptoms abate, after the Bleeding and other Remedies; without any subsequent Amendment in the Throat, or any Signs of Suppuration. In such Cases we must chiefly persist in the Gargarisms and the Steams; and where an experienced and dexterous Surgeon can be procured, it were proper he should scarify the inflamed Tonsils. These discharge, in such Cases, a moderate Quantity of Blood; and this Evacuation relieves, very readily, as many as make use of it. § 112. If the Inflammation is no ways disposed to disperse, so that an Abscess is forming, which almost ever happens, if it has not been obviated at the Invasion of the Disease; then the Symptoms attending the Fever continue, though raging a little less after the fourth Day: the Throat continues red, but of a less florid and lively Redness: a Pain also continues, though less acute, accompanied sometimes with Pulsations, and at other Times intirely without any; of which it is proper to take Notice: the Pulse commonly grows a little softer; and on the fifth or sixth Day, and sometimes sooner, the Abscess is ready to break. This may be discovered by the Appearance of a small white and soft Tumour, when the Mouth is open, which commonly appears about the Centre or Middle of the Inflammation. It bursts of itself; or, should it not, it must be opened. This is effected by strongly securing a Lancet to one End of a small Stick or Handle, and enveloping, or wrapping up the whole Blade of it, except the Point and the Length of one fourth or a third of an Inch, in some Folds of soft Linnen; after which the Abscess is pierced with the Point of this Lancet. The Instant it is opened, the Mouth is filled with the Discharge of a Quantity of _Pus_, of the most intolerable Savour and Smell. The Patient should gargle himself after the Discharge of it with the detersive, or cleansing Gargarism Nº. 19. It is surprising sometimes to see the Quantity of Matter discharged from this Imposthumation. In general there is but one; though sometimes I have seen two of them. § 113. It happens, and not seldom, that the Matter is not collected exactly in the Place, where the Inflammation appeared, but in some less exposed and less visible Place: whence a Facility of swallowing is almost entirely restored; the Fever abates; the Patient sleeps; he imagines he is cured, and that no Inconvenience remains, but such as ordinarily occurs in the earliest Stage of Recovery. A Person who is neither a Physician, nor a Surgeon, may easily deceive himself, when in this State. But the following Signs may enable him to discover that there is an Abscess, viz. A certain Inquietude and general Uneasiness; a Pain throughout the Mouth; some Shiverings from Time to Time; frequently sharp, but short and transient, Heat: a Pulse moderately soft, but not in a natural State; a Sensation of Thickness and Heaviness in the Tongue; small white Eruptions on the Gums, on the Inside of the Cheek, on the Inside and Outside of the Lips, and a disagreeable Taste and Odour. § 114. In such Cases Milk or warm Water should frequently be retained in the Mouth; the Vapour of hot Water should be conveyed into it; and emollient Cataplasms may be applied about the Neck. All these Means concur to the softening and breaking of the Abscess. The Finger may also be introduced to feel for its Situation; and when discovered, the Surgeon may easily open it. I happened once to break one under my Finger, without having made the least Effort to do it. Warm Water may be injected pretty forcibly, either by the Mouth or the Nostrils: this sometimes occasions a kind of Cough, or certain Efforts which tend to break it. I have seen this happen even from laughing. As to the rest, the Patient should not be too anxious or uneasy about the Event. I never saw a single Instance of a Person's dying of a Quinsey of this kind, after the Suppuration is truly effected; neither has it happened perhaps after the Time it is forming for Suppuration. § 115. The glairy Matter with which the Throat is over-charged, and the very Inflammation of that Part, which, from its Irritation, produces the same Effect, as the Introduction of a Finger into it, occasions some Patients to complain of incessant Propensities to vomit. We must be upon our Guard here, and not suppose that this Heart-Sickness, as some have called it, results from a Disorder of, or a Load within, the Stomach, and that it requires a Vomit for its Removal. The giving one here would often prove a very unfortunate Mistake. It might, in a high Inflammation, further aggravate it; or we might be obliged (even during the Operation of the Vomit) to bleed, in order to lessen the Violence of the Inflammation. Such Imprudence with its bad Consequences, often leaves the Patient, even after the Disease is cured, in a State of Languor and Weakness for a considerable Time. Nevertheless, there are some particular Disorders of the Throat, attended with a Fever, in which a Vomit may be prudently given. But this can only be, when there is no Inflammation, or after it is dispersed; and there still remains some putrid Matter in the first Passages. Of such Cases I shall speak hereafter. [29] [29] In Diseases of the Throat, which have been preceded by such Excesses in Food or strong Drink, as occur too often in many Countries, when the Patient has very strong Reachings to vomit, and the Tongue is moist at the same Time; we should not hesitate, after appeasing the first Symptoms of the Inflammation [by sufficient Bleedings, &c.] to assist the Efforts of Nature, and to give a small Dose of Tartar emetic, dissolved in some Spoonfuls of Water. This Remedy in this Case, promotes the Dispersion of the Inflammation, beyond any other. _E. L._ § 116. We often see in _Swisserland_ a Disorder different from these of the Throat, of which we have just treated; though, like these, attended with a Difficulty of swallowing. It is termed in French the _Oreillons_, and often the _Ourles_, or swelled Ears. It is an Overfulness and Obstruction of those Glands and their Tubes, which are to furnish the _Saliva_ or Spittle; and particularly of the two large Glands which lie between the Ear and the Jaw; which are called the _Parotides_; and of two under the Jaw, called the _Maxillares_. All these being considerably swelled in this Disease, do not only produce a great Difficulty of swallowing; but also prevent the Mouth from opening; as an Attempt to do it is attended with violent Pain. Young Children are much more liable to this Disease than grown Persons. Being seldom attended with a Fever, there is no Occasion for Medicines: It is sufficient to defend the Parts affected from the external Air; to apply some proper Poultice over them; to lessen the Quantity of their Food considerably, denying them Flesh and Wine; but indulging them plentifully in some light warm Liquid, to dilute their Humours and restore Perspiration. I cured myself of this Disorder in 1754, by drinking nothing, for four Days, but Balm Tea, to which I added one fourth part Milk, and a little Bread. The same _Regimen_ has often cured me of other light Complaints of the Throat. § 117. In the Spring of 1761, there were an astonishing Number of Persons attacked with Disorders of the Throat, of two different Kinds. Some of them were seized with that common Sort which I have already described. Without adding any thing more particularly, in Respect to this Species, it happened frequently to grown Persons, who were perfectly cured by the Method already recited. The other Species, on which I shall be more particular in this Place (because I know they have abounded in some Villages, and were very fatal) invaded Adults, or grown Persons also, but especially Children, from the Age of one Year, and even under that, to the Age of twelve or thirteen. The first Symptoms were the same with those of the common Quinsey, such as the Shivering, the ensuing Heat or Fever, Dejection, and a Complaint of the Throat: but the following Symptoms distinguished these from the common inflammatory Quinseys. 1. The Sick had often something of a Cough, and a little Oppression. 2. The Pulse was quicker, but less hard, and less strong, than generally happens in Diseases of the Throat. 3. The Patients were afflicted with a sharp, stinging and dry Heat, and with great Restlessness. 4. They spat less than is usual in a common Quinsey; and their Tongues were extremely dry. 5. Though they had some Pain in swallowing, this was not their principal Complaint, and they could drink sufficiently. 6. The Swelling and Redness of the Tonsils, of the Palate, and of its Process were not considerable; but the parotid and maxillary Glands, and especially the former, being extremely swelled and inflamed, the Pain they chiefly complained of, was this outward one. 7. When the Disease proved considerably dangerous, the whole Neck swelled; and sometimes even the Veins, which return the Blood from the Brain, being overladen, as it were, the Sick had some Degree of Drowsiness, and of a _Delirium_, or Raving. 8. The Paroxysms, or Returns, of the Fever were considerably irregular. 9. The Urine appeared to be less inflamed, than in other Diseases of the Throat. 10. Bleeding and other Medicines did not relieve them, as soon as in the other kind; and the Disease itself continued a longer Time. 11. It did not terminate in a Suppuration like other Quinsies, but sometimes the Tonsils were ulcerated. 12. [30] Almost every Child, and indeed a great many of the grown Persons assaulted with this Disease, threw out, either on the first Day, or on some succeeding one, within the first six Days, a certain Efflorescence, or Eruptions, resembling the Measles considerably in some, but of a less lively Colour, and without any Elevation, or rising above the Skin. It appeared first in the Face, next in the Arms, and descended to the Legs, Thighs and Trunk; disappearing gradually at the End of two or three Days, in the same Order it had observed in breaking out. A few others (I have seen but five Instances of it) suffered the most grievous Symptoms before the Eruption; and threw out the genuine _purpura_, or white miliary Eruption. [30] This seems to have been the same kind of Quinsey, of which Drs. _Huxham_, _Fothergil_, _Cotton_ and others wrote, though under different Appellations. _K._ 13. As soon as these Efflorescences or Eruptions appeared, the Sick generally found themselves better. That, last mentioned, continued four, five, or six Days, and frequently went off by Sweats. Such as had not these Ebullitions, which was the Case of many Adults, were not cured without very plentiful Sweats towards the Termination of the Disease: those which occurred at the Invasion of it being certainly unprofitable, and always hurtful. 14. I have seen some Patients, in whom the Complaint of the Throat disappeared entirely, without either Eruptions or Sweats: but such still remained in very great Inquietude and Anguish, with a quick and small Pulse. I ordered them a sudorific Drink, which being succeeded by the Eruption, or by Sweating, they found themselves sensibly relieved. 15. But whether the Sick had, or had not, these external Rednesses or Eruptions, every one of them parted with their Cuticle or Scarf Skin, which fell off, in large Scales, from the whole Surface of the Body: so great was the Acrimony or Sharpness of that Matter, which was to be discharged through the Skin. 16. A great Number suffered a singular Alteration in their Voice, different from that which occurs in common Quinsies, the Inside of their Nostrils being extremely dry. 17. The Sick recovered with more Difficulty after this, than after the common Quinsies: and if they were negligent or irregular, during their Recovery; particularly, if they exposed themselves too soon to the Cold, a Relapse ensued, or some different Symptoms; such as a Stuffing with Oppression, a Swelling of the Belly, windy Swellings in different Parts; Weakness, Loathings, Ulcerations behind the Ears, and something of a Cough and Hoarseness. 18. I have been sent for to Children, and also to some young Folks, who, at the End of several Weeks, had been taken with a general Inflammation of the whole Body, attended with great Oppression, and a considerable Abatement of their Urine, which was also high-coloured and turbid, or without Separation. They seemed also in a very singular State of Indifference, or Disregard, with Respect to any Object, or Circumstance. I recovered every one of them entirely by Blisters, and the Powder Nº. 25. The first Operation of this Medicine was to vomit them: to this succeeded a Discharge by Urine, and at last very plentiful Sweating, which compleated the Cure. Two Patients only, of a bad Constitution, who were a little ricketty, and disposed to glandular Scirrhosity or Knottiness, relapsed and died, after being recovered of the Disease itself for some Days. § 118. I have bled some adult Persons, and made Use of the cooling Regimen, as long as there was an evident Inflammation: it was necessary after this to unload the first Passages; and at last to excite moderate Sweats. The same Powders Nº. 25 have often effected both these Discharges, and with entire Success. In other Cases I have made Use of Ipecacuanha, as directed Nº. 35. In some Subjects there did not appear any inflammatory Symptom; and the Distemper resulted solely from a Load of putrid Matter in the first Passages. Some Patients also discharged Worms. In such Cases I never bled; but the Vomit had an excellent Effect, at the very Onset of the Disease; it produced a perceivable Abatement of all the Symptoms; Sweating ensued very kindly and naturally, and the Patient recovered entirely a few Hours after. § 119. There were some Places, in which no Symptom or Character of Inflammation appeared; and in which it was necessary to omit Bleeding, which was attended with bad Consequences. I never directed Infants to be bled. After opening the first Passages, Blisters and diluting Drinks proved their only Remedies. A simple Infusion of Elder Flowers, and those of the Lime Tree, has done great Service to those who drank plentifully of it. § 120. I am sensible that in many Villages a great Number of Persons have died, with a prodigious Inflation or Swelling of the Neck. Some have also died in the City, and among others a young Woman of twenty Years of Age, who had taken nothing but hot sweating Medicines and red Wine, and died the fourth Day, with violent Suffocations, and a large Discharge of Blood from the Nose. Of the great Number I have seen in Person, only two died. One was a little Girl of ten Months old. She had an Efflorescence which very suddenly disappeared: at this Time I was called in; but the Humour had retreated to the Breast, and rendered her Death inevitable. The other was a strong Youth from sixteen to seventeen Years old, whose sudden Attack from the Disease manifested, from the very Beginning, a violent Degree of it. Nevertheless, the Symptoms subsiding, and the Fever nearly terminating, the Sweats which approached would probably have saved him. But he would not suffer them to have their Course, continually stripping himself quite naked. The Inflammation was immediately repelled upon the Lungs, and destroyed him within the Space of thirty Hours. I never saw a Person die with so very dry a Skin. The Vomit affected him very little upwards, and brought on a purging. His own bad Conduct seems to have been the Occasion of his Death; and may this serve as one Example of it. § 121. I chose to expatiate on this Disease, as it may happen to reach other Places, where it may be useful to have been apprized of its Marks, and of its Treatment, which agrees as much with that of putrid Fevers, of which I shall speak hereafter, as with that of the inflammatory Diseases I have already considered: since in some Subjects the Complaint of the Throat has evidently been a Symptom of a putrid Fever, rather than of the chiefly apparent Disease, a Quinsey. [31] § 122. Disorders of the Throat are, with Respect to particular Persons, an habitual Disease returning every Year, and sometimes oftner than once a Year. They may be prevented by the same Means, which I have directed for the Preservation from habitual Pleurisies § 100; and by defending the Head and the Neck from the Cold; especially after being heated by Hunting, or any violent Exercise, or even by singing long and loud, which may be considered as an extraordinary Exercise of some of the Parts affected in this Disease. [31] I reserve some other interesting Reflections on this Disease, for the second Edition of my Treatise on Fevers; and the Editor at _Paris_ has very well observed, that it has some Relation to the gangrenous sore Throat, which has been epidemical these twenty Years past, in many Parts of _Europe_.----This Note is from Dr. _Tissot_ himself. __Chapter VII.__ _Of Colds._ __Sect.__ 123. There are many erroneous Prejudices, with Regard to Colds, all of which may be attended with pernicious Consequences. The first is, that a Cold is never dangerous; an Error which daily destroys the Lives of many. I have already complained of it for many Years past; and I have since beheld a Multitude of such Examples of it, as have but too sufficiently warranted my Complaints. No Person however, it is certain, dies merely of a Cold, as long as it is nothing but a Cold simply; but when, from Inattention and Neglect, it is thrown upon, and occasions Distempers of the Breast, it may, and often does, prove mortal. _Colds destroy more than Plagues_, was the Answer of a very sagacious and experienced Physician to one of his Friends, who, being asked, how he was in Health, replied, Very well, I have nothing but a Cold. A second erroneous Prejudice is, that Colds require no Means, no Medicines, and that they last the longer for being nursed, or tampered with. The last Article may be true indeed, with Respect to the Method, in which the Person affected with them treats them; but the Principle itself is false. Colds, like other Disorders, have their proper Remedies; and are removed with more or less Facility, as they are conducted better or worse. § 124. A third Mistake is, that they are not only considered as not dangerous, but are even supposed wholesome too. Doubtless a Man had better have a Cold than a more grievous Disease; though it must be still better to have neither of them. The most that can reasonably be said and admitted on this Point, is, that when a checked, or an obstructed Perspiration becomes the Cause of a Distemper, it is fortunate that it produces rather a Cold, than any very dreadful Disease, which it frequently does: though it were to be wished, that neither the Cause, nor its Effect existed. A Cold constantly produces some Disorder or Defect in the Functions of some Part or Parts of the Body, and thus becomes the Cause of a Disease. It is indeed a real Disorder itself, and which, when in a violent Degree, makes a very perceivable Assault upon our whole Machine. Colds, with their Defluxions, considerably weaken the Breast, and sooner or later considerably impair the Health. Persons subject to frequent Colds are never robust or strong; they often sink into languid Disorders; and a frequent Aptitude to take Cold is a Proof, that their Perspiration may be easily checked and restrained; whence the Lungs become oppressed and obstructed, which must always be attended with considerable Danger. § 125. We may be convinced of the Weakness and Fallacy of these Prejudices, by considering attentively the Nature of Colds; which are nothing else than the very Diseases already described in the three preceding Chapters, though in their greatest Degree only. A Cold in Truth is almost constantly an inflammatory Disease; a light Inflammation of the Lungs, or of the Throat; of the Membrane or very thin Skin, which lines the Nostrills, and the Inside of certain Cavities in the Bones of the Cheeks and Forehead. These Cavities communicate with the Nose, in such a Manner, that when one Part of this Membrane is affected with an Inflammation, it is easily communicated to the other Parts. § 126. It is scarcely necessary to describe the Symptoms of a Cold, and it may be sufficient to remark, 1. That their chief Cause is the same with that, which most commonly produces the Diseases already treated of, that is, an obstructed Perspiration, and a Blood somewhat inflamed. 2. That whenever these Diseases affect great Numbers, many Colds prevail at the same Time. 3. That the Symptoms which manifest a violent Cold, greatly resemble those which precede or usher in these Diseases. People are rarely attacked by great Colds, without a shivering and Fever; which last sometimes continues for many Days. There is a Cough, a dry Cough, for some Time; after which some Expectoration ensues; which allays the Cough, and lightens the Oppression; at which Time the Cold may be said to be maturated, or ripe. There are pretty often slight Stitches, but unfixed or flying about, with a little Complaint of the Throat. When the Nostrills happen to be the Seat of the Disorder, which is then very improperly termed a Cold of the Brain, it is often attended with a vehement Head-ach; which sometimes depends on an Irritation of the Membrane, that lines the Cavities in the Bone of the Forehead, or the maxillary Sinusses, that is, the Cavities in the Jaws: At first the Running from the Nose is very clear; thin and sharp; afterwards, in Proportion to the Abatement of the Inflammation, it becomes thicker; and the Consistence and Colour of it resemble those of what others cough up. The Smell, the Taste and the Appetite are commonly impaired by it. § 127. Colds seem to be of no certain Duration or Continuance. Those of the Head or Brain generally last but a few Days; of the Breast longer. Some Colds nevertheless terminate in four or five Days. If they extend beyond this Term they prove really hurtful. 1. Because the Violence of the Cough disorders the whole Machine; and particularly, by forcing up the Blood to the Head. 2. By depriving the Person afflicted of his usual Sleep, which is almost constantly diminished by it. 3. By impairing the Appetite, and confusing the Digestion, which is unavoidably lessened by it. 4. By weakening the very Lungs, by the continual Agitations from Coughing; whence all the Humours being gradually determined towards them, as the weakest Part, a continual Cough subsists. Hence also they become overcharged with Humours, which grow viscid there; the Respiration is overloaded and oppressed; a slow Fever appears; Nutrition almost ceases; the Patient becomes very weak; sinks into a Wasting; an obstinate Wakefulness and Anguish, and often dies in a short Time. 5. By Reason that the Fever, which almost constantly accompanies great Cold, concurs to wear the body down. § 128. Wherefore, since a Cold is a Disease of the same kind with Quinsies, Peripneumonies and Inflammations of the Breast, it ought to be treated in the same Manner. If it is a violent one, Blood should be taken from the Arm, which may considerably shorten its Duration: and this becomes most essentially necessary, whenever the Patient is of a sanguineous ruddy Complexion, abounds with Blood, and has a strong Cough, and great Head-ach. The Drinks Nº. 1, 2, 3, 4, should be very plentifully used. It is advantagious to bathe the Feet in warm Water every Night at going to Bed. [32] In a Word, if the Patient is put into a Regimen, the Cure is very speedily effected. [32] It frequently happens, that the Bathings alone remove the Head-ach, and the Cough too, by relaxing the lower Parts, and the entire Surface of the Body. If the Patient is costive, he should receive Glysters of warm Water, in which some Bran has been boiled, with the Addition of a little common Soap or Butter. _E. L._ § 129. The Disorder indeed, however, is often so very slight, that it may be thought to require very little, if any, medical Treatment, and may be easily cured without Physick, by abstaining from Flesh, Eggs, Broth, and Wine; from all Food that is sharp, fat and heavy; and by dieting upon Bread, Pulse, Fruit, and Water; particularly by eating little or no Supper; and drinking, if thirsty, a simple Ptisan of Barley, or an Infusion of Elder Flowers, with the Addition of a third or fourth Part of Milk. Bathing the Feet, and the Powder Nº. 20 contribute to dispose the Patient to sleep. Five Tea-Cups of an Infusion of the Red, or wild Poppy Leaves may also be ventured on safely. § 130. When the Fever, Heat and Inflammation wholly disappear; when the Patient has kept to his Regimen for some Days, and his Blood is well diluted, if the Cough and Want of Sleep still continues, he may take in the Evening a Dose of Storax [33] Pill, or of Venice Treacle with Elder Flower Tea, after bathing his Feet. These Remedies by stilling the Cough, and restoring Perspiration, frequently cure the Cold in the Space of one Night. I confess at the same Time, I have seen bad Consequences from such Opiates, when given too early in the Complaint. It is also necessary, when they are given, that the Patient should have supt but very moderately, and that his Supper should be digested. [33] Under these Circumstances of a tickling Cough from a Cold, without a Fever, and with very little Inflammation, I have known great and very frequent Success, from a Dose of _Elixir paregoricum_, taken at Bed-time, after a very light thin Supper. If the Patient be sanguine, strong and costive, Bleeding in a suitable Quantity, and a gently opening Potion, or purging Glyster, may be prudently premised to it. Grown Persons may take from 30 to 80, or even 100 Drops of it, in Barley Water, or any other pectoral Drink; and Children in the Chincough from five to twenty Drops; half an Ounce of it by Measure containing about one Grain of Opium, which is the Quantity contained in less than quite six Grains of the Storax Pill; this last being a very available pectoral Opiate too in Coughs from a Distillation, in more adult Bodies, who may also prefer a Medicine in that small Size, and Form. _K._ § 131. An immense Number of Remedies are cried up for the Cure of Colds; such as Ptisans of Apples or Pippins, of Liquorice, of dry Raisins, of Figs, of Borage, of Ground-Ivy, of _Veronica_ or Speedwell, of Hysop, of Nettles, _&c. &c._ I have no Design to depreciate them; as all of them may possibly be useful: But unfortunately, those who have seen any particular one of them succeed in one Case, readily conclude it to be the most excellent of them all; which is a dangerous Error, because no one Case is a sufficient Foundation to decide upon: which besides none are qualified to do, who have not often seen a great Number of such Cases; and who do not so attentively observe the Effects of different Medicines, as to determine on those which most frequently agree with the Disorder; and which, in my Judgment, are those I have just enumerated. I have known a Tea or Infusion of Cherry Stalks, which is not a disagreeable Drink, to cure a very inveterate Cold. § 132. In Colds of the Head or Brain, the Steam of warm Water alone, or that in which Elder Flowers, or some other mild aromatic Herbs, have been boiled, commonly afford a pretty speedy Relief. These are also serviceable in Colds fallen on the Breast. See § 55. It has been a Practice, though of no very long standing, to give the Fat of a Whale in these Cases; but this is a very crude indigestible kind of Fat, and greasy oily Medicines seldom agree with Colds. Besides, this Whales' Fat is very disagreeable and rancid, that is rank; so that it were better to forbear using it: I have sometimes seen ill Effects from it, and rarely any good ones. [34] [34] This seems but too applicable to the very popular Use of _Spermaceti_, &c. in such Cases, which can only grease the Passage to the Stomach; must impair its digestive Faculty, and cannot operate against the Cause of a Cold; though that Cure of it, which is effected by the Oeconomy of Nature in due Time, is often ascribed to such Medicines, as may rather have retarded it. _K._ § 133. Such Persons as abate nothing of the usual Quantity of their Food, when seized with a Cold, and who swallow down large Quantities of hot Water, ruin their Health. Their Digestion ceases; the Cough begins to affect the Stomach, without ceasing to afflict the Breast; and they incur a Chance of sinking into the Condition described § 127, Nº. 4. Burnt Brandy and spiced Wine are very pernicious in the Beginning of Colds, and the Omission of them must be a very prudent Omission. If any good Effects have ever been known to attend the Use of them, it has been towards the going off of the Cold; when the Disorder maintained its Ground, solely from the Weakness of the Patient. Whenever this is the Case, there is not the least Room for farther Relaxation; but the Powders Nº. 14, should be taken every Day in a little Wine; and should the Humours seem likely to be thrown upon the Lungs, Blisters ought to be applied to the fleshy Part of the Legs. § 134. Drams, or _Liqueurs_, as they are called in _French_, agree so very little in this last State, that frequently a very small Quantity of them revives a Cold that was just expiring. There really are some Persons who never drink them without taking Cold, which is not to be wondered at, as they occasion a light Inflammation in the Breast, which is equivalent to a Cold or Distillation. Nevertheless, People in this Disorder should not expose themselves to violent cold Weather, if there is a Possibility of avoiding it: though they should equally guard too against excessive Heat. Those, who inclose themselves in very hot Rooms, never get quite cured; and how is it possible they should be cured in such a Situation? Such Rooms, abstracted from the Danger of coming out of them, produce Colds in the same Manner that Drams do, by producing a light inflammation in the Breast. § 135. Persons subject to frequent Colds, which Habits are sometimes termed _fluxionary_, or liable to Distillations, imagine, they ought to keep themselves very hot. This is an Error which thoroughly destroys their Health. Such a Disposition to take Cold arises from two Causes; either because their Perspiration is easily impaired; or sometimes from the Weakness of the Stomach or the Lungs, which require particular Remedies. When the Complaint arises from the Perspiration's being easily disturbed and lessened, the hotter they keep themselves, the more they sweat, and increase their Complaint the more. This incessantly warm Air lets down and weakens the whole Machine, and more particularly the Lungs; where the Humours finding less Resistance, are continually derived, and are accumulated there. The Skin, being constantly bathed in a small Sweat, becomes relaxed, soft, and incapable of compleating its Functions: from which Failure the slightest Cause produces a total Obstruction of Perspiration; and a Multitude of languid Disorders ensue. These Patients thus circumstanced, redouble their Precautions against the Cold, or even the Coolness of the Air, while their utmost Cautions are but so many effectual Means to lower their Health; and this the more certainly, as their Dread of the free Air necessarily subjects them to a sedentary Life, which increases all their Symptoms; while the hot Drinks they indulge in, compleat their Severity. There is but one Method to cure People thus situated; that is, by accustoming them gradually to the Air; to keep them out of hot Chambers; to lessen their Cloathing by Degrees; to make them sleep cool; and to let them eat or drink nothing but what is cold, Ice itself being wholesome in their Drink: to make them use much Exercise; and finally, if the Disorder be inveterate, to give them for a considerable Time the Powder Nº. 14, and make them use the cold Bath. This Method succeeds equally too with those, in whom the Disease originally depended on a Weakness of the Stomach, or of the Lungs: and in fact, at the End of a certain Period, these three Causes are always combined. Some Persons who have been subject, for many Years, to catch Colds throughout the Winter; and who, during that Season, never went out, and drank every thing warm, have been evidently the better, during the Winter of 1761, and 1762, for the Direction I have given here. They now walk out every Day; drink their Liquids cold; and by this Means entirely escape Colds, and enjoy perfect Health. § 136. It is more customary indeed in Town, than in the Country, to have different Troches, and Compositions in the Mouth. I am not for excluding this Habit; though I think nothing is so efficacious as Juice of Liquorice; and provided a sufficient Dose be taken, it affords certain Relief. I have taken an Ounce and a half in one Day, and have felt the good Consequences of it very remarkably. __Chapter VIII.__ _Of Diseases of the Teeth._ __Sect.__ 137. The Diseases of the Teeth, which are sometimes so tedious and so violent, as to cause obstinate Wakefulness, a considerable Degree of Fever, Raving, Inflammations, Abscesses, Rottenness of the Bones, Convulsions and Faintings, depend on three principal Causes. 1. On a _Caries_ or Rottenness of the Teeth. 2. On an Inflammation of the Nerves of the Teeth, or of the Membrane which invests and covers them; and which affects the Membrane of the Gums. 3. A cold Humour or Defluxion that is determined to the Teeth, and to their Nerves and Membrane. § 138. In the first of these Cases, the _Caries_ having eat down to, and exposed the naked Nerve, the Air, Food and Drink irritate, or, as it were sting it; and this irritation is attended with Pain more or less violent. Every thing that increases the Motion or Action of the affected Part, as Exercise, Heat or Food, will be attended with the same Consequence. When the Tooth is greatly decayed, there is no other Cure besides that by extracting it, without which the Pain continues; the Breath becomes very offensive; the Gum is eat down; the other Teeth, and sometimes even the Jaw-bone, are infected with the Rottenness: besides, that it prevents the Use of the other Teeth, which are infected with a kind of tartarous Matter, and decay. But when the Disorder is less considerable, the Progress of it may sometimes be restrained, by burning the Tooth with a hot Iron, or by filling it with Lead, if it is fitted to receive and to retain it. Different corroding Liquids are sometimes used on these Occasions, _Aqua fortis_ itself, and Spirit of Vitriol: but such Applications are highly dangerous, and ought to be excluded. When the Patients, from Dread, reject the Operations just mentioned, a little Oyl of Cloves may be applied, by introducing a small Pellet of Cotton, dipt in it, to the rotten hollow Tooth; which often affords considerable Ease, and Respite. Some make use of a Tincture of Opium, or Laudanum, after the same Manner; and indeed these two Medicines may be used together in equal Quantities. I have often succeeded with _Hoffman's_ mineral anodyne Liquor; which seemed indeed, for a few Moments, to increase the Pain; but Ease generally ensues after spitting a little Time. A Gargarism made of the Herb _Argentina_; that is Silver-weed or wild Tansey, in Water, frequently appeases the Pain that results from a _Caries_ of the Teeth: and in such Cases many People have found themselves at Ease, under a constant Use of it. It certainly is an Application that cannot hurt, and is even beneficial to the Gums. Others have been relieved by rubbing their Faces over with Honey. § 139. The second Cause is the Inflammation of the Nerve within the Substance, or of the Membrane on the Outside, of the Tooth. This is discovered by the Patient's Temperament, Age and Manner of living. They who are young, sanguine, who heat themselves much, whether by Labour, by their Food, their Drink, by sitting up late, or by any other Excess: they who have been accustomed to any Discharges or Eruptions of Blood, whether natural or artificial, and who cease to have them as usual, are much exposed to the Tooth-ach, from this Cause. This Pain, or rather Torment, if in an acute Degree, commonly happens very suddenly, and often after some heating Cause. The Pulse is strong and full; the Countenance considerably red; the Mouth extremely hot: there is often a pretty high Fever, and a violent Head-ach. The Gums, or some Part of them, become inflamed, swelled, and sometimes an Abscess appears. At other times the Humours throw themselves upon the more external Parts; the Cheek swells, and the Pain abates. When the Cheek swells, but without any Diminution of the Pain, it then becomes an Augmentation, but no essential Change, of the Disorder. § 140. In this Species of the Disease, we must have Recourse to the general Method of treating inflammatory Disorders, and direct Bleeding, which often produces immediate Ease, if performed early. After Bleeding, the Patient should gargle with Barley Water, or Milk and Water; and apply an emollient Cataplasm to the Cheek. If an Abscess or little Imposthume appears, the Suppuration or ripening of it is to be promoted, by holding continually in the Mouth some hot Milk, or Figs boiled in some Milk: and as soon as ever it seems ripe, it should be opened, which may be done easily, and without any Pain. The Disorder, when depending on this Cause, is sometimes not so violent, but of a longer Duration, and returns whenever the Patient heats himself; when he goes to Bed; when he eats any heating Food, or Drink, Wine or Coffee. In this Case he should be bled, without which his other Medicines will have little Effect; and he should bathe his Feet in warm Water for some Evenings successively, taking one Dose of the Powder Nº. 20. Entire Abstinence from Wine and Meat, especially at Night, has cured several Persons of inveterate and obstinate Maladies of the Teeth. In this Species of Tooth-ach, all hot Remedies are pernicious; and it often happens that Opium, Venice Treacle, and Storax Pills, are so far from producing the Relief expected from them, that they have aggravated the Pain. § 141. When the Disease arises from a cold Distillation, or Humour, tending to these Parts, it is commonly (though equally painful) attended with less violent Symptoms. The Pulse is neither strong, full nor quick; the Mouth is less heated, and less swelled. In such Cases, the afflicted should be purged with the Powder Nº. 21, which has sometimes perfectly cured very obstinate Complaints of this Sort. After purging they should make Use of the Diet Drink of the Woods Nº. 22. This has cured Tooth-achs, which have baffled other Attempts for many Years; but it must be added, this Drink would be hurtful in the Disease from a different Cause. Blisters to the Nape of the Neck, or [35] elsewhere, it matters not greatly where, have often extraordinary good Effects, by diverting the Humour, and restoring a compleat Perspiration. In short in this Species, we may employ, not only with Safety, but with Success (especially after due purging) Pills of Storax, Opium and Venice Treacle. Acrid sharp Remedies, such as hard spun [35] Tobacco, Root of Pellitory of _Spain_, &c. by exciting much Spitting, discharge part of the Humour which causes the Disease, and hence diminish the Pain. The Smoke of Tobacco also succeeds now and then in this Disorder, whether this happens from the Discharge of the Rheum or Spittle it occasions; or whether it is owing to any anodyne Efficacy of this Plant, in which it resembles Opium. [35] A small Blister behind the Ear of the affected Side, or both Ears, has very often removed the Pain, when from a Defluxion. It is pretty common for the Subjects of this Disease to be very costive, during the Exacerbations of it, which I have sometimes experienced to be pretty regularly and severely quotidian, for a Week or two. The Custom of smoking Tobacco very often, which the Violence of this Pain has sometimes introduced, often disposes to a Blackened and premature Decay of the Teeth, to which the Chewers of it are less obnoxious: and this Difference may result from some particles of its chemical Oil rising by Fumigation, and being retained in the Teeth, which Particles are not extracted by Mastication. But with Regard to the habitual Use of this very acrid and internally violent Herb, for, but chiefly after, this Disease, it should be considered well, whether in some Constitutions it may not pave the Way to a more dangerous one, than it was introduced to remove. _K._ § 142. As this last Cause is often the Consequence of a Weakness in the Stomach, it daily happens that we see some People, whose Disorder from this Cause is augmented, in Proportion as they indulge in a cooling, refreshing Way of living. The Increase of the Disorder disposes them to increase the Dose of what they mistake for its Remedy, in Proportion to which their Pain only increases. There is a Necessity that such Persons should alter this Method; and make use of such Medicines as are proper to strengthen the Stomach, and to restore Perspiration. The Powder Nº. 14. has often produced the best Consequences, when I have ordered it in these Cases; and it never fails to dissipate the Tooth-ach very speedily, which returns periodically at stated Days and Hours. I have also cured some Persons who never drank Wine, by advising them to the Use of it. § 143. But besides the Diseases of the Teeth, that are owing to these three principal Causes, which are the most common ones; there are some very tedious and most tormenting Disorders of them, that are occasioned by a general Acrimony, or great Sharpness, of the Mass of Blood, and which are never cured by any other Medicines but such, as are proper to correct that Acrimony. When it is of a scorbutic Nature, the wild Horse-radish (Pepperwort) Water Cresses, Brooklime, Sorrel, and Wood-sorrell correct and cure it. If it is of a different Nature, it requires different Remedies. But very particular Details do not come within the Plan of this Work. As the Malady is of the chronical or tedious kind, it allows Time to consider and consult more particularly about it. The Gout and the Rheumatism are sometimes transferred to the Teeth, and give Rise to the most excruciating Pains; which must be treated like the Diseases from which they arise. § 144. From what has been said on this Disorder, the Reader will discern, in what that imaginary Oddness may consist, which has been ascribed to it, from the same Application's relieving one Person in it, and not affording the least Relief to another. Now the plain Reason of this is, that these Applications are always directed, without an exact Knowledge of the particular Cause of the Disease, in different Subjects and Circumstances; whence the Pain from a rotten Tooth, is treated like that from an Inflammation; that from an Inflammation, like the Pain from a cold Humour or Fluxion; and this last like a Pain caused by a scorbutic Acrimony: so that the Disappointment is not in the least surprizing. Perhaps Physicians themselves do not always attend distinctly enough to the Nature of each particular Disorder: and even when they do, they content themselves with directing some of the less potent Medicines, which may be inadequate to accomplish the necessary Effect. If the Distemper truly be of an inflammatory Disposition, Bleeding is indispensible to the Cure. It happens in Fact, with Regard to the Diseases of the Teeth, as well as to all other Diseases, that they arise from different Causes; and if these Causes are not opposed by Medicines suited to them, the Disease, far from being cured, is aggravated. I have cured violent Tooth-achs, of the lower Jaw, by applying a Plaister of Meal, the White of an Egg, Brandy and Mastich, at the Corner of that Jaw, over the Spot where the Pulsation of the Artery may be perceived: and I have also mitigated the most excruciating Pains of the Head, by applying the same Plaister upon the temporal Artery. __Chapter IX.__ _Of the Apoplexy._ __Sect.__ 145. Every Person has some Idea of the Disease termed an Apoplexy, which is a sudden Privation or Loss of all Sense, and of all voluntary Motion; the Pulse at the same Time being kept up, but Respiration or Breathing, being oppressed. I shall treat of this Disease only in a brief Manner, as it is not common in our Country Villages; and as I have expatiated on it in a different Manner in a Letter to Dr. _Haller_, published in 1761. § 146. This Disease is generally distinguished into two Kinds, the sanguineous and serous Apoplexy. Each of them results from an Overfulness of the Blood Vessels of the Brain, which presses upon, and prevents or impairs the Functions of the Nerves. The whole Difference between these two Species consists in this, that the sanguineous Apoplexy prevails among strong robust Persons, who have a rich, heavy, thick and inflammable Blood, and that in a large Quantity; in which Circumstance it becomes a genuine inflammatory Distemper. The serous, or humoral Apoplexy invades Persons of a less robust Constitution; whose Blood is more dilute or watery; and rather viscid, or lightly gelatinous, than heavy or rich; whole Vessels are in a more relaxed State; and who abound more in other Humours than in red Blood. § 147. When the first kind of this Disease exists in its most violent Degree, it is then sometimes termed, an apoplectic Stroke, or thundering Apoplexy, which kills in a Moment or instantaneously, and admits of no Remedies. When the Assault is less violent, and we find the Patient with a strong, full and raised Pulse, his Visage red and bloated, and his Neck swelled up; with an oppressed and loud hoarse Respiration; being sensible of nothing, and capable of no other Motions, except some Efforts to vomit, the Case is not always equally desperate. We must therefore immediately, 1. Entirely uncover the Patient's Head, covering the rest of his Body but very lightly; procure him instantly very fresh free Air, and leave his Neck quite unbound and open. 2. His Head should be placed as high as may be, with his Feet hanging down. 3. He must lose from twelve to fifteen Ounces of Blood, from a free open Orifice in the Arm: the Strength or Violence with which the Blood sallies out, should determine the Surgeon to take a few Ounces more or less. It should be repeated to the third or fourth Time, within the Space of three or four Hours; if the Symptoms seem to require it, either in the Arm, or in the Foot. 4. A Glyster should be given of a Decoction of the first emollient opening Herbs that can be got, with four Spoonfuls of Oil, one Spoonful of Salt: and this should be repeated every three Hours. 5. If it is possible, he should be made to swallow Water plentifully, in each Pot of which three Drams of Nitre are to be dissolved. 6. As soon as the Height and Violence of the Pulse abates; when his Breathing becomes less oppressed and difficult, and his Countenance less inflamed, he should take the Decoction Nº. 23; or, if it cannot be got ready in Time, he should take three Quarters of an Ounce of Cream of Tartar, and drink Whey plentifully after it. This Medicine succeeded extremely well with me in a Case, where I could not readily procure any other. 7. He should avoid all strong Liquor, Wine, distilled Spirit, whether inwardly or by outward Application, and should even be prevented from [36] smelling them. [36] I have been very authentically assured of the Death of a hale Man, which happened in the very Act of pouring out a large Quantity of distilled Spirits, by Gallons or Bucketfulls, from one Vessel into another. _K._ 8. The Patient should be stirred, moved, or even touched, as little as it is possible: in a Word every Thing must be avoided that can give him the least Agitation. This Advice, I am sensible, is directly contrary to the common Practice; notwithstanding which it is founded in Reason, approved by Experience, and absolutely necessary. In Fact, the whole Evil results from the Blood being forced up with too much Force, and in too great a Quantity, to the Brain; which being thence in a State of Compression, prevents every Movement and every Influence of the Nerves. In Order, therefore, to re-establish these Movements, the Brain must be unloaded, by diminishing the Force of the Blood. But strong Liquors, Wines, Spirits, volatile Salts, all Agitation and Frictions augment it, and by that very Means increase the Load, the Embarrassment of the Brain, and thus heighten the Disease itself. On the contrary, every Thing that calms the Circulation, contributes to recall Sensation and voluntary Motion the sooner. 9. Strong Ligatures should be made about the Thighs under the Ham: By this Means the Blood is prevented in its Ascent from the Legs, and less is carried up to the Head. If the Patient seems gradually, and in Proportion as he takes proper Medicines, to advance into a less violent State, there may be some Hopes. But if he rather grows worse after his earliest Evacuations, the Case is desperate. § 148. When Nature and Art effect his Recovery, his Senses return: though there frequently remains a little _Delirium_ or Wandering for some Time; and almost always a paralytic Defect, more or less, of the Tongue, the Arm, the Leg, and the Muscles of the same Side of the Face. This Palsy sometimes goes off gradually, by the Help of cooling Purges from Time to Time, and a Diet that is but very moderately and lightly nourishing. All hot Medicines are extremely hurtful in this Case, and may pave the Way to a repeated Attack. A Vomit might be even fatal, and has been more than once so. It should be absolutely forbidden; nor should we even promote, by Draughts of warm Water, the Efforts of the Patient to vomit. They do not any ways depend on any Humour or Mass in the Stomach; but on the Oppression and Embarrassment of the Brain: and the more considerable such Efforts are, the more such Oppression is increased: by Reason that as long as they continue, the Blood cannot return from the Head, by which Means the Brain remains overcharged. § 149. The other Species of Apoplexy is attended with the like Symptoms, excepting the Pulse not being so high nor strong; the Countenance being also less red, sometimes even pale; the Breathing seems less oppressed; and sometimes the Sick have a greater Facility to vomit, and discharge more upwards. As this Kind of the Disease attacks Persons who abound less in Blood; who are less strong, and less heated or inflamed, Bleeding is not often at all necessary: at least the Repetition of it is scarcely ever so: and should the Pulse have but a small Fulness, and not the least unnatural Hardness, Bleeding might even be pernicious. 1. The Patient however should be placed as was directed in the former Mode of this Disease; though it seems not equally necessary here. 2. He should receive a Glyster, but without Oil, with double the Quantity of Salt, and a Bit of Soap of the Size of a small Egg; or with four or five Sprigs of Hedge Hyssop. It may be repeated twice a Day. 3. He should be purged with the Powder Nº. 4. [37] [37] Vomits which are so pernicious in the sanguineous Apoplexy, where the Patient's Countenance and Eyes are inflamed; and which are also dangerous or useless, when a Person has been very moderate in his Meals, or is weakened by Age or other Circumstances, and whole Stomach is far from being overloaded with Aliment, are nevertheless very proper for gross Feeders, who are accustomed to exceed at Table, who have Indigestions, and have a Mass of viscid glairy Humours in their Stomachs; more especially, if such a one has a little while before indulged himself excessively, whence he has vomited without any other evident Cause, or at least had very Strong _Nauseas_, or Loathings. In brief, Vomits are the true Specific for Apoplexies, occasioned by any narcotic or stupifying Poisons, the pernicious Effects of which cease, the Moment the Persons so poisoned vomit them up. An attentive Consideration of what has occurred to the Patient before his Seizure; his small natural Propensity to this Disease, and great and incessant Loathings, render it manifest, whether it has been caused by such Poisons, or such poisonous Excesses. In these two Last Cases a double Dose of Tartar emetic should be dissolved in a Goblet or Cup of Water, of which the Patient should immediately take a large Spoonful; which should be repeated every Quarter of an Hour, till it operates. _E. L._ 4. His common Drink may be a Strong Infusion of Leaves of Balm. 5. The Purge should be repeated the third Day. 6. Blisters should immediately be applied to the fleshy Part of the Legs, or between the Shoulder Blades. [38] [38] These Blisters may be preceded by Cupping with Scarification on the Nape of the Neck. This Remedy, often used by the ancient Physicians, but too little practiced in France, is one of the most speedy, and not the least efficacious, Applications in both sanguine and serous Apoplexies. _E. L._ 7. Should Nature seem disposed to relieve herself by Sweatings, it should be encouraged; and I have often known an Infusion of the _Carduus benedictus_, or blessed Thistle, produce this Effect very successfully. If this Method be entered upon, the Sweat ought to be kept up (without stirring if possible) for many Days. It has then sometimes happened, that at the End of nine Days, the Patient has been totally freed from the Palsy, which commonly succeeds this Species of the Apoplexy, just as it does the other. § 150. Persons who have been attacked with either kinds of this Disease are liable to subsequent ones; each of which is more dangerous than that preceding: whence an Endeavour to obviate or prevent such Relapses becomes of the utmost Importance. This is to be effected in each Sort by a very exact, and rather severe Diet, even to diminishing the usual Quantity of the Patient's Food; the most essential Precaution, to be observed by any who have been once assaulted with it, being entirely to leave off Suppers. Indeed those, who have been once attacked with the _first_, the _sanguineous Apoplexies_, should be still more exact, more upon their Guard, than the others. They should deny themselves whatever is rich and juicy, hot or aromatic, sharp, Wine, distilled Liquors and Coffee. They should chiefly confine themselves to Garden-Stuff, Fruits and Acids; such should eat but little Flesh, and only those called white; taking every Week two or three Doses of the Powder Nº. 24, in a Morning fasting, in a Glass of Water. They should be purged twice or thrice a Year with the Draught Nº. 23; use daily Exercise; avoid very hot Rooms, and the violent Heat of the Sun. They should go to Bed betimes, rise early, never lie in Bed above eight Hours: and if it is observed that their Blood increases considerably, and has a Tendency towards the Head, they should be bled without Hesitation: and for some Days restrain themselves entirely to a thin and low Regimen, without taking any solid Food. In these Circumstances warm Bathings are hurtful. In the other, the serous, Apoplexy, instead of purging with Nº. 23, the Patient should take the Purge Nº. 21. § 151. The same Means, that are proper to prevent a Relapse, might also obviate or keep off a primary or first Assault, if employed in Time: for notwithstanding it may happen very suddenly, yet this Disease foreshews itself many Weeks, sometimes many Months, nay even Years beforehand, by Vertigos, Heaviness of the Head; small Defects of the Tongue or Speech; short and momentary Palsies, sometimes of one, sometimes of another, Part: sometimes by Loathings and Reachings to vomit; without supposing any Obstruction or Load in the first Passages, or any other Cause in the Stomach, or the adjoining Parts. There happens also some particular Change in the Looks and Visage not easy to be described: sharp and short Pains about the Region of the Heart; an Abatement of the Strength, without any discernible Cause of it. Besides there are still some other Signs, which signify the Ascent of the Humours too much to the Head, and shew, that the Functions of the Brain are embarrassed. Some Persons are liable to certain Symptoms and Appearances, which arise from the same Cause as an Apoplexy; and which indeed may be considered as very light benign Apoplexies, of which they sustain many Attacks, and yet without any considerable Annoyance of their Health. The Blood, all at once as it were, flushes up to their Heads: they appear heedless or blundering; and have sometimes Disgusts and _Nauseas_, and yet without any Abatement of their Understanding, their Senses, or Motion of any Sort. Tranquillity of Mind and Body, once Bleeding, and a few Glysters usually carry it off soon after its Invasion. The Returns of it may be prevented by the Regimen directed § 150; and especially by a frequent Use of the Powder Nº. 24. At the long Run however, one of these Attacks commonly degenerates into a mortal Apoplexy: though this may be retarded for a very long Time by an exact Regimen, and by avoiding all strong Commotions of the Mind, but especially that of Anger or violent Rage. __Chapter X.__ _Of the violent Influence, or Strokes, of the Sun._ __Sect.__ 152. This Appellation is applied to those Disorders, which arise from too violent an Influence of the Heat of the Sun, immediately upon the Head; and which in one Word may be termed _Insolation_. If we consider that Wood, Stone and Metals, when long exposed to the Sun, become very hot, and that even in temperate Climates, to such a Degree, that they can scarcely be touched without some Sensation of burning, we may easily conceive the Risk a Person undergoes, in having his Head exposed to the same Degree of Heat. The Blood-Vessels grow dry, the Blood itself becomes condensed or thickened, and a real Inflammation is formed, which has proved mortal in a very little Time. It was this Distemper, a Stroke of the Sun, which killed _Manasses_ the Husband of _Judith_. 'For as he was among the Labourers who bound up the Sheafs in the Fields, the Heat struck upon his Head, and he was taken ill; he went to Bed and he died.' The Signs which precede and attend this Disease are, being exposed in a Place where the Sun shines forth with great Force and Ardour; a violent Head-ach, attended with a very hot and extremely dry Skin: the Eyes are also dry and red, being neither able to remain open, nor yet to bear the Light; and sometimes there is a kind of continual and involuntary Motion in the Eyelid; while some Degree of Relief is perceivable from the Application of any cooling Liquor. It often happens that some cannot possibly sleep; and at other times they have a great Drowsiness, but attended with outrageous Wakenings: there is a very strong Fever; a great Faintness, and a total Disrelish and Loathing. Sometimes the Patient is very thirsty, and at other times not at all: and the Skin of his Face often looks as though it were burnt. § 153. People may be affected with the Disease from this Cause, at two different Seasons of the Year; that is, either in the Spring, or during the very raging Heats; but their Events are very different. Country People and Labourers are but little liable to the former. They chiefly affect the Inhabitants of Cities, and delicate Persons, who have used very little Exercise in the Winter, and abound with superfluous Humours. If thus circumstanced they expose themselves to the Sun, as even in the Spring he attains a considerable Force; and, by the Course of Life they have led, their Humours are already much disposed to mount to the Head; while the Coolness of the Soil, especially when it has rained, prevents their Feet from being so easily warmed; the Power of the Sun acts upon their Head like a Blister, attracting a great Quantity of Humours to it. This produces excruciating Pains of the Head, frequently accompanied with quick and violent Shootings, and with Pain in the Eyes; notwithstanding this Degree of the Malady is seldom dangerous. Country People, and even such Inhabitants of Cities and Towns, as have not forbore to exercise themselves in Winter, have no Sort of Dread of these Strokes of the Sun, in the Spring of the Year. Its Summer Strokes are much more vehement and troublesome, and assault Labourers and Travellers, who are for a long Time exposed to the Fervour of it. Then it is that the Disease is aggravated to its highest Pitch, those who are thus struck often dying upon the Spot. In the hot Climates this Cause destroys many in the very Streets, and makes dreadful Havock among Armies on the March, and at Sieges. Some tragical Effects of it, on such Occasions, are seen even in the temperate Countries. After having marched a whole Day in the Sun, a Man shall fall into a Lethargy, and die within some Hours, with the Symptoms of raving Madness. I have seen a Tyler in a very hot Day, complaining to his Comrade of a violent Pain in his Head, which increased every Moment almost; and at the very Instant when he purposed to retire out of the Sun, he sunk down dead, and fell down from the House he was slating. This same Cause produces very often in the Country some most dangerous Phrenzies, which are called there hot or burning Fevers. Every Year furnishes but too many of them. § 154. The Vehemence of the Sun is still more dangerous to those, who venture to sleep exposed to it. Two Mowers who fell asleep on a Haycock, being wakened by some others, immediately on waking, staggered, and pronouncing a few incoherent unmeaning Words, died. When the Violence of Wine and that of the Sun are combined, they kill very suddenly: nor is there a single Year in which Peasants are not found dead on the Highroads; who being drunk endeavoured to lie down in some Corner, where they perished by an Apoplexy, from the Heat of the Sun and of strong Drink. Those of them who escape so speedy and premature a Death, are subject for the Remainder of their Lives, to chronical, or tedious Head-achs; and to suffer some little Disorder and Confusion in their Ideas. I have seen some Cases, when after violent Head-achs of some Days Continuance, the Disease has been transferred to the Eyelids, which continued a long Time red and distended, so that they could not be kept asunder or open. It has also been known, that some Persons have been struck by the Sun into a _Delirium_ or Raving, without a Fever, and without complaining of a Head-ach. Sometimes a _Gutta Serena_ has been its Consequence; and it is very common to see People, whose long Continuance under the strong Light and Influence of the Sun, has made such an Impression upon the Eyes, as presents them with different Bodies flying about in the Air, which distract and confuse their Sight. A Man of forty two Years of Age, having been exposed for several Hours to the violent Heat of the Sun, with a very small Cap or Bonnet; and having past the following Night in the open Air, was attacked the next Day with a most severe Head-ach, a burning Fever, Reachings to vomit, great Anguish, and red and sparkling Eyes. Notwithstanding the best Assistance of several Physicians, he became phrenitic on the fifth Day, and died on the ninth. Suppurated Matter was discharged from his Mouth, one of his Nostrils, and his right Ear, a few Hours before his Death; upon Dissection a small Abscess was found within the Skull; and the whole Brain, as well as all the Membranes inclosing it, were entirely corrupted. § 155. In very young Children, who are not, or never should be, exposed for any long Time to such excessive Heat (and whom a slight Cause will often affect) this Malady discovers itself by a heavy deep Drowsiness, which lasts for several Days; also by incessant Ravings mingled with Rage and Terror, much the same as when they are affected with violent Fear: and sometimes by convulsive Twitchings; by Head-achs which returned at certain Periods, and continual Vomitings. I have seen Children, who, after a Stroke of the Sun, have been harrassed a long Time with a little Cough. § 156. Old Men who often expose themselves imprudently to the Sun, are little apprized of all the Danger they incur by it. A certain Person, who purposely sunned himself for a considerable Time, in the clear Day of an intermitting tertian Fever, underwent the Assault of an Apoplexy, which carried him off the following Day. And even when the Disease may not be so speedy and violent, yet this Custom (of sunning in hot Weather) certainly disposes to an Apoplexy, and to Disorders of the Head. One of the slightest Effects of much solar Heat upon the Head is, to cause a Defluxion from the Brain, a Swelling of the Glands of the Neck, and a Dryness of the Eyes, which sometimes continues for a considerable Term after it. § 157. The effect of too much culinary, or common Fire, is of the same Quality with that of the Sun. A Man who fell asleep with his Head directly opposite, and probably, very near to the Fire, went off in an Apoplexy, during his Nap. § 158. The Action of too violent a Sun is not only pernicious, when it falls upon the Head; but it is also hurtful to other Parts; and those who continue long exposed to it, though their Heads should not be affected, experience violent Pains, a disagreeable Sensation of Heat, and a considerable Stiffness in the Parts that have been, in some Manner, parched by it; as in the Legs, the Knees, the Thighs, Reins and Arms; and sometimes they prove feverish. § 159. In contemplating the Case of a Patient, _Sun-struck_, as we may term it, we must endeavour to distinguish, whether there may not be also some other joint Causes concurring to the Effect. A Traveller, a labouring Man, is often as much affected by the Fatigue of his Journey, or of his Labour, as he is by the Influence of solar Heat. § 160. It is necessary to set about the Cure of this Disease, as soon as ever we are satisfied of its Existence: for such as might have been easily preserved by an early Application, are considerably endangered by a Neglect of it. The Method of treating this is very much the same, with that of the inflammatory Diseases already mentioned; that is, by Bleeding, and cooling Medicines of various Kinds in their Drinks, by Bathings, and by Glysters. And 1. If the Disease be very high and urgent, a large Quantity of Blood should be taken away, and occasionally repeated. _Lewis_ the XIV. was bled nine Times to prevent the Fatality of a Stroke of the Sun, which he received in Hunting in 1658. 2. After Bleeding, the Patient's Legs should be plunged into warm Water. This is one of the Applications that affords the most speedy Relief; and I have seen the Head-ach go off and return again, in Proportion to the Repetition, and the Duration, of these Bathings of the Legs. When the Disorder is highly dangerous, it will be necessary to treat the Patient with _Semicupia_, or warm Baths, in which he may sit up to his Hips; and in the most dangerous Degrees of it, even to bathe the whole Body: but the Water in this Case, as well as in Bathings of the Feet, should be only sensibly warm: the Use of hot would be highly pernicious. 3. Glysters made from a Decoction of any of the emollient Herbs are also very effectual. 4. The Patient should drink plentifully of Almond Emulsion Nº. 4; of Limonade, which is a Mixture of the Juice of Lemons and Water, (and is the best Drink in this Disease) of Water and Vinegar, which is a very good Substitute for Limonade; and of, what is still more efficacious, very clear Whey, with the Addition of a little Vinegar. These various Drinks may all be taken cold; Linen Cloths dipt in cold Water and Vinegar of Roses may be applied to the Forehead, the Temples, or all over the Head, which is equivalent to every other Application used upon such Occasions. Those which are the most cried up, are the Juice of Purslain, of Lettuce, of Houseleek, and of Vervain. The Drink Nº. 32 is also serviceable, taken every Morning fasting. § 161. Cold Baths have sometimes recovered Persons out of such violent Symptoms, from this Cause, as have been almost quite despaired of. A Man twenty Years of Age, having been a very long Time exposed to the scorching Sun, became violently delirious, without a Fever, and proved really mad. After repeated Bleedings, he was thrown into a cold Bath, which was also frequently repeated; pouring cold Water, at the same Time, upon his Head. With such Assistance he recovered, though very gradually. An Officer who had rode Post for several Days successively, in very hot Weather, swooned away, immediately on dismounting; from which he could not be recovered by the ordinary Assistance in such Cases. He was saved however, in Consequence of being plunged into a Bath of freezing Water. It should be observed however, that in these Cases the cold Bath should never be recurred to, without previous Bleeding. § 162. It is past Doubt, that if a Person stands still in the violent Heat of the Sun, he is more liable to be struck with it, than if he walks about; and the Use of white Hats, or of some Folds of clean white Paper under a black one, may sensibly contribute to prevent any Injury from the considerable Heat of the Sun; though it is a very incompetent Defence against a violent Degree of it. The natural Constitution, or even that Constitution, which has been formed from long Custom and Habit, make a very great Difference between the Effects of solar Heat on different Persons. People insensibly accustom themselves to the Impressions of it, as they do to those of all the other Bodies and Elements, which are continually acting upon us; and by Degrees we arrive at a Power of sustaining his violent Heat with Impunity: just as others arrive at the Hardiness of bearing the most rigid Colds, with very little Complaint or Inconvenience. The human Body is capable of supporting many more Violences and Extremes, than it commonly does. Its natural Force is scarcely ever ascertained among civilized Nations; because their Education generally tends to impair and lessen it, and always succeeds in this Respect. If we were inclined to consider a purely natural, a simply physical Man, we must look for him among savage Nations; where only we can discover what we are able to be, and to bear. We certainly could not fail of being Gainers, by adopting their corporal Education; neither does it seem as yet to have been infallibly demonstrated, that we should be great Losers in commuting our moral Education for theirs. [39] [39] As some may think an Apology necessary for a Translation of this Chapter on a Disease, which never, or very seldom, exists in this or the adjacent Island, I shall observe here, that, abstracted from the Immorality of a narrow and local Solicitude only for ourselves, we are politically interested as a Nation always in Trade, and often at War (and whose Subjects are extended into very distant and different Climates) to provide against a sudden and acute Distemper, to which our Armies, our Sailors and Colonies are certainly often exposed. A Fatality from this Cause is not restrained to our Islands within the Tropic, where several Instances of it have occurred during the late War: but it has also been known to prevail as far Northward as _Pensylvania_, in their Summers, and even in their Harvests. I once received a sensible Scald on the Back of my Thumb, from the Sun suddenly darting out through a clear Hole, as it were, in a Cloud, after a short and impetuous Shower in Summer; which Scald manifestly blistered within some Minutes after. Had this concentrated Ray been darted on my bare Head, the Consequence might have been more dangerous; or perhaps as fatal as some of the Cases recorded by Dr. _Tissot_, in this Chapter. _K._ __Chapter XI.__ _Of the Rheumatism._ __Sect.__ 163. The Rheumatism may exist either with or without a Fever. The first of these may be classed among the Diseases, of which I have already treated; being an Inflammation which is manifested by a violent Fever, preceded by Shivering, a subsequent Heat, hard Pulse, and a Head-ach. Sometimes indeed an extraordinary Coldness, with general Uneasiness and Inquietude, exists several Days before the Fever is perceived. On the second or third Day, and sometimes even on the first, the Patient is seized with a violent Pain in some Part of his Body, but especially about the Joints, which entirely prevents their Motion, and which is often accompanied with Heat, Redness and a Swelling of the Part. The Knee is often the first Part attacked, and sometimes both the Knees at once. When the Pain is fixed, an Abatement of the Fever frequently happens; though in some other Persons it continues for several Days, and increases every Evening. The Pain diminishes in one Part after a Duration of some Days, and then invades some other. From the Knee it descends to the Foot, or mounts to the Hip, to the Loins, the Shoulder-blades, Elbow, Wrist, the Nape of the Neck, and frequently is felt in the intermediate Parts. Sometimes one Part is quite free from Pain, when another is attacked; at other Times many Parts are seized nearly at the same Instant; and I have sometimes seen every Joint afflicted at once. In this Case the Patient is in a very terrible Situation, being incapable of any Motion, and even dreading the Assistance of his Attendants, as he can scarcely admit of touching, without a sensible Aggravation of his Pains. He is unable to bear even the Weight of the Bed-clothes, which must be, as it were, arched over his Limbs by a proper Contrivance, to prevent their Pressure: and the very walking across the Chamber increases his Torments. The Parts in which they are the most excruciating, and obstinate, are the Region of the Loins, the Hips, and the Nape or hinder Part of the Neck. § 164. This Disease is also often extended over the Scalp and the Surface of the Head; and there the Pains are excessive. I have seen them affect the Eyelids and the Teeth with inexpressible Torment. As long as the Distemper is situated in the more external Parts, the Patient, however painful his Situation may prove, is in no great Danger, if he be properly treated: but if by some Accident, some Error, or by any latent Cause, the Disease be repelled upon an internal Part or Organ, his Case is extremely dangerous. If the Brain is attacked, a frantic raging _Delirium_ is the Consequence; if it falls upon the Lungs, the Patient is suffocated: and if it attacks the Stomach or the Bowels, it is attended with the most astonishing Pains, which are caused by the Inflammation of those Parts, and which Inflammation, if violent, is [40] speedily fatal. About two Years since I was called to a robust Man, whose Guts were already in a gangrenous State, which was the Consequence of a Rheumatism, that first attacked one Arm and one Knee; the Cure of which had been attempted by sweating the Patient with some hot Remedies. These indeed brought on a plentiful Sweat; but the inflammatory Humour seized the Intestines, whose Inflammation degenerated into a Gangrene, after a Duration of the most acute Pain for thirty-six Hours; his Torments terminating in Death two Hours after I saw him. [40] See Note [16] to Page 59. § 165. This Malady however is often in a less violent Degree; the Fever is but moderate, and ceases entirely when the Pain begins; which is also confined to one, or not more than two Parts. § 166. If the Disease continues fixed, for a considerable Time, in one Joint, the Motion of it is impaired for Life. I have seen a Person, who has now a wry Neck, of twenty Years standing, in Consequence of a Rheumatism in the Nape of the Neck; and I also saw a poor young Man from _Jurat_, who was Bed-ridden, and who had lost the Motion of one Hip and both Knees. He could neither stand nor sit, and there were but a few Postures in which he could even lie in Bed. § 167. An obstructed Perspiration, an inflammatory Thickness of the Blood, constitute the most general Cause of the Rheumatism. This last concurring Cause is that we must immediately encounter; since, as long as that subsists, Perspiration cannot be perfectly re-established, which follows of Course, when the Inflammation is cured. For which Reason this Distemper must be conducted like the other inflammatory ones, of which I have already treated. § 168. As soon as it is sufficiently manifest, the Glyster Nº. 5, should be injected; and twelve Ounces of Blood be taken from the Arm an Hour after. The Patient is to enter upon a Regimen, and drink plentifully of the Ptisan Nº. 2, and of Almond Milk or Emulsion Nº. 4. As this last Medicine may be too costly in Country Places for the poor Peasantry; they may drink, in Lieu of it, very clear Whey, sweetened with a little Honey. I have known a very severe Rheumatism cured, after twice bleeding, without any other Food or Medicine, for the Space of thirteen Days. The Whey also may be happily used by Way of Glyster. § 169. If the Distemper is not considerably asswaged by the first Bleeding, it should be repeated some Hours after. I have ordered it four Times within the first two Days; and some Days after I have even directed a fifth Bleeding. But in general the Hardness of the Pulse becomes less after the second: and notwithstanding the Pains may continue as severe as before, yet the Patient is sensible of less Inquietude. The Glyster must be repeated every Day, and even twice a Day, if each of them is attended only with a small Discharge; and particularly if there be a violent Head-ach. In such Cases as are excessively painful, the Patient can scarcely dispose himself into a proper Attitude or Posture to receive Glysters: and in such Circumstances his Drinks should be made as opening as possible; and a Dose of the Cream of Tartar Nº. 24 should be given Night and Morning. This very Medicine, with the Assistance of Whey, cured two Persons I advised it to, of rheumatic Pains, of which they had been infested with frequent Returns for many Years, and which were attended with a small Fever. Apples coddled, Prunes stewed, and well ripened Summer Fruits are the properest Nourishment in this Disease. We may save the Sick a good deal of Pain, by putting one strong Towel always under their Back, and another under their Thighs, in order to move them the more easily. When their Hands are without Pain, a third Towel hung upon a Cord, which is fastened across the Bed, must considerably assist them in moving themselves. § 170. When the Fever entirely disappears, and the Hardness of the Pulse is removed, I have ordered the Purge Nº. 23 with a very good Effect; and if it is attended with five or six Motions, the Patient is very sensibly relieved. The Day but one after it may be repeated successfully, and a third Time, after an Interval of a greater Number of Days. § 171. When the Pains are extremely violent, they admit of no Application: Vapour-Baths however may be employed, and provided they are often used, and for a considerable Time, they prove very efficacious. The Purpose of these Baths is only to convey the Steam of boiling Water to the Parts affected; which may always easily be effected, by a Variety of simple and easy Contrivances; the Choice of which must depend on the different Circumstances and Situation of the Sick. Whenever it is possible, some of the emollient Applications Nº. 9, should be continually employed. A half Bath, or an entire Bath of warm Water, in which the Patient should remain an Hour, after sufficient Bleedings and many Glysters, affords the greatest Relief. I have seen a Patient, under the most acute Pains of the Loins, of the Hips, and of one Knee, put into one. He continued still under extreme Torment in the Bath, and on being taken out of it: but an Hour after he had been put to Bed, he sweated, to an incredible Quantity, for thirty six Hours, and was cured. The Bath should never be made use of, until after repeated Bleedings, or at least other equivalent Evacuations: for otherwise timed, it would aggravate the Disease. § 172. The Pains are generally most severe in the Night; whence it has been usual to give composing soporific Medicines. This however has been very erroneous, as Opiates really augment the Cause of the Disease, and destroy the Efficacy of the proper Remedies: and, even not seldom, far from asswaging the Pains, they increase them. Indeed they agree so little in this Disease, that even the Patient's natural Sleep at the Invasion of this Complaint, is rather to his Detriment. They feel, the very Moment they are dropping asleep, such violent Jirks as awaken them with great Pain: or if they do sleep a few Minutes, the Pains are stronger when they awake. § 173. The Rheumatism goes off either by Stool, by turbid thick Urine which drops a great Proportion of a yellowish Sediment, or by Sweats: and it generally happens that this last Discharge prevails towards the Conclusion of the Disease. It may be kept up by drinking an Infusion of Elder Flowers. At the Beginning however Sweating is pernicious. § 174. It happens also, though but very seldom, that Rheumatisms determine by depositing a sharp Humour upon the Legs; where it forms Vesications, or a kind of Blisterings; which burst open and form Ulcers, that ought not to be healed and dried up too hastily; as this would occasion a speedy Return of the rheumatic Pains. They are disposed to heal naturally of themselves, by the Assistance of a temperate regular Diet, and a few gentle Purges. § 175. Sometimes again, an Abscess is formed either in the affected Part, or in some neighbouring one. I have seen a Vineyard Dresser, who after violent Pains of the Loins, had an Abscess in the upper Part of the Thigh, which he neglected for a long Time. When I saw him, it was of a monstrous Size. I ordered it to be opened, when at once above three Pots of [41] Matter rushed out of it: but the Patient, being exhausted, died some Time after it. [41] This, according to our Author's Estimation of the Pot-Measure at _Berne_, which is that he always means, and which he says contains exactly (of Water we suppose) fifty one Ounces and a Quarter (though without a material Error it may be computed at three Pounds and a Quarter) will amount at least to nine Pounds and three Quarters of Matter, supposing this no heavier than Water. By Measure it will want but little of five of our Quarts: a very extraordinary Discharge indeed of _Pus_ at once, and not unlikely to be attended by the Event which soon followed. _K._ Another Crisis of the Rheumatism has happened by a kind of Itch, which breaks out upon all the Parts adjacent to the Seat of this Disease. Immediately after this Eruption the Pains vanish; but the Pustules sometimes continue for several Weeks. § 176. I have never observed the Pains to last, with considerable Violence, above fourteen Days, in this Species of the Rheumatism; though there remains a Weakness, Numbness, and some Inflation, or Puffing, of the adjoining Parts: and it will also be many Weeks, and sometimes even Months; especially if the Distemper attacked them in the Fall, before the Sick recover their usual Strength. I have known some Persons, who, after a very painful Rheumatism, have been troubled with a very disagreeable Sensation of Lassitude; which did not go off till after a great Eruption, all over the Body, of little Vesications or Blisterings, full of a watery Humour; many of them burst open, and others withered and dried up without bursting. § 177. The Return of Strength into the Parts affected may be promoted by Frictions Night and Morning, with Flannel or any other woollen Stuff; by using Exercise; and by conforming exactly to the Directions given in the Chapter on Convalescence, or Recovery from acute Diseases. The Rheumatism may also be prevented by the Means I have pointed out, in treating of Pleurisies and Quinsies. § 178. Sometimes the Rheumatism, with a Fever, invades Persons who are not so sanguine, or abounding in Blood; or whose Blood is not so much disposed to Inflammation; those whose Flesh and Fibres are softer; and in whose Humours there is more Thinness and Sharpness, than Viscidity and Thickness. Bleeding proves less necessary for Persons so constituted, notwithstanding the Fever should be very strong. Some Constitutions require more Discharges by Stool; and after they are properly evacuated, some Blisters should be applied, which often afford them a sensible Relief as soon as ever they begin to operate. Nevertheless they should never be used where the Pulse is hard. The Powder Nº. 25 answers very well in these Cases. § 179. There is another Kind of Rheumatism, called chronical, or lasting. It is known by the following Characters or Marks. 1. It is commonly unattended with a Fever. 2. It continues a very long Time. 3. It seldom attacks so many Parts at once as the former. 4. Frequently no visible Alteration appears in the affected Part, which is neither more hot, red, or swelled than in its healthy State; though sometimes one or other of these Symptoms is evident. 5. The former, the inflammatory, Rheumatism assaults strong, vigorous, robust Persons: but this rather invades People arrived at a certain Period of Life, or such as are weak and languishing. § 180. The Pain of the chronical Rheumatism, when left to itself, or injudiciously treated, lasts sometimes many Months, and even Years. It is particularly and extremely obstinate, when it is exerted on the Head, the Loins, or on the Hip, and along the Thighs, when it is called the _Sciatica_. There is no Part indeed which this Pain may not invade; sometimes it fixes itself in a small Spot, as in one Corner of the Head; the Angle of the Jaw; the Extremity of a Finger; in one Knee; on one Rib, or on the Breast, where it often excites Pains, which make the Patient apprehensive of a Cancer. It penetrates also to the internal Parts. When it affects the Lungs, a most obstinate Cough is the Consequence; which degenerates at length into very dangerous Disorders of the Breast. In the Stomach and Bowels it excites most violent Pains like a Cholic; and in the Bladder, Symptoms so greatly resembling those of the Stone, that Persons, who are neither deficient in Knowlege nor Experience, have been more than once deceived by them. § 181. The Treatment of this chronical Rheumatism does not vary considerably from that of the former. Nevertheless, in the first Place, if the Pain is very acute, and the Patient robust, a single Bleeding at the Onset is very proper and efficacious. 2. The Humours ought to be diluted, and their Acrimony or Sharpness should be diminished, by a very plentiful Use of a Ptisan of [42] Burdock Roots Nº. 26. 3. Four or five Days after drinking abundantly of this, the purging [43] Powder Nº. 21 may be taken with Success. In this Species of the Rheumatism, a certain Medicine is sometimes found serviceable. This has acquired some Reputation, particularly in the Country, where they bring it from, _Geneva_; under the Title of the Opiate for the Rheumatism, tho' I cannot say for what Reason; as it is indeed neither more nor less than the Electuary _Caryocostinum_, which may be procured at our Apothecaries. I shall observe however, that this Medicine has done Mischief in the inflammatory Rheumatism, and even in this, as often as the Persons afflicted with it are feeble, thin and of a hot Temperament; and either when they have not previously taken diluting Drinks, or when it has been used too long. For, in such a Circumstance, it is apt to throw the Patient into an irrecoverable Weakness. The Composition consists of the hottest Spices, and of very sharp Purgatives. [42] Half a Pint of a pretty strong Infusion of the Leaves of Buckbean, which grows wild here, taken once a Day rather before Noon, has also been found very serviceable in that Species of a chronical Rheumatism, which considerably results from a scorbutic State of the Constitution. _K._ [43] Another very good Purge, in this Kind of Rheumatism, may also be compounded of the best Gum Guiacum in Powder from 30 to 40 Grains; dissolved in a little Yolk of a fresh Egg; adding from 6 to 10 Grains of Jallap powdered, and from 3 to 5 Grains of powdered Ginger, with as much plain or sorrel Water, as will make a purging Draught for a stronger or weaker grown Patient. Should the Pains frequently infest the Stomach, while the Patient continues costive, and there is no other Fever than such a small symptomatic one, as may arise solely from Pain, he may safely take, if grown up, from 30 to 45 Drops of the volatile Tincture of Gum Guiacum, in any diluting Infusion, that may not coagulate or separate the Gum. It generally disposes at first to a gentle _Diaphoresis_ or Sweat, and several Hours after to one, and sometimes to a second Stool, with little or no Griping. _K._ § 182. When general Remedies have been used, and the Disorder still continues, Recourse should be had to such Medicines, as are available to restore Perspiration; and these should be persisted in for a considerable Time. The Pills Nº. 18, with a strong Infusion of Elder Flowers, have often succeeded in this Respect: and then after a long Continuance of diluting Drinks, if the Fever is entirely subdued; if the Stomach exerts its Functions well; the Patient is no ways costive; if he is not of a dry Habit of Body; and the Part affected remains without Inflammation, the Patient may safely take the Powder Nº. 29, at Night going to Bed, with a Cup or two of an Infusion of _Carduus benedictus_, or the blessed Thistle, and a Morsel of Venice Treacle of the Size of a Hazel Nut, or a Filberd. This Remedy brings on a very copious Sweating, which often expells the [44] Disease. These Sweats may be rendered full more effectual, by wrapping up the affected Part in a Flanel dipt in the Decoction Nº. 27. [44] Gum Guaiacum, given from six to ten Grains Morning and Night, is often very successful in these Cases. It may be made into Pills or Bolusses with the Rob of Elder, or with the Extract of Juniper. _E. L._ § 183. But of all these Pains, the Sciatica is one of the most tedious and obstinate. Nevertheless I have seen the greatest Success, from the Application of seven or eight Cupping-Glasses on the tormented Part; by which, without the Assistance of any other Remedy, I have cured, in a few Hours, Sciaticas of many Years standing, which had baffled other Remedies. Blisters, or any such stimulating Plaisters, as bring on a Suppuration and Discharge from the afflicted Part, contribute also frequently to the Cure; tho' less effectually than Cupping, which should be repeated several Times. Green Cere-cloth, commonly called Oil-cloth, (whether the Ingredients be spread on Taffety or on Linen) being applied to the diseased Part, disposes it to sweat abundantly, and thus to discharge the sharp Humour which occasions the Pain. Sometimes both these Applications, but especially that spread on Silk (which may be applied more exactly and closely to the Part, and which is also spread with a different Composition) raise a little Vesication on the Part as Blisters do. A Plaister of Quicklime and Honey blended together has cured inveterate Sciaticas. Oil of Eggs has sometimes succeeded in such Cases. A Seton has also been successfully made in the lower Part of the Thigh. Finally some Pains, which have not yielded to any of these Applications, have been cured by actual burning, inflicted on the very Spot, where the most violent Pain has been felt; except some particular Reason, drawn from an anatomical Knowlege of the Part, should determine the Surgeon not to apply it there. The Scull or Head should never be cauterized with a burning Iron. § 184. The hot Baths of _Bourbon_, _Plombiers_, _Aix-la-Chapelle_ and many others are often very efficacious in these chronical Pains: notwithstanding I really think, there is no rheumatic Pain that may not be cured without them. The common People substitute to these a Bath made of the Husk of Grapes, after their Juice is expressed, which cures some by making them sweat abundantly. Cold Baths however are the best to keep off this Disease; but then they cannot always be safely ventured on. Many Circumstances render the Use of them impracticable to particular Persons. Such as are subject to this chronical Rheumatism, would do very well to rub their whole Bodies every Morning, if they could, but especially the afflicted Parts, with Flanel. This Habit keeps up Perspiration beyond any other Assistance; and indeed sometimes even increases it too much. It would be serviceable too, if such Subjects of this cruel Disease wore Flanel all over their Skin, during the Winter. After a violent Rheumatism, People should long be careful to avoid that cold and moist Air, which disposes them to relapse. § 185. Rheumatic People have too frequent a Recourse to very improper and hurtful Medicines, in this Distemper, which daily produce very bad Consequences. Such are spirituous Medicines, Brandy, and Arquebusade Water. They either render the Pain more obstinate and fixed, by hardening the Skin; or they repell the Humour to some inward Part. And Instances are not wanting of Persons who have died suddenly, from the Application of Spirit of Wine upon the Parts, that were violently afflicted with the Rheumatism. It also happens sometimes that the Humour, having no Outlet through the Skin, is thrown internally on the Bone and affects it. A very singular Fact occurred in this Respect, an Account of which may be serviceable to some Persons afflicted with the Disease. A Woman at Night was chaffing the Arm of her Husband, who had the Rheumatism there, with Spirit of Wine; when a very lucky Accident prevented the Mischief she might have occasioned by it. The Spirit of Wine took Fire from the Flame of the Candle she made use of, and burned the diseased Part. It was drest of Course, and the Suppuration that attended it, entirely cured the Rheumatism. Sharp and greasy Unctions or Ointments produce very bad Effects, and are equally dangerous. A _Caries_, a Rottenness of the Bones, has ensued upon the Use of a Medicine called, The Balsam of Sulphur with Turpentine. I was consulted in 1750, three Days before her Decease, about a Woman, who had long endured acute rheumatic Pains. She had taken various Medicines, and, among the rest, a considerable Quantity of a Ptisan, in which Antimony was blended with some purging Medicines, and a greasy spirituous Balsam had been rubbed into the Part. The Fever, the Pains, and the Dryness of the Skin soon increased; the Bones of the Thighs and Arms became carious: and in moving the Patient no more than was necessary for her Relief and Convenience, without taking her out of her Bed, both Thighs and one Arm broke. So dreadful an Example should make People cautious of giving or applying Medicines inconsiderately, even in such Diseases, as appear but trifling in themselves. I must also inform the Readers, there are some rheumatic Pains, which admit of no Application; and that almost every Medicine aggravates them. In such Cases the afflicted must content themselves with keeping the Parts affected from the Impressions of the Air, by a Flanel, or the Skin of some Animal with the Fur on. It is also more advisable sometimes to leave a sufferable and inveterate Pain to itself, especially in old or weakly People, than to employ too many Medicines, or such violent ones, as should affect them more importantly than the Pains did. § 186. If the Duration of the Pains fixed in the same Place, should cause some Degree of Stiffness in the Joint affected, it should be exposed twice a Day to the Vapour of warm Water, and dried well afterwards with hot Linen: then it should be well chaffed, and lastly touched over with Ointment of Marsh-mallows. Pumping, if superadded to this Vapour, considerably increases its Efficacy. I directed, for a Case of this Sort, a very simple Machine of white Tin, or Lattin, which combined the Application of the Steam and the Pump. § 187. Very young Children are sometimes subject to such violent and extended Pains, that they cannot bear touching in any Part, without excessive Crying. We must be careful to avoid mistaking these Cases, and not to treat them like Rheumatisms. They sometimes are owing to Worms, and go off when these have been discharged. __Chapter XII.__ _Of the Bite of a mad Dog._ __Sect.__ 188. Men may contract the particular and raging Symptom, which is very generally peculiar to this Disease from this Cause, and even without any Bite; but this happens very rarely indeed. It is properly a Distemper belonging to the canine _Genus_, consisting of the three Species of Dogs, Wolves, and Foxes, to whom only it seems inherent and natural; scarcely ever arising in other Animals, without its being inflicted by them. Whenever there occurs one of them who breeds it, he bites others, and thus the Poison, the Cause of this terrible Disease, is diffused. Other Animals besides the canine Species, and Men themselves being exposed to this Accident, do sometimes contract the Disease in all its Rage and Horror: though it is not to be supposed, that this is always an unfailing Consequence. § 189. If a Dog who used to be lively and active, becomes all at once moapish and morose; if he has an Aversion to eat; a particular and unusual Look about his Eyes; a Restlessness, which appears from his continually running to and fro, we may be apprehensive he is likely to prove mad; at which very Instant he ought to be tied up securely, that it may be in our Power to destroy him as soon as the Distemper is evident. Perhaps it might be even still safer to kill him at once. Whenever the Malady is certain, the Symptoms heighten pretty soon. His Aversion to Food, but especially to Drink, grows stronger. He no longer seems to know his Master, the Sound of his Voice changes; he suffers no Person to handle or approach him; and bites those who attempt it. He quits his ordinary Habitation, marching on with his Head and his Tail hanging downwards; his Tongue lolling half out, and covered with Foam or Slaver, which indeed not seldom happens indifferently to all Dogs. Other Dogs scent him, not seldom at a considerable Distance, and fly him with an Air of Horror, which is a certain Indication of his Disease. Sometimes he contents himself with biting only those who happen to be near him: while at other Times becoming more enraged, he springs to the right and left on all Men and Animals about him. He hurries away with manifest Dread from whatever Waters occur to him: at length he falls down as spent and exhausted; sometimes he rises up again, and drags himself on for a little Time, commonly dying the third, or, at the latest, on the fourth Day after the manifest Appearance of the Disease, and sometimes even sooner. § 190. When a Person is bit by such a Dog, the Wound commonly heals up as readily, as if it was not in the least poisonous: but after the Expiration of a longer or shorter Term, from three Weeks to three Months; but most commonly in about six Weeks, the Person bitten begins to perceive, in the Spot that was bit, a certain dull obtuse Pain. The Scar of it swells, inflames, bursts open, and weeps out a sharp, foetid, and sanious, or somewhat bloody Humour. At the same Time the Patient becomes sad and melancholy: he feels a kind of Indifference, Insensibility, and general Numbness; an almost incessant Coldness; a Difficulty of breathing; a continual Anguish, and Pains in his Bowels. His Pulse is weak and irregular, his sleep restless, turbid, and confused with Ravings; with starting up in Surprize, and with terrible Frights. His Discharges by Stool are often much altered and irregular, and small cold Sweats appear at very short Intervals. Sometimes there is also a slight Pain or Uneasiness in the Throat. Such is the first Degree of this Disease, and it is called by some Physicians the dumb Rage, or Madness. § 191. Its second Degree, the confirmed or downright Madness, is attended with the following Symptoms. The Patient is afflicted with a violent Thirst, and a Pain in drinking. Soon after this he avoids all Drink, but particularly Water, and within some Hours after, he even abhors it. This Horror becomes so violent, that the bringing Water near his Lips, or into his Sight, the very Name of it, or of any other Drink; the Sight of Objects, which, from their Transparence, have any Resemblance of Water, as a Looking Glass, _&c._ afflicts him with extreme Anguish, and sometimes even with Convulsions. They continue however still to swallow (though not without violent Difficulty) a little Meat or Bread, and sometimes a little Soup. Some even get down the liquid Medicines that are prescribed them, provided there be no Appearance of Water in them; or that Water is not mentioned to them, at the same Time. Their Urine becomes thick and high-coloured, and sometimes there is a Suppression or Stoppage of it. The Voice either grows hoarse, or is almost entirely abolished: but the Reports of the bitten barking like Dogs are ridiculous and superstitious Fictions, void of any Foundation; as well as many other Fable, that have been blended with the History of this Distemper. The Barking of Dogs however is very disagreeable to them. They are troubled with short _Deliriums_ or Ravings, which are sometimes mixed with Fury. It is at such times that they spit all around them; that they attempt also to bite, and sometimes unhappily effect it. Their Looks are fixed, as it were, and somewhat furious, and their Visage frequently red. It is pretty common for these miserable Patients to be sensible of the Approach of their raging Fit, and to conjure the Bystanders to be upon their Guard. Many of them never have an Inclination to bite. The increasing Anguish and Pain they feel become inexpressible: they earnestly wish for Death; and some of them have even destroyed themselves, when they had the Means of effecting it. § 192. It is with the Spittle, and the Spittle only, that this dreadful Poison unites itself. And here it may be observed, 1, That if the Wounds have been made through any of the Patient's Cloaths, they are less dangerous than those inflicted immediately on the naked Skin. 2, That Animals who abound in Wool, or have very thick Hair, are often preserved from the mortal Impression of the Poison; because in these various Circumstances, the Cloaths, the Hair, or the Wool have wiped, or even dried up, the Slaver of their Teeth. 3, The Bites inflicted by an infected Animal, very soon after he has bitten many others, are less dangerous than the former Bites, because their Slaver is lessened or exhausted. 4, If the Bite happens in the Face, or in the Neck, the Danger is greater, and the Operation of the Venom is quicker too; by Reason the Spittle of the Person so bit is sooner infected. 5, The higher the Degree of the Disease is advanced, the Bites become proportionably more dangerous. From what I have just mentioned here it may be discerned, why, of many who have been bitten by the same Sufferer, some have been infected with this dreadful Disease, and others not. § 193. A great Number of Remedies have been highly cried up, as famous in the Cure of this Disease; and, in _Swisserland_ particularly, the Root of the Eglantine or wild Rose, gathered at some particular times, under the favorable Aspects of the Moon, and dried with some extraordinary Precautions. There is also the Powder of _Palmarius_ of calcined Egg Shells, that of the _Lichen terrestris_, or Ground Liverwort, with one third Part of Pepper, a Remedy long celebrated in _England_; Powder of Oyster-Shells; of Vervain; bathing in Salt Water; St. Hubert's Key, _&c. &c._ But the Death of a Multitude of those who have been bitten, notwithstanding their taking the greatest Part of all these boasted Antidotes; and the Certainty of no one's escaping, who had been attacked with the high raging Symptom, the _Hydrophobia_, have demonstrated the Inefficacy of them all, to all _Europe_. It is incontestable that to the Year 1730, not a single Patient escaped, in whom the Disease was indisputably manifest; and that every Medicine then employed against it was useless. When Medicines had been given before the great Symptom appeared, in some of those who took them, it afterwards appeared, in others not. The same different Events occurred also to others who were bitten, and who took not the least Medicine; so that upon the whole, before that Date, no Medicine seemed to be of any Consequence. Since that Time, we have had the Happiness to be informed of a certain Remedy, which is Mercury, joined to a few others. § 194. In short there is a Necessity for destroying or expelling the Poison itself, which Mercury effects, and is consequently the Counter-poison of it. That poison produces a general Irritation of the Nerves; this is to be removed or asswaged by Antispasmodics: so that in Mercury, or Quicksilver, joined to Antispasmodics, consists the whole that is indicated in the Cure of this Disease. There really have been many Instances of Persons cured by these Medicines, in whom the Distemper had been manifest in its Rage and Violence; and as many as have unfortunately received the Cause of it in a Bite, should be firmly persuaded, that in taking these Medicines, and using all other proper Precautions, they shall be entirely secured from all its ill Consequences. Those also in whom the Rage and Fury of this Distemper is manifest, ought to use the same Medicines, with entire [45] Hope and Confidence, which may justly be founded on the many Cures effected by them. It is acknowledged however, that they have proved ineffectual in a few Cases; but what Disease is there, which does not sometimes prove incurable? [45] This Advice is truly prudent and judicious; Hope, as I have observed on a different Occasion, being a powerful, though impalpable, Cordial: and in such perilous Situations, we should excite the most agreeable Expectations we possibly can in the Patient; that Nature, being undepressed by any desponding melancholy ones, may exert her Functions the more firmly, and co-operate effectually with the Medicines, against her internal Enemy. _K._ § 195. The very Moment after receiving the Bite, is it happens to be in the Flesh, and if it can safely be effected, all the Part affected should be cut [46] away. The Ancients directed it to be cauterized, or burnt with a red hot Iron (meer Scarification being of very little Effect) and this Method would very probably prove effectual. It requires more Resolution, however, than every Patient is endued with. The Wound should be washed and cleansed a considerable Time with warm Water, with a little Sea-Salt dissolved in it. After this into the Lips and Edges of the Wound, and into the Surface of the Part all about it, should be rubbed a Quarter of an Ounce of the Ointment Nº. 28; and the Wound should be dressed twice daily, with the soft lenient Ointment Nº. 29, to promote Suppuration; but that of Nº. 28 is to be used only once a Day. [46] I knew a brave worthy Gentleman abroad, who above forty Years past thus preserved his Life, after receiving the Bite of a large Rattle-Snake, by resolutely cutting it and the Flesh surrounding it out, with a sharp pointed Penknife.--Perhaps those who would not suffer the Application of the actual Cautery, that is, of a red hot Iron (which certainly promises well for a Cure) might be persuaded to admit of a potential Cautery, where the Bite was inflicted on a fleshy Part. Though even this is far from being unpainful, yet the Pain coming on more gradually, is less terrifying and horrid. And when it had been applied quickly after, and upon the Bite, and kept on for 3 or 4 Hours, the Discharge, after cutting the _Eschar_, would sooner ensue, and in more Abundance, than that from the actual Cautery; the only Preference of which seems to consist in its being capable perhaps of absorbing, or otherwise consuming, all the poisonous _Saliva_ at once. This Issue should be dressed afterwards according to our Author's Direction; and in the gradual healing of the Ulcer, it may be properly deterged by adding a little Præcipitate to the Digestive. Neither would this interfere with the Exhibition of the _Tonquin_ Powder Nº. 30, nor the antispasmodic _Bolus_ Nº. 31, if they should be judged necessary. And these perhaps might prove the most certain Means of preventing the mortal Effects of this singular animal Poison, which it is so impossible to analyze, and so extremely difficult to form any material Idea of; but which is not the Case of some other Poisons. _K._ In point of Regimen, the Quantity of Nourishment should be less than usual, particularly in the Article of [47] Flesh: he should abstain from Wine, spirituous Liquors, all Sorts of Spices and hot inflaming Food. He should drink only Barley-Water, or an Infusion of the Flowers of the Lime-tree. He should be guarded against Costiveness by a soft relaxing Diet, or by Glysters, and bathe his Legs once a Day in warm Water. Every third Day one Dose of the Medicine Nº. 30 should be taken; which is compounded of Mercury, that counterworks the Poison, and of Musk which prevents the Spasms, or convulsive Motions. I confess at the same Time that I have less Dependance on the Mercury given in this Form, and think the rubbing in of its Ointment considerably more efficacious, which I should hope may always prevent the Fatality of this dreadful, surprizing Disease. [48] [47] It seems not amiss to try the Effects of a solely vegetable Diet (and that perhaps consisting more of the acescent than alcalescent Herbs and Roots) in this Disease, commencing immediately from the Bite of a known mad Dog. These carnivorous Animals, who naturally reject all vegetable Food, are the only primary Harbingers or Breeders of it; though they are capable of transmitting it by a Bite to graminivorous and granivorous ones. The Virtue of Vinegar in this Disease, said to have been accidentally discovered on the Continent, seems not to have been hitherto experienced amongst us; yet in Case of such a morbid Accident it may require a Tryal; tho' not so far, as to occasion the Omission of more certainly experienced Remedies, with some of which it might be improper. _K._ [48] The great Usefulness of mercurial Frictions, we may even say, the certain Security which they procure for the Patients, in these Cases, provided they are applied very soon after the Bite, have been demonstrated by their Success in _Provence_, at _Lyons_, at _Montpellier_, at _Pondacherry_, and in many other Places. Neither have these happy Events been invalidated by any Observations or Instances to the contrary. It cannot therefore be too strongly inculcated to those who have been bitten by venomous Animals, to comply with the Use of them. They ought to be used in such a Quantity, and after such a Manner, as to excite a moderate Salivation, for fifteen, twenty, or even thirty Days. _E. L._ Though this Practice may justly be pursued from great Caution, when no Cautery had been speedily applied to, and no such Discharge had been obtained from, the bitten Part; yet wherever it had, this long and depressing Salivation, I conceive, would be very seldom necessary; and might be hurtful to weak Constitutions. _K._ § 196. If the raging Symptom, the Dread of Water, has already appeared, and the Patient is strong, and abounds with Blood, he should, 1, be bled to a considerable Quantity, and this may be repeated twice, thrice, or even a fourth Time, if Circumstances require it. 2, The Patient should be put, if possible, into a warm Bath; and this should be used twice daily. 3, He should every Day receive two, or even three of the emollient Glysters Nº. 5. 4, The Wound and the Parts adjoining to it should be rubbed with the Ointment Nº. 28, twice a Day. 5, The whole Limb which contains the Wound should be rubbed with Oil, and be wrapped up in an oily Flanel. 6, Every three Hours a Dose of the Powder Nº. 30, should be taken in a Cup of the Infusion of Lime-tree and Elder Flowers. 7, The Prescription Nº. 31, is to be given every Night, and to be repeated in the Morning, if the Patient is not easy, washing it down with the same Infusion. 8, If there be a great Nauseousness at Stomach, with a Bitterness in the Mouth, give the Powder Nº. 35, which brings up a copious Discharge of glewy and bilious Humours. 9, There is very little Occasion to say any thing relating to the Patient's Food, in such a Situation. Should he ask for any, he may be allowed Panada, light Soup, Bread, Soups made of farinaceous or mealy Vegetables, or a little Milk. § 197. By the Use of these Remedies the Symptoms will be observed to lessen, and to disappear by Degrees; and finally Health will be re-established. But if the Patient should long continue weak, and subject to Terrors, he may take a Dose of the Powder Nº. 14, thrice a Day. § 198. It is certain that a Boy, in whom the raging Symptom of This Disease had just appeared, was perfectly cured, by bathing all about the wounded Part with Sallad-Oil, in which some Camphire and Opium were dissolved; with the Addition of repeated Frictions of the Ointment Nº. 28, and making him take some _Eau de luce_ with a little Wine. This Medicine, a Coffee-Cup of which may be given every four Hours, allayed the great Inquietude and Agitation of the Patient; and brought on a very plentiful Sweat, on which all the Symptoms vanished. § 199. Dogs may be cured by rubbing in a triple Quantity of the same Ointment directed for Men, and by giving them the Bolus Nº. 33. But both these Means should be used as soon as ever they are bit. When the great Symptom is manifest, there would be too much Danger in attempting to apply one, or to give the other; and they should be immediately killed. It might be well however to try if they would swallow down the Bolus, on its being thrown to them. As soon as ever Dogs are bit, they should be safely tied up, and not let loose again, before the Expiration of three or four Months. § 200. A false and dangerous Prejudice has prevailed with Regard to the Bites from Dogs, and it is this--That if a Dog who had bit any Person, without being mad at the Time of his biting, should become mad afterwards, the Person so formerly bitten, would prove mad too at the same Time. Such a Notion is full as absurd, as it would be to affirm, that if two Persons had slept in the same Bed, and that one of them should take the Itch, the Small-Pocks, or any other contagious Disease, ten or twelve Years afterwards, that the other should also be infected with that he took, and at the same Time too. Of two Circumstances, whenever a Person is bit, one must certainly be. Either the Dog which gives the Bite, is about to be mad himself, in which Case this would be evident in a few Days; and then it must be said the Person was bitten by a mad Dog: Or else, that the Dog was absolutely sound, having neither conceived, or bred in himself, nor received from without the Cause, the Principle, of Madness: in which last Case I ask any Man in his Senses, if he could communicate it. No Person, no Thing imparts what it has not. This false and crude Notion excites those who are possessed with it to a dangerous Action: they exercise that Liberty the Laws unhappily allow them of killing the Dog; by which Means they are left uncertain of his State, and of their own Chance. This is a dreadful Uncertainty, and may be attended with embarrassing and troublesome Consequences, independant of the Poison itself. The reasonable Conduct would be to secure and observe the Dog very closely, in Order to know certainly whether he is, or is not, mad. § 201. It is no longer necessary to represent the Horror, the Barbarity and Guilt of that cruel Practice, which prevailed, not very long since, of suffocating Persons in the Height of this Disease, with the Bed-cloaths, or between Matrasses. It is now prohibited in most Countries; and doubtless will be punished, or, at least ought to be, even in those where as yet it is not. Another Cruelty, of which we hope to see no repeated Instance, is that of abandoning those miserable Patients to themselves, without the least Resource or Assistance: a most detestable Custom even in those Times, when there was not the least Hope of saving them; and still more criminal in our Days, when they may be recovered effectually. I do again affirm, that it is not very often these afflicted Patients are disposed to bite; and that even when they are, they are afraid of doing it; and request the Bystanders to keep out of their Reach: So that no Danger is incurred; or where there is any, it may easily be avoided by a few Precautions. __Chapter XIII.__ _Of the Small-Pocks._ __Sect.__ 202. The Small-Pocks is the most frequent, the most extensive of all Diseases; since out of a hundred Persons there are not more than [49] four or five exempted from it. It is equally true however, that if it attacks almost every Person, it attacks them but once, so that having escaped through it, they are always secure from [50] it. It must be acknowleged, at the same Time, to be one of the most destructive Diseases; for if in some Years or Seasons, it proves to be of a very mild and gentle Sort, in others it is almost as fatal as the Plague: it being demonstrated, by calculating the Consequences of its most raging, and its gentlest Prevalence, that it kills one seventh of the Number it attacks. [49] As far as the Number of inoculated Persons, who remained entirely uninfected (some very few after a second Inoculation) has enabled me, I have calculated the Proportion naturally exempted from this Disease, though residing within the Influence of it, to be full 25 in 1000. See Analysis of Inoculation, Ed. 2d. P. 157. Note *. _K._ [50] It has sometimes been observed (and the Observation has been such, as not to be doubted) that a very mild distinct Small-Pocks has sometimes invaded the same Person twice: But such Instances are so very rare, that we may very generally affirm, those who have once had it, will never have it again. _E. L._----In Deference to a few particular Authorities, I have also supposed such a repeated Infection. (Analysis of Inoculation, Ed. 2d. P. 43.) though I have really never seen any such myself; nor ever heard more than two Physicians affirm it, one at _Versailles_, and another in _London_; the last of whom declared, he took it upon the Credit of a Country Physician, thoroughly acquainted with this Disease, and a Witness to the Repetition of it. Hence we imagine the Editor of this Work at _Lyons_ might have justly termed this Re-infection _extremely_ rare, which would have a Tendency to reconcile the Subjects of the Small-Pocks, more generally, to the most salutary Practice of Inoculation. Doubtless some other eruptive Fevers, particularly, the Chicken Pocks, Crystals, _&c._ have been often mistaken for the real Small-Pocks by incompetent Judges, and sometimes even by Persons better qualified, yet who were less attentive to the Symptoms and Progress of the former. But whoever will be at the Pains to read Dr. _Paux' Paralléle de la petite verole naturalle avec l'artificielle_, or a practical Abstract of Part of it in the Monthly Review. Vol. XXV. P. 307 to 311, will find such a just, clear and useful Distinction of them, as may prevent many future Deceptions on this frequently interesting Subject. _K._ § 203. People generally take the Small-Pocks in their Infancy, or in their Childhood. It is very seldom known to attack only one Person in one Place: its Invasions being very generally epidemical, and seizing a large Proportion of those who have not suffered it. It commonly ceases at the End of some Weeks, or of some Months, and rarely ever appears again in the same Place, until four, five or six Years after. § 204. This Malady often gives some Intimation of its Approach, three or four Days before the Appearance of the Fever, by a little Dejection; less Vivacity and Gaiety than usual; a great Propensity to sweat; less Appetite; a slight Alteration of the Countenance, and a kind of pale livid Colour about the Eyes: Notwithstanding which, in Children of a lax and phlegmatic Constitution, I have known a moderate Agitation of their Blood, (before their Shivering approached) give them a [51] Vivacity, Gaiety, and a rosy Improvement of their Complexion, beyond what Nature had given them. [51] The same Appearances very often occur in such Subjects by Inoculation, before actual Sickening, as I have observed and instanced, Ed. 1st. P. 62, Ed. 2. P. 75, 76. _K._ Certain short Vicissitudes of Heat or Coldness succeed the former introductory Appearances, and at length a considerable Shivering, of the Duration of one, two, three or four Hours: This is succeeded by violent Heat, accompanied with Pains of the Head, Loins, Vomiting, or at least with a frequent Propensity to vomit. This State continues for some Hours, at the Expiration of which the Fever abates a little in a Sweat, which is sometimes a very large one: the Patient then finds himself better, but is notwithstanding cast down, torpid or heavy, very squeamish, with a Head-ach and Pain in the Back, and a Disposition to be drowsy. The last Symptom indeed is not very common, except in Children, less than seven or eight Years of Age. The Abatement of the Fever is of small Duration; and some Hours after, commonly towards the Evening, it returns with all its Attendants, and terminates again by Sweats, as before. This State of the Disease lasts three or four Days; at the End of which Term, and seldom later, the first Eruptions appear among the Sweat, which terminates the Paroxysm or Return of the Fever. I have generally observed the earliest Eruption to appear in the Face, next to that on the Hands, on the fore Part of the Arms; on the Neck, and on the upper Part of the Breast. As soon as this Eruption appears, if the Distemper is of a gentle Kind and Disposition, the Fever almost entirely vanishes: the Patient continues to sweat a little, or transpire; the Number of Eruptions increases, others coming out on the Back, the Sides, the Belly, the Thighs, the Legs, and the Feet. Sometimes they are pushed out very numerously even to the Soles of the Feet; where, as they increase in Size, they often excite very sharp Pain, by Reason of the great Thickness and Hardness of the Skin in these Parts. Frequently on the first and second Day of Eruption (speaking hitherto always of the mild Kind and Degree of the Disease) there returns again a very gentle Revival of the Fever about the Evening, which, about the Termination of it, is attended with a considerable and final Eruption: though as often as the Fever terminates perfectly after the earliest Eruption, a very distinct and very small one is a pretty certain Consequence. For though the Eruption is already, or should prove only moderate, the Fever, as I have before said, does not totally disappear; a small Degree of it still remaining, and heightening a little every Evening. These Pustules, or Efflorescences, on their first Appearance, are only so many very little red Spots, considerably resembling a Flea-bite; but distinguishable by a small white Point in the Middle, a little raised above the rest, which gradually increases in Size, with the Redness extended about it. They become whiter, in Proportion as they grow larger; and generally upon the sixth Day, including that of their first Eruption, they attain their utmost Magnitude, and are full of _Pus_ or Matter. Some of them grow to the Size of a Pea, and some still a little larger; but this never happens to the greatest Number of them. From this Time they begin to look yellowish, they gradually become dry, and fall off in brown Scales, in ten or eleven Days from their first Appearance. As their Eruption occurred on different Days, they also wither and fall off successively. The Face is sometimes clear of them, while Pustules still are seen upon the Legs, not fully ripe, or suppurated: and those in the Soles of the Feet often remain much longer. § 205. The Skin is of Course extended or stretched out by the Pustules; and after the Appearance of a certain Quantity, all the Interstices, or Parts between the Pustules, are red and bright, as it were, with a proportionable Inflation or Swelling of the Skin. The Face is the first Part that appears bloated, from the Pustules there first attaining their utmost Size: and this inflation is sometimes so considerable, as to look monstrous; the like happens also to the Neck, and the Eyes are entirely closed up by it. The Swelling of the Face abates in Proportion to the scabbing and drying up of the Pustules; and then the Hands are puffed up prodigiously. This happens successively to the Legs, the Tumour or Swelling, being the Consequence of the Pustules attaining their utmost Size, which happens by Succession, in these different Parts. § 206. Whenever there is a very considerable Eruption, the Fever is heightened at the Time of Suppuration, which is not to be wondered at; one single Boil excites a Fever: How is it possible then that some hundred, nay some thousand of these little Abscesses should not excite one? This Fever is the most dangerous Period, or Time of the Disease, and occurs between the ninth and the thirteenth Days; as many Circumstances vary the Term of Suppuration, two or three Days. At this painful and perilous Season then, the Patient becomes very hot, and thirsty: he is harrassed with Pain; and finds it very difficult to discover a favourable easy Posture. If the Malady runs very high, he has no Sleep; he raves, becomes greatly oppressed, is seized with a heavy Drowsiness; and when he dies, he dies either suffocated or lethargic, and sometimes in a State compounded of both these Symptoms. The Pulse, during this Fever of Suppuration, is sometimes of an astonishing Quickness, while the Swelling of the Wrists makes it seem, in some Subjects, to be very small. The most critical and dangerous Time is, when the Swellings of the Face, Head and Neck are in their highest Degree. Whenever the Swelling begins to fall, the Scabs on the Face to dry [_supposing neither of these to be too sudden and premature, for the visible Quantity of the Pustules_] and the Skin to shrivel, as it were, the Quickness of the Pulse abates a little, and the Danger diminishes. When the Pustules are very few, this second Fever is so moderate, that it requires some Attention to discern it, so that the Danger is next to none. § 207. Besides those Symptoms, there are some others, which require considerable Attention and Vigilance. One of these is the Soreness of the Throat, with which many Persons in the Small-Pocks are afflicted, as soon as the Fever grows pretty strong. It continues for two or three Days; feels very strait and troublesome in the Action of Swallowing; and whenever the Disease is extremely acute, it entirely prevents Swallowing. It is commonly ascribed to the Eruption of Pustules in the Throat; but this is a Mistake, such Pustules being almost constantly [52] imaginary. It begins, most frequently, before the Eruption appears; if this Complaint is in a light Degree, it terminates upon the Eruption; and whenever it revives again in the Course of the Disease, it is always in Proportion to the Degree of the Fever. Hence we may infer it does not arise from the Pustules, but is owing to the Inflammation; and as often as it is of any considerable Duration, it is almost ever attended with another Symptom, the Salivation, or a Discharge of a great Quantity of Spittle. This Salivation rarely exists, where the Disease is very gentle, or the Patient very young; and is full as rarely absent, where it is severe, and the Patient is past seven or eight Years old: but when the Eruption is very confluent, and the Patient adult, or grown up, the Discharge is surprizing. Under these Circumstances it flows out incessantly, allowing the afflicted Patient no Rest or Respite; and often incommodes him more than any other Symptom of the Distemper; and so much the more, as after its Continuance for some Days, the Lips, the Inside of the Cheeks, the Tongue, and the Roof of the Mouth are entirely peeled or flead, as it were. Nevertheless, however painful and embarrassing this Discharge may prove, it is very important and salutary. Meer Infants are less subject to it, some of them having a Looseness, in Lieu of it: and yet I have observed even this last Discharge to be considerably less frequent in them, than a Salivation is in grown People. [52] As Pustules are, and not very seldom, visible on the Tongue, and sometimes on the Roof, even to its Process called the Palate, which I have plainly seen; it seems not very easy to assign any insuperable Obstacle to the Existence of a few within the Throat; though this scarcely ever occurs, in the distinct Small-Pocks. Doubtless however, a considerable Inflammation of that Part will be as likely to produce the great Difficulty of Swallowing, as the Existence of Pustules there; which our learned Author does not absolutely reject, and consequently will forgive this Supposition of them; especially if he credits the ocular Testimony of Dr. _Violante_, cited in the Analysis, Ed. 2d. p 71. _K._ § 208. Children, to the Age of five or six Years, are liable to Convulsions, before Eruption: these however are not dangerous, if they are not accompanied with other grievous and violent Symptoms. But such Convulsions as supervene, either when Eruption having already occurred, suddenly retreats, or _strikes in_, according to the common Phrase; or during the Course of the Fever of Suppuration, are greatly more terrifying. Involuntary Discharges of Blood from the Nose often occur, in the first Stage of this Distemper, which are extremely serviceable, and commonly lessen, or carry off, the Head-ach. Meer Infants are less subject to this Discharge; though they have sometimes a little of it: and I have known a considerable _Stupor_ or Drowsiness, vanish immediately after this Bleeding. § 209. The Small-Pocks is commonly distinguished into two Kinds, the confluent and the distinct, such a Distinction really existing in Nature: but as the Treatment of each of them is the same; and as the Quantity or Dose of the Medicines is only to be varied, in Proportion to the Danger of the Patient (not to enter here into very tedious Details, and such as might exceed the Comprehension of many of our Readers; as well as whatever might relate particularly to the malignant Small-Pocks) I shall limit myself within the Description I have premised, which includes all the Symptoms common to both these Kinds of the Small-Pocks. I content myself with adding here, that we may expect a very confluent and dangerous Pock, is, at the very Time of seizure, the Patient is immediately attacked with many violent Symptoms; more especially if his Eyes are extremely quick, lively, and even glistening, as it were; if he vomits almost continually; if the Pain of his Loins be violent; and if he suffers at the same Time great Anguish and Inquietude: If in Infants there is great _Stupor_ or Heaviness; if Eruption appears on the third Day, and sometimes even on the second: as the hastier Eruptions in this Disease signify the most dangerous Kind and Degree of it; and on the contrary, the slower Eruption is, it is the safer too; supposing this Slowness of the Eruption not to have been the Consequence of great Weakness, or of some violent inward Pain. § 210. The Disorder is sometimes so very mild and slight, that Eruption appears with scarcely any Suspicion of the Child's having the least Ailment, and the Event is as favourable as the Invasion. The Pustules appear, grow large, suppurate and attain their Maturity, without confining the Patient to his Bed, or lessening either his Sleep, or Appetite. It is very common to see Children in the Country (and they are seldom more than Children who have it so very gently) run about in the open Air, through the whole Course of this Disease, and feeding just as they do in Health. Even those who take it in a somewhat higher Degree, commonly go out when Eruption is finished, and give themselves up, without Reserve, to the Voracity of their Hunger. Notwithstanding all this Neglect, many get perfectly cured; though such a Conduct should never be proposed for Imitation, since Numbers have experienced its pernicious Consequences, and several of these Children have been brought to me, especially from _Jurat_, who after such Neglect, in the Course of the mild and kindly Sort of this Distemper, have contracted Complaints and Infirmities of different Kinds, which have been found very difficult to subdue. § 211. This still continues to be one of these Distempers, whose Danger has long been increased by its improper Treatment, and especially by forcing the Patients into Sweats; and it still continues to be increased, particularly among Country People. They have seen Eruption appear, where the Patient sweats, and observed he found himself better after its Appearance: and hence they conclude that, by quickening and forcing out this Eruption, they contribute to his Relief; and suppose, that by increasing the Quantity of his Sweats, and the Number of his Eruptions, the Blood is the better cleared and purified from the Poison. These are mortal Errors, which daily Experience has demonstrated, by their tragical Consequences. When the Contagion or Poison, which generates this Disease, has been admitted into the Blood, it requires a certain Term to produce its usual Effects: at which Time the Blood being tainted by the Venom it has received, and by that which such Venom has formed or assimilated from it, Nature makes an Effort to free herself of it, and to expell it by the Skin, precisely at the Time when every Thing is predisposed for that Purpose. This Effort pretty generally succeeds, being very often rather too rapid and violent, and very seldom too weak. Hence it is evident, that whenever this Effort is deficient, it ought not to be heightened by hot Medicines or Means, which make it too violent and dangerous: for when it already exceeds in this Respect, a further Increase of such Violence must render it mortal. There are but few Cases in which the Efforts of Nature, on this Occasion, are too languid and feeble, especially in the Country; and whenever such rare Cases do occur, it is very difficult to form a just and proper Estimation of them: for which Reason we should be very reserved and cautious in the Use of heating Medicines, which are so mortally pernicious in this Disease. Wine, Venice Treacle, cordial Confections, hot Air, and Loads of Bed-cloths, annually sweep off Thousands of Children, who might have recovered, if they had taken nothing but warm Water: and every Person who is interested in the Recovery of Patients in this Distemper, ought carefully to prevent the smallest Use of such Drugs; which, if they should not immediately aggravate it to a fatal Degree, yet will certainly increase the Severity and Torment of it, and annex the most unhappy and tragical Consequences to it. The Prejudice in this Point is so strongly rooted, that a total Eradication of it must be very difficult: but I only desire People would be convinced by their own Eyes, of the different Success of the hot Regimen, and of that I shall propose. And here indeed I must confess, I found more Attention and Docility, on this Point, among the Inhabitants of the City, and especially in the last epidemical spreading of the Small-Pocks, than I presumed to hope for. Not only as many as consulted me on the Invasion of it, complied exactly with the cooling Regimen I advised them; but their Neighbours also had Recourse to it, when their Children sickened: and being often called in when it had been many Days advanced, I observed with great Pleasure, that in many Houses, not one heating Medicine had been given; and great Care had been taken to keep the Air of the Patient's Chamber refreshingly cool and temperate. This encourages me to expect, that this Method hereafter will become general here. What certainly ought most essentially to conduce to this is, that notwithstanding the Diffusion or spreading of this Disease was as numerous and extensive as any of the former, the Mortality, in Consequence of it, was evidently less. § 212. At the very Beginning of the Small-Pocks (which may be reasonably suspected, from the Presence of the Symptoms I have already described; supposing the Person complaining never to have had it, and the Disease to prevail near his Residence) the Patient is immediately to be put on a strict Regimen, and to have his Legs bathed Night and Morning in warm Water. This is the most proper and promising Method to lessen the Quantity of Eruption in the Face and Head, and to facilitate it every where else on the Surface. Glysters also greatly contribute to abate the Head-ach, and to diminish the Reachings to vomit, and the actual Vomitings, which greatly distress the Patient; but which however it is highly absurd and pernicious to stop by any stomachic cordial Confection, or by Venice Treacle; and still more dangerous to attempt removing the Cause of them, by a Vomit or Purge, which are hurtful in the beginning of the Small-Pocks. If the Fever be moderate, the Bathings of the Legs on the first Day of sickening, and one Glyster may suffice then. The Patient must be restrained to his Regimen; and instead of the Ptisan Nº. 1, 2, 4, a very young Child should drink nothing but Milk diluted with two thirds of Elder Flower or Lime-tree Tea, or with Balm Tea, if there be no perceivable Fever; and in short, if they have an Aversion to the Taste of them all, with only the same Quantity of good clear [53] Water. An Apple coddled or baked may be added to it; and if they complain of Hunger, a little Bread may be allowed; but they must be denied any Meat, or Meat Broth, Eggs and strong Drink; since it has appeared from Observations frequently repeated, that Children who had been indulged with such Diet proved the worse for it, and recovered more slowly than others. In this early Stage too, clear Whey alone may serve them instead of every other Drink, the good Effects of which I have frequently been a Witness to; or some Buttermilk may be allowed. When the Distemper is of a mild Species, a perfect Cure ensues, without any other Assistance or Medicine: but we should not neglect to purge the Patient as soon as the Pustules are perfectly scabbed on the greater Part of his Face, with the Prescription Nº. 11, which must be repeated six Days after. He should not be allowed Flesh 'till after this second Purge; though after the first he may he allowed some well-boiled Pulse, or Garden-stuff and Bread, and in such a Quantity, as not to be pinched with Hunger, while he recovers from the Disease. [53] A Negro Girl, about five or six Years old, under a coherent Pock, stole by Night out of the Garret where she lay, into a Kitchen out of Doors, where she drank plentifully of cold Water. How often she repeated these nightly cooling Potions I never could certainly learn, though they occurred in my own House in _South-Carolina_ in Summer. But it is certain the Child recovered as speedily as others, whose Eruption was more distinct, and who drank Barley-Water, very thin Rice or Indian Corn Gruel, Balm Tea, or the like. In fact, throughout the Course of this Visitation from the Small Pocks in _Carolina_ in 1738, we had but too many Demonstrations of the fatal Co-operation of violent Heat with their Contagion; and not a very few surprizing Instances of the salutary Effects of being necessarily and involuntarily exposed to same very cooling Accidents after Infection, and in some Cases after Eruption too: which I then more particularly mentioned is a small controversial Tract printed there. _K._ § 213. But if the Fever should be strong, the Pulse hard, and the Pain of the Head and Loins should be violent, he must, 1. immediately lose Blood from the Arm; receive a Glyster two Hours after; and, if the Fever continues, the Bleeding must be repeated. I have directed a Repetition of it even to the fourth Time, within the two first Days, to young People under the Age of eighteen; and it is more especially necessary in such Persons as, with a hard and full Pulse, are also affected with a heavy Drowsiness and a _Delirium_, or Raving. 2. As long as the Fever continues violently, two, three, and even four Glysters should be given in the 24 Hours; and the Legs should be bathed twice. 3. The Patient is to be taken out of Bed, and supported in a Chair as long as he can tolerably bear it. 4. The Air of his Chamber should frequently be renewed, and if it be too hot, which it often is in Summer, in Order to refresh it, and the Patient, the Means must be employed which are directed § 36. 5. He is to be restrained to the Ptisans Nº. 2 or 4; and if that does not sufficiently moderate the Fever, he should take every Hour, or every two Hours, according to the Urgency of the Case, a Spoonful of the Mixture Nº. 10; mixed with a Cup of Ptisan. After the Eruption, the Fever being then abated, there is less Occasion for Medicine; and should it even entirely disappear, the Patient may be regulated, as directed, § 212. § 214. When, after a Calm, a Remission or Intermission of some Days, the Process of Suppuration revives the Fever, we ought first, and especially, to keep the [54] Body very open. For this Purpose, _a_ an Ounce of _Catholicon_ should be added to the Glysters; or they might be simply made of Whey, with Honey, Oil and Salt. _b_ Give the Patient three times every Morning, at the Interval of two Hours between each, three Glasses of the Ptisan Nº. 32. _c_ Purge him _after_ two Days, with the Potion Nº. 23, but on that Day he must not take the Ptisan Nº. 32. [54] We must remember that Dr. _Tissot_ is treating _here_ of the higher or confluent Degrees of this Disease; for in the distinct Small-Pocks, it is common to find Persons for several Days without a Stool, and without the least perceiveable Disorder for Want of one (their whole Nourishment being very light and liquid) in which Cases, while Matters proceeded well in all other Respects, there seems little Occasion for a great Solicitude about Stools: But if one should be judged necessary after four or five Days Costiveness, accompanied with a Tightness or Hardness of the Belly, doubtless the Glyster should be of the lenient Kind (as those directed by our Author are) and not calculated to produce more than a second Stool at the very most. Indeed, where there is Reason to apprehend a strong secondary Fever, from the Quantity of Eruption, and a previously high Inflammation, it is more prudent to provide for a Mitigation of it, by a moderately open Belly, than to suffer a long Costiveness; yet so as to incur very little Hazard of abating the Salivation, or retarding the Growth or Suppuration of the Pustules, by a Superpurgation, which it may be too easy to excite in some Habits. If the Discharge by spitting, and the Brightness and Quantity of Suppuration, have been in Proportion to the Number of Eruptions; though the Conflict from the secondary Fever, where these have been numerous, is often acute and high; and the Patient, who is in great Anguish, is far from being out of Danger, yet Nature pretty generally proves stronger than the Disease, in such Circumstances. As the _Elect. Catholicon_, is little used, or made here, the lenitive Electuary of our Dispensatory may be substituted for it, or that of the _Edinburgh_ Dispensatory, which was calculated particularly for Glysters. _K._ 2. He must, if the Distemper be very violent, take a double Dose of the Mixture Nº. 10. 3. The Patient should be taken out of Bed, and kept up in a Room well aired Day and Night, until the Fever has abated. Many Persons will probably be surprized at this Advice; nevertheless it is that which I have often experienced to be the most efficacious, and without which the others are ineffectual. They will say, how shall the Patient sleep at this Rate? To which it may be answered, Sleep is not necessary, nay, it is hurtful in this State and Stage of the Disease. Besides, he is really unable to sleep: the continual Salivation prevents it, and it is very necessary to keep up the Salivation; which is facilitated by often injecting warm Water and Honey into his Throat. It is also of considerable Service to throw some up his Nostrils, and often thus to cleanse the Scabs which form within them. A due Regard to these Circumstances not only contributes to lessen the Patient's Uneasiness, but very effectually also to his Cure. 4. If the Face and Neck are greatly swelled, emollient Cataplasms are to be applied to the Soles of the Feet; and if these should have very little Effect, Sinapisms should be applied. These are a kind of Plaister or Application composed of Yeast, Mustard-flower, and some Vinegar. They sometimes occasion sharp and almost burning Pain, but in Proportion to the Sharpness and Increase of these Pains, the Head and Neck are remarkably relieved. § 215. The Eyelids are puffed up and swelled when the Disease runs high, so as to conceal the Eyes, which are closed up fast for several Days. Nothing further should be attempted, with Respect to this Circumstance, but the frequent moistening of them with a little warm Milk and Water. The Precautions which some take to stroke them with Saffron, a gold Ducat, or Rose-water are equally childish and insignificant. What chiefly conduces to prevent the Redness or Inflammation of the Eyes after the Disease, and in general all its other bad Consequences, is to be content for a considerable Time, with a very moderate Quantity of Food, and particularly to abstain from Flesh and Wine. In the very bad Small Pocks, and in little Children, the Eyes are closed up from the Beginning of the Eruption. § 216. One extremely serviceable Assistance, and which has not been made use of for a long Time past, except as a Means to preserve the Smoothness and Beauty of the Face; but yet which has the greatest Tendency to preserve Life itself, is the Opening of the Pustules, not only upon the Face, but all over the Body. In the first Place, by opening them, the Lodgment or Retention of _Pus_ is prevented, which may be supposed to prevent any Erosion, or eating down, from it; whence Scars, deep Pitts and other Deformities are obviated. Secondly, in giving a Vent to the Poison, the Retreat of it into the Blood is cut off, which removes a principal Cause of the Danger of the Small-Pocks. Thirdly, the Skin is relaxed; the Tumour of the Face and Neck diminish in Proportion to that Relaxation; and thence the Return of the Blood from the Brain is facilitated, which must prove a great Advantage. The Pustules should be opened every where, successively as they ripen. The precise Time of doing it is when they are entirely white; when they just begin to turn but a very little yellowish; and when the red Circle surrounding them is quite pale. They should be opened with very fine sharp-pointed Scissars; this does not give the Patient the least Pain; and when a certain Number of them are opened, a Spunge dipt in a little warm Water is to be repeatedly applied to suck up and remove that _Pus_, which would soon be dried up into Scabs. But as the Pustules, when emptied thus, soon fill again, a Discharge of this fresh Matter must be obtained in the same Manner some Hours after; and this must sometimes be repeated five or even six Times successively. Such extraordinary Attention in this Point may probably be considered as minute, and even trivial, by some; and is very unlikely to become a [55] general Practice: but I do again affirm it to be of much more Importance than many may imagine; and that as often as the Fever attending Suppuration is violent and menacing, a very general, exact and repeated opening, emptying, and absorbing of the ripened Pustules, is a Remedy of the utmost Importance and Efficacy; as it removes two very considerable Causes of the Danger of this Disease, which are the Matter itself, and the great Tension and Stiffness of the Skin. [55] This Practice which I had heard of, and even suggested to myself, but never seen actually enterprized, seems so very rational as highly to deserve a fair Trial in the confluent Degrees of the Small-Pocks [for in the distinct it can scarcely be necessary] wherein every probable Assistance should be employed, and in which the most potent Medicines are very often unsuccessful. We have but too many Opportunities of trying it sufficiently; and it certainly has a more promising Aspect than a Practice so highly recommended many Years ago, of covering all the Pustules (which is sometimes the whole Surface of the Patient) in Melilot, or suppose any other suppurating, Plaister; which will effectually prevent all Perspiration, and greatly increase the Soreness, Pain and Embarrassment of the Patient, at the Height of the Disease. I can conceive but one bad Consequence that might possibly sometimes result from the former; but this (besides the Means that may be used to avert it) is rather remote, and so uncertain, until the Trial is repeatedly made, that I think it ought not to be named, in Competition with the Benefits that may arise from it in such Cases, as seem, otherwise, too generally irrecoverable. _K._ § 217. In the Treatment of this Disease, I have said nothing with Respect to Anodynes, or such Medicines as procure Sleep, which I am sensible are pretty generally employed in it, but which I scarcely ever direct in this violent Degree of the Disease, and the Dangers of which Medicine in it I have demonstrated in the Letter to Baron _Haller_, which I have already mentioned. For which Reason, wherever the Patient is not under the Care and Direction of a Physician, they should very carefully abstain from the Use of Venice Treacle, Laudanum, _Diacodium_, that is the Syrup of white Poppies, or even of the wild red Poppy; Syrup of Amber, Pills of Storax, of _Cynoglossum_ or Hounds-tongue, and, in one Word, of every Medicine which produces Sleep. But still more especially should their Use be entirely banished, throughout the Duration of the secondary Fever, when even natural Sleep itself is dangerous. One Circumstance in which their Use may sometimes be permitted, is in the Case of weakly Children, or such as are liable to Convulsions, where Eruption is effected not without Difficulty. But I must again inculcate the greatest Circumspection, in the Use of such Medicines, whose Effects are fatal, [56] when the Blood-vessels are turgid or full; whenever there is Inflammation, Fever, a great Distension of the Skin; whenever the Patient raves, or complains of Heaviness and Oppression; and when it is necessary that the Belly should be open; the Urine plentifully discharged; and the Salivation be freely promoted. [56] The Use of Opiates in this Disease undoubtedly requires no Small Consideration, the great _Sydenham_ himself not seeming always sufficiently guarded in the Exhibition of them; as far as Experience since his Day has enabled Physicians to judge of this Matter. In general our Author's Limitations of them seem very just; though we have seen a few clear Instances, in which a light Raving, which evidently arose from Want of Sleep (joined to some Dread of the Event of the Disease by Inoculation) was happily removed, with every other considerable Complaint, by a moderate Opiate. In sore and fretful Children too, under a large or middling Eruption, as the Time gained to Rest is taken from Pain, and from wasting their Spirits in Crying and Clamour, I have seen Suppuration very benignly promoted by _Diacodium_. But in the _Crisis_ of the secondary Fever in the confluent or coherent Pock, when there is a morbid Fulness, and Nature is struggling to unload herself by some other Outlets than those of the Skin, which now are totally obstructed (and which seems the only Evacuation, that is not restrained by Opiates) the giving and repeating them then, as has too often been practised, seems importantly erroneous; for I think Dr. _Swan_ has taken a judicious Liberty of dissenting from the great Author he translates, in forbidding an Opiate, if the Spitting abates, or grows so tough and ropy, as to endanger Suffocation. As the Difference of our Oeconomy in the Administration of Physic from that in _Swisserland_, and Dr. _Tissot's_ just Reputation may dispose many Country Practitioners to peruse this Treatise, I take the Liberty of referring such Readers, for a Recollection of some of my Sentiments of Opiates, long before the Appearance of this Work in French, to the second Edition of the Analysis from P. 94 to 97, _&c._ _K._ § 218. If Eruption should suddenly retreat, or strike in, heating, soporific, spirituous and volatile Remedies should carefully be avoided: but the Patient may drink plentifully of the Infusion Nº. 12 pretty hot, and should be blistered on the fleshy Part of the Legs. This is a very embarrassing and difficult Case, and the different Circumstances attending it may require different Means and Applications, the Detail and Discussion of which are beyond my Plan here. Sometimes a single Bleeding has effectually recalled Eruption at once. § 219. The only certain Method of surmounting all the Danger of this Malady, is to inoculate. But this most salutary Method, which ought to be regarded as a particular and gracious Dispensation of Providence, can scarcely be attainable by, or serviceable to, the Bulk of the People, except in those Countries, where Hospitals [57] are destined particularly for Inoculation. In these where as yet there are none, the only Resource that is left for Children who cannot be inoculated at home, is to dispose them happily for the Distemper, by a simple easy Preparation. [57] That I have long since had the Honour of agreeing with our learned Author, in this Consideration for the Benefit of the Body of the People, which is the Benefit of the State, will appear from p. 288 of Analys. Ed. 1st. and from p. 371, 372 of the Second. _K._ § 220. This Preparation consists, upon the whole, in removing all Want of, and all Obstructions to, the Health of the Person subject to this Disease, if he have any such; and in bringing him into a mild and healthy, but not into a very robust and vigorous, State; as this Distemper is often exceedingly violent in this last. It is evident, that since the Defects of Health are very different in different Bodies, the Preparations of them must as often vary; and that a Child subject to some habitual Disorder, cannot be prepared in the same Method with another who has a very opposite one. The Detail and Distinctions which are necessary on this important Head, would be improper here, whether it might be owing to their unavoidable Length; or to the Impossibility of giving Persons, who are not Physicians, sufficient Knowlege and Information to qualify them for determining on, and preferring, the most proper Preparation in various Cases. Nevertheless I will point out some such as may be very likely to agree, pretty generally, with Respect to strong and healthy Children. [58] [58] The Substance of this Section flows from the Combination of an excellent Understanding with great Experience, mature Reflection, and real Probity; and fundamentally exposes both the Absurdity of such as universally decry any Preparation of any Subject previous to Inoculation, (which is said to be the Practice of a present very popular Inoculator in _Paris_) and the opposite Absurdity of giving one and the very same Preparation to all Subjects, without Distinction; though this was avowed to have been successfully fully practised in _Pensylvania_, some Years since; which the Reader may see Analys. Ed. 2d, from p. 329 to 331 and the Note there. _K._ The first Step then is an Abatement of their usual Quantity of Food. Children commonly eat too much. Their Limitation should be in Proportion to their Size and Growth, where we could exactly ascertain them: but with Regard to all, or to much the greater Number of them, we may be allowed to make their Supper very light, and very small. Their second Advantage will consist in the Choice of their Food. This Circumstance is less within the Attainment of, and indeed less necessary for, the common People, who are of Course limited to a very few, than to the Rich, who have Room to make great Retrenchments on this Account. The Diet of Country People being of the simplest Kind, and almost solely consisting of Vegetables and of Milk-meats, is the most proper Diet towards preparing for this Disease. For this Reason, such Persons have little more to attend to in this Respect, but that such Aliments be sound and good in their Kind; that their Bread be well baked; their Pulse dressed without Bacon, or rancid strong Fat of any sort; that their Fruits should be well ripened; that their Children should have no Cakes or Tarts, [But see Note [11], P. 40, 41.] and but little Cheese. These simple Regulations may be sufficient, with Regard to this Article of their Preparation. Some Judgment may be formed of the good Consequences of their Care on these two Points, concerning the Quantity and Quality of the Childrens Diet, by the moderate Shrinking of their Bellies; as they will be rendered more lively and active by this Alteration in their living; and yet, notwithstanding a little less Ruddiness in their Complexion, and some Abatement of their common Plight of Body, their Countenances, upon the whole, will seem improved. The third Article I would recommend, is to bathe their Legs now and then in warm Water, before they go to Bed. This promotes Perspiration, cools, dilutes the Blood, and allays the Sharpness of it, as often as it is properly timed. The fourth Precaution, is the frequent Use of very clear Whey. This agreeable Remedy, which consists of the Juices of Herbs filtred through, and concocted, or as it were, sweetened by the Organs of a healthy Animal, answers every visible Indication (I am still speaking here of sound and hearty Children). It imparts a Flexibility, or Soupleness to the Vessels; it abates the Density, the heavy Consistence and Thickness of the Blood; which being augmented by the Action of the poisonous Cause of the Small-Pocks, would degenerate into a most dangerous inflammatory [59] Viscidity or Thickness. It removes all Obstructions in the _Viscera_, or Bowels of the lower Cavity, the Belly. It opens the Passages which strain off the Bile; sheaths, or blunts, its Sharpness, gives it a proper Fluidity, prevents its Putridity, and sweetens whatever excessive Acrimony may reside throughout the Mass of Humours. It likewise promotes Stools, Urine and Perspiration; and, in a Word, it communicates the most favourable Disposition to the Body, not to be too violently impressed and agitated by the Operation of an inflammatory Poison: And with Regard to such Children as I have mentioned, for those who are either sanguine or bilious, it is beyond all Contradiction, the most effectual preparatory Drink, and the most proper to make them amends for the Want of Inoculation. [59] There may certainly be an inflammatory Acrimony or Thinness, as well as Thickness of the Blood; and many medical Readers may think a morbid Fusion of the red Globules to be a more frequent Effect of this Contagion, than an increased Viscidity of them. See Analys. Ed. 2d. p. 75 to 83. But this Translation, conforming to the Spirit of its Original, admits very little Theory, and still less Controversy, into its Plan. _K._ I have already observed, that it may also be used to great Advantage, during the Course of the Disease: but I must also observe, that however salutary it is, in the Cases for which I have directed it, there are many others in which it would be hurtful. It would be extremely pernicious to order it to weak, languishing, scirrhous, pale Children, subject to Vomitings, Purgings, Acidities, and to all Diseases which prove their Bowels to be weak, their Humours to be sharp: so that People must be very cautious not to regard it as an universal and infallible Remedy, towards preparing for the Small-Pocks. Those to whom it is advised, may take a few Glasses every Morning, and even drink it daily, for their common Drink; they may also sup it with Bread for Breakfast, for Supper, and indeed at any Time. If Country People will pursue these Directions, which are very easy to observe and to comprehend, whenever the Small-Pocks rages, I am persuaded it must lessen the Mortality attending it. Some will certainly experience the Benefit of them; such I mean as are very sensible and discreet, and strongly influenced by the truest Love of their Children. Others there are Alas! who are too stupid to discern the Advantage of them, and too unnatural to take any just Care of their Families. __Chapter XIV.__ _Of the Measles._ __Sect.__ 221. The Measles, to which the human Species are as generally liable, as to the Small-Pocks, is a Distemper considerably related to it; though, generally speaking, it is less fatal; notwithstanding which, it is not a little destructive in some Countries. In _Swisserland_ we lose much fewer, immediately in the Disease, than from the Consequences of it. It happens now and then that the Small-Pocks and the Measles rage at the same Time, and in the same Place; though I have more frequently observed, that each of them was epidemical in different Years. Sometimes it also happens that both these Diseases are combined at once in the same Person; and that one supervenes before the other has finished its Course, which makes the Case very perilous. § 222. In some Constitutions the Measles gives Notice of its Approach many Days before its evident Invasion, by a small, frequent and dry Cough, without any other sensible Complaint: though more frequently by a general Uneasiness; by Successions of Shivering and of Heat; by a severe Head-ach in grown Persons; a Heaviness in Children; a considerable Complaint of the Throat; and, by what particularly characterizes this Distemper, an Inflammation and a considerable Heat in the Eyes, attended with a Swelling of the Eye-lids, with a Defluxion of sharp Tears, and so acute a Sensation, or Feeling of the Eyes, that they cannot bear the Light; by very frequent Sneezings, and a Dripping from the Nose of the same Humour with that, which trickles from the Eyes. The Heat and the Fever increases with Rapidity; the Patient is afflicted with a Cough, a Stuffing, with Anguish, and continual Reachings to vomit; with violent Pains in the Loins; and sometimes with a Looseness, under which Circumstance he is less persecuted with Vomiting. At other times, and in other Subjects, Sweating chiefly prevails, though in less Abundance than in the Small-Pocks. The Tongue is foul and white; the Thirst is often very high; and the Symptoms are generally more violent than in the mild Small-Pocks. At length, on the fourth or fifth Day, and sometimes about the End of the third, a sudden Eruption appears and in a very great Quantity, especially about the Face; which in a few Hours is covered with Spots, each of which resembles a Flea-bite; many of them soon joining form red Streaks or Suffusions larger or smaller, which inflame the Skin, and produce a very perceivable Swelling of the Face; whence the very Eyes are sometimes closed. Each small Spot or Suffusion is raised a little above the Surface, especially in the Face, where they are manifest both to the Sight and the Touch. In the other Parts of the Body, this Elevation or Rising is scarcely perceivable by any Circumstance, but the Roughness of the Skin. The Eruption, having first appeared in the Face, is afterwards extended to the Breast, the Back, the Arms, the Thighs and Legs. It generally spreads very plentifully over the Breast and the Back, and sometimes red Suffusions are found upon the Breast, before any Eruption has appeared in the Face. The Patient is often relieved, as in the Small-Pocks, by plentiful Discharges of Blood from the Nose, which carry off the Complaints of the Head, of the Eyes, and of the Throat. Whenever this Distemper appears in its mildest Character, almost every Symptom abates after Eruption, as it happens in the Small-Pocks; though, in general, the Change for the better is not as thoroughly perceivable, as it is in the Small-Pocks. It is certain the Reachings and Vomitings cease almost entirely; but the Fever, the Cough, the Head-ach continue; and I have sometimes observed that a bilious Vomiting, a Day or two after the Eruption, proved a more considerable Relief to the Patient than the Eruption had. On the third or fourth Day of the Eruption, the Redness diminishes; the Spots, or very small Pustules, dry up and fall off in very little branny Scales; the Cuticle, or superficial Skin also shrivels off; and is replaced by one succeeding beneath it. On the ninth Day, when the Progress of the Malady has been speedy, and on the eleventh, when it has been very slow, no Trace of the Redness is to be found; and the Surface immediately resumes its usual Appearance. § 223. Notwithstanding all which the Patient is not safe, except, during the Course of the Distemper, or immediately after it, he has had some considerable Evacuation; such as the Vomiting I have just mentioned; or a bilious Looseness; or considerable Discharges by Urine; or very plentiful Sweating. For when any of these Evacuations supervene, the Fever vanishes; the Patient resumes his Strength, and perfectly recovers. It happens sometimes too, and even without any of these perceivable Discharges, that insensible Perspiration expels the Relics of the poisonous Cause of this Disease, and the Patient recovers his Health. Yet it occurs too often, that this Venom not having been entirely expelled (or its internal Effects not having been thoroughly effaced) it is repelled upon the Lungs, where it produces a slight Inflammation. In Consequence of this the Oppression, the Cough, the Anguish, and Fever return, and the Patient's Situation becomes very dangerous. This Outrage is frequently less vehement, but it proves tedious and chronical, leaving a very obstinate Cough behind it, with many Resemblances of the Whooping-Cough. In 1758 there was an epidemic State of the Measles here extremely numerous, which affected great Numbers: Almost all who had it, and who were not very carefully and judiciously attended, were seized in Consequence of it with that Cough, which proved very violent and obstinate. § 224. However, notwithstanding this be the frequent Progress and Consequence of this Disease, when left entirely to itself, or erroneously treated, and more particularly when treated with a hot Regimen; yet when proper Care was taken to moderate the Fever at the Beginning, to dilute, and to keep up the Evacuations, such unhappy Consequences have been very rare. § 225. The proper Method of conducting this Distemper is much the same with that of the Small-Pocks. 1, If the Fever be high, the Pulse hard, the Load and Oppression heavy, and all the Symptoms violent, the Patient must be bled once or twice. 2, His Legs must be bathed, and he must take some Glysters: the Vehemence of the Symptoms must regulate the Number of each. 3, The Ptisans Nº. 3 or 4 must be taken, or a Tea of Elder and Lime-tree Flowers, to which a fifth Part Milk may be added. 4, The Vapour, the Steam of warm Water should also be employed, as very conducive to asswage the Cough; the Soreness of the Throat, and the Oppression the Patient labours under. 5, As soon as the Efflorescence, the Redness becomes pale, the Patient is to be purged with the Draught Nº. 23. 6, He is still to be kept strictly to his Regimen, for two Days after this Purge; after which he is to be put upon the Diet of those who are in a State of Recovery. 7, If during the Eruption such Symptoms supervene as occur [at the same Term] in the Small-Pocks, they are to be treated in the Manner already directed there. § 226. Whenever this Method has not been observed, and the Accidents described § 223 supervene, the Distemper must be treated like an Inflammation in its first State, and all must be done as directed § 225. If the Disease is not vehement, [60] Bleeding may be omitted. If it is of some standing in gross Children, loaded with Humours, inactive, and pale, we must add to the Medicines already prescribed the Potion Nº. 8, and Blisters to the Legs. [60] Our Author very prudently limits this Discharge, and the Repetition of it, in this Disease (§ 225) as an erroneous Excess of it has sometimes prevailed. I have seen a very epidemical Season of the Measles, where Bleeding was not indicated in one third of the infected. And yet I have known such an Abuse of Bleeding in it, that being repeated more than once in a Case before Eruption (the Measles probably not being suspected) the Eruption was retarded several Days; and the Patient, a young Lady of Condition, remained exceeding low, faint and sickish; 'till after recruiting a very little, the Measles appeared, and she recovered. In a Youth of a lax Fibre, where the Measles had appeared, a seventh or eighth Bleeding was ordered on a Stitch in the Side, supervening from their too early Disappearance, and the Case seemed very doubtful. But Nature continued very obstinately favourable in this Youth, who at length, but very slowly, recovered. His Circulation remained so languid, his Strength, with his Juices, so exhausted, that he was many Weeks before he could sit upright in a Chair, being obliged to make Use of a Cord depending from the Ceiling, to raise himself erectly in his Seat. _K._ § 227. It often happens from the Distance of proper Advice, that the Relics, the Dregs as it were, of the Disease have been too little regarded, especially the Cough; in which Circumstance it forms a real Suppuration in the Lungs, attended with a slow Fever. I have seen many Children in Country Villages destroyed by this Neglect. Their Case is then of the same Nature with that described § 68 and 82, and terminates in the same Manner in a Looseness, (attended with very little Pain) and sometimes a very foetid one, which carries off the Patient. In such Cases we must recur to the Remedies prescribed § 74, Article 3, 4, 5; to the Powder Nº. 14; and to Milk and Exercise. But it is so very difficult to make Children take the Powder, that it may be sometimes necessary to trust to the Milk without it, which I have often seen in such Situations accomplish a very difficult Cure. I must advise the Reader at the same Time, that it has not so compleat an Effect, as when it is taken solely unjoined by any other Aliment; and that it is of the last Importance not to join it with any, which has the least Acidity or Sharpness. Persons in easy Circumstances may successfully take, at the same Time, _Pfeffer_, [61] _Seltzer_, _Peterstal_, or some other light Waters, which are but moderately loaded with mineral Ingredients. These are also successfully employed in all the Cases, in which the Cure I have mentioned is necessary. [61] Bristol Water will be no bad Substitute for any of these, in such Cases. _K._ § 228. Sometimes there remains, after the Course of the Measles, a strong dry Cough, with great Heat in the Breast, and throughout the whole Body, with Thirst, an excessive Dryness of the Tongue, and of the whole Surface of the Body. I have cured Persons thus indisposed after this Distemper, by making them breathe in the Vapour of warm Water; by the repeated Use of warm Baths; and by allowing them to take nothing for several Days but Water and Milk. Before I take leave of this Subject, I assure the Reader again, that the contagious Cause of the Measles is of an extremely sharp and acrid Nature. It appears to have some Resemblance to the bilious Humour, which produces the _Erisipelas_, or St. Anthony's Fire; and thence it demands our particular Attention and Vigilance; without which very troublesome and dangerous Consequences may be apprehended. I have seen, not very long since, a young Girl, who was in a very languid State after the Measles, which she had Undergone three Years before: It was at length attended with an Ulceration in her Neck, which was cured, and her Health finally restored by _Sarsaparilla_ with Milk and Water. § 229. The Measles have been communicated by [62] Inoculation in some Countries, where it is of a very malignant Disposition; and that Method might also be very advantageous in this. But what we have already observed, with Respect to the Inoculation of the Small-Pocks, _viz._ That it cannot be extended to the general Benefit of the People, without the Foundation of Hospitals for that very Purpose, is equally applicable to the Inoculation of the Measles. [62] The only Account I have read of this Practice, is in the learned Dr. _Home's_ _Medical Facts and Experiments_, published in 1759, which admits, that but nine out of fifteen of the Subjects of this Practice took. Cotton dipt in the Blood of a Patient in the Measles was inserted into the Arms of twelve; and three received the Cotton into their Nostrils, after the Chinese Manner of infusing the Small-Pocks; but of these last not one took, and one of those who had taken, had the Measles again two Months after. We think the sharp hot Lymph distilling from the inflamed Eyes of Persons in this Disease, a likelier Vehicle to communicate it than the Blood, especially the dry Blood, which was sometimes tried; since the human _Serum_ seems the Fluid more particularly affected by it; and this must have been evaporated when the Blood grew dry. A few practical Strictures on this Work, and particularly on this Practice described in it, appeared in the Monthly Review Vol. XXI. P. 68 to 75. _K._ __Chapter XV.__ _Of the ardent or burning Fever._ __Sect.__ 230. The much greater Number of the Diseases I have hitherto considered, result from an Inflammation of the Blood, combined with the particular Inflammation of some Part, or occasioned by some Contagion or Poison, which must be evacuated. But when the Blood is solely and strongly inflamed, without an Attack on any particular Part, this Fever, which we term hot or burning, is the Consequence. § 231. The Signs which make it evident are, a Hardness and Fulness of the Pulse in a higher Degree than happens in any other Malady; an excessive Heat; great Thirst; with an extraordinary Dryness of the Eyes, Nostrils, Lips, of the Tongue, and of the Throat; a violent Head-ach; and sometimes a Raving at the Height of the Paroxysm, or Increase of the Fever, which rises considerably every Evening. The Respiration is also somewhat oppressed, but especially at the Return of this Paroxysm, with a Cough now and then; though without any Pain in the Breast, and without any Expectoration, or coughing up. The Body is costive; the Urine very high coloured, hot, and in a small Quantity. The Sick are also liable to start sometimes, but especially when they seem to sleep; for they have little sound refreshing Sleep, but rather a kind of Drowsiness, that makes them very little attentive to, or sensible of, whatever happens about them, or even of their own Condition. They have sometimes a little Sweat or Moisture; though commonly a very dry Skin; they are manifestly weak, and have either little or no Smell or Taste. § 232. This Disease, like all other inflammatory ones, is produced by the Causes which thicken the Blood, and increase its Motion; such as excessive Labour, violent Heat, Want of Sleep, the Abuse of Wine or other strong Liquors; the long Continuance of a dry Constitution of the Air, Excess of every kind, and heating inflaming Food. § 233. The Patient, under these Circumstances, ought, 1, immediately to be put upon a Regimen; to have the Food allowed him given only every eight Hours, and, in some Cases, only twice a Day: and indeed, when the Attack is extremely violent, Nourishment may be wholly omitted. 2, Bleeding should be performed and repeated, 'till the Hardness of the Pulse is sensibly abated. The first Discharge should be considerable, the second should be made four Hours after. If the Pulse is softened by the first, the second may be suspended, and not repeated before it becomes sufficiently hard again, to make us apprehensive of Danger: but should it continue strong and hard, the Bleeding may be repeated on the same Day to a third Time, which often happens to be all the Repetitions that are necessary. 3, The Glyster Nº. 5 should be given twice, or even thrice, daily. 4, His Legs are to be bathed twice a Day in warm Water: his Hands may be bathed in the same Water. Linen or Flanel Cloths dipt in warm Water may be applied over the Breast, and upon the Belly; and he should regularly drink the Almond Milk Nº. 4 and the Ptisan Nº. 7. The poorest Patients may content themselves with the last, but should drink very plentifully of it; and after the Bleeding properly repeated, fresh Air and the plentiful Continuance of small diluting Liquors generally establish the Health of the Patient. 5, If notwithstanding the repeated Bleedings, the Fever still rages highly, it may be lessened by giving a Spoonful of the Potion Nº. 10 every Hour, till it abates; and afterwards every three Hours, until it becomes very moderate. § 234. Hæmorrhages, or Bleedings, from the Nose frequently occur in this Fever, greatly to the Relief and Security of the Patient. The first Appearances of Amendment are a softening of the Pulse, (which however does not wholly lose all its Hardness, before the Disease entirely terminates) a sensible Abatement of the Head-ach; a greater Quantity of Urine, and that less high coloured; and a manifestly approaching Moisture of the Tongue. These favourable Signs keep increasing in their Degree, and there frequently ensue between the ninth and the fourteenth Day, and often after a Flurry of some Hours Continuance, very large Evacuations by Stool; a great Quantity of Urine, which lets fall a palely reddish Sediment; the Urine above it being very clear, and of a natural Colour; and these accompanied with Sweats in a less or greater Quantity. At the same Time the Nostrils and the Mouth grow moist: the brown and dry Crust which covered the Tongue, and which was hitherto inseparable from it, peels off of itself; the Thirst is diminished; the Clearness of the Faculties rises; the Drowsiness goes off, it is succeeded by comfortable Sleep, and the natural Strength is restored. When Things are evidently in this Way, the Patient should take the Potion Nº. 23, and be put upon the Regimen of those who are in a State of Recovery. It should be repeated at the End of eight or ten Days. Some Patients have perfectly recovered from this Fever, without the least Sediment in their Urine. § 235. The augmenting Danger of this Fever may be discerned, from the continued Hardness of the Pulse, though with an Abatement of its Strength; if the Brain becomes more confused; the Breathing more difficult; if the Eyes, Nose, Lips and Tongue become still more dry, and the Voice more altered. If to these Symptoms there be also added a Swelling of the Belly; a Diminution of the Quantity of Urine; a constant Raving; great Anxiety, and a certain Wildness of the Eyes, the Case is in a manner desperate; and the Patient cannot survive many Hours. The Hands and Fingers at this Period are incessantly in Motion, as if feeling for something upon the Bed-Cloths, which is commonly termed, their hunting for Flies. __Chapter XVI.__ _Of putrid Fevers._ __Sect.__ 236. Having treated of such feverish Distempers, as arise from an Inflammation of the Blood, I shall here treat of those produced by corrupt Humours, which stagnate in the Stomach, the Guts, or other Bowels of the lower Cavity, the Belly; or which have already passed from them into the Blood. These are called putrid Fevers, or sometimes bilious Fevers, when a certain Degeneracy or Corruption of the Bile seems chiefly to prevail in the Disease. § 237. This Distemper frequently gives Notice of its Approach, several Days before its manifest Attack; by a great Dejection, a Heaviness of the Head; Pains of the Loins and Knees; a Foulness of the Mouth in the Morning; little Appetite; broken Slumber; and sometimes by an excessive Head-ach for many Days, without any other Symptom. After this, or these Disorders, a Shivering comes on, followed by a sharp and dry Heat: the Pulse, which was small and quick during the Shivering, is raised during the Heat, and is often very strong, though it is not attended with the same Hardness, as in the preceding Fever; except the putrid Fever be combined with an inflammatory one, which it sometimes is. During this Time, that is the Duration of the Heat, the Head-ach is commonly extremely violent; the Patient is almost constantly affected with Loathings, and sometimes even with Vomiting; with Thirst, disagreeable Risings, a Bitterness in the Mouth; and very little Urine. This Heat continues for many Hours, frequently the whole Night; it abates a little in the Morning, and the Pulse, though always feverish, is then something less so, while the Patient suffers less, though still greatly dejected. The Tongue is white and furred, the Teeth are foul, and the Breath smells very disagreeably. The Colour, Quantity and Consistence of the Urine, are very various and changeable. Some Patients are costive, others frequently have small Stools, without the least Relief accruing from them. The Skin is sometimes dry, and at other Times there is some sensible Perspiration, but without any Benefit attending it. The Fever augments every Day, and frequently at unexpected irregular Periods. Besides that _great_ Paroxysm or Increase, which is perceivable in all the Subjects of this Fever, some have also other _less_ intervening ones. § 238. When the Disease is left to itself, or injudiciously treated; or when it proves more powerful than the Remedies against it, which is by no Means seldom the Case, the Aggravations of it become longer, more frequent and irregular. There is scarcely an Interval of Ease. The Patient's Belly is swell'd out like a Foot-ball; a _Delirium_ or Raving comes on; he proves insensible of his own Evacuations, which come away involuntarily; he rejects Assistance, and keeps muttering continually, with a quick, small, irregular Pulse. Sometimes little Spots of a brown, or of a livid Colour appear on the Surface, but particularly about the Neck, Back and Breast. All the Discharges from his Body have a most foetid Smell: convulsive Motions also supervene, especially in the Face; he lies down only on his Back, sinks down insensibly towards the Foot of the Bed, and picks about, as if catching Flies; his Pulse becomes so quick and so small, that it cannot be perceived without Difficulty, and cannot be counted. His Anguish seems inexpressible: his Sweats stream down from Agony: his Breast swells out as if distended by Fullness, and he dies miserably. § 239. When this Distemper is less violent, or more judiciously treated, and the Medicines succeed well, it continues for some Days in the State described § 237, without growing worse, though without abating. None of these Symptoms however appear, described § 238; but, on the contrary, all the Symptoms become milder, the Paroxysms, or Aggravations, are shorter and less violent, the Head-ach more supportable; the Discharges by Stool are less frequent, but more at once, and attended with Relief to the Patient. The Quantity of Urine is very considerable, though it varies at different Times in Colour and Consistence, as before. The Patient soon begins to get a little Sleep, and grows more composed and easy. The Tongue disengages itself from its Filth and Furriness, and Health gradually, yet daily, advances. § 240. This Fever seems to have no critical Time, either for its Termination in Recovery, or in Death. When it is very violent, or very badly conducted, it proves sometimes fatal on the ninth Day. Persons often die of it from the eighteenth to the twentieth; sometimes only about the fortieth; after having been alternately better and worse. When it happens but in a light Degree, it is sometimes cured within a few Days, after the earliest Evacuations. When it is of a very different Character, some Patients are not out of Danger before the End of six Weeks, and even still later. Nevertheless it is certain, that these Fevers, extended to this Length of Duration, often depend in a great Measure on the Manner of treating them; and that in general their Course must be determined, some time from the fourteenth to the thirtieth Day. § 241. The Treatment of this Species of Fevers is comprized in the following Method and Medicines. 1, The Patient must be put into a _Regimen_; and notwithstanding he is far from costive, and sometimes has even a small Purging, he should receive one Glyster daily. His common Drink should be Lemonade, (which is made of the Juice of Lemons, Sugar and Water) or the Ptisan Nº. 3. Instead of Juice of Lemons, Vinegar may be occasionally substituted, which, with Sugar and Water, makes an agreeable and very wholesome Drink in these Fevers. 2, If there be an Inflammation also, which may be discovered by the Strength and the Hardness of the Pulse, and by the Temperament and Complexion of the Patient; if he is naturally robust, and has heated himself by any of the Causes described, § 232, he should be bled once, and even a second Time, if necessary, some Hours after. I must observe however, that very frequently there is no such Inflammation, and that in such a Case, Bleeding would be hurtful. 3, When the Patient has drank very plentifully for two Days of these Liquids, if his Mouth still continues in a very foul State, and he has violent Reachings to vomit, he must take the Powder Nº. 34, dissolved in half a [63] Pot of warm Water, a [64] Glass of it being to be drank every half Quarter of an Hour. But as this Medicine vomits, it must not be taken, except we are certain the Patient is not under any Circumstance, which forbids the Use of a Vomit: all which Circumstances shall be particularly mentioned in the Chapter, respecting the Use of such Medicines, as are taken by way of Precaution, or Prevention. If the first Glasses excite a plentiful Vomiting, we must forbear giving another, and be content with obliging the Patient to drink a considerable Quantity of warm Water. But if the former Glasses do not occasion Vomiting, they must be repeated, as already directed until they do. Those who are afraid of taking this Medicine, which is usually called, the Emetic, may take that of Nº. 35, also drinking warm Water plentifully during its Operation; but the former is preferable, as more prevalent, in dangerous Cases. We must caution our Readers at the same Time, that wherever there is an Inflammation of any Part, neither of these Medicines must be given, which might prove a real Poison in such a Circumstance; and even if the Fever is extremely violent, though there should be no particular Inflammation, they should not be given. [63] That is about two Ounces more than a Pint and a half of our Measure. [64] About three Ounces. The Time of giving them is soon after the End of the Paroxysm, when the Fever is at the lowest. The Medicine Nº. 34 generally purges, after it ceases to make the Patient vomit: But Nº. 35 is seldom attended with the same Effect. When the Operation of the Vomit is entirely over, the Sick should return to the Use of the Ptisan; and great Care must be taken to prohibit them from the Use of Flesh Broth, under the Pretext of working off a Purging with it. The same Method is to be continued on the following Days as on the first; but as it is of Importance to keep the Body open, he should take every Morning some of the Ptisan Nº. 32. Such, as this would be too expensive for, may substitute, in the room of it, a fourth Part of the Powder Nº. 34 in five or six Glasses of Water, of which they are to take a Cup every two Hours, beginning early in the Morning. Nevertheless, if the Fever be very high, Nº. 32 should be preferred to it. 4, After the Operation of the Vomit, if the Fever still continue, if the Stools are remarkably foetid, and if the Belly is tense and distended as it were, and the Quantity of Urine is small, a Spoonful of the Potion Nº. 10 should be given every two Hours, which checks the Putridity and abates the Fever. Should the Distemper become violent, and very pressing, it ought to be taken every Hour. 5, Whenever, notwithstanding the giving all these Medicines as directed, the Fever continues obstinate; the Brain is manifestly disordered; there is a violent Head-ach, or very great Restlessness, two blistering Plaisters Nº. 36 must be applied to the inside and fleshy Part of the Legs, and their Suppuration and Discharge should be continued as long as possible. 6, If the Fever is extremely violent indeed, there is a Necessity absolutely to prohibit the Patient from receiving the least Nourishment. 7, When it is thought improper, or unsafe, to give the Vomit, the Patient should take in the Morning, for two successive Days, three Doses of the Powder Nº. 24, at the Interval of one Hour between each: This Medicine produces some bilious Stools, which greatly abate the Fever, and considerably lessen the Violence of all the other Symptoms of the Disease. This may be done with Success, when the excessive Height of the Fever prevents us from giving the Vomit: and we should limit ourselves to this Medicine, as often as we are uncertain, what ever the Circumstances of the Disease and the Patient will admit of the Vomiting; which may thus be dispensed with, in many Cases. 8, When the Distemper has manifestly and considerably declined; the Paroxysms are more slight; and the Patient continues without any Fever for several Hours, the daily use of the purging opening Drinks should be discontinued. The common Ptisans however should be still made use of; and it will be proper to give every other Day two Doses of the Powder Nº. 24, which sufficiently obviates every ill Consequence from this Disease. 9, If the Fever has been clearly off for a long Part of the Day; if the Tongue appears in a good healthy State; if the Patient has been well purged; and yet one moderate Paroxysm of the Fever returns every Day, he should take four Doses of the Powder Nº. 14 between the End of one Return and the Beginning of the next, and continue this Repetition some Days. People who cannot easily procure this Medicine, may substitute, instead of it, the bitter Decoction Nº. 37. four Glasses of which may be taken at equal Intervals, between the two Paroxysms or Returns of the Fever. 10, As the Organs of Digestion have been considerably weakened through the Course of this Fever, there is a Necessity for the Patient's conducting himself very prudently and regularly long after it, with Regard both to the Quantity and Quality of his Food. He should also use due Exercise as soon as his Strength will permit, without which he may be liable to fall into some chronical and languishing Disorder, productive of considerable Languor and Weakness. * [*] As our Jail, Hospital, and Camp Fevers may often be ranged in this Class, as of the most putrid Kind, and not seldom occasioned by bad Food, bad Air, unclean, unwholesome Lodging, _&c._ a judicious Use may certainly be made of a small Quantity of genuine, and not ungenerous, Wine in such of them, as are not blended with an inflammatory Cause, or inflammable Constitution, or which do not greatly result from a bilious Cause; though in these last, where there is manifest Lowness and Dejection, perhaps a little Rhenish might be properly interposed between the Lemonade and other Drinks directed § 241. Doubtless Dr. _Tissot_ was perfectly apprized of this salutary Use of it in some low Fevers; but the Necessity of its being regulated by the Presence of a Physician has probably disposed him rather to omit mentioning it, than to leave the Allowance of it to the Discretion of a simple Country Patient, or his ignorant Assistants. _K._ __Chapter XVII.__ _Of malignant Fevers._ __Sect.__ 242. Those Fevers are termed malignant, in which the Danger is more than the Symptoms would make us apprehensive of: they have frequently a fatal Event without appearing so very perilous; on which Account it has been well said of this Fever, that it is a Dog which bites without barking. § 243. The distinguishing _Criterion_ or Mark of malignant Fevers is a total Loss of the Patient's Strength, immediately on their first Attack. They arise from a Corruption of the Humours, which is noxious to the very Source and Principle of Strength, the Impairing or Destruction of which is the Cause of the Feebleness of the Symptoms; by Reason none of the Organs are strong enough to exert an Opposition sufficiently vigorous, to subdue the Cause of the Distemper. If, for Instance or Illustration, we were to suppose, that when two Armies were on the Point of engaging, one of them should be nearly deprived of all their Weapons, the Contest would not appear very violent, nor attended with great Noise or Tumult, though with a horrible Massacre. The Spectator, who, from being ignorant of one of the Armies being disarmed, would not be able to calculate the Carnage of the Battle, but in Proportion to its Noise and Tumult, must be extremely deceived in his Conception of it. The Number of the Slain would be astonishing, which might have been much less (though the Noise and Clangor of it had been greater) if each Army had been equally provided for the Combat. § 244. The Causes of this Disease are a long Use of animal Food or Flesh alone, without Pulse, Fruits or Acids; the continued Use of other bad Provisions, such as Bread made of damaged Corn or Grain, or very stale Meat. Eight Persons, who dined together on corrupt Fish, were all seized with a malignant Fever, which killed five of them, notwithstanding the Endeavours of the most able Physicians. These Fevers are also frequently the Consequence of a great Dearth or Famine; of too hot and moist an Air, or an Air, which highly partakes of these two Qualities; so that they happen to spread most in hot Years, in Places abounding with Marshes and standing Waters. They are also the Effect of a very close and stagnant Air, especially if many Persons are crouded together in it, this being a Cause that particularly tends to corrupt the Air. Tedious Grief and Vexation also contribute to generate these Fevers. § 245. The Symptoms of malignant Fevers are, as I have already observed, a total and sudden Loss of Strength, without any evident preceding Cause, sufficient to produce such a Privation of Strength: at the same Time there is also an utter Dejection of the Mind, which becomes almost insensible and inattentive to every Thing, and even to the Disease itself; a sudden Alteration in the Countenance, especially in the Eyes: some small Shiverings, which are varied throughout the Space of twenty-four Hours, with little Paroxysms or Vicissitudes of Heat; sometimes there is a great Head-ach and a Pain in the Loins; at other Times there is no perceivable Pain in any Part; a kind of Sinkings or Faintings, immediately from the Invasion of the Disease, which is always very unpromising; not the least refreshing Sleep; frequently a kind of half Sleep, or Drowsiness; a light and silent or inward Raving, which discovers itself in the unusual and astonished Look of the Patient, who seems profoundly employed in meditating on something, but really thinks of nothing, or not at all: Some Patients have, however, violent Ravings; most have a Sensation of Weight or Oppression, and at other Times of a Binding or Tightness about, or around, the Pit of the Stomach. The sick Person seems to labour under great Anguish: he has sometimes slight convulsive Motions and Twitchings in his Face and his Hands, as well as in his Arms and Legs. His Senses seem torpid, or as it were benumbed. I have seen many who had lost, to all Appearance, the whole five, and yet some of them recover. It is not uncommon to meet with some, who neither see, understand, nor speak. Their Voices change, become weak, and are sometimes quite lost. Some of them have a fixed Pain in some Part of the Belly: this arises from a Stuffing or Obstruction, and often ends in a Gangrene, whence this Symptom is highly dangerous and perplexing. The Tongue is sometimes very little altered from its Appearance in Health; at other Times covered over with a yellowish brown Humour; but it is more rarely dry in this Fever than in the others; and yet it sometimes does resemble a Tongue that has been long smoaked. The Belly is sometimes very soft, and at other Times tense and hard. The Pulse is weak, sometimes pretty regular, but always more quick than in a natural State, and at some Times even very quick; and such I have always found it, when the Belly has been distended. The Skin is often neither hot, dry, nor moist: it is frequently overspread with petechial or eruptive Spots (which are little Spots of a reddish livid Colour) especially on the Neck, about the Shoulders, and upon the Back. At other Times the Spots are larger and brown, like the Colour of Wheals from the Strokes of a Stick. The Urine of the Sick is almost constantly crude, that is of a lighter Colour than ordinary. I have seen some, which could not be distinguished, merely by the Eye, from Milk. A black and stinking Purging sometimes attends this Fever, which is mortal, except the Sick be evidently relieved by the Discharge. Some of the Patients are infested with livid Ulcers on the Inside of the Mouth, and on the Palate. At other Times Abscesses are formed in the Glands of the Groin, of the Arm-pit, in those between the Ears and the Jaw; or a Gangrene may appear in some Part, as on the Feet, the Hands, or the Back. The Strength proves entirely spent, the Brain is wholly confused: the miserable Patient stretched out on his Back, frequently expires under Convulsions, an enormous Sweat, and an oppressed Breast and Respiration. Hæmorrhages also happen sometimes and are mortal, being almost unexceptionably such in this Fever. There is also in this, as in all other Fevers, an Aggravation of the Fever in the Evening. § 246. The Duration and _Crisis_ of these malignant, as well as those of putrid Fevers, are very irregular. Sometimes the Sick die on the seventh or eighth Day, more commonly between the twelfth and the fifteenth, and not infrequently at the End of five or six Weeks. These different Durations result from the different Degree and Strength of the Disease. Some of these Fevers at their first Invasion are very slow; and during a few of the first Days, the Patient, though very weak, and with a very different Look and Manner, scarcely thinks himself sick. The Term or Period of the Cure or the Recovery, is as uncertain as that of Death in this Distemper. Some are out of Danger at the End of fifteen Days, and even sooner; others not before the Expiration of several Weeks. The Signs which portend a Recovery are, a little more Strength in the Pulse; a more concocted Urine; less Dejection and Discouragement; a less confused Brain; an equal kindly Heat; a pretty warm or hot Sweat in a moderate Quantity, without Inquietude or Anguish; the Revival of the different Senses that were extinguished, or greatly suspended in the Progress of the Disease; though the Deafness is not a very threatening Symptom, if the others amend while it endures. This Malady commonly leaves the Patient in a very weak Condition; and a long Interval will ensue between the End of it, and their recovering their full Strength. § 247. It is, in the first place, of greater Importance in this Distemper than in any other, both for the Benefit of the Patients, and those who attend them, that the Air should be renewed and purified. Vinegar should often be evaporated from a hot Tile or Iron in the Chamber, and one Window kept almost constantly open. 2, The Diet should be light; and the Juice of Sorrel may be mixed with their Water; the Juice of Lemons may be added to Soups prepared from different Grains and Pulse; the Patient may eat sharp acid Fruits, such as tart juicy [65] Cherries, Gooseberries, small black Cherries; and those who can afford them, may be allowed Lemons, Oranges and Pomgranates. [65] The French Word is _Griettes_, which _Beyer_ englishes, _the Agriot, the red or sour Cherry_; and _Chambaud, the sweeter large black Cherry or Mazzard_--But as Dr. _Tissot_ was recommending the Use of Acids, it is more probably the first of these: so that our Morellas, which make a pleasant Preserve, may be a good Substitute to them, supposing them not to be the same. Our Berbery Jam, and Jelly of Red Currants, may be also employed to answer the same Indication. _K._ 3, The Patient's Linen should be changed every two Days. 4, Bleeding is very rarely necessary, or even proper, in this Fever; the Exceptions to which are very few, and cannot be thoroughly ascertained, as fit and proper Exceptions to the Omission of Bleeding, without a Physician, or some other very skilful Person's seeing the Patient. 5, There is often very little Occasion for Glysters, which are sometimes dangerous in this Fever. 6, The Patient's common Drink should be Barley Water made acid with the Spirit Nº. 10, at the Rate of one Quarter of an Ounce to at least full three Pints of the Water, or acidulated agreeably to his Taste. He may also drink Lemonade. 7, It is necessary to open and evacuate the Bowels, where a great Quantity of corrupt Humours is generally lodged. The Powder Nº. 35 may be given for this Purpose, after the Operation of which the Patient generally finds himself better, at least for some Hours. It is of Importance not to omit this at the Beginning of the Disease; though if it has been omitted at first, it were best to give it even later, provided no particular Inflammation has supervened, and the Patient has still some Strength. I have given it, and with remarkable Success, on the twentieth Day. 8, Having by this Medicine expelled a considerable Portion of the bad Humours, which contribute to feed and keep up the Fever, the Patient should take every other Day, during the Continuance of the Disease, and sometimes even every Day, one Dose of the Cream of Tartar and Rhubarb Nº. 38. This Remedy evacuates the corrupt Humours, prevents the Corruption of the others; expells the Worms that are very common in these Fevers, which the Patient sometimes discharges upwards and downwards; and which frequently conduce to many of the odd and extraordinary Symptoms, that are observed in malignant Fevers. In short it strengthens the Bowels, and, without checking the necessary Evacuations, it moderates the Looseness, when it is hurtful. 9, If the Skin be dry, with a Looseness, and that by checking it, we design to increase Perspiration, instead of the Rhubarb, the Cream of Tartar may be blended with the Ipecacuana, Nº. 39, which, being given in small and frequent Doses, restrains the Purging, and promotes Perspiration. This Medicine, as the former, is to be taken in the Morning; two Hours after, the Sick must begin with the Potion Nº. 40, and repeat it regularly every three Hours; until it be interrupted by giving one of the Medicines Nº. 38 or 39: After which the Potion is to be repeated again, as already directed, till the Patient grows considerably better. 10, If the Strength of the Sick be very considerably depressed, and he is in great Dejection and Anguish, he should take, with every Draught of the Potion, the Bolus, or Morsel Nº. 41. If the _Diarrhoea_, the Purging is violent, there should be added, once or twice a Day to the Bolus, the Weight of twenty Grains, or the Size of a very small Bean, of _Diascordium_; or if that is not readily to be got, as much Venice Treacle. 11, Whenever, notwithstanding all this Assistance, the Patient continues in a State of Weakness and Insensibility, two large Blisters should be applied to the fleshy Insides of the Legs, or a large one to the Nape of the Neck: and sometimes, if there be a great Drowsiness, with a manifest Embarrassment of the Brain, they may be applied with great Success over the whole Head. Their Suppuration and Discharge is to be promoted abundantly; and, if they dry up within a few Days, others are to be applied, and their Evacuation is to be kept up for a considerable Time. 12, As soon as the Distemper is sufficiently abated, for the Patient to remain some Hours with very little or no Fever, we must avail ourselves of this Interval, to give him six, or at least five Doses of the Medicine Nº. 14, and repeat the same the next Day, which may prevent the Return of the Fever: [66] after which it may be sufficient to give daily only two Doses for a few Days. [66] Observation and Experience have demonstrated the Advantage of the Bark, to obviate a Gangrene, and prevent the Putrefaction of animal Substances. We therefore conclude it may be usefully employed in malignant Fevers, as soon as the previous and necessary Evacuations shall have taken Place. _E. L._--Provided there be very clear and regular Remissions at least. _K._ 13, When the Sick continue entirely clear of a Fever, or any Return, they are to be put into the _Regimen_ of Persons in a State of Recovery. But if his Strength returns very slowly, or not at all; in Order to the speedier Establishment and Confirmation of it, he may take three Doses a Day of the _Theriaca Pauperum_, or poor Man's Treacle Nº. 42, the first of them fasting, and the other twelve Hours after. It were to be wished indeed, this Medicine was introduced into all the Apothecaries Shops, as an excellent Stomachic, in which Respect it is much preferable to Venice Treacle, which is an absurd Composition, dear and often dangerous. It is true it does not dispose the Patients to Sleep; but when we would procure them Sleep, there are better Medicines than the Treacle to answer that Purpose. Such as may not think the Expence of the Medicine Nº. 14, too much, may take three Doses of it daily for some Weeks, instead of the Medicine Nº. 42, already directed. § 248. It is necessary to eradicate a Prejudice that prevails among Country People, with Regard to the Treatment of these Fevers; not only because it is false and ridiculous, but even dangerous too. They imagine that the Application of Animals can draw out the Poison of the Disease; in Consequence of which they apply Poultry, or Pigeons, Cats or sucking Pigs to the Feet, or upon the Head of the Patient, having first split the living Animals open. Some Hours after they remove their strange Applications, corrupted, and stinking very offensively; and then ascribe such Corruption and horrid Stink to the Poison they suppose their Application to be charged with; and which they suppose to be the Cause of this Fever. But in this supposed Extraction of Poison, they are grosly mistaken, since the Flesh does not stink in Consequence of any such Extraction, but from its being corrupted through Moisture and Heat: and they contract no other Smell but what they would have got, if they had been put in any other Place, as well as on the Patient's Body, that was equally hot and moist. Very far from drawing out the Poison, they augment the Corruption of the Disease; and it would be sufficient to communicate it to a sound Person, if he was to suffer many of these animal Bodies, thus absurdly and uselessly butchered, to be applied to various Parts of his Body in Bed; and to lie still a long Time with their putrified Carcases fastened about him, and corrupting whatever Air he breathed there. With the same Intention they fasten a living Sheep to the Bed's-foot for several Hours; which, though not equally dangerous, is in some Measure hurtful, since the more Animals there are in a Chamber, the Air of it is proportionably corrupted, or altered at least from its natural Simplicity, by their Respiration and Exhalations: but admitting this to be less pernicious, it is equally absurd. It is certain indeed, the Animals who are kept very near the sick Person breathe in the poisonous, or noxious Vapours which exhale from his Body, and may be incommoded with them, as well as his Attendants: But it is ridiculous to suppose their being kept near the Sick causes such Poison to come out of their Bodies. On the very contrary, in contributing still further to the Corruption of the Air, they increase the Disease. They draw a false Consequence, and no Wonder, from a false Principle; saying, if the Sheep dies, the Sick will recover. Now, most frequently the Sheep does not die; notwithstanding which the Sick sometimes recover; and sometimes they both die. § 249. The Cause of Malignant Fevers is, not infrequently, combined with other Diseases, whose Danger it extremely increases. It is blended for Instance, with the Poison of the Small-Pocks, or of the Measles. This may be known by the Union of those Symptoms, which carry the Marks of Malignity, with the Symptoms of the other Diseases. Such combined Cases are extremely dangerous; they demand the utmost Attention of the Physician; nor is it possible to prescribe their exact Treatment here; since it consists in general of a Mixture of the Treatment of each Disease; though the Malignity commonly demands the greatest Attention. __Chapter XVIII.__ _Of intermitting Fevers._ __Sect.__ 250. Intermitting Fevers, commonly called here, Fevers and Agues, are those, which after an Invasion and Continuance for some Hours, abate very perceivably, as well as all the Symptoms attending them, and then entirely cease; nevertheless, not without some periodical or stated Return of them. They were very frequent with us some Years since; and indeed might even be called epidemical: but for the five or six last Years, they have been much less frequent throughout the greater Part of _Swisserland_: notwithstanding they still continue in no small Number in all Places, where the Inhabitants breathe the Air that prevails in all the marshy Borders of the _Rhone_, and in some other Situations that are exposed to much the same humid Air and Exhalations. § 251. There are several Kinds of intermitting Fevers, which take their different Names from the Interval or different Space of Time, in which the Fits return. If the Paroxysm or Fit returns every Day, it is either a true Quotidian, or a double Tertian Fever: The first of these may be distinguished from the last by this Circumstance, that in the Quotidian, or one Day Fever, the Fits are long; and correspond pretty regularly to each other in Degree and Duration. This however is less frequent in _Swisserland_. In the double Tertian, the Fits are shorter, and one is alternately light, and the other more severe. In the simple Tertian, or third Day's Fever, the Fits return every other Day; so that three Days include one Paroxysm, and the Return of another. In a Quartan, the Fit returns every fourth Day, including the Day of the first and that of the second Attack: so that the Patient enjoys two clear Days between the two sick ones. The other kinds of Intermittents are much rarer. I have seen however one true Quintan, or fifth Day Ague, the Patient having three clear Days between two Fits; and one regularly weekly Ague, as it may be called, the Visitation of every Return happening every Sunday. § 252. The first Attack of an intermittent Fever often happens, when the Patient thought himself in perfect Health. Sometimes however it is preceded by a Sensation of Cold and a kind of Numbness, which continue some Days before the manifest Invasion of the Fit. It begins with frequent Yawnings, a Lassitude, or Sensation of Weariness, with a general Weakness, with Coldness, Shivering and Shaking: There is also a Paleness of the extreme Parts of the Body, attended with Loathings, and sometimes an actual Vomiting. The Pulse is quick, weak, and small, and there is a considerable Degree of Thirst. At the End of an Hour or two, and but seldom so long as three or four Hours, a Heat succeeds, which increases insensibly, and becomes violent at its Height. At this Period the whole Body grows red, the Anxiety of the Patient abates; the Pulse is very strong and large, and his Thirst proves excessive. He complains of a violent Head-ach, and of a Pain in all his Limbs, but of a different sort of Pain from that he was sensible of, while his Coldness continued. Finally, having endured this hot State, four, five or six Hours, he falls into a general Sweat for a few more: upon which all the Symptoms already mentioned abate, and sometimes Sleep supervenes. At the Conclusion of this Nap the Patient often wakes without any sensible Fever; complaining only of Lassitude and Weakness. Sometimes his Pulse returns entirely to its natural State between the two Fits; though it often continues a little quicker than in perfect Health; and does not recover its first Distinctness and Slowness, till some Days after the last Fit. One Symptom, which most particularly characterises these several Species of intermitting Fevers, is the Quality of the Urines which the Sick pass after the Fit. They are of a reddish Colour, and let fall a Sediment, or Settling, which exactly resembles Brick-dust. They are sometimes frothy too, and a Pellicle, or thin filmy Skin, appears on the Top, and adheres to the Sides of the Glass that contains them. § 253. The Duration of each Fit is of no fixed Time or Extent, being various according to the particular sort of Intermittents, and through many other Circumstances. Sometimes they return precisely at the very same Hour; at other Times they come one, two, or three Hours sooner, and in other Instances as much later than the former. It has been imagined that those Fevers, whose Paroxysms returned sooner than usual, were sooner finally terminated: but there seems to be no general Rule in this Case. § 254. Intermitting Fevers are distinguished into those of Spring and Autumn. The former generally prevail from February to June: the latter are those which reign from July to January. Their essential Nature and Characters are the very same, as they are not different Distempers; though the various Circumstances attending them deserve our Consideration. These Circumstances depend on the Season itself, and the Constitution of the Patients, during such Seasons. The Spring Intermittents are sometimes blended with an inflammatory Disposition, as that is the Disposition of Bodies in that Season; but as the Weather then advances daily into an improving State, the Spring Fevers are commonly of a shorter Duration. The autumnal Fevers are frequently combined and aggravated with a Principle of Putrefaction; and as the Air of that Season rather degenerates, they are more tedious and obstinate. § 255. The autumnal Fevers seldom begin quite so early as July, but much oftner in August: and the Duration to which they are often extended, has increased the Terror which the People entertain of Fevers that begin in that Month. But that Prejudice which ascribes their Danger to the Influence of August, is a very absurd Error; since it is better they should set in then than in the following Months; because they are obstinate in Proportion to the Tardiness, the Slowness of their Approach. They sometimes appear at first considerably in the Form of putrid Fevers, not assuming that of Intermittents till some Days after their Appearance: but very happily there is little or no Danger in mistaking them for putrid Fevers, or in treating them like such. The Brick-coloured Sediment, and particularly the Pellicle or Film on the Surface of the Urine, are very common in autumnal Intermittents, and are often wanting in the Urine of putrid Fevers. In these latter, it is generally less high coloured, and leaning rather to a yellow, a kind of Cloudiness is suspended in the Middle of it. These also deposite a white Sediment, which affords no bad Prognostic. § 256. Generally speaking, intermitting Fevers are not mortal; often terminating in Health of their own Accord (without the Use of any Medicine) after some Fits. In this last Respect Intermittents in the Spring differ considerably from those in the Fall, which continue a long Time, and sometimes even until Spring, if they are not removed by Art, or if they have been improperly treated. Quartan Fevers are always more obstinate and inveterate than Tertians; the former sometimes persevering in certain Constitutions for whole Years. When these Sorts of Fevers occur in boggy marshy Countries, they are not only very chronical or tedious, but Persons infested with them are liable to frequent Relapses. § 257. A few Fits of an Intermittent are not very injurious, and it happens sometimes, that they are attended with a favourable Alteration of the Habit in Point of Health; by their exterminating the Cause or Principle of some languid and tedious Disorder; though it is erroneous to consider them as salutary. If they prove tedious and obstinate, and the Fits are long and violent, they weaken the whole Body, impairing all its Functions, and particularly the Digestions: They make the Humours sharp and unbalmy, and introduce several other Maladies, such as the Jaundice, Dropsy, Asthma and slow wasting Fevers. Nay sometimes old Persons, and those who are very weak, expire in the Fit; though such an Event never happens but in the cold Fit. § 258. Very happily Nature has afforded us a Medicine, that infallibly cures these Fevers: this is the _Kinkina_, or Jesuits Bark; and as we are possessed of this certain Remedy, the only remaining Difficulty is to discover, if there be not some other Disease combined with these Fevers, which Disease might be aggravated by the Bark. Should any such exist, it must be removed by Medicines adapted to it, before the Bark is given. [67] [67] This admirable Medicine was unknown in Europe, till about one hundred and twenty Years past; we are obliged to the Spaniards for it, who found it in the Province of Quito in Peru; the Countess of Chinchon being the first European who used it in America, whence it was brought to Spain, under the Name of the Countesses Powder. The Jesuits having soon dispensed and distributed it abroad, it became still more publick by the Name of the Jesuits Powder: and since it has been known by that of _Kinkina_ or the Peruvian Bark. It met with great Opposition at first; some deeming it a Poison, while others considered it as a divine Remedy: so that the Prejudices of many being heightened by their Animosity, it was nearly a full Century, before its true Virtue and its Use were agreed to: and about twenty Years since the most unfavourable Prejudices against it pretty generally subsided. The Insufficience of other Medicines in several Cases; its great Efficaciousness; and the many and surprizing Cures which it did, and daily does effect; the Number of Distempers; the different kinds of Fevers, in which it proves the sovereign Remedy; its Effects in the most difficult chirurgical Cases; the Comfort, the Strength and Sprits it gives those who need and take it, have at length opened every Persons Eyes; so that it has almost unanimously obtained the first Reputation, among the most efficacious Medicines. The World is no longer amused with Apprehensions of its injuring the Stomach; of its fixing, or _shutting up_ the Fever (as the Phrase has been) without curing it; that it shuts up the Wolf in the Sheepfold; that it throws those who take it into the Scurvy, the Asthma, the Dropsy, the Jaundice. On the contrary they are persuaded it prevents there very Diseases; and, that if it is ever hurtful, it is only when it is either adulterated, as most great Remedies have been; or has been wrongly prescribed, or improperly taken: or lastly when it meets with some latent, some unknown Particularities in a Constitution, which Physicians term an _Idiosyncrasy_, and which prevent or pervert its very general Effects. _Tissot._ § 259. In the vernal, or Spring-Fevers, if the Fits are not very severe; if the Patient is evidently well in their Intervals; if his Appetite, his Strength, and his Sleep continue as in Health, no Medicine should be given, nor any other Method be taken, but that of putting the Person, under such a gentle Intermittent, upon the Regimen directed for Persons in a State of Recovery. This is such a Regimen as pretty generally agrees with all the Subjects of these Fevers: for if they should be reduced to the Regimen proper in acute Diseases, they would be weakened to no Purpose, and perhaps be the worse for it. But at the same Time if we were not to retrench from the Quantity, nor somewhat to vary the Quality of their usual Food in a State of Health; as there is not the least Digestion made in the Stomach, during the whole Term of the Fit; and as the Stomach is always weakened a little by the Disease, crude and indigested Humours would be produced, which might afford a Fuel to the Disease. Not the least solid Food should be allowed, for at least two Hours before the usual Approach of the Fit. § 260. If the Fever extends beyond the sixth, or the seventh Fit; and the Patient seems to have no Occasion for a Purge; which may be learned by attending to the Chapter, which treats of Remedies to be taken by Way of Precaution; [68] he may take the Bark, that is the Powder Nº. 14. If it is a Quotidian, a daily Fever, or a double Tertian, six Doses, containing three Quarters of an Ounce, should be taken between the two Fits; and as these Intermissions commonly consist of but ten or twelve, or at the most of fourteen or fifteen Hours, there should be an Interval of only one Hour and a half between each Dose. During this Interval the Sick may take two of his usual Refreshments or Suppings. [68] It happens very seldom that intermitting Fevers require [69] no Purge towards their Cure, especially in Places, which are disposed to generate Putridity. There is always some material Cause essential to these Fevers, of which Nature disembarrasses herself more easily by Stools, than by any other Discharge: And as there is not the least Danger to be apprehended from a gentle Purge, such at those of Nº. 11 or 23, we think it would be prudent always to premise a Dose or two of either to the Bark. _E. L._ [69] Yet I have known many in whom no Purge was necessary, and have seen some rendered more obstinate and chronical by erroneous Purging. But a Vomit is very generally necessary before the Bark is given. _K._ When the Fever is a Tertian, an Ounce should be given between the two Fits: which makes eight Doses, one of which is to be taken every three Hours. In a Quartan I direct one Ounce and a half, to be taken in the same Manner. It is meer trifling to attempt preventing the Returns with smaller Doses. The frequent Failures of the Bark are owing to over small Doses. On such Occasions the Medicine is cried down, and censured as useless, when the Disappointment is solely the Fault of those who do not employ it properly. The last Dose is to be given two Hours before the usual Return of the Fit. The Doses, just mentioned, frequently prevent the Return of the Fit; but whether it returns or not, after the Time of its usual Duration is past, repeat the same Quantity, in the same Number of Doses, and Intervals, which certainly keeps off another. For six Days following, half the same Quantity must be continued, in the Intervals that would have occurred between the Fits, if they had returned: and during all this Time the Patient should inure himself to as much Exercise, as he can well bear. § 261. Should the Fits be very strong, the Pain of the Head violent, the Visage red, the Pulse full and hard; if there is any Cough; if, even after the Fit is over, the Pulse still is perceivably hard; if the Urine is inflamed, hot and high-coloured, and the Tongue very dry, the Patient must be bled, and drink plentifully of Barley Water Nº. 3. These two Remedies generally bring the Patient into the State described § 259: in which State he may take on a Day, when the Fever is entirely off, three or four Doses of the Powder Nº. 24, and then leave the Fever to pursue its own Course for the Space of a few Fits. But should it not then terminate of itself, the Bark must be recurred to. If the Patient, even in the Interval of the Returns, has a foetid, furred Mouth, a Loathing, Pains in the Loins, or in the Knees, much Anxiety, and bad Nights, he should be purged with the Powder Nº. 21 or the Potion Nº. 23, before he takes the Bark. § 262. If Fevers in Autumn appear to be of the continual kind, and very like putrid Fevers, the Patients should drink abundantly of Barley Water; and if at the Expiration of two or three Days, there still appears to be a Load or Oppression at the Stomach, the Powder Nº. 34 or that of 35 is to be given (but see § 241): and if, after the Operation of this, the Signs of Putridity continue, the Body is to be opened with repeated Doses of the Powder Nº. 24; or, where the Patients are very robust, with Nº. 21; and when the Fever becomes quite regular, with distinct _Remissions_ at least, the Bark is to be given as directed § 260. But as autumnal Fevers are more obstinate; after having discontinued the Bark for eight Days; and notwithstanding there has been no Return of the Fever, it is proper to resume the Bark, and to give three Doses of it daily for the succeeding eight Days, more especially if it was a Quartan; in which Species I have ordered it to be repeated, every other eight Days, for six Times. Many People may find it difficult to comply with this Method of Cure, which is unavoidably expensive, through the Price of the Bark. I thought however this ought not to prevent me from averring it to be the only certain one; since nothing can be an equivalent _Succedaneum_ or Substitute to this Remedy, which is the only sure and safe one in all these Cases. The World had long been prepossessed with Prejudices to the contrary: it was supposed to be hurtful to the Stomach; to prevent which it has been usual to make the Sick eat something an Hour after it. Nevertheless, very far from injuring the Stomach, it is the best Medicine in the Universe to strengthen it; and it is a pernicious Custom, when a Patient is obliged to take it often, to eat an Hour after it. It had also been imagined to cause Obstructions, and that it subjected Patients to a Dropsy: but at present we are convinced, it is the obstinate and inveterate Duration of the Intermittent, that causes Obstructions, and paves the Way to a Dropsy. The Bark, in Consequence of its speedily curing the Fever, does not only prevent the former Disease; but when it continues, through an injudicious Omission of the Bark, a proper Use of it is serviceable in the Dropsy. In a Word, if there is any other Malady combined with the Fever, sometimes that indeed prevents the Success of the Bark, yet without rendering it hurtful. But whenever the intermitting Fever is simple and uncombined, it ever has, and ever will render the Patient all possible Service. In another Place I shall mention such Means and Methods as may in some Degree, though but imperfectly, be substituted instead of it. After the Patient has begun with the Bark, he must take no purging Medicine, as that Evacuation would, with the greatest Probability, occasion a Return of the Fever. § 263. Bleeding is never, or extremely seldom indeed necessary in a Quartan Ague, which occurs in the Fall oftner than in the Spring; and with the Symptoms of Putridity rather than of Inflammation. § 264. The Patient ought, two Hours before the Invasion of the Fit, to drink a small Glass of warm Elder Flower Tea, sweetened with Honey, every Quarter of an Hour, and to walk about moderately; this disposes him to a very gentle Sweat, and thence renders the ensuing Coldness and the whole Fit milder. He is to continue the same Drink throughout the Duration of the cold Fit; and when the hot one approaches, he may either continue the same, or substitute that of Nº. 2, which is more cooling. It is not necessary however, in this State, to drink it warm, it is sufficient that it be not over cold. When the Sweat, at the Termination of the hot Fit, is concluded, the Patient should be well wiped and dried, and may get up. If the Fit was very long, he may be allowed a little Gruel, or some other such Nourishment during the Sweat. § 265. Sometimes the first, and a few successive Doses of the Bark purge the Patient. This is no otherwise an ill Consequence, than by its retarding the Cure; since, when it purges, it does not commonly prevent the Return of the Fever; so that these Doses may be considered as to no Purpose, and others should be repeated, which, ceasing to purge, do prevent it. Should the Looseness notwithstanding continue, the Bark must be discontinued for one entire Day, in order to give the Patient half a Quarter of an Ounce of Rhubarb: after which the Bark is to be resumed again, and if the Looseness still perseveres, fifteen Grains of Venice Treacle should be added to each Dose, but not otherwise. All other Medicines which are superadded, very generally serve only to increase the Bulk of the Dose, while they lessen its Virtue. § 266. Before our thorough Experience of the Bark, other bitter Medicines were used for the same Purpose: these indeed were not destitute of Virtue in such Cases, though they were considerably less available than the Bark. Under Nº. 43, some valuable Prescriptions of that kind may be seen, whose Efficacy I have often experienced: though at other Times I have been obliged to leave them off, and recur to the Bark more successfully. Filings of Iron, which enter into the third Prescription, are an excellent Febrifuge in particular Cases and Circumstances. In the Middle of the Winter 1753, I cured a Patient of a Quartan Ague with it, who would not be prevailed on to take the Bark. It must be confessed he was perfectly regular in observing the _Regimen_ directed for him; and that, during the most rigid Severity of the Winter, he got every Day on Horseback, and took such a Degree of other Exercise in the open Air, as disposed him to perspire abundantly. § 267. Another very practicable easy Method, of which I have often availed my Patients, under tertian Fevers (but which succeeded with me only twice in Quartans) was to procure the Sufferer a very plentiful Sweat, at the very Time when the Fit was to return, in its usual Course. To effect this he is to drink, three or four Hours before it is expected, an Infusion of Elder Flowers sweetened with Honey, which I have already recommended § 264; and one Hour before the usual Invasion of the Shivering, he is to go into Bed, and take, as hot as he can drink it, the Prescription Nº. 44. I have also cured some Tertians and even Quartans, in 1751 and 1752, by giving them, every four Hours between the Fits, the Powder Nº. 45. But I must acknowledge that, besides its having often failed me, and its never succeeding so speedily as the Bark, I have found it weaken some Patients; it disorders, or disagrees with, their Stomachs: and in two Cases, where it had removed the Fever, I was obliged to call in the Bark for a thorough Establishment of the Patient's Health. Nevertheless, as these Medicines are very cheap and attainable, and often do succeed, I thought I could not properly omit them. § 268. A Multitude of other Remedies are cried up for the Cure of Fevers: though none of them are equally efficacious with those I have directed: and as many of them are even dangerous, it is prudent to abstain from them. Some Years since certain Powders were sold here, under the Name of the _Berlin_ Powders; these are nothing but the Bark masqued or disguised (which has sometimes been publickly discovered) and have always been sold very dear: though the Bark well chosen, and freshly powdered when wanted, is greatly preferable. § 269. I have often known Peasants, who had laboured for several Months under intermitting Fevers; having made Use of many bad Medicines and Mixtures for them, and observed no Manner of Regimen. Such I have happily treated by giving them the Remedies Nº. 34, or 35; and afterwards, for some Days, that of Nº. 38; at the End of which Time, I have ordered them the Bark (See § 260) or other Febrifuges, as at § 266, 267; and then finally ordered them for some Days, to take Morsels of the poor Man's Treacle (See § 247, _Art._ 13) to strengthen and confirm their Digestions, which I have found very weak and irregular. § 270. Some Intermittents are distinguished as pernicious or malignant, from every Fit's being attended with the most violent Symptoms. The Pulse is small and irregular, the Patient exceedingly dejected, and frequently swooning; afflicted with inexpressible Anguish, Convulsions, a deep Drowsiness, and continual Efforts to go to Stool, or make Urine, but ineffectually. This Disease is highly pressing and dangerous; the Patient may die in the third Fit, and rarely survives the sixth, if he is not very judiciously treated. Not a Moment should be lost, and there is no other Step to be taken, but that of giving the Bark continually, as directed § 260, to prevent the succeeding Fits. These worst Kinds of Intermittents are often combined with a great Load of putrid Humours in the first Passages: and as often as such an aggravating Combination is very evident, we should immediately after the End of one Fit, give a Dose of Ipecacuana Nº. 35, and, when its Operation is finished, give the Bark. But I chuse to enter into very few Details on this Species of Intermittents, both as they occur but seldom, and as the Treatment of them is too difficult and important, to be submitted to the Conduct of any one but a Physician. My Intention has only been to represent them sufficiently, that they may be so distinguished when they do occur, as to apprize the People of their great Danger. § 271. The same Cause which produces these intermitting Fevers, frequently also occasions Disorders, which return periodically at the same Hour, without Shivering, without Heat, and often without any Quickness of the Pulse. Such Disorders generally preserve the Intermissons of quotidian or tertian Fevers, but much seldomer those of Quartans. I have seen violent Vomittings, and Reachings to vomit, with inexpressible Anxiety; the severest Oppressions, the most racking Cholics; dreadful Palpitations and excessive Tooth-achs: Pains in the Head, and very often an unaccountable Pain over one Eye, the Eyelid, Eyebrow and Temple, on the same Side of the Face; with a Redness of that Eye, and a continual, involuntary trickling of Tears. I have also seen such a prodigious Swelling of the affected Part, that the Eye projected, or stood out, above an Inch from the Head, covered by the Eyelid, which was also extremely inflated or puffed up. All these Maladies begin precisely at a certain Hour; last about the usual Time of a Fit; and terminating without any sensible Evacuation, return exactly at the same Hour, the next Day, or the next but one. There is but one known Medicine that can effectually oppose this Sort, which is the Bark, given as directed § 260. Nothing affords Relief in the Fit, and no other Medicine ever suspends or puts it off. But I have cured some of these Disorders with the Bark, and especially those affecting the Eyes, which happen oftner than the other Symptoms, after their Duration for many Weeks, and after the ineffectual Use of Bleeding, Purging, Baths, Waters, Blisters, and a great Number of other Medicines. If a sufficient Dose of it be given, the next Fit is very mild; the second is prevented; and I never saw a Relapse in these Cases, which sometimes happens after the Fits of common Intermittents seemed cured. § 272. In Situations where the Constitution of the Air renders these Fevers very common, the Inhabitants should frequently burn in their Rooms, at least in their lodging Rooms, some aromatic Wood or Herbs. They should daily chew some Juniper Berries, and drink a fermented Infusion of them. These two Remedies are very effectual to fortify the weakest Stomachs, to prevent Obstructions, and to promote Perspiration. And as these are the Causes which prolong these Fevers the most obstinately; nothing is a more certain Preservation from them than these cheap and obvious Assistances. [70] [70] I have seen several Cases in very marshy maritime Countries, with little good drinking Water, and far South of _Swisserland_, where intermitting Fevers, with Agues at different Intervals, are annually endemic, very popular, and often so obstinate as to return repeatedly, whenever the weekly precautionary Doses of the Bark have been omitted (through the Patient's nauseating the frequent Swallowing of it) so that the Disease has sometimes been extended beyond the Term of a full Year, and even far into a second, including the temporary Removals of it by the Bark. Nevertheless, in some such obstinate Intermittents, and particularly Quartans there, wherein the Bark alone has had but a short and imperfect Effect, I have known the following Composition, after a good Vomit, attended with speedy and final Success, _viz._ Take of fresh Sassafras Bark, of Virginia Snake-root, of Roch-Allom, of Nutmeg, of diaphoretic Antimony, and of Salt of Wormwood of each one Drachm. To these well rubbed together into fine Powder, add the Weight of the whole, of the best and freshest Bark; then drop in three Drops of the chemical Oil of Mint, and with Syrup of Cloves make it into the Consistence of an Electuary or Bolus, for 12 Doses for a grown Person, to be taken at the Distance of three or four Hours from each other, while the Patient is awake, according to the longer or shorter Intermission of the Fever. I have also known, particularly in obstinate autumnal Agues there, an Infusion of two Ounces of the best Bark in fine Powder, or two Ounces and a half in gross Powder, in a Quart of the best Brandy, for three or four Days (a small Wine Glass to be taken by grown Persons at the Distance of from four to six Hours) effectually and speedily terminate such intermittent Agues, as had given but little Way to the Bark in Substance. This was certainly more suitable for those who were not of a light delicate Habit and Temperament, and who had not been remarkable for their Abstinence from strong Liquors: the inebriating Force of the Brandy being remarkably lessened, by the Addition and long Infusion of the Bark. These Facts which I saw, are the less to be wondered at, as in such inveterate, but perfectly clear and distinct Intermittents, both the State of the Fluids and Solids seem very opposite to their State in an acutely inflammatory Disease. _K._ __Chapter XIX.__ _Of the Erisipelas, and the Bites of Animals._ __Sect.__ 273. The Erisipelas, commonly called in English, St. Anthony's Fire, and in Swisserland _the Violet_, is sometimes but a very slight Indisposition which appears on the Skin, without the Person's being sensible of any other Disorder; and it most commonly breaks out either in the Face, or on the Legs. The Skin becomes tense, or stiff, rough and red; but this Redness disappears on pressing the Spot with a Finger, and returns on removing it. The Patient feels in the Part affected a burning Heat, which makes him uneasy, and sometimes hinders him from sleeping. The Disorder increases for the Space of two or three Days; continues at its Height one or two, and then abates. Soon after this, that Part of the Skin that was affected, falls off in pretty large Scales, and the Disorder entirely terminates. § 274. But sometimes this Malady is considerably more severe, beginning with a violent Shivering, which is succeeded by a burning Heat, a vehement Head-ach, a Sickness at Heart, as it is commonly termed, or Reachings to vomit, which continue till the _Erisipelas_ appears, which sometimes does not happen before the second, or even the third Day. The Fever then abates, and the Sickness goes off, though frequently a less Degree of Fever, and of Sickness or Loathing remain, during the whole Time, in which the Disease is in its increasing State. When the Eruption and Inflammation happen in the Face, the Head-ach continues, until the Decline, or going off, of the Disease. The Eyelid swells, the Eye is closed, and the Patient has not the least Ease or Tranquillity. It often passes from one Cheek to the other, and extends successively over the Forehead, the Neck, and the Nape of the Neck; under which Circumstance the Disease is of a more than ordinary Duration. Sometimes also when it exists in a very high Degree, the Fever continues, the Brain is obstructed and oppressed; the Patient raves; his Case becomes extremely dangerous; whence sometimes, if he is not very judiciously assisted, he dies, especially if of an advanced Age. A violent _Erisipelas_ on the Neck brings on a Quinsey, which may prove very grievous, or even fatal. When it attacks the Leg, the whole Leg swells up; and the Heat and Irritation from it is extended up to the Thigh. Whenever this Tumour is considerable, the Part it seizes is covered with small Pustules filled with a clear watery Humour, resembling those which appear after a Burn, and drying afterwards and scaling off. I have sometimes observed, especially when this Distemper affected the Face, that the Humour, which issued from these little Pustules, was extremely thick or glewy, and formed a thick Scurf, or Scabs nearly resembling those of sucking Children: they have continued fast on the Face many Days before they fell off. When the Disease may be termed violent, it sometimes continues eight, ten, twelve Days at the same Height; and is at last terminated by a very plentiful Sweat, that may sometimes be predicted by a Restlessness attended with Shiverings, and a little Anxiety of some Hours Duration. Throughout the Progress of the Disease, the whole Skin is very dry, and even the Inside of the Mouth. § 275. An _Erisipelas_ rarely comes to Suppuration, and when it does, the Suppuration is always unkindly, and much disposed to degenerate into an Ulcer. Sometimes a malignant kind of _Erisipelas_ is epidemical, seizing a great Number of Persons, and frequently terminating in Gangrenes. § 276. This Distemper often shifts its Situation; it sometimes retires suddenly; but the Patient is uneasy and disordered; he has a Propensity to vomit, with a sensible Anxiety and Heat: the _Erisipelas_ appears again in a different Part, and he feels himself quite relieved from the preceding Symptoms. But if instead of re-appearing on some other Part of the Surface, the Humour is thrown upon the Brain, or the Breast, he dies within a few Hours; and these fatal Changes and Translations sometimes occur, without the least Reason or Colour for ascribing them either to any Error of the Patient, or of his Physician. If the Humour has been transferred to the Brain, the Patient immediately becomes delirious, with a highly flushed Visage, and very quick sparkling Eyes: very soon after he proves downright frantic, and goes off in a Lethargy. If the Lungs are attacked, the Oppression, Anxiety, and Heat are inexpressible. § 277. There are some Constitutions subject to a very frequent, and, as it were, to an habitual _Erisipelas_. If it often affects the Face, it is generally repeated on the same Side of it, and that Eye is, at length, considerably weakened by it. § 278. This Distemper results from two Causes; the one, an acrid sharp Humour, which is commonly bilious, diffused through the Mass of Blood; the other consists in that Humour's not being sufficiently discharged by Perspiration. § 279. When this Disease is of a gentle Nature, such as it is described § 273, it will be sufficient to keep up a very free Perspiration, but without heating the Patient; and the best Method to answer this Purpose is putting him upon the Regimen so often already referred to, with a plentiful Use of Nitre in Elder Tea. Flesh, Eggs and Wine are prohibited of Course, allowing the Patient a little Pulse and ripe Fruits. He should drink Elder Flower Tea abundantly, and take half a Drachm of Nitre every three Hours; or, which amounts to the same Thing, let three Drachms of Nitre be dissolved in as much Infusion of Elder Flowers, as he can drink in twenty-four Hours. Nitre may be given too in a Bolus with Conserve of Elder-berries. These Medicines keep the Body open, and increase Urine and Perspiration. § 280. When the Distemper prevails in a severer Degree, if the Fever is very high, and the Pulse, at the same Time, strong or hard, it may be necessary to bleed once: but this should never be permitted in a large Quantity at a Time in this Disease; it being more adviseable, if a sufficient Quantity has not been taken at once, to bleed a second Time, and even a third, if the Fever should prove very high, as it often does, and that sometimes in so violent a Degree, as to render it extremely dangerous: and in some such Cases Nature has sometimes saved the Patients by effecting a large Hemorrhage, or Bleeding, to the Quantity of four or five Pounds. This Conduct a very intelligent and prudent Physician may presume to imitate; but I dare not advise the same Conduct to that Class of Physicians, for which only I write: it being safer for them to use repeated Bleedings in such Cases, than one in an excessive Quantity. These erisipelatous Fevers are often excited by a Person's being too long over-heated. After Bleeding the Patient is to be restrained to his Regimen; Glysters are to be given until there is a sensible Abatement of the Fever; and he should drink the Barley Water freely, Nº. 3. When the Fever is somewhat diminished, either the Purge Nº. 23 should be given, or a few Doses every Morning of Cream of Tartar Nº. 24. Purging is absolutely necessary to carry off the stagnant Bile, which is generally the first Cause of the violent Degrees of this Distemper. It may sometimes be really necessary too, if the Disease is very tedious; if the Loathing and Sickness at Stomach is obstinate; the Mouth ill-favoured, and the Tongue foul, (provided there be only a slight Fever, and no Fear of an Inflammation) to give the Medicines Nº. 34 or 35, which, in Consequence of the Agitation, the Shaking they occasion, remove these Impediments still better than Purges. It commonly happens that this Disease is more favourable after these Evacuations; nevertheless it is sometimes necessary to repeat them the next Day, or the next but one; especially if the Malady affects the Head. Purging is the true Evacuation for curing it, whenever it attacks this Part. By carrying off the Cause of the Disease, they diminish it, and prevent its worst Effects. Whenever, even after these Evacuations, the Fever still continues to be very severe, the Patient should take every two Hours, or occasionally, oftner, two Spoonfuls of the Prescription Nº. 10, added to a Glass of Ptisan. It will be very useful, when this Disease is seated in the Head or Face, to bathe the Legs frequently in warm Water; and where it is violent there, also to apply Sinapisms to the Soles of the Feet. I have seen this Application, in about four Hours attract, or draw down an _Erisipelas_ to the Legs, which had spread over the Nose, and both the Eyes. When the Distemper once begins to go off by Sweating, this should be promoted by Elder-flower Tea and Nitre (See § 279) and the Sweating may be encouraged to Advantage for some Hours. § 281. The best Applications that can be made to the affected Part are 1st, The Herb Robert, a Kind of _Geranium_, or Crane's-Bill; or Chervil, or Parsley, or Elder Flowers: and if the Complaint be of a very mild Disposition, it may be sufficient to apply a very soft smooth Linen over it, which some People dust over with a little dry Meal. 2, If there is a very considerable Inflammation, and the Patient is so circumstanced as to be very tractable and regularly attended, Flanels wrung out of a strong Decoction of Elder-flowers and applied warm, afford him the speediest Ease and Relief. By this simple Application I have appeased the most violent Pains of a St. Anthony's Fire, which is the most cruel Species of an Erisipelas, and has some peculiar Marks or Symptoms extraordinary. 3, The Plaister of Smalt, and Smalt itself Nº. 46, are also very successfully employed in this Disease. This Powder, the farinaceous, or mealy ones, or others cried up for it, agree best when a thin watery Humour distills or weeps from the little Vesications attending it, which it is convenient to absorb by such Applications; without which Precaution it might gall, or even ulcerate the Part. All other Plaisters, which are partly compounded of greasy, or of resinous Substances, are very dangerous: they often repel, or strike in the _Erisipelas_, occasioning it to ulcerate, or even to gangrene. If People who are naturally subject to this Disease should apply any such Plaister to their Skin, even in its soundest State, an _Erisipelas_ is the speedy Consequence. § 282. Whenever the Humour occasioning the Distemper is repelled, and thrown upon the Brain, the Throat, the Lungs, or any internal Part, the Patient should be bled; Blisters must be applied to the Legs; and Elder Tea, with Nitre dissolved in it, should be plentifully drank. § 283. People who are liable to frequent Returns of an Erisipelas, should very carefully avoid using Milk, Cream, and all fat and viscid, or clammy Food, Pies, brown Meat, Spices, thick and heady Liquors, a sedentary Life, the more active Passions, especially Rage, and, if possible, all Chagrin too. Their Food should chiefly consist of Herbage, Fruits, of Substances inclining to Acidity, and which tend to keep the Body open; they should drink Water, and some of the light white Wines; by no Means omitting the frequent Use of Cream of Tartar. A careful Conformity to these Regulations is of real Importance, as, besides the Danger of the frequent Visitations of this Disease, they denote some slight Indispositions of the Liver and the Gall-bladder; which, if too little attended to, might in Time prove very troublesome and pernicious. Such mineral Waters as are gently opening are very proper for these Constitutions, as well as the Juice of Succory, and clarified Whey, of which they should take about three Pints every Morning, during the five or six Summer Months. This becomes still more efficacious, if a little Cream of Tartar and Honey be added to it. _Of the Stings, or little Wounds, by Animals._ § 284. The Stings or little Bites of Animals, frequently producing a kind of _Erisipelas_, I shall add a very few Words concerning them in this Place. Of the Serpents in this Country none but the Vipers are poisonous; and none of these are found except at _Baume_, where there is a _Viperary_, if we may be allowed that Word. We have no Scorpions, which are somewhat poisonous; our Toads are not in the least so: whence the only Stings we are exposed to, are those of Bees, Wasps, Hornets, Muskitos or Gnats, and Dragon [71] Flies: all of which are sometimes attended with severe Pain, a Swelling, and a very considerable erisipelatous Redness; which, if it happens in the Face, sometimes entirely closes the Eyes up; occasioning also a Fever, Pains of the Head, Restlessness, and Sickness at Heart; and, when the Pains are in a violent Degree, Faintings and Convulsions, though always without any mortal Consequence. These Symptoms go off naturally within a few Days, without any Assistance: Nevertheless they may either be prevented, diminished in Degree, or shortned in Duration. [71] These, in some Parts of America, are called Muskito Hawks; but we do not recollect their biting there. _K._ 1, By extracting the Sting of the Animal, if it is left behind. 2, By a continual Application of one of the Remedies directed § 281, Article 1 and 2, particularly the Infusion of Elder-flowers, to which a little Venice Treacle is added; or by covering the Part affected with a Pultice, made of Crum of Bread, Milk, Honey, and a little Venice Treacle. [72] [72] Pounded Parsley is one of the most availing Applications in such Accidents. _E.L._ 3, By bathing the Legs of the Person stung repeatedly in warm Water. 4, By retrenching a little of their customary Food, especially at Night, and by making them drink an Infusion of Elder-flowers, with the Addition of a little Nitre. Oil, if applied very quickly after the Sting, sometimes prevents the Appearance of any Swelling, and from thence the Pains that attend it. __Chapter XX.__ _Of spurious, or false Inflammations of the Breast, and of spurious, bilious, Pleurisies._ __Sect.__ 285. The Inflammation of the Breast and that Pleurisy, which is called _bilious_, are the same Disease. It is properly a putrid Fever, attended with an Infarction or Stuffing of the Lungs, though without Pain; in which Circumstance it is called a putrid or bilious Peripneumony: but when attended with a Pain of the Side, a Stitch, it is called a spurious or bastard Pleurisy. § 286. The Signs which distinguish these Diseases from the inflammatory ones of the same Name, described Chap. IV and V, are a less hard and less strong, but a quicker Pulse, though unaccompanied with the same Symptoms which constitute the inflammatory ones (See § 47 and 90). The Mouth is foul, and has a Sensation of Bitterness; the Patient is infested with a sharp and dry Heat; he has a Feeling of Heaviness and Anxiety all about his Stomach, with Loathings: he is less flushed and red in these, than in the inflammatory Diseases, but rather a little yellow. He has a dejected wan Look; his Urine resembles that in putrid Fevers, and not that of inflammatory ones; and he has very often a small bilious Looseness, which is extremely offensive. The Skin is commonly very dry in this Disease; the Humour spit up is less thick, less reddish, and rather more yellow than in the inflammatory Diseases of the same Names. § 287. They must be treated after the manner of putrid Fevers, as in § 241. Supposing some little Degree of Inflammation to be combined with the Disease, it may be removed by a single Bleeding. After this the Patient is to drink Barley Water Nº. 3, to make Use of Glysters; and as soon as all Symptoms of any Inflammation wholly disappear, he is to take the vomiting and purging Draught Nº. 34. But the utmost Caution must be taken not to give it, before every Appearance of any Inflammation is totally removed; as giving it sooner would be certain Death to the Sick: and it is dreadful but to think of agitating, by a Vomit, Lungs that are inflamed, and overloaded with Blood, whose Vessels burst and discharge themselves, only from the Force of Expectoration. After an Interval of some Days, he may be purged again with the Medicine Nº. 23. The Prescription Nº. 25 succeeds also very well as a Vomit. If the Fever is violent, he must drink plentifully of the Potion Nº. 10. Blisters to the Legs are very serviceable, when the Load and Oppression are not considerably abated after general Evacuations. § 288. The false Inflammation of the Breast is an Overfulness or Obstruction in the Lungs, accompanied with a Fever; and it is caused by extremely thick and tenacious Humours; and not by a really inflammatory Blood, or by any putrid or bilious Humour. § 289. This Distemper happens more frequently in the Spring, than in any other Season. Old Men, puny, ill-constitutioned Children, languid Women, feeble young Men, and particularly such as have worn their Constitutions out by drinking, are the Subjects most frequently attacked by it; especially if they have used but little Exercise throughout the Winter: if they have fed on viscid, mealy and fat Aliments, as Pastry, Chesnuts, thick Milk or Pap, and Cheese. All their Humours have contracted a thick glutinous Quality; they are circulated with Difficulty, and when Heat or Exercise in the Spring increases their Motion at once, the Humours, already stuffing up the Lungs, still more augment that Plenitude, whence these vital Organs are fatally extended, and the Patient dies. § 290. This Distemper is known to exist, 1, By the previous Existence of the Causes already mentioned. 2, By the Symptoms which precede and usher it in. For Example, the Patient many Days before-hand has a slight Cough; a small Oppression when he moves about; a little Restlessness, and is sometimes a little choleric or fretful. His Countenance is higher coloured than in Health; he has a Propensity to sleep, but attended with Confusion and without Refreshment, and has sometimes an extraordinary Appetite. 3, When this State has continued for some Days, there comes on a cold Shivering, though more considerable for its Duration than its Violence; it is succeeded by a moderate Degree of Heat, but that attended with much Inquietude and Oppression. The sick Person cannot confine himself to the Bed; but walks to and fro in his Chamber, and is greatly dejected. The Pulse is weak and pretty quick; the Urine is sometimes but little changed from that in Health; at other Times it is discharged but in a small Quantity, and is higher coloured: he coughs but moderately, and does not expectorate, or cough up, but with Difficulty. The Visage becomes very red, and even almost livid; he can neither keep awake, nor sleep well; he raves for some Moments, and then his Head grows clear again. Sometimes it happens, especially to Persons of advanced Age, that this State suddenly terminates in a mortal Swoon or Fainting: at other Times and in other Cases, the Oppression and Anguish increase; the Patient cannot breathe but when sitting up, and that with great Difficulty and Agony: the Brain is utterly disturbed and embarrassed; this State lasts for some Hours, and then terminates of a sudden. § 291. This is a very dangerous Distemper; because, in the first Place, it chiefly attacks those Persons whose Temperament and Constitution are deprived of the ordinary Resources for Health and Recovery: in the second Place, because it is of a precipitate Nature, the Patient sometimes dying on the third Day, and but seldom surviving the seventh; while the Cause of it requires a more considerable Term for its Removal or Mitigation. Besides which, if some Indications present for the Employment of a Remedy, there are frequently others which forbid it; and all that seems to be done is, as follows; 1, If the Patient has still a pretty good Share of Health; if he is not of too advanced an Age; if the Pulse has a perceivable Hardness, and yet at the same Time some Strength; if the Weather is dry, and the Wind blows from the North, he should be bled once, to a moderate Quantity. But if the greater Part of these Circumstances are wanting, Bleeding would be very prejudicial. Were we obliged to establish some general and positive Rule in this Case, it were better to exclude Bleeding, than to admit it. 2, The Stomach and the Bowels should be unloaded from their viscid glutinous Contents; and the Medicines which succeed the best in this Respect are Nº. 35, when the Symptoms shew there is a great Necessity for vomiting, and there is no Inflammation; or the Prescription Nº. 25, which after vomiting, purges by Stool, promotes Urine, breaks down and divides the viscid Humours that occasion the Disease, and increase Perspiration. When we are afraid of hazarding the Agitation of a Vomit and its Consequences, the Potion, Nº. 11 may be given; but we must be very cautious, in Regard to old Men, even with this; as such may expire during the Operation of it. 3, They should, from the Beginning of the Disease, drink plentifully of the Ptisan Nº. 26, which is the best Drink in this Disease; or that of Nº. 12, adding half a Dram of Nitre to every Pint of it. 4, A Cup of the Mixture Nº. 8 must be taken every two Hours. 5. Blisters are to be applied to the Insides of the Legs. When the Case is very doubtful and perplexing, it were best to confine ourselves to the three last-mentioned Remedies, which have often been successful in severe Degrees of this Disease; and which can occasion no ill Consequence. § 292. When this Malady invades old People, though they partly recover, they never recover perfectly, entirely, from it: and if due Precaution is not taken, they are very liable to fall into a Dropsy of the Breast after it. § 293. The spurious or false Pleurisy is a Distemper that does not affect the Lungs, but only the Teguments, the Skin, and the Muscles which cover the Ribs. It is the Effect of a rheumatic Humour thrown upon these Parts, in which, as it produces very sharp Pains resembling that which is called a _Stitch_, it has from this Circumstance, been termed a Pleurisy. It is generally supposed by the meer Multitude, and even by some of a different Rank, that a false Pleurisy is more dangerous than a genuine, a true one; but this is a Mistake. It is often ushered in by a Shivering, and almost ever attended with a little Fever, a small Cough, and a slight Difficulty of breathing; which, as well as the Cough, is occasioned from the Circumstance of a Patient's (who feels Pain in Respiration, or Breathing) checking Breathing as much as he can; this accumulates a little too much Blood in the Lungs; but yet he has no Anguish, nor the other Symptoms of acute true Pleurisies. In some Patients this Pain is extended, almost over the whole Breast, and to the Nape of the Neck. The sick Person cannot repose himself on the Side affected. This Disorder is not more dangerous than a Rheumatism, except in two Cases; 1, When the Pain is so very severe, that the Patient strongly endeavours not to breathe at all, which brings on a great Infarction or Stoppage in the Lungs. 2, When this Humour, like any other rheumatic one, is transferred to some internal Part. § 294. It must be treated exactly like a Rheumatism. See § 168 and 169. After bleeding once or more, a Blister applied to the affected Part is often attended with a very good Effect: This being indeed the Kind of [73] Pleurisy, in which it particularly agrees. [73] The Seneka Rattle-Snake root, already recommended in true Pleurisies, will, with the greatest Probability, be found not less effectual in these false ones, in which the Inflammation of the Blood is less. The Method of giving it may be seen P. 118, N. ([26].) By Dr. _Tissot's_ having never mentioned this valuable Simple throughout his Work, it may be presumed, that when he wrote it, this Remedy had not been admitted into the Apothecaries Shops in _Swisserland_. _K._ § 295. This Malady sometimes gives Way to the first Bleeding; often terminating on the third, fourth or fifth Day, by a very plentiful Sweat, and rarely lasting beyond the seventh. Sometimes it attacks a Person very suddenly, after a Stoppage of Perspiration; and then, if at once before the Fever commences, and has had Time to inflame the Blood, the Patient takes some _Faltrank_, it effects a speedy Cure by restoring Perspiration. They are such Cases as these, or that mentioned § 96, which have given this Composition the Reputation it has obtained in this Disease: a Reputation nevertheless, which has every Year proved tragical in its Consequences to many Peasants, who being deceived by some misleading Resemblances in this Distemper, have rashly and ignorantly made Use of it in true inflammatory Pleurisies. __Chapter XXI.__ _Of the Cholic and its different Kinds._ __Sect.__ 296. The Appellation of a Cholic is commonly given to all Pains of the Belly indiscriminately; but I apply it in this Place only to such as attack the Stomach, or the Intestines, the Guts. Cholics may and do result from very many Causes; and the greater Number of Cholics are chronical or tedious Complaints, being more common among the inactive Inhabitants of Cities, and Workmen in sedentary Trades, than among Country People. Hence I shall treat here only of the small Variety of Cholics, which happen the most usually in Villages. I have already proved that the fatal Events of some Distempers were occasioned by endeavouring to force the Patients into Sweats; and the same unhappy Consequences have attended Cholics, from accustoming the Subjects of this Disease to Drams, and hot inflaming spirituous Liquors, with an Intention to expel the Wind. _Of the inflammatory Cholic._ § 297. The most violent and dangerous kind of Cholic is that, which arises from an Inflammation of the Stomach, or of the Intestines. It begins most commonly without any Shivering, by a vehement Pain in the Belly, which gradually becomes still more so. The Pulse grows quick and hard; a burning Pain is felt through the whole Region of the Belly; sometimes there is a watery _Diarrhoea_, or Purging; at other Times the Belly is rather costive, which is attended with Vomiting, a very embarrassing and dangerous Symptom: the Countenance becomes highly flushed; the Belly tense and hard; neither can it be touched scarcely without a cruel Augmentation of the Patient's Pain, who is also afflicted with extreme Restlessness; his Thirst is very great, being unquenchable by Drink; the Pain often extends to the Loins, where it proves very sharp, and severe; little Urine is made, and that very red, and with a kind of burning Heat. The tormented Patient has not a Moment's Rest, and now and then raves a little. If the Disease is not removed or moderated, before the Pains rise to their utmost Height and Violence, the Patient begins at length to complain less; the Pulse becomes less strong and less hard than before, but quicker: his Face first abates of its Flush and Redness, and soon after looks pale; the Parts under the Eyes become livid; the Patient sinks into a low stupid Kind of _Delirium_, or Raving; his Strength entirely deserts him; the Face, Hands, Feet, and the whole Body, the Belly only excepted, become cold: the Surface of the Belly appears bluish; extreme Weakness follows, and the Patient dies. There frequently occurs, just a Moment before he expires, an abundant Discharge of excessively foetid Matter by Stool; and during this Evacuation he dies with his Intestines quite gangrened, or mortified. When the Distemper assaults the Stomach, the Symptoms are the very same, but the Pain is felt higher up, at the Pit of the Stomach. Almost every thing that is swallowed is cast up again; the Anguish of the tortured Patient is terrible, and the Raving comes on very speedily. This Disease proves mortal in a few Hours. § 298. The only Method of succeeding in the Cure of it is as follows: 1, Take a very large Quantity of Blood from the Arm; this almost immediately diminishes the Violence of the Pains, and allays the Vomiting: besides its contributing to the greater Success of the other Remedies. It is often necessary to repeat this Bleeding within the Space of two Hours. 2, Whether the Patient has a Looseness, or has not, a Glyster of a Decoction of Mallows, or of Barley Water and Oil, should be given every two Hours. 3, The Patient should drink very plentifully of Almond Milk Nº. 4; or a Ptisan of Mallow Flowers, or of Barley, all which should be warm. 4, Flanels dipt in hot, or very warm Water should be continually applied over the Belly, shifting them every Hour, or rather oftner; for in this Case they very quickly grow dry. 5, If the Disease, notwithstanding all this, continues very obstinate and violent, the Patient should be put into a warm Water Bath, the extraordinary Success of which I have observed. When the Distemper is over, that is to say, when the Pains have terminated, and the Fever has ceased, so that the Patient recovers a little Strength, and gets a little Sleep, it will be proper to give him a Purge, but a very gentle one. Two Ounces of Manna, and a Quarter of an Ounce of Sedlitz [74] Salt dissolved in a Glass of clear Whey is generally sufficient, at this Period, to purge the most robust and hardy Bodies. Manna alone may suffice for more delicate Constitutions: as all acrid sharp Purges would be highly dangerous, with Regard to the great Sensibility and tender Condition of the Stomach, and of the Intestines after this Disease. [74] Glauber or Epsom Salt may be substituted, where the other is not to be readily procured. _K._ § 299. It is sometimes the Effect of a general Inflammation of the Blood; and is produced, like other inflammatory Diseases, by extraordinary Labour, very great Heat, heating Meats or Drinks, _&c._ It is often the Consequence of other Cholics which have been injudiciously treated, and which otherwise would not have degenerated into inflammatory ones; as I have many Times seen these Cholics introduced after the Use of heating Medicines; one Instance of which may be seen § 164. § 300. Ten Days after I had recovered a Woman out of a severe Cholic, the Pains returned violently in the Night. She, supposing them to arise only from Wind, hoped to appease them by drinking a deal of distilled Walnut Water; which, far from producing any such Effect, rendered them more outrageous. They soon were heightened to a surprising Degree, which might reasonably be expected. Being sent for very early in the Morning, I found her Pulse hard, quick, short; her Belly was tense and hard; she complained greatly of her Loins: her Urine was almost entirely stopt. She past but a few Drops, which felt as it were scalding hot, and these with excessive Pain. She went very frequently to the Close-stool, with scarcely any Effect; her Anguish, Heat, Thirst, and the Dryness of her Tongue were even terrifying: and her wretched State, the Effect of the strong hot Liquor she had taken, made me very apprehensive for her. One Bleeding, to the Quantity of fourteen Ounces, somewhat abated all the Pains; she took several Glysters, and drank off a few Pots of _Orgeat_ in a few Hours. By these Means the Disease was a little mitigated; by continuing the same Drink and the Glysters the Looseness abated; the Pain of the Loins went off, and she passed a considerable Quantity of Urine, which proved turbid, and then let fall a Sediment, and the Patient recovered. Nevertheless I verily believe, if the Bleeding had been delayed two Hours longer, this spirituous Walnut Water would have been the Death of her. During the Progress of this violent Disease, no Food is to be allowed; and we should never be too inattentive to such Degrees of Pain, as sometimes remain after their Severity is over; lest a _Scirrhus_, an inward hard Tumour, should be generated, which may occasion the most inveterate and tedious Maladies. § 301. An Inflammation of the Intestines, and one of the Stomach, may also terminate in an Abscess, like an Inflammation of any other Part; and it may be apprehended that one is forming, when, though the Violence of the Pains abates, there still remains a slow, obtuse, heavy Pain, with general Inquietude, little Appetite, frequent Shiverings; the Patient at the same Time not recovering any Strength. In such Cases the Patient should be allowed no other Drinks, but what are already directed in this Chapter, and some Soops made of Pulse, or other farinaceous Food. The Breaking of the Abscess may sometimes be discovered by a slight Swoon or fainting Fit; attended with a perceivable Cessation of a Weight or Heaviness in the Part, where it was lately felt: and when the _Pus_, or ripe Matter, is effused into the Gut, the Patient sometimes has Reachings to vomit, a _Vertigo_, or Swimming in the Head, and the Matter appears in the next Stools. In this Case there remains an Ulcer within the Gut, which, if either neglected, or improperly treated, may pave the Way to a slow wasting Fever, and even to Death. Yet this I have cured by making the Patient live solely upon skimmed Milk, diluted with one third Part Water, and by giving every other Day a Glyster, consisting of equal Parts of Milk and Water, with the Addition of a little Honey. When the Abscess breaks on the Outside of the Gut, and discharges its Contents into the Cavity of the Belly, it becomes a very miserable Case, and demands such further Assistance as cannot be particularized here. _Of the bilious Cholic._ § 302. The bilious Cholic discovers itself by very acute Pains, but is seldom accompanied with a Fever; at least not until it has lasted a Day or two. And even if there should be some Degree of a Fever, yet the Pulse, though quick, is neither strong nor hard: the Belly is neither tense or stretched as it were, nor burning hot, as in the former Cholic: the Urine comes away with more Ease, and is less high-coloured: Nevertheless the inward Heat and Thirst are considerable; the Mouth is bitter; the Vomiting or Purging, when either of them attend it, discharge a yellowish Humour or Excrement; and the Patient's Head is often vertiginous or dizzy. § 303. The Method of curing this is, 1, By injecting Glysters of Whey and Honey; or, if Whey is not readily procurable, by repeating the Glyster, Nº. 5. 2, By making the Sick drink considerably of the same Whey, or of a Ptisan made of the Root of Dog's-Grass (the common Grass) and a little Juice of Lemon, for want of which, a little Vinegar and Honey may be substituted instead of it. [75] [75] Pullet, or rather Chicken Water, but very weak, may often do instead of Ptisan, or serve for a little Variety of Drink to some Patients. _E. L._--K. 3, By giving every Hour one Cup of the Medicine Nº. 32; or where this is not to be had, half a Drachm of Cream of Tartar at the same short Intervals. 4, Fomentations of warm Water and Half-baths are also very proper. 5, If the Pains are sharp and violent, in a robust strong Person, and the Pulse is strong and tense, Bleeding should be used to prevent an Inflammation. 6, No other Nourishment should be given, except some maigre Soops, made from Vegetables, and particularly of Sorrel. 7, After plentiful Dilution with the proper Drink, if no Fever supervenes; if the Pains still continue, and the Patient discharges but little by Stool, he should take a moderate Purge. That directed Nº. 47 is a very proper one. § 304. This bilious Cholic is habitual to many Persons; and may be prevented or greatly mitigated by an habitual Use of the Powder Nº. 24; by submitting to a moderate Retrenchment in the Article of Flesh-meat; and by avoiding heating and greasy Food, and the Use of Milk. _Of Cholics from Indigestions, and of Indigestion._ § 305. Under this Appellation I comprehend all those Cholics, which are either owing to any overloading Quantity of Food taken at once; or to a Mass or Accumulation of Aliments formed by Degrees in such Stomachs, as digest but very imperfectly; or which result from noxious Mixtures of Aliment in the Stomach, such as that of Milk and Acids; or from Food either not wholesome in its self, or degenerated into an unwholesome Condition. This kind of Cholic may be known from any of these Causes having preceded it; by its Pains, which are accompanied with great Restlessness, and come on by Degrees, being less fixed than in the Cholics before treated of. These Cholics are also without any Fever, Heat or Thirst, but accompanied with a Giddiness of the Head, and Efforts to vomit, and rather with a pale, than a high-coloured Visage. § 306. These Disorders, from these last Causes, are scarcely ever dangerous in themselves; but may be made such by injudicious Management, and doing more than is necessary or proper: as the only Thing to be done is to promote the Discharges by warm Drinks. There are a considerable Variety of them, which seem equally good, such as warm Water, or even cold Water with a Toast, with the Addition either of a little Sugar, or a little Salt: a light Infusion of Chamomile, or of Elder-flowers, common Tea, or Baum, it imports little which, provided the Patient drink plentifully of them: in Consequence of which the offending Matter is discharged, either by vomiting, or a considerable purging; and the speedier and more in Quantity these Discharges are, the sooner the Patient is relieved. If the Belly is remarkably full and costive, Glysters of warm Water and Salt should be injected. The Expulsion of the obstructing Matter is also facilitated, by rubbing the Belly heartily with hot Cloths. Sometimes the Humours, or other retained Contents of the Belly, are more pernicious from their Quality, than their Quantity; and then the Malady may be dissipated without the former Discharges, by the irritating sharp Humour being diluted, or even drowned, as it were, in the Abundance of small watery Drinks. When the Pains invade first in the Stomach, they become less sharp, and the Patient feels less Inquietude, as soon as the Cause of the Pain has descended out of the Stomach into the Intestines, whose Sensations are something less acute than, or somewhat different from, those of the Stomach. It is often found that after these plentiful Discharges, and when the Pains are over, there remains a very disagreeable Taste in the Mouth, resembling the Savour of rotten Eggs. This may be removed by giving some Doses of the Powder Nº. 24, and drinking largely of good Water: It is an essential Point in these Cases, to take no Food before a perfect Recovery. § 307. Some have been absurd enough in them, to fly at once to some heating Cordial Confection, to Venice Treacle, Aniseed Water, Geneva, or red Wine to stop these Evacuations; but there cannot be a more fatal Practice: since these Evacuations are the only Thing which can cure the Complaint, and to stop them is to deprive the Person, who was in Danger of drowning, of the Plank which might save him. Nay should this Endeavour of stopping them unhappily succeed, the Patient is either thrown into a putrid Fever, or some chronical tedious Malady; unless Nature, much wiser than such a miserable Assistant, should prevail over the Obstacles opposed to her Recovery, and restore the obstructed Evacuations by her own Oeconomy, in the Space of a few Days. § 308. Sometimes an Indigestion happens, with very little Pain or Cholic, but with violent Reachings to vomit, inexpressible Anguish, Faintings, and cold Sweats: and not seldom also the Malady begins, only with a very sudden and unexpected Fainting: the Patient immediately loses all his Senses, his Face is pale and wan: he has some Hickups rather than Reachings to vomit, which joined to the Smallness of his Pulse, to the Easiness of his respiring, or breathing, and to the Circumstance of his being attacked immediately, or very soon, after a Meal, makes this Disorder distinguishable from a real Apoplexy. Nevertheless, when it rises to this Height, with these terrible Symptoms, it sometimes kills in a few Hours. The first thing to be done is to throw up a sharp Glyster, in which Salt and Soap are to be dissolved; next to get down as much Salt and Water as he can swallow; and if that is ineffectual, the Powder Nº. 34 is to be dissolved in three Cups of Water; one half of which is to be given directly; and, if it does not operate in a Quarter of an Hour, the other half. Generally speaking the Patient's Sense begins to return, as soon as he begins to vomit. _Of the flatulent or windy Cholic._ § 309. Every Particular which constitutes our Food, whether solid or liquid, contains much Air, but some of them more than others. If they do not digest soon enough, or but badly, which occasions a sensible Escape of such Air; if they are such as contain an extraordinary Quantity of Air; or if the Guts being straitened or compressed any where in the Course of their Extent, prevent that Air from being equally diffused (which must occasion a greater Proportion of it in some Places) then the Stomach and the Guts are distended by this Wind; and this Distention occasions these Pains, which are called flatulent, or windy. This Sort of Cholic rarely appears alone and simple; but is often complicated with, or added, as it were, to the other Sorts, of which it is a Consequence; and is more especially joined with the Cholic from Indigestions, whose Symptoms it multiplies and heightens. It may be known, like that, by the Causes which have preceded it, by its not being accompanied either with Fever, Heat, or Thirst; the Belly's being large and full, though without Hardness, being unequal in its Largeness, which prevails more in one Part of it than in another, forming something like Pockets of Wind, sometimes in one Part, sometimes in another; and by the Patient's feeling some Ease merely from the rubbing of his Belly, as it moves the Wind about; which escaping either upwards or downwards affords him still a greater Relief. § 310. When it is combined with any different Species of the Cholic, it requires no distinct Treatment from that Species; and it is removed or dissipated by the Medicines which cure the principal Disease. Sometimes however it does happen to exist alone, and then it depends on the Windiness of the solid and liquid Food of the Person affected with it, such as the _Must_ or new Wine, Beer, especially very new Beer, certain Fruits and Garden-stuff. It may be cured by a Glyster; by chaffing the Belly with hot Cloths; by the Use of Drink moderately spiced; and especially by Camomile Tea, to which a little cordial Confection, or even Venice Treacle, may be added. When the Pains are almost entirely vanished, and there is no Fever, nor any unhealthy Degree of Heat; and if the Patient is sensible of a Weakness at Stomach, he may take a little aromatic, or spiced Wine, or even a small cordial stomachic Dram. It should be observed, that these are not to be allowed in any other Kind of Cholic. § 311. When any Person is frequently subject to cholic-like Pains, it is a Proof that the digestive Faculty is impaired; the restoring of which should be carefully attended to; without which the Health of the Patient must suffer considerably, and he must be very likely to contract many tedious and troublesome Disorders. _Of Cholics from Cold._ § 312. When any Person has been very cold, and especially in his Feet, it is not uncommon for him to be attacked, within a few Hours after it, with violent Cholic Pains, in which heating and spirituous Medicines are very pernicious: but which are easily cured by rubbing the Legs well with hot Cloths; and keeping them afterwards for a considerable Time in warm Water; advising them at the same Time to drink freely of a light Infusion of Chamomile or Elder-flowers. The Cure will be effected the sooner, if the Patient is put to Bed and sweats a little, especially in the Legs and Feet. A Woman who had put her Legs into a pretty cool Spring, after travelling in the Height of Summer, was very quickly after attacked with a most violent Cholic. She took different hot Medicines; she became still worse; she was purged, but the Distemper was still further aggravated. I was called in on the third Day, a few Hours before her Decease. In such Cases, if the Pain be excessive, it may be necessary to bleed; [76] to give a Glyster of warm Water; to keep the Legs several Hours over the Steam of hot Water, and afterwards in the Water; to drink plentifully of an Infusion of the Flowers of the Lime-tree, with a little Milk; and if the Distemper is not subdued by these Means, Blisters should be applied to the Legs, which I have known to be highly efficacious. [76] Bleeding should not be determined on too hastily in this Sort of Cholic, but rather be omitted, or deferred at least, till there be an evident Tendency to an Inflammation. _E. L._ The Propriety or Impropriety of Bleeding in a Cholic from this Cause should be determined, I think, from the State of the Person it happens to: So that Bleeding a strong Person with a firm Fibre, and a hard Pulse, may be very prudent and precautionary: But if it be a weakly lax Subject with a soft and low Pulse, there may be Room either for omitting, or for suspending it. _K._ § 313. It appears, through the Course of this Chapter, that it is necessary to be extremely on our Guard, against permitting the Use of heating and spirituous Medicines in Cholics, as they may not only aggravate, but even render them mortal. In short they should never be given, and when it is difficult to discover the real Cause of the Cholic, I advise Country People to confine themselves to the three following Remedies, which cannot be hurtful in any Sort of Cholic, and may remove as many as are not of a violent Nature. First then, let Glysters be frequently repeated. 2, Let the Patient drink warm Water plentifully, or Elder Tea. 3, Let the Belly be often fomented in pretty warm Water, which is the most preferable Fomentation of any. § 314 I have said nothing here of the Use of any Oils in this Disease, as they agree but in very few Species of Cholics, and not at all in those of which I have been treating. For this Reason I advise a total Disuse of them, since they may be of bad Consequence in many Respects. § 315. Chronical Diseases not coming within the Plan of this Work, I purposely forbear treating of any Kind of those tedious Cholics, which afflict some People for many Years: but I think it my Duty to admonish such, that their Torments being very generally occasioned by Obstructions in the _Viscera_, or different Bowels of the Belly, or by some other Fault, and more particularly in those Organs, which are intended to prepare the Bile, they should, 1, avoid with the greatest Care, the Use of sharp, hot, violent Medicines, Vomits, strong Purges, Elixirs, _&c._ 2, They should be thoroughly on their Guard against all those, who promise them a very speedy Cure, by the Assistance of some specific Remedy; and ought to look upon them as Mountebanks, into whose Hands it is highly dangerous to trust themselves. 3, They should be persuaded, or rather convinced, that they can entertain no reasonable Hope of being cured, without an exact Conformity to a proper and judicious Regimen, and a long Perseverance in a Course of mild and safe Remedies. 4, They should continually reflect with themselves, that there is little Difficulty in doing them great Mischief; and that their Complaints are of that Sort, which require the greatest Knowledge and Prudence in those Persons, to whom the Treatment and Cure of them are confided. __Chapter XXII.__ _Of the Iliac Passion, and of the Cholera-morbus._ __Sect.__ 316. These violent Diseases are fatal to many Country People, while their Neighbours are frequently so ignorant of the Cause of their Death, that Superstition has ascribed it to Poison, or to Witchcraft. § 317. The first of these, the _Miserere_, or Iliac Passion, is one of the most excruciating Distempers. If any Part of the Intestines, the Cavity of the Guts is closed up, whatever may have occasioned it, the Course or Descent of the Food they contain is necessarily stopped; in which Case it frequently happens, that that continual Motion observed in the Guts of a living Animal dissected, and which was intended to detrude, or force their Contents downwards, is propagated in a directly contrary Manner, from the Guts towards the Mouth. This Disease sometimes begins after a Constipation, or Costiveness, of some Days; at other Times without that Costiveness having been preceded by Pains in any Part of the Belly, especially around the Navel; but which Pains, gradually increasing after their Commencement, at length become extremely violent, and throw the Patient into excessive Anguish. In some of these Cases a hard Tumour may be felt, which surrounds the Belly like a Cord. The Flatulences within become very audible, some of them are discharged upwards; in a little Time after, Vomitings come on, which increase till the Patient has thrown up all he had taken in, with a still further Augmentation of the excessive Pain. With the first of his Vomitings he only brings up the last Food he had taken, with his Drink and some yellowish Humour: but what comes up afterwards proves stinking; and when the Disease is greatly heightened, they have what is called the Smell of Excrement or Dung; but which rather resembles that of a putrid dead Body. It happens too sometimes, that if the Sick have taken Glysters composed of Materials of a strong Smell, the same Smell is discernible in the Matter they vomit up. I confess however I never saw either real Excrements, or the Substance of their Glysters, brought up, much less the Suppositories that were introduced into the Fundament: and were it credible that Instances of this Kind had occurred, they must be allowed very difficult to account for. Throughout this whole Term of the Disease, the Patient has not a single Discharge by Stool; the Belly is greatly distended; the Urine not seldom suppressed, and at other Times thick and foetid. The Pulse, which at first was pretty hard, becomes quick and small; the Strength entirely vanishes; a Raving comes on; a Hiccup almost constantly supervenes, and sometimes general Convulsions; the Extremities grow cold, the Pulse scarcely perceivable; the Pain and the Vomiting cease, and the Patient dies very quickly after. § 318. As this Disease is highly dangerous, the Moment it is strongly apprehended, it is necessary to oppose it by proper Means and Remedies: the smallest Error may be of fatal Consequence, and hot inflaming Liquids have been known to kill the Patient in a few Hours. I was called in the second Day of the Disease to a young Person, who had taken a good deal of Venice Treacle: Nothing could afford her any Relief, and she died early on the third Day. This Disease should be treated precisely in the same Manner as an inflammatory Cholic; the principal Difference being, that in the former there are no Stools, but continual Vomitings. 1, First of all then the Patient should be plentifully bled, if the Physician has been called in early enough, and before the Sick has lost his Strength. 2, He should receive opening Glysters made of a Decoction of Barley Water, with five or six Ounces of Oil in each. 3, We should endeavour to allay the violent Efforts to vomit, by giving every two Hours a Spoonful of the Mixture Nº. 48. 4, The Sick should drink plentifully, in very small Quantities, very often repeated, of an appeasing, diluting, refreshing Drink, which tends at the same Time to promote both Stools and Urine. Nothing is preferable to the Whey Nº. 49, if it can be had immediately: if not, give simple clear Whey sweetened with Honey, and the Drinks prescribed § 298, Art. 3. 5, The Patient is to be put into a warm Bath, and kept as long as he can bear it, repeating it as often daily too, as his Strength will permit. 6, After Bleeding, warm Bathing, repeated Glysters and Fomentations, if each and all of these have availed nothing; the Fume or Smoak of Tobacco may be introduced in the Manner of a Glyster, of which I shall speak further, in the Chapter on Persons drowned. I cured a Person of this Disease, by conveying him into a Bath, immediately after bleeding him, and giving him a Purge on his going into the Bath. § 319. If the Pain abates before the Patient has quite lost his Strength; if the Pulse improves at the same Time; if the Vomitings are less in Number, and in the Quantity of the Matter brought up; if that Matter seems in a less putrid offensive State; if he feels some Commotion and Rumbling in his Bowels; if he has some little Discharge by Stool; and if at the same Time he feels himself a little stronger than before, his Cure may reasonably be expected; but if he is otherwise circumstanced he will soon depart. It frequently happens, a single Hour before Death, that the Pain seems to vanish, and a surprising Quantity of extremely foetid Matter is discharged by Stool: the Patient is suddenly seized with a great Weakness and Sinking, falls into a cold Sweat, and immediately expires. § 320. This is the Disease which the common People attribute to, and term, the _Twisting of the Guts_; and in which they make the Patients swallow Bullets, or large Quantities of Quick-silver. This twisting, tangling, or Knoting of the Guts is an utter, an impossible Chimera; for how can they admit of such a Circumstance, as one of their Extremities, their Ends, is connected to the Stomach, and the other irremoveably fastened to the Skin of the Fork or Cleft of the Buttocks? In Fact this Disease results from a Variety of Causes, which have been discovered on a Dissection of those who have died of it. It were to be wished indeed this prudent Custom, so extremely conducive to enrich, and to perfect, the Art of Physick, were to prevail more generally; and which we ought rather to consider as a Duty to comply with, than a Difficulty to submit to; as it is our Duty to contribute to the Perfection of a Science, on which the Happiness of Mankind so considerably depends. I shall not enter into a Detail of these Causes; but whatever they are, the Practice of swallowing Bullets in the Disease is always pernicious, and the like Use of Mercury must be often so. Each of these pretended Remedies may aggravate the Disease, and contribute an insurmountable Obstacle to the Cure--Of that Iliac Passion, which is sometimes a Consequence of Ruptures, I shall treat in another Place. _Of the Cholera-morbus._ § 321. This Disease is a sudden, abundant, and painful Evacuation by vomiting and by Stool. It begins with much Flatulence, or Wind, with Swelling and slight Pains in the Belly, accompanied with great Dejection; and followed with large Evacuations either by Stool or by Vomit at first, but whenever either of them has begun, the other quickly follows. The Matter evacuated is either yellowish, green, brown, whitish, or black; the Pains in the Belly violent; the Pulse, almost constantly feverish, is sometimes strong at first, but soon sinks into Weakness, in Consequence of the prodigious Discharge. Some Patients purge a hundred Times in the Compass of a few Hours: they may even be seen to fall away; and if the Disease exists in a violent Degree, they are scarcely to be known within three or four Hours from the Commencement of these Discharges. After a great Number of them they are afflicted with Spasms, or Cramps, in their Legs, Thighs, and Arms, which torment them as much as the Pains in the Belly. When the Disease rages too highly to be asswaged, Hiccups, Convulsions and a Coldness of the Extremities approach; there is a scarcely intermitting Succession of fainting, or swooning Fits, the Patient dying either in one of them, or in Convulsions. § 322. This Disease, which constantly depends on a Bile raised to the highest Acrimony, commonly prevails towards the End of July and in August: especially if the Heats have been very violent, and there have been little or no Summer Fruits, which greatly conduce to attempt: and allay the putrescent Acrimony of the Bile. § 323. Nevertheless, however violent this Distemper may be, it is less dangerous, and also less tormenting than the former, many Persons recovering from it. 1, Our first Endeavour should be to dilute, or even to drown this acrid Bile, by Draughts, by Deluges, of the most mitigating Drinks; the irritation being so very great, that every Thing having the least Sharpness is injurious. Wherefore the patient should continually take in, by Drink, and by Way of Glyster, either Barley-Water, Almond-Milk, or pure Water, with one eighth Part Milk, which has succeeded very well in my Practice. Or he may use a very light Decoction, or Ptisan, as it were, of Bread, which is made by gently boiling a Pound of toasted Bread, in three or four Pots of Water for half an Hour. In _Swisserland_ we prefer Oat bread. We also successfully use pounded Rye, making a light Ptisan of it. A very light thin Soup made of a Pullet, a Chicken, or of one Pound of lean Veal, in three Pots of Water, is very proper too in this Disease. Whey is also employed to good Purpose; and in those Places, where it can easily be had, Butter-milk is the best Drink of any. But, whichever of these Drinks shall be thought preferable, it is a necessary Point to drink very plentifully of it; and the Glysters should be given every two Hours. 2, If the Patient is of a robust Constitution, and sanguine Complexion, with a strong Pulse at the Time of the Attack, and the Pains are very severe, a first, and in some Cases, a second Bleeding, very early in the Invasion, asswages the Violence of the Malady, and allows more Leisure for the Assistance of other Remedies. I have seen the Vomiting cease almost entirely, after the first Bleeding. The Rage of this Disease abates a little after a Duration of five or six Hours: we must not however, during this Remission or Abatement, forbear to throw in proper Remedies; since it returns soon after with great Force, which Return however indicates no Alteration of the Method already entered upon. 3, In general the warm Bath refreshes the Patient while he continues in it; but the Pains frequently return soon after he is taken out, which, however, is no Reason for omitting it, since it has frequently been found to give a more durable Relief. The Patient should continue in it a considerable Time, and, during that Time, he should take six or seven Glasses of the Potion Nº. 32, which has been very efficacious in this Disease. By these Means the Vomiting has been stopt; and the Patient, upon going out of the Bath, has had several large Stools, which very considerably diminished the Violence of the Disease. 4, If the Patient's Attendants are terrified by these great Evacuations, and determine to check them (however prematurely) by Venice Treacle, Mint Water, Syrup of white Poppies, called Diacodium, by Opium or Mithridate, it either happens, that the Disease and all its Symptoms are heightened, to which I have been a Witness; or, if the Evacuations should actually be stopt, the Patient, in Consequence of it, is thrown into a more dangerous Condition. I have been obliged to give a Purge, in order to renew the Discharges, to a Man, who had been thrown into a violent Fever, attended with a raging _Delirium_, by a Medicine composed of Venice Treacle, Mithridate and Oil. Such Medicines ought not to be employed, until the Smallness of the Pulse, great Weakness, violent and almost continual Cramps, and even the Insufficience of the Patient's Efforts to vomit, make us apprehensive of his sinking irrecoverably. In such Circumstances indeed he should take, every Quarter or half Quarter of an Hour, a Spoonful of the Mixture Nº. 50, still continuing the diluting Drinks. After the first Hour, they should only be given every Hour, and that only to the Extent of eight Doses. But I desire to insist upon it here, that this Medicine should not be given too early in this Distemper. § 324. If the Patient is likely to recover, the Pains and the Evacuations gradually abate; the Thirst is less; the Pulse continues very quick, but it becomes regular. There have been Instances of their Propensity to a heavy kind of Drowsiness at this Time; for perfect refreshing Sleep advances but slowly after this Disease. It will still be proper to persevere in the Medicines already directed, though somewhat less frequently. And now we may begin to allow the Patient a few Soups from farinaceous mealy Substances; and as soon as the Evacuations accompanying this Disease are evidently ceased, and the Pains are vanished; though an acute Sensibility and great Weakness continues, beside such Soups, he may be allowed some new-laid Eggs, very lightly boiled, or even raw, for some Days. After this he must be referred to the Regimen so frequently recommended to Persons in a State of Recovery: when the concurring Use of the Powder Nº. 24, taken twice a Day, will greatly assist to hasten and to establish his Health. __Chapter XXIII.__ _Of a Diarrhoea, or Looseness._ __Sect.__ 325. Every one knows what is meant by a Looseness or Purging, which the Populace frequently call a Flux, and sometimes a Cholic. There are certain very chronical, or tedious and obstinate ones, which arise from some essential Fault in the Constitution. Of such, as foreign to my Plan, I shall say nothing. Those which come on suddenly, without any preceding Disorder, except sometimes a slight Qualm or short Loathing, and a Pain in the Loins and Knees; which are not attended with smart Pains nor a Fever (and frequently without any Pain, or any other Complaint) are oftener of Service than prejudicial. They carry off a Heap of Matter that may have been long amassed and corrupted in the Body; which, if not discharged, might have produced some Distemper; and, far from weakening the Body, such Purgings as these render it more strong, light and active. § 326. Such therefore ought by no Means to be stopped, nor even speedily checked: they generally cease of themselves, as soon as all the noxious Matter is discharged; and as they require no Medicine, it is only necessary to retrench considerably from the ordinary Quantity of Nourishment; to abstain from Flesh, Eggs and Wine or other strong Drink; to live only on some Soups, on Pulse, or on a little Fruit, whether raw or baked, and to drink rather less than usual. A simple Ptisan with a little Syrup of _Capillaire_, or Maiden-hair, is sufficient in these Purgings, which require no Venice Treacle, Confection, nor any Drug whatever. § 327. But should it continue more than five or six Days, and manifestly weaken the Patient; if the Pain attending it grows a little severe; and especially if the Irritation, the urging to Stool, proves more frequent, it becomes seasonable to check, or to stop, it. For this Purpose the Patient is to be put into a Regimen; and if the Looseness has been accompanied with a great Loathing, with Risings or Wamblings at Stomach, with a foul furred Tongue, and a bad Taste in the Mouth, he must take the Powder Nº. 35. But if these Symptoms do not appear, give him that of Nº. 51: and during the three following Hours, let him take, every half Hour, a Cup of weak light Broth, without any Fat on it. If the Purging, after being restrained by this Medicine, should return within a few Days, it would strongly infer, there was still some tough viscid Matter within, that required Evacuation. To effect this he should take the Medicines Nº. 21, 25 or 27; and afterwards take fasting, for two successive Mornings, half the Powder, Nº. 51. On the Evening of that Day when the Patient took Nº. 35, or Nº. 51, or any other Purge, he may take a small Dose of Venice Treacle. § 328. A Purging is often neglected for a long Time, without observing the least Regimen, from which Neglect they degenerate into tedious and as it were habitual, perpetual ones, and entirely weaken the Patient. In such Cases, the Medicine Nº. 35 should be given first; then, every other Day for four Times successively, he should take Nº. 51: during all which Time he should live on nothing but Panada (See § 57) or on Rice boiled in weak Chicken-broth. A strengthing stomachic Plaister has sometimes been successfully applied, which may be often moistened in a Decoction of Herbs boiled in Wine. Cold and Moisture should be carefully avoided in these Cases, which frequently occasion immediate Relapses, even after the Looseness had ceased for many Days. __Chapter XXIV.__ _Of the Dysentery, or Bloody-flux._ __Sect.__ 329. The Dysentery is a Flux or Looseness of the Belly, attended with great Restlessness and Anguish, with severe Gripings, and frequent Propensities to go to Stool. There is generally a little Blood in the Stools, though this is not a constant Symptom, and is not essential to the Existence of a Dysentery; notwithstanding it may not be much less dangerous, for the Absence of this Symptom. § 330. The Dysentery is often epidemical; beginning sometimes at the End of July, though oftner in August, and going off when the Frosts set in. The great preceding Heats render the Blood and the Bile acrid or sharp; and though, during the Continuance of the Heat, Perspiration is kept up (See Introduct. P. 28) yet as soon as the Heat abates, especially in the Mornings and Evenings, that Discharge is diminished; and by how much the more Viscidity or Thickness the Humours have acquired, in Consequence of the violent Heats, the Discharge of the sharp Humour by Perspiration being now checked, it is thrown upon the Bowels which it irritates, producing Pains in, and Evacuations from them. This Kind of Dysentery may happen at all Times, and in all Countries; but if other Causes, capable of producing a Putridity of the Humours, be complicated with it; such as the crouding up a great Number of People into very little Room, and very close Quarters, as in Hospitals, Camps, or Prisons, this introduces a malignant Principle into the Humours, which, co-operating with the simpler Cause of the Dysentery, renders it the more difficult and dangerous. § 331. This Disease begins with a general Coldness rather than a Shivering, which lasts some Hours; the Patient's Strength soon abates, and he feels sharp Pains in his Belly, which sometimes continue for several Hours, before the Flux begins. He is affected with _Vertigos_, or Swimmings in the Head, with Reachings to vomit, and grows pale; his Pulse at the same Time being very little, if at all, feverish, but commonly small, and at length the Purging begins. The first Stools are often thin, and yellowish; but in a little Time they are mixt with a viscid ropy Matter, which is often tinged with Blood. Their Colour and Consistence are various too, being either brown, greenish or black, thinner or thicker, and foetid: The Pains increase before each of the Discharges, which grow very frequent, to the Number of eight, ten, twelve or fifteen in an Hour: then the Fundament becomes considerably irritated, and the _Tenesmus_ (which is a great Urgency to go to Stool, though without any Effect) is joined to the Dysentery or Flux, and often brings on a Protrusion or falling down of the Fundament, the Patient being now most severely afflicted. Worms are sometimes voided, and glairy hairy Humours, resembling Pieces or Peelings of Guts, and sometimes Clots of Blood. If the Distemper rises to a violent Height, the Guts become inflamed, which terminates either in Suppuration or in Mortification; the miserable Patient discharges _Pus_, or black and foetid watery Stools: the Hiccup supervenes; he grows delirious; his Pulse sinks; and he falls into cold Sweats and Faintings which terminate in Death. A kind of Phrenzy, or raging _Delirium_, sometimes comes on before the Minute of Expiration. I have seen a very unusual Symptom accompany this Disease in two Persons, which was an Impossibility of swallowing, for three Days before Death. But in general this Distemper is not so extremely violent; the Discharges are less frequent, being from twenty-five to forty within a Day and Night. Their Contents are less various and uncommon, and mixed with very little Blood; the Patient retains more Strength; the Number of Stools gradually decrease; the Blood disappears; the Consistence of the Discharges improves; Sleep and Appetite return, and the Sick recovers. Many of the Sick have not the least Degree of Fever, nor of Thirst, which perhaps is less common in this Disease, than in a simple Purging or Looseness. Their Urine sometimes is but in a small Quantity; and many Patients have ineffectual Endeavours to pass it, to their no small Affliction and Restlessness. § 332. The most efficacious Remedy for this Disease is a Vomit. That of Nº. 34, (when there is no present Circumstance that forbids the giving a Vomit) if taken immediately on the first Invasion of it, often removes it at once; and always shortens its Duration. That of Nº. 35 is not less effectual; it has been considered for a long Time, even as a certain Specific, which it is not, though a very useful Medicine. If the Stools prove less frequent after the Operation of either of them, it is a good Sign; if they are no Ways diminished, we may apprehend the Disease is like to be tedious and obstinate. The Patient is to be ordered to a Regimen, abstaining from all Flesh-meat with the strictest Attention, until the perfect Cure of the Disease. The Ptisan Nº. 3 is the best Drink for him. The Day after the Vomit, he must take the Powder Nº. 51 divided into two Doses: the next Day he should take no other Medicine but his Ptisan; on the fourth the Rhubarb must be repeated; after which the Violence of the Disease commonly abates: His Diet during the Disease is nevertheless to be continued exactly for some Days; after which he may be allowed to enter upon that of Persons in a State of Recovery. § 333. The Dysentery sometimes commences with an inflammatory Fever; a feverish, hard, full Pulse, with a violent Pain in the Head and Loins, and a stiff distended Belly. In such a Case the Patient must be bled once; and daily receive three or even four of the Glysters Nº. 6, drinking plentifully of the Drink Nº. 3. When all Dread of an Inflammation is entirely over, the Patient is to be treated in the Manner just related; though often there is no Necessity for the Vomit: and if the inflammatory Symptoms have run high, his first Purge should be that of Nº. 11, and the Use of the Rhubarb may be postponed, till about the manifest Conclusion of the Disease. I have cured many Dysenteries, by ordering the Sick no other Remedy, but a Cup of warm Water every Quarter of an Hour; and it were better to rely only on this simple Remedy, which must be of some Utility, than to employ those, of whose Effects Country People are ignorant, and which are often productive of very dangerous ones. § 334. It sometimes happens that the Dysentery is combined with a putrid Fever, which makes it necessary, after the Vomit, to give the Purges Nº. 23 or 47, and several Doses of Nº. 24, before the Rhubarb is given. Nº. 32 is excellent in this combined Case. There was in _Swisserland_ in the Autumn of 1755, after a very numerous Prevalence of epidemical putrid Fevers had ceased, a Multitude of Dysenteries, which had no small Affinity with, or Relation to, such Fevers. I treated them first, with the Prescription Nº. 34, giving afterwards Nº. 32; and I directed the Rhubarb only to very few, and that towards the Conclusion of the Disease. By much the greater Number of them were cured at the End of four or five Days. A small Proportion of them, to whom I could not give the Vomit, or whose Cases were more complicated, remained languid a considerable Time, though without Fatality or Danger. § 335. When the Dysentery is blended with Symptoms of Malignity (See § 245) after premising the Prescription Nº. 35, those of Nº. 38 and 39 may be called in successfully. § 336. When the Disease has already been of many Days standing, without the Patient's having taken any Medicines, or only such as were injurious to him, he must be treated as if the Distemper had but just commenced; unless some Symptoms, foreign to the Nature of the Dysentery, had supervened upon it. § 337. Relapses sometimes occur in Dysenteries, some few Days after the Patients appeared well; much the greater Number of which are occasioned either by some Error in Diet, by cold Air, or by being considerably over-heated. They are to be prevented by avoiding these Causes of them; and may be removed by putting the Patient on his Regimen, and giving him one Dose of the Prescription Nº. 51. Should it return even without any such discoverable Causes, and if it manifests itself to be the same Distemper renewed, it must be treated as such. § 338. This Disease is sometimes combined too with an intermitting Fever; in which Case the Dysentery must be removed first, and the intermittent afterwards. Nevertheless if the Access, the Fits of the Fever have been very strong, the Bark must be given as directed § 259. § 339. One pernicious Prejudice, which still generally prevails is, that Fruits are noxious in a Dysentery, that they even give it, and aggravate it; and this perhaps is an extremely ill-grounded one. In truth bad Fruits, and such as have not ripened well, in unseasonable Years, may really occasion Cholics, a Looseness (though oftner a Costiveness) and Disorders of the Nerves, and of the Skin; but never can occasion an epidemical Dysentery or Flux. Ripe Fruits, of whatever Species, and especially Summer Fruits, are the real Preservatives from this Disease. The greatest Mischief they can effect, must result from their thinning and washing down the Humours, especially the thick glutinous Bile, if they are in such a State; good ripe Fruits being the true Dissolvents of such; by which indeed they may bring on a Purging, but such a one, as is rather a Guard against a Dysentery. We had a great, an extraordinary Abundance of Fruit in 1759 and 1760, but scarcely any Dysenteries. It has been even observed to be more rare, and less dangerous than formerly; and if the Fact is certain, it cannot be attributed to any thing more probably, than to the very numerous Plantations of Trees, which have rendered Fruit very plenty, cheap and common. Whenever I have observed Dysenteries to prevail, I made it a Rule to eat less Flesh, and Plenty of Fruit; I have never had the slightest Attack of one; and several Physicians use the same Caution with the same Success. I have seen eleven Patients in a Dysentery in one House, of whom nine were very tractable; they eat Fruit and recovered. The Grandmother and one Child, whom she loved more than the rest, were carried off. She managed the Child after her own Fashion, with burnt Wine, Oil, and some Spices, but no Fruit. She conducted herself in the very same Manner, and both died. In a Country Seat near _Berne_, in the Year 1751, when these Fluxes made great Havock, and People were severely warned against the Use of Fruits, out of eleven Persons in the Family, ten eat plentifully of Prunes, and not one of them was seized with it: The poor Coachman alone rigidly observed that Abstinence from Fruit injoined by this Prejudice, and took a terrible Dysentery. This same Distemper had nearly destroyed a Swiss Regiment in Garrison in the South of _France_; the Captains purchased the whole Crop of several Acres of Vineyard; there they carried the sick Soldiers, and gathered the Grapes for such as could not bear being carried into the Vineyard; those who were well eating nothing else: after this not one more died, nor were any more even attacked with the Dysentery. A Clergyman was seized with a Dysentery, which was not in the least mitigated by any Medicines he had taken. By meer Chance he saw some red Currans; he longed for them, and eat three Pounds of them between seven and nine o'Clock in the Morning; that very Day he became better, and was entirely well on the next. I could greatly enlarge the Number of such Instances; but these may suffice to convince the most incredulous, whom I thought it might be of some Importance to convince. Far from forbidding good Fruit, when Dysenteries rage, the Patients should be encouraged to eat them freely; and the Directors of the Police, instead of prohibiting them, ought to see the Markets well provided with them. It is a Fact of which Persons, who have carefully informed themselves, do not in the least doubt. Experience demonstrates it, and it is founded in Reason, as good Fruit counter-operates all the Causes of Dysenteries. [77] [77] The Experience of all Countries and Times so strongly confirms these important Truths, that they cannot be too often repeated, too generally published, whenever and wherever this Disease rages. The Succession of cold Showers to violent Heats; too moist a Constitution of the Air; an Excess of animal Food; Uncleanliness and Contagion, are the frequent Causes of epidemical Fluxes. _E. L._ I have retained the preceding Note, abridged from this Gentleman, as it contains the Suffrage of another experienced Physician, against that Prejudice of ripe Fruits occasioning Fluxes, which is too popular among ourselves, and probably more so in the Country than in _London_. I have been also very credibly assured, that the Son of a learned Physician was perfectly cured of a very obstinate Purging, of a Year's Continuance (in Spite of all the usual officinal Remedies) by his devouring large Quantities of ripe Mulberries, for which he ardently longed, and drinking very freely of their expressed Juice. The Fact occurred after his Father's Decease, and was affirmed to me by a Gentleman intimately acquainted with them both. _K._ § 340. It is important and even necessary, that each Subject of this Disease should have a Close-stool or Convenience apart to himself, as the Matter discharged is extremely infectious: and if they make Use of Bed-pans, they should be carried immediately out of the Chamber, the Air of which should be continually renewed, burning Vinegar frequently in it. It is also very necessary to change the Patient's Linen frequently; without all which Precautions the Distemper becomes more violent, and attacks others who live in the same House. Hence it is greatly to be wished the People in general were convinced of these Truths. It was _Boerhaave's_ Opinion, that all the Water which was drank, while Dysenteries were epidemical, should be _stummed_, as we term it, or sulphurized. [78] [78] Our learned Author, or his medical Editor at _Lyons_, observes here, 'that in the Edition of this Treatise at _Paris_, there was an essential Mistake, by making _Boerhaave_ recommend the Addition of Brandy, _Eau de vie_, instead of stumming or sulphurizing it,' for which this Note, and the Text too use the Verb _branter_, which Word we do not find in any Dictionary. We are told however, it means to impregnate the Casks in which the Water is reserved, with the Vapour of Sulphur, and then stopping them; in the same Manner that Vessels are in some Countries, for the keeping of Wine. He observes the Purpose of this is to oppose Corruption by the acid Steams of the Sulphur. _K._ § 341. It has happened, by some unaccountable Fatality, that there is no Disease, for which a greater Number of Remedies are advised, than for the Dysentery. There is scarcely any Person but what boasts of his own Prescription, in Preference to all the rest, and who does not boldly engage to cure, and that within a few Hours, a tedious severe Disease, of which he has formed no just Notion, with some Medicine or Composition, of whose Operation he is totally ignorant: while the poor Sufferer, restless and impatient, swallows every Body's Recommendation, and gets poisoned either through Fear, downright Disgust or Weariness, or through entire Complaisance. Of these many boasted Compositions, some are only indifferent, but others pernicious. I shall not pretend to detail all I know myself, but after repeatedly affirming, that the only true Method of Cure is that I have advised here, the Purpose of which is evacuating the offending Matter; I also affirm that all those Methods, which have a different Scope or Drift, are pernicious; but shall particularly observe, that the Method most generally followed, which is that of stopping the Stools by Astringents, or by Opiates, is the worst of all, and even so mortal a one, as to destroy a Multitude of People annually, and which throws others into incurable Diseases. By preventing the Discharge of these Stools, and inclosing the Wolf in the Fold, it either follows, 1, that this [79] retained Matter irritates and inflames the Bowels from which Inflammation excruciating Pains arise, an acute inflammatory Cholic, and finally a Mortification and Death; or a _Schirrhus_, which degenerates into a _Cancer_, (of which I have seen a dreadful Instance) or else an Abscess, Suppuration and Ulcer. Or 2, this arrested Humour is repelled elsewhere, producing a _Scirrhus_ in the Liver, or Asthmas, Apoplexy, Epilepsy, or Falling Sickness; horrible rheumatic Pains, or incurable Disorders of the Eyes, or of the Teguments, the Skin and Surface. [79] A first or second Dose of Glauber Salt has been known to succeed in the epidemical Summer Fluxes of the hotter Climates, when repeated Doses of Rhubarb and Opiates had failed. Such Instances seems a collateral Confirmation of Dr. _Tissot's_ rational and successful Use of cooling opening Fruits in them. _K._ Such are the Consequences of all the astringent Medicines, and of those which are given to procure Sleep in this Disease, as Venice Treacle, Mithridate and Diascordium, when given too early in Dysenteries. I have been consulted on Account of a terrible Rheumatism, which ensued immediately after taking a Mixture of Venice Treacle and Plantain, on the second Day of a Dysentery. As those who advise such Medicines, are certainly unaware of their Consequences, I hope this Account of them will be sufficient, to prevent their Repetition. § 342. Neither are Purges without their Abuse and Danger; they determine the Course of all the Humours more violently to the tender afflicted Parts; the Body becomes exhausted; the Digestions fail; the Bowels are weakened, and sometimes even lightly ulcerated, whence incurable _Diarrhoeas_ or Purgings ensue, and prove fatal after many Years Affliction. § 343. If the Evacuations prove excessive, and the Distemper tedious, the Patient is likely to fall into a Dropsy; but if this is immediately opposed, it may be removed by a regular and drying Diet, by Strengthners, by Friction and proper Exercise. __Chapter XXV.__ _Of the Itch._ __Sect.__ 344. The Itch is an infectious Disorder contracted by touching infected Persons or Cloaths, but not imbibed from the Air: So that by carefully avoiding the _Medium_, or Means of Contagion, the Disorder may be certainly escaped. Though any Part of the Body may be infested with the Itch, it commonly shews itself on the Hands, and chiefly between the Fingers. At first one or two little Pimples or Pustules appear, filled with a kind of clear Water, and excite a very disagreeable Itching. If these Pustules are broke by scratching them, the Water oozing from them infects the neighbouring Parts. At the Beginning of this Infection it can scarcely be distinguished, if a Person is not well apprized of its Nature; but in the Progress of it, the little Pustules increase both in Number and Size; and when they are opened by scratching, a loathsome kind of Scab is formed, and the Malady extends over the whole Surface. Where they continue long, they produce small Ulcers, and are at that Time highly contagious. § 345. Bad Diet, particularly the Use of Salt Meat, bad unripe Fruit, and Uncleanliness occasion this Disease; though it is oftnest taken by Contagion. Some very good Physicians suppose it is never contracted otherwise; but I must take Leave to dissent, as I have certainly seen it exist without Contagion. When it happens to a Person, who cannot suspect he has received it by Contact, his Cure should commence with a total Abstinence from all Salt, sour, fat and spicy Food. He should drink a Ptisan of wild and bitter Succory, or that of Nº. 26, five or six Glasses of which may be daily taken; at the End of four or five Days, he may be purged with Nº. 21, or with an Ounce of _Sedlitz_ [or _Epsom_] Salt. His Abstinence, his Regimen is to be continued; the Purge to be repeated after six or seven Days; and then all the Parts affected, and those very near them, are to be rubbed in the Morning fasting, with a fourth Part of the Ointment Nº. 52. The three following Days the same Friction is to be repeated, after which the same Quantity of Ointment is to be procured, and used in the same Proportion; but only every other Day. It happens but seldom that this Method fails to remove this disagreeable Malady; sometimes however it will return, in which Case, the Patient must be purged again, and then recur to the Ointment, whose good Effects I have experienced, and continually do. If the Disease has been very lately contracted, and most certainly by Contact, the Ointment may be fearlessly employed, as soon as it is discovered, without taking any Purge before it. But if, on the contrary, the Disease has been long neglected, and has rose to a high Degree, it will be necessary to restrain the Patient a long Time to the Regimen I have directed; he must be repeatedly purged, and then drink plentifully of the Ptisan Nº. 26, before the Ointment is rubbed in. When the Malady is thus circumstanced, I have always begun with the Ointment Nº. 28, half a Quarter of which is to be used every Morning. I have also frequently omitted the Use of that Nº. 52, having always found the former as certain, but a little slower in its Effects. § 346. While these Medicines are employed, the Patient must avoid all Cold and Wet, especially if he makes Use of Nº. 28, [80] in which there is Quick-silver; which, if such Precautions were neglected, might bring on a Swelling of the Throat and Gums, and even rise to a Salivation. Yet this Ointment has one Advantage in its having no Smell, and being susceptible of an agreeable one; while it is very difficult to disguise the disagreeable Odour of the other. The Linen of a Person in this Disease ought to be often changed; but his upper Cloaths must not be changed: because these having been infected, might, when worn again, communicate the Itch to the Wearer again, after he had been cured. Shirts, Breeches and Stockings may be fumigated with Sulphur, before they are put on; and this Fumigation should be made in the open Air. [80] I have seen a pretty singular Consequence from the Abuse of mercurial Unction for the Itch; whether it happened from the Strength or Quantity of the Ointment, or from taking Cold after applying it, as this Subject, a healthy Youth of about sixteen, probably did, by riding three or four Miles through the Rain. But without any other previous Complaint, he awoke quite blind one Morning, wondering, as he said, when it would be Day. His Eyes were very clear, and free from Inflammation, but the Pupil was wholly immoveable, as in a _Gutta serena_. I effected the Cure by some moderate Purges repeated a few Times; by disposing him to sweat by lying pretty much in Bed (it being towards Winter) and by promoting his Perspiration, chiefly with Sulphur: after which the shaved Scalp was embrocated with a warm nervous Mixture, in which Balsam of _Peru_ was a considerable Ingredient. In something less than three Weeks he could discern a glowing Fire, or the bright Flame of a Candle. As his Sight increased, he discerned other Objects, which appeared for some Days inverted to him, with their Colours confused; but Red was most distinguishable. He discovered the Aces sooner than other Cards; and in about six or seven Weeks recovered his full Sight in all its natural Strength, which he now enjoys. _K._ § 347. If this Disorder becomes very inveterate and tedious, it exhausts the Patient, in Consequence of its not suffering him to sleep at Nights, as well as by his restless Irritation; and sometimes even brings on a Fever, so that he falls away in Flesh, and his Strength abates. In such a Case he must take, 1, a gentle Purge. 2, Make Use frequently of warm Baths. 3, He must be put on the Regimen of Persons in a State of Recovery. 4, He must take Morning and Evening, fifteen Days successively, the Powder Nº. 53, with the Ptisan Nº. 26. This Malady is often very obstinate, and then the Medicines must be varied according to the Circumstances, the Detail of which I avoid here. § 348. After giving repeated Purges in such obstinate Cases, mineral Waters abounding with Sulphur, such as [81] those of _Yverdun_, &c. often effect a Cure; and simple cold Bathings in Rivers or Lakes have sometimes succeeded in very inveterate Cases of this Disorder. [81] Sea water, and those of _Dulwich_, _Harrigate_, _Shadwell_, &c. will be full as effectual. _K._ Nothing conduces more to the long Continuance of this Malady, than the Abuse of hot Waters, such as infusions of Tea, &c. § 349. I shall conclude this Chapter, with a repeated Injunction not to be too free or rash in the Use of the Ointment Nº. 52, and other outward Remedies for extinguishing the Itch. There is hardly any Complaint, but what has been found to be the Consequence of too sudden a Removal of this Disorder by outward Applications, before due Evacuations have been made, and a moderate Abatement of the Sharpness of the Humours has been effected. __Chapter XXVI.__ _The Treatment of Diseases peculiar to Women._ __Sect.__ 350. Besides all the preceding Diseases, to which Women are liable in common with Men, their Sex also exposes them to others peculiar to it, and which depend upon four principal Sources; which are their monthly Discharges, their Pregnancy, their Labours in Child-birth, and the Consequences of their Labours. It is not my present Design to treat professedly on each of the Diseases arising from these Causes, which would require a larger Volume than I have proposed; but I shall confine myself to certain general Directions on these four Heads. § 351. Nature, who intended Women for the Increase, and the Nourishment of the human Race at the Breast, has subjected them to a periodical Efflux, or Discharge, of Blood: which Circumstance constitutes the Source, from whence the Infant is afterwards to receive his Nutrition and Growth. This Discharge generally commences, with us, between the Age of sixteen and eighteen. Young Maidens, before the Appearance of this Discharge, are frequently, and many for a long Time, in a State of Weakness, attended with various Complaints, which is termed the _Chlorosis_, or Green Sickness, and Obstructions: and when their Appearance is extremely slow and backward, it occasions very grievous, and sometimes even mortal Diseases. Nevertheless it is too usual, though very improper, to ascribe all the Evils, to which they are subject at this Term of Life, solely to this Cause; while they really often result from a different Cause, of which the Obstructions themselves are sometimes only the Effect; and this is the natural, and, in some Degree, even necessary Feebleness of the Sex. The Fibres of Women which are intended to be relaxed, and to give Way, when they are unavoidably extended by the Growth of the Child, and its inclosing Membranes (which frequently arise to a very considerable Size) should necessarily be less stiff and rigid, less strong, and more lax and yielding than the Fibres of Men. Hence the Circulation of their Blood is more slow and languid than in Males; their Blood is less compact and dense, and more watery; their Fluids are more liable to stagnate in their different Bowels, and to form Infarctions and Obstructions. § 352. The Disorders to which such a Constitution subjects them might, in some Measure, be prevented, by assisting that Languor or Feebleness of their natural Movements, by such an Increase of their Force, as Exercise might contribute to: But this Assistance, which in some Manner is more necessary for Females than Males, they are partly deprived of, by the general Education and Habitude of the Sex; as they are usually employed in managing Household Business, and such light sedentary Work, as afford them less Exercise and Motion, than the more active Occupations of Men. They stir about but little, whence their natural Tendency to Weakness increases from Habit, and thence becomes morbid and sickly. Their Blood circulates imperfectly; its Qualities become impaired; the Humours tend to a pretty general Stagnation; and none of the vital Functions are completely discharged. From such Causes and Circumstances they begin to sink into a State of Weakness, sometimes while they are very young, and many Years before this periodical Discharge could be expected. This State of Languor disposes them to be inactive; a little Exercise soon fatigues them, whence they take none at all. It might prove a Remedy, and even effect a Cure, at the Beginning of their Complaint; but as it is a Remedy, that is painful and disagreeable to them, they reject it, and thus increase their Disorders. Their Appetite declines with the other vital Functions, and gradually becomes still less; the usual salutary Kinds of Food never exciting it; instead of which they indulge themselves in whimsical Cravings, and often of the oddest and most improper Substances for Nutrition, which entirely impair the Stomach with its digestive Functions, and consequently Health itself. But sometimes after the Duration of this State for a few Years, the ordinary Time of their monthly Evacuations approaches, which however make not the least Appearance, for two Reasons. The first is, that their Health is too much impaired to accomplish this new Function, at a Time when all the others are so languid: and the second is, that under such Circumstances, the Evacuations themselves are unnecessary; since their final Purpose is to discharge (when the Sex are not pregnant) that superfluous Blood, which they were intended to produce, and whose Retention would be unhealthy, when not applied to the Growth of the Foetus, or Nourishment of the Child: and this Superfluity of Blood does not exist in Women, who have been long in a very low and languishing State. § 353. Their Disorder however continues to increase, as every one daily must, which does not terminate. This Increase of it is attributed to the Suppression or Non-appearance of their monthly Efflux, which is often erroneous; since the Disorder is not always owing to that Suppression, which is often the Effect of their Distemperature. This is so true, that even when the Efflux happens, if their Weakness still continues, the Patients are far from being the better for it, but the reverse. Neither is it unusual to see young Lads, who have received from Nature, and from their Parents, a sort of feminine Constitution, Education and Habitude, infested with much the same Symptoms, as obstructed young Women. Country Girls, who are generally more accustomed to such hardy Work and Exercise as Country Men, are less subject to these Complaints, than Women who live in Cities. § 354. Let People then be careful not to deceive themselves on this important Account; since all the Complaints of young Maidens are not owing to the Want of their Customs. Nevertheless it is certain there are some of them, who are really afflicted from this Cause. For Instance, when a strong young Virgin in full Health, who is nearly arrived to her full Growth, and who manifestly abounds with Blood, does not obtain this Discharge at the usual Time of Life, then indeed this superfluous Blood is the Fountain of very many Disorders, and greatly more violent ones than those, which result from the contrary Causes already mentioned. If the lazy inactive City Girls are more subject to the Obstructions, which either arise from the Weakness and Languor I have formerly taken Notice of, or which accompany it; Country Girls are more subject to Complaints from this latter Cause (too great a Retention of superfluous Blood) than Women who live in Cities: and it is this last Cause that excites those singular Disorders, which appear so supernatural to the common People, that they ascribe them to Sorcery. § 355. And even after these periodical Discharges have appeared, it is known that they have often been suppressed, without the least unhealthy Consequence resulting from that Suppression. They are often suppressed, in the Circumstances mentioned § 351, by a Continuance of the Disease, which was first an Obstacle or Retardment to their Appearance; and in other Cases, they have been suppressed by other Causes, such as Cold, Moisture, violent Fear, any very strong Passion; by too chilly a Course of Diet, with Indigestion; or too hot and irritating Diet; by Drinks cooled with Ice, by Exercise too long continued, and by unusual Watching. The Symptoms, occasioned by such Suppressions, are sometimes more violent than those, which preceded the first Appearance of the Discharge. § 356. The great Facility with which this Evacuation may be suppressed, diminished, or disordered, by the Causes already assigned; the terrible Evils which are the Consequences of such Interruptions and Irregularities of them, seem to me very cogent Reasons to engage the Sex to use all possible Care, in every Respect, to preserve the Regularity of them; by avoiding, during their Approach and Continuance, every Cause that may prevent or lessen them. Would they be thoroughly persuaded, not solely by my Advice, but by that of their Mothers, their Relations, their Friends, and by their own Experience, of what great Importance it is to be very attentive to themselves, at those critical Times, I think there is not one Woman, who from the first, to the very last Appearance of them, would not conduct herself with the most scrupulous Regularity. Their Demeanour, in these Circumstances, very fundamentally interests their own Health, as well as that of their Children; and consequently their own Happiness, as well as that of their Husbands and Families. The younger and more delicate they are, Caution becomes the more necessary for them. I am very sensible a strong Country Girl is too negligent in regulating herself at those critical Seasons, and sometimes without any ill Consequence; but at another Time she may suffer severely for it: and I could produce a long List of many, who, by their Imprudence on such Occasions, have thrown themselves into the most terrible Condition. Besides the Caution with which Females should avoid these general Causes, just mentioned in the preceding Section, every Person ought to remember what has most particularly disagreed with her during that Term, and for ever constantly to reject it. § 357. There are many Women whose Customs visit them without the slightest Impeachment of their Health: others are sensibly disordered on every Return of them; and to others again they are very tormenting, by the violent Cholics, of a longer or a shorter Duration, which precede or accompany them. I have known some of these violent Attacks last but some Minutes, and others which continued a few Hours. Nay some indeed have persisted for many Days, attended with Vomiting, Fainting, with Convulsions from excessive Pain, with Vomiting of Blood, Bleedings from the Nose, _&c._ which, in short, have brought them to the very Jaws of Death. So very dangerous a Situation requires the closest Attention; though, as it results from several and frequently very opposite Causes, it is impossible within the present Plan, to direct the Treatment that may be proper for each Individual. Some Women have the Unhappiness to be subject to these Symptoms every Month, from the first Appearance, to the final Termination, of these Discharges; except proper Remedies and Regimen, and sometimes a happy Child-birth, remove them. Others complain but now and then, every second, third, or fourth Month; and there are some again, who having suffered very severely during the first Months, or Years, after their first Eruptions, suffer no more afterwards. A fourth Number, after having had their Customs for a long Time, without the least Complaint, find themselves afflicted with cruel Pains, at every Return of them; if by Imprudence, or some inevitable Fatality, they have incurred any Cause, that has suppressed, diminished, or delayed them. This Consideration ought to suggest a proper Caution even to such, as generally undergo these Discharges, without Pain or Complaint: since all may be assured, that though they suffer no sensible Disorder at that Time, they are nevertheless more delicate, more impressible by extraneous Substances, more easily affected by the Passions of the Mind, and have also weaker Stomachs at these particular Periods. § 358. These Discharges may also be sometimes too profuse in Quantity, in which Case the Patients become obnoxious to very grievous Maladies; into the Discussion of which however I shall not enter here, as they are much less frequent than those, arising from a Suppression of them. Besides which, in such Cases, Recourse may be had to the Directions I shall give hereafter, when I treat of that Loss of Blood, which may be expedient, during the Course of Gravidation or Pregnancy. See § 365. § 359. Finally, even when they are the most regular, after their Continuance for a pretty certain Number of Years (rarely exceeding thirty-five) they go off of their own Accord, and necessarily, between the Age of forty-five and fifty; sometimes even sooner, but seldom continuing longer: and this _Crisis_ of their ceasing is generally a very troublesome, and often a very dangerous, one for the Sex. § 360. The Evils mentioned § 352 may be prevented, by avoiding the Causes producing them; and, 1, by obliging young Maidens to use considerable Exercise; especially as soon as there is the least Reason to suspect the Approach of this Disorder, the _Chlorosis_, or Green Sickness. 2, By watching them carefully, that they eat nothing unwholesome or improper; as there are scarcely any natural Substances, even among such as are most improper for them, and the most distasteful, which have not sometimes been the Objects of their sickly, their unaccountable Cravings. Fat Aliments, Pastry, farinaceous or mealy, and sour and watery Foods are pernicious to them. Herb-Teas, which are frequently directed as a Medicine for them, are sufficient to throw them into the Disorder, by increasing that Relaxation of their Fibres, which is a principal Cause of it. If they must drink any such Infusions, as medicated Drinks, let them be taken cold: but the best Drink for them is Water, in which red hot Iron has been extinguished. 3, They must avoid hot sharp Medicines, and such as are solely intended to force down their Terms, which are frequently attended with very pernicious Consequences, and never do any good: and they are still the more hurtful, as the Patient is the younger. 4, If the Malady increases, it will be necessary to give them some Remedies; but these should not be Purges, nor consist of Diluters, and Decoctions of Herbs, of Salts, and a Heap of other useless and noxious Ingredients; but they should take Filings of Iron, which is the most certain Remedy in such Cases. These Filings Should be of true simple Iron, and not from Steel; and Care should be taken that it be not rusty, in which State it has very little Effect. At the Beginning of this Distemper, and to young Girls, it is sufficient to give twenty Grains daily, enjoining due Exercise and a suitable Diet. When it prevails in a severer Degree, and the Patient is not so young, a Quarter of an Ounce may be safely ventured on: Certain Bitters or Aromatics may be advantageously joined to the Filings, which are numbered in the Appendix, 54, 55, 56, and constitute the most effectual Remedies in this Distemper, to be taken in the Form of Powder, of vinous Infusion, or of Electary. [82] When there is a just Indication to bring down the Discharge, the vinous Infusion Nº. 55 must be given, and generally succeeds: but I must again repeat it (as it should carefully be considered) that the Stoppage or Obstruction of this Discharge is frequently the Effect, not the Cause, of this Disease; and that there should be no Attempt to force it down, which in such a Case, may sometimes prove more hurtful than beneficial; since it would naturally return of its own Accord, on the Recovery, and with the Strength, of the Patient: as their Return should follow that of perfect Health, and neither can precede Health, nor introduce it. There are some Cases particularly, in which it would be highly dangerous to use hot and active Medicines, such Cases for Instance, as are attended with some Degree of Fever, a frequent Coughing, a Hæmorrhage, or Bleeding, with great Leanness and considerable Thirst: all which Complaints should be removed, before any hot Medicines are given to force this Evacuation, which many very ignorantly imagine cures all other female Disorders; an Error, that has prematurely occasioned the Loss of many Womens' Lives. [82] The _French_ Word here, _Opiat_, is sometimes used by them for a compound Medicine of the Consistence of an Electary; and cannot be supposed, in this Place, to mean any Preparation, into which _Opium_ enters. _K._ § 361. While the Patient is under a Course of these Medicines, she should not take any of those I have forbidden in the preceding Sections; and the Efficacy of these should also be furthered with proper Exercise. That in a Carriage is very healthy; Dancing is so too, provided it be not extended to an Excess. In Case of a Relapse in these Disorders, the Patient is to be treated, as if it were an original Attack. § 362. The other Sort of Obstructions described § 354 requires a very different Treatment. Bleeding, which is hurtful in the former Sort, and the Use, or rather Abuse, of which has thrown several young Women into irrecoverable Weaknesses, has often removed this latter Species, as it were, in a Moment. Bathing of the Feet, the Powders Nº. 20, and Whey have frequently succeeded: but at other Times it is necessary to accommodate the Remedies and the Method to each particular Case, and to judge of it from its own peculiar Circumstances and Appearances. § 363. When these Evacuations naturally cease through Age (See § 359) if they stop suddenly and all at once, and had formerly flowed very largely, Bleeding must, 1, necessarily be directed, and repeated every six, every four, or even every three Months. 2, The usual Quantity of Food should be somewhat diminished, especially of Flesh, of Eggs and of strong Drink. 3, Exercise should be increased. 4, The Patient should frequently take, in a Morning fasting, the Powder Nº. 24, which is very beneficial in such Cases; as it moderately increases the natural Excretions by Stool, Urine and Perspiration; and thence lessens that Quantity of Blood, which would otherwise superabound. Nevertheless, should this total Cessation of the monthly Discharge be preceded by, or attended with, any extraordinary Loss of Blood, which is frequently the Case, Bleeding is not so necessary; but the Regimen and Powder just directed are very much so; to which the Purge Nº. 23 should now and then be joined, at moderate Intervals. The Use of astringent Medicines at this critical Time might dispose the Patient to a Cancer of the Womb. Many Women die about this Age, as it is but too easy a Matter to injure them then; a Circumstance that should make them very cautious and prudent in the Medicines they recur to. On the other Hand it also frequently happens, that their Constitutions alter for the better, after this critical Time of Life; their Fibres grow stronger; they find themselves sensibly more hearty and hardy; many former slight Infirmities disappear, and they enjoy a healthy and happy old Age. I have known several who threw away their Spectacles at the Age of fifty-two, or fifty-three, which they had used five or six Years before. The Regimen I have just directed, the Powder Nº. 24, and the Potion Nº. 32, agree very well in almost all inveterate Discharges (I speak of the female Peasantry) at whatever Time of Life. _Of Disorders attending Gravidation, or the Term of going with Child._ § 364. Gravidation is generally a less ailing or unhealthy State in the Country, than in very populous Towns. Nevertheless Country Women are subject, as well as Citizens, to Pains of the Stomach, to vomiting in a Morning, to Head-ach and Tooth-ach; but these Complaints very commonly yield to Bleeding, which is almost the only Remedy necessary [83] for pregnant Women. [83] Too great a Fulness of Blood is undoubtedly the Cause of all these Complaints; but as there are different Methods of opposing this Cause, the gentlest should always be preferred; nor should the Constitution become habituated to such Remedies, as might either impair the Strength of the Mother, or of her Fruit. Some Expedients therefore should be thought of, that may compensate for the Want of Bleeding, by enjoining proper Exercise in a clear Air, with a less nourishing, and a less juicy Diet. _E. L._ This Note might have its Use sometimes, in the Cases of such delicate and hysterical, yet pregnant Women, as are apt to suffer from Bleeding, or any other Evacuation, though no ways immoderate. But it should have been considered, that Dr. _Tissot_ was professedly writing here to hearty active Country Wives, who are very rarely thus constituted; and whom he might be unwilling to confuse with such multiplied Distinctions and Directions, as would very seldom be necessary, and might sometimes prevent them from doing what was so. Besides which, this Editor might have seen, our Author has hinted at such Cases very soon after. _K._ § 365. Sometimes after carrying too heavy Burthens; after too much or too violent Work; after receiving excessive Jolts, or having had a Fall, they are subject to violent Pains of the Loins, which extend down to their Thighs, and terminate quite at the Bottom of the Belly; and which commonly import, that they are in Danger of an Abortion, or Miscarrying. To prevent this Consequence, which is always dangerous, they should, 1, immediately go to Bed; and if they have not a Mattrass, they should lie upon a Bed stuffed with Straw, a Feather-bed being very improper in such Cases. They should repose, or keep themselves quite still in this Situation for several Days, not stirring, and speaking as little as possible. 2, They should directly lose eight or nine Ounces of Blood from the Arm. 3, They should not eat Flesh, Flesh-broth, nor Eggs; but live solely on Soups made of farinaceous or mealy Substances. 4, They should take every two Hours half a Paper of the Powder Nº. 20; and should drink nothing but the Ptisan Nº. 2. Some sanguine robust Women are very liable to miscarry at a certain Time, or Stage, of their Pregnancy. This may be obviated by their bleeding some Days before that Time approaches, and by their observing the Regimen I have advised. But this Method would avail very little for delicate Citizens, who miscarry from a very different Cause; and whose Abortions are to be prevented by a very different Treatment. _Of Delivery, or Child-birth._ § 366. It has been observed that a greater Proportion of Women die in the Country in, or very speedily after, their Delivery, and that from the Scarcity of good Assistance, and the great Plenty of what is bad; and that a greater Proportion of those in Cities die after their Labours are effected, by a Continuance of their former bad Health. The Necessity there is for better instructed, better qualified Midwives, through a great Part of _Swisserland_, is but too manifest an Unhappiness, which is attended with the most fatal Consequences, and which merits the utmost Attention of the Government. The Errors which are incurred, during actual Labour, are numberless, and too often indeed are also irremediable. It would require a whole Book, expressly for that Purpose (and in some Countries there are such) to give all the Directions that are necessary, to prevent so many Fatalities: and it would be as necessary to form a sufficient Number of well-qualified Midwives to comprehend, and to observe them; which exceeds the Plan of the Work I have proposed. I shall only mark out one of the Causes, and the most injurious one on this Occasion: This is the Custom of giving hot irritating Things, whenever the Labour is very painful, or is slow; such as Castor, or its Tincture, Saffron, Sage, Rue, Savin, Oil of Amber, Wine, Venice Treacle, Wine burnt with Spices, Coffee, Brandy, Aniseed-Water, Walnut-Water, Fennel-Water, and other Drams or strong Liquors. All these Things are so many Poisons in this Respect, which, very far from promoting the Woman's Delivery, render it more difficult by inflaming the Womb (which cannot then so well contract itself) and the Parts, through which the Birth is to pass, in Consequence of which they swell, become more straitened, and cannot yield or be dilated. Sometimes these stimulating hot Medicines also bring on Hæmorrhages, which prove mortal in a few Hours. § 367. A considerable Number, both of Mothers and Infants, might be preserved by the directly opposite Method. As soon as a Woman who was in very good Health, just before the Approach of her Labour, being robust and well made, finds her Travail come on, and that it is painful and difficult; far from encouraging those premature Efforts, which are always destructive; and from furthering them by the pernicious Medicines I have just enumerated, the Patient should be bled in the Arm, which will prevent the Swelling and Inflammation; asswage the Pains; relax the Parts, and dispose every thing to a favourable Issue. During actual Labour no other Nourishment should be allowed, except a little Panada every three Hours, and as much Toast and Water, as the Woman chuses. Every fourth Hour a Glyster should be given, consisting of a Decoction of Mallows and a little Oil. In the Intervals between these Glysters she should be set over a kind of Stove, or in a pierced easy Chair, containing a Vessel in which there is some hot Water: the Passage should be gently rubbed with a little Butter; and Stapes wrung out of a Fomentation of simple hot Water, which is the most efficacious of any, should be applied over the Belly. The Midwives, by taking this Method, are not only certain of doing no Mischief, but they also allow Nature an Opportunity of doing Good: as a great many Labours, which seem difficult at time, terminate happily; and this safe and unprecipitate Manner of proceeding at least affords Time to call in further Assistance. Besides, the Consequences of such Deliveries are healthy and happy; when by pursuing the heating oppressing Practice, even though the Delivery be effected, both Mother and Infant have been so cruelly, though undesignedly, tormented, that both of them frequently perish. § 368. I acknowledge these Means are insufficient, when the Child is unhappily situated in the Womb; or when there is an embarrassing Conformation in the Mother: though at least they prevent the Case from proving worse, and leave Time for calling in Men-Midwives, or other female ones, who may be better qualified. I beg leave again to remind the Midwives, that they should be very cautious of urging their Women to make any forced Efforts to forward the Birth, which are extremely injurious to them, and which may render a Delivery very dangerous and embarrassing, that might otherwise have been happily effected: and I insist the more freely on the Danger attending these unreasonable Efforts, and on the very great Importance of Patience, as the other very pernicious Practice is become next to universal amongst us. The Weakness, in which the labouring Woman appears, makes the By-standers fearful that she will not have Strength enough to be delivered; which they think abundantly justifies them in giving her Cordials; but this Way of Reasoning is very weak and chimerical. Their Strength, on such Occasions, is not so very speedily dissipated: the small light Pains sink them, but in Proportion as the Pains become stronger, their Strength arises; being never deficient, when there is no extraordinary and uncommon Symptom; and we may reasonably be assured, that in a healthy, well formed Woman, meer Weakness never prevents a Delivery. _Of the Consequences of Labour, or Childbirth._ § 369. The most usual Consequences of Childbirth in the Country are, 1, An excessive Hæmorrhage. 2, An Inflammation of the Womb. 3, A sudden Suppression of the _Lochia_, or usual Discharges after Delivery. And, 4, the Fever and other Accidents, resulting from the Milk. Excessive Bleedings or Floodings, should be treated according to the Manner directed § 365: and if they are very excessive, Folds of Linen, which have been wrung out of a Mixture of equal Parts of Water and Vinegar, should be applied to the Belly, the Loins, and the Thighs: these should be changed for fresh moist ones, as they dry; and should be omitted, as soon as the Bleeding abates. § 370. The Inflammation of the Womb is discoverable by Pains in all the lower Parts of the Belly; by a Tension or Tightness of the whole; by a sensible Increase of Pain upon touching it; a kind of red Stain or Spot, that mounts to the Middle of the Belly, as high as the Navel; which Spot, as the Disease increases, turns black, and then is always a mortal Symptom; by a very extraordinary Degree of Weakness; an astonishing Change of Countenance; a light _Delirium_ or Raving; a continual Fever with a weak and hard Pulse; sometimes incessant Vomitings; a frequent Hiccup; a moderate Discharge of a reddish, stinking, sharp Water; frequent Urgings to go to Stool; a burning kind of Heat of Urine; and sometimes an entire Suppression of it. § 371. This most dangerous and frequently mortal Disease should be treated like inflammatory ones. After Bleeding, frequent Glysters of warm Water must by no Means be omitted; some should also be injected into the Womb, and applied continually over the Belly. The Patient may also drink continually, either of simple Barley-Water, with a Quarter of an Ounce of Nitre in every Pot of it, or of Almond Milk Nº. 4. § 372. The total Suppression of the _Lochia_, the Discharges after Labour, which proves a Cause of the most violent Disorders, should be treated exactly in the same Manner: but if unhappily hot Medicines have been given, in order to force them down, the Case will very generally prove a most hopeless one. § 373. If the Milk-fever run very high, the Barley Ptisan directed § 371, and Glysters, with a very light Diet, consisting only of Panada, or made of some other farinaceous Substances, and very thin, very generally remove it. § 374. Delicate infirm Women, who have not all the requisite and necessary Attendance they want; and such as from Indigence are obliged to work too soon, are exposed to many Accidents, which frequently arise from a Want of due Perspiration, and an insufficient Discharge of the _Lochia_; and hence, the Separation of the Milk in their Breasts being disturbed, there are milky Congestions, or Knots as it were, which are always very painful and troublesome, and especially when they are formed more inwardly. They often happen on the Thighs, in which Case the Ptisan Nº. 58 is to be drank, and the Pultices Nº. 59 must be applied. These two Remedies gradually dissipate and remove the Tumour, if that may be effected without Suppuration. But if that proves impossible, and _Pus_, or Matter, is actually formed, a Surgeon must open the Abscess, and treat it like any other. § 375. Should the Milk coagulate, or curdle as it were, in the Breast, it is of the utmost Importance immediately to attenuate or dissolve that Thickness, which would otherwise degenerate into a Hardness and prove a _Scirrhus_; and from a _Scirrhus_ in Process of Time a Cancer, that most tormenting and cruel Distemper. This horrible Evil however may be prevented by an Application to these small Tumours, as soon as ever they appear, For this Purpose nothing is more effectual than the Prescriptions Nº. 57 and 60; but under such menacing Circumstances, it is always prudent to take the best Advice, as early as possible. From the Moment these hard Tumours become excessively and obstinately so, and yet without any Pain, we should abstain from every Application, all are injurious; and greasy, sharp, resinous and spirituous ones speedily change the _Scirrhus_ into a Cancer. Whenever it becomes manifestly such, all Applications are also equally pernicious, except that of Nº. 60. Cancers have long been thought and found incurable; but within a few Years past some have been cured by the Remedy Nº. 57; which nevertheless is not infallible, though it should always be tried. [84] [84] The Use of Hemlock, which has been tried at _Lyons_, by all who have had cancerous Patients, having been given in very large Doses, has been attended with no Effect there, that merited the serious Attention of Practitioners. Many were careful to obtain the Extract from _Vienna_, and even to procure it from Dr. _Storck_ himself. But now it appears to have had so little Success, as to become entirely neglected. _E. L._ Having exactly translated in this Place, and in the Table of Remedies, our learned Author's considerable Recommendation of the Extract of Hemlock in Cancers, we think it but fair, on the other Hand, to publish this Note of his Editor's against it; that the real Efficacy or Inefficacy of this Medicine may at length be ascertained, on the most extensive Evidence and Experience. As far as my own Opportunities and Reflections, and the Experience of many others, have instructed me on this Subject, it appears clear to myself, that though the Consequences of it have not been constantly unsuccessful with us, yet its Successes have come very short of its Failures. Nevertheless, as in all such Cancers, every other internal Medicine almost universally fails, we think with Dr. _Tissot_ it should always be tried (from the meer Possibility of its succeeding in some particular Habit and Circumstances) at least till longer Experience shall finally determine against it. _K._ § 376. The Nipples of Women, who give Milk, are often fretted or excoriated, which proves very severely painful to them. One of the best Applications is the most simple Ointment, being a Mixture of Oil and Wax melted together; or the Ointment Nº. 66. Should the Complaint prove very obstinate, the Nurse ought to be purged, which generally removes it. __Chapter XXVII.__ _Medical Directions concerning Children._ __Sect.__ 377. The Diseases of Children, and every Thing relating to their Health, are Objects which generally seem to have been too much neglected by Physicians; and have been too long confided to the Conduct of the most improper Persons for such a Charge. At the same Time it must be admitted their Health is of no little Importance; their Preservation is as necessary as the Continuance of the human Race; and the Application of the Practice of Physick to their Disorders is susceptible of nearer Approaches to Perfection, than is generally conceived. It seems to have even some Advantage over that Practice which regards grown Persons; and it consists in this, that the Diseases of Children are more simple, and less frequently complicated than those of Adults. It may be said indeed, they cannot make themselves so well understood, and meer Infants certainly not at all. This is true in Fact to a certain Degree, but not rigidly true; for though they do not speak our Language, they have one which we should contrive to understand. Nay every Distemper may be said, in some Sense, to have a Language of its own, which an attentive Physician will learn. He should therefore use his utmost Care to understand that of Infants, and avail himself of it, to increase the Means of rendering them healthy and vigorous, and to cure them of the different Distempers to which they are liable. I do not propose actually to compleat this Task myself, in all that Extent it may justly demand; but I shall set forth the principal Causes of their Distempers, and the general Method of treating them. By this Means I shall at least preserve them from some of the Mischiefs which are too frequently done them; and the lessening such Evils as Ignorance, or erroneous Practice, occasions, is one of the most important Purposes of the present Work. § 378. Nearly all the Children who die before they are one Year, and even two Years, old, die _with_ Convulsions: People say they died _of_ them, which is partly true, as it is in Effect, the Convulsions that have destroyed them. But then these very Convulsions are the Consequences, the Effects, of other Diseases, which require the utmost Attention of those, who are entrusted with the Care and Health of the little Innocents: as an effectual Opposition to these Diseases, these morbid Causes, is the only Means of removing the Convulsions. The four principal known Causes are, the _Meconium_; the Excrements contained in the Body of the Infant, at the Birth; _Acidities_, or sharp and sour Humours; the Cutting of the Teeth, and Worms. I shall treat briefly of each. _Of the Meconium._ §379. The Stomach and Guts of the Infant, at its Entrance into the World, are filled with a black Sort of Matter, of a middling Consistence, and very viscid or glutinous, which is called the _Meconium_. It is necessary this Matter should be discharged before the Infant sucks, since it would otherwise corrupt the Milk, and, becoming extremely sharp itself, there would result from their Mixture a double Source of Evils, to the Destruction of the Infant. The Evacuation of this Excrement is procured, 1, By giving them no Milk at all for the first twenty-four Hours of their Lives. 2, By making them drink during that Time some Water, to which a little Sugar or Honey must be added, which will dilute this _Meconium_, and promote the Discharge of it by Stool, and sometimes by vomiting. To be the more certain of expelling all this Matter, they should take one Ounce of Compound Syrup [85] of Succory, which should be diluted with a little Water, drinking up this Quantity within the Space of four or five Hours. This Practice is a very beneficial one, and it is to be wished it were to become general. This Syrup is greatly preferable to all others, given in such Cases, and especially to Oil of Almonds. [85] This Method (says the Editor and Annotator of _Lyons_) is useful, whenever the Mother does not suckle her Child. Art is then obliged to prove a Kind of Substitute to Nature, though always a very imperfect one. But when a Mother, attentive to her own true Interest, as well as her Infant's, and, listening to the Voice of Nature and her Duty, suckles it herself, these Remedies [he adds] seem hurtful, or at least, useless. The Mother should give her Child the Breast as soon as she can. The first Milk, the _Colostrum_, or _Strippings_, as it is called in Quadrupeds, which is very serous or watery, will be serviceable as a Purgative; it will forward the Expulsion of the _Meconium_, prove gradually nourishing, and is better than Biscuits, or Panada, which (he thinks) are dangerous in the first Days after the Birth. _E. L._ This Syrup of Succory being scarcely ever prepared with us, though sufficiently proper for the Use assigned it here, I have retained the preceding Note, as the Author of it directs these _Strippings_, for the same Purpose, with an Air of certain Experience; and as this Effect of them seems no Ways repugnant to the physical Wisdom and Oeconomy of Nature, on such important Points. Should it in fact be their very general Operation, it cannot be unknown to any Male or Female Practitioner in Midwifery, and may save poor People a little Expence, which was one Object of our humane Author's Plan. The Oil Of _Ricinus_, corruptly called _Castor_ Oil (being expressed from the Berries of the _Palma Christi_) is particularly recommended by some late medical Writers from _Jamaica_, _&c._ for this Purpose of expelling the _Meconium_, to the Quantity of a small Spoonful. These Gentlemen also consider it as the most proper, and almost specific Opener, in the dry Belly-ach of that torrid Climate, which tormenting Disease has the closest Affinity to the _Miserere_, or Iliac Passion, of any I have seen. The Annotator's Objection to our Author's very _thin light_ Panada, seems to be of little Weight. _K._ Should the great Weakness of the Child seem to call for some Nourishment, there would be no Inconvenience in allowing a little Biscuit well boiled in Water, which is pretty commonly done, or a little very thin light Panada. _Of Acidities, or sharp Humours._ § 380. Notwithstanding the Bodies of Children have been properly emptied speedily after their Birth, yet the Milk very often turns sour in their Stomachs, producing Vomitings, violent Cholics, Convulsions, a Looseness, and even terminating in Death. There are but two Purposes to be pursued in such Cases, which are to carry off the sour or sharp Humours, and to prevent the Generation of more. The first of these Intentions is best effected by the Syrup of Succory [86] just mentioned. [86] Or, for Want of it, the solutive Syrup of Roses. _K._ The Generation of further Acidities is prevented, by giving three Doses daily, if the Symptoms are violent, and but two, or even one only, if they are very moderate, of the Powder Nº. 61, drinking after it Bawm Tea, or a Tea of Lime-tree Leaves. § 381. It has been a Custom to load Children with Oil of Almonds, [87] as soon as ever they are infested with Gripes: but it is a pernicious Custom, and attended with very dangerous Consequences. It it very true that this Oil sometimes immediately allays the Gripes, by involving, or sheathing up, as it were, the acid Humours, and somewhat blunting the Sensibility of the Nerves. But it proves only a palliative Remedy, or asswaging for a Time, which, far from removing, increases the Cause, since it becomes sharp and rancid itself; whence the Disorder speedily returns, and the more Oil the Infant takes, it is griped the more. I have cured some Children of such Disorders, without any other Remedy, except abstaining from Oil, which weakens their Stomachs, whence their Milk is less perfectly, and more slowly digested, and becomes more easily soured. Besides this Weakness of the Stomach, which thus commences at that very early Age, has sometimes an unhealthy Influence on the Constitution of the Child, throughout the Remainder of his Life. [87] The _Magnesia_ is an excellent Substitute in Children, for these Oils Dr. _Tissot_ so justly condemns here. _K._ A free and open Belly is beneficial to Children; now it is certain that the Oil very often binds them, in Consequence of its diminishing the Force and Action of the Bowels. There is scarcely any Person, who cannot observe this Inconvenience attending it; notwithstanding they all continue to advise and to give it, to obtain a very different Purpose: But such is the Power of Prejudice in this Case, and in so many others; People are so strongly pre-possessed with a Notion, that such a Medicine must produce such an Effect; that its never having produced it avails nothing with them, their Prejudice still prevails; they ascribe its Want of Efficacy to the Smallness of the Doses; these are doubled then, and notwithstanding its bad Effects are augmented, their obstinate Blindness continues. This Abuse of the Oil also disposes their Child to knotty hard Tumours, and at length often proves the first Cause of some Diseases of the Skin, whose Cure is extremely difficult. Hence it is evident, this Oil should be used on such Occasions but very seldom; and that it is always very injudicious to give it in Cholics, which arise from sharp and sour Humours in the Stomach, or in the Bowels. § 382. Infants are commonly most subject to such Cholics during their earliest Months; after which they abate, in Proportion as their Stomachs grow stronger. They may be relieved in the Fit by Glysters of a Decoction of Chamomile Flowers, in which a Bit of Soap of the Size of a Hazel Nut is dissolved. A Piece of Flanel wrung out of a Decoction of Chamomile Flowers, with the Addition of some Venice Treacle, and applied hot over the Stomach and on the Belly, is also very beneficial, and relieving. Children cannot always take Glysters, the Continuance of which Circumstance might be dangerous to them; and every one is acquainted with the common Method of substituting Suppositories to them, whether they are formed of the smooth and supple Stalks of Vines, _&c._ of Soap, or of Honey boiled up to a proper Consistence. But one of the most certain Means to prevent these Cholics, which are owing to Children's not digesting their Milk, is to move and exercise them as much as possible; having a due Regard however to their tender Time of Life. § 383. Before I proceed to the third Cause of the Diseases of Children, which is, the Cutting of their Teeth, I must take Notice of the first Cares their Birth immediately requires, that is the Washing of them the first Time, meerly to cleanse, and afterwards, to strengthen them. _Of washing Children._ § 384. The whole Body of an Infant just born is covered with a gross Humour, which is occasioned by the Fluids, in which it was suspended in the Womb. There is a Necessity to cleanse it directly from this, for which nothing is so proper as a Mixture of one third Wine, and two thirds Water; Wine alone would be dangerous. This Washing may be repeated some Days successively; but it is a bad Custom to continue to wash them thus warm, the Danger of which is augmented by adding some Butter to the Wine and Water, which is done too often. If this gross Humour, that covers the Child, seems more thick and glutinous than ordinary, a Decoction of Chamomile Flowers, with a little Bit of Soap, may be used to remove it. The Regularity of Perspiration is the great Foundation of Health; to procure this Regularity the Teguments, the Skin, must be strengthened; but warm Washing tends to weaken it. When it is of a proper Strength it always performs its Functions; nor is Perspiration disordered sensibly by the Alteration of the Weather. For this Reason nothing should be omitted, that may fix it in this State; and to attain so important an Advantage, Children should be washed, some few Days after their Birth, with cold Water, in the State it is brought from the Spring. For this Purpose a Spunge is employed, with which they begin, by washing first the Face, the Ears, the back Part of the Head (carefully avoiding the [88] _Fontanelle_, or Mould of the Head) the Neck, the Loins, the Trunck of the Body, the Thighs, Legs and Arms, and in short every Spot. This Method which has obtained for so many Ages, and which is practised at present by many People, who prove very healthy, will appear shocking to several Mothers; they would be afraid of killing their Children by it; and would particularly fail of Courage enough to endure the Cries, which Children often make, the first Time they are washed. Yet if their Mothers truly love them, they cannot give a more substantial Mark of their Tenderness to them, than by subduing their Fears and their Repugnance, on this important Head. [88] That Part of the Head where a Pulsation may be very plainly felt, where the Bones are less hard, and not as yet firmly joined with those about them. Weakly Infants [89] are those who have the greatest Need of being washed: such as are remarkably strong may be excused from it; and it seems scarcely credible (before a Person has frequently seen the Consequences of it) how greatly this Method conduces to give, and to hasten on, their Strength. I have had the Pleasure to observe, since I first endeavoured to introduce the Custom among us, that several of the most affectionate and most sensible Mothers, have used it with the greatest Success. The Midwives, who have been Witnesses of it; the Nurses and the Servants of the Children, whom they have washed, publish it abroad; and should the Custom become as general, as every thing seems to promise it will, I am fully persuaded, that by preserving the Lives of a great Number of Children, it will certainly contribute to check the Progress of Depopulation. [89] There is however a certain Degree of Weakness, which may very reasonably deter us from this Washing; as when the Infant manifestly wants Heat, and needs some Cordial and frequent Frictions, to prevent its expiring from downright Feebleness; in which Circumstances Washing must be hurtful to it. _Tissot._ They should be washed very regularly every Day, in every Season, and every Sort of Weather; and in the fine warm Season they should be plunged into a large Pail of Water, into the Basins around Fountains, in a Brook, a River, or a Lake. After a few Days crying, they grow so well accustomed to this Exercise, that it becomes one of their Pleasures; so that they laugh all the Time of their going through it. The first Benefit of this Practice is, as I have already said, the keeping up their Perspiration, and rendering them less obnoxious to the Impressions of the Air and Weather: and it is also in Consequence of this first Benefit, that they are preserved from a great Number of Maladies, especially from knotty Tumours, often called Kernels; from Obstructions; from Diseases of the Skin, and from Convulsions, its general Consequence being to insure them firm, and even robust Health. § 385. But Care should be taken not to prevent, or, as it were to undo, the Benefit this Washing procures them, by the bad Custom of keeping them too hot. There is not a more pernicious one than this, nor one that destroys more Children. They should be accustomed to light Cloathing by Day, and light Covering by Night, to go with their Heads very thinly covered, and not at all in the Day-time, after their attaining the Age of two Years. They should avoid sleeping in Chambers that are too hot, and should live in the open Air, both in Summer and Winter, as much as possible. Children who have been kept too hot in such Respects, are very often liable to Colds; they are weakly, pale, languishing, bloated and melancholy. They are subject to hard knotty Swellings, a Consumption, all Sorts of languid Disorders, and either die in their Infancy, or only grow up into a miserable valetudinary Life; while those who are washed or plunged into cold Water, and habitually exposed to the open Air, are just in the opposite Circumstances. § 386. I must further add here, that Infancy is not the only Stage of Life, in which cold Bathing is advantagious. I have advised it with remarkable Success to Persons of every Age, even to that of seventy: and there are two Kinds of Diseases, more frequent indeed in Cities than in the Country, in which cold Baths succeed very greatly; that is, in Debility, or Weakness of the Nerves; and when Perspiration is disordered, when Persons are fearful of every Breath of Air, liable to Defluxions or Colds, feeble and languishing, the cold Bath re-establishes Perspiration; restores Strength to the Nerves; and by that Means dispels all the Disorders, which arise from these two Causes, in the animal Oeconomy. They should be used before Dinner. But in the same Proportion that cold Bathing is beneficial, the habitual Use, or rather Abuse, of warm Bathing is pernicious; they dispose the Persons addicted to them to the Apoplexy; to the Dropsy; to Vapours, and to the hypochondriacal Disease: and Cities, in which they are too frequently used, become, in some Measure, desolate from such Distempers. _Of the Cutting of the Teeth._ § 387. Cutting of the Teeth is often very tormenting to Children, some dying under the severe Symptoms attending it. If it proves very painful, we should during that Period, 1, Keep their Bellies open by Glysters consisting only of a simple Decoction of Mallows: but Glysters are not necessary, if the Child, as it sometimes happens then, has a Purging. 2, Their ordinary Quantity of Food should be lessened for two Reasons; first, because the Stomach is then weaker than usual; and next, because a small Fever sometimes accompanies the Cutting. 3, Their usual Quantity of Drink should be increased a little; the best for them certainly is an Infusion of the Leaves or Flowers, of the Lime or Linden-tree, to which a little Milk may be added. 4, Their Gums should frequently be rubbed with a Mixture of equal Parts of Honey, and Mucilage of Quince-seeds; and a Root of March-Mallows, or of Liquorice, may be given them to chew. It frequently happens, that during Dentition, or the Time of their toothing, Children prove subject to Knots or Kernels. _Of Worms._ § 388. The _Meconium_, the Acidity of the Milk, and Cutting of the Teeth are the three great Causes of the Diseases of Children. There is also a fourth, Worms, which is likewise very often pernicious to them; but which, nevertheless, is not, at least not near so much, a general Cause of their Disorders, as it is generally supposed, when a Child exceeding two Years of Age proves sick. There are a great Variety of Symptoms, which dispose People to think a Child has Worms; though there is but one that demonstrates it, which is discharging them upwards or downwards. There is great Difference among Children too in this Respect, some remaining healthy, though having several Worms, and others being really sick with a few. They prove hurtful, 1, by obstructing the Guts, and compressing the neighbouring Bowels by their Size. 2, By sucking up the Chyle intended to nourish the Patient, and thus depriving him of his very Substance as well as Subsistence: and, 3, by irritating the Guts and even [90] gnawing them. [90] I have seen a Child about three Years old, whose Navel, after swelling and inflaming, suppurated, and through a small Orifice (which must have communicated with the Cavity of the Gut or the Belly) discharged one of these Worms we call _teretes_, about three Inches long. He had voided several by Stool, after taking some vermifuge Medicines. The Fact I perfectly remember; and to the best of my Recollection, the Ulcer healed some Time after, and the Orifice closed: but the Child died the following Year of a putrid Fever, which might be caused, or was aggravated, by Worms. _K._ § 389. The Symptoms which make it probable they are infested with Worms, are slight, frequent and irregular Cholics; a great Quantity of Spittle running off while they are fasting; a disagreeable Smell of their Breath, of a particular Kind, especially in the Morning; a frequent Itchiness of their Noses which makes them scratch or rub them often; a very irregular Appetite, being sometimes voracious, and at other Times having none at all: Pains at Stomach and Vomitings: sometimes a costive Belly; but more frequently loose Stools of indigested Matter; the Belly rather larger than ordinary, the rest of the Body meagre; a Thirst which no Drink allays; often great Weakness, and some Degree of Melancholy. The Countenance has generally an odd unhealthy Look, and varies every Quarter of an Hour; the Eyes often look dull, and are surrounded with a Kind of livid Circle: the White of the Eye is sometimes visible while they sleep, their Sleep being often attended with terrifying Dreams or _Deliriums_, and with continual Startings, and Grindings of their Teeth. Some Children find it impossible to be at Rest for a single Moment. Their Urine is often whitish, I have seen it from some as white as Milk. They are afflicted with Palpitations, Swoonings, Convulsions, long and profound Drowsiness; cold Sweats which come on suddenly; Fevers which have the Appearances of Malignity; Obscurities and even Loss of Sight and of Speech, which continue for a considerable Time; Palsies either of their Hands, their Arms, or their Legs, and Numbnesses. Their Gums are in a bad State, and as though they had been gnawed or corroded: they have often the Hickup, a small and irregular Pulse, Ravings, and, what is one of the least doubtful Symptoms, frequently a small dry Cough; and not seldom a Mucosity or Sliminess in their Stools: sometimes very long and violent Cholics, which terminate in an Abscess on the Outside of the Belly, from whence Worms issue. (See Note [90] p. 388.) § 390. There are a great Multitude of Medicines against Worms. The [91] _Grenette_ or Worm-seed, which is one of the commonest, is a very good one. The Prescription Nº. 62, is also a very successful one; and the Powder Nº. 14 is one of the best. Flower of Brimstone, the Juice of _Nasturtium_, or Cresses, Acids and Honey Water have often been very serviceable; but the first three I have mentioned, succeeded by a Purge, are the best. Nº. 63 is a purging Medicine, that the most averse and difficult Children may easily take. But when, notwithstanding these Medicines, the Worms are not expelled, it is necessary to take Advice of some Person qualified to prescribe more efficacious ones. This is of considerable Importance, because, notwithstanding a great Proportion of Children may probably have Worms, and yet many of them continue in good Health, there are, nevertheless, some who are really killed by Worms, after having been cruelly tormented by them for several Years. [91] This Word occurs in none of the common Dictionaries; but suspecting it for the _Semen Santonici_ of the Shops, I find the learned Dr. _Bikker_ has rendered it so, in his very well received Translation of this valuable Work into _Low Dutch_. _K._ A Disposition to breed Worms always shews the Digestions are weak and imperfect; for which Reason Children liable to Worms should not be nourished with Food difficult to digest. We should be particularly careful not to stuff them with Oils, which, admitting such Oils should immediately kill some of their Worms, do yet increase that Cause, which disposes them to generate others. A long continued Use of Filings of Iron is the Remedy, that most effectually destroys this Disposition to generate Worms. _Of Convulsions._ § 391. I have already said, § 378, that the Convulsions of Children are almost constantly the Effect of some other Disease, and especially of some of the four I have mentioned. Some other, though less frequent Causes, sometimes occasion them, and these may be reduced to the following. The first of them is the corrupted Humours, that often abound in their Stomachs and Intestines; and which, by their Irritation, produce irregular Motions throughout the whole System of the Nerves, or at least through some Parts of them; whence those Convulsions arise, which are merely involuntary Motions of the Muscles. These putrid Humours are the Consequence of too great a Load of Aliments, of unsound ones, or of such, as the Stomachs of Children are incapable of digesting. These Humours are also sometimes the Effect of a Mixture and Confusion of different Aliments, and of a bad Distribution of their Nourishment. It may be known that the Convulsions of a Child are owing to this Cause, by the Circumstances that have preceded them, by a disgusted loathing Stomach; by a certain Heaviness and Load at it; by a foul Tongue; a great Belly; by its bad Complexion, and its disturbed unrefreshing Sleep. The Child's proper Diet, that is, a certain Diminution of the Quantity of its Food; some Glysters of warm Water, and one Purge of Nº. 63, very generally remove such Convulsions. § 392. The second Cause is the bad Quality of their Milk. Whether it be that the Nurse has fallen into a violent Passion, some considerable Disgust, great Fright or frequent Fear: whether she has eat unwholesome Food, drank too much Wine, spirituous Liquors, or any strong Drink: whether she is seized with a Descent of her monthly Discharges, and that has greatly disordered her Health; or finally whether she prove really sick: In all these Cases the Milk is vitiated, and exposes the Infant to violent Symptoms, which sometimes speedily destroy it. The Remedies for Convulsions, from this Cause, consist, 1, In letting the Child abstain from this corrupted Milk, until the Nurse shall have recovered her State of Health and Tranquillity, the speedy Attainment of which may be forwarded by a few Glysters; by gentle pacific Medicines; by an entire Absence of whatever caused or conduced to her bad Health; and by drawing off all the Milk that had been so vitiated. 2, In giving the Child itself some Glysters: in making it drink plentifully of a light Infusion of the Lime-tree Flowers, in giving it no other Nourishment for a Day or two, except Panada and other light Spoon-meat, without Milk. 3, In purging the Child (supposing what has been just directed to have been unavailable) with an Ounce, or an Ounce and a Half, of compound Syrup of Succory, or as much Manna. These lenient gentle Purges carry off the Remainder of the corrupted Milk, and remove the Disorders occasioned by it. § 393. A third Cause which also produces Convulsions, is the feverish Distempers which attack Children, especially the Small-pocks and the Measles; but in general such Convulsions require no other Treatment, but that proper for the Disease, which has introduced them. § 394. It is evident from what has been said in the Course of this Chapter, and it deserves to be attended to, that Convulsions are commonly a Symptom attending some other Disease, rather than an original Disease themselves: that they depend on many different Causes; that from this Consideration there can be no general Remedy for removing or checking them; and that the only Means and Medicines which are suitable in each Case, are those, which are proper to oppose the particular Cause producing them, and which I have already pointed out in treating of each Cause. The greater Part of the pretended Specifics, which are indiscriminately and ignorantly employed in all Sorts of Convulsions, are often useless, and still oftner prejudicial. Of this last Sort and Character are, 1, All sharp and hot Medicines, spirituous Liquors, Oil of Amber,--other hot Oils and Essences, volatile Salts, and such other Medicines, as, by the Violence of their Action on the irritable Organs of Children, are likelier to produce Convulsions, than to allay them. 2, Astringent Medicines, which are highly pernicious, whenever the Convulsions are caused by any sharp Humour, that ought to be discharged from the Body by Stool; or when such Convulsions are the Consequences of an [92] Effort of Nature, in Order to effect a _Crisis_: And as they almost ever depend on one or the other of these Causes, it follows that Astringents can very rarely, if ever, be beneficial. Besides that there is always some Danger in giving them to Children without a mature, a thorough Consideration of their particular Case and Situation, as they often dispose them to Obstructions. [92] This very important Consideration, on which I have treated pretty largely, in the _Analysis_, seems not to be attended to in Practice, as frequently as it ought. _K._ 3, The over early, and too considerable Use of Opiates, either not properly indicated, or continued too long, such as Venice Treacle, Mithridate, Syrup of Poppies (and it is very easy to run upon some of these Sholes) are also attended with the most embarrassing Events, in Regard to Convulsions; and it may be affirmed they are improper, for nine Tenths of those they are advised to. It is true they often produce an apparent Ease and Tranquillity for some Minutes, and sometimes for some Hours too; but the Disorder returns even with greater Violence for this Suspension, by Reason they have augmented all the Causes producing it; they impair the Stomach; they bind up the Belly; they lessen the usual Quantity of Urine; and besides, by their abating the Sensibility of the Nerves, which ought to be considered as one of the chief Centinels appointed by Nature, for the Discovery of any approaching Danger, they dispose the Patient insensibly to such Infarctions and Obstructions, as tend speedily to produce some violent and mortal Event, or which generate a Disposition to languid and tedious Diseases: and I do again repeat it, that notwithstanding there are some Cases, in which they are absolutely necessary, they ought in general to be employed with great Precaution and and Prudence. To mention the principal Indications for them in convulsive Cases, they are proper, 1, When the Convulsions still continue, after the original Cause of them is removed. 2, When they are so extremely violent, as to threaten a great and very speedy Danger of Life; and when they prove an Obstacle to the taking Remedies calculated to extinguish their Cause; and, 3, When the Cause producing them is of such a Nature, as is apt to yield to the Force of Anodynes; as when, for Instance, they have been the immediate Consequence of a Fright. § 395. There is a very great Difference in different Children, in Respect to their being more or less liable to Convulsions. There are some, in whom very strong and irritating Causes cannot excite them; not even excruciating Gripes and Cholics; the most painful Cutting of their Teeth; violent Fevers; the Small Pocks; Measles; and though they are, as it were, continually corroded by Worms, they have not the slightest Tendency to be convulsed. On the other Hand, some are so very obnoxious to Convulsions, or so easily _convulsible_, if that Expression may be allowed, that they are very often seized with them from such very slight Causes, that the most attentive Consideration cannot investigate them. This Sort of Constitution, which is extremely dangerous, and exposes the unhappy Subject of it, either to a very speedy Death, or to a very low and languid State of Life, requires some peculiar Considerations; the Detail of which would be the more foreign to the Design of this Treatise, as they are pretty common in Cities, but much less so in Country Places. In general cold Bathing and the Powder Nº. 14 are serviceable in such Circumstances. _General Directions, with Respect to Children._ § 396. I shall conclude this Chapter by such farther Advice, as may contribute to give Children a more vigorous Constitution and Temperament, and to preserve them from many Disorders. First then, we should be careful not to cram them too much, and to regulate both the Quantity and the set Time of their Meals, which is a very practicable Thing, even in the very earliest Days of their Life; when the Woman who nurses them, will be careful to do it regularly. Perhaps indeed this is the very Age, when such a Regulation may be the most easily attempted and effected; because it is that Stage, when the constant Uniformity of their Way of living should incline us to suppose, that what they have Occasion for is most constantly very much the same. A Child who has already attained to a few Years, and who is surrendered up more to his own Exercise and Vivacity, feels other Calls; his Way of Life is become a little more various and irregular, whence his Appetite must prove so too. Hence it would be inconvenient to subject him over exactly to one certain Rule, in the Quantity of his Nourishment, or the Distance of his Meals. The Dissipation or passing off of his Nutrition being unequal, the Occasions he has for repairing it cannot be precisely dated and regular. But with Respect to very little Children in Arms, or on the Lap, a Uniformity in the first of these Respects, the Quantity of their Food, very consistently conduces to a useful Regularity with Respect to the second, the Times of feeding them. Sickness is probably the only Circumstance, that can warrant any Alteration in the Order and Intervals of their Meals; and then this Change should consist in a Diminution of their usual Quantity, notwithstanding a general and fatal Conduct seems to establish the very Reverse; and this pernicious Fashion authorizes the Nurses to cram these poor little Creatures the more, in Proportion as they have real Need of less feeding. They conclude of Course, that all their Cries are the Effects of Hunger, and the Moment an Infant begins, then they immediately stop his Mouth with his Food; without once suspecting, that these Wailings may be occasioned by the Uneasiness an over-loaded Stomach may have introduced; or by Pains whose Cause is neither removed nor mitigated, by making the Children eat; though the meer Action of eating may render them insensible to slight Pains, for a very few Minutes; in the first Place, by calling off their Attention; and secondly, by hushing them to sleep, a common Effect of feeding in Children, being in fact, a very general and constant one, and depending on the same Causes, which dispose so many grown Persons to sleep after Meals. A Detail of the many Evils Children are exposed to, by thus forcing too much Food upon them, at the very Time when their Complaints are owing to Causes, very different from Hunger, might appear incredible. They are however so numerous and certain, that I seriously wish sensible Mothers would open their Eyes to the Consideration of this Abuse, and agree to put an End to it. Those who overload them with Victuals, in Hopes of strengthening them, are extremely deceived; there being no one Prejudice equally fatal to such a Number of them. Whatever unnecessary Aliment a Child receives, weakens, instead of strengthening him. The Stomach, when over-distended, suffers in its Force and Functions, and becomes less able to digest thoroughly. The Excess of the Food last received impairs the Concoction of the Quantity, that was really necessary: which, being badly digested, is so far from yielding any Nourishment to the Infant, that it weakens it, and proves a Source of Diseases, and concurs to produce Obstructions, Rickets, the Evil, slow Fevers, a Consumption and Death. Another unhappy Custom prevails, with Regard to the Diet of Children, when they begin to receive any other Food besides their Nurse's Milk, and that is, to give them such as exceeds the digestive Power of their Stomachs; and to indulge them in a Mixture of such Things in their Meals, as are hurtful in themselves, and more particularly so, with Regard to their feeble and delicate Organs. To justify this pernicious Indulgence, they affirm it is necessary to accustom their Stomachs to every Kind of Food; but this Notion is highly absurd, since their Stomachs should first be strengthened, in Order to make them capable of digesting every Food; and crouding indigestible, or very difficultly digestible Materials into it, is not the Way to strengthen it. To make a Foal sufficiently strong for future Labour, he is exempted from any, till he is four Years old; which enables him to submit to considerable Work, without being the worse for it. But if, to inure him to Fatigue, he should be accustomed, immediately from his Birth, to submit to Burthens above his Strength, he could never prove any Thing but an utter Jade, incapable of real Service. The Application of this to the Stomach of a Child is very obvious. I shall add another very important Remark, and it is this, that the too early Work to which the Children of Peasants are forced, becomes of real Prejudice to the Publick. Hence Families themselves are less numerous, and the more Children that are removed from their Parents, while they are very young, those who are left are the more obliged to Work, and very often even at hard Labour, at an Age when they should exercise themselves in the usual Diversions and Sports of Children. Hence they wear out in a Manner, before they attain the ordinary Term of Manhood; they never arrive at their utmost Strength, nor reach their full Stature; and it is too common to see a Countenance with the Look of twenty Years, joined to a Stature of twelve or thirteen. In fact, they often sink under the Weight of such hard involuntary Labour, and fall into a mortal Degree of Wasting and Exhaustion. § 397. Secondly, which indeed is but a Repetition of the Advice I have already given, and upon which I cannot insist too much, they must be frequently washed or bathed in cold Water. § 398. Thirdly, they should be moved about and exercised as much as they can bear, after they are some Weeks old: the earlier Days of their tender Life seeming consecrated, by Nature herself, to a nearly total Repose, and to sleeping, which seems not to determine, until they have Need of Nourishment: so that, during this very tender Term of Life, too much Agitation or Exercise might be attended with mortal Consequences. But as soon as their Organs have attained a little more Solidity and Firmness, the more they are danced about (provided it is not done about their usual Time of Repose, which ought still to be very considerable) they are so much the better for it; and by increasing it gradually, they may be accustomed to a very quick Movement, and at length very safely to such, as may be called hard and hearty Exercise. That Sort of Motion they receive in Go-Carts, or other Vehicles, particularly contrived for their Use, is more beneficial to them, than what they have from their Nurses Arms, because they are in a better Attitude in the former; and it heats them less in Summer, which is a Circumstance of no small Importance to them; considerable Heat and Sweat disposing them to be ricketty. § 399. Fourthly, they should be accustomed to breathe in the free open Air as much as possible. If Children have unhappily been less attended to than they ought, whence they are evidently feeble, thin, languid, obstructed, and liable to Scirrhosities (which constitute what is termed a ricketty or consumptive State) these four Directions duly observed retrieve them from that unhappy State; provided the Execution of them has not been too long delayed. § 400. Fifthly, If they have any natural Discharge of a Humour by the Skin, which is very common with them, or any Eruption, such as Tetters, white Scurf, a Rashe, or the like, Care must be taken not to check or repel them, by any greasy or restringent Applications. Not a Year passes without Numbers of Children having been destroyed by Imprudence in this Respect; while others have been reduced to a deplorable and weakly Habit. I have been a Witness to the most unhappy Consequences of external Medicines applied for the Rashe and white Scurf; which, however frightful they may appear, are never dangerous; provided nothing at all is applied to them, without the Advice and Consideration of a truly skilful Person. When such external Disorders prove very obstinate, it is reasonable to suspect some Fault or Disagreement in the Milk the Child sucks; in which Case it should immediately be discontinued, corrected, or changed. But I cannot enter here into a particular Detail of all the Treatment necessary in such Cases. __Chapter XXVIII.__ _Directions with Respect to drowned Persons._ [93] [93] The Misfortune of a young Man drowned in bathing himself, at the Beginning of the Season, occasioned the Publication of this Chapter by itself in _June_, 1761. A few Days after, the like Misfortune happened to a labouring Man; but he was happily taken out of the water sooner than the first (who had remained about half an Hour under it) and he was recovered by observing Part of the Advice this Chapter contains; of which Chapter several Bystanders had Copies.--This Note seems to be from the Author himself. __Sect.__ 401. Whenever a Person who has been drowned, has remained a Quarter of an Hour under Water, there can be no considerable Hopes of his Recovery: the Space of two or three Minutes in such a Situation being often sufficient to kill a Man irrecoverably. Nevertheless, as several Circumstances may happen to have continued Life, in such an unfortunate Situation, beyond the ordinary Term, we should always endeavour to afford them the most effectual Relief, and not give them up as irrecoverable too soon: since it has often been known, that until the Expiration of two, and sometimes even of three Hours, such Bodies have exhibited some apparent Tokens of Life. Water has sometimes been found in the Stomach of drowned Persons; at other times none at all. Besides, the greatest Quantity which has ever been found in it has not exceeded that, which may be drank without any Inconvenience; whence we may conclude, the meer Quantity was not mortal; neither is it very easy to conceive how drowned Persons can swallow Water. What really kills them is meer Suffocation, or the Interception of Air, of the Action of breathing; and the Water which descends into the Lungs, and which is determined there, by the Efforts they necessarily, though involuntarily make, to draw Breath, after they are under Water: for there absolutely does not any Water descend, either into the Stomach or the Lungs of Bodies plunged into Water, after they are dead; a Circumstance, which serves to establish a legal Sentence and Judgment in some criminal Cases, and Trials: This Water intimately blending itself with the Air in the Lungs, forms a viscid inactive Kind of Froth, which entirely destroys the Functions of the Lungs; whence the miserable Sufferer is not only suffocated, but the Return of the Blood from the Head being also intercepted, the Blood Vessels of the Brain are overcharged, and an Apoplexy is combined with the Suffocation. This second Cause, that is, the Descent of the Water into the Lungs, is far from being general, it having been evident from the Dissection of several drowned Bodies, that it really never had existed in them. § 402. The Intention that should be pursued, is that of unloading the Lungs and the Brain, and of reviving the extinguished Circulation. For which Purpose we should, 1, immediately strip the Sufferer of all his wet Cloaths; rub him strongly with dry coarse Linnen; put him, as soon as possible, into a well heated Bed, and continue to rub him well a very considerable Time together. 2, A strong and healthy Person should force his own warm Breath into the Patient's Lungs; and the Smoke of Tobacco, if some was at Hand, by Means of some Pipe, Chanel, Funnel or the like, that may be introduced into the Mouth. This Air or Fume, being forcibly blown in, by stopping the Sufferer's Nostrils close at the same Time, penetrates into the Lungs, and there rarifies by its Heat that Air, which blended with the Water, composed the viscid Spume or Froth. Hence that Air becomes disengaged from the Water, recovers its Spring, dilates the Lungs; and, if there still remains within any Principle of Life, the Circulation is renewed again that Instant. 3, If a moderately expert Surgeon is at Hand, he must open the jugular Vein, or any large Vein in the Neck, and let out ten or twelve Ounces of Blood. Such a Bleeding is serviceable on many Accounts. First, merely as Bleeding, it renews the Circulation, which is the constant Effect of Bleeding in such Swoonings, as arise from an intercepted or suffocated Circulation. Secondly, it is that particular Bleeding, which most suddenly removes, in such Cases, the Infarction or Obstruction of the Head and Lungs; and, thirdly, it is sometimes the only Vessel, whence Blood will issue under such Circumstances. The Veins of the Feet then afford none; and those of the Arms seldom; but the Jugulars almost constantly furnish it. Fourthly, the Fume of Tobacco should be thrown up, as speedily and plentifully as possible, into the Intestines by the Fundament. There are very commodious Contrivances devised for this Purpose; but as they are not common, it may be effected by many speedy Means. One, by which a Woman's Life was preserved, consisted only in introducing the small Tube of a Tobacco Pipe well lighted up: the Head or Bowl of it was wrapped up in a Paper, in which several Holes were pricked, and through these the Breath was strongly forced. At the fifth Blast a considerable Rumbling was heard in the Woman's Belly; she threw up a little Water, and a Moment afterwards came to her Senses. Two Pipes may be thus lighted and applied, with their Bowls covered over; the Extremity of one is to be introduced into the Fundament; and the other may be blown through into the Lungs. Any other Vapour may also be conveyed up, by introducing a _Canula_, or any other Pipe, with a Bladder firmly fixed to it. This Bladder is fastened at its other End to a large Tin Funnel, under which Tobacco is to be lighted. This Contrivance has succeeded with me upon other Occasions, in which Necessity compelled me to invent and apply it. Fifthly, the strongest Volatiles should be applied to the Patient's Nostrils. The Powder of some strong dry Herb should be blown up his Nose, such as Sage, Rosemary, Rue, Mint, and especially Marjoram, or very well dried Tobacco; or even the Fume, the Smoke of these Herbs. But all these Means are most properly employed after Bleeding, when they are most efficacious and certain. Sixthly, as long as the Patient shews no Signs of Life, he will be unable to swallow, and it is then useless, and even dangerous, to pour much Liquid of any kind into his Mouth, which could do nothing but keep up, or increase Suffocation. It is sufficient, in such Circumstances, to instil a few Drops of some irritating Liquor, which might also be cordial and reviving. But as soon as ever he discovers any Motion, he should take, within the Space of one Hour, five or six common Spoonfuls of Oxymel of Squills diluted with warm Water: or if that Medicine was not to be had very speedily, a strong Infusion of the blessed Thistle, or _Carduus benedictus_, of Sage, or of Chamomile Flowers sweetened with Honey, might do instead of it: and supposing nothing else to be had, some warm Water, with the Addition of a little common Salt, should be given. Some Persons are bold enough to recommend Vomits in such Cases; but they are not without their Inconvenience; and it is not as a Vomit that I recommend the Oxymel of Squills in them. Seventhly, Notwithstanding the Sick discover some Tokens of Life, we should not cease to continue our Assistance; since they sometimes irrecoverably expire, after these first Appearances of recovering. And lastly, though they should be manifestly re-animated, there sometimes remains an Oppression, a Coughing and Feverishness, which effectually constitute a Disease: and then it becomes necessary sometimes to bleed them in the Arms; to give them Barley Water plentifully, or Elder-flower Tea. § 403. Having thus pointed out such Means as are necessary, and truly effectual, in such unfortunate Accidents, I shall very briefly mention some others, which it is the general Custom to use and apply in the first Hurry. 1, These unhappy People are sometimes wrapped up in a Sheep's, or a Calf's, or a Dog's Skin, immediately flead from the Animal: these Applications have sometimes indeed revived the Heat of the Drowned; but their Operations are more slow, and less efficacious, than the Heat of a well-warmed Bed; with the additional Vapour of burnt Sugar, and long continued Frictions with hot Flanels. 2, The Method of rolling them in an empty Hogshead is dangerous, and mispends a deal of important Time. 3, That also of hanging them up by the Feet is attended with Danger, and ought to be wholly discontinued. The Froth or Foam, which is one of the Causes of their Death, is too thick and tough to discharge itself, in Consequence of its own Weight. Nevertheless, this is the only Effect that can be expected, from this Custom of suspending them by the Feet; which must also be hurtful, by its tending to increase the Overfulness of the Head and of the Lungs. § 404. It is some Years since a Girl of eighteen Years old was recovered [though it is unknown whether she remained under Water only a little Time or some Hours] who was motionless, frozen as it were, insensible, with her Eyes closed, her Mouth wide open, a livid Colour, a swoln Visage, a Tumour or bloating of the whole Body, which was overladen as it were, or Water-soaked. This miserable Object was extended on a Kind of Bed, of hot or very warm Ashes, quickly heated in great Kettles; and by laying her quite naked on these Ashes; by covering her with others equally hot; by putting a Bonnet round her Head, with a Stocking round her Neck stuffed with the same, and heaping Coverings over all this, at the End of half an Hour her Pulse returned, she recovered her Speech, and cried out, _I freeze, I freeze_: A little Cherry-Brandy was given her, and then she remained buried, as it were, eight Hours under the Ashes; being taken out of them afterwards without any other Complaint, except that of great Lassitude or Weariness, which went entirely off the third Day. This Method was undoubtedly so effectual, that it well deserves Imitation; but it should not make us inattentive to the others. Heated Gravel or Sand mixed with Salt, or hot Salt alone, would have been equally efficacious, and they have been found so. At the very Time of writing this, two young Ducks, who were drowned, have been revived by a dry Bath of hot Ashes. The Heat of a Dung-heap may also be beneficial; and I have just been informed, by a very creditable and sensible Spectator of it, that it effectually contributed to restore Life to a Man, who had certainly remained six Hours under Water. § 405. I shall conclude these Directions with an Article printed in a little Work at _Paris_, about twenty Years since, by Order of the King, to which there is not the least Doubt, but that any other Sovereign will readily accede. "Notwithstanding the common People are very generally disposed to be compassionate, and may wish to give all Assistance to drowned Persons, it frequently happens they do not, only because they dare not; imagining they expose themselves by it to Prosecutions. It is therefore necessary, that they should know, and it cannot be too often repeated, in order to eradicate such a pernicious Prejudice, that the Magistrates have never interposed to prevent People from trying every possible Means to recover such unfortunate Persons, as shall be drowned and taken out of the Water. It is only in those Cases, when the Persons are known to be absolutely and irrecoverably dead, that Justice renders it necessary to seize their Bodies." __Chapter XXIX.__ _Of Substances stopt between the Mouth and the Stomach._ __Sect.__ 406. The Food we take in descends from the Mouth through a very strait Passage or Chanel, called the _Oesophagus_, the Gullet, which, going parallel with the Spine or Backbone, joins to, or terminates at, the Stomach. It happens sometimes that different Bodies are stopt in this Chanel, without being able either to descend or to return up again; whether this Difficulty arises from their being too large; or whether it be owing to their having such Angles or Points, as by penetrating into, and adhering to the Sides of this membranous Canal, absolutely prevent the usual Action and Motion of it. § 407. Very dangerous Symptoms arise from this Stoppage, which are frequently attended with a most acute Pain in the Part; and at other Times, with a very incommodious, rather than painful, Sensation; sometimes a very ineffectual Commotion at, or rising of, the Stomach, attended with great Anguish; and if the Stoppage be so circumstanced, that the _Glottis_ is closed, or the Wind-pipe compressed, a dreadful Suffocation is the Consequence: the Patient cannot breathe, the Lungs are quite distended; and the Blood being unable to return from the Head, the Countenance becomes red, then livid; the Neck swells; the Oppression increases, and the poor Sufferer speedily dies. When the Patient's Breathing is not stopt, nor greatly oppressed; if the Passage is not entirely blocked up, and he can swallow something, he lives very easily for a few Days, and then his Case becomes a particular Disorder of the _Oesophagus_, or Gullet. But if the Passage is absolutely closed, and the Obstruction cannot be removed for many Days, a terrible Death is the Consequence. § 408. The Danger of such Cases does not depend so much on the Nature of the obstructing Substance, as on its Size, with Regard to that of the Passage of the Part where it stops, and of the Manner in which it forms the Obstruction; and frequently the very Food may occasion Death; while Substances less adapted to be swallowed are not attended with any violent Consequences, though swallowed. A Child of six Days old swallowed a Comfit or Sugar Plumb, which stuck in the Passage, and instantly killed it. A grown Person perceived that a Bit of Mutton had stopt in the Passage; not to alarm any Body he arose from Table; a Moment afterwards, on looking where he might be gone, he was found dead. Another was choaked by a Bit of Cake; a third by a Piece of the Skin of a Ham; and a fourth by an Egg, which he swallowed whole in a Bravo. A Child was killed by a Chesnut swallowed whole. Another died suddenly, choaked (which is always the Circumstance, when they die instantly after such Accidents) by a Pear which he had tossed up, and catched in his Mouth. A Woman was choaked with another Pear. A Piece of a Sinew continued eight Days in the Passage, so that it prevented the Patient from getting down any Thing else; at the Expiration of that Time it fell into the Stomach, being loosened by its Putridity: The Patient notwithstanding died soon after, being killed by the Inflammation, Gangrene and Weakness it had occasioned. Unhappily there occur but too many Instances of this Sort, of which it is unnecessary to cite more. § 409. Whenever any Substance is thus detained in the Gullet, there are two Ways of removing it; that is either by extracting it, or pushing it down. The safest and most certain Way is always to extract or draw it out, but this is not always the easiest: and as the Efforts made for this Purpose greatly fatigue the Patient, and are sometimes attended with grievous Consequences; and yet if the Occasion is extremely urging, it may be eligible to thrust it down, if that is easier; and if there is no Danger from the obstructing Bodies Reception into the Stomach. The Substances which may be pushed down without Danger, are all common nourishing ones, as Bread, Meat, Cakes, Fruits, Pulse, Morsels of Tripe, and even Skin of Bacon. It is only very large Morsels of particular Aliments, that prove very difficult to digest; yet even such are rarely attended with any Fatality. § 410. The Substances we should endeavour to extract or draw out, though it be more painful and less easy than to push them down, are all those, whose Consequences might be highly dangerous, or even mortal, if swallowed. Such are all totally indigestible Bodies, as Cork, Linen-Rags, large Fruit Stones, Bones, Wood, Glass, Stones, Metals; and more especially if any further Danger may be superadded to that of its Indigestibility, from the Shape, whether rough, sharp, pointed, or angular, of the Substance swallowed. Wherefore we should chiefly endeavour to extract Pins, Needles, Fish-bones, other pointed Fragments of Bones, Bits of Glass, Scissars, Rings, or Buckles. Nevertheless it has happened, that every one of these Substances have at one Time or another been swallowed, and the most usual Consequences of them are violent Pains of the Stomach, and in the Guts; Inflammations, Suppurations, Abscesses, a slow Fever, Gangrene, the _Miserere_ or Iliac Passion; external Abscesses, through which the Bodies swallowed down have been discharged; and frequently, after a long Train of Maladies, a dreadful Death. § 411. When such Substances have not passed in too deep, we should endeavour to extract them with our Fingers, which often succeeds. If they are lower, we should make use of Nippers or a small _Forceps_; of which Surgeons are provided with different Sorts. Those which some Smoakers carry about them might be very convenient for such Purposes; and in Case of Necessity they might be made very readily out of two Bits of Wood. But this Attempt to extract rarely succeeds, if the Substance has descended far into the _Oesophagus_, and if the Substance be of a flexible Nature, which exactly applies itself to, and fills up the Cavity or Chanel of it. § 412. If the Fingers and the Nippers fail, or cannot be duly applied, Crotchets, a Kind of Hooks, must be employed. These may be made at once with a pretty strong iron Wire, crooked at the End. It must be introduced in the flat Way, and for the better conducting of it, there should be another Curve or Hook at the End it is held by, to serve as a Kind of Handle to it, which has this further Use, that it may be secured by a String tied to it; a Circumstance not to be omitted in any Instrument employed on such Occasions, to avoid such ill Accidents as have sometimes ensued, from these Instruments slipping out of the Operators Hold. After the Crotchet has passed beyond and below the Substance, that obstructs the Passage, it is drawn up again, and hooks up with it and extracts that Impediment to swallowing. This Crotchet is also very convenient, whenever a Substance somewhat flexible, as a Pin or a Fishbone stick, as it were, across the Gullet: the Crotchet in such Cases seizing them about their middle Part, crooks and thus disengages them. If they are very brittle Substances, it serves to break them; and if any Fragments still stick within, some other Means must be used to extract them. § 413. When the obstructing Bodies are small, and only stop up Part of the Passage; and which may either easily elude the Hook, or straiten it by their Resistance, a Kind of Rings may be used, and made either solid or flexible. The solid ones are made of iron Wire, or of a String of very fine brass Wire. For this Purpose the Wire is bent into a Circle about the middle Part of its Length, the Sides of which Circle do not touch each other, but leave a Ring, or hollow Cavity, of about an Inch Diameter. Then the long unbent Sides of the Wire are brought near each other; the circular Part or Ring is introduced into the Gullet, in order to be conducted about the obstructing Body, and so to extract it. Very flexible Rings may be made of Wool, Thread, Silk, or small Packthread, which may be waxed, for their greater Strength and Consistence. Then they are to be tied fast to a Handle of Iron-Wire, of Whale-bone, or of any flexible Wood; after which the Ring is to be introduced to surround the obstructing Substance, and to draw it out. Several of these Rings passed through one another are often made use of, the more certainly to lay hold of the obstructing Body, which may be involved by one, if another should miss it. This Sort of Rings has one Advantage, which is, that when the Substance to be extracted is once laid hold of, it may then, by turning the Handle, be retained so strongly in the Ring thus twisted, as to be moved every Way; which must be a considerable Advantage in many such Cases. § 414. A fourth Material employed on these unhappy Occasions is the Sponge. Its Property of swelling considerably, on being wet, is the Foundation of its Usefulness here. If any Substance is stopt in the Gullet, but without filling up the whole Passage, a Bit of Sponge is introduced, into that Part that is unstopt, and beyond the Substance. The Sponge soon dilates, and grows larger in this moist Situation, and indeed the Enlargement of it may be forwarded, by making the Patient swallow a few Drops of Water; and then drawing back the Sponge by the Handle it is fastened to, as it is now too large to return through the small Cavity, by which it was conveyed in, it draws out the obstructing Body with it, and thus unplugs, as it were, and opens the Gullet. As dry Sponge may shrink or be contracted, this Circumstance has proved the Means of squeezing a pretty large Piece of it into a very small Space. It becomes greatly compressed by winding a String or Tape very closely about it, which Tape may be easily unwound and withdrawn, after the Sponge has been introduced. It may also be inclosed in a Piece of Whalebone, split into four Sticks at one End, and which, being endued with a considerable Spring, contracts upon the Sponge. The Whalebone is so smoothed and accommodated, as not to wound; and the Sponge is also to be safely tied to a strong Thread; that after having disengaged the Whalebone from it, the Surgeon may also draw out the Sponge at Pleasure. Sponge is also applied on these Occasions in another Manner. When there is no Room to convey it into the Gullet, because the obstructing Substance ingrosses its whole Cavity; and supposing it not hooked into the Part, but solely detained by the Straitness of the Passage, a pretty large Bit of Sponge is to be introduced towards the Gullet, and close to the obstructing Subtance: Thus applied, the Sponge swells, and thence dilates that Part of the Passage that is above this Substance. The Sponge is then withdrawn a little, and but a very little, and this Substance being less pressed upon above than below, it sometimes happens, that the greater Staitness and Contraction of the lower Part of the Passage, than of its upper Part, causes that Substance to ascend; and as soon as this first Loosening or Disengagement of it has happened, the total Disengagement of it easily follows. § 415. Finally, when all these Methods prove unavailable, there remains one more, which is to make the Patient vomit; but this can scarcely be of any Service, but when such obstructing Bodies are simply engaged in, and not hooked or stuck into the Sides of the _Oesophagus_; since under this latter Circumstance vomiting might occasion further Mischief. If the Patient can swallow, a Vomiting may be excited with the Prescription Nº. 8, or with Nº. 34, or 35. By this Operation a Bone was thrown out, which had stopt in the Passage four and twenty Hours. When the Patient cannot swallow, an Attempt should be made to excite him to vomit by introducing into, and twirling about the feathery End of a Quill in, the Bottom of the Throat, which the Feather however will not effect, if the obstructing Body strongly compresses the whole Circumference of the Gullet; and then no other Resource is left, but giving a Glyster of Tobacco. A certain Person swallowed a large Morsel of Calf's Lights, which stopt in the Middle of the Gullet, and exactly filled up the Passage. A Surgeon unsuccessfully attempted various Methods to extract it; but another seeing how unavailable all of them were; and the Patient's Visage becoming black and swelled; his Eyes ready to start, as it were, out of his Head; and falling into frequent Swoonings, attended with Convulsions too, he caused a Glyster of an Ounce of Tobacco boiled to be thrown up; the Consequence of which was a violent Vomiting, which threw up the Substance that was so very near killing him. § 416. A sixth Method, which I believe has never hitherto been attempted, but which may prove very useful in many Cases, when the Substances in the Passage are not too hard, and are very large, would be to fix a Worm (used for withdrawing the Charge of Guns that have been loaded) fast to a flexible Handle, with a waxed Thread fastened to the Handle, in Order to withdraw it, if the Handle slipt from the Worm; and by this Contrivance it might be very practicable, if the obstructing Substance was not too deep in the Passage of the Gullet, to extract it--It has been known that a Thorn fastened in the Throat, has been thrown out by laughing. § 417. In the Circumstances mentioned § 409, when it is more easy and convenient to push the obstructing Body downwards, it has been usual to make Use of Leeks, which may generally be had any where (but which indeed are very subject to break) or of a Wax-candle oiled, and but a very little heated, so as to make it flexible; or of a Piece of Whale-bone; or of Iron-Wire; one Extremity of which may be thickened and blunted in a Minute with a little melted Lead. Small Sticks of some flexible Wood may be as convenient for the same Use, such as the Birch-tree, the Hazel, the Ash, the Willow, a flexible Plummet, or a leaden Ring. All these Substances should be very smooth, that they may not give the least Irritation; for which Reason they are sometimes covered over with a thin Bit of Sheep's Gut. Sometimes a Sponge is fastened to one End of them, which, completely filling up the whole Passage, pushes down whatever Obstacle it meets with. In such Cases too, the Patient may be prompted to attempt swallowing down large Morsels of some unhurtful Substance, such as a Crust of Bread, a small Turnep, a Lettuce Stalk, or a Bullet, in Hopes of their carrying down the obstructing Cause with them. It must be acknowledged, however, that these afford but a feeble Assistance; and if they are swallowed without being well secured to a Thread, it may be apprehended they may even increase the Obstruction, by their own Stoppage. It has sometimes very happily, though rarely, occurred, that those Substances attempted to be detruded or thrust downwards, have stuck in the Wax-Candle, or the Leek, and sprung up and out with them: but this can never happen except in the Case of pointed Substances. § 418. Should it be impossible to extract the Bodies mentioned § 410, and all such as it must be dangerous to admit into the Stomach, we must then prefer the least of two Evils, and rather run the Hazard of pushing them down, than suffer the Patient to perish dreadfully in a few Moments. And we ought to scruple this Resolution the less, as a great many Instances have demonstrated, that notwithstanding several bad Consequences, and even a tormenting Death, have often followed the swallowing of such hurtful or indigestible Substances; yet at other times they have been attended with little or no Disorder. § 419. One of these four Events is always the Case, after swallowing such Things. They either, 1, go off by Stool; or, 2, they are not discharged and kill the Patient. Or else, 3, they are discharged by Urine; or, 4, are visibly extruded to the Skin. I shall give some Instances of each of these Events. § 420. When they are voided by Stool, they are either voided soon after they have been swallowed, and that without having occasional scarce any troublesome Symptom; or the voiding of them has not happened till a long Time after swallowing, and is preceded with very considerable Pain. It has been seen that a Bone of the Leg of a Fowl, a Peach-stone, the Cover of a small Box of Venice Treacle, Pins, Needles, and Coins of different Sorts, have been voided within a few Days after they had slipt down into the Stomach; and that with little or no Complaint. A small Flute, or Pipe also, four Inches long, which occasioned acute Pains for three Days, has been voided happily afterwards, besides, Knives, Razors, and one Shoe-buckle. I have seen but a few Days since a Child between two and three Years old, who swallowed a Nail above an Inch long, the Head of which was more than three Tenths of an Inch broad: it stopt a few Moments about the Neck, but descended while its Friends were looking for me; and was voided with a Stool that Night, without any bad Consequence. And still more lately I have known the entire Bone of a Chicken's Wing thus swallowed, which only occasioned a slight Pain in the Stomach for three or four Days. Sometimes such Substances are retained within for a long Time, not being voided till after several Months, and even Years, without the least ill Effect: and some of them have never either appeared, nor been complained of. § 421. But the Event is not always so happy; and sometimes though they are discharged through the natural Passages, the Discharges have been preceded by very acute Pains in the Stomach, and in the Bowels. A Girl swallowed down some Pins, which afflicted her with violent Pains for the Space of six Years; at the Expiration of which Term she voided them and recovered. Three Needles being swallowed brought on Cholics, Swoonings and Convulsions for a Year after: and then being voided by Stool, the Patient recovered. Another Person who swallowed two, was much happier in suffering but six Hours from them; when they were voided by Stool, and he did well. It sometimes happens that such indigestible Substances, after having past all the Meanders, the whole Course of the Intestines, have been stopt in the Fundament, and brought on very troublesome Symptoms; but such however, as an expert Surgeon may very generally remove. If it is practicable to cut them, as it is when they happen to be thin Bones, the Jaw-bones of Fish, or Pins, they are then very easily extracted. § 422. The second Event is, when these fatal Substances are never voided, but cause very embarrassing Symptoms which finally kill the Patient; and of these Cases there have been but too many Examples. A young Girl having swallowed some Pins, which she held in her Mouth, some of them were voided by Stool; but others of them pricked and pierced into her Guts, and even into the Muscles of her Belly, with the severest Pain; and killed her at the End of three Weeks. A Man swallowed a Needle, which pierced through his Stomach, and into his Liver, [94] and ended in a mortal Consumption. [94] I saw a very similar Instance and Event in a Lady's little favourite Bitch, whole Body she desired to be opened, from suspecting her to have been poisoned. But it appeared that a small Needle with fine Thread, which she had swallowed, had passed out of the Stomach into the _Duodenum_ (one of the Guts) through which the Point had pierced and pricked and corroded the concave Part of the Liver, which was all rough and putrid. The whole Carcase was greatly bloated and extremely offensive, very soon after the poor Animal's Death, which happened two or three Months after the Accident, and was preceded by a great Wheezing, Restlessness and Loss of Appetite. The Needle was rusty, but the Thread entire, and very little altered. _K._ A Plummet which slipt down, while the Throat of a Patient was searching, killed him at the End of two Years. It is very common for different Coins, and of different Metals, to be swallowed without any fatal or troublesome Effects. Even a hundred Luidores [95] have been swallowed, and all voided. Nevertheless these fortunate Escapes ought not to make People too secure and incautious on such Occasions, since such melancholy Consequences have happened, as may very justly alarm them. One single Piece of Money that was swallowed, entirely obstructed the Communication between the Stomach and the Intestines, and killed the Patient. Whole Nuts have often been inadvertently swallowed; but there have been some Instances of Persons in whom a Heap [96] of them has been formed, which proved the Cause of Death, after producing much Pain and Inquietude. [95] I knew a Man of the Name of _Poole_, who being taken in the same Ship with me, 1717 or 18, by Pirates, had swallowed four Ginueas, and a gold Ring, all which he voided some Days after without any Injury or Complaint, and saved them. I forget the exact Number of Days he retained them, but the Pirates staid with us from Saturday Night to Thursday Noon. _K._ [96] Many fatal Examples of this Kind may be seen in the _Philosophical Transactions_; and they should caution People against swallowing Cherry-stones, and still more against those of Prunes, or such as are pointed, though not very acutely. _K._ § 423. The third Issue or Event is, when these Substances, thus swallowed down, have been discharged by Urine: but these Cases are very rare. A Pin of a middling Size has been discharged by Urine, three Days after it slipt down; and a little Bone has been expelled the same Way, besides Cherry-stones, Plumb-stones, and even one Peach-stone. § 424. Finally, the fourth Consequence or Event is, when the indigestible Substances thus swallowed, have pierced through the Stomach or Intestines, and even to the Skin itself; and occasioning an Abscess, have made an Outlet for themselves, or have been taken out of the Abscess. A long Time is often required to effect this extraordinary Trajection and Appearance of them; sometimes the Pains they occasion are continual; in other Cases the Patient complains for a Time, after which the Pain ceases, and then returns again. The Imposthume, or Gathering, is formed in the Stomach, or in some other Part of the Belly: and sometimes these very Substances, after having pierced through the Guts, make very singular Routs, and are discharged very remotely from the Belly. One Needle that had been swallowed found its Way out, at the End of four Years, through the Leg; another at the Shoulder. § 425. All these Examples, and many others of cruel Deaths, from swallowing noxious Substances, demonstrate the great Necessity of an habitual Caution in this Respect; and give in their Testimony against the horrid, I had almost said, the criminal Imprudence, of People's amusing themselves with such Tricks as may lead to such terrible Accidents; or even holding any such Substance in their Mouths, as by slipping down through Imprudence or Accident, may prove the Occasion of their Death. Is it possible that any one, without shuddering, can hold Pins or Needles in their Mouths, after reflecting on the dreadful Accidents, and cruel Deaths, that have thus been caused by them. § 426. It has been shewn already, that Substances obstructing the Passage of the Gullet sometimes suffocate the Patient; that at other Times they can neither be extracted nor thrust down; but that they stop in the Passage, without killing the Patient, at least not immediately and at once. This is the Case when they are so circumstanced, as not to compress the _Trachæa_, the Wind-pipe, and not totally to prevent the swallowing of Food; which last Circumstance can scarcely happen, except the Obstruction has been formed by angular or pointed Bodies. The Stoppage of such Bodies is sometimes attended, and that without much Violence, with a small Suppuration, which loosens them; and then they are either returned upwards through the Mouth, or descend into the Stomach. But at other Times an extraordinary Inflammation is produced, which kills the Patient. Or if the Contents of the Abscess attending the Inflammation tend outwardly, a Tumour is formed on the external Part of the Neck, which is to be opened, and through whose Orifice the obstructing Body is discharged. In other Instances again they take a different Course, attended with little or no Pain, and are at length discharged by a Gathering behind the Neck, on the Breast, the Shoulder, or various other Parts. § 427. Some Persons, astonished at the extraordinary Course and Progression of such Substances, which, from their Size, and especially from their Shape, seem to them incapable of being introduced into, and in some Sort, circulating through the human Body, without destroying it, are very desirous of having the Rout and Progression of such intruding Substances explained to them. To gratify such Inquirers, I may be indulged in a short Digression, which perhaps is the less foreign to my Plan; as in dissipating what seems marvelous, and has been thought supernatural in such Cases, I may demolish that superstitious Prejudice, which has often ascribed Effects of this Sort to Witchcraft; but which admit of an easy Explanation. This very Reason is the Motive that has determined me to give a further Extent to this Chapter. Wherever an Incision is made through the Skin, a certain Membrane appears, which consists of two Coats or _Laminæ_, separated from each other by small Cells or Cavities, which all communicate together; and which are furnished, more or less, with Fat. There is not any Fat throughout the human Body, which is not inclosed in, or enveloped with, this Coat, which is called the adipose, fatty, or cellular Membrane. This Membrane is not only found under the Skin, but further plying and insinuating itself in various Manners, it is extended throughout the whole Body. It distinguishes and separates all the Muscles; it constitutes a Part of the Stomach, of the Guts, of the Bladder, and of all the _Viscera_ or Bowels. It is this which forms what is called the Cawl, and which also furnishes a Sheath or Envelopement to the Veins, Arteries, and Nerves. In some Parts it is very thick, and is abundantly replenished with Fat; in others it is very thin and unprovided with any; but wherever it extends, it is wholly insensible, or void of all Sensation, all Feeling. It may be compared to a quilted Coverlet, the Cotton, or other Stuffing of which, is unequally distributed; greatly abounding in some Places, with none at all in others, so that in these the Stuff above and below touch each other. Within this Membrane, or Coverlet, as it were, such extraneous or foreign Substances are moved about; and as there is a general Communication throughout the whole Extent of the Membrane, it is no ways surprizing, that they are moved from one Part to another very distant, in a long Course and Duration of Movement. Officers and Soldiers very often experience, that Bullets which do not pass through the Parts where they have entered, are transferred to very different and remote ones. The general Communication throughout this Membrane is daily demonstrated by Facts, which the Law prohibits; this is the Butchers inflating, or blowing up, the cellular Membrane throughout the whole Carcase of a Calf, by a small Incision in the Skin, into which they introduce a Pipe or the Nozzle of a small Bellows; and then, blowing forcibly, the Air evidently puffs up the whole Body of the Calf into this artificial Tumour or Swelling. Some very criminal Impostors have availed themselves of this wicked Contrivance, thus to bloat up Children into a Kind of Monsters, which they afterwards expose to View for Money. In this cellular Membrane the extravasated Waters of hydropic Patients are commonly diffused; and here they give Way to that Motion, to which their own Weight disposes them. But here I may be asked--As this Membrane is crossed and intersected in different Parts of it, by Nerves, Veins, Arteries, _&c._ the wounding of which unavoidably occasions grievous Symptoms, how comes it, that such do not ensue upon the Intrusion of such noxious Substances? To this I answer, 1, that such Symptoms do sometimes really ensue; and 2, that nevertheless they must happen but seldom, by Reason that all the aforesaid Parts, which traverse and intersect this Membrane, being harder than the Fat it contains; such foreign Substances must almost necessarily, whenever they rencounter those Parts, be turned aside towards the Fat which surrounds them, whose Resistance is very considerably less; and this the more certainly so, as these Nerves, _&c._ are always of a cylindrical Form.----But to return from this necessary Digression. § 428. To all these Methods and Expedients I have already recommended on the important Subject of this Chapter, I shall further add some general Directions. 1. It is often useful, and even necessary, to take a considerable Quantity of Blood from the Arm; but especially if the Patient's Respiration, or Breathing, is extremely oppressed; or when we cannot speedily succeed in our Efforts to remove the obstructing Substance; as the Bleeding is adapted to prevent the Inflammation, which the frequent Irritations from such Substances occasion; and as by its disposing the whole Body into a State of Relaxation, it might possibly procure an immediate Discharge of the offending Substance. 2. Whenever it is manifest that all Endeavours, either to extract, or to push down the Substance stopt in the Passage, are ineffectual, they should be discontinued; because the Inflammation occasioned by persisting in them, would be as dangerous as the Obstruction itself; as there have been Instances of People's dying in Consequence of the Inflammation; notwithstanding the Body, which caused the Obstruction, had been entirely removed. 3. While the Means already advised are making Use of, the Patient should often swallow, or if he cannot, he should frequently receive by Injection through a crooked Tube or Pipe, that may reach lower down than the _Glottis_, some very emollient Liquor, as warm Water, either alone or mixed with Milk, or a Decoction of Barley, of Mallows, or of Bran. A two-fold Advantage may arise from this; the first is, that these softening Liquors smooth and sooth the irritated Parts; and secondly, an Injection, strongly thrown in, has often been more successful in loosening the obstructing Body, than all Attempts with Instruments. 4. When after all we are obliged to leave this in the Part, the Patient must be treated as if he had an inflammatory Disease; he must be bled, ordered to a Regimen, and have his whole Neck surrounded with emollient Pultices. The like Treatment must also be used, though the obstructing Substance be removed; if there is Room to suppose any Inflammation left in the Passage. 5. A proper Degree of Agitation has sometimes loosened the inhering Body, more effectually than Instruments. It has been experienced that a Blow with the Fist on the Spine, the Middle of the Back, has often disengaged such obstructed and obstructing Bodies; and I have known two Instances of Patients who had Pins stopt in the Passage; and who getting on Horseback to ride out in Search of Relief at a neighbouring Village, found each of them the Pin disengaged after an Hour's riding: One spat it out, and the other swallowed it, without any ill Consequence. 6. When there is an immediate Apprehension of the Patient's being suffocated; when bleeding him has been of no Service; when all Hope of freeing the Passage in time is vanished, and Death seems at Hand, if Respiration be not restored; the Operation of _Bronchotomy_, or opening of the Wind-pipe, must be directly performed; an Operation neither difficult to a tolerably knowing and expert Surgeon, nor very painful to the Patient. 7. When the Substance that was stopt passes into the Stomach, the Patient must immediately be put into a very mild and smooth Regimen. He should avoid all sharp, irritating, inflaming Food; Wine, spirituous Liquors, all strong Drink, and Coffee; taking but little Nourishment at once, and no Solids, without their having been thoroughly well chewed. The best Diet would be that of farinaceous mealy Soups, made of various leguminous Grains, and of Milk and Water, which is much better than the usual Custom of swallowing different Oils. § 429. The Author of Nature has provided, that in eating, nothing should pass by the _Glottis_ into the Wind-pipe. This Misfortune nevertheless does sometimes happen; at which very Instant there ensues an incessant and violent Cough, an acute Pain, with Suffocation; all the Blood being forced up into the Head, the Patient is in extreme Anguish, being agitated with violent and involuntary Motions, and sometimes dying on the Spot. A _Hungarian_ Grenadier, by Trade a Shoemaker, was eating and working at the same time. He tumbled at once from his Seat, without uttering a single Word. His Comrades called out for Assistance; some Surgeons speedily arrived, but after all their Endeavours he discovered no Token of Life. On opening the Body, they found a Lump, or large Morsel, of Beef, weighing two Ounces, forced into the Windpipe, which it plugged up so exactly, that not the least Air could pass through it into the Lungs. § 430. In a Case so circumstanced, the Patient should be struck often on the Middle of the Back; some Efforts to vomit should be excited; he should be prompted to sneeze with Powder of Lilly of the Valley, Sage, or any cephalic Snuffs, which should be blown strongly up his Nose. A Pea, pitched into the Mouth in playing, entered into the Wind-pipe, and sprung out again by vomiting the Patient with Oil. A little Bone was brought up by making another sneeze, with powdered Lilly of the Valley. In short, if all these Means of assisting, or saving the Patient are evidently ineffectual, _Bronchotomy_ must be speedily performed (See Nº. 6, of the preceding Section.) By this Operation, some Bones, a Bean, and a Fish-bone have been extracted, and the Patient has been delivered from approaching Death. § 431. Nothing should be left untried, when the Preservation of human Life is the Object. In those Cases, when an obstructing Body can neither be disengaged from the Throat, the Passage to the Stomach, nor be suffered to remain there without speedily killing the Patient, it has been proposed to make an Incision into this Passage, the _Oesophagus_, through which such a Body is to be extracted; and to employ the like Means, when a Substance which had slipt even into the Stomach itself, was of a Nature to excite such Symptoms, as must speedily destroy the Patient. When the _Oesophagus_ is so fully and strongly closed, that the Patient can receive no Food by the Mouth, he is to be nourished by Glysters of Soup, Gelly, and the like. __Chapter XXX.__ _Of external Disorders, and such as require chirurgical Application. Of Burns, Wounds, Contusions or Bruises: Of Sprains, Ulcers, frostbitten Limbs, Chilblains, Ruptures, Boils. Of Fellons, Thorns or Splinters in the Fingers or Flesh; of Warts, and of Corns._ __Sect.__ 432. Labouring Countrymen are exposed in the Course of their daily Work, to many outward Accidents, such as Cuts, Contusions, _&c_. which, however considerable in themselves, very generally end happily; and that chiefly in Consequence of the pure and simple Nature of their Blood, which is generally much less acrimonious, or sharp, in the Country, than in great Towns or Cities. Nevertheless, the very improper Treatment of such Accidents, in the Country, frequently renders them, however light in themselves, very troublesome; and indeed, I have seen so many Instances of this, that I have thought it necessary to mark out here the proper Treatment of such Accidents, as may not necessarily require the Hand or Attendance of a Surgeon. I shall also add something very briefly, concerning some external Disorders, which at the same Time result from an inward Cause. _Of Burns._ § 433. When a Burn is very trifling and superficial, and occasions no Vesication or Blister, it is sufficient to clap a Compress of several Folds of soft Linen upon it, dipt in cold Water, and to renew it every Quarter of an Hour, till the Pain is entirely removed. But when the Burn has blistered, a Compress of very fine Linen, spread over with the Pomatum, Nº. 64, should be applied over it, and changed twice a Day. If the true Skin is burnt, and even the Muscles, the Flesh under it, be injured, the same Pomatum may be applied; but instead of a Compress, it should be spread upon a Pledget of soft Lint, to be applied very exactly over it, and over the Pledget again, a Slip of the simple Plaister Nº. 65, which every Body may easily prepare; or, if they should prefer it, the Plaister Nº. 66. But, independently of these external Applications, which are the most effectual ones, when they are directly to be had; whenever the Burn has been very violent, is highly inflamed, and we are apprehensive of the Progress and the Consequences of the Inflammation, the same Means and Remedies must be recurred to, which are used in violent Inflammations: the Patient should be bled, and, if it is necessary, it should be repeated more than once, and he should be put into a Regimen; drink nothing but the Ptisans Nº. 2 and 4, and receive daily two simple Glysters. If the Ingredients for the Ointment, called _Nutritum_, are not at Hand to make the Pomatum Nº. 64; one Part of Wax should be melted in eight such Parts of Oil, to two Ounces of which Mixture the Yolk of an Egg should be added. A still more simple and sooner prepared Application, is that of one Egg, both the Yolk and the White, beat up with two common Spoonfuls of the sweetest Oil, without any Rankness. When the Pain of the Burn, and all its other Symptoms have very nearly disappeared, it is sufficient to apply the Sparadrap, or Oil-cloth Nº. 66. _Of Wounds._ § 434. If a Wound has penetrated into any of the Cavities, and has wounded any Part contained in the Breast, or in the Belly: Or if, without having entered into one of the Cavities, it has opened some great Blood-vessel; or if it has wounded a considerable Nerve, which occasions Symptoms much more violent, than would otherwise have happened; if it has penetrated even to and injured the Bone: in short, if any great and severe Symptom supervenes, there is an absolute Necessity for calling in a Surgeon. But whenever the Wound is not attended with any of these Circumstances; when it affects only the Skin, the fat Membrane beneath it, the fleshy Parts and the small Vessels, it may be easily and simply dressed without such Assistance; since, in general, all that is truly necessary in such Cases is, to defend the Wound from the Impressions of the Air; and yet not so, as to give any material Obstruction to the Discharge of the Matter, that is to issue from the Wound. § 435. If the Blood does not particularly flow out of any considerable Vessel, but trickles almost equally from every Spot of the Wound, it may very safely be permitted to bleed, while some Lint is speedily preparing. As soon as the Lint is ready, so much of it may be introduced into the Wound as will nearly fill it, without being forced in; which is highly improper, and would be attended with the same Inconveniences as Tents and Dossils. It should be covered over with a Compress dipt in sweet Oil, or with the Cerecloth Nº. 65; though I prefer the Compress for the earliest Dressings: and the whole Dressing should be kept on, with a Bandage of two Fingers Breadth, and of a Length proportioned to the Size of the Part it is to surround: This should be rolled on tight enough to secure the Dressings, and yet so moderately, as to bring on no Inflammation. This Bandage with these Dressings are to remain on twenty-four or forty-eight Hours; Wounds being healed the sooner, for being less frequently drest. At the second Dressing all the Lint must be removed, which can be done with Ease, and with reasonable Speed, to the Wounded; and if any of it should stick close, in Consequence of the clogged and dried Blood, it should be left behind, adding a little fresh Lint to it; this Dressing in other Respects exactly resembling the first. When, from the Continuance of this simple Dressing, the Wound is become very superficial, it is sufficient to apply the Cerecloth, or Plaister, without any Lint. Such as have conceived an extraordinary Opinion of any medical Oils, impregnated with the Virtues of particular Plants, may, if that will increase their Satisfaction, make use of the common Oil of Yarrow, of Trefoil, of Lilies, of Chamomile, of Balsamines, or of red Roses; only being very careful, that such Oils are not become stale and rank. § 436. When the Wound is considerable, it must be expected to inflame before Suppuration (which, in such a Case, advances more slowly) can ensue; which Inflammation will necessarily be attended with Pain, with a Fever, and sometimes with a Raving, or Wandering, too. In such a Situation, a Pultice of Bread and Milk, with the Addition of a little Oil, that it may not stick too close, must be applied instead of the Compress or the Plaister: which Pultice is to be changed, but without uncovering the Wound, thrice and even four times every Day. § 437. Should some pretty considerable Blood-vessel be opened by the Wound, there must be applied over it, a Piece of Agaric of the Oak, Nº. 67, with which no Country place ought to be unprovided. It is to be kept on, by applying a good deal of Lint over it; covering the whole with a thick Compress, and then with a Bandage a little tighter than usual. If this should not be sufficient to prevent the Bleeding from the large Vessel, and the Wound be in the Leg or Arm, a strong Ligature must be made above the Wound with a _Turniquet_, which is made in a Moment with a Skain of Thread, or of Hemp, that is passed round the Arm circularly, into the Middle of which is inserted a Piece of Wood or Stick of an Inch Thickness, and four or five Inches long; so that by turning round this Piece of Wood, any Tightness or Compression may be effected at Pleasure; exactly as a Country-man secures a Hogshead, or a Piece of Timber on his Cart, with a Chain and Ring. But Care must be taken, 1, to dispose the Skain in such a Manner, that it must always be two Inches wider than the Part it surrounds: and, 2, not to strain it so tight as to bring on an Inflammation, which might terminate in a Gangrene. § 438. All the boasted Virtues of a Multitude of Ointments are downright Nonsense or Quackery. Art, strictly considered, does not in the least contribute to the healing of Wounds; the utmost we can do amounting only to our removing those Accidents, which are so many Obstacles to their Re-union. On this Account, if there is any extraneous Body in the Wound, such as Iron, Lead, Wood, Glass, Bits of Cloth or Linen, they must be extracted, if that can be very easily done; but if not, Application must be made to a good Surgeon, who considers what Measures are to be taken, and then dresses the Wound, as I have already advised. Very far from being useful, there are many Ointments that are pernicious on these Occasions; and the only Cases in which they should be used, are those in which the Wounds are distinguished with some particular Appearances, which ought to be removed by particular Applications: But a simple recent Wound, in a healthy Man, requires no other Treatment but what I have already directed, besides that of the general Regimen. Spirituous Applications are commonly hurtful, and can be suitable and proper but in a few Cases, which Physicians and Surgeons only can distinguish. When Wounds occur in the Head, instead of the Compress dipt in Oil, or of the Cerecloth, the Wound should be covered with a Betony Plaister; or, when none is to be had in time, with a Compress squeezed out of hot Wine. § 439. As the following Symptoms, of which we should be most apprehensive, are such as attend on Inflammations, the Means we ought to have Recourse to are those which are most likely to prevent them; such as Bleeding, the usual Regimen, moderate Coolers and Glysters. Should the Wound be very inconsiderable in its Degree, and in its Situation, it may be sufficient to avoid taking any Thing heating; and above all Things to retrench the Use of any strong Drink, and of Flesh-meat. But when it is considerable, and an Inflammation must be expected, there is a Necessity for Bleeding; the Patient should be kept in the most quiet and easy Situation; he should be ordered immediately to a Regimen; and sometimes the Bleeding also must be repeated. Now all these Means are the more indispensably necessary, when the Wound has penetrated to some internal Part; in which Situation, no Remedy is more certain than that of an extremely light Diet. Such wounded Persons as have been supposed incapable of living many Hours, after Wounds in the Breast, in the Belly, or in the Kidnies, have been completely recovered, by living for the Course of several Weeks, on nothing but a Barley, or other farinaceous mealy, Ptisans, without Salt, without Soup, without any Medicine; and especially without the Use of any Ointments. § 440. In the same Proportion that Bleeding, moderately and judiciously employed, is serviceable, in that very same an Excess of it becomes pernicious. Great Wounds are generally attended with a considerable Loss of Blood, which has already exhausted the wounded Person; and the Fever is often a Consequence of this copious Loss of Blood. Now if under such a Circumstance, Bleeding should be ordered and performed, the Patient's Strength is totally sunk; the Humours stagnate and corrupt; a Gangrene supervenes, and he dies miserably, at the End of two or three Days, of a _Series_ of repeated Bleedings, but not of the Wound. Notwithstanding the Certainty of this, the Surgeon frequently boasts of his ten, twelve, or even his fifteen Bleedings; assuring his Hearers of the insuperable Mortality of the Wound, since the letting out such a Quantity of Blood could not recover the Patient; when it really was that excessive artificial Profusion of it, that downright dispatched him.------The Pleasures of Love are very mortal ones to the Wounded. § 441. The Balsams and vulnerary Plants, which have often been so highly celebrated for the Cure of Wounds, are very noxious, when taken inwardly; because the Introduction of them gives or heightens the Fever, which ought to have been abated. _Of Contusions, or Bruises._ § 442. A Contusion, which is commonly called a Bruise, is the Effect of the forcible Impression or Stroke of a Substance not sharp or cutting, on the Body of a Man, or any Animal; whether such an Impression be violently made on the Man, as when he is struck by a Stick, or by a Stone thrown at him; or whether the Man be involuntarily forced against a Post, a Stone, or any hard Substance by a Fall; or whether, in short, he is squeezed and oppressed betwixt two hard Bodies, as when his Finger is squeezed betwixt the Door and the Door-Post, or the whole Body jammed in betwixt any Carriage and the Wall. These Bruises, however, are still more frequent in the Country than Wounds, and commonly more dangerous too; and indeed the more so, as we cannot judge so exactly, and so soon, of the whole Injury that has been incurred; and because all that is immediately visible of it is often but a small Part of the real Damage attending it: since it frequently happens that no Hurt appears for a few successive Days; nor does it become manifest, until it is too late to admit of an effectual Cure. § 443. It is but a few Weeks since a Cooper came to ask my Advice. His Manner of breathing, his Aspect, the Quickness, Smallness, and Irregularity of his Pulse, made me apprehensive at once, that some Matter was formed within his Breast. Nevertheless he still kept up, and went about, working also at some Part of his Trade. He had fallen in removing some Casks or Hogsheads; and the whole Weight of his Body had been violently impressed upon the right Side of his Breast. Notwithstanding this, he was sensible of no Hurt at first; but some Days afterwards he began to feel a dull heavy Pain in that Part, which continued and brought on a Difficulty of Breathing, Weakness, broken Sleep and Loss of Appetite. I ordered him immediately to Stillness and Repose, and I advised him to drink a Ptisan of Barley sweetened with Honey, in a plentiful Quantity. He regularly obeyed only the latter Part of my Directions: yet on meeting him a few Days after, he told me he was better. The very same Week, however, I was informed he had been found dead in his Bed. The Imposthume had undoubtedly broke, and suffocated him. § 444. A young Man, run away with by his Horse, was forced with Violence against a Stable-Door, without being sensible of any Damage at the Time. But at the Expiration of twelve Days, he found himself attacked by some such Complaints, as generally occur at the Beginning of a Fever. This Fever was mistaken for a putrid one, and he was very improperly treated, for the Fever it really was, above a Month. In short, it was agreed at a Consultation, that Matter was collected in the Breast. In Consequence of this, he was more properly attended, and at length happily cured by the Operation for an _Empyema_, after languishing a whole Year. I have published these two Instances, to demonstrate the great Danger of neglecting violent Strokes or Bruises; since the first of these Patients might have escaped Death; and the second a tedious and afflicting Disorder, if they had taken, immediately after each Accident, the necessary Precautions against its Consequences. § 445. Whenever any Part is bruised, one of two Things always ensues, and commonly both happen together; especially if the Contusion is pretty considerable: Either the small Blood-vessels of the contused Part are broken, and the Blood they contained is spread about in the adjoining Parts; or else, without such an Effusion of it, these Vessels have lost their Tone, their active Force, and no longer contributing to the Circulation, their Contents stagnate. In each of these Cases, if Nature, either without or with the Assistance of Art, does not remove the Impediment, an Inflammation comes on, attended with an imperfect, unkindly Suppuration, with Putrefaction and a Gangrene; without mentioning the Symptoms that arise from the Contusion of some particular Substance, as a Nerve, a large Vessel, a Bone, _&c._ Hence we may also conceive the Danger of a Contusion, happening to any inward Part, from which the Blood is either internally effused, or the Circulation wholly obstructed in some vital Organ. This is the Cause of the sudden Death of Persons after a violent Fall; or of those who have received the violent Force of heavy descending Bodies on their Heads; or of some violent Strokes, without any evident external Hurt or Mark. There have been many Instances of sudden Deaths after one Blow on the Pit of the Stomach, which has occasioned a Rupture of the Spleen. It is in Consequence of Falls occasioning a general slight Contusion, as well internal as external, that they are sometimes attended with such grievous Consequences, especially in old Men, where Nature, already enfeebled, is less able to redress such Disorders. And thus in Fact has it been, that many such, who had before enjoyed a firm State of Health, have immediately lost it after a Fall (which seemed at first to have affected them little or not at all) and languished soon after to the Moment of their Death, which such Accidents very generally accelerate. § 446. Different external and internal Remedies are applicable in Contusions. When the Accident has occurred in a slight Degree, and there has been no great nor general Shock, which might produce an internal Soreness or Contusion, external Applications may be sufficient. They should consist of such Things as are adapted, first, to attenuate and resolve the effused and stagnant Blood, which shews itself so apparently; and which, from its manifest Blackness very soon after the Contusion, becomes successively brown, yellow, and greyish, in Proportions as the Magnitude of the Suffusion or Sealing decreases, till at last it disappears entirely, and the Skin recovers its Colour, without the Blood's having been discharged through the external Surface, as it has been insensibly and gradually dissolved, and been taken in again by the Vessels: And secondly, the Medicines should be such as are qualified to restore the Tone, and to recover the Strength of the affected Vessels. The best Application is Vinegar, diluted, if very sharp, with twice as much warm Water; in which Mixture Folds of Linnen are to be dipt, within which the contused Parts are to be involved; and these Folds are to be remoistened and re-applied every two Hours on the first Day. Parsley, Chervil, and Houseleek Leaves, lightly pounded, have also been successfully employed; and these Applications are preferable to Vinegar, when a Wound is joined to the Bruise. The Pultices, Nº. 68, may also be used with Advantage. § 447. It has been a common Practice immediately to apply spirituous Liquors, such as Brandy, Arquebussade and [97] Alibour Water, and the like; but a long Abuse ought not to be established by Prescription. These Liquids which coagulate the Blood, instead of resolving it, are truly pernicious; notwithstanding they are sometimes employed without any visible Disadvantage on very slight Occasions. Frequently by determining the settled Blood towards the Insterstices of the Muscles, the fleshy Parts; or sometimes even by preventing the Effusion, or visible Settling of the Blood, and fixing it, as it were, within the bruised Vessels, they seem to be well; though this only arises from their concentring and concealing the Evil, which, at the End of a few Months, breaks forth again in a very troublesome Shape. Of this I have seen some miserable Examples, whence it has been abundantly evinced, that Applications of this Sort should never be admitted; and that Vinegar should be used instead of them. At the utmost it should only be allowed, (after there is Reason to suppose all the stagnant Blood resolved and resorbed into the Circulation) to add a third Part of Arquebusade Water to the Vinegar; with an Intention to restore some Strength to the relaxed and weakened Parts. [97] This, Dr. _Tissot_ informs me, is a Solution of white Vitriol and some other Drugs in Spirit of Wine, and is never used in regular Practice now. It has its Name from the Author of the Solution. _K._ § 448. It is still a more pernicious Practice to apply, in Bruises, Plaisters composed of greasy Substances, Rosins, Gums, Earths, _&c._ The most boasted of these is always hurtful, and there have been many Instances of very slight Contusions being aggravated into Gangrenes by such Plaisters ignorantly applied; which Bruises would have been entirely subdued by the Oeconomy of Nature, if left to herself, in the Space of four Days. Those Sacs or Suffusions of coagulated Blood, which are visible under the Skin, should never be opened, except for some urgent Reason; since however large they may be, they insensibly disappear and dissipate; instead of which Termination, by opening them, they sometimes terminate in a dangerous Ulceration. § 449. The internal Treatment of Contusions is exactly the same with that of Wounds; only that in these Cases the best Drink is the Prescription, Nº. 1, to each Pot of which a Drachm of Nitre must be added. When any Person has got a violent Fall; has lost his Senses, or is become very stupid; when the Blood starts out of his Nostrils, or his Ears; when he is greatly oppressed, or his Belly feels very tight and tense, which import an Effusion of Blood either into the Head, the Breast or the Belly, he must, first of all, be bled upon the Spot, and all the Means must be recurred to, which have been mentioned § 439, giving the wretched Patient the least possible Disturbance or Motion; and by all means avoiding to jog or shake him, with a Design to bring him to his Senses; which would be directly and effectually killing him, by causing a further Effusion of Blood. Instead of this the whole Body should be fomented, with some one of the Decoctions already mentioned: and when the Violence has been chiefly impressed on the Head, Wine and Water should be prefered to Vinegar. Falls attended with Wounds, and even a Fracture of the Skull, and with the most alarming Symptoms, have been cured by these internal Remedies, and without any other external Assistance, except the Use of the aromatic Fomentation, Nº. 68. A Man from _Pully-petit_ came to consult me some Months ago, concerning his Father, who had a high Fall out of a Tree. He had been twenty-four Hours without Feeling or Sense, and without any other Motion than frequent Efforts to vomit; and Blood had issued both from his Nose and Ears. He had no visible outward Hurt neither on his Head, nor any other Part; and, very fortunately for him, they had not as yet exerted the least Effort to relieve him. I immediately directed a plentiful Bleeding in the Arm; and a large Quantity of Whey sweetened with Honey to be drank, and to be also injected by Way of Glyster. This Advice was very punctually observed; and fifteen Days after the Father came to _Lausanne_, which is four Leagues from _Pully-petit_, and told me he was very well. It is proper, in all considerable Bruises, to open the Patient's Belly with a mild cooling Purge, such as Nº. 11, 23, 32, 49. The Prescription Nº. 24, and the honyed Whey are excellent Remedies, from the same Reason. § 450. In these Circumstances, Wine, distiled Spirits, and whatever has been supposed to revive and to rouse, is mortal. For this Reason People should not be too impatient, because the Patients remain some Time without Sense or Feeling. The giving of Turpentine is more likely to do Mischief than Good; and if it has been sometimes serviceable, it must have been in Consequence of its purging the Patient, who probably then needed to be purged. The Fat of a Whale, (_Sperma cæti_) Dragons Blood, Crabs-Eyes, and Ointments of whatsoever Sort are at least useless and dangerous Medicine, if the Case be very hazardous; either by the Mischief they do, or the Good they prevent from being done. The proper Indication is to dilute the Blood, to render it more fluid and disposed to circulate; and the Medicines just mentioned produce a very contrary Effect. § 451. When an aged Person gets a Fall, which is the more dangerous in Proportion to his Age and Grossness; notwithstanding he should not seem in the least incommoded by it, if he is sanguine and still somewhat vigorous, he should part with three or four Ounces of Blood. He should take immediately a few successive Cups of a lightly aromatic Drink, which should be given him hot; such, for Instance, as an Infusion of Tea sweetened with Honey, and he should be advised to move gently about. He must retrench a little from the usual Quantity of his Food, and accustom himself to very gentle, but very frequent, Exercise. § 452. Sprains or Wrenches, which very often happen, produce a Kind of Contusion, in the Parts adjoining to the sprained Joint. This Contusion is caused by the violent Friction of the Bone against the neighbouring Parts; and as soon as the Bones are immediately returned into their proper Situation, the Disorder should be treated as a Contusion. Indeed if the Bones should not of themselves return into their proper natural Position, Recourse must be had to the Hand of a Surgeon. The best Remedy in this Case is absolute Rest and Repose, after applying a Compress moistened in Vinegar and Water, which is to be renewed and continued, till the Marks of the Contusion entirely disappear; and there remains not the smallest Apprehension of an Inflammation. Then indeed, and not before, a little Brandy or Arquebusade Water may be added to the Vinegar; and the Part (which is almost constantly the Foot) should be strengthened and secured for a considerable Time with a Bandage; as it might otherwise be liable to fresh Sprains, which would daily more and more enfeeble it: and if this Evil is overlooked too much in its Infancy, the Part never recovers its full Strength; and a small Swelling often remains to the End of the Patient's Life. If the Sprain is very slight and moderate, a Plunging of the Part into cold Water is excellent; but if this is not done at once immediately after the Sprain, or if the Contusion is violent, it is even hurtful. The Custom of rolling the naked Foot upon some round Body is insufficient, when the Bones are not perfectly replaced; and hurtful, when the Sprain is accompanied with a Contusion. It happens continually almost that Country People, who encounter such Accidents, apply themselves either to ignorant or knavish Imposters, who find, or are determined to find, a Disorder or Dislocation of the Bones, where there is none; and who, by their violent Manner of handling the Parts, or by the Plaisters they surround them with, bring on a dangerous Inflammation, and change the Patient's Dread of a small Disorder, into a very grievous Malady. These are the very Persons who have created, or indeed rather imagined, some impossible Diseases, such as the Opening, the Splitting of the Stomach, and of the Kidnies. But these big Words terrify the poor Country People, and dispose them to be more easily and effectually duped. _Of Ulcers._ § 453. Whenever Ulcers arise from a general Fault of the Blood, it is impossible to cure them, without destroying the Cause and Fuel of them. It is in Fact imprudent to attempt to heal them up by outward Remedies; and a real Misfortune to the Patient, if his Assistant effectually heals and closes them. But, for the greater Part, Ulcers in the Country are the Consequence of some Wound, Bruise, or Tumour improperly treated; and especially of such as have been dressed with too sharp, or too spirituous Applications. Rancid Oils are also one of the Causes, which change the most simple Wounds into obstinate Ulcers, for which Reason they should be avoided; and Apothecaries should be careful, when they compound greasy Ointments, to make but little at a Time, and the oftner, as a very considerable Quantity of any of them becomes rank before it is all sold; notwithstanding sweet fresh Oil may have been employed in preparing them. § 454. What serves to distinguish Ulcers from Wounds, is the Dryness and Hardness of the Sides or Borders of Ulcers, and the Quality of the Humour discharged from them; which, instead of being ripe consistent Matter, is a Liquid more thin, less white, sometimes yielding a disagreable Scent, and so very sharp, that if it touch the adjoining Skin, it produces Redness, Inflammation, or Pustules there; sometimes a serpiginous, or Ring-worm like Eruption, and even a further Ulceration. § 455. Such Ulcers as are of a long Duration, which spread wide, and discharge much, prey upon the Patient, and throw him into a slow Fever, which melts and consumes him. Besides, when an Ulcer is of a long Standing, it is dangerous to dry it up; and indeed this never should be done, but by substituting in the Place of one Discharge that is become almost natural, some other Evacuation, such as Purging from Time to Time. We may daily see sudden Deaths, or very tormenting Diseases, ensue the sudden drying up such Humours and Drains as have been of a long Continuance: and whenever any Quack (and as many as promise the speedy Cure of such, deserve that Title) assures the Patient of his curing an inveterate Ulcer in a few Days, he demonstrates himself to be a very dangerous and ignorant Intermeddler, who must kill the Patient, if he keeps his Word. Some of these impudent Impostors make use of the most corrosive Applications, and even arsenical ones; notwithstanding the most violent Death is generally the Consequence of them. § 456. The utmost that Art can effect, with Regard to Ulcers, which do not arise from any Fault in the Humours, is to change them into Wounds. To this End, the Hardness and Dryness of the Edges of the Ulcer, and indeed of the whole Ulcer, must be diminished, and its Inflammation removed. But sometimes the Hardness is so obstinate, that this cannot be mollified any other Way, than by scarifying the Edges with a Lancet. But when it may be effected by other Means, let a Pledget spread with the Ointment, Nº. 69, be applied all over the Ulcer; and this Pledget be covered again with a Compress of several Folds, moistened in the Liquid, Nº. 70, which should be renewed three times daily; though it is sufficient to apply a fresh Pledget only twice. As I have already affirmed that Ulcers were often the Consequence of sharp and spirituous Dressings, it is evident such should be abstained from, without which Abstinence they will prove incurable. To forward the Cure, salted Food, Spices, and strong Drink should be avoided; the Quantity of Flesh-meat should be lessened; and the Body be kept open by a Regimen of Pulse, of Vegetables, and by the habitual Use of Whey sweetened with Honey. If the Ulcers are in the Legs, a very common Situation of them, it is of great Importance, as well as in Wounds of the same Parts, that the Patient should walk about but little; and yet never stand up without walking. This indeed is one of these Cases, in which those, who have some Credit and Influence in the Estimation of the People, should omit nothing to make them thoroughly comprehend the Necessity of confining themselves, some Days, to undisturbed Tranquillity and Rest; and they should also convince them, that this Term of Rest is so far from being lost Time, that it is likely to prove their most profitable Time of Life. Negligence, in this material Point, changes the slightest Wounds into Ulcers, and the most trifling Ulcers into obstinate and incurable ones: insomuch that there is scarcely any Man, who may not observe some Family in his Neighbourhood, reduced to the Hospital, [98] from their having been too inattentive to the due Care of some Complaint of this Sort. [98] This seems just the same as _coming on the Parish_, or being received into an Alms house here; in Consequence of such an incurable Disability happening to the poor working Father of a Family. _K._ I conclude this Article on Ulcers with repeating, that those which are owing to some internal Cause; or even such as happen from an external one, in Persons of a bad Habit of Body, frequently require a more particular Treatment. _Of Frozen Limbs._ § 457. It is but too common, in very rigorous Winters, for some Persons to be pierced with so violent a Degree of Cold, that their Hands or Feet, or sometimes both together are frozen at once, just like a Piece of Flesh-meat exposed to the Air. If a Person thus pierced with the Cold, dispose himself to walk about, which seems so natural and obvious a Means to get warm; and especially, if he attempts to [99] warm the Parts that have been frozen, his Case proves irrecoverable. Intolerable Pains are the Consequence, which Pains are speedily attended with an incurable Gangrene; and there is no Means left to save the Patient's Life, but by cutting off the gangrened Limbs. [99] The Reason of the Fatality of Heat, in these Cases, and of the Success of an opposite Application, (See § 459) seems strictly and even beautifully analogous to what _Hippocrates_ has observed of the Danger, and even Fatality, of all great and sudden Changes in the human Body, whether from the Weather or otherwise. Whence this truly great Founder of Physick, when he observes elsewhere, that Diseases are to be cured by something contrary to their Causes, very consistently advises, not a direct and violent Contrariety, but a gradual and regulated one, a _Sub-contrariety_. _K._ There was a very late and terrible Example of this, in the Case of an Inhabitant at _Cossonay_, who had both his Hands frozen. Some greasy Ointments were applied hot to them, the Consequence of which was, the Necessity of cutting off six of his Fingers. § 458. In short, there is but one certain Remedy in such Cases, and this is to convey the Person affected into some Place where it does not freeze, but where, however, it is but very moderately hot, and there continually to apply, to the frozen Parts, Snow, if it be at hand; and if not, to keep washing them incessantly, but very gently (since all Friction would at this Juncture prove dangerous) in Ice-water, as the Ice thaws in the Chamber. By this Application the Patients will be sensible of their Feeling's returning very gradually to the Part, and that they begin to recover their Motion. In this State they may Safely be moved into a Place a little warmer, and drink some Cups of the Potion Nº. 13, or of another of the like Quality. § 459. Every Person may be a competent judge of the manifest Danger of attempting to relieve such Parts by heating them, and of the Use of Ice-water, by a common, a daily Experience. Frozen Pears, Apples, and Radishes, being put into Water just about to freeze, recover their former State, and prove quickly eatable. But if they are put into warm Water, or into a hot Place, Rottenness, which is one Sort of Gangrene, is the immediate Effect. The following Case will make this right Method of treating them still more intelligible, and demonstrate its Efficacy. A Man was travelling to the Distance of six Leagues in very cold Weather; the Road being covered with Snow and Ice. His Shoes, not being very good, failed him on his March, so that he walked the three last Leagues bare-footed; and felt, immediately after the first Half League, sharp Pains in his Legs and Feet, which increased as he proceeded. He arrived at his Journey's End in a Manner nearly deprived of his lower Extremities. They set him before a great Fire, heated a Bed well, and put him into it. His Pains immediately became intolerable: he was incessantly in the most violent Agitations, and cried out in the most piercing and affecting Manner. A Physician, being sent for in the Night, found his Toes of a blackish Colour, and beginning to lose their Feeling. His Legs and the upper Part of his Feet, which were excessively swelled, of a purplish Red, and varied with Spots of a violet Colour, were still sensible of the most excruciating Pains. The Physician ordered in a Pail of Water from the adjoining River, adding more to it, and some Ice withal. In this he obliged the Patient to plunge his Legs; they were kept in near an Hour, and within that Time, the Pains became less violent. After another Hour he ordered a second cold Bath, from which the Patient perceiving still further Relief, prolonged it to the Extent of two Hours. During that Time, some Water was taken out of the Pail, and some Ice and Snow were put into it. Now his Toes, which had been black, grew red; the violet Spots in his Legs disappeared; the Swelling abated; the Pains became moderate, and intermitted. The Bath was nevertheless repeated six times; after which there remained no other Complaint, but that of a great Tenderness or extraordinary Sensibility in the Soles of his Feet, which hindered him from walking. The Parts were afterwards bathed with some aromatic Fomentations; and he drank a Ptisan of Sarsaparilla [one of Elder Flowers would have answered the same Purpose, and have been less expensive.] On the eighth Day from his Seizure he was perfectly recovered, and returned home on Foot on the fifteenth. § 460. When cold Weather is extremely severe, and a Person is exposed to it for a long Time at once, it proves mortal, in Consequence of its congealing the Blood, and because it forces too great a Proportion of Blood up to the Brain; so that the Patient dies of a Kind of Apoplexy, which is preceded by a Sleepiness. In this Circumstance the Traveller, who finds himself drowsy, should redouble his Efforts to extricate himself from the eminent Danger he is exposed to. This Sleep, which he might consider as some Alleviation of his Sufferings, if indulged, would prove his last. § 461. The Remedies in such Cases are the same with those directed in frozen Limbs. The Patient must be conducted to an Apartment rather cold than hot, and be rubbed with Snow or with Ice-water. There have been many well attested Instances of this Method; and as such Cases are still more frequent in more northern Climates, a Bath of the very coldest Water has been found the surest Remedy. Since it is known that many People have been revived, who had remained in the Snow, or had been exposed to the freezing Air during five, or even six successive Days, and who had discovered no one Mark of Life for several Hours, the utmost Endeavours should be used for the Recovery of Persons in the like Circumstances and Situation. _Of Kibes, or Chilblains._ § 462. These troublesome and smarting Complaints attack the Hands, Feet, Heels, Ears, Nose and Lips, those of Children especially, and mostly in Winter; when these Extremities are exposed to the sudden Changes from hot to cold, and from cold to hot Weather. They begin with an Inflation or kind of Swelling, which, at first, occasions but little Heat, Pain or Itching. Sometimes they do not exceed this first State, and go off spontaneously without any Application: But at other Times (which may be termed the second Degree of the Disorder, whether it happens from their being neglected, or improperly treated) their Heat, Redness, Itching and Pain increase considerably; so that the Patient is often deprived of the free Use of his Fingers by the Pain, Swelling and Numbness: in which Case the Malady is still aggravated, if effectual Means are not used. Whenever the Inflammation mounts to a still higher Degree, small Vesications or Blisters are formed, which are not long without bursting; when they leave a slight Excoriation, or Rawness, as it were, which speedily ulcerates, and frequently proves a very deep and obstinate Ulcer, discharging a sharp and ill-conditioned Matter. The last and most virulent Degree of Chilblains, which is not infrequent in the very coldest Countries, though very rare in the temperate ones, is, when the Inflammation degenerates into a Gangrene. § 463. These Tumours are owing to a Fulness and Obstruction of the Vessels of the Skin, which occurs from this Circumstance, that the Veins, which are more superficial than the Arteries, being proportionably more affected and straitened by the Cold, do not carry off all the Blood communicated to them by the Arteries; and perhaps also the Particles or Atoms of Cold, which are admitted through the Pores of the Skin, may act upon our Fluids, as it does upon Water, and occasion a Congelation of them, or a considerable Approach towards it. If these Complaints are chiefly felt, which in Fact is the Case, rather on the extreme Parts than on others, it arises from two Causes, the principal one being, that the Circulation's being weaker at the Extremities than elsewhere, the Effect of those Causes, that may impair it, must be more considerably felt there. The second Reason is, because these Parts are more exposed to the Impressions from without than the others. They occur most frequently to Children, from their Weakness and the greater Tenderness and Sensibility of their Organs, which necessarily increases the Effect of external Impressions. It is the frequent and strong Alteration from Heat to Cold, that seems to contribute the most powerfully to the Production of Chilblains; and this Effect of it is most considerable, when the Heat of the Air is at the same Time blended with Moisture; whence the extreme and superficial Parts pass suddenly as it were, out of a hot, into a cold, Bath. A Man sixty Years of Age, who never before was troubled with Kibes, having worn, for some Hours on a Journey, a Pair of furred Gloves, in which his Hands sweated, felt them very tender, and found them swelled up with Blood: as the common Effect of the warm Bath is to soften and relax, and to draw Blood abundantly to the bathed Parts, whence it renders them more sensible. This Man, I say, thus circumstanced, was at that Age first attacked with Chilblains, which proved extremely troublesome; and he was every succeeding Winter as certainly infested with them, within Half an Hour after he left off his Gloves, and was exposed to a very cold Air. It is for this Reason, that several Persons are never infested with Chilblains, but when they use themselves to Muffs, which are scarcely known in hot Countries; nor are they very common among the more northern ones, in which the extraordinary Changes from Cold to Heat are very rare and unusual. Some People are subject to this troublesome Complaint in the Fall; while others have it only in the Spring. The Child of a labouring Peasant, who has a hard Skin, and one inured to all the Impressions of the Seasons and of the Elements, is, and indeed necessarily must be, less liable to Kibes, than the Child of a rich Citizen, whose Skin is often cherished, at the Expence of his Constitution. But even among Children of the same Rank in Life and Circumstances, who seem pretty much of the same Complexion, and live much in the same Manner; whence they might of Course be supposed equally liable to the same Impressions, and to the like Effects of them, there is, nevertheless, a very great Difference with Respect to their constitutional Propensity to contract Chilblains. Some are very cruelly tormented with them, from the setting in of Autumn, to the very End of the Spring: others have either none at all, or have them but very slightly, and for a very short Time. This Difference undoubtedly arises from the different Quality of their Humours, and the Texture of their whole Surface, but particularly from that of the Skin of their Hands; though we readily confess it is by no Means easy to determine, with Certainty and Precision, in what this Difference essentially consists. Children of a sanguine Complexion and delicate Skin are pretty generally subject to this Disorder, which is often regarded much too slightly, though it is really severe enough to engage our Attention more; since, even abstracted from the sharp Pains which smart these unhappy Children for several Months; it sometimes gives them a Fever, hinders them from sleeping, and yet confines them to their Bed, which is very prejudicial to their Constitutions. It also breaks in upon the Order of their different Duties and Employments; it interrupts their innocent salutary Pleasures; and sometimes, when they are obliged to earn their daily Bread by doing some Work or other, it sinks them down to Misery. I knew a young Man, who from being rendered incapable by Chilblains, of serving out his Apprenticeship to a Watch-maker, is become a lazy Beggar. Chilblains which attack the Nose, often leave a Mark that alters the Physiognomy, the Aspect of the Patient, for the Remainder of his Life: and the Hands of such as have suffered from very obstinate ones, are commonly ever sensible of their Consequences. § 464. With Respect, therefore, to these afflicting Tumours and Ulcerations, we should, in the first Place, do our utmost to prevent them; and next exert our best Endeavours to cure such as we could not prevent. § 465. Since they manifestly depend on the Sensibility of the Skin, the Nature of the Humours, and the Changes of the Weather from Heat to Cold, in Order to prevent them, in the first Place, the Skin must be rendered firmer or less tender. 2, That vicious Quality of the Temperament, which contributes to their Existence, must be corrected; and, 3, the Persons so liable must guard themselves as well as possible, against these Changes of the Weather. Now the Skin of the Hands, as well as that of the whole Body, may be strengthened by that Habit of washing or bathing in cold Water, which I have described at large, § 384; and in Fact I have never seen Children, who had been early accustomed and inured to this Habit, as much afflicted with Chilblains as others. But still a more particular Regard should be had to fortify the Skin of the Hands, which are more obnoxious to this Disorder than the Feet, by making Children dip them in cold Water, and keep them for some Moments together in it every Morning, and every Evening too before Supper, from the very Beginning of the Fall. It will give the Children no Sort of Pain, during that Season, to contract this Habit; and when it is once contracted, it will give them no Trouble to continue it throughout the Winter, even when the Water is ready to freeze every where. They may also be habituated to plunge their Feet into cold Water twice or thrice a Week: and this Method, which might be less adapted for grown Persons, who had not been accustomed to it, must be without Objection with Respect to such Children, as have been accustomed to it; to whom all its Consequences must be useful and salutary. At the same Time Care must be taken not to defeat or lessen the Effect of the cold bathing, by suffering the Bather or Washer, to grow too warm between two Baths or Dippings; which is also avoiding the too speedy Successions of Heat and Cold. For this Purpose, 1, the Children must be taught never to warm their Hands before the Fire at such Times, and still less before the Stoves, which very probably are one of the principal Causes of Chilblains, that are less usual in Countries which use no such Stoves, and among those Individuals who make the least Use of them, where they are. Above all, the Use of _Cavettes_ (that is, of Seats or little Stairs, as it were, contrived between the Stove and the Wall) is prejudicial to Children, and even to grown People, upon several Accounts. 2, They should never accustom themselves to wear Muffs. 3, It would be also proper they should never use Gloves, unless some particular Circumstances require it; and I recommend this Abstinence from Gloves, especially to young Boys: but if any should be allowed them, let the Gloves be thin and smooth. § 466. When Chilblains seem to be nourished by some Fault in the Temperament or Humours, the Consideration of a Physician becomes necessary, to direct a proper Method of removing or altering it. I have seen Children from the Age of three, to that of twelve or thirteen Years, in whom their Chilblains, raw and flead, as it were, for eight Months of the Year, seemed to be a particular Kind of Issue, by which Nature freed herself of an inconvenient Superfluity of Humours, when the Perspiration was diminished by the Abatement of the violent Heats. In such Cases I have been obliged to carry them through a pretty long Course of Regimen and Remedies; which, however, being necessarily various from a Variety of Circumstances, cannot be detailed here. The milder Preparations of Antimony are often necessary in such Cases; and some Purges conduce in particular ones to allay and to abridge the Disorder. § 467. The first Degree of this Complaint goes off, as I have already said, without the Aid of Medicine; or should it prove somewhat more obstinate, it may easily be dissipated by some of the following Remedies. But when they rise to the second Degree, they must be treated like other Complaints from Congelation, or Frost-biting (of which they are the first Degree) with cold Water, Ice-water and Snow. No other Method or Medicine is nearly as efficacious as very cold Water, so as to be ready to freeze, in which the Hands are to be dipt and retained for some Minutes together, and several Times daily. In short it is the only Remedy which ought to be applied, when the Hands are the Parts affected; when the Patient has the Courage to bear this Degree of Cold; and when he is under no Circumstance which may render it prejudicial. It is the only Application I have used for myself, after having been attacked with Chilblains for some Years past, from having accustomed myself to too warm a Muff. There ensues a slight Degree of Pain for some Moments after plunging the Hand into Water, but it diminishes gradually. On taking the Hand out, the Fingers are numbed with the Cold, but they presently grow warm again; and within a Quarter of an Hour, it is entirely over. The Hands, on being taken out of the Water, are to be well dried, and put into Skin Gloves; after bathing three or four Times, their Swelling subsides, so that the Skin wrinkles: but by continuing the cold Bathing, it grows tight and smooth again; the Cure is compleated after using it three or four Days; and, in general, the Disorder never returns again the same Winter. The most troublesome raging Itching is certainly assuaged by plunging the Hands into cold Water. The Effect of Snow is, perhaps, still more speedy: the Hands are to be gently and often rubbed with it for a considerable Time; they grow hot, and are of a very high Red for some Moments, but entire Ease very quickly succeeds. Nevertheless, a very small Number of Persons, who must have extremely delicate and sensible Skins, do not experience the Efficacy of this Application. It seems too active for them; it affects the Skin much like a common blistering Plaister; and by bringing on a large flow of Humours there, it increases, instead of lessening the Complaint. § 468. When this last Reason indeed, or some other Circumstance exists; such as the Child's Want of Courage, or its Affliction; the monthly Discharges in a Woman; a violent Cough; habitual Colics; and some other Maladies, which have been observed to be renewed or aggravated by the Influence of Cold at the Extremities, do really forbid this very cold Application, some others must be substituted. One of the best is to wear Day and Night, without ever putting it off, a Glove made of some smooth Skin, such as that of a Dog; which seldom fails to extinguish the Disorder in some Days time. When the Feet are affected with Chilblains, Socks of the same Skin should be worn; and the Patient keep close to his Bed for some Days. § 469. When the Disorder is violent, the Use of cold Water prohibited, and the Gloves just recommended have but a slow Effect, the diseased Parts should be gently fomented or moistened several times a Day, with some Decoction, rather more than warm; which at the same time should be dissolving and emollient. Such is that celebrated Decoction of the Scrapings, the Peel of Radishes, whose Efficacy is still further increased, by adding one sixth Part of Vinegar to the Decoction. Another Decoction, of whose great Efficacy I have been a Witness, but which dies the Hands yellow for a few Days, is the Prescription Nº. 71. Many others may be made, of nearly the same Virtues, with all the vulnerary Herbs, and even with the _Faltranc_. Urine, which some boast of in these Cases, from their having used it with Success; and the Mixture of Urine and Lime-water have the like Virtues with the former Decoctions. [100] �[100] Chilblains may also be advantageously washed with Water and Flower of Mustard, which will concur, in a certain and easy Manner, both to cleanse and to cure them. _E. L._ As soon as the Hands affected are taken out of these Decoctions, they must be defended from the Air by Gloves. § 470. Vapours or Steams are often more efficacious than Decoctions; whence instead of dipping the Hands into these already mentioned, we may expose them to their Vapours, with still more Success. That of hot Vinegar is one of the most powerful Remedies; those of [101] _Asphalt_, or of Turpentine have frequently succeeded too. It may be needless to add that the affected Parts must be defended from the Air, as well after the Steams as the Decoctions; since it is from this Cause of keeping off the Air, that the Cerecloths are of Service; and hence also the Application of Suet has sometimes answered. �[101] This is or should be, the same with the _Bitumen Judaicum_, formerly kept in the Shops; but which is never directed, except in that strange Medley the _Venice_ Treacle, according to the old Prescription. The best is found in _Egypt_, and on the _Red Sea_: but a different Sort, from _Germany_, _France_, and _Swisserland_, is now generally substituted here. _K._ When the Distemper is subdued by the Use of Bathings or Steams, which make the Skin supple and soft, then it should be strengthened by washing the Parts with a little camphorated Brandy, diluted with an equal Quantity of Water. § 471. When the Nose is affected with a Chilblain, the Steam of Vinegar, and an artificial Nose, or Covering for it, made of Dog-skin, are the most effectual Applications. The same Treatment is equally proper for the Ears and the Chin, when infested with them. Frequently washing these Parts in cold Water is a good Preservative from their being attacked. § 472. Whenever the Inflammation rises very high, and brings on some Degree of a Fever, the Patient's usual Quantity of strong Drink and of Flesh-meat must be lessened; his Body should be kept open by a few Glysters; he should take every Evening a Dose of Nitre as prescribed, Nº. 20; and if the Fever proved strong, he should lose some Blood too. As many as are troubled with obstinate Chilblains, should always be denied the Use of strong Liquor and Flesh. § 473. When this Distemper prevails in its third Degree, and the Parts are ulcerated; besides keeping the Patients strictly to the Regimen of Persons in a Way of Recovery, and giving them a Purge of Manna, the swelled Parts should be exposed to the Steams of Vinegar; the Ulcerations should be covered with a Diapalma Plaister; and the whole Part should be enveloped in a smooth soft Skin, or in thin Cerecloths. § 474. The fourth Degree of this Disease, in which the Parts become gangrenous, must be prevented by the Method and Medicines which remove an Inflammation; but if unhappily a Gangrene has already appeared, the Assistance of a Surgeon proves indispensably necessary. _Of Ruptures._ § 475. _Hernias_ or Ruptures, which Country-People term _being bursten_, are a Disorder which sometimes occurs at the very Birth; though more frequently they are the Effects of violent crying, of a strong forcing Cough, or of repeated Efforts to vomit, in the first Months of Infancy. They may happen afterwards indiscriminately at every Age, either as Consequences of particular Maladies, or Accidents, or from Peoples' violent Exertions of their Strength. They happen much oftner to Men than Women; and the most common Sort, indeed the only one of which I propose to treat, and that but briefly, is that which consists in the Descent of a Part of the Guts, or of the Cawl, into the Bag or Cod-piece. It is not difficult to distinguish this Rupture. When it occurs in little Children, it is almost ever cured by making them constantly wear a Bandage which should be made only of Fustian, with a little Pillow or Pincushion, stuffed with Linen Rags, Hair or Bran. There should be at least two of these Bandages, to change them alternately; nor should it ever be applied, but when the Child is laid down on its Back, and after being well assured that the Gut or Cawl, which had fallen down, has been safely returned into the Cavity of the Belly; since without this Precaution it might occasion the worst Consequences. The good Effect of the Bandage may be still further promoted, by applying upon the Skin, and within the Plait or Fold of the Groin (under which Place the Rings, or Passage out of the Belly into the Bag lie) some pretty astringent or strengthening Plaister, such as that commonly used for Fractures, or that I have already mentioned, § 144. Here we may observe by the Way, that ruptured Children should never be set on a Horse, nor be carried by any Person on Horseback, before the Rupture is perfectly cured. § 476. In a more advanced Age, a Bandage only of Fustian is not sufficient; one must be procured with a Plate of Steel, even so as to constrain and incommode the Wearer a little at first: nevertheless it soon becomes habitual, and is then no longer inconvenient to them. § 477. Ruptures sometimes attain a monstrous Size; and a great Part of the Guts fall down in to the _Scrotum_ or Bag, without any Symptom of an actual Disease. This Circumstance, nevertheless, is accompanied with very great Inconvenience, which disables Persons affected with it to work; and whenever the Malady is so considerable, and of a long Standing too, there are commonly some Obstacles that prevent a compleat Return of the Guts into the Belly. In this State indeed, the Application of the Bandage or Truss is impracticable, and the miserable Patients are condemned to carry their grievous Burthen for the Remainder of their Lives; which may however, be palliated a little by the Use of a Suspensory and Bag, adapted to the Size of the Rupture. This Dread of its increasing Magnitude is a strong Motive for checking the Progress of it, when it first appears. But there is another still stronger, which is, that Ruptures expose the Patient to a Symptom frequently mortal. This occurs when that Part of the Intestines fallen into the _Scrotum_ inflames; when still increasing in its Bulk, and being extremely compressed, acute Pains come on: for now from the Increase of the Rupture's Extent, the Passage which gave Way to its Descent, cannot admit of its Return or Ascent; the Blood-vessels themselves being oppressed, the Inflammation increases every Moment; the Communication between the Stomach and the Fundament is often entirely cut off; so that nothing passes through, but incessant Vomitings come on [this being the Kind of _Miserere_, or Iliac Passion I have mentioned, § 320] which are succeeded by the Hickup, Raving, Swooning, cold Sweats, and Death. § 478. This Symptom supervenes in Ruptures, when the Excrements become hard in that Part of the Guts fallen into the _Scrotum_; when the Patient is overheated with Wine, Drams, an inflammatory Diet, _&c._ or when he has received a Stroke on the ailing Part, or had a Fall. § 479. The best Means and Remedies are, 1, as soon as ever this Symptom or Accident is manifest, to bleed the Patient very plentifully, as he lies down in his Bed and upon his Back, with his Head a little raised, and his Legs somewhat bent, so that his Knees may be erect. This is the Attitude or Posture they should always preserve as much as possible. When the Malady is not too far advanced, the first Bleeding often makes a compleat Cure; and the Guts return up as soon as it is over. At other Times this Bleeding is less successful, and leaves a Necessity for its Repetition. 2, A Glyster must be thrown up consisting of a strong Decoction of the large white Beet Leaves, with a small Spoonful or Pinch of common Salt, and a Bit of fresh Butter of the Size of an Egg. 3, Folds of Linen dipt in Ice-water must be applied all over the Tumour, and constantly renewed every Quarter of an Hour. This Remedy, when immediately applied, has produced the most happy Effects; but if the Symptom has endured violently more than ten or twelve Hours, it is often too late to apply it; and then it is better to make Use of Flanels dipt in a warm Decoction of Mallow and Elder Flowers, shifting them frequently. It has been known however, that Ice-water, or Ice itself has succeeded as late as the third Day. [102] �[102] Pieces of Ice applied between two Pieces of Linen, directly upon the Rupture, as soon as possible after its first Appearance, is one of those extraordinary Remedies, which we should never hesitate to make immediate Use of. We may be certain by this Application, if the Rupture is simple, and not complicated from some aggravating Cause, to remove speedily, and with very little Pain, a Disorder, that might be attended with the most dreadful Consequences. But the Continuance of this Application must be proportioned to the Strength of the Person ruptured, which may be sufficiently estimated by the Pulse. _E. L._ 4, When these Endeavours are insufficient, Glysters of Tobacco Smoke must be tried, which has often redressed and returned Ruptures, when every Thing else had failed. 5, And lastly, if all these Attempts are fruitless, the Operation must be resolved on, without losing a Moment's Time; as this local Disease proves sometimes mortal in the Space of two Days; but for this Operation an excellent Surgeon is indispensably necessary. The happy Consequence with which I have ordered it, in a most desperate Case since the first Edition of this Work, on the sixth Day after a Labour, has convinced me, still more than any former Observation I had made, that the Trial of it ought never to be omitted, when other Attempts have been unavailing. It cannot even hasten the Patient's Death, which must be inevitable without it, but it rather renders that more gentle, where it might fail to prevent it. When it is performed as Mr. _Levade_ effected it, in the Case I have just referred to, the Pain attending it is very tolerable and soon over. I shall not attempt to describe the Operation, as I could not explain myself sufficiently to instruct an ignorant Surgeon in it; and an excellent and experienced one must be sufficiently apprized of all I could say concerning it. A certain Woman in this Place, but now dead, had the great and impudent Temerity to attempt this Operation, and killed her Patients after the most excruciating Torments, and an Extirpation, or cutting away of the Testicle; which Quacks and ignorant Surgeons always do, but which a good Surgeon never does in this Operation. This is often the Custom too (in Country Places) of those Caitiffs, who perform this Operation without the least Necessity; and mercilessly emasculate a Multitude of Infants; whom Nature, if left to her own Conduct, or assisted only by a simple Bandage, would have perfectly cured; instead of which, they absolutely kill a great many, and deprive those of their Virility, who survive their Robbery and Violence. It were religiously to be wished such Caitiffs were to be duly, that is, severely punished; and it cannot be too much inculcated into the People, that this Operation (termed the _Bubonocele_) in the Manner it is performed by the best Surgeons, is not necessary; except in the Symptoms and Circumstances I have mentioned, and that the cutting off the Testicle never is so. _Of Phlegmons or Boils._ § 480. Every Person knows what Boils are at Sight, which are considerably painful when large, highly inflamed, or so situated as to incommode the Motions, or different Positions of the Body. Whenever their Inflammation is very considerable; when there are a great many of them at once, and they prevent the Patients from sleeping, it becomes necessary to enter them into a cooling Regimen; to throw up some opening Glysters; and to make them drink plentifully of the Ptisan, Nº. 2. Sometimes it is also necessary to bleed the Patient. Should the Inflammation be very high indeed, a Pultice of Bread and Milk, or of Sorrel a little boiled and bruised, must be applied to it. But if the Inflammation is only moderate, a Mucilage Plaister, or one of the simple Diachylon, may be sufficient. Diachylon with the Gums is more active and efficacious; but it so greatly augments the Pain of some Persons afflicted with Boils, that they cannot bear it. Boils, which often return, signify some Fault in the Temperament, and frequently one so considerable, that might dispose a Physician to be so far apprehensive of its Consequences, as to enquire into the Cause, and to attempt the Extinction of it. But the Detail of this is no Part nor Purpose of the present Work. § 481. The Phlegmon, or Boil, commonly terminates in Suppuration, but a Suppuration of a singular Kind. It breaks open at first on its Top, or the most pointed Part, when some Drops of a _Pus_ like that of an Abscess comes out, after which the Germ, or what is called the Core of it may be discerned. This is a purulent Matter or Substance, but so thick and tenacious, that it appears like a solid Body; which may be drawn out entirely in the Shape of a small Cylinder, like the Pith of Elder, to the Length of some Lines of an Inch; sometimes to the Length of a full Inch, and even more. The Emission of this Core is commonly followed by the Discharge of a certain Quantity, according to the Size of the Tumour, of liquid Matter, spread throughout the Bottom of it. As soon as ever this Discharge is made, the Pain goes entirely off; and the Swelling disappears at the End of a few Days, by continuing to apply the simple Diachylon, or the Ointment Nº. 66. _Of Fellons or Whitlows._ § 482. The Danger of these small Tumours is much greater than is generally supposed. It is an Inflammation at the Extremity or End of a Finger, which is often the Effect of a small Quantity of Humour extravasated, or stagnant, in that Part; whether this has happened in Consequence of a Bruise, a Sting, or a Bite. At other times it is evident that it has resulted from no external Cause, but is the Effect of some inward one. It is distinguished into many Kinds, according to the Place in which the Inflammation begins; but the essential Nature of the Malady is always the same, and requires the same Sort of Remedies. Hence such as are neither Physicians nor Surgeons, may spare themselves the Trouble of enquiring into the Divisions of this Distemper; which, though they vary the Danger of it, and diversify the Manner of the Surgeons Operation, yet have no Relation to the general Treatment of it; the Power and Activity of which must be regulated by the Violence of the Symptoms. § 483. This Disorder begins with a slow heavy Pain, attended by a slight Pulsation, without Swelling, without Redness, and without Heat; but in a little Time the Pain, Heat, and Pulsation or Throbbing becomes intolerable. The Part grows very large and red; the adjoining Fingers and the whole Hand swelling up. In some Cases a Kind of red and inflated Fuse or Streak may be observed, which, beginning at the affected Part, is continued almost to the Elbow; neither is it unusual for the Patients to complain of a very sharp Pain under the Shoulder; and sometimes the whole Arm is excessively inflamed and swelled. The Sick have not a Wink of Sleep, the Fever and other Symptoms quickly increasing. If the Distemper rises to a violent Degree indeed, a _Delirium_ and Convulsions supervene. This Inflammation of the Finger determines, either in Suppuration, or in a Gangrene. When the last of these occurs, the Patient is in very great Danger, if he is not very speedily relieved; and it has proved necessary more than once to cut off the Arm, for the Preservation of his Life. When Suppuration is effected, if the Matter lies very deep and sharp, or if the Assistance of a Surgeon has arrived too late, the Bone of the last _Phalanx_, or Row of Bones of the Finger, is generally carious and lost. But how gentle soever the Complaint has been, the Nail is very generally separated and falls off. § 484. The internal Treatment in Whitlows, is the same with that in other inflammatory Distempers. The Patient must enter upon a Regimen more or less strict, in Proportion to the Degree of the Fever; and if this runs very high, and the Inflammation be very considerable, there may be a Necessity for several Bleedings. The external Treatment consists in allaying the Inflammation; in softening the Skin; and in procuring a Discharge of the Matter, as soon as it is formed. For this Purpose, 1, The Finger affected is to be plunged, as soon as the Disorder is manifest, in Water a little more than warm: the Steam of boiling Water may also by admitted into it; and by doing these Things almost constantly for the first Day, a total Dissipation of the Malady has often been obtained. But unhappily it has been generally supposed, that such slight Attacks could have but very slight Consequences, whence they have been neglected until the Disorder has greatly advanced; in which State Suppuration becomes absolutely necessary. 2, This Suppuration therefore may be forwarded, by continually involving the Finger, as it were, in a Decoction of Mallow Flowers boiled in Milk, or with a Cataplasm of Bread and Milk. This may be rendered still more active and ripening, by adding a few white Lilly Roots, or a little Honey. But this last must not be applied before the Inflammation is somewhat abated, and Suppuration begins; before which Term, all sharp Applications are very dangerous. At this Time, Yeast or Leaven may be advantagiously used, which powerfully promotes Suppuration. The Sorrel Pultice, mentioned § 480, is also a very efficacious one. § 485. A speedy Discharge of the ripe Matter is of considerable Importance, but this particularly requires the Attention of the Surgeon; as it is not proper to wait till the Tumour breaks and discharges of itself; and this the rather, as from the Skin's proving sometimes extremely hard, the Matter might be inwardly effused between the Muscles, and upon their Membranes, before it could penetrate through the Skin. For this Reason, as soon as Matter is suspected to be formed, a Surgeon should be called in, to determine exactly on the Time, when an Opening should be made; which had better be performed a little too soon than too late; and a little too deep, than not deep enough. When the Orifice has been made, and the Discharge is effected, it is to be dressed up with the Plaister Nº. 66, spread upon Linen, or with the Cerecloth; and these Dressings are to be repeated daily. § 486. When the Whitlow is caused by a Humour extravasated very near the Nail, an expert Surgeon speedily checks its Progress, and cures it effectually by an Incision which lets out the Humour. Yet, notwithstanding this Operation is in no wise difficult, all Surgeons are not qualified to perform it, and but too many have no Idea at all of it. § 487. Fungous, or, as it is commonly called, proud Flesh sometimes appears during the incarning or healing of the Incision. Such may be kept down with sprinkling a little _Minium_ (red Lead) or burnt Alum over it. § 488. If a _Caries_, a Rottenness of the Bone, should be a Consequence, there is a Necessity for a Surgeon's Attendance, as much as if there was a Gangrene; for which Reason, I shall add nothing with Respect to either of these Symptoms; only observing, there are three very essential Remedies against the last; _viz._ the Bark, Nº. 14, a Drachm of which must be taken every two Hours; Scarifications throughout the whole gangrened Part; and Fomentations with a Decoction of the Bark, and the Addition of Spirit of Sulphur. This Medicine is certainly no cheap one; but a Decoction of other bitter Plants, with the Addition of Spirit of Salt, may sometimes do instead of it. And here I take leave to insist again upon it, that in most Cases of gangrened Limbs, it is judicious not to proceed to an Amputation of the mortified Part, till the Gangrene stops, which may be known by a very perceivable Circle, (and easily distinguished by the most ignorant Persons) that marks the Bounds of the Gangrene, and separates the living from the mortified Parts. _Of Thorns, Splinters, or other pointed Substances piercing into the Skin, or Flesh._ § 489. It is very common for the Hands, Feet or Legs, to be pierced by the forcible Intrusion of small pointed Substances, such as Thorns or Prickles, whether of Roses, Thistles or Chestnuts, or little Splinters of Wood, Bone, _&c._ If such Substances are immediately and entirely extracted, the Accident is generally attended with no bad Consequences; though more certainly to obviate any such, Compresses of Linen dipt in warm Water may be applied to the Part, or it may be kept a little while in a warm Bath. But if any such pointed penetrating Body cannot be directly extracted, or if a Part of it be left within, it causes an Inflammation, which, in its Progress, soon produces the same Symptoms as a Whitlow: or if it happens in the Leg, it inflames and forms a considerable Abscess there. § 490. To prevent such Consequences, if the penetrating Substance is still near the Surface, and an expert Surgeon is at Hand, he must immediately make a small Incision, and thence extract it. But if the Inflammation were already formed, this would be useless, and even dangerous. When the Incision, therefore, is improper; there should be applied to the affected Part, (after conveying the Steam of some hot Water into it) either some very emollient Pultices of the Crumb of Bread, Milk and Oil, or some very emollient unctuous Matter alone, the Fat of a [103] Hare being generally employed in such Cases, and being indeed very effectual to relax and supple the Skin; and, by thus diminishing its Resistance, to afford the offensive penetrating Body an Opportunity of springing forth. Nothing however, but the grossest Prejudice, could make any one imagine, that this Fat attracted the Splinter, Thorn, or any other intruded Substance by any sympathetic Virtue; no other Sympathy in Nature being clearly demonstrated, except that very common one between wrong Heads, and absurd extravagant Opinions. �[103] These Creatures perhaps are fatter in _Swisserland_, than we often see them here. _K._ It is absolutely necessary that the injured Part should be kept in the easiest Posture, and as immoveable as possible. If Suppuration has not been prevented by an immediate Extraction of the offending Substance, the Abscess should be opened as soon as ever Matter is formed. I have known very troublesome Events from its being too long delayed. § 491. Sometimes the Thorn, after having very painfully penetrated through the Teguments, the Skin, enters directly into the Fat; upon which the Pain ceases, and the Patient begins to conclude no sharp prickling Substance had ever been introduced into the Part; and of Course supposes none can remain there. Nevertheless some Days after, or, in other Instances, some Weeks, fresh Pains are excited, to which an Inflammation and Abscess succeed, which are to be treated as usual, with Emollients, and seasonably opened. A Patient has been reduced to lose his Hand, in Consequence of a sharp Thorn's piercing into his Finger; from its having been neglected at first, and improperly treated afterwards. _Of Warts._ § 492. Warts are sometimes the Effects of a particular Fault in the Blood, which feeds and extrudes a surprizing Quantity of them. This happens to some Children, from four to ten Years old, and especially to those who feed most plentifully on Milk or Milk-meats. They may be removed by a moderate Change of their Diet, and the Pills prescribed Nº. 18. But they are more frequently an accidental Disorder of the Skin, arising from some external Cause. In this last Case, if they are very troublesome in Consequence of their great Size, their Situation or their long Standing, they may be destroyed, 1, by tying them closely with a Silk Thread, or with a strong flaxen one waxed. 2, By cutting them off with a sharp Scissars or a Bistory, and applying a Plaister of Diachylon, with the Gums, over the cut Wart, which brings on a small Suppuration that may destroy or dissolve the Root of the Wart: and, 3, By drying, or, as it were, withering them up by some moderately corroding Application, such as that of the milky Juice of [104] Purslain, of Fig-leaves, of _Chelidonium_ (Swallow-wort) or of Spurge. But besides these corroding vegetable Milks being procurable only in Summer, People who have very delicate thin Skins should not make Use of them, as they may occasion a considerable and painful Swelling. Strong Vinegar, charged with as much common Salt as it will dissolve, is a very proper Application to them. A Plaister may also be composed from Sal Ammoniac and some Galbanum, which being kneaded up well together and applied, seldom fails of destroying them. �[104] Our Garden Purslain, though a very juicy Herb, cannot strictly be termed milky. In the hotter Climates where it is wild, and grows very rankly, they sometimes boil the Leaves and Stalks (besides eating them as a cooling Salad) and find the whole an insipid mucilaginous Pot-herb. But Dr. _Tissot_ observes to me, that its Juice will inflame the Skin; and that some Writers on Diet, who disapprove it internally, affirm they have known it productive of bad Effects. Yet none such have ever happened to myself, nor to many others, who have frequently eaten of it. Its Seeds have sometimes been directed in cooling Emulsions. The Wart Spurge is a very milky and common Herb, which flowers in Summer here. _K._ The most powerful Corrosives should never be used, without the Direction of a Surgeon; and even then it is full as prudent not to meddle with them, any more than with actual Cauteries. I have lately seen some very tedious and troublesome Disorders and Ulcerations of the Kidnies, ensue the Application of a corrosive Water, by the Advice of a Quack. Cutting them away is a more certain, a less painful, and a less dangerous Way of removing them. Wens, if of a pretty considerable Size, and Duration, are incurable by any other Remedy, except Amputation. _Of Corns._ § 493. The very general or only Causes of Corns, are Shoes either too hard and stiff, or too small. The whole Cure consists in softening the Corns by repeated Washings and Soakings of the Feet in pretty hot Water; then in cutting them, when softened, with a Penknife or Scissars, without wounding the sound Parts (which are the more sensible, in Proportion as they are more extended than usual) and next in applying a Leaf of House-leek, of Ground-ivy, or of Purslain dipt in Vinegar, upon the Part. Instead of these Leaves, if any Person will give himself the little Trouble of dressing them every Day, he may apply a Plaister of simple Diachylon, or of Gum Ammoniacum softened in Vinegar. The Increase or Return of Corns can only be prevented, by avoiding the Causes that produce them. __Chapter XXXI.__ _Of some Cases which require immediate Assistance; such as Swoonings; Hæmorrhages, or involuntary Loss of Blood; Convulsion Fitts, and Suffocations; the sudden Effects of great Fear; of Disorders caused by noxious Vapours; of Poisons, and of acute Pains._ _Of Swoonings._ __Sect.__ 494. There are many Degrees of Swooning, or fainting away: the slightest is that in which the Patient constantly perceives and understands, yet without the Power of speaking. This is called a Fainting, which happens very often to vapourish Persons, and without any remarkable Alteration of the Pulse. If the Patient entirely loses Sensation, or Feeling, and Understanding, with a very considerable Sinking of the Pulse, this is called a _Syncopè_, and is the second Degree of Swooning. But if this _Syncopè_ is so violent, that the Pulse seems totally extinguished; without any discernible Breathing; with a manifest Coldness of the whole Body; and a wanly livid Countenance, it constitutes a third and last Degree, which is the true Image of Death, that in Effect sometimes attends it, and it is called an _Asphixy_, which may signify a total Resolution. Swoonings result from many different Causes, of which I shall only enumerate the principal; and these are, 1, Too large a Quantity of Blood. 2, A Defect or insufficient Proportion of it, and a general Weakness. 3, A Load at and violent Disorders of the Stomach. 4, Nervous Maladies. 5, The Passions; and, 6, some Kinds of Diseases. _Of Swoonings occasioned by Excess of Blood._ § 495. An excessive Quantity of Blood is frequently a Cause of Swooning; and it may be inferred that it is owing to this Cause, when it attacks sanguine, hearty and robust Persons; and more especially when it attacks them, after being combined with any additional or supervening Cause, that suddenly increased the Motion of the Blood; such as heating Meats or Drinks, Wine, spirituous Liquors: smaller Drinks, if taken very hot and plentifully, such as Coffee, Indian Tea, Bawm Tea and the like; a long Exposure to the hot Sun, or being detained in a very hot Place; much and violent Exercise; an over intense and assiduous Study or Application, or some excessive Passion. In such Cases, first of all the Patient should be made to smell to, or even to snuff up, some Vinegar; and his Forehead, his Temples and his Wrists should be bathed with it; adding an equal Quantity of warm Water, if at Hand. Bathing them with distilled or spirituous Liquids would be prejudicial in this Kind of Swooning. 2, The Patient should be made, if possible, to swallow two or three Spoonfuls of Vinegar, with four or five Times as much Water. 3, The Patient's Garters should be tied very tightly above his Knees; as by this Means a greater Quantity of Blood is retained in the Legs, whence the Heart may be less overladen with it. 4, If the Fainting proves obstinate, that is, if it continues longer than a Quarter of an Hour, or degenerates into a _Syncopè_, an Abolition of Feeling and Understanding, he must be bled in the Arm, which quickly revives him. 5, After the Bleeding, the Injection of a Glyster will be highly proper; and then the Patient should be kept still and calm, only letting him drink, every half Hour, some Cups of Elder Flower Tea, with the Addition of a little Sugar and Vinegar. When Swoonings which result from this Cause occur frequently in the same Person, he should, in Order to escape them, pursue the Directions I shall hereafter mention, § 544, when treating of Persons who superabound with Blood. The very same Cause, or Causes, which occasion these Swoonings, also frequently produce violent Palpitations, under the same Circumstances; the Palpitation often preceding or following the _Deliquium_, or Swooning. _Of Swoonings occasioned by Weakness._ § 496. If too great a Quantity of Blood, which may be considered as some Excess of Health, is sometimes the Cause of Swooning, this last is oftener the Effect of a very contrary Cause, that is, of a Want of Blood, or an Exhaustion of too much. This Sort of Swooning happens after great Hæmorrhages, or Discharges of Blood; after sudden or excessive Evacuations, such as one of some Hours Continuance in a _Cholera Morbus_ (§ 321) or such as are more slow, but of longer Duration, as for Instance, after an inveterate _Diarrhoea_, or Purging; excessive Sweats; a Flood of Urine; such Excesses as tend to exhaust Nature; obstinate Wakefulness; a long Inappetency, which, by depriving the Body of its necessary Sustenance, is attended with the same Consequence as profuse Evacuations. These different Causes of Swooning should be opposed by the Means and Remedies adapted to each of them. A Detail of all these would be improper here; but the Assistances that are necessary at the Time of Swooning, are nearly the same for all Cases of this Class; excepting for that attending a great Loss of Blood, of which I shall treat hereafter: first of all, the Patients should be laid down on a Bed, and being covered, should have their Legs and Thighs, their Arms, and their whole Bodies rubbed pretty strongly with hot Flanels; and no Ligature should remain on any Part of them. 2, They should have very spirituous Things to smell or snuff up, such as the Carmelite Water, Hungary Water, the [105] _English_ Salt, Spirit of Sal Ammoniac, strong smelling Herbs, such as Rue, Sage, Rosemary, Mint, Wormwood, and the like. �[105] Dr. _Tissot_ informs me, that in _Swisserland_, they call a volatile Salt of Vipers, or the volatile Salt of raw Silk, _Sel. d'Angleterre_, of which one _Goddard_ made a Secret, and which he brought into Vogue the latter End of the last Century. But he justly observes at the same Time, that on the present Occasion every other volatile Alkali will equally answer the Purpose; and indeed the Smell of some of them, as the Spirit of Sal Ammoniac with Quicklime, _Eau de Luce_, _&c._ seem more penetrating. _K._ 3, These should be conveyed into their Mouths; and they should be forced, if possible, to swallow some Drops of Carmelite Water, or of Brandy, or of some other potable Liquor, mixed with a little Water; while some hot Wine mixed with Sugar and Cinnamon, which makes one of the best Cordials, is getting ready. 4, A Compress of Flanel, or of some other woollen Stuff, dipt in hot Wine, in which some aromatic Herb has been steeped, must be applied to the Pit of the Stomach. 5, If the Swooning seems likely to continue, the Patient must be put into a well heated Bed, which has before been perfumed with burning Sugar and Cinnamon; the Frictions of the whole Body with hot Flanels being still continued. 6, As soon as the Patient can swallow, he should take some Soup or Broth, with the Yolk of an Egg; or a little Bread or Biscuit; soaked in the hot spiced Wine. 7, Lastly, during the whole Time that all other Precautions are taken to oppose the Cause of the Swooning, Care must be had for some Days to prevent any _Deliquium_ or Fainting, by giving them often, and but little at a time, some light yet strengthening Nourishment, such as Panada made with Soup instead of Water, new laid Eggs very lightly poached, light roast Meats with sweet Sauce, Chocolate, Soups of the most nourishing Meats, Jellies, Milk, _&c._ § 497. Those Swoonings, which are the Effect of Bleeding, or of the violent Operation of some Purge, are to be ranged in this Class. Such as happen after artificial Bleeding, are generally very moderate, commonly terminating as soon as the Patient is laid upon the Bed: and Persons subject to this Kind, should be bled lying down, in Order to prevent it. But should the Fainting continue longer than usual, some Vinegar smelt to, and a little swallowed with some Water, is a very good Remedy. The Treatment of such Faintings or Swoonings, as are the Consequences of too violent Vomits or Purges, may be seen hereafter § 552. _Of Faintings occasioned by a Load, or Uneasiness, at Stomach._ § 498. It has been already observed, § 308, that Indigestions were sometimes attended with Swoonings, and indeed such vehement ones, as required speedy and very active Succour too, such as that of a Vomit. The Indigestion is sometimes less the Effect of the Quantity, than of the Quality, or the Corruption of the Food, contained in the Stomach. Thus we see there are some Persons, who are disordered by eating Eggs, Fish, Craw Fish, or any fat Meat; being thrown by them into inexpressible Anguish attended with Swooning too. It may be supposed to depend on this Cause, when these very Aliments have been lately eaten; and when it evidently neither depends on the other Causes I have mentioned; nor on such as I shall soon proceed to enumerate. We should in Cases of this Sort, excite and revive the Patients as in the former, by making them receive some very strong Smell, of whatever Kind is at hand; but the most essential Point is to make them swallow down a large Quantity of light warm Fluid; which may serve to drown, as it were, the indigested Matter; which may soften its Acrimony; and either effect the Discharge of it by vomiting, or force it down into the Chanel of the Intestines. A light Infusion of Chamomile Flowers, of Tea, of Sage, of Elder Flowers, or of _Carduus Benedictus_, operate with much the same Efficacy; though the Chamomile and Carduus promote the Operation of vomiting rather more powerfully; which warm Water alone will sometimes sufficiently do. The Swooning ceases, or at least, considerably abates in these Cases, as soon as ever the Vomiting commences. It frequently happens too, that, during the Swooning, Nature herself brings on certain _Nausea_, a Wambling and sickish Commotion of the Stomach, that revives or rouses the Patient for a Moment; but yet not being sufficient to excite an actual Vomiting, lets him soon sink down again into this temporary Dissolution, which often continues a pretty considerable Time; leaving behind it a Sickness at Stomach, Vertigos, and a Depression and Anxiety, which do not occur in the former Species of this Malady. Whenever these Swoonings from this Cause are entirely terminated, the Patient must be kept for some Days to a very light Diet, and take, at the same Time, every Morning fasting, a Dose of the Powder, Nº. 38, which relieves and exonerates the Stomach of whatever noxious Contents might remain in it; and then restores its natural Strength and Functions. § 499. There is another Kind of Swooning, which also results from a Cause in the Stomach; but which is, nevertheless, very different from this we have just been treating of; and which requires a very different Kind of Assistance. It arises from an extraordinary Sensibility of this important Organ, and from a general Weakness of the Patient. Those subject to this Malady are valetudinary weakly Persons, who are disordered from many slight Causes, and whose Stomachs are at once very feeble and extremely sensible. They have almost continually a little Uneasiness after a Meal, though they should indulge but a little more than usual; or if they eat of any Food not quite so easy of Digestion, they have some Qualm or Commotion after it: Nay, should the Weather only be unfavourable, and sometimes without any perceivable assignable Cause, their Uneasiness terminates in a Swoon. Patients swooning, from these Causes, have a greater Necessity for great Tranquillity and Repose, than for any other Remedy; and it might be sufficient to lay them down on the Bed: But as the Bystanders in such Cases find it difficult to remain inactive Spectators of Persons in a Swoon, some spirituous Liquid may be held to their Nose, while their Temples and Wrists are rubbed with it; and at the same Time a little Wine should be given them. Frictions are also useful in these Cases. This Species of Swooning is oftener attended with a little Feverishness than the others. _Of those Swoonings, which arise from nervous Disorders._ § 500. This Species of Swooning is almost wholely unknown to those Persons, for whom this Treatise is chiefly intended. Yet as there are some Citizens who pass a Part of their Lives in the Country; and some Country People who are unhappily afflicted with the Ailments of the Inhabitants of large Towns and Cities, it seemed necessary to treat briefly of them. By Disorders of the Nerves, I understand in this Place, only that Fault or Defect in them, which is the Cause of their exciting in the Body, either irregular Motions, that is, Motions without any external Cause, at least any perceivable one; and without our Will's consenting to the Production of them: or such Motions, as are greatly more considerable than they should be, if they had been proportioned to the Force of the Impression from without. This is very exactly that State, or Affection termed the _Vapours_; and by the common People, the _Mother_: And as there is no Organ unprovided with Nerves; and none, or hardly any Function, in which the Nerves have not their Influence; it may be easily comprehended, that the Vapours being a State or Condition, which arises from the Nerves exerting irregular involuntary Motions, without any evident Cause, and all the Functions of the Body depending partly on the Nerves; there is no one Symptom of other Diseases which the Vapours may not produce or imitate; and that these Symptoms, for the same Reason, must vary infinitely, according to those Branches of the Nerves which are disordered. It may also hence be conceived, why the Vapours of one Person have frequently no Resemblance to those of another: and why the Vapours of the very same Person, in one Day, are so very different from those in the next. It is also very conceivable that the Vapours are a certain, a real Malady; and that Oddity of the Symptoms, which cannot be accounted for, by People unacquainted with the animal Oeconomy, has been the Cause of their being considered rather as the Effect of a depraved Imagination, than as a real Disease. It is very conceiveable, I say, that this surprizing Oddity of the Symptoms is a necessary Effect of the Cause of the Vapours; and that no Person can any more prevent his being invaded by the Vapours, than he can prevent the Attack of a Fever, or of the Tooth-ach. § 501. A few plain Instances will furnish out a more compleat Notion of the Mechanism, or Nature, of Vapours. An Emetic, a vomiting Medicine, excites the Act, or rather the Passion, the Convulsion of Vomiting, chiefly by the Irritation it gives to the Nerves of the Stomach; which Irritation produces a Spasm, a Contraction of this Organ. Now if in Consequence of this morbid or defective Texture of the Nerves, which constitutes the Vapours, those of the Stomach are excited to act with the same Violence, as in Consequence of taking a Vomit, the Patient will be agitated and worked by violent Efforts to vomit, as much as if he had really taken one. If an involuntary unusual Motion in the Nerves, that are distributed through the Lungs, should constrain and straiten the very little Vesicles, or Bladders, as it were, which admit the fresh Air at every Respiration, the Patient will feel a Degree of Suffocation; just as if that Straitening or Contraction of the Vesicles were occasioned by some noxious Steam or Vapour. Should the Nerves which are distributed throughout the whole Skin, by a Succession of these irregular morbid Motions, contract themselves, as they may from external Cold, or by some stimulating Application, Perspiration by the Pores will be prevented or checked; whence the Humours, which should be evacuated through the Pores of the Skin, will be thrown upon the Kidnies, and the Patient will make a great Quantity of thin clear Urine, a Symptom very common to vapourish People; or it may be diverted to the Glands of the Intestines, the Guts, and terminate in a watery _Diarrhoea_, or Looseness, which frequently proves a very obstinate one. § 502. Neither are Swoonings the least usual Symptoms attending the Vapours: and we may be certain they spring from this Source, when they happen to a Person subject to the Vapours; and none of the other Causes producing them are evident, or have lately preceded them. Such Swoonings, however, are indeed very rarely dangerous, and scarcely require any medical Assistance. The Patient should be laid upon a Bed; the fresh Air should be very freely admitted to him; and he should be made to smell rather to some disagreeable and fetid, than to any fragrant, Substance. It is in such Faintings as these that the Smell of burnt Leather, of Feathers, or of Paper, have often proved of great Service. § 503. Patients also frequently faint away, in Consequence of fasting too long; or from having eat a little too much; from being confined in too hot a Chamber; from having seen too much Company; from smelling too over-powering a Scent; from being too costive; from being too forcibly affected with some Discourse or Sentiments; and, in a Word, from a great Variety of Causes, which might not make the least Impression on Persons in perfect Health; but which violently operate upon those vapourish People, because, as I have said, the Fault of their Nerves consists in their being too vividly, too acutely affected; the Force of their Sensation being nowise proportioned to the external Cause of it. As soon as that particular Cause is distinguished from all the rest, which has occasioned the present Swooning; it is manifest that this Swooning is to be remedied by removing that particular Cause of it. _Of Swoonings occasioned by the Passions._ § 504. There have been some Instances of Persons dying within a Moment, through excessive Joy. But such Instances are so very rare and sudden, that Assistance has seldom been sought for on this Occasion. The Case is otherwise with Respect to those produced from Rage, Vexation, and Dread or Horror. I shall treat in a separate Article of those resulting from great Fear; and shall briefly consider here such as ensue from Rage, and vehement Grief or Disappointment. § 505. Excessive Rage and violent Affliction are sometimes fatal in the Twinkling of an Eye; though they oftener terminate in fainting only. Excessive Grief or Chagrine is especially accompanied with this Consequence; and it is very common to see Persons thus affected, sink into successive Faintings for several Hours. It is plainly obvious that very little Assistance can be given in such Cases: it is proper, however, they should smell to strong Vinegar; and frequently take a few Cups of some hot and temperately cordial Drink, such as Bawm Tea, or Lemonade with a little Orange or Lemon-peel. The calming asswaging Cordial, that has seemed the most efficacious to me, is one small Coffee Spoonful of a Mixture of three Parts of the Mineral Anodyne Liquor of _Hoffman_, [106] and one Part of the spirituous Tincture of Amber, which should be swallowed in a Spoonful of Water; taking after it a few Cups of such Drinks as I shall presently direct. �[106] Our sweet Spirit of Vitriol is a similar, and as effectual a Medicine. _K._ It is not to be supposed that Swoonings or Faintings, from excessive Passions, can be cured by Nourishment. The physical State or Condition, into which vehement Grief throws the Body, is that, of all others, in which Nourishment would be most injurious to it: and as long as the Vehemence of the Affliction endures, the Sufferer should take nothing but some Spoonfuls of Soup or Broth, or a few Morsels of some light Meat roasted. § 506. When Wrath or Rage has risen to so high a Pitch, that the human Machine, the Body, entirely exhausted, as it were, by that violent Effort, sinks down at once into excessive Relaxation, a Fainting sometimes succeeds, and even the most perilous Degree of it, a _Syncopè_. It is sufficient, or rather the most that can be done here, to let the Patient be perfectly still a while in this State; only making him smell to some Vinegar. But when he is come to himself, he should drink plentifully of hot Lemonade, and take one or more of the Glysters Nº. 5. Sometimes there remain in these Cases Sicknesses at Stomach, Reachings to vomit, a Bitterness in the Mouth, and some vertiginous Symptoms which seem to require a Vomit. But such a Medicine must be very carefully avoided, since it may be attended with the most fatal Consequence; and Lemonade with Glysters generally and gradually remove these Swoonings. If the _Nausea_ and Sickness at Stomach continue, the utmost Medicine we should allow besides, would be that of Nº. 23, or a few Doses of Nº. 24. _Of symptomatical Swoonings, or such, as happen in the Progress of other Diseases._ § 507. Swoonings, which supervene in the Course of other Diseases, never afford a favourable Prognostic; as they denote Weakness, and Weakness is an Obstacle to Recovery. In the Beginning of putrid Diseases, they also denote an Oppression at Stomach, or a Mass of corrupt Humours; and they cease as soon as an Evacuation supervenes, whether by Vomit or Stool. When they occur at the Beginning of malignant Fevers, they declare the high Degree of their Malignancy, and the great Diminution of the Patient's natural Strength. In each of these Cases Vinegar, used externally and internally, is the best Remedy during the Exacerbation or Height of the Paroxysm; and Plenty of Lemon Juice and Water after it. § 508. Swoonings which supervene in Diseases, accompanied with great Evacuations, are cured like those which are owing to Weakness; and Endeavours should be used to restrain or moderate the Evacuations. § 509. Those who have any inward Abscess or Imposthume are apt to swoon frequently. They may sometimes be revived a little by Vinegar, but they prove too frequently mortal. § 510. Many Persons have a slighter or a deeper Swooning, at the End of a violent Fit of an intermitting Fever, or at that of each Exacerbation of a continual Fever; this constantly shews the Fever has run very high, the Swooning having been the Consequence of that great Relaxation, which has succeeded to a very high Tension. A Spoonful or two of light white Wine, with an equal Quantity of Water, affords all the Succour proper in such a Case. § 511. Persons subject to frequent Swoonings, should neglect nothing that may enable them to remove them when known; since the Consequences of them are always detrimental, except in some Fevers, in which they seem to mark the _Crisis_. Every swooning Fit leaves the Patient in Dejection and Weakness; the Secretions from the Blood are suspended; the Humours disposed to Stagnation; Grumosities, or Coagulations, and Obstructions are formed; and if the Motion of the Blood is totally intercepted, or considerably checked, _Polypus's_, and these often incurable, are formed in the Heart, or in the larger Vessels; the Consequences of which are dreadful, and sometimes give Rise to internal Aneurisms, which always prove mortal, after long Anxiety and Oppression. Swoonings which attack old People, without any manifest Cause, always afford an unfavourable Prognostic. _Of Hæmorrhages, or an involuntary Loss of Blood._ § 512. Hæmorrhages of the Nose, supervening in inflammatory Fevers, commonly prove a favourable _Crisis_; which Bleeding we should carefully avoid stopping; except it becomes excessive, and seems to threaten the Patient's Life. As they scarcely ever happen in very healthy Subjects, but from a superfluous Abundance of Blood, it is very improper to check them too soon; lest some internal Stuffings and Obstructions should prove the Consequence. A Swooning sometimes ensues after the Loss of only a moderate Quantity of Blood. This Swooning stops the Hæmorrhage, and goes off without any further Assistance, except the smelling to Vinegar. But in other Cases there is a Succession of fainting Fits, without the Blood's stopping; while at the same time slight convulsive Motions and Twitchings ensue, attended with a Raving, when it becomes really necessary to stop the Bleeding: and indeed, without waiting till these violent Symptoms appear, the following Signs will sufficiently direct us, when it is right to stop the Flux of Blood, or to permit its Continuance--As long as the Pulse is still pretty full; while the Heat of the Body is equally extended to the very Extremities; and the Countenance and Lips preserve their natural Redness, no ill Consequence is to be apprehended from the Hæmorrhage, though it has been very copious, and even somewhat profuse. But whenever the Pulse begins to faulter and tremble; when the Countenance and the Lips grow pale, and the Patient complains of a Sickness at Stomach, it is absolutely necessary to stop the Discharge of Blood. And considering that the Operation of Remedies does not immediately follow the Exhibition or Application of them, it is safer to begin a little too early with them, than to delay them, though ever so little too long. § 513. First of all then, tight Bandages, or Ligatures, should be applied round both Arms, on the Part they are applied over in order to Bleeding; and round the lower Part of both Thighs, on the gartering Place; and all these are to be drawn very tight, with an Intention to detain and accumulate the Blood in the Extremities. 2, In Order to increase this Effect, the Legs are to be plunged in warm Water up to the Knees; for by relaxing the Blood-vessels of the Legs and Feet, they are dilated at the same time, and thence receive, and, in Consequence of the Ligatures above the Knees, retain the more Blood. If the Water were cold, it would repel the Blood to the Head; if hot, it would increase the Motion of it; and, by giving a greater Quickness to the Pulse, would even contribute to increase the Hæmorrhage. As soon however, as the Hæmorrhage is stopt, these Ligatures [on the Thighs] may be relaxed a little, or one of them be entirely removed; allowing the others to continue on an Hour or two longer without touching them: but great Precaution should be taken not to slacken them entirely, nor all at once. 3, Seven or eight Grains of Nitre, and a Spoonful of Vinegar, in half a Glass of cool Water, should be given the Patient every half Hour. 4, One Drachm of white Vitriol must be dissolved in two common Spoonfuls of Spring Water; and a Tent of Lint, or Bits of soft fine Linen dipt in this Solution, are to be introduced into the Nostrils, horizontally at first, but afterwards to be intruded upwards, and as high as may be, by the Assistance of a flexible Bit of Wood or Whale-bone. But should this Application be ineffectual, the Mineral Anodyne Liquor of _Hoffman_ is certain to succeed: and in the Country, where it often happens that neither of these Applications are to be had speedily, Brandy, and even Spirit of Wine, mixt with a third Part Vinegar, have answered entirely well, of which I have been a Witness. The Prescription Nº. 67, which I have already referred to, on the Article of Wounds, may also be serviceable on this Occasion. It must be reduced to Powder, and conveyed up the Nostrils as high as may be, on the Point or Extremity of a Tent of Lint, which may easily be covered with it. Or a Quill, well charged with the Powder, may be introduced high into the Nostrils, and its Countents be strongly blown up from its other Extremity: though after all the former Method is preferable. 5, When the Flux of Blood is totally stopt, the Patient is to be kept as still and quiet as possible; taking great Care not to extract the Tent which remains in the Nose; nor to remove the Clots of coagulated Blood which fill up the Passage. The loosening and removing of these should be effected very gradually and cautiously; and frequently the Tent does not spring out spontaneously, till after many Days. § 514. I have not, hitherto, said any thing of artificial Bleeding in these Cases, as I think it at best unserviceable; since, though it may sometimes have stopt the morbid Loss of Blood, it has at other times increased it. Neither have I mentioned Anodynes here, whose constant Effect is to determine a larger Quantity of Blood to the Head. Applications of cold Water to the Nape of the Neck ought to be wholly disused, having sometimes been attended with the most embarrassing Consequences. In all Hæmorrhages, all Fluxes of Blood, great Tranquillity, Ligatures, and the Use of the Drinks Nº. 2 or 4, are very useful. § 515. People who are very liable to frequent Hæmorrhages, ought to manage themselves conformably to the Directions contained in the next Chapter, § 544. They should take very little Supper; avoid all sharp and spirituous Liquors; Apartments that are over hot, and cover their Heads but very lightly. When a Patient has for a long time been subject to Hæmorrhages, if they cease, he should retrench from his usual Quantity of Food; accustom himself to artificial Bleedings at proper Intervals; and take some gentle opening Purges, especially that of Nº. 24, and frequently a little Nitre in an Evening. _Of Convulsion Fits._ § 516. Convulsions are, in general, more terrifying than dangerous; they result from many and various Causes; and on the Removal or Extirpation of these, their Cure depends. In the very Fit itself very little is to be done or attempted. As nothing does shorten the Duration, nor even lessen the Violence, of an epileptic Fit, so nothing at all should be attempted in it; and the rather, because Means and Medicines often aggravate the Disease. We should confine our Endeavours solely to the Security of the Patient, by preventing him from giving himself any violent Strokes; by getting something, if possible, between his Teeth, such as a small Roller of Linen to prevent his Tongue from being hurt, or very dangerously squeezed and bruised, in a strong Convulsion. The only Case which requires immediate Assistance in the Fit, is, when it is so extremely violent, the Neck so swelled, and the Face so very red, that there is Room to be apprehensive of an Apoplexy, which we should endeavour to obviate, by drawing eight or ten Ounces of Blood from the Arm. As this terrible Disease is common in the Country, it is doing a real Service to the unfortunate Victims of it, to inform them how very dangerous it is to give themselves blindly up to take all the Medicines, which are cried up to them in such Cases. If there be any one Disease, which requires a more attentive, delicate, and exquisite Kind of Treatment, it is this very Disease. Some Species of it are wholly incurable: and such as may be susceptible of a Cure, require the utmost Care and Consideration of the most enlightned and most experienced Physicians: while those who pretend to cure all epileptic Patients, with one invariable Medicine, are either Ignorants, or Impostors, and sometimes both in one. § 517. Simple Convulsion Fits, which are not epileptic, are frequently of a long Continuance, persevering, with very few and short Intervals, for Days and even for Weeks. The true genuine Cause should be investigated as strictly as possible, though nothing should be attempted in the Fit. The Nerves are, during that Term, in so high a Degree of Tension and Sensibility, that the very Medicines, supposed to be strongly indicated, often redouble the Storm they were intended to appease. Thin watery Liquors, moderately imbued with Aromatics, are the least hurtful, the most innocent Things that can be given; such as Bawm, Lime-tree, and Elder Flower Tea. A Ptisan of Liquorice Root only has sometimes answered better than any other. _Of suffocating, or strangling Fits._ § 518. These Fits (by whatever other Name they may be called) whenever they very suddenly attack a Person, whose Breathing was easy and natural just before, depend almost constantly on a Spasm or Contraction of the Nerves, in the Vesicles of the Lungs; or upon an Infarction, a Stuffing of the same Parts, produced by viscid clammy Humours. That Suffocation which arises from a Spasm is not dangerous, it goes off of itself, or it may be treated like Swoonings owing to the same Cause. See § 502. § 519. That Suffocation, which is the Effect of a sanguineous Fulness and Obstruction, may be distinguished by its attacking strong, vigorous, sanguine Persons, who are great Eaters, using much juicy nutritious Food, and strong Wine and Liquors, and who frequently eat and inflame themselves; and when the Fit has come on after any inflaming Cause; when the Pulse is full and strong, and the Countenance red. Such are cured, 1, by a very plentiful Discharge of Blood from the Arm, which is to be repeated, if necessary. 2, By the Use of Glysters. 3, By drinking plentifully of the Ptisan Nº. 1; to each Pot of which, a Drachm of Nitre is to be added; and, 4, By the Vapour of hot Vinegar, continually received by Respiration or Breathing. See § 55. § 520. There is Reason to think that one of these Fits is owing to a Quantity of tough viscid Humours in the Lungs, when it attacks Persons, whose Temperament, and whose Manner of living are opposite to those I have just described; such as valetudinary, weakly, phlegmatic, pituitous, inactive, and squeamish Persons, who feed badly, or on fat, viscid, and insipid Diet, and who drink much hot Water, either alone, or in Tea-like Infusions. And these Signs of Suffocation, resulting from such Causes, are still more probable, if the Fit came on in rainy Weather, and during a southerly Wind; and when the Pulse is soft and small, the Visage pale and hollow. The most efficacious Treatment we can advise, is, 1, To give every half Hour half a Cup of the Potion, Nº. 8, if it can be readily had. 2, To make the Patient drink very plentifully of the Drink Nº. 12; and, 3, to apply two strong Blisters to the fleshy Parts of his Legs. If he was strong and hearty before the Fit, and the Pulse still continues vigorous, and feels somewhat full withall, the Loss of seven or eight Ounces of Blood is sometimes indispensably necessary. A Glyster has also frequently been attended with extraordinary good Effects. Those afflicted with this oppressing Malady are commonly relieved, as soon as they expectorate, and sometimes even by vomiting a little. The Medicine Nº. 25, a Dose of which may be taken every two Hours, with a Cup of the Ptisan Nº. 12, often succeeds very well. But if neither this Medicine, nor the Prescription of Nº. 8 are at Hand, which may be the Case in Country Places; an Onion of a moderate Size should be pounded in an Iron or Marble Mortar; upon this, a Glass of Vinegar is to be poured, and then strongly squeezed out again through a Piece of Linen. An equal Quantity of Honey is then to be added to it. A Spoonful of this Mixture, whose remarkable Efficacy I have been a Witness of, is to be given every half Hour. _Of the violent Effects of Fear._ § 521. Here I shall insert some Directions to prevent the ill Consequences of great Fear or Terror, which are very prejudicial at every Term of Life, but chiefly during Infancy. The general Effects of Terror, are a great Straitening or Contraction of all the small Vessels, and a Repulsion of the Blood into the large and internal ones. Hence follows the Suppression of Perspiration, the general Seizure or Oppression, the Trembling, the Palpitations and Anguish, from the Heart and the Lungs being overcharged with Blood; and sometimes attended with Swoonings, irremediable Disorders of the Heart, and Death itself. A heavy Drowsiness, Raving, and a Kind of furious or raging _Delirium_ happen in other Cases, which I have frequently observed in Children, when the Blood-vessels of the Neck were swelled and stuffed up; and Convulsions, and even the Epilepsy have come on, all which have proved the horrible Consequence of a most senseless and wicked Foolery or Sporting. One half of those Epilepsies which do not depend on such Causes, as might exist before the Child's Birth, are owing to this detestable Custom; and it cannot be too much inculcated into Children, never to frighten one another; a Point which Persons intrusted with their Education, ought to have the strictest Regard to. When the Humours that should have passed off by Perspiration, are repelled to the Intestines, a tedious and very obstinate Looseness is the frequent Consequence. § 522. Our Endeavours should be directed, to re-establish the disordered Circulation; to restore the obstructed Perspiration; and to allay the Agitation of the Nerves. The popular Custom in these Cases has been to give the terrified Patient some cold Water directly; but when the Fright has been considerable, this is a very pernicious custom, and I have seen some terrible Consequences from it. They should, on the contrary, be conveyed into some very quiet Situation, leaving there but very few Persons, and such only as they are thoroughly familiar with. They should take a few Cups of pretty warm Drink, particularly of an Infusion of Lime-tree Flowers and Bawm. Their Legs should be put into warm Water, and remain there an Hour, if they will patiently permit it, rubbing them gently now and then, and giving them every half-quarter of an Hour, a small Cup of the said Drink. When their Composure and Tranquillity are returned a little, and their Skin seems to have recovered its wonted and general Warmth, Care should be taken to dispose them to sleep, and to perspire plentifully. For this Purpose they may be allowed a few Spoonfuls of Wine, on putting them into Bed, with one Cup of the former Infusion; or, which is more certain and effectual, a few Drops of _Sydenham's_ Liquid Laudanum, Nº. 44; but should that not be near at Hand, a small Dose of _Venice_ Treacle. § 523. It sometimes happens that Children do not seem at first extremely terrified; but the Fright is renewed while they sleep, and with no small Violence. The Directions I have just given must then be observed, for some successive Evenings, before they are put to Bed. Their Fright frequently returns about the latter End of the Night, and agitates them violently every Day. The same Treatment should be continued in such Cases; and we should endeavour to dispose them to be a-sleep at the usual Hour of its Return. By this very Method, I have dissipated the dismal Consequences of Fear of Women in Child-bed, which is so commonly, and often speedily, mortal. If a Suffocation from this Cause is violent, there is sometimes a Necessity for opening a Vein in the Arm. These Patients should gradually be inured to an almost continual, but gentle, Kind of Exercise. All violent Medicines render those Diseases, which are the Consequences of great Fear, incurable. A pretty common one is that of an Obstruction of the Liver, which has been productive of a Jaundice. [107] �[107] I have seen this actually verified by great and disagreeable Surprize, attended indeed with much Concern, in a Person of exquisite Sensations. _K._ _Of Accidents or Symptoms produced by the Vapours of Coal, and of Wine._ § 524. Not a single Year passes over here, without the Destruction of many People by the Vapour of Charcoal, or of small Coal, and by the Steam or Vapour of Wine. The Symptoms by Coal occur, when [108] small Coal, and especially when [109] Charcoal is burnt in a Chamber close shut, which is direct Poison to a Person shut up in it. The sulphureous Oil, which is set at Liberty and diffused by the Action of Fire, expands itself through the Chamber; while those who are in it perceive a Disorder and Confusion in their Heads; contract Vertigos, Sickness at Stomach, a Weakness, and very unusual Kind of Numbness; become raving, convulsed and trembling; and if they fail of Presence of Mind, or of Strength, to get out of the Chamber, they die within a short Time. �[108] _La Braise._ �[109] _Charbon._ Dr. _Tissot_ informs me, their Difference consists in this, that the Charcoal is prepared from Wood burnt in a close or stifled Fire; and that the small Coal is made of Wood (and of smaller Wood) burnt in an open Fire, and extinguished before it is reduced to the State of a Cinder. He says the latter is smaller, softer, less durable in the Fire, and the Vapour of it less dangerous than that of Charcoal. I have seen a Woman who had vertiginous Commotions in her Head for two Days, and almost continual Vomitings, from her having been confined less than six Minutes in a Chamber (and that notwithstanding, both one Window and one Door were open) in which there was a Chafing-dish with some burning Coals. Had the Room been quite close, she must have perished by it. This Vapour is narcotic or stupefying, and proves mortal in Consequence of its producing a sleepy or apoplectic Disorder, though blended, at the same time, with something convulsive; which sufficiently appears from the Closure of the Mouth, and the strict Contraction or Locking of the Jaws. The Condition of the Brain, in the dissected Bodies of Persons thus destroyed, proves that they die of an Apoplexy: notwithstanding it is very probable that Suffocation is also partly the Cause of their Deaths; as the Lungs have been found stuffed up with Blood and livid. It has also been observed in some other such Bodies, that Patients killed by the Vapour of burning Coals, have commonly their whole Body swelled out to one third more than their Magnitude, when living. The Face, Neck, and Arms are swelled out, as if they had been blown up; and the whole human Machine appears in such a State, as the dead Body of a Person would, who had been violently strangled; and who had made all possible Resistance for a long time, before he was overpowered. § 525. Such as are sensible of the great Danger they are in, and retreat seasonably from it, are generally relieved as soon as they get into the open Air; or if they have any remaining Uneasiness, a little Water and Vinegar, or Lemonade, drank hot, affords them speedy Relief. But when they are so far poisoned, as to have lost their Feeling and Understanding, if there be any Means of reviving them, such Means consist, 1, In exposing them to a very pure, fresh and open Air. 2, In making them smell to some very penetrating Odour, which is somewhat stimulating and reviving, such as the volatile Spirit of Sal Ammoniac, the [110] _English_ Salt; and afterwards to surround them, as it were, with the Steam of Vinegar. �[110] See Note [105] Page 495. 3, In taking some Blood from their Arm. 4, In putting their Legs into warm or hot Water, and chafing them well. 5, In making them swallow, if practicable, much Lemonade, or Water and Vinegar, with the Addition of Nitre: and, 6, In throwing up some sharp Glysters. As it is manifest there is something spasmodic in these Cases, it were proper to be provided with some antispasmodic Remedies, such as the Mineral Anodyne Liquid of _Hoffman_. Even Opium has sometimes been successfully given here, but it should be allowed to Physicians only to direct it in such Cases. A Vomit would be hurtful; and the Reachings to vomit arise only from the Oppression on the Brain. It is a common but erroneous Opinion, that if the Coal be suffered to burn for a Minute or so in the open Air, or in a Chimney, it is sufficient to prevent any Danger from the Vapour of it. Hence it amounts even to a criminal Degree of Imprudence, to sleep in a Chamber while Charcoal or small Coal is burning in it; and the Number of such imprudent Persons, as have never awaked after it, is so considerable, and so generally known too, that the Continuance of this unhappy Custom is astonishing. § 526. The Bakers, who make Use of much small Coal, often keep great Quantities of it in their Cellars, which frequently abound so much with the Vapour of it, that it seizes them violently the Moment they enter into the Cellar. They sink down at once deprived of all Sensation, and die if they are not drawn out of it soon enough to be assisted, according to the Directions I have just given. One certain Means of preventing such fatal Accidents is, upon going into the Cellar to throw some flaming Paper or Straw into it, and if these continue to flame out and consume, there is no Reason for dreading the Vapour: but if they should be extinguished, no Person should venture in. But after opening the Vent-hole, a Bundle of flaming Straw must be set at the Door, which serves to attract the external Air strongly. Soon after the Experiment of the flaming Paper must be repeated, and if it goes out, more Straw is to be set on Fire before the Cellar Door. § 527. Small Coal, burnt in an open Fire, is not near so dangerous as _Charcoal_, properly so called, the Danger of which arises from this, that in extinguishing it by the usual Methods, all those sulphureous Particles of it, in which its Danger consists, are concentred. Nevertheless, small Coal is not entirely deprived of all its noxious Quality, without some of which it could not strictly be Coal. The common Method of throwing some Salt on live Coals, before they are conveyed into a Chamber; or of casting a Piece of Iron among them to imbibe some Part of their deadly narcotic Sulphur, is not without its Utility; though by no means sufficient to prevent all Danger from them. § 528. When the most dangerous Symptoms from this Cause disappear, and there remains only some Degree of Weakness, of Numbness, and a little Inappetency, or Loathing at Stomach, nothing is better than Lemonade with one fourth Part Wine, half a Cup of which should frequently be taken, with a small Crust of Bread. § 529. The Vapour which exhales from Wine, and in general from all fermenting Liquors, such as Beer, Cyder, _&c._ contains something poisonous, which kills in the like Manner with the Vapour of Coal; and there is always some Danger in going into a Cellar, where there is much Wine in the State of Fermentation; if it has been shut up close for several Hours. There have been many Examples of Persons struck dead on entering one, and of others who have escaped out of it with Difficulty. When such unhappy Accidents occur, Men should not be successively exposed, one after another, to perish, by endeavouring to fetch out the first who sunk down upon his Entrance; but the Air should immediately be purified by the Method already directed, or by discharging some Guns into the Cellar; after which People may venture in with Precaution. And when the Persons unfortunately affected are brought out, they are to be treated like those, who were affected with the Coal-Vapour. I saw a Man, about eight Years since, who was not sensible of the Application of Spirit of Sal Ammoniac, till about an Hour after he was struck down, and who was entirely freed at last by a plentiful Bleeding; though he had been so insensible, that it was several Hours before he discovered a very great Wound he had, which extended from the Middle of his Arm to his Armpit, and which was made by a Hook intended to be used, in Case of a House catching Fire, to assist Persons in escaping from the Flames. § 530. When subterraneous Caves that have been very long shut are opened; or when deep Wells are cleaned, that have not been emptied for several Years, the Vapours arising from them produce the same Symptoms I have mentioned, and require the same Assistance. They are to be cleansed and purified by burning Sulphur and Salt Petre in them, or Gunpowder, as compounded of both. § 531. The offensive Stink of Lamps and of Candles, especially when their Flames are extinguished, operate like other Vapours, though with less Violence, and less suddenly. Nevertheless there have been Instances of People killed by the Fumes of Lamps fed with Nut Oil, which had been extinguished in a close Room. These last Smells or Fumes prove noxious also, in Consequence of their Greasiness, which being conveyed, together with the Air, into the Lungs, prevent their Respiration: And hence we may observe, that Persons of weak delicate Breasts find themselves quickly oppressed in Chambers or Apartments, illuminated with many Candles. The proper Remedies have been already directed, § 525. The Steam of Vinegar is very serviceable in such Cases. _Of Poisons._ § 532. There are a great Number of Poisons, whose Manner of acting is not alike; and whose ill Effects are to be opposed by different Remedies: But Arsenic, or Ratsbane, and some particular Plants are the Poisons which are the most frequently productive of Mischief, in Country Places. § 533. It is in Consequence of its excessive Acrimony, or violent Heat and Sharpness, which corrodes or gnaws, that Arsenic destroys by an excessive Inflammation, with a burning Fire as it were, most torturing Pains in the Mouth, Throat, Stomach, Guts; with rending and often bloody Vomitings, and Stools, Convulsions, Faintings, _&c._ The best Remedy of all is pouring down whole Torrents of Milk, or, where there is not Milk, of warm Water. Nothing but a prodigious Quantity of such weak Liquids can avail such a miserable Patient. If the Cause of the Disorder is immediately known, after having very speedily taken down a large Quantity of warm Water, Vomiting may be excited with Oil, or with melted Butter, and by tickling the Inside of the Throat with a Feather. But when the Poison has already inflamed the Stomach and the Guts, we must not expect to discharge it by vomiting. Whatever is healing or emollient, Decoctions of mealy Pulse, of Barley, of Oatmeal, of Marsh-mallows, and Butter and Oil are the most suitable. As soon as ever the tormenting Pains are felt in the Belly, and the Intestines seem attacked, Glysters of Milk must be very frequently thrown up. If at the very Beginning of the Attack, the Patient has a strong Pulse, a very large Bleeding may be considerably serviceable by its delaying the Progress, and diminishing the Degree of Inflammation. And even though it should happen that a Patient overcomes the first Violence of this dreadful Accident, it is too common for him to continue in a languid State for a long Time, and sometimes for all the Remainder of his Life. The most certain Method of preventing this Misery, is to live for some Months solely upon Milk, and some very new laid Eggs, just received from the Hen, and dissolved or blended in the Milk, without boiling them. § 534. The Plants which chiefly produce these unhappy Accidents are some Kinds of Hemlock, whether it be the Leaf or the Root, the Berries of the _Bella Donna_, or deadly Nightshade, which Children eat by mistake for Cherries; some Kind of Mushrooms, the Seed of the _Datura_, or the stinking Thorn-Apple. All the Poisons of this Class prove mortal rather from a narcotic, or stupefying, than from an acrid, or very sharp Quality. Vertigos, Faintings, Reachings to vomit, and actual Vomitings are the first Symptoms produced by them. The Patient should immediately swallow down a large Quantity of Water, moderately seasoned with Salt or with Sugar; and then a Vomiting should be excited as soon as possible by the Prescription Nº. 34 or 35: or, if neither of these is very readily procurable, with Radish-seed pounded, to the Quantity of a Coffee Spoonful, swallowed in warm Water, soon after forcing a Feather or a Finger into the Patient's Throat, to expedite the Vomiting. After the Operation of the Vomit, he must continue to take a large Quantity of Water, sweetened with Honey or Sugar, together with a considerable Quantity of Vinegar, which is the true Specific, or Antidote, as it were, against those Poisons: the Intestines must also be emptied by a few Glysters. Thirty-seven Soldiers having unhappily eaten, instead of Carrots, of the Roots of the _Oenanthè_; or Water-hemlock, became all extremely sick; when the Emetic, Nº. 34, with the Assistance of Glysters, and very plentiful drinking of warm Water, saved all but one of them, who died before he could be assisted. § 535. If a Person has taken too much Opium; or any Medicine into which it enters, as _Venice_ Treacle, Mithridate, Diascordium, _&c._ whether by Imprudence, Mistake, Ignorance, or through any bad Design, he must be bled upon the Spot, and treated as if he had a sanguine Apoplexy, (See § 147) by Reason that Opium in Effect produces such a one. He should snuff up and inhale the Vapour of Vinegar plentifully, adding it also liberally to the Water he is to drink. _Of acute Pains._ § 536. It is not my Intention to treat here of those Pains, that accompany any evident known Disease, and which should be conducted as relating to such Diseases; nor of such Pains as infirm valetudinary Persons are habitually subject to; since Experience has informed such of the most effectual Relief for them: But when a Person sound and hale, finds himself suddenly attacked with some excessive Pain, in whatever Part it occurs, without knowing either the Nature, or the Cause of it, they may, till proper Advice can be procured, 1, Part with some Blood, which, by abating the Fulness and Tension, almost constantly asswages the Pains, at least for some Time: and it may even be repeated, if, without weakening the Patient much, it has lessened the Violence of the Pain. 2, The Patient should drink abundantly of some very mild temperate Drink, such as the Ptisan Nº. 2, the Almond Emulsion Nº. 4, or warm Water with a fourth or fifth Part Milk. 3, Several emollient Glysters should be given. 4, The whole Part that is affected, and the adjoining Parts should be covered with Cataplasms, or soothed with the emollient Fomentation, Nº. 9. 5, The warm Bath may also be advantagiously used. 6, If notwithstanding all these Assistances, the Pain should still continue violent, and the Pulse is neither full nor hard, the grown Patient may take an Ounce of Syrup of Diacodium, or sixteen Drops of liquid Laudanum; and when neither of these are to be had, [111] an _English_ Pint of boiling Water must be poured upon three or four Poppy-heads with their Seeds, but without the Leaves, and this Decoction is to be drank like Tea. �[111] _Une Quartette._ § 537. Persons very subject to frequent Pains, and especially to violent Head-achs, should abstain from all strong Drink; such Abstinence being often the only Means of curing them: And People are very often mistaken in supposing Wine necessary for as many as seem to have a weak Stomach. __Chapter XXXII.__ _Of Medicines taken by Way of Precaution, or Prevention._ __Sect.__ 538. I Have pointed out, in some Parts of this Work, the Means of preventing the bad Effects of several Causes of Diseases; and of prohibiting the Return of some habitual Disorders. In the present Chapter I shall adjoin some Observations, on the Use of the principal Remedies, which are employed as general Preservatives; pretty regularly too at certain stated Times, and almost always from meer Custom only, without knowing, and often with very little Consideration, whether they are right or wrong. Nevertheless, the Use, the Habit of taking Medicines, is certainly no indifferent Matter: it is ridiculous, dangerous, and even criminal to omit them, when they are necessary, but not less so to take them when they are not wanted. A good Medicine taken seasonably, when there is some Disorder, some _Disarrangement_ in the Body, which would in a short time occasion a Distemper, has often prevented it. But yet the very same Medicine, if given to a Person in perfect Health, if it does not directly make him sick, leaves him at the best in a greater Propensity to the Impressions of Diseases: and there are but too many Examples of People, who having very unhappily contracted a Habit, a Disposition to take Physick, have really injured their Health, and impaired their Constitution, however naturally strong, by an Abuse of those Materials which Providence has given for the Recovery and Re-establishment of it; an Abuse which, though it should not injure the Health of the Person, would occasion those Remedies, when he should be really sick, to be less efficacious and serviceable to him, from their having been familiar to his Constitution; and thus he becomes deprived of the Assistance he would have received from them, if taken only in those Times and Circumstances, in which they were necessary for him. _Of Bleeding._ § 539. Bleeding is necessary only in these four Cases. 1, When there is too great a Quantity of Blood in the Body. 2, When there is any Inflammation, or an inflammatory Disease. 3, When some Cause supervenes, or is about to supervene, in the Constitution, which would speedily produce an Inflammation, or some other dangerous Symptom, if the Vessels were not relaxed by Bleeding. It is upon this Principle that Patients are bled after Wounds, and after Bruises; that Bleeding is directed for a pregnant Woman, if she has a violent Cough; and that Bleeding is performed, by Way of Precaution, in several other Cases. 4, We also advise Bleeding sometimes to asswage an excessive Pain, though such Pain is not owing to Excess of Blood, nor arises from an inflamed Blood; but in Order to appease and moderate the Pain by Bleeding; and thereby to obtain Time for destroying the Cause of it by other Remedies. But as these two last Reasons are in Effect involved or implied in the two first; it may be very generally concluded, that an Excess of Blood, and an inflamed State of it, are the only two necessary Motives for Bleeding. § 540. An Inflammation of the Blood is known by the Symptoms accompanying those Diseases, which that Cause produces. Of these I have already spoken, and I have at the same time regulated the Practice of Bleeding in such Cases. Here I shall point out those Symptoms and Circumstances, which manifest an Excess of Blood. The first, then, is the general Course and Manner of the Patient's living, while in Health. If he is a great Eater, and indulges in juicy nutritious Food, and especially on much Flesh-meat; if he drinks rich and nourishing Wine, or other strong Drink, and at the same time enjoys a good Digestion; if he takes but little Exercise, sleeps much, and has not been subject to any very considerable Evacuation, he may well be supposed to abound in Blood. It is very obvious that all these Causes rarely occur in Country People; if we except only the Abatement of their Exercise, during some Weeks in Winter, which indeed may contribute to their generating more Blood than they commonly do. The labouring Country-man, for much the greater part of his Time, lives only on Bread, Water and Vegetables; Materials but very moderately nourishing, as one Pound of Bread probably does not make, in the same Body, more Blood than one Ounce of Flesh; though a general Prejudice seems to have established a contrary Opinion. 2, The total Stopping or long Interruption of some involuntary Bleeding or Hæmorrhage, to which he had been accustomed. 3, A full and strong Pulse, and Veins visibly filled with Blood, in a Body that is not lean and thin, and when he is not heated. 4, A florid lively Ruddiness. 5, A considerable and unusual Numbness; Sleep more profound, of more Duration, and yet less tranquil and calm, than at other times; a greater Propensity than ordinary to be fatigued after moderate Exercise or Work; and a little Oppression and Heaviness from walking. 6, Palpitations, accompanied sometimes with very great Dejection, and even with a slight fainting Fit; especially on being in any hot Place, or after moving about considerably. 7, Vertigos, or Swimmings of the Head, especially on bowing down and raising it up at once, and after sleeping. 8, Frequent Pains of the Head, to which the Person was not formerly subject; and which seem not to arise from any Defect in the Digestions. 9, An evident Sensation of Heat, pretty generally diffused over the whole Body. 10, A smarting Sort of Itching all over, from a very little more Heat than usual. And lastly, frequent Hæmorrhages, and these attended with manifest Relief, and more Vivacity. People should, notwithstanding, be cautious of supposing an unhealthy Excess of Blood, from any one of these Symptoms only. Many of them must concur; and they should endeavour to be certain that even such a Concurrence of them does not result from a very different Cause, and wholly opposite in Effect to that of an Excess of Blood. But when it is certain, from the whole Appearance, that such an Excess doth really exist, then a single, or even a second Bleeding is attended with very good Effects. Nor is it material, in such Cases, from what Part the Blood is taken. § 541. On the other Hand, when these Circumstances do not exist, Bleeding is in no wise necessary: nor should it ever be practised in these following Conditions and Circumstances; except for some particular and very strong Reasons; of the due Force of which none but Physicians can judge. First, when the Person is in a very advanced Age, or in very early Infancy. 2, When he is either naturally of a weakly Constitution, or it has been rendered such by Sickness, or by some other Accident. 3, When the Pulse is small, soft, feeble, and intermits, and the Skin is manifestly pale. 4, When the Limbs, the Extremities of the Body, are often cold, puffed up and soft. 5, When their Appetite has been very small for a long time; their Food but little nourishing, and their Perspiration too plentiful, from great Exercise. 6, When the Stomach has long been disordered, and the Digestion bad, whence very little Blood could be generated. 7, When the Patient has been considerably emptied, whether by Hæmorrhages, a Looseness, profuse Urine or Sweat: or when the _Crisis_ of some Distemper has been effected by any one of these Evacuations. 8, When the Patient has long been afflicted with some depressing Disease; and troubled with many such Obstructions as prevent the Formation of Blood. 9, Whenever a Person is exhausted, from whatever Cause. 10, When the Blood is in a thin, pale, and dissolved State. § 542, In all these Cases, and in some others less frequent, a single Bleeding often precipitates the Patient into an absolutely incurable State, an irreparable Train of Evils. Many dismal Examples of it are but too obvious. Whatever, therefore, be the Situation of the Patient, and however naturally robust, that Bleeding, which is unnecessary, is noxious. Repeated, re-iterated Bleedings, weaken and enervate, hasten old Age, diminish the Force of the Circulation, thence fatten and puff up the Body; and next by weakening, and lastly by destroying, the Digestions, they lead to a fatal Dropsy. They disorder the Perspiration by the Skin, and leave the Patient liable to Colds and Defluxions: They weaken the nervous System, and render them subject to Vapours, to the hypochondriac Disorders, and to all nervous Maladies. The ill Consequence of a single, though erroneous Bleeding is not immediately discernible: on the contrary, when it was not performed in such a Quantity, as to weaken the Patient perceivably, it appears to have been rather beneficial. Yet I still here insist upon it, that it is not the less true that, when unnecessary, it is prejudicial; and that People should never bleed, as sometimes has been done, for meer Whim, or, as it were, for Diversion. It avails nothing to affirm, that within a few Days after it, they have got more Blood than they had before it, that is, that they weigh more than at first, whence they infer the Loss of Blood very speedily repaired. The Fact of their augmented Weight is admitted; but this very Fact testifies against the real Benefit of that Bleeding; hence it is a Proof, that the natural Evacuations of the Body are less compleatly made; and that Humours, which ought to be expelled, are retained in it. There remains the same Quantity of Blood, and perhaps a little more; but it is not a Blood so well made, so perfectly elaborated; and this is so very true, that if the thing were otherwise; if some Days after the Bleeding they had a greater Quantity of the same Kind of Blood, it would amount to a Demonstration, that more re-iterated Bleedings must necessarily have brought on an inflammatory Disease, in a Man of a robust Habit of Body. § 543. The Quantity of Blood, which a grown Man may Part with, by Way of Precaution, is about ten Ounces. § 544. Persons so constituted as to breed much Blood, should carefully avoid all those Causes which tend to augment it, (See § 540, Nº. 1) and when they are sensible of the Quantity augmented, they should confine themselves to a light frugal Diet, on Pulse, Fruits, Bread and Water; they should often bathe their Feet in warm Water, taking Night and Morning the Powder Nº. 20; drink of the Ptisan Nº. 1; sleep but very moderately, and take much Exercise. By using these Precautions they may either prevent any Occasion for Bleeding, or should they really be obliged to admit of it, they would increase and prolong its good Effects. These are also the very Means, which may remove all the Danger that might ensue from a Person's omitting to bleed, at the usual Season or Interval, when the Habit, the Fashion of Bleeding had been inveterately established in him. § 545. We learn with Horror and Astonishment, that some have been bled eighteen, twenty and even twenty-four times in two Days; and some others, some [112] hundred times, in the Course of some Months. Such Instances irrefragably demonstrate the continual Ignorance of their Physician or Surgeon; and should the Patient escape, we ought to admire the inexhaustible Resources of Nature, that survived so many murderous Incisions. �[112] How shocking is this! and yet how true in some Countries! I have been most certainly assured, that Bleeding has been inflicted and repeated in the last sinking and totally relaxing Stage of a Sea-Scurvy, whose fatal Termination it doubtless accelerated. This did not happen in our own Fleet; yet we are not as yet Wholly exempt on Shore, from some Abuse of Bleeding, which a few raw unthinking Operators are apt to consider as a meer Matter of Course. I have in some other Place stigmatized the Madness of Bleeding in Convulsions, from manifest Exhaustion and Emptiness, with the Abhorrence it deserves. _K._ § 546. The People entertain a common Notion, which is, that the first Time of bleeding certainly saves the Life of the Patient; but to convince them of the Falsity of this silly Notion, they need only open their Eyes, and see the very contrary Fact to this occur but too unhappily every Day; many People dying soon after their first Bleeding. Were their Opinion right, it would be impossible that any Person should die of the first Disease that seized him, which yet daily happens. Now the Extirpation of this absurd Opinion is really become important, as the Continuance of it is attended with some unhappy Consequences: their Faith in, their great Dependance on, the extraordinary Virtue of this first Bleeding makes them willing to omit it, that is, to treasure it up against a Distemper, from which they shall be in the greatest Danger; and thus it is deferred as long as the Patient is not extremely bad, in Hopes that if they can do without it then, they shall keep it for another and more pressing Occasion. Their present Disease in the mean time rises to a violent Height; and then they bleed, but when it is too late, and I have seen Instances of many Patients, who were permitted to die, that the first Bleeding might be reserved for a more important Occasion. The only Difference between the first Bleeding, and any subsequent one is, that the first commonly gives the Patient an Emotion, that is rather hurtful than salutary. _Of Purges._ § 547. The Stomach and Bowels are emptied either by Vomiting, or by Stools, the latter Discharge being much more natural than the first, which is not effected without a violent Motion, and one indeed to which Nature is repugnant. Nevertheless, there are some Cases, which really require this artificial Vomiting; but these excepted (some of which I have already pointed out) we should rather prefer those Remedies, which empty the Belly by Stool. § 548. The Signs, which indicate a Necessity for Purging, are, 1, a disagreeable Tast or Savour of the Mouth in a Morning, and especially a bitter Tast; a foul, furred Tongue and Teeth, disagreable Eructations or Belchings, Windiness and Distension. 2, A Want of Appetite which increases very gradually, without any Fever, which degenerates into a Disgust or total Aversion to Food; and sometimes communicates a bad Tast to the very little such Persons do eat. 3, Reachings to vomit in a Morning fasting, and sometimes throughout the Day; supposing such not to depend on a Woman's Pregnancy, or some other Disorder, in which Purges would be either useless or hurtful. 4, A vomiting up of bitter, or corrupted, Humours. 5, A manifest Sensation of a Weight, or Heaviness in the Stomach, the Loins, or the Knees. 6, A Want of Strength sometimes attended with Restlessness, ill Humour, or Peevishness, and Melancholy. 7, Pains of the Stomach, frequent Pains of the Head, or Vertigos; sometimes a Drowsiness, which increases after Meals. 8, Some Species of Cholics; irregular Stools which are sometimes very great in Quantity, and too liquid for many Days together; after which an obstinate Costiveness ensues. 9, A Pulse less regular, and less strong, than what is natural to the Patient, and which sometimes intermits. § 549. When these Symptoms, or some of them, ascertain the Necessity of purging a Person, not then attacked by any manifest Disease (for I am not speaking here of Purges in such Cases) a proper purging Medicine may be given him. The bad Tast in his Mouth; the continual Belchings; the frequent Reachings to vomit; the actual Vomitings and Melancholy discover, that the Cause of his Disorder resides in the Stomach, and shew that a Vomit will be of Service to him. But when such Signs or Symptoms are not evident, the Patient should take such purging or opening Remedies, as are particularly indicated by the Pains, whether of the Loins; from the Cholic; or by a Sensation of Weight or Heaviness in the Knees. § 550. But we should abstain from either vomiting or purging, 1, Whenever the Complaints of the Patients are founded in their Weakness, and their being already exhausted, 2, When there is a general Dryness of the Habit, a very considerable Degree of Heat, some Inflammation, or a strong Fever. 3, Whenever Nature is exerting herself in some other salutary Evacuation; whence purging must never be attempted in critical Sweats, during the monthly Discharges, nor during a Fit of the Gout. 4, Nor in such inveterate Obstructions as Purges cannot remove, and really do augment. 5, Neither when the nervous System is considerably weakened. § 551. There are other Cases again, in which it may be proper to purge, but not to give a Vomit. These Cases are, 1, When the Patient abounds too much with Blood, (See § 540) since the Efforts which attend vomiting, greatly augment the Force of the Circulation; whence the Blood-vessels of the Head and of the Breast, being extremely distended with Blood, might burst, which must prove fatal on the Spot, and has repeatedly proved so. 2, For the same Reason they should not be given to Persons, who are subject to frequent Bleeding from the Nose, or to coughing up or vomiting of Blood; to Women who are subject to excessive or unseasonable Discharges of Blood, _&c._ from the _Vagina_, the Neck of the Womb; nor to those who are with Child. 3, Vomits are improper for ruptured Persons. § 552. When any Person has taken too acrid, too sharp, a Vomit, or a Purge, which operates with excessive Violence; whether this consists in the most vehement Efforts and Agitations, the Pains, Convulsions, or Swoonings, which are their frequent Consequences; or whether that prodigious Evacuation and Emptiness their Operation causes, (which is commonly termed a _Super-purgation_) and which may hurry the Patient off; Instances of which are but too common among the lower Class of the People, who much too frequently confide themselves to the Conduct of ignorant Men-slayers: In all such unhappy Accidents, I say, we should treat these unfortunate Persons, as if they had been actually poisoned, by violent corroding Poisons, (See § 533) that is, we should fill them, as it were, with Draughts of warm Water, Milk, Oil, Barley-water, Almond Milk, emollient Glysters with Milk, and the Yolks of Eggs; and also bleed them plentifully, if their Pains are excessive, and their Pulses strong and feverish. The Super-purgation, the excessive Discharge, is to be stopt, after having plied the Patient plentifully with diluting Drinks, by giving the calming Anodyne Medicines directed in the Removal of acute Pains, § 536, Nº. 6. Flanels dipt in hot Water, in which some _Venice_ Treacle is dissolved, are very serviceable: and should the Evacuations by Stool be excessive, and the Patient has not a high Fever, and a parching Kind of Heat, a Morsel of the same Treacle, as large as a Nutmeg, may be dissolved in his Glyster. But should the Vomiting solely be excessive, without any Purging, the Number of the emollient Glysters with Oil and the Yolk of an Egg must be increased; and the Patient should be placed in a warm Bath. § 553. Purges frequently repeated, without just and necessary Indications, are attended with much the same ill Effects as frequent Bleedings. They destroy the Digestions; the Stomach no longer, or very languidly, exerts its Functions; the Intestines prove inactive; the Patient becomes liable to very severe Cholics; the Plight of the Body, deprived of its salutary Nutrition, falls off; Perspiration is disordered; Defluxions ensue; nervous Maladies come on, with a general Languor; and the Patient proves old, long before the Number of his Years have made him so. Much irreparable Mischief has been done to the Health of Children, by Purges injudiciously given and repeated. They prevent them from attaining their utmost natural Strength, and frequently contract their due Growth. They ruin their Teeth; dispose young Girls to future Obstructions; and when they have been already affected by them, they render them still more obstinate. It is a Prejudice too generally received, that Persons who have little or no Appetite need purging; since this is often very false, and most of those Causes, which lessen or destroy the Appetite, cannot be removed by purging; though many of them may be increased by it. Persons whose Stomachs contain much glairy viscid Matter suppose, they may be cured by Purges, which seem indeed at first to relieve them: but this proves a very slight and deceitful Relief. These Humours are owing to that Weakness and Laxity of the Stomach, which Purges augment; since notwithstanding they carry off Part of these viscid Humours generated in it, at the Expiration of a few Days there is a greater Accumulation of them than before; and thus, by a Re-iteration of purging Medicines, the Malady soon becomes incurable, and Health irrecoverably lost. The real Cure of such Cases is effected by directly opposite Medicines. Those referred to, or mentioned, § 272, are highly conducive to it. § 554. The Custom of taking stomachic Medicines infused in Brandy, Spirit of Wine, Cherry Water, _&c._ is always dangerous; for notwithstanding the present immediate Relief such Infusions afford in some Disorders of the Stomach, they really by slow Degrees impair and ruin that Organ; and it may be observed, that as many as accustom themselves to Drams, go off, just like excessive Drinkers, in Consequence of their having no Digestion; whence they sink into a State of Depression and Languor, and die dropsical. § 555. Either Vomits or Purges may be often beneficially omitted, even when they have some Appearance of seeming necessary, by abating one Meal a Day for some time; by abstaining from the most nourishing Sorts of Food; and especially from those which are fat; by drinking freely of cool Water, and taking extraordinary Exercise. The same Regimen also serves to subdue, without the Use of Purges, the various Complaints which often invade those, who omit taking purging Medicines, at those Seasons and Intervals, in which they have made it a Custom to take them. § 556. The Medicines, Nº. 34 and 35, are the most certain Vomits. The Powder, Nº. 21, is a good Purge, when the Patient is in no wise feverish. The Doses recommended in the Table of Remedies are those, which are proper for a grown Man, of a vigorous Constitution. Nevertheless there are some few, for whom they may be too weak: in such Circumstances they may be increased by the Addition of a third or fourth Part of the Dose prescribed. But should they not operate in that Quantity, we must be careful not to double the Dose, much less to give a three-fold Quantity, which has sometimes been done, and that even without its Operation, and at the Risque of killing the Patient, which has not seldom been the Consequence. In Case of such purging not ensuing, we should rather give large Draughts of Whey sweetened with Honey, or of warm Water, in a Pot of which an Ounce, or an Ounce and a half of common Salt must be dissolved; and this Quantity is to be taken from time to time in small Cups, moving about with it. The Fibres of Country People who inhabit the Mountains, and live almost solely on Milk, are so little susceptible of Sensation, that they must take such large Doses to purge them, as would kill all the Peasantry in the Vallies. In the Mountains of _Valais_ there are Men who take twenty, and even twenty-four Grains of Glass of Antimony for a single Dose; a Grain or two of which were sufficient to poison ordinary Men. § 557. Notwithstanding our Cautions on this important Head, whenever an urgent Necessity commands it, Purging must be recurred to at all Times and Seasons: but when the Season may be safely selected, it were right to decline Purging in the Extremities of either Heat or Cold; and to take the Purge early in the Morning, that the Medicines may find less Obstruction or Embarrassment from the Contents of the Stomach. Every other Consideration, with Relation to the Stars and the Moon, is ridiculous, and void of any Foundation. The People are particularly averse to purging in the Dog-days; and if this were only on Account of the great Heat, it would be very pardonable: but it is from an astrological Prejudice, which is so much the more absurd, as the real Dog-days are at thirty-six Days Distance from those commonly reckoned such; and it is a melancholy Reflection, that the Ignorance of the People should be so gross, in this Respect, in our enlightened Age; and that they should still imagine the Virtue and Efficacy of Medicines to depend on what Sign of the Zodiac the Sun is in, or in any particular Quarter of the Moon. Yet it is certain in this Point, they are so inveterately attached to this Prejudice, that it is but too common to see Country-People die, in waiting for the Sign or Quarter most favourable to the Operation and Effect of a Medicine, which was truly necessary five or six Days before either of them. Sometimes too that particular Medicine is given, to which a certain Day is supposed to be auspicious and favourable, in Preference to that which is most prevalent against the Disease. And thus it is, than an ignorant Almanack Maker determines on the Lives of the human Race; and contracts the Duration of them with Impunity. § 558. When a Vomit or a Purge is to be taken, the Patient's Body should be prepared for the Reception of it twenty-four Hours beforehand; by taking very little Food, and drinking some Glasses of warm Water, or of a light Tea of some Herbs. He should not drink after a Vomit, until it begins to work; but then he should drink very plentifully of warm Water, or a light Infusion of Chamomile Flowers, which is preferable. It is usual, after Purges, to take some thin Broth or Soup during their Operation; but warm Water sweetened with Sugar or Honey, or an Infusion of Succory Flowers, would sometimes be more suitable. § 559. As the Stomach suffers, in some Degree, as often as either a Vomit, or a Purge, is taken, the Patient should be careful how he lives and orders himself for some Days after taking them, as well in Regard to the Quantity as Quality of his Food. § 560. I shall say nothing of other Articles taken by Way of Precaution, such as Soups, Whey, Waters, _&c._ which are but little used among the People; but confine myself to this general Remark, that when they take any of these precautionary Things, they should enter on a Regimen or Way of living, that may co-operate with them, and contribute to the same Purpose. Whey is commonly taken to refresh and cool the Body; and while they drink it, they deny themselves Pulse, Fruits, and Sallads. They eat nothing then, but the best and heartiest Flesh-meats they can come at; such Vegetables as are used in good Soups, Eggs, and good Wine; notwithstanding this is to destroy, by high and heating Aliments, all the attemperating cooling Effects expected from the Whey. Some Persons propose to cool and attemperate their Blood by Soups and a thin Diet, into which they cram Craw-fish, that heat considerably, or _Nasturtium_, Cresses which also heat, and thus defeat their own Purpose. Happily, in such a Case, the Error in one Respect often cures that in the other; and these Kinds of Soup, which are in no wise cooling, prove very serviceable, in Consequence of the Cause of the Symptoms, which they were intended to remove, not requiring any Coolers at all. The general physical Practice of the Community, which unhappily is but too much in Fashion, abounds with similar Errors. I will just cite one, because I have seen its dismal Effects. Many People suppose Pepper cooling, though their Smell, Taste, and common Sense concur to inform them of the contrary. It is the very hottest of Spices. § 561. The most certain Preservative, and the most attainable too by every Man, is to avoid all Excess, and especially Excess in eating and in drinking. People generally eat more than thoroughly consists with Health, or permits them to attain the utmost Vigour, of which their natural Constitutions are capable. The Custom is established, and it is difficult to eradicate it: notwithstanding we should at least resolve not to eat, but through Hunger, and always under a Subjection to Reason; because, except in a very few Cases, Reason constantly suggests to us not to eat, when the Stomach has an Aversion to Food. A sober moderate Person is capable of Labour, I may say, even of excessive Labour of some Kinds; of which greater Eaters are absolutely incapable. Sobriety of itself cures such Maladies as are otherwise incurable, and may recover the most shattered and unhealthy Persons. __Chapter XXXIII.__ _Of Mountebanks, Quacks, and Conjurers._ __Sect.__ 562. One dreadful Scourge still remains to be treated of, which occasions a greater Mortality, than all the Distempers I have hitherto described; and which, as long as it continues, will defeat our utmost Precautions to preserve the Healths and Lives of the common People. This, or rather, these Scourges, for they are very numerous, are Quacks; of which there are two Species: The Mountebanks or travelling Quacks, and those pretended Physicians in Villages and Country-Places, both male and female, known in _Swisserland_ by the Name of Conjurers, and who very effectually unpeople it. The first of these, the Mountebanks, without visiting the Sick, or thinking of their Distempers, sell different Medicines, some of which are for external Use, and these often do little or no Mischief; but their internal ones are much oftener pernicious. I have been a Witness of their dreadful Effects, and we are not visited by one of these wandering Caitiffs, whose Admission into our Country is not mortally fatal to some of its Inhabitants. They are injurious also in another Respect, as they carry off great Sums of Money with them, and levy annually some thousands of Livres, amongst that Order of the People, who have the least to spare. I have seen, and with a very painful Concern, the poor Labourer and the Artisan, who have scarcely possessed the common Necessaries of Life, borrow wherewithal to purchase, and at a dear Price, the Poison that was to compleat their Misery, by increasing their Maladies; and which, where they escaped with their Lives, has left them in such a languid and inactive State, as has reduced their whole Family to Beggary. § 563. An ignorant, knavish, lying and impudent Fellow will always seduce the gross and credulous Mass of People, incapable to judge of and estimate any thing rightly; and adapted to be the eternal Dupes of such, as are base enough to endeavour to dazzle their weak Understandings; by which Method these vile Quacks will certainly defraud them, as long as they are tolerated. But ought not the Magistrates, the Guardians, the Protectors, the political Fathers of the People interpose, and defend them from this Danger, by severely prohibiting the Entrance of such pernicious Fellows into a Country, where Mens' Lives are very estimable, and where Money is scarce; since they extinguish the first, and carry off the last, without the least Possibility of their being in anywise useful to it. Can such forcible Motives as these suffer our Magistrates to delay _their_ Expulsion any longer, _whom_ there never was the least Reason for admitting? § 564. It is acknowledged the Conjurers, the residing Conjurers, do not carry out the current Money of the Country, like the itinerant Quacks; but the Havock they make among their Fellow Subjects is without Intermission, whence it must be very great, as every Day in the Year is marked with many of their Victims. Without the least Knowledge or Experience, and offensively armed with three or four Medicines, whose Nature they are as thoroughly ignorant of, as of their unhappy Patients Diseases; and which Medicines, being almost all violent ones, are very certainly so many Swords in the Hands of raging Madmen. Thus armed and qualified, I say, they aggravate the slightest Disorders, and make those that are a little more considerable, mortal; but from which the Patients would have recovered, if left solely to the Conduct of Nature; and, for a still stronger Reason, if they had confided to the Guidance of her experienced Observers and Assistants. § 565. The Robber who assassinates on the High-way, leaves the Traveller the Resource of defending himself, and the Chance of being aided by the Arrival of other Travellers: But the Poisoner, who forces himself into the Confidence of a sick Person, is a hundred times more dangerous, and as just an Object of Punishment. The Bands of Highwaymen, and their Individuals, that enter into any Country or District, are described as particularly as possible to the Publick. It were equally to be wished, we had also a List of these physical Impostors and Ignorants male and female; and that a most exact Description of them, with the Number, and a brief Summary of their murderous Exploits, were faithfully published. By this Means the Populace might probably be inspired with such a wholesome Dread of them, that they would no longer expose their Lives to the Mercy of such Executioners. § 566. But their Blindness, with Respect to these two Sorts of maleficent Beings, is inconceivable. That indeed in Favour of the Mountebank is somewhat less gross, because as they are not personally acquainted with him, they may the more easily credit him with some Part of the Talents and the Knowledge he arrogates. I shall therefore inform them, and it cannot be repeated too often, that whatever ostentatious Dress and Figure some of these Impostors make, they are constantly vile Wretches, who, incapable of earning a Livelyhood in any honest Way, have laid the Foundation of their Subsistence on their own amazing Stock of Impudence, and that of the weak Credulity of the People; that they have no scientific Knowledge; that their Titles and Patents are so many Impositions, and inauthentic; since by a shameful Abuse, such Patents and Titles are become Articles of Commerce, which are to be obtained at very low Prices; just like the second-hand laced Cloaks which they purchase at the Brokers. That their Certificates of Cures are so many Chimeras or Forgeries; and that in short, if among the prodigious Multitudes of People who take their Medicines, some of them should recover, which it is almost physically impossible must not sometimes be the Case, yet it would not be the less certain, that they are a pernicious destructive Set of Men. A Thrust of a Rapier into the Breast has saved a Man's Life by seasonably opening an Imposthume in it, which might otherwise have killed him: and yet internal penetrating Wounds, with a small Sword, are not the less mortal for one such extraordinary Consequence. Nor is it even surprizing that these Mountebanks, which is equally applicable to Conjurers, who kill thousands of People, whom Nature alone, or assisted by a Physician, would have saved, should now and then cure a Patient, who had been treated before by the ablest Physicians. Frequently Patients of that Class, who apply to these Mountebanks and Conjurers (whether it has been, that they would not submit to the Treatment proper for their Distempers; or whether the real Physician tired of the intractable Creatures has discontinued his Advice and Attendance) look out for such Doctors, as assure them of a speedy Cure, and venture to give them such Medicines as kill many, and cure one (who has had Constitution enough to overcome them) a little sooner than a justly reputable Physician would have done. It is but too easy to procure, in every Parish, such Lists of their Patients, and of their Feats, as would clearly evince the Truth of whatever has been said here relating to them. § 567. The Credit of this Market, this Fair-hunting Doctor, surrounded by five or six hundred Peasants, staring and gaping at him, and counting themselves happy in his condescending to cheat them of their very scarce and necessary Cash, by selling them, for twenty times more than its real Worth, a Medicine whose best Quality were to be only a useless one; the Credit, I say, of this vile yet tolerated Cheat, would quickly vanish, could each of his Auditors be persuaded, of what is strictly true, that except a little more Tenderness and Agility of Hand, he knows full as much as his Doctor; and that if he could assume as much Impudence, he would immediately have as much Ability, would equally deserve the same Reputation, and to have the same Confidence reposed in him. § 568. Were the Populace capable of reasoning, it were easy to disabuse them in these Respects; but as it is, their Guardians and Conductors should reason for them. I have already proved the Absurdity of reposing any Confidence in Mountebanks, properly so called; and that Reliance some have on the Conjurers is still more stupid and ridiculous. The very meanest Trade requires some Instruction: A Man does not commence even a Cobler, a Botcher of old Leather, without serving an Apprenticeship to it; and yet no Time has been served, no Instruction has been attended to, by these Pretenders to the most necessary, useful and elegant Profession. We do not confide the mending, the cleaning of a Watch to any, who have not spent several Years in considering how a Watch is made; what are the Requisites and Causes of its going right; and the Defects or Impediments that make it go wrong: and yet the preserving and rectifying the Movements of the most complex, the most delicate and exquisite, and the most estimable Machine upon Earth, is entrusted to People who have not the least Notion of its Structure; of the Causes of its Motions; nor of the Instruments proper to rectify their Deviations. Let a Soldier discarded from his Regiment for his roguish Tricks, or who is a Deserter from it, a Bankrupt, a disreputable Ecclesiastic, a drunken Barber, or a Multitude of such other worthless People, advertize that they mount, set and fit up all Kinds of Jewels and Trinkets in Perfection; if any of these are not known; if no Person in the Place has ever seen any of their Work; or if they cannot produce authentic Testimonials of their Honesty, and their Ability in their Business, not a single Individual will trust them with two Pennyworth of false Stones to work upon; in short they must be famished. But if instead of professing themselves Jewellers, they post themselves up as Physicians, the Croud purchase, at a high Rate, the Pleasure of trusting them with the Care of their Lives, the remaining Part of which they rarely fail to empoison. § 569. The most genuine and excellent Physicians, these extraordinary Men, who, born with the happiest Talents, have began to inform their Understandings from their earliest Youth; who have afterwards carefully qualified themselves by cultivating every Branch of Physic; who have sacrificed the best and most pleasurable Days of their Lives, to a regular and assiduous Investigation of the human Body; of its various Functions; of the Causes that may impair or embarrass them, and informed themselves of the Qualities and Virtues of every simple and compound Medicine; who have surmounted the Difficulty and Loathsomness of living in Hospitals among thousands of Patients; and who have added the medical Observations of all Ages and Places to their own; these few and extraordinary Men, I say, still consider themselves as short of that perfect Ability and consummate Knowledge, which they contemplate and wish for, as necessary to guarding the precious _Depositum_ of human Life and Health, confided to their Charge. Nevertheless we see the same inestimable Treasures, intrusted to gross and stupid Men, born without Talents; brought up without Education or Culture; who frequently can scarcely read; who are as profoundly ignorant of every Subject that has any Relation to Physic, as the Savages of _Asia_; who awake only to drink away; who often exercise their horrid Trade merely to find themselves in strong Liquor, and execute it chiefly when they are drunk: who, in short, became Physicians, only from their Incapacity to arrive at any Trade or Attainment! Certainly such a Conduct in Creatures of the human Species must appear very astonishing, and even melancholy, to every sensible thinking Man; and constitute the highest Degree of Absurdity and Extravagance. Should any Person duly qualified enter into an Examination of the Medicines they use, and compare them with the Situation and Symptoms of the Patients to whom they give them, he must be struck with Horror; and heartily deplore the Fate of that unfortunate Part of the human Race, whose Lives, so important to the Community, are committed to the Charge of the most murderous Set of Beings. § 570. Some of these Caitiffs however, apprehending the Force and Danger of that Objection, founded on their Want of Study and Education, have endeavoured to elude it, by infusing and spreading a false, and indeed, an impudent impious Prejudice among the People, which prevails too much at present; and this is, that their Talents for Physic are a supernatural Gift, and, of Course, greatly superior to all human Knowledge. It were going out of my Province to expatiate on the Indecency, the Sin, and the Irreligion of such Knavery, and incroaching upon the Rights and perhaps the Duty of the Clergy; but I intreat the Liberty of observing to this respectable Order of Men, that this Superstition, which is attended with dreadful Consequences, seems to call for their utmost Attention: and in general the Expulsion of Superstition is the more to be wished, as a Mind, imbued with false Prejudices, is less adapted to imbibe a true and valuable Doctrine. There are some very callous hardened Villains among this murdering Band, who, with a View to establish their Influence and Revenue as well upon Fear as upon Hope, have horridly ventured so far as to incline the Populace to doubt, whether they received their boasted Gift and Power from Heaven or from Hell! And yet these are the Men who are trusted with the Health and the Lives of many others. § 571. One Fact which I have already mentioned, and which it seems impossible to account for is, that great Earnestness of the Peasant to procure the best Assistance he can for his sick Cattle. At whatever Distance the Farrier lives, or some Person who is supposed qualified to be one (for unfortunately there is not one in _Swisserland_) if he has considerable Reputation in this Way, the Country-man goes to consult him, or purchases his Visit at any Price. However expensive the Medicines are, which the Horse-doctor directs, if they are accounted the best, he procures them for his poor Beast. But if himself, his Wife or Children fall sick, he either calls in no Assistance nor Medicines; or contents himself with such as are next at Hand, however pernicious they may be, though nothing the cheaper on that account: for certainly the Money, extorted by some of these physical Conjurers from their Patients, but oftner from their Heirs, is a very shameful Injustice, and calls loudly for Reformation. § 572. In an excellent Memoir or Tract, which will shortly be published, on the Population of _Swisserland_, we shall find an important and very affecting Remark, which strictly demonstrates the Havock made by these immedical Magicians or Conjurers; and which is this: That in the common Course of Years, the Proportion between the Numbers and Deaths of the Inhabitants of any one Place, is not extremely different in City and Country: but when the very same epidemical Disease attacks the City and the Villages, the Difference is enormous; and the Number of Deaths of the former compared with that of the Inhabitants of the Villages, where the Conjurer exercises his bloody Dominion, is infinitely more than the Deaths in the City. I find in the second Volume of the Memoirs of the oeconomical Society of _Berne_, for the Year 1762, another Fact equally interesting, which is related by one of the most intelligent and sagacious Observers, concerned in that Work. "Pleurisies and Peripneumonies (he says) prevailed at _Cottens a la Côte_; and some Peasants died under them, who had consulted the Conjurers and taken their heating Medicines; while of those, who pursued a directly opposite Method, almost every one recovered." § 573. But I shall employ myself no longer on this Topic, on which the Love of my Species alone has prompted me to say thus much; though it deserves to be considered more in Detail, and is, in Reality, of the greatest Consequence. None methinks could make themselves easy with Respect to it so much as Physicians, if they were conducted only by lucrative Views; since these Conjurers diminish the Number of those poor People, who sometimes consult the real Physicians, and with some Care and Trouble, but without the least Profit, to those Gentlemen. But what good Physician is mean and vile enough to purchase a few Hours of Ease and Tranquillity at so high, so very odious a Price? § 574. Having thus clearly shewn the Evils attending this crying Nusance, I wish I were able to prescribe an effectual Remedy against it, which I acknowledge is far from being easy to do. The first necessary Point probably was to have demonstrated the great and public Danger, and to dispose the State to employ their Attention on this fatal, this mortal Abuse; which, joined to the other Causes of Depopulation, has a manifest Tendency to render _Swisserland_ a Desert. § 575. The second, and doubtless the most effectual Means, which I had already mentioned is, not to admit any travelling Mountebank to enter this Country; and to set a Mark on all the Conjurers: It may probably also be found convenient, to inflict corporal Punishment on them; as it has been already adjudged in different Countries by sovereign Edicts. At the very least they should be marked with public Infamy, according to the following Custom practised in a great City in _France_. "When any Mountebanks appeared in _Montpellier_, the Magistrates had a Power to mount each of them upon a meagre miserable Ass, with his Head to the Ass's Tail. In this Condition they were led throughout the whole City, attended with the Shouts and Hooting of the Children and the Mob, beating them, throwing Filth and Ordure at them, reviling them, and dragging them all about." § 576. A third conducive Means would be the Instructions and Admonition of the Clergy on this Subject, to the Peasants in their several Parishes. For this Conduct of the common People amounting, in Effect, to Suicide, to Self-murder, it must be important to convince them of it. But the little Efficacy of the strongest and repeated Exhortations on so many other Articles, may cause us to entertain a very reasonable Doubt of their Success on this. Custom seems to have determined, that there is nothing in our Day, which excludes a Person from the Title and Appellation of an honest or honourable Man, except it be meer and convicted Theft; and that for this simple and obvious Reason, that we attach ourselves more strongly to our Property, than to any Thing else. Even Homicide is esteemed and reputed honourable in many Cases. Can we reasonably then expect to convince the Multitude, that it is criminal to confide the Care of their Health to these Poisoners, in Hopes of a Cure of their Disorders? A much likelier Method of succeding on this Point would certainly be, to convince the deluded People, that it will cost them less to be honestly and judiciously treated, than to suffer under the Hands of these Executioners. The Expectation of a good and cheap Health-market will be apt to influence them more, than their Dread of a Crime would. § 577. A fourth Means of removing or restraining this Nusance would be to expunge, from the Almanacs, all the astrological Rules relating to Physick; as they continually conduce to preserve and increase some dangerous Prejudices and Notions in a Science, the smallest Errors in which are sometimes fatal. I had already reflected on the Multitude of Peasants that have been lost, from postponing, or mistiming a Bleeding, only because the sovereign Decision of an Almanac had directed it at some other Time. May it not also be dreaded, to mention it by the Way, that the same Cause, the Almanacs, may prove injurious to their rural Oeconomy and Management; and that by advising with the Moon, who has no Influence, and is of no Consequence in Vegetation or other Country Business, they may be wanting in a due Attention to such other Circumstances and Regulations, as are of real Importance in them? § 578. A fifth concurring Remedy against this popular Evil would be the Establishment of Hospitals, for the Reception of poor Patients, in the different Cities and Towns of _Swisserland_. There may be a great many easy and concurring Means of erecting and endowing such, with very little new Expence; and immense Advantages might result from them: besides, however considerable the Expenses might prove, is not the Object of them of the most interesting, the most important Nature? It is incontestably our serious Duty; and it would soon be manifest, that the Performance of it would be attended with more essential intrinsic Benefit to the Community, than any other Application of Money could produce. We must either admit, that the Multitude, the Body of the People is useless to the State, or agree, that Care should be taken to preserve and continue them. A very respectable _English_ Man, who, after a previous and thorough Consideration of this Subject, had applied himself very assiduously and usefully on the Means of increasing the Riches and the Happiness of his Country-men, complains that in _England_, the very Country in which there are the most Hospitals, the Poor who are sick are not sufficiently assisted. What a deplorable Deficience of the necessary Assistance for such must then be in a Country, that is not provided with a single Hospital? That Aid from Surgery and Physic, which abounds in Cities, is not sufficiently diffused into Country-places: and the Peasants are liable to some simple and moderate Diseases, which, for Want of proper Care, degenerate into a State of Infirmity, that sinks them into premature Death. § 579. In fine, if it be found impossible to extinguish these Abuses (for those arising from Quacks are not the only ones, nor is that Title applied to as many as really deserve it) beyond all Doubt it would be for the Benefit and Safety of the Public, upon the whole, entirely to prohibit the Art, the Practice of Physic itself. When real and good Physicians cannot effect as much Good, as ignorant ones and Impostors can do Mischief, some real Advantage must accrue to the State, and to the whole Species, from employing none of either. I affirm it, after much Reflection, and from thorough Conviction, that Anarchy in Medicine is the most dangerous Anarchy. For this Profession, when loosed from every Restraint, and subjected to no Regulations, no Laws, is the more cruel Scourge and Affliction, from the incessant Exercise of it; and should its Anarchy, its Disorders prove irremediable, the Practice of an Art, become so very noxious, should be prohibited under the severest Penalties: Or, if the Constitution of any Government was inconsistent with the Application of so violent a Remedy, they should order public Prayers against the Mortality of it, to be offered up in all the Churches; as the Custom has been in other great and general Calamities. § 580. Another Abuse, less fatal indeed than those already mentioned (but which, however, has real ill Consequences, and at the best, carries out a great deal of Money from us, though less at the Expense of the common People, than of those of easy Circumstances) is that Blindness and Facility, with which many suffer themselves to be imposed upon, by the pompous Advertisements of some _Catholicon_, some universal Remedy, which they purchase at a high Rate, from some foreign Pretender to a mighty Secret or _Nostrum_. Persons of a Class or two above the Populace do not care to run after a Mountebank, from supposing they should depretiate themselves by mixing with the Herd. Yet if that very Quack, instead of coming among us, were to reside in some foreign City; if, instead of posting up his lying Puffs and Pretentions at the Corners of the Streets, he would get them inserted in the Gazettes, and News-papers; if, instead of selling his boasted Remedies in Person, he should establish Shops or Offices for that Purpose in every City; and finally, if instead of selling them twenty times above their real Value, he would still double that Price; instead of having the common People for his Customers, he would take in the wealthy Citizen, Persons of all Ranks, and from almost every Country. For strange as it seems, it is certain, that a Person of such a Condition, who is sensible in every other Respect; and who will scruple to confide his Health to the Conduct of such Physicians as would be the justest Subjects of his Confidence, will venture to take, through a very unaccountable Infatuation, the most dangerous Medicine, upon the Credit of an imposing Advertisement, published by as worthless and ignorant a Fellow as the Mountebank whom he despises, because the latter blows a Horn under his Window; and yet who differs from the former in no other Respects except those I have just pointed out. § 581. Scarcely a Year passes, without one or another such advertized and vaunted Medicine's getting into high Credit; the Ravages of which are more or less, in Proportion to its being more or less in Vogue. Fortunately, for the human Species, but few of these _Nostrums_ have attained an equal Reputation with _Ailbaud_'s Powders, an Inhabitant of _Aix_ in _Provence_, and unworthy the Name of a Physician; who has over-run _Europe_ for some Years, with a violent Purge, the Remembrance of which will not be effaced before the Extinction of all its Victims. I attend now, and for a long time past, several Patients, whose Disorders I palliate without Hopes of ever curing them; and who owe their present melancholy State of Body to nothing but the manifest Consequences of these Powders; and I have actually seen, very lately, two Persons who have been cruelly poisoned by this boasted Remedy of his. A French Physician, as eminent for his Talents and his Science, as estimable from his personal Character in other Respects, has published some of the unhappy and tragical Consequences which the Use of them has occasioned; and were a Collection published of the same Events from them, in every Place where they have been introduced, the Size and the Contents of the Volume would make a very terrible one. § 582. It is some Comfort however, that all the other Medicines thus puffed and vended have not been altogether so fashionable, nor yet quite so dangerous: but all posted and advertized Medicines should be judged of upon this Principle (and I do not know a more infallible one in Physics, nor in the Practice of Physic), that whoever advertises any Medicine, as a universal Remedy for all Diseases, is an absolute Impostor, such a Remedy being impossible and contradictory. I shall not here offer to detail such Proofs as may be given of the Verity of this Proposition: but I freely appeal for it to every sensible Man, who will reflect a little on the different Causes of Diseases; on the Opposition of these Causes; and on the Absurdity of attempting to oppose such various Diseases, and their Causes, by one and the same Remedy. As many as shall settle their Judgments properly on this Principle, will never be imposed upon by the superficial Gloss of these Sophisms contrived to prove, that all Diseases proceed from one Cause; and that this Cause is so very tractable, as to yield to one boasted Remedy. They will perceive at once, that such an Assertion must be founded in the utmost Knavery or Ignorance; and they will readily discover where the Fallacy lies. Can any one expect to cure a Dropsy, which arises from too great a Laxity of the Fibres, and too great an Attenuation or Thinness of the Blood, by the same Medicines that are used to cure an inflammatory Disease, in which the Fibres are too stiff and tense, and the Blood too thick and dense? Yet consult the News-papers and the Posts, and you will see published in and on all of them, Virtues just as contradictory; and certainly the Authors of such poisonous Contradictions ought to be legally punished for them. § 583. I heartily wish the Publick would attend here to a very natural and obvious Reflection. I have treated in this Book, but of a small Number of Diseases, most of them acute ones; and I am positive that no competent well qualified Physician has ever employed fewer Medicines, in the Treatment of the Diseases themselves. Nevertheless I have prescribed seventy-one, and I do not see which of them I could retrench, or dispense with the Want of, if I were obliged to use one less. Can it be supposed then, that any one single Medicine, compound or simple, shall cure thirty times as many Diseases as those I have treated of? § 584. I shall add another very important Observation, which doubtless may have occurred to many of my Readers; and it is this, that the different Causes of Diseases, their different Characters; the Differences which arise from the necessary Alterations that happen throughout their Progress and Duration; the Complications of which they are susceptible; the Varieties which result from the State of different Epidemics, of Seasons, of Sexes, and of many other Circumstances; that these Diversities, I say, oblige us very often to vary and change the Medicines; which proves how very ticklish and dangerous it is to have them directed by Persons, who have such an imperfect Knowledge of them, as those who are not Physicians must be supposed to have. And the Circumspection to be used in such Cases ought to be proportioned to the Interest the Assistant takes in the Preservation of the Patient; and that Love of his Neighbour with which he is animated. § 585. Must not the same Arguments and Reflections unavoidably suggest the Necessity of an entire Tractability on the Part of the Patient, and his Friends and Assistants? The History of Diseases which have their stated Times of Beginning, of manifesting and displaying themselves; of arriving at, and continuing in their Height, and of decreasing; do not all these demonstrate the Necessity of continuing the same Medicines, as long as the Character of the Distemper is the same; and the Danger of changing them often, only because what has been given has not afforded immediate Relief? Nothing can injure the Patient more than this Instability and Caprice. After the Indication which his Distemper suggests, appears to be well deduced, the Medicine must be chosen that is likeliest to resist the Cause of it; and it must be continued as long as no new Symptom or Circumstance supervenes, which requires an Alteration of it; except it should be evident, that an Error had been incurred in giving it. But to conclude that a Medicine is useless or insignificant, because it does not remove or abate the Distemper as speedily, as the Impatience of the Sick would naturally desire it; and to change it for another, is as unreasonable, as it would be for a Man to break his Watch, because the Hand takes twelve Hours, to make a Revolution round the Dial-plate. § 586. Physicians have some Regard to the State of the Urine of sick Persons, especially in inflammatory Fevers; as the Alterations occurring in it help them to judge of the Changes that may have been made in the Character and Consistence of the Humours in the Mass of Blood; and thence may conduce to determine the Time, in which it will be proper to dispose them to some Evacuation. But it is gross Ignorance to imagine, and utter Knavery and Imposture to persuade the Sick, that the meer Inspection of their Urine solely, sufficiently enables others to judge of the Symptoms and Cause of the Disease, and to direct the best Remedies for it. This Inspection of the Urine can only be of Use when it is duly inspected; when we consider at the same time the exact State and the very Looks of the Patient; when these are compared with the Degree of the Symptoms of the Malady; with the other Evacuations; and when the Physician is strictly informed of all external Circumstances, which may be considered as foreign to the Malady; which may alter or affect the Evacuations, such as particular Articles of Food, particular Drinks, different Medicines, or the very Quantity of Drink. Where a Person is not furnished with an exact Account of these Circumstances, the meer Inspection of the Urine is of no Service, it suggests no Indication, nor any Expedient; and meer common Sense sufficiently proves, and it may be boldly affirmed, that whoever orders any Medicine, without any other Knowledge of the Disease, than what an Inspection of the Urine affords, is a rank Knave, and the Patient who takes them is a Dupe. § 587. And here now any Reader may very naturally ask, whence can such a ridiculous Credulity proceed, upon a Subject so essentially interesting to us as our own Health? In Answer to this it should be observed, that some Sources, some Causes of it seem appropriated merely to the People, the Multitude. The first of these is, the mechanical Impression of Parade and Shew upon the Senses. 2, The Prejudice they have conceived, as I said before, of the Conjurers curing by a supernatural Gift. 3, The Notion the Country People entertain, that their Distemper and Disorders are of a Character and Species peculiar to themselves, and that the Physicians, attending the Rich, know nothing concerning them. 4, The general Mistake that their employing the Conjurer is much cheaper. 5, Perhaps a sheepish shame-faced Timidity may be one Motive, at least with some of them. 6, A Kind of Fear too, that Physicians will consider their Cases with less Care and Concern, and be likely to treat them more cavalierly; a Fear which increases that Confidence which the Peasant, and which indeed every Man has in his Equal, being sounded in Equality itself. And 7, the Discourse and Conversation of such illiterate Empirics being more to their Tast, and more adapted to their Apprehension. But it is less easy to account for this blind Confidence, which Persons of a superior Class (whole Education being considered as much better are regarded as better Reasoners) repose in these boasted Remedies; and even for some Conjurer in Vogue. Nevertheless even some of their Motives may be probably assigned. The first is that great Principle of _Seïty_, or _Selfness_, as it may be called, innate to Man, which attaching him to the Prolongation of his own Existence more than to any other thing in the Universe, keeps his Eyes, his utmost Attention, continually fixed upon this Object; and compels him to make it the very Point, the Purpose of all his Advances and Proceedings; notwithstanding it does not permit him to distinguish the safest Paths to it from the dangerous ones. This is the surest and shortest Way says some Collector at the Turnpike, he pays, passes, and perishes from the Precipices that occur in his Route. This very Principle is the Source of another Error, which consists in reposing, involuntarily, a greater Degree of Confidence in those, who flatter and fall in the most with us in our favourite Opinions. The well apprised Physician, who foresees the Length and the Danger of a Disease; and who is a Man of too much Integrity to affirm what he does not think, must, from a necessary Construction of the human Frame and Mind, be listened to less favourably, than he who flatters us by saying what we wish. We endeavour to elongate, to absent ourselves, from the Sentiments, the Judgment of the first; we smile, from Self-complacency, at those of the last, which in a very little time are sure of obtaining our Preference. A third Cause, which results from the same Principle is, that we give ourselves up the most readily to his Conduct, whose Method seems the least disagreeable, and flatters our Inclinations the most. The Physician who enjoins a strict Regimen; who insists upon some Restraints and Self-denials; who intimates the Necessity of Time and Patience for the Accomplishment of the Cure, and who expects a thorough Regularity through the Course of it, disgusts a Patient who has been accustomed to indulge his own Tast and Humour; the Quack, who never hesitates at complying with it, charms him. The Idea of a long and somewhat distant Cure, to be obtained at the End of an unpleasant and unrelaxing Regimen, supposes a very perilous Disease; this Idea disposes the Patient to Disgust and Melancholy, he cannot submit to it without Pain; and he embraces, almost unconsciously, merely to avoid this, an opposite System which presents him only with the Idea of such a Distemper, as will give Way to a few Doses of Simples. That Propensity to the New and Marvellous, which tyrannizes over so large a Proportion of our Species, and which has advanced so many absurd Persons and Things into Reputation, is a fourth and a very powerful Motive. An irksome Satiety, and a Tiresomeness, as it were, from the same Objects, is what our Nature is apt to be very apprehensive of; though we are incessantly conducted towards it, by a Perception of some Void, some Emptiness in ourselves, and even in Society too: But new and extraordinary Sensations rousing us from this disagreeable State, more effectually than any Thing else, we unthinkingly abandon ourselves to them, without foreseeing their Consequences. A fifth Cause arises from seven Eighths of Mankind being managed by, or following, the other Eighth; and, generally speaking, the Eighth that is so very forward to manage them, are the least fit and worthy to do it; whence all must go amiss, and absurd and embarrassing Consequences ensue from the Condition of Society. A Man of excellent Sense frequently sees only through the Eyes of a Fool, of an intriguing Fellow, or of a Cheat; in this he judges wrong, and his Conduct must be so too. A man of real Merit cannot connect himself with those who are addicted to caballing; and yet such are the Persons, who frequently conduct others. Some other Causes might be annexed to these, but I shall mention only one of them, which I have already hinted, and the Truth of which I am confirmed in from several Years Experience; which is, that we generally love those who reason more absurdly than ourselves, better than those who convince us of our own weak Reasoning. I hope the Reflexions every Reader will make on these Causes of our ill Conduct on this important Head, may contribute to correct or diminish it; and to destroy those Prejudices whose fatal Effects we may continually observe. [N. B. _The Multitude of_ all _the Objects of this excellent Chapter in this Metropolis, and doubtless throughout_ England, _were strong Inducements to have taken a little wholesome Notice of the Impostures of a few of the most pernicious. But on a second Perusal of this Part of the Original and its Translation, I thought it impossible (without descending to personal, nominal Anecdotes about the Vermin) to add any Thing material upon a Subject, which the Author has with such Energy exhausted. He even seems, by some of his Descriptions, to have taken Cognizance of a few of our most self-dignified itinerant Empirics; as these Genius's find it necessary sometimes to treat themselves with a little Transportation. In reality Dr._ _Tissot_ _has, in a very masterly Way, thoroughly dissected and displayed the whole_ Genus, _every Species of Quacks. And when he comes to account for that Facility, with which Persons of very different Principles from them, and of better Intellects, first listen to, and finally countenance such Caitiffs, he penetrates into some of the most latent Weaknesses of the human Mind; even such as are often Secrets to their Owners. It is difficult, throughout this Disquisition, not to admire the Writer; but impossible not to love the Man, the ardent Philanthropist. His Sentiment that--"A Man of real Merit cannot connect himself with those who are addicted to caballing,"--is exquisitely just, and so liberal, that it never entered into the Mind of any disingenuous Man, however dignified, in any Profession. Persons of the simplest Hearts and purest Reflections must shrink at every Consciousness of Artifice; and secretly reproach themselves for each Success, that has redounded to them at the Expence of Truth._] K. __Chapter XXXIV.__ _Containing Questions absolutely necessary to be answered exactly by the Patient, who consults a Physician._ __Sect.__ 588. Great Consideration and Experience are necessary to form a right Judgment of the State of a Patient, whom the Physician has not personally seen; even though he should receive the best Information it is possible to give him, at a Distance from the Patient. But this Difficulty is greatly augmented, or rather changed into an Impossibility, when his Information is not exact and sufficient. It has frequently happened to myself, that after having examined Peasants who came to get Advice for others, I did not venture to prescribe, because they were not able to give me a sufficient Information, in order to my being certain of the Distemper. To prevent this great Inconvenience, I subjoin a List of such Questions, as indispensably require clear and direct Answers. _General Questions._ What is the Patient's Age? Is he generally a healthy Person? What is his general Course of Life? How long has he been sick? In what Manner did his present Sickness begin, or appear? Has he any Fever? Is his Pulse hard or soft? Has he still tolerable Strength, or is he weak? Does he keep his Bed in the Day Time, or quit it? Is he in the same Condition throughout the whole Day? Is he still, or restless? Is he hot, or cold? Has he Pains in the Head, the Throat, the Breast, the Stomach, the Belly, the Loins, or in the Limbs, the Extremities of the Body? Is his Tongue dry? does he complain of Thirst? of an ill Tast in his Mouth? of Reachings to vomit, or of an Aversion to Food? Does he go to stool often or seldom? What Appearance have his Stools, and what is their usual quantity? Does he make much Urine? What Appearance has his Urine, as to Colour and Contents? Are they generally much alike, or do they change often? Does he sweat? Does he expectorate, or cough up? Does he get Sleep? Does he draw his Breath easily? What Regimen does he observe in his Sickness? What Medicines has he taken? What Effects have they produced? Has he never had the same Distemper before? § 589. The Diseases of Women and Children are attended with peculiar Circumstances; so that when Advice is asked for them, Answers must be given, not only to the preceding Questions, which relate to sick Persons in general; but also to the following, which regard these particularly. _Questions with Respect to Women._ Have they arrived at their monthly Discharges, and are these regular? Are they pregnant? Is so, how long since? Are they in Child-bed? Has their Delivery been happily accomplished? Has the Mother cleansed sufficiently? Has her Milk come in due Time and Quantity? Does she suckle the Infant herself? Is she subject to the Whites? _Questions relating to Children._ What is the Child's exact Age? How many Teeth has he cut? Does he cut them painfully? Is he any-wise ricketty, or subject to Knots or Kernels? Has he had the Small Pocks? Does the Child void Worms, upwards or downwards? Is his Belly large, swelled, or hard? Is his Sleep quiet, or otherwise? § 590. Besides these general Questions, common in all the Diseases of the different Sexes and Ages, the Person consulting must also answer to those, which have a close and direct Relation to the Disease, at that very Time affecting the Sick. For Example, in the Quinsey, the Condition of the Throat must be exactly inquired into. In Diseases of the Breast, an Account must be given of the Patient's Pains; of his Cough; of the Oppression, and of his Breathing, and Expectoration. I shall not enter upon a more particular Detail; common Sense will sufficiently extend this Plan or Specimen to other Diseases; and though these Questions may seem numerous, it will always be easy to write down their Answers in as little Room, as the Questions take up here. It were even to be wished that Persons of every Rank, who occasionally write for medical Advice and Directions, would observe such a Plan or Succession, in the Body of their Letters. By this Means they would frequently procure the most satisfactory Answers; and save themselves the Trouble of writing second Letters, to give a necessary Explanation of the first. The Success of Remedies depends, in a very great Measure, on a very exact Knowledge of the Disease; and that Knowledge on the precise Information of it, which is laid before the Physician. __FINIS.__ _TABLE_ _Of the Prescriptions and Medicines, referred to in the foregoing Treatise: Which, with the Notes beneath them, are to be read before the taking, or Application, of any of the said Medicines._ As in Order to ascertain the Doses of Medicines, I have generally done it by Pounds, Ounces, Half-Ounces, _&c. &c._ and as this Method, especially to the common People, might prove a little too obscure and embarrassing, I have specified here the exact Weight of Water, contained in such Vessels or liquid Measures, as are most commonly used in the Country. The Pound which I mean, throughout all these Prescriptions, is that consisting of sixteen Ounces. These Ounces contain eight Drachms, each Drachm consisting of three Scruples, and each Scruple of twenty Grains; the medical Scruple of _Paris_ solely containing twenty-four Grains. The liquid Measure, the _Pot_ used at _Berne_, being that I always speak of, may be estimated, without any material Error, to contain three Pounds and a Quarter, which is equal to three Pints, and eight common Spoonfuls English Measure. But the exact Weight of the Water, contained in the Pot of _Berne_, being fifty-one Ounces and a Quarter only, it is strictly equal but to three Pints and six common Spoonfuls _English_. This however is a Difference of no Importance, in the usual Drinks or Aliments of the Sick. The small drinking Glass we talk of, filled so as not to run over, contains three Ounces and three Quarters. But filled, as we propose it should for the Sick, it is to be estimated only at three Ounces. The common middle sized Cup, though rather large than little, contains three Ounces and a Quarter. But as dealt out to the Sick, it should not be estimated, at the utmost, above three Ounces. The small Glass contains seven common Spoonfuls; so that a Spoonful is supposed to contain half an Ounce. The small Spoon, or Coffee Spoon, when of its usual Size and Cavity, may contain thirty Drops, or a few more; but, in the Exhibition of Medicines, it may be reckoned at thirty Drops. Five or six of these are deemed equal in Measure, to a common Soup-Spoon. The Bason or Porrenger, mentioned in the present Treatise, holds, without running over, the Quantity of five Glasses, which is equivalent to eighteen Ounces and three Quarters. It may be estimated however, without a Fraction, at eighteen Ounces: and a sick Person should never be allowed to take more than a third Part of this Quantity of Nourishment, at any one Time. The Doses in all the following Prescriptions are adjusted to the Age of an Adult or grown Man, from the Age of eighteen to that of sixty Years. From the Age of twelve to eighteen, two thirds of that Dose will generally be sufficient: and from twelve down to seven Years one half, diminishing this still lower, in Proportion to the greater Youth of the Patient: so that not more than one eighth of the Dose prescribed should be given to an infant of some Months old, or under one Year. But it must also be considered, that their different Constitutions will make a considerable Difference in adjusting their different Doses. It were to be wished, on this Account, that every Person would carefully observe whether a strong Dose is necessary to purge him, or if a small one is sufficient; as Exactness is most important in adjusting the Doses of such Medicines, as are intended to purge, or to evacuate in any other Manner. Nº. 1. Take a Pugil or large Pinch between the Thumb and Fingers of Elder Flowers; put them into an earthen-ware Mug or Porrenger, with two Ounces of Honey, and an Ounce and a half of good Vinegar. Pour upon them three Pints and one Quarter of boiling Water. Stir it about a little with a Spoon to mix and dissolve the Honey; then cover up the Mug; and, when the Liquor is cold, strain it through a Linen Cloth. Nº. 2. Take two Ounces of whole Barley, cleanse and wash it well in hot Water, throwing away this Water afterwards. Then boil it in five Chopins or _English_ Pints of Water, till the Barley bursts and opens. Towards the End of the boiling, throw in one Drachm and a half of Nitre [Salt Petre] strain it through a Linen Cloth, and then add to it one Ounce and a half of Honey, and one Ounce of Vinegar. [113] �[113] This makes an agreeable Drink; and the Notion of its being windy is idle; since it is so only to those, with whom Barley does not agree. It may, where Barley is not procurable, be made from Oats. Nº. 3. Take the same Quantity of Barley as before, and instead of Nitre, boil in it, as soon as the Barley is put in to boil, a Quarter of an Ounce of Cream of Tartar. Strain it, and add nothing else [114] to it. �[114] In those Cases mentioned § 241, 262, 280, instead of the Barley, four Ounces of Grass Roots may be boiled in the same Quantity of Water for half an Hour, with the Cream of Tartar. Nº. 4. Take three Ounces of the freshest sweet Almonds, and one Ounce of Gourd or Melon Seed; bruise them in a Mortar, adding to them by a little at a time, one Pint of Water, then strain it through Linen. Bruise what remains again, adding gradually to it another Pint of Water, then straining; and adding Water to the Residue, till full three Pints at least of Water are thus used: after which it may again be poured upon the bruised Mass, stirred well about, and then be finally strained off. Half an Ounce of Sugar may safely be bruised with the Almonds and Seeds at first, though some weakly imagine it too heating; and delicate Persons may be allowed a little Orange Flower Water with it. Nº. 5. Take two Pugils of Mallow Leaves and Flowers, cut them small, and pour a Pint of boiling Water upon them. After standing some time strain it, adding one Ounce of Honey to it. For Want of Mallows, which is preferable, a similar Glyster may be made of the Leaves of Mercury, Pellitory of the Wall, the Marsh-Mallows, the greater Mallows, from Lettuce, or from Spinage. A few very particular Consititutions are not to be purged by any Glyster but warm Water alone; such should receive no other, and the Water should not be very hot. Nº. 6. Boil a Pugil of Mallow Flowers, in a Pint of Barley Water for a Glyster. Nº. 7. Take three Pints of simple Barley Water, add to it three Ounces of the Juice of Sow-thistle, or of Groundsel, or of the greater Houseleek, or of Borage. [115] �[115] These Juices are to be procured from the Herbs when fresh and very young, if possible, by beating them in a Marble Mortar, or for Want of such [or a wooden Mortar] in an Iron one, and then squeezing out the Juice through a Linen Bag. It must be left to settle a little in an earthen Vessel, after which the clear Juice must be decanted gently off, and the Sediment be left behind. Nº. 8. To one Ounce of Oxymel of Squills, add five Ounces of a strong Infusion of Elder Flowers. Nº. 9. There are many different emollient Applications, which have very nearly the same Virtues. The following are the most efficacious. 1, Flanels wrung out of a hot Decoction of Mallow Flowers. 2, Small Bags filled with Mallow Flowers, or with those of Mullein, of Elder, of Camomile, of wild Corn Poppy, and boiled either in Milk or Water. 3, Pultices of the same Flowers boiled in Milk and Water. 4, Bladders half filled with hot Milk and Water, or with some emollient Decoction. 5, A Pultice of boiled Bread and Milk, or of Barley or Rice boiled till thoroughly soft and tender. 6, In the Pleurisy (See § 89) the affected Part may be rubbed sometimes with Ointment of Marsh-mallows. Nº. 10. To one Ounce of Spirit of Sulphur, add six Ounces of Syrup of Violets, or for want of the latter, as much Barley Water, of a thicker Consistence than ordinary. [116] �[116] Some Friends, says Dr. _Tissot_, whose judgment I greatly respect, have thought the Doses of acid Spirit which I direct extremely strong; and doubtless they are so, if compared with the Doses generally prescribed, and to which I should have limited myself, if I had not frequently seen their Insufficience. Experience has taught me to increase them considerably; and, augmenting the Dose gradually, I now venture to give larger Doses of them than have ever been done before, and always with much Success; the same Doses which I have advised in this Work not being so large as those I frequently prescribe. For this Reason I intreat those Physicians, who have thought them excessive, to try the acid Spirits in larger Doses than those commonly ordered; and I am persuaded they will see Reason to congratulate themselves upon the Effect. [117] �[117] Our Author's _French_ Annotator has a Note against this Acid, which I have omitted; for though I have given his Note Page 84 [with the Substance of the immediately preceding one] to which I have also added some Doubts of my own, from Facts, concerning the Benefit of Acids in inflammatory Disorders of the Breast; yet with Regard to the ardent, the putrid, the malignant Fever, and _Erisipelas_, in which Dr. _Tissot_ directs this, I have no Doubt of its Propriety (supposing no insuperable Disagreement to Acids in the Constitution) and with Respect to their Doses, I think we may safely rely on our honest Author's Veracity. Dr. _Fuller_ assures us, a Gentleman's Coachman was recovered from the Bleeding Small Pocks, by large and repeated Doses of the Oil of Vitriol, in considerable Draughts of cold Water. _K._ Nº. 11. Take two Ounces of Manna, and half an Ounce of Sedlitz Salt, or for want of it, as much Epsom Salt; dissolving them in four Ounces of hot Water, and straining them. Nº. 12. Take of Elder Flowers one Pugil, of Hyssop Leaves half as much. Pour three Pints of boiling Water upon them. After infusing some time, strain, and dissolve three Ounces of Honey in the Infusion. Nº. 13. Is only the same Kind of Drink made by omitting the Hyssop, and adding instead of it as much more Elder Flowers. Nº. 14. Let one Ounce of the best Jesuits Bark in fine Powder be divided into sixteen equal Portions. Nº. 15. Take of the Flowers of St. _John's_ Wort, of Elder, and of Melilot, of each a few Pinches; put them into the Bottom of an Ewer or Vessel containing five or six _English_ Pints, with half an Ounce of Oil of Turpentine, and fill it up with boiling Water. Nº. 16. Is only the Syrup of the Flowers of the wild red Corn Poppy. Nº. 17. Is only very clear sweet Whey, in every Pint of which one Ounce of Honey is to be dissolved. Nº. 18. Take of Castile or hard white Soap six Drachms; of Extract of Dandelion one Drachm and a half; of Gum Ammoniacum half a Drachm, and with Syrup of Maidenhair make a Mass of Pills, to be formed into Pills, weighing three Grains each. Nº. 19. Gargarisms may be prepared from a Decoction, or rather an Infusion, of the Leaves of Periwinkle, or of Red Rose-Leaves, or of Mallows. Two Ounces of Vinegar and as much Honey must be added to every Pint of it, and the Patient should gargle with it pretty hot. The deterging, cleansing Gargarisin referred to § 112, is a light Infusion of the Tops of Sage, adding two Ounces of Honey to each Pint of it. Nº. 20. Is only one Ounce of powdered Nitre, divided into sixteen equal Doses. Nº. 21. Take of Jalap, of Senna, and of Cream of Tartar of each thirty Grains finely powdered; and let them be very well mixed. [118] �[118] This, our Author observes, will work a strong Country-man very well: by which however he does not seem to mean an Inhabitant of the Mountains in _Valais_. See P. 547. Nº. 22. Take of _China_ Root, and of Sarsaparilla of each one Ounce and a half, of Sassafras Root, and of the Shavings of Guiacum, otherwise called _Lignum vitæ_, of each one Ounce. Let the whole be cut very fine. Then put them into a glazed earthen Vessel; pouring upon them about five pints of boiling Water. Let them boil gently for an Hour; then take it from the Fire, and strain it off through Linen. This is called the Decoction of the Woods, and is often of different Proportions of these Ingredients, or with the Addition of a few others. More Water may, after the first boiling, be poured on the same Ingredients, and be boiled up into a small Decoction for common Drink. Nº. 23. Take one Ounce of the Pulp of Tamarinds, half a Drachm of Nitre, and four Ounces of Water; let them boil not more than one Minute, then add two Ounces of Manna, and when dissolved strain the Mixture off. Nº. 24. Is only an Ounce of Cream of Tartar, divided into eight equal Parts. Nº. 25. This Prescription is only the Preparation of Kermes mineral, otherwise called the Chartreusian Powder. Dr. _Tissot_ orders but one Grain for a Dose. It has been directed from one to three. Nº. 26. Take three Ounces of the common Burdock Root; boil it for half an Hour, with half a Drachm of Nitre, in three full Pints of Water. Nº. 27. Take half a Pinch of the Herbs prescribed Nº. 9, Article 2, and half an Ounce of hard white Soap shaved thin. Pour on these one Pint and a half of boiling Water, and one Glass of Wine. Strain the Liquor and squeeze it strongly out. Nº. 28. Take of the purest Quicksilver one Ounce; of Venice Turpentine half a Drachm, of the freshest Hog's Lard two Ounces, and let the whole be very well rubbed together into an Ointment. [119] �[119] This Ointment should be prepared at the Apothecaries; the Receipt of it being given here, only because the Proportions of the Quicksilver and the Lard are not always the same in different Places. Nº. 29. This Prescription is nothing but the yellow Basilicon. Nº. 30. Take of natural and factitious, or artificial Cinnabar, twenty-four Grains each; of Musk sixteen Grains, and let the whole be reduced into fine Powder, and very well mixed. [120] �[120] This Medicine is known by the Name of _Cob's_ Powder; and as its Reputation is very considerable, I did not chuse to omit it; though I must repeat here what I have said § 195--That the Cinnabar is probably of little or no Efficacy; and there are other Medicines that have also much more than the Musk; which besides is extremely dear for poor People, as the requisite Doses of it, in very dangerous Cases, would cost ten or twelve Shillings daily. The Prescription, Nº. 31, is more effectual than the Musk; and instead of the useless Cinnabar, the powerful Quicksilver may be given to the Quantity of forty-five Grains. I have said nothing hitherto in this Work of the red blossomed Mulberry Tree, which passes for a real Specific, among some Persons, in this dreadful Malady. An Account of it may be seen in the first Volume of the Oeconomical Journal of _Berne_. It is my Opinion however, that none of the Instances related there are satisfactory and decisive; its Efficacy still appearing to me very doubtful. Nº. 31. Take one Drachm of _Virginia_ Snake Root in Powder; of Camphor and of Assa-foetida ten Grains each; of Opium one Grain, and with a sufficient Quantity of Conserve, or Rob of Elder, make a Bolus. [121] �[121] When this is preferred to Nº. 30, of which Musk is an Ingredient, the Grain of Opium should be omitted, except once or at most twice in the twenty-four Hours. Two Doses of Quicksilver, of fifteen Grains each, should be given daily in the Morning, in the Interval between the other Bolus's. Nº. 32. Take three Ounces of Tamarinds. Pour on them one Pint of boiling Water, and after letting them boil a Minute or two, strain the Liquor through a Linen Cloth. Nº. 33. Take seven Grains of Turbith Mineral; and make it into a Pill or Bolus with a little Crumb of Bread. [122] �[122] This Medicine makes the Dogs vomit and slaver abundantly. It has effected many Cures after the _Hydrophobia_, the Dread of Water, was manifest. It must be given three Days successively, and afterwards twice a Week, for fifteen Days. Nº. 34. This is nothing but a Prescription of six Grains of Tartar [123] emetic. �[123] When People are ignorant of the Strength of the Tartar emetic (which is often various) or of the Patient's being easy or hard to vomit, a Dose and a half may be dissolved in a Quart of warm Water, of which he may take a Glass every Quarter of an Hour, whence the Operation may be forwarded, or otherwise regulated, according to the Number of Vomits or Stools. This Method, much used in _Paris_, seems a safe and eligible one. Nº. 35. Take thirty-five Grains of Ipecacuanna, which, in the very strongest Constitutions, may be augmented to forty-five, or even to fifty Grains. Nº. 36. Prescribes only the common blistering Plaister; and the Note observes that very young Infants who have delicate Skins may have Sinapisms applied instead of Blisters; and made of a little old Leaven, kneaded up with a few Drops of sharp Vinegar. Nº. 37. Take of the Tops of _Chamaedrys_ or Ground Oak, of the lesser Centaury, of Wormwood and of Camomile, of each one Pugil. Pour on them three Pints of boiling Water; and suffering them to infuse until it is cold, strain the Liquor through a Linen Cloth, pressing it out strongly. Nº. 38. Take forty Grains of Rhubarb, and as much Cream of Tartar in Powder, mixing them well together. Nº. 39. Take three Drachms of Cream of Tartar, and one Drachm of Ipecacuanna finely powdered. Rub them well together, and divide them into six equal Parts. Nº. 40. Take of the simple Mixture one Ounce, of Spirit of Vitriol half an Ounce, and mix them. The Dose is one or two Tea Spoonfuls in a Cup of the Patient's common Drink. The simple Mixture is composed of five Ounces of Treacle Water camphorated, of three Ounces of Spirit of Tartar rectified, and one Ounce of Spirit of Vitriol. If the Patient has an insuperable Aversion to the Camphor, it must be omitted, though the Medicine is less efficacious without it. And if his Thirst is not very considerable, the simple Mixture may be given alone, without any further Addition of Spirit of Vitriol. Nº. 41. Take half a Drachm of _Virginia_ Snake-root, ten Grains of Camphor, and make them into a Bolus with Rob of Elder-Berries. If the Patient's Stomach cannot bear so large a Dose of Camphor, he may take it in smaller Doses and oftner, _viz._ three Grains, every two Hours. If there is a violent Looseness, Diascordium must be substituted instead of the Rob of Elder-berries. Nº. 42. Prescribes only the _Theriaca pauperum_, or poor Man's Treacle, in the Dose of a Quarter of an Ounce. The following Composition of it is that chiefly preferred by our Author. Take equal Parts of round Birthwort Roots, of Elecampane, of Myrrh, and of Rob or Conserve of Juniper-berries, and make them into an Electuary of a rather thin, than very stiff Consistence, with Syrup of Orange-peel. Nº. 43. The first of the three Medicines referred to in this Number, is that already directed, Nº. 37. The second is as follows. Take equal Parts of the lesser Centaury, of Wormwood, of Myrrh, all powdered, and of Conserve of Juniper-berries, making them up into a pretty thick Consistence with Syrup of Wormwood. The Dose is a Quarter of an Ounce; to be taken at the same Intervals as the Bark. For the third Composition--Take of the Roots of Calamus Aromaticus and Elecampane well bruised, two Ounces; of the Tops of the lesser Centaury cut small, a Pugil; of Filings of unrusted Iron two Ounces, of old white Wine, three Pints. Put them all into a wide necked Bottle, and set it upon Embers, or on a Stove, or by the Chimney, that it may be always kept hot. Let them infuse twenty-four Hours, shaking them well five or six Times; then let the Infusion settle, and strain it. The Dose is a common Cup every four Hours, four Times daily, and timing it one Hour before Dinner. Nº. 44. Take a Quarter of an Ounce of Cream of Tartar, a Pugil of common Camomile; boil them in twelve Ounces of Water for half an Hour, and strain it off. Nº. 45. Directs only the common Sal Ammoniac, from two Scruples to one Drachm for a Dose. The Note to it adds, that it may be made into a Bolus with Rob of Elder; and observes, that those feverish Patients, who have a weak delicate Stomach, do not well admit of this Salt; no more than of several others, which affect them with great Disorder and Anxiety. Nº. 46. The Powder. Take one Pugil of Camomile Flowers, and as much Elder Flowers, bruising them well; of fine Flour or Starch three Ounces; of Ceruss and of blue Smalt each half an Ounce. Rub the whole, and mix them well. This Powder may be applied immediately to the Part. The Plaister. Take of the Ointment called _Nutritum_, made with the newest sweet Oil, two Ounces; of white Wax three Quarters of an Ounce, and one Quarter of an Ounce of blue Smalt. Melt the Wax, then add the _Nutritum_ to it, after the Smalt finely powdered has been exactly incorporated with it; stirring it about with an Iron Spatula or Rod, till the whole is well mixed and cold. This is to be smoothly spread on Linen Cloth. A Quarter of an Ounce of Smalt may also be mixed exactly with two Ounces of Butter or Ointment of Lead, to be used occasionally instead of the Plaister. Nº. 47. Take one Ounce of Sedlitz, or for want of that, as much Epsom Salt, and two Ounces of Tamarinds: pour upon them eight Ounces of boiling Water, stirring them about to dissolve the Tamarinds. Strain it off; and divide it into two equal Draughts, to be given at the Interval of Half an Hour between the first and last. Nº. 48. Take of _Sydenham_'s Liquid Laudanum eighty Drops; of Bawm Water two Ounces and a half. If the first, or the second, Dose stops or considerably lessens the Vomiting, this [124] Medicine should not be further repeated. �[124] The medical Editor at _Lyons_ justly notes here, that these eighty Drops are a very strong Dose of liquid Laudanum; adding that it is scarcely ever given at _Lyons_ in a greater Dose than thirty Drops; and recommending a Spoonful of Syrup of Lemon-peel to be given with it--But we must observe here in answer to this Note, that when Dr. _Tissot_ directs this Mixture in the Iliac Passion § 318, to appease the Vomitings, Art. 3, he orders but one spoonful of this Mixture to be taken at once, and an Interval of two Hours to be observed between the first and second Repetition, which reduces each Dose to sixteen Drops, and which is not to be repeated without Necessity. Nº. 49. Dissolve three Ounces of Manna and twenty Grains of Nitre in twenty Ounces, or six Glasses, of sweet Whey. Nº. 50. To two Ounces of Syrup of Diacodium, or white Poppy Heads, add an equal Weight of Elder Flower Water, or, for want of it, of Spring Water. Nº. 51. Directs nothing but a Drachm of Rhubarb in Powder. Nº. 52. Take of _Sulphur vivum_, or of Flower of Brimstone, one Ounce; of Sal Ammoniac, one Drachm; of fresh Hogs Lard, two Ounces; and mix the whole very well in a Mortar. Nº. 53. Take two Drachms of crude Antimony and as much Nitre, both finely powdered and very well mixed; dividing the whole into eight equal Doses. [125] �[125] This Medicine, which often occasions Cholics in some Persons of a weakly Stomach, is attended with no such Inconvenience in strong Country People; and has been effectual in some Disorders of the Skin, which have baffled other Medicines--The Remainder of this Note observes the great Efficacy of Antimony in promoting Perspiration, and the extraordinary Benefit it is of to Horses in different Cases. Nº. 54. Take of Filings of Iron, not the least rusty, and of Sugar, each one Ounce; of Aniseeds Powdered, half an Ounce. After rubbing then very well together, divide the Powder into twenty-four equal Portions; one of which is to be taken three times a Day an Hour before eating. [126] �[126] The Prescriptions Nº. 54, 55, 56, are calculated against Distempers which arise from Obstructions, and a Stoppage of the monthly Discharges; which Nº. 55 is more particularly intended to remove; those of 54 and 56 are most convenient, either when the Suppression does not exist, or is not to be much regarded, if it does. This Medicine may be rendered less unpalatable for Persons in easy Circumstances, by adding as much Cinamon instead of Aniseeds; and though the Quantity of Iron be small, it may be sufficient, if given early in the Complaint; one, or at the most, two of these Doses daily, being sufficient for a very young Maiden. Nº. 55. Take of Filings of sound Iron two Ounces; of Leaves of Rue, and of white Hoar-hound one Pugil each; of black Hellebore Root, one Quarter of an Ounce, and infuse the whole in three Pints of Wine in the Manner already directed, Nº. 43. The Dose of this is one small Cup three times a Day, an Hour before eating. [127] �[127] I chuse to repeat here, the more strongly to inculcate so important a Point, that in Women who have long been ill and languid, our Endeavours must be directed towards the restoring of the Patient's Health and Strength, and not to forcing down the monthly Discharges, which is a very pernicious Practice. These will return of Course, if the Patient is of a proper Age, as she grows better. Their Return succeeds the Return of her Health, and should not, very often cannot, precede it. Nº. 56. Take two Ounces of Filings of Iron; of Rue Leaves and Aniseed powdered, each half an Ounce. Add to them a sufficient Quantity of Honey to make an Electuary of a good Consistence. The Dose is a Quarter of an Ounce three times daily. Nº. 57. Take of the Extract of the stinking Hemlock, with the purple spotted Stalk, one Ounce. Form it into Pills weighing two Grains each; adding as much of the Powder of dry Hemlock Leaves, as the Pills will easily take up. Begin the Use of this Medicine by giving one Pill Night and Morning. Some Patients have been so familiarized to it, as to take at length Half an Ounce daily. [128] �[128] Our learned and candid Author has a very long Note in this Place, strongly in Favour of _Storck's_ Extract of Hemlock, in which it is evident he credits the greater Part of the Cures affirmed by Dr. _Storck_ to have been effected by it. He says he made some himself, but not of the right Hemlock, which we think it very difficult to mistake, from its peculiar rank fetid Smell, and its purple spotted Stalk. After first taking this himself, he found it mitigated the Pain of Cancers, but did not cure them. But then addressing himself to Dr. _Storck_, and exactly following his Directions in making it, he took of Dr. _Storck's_ Extract, and of his own, which exactly resembled each other, to the Quantity of a Drachm and a half daily; and finding his Health not in the least impaired by it, he then gave it to several Patients, curing many scrophulous and cancerous Cases, and mitigating others, which he supposes were incurable. So that he seems fully persuaded Dr. _Storck's_ Extract is always innocent [which in Fact, except in a very few Instances, none of which were fatal, it has been] and he thinks it a Specific in many Cases, to which nothing can be substituted as an equivalent Remedy; that it should be taken with entire Confidence, and that it would be absurd to neglect its Continuance. The Translator of this Work of Dr. _Tissot's_ has thought it but fair to give all the Force of this Note here, which must be his own, as his Editor at _Lyons_ seems to entertain a very different Opinion of the Efficacy of this Medicine; for which Opinion we refer back to his Note, § 375, of this Treatise, which the Reader may compare with this of our Author's. _K._ Nº. 58. Take of the Roots of Grass and of Succory well washed, each one Ounce. Boil them a Quarter of an Hour in a Pint of Water. Then dissolve in it Half an Ounce of Sedlitz, or of _Epsom_ Salt, and two Ounces of Manna; and strain it off to drink one Glass of it from Half Hour, to Half Hour, till its Effects are sufficient. It is to be repeated at the Interval of two or three Days. Nº. 59. Is a Cataplasm or Pultice made of Crumb of Bread, with Camomile Flowers boiled in Milk, with the Addition of some Soap, so that each Pultice may contain half a Quarter of an Ounce of this last Ingredient. And when the Circumstances of female Patients have not afforded them that regular Attendance, which the Repetition of the Pultice requires, as it should be renewed every three Hours, I have successfully directed the Hemlock Plaister of the Shops. Nº. 60. Take a sufficient Quantity of dry Hemlock Leaves. Secure them properly between two Pieces of thin Linen Cloth, so as to make a very flexible Sort of small Matrass, letting it boil a few Moments in Water, then squeeze it out and apply it to the affected Part. It must thus be moistened and heated afresh, and re-applied every two Hours. Nº. 61. Take of the Eyes of the Craw-fish, or of the true white Magnesia, two Drachms; of Cinnamon powdered four Grains. Rub them very well together, and divide the whole into eight Doses. One of these is to be given in a Spoonful of Milk, or of Water, before the Infant sucks. Nº. 62. Take of an Extract of Walnuts, made in Water, two Drachms; and dissolve it in half an Ounce of Cinnamon Water. Fifty Drops a Day of this Solution is to be given to a Child of two Years old; and after the whole has been taken, the Child should be purged. This Extract is to be made of the unripe Nuts, when they are of a proper Growth and Consistence for pickling. Nº. 63. Take of Rezin of Jalap two Grains. Rub it a considerable time with twelve or fifteen Grains of Sugar, and afterwards with three or four sweet Almonds; adding, very gradually, two common Spoonfuls of Water. Then strain it through clear thin Linen, as the Emulsion of Almonds was ordered to be. Lastly, add a Tea Spoonful of Syrup of Capillaire to it. This is no disagreable Draught, and may be given to a Child of two Years old: and if they are older, a Grain or two more of the Rezin may be allowed. But under two Years old, it is prudent to purge Children rather with Syrup of Succory, or with Manna. Nº. 64. Take of the Ointment called _Nutritum_ one Ounce; the entire Yolk of one small Egg, or the Half of a large one, and mix them well together. This _Nutritum_ may be readily made by rubbing very well together, and for some time, two Drachms of Ceruss [white Lead] half an Ounce of Vinegar, and three Ounces of common Oil. Nº. 65. Melt four Ounces of white Wax; add to it, if made in Winter two Spoonfuls of Oil; if in Summer none at all, or at most, not above a Spoonful. Dip in this Slips of Linen Cloth not worn too thin, and let them dry: or spread it thin and evenly over them. Nº. 66. Take of Oil of Roses one Pound; of red Lead half a Pound; of Vinegar four Ounces. Boil them together nearly to the Consistence of a Plaister; then dissolve in the liquid Mass an Ounce and a Half of yellow Wax, and two Drachms of Camphor, stirring the whole about well. Remove it then from the Fire, and spread it on Sheets or Slips of Paper, of what Size you think most convenient. The Ointment of _Chambauderie_, so famous in many Families on the Continent, is made of a Quarter of a Pound of yellow Wax, of the Plaister of three Ingredients (very nearly the same with Nº. 66) of compound Diachylon and of common Oil, of each the same Quantity, all melted together, and then stirred about well, after it is removed from the Fire, till it grows cold. To make a Sparadrap, or Oil Cloth, which is Linen, covered with, or dipt in an emplastic Substance or Ointment, it must be melted over again with the Addition of a little Oil, and applied to the Linen as directed at Nº. 65. Nº. 67. Gather in Autumn, while the fine Weather lasts, the Agaric of the Oak, which is a Kind of _Fungus_ or Excrescence, issuing from the Wood of that Tree. It consists at first of four Parts, which present themselves successively, 1, The outward Rind or Skin, which may be thrown away. 2, That Part immediately under this Rind, which is the best of all. This is to be beat well with a Hammer, till it becomes soft and very pliable. This is the only Preparation it requires, and a Slice of it of a proper Size is to be applied directly over the bursting, open Blood-vessels. It constringes and brings them close together; stops the Bleedings; and generally falls off at the End of two Days. 3, The third Part, adhering to the second may serve to stop the Bleeding from the smaller Vessels; and the fourth and last Part may be reduced to Powder, as conducing to the same Purpose. [129] �[129] Our Author attests his seeing the happiest Consequences from this Application, which M. _Brossard_, a very eminent _French_ Surgeon, first published; and declared his Preference of that Agaric which sprung from those Parts of the Tree, from whence large Boughs had been lopped. Nº. 68. Take four Ounces of Crumbs of Bread, a Pugil of Elder Flowers, and the same Quantity of those of Camomile, and of St. _John's_ Wort. Boil them into a Pultice in equal Quantities of Vinegar and Water. If Fomentations should be thought preferable, take the same Herbs, or some Pugils of the Ingredients for _Faltrank_: throw them into a Pint and a Half of boiling Water: and let them infuse some Minutes. Then a Pint of Vinegar is to be added, and Flanels or other woollen Cloths dipt in the Fomentation, and wrung out, are to be applied to the Part affected. For the aromatic Fomentations recommended § 449, take Leaves of Betony and of Rue, Flowers of Rosemary or Lavender, and red Roses, of each a Pugil and a Half. Boil them for a Quarter of an Hour in a Pot with a Cover, with three Pints of old white Wine. Then strain off, squeezing the Liquor strongly from the Herbs, and apply it as already directed. Nº. 69. Directs only the Plaister of Diapalma. [130] �[130] To spread this upon Lint as directed, § 456, it must be melted down again with a little Oil. Nº. 70. Directs only a Mixture of two Parts Water, and one Part of Vinegar of Litharge. Nº. 71. Take of the Leaves of Sow-bread, and of Camomile Tops, of each one Pugil. Put them into an earthen Vessel with half an Ounce of Soap, and as much Sal Ammoniac, and pour upon them three Pints of boiling Water. _N. B._ I conceive all the Notes to this Table, in which I have not mentioned the Editor at _Lyons_, nor subscribed with my initial Letter _K_, to come from the Author, having omitted nothing of them, but the Prices. ERRATA. Page 4, Line 6, for _os_ read _of_. p. 16, l. 16, for _be_ read _me_. p. 29, l. 12, after _it_ add . p. 49, l. 12, dele _and_ at the End of it. p. 51, in the running Title, for _Causss_ read _Causes_. ib. l. 2, dele _and_. ib. l. 7, dele _and_. p. 57, last line, for _hurtsul_ read _hurtful_. p. 67, l. 17, after _Water_, add, _may be placed within the Room_. p. 74, line last but two, after _never_, dele , p. 96, l. 11, for _Aiiment_ read _Ailment_. p. 106, l. 23, for the second _is_ read _has_. p. 126, l. 21, for _breath_ read _breathe_. p. 137, l. 13, for _Efflorescene_ read _Efflorescence_, p. 145, l. 1, for _Water_ read _Tea_. p. 148, l. 19, for _beomes_ read _becomes_. p. 163, l. 30. in the Note, for _occured_ read _occurred_; p. 171, l. 20, dele _and_. p. 189, l. 28, dele _of_. p. 199, l. 6, for _Paulmier_ read _Palmarius_, being the _Latinized_ Name of that _Physician_; as we say for _Fernel Fernelius, Holler Hollerius, &c._ _N. B._ His Powder for the Bite of a mad Dog consisted of equal Parts of Rue, Vervain, Plantain, Polypody, common Wormwood, Mugwort, Bastard Baum, Betony, St. _John's_ Wort, and lesser Centaury Tops, to which _Default_ adds Coraline.----p. 237, l. 2, for _Streakes_ read _Streaks_. p. 256, first line of the Note * _dele_ the first _often_. p. 261, l. 15, for _happens_ read _happen_. p. 270, l. 12, dele _t_ in _Switsserland_. p. 282, l. 23, for _enters_ read _enter_. p. 283, l. 23, for _Stomach_ read _Stomachs_. p. 284, l. 12, for _it_ read _them_. p. 287, Note * l. 25, for _here_ read _there_. p. 303, l. 14, for _doubtsul_ read _doubtful_. p. 311, l. 18, for _abate_ read _abates_. p. 337, l. 7, for _glary_ read _glairy_. N. B. In the first Page that is folio'd 445 read 345. p. 346, l. 19, for _two_ read _too_. p. 351, l. 25, after Waters add, _such as Infusions of Tea, &c._ p. 375, l. 7, for _two_ read _too_. p. 392, last line, for _Leaves_ read _Flowers_. p. 393, l. 26, after _them_, insert _and_. p. 397, l. 1 and 2, for Temparrament read _Temperament_. p. 422, l. 6, between _several_ and _Consequences_ insert _bad_. p. 454, l. 5, for _Diflocation_ read _Dislocation_. p. 459, l. 17, in _Ice-thaws_ dele - p. 466, l. 16, to _Constitution_ add _s_. p. 486, l. 29, after _or_ add _if_. p. 487, l. 12, for _Parts_ read _Part_. p. 511, l. 12, for _not_ read _nor_. p. 533, l. 12, for _arrives_ read _arises_. p. 542, l. 22, for _Patient_ read _Patients_. p. 562, l. 14, for _fays_ read _says_. p. 573, l. 10, after _Cause_, dele _Comma_. _Table_ _of the several Chapters, and their principal Contents._ Introduction ---- Page 1 The first Cause of Depopulation, Emigrations ---- _ib._ The second Cause, Luxury ---- 6 Third Cause, Decay of Agriculture ---- 10 Fourth Cause, the pernicious Treatment of Diseases ---- 12 Means for rendering this Treatise useful ---- 15 Explanation of certain physical Terms, and Phrases ---- 26 _Chapter I._ _The most common Causes of popular Sickness_ ---- 31 First Cause, excessive Labour ---- _ib._ Second Cause, the Effect of cold Air, when a Person is hot ---- 33 Third Cause, taking cold Drink, when in a Heat ---- _ib._ _&_ 34 Fourth Cause, the Inconstancy and sudden Change of the Weather ---- 35 Fifth Cause, the Situation of Dunghills, and Marshes, near inhabited Houses, and the bad confined Air in the Houses ---- 37 Sixth Cause, Drunkenness ---- 38 Seventh Cause, the Food of Country People ---- 39 Eighth Cause, the Situation, or Exposure of Houses ---- 42 Concerning the Drink of Country People ---- 43 _Chap. II._ _Of Causes which increase the Diseases of the People, with general Considerations_ ---- 47 First Cause, the great Care employed to force the Sick to sweat, and the Methods taken for that Purpose ---- _ib._ _&_ 48 The Danger of hot Chambers ---- 49 The Danger of hot Drinks and heating Medicines ---- 50 Second Cause, the Quantity and Quality of the Food given sick Persons ---- 53 Third Cause, the giving Vomits and Purges at the Beginning of the Disease ---- 57 _Chap. III._ _Concerning what should be done in the Beginning of Diseases, and the Diet in acute Diseases_ ---- 61 Signs which indicate approaching Diseases; with Means to prevent them ---- 62 The common Regimen, or Regulations, for the Sick ---- 64 The Benefits of ripe sound Fruits ---- 68 Cautions and Means to be used, on Recovery ---- 73, 74 _Chap. IV._ _Of the Inflammation of the Breast_ ---- 77 The Signs of this Disease ---- _ib._ _&_ 78 The Advantage of Bleeding ---- 81 Signs of Recovery ---- 85 Of _Crises_, and the Symptoms that precede them ---- 86 The Danger of Vomits, of Purges, and of Anodynes ---- 88 Of the Suppression of Expectoration, and the Means to restore it. ---- 89 Of the Formation of _Vomicas_, or Imposthumes in the Lungs, and the Treatment of them ---- 90 Of the Danger of Remedies, termed Balsamics ---- 103 The Inefficacy of the Antihectic of _Poterius_ ---- 104 Of an _Empyema_ ---- 105 Of a Gangrene of the Lungs ---- 106 Of a _Scirrhus_ of the Lungs ---- _ib._ _Chap. V._ _Of the Pleurisy_ ---- 108 The Danger of heating Remedies ---- 112 to 115 Of frequent, or habitual, Pleurisies ---- 116 Of Goats Blood; the Soot of a stale Egg, and of the Wormwood of the Alps, in Pleurisies ---- 117, 118 _Chap. VI._ _Of Diseases of the Throat_ ---- 119 Of their proper Treatment ---- 124 Of the Formation of an Abscess there ---- 127 Of swelled Ears, from the Obstruction of the parotid and maxillary Glands ---- 131 Of the epidemic and putrid Diseases of the Throat, which prevailed in 1761 at _Lausanne_ ---- 132 _Chap. VII._ _Of Colds_ ---- 139 Different Prejudices concerning Colds ---- _ib._ _&_ 140 The Danger of drinking much hot Water, and of strong spirituous Liquors, _&c._ ---- 146 Means for strengthening and curing Persons very subject to Colds ---- 148 _Chap. VIII._ _Of Diseases of the Teeth_ ---- 150 _Chap. IX._ _Of the Apoplexy_ ---- 158 Of sanguine Apoplexy ---- _ib._ _&_ 159 Of a serous, or watery, Apoplexy ---- 162 Means to prevent relapsing into them ---- 164 _& seq._ _Chap. X._ _Of morbid Strokes of the Sun_ ---- 167 _Chap. XI._ _Of the Rheumatism_ ---- 177 Of the acute Rheumatism, attended with a Fever ---- _ib._ Of the flow, or chronical, without a Fever ---- 186 The Danger of spirituous and greasy Remedies ---- 191, 192 _Chap. XII._ _Of the Bite of a mad Dog_ ---- 194 _Chap. XIII._ _Of the Small Pocks._ ---- 207 Of the preceding Symptoms of this Disease ---- 209 --The Danger of sweating Medicines ---- 217 --The Treatment of the benign distinct Small Pocks ---- 220 --The Use of Bleeding ---- 222 --The Fever of Suppuration ---- 223 --The Necessity of opening the ripe Pustules ---- 226 --The Danger of Anodynes ---- 228 Of the striking in of the Eruptions ---- 229 Preparations for receiving it favorably ---- 230 _Chap. XIV._ _Of the Measles_ ---- 235 Of their Treatment and the Means to prevent any of their bad Consequences, to ---- 243 _Chap. XV._ _Of the hot, or burning, Fever_ ---- 244 _Chap. XVI._ _Of putrid Fevers_ ---- 248 _Chap. XVII._ _Of malignant Fevers_ ---- 257 The Danger of applying living Animals in them ---- 267 _Chap. XVIII._ _Of intermitting Fevers_ ---- 269 --Spring and Autumn Intermittents ---- 272 Method of Cure by the Bark ---- 275 Method of treating the Patient in the Fit ---- 277 Of other Febrifuges, besides the Bark ---- 278 The Treatment of long and obstinate Intermittents ---- 279 Of some very dangerous Intermittents ---- 284 Of some periodical Disorders, which may be termed, Fevers disguised ---- 285 Of Preservatives from unwholesome Air ---- 286 _Chap. XIX._ _Of an_ Erisipelas, _or St._ Anthony's _Fire._ ---- 288 Of a frequent or habitual _Erisipelas_ ---- 295 Of the Stings or Bites of Animals ---- 296 _Chap. XX._ _Of Inflammations of the Breast, and of Bastard and bilious Pleurisies_ ---- 298 --Of the false Inflammation of the Breast ---- 300 --The false Pleurisy ---- 303 _Chap. XXI._ _Of Cholics_ ---- 306 Of the inflammatory Cholic ---- 307 --the bilious Cholic ---- 312 --the Cholic from Indigestion, and of Indigestions ---- 314 --the flatulent, or windy, Cholic ---- 317 --the Cholic, from taking Cold ---- 319 _Chap. XXII._ _Of the_ Miserere, _or Iliac Passion, and of the_ Cholera Morbus ---- 322 The _Miserere_ ---- _ib._ _&_ 323 The _Cholera Morbus_ ---- 327 _Chap. XXIII._ _Of a_ Diarrhoea, _or Looseness_ ---- 332 _Chap. XXIV._ _Of a Dysentery, or Bloody-Flux_ ---- 335 The Symptoms of the Disease ---- 336 The Remedies against it ---- 338 Of the beneficial Use of ripe Fruits ---- 341 Of the Danger of taking a great Number of popular Remedies in it ---- 345 _Chap. XXV._ _Of the Itch_ ---- 347 _Chap. XXVI._ _Directions peculiar to the Sex_ ---- 352 Of the monthly Customs ---- 353 Of Gravidation, or going with Child ---- 365 Of Labours or Deliveries, ---- 367 Of their Consequences ---- 371 Of a Cancer ---- 373 _Chap. XXVII._ _Directions with Regard to Children_ ---- 375 Of the first Cause of their Disorders, the _Meconium_ ---- 377 --the second, the souring of their Milk ---- 379 --the Danger of giving them Oil ---- _ib._ --Disorders from their Want of Perspiration, the Means of keeping it up, and of washing them in cold Water ---- 381 _&_ 382 --the third Cause, the cutting of their Teeth ---- 386 --the fourth Cause, Worms ---- 387 Of Convulsions ---- 391 Methods necessary to make them strong and hardy, with general Directions about them ---- 396 _& seq._ _Chap. XXVIII._ _Of Assistances for drowned Persons_ ---- 403 _Chap. XXIX._ _Of Substances stopt between the Mouth and the Stomach_ ---- 411 _Chap. XXX._ _Of Disorders requiring the Assistance of a Surgeon_ ---- 435 Of Burns ---- 436 Of Wounds ---- 437 Of Bruises, and of Falls ---- 444 Of Ulcers ---- 454 Of frozen Limbs, or Joints ---- 458 Of Chilblains ---- 462 Of Ruptures ---- 474 Of Phlegmons, or Boils ---- 480 Of Fellons, or Whitlows ---- 481 Of Thorns, Splinters, _&c._ in the Skin or Flesh ---- 486 Of Warts ---- 488 Of Corns ---- 490 _Chap. XXXI._ _Of some Cases which require immediate Assistance_ ---- 491 Of Swoonings, from Excess of Blood ---- 492 Of Swoonings, from great Weakness ---- 494 Of Swoonings, occasioned by a Load on the Stomach ---- 497 Of Swoonings, resulting from Disorders of the Nerves 500 Of Swoonings, occasioned by the Passions ---- 504 Of the Swoonings, which occur in Diseases ---- 506 Of Hæmorrhages, or Fluxes of Blood ---- 508 Of Convulsion Fits ---- 512 Of suffocating, or strangling Fits ---- 514 Of the violent Effects of great Fear ---- 516 Of Accidents produced by the Vapours of Charcoal, and of Wine ---- 519 Of Poisons ---- 526 Of acute and violent Pains ---- 529 _Chap. XXXII._ _Of giving Remedies by Way of Precaution_ ---- 531 Of Bleeding ---- 532 Of Purges ---- 540 Remedies to be used after excessive Purging ---- 544 Reflections on some other Remedies ---- 546, _&c._ _Chap. XXXIII._ _Of Quacks, Mountebanks, and Conjurers_ ---- 551 _Chap. XXXIV._ _Questions necessary to be answered by any Person, who goes to consult a Physician_ ---- 579 The Table of Remedies ---- 584 Transcription note Old and variant spellings, like _surprising_ / _surprizing_, Buttermilk / _Butter-milk_, _Blood-vessels_ / _Blood-Vessels_, _Faltranc_ / _Faltrank_, _wholesome_ / _wholsome_, _fetid_ / _foetid_, _public_ / _publick_, _Physic_ / _Physick_, etc. have been preserved in the present transcription. In some cases of doubt, the present edition has been compared with scans of the 1766 edition printed by Donaldson, which differs slightly in setting, for instance having all names not capitalized, and corrects many typographic mistakes. Corrections listed in the Errata at the end of the book have been carried into this transcription (excepting those which are not relevant for the transcription, like those in running titles). Typographic errors, occurring at the following pages and lines in the original, have been corrected (negative numbers indicate lines from the bottom of the page): - *p. 23, note *, l. -6* their Druggs --> their Drugs - *p. 29, l. 12* thorough Attentention --> thorough Attention - *p. 39, l. 2* btutal Souls --> brutal Souls - *p. 48, l. 12-13* thick, and and that --> thick, and that - *p. 55, l. -5* increases our Horrour --> increases our Horror - *p. 61, l. 3-4* deserves a Patients Confidence --> deserves a Patient's Confidence - *p. 62, l. 16* Drink and Glisters --> Drink and Glysters - *p. 87, l. -8* the loosening Glyster No. 5 --> the loosening Glyster Nº. 5 - *p. 106, l. 1* Inflammamations --> Inflammations - *p. 148, l. 21-22* Perspiraration --> Perspiration - *p. 182, l. 19* Applications N. 9 --> Applications Nº. 9 - *p. 189, l. 1* the Powder No. 29 --> the Powder Nº. 29 - *p. 223, note *, l. 4* without the least peceiveable --> without the least perceiveable - *p. 226, l. 17-18* Relax-tion --> Relaxation - *p. 244, l. 4-5* Dis-seases --> Diseases - *p. 261, l. 15* Hæmmorrhages --> Hæmorrhages - *p. 283, l. 14-15* Pre-Precription --> Prescription - *p. 344, note +, l. -2* _missing closing quote conjecturally inserted after_ instead of stumming or sulphurizing it,' - *p. 353, l. 1* stance constitutes --> Circumstance constitutes - *p. 355, l. 18* not pregant --> not pregnant - *p. 383, l. 6* the back Bart of the Head --> the back Part of the Head - *p. 485, l. 13* checks it Progress --> checks its Progress - *p. 495, l. 19* strong swelling Herbs --> strong smelling Herbs - *p. 506, l. 15* Weakness is an Obstable --> Weakness is an Obstacle - *p. 506, l. 19* an Evacution supervenes --> an Evacuation supervenes - *p. 525, l. -2,-1* Never-vertheless --> Nevertheless - *p. 560, l. -7* Villians --> Villains - *p. 573, l. 6* some Evacution --> some Evacuation - *p. 608. l. -7* Temparrament --> Temperrament - *p. 611, col. 2, l. 4* _Of a_ Diarrhæa --> _Of a_ Diarrhoea So has been corrected the punctuation: - *p. xxii, last line, note* published at _Lyons_. [missing period] - *p. xxix, l. 10* _Infusion_ Nº. 1; [missing dot] - *p. xxix, l. 13-14* Numbers 1. 2, and 4 --> Numbers 1, 2, and 4 - *p. 63, l. 15* of the Ptisans Nº. 1 [missing dot] - *p. 84, l. -7, note* the Mixture, Nº. 10 [missing dot] - *p. 88, l. 21* the purging Potion Nº. 11 [missing dot] - *p. 89, l. 12* and drink plentifully of the Ptisan Nº. 2 [missing dot] - *p. 89, l. -7* should drink plentifully of the Ptisan Nº. 12 [missing dot] - *p. 117, l. 12-13* or some of those Diet-Drinks Nº. 1, 2, 4; [dots instead of commas] - *p. 118, note *, l. 3* it in his late _Materia Medica._ K. [missing period] - *p. 173, l. -8* in Hunting in 1658. [additional comma] - *p. 198, l. 16* 3. The Bites --> 3, The Bites - *p. 203, note, l. 5* in many other Places. [missing period] - *p. 231, note, l- 1* and the Note there. [comma instead of period] - *p. 233, l. 10* sound and hearty Children). [missing period] - *p. 265, l. -6* 12, As soon as the Distemper [period instead of comma] - *p. 320, last line of the note* or for suspending it. _K._ [missing dot] - *p. 371, l. 7* 2, An Inflammation [period instead of comma] - *p. 531, l. -6* or wrong. [missing period] - *p. 538, l. -9* Powder Nº. 20 [missing dot] - *p. 601, first line of the note* The Prescriptions Nº. 54, 55, 56 [missing dot after Nº and periods instead of commas] The footnotes, marked in the text mostly by asterisks, symbols and alphabetic letters on a page by page basis, have been renumbered progressively throughout the book. The footnote * on page 256 does not appear to be referenced at any specific point on the printed page, and has been treated as footnote to the last word of the paragraph. Italics markup of abbreviations like _&c._, _K._, which was not always consistent in the original, has been retained as printed. The Greek letters _{alpha}_, _{beta}_, _{gamma}_ enumerating the prescriptions of § 214 have been replaced by the Latin letters _a_, _b_, _c_ for better character set portability. 
18467	----	[Illustration] * * * * * THE PEOPLE'S COMMON SENSE MEDICAL ADVISER IN PLAIN ENGLISH: OR, MEDICINE SIMPLIFIED. BY R.V. PIERCE, M.D. ONE OF THE STAFF OF CONSULTING PHYSICIANS AND SURGEONS AT THE INVALIDS' HOTEL AND SURGICAL INSTITUTE, AND PRESIDENT OF THE WORLD'S DISPENSARY MEDICAL ASSOCIATION. FIFTY-FOURTH EDITION. ONE MILLION, SIX HUNDRED AND FIFTY THOUSAND. _Carefully Revised by the Author, assisted by his full Staff of Associate Specialists in Medicine and Surgery, the Faculty of the Invalids' Hotel and Surgical Institute._ * * * * * Entered according to Act of Congress, in the year 1895, by the WORLD'S DISPENSARY MEDICAL ASSOCIATION, In the office of the Librarian of Congress, at Washington, D.C. * * * * * TO MY PATIENTS, WHO HAVE SOLICITED MY PROFESSIONAL SERVICES, FROM THEIR HOMES IN EVERY STATE, CITY, TOWN, AND ALMOST EVERY HAMLET, WITHIN THE AMERICAN UNION; ALSO TO THOSE DWELLING IN EUROPE, MEXICO, SOUTH AMERICA, THE EAST AND WEST INDIES, AND OTHER FOREIGN LANDS, I RESPECTFULLY DEDICATE THIS WORK. * * * * * TABLE OF CONTENTS PREFACE TO THE PRESENT EDITION PREFACE_TO_THE_FIRST_EDITION INTRODUCTORY WORDS PART I CHAPTER I. BIOLOGY CHAPTER II. PHYSIOLOGICAL ANATOMY. THE BONES. CHAPTER III. PHYSIOLOGICAL ANATOMY. THE MUSCLES. CHAPTER IV. PHYSIOLOGICAL ANATOMY. THE DIGESTIVE ORGANS. CHAPTER V. PHYSIOLOGICAL ANATOMY. ABSORPTION. CHAPTER VI. PHYSICAL AND VITAL PROPERTIES OF THE BLOOD. CHAPTER VII. PHYSIOLOGICAL ANATOMY. CIRCULATORY ORGANS. CHAPTER VIII. PHYSIOLOGICAL ANATOMY. THE ORGANS OF RESPIRATION. CHAPTER IX. PHYSIOLOGICAL ANATOMY. THE SKIN. CHAPTER X. PHYSIOLOGICAL ANATOMY. SECRETION. CHAPTER XI. PHYSIOLOGICAL ANATOMY. EXCRETION. CHAPTER XII. PHYSIOLOGICAL ANATOMY. THE NERVOUS SYSTEM. CHAPTER XIII. THE SPECIAL SENSES. SIGHT. CHAPTER XIV. CEREBRAL PHYSIOLOGY. CHAPTER XV. THE HUMAN TEMPERAMENTS. CHAPTER XVI. MARRIAGE. LOVE. CHAPTER XVII. REPRODUCTION. PART II. HYGIENE. CHAPTER I. HYGIENE DEFINED.--PURE AIR. CHAPTER II. FOOD. BEVERAGES. ALCOHOLIC LIQUORS. CLOTHING. CHAPTER III. PHYSICAL EXERCISE. MENTAL CULTURE. SLEEP. CLEANLINESS. CHAPTER IV. HYGIENE OF THE REPRODUCTIVE ORGANS. CHAPTER V. PRACTICAL SUMMARY OF HYGIENE. PART III. RATIONAL MEDICINE. CHAPTER I. THE PROGRESS OF MEDICINE. CHAPTER II. REMEDIES FOR DISEASE. CHAPTER III. BATHS AND MOTION AS REMEDIAL AGENTS. CHAPTER IV. HYGIENIC TREATMENT OF THE SICK. PART IV. DISEASES AND THEIR REMEDIAL TREATMENT. INDEX FOOTNOTES * * * * * PREFACE TO THE PRESENT EDITION The popular favor with which former editions of this work have been received has required the production of such a vast number of copies, that the original electrotype plates from which it has heretofore been printed, have been completely worn out. The book has been re-produced in London, England, where six editions have already been necessary to supply the demand for it. In order to continue its publication to meet the demand which is still active in this country, it has been necessary, inasmuch as the original electrotype plates have become worn and useless, to re-set the work throughout. This has afforded the Author an opportunity to carefully revise the book and re-write many portions, that it may embody the latest discoveries and improvements in medicine and surgery. In performing this labor he has been greatly assisted by contributions and valuable aid kindly supplied by his staff of associate specialists in medicine and surgery who constitute the Faculty of the Invalids' Hotel and Surgical Institute. That part of the book treating of Diseases and Their Remedies will be found to be thoroughly reliable; the prescriptions recommended therein having all received the sanction and endorsement of medical gentlemen of rare professional attainments and mature experience. THE AUTHOR. BUFFALO, N.Y., January, 1895. * * * * * PREFACE TO THE FIRST EDITION. Every family needs a COMMON SENSE MEDICAL ADVISER. The frequent inquiries from his numerous patients throughout the land, suggested to the Author the importance and popular demand for a reliable work of this kind. Consequently, he has been induced to prepare and publish an extensive dissertation on Physiology, Hygiene, Temperaments, Diseases and Domestic Remedies. It is for the interest and welfare of _every_ person, not only to understand the means for the preservation of health, but also to know what remedies should be employed for the alleviation of the common ailments of life. The frequency of accidents of all kinds, injuries sustained by machinery, contusions, drowning, poisoning, fainting, etc., and also of sudden attacks of painful diseases, such as headache, affections of the heart and nerves, inflammation of the eye, ear and other organs, renders it necessary that non-professionals should possess sufficient knowledge to enable them to employ the proper means for speedy relief. To impart this important information is the aim of the author. Moreover, this volume treats of Human Temperaments, not only of their influence upon mental characteristics and bodily susceptibilities, but also of their vital and non-vital combinations, which transmit to the offspring either health, hardihood, and longevity, or feebleness, disease, and death. It clearly points out those temperaments which are compatible with each other and harmoniously blend, and also those which, when united in marriage, result in barrenness, or produce in the offspring imbecility, deformity, and idiocy. These matters are freely discussed from original investigations and clinical observations, thus rendering the work a true and scientific guide to marriage. While instruction is imparted for the care of the body, those diseases (alas how prevalent!) are investigated which are sure to follow as a consequence of certain abuses, usually committed through ignorance. That these ills do exist is evident from the fact that the Author is consulted by multitudes of unfortunate young men and women, who are desirous of procuring relief from the weaknesses and derangements incurred by having unwittingly violated physiological laws. Although some of these subjects may seem out of place in a work designed for _every_ member of the family, yet they are presented in a style which cannot offend the most fastidious, and with a studied avoidance of all language that can possibly displease the chaste, or disturb the delicate susceptibilities of persons of either sex. This book should not be excluded from the young, for it is eminently adapted to their wants, and imparts information without which millions will suffer untold misery. It is a _false_ modesty which debars the youth of our land from obtaining such information. As its title indicates, the Author aims to make this book a useful and practical Medical Adviser. He proposes to express himself in plain and simple language, and, so far as possible, to avoid the employment of technical words, so that all his readers may readily comprehend the work, and profit by its perusal. Written as it is amid the many cares attendant upon a practice embracing the treatment of thousands of cases annually, and therefore containing the fruits of a rich and varied experience, some excuse exists for any literary imperfections which the critical reader may observe. THE AUTHOR. BUFFALO, N.Y., July, 1875. * * * * * INTRODUCTORY WORDS. Health and disease are physical conditions upon which pleasure and pain, success and failure, depend. Every _individual_ gain increases public gain. Upon the health of its people is based the prosperity of a nation; by it every value is increased, every joy enhanced. Life is incomplete without the enjoyment of healthy organs and faculties, for these give rise to the delightful sensations of existence. Health is essential to the accomplishment of every purpose; while sickness thwarts the best intentions and loftiest aims. We are continually deciding upon those conditions which are either the source of joy and happiness or which occasion pain and disease. Prudence requires that we should meet the foes and obviate the dangers which threaten us, by turning all our philosophy, science, and art, into practical _common sense_. The profession of medicine is no _sinecure_; its labors are constant, its toils unremitting, its cares unceasing. The physician is expected to meet the grim monster, "break the jaws of death, and pluck the spoil out of his teeth." _His_ ear is ever attentive to entreaty, and within his faithful breast are concealed the disclosures of the suffering. Success may elate him, as conquest flushes the victor. Honors are lavished upon the brave soldiers who, in the struggle with the foe, have covered themselves with glory, and returned victorious from the field of battle; but how much more brilliant is the achievement of those who overwhelm disease, that common enemy of mankind, whose victims are numbered by millions! Is it meritorious in the physician to modestly veil his discoveries, regardless of their importance? If he have light, why hide it from the world? Truth should be made as universal and health-giving as sunlight. We say, give light to all who are in darkness, and a remedy to the afflicted everywhere. We, as a people, are becoming idle, living in luxury and ease, and in the gratification of artificial wants. Some indulge in the use of food rendered unwholesome by bad cookery, and think more of gratifying a morbid appetite than of supplying the body with proper nourishment. Others devote unnecessary attention to the display of dress and a genteel figure, yielding themselves completely to the sway of fashion. Such intemperance in diet and dress manifests itself in the general appearance of the unfortunate transgressor, and exposes his folly to the world, with little less precision than certain vices signify their presence by a tobacco-tainted breath, beer-bloated body, rum-emblazoned nose, and kindred manifestations. They coddle themselves instead of practicing self-denial, and appear to think that the chief end of life is gratification, rather than useful endeavor. I purpose to express myself candidly and earnestly on all topics relating to health, and appeal to the common sense of the reader for justification. Although it is my aim to simplify the work, and render it a practical common-sense guide to the farmer, mechanic, mariner, and day-laborer, yet I trust that it may not prove less acceptable to the scholar, in its discussion of the problems of Life. Not only does the method adopted in this volume of treating of the Functions of the Brain and Nervous System present many new suggestions, in its application to hygiene, the management of disease, generation and the development and improvement of man, but the conclusions correspond with the results of the latest investigations of the world's most distinguished _savants_. My object is to inculcate the facts of science rather than the theories of philosophy. Unto us are committed important health trusts, which we hold, not merely in our own behalf, but for the benefit of others. If we discharge the obligations of our trusteeship, we shall enjoy present strength, usefulness, and length of days; but if we fail in their performance, then inefficiency, incapacity, and sickness, will follow, the sequel of which is pain and death. Let us, then, prove worthy of this generous commission, that we may enjoy the sweetest of all pleasures, the delicious fruitage of honest toil and faithful obedience. * * * * * PART I. PHYSIOLOGY. CHAPTER I. BIOLOGY. In this chapter we propose to consider Life in its primitive manifestations. _Biology_ is the science of living bodies, or the science of life. Every organ of a living body has a function to perform, and _Physiology_ treats of these functions. _Function_ means the peculiar action of some particular organ or part. There can be no vital action without change, and no change without organs. Every living thing has a structure, and _Anatomy_ treats of the structures of organized bodies. Several chapters of this work are devoted to _Physiological Anatomy_, which treats of the human organism and its functions. The beginning of life is called _generation_; its perpetuation, _reproduction_. By the former function, individual life is insured; by the latter, it is maintained. Since nutrition sustains life, it has been pertinently termed _perpetual reproduction_. LATENT LIFE is contained in a small globule, a mere atom of matter, in the sperm-cell. This element is something which, under certain conditions, develops into a living organism. The entire realm of nature teems with these interesting phenomena, thus manifesting that admirable adjustment of internal to external relations, which claims our profound attention. We are simply humble scholars, waiting on the threshold of nature's glorious sanctuary, to receive the interpretation of her divine mysteries. Some have conjectured that chemical and physical forces account for all the phenomena of life, and that organization is not the result of vital forces. Physical science cannot inform us what the beginning was, or how vitality is the result of chemical forces; nor can it tell us what transmutations will occur at the end of organized existence. This mysterious life-principle eludes the grasp of the profoundest scientists, and its presence in the world will ever continue to be an astonishing and indubitable testimony of Divine Power. The physical act of generation is accomplished by the union of two cells; and as this conjugation is known to be so generally indispensable to the organization of life, we may fairly infer that it is a universal necessity. Investigations with the microscope have destroyed the hypothesis of "spontaneous generation." These show us that even the minutest living forms are derived from a parent organization. GENERATION. So long as the vital principle remains in the sperm-cell, it lies dormant. That part of the cell which contains this principle is called the _spermatozoön_, which consists of a flattened body, having a long appendage tapering to the finest point. If it be remembered that a line is the one-twelfth part of an inch in length, some idea may be formed of the extreme minuteness of the body of a human spermatozoön, when we state that it is from 1/800 to 1/600 part of a line, and the filiform tail 1/50 of a line, in length. This life-atom, which can be discerned only with a powerful magnifying glass, is perfectly transparent, and moves about by executing a vibratile motion with its long appendage. Within this speck of matter are hidden the multifarious forces which, under certain favorable conditions, result in organization. Magnify this infinitesimal atom a thousand times, and no congeries of formative powers is perceived wherewith to work out the wonders of its existence. Yet it contains the principle, which is the contribution on the part of the male toward the generation of a new being. The _ovum_ or germ-cell, is the special contribution on the part of the female for the production of another being. The human ovum, though larger than the spermatozoön, is also extremely small, measuring not more than from 1/20 to 1/10 of a line, or from 1/240 to 1/120 of an inch, in diameter. [Illustration: Fig. 1. _A_. Human Spermatozoön magnified about 3,800 diameters. _B_. Vertical and lateral views of spermatozoa of man. _C, D, E, F._ Development of spermatozoa within the vesicles of evolution. _G_. Cell of the sponge resembling a spermatozoön. _H_. Vesicles of evolution from the seminal fluid of the dog in the parent cell _I_. Single vesicles of different sizes. _J_. Human spermatozoön forming in its cell. _K_. Rupture of the cell and escape of the spermatozoön. ] The sperm and the germ-cells contain the primary elements of all organic structures, and both possess the special qualities and conditions by which they may evolve organic beings. Every cell is composed of minute grains, within which vital action takes place. The interior of a cell consists of growing matter; the exterior, of matter which has assumed its form and is less active. When the vital principle is communicated to it, the cell undergoes a rapid transformation. While this alteration takes place within the cell, deteriorating changes occur in the cell-wall. Although vital operations build up these structures, yet the animal and nervous functions are continually disintegrating, or wasting, them. Throughout the animal kingdom, germ-cells present the same external aspect when carefully examined with the microscope. No difference can be observed between the cells of the flowers of the oak and those of the apple, but the cells of the one always produce oak trees, while those of the other always produce apple trees. The same is true of the germs of animals, there being not the slightest apparent difference. We are unable to perceive how one cell should give origin to a dog, while another exactly like it becomes a man. For aught we know, the ultimate atoms of these cells are identical in physical character; at least we have no means of detecting any difference. SPECIES. The term species is generally used merely as a convenient name to designate certain assemblages of individuals having various striking points of resemblance. Scientific writers, as a rule, no longer hold that what are usually called _species_ are constantly unvarying and unchangeable quantities. Recent researches point to the conclusion that _all species vary more or less_, and, in some instances, that the variation is so great that the limits of general specific distinctness are sometimes exceeded. Our space will not permit us to do more than merely indicate the two great fundamental ideas upon which the leading theories of the time respecting the origin of species are based. These are usually termed the doctrine of _Special Creation_ and the doctrine of _Evolution_. According to the doctrine of Special Creation, it is thought that species are practically immutable productions, each species having a _specific centre_ where it was originally created, and from which it spread over a certain area until its further progress was obstructed by unfavorable conditions. The advocates of the doctrine of Evolution hold, on the contrary, that species are not permanent and immutable, but that they are subject to modification, and that "the existing forms of life are descendants by true generation of pre-existing forms."[1] Most naturalists are now inclined to admit the general truth of the theory of evolution, but they differ widely respecting the mode in which it occurred. THE PROCESS OF GENERATION. The vital _principle_, represented in the _sperm_-cell by a spermatozoön, must be imparted to a _germ_-cell in order to effect impregnation. After touching each other, separate them immediately, and observe the result. If, with the aid of a powerful lens, we directly examine the spermatozoön, it will be perceived that, for a short time, it preserves its dimensions and retains all its material aspects. But it does not long withstand the siege of decay, and, having fulfilled its destiny, loses its organic characteristics, and begins to shrink. If we examine the fertilized germ, we discover unusual activity, the result of impregnation. Organic processes succeed one another with wonderful regularity, as if wrought out by inexplicable intelligence. Here begin the functions which constitute human physiology. Generation requires that a spermatozoön be brought into actual contact with a germ that fecundation may follow. If a spermatic cell, or spermatozoön, together with several unimpregnated ova, no matter how near to one another, if not actually touching, be placed on the concave surface of a watch-crystal, and covered with another crystal, keeping them warm, and even though the vapor of the ova envelops it, no impregnation will occur. Place the spermatozoön in contact with an ovum, and impregnation is instantly and perfectly accomplished. Should this vitalizing power be termed nerve-force, electricity, heat, or motion? It is known that these forces may be metamorphosed; for instance, nervous force may be converted into electricity, electricity into heat, and heat into motion, thus illustrating their affiliation and capability of transformation. But nothing is explained respecting the real nature of the vital principle, if we assert its identity with any of these forces; for who can reveal the true nature of any of these, or even of matter? ALTERNATE GENERATION. In several insect families, the species is not wholly represented in the adult individuals of both sexes, or in their development, but, to complete this series, supplementary individuals, as it were, of one or of several preceding generations, are required. The son may not resemble the father, but the grandfather, and in some instances, the likeness re-appears only in latter generations. Agassiz states: "Alternate generation was first observed among the Salpae. These are marine mollusks, without shells, belonging to the family Tunicata. They are distinguished by the curious peculiarity of being united together in considerable numbers so as to form long chains, which float in the sea, the mouth(_m_) however being free in each. [Illustration: Fig. 2. ] [Illustration: Fig. 3. ] "Fig. 2. The individuals thus joined in floating colonies produce eggs; but in each animal there is generally but one egg formed, which is developed in the body of the parent, and from which is hatched a little mollusk. "Fig. 3, which remains solitary, and differs in many respects from the parent. This little animal, on the other hand, does not produce eggs, but propagates, by a kind of budding, which gives rise to chains already seen in the body of their parent(a), and these again bring forth solitary individuals, etc." It therefore follows that generation in some animals require? two different bodies with intermediate ones, by means of which and their different modes of reproduction, a return to the original stock is effected. UNIVERSALITY OF ANIMALCULAR LIFE.--Living organisms are universally diffused over every part of the globe. The gentle zephyr wafts from flower to flower invisible, fructifying atoms, which quicken beauty and fragrance, giving the promise of a golden fruitage, to gladden and nourish a dependent world. Nature's own sweet cunning invests all living things constraining into her service chemical affinities, arranging the elements and disposing them for her own benefit, in such numberless ways that we involuntarily exclaim, "The course of Nature is the art of God." The microscope reveals the fact that matter measuring only 1/120000 of an inch diameter may be endowed with vitality, and that countless numbers of animalcules often inhabit a single drop of stagnant water. These monads do not vary in form, whether in motion or at rest. The life of one, even, is an inexplicable mystery to the philosopher. Ehrenberg writes: "Not only in the polar regions is there an uninterrupted development of active microscopic life, where larger animals cannot exist, but we find that those minute beings collected in the Antarctic expedition of Captain James Ross exhibit a remarkable abundance of unknown, and often most beautiful forms." Even the interior of animal bodies is inhabited by animalcules. They have been found in the blood of the frog and the salmon, and in the optic fluid of fishes. Organic beings are found in the interior of the earth, into which the industry of the miner has made extensive excavations, sunk deep shafts, and thus revealed their forms; likewise, the smallest fossil organisms form subterranean strata many fathoms deep. Not only do lakes and inland seas abound with life, but also, from unknown depths, in volcanic districts, arise thermal springs which contain living insects. Were we endowed with a microscopic eye, we might see myriads of ethereal voyagers wafted by on every breeze, as we now behold drifting clouds of aqueous vapor. While the continents of earth furnishes evidences of the universality of organic beings, recent observations prove that "animal life predominates amid the eternal night of the depths of the liquid ocean." THE ORIGIN OF LIFE. The ancients, rude in many of their ideas, referred the origin of life to divine determination. The thought was crudely expressed, but well represented, in the following verse: "Then God smites his hands together, And strikes out a soul as a spark, Into the organized glory of things. From the deeps of the dark." According to a Greek myth, Prometheus formed a human image from the dust of the ground, and then, by fire stolen from heaven, animated it with a living soul. Spontaneous generation once held its sway, and now the idea of natural evolution is popular. Some believe that the inpenetrable mystery of life is evolved from the endowments of nature, and build their imperfect theory on observations of her concrete forms and their manifestations, to which all our investigations are restricted. But every function indicates purpose, every organism evinces intelligent design, and _all_ proclaim a Divine Power. Something cannot come out of nothing. With reason and philosophy, _chance_ is an impossibility. We, therefore, accept the display of wisdom in nature as indicative of the designs of God. Thus "has He written His claims for our profoundest admiration and homage all over every object that He has made." If you ask: Is there any advantage in considering the phenomena of nature as the result of DIVINE VOLITION? we answer, that this belief corresponds with the universally acknowledged ideas of accountability; for, with a wise, and efficient Cause, we infer there is an intelligent creation, and the desire to communicate, guide and bless, is responded to by man, who loves, obeys, and enjoys. Nothing is gained by attributing to nature vicegerent forces. Is it not preferable to say that she responds to intelligent, loving Omnipotence? Our finiteness is illustrated by our initiation into organized being. Emerging from a rayless atom, too diminutive for the sight, we gradually develop and advance to the maturity of those _conscious powers_, the exercise of which furnishes indubitable evidence of our immortality. We are pervaded with invisible influences, which, like the needle of the compass trembling on its pivot, point us to immortality as our ultimate goal, where in the sunny clime of Love, even in a spiritual realm of joy and happiness, we may eternally reign with Him who is all in all. * * * * * CHAPTER II. PHYSIOLOGICAL ANATOMY. THE BONES. All living bodies are made up of tissues. There is no part, no organ, however soft and yielding, or hard and resisting, which has not this peculiarity of structure. The _bones_ of animals, as well as their flesh and fat, are composed of tissues, and all alike made up of cells. When viewed under a microscope, each cell is seen to consist of three distinct parts, a _nucleolus_, or dark spot, in the center of the cell, around which lies a mass of granules, called the _nucleus;_ and this, in turn, is surrounded with a delicate, transparent membrane, termed the _envelope_. Each of the granules composing the nucleus assimilates nourishment, thereby growing into an independent cell, which possesses a triple organization similar to that of its parent, and in like manner reproduces other cells. [Illustration: Fig. 4. Nucleated cell. From Goeber. 1. Periphery of the cell, or cell-wall. 2. Nucleus. 3. Nucleolus in the center.] A variety of tissues enters into the composition of an animal structure, yet their differences are not always distinctly marked, since the characteristics of some are not unlike those of others. We shall notice, however, only the more important of the tissues. The _Areolar_, or _Connective Tissue_, is a complete network of delicate fibers, spread over the body, and serves to bind the various organs and parts together. The fibrous and serous tissues are modifications of the areolar. The _Nervous Tissue_ is of two kinds: The gray, which is pulpy and granulated, and the white fibrous tissue. The _Adipose Tissue_ is an extremely thin membrane, composed of closed cells which contain fat. It is found principally just beneath the skin, giving it a smooth, plump appearance. [Illustration: Fig. 5. Arrangement of fibers in the Areolar Tissue. Magnified 135 diameters.] The _Cartilaginous Tissue_ consists of nucleated cells, and, with the exception of bone, is the hardest part of the animal frame. The _Osseous Tissue_, or bone, is more compact and solid than the cartilaginous, for it contains a greater quantity of lime. The _Muscular Tissue_ is composed of bundles of fibers, which are enclosed in a cellular membrane. [Illustration: Fig. 6. Human Adipose Tissue.] Various opinions have been entertained in regard to the formation, or growth, of bone. Some anatomists have supposed that all bone is formed in cartilage. But this is not true, for there is an _intra-membranous_, as well as an _intra-cartilaginous_, formation of bone, as may be seen in the development of the cranial bones, where the gradual calcification takes place upon the inner layers of the fibrous coverings. Intra-cartilaginous deposit is found in the vicinity of the blood-vessels, within the cartilaginous canals; also, there are certain points first observed in the shafts of long bones, called _centers of ossification_. These points are no sooner formed than the cartilage corpuscles arrange themselves in concentric zones, and, lying in contact with one another, become very compact. As ossification proceeds, the cup-shaped cavities are converted into closed interstices of bone, with extremely thin lamellæ, or layers. These, however, soon increase in density, and no blood-vessels can be observed within them. [Illustration: Fig. 7. Vertical section of cartilage near the surface of ossification. _1_. Ordinary appearance of the temporary cartilage. _1_'. Portion of the same more highly magnified. _2_. The cells beginning to form into concentric zones. _2_'. Portion more magnified. _3_. The ossification is extending in the inter-cellular spaces, and the rows of cells are seen resting in the cavities so formed, the nuclei being more separated than above. _3_'. Portion of the same more highly magnified.] [Illustration: Fig. 8. Thigh-bone, sawn open lengthwise.] [Illustration: Fig. 9. Lower end of the thigh-bone sawn across, showing its central cavity.] The bony plates form the boundaries of the _Haversian_, or nutritive canals of the bones. In the _second stage of ossification_, the cartilage corpuscles are converted into bone. Becoming flattened against the osseous lamellæ already formed, they crowd upon one another so as to entirely obliterate the lines that distinguish them; and, simultaneously with these changes, a calcareous deposit takes place upon their interior. Bones grow by additions to their ends and surfaces. In the child, their extremities are separated from the body of the bone by layer of cartilage, and the cancellated, or cellular structure, which remains for a time in the interior, represents the early condition of the ossifying substances. The bones contain more earthy matter in their composition than any other part of the human body, being firm, hard, and of a lime color. They compose the skeleton or frame work, and, when united by natural ligaments, form what is known as the _natural_ skeleton; when they are wired together, they are called an _artificial_ skeleton. The number of bones in the human body is variously estimated; for those regarded as single by some anatomists are considered by others to consist of several distinct pieces. There are two hundred distinct bones in the human skeleton besides the teeth. These may be divided into those of the Head, Trunk, Upper Extremities, and Lower Extremities. [Illustration: Fig. 10. The bones of the skull separated. _1_. Frontal, only half is seen. _2_. Parietal. _3_. Occipital, only half is seen. _4_. Temporal. _5_. Nasal. _6_. Malar. _7_. Superior maxillary (upper jaw). _8_. Lachrymal. _9_. Inferior maxillary (lower jaw). Between _4_ and _6_ a part of the sphenoid or wedge-shaped bone, is seen. Another bone assisting to form the skull, but not here seen, is called the _ethmoid_ (sieve-like, from being full of holes), and is situated between the sockets of the eyes, forming the roof of the nose.] THE BONES OF THE HEAD are classed as follows: eight belonging to the Cranium, and fourteen to the Face. The bones of the Cranium are the _occipital_, two _parietal_, two _temporal, frontal, sphenoid_, and _ethmoid_. Those composing the face are, the two _nasal_, two _superior maxillary,_ two _lachrymal_, two _malar_ two _palate_, two _inferior turbinated, vomer_, and _inferior maxillary_. The cranial bones are composed of two dense plates, between which there is, in most places a cancellated or cellular tissue. The external plate is fibrous, the internal, compact and vitreous. The skull is nearly oval in form, convex externally, the bone being much thicker at the base than elsewhere, and it is, in every respect admirably adapted to resist any injury to which it may be exposed, thus affording ample protection to the brain substance which it envelops. The internal surface of the cranium presents eminences and depressions for lodging the convolutions of the brain, and numerous furrows for the ramifications of the blood-vessels. The bones of the cranium are united to one another by ragged edges called _sutures_, which are quite distinct in the child but which in old age are nearly effaced. Some authorities suppose that by this arrangement the cranium is less liable to be fractured by blows; others think that the sutures allow the growth of these bones, which takes place by a gradual osseous enlargement at the margins. The bones of the _Face_ are joined at the lower part and in front of the cranium, and serve for the attachment of powerful muscles which assist in the process of mastication. Although the soft parts of the face cover the bony structure, yet they do not conceal its principal features, or materially change its proportions. The form of the head and face presents some remarkable dissimilarities in different races. [Illustration: Fig. 11. _1_. The first bone of the sternum (breast-bone). _2_. The second bone of the sternum. _3_. The cartilage of the sternum. _4_. The first dorsal vertebra (a bone of the spinal column). _5_. The last dorsal vertebra. _6_. The first rib. _7_. Its head. _8_. Its neck. _9_. Its tubercle. _10_. The seventh or last true rib. _11_. The cartilage of the third rib. _12._ The floating ribs.] [Illustration: Fig. 12. A vertebra of the neck. _1_. The body of the vertebra. _2_. The spinal canal. _4_. The spinous process cleft at its extremity. _5_. The transverse process. _7_. The interior articular process. _8_. The superior articular process.] THE TRUNK has fifty-four bones, which are as follows: The _Os Hyoides_, the _Sternum_, twenty-four Ribs, twenty-four _vertebræ_ or bones of the Spinal Column, the _Sacrum_, the _Coccyx_, and two _Ossa Innominata_. The _Os Hyoides_, situated at the base of the tongue, is the most isolated bone of the skeleton, and serves for the attachment of muscles. The _Sternum_, or breast-bone, in a child is composed of six pieces, in the adult of three, which in old age are consolidated into one bone. The _Ribs_ are thin, curved bones, being convex externally. There are twelve on each side, and all are attached to the spinal column. The seven upper ribs, which are united in front of the sternum, are termed _true_ ribs; the next three, which are not attached to the sternum, but to one another are called _false_ ribs; and the last two, which are joined only to the vertebræ, are designated as _floating_ ribs. The first rib is the shortest, and they increase in length as far as the eighth, after which this order is reversed. [Illustration: Fig. 13. _1_. The cartilaginous substance which connects the bodies of the vertebræ. _2_. The body of the vertebra. _3_. The spinous process. _4,4_. The transverse processes. _5,5_. The articular processes. _6,6_. A portion of the bony bridge which assists in forming the spinal canal (7).] [Illustration: Fig. 14. Backbone, spinal column, or vertebral column. All animals possessing such a row of bones are called _vertebrates_. Above _b_ are the cervical (neck) vertebræ; _b_ to _c_, dorsal (back) or chest vertebræ; _c_ to _d_, lumbar (loins) vertebræ; _d_ to _e_, sacrum; _e_ to _f_, coccyx.] The _Spinal Column_ or backbone, when viewed from the front presents a perpendicular appearance, but a side view shows four distinct curves. The bones composing it are called _vertebræ_. The body part of a vertebra is light and spongy in texture, having seven projections called _processes_, four of which are the _articular_ processes, which furnish surfaces to join the different vertebræ of the spinal column. Two are called _transverse_, and the remaining one is termed the _spinous_. The transverse and spinous processes serve for the attachment of the muscles belonging to the back. All these processes are more compact than the body of the vertebra, and, when naturally connected, are so arranged as to form a tube which contains the _medulla spinalis_, or spinal cord. Between the vertebræ is a highly-elastic, cartilaginous and cushion-like substance, which freely admits of motion, and allows the spine to bend as occasion requires. The natural curvatures of the spinal column diminish the shock produced by falling, running or leaping, which would otherwise be more directly transmitted to the brain. The ribs at the sides, the sternum in front, and the twelve dorsal bones of the spinal column behind, bound the thoracic cavity, which contains the lungs, heart, and large blood-vessels. [Illustration: Fig. 15. A representation of the pelvic bones. _e_. The lumbo-sacral joint. 2. The sacrum. _3_. Coccyx. _1,1_. The innominata. _4,4_. Acetabula.] The _Pelvis_ is an open bony structure, consisting of the Os Innominata, one on either side, and the Sacrum and Coccyx behind. The _Sacrum_, during childhood, consists of five bones, which in later years unite to form one bone. It is light and spongy in texture, and the upper surface articulates with the lowest vertebra, while it is united at its inferior margin to the coccyx. The _Coccyx_ is the terminal bone of the spinal column. In infancy it is cartilaginous and composed of several pieces, but in the adult these unite and form one bone. The _Innominata_, or nameless bones, during youth, consist of three separate pieces on each side; but as age advances they coalesce and form one bone. A deep socket, called the _acetabulum_, is found near their junction, which serves for the reception of the head of the thigh-bone. [Illustration: Fig. 16. 1. Portions of the backbone. 2. Cranial bones. _4_. Breast-bone. _5_. Ribs. _7_. Collar-bone. _8_. Arm-bone (humerus). _9_. Shoulder-joint. _10, 11_. Bones of the fore-arm (ulna and radius). _12_. Elbow-joint. _13_. Wrist-joint. _14_. Bones of the hand. _15, 16_. Pelvic bones. _17_. Hip-joint. _18_. Femur. _19, 20_. Bones of the knee-joint. _21, 22_. Fibula and tibia. _23_. Ankle bone. _24_. Bones of the foot.] THE BONES OF THE UPPER EXTREMITIES are sixty-four in number, and are classified as follows: The Scapula, Clavicle, Humerus, Ulna, Radius, Carpus, Metacarpus, and Phalanges. The _Scapula_, or shoulder-blade, is an irregular, thin, triangular bone, situated at the posterior part of the shoulder, and attached to the upper and back part of the chest. The _Clavicle_, or collar-bone, is located at the upper part of the chest, between the sternum and scapula, and connects with both. Its form resembles that of the italic letter _f_, and it prevents the arms from sliding forward. The _Humerus_, the first bone of the arm, is long, cylindrical, and situated between the scapula and fore-arm. The _Ulna_ is nearly parallel with the radius, and situated on the inner side of the fore-arm. It is the longer and larger of the two bones, and in its articulation with the humerus, forms a perfect hinge-joint. The _Radius_, so called from its resemblance to a spoke, is on the outer side of the fore-arm, and articulates with the bones of the wrist, forming a joint. The ulna and radius also articulate with each other at their extremities. The _Carpus_, or wrist, consists of eight bones, arranged in two rows. The _Metacarpus_, or palm of the hand, is composed of five bones situated between the carpus and fingers. The _Phalanges_, fourteen in number, are the bones of the fingers and thumb, the fingers each having three and the thumb two. THE BONES OF THE LOWER EXTREMITIES, sixty in number, are classed as follows: The Femur, Patella, Tibia, Fibula, Tarsus, Metatarsus, and Phalanges. The _Femur_, or thigh-bone, is the longest bone in the body. It has a large round head, which is received into the acetabulum, thus affording a good illustration of a ball and socket joint. The _Patella,_ or knee-pan, is the most complicated articulation of the body. It is of a round form, connects with the tibia by means of a strong ligament, and serves to protect the front of the joint, and to increase the leverage of the muscles attached to it, by causing them to act at a greater angle. The _Tibia_, or shin bone, is enlarged at each extremity and articulates with the femur above and the astragalus, the upper bone of the tarsus, below. The _Fibula_, the small bone of the leg, is situated on the outer side of the tibia, and is firmly bound to it at each extremity. The _Tarsus_, or instep, is composed of seven bones, and corresponds to the carpus of the upper extremities. The _Metatarsus_, the middle of the foot, bears a dose resemblance to the metacarpus, and consists of five bones situated between the tarsus and the phalanges. The tarsal and the metatarsal bones are so united as to give an arched appearance to the foot, thus imparting elasticity. The _Phalanges_, the toes, consist of fourteen bones, arranged in a manner similar to that of the fingers. We are not less interested in tracing the formation of bone through its several stages, than in considering other parts of the human system. The formation of the Haversian canals for the passage of blood-vessels to nourish the bones, the earlier construction of bony tissue by a metamorphosis of cartilaginous substance, and also the commencement of ossification at distinct points, called _centers of ossification_, are all important subjects, requiring the student's careful attention. The bones are protected by an external membranous envelope, which, from its situation is called the _periosteum_. The bones are divided into four classes, _long, short, flat_ and _irregular_, being thus adapted to subserve a variety of purposes. The Long Bones are found in the limbs, where they act as levers to sustain the body and aid in locomotion. Each_long_ bone is composed of a cylinder, known as the _shaft_, and two _extremities_. The shaft is hollow, its wails being _thickest_ in THE middle and growing thinner toward the extremities. The _extremities_ are usually considerably enlarged, for convenience of connection with other bones, and to afford a broad surface for the attachment of muscles. The clavical, humerus, radius, ulna, femur, tibia, fibula, the bones of the metacarpus, metatarsus and the phalanges, are classed as long bones. Where the principal object to be attained is strength, and the motion of the skeleton is limited, the individual bones are short and compressed, as the bones of the carpus and tarsus. The structure of these bones is spongy, except at the surface, where there is a thin crust of compact matter. [Illustration: Fig. 17. Anatomy of a joint, _1, 1_. Bones of a joint. _2, 2_. Cartilage. _3, 3, 3, 3_. Synovial membrane.] [Illustration: Fig. 18. Anatomy of knee joint. _1._ Lower end of thigh-bone. _3._ Knee-pan. _2, 4_ Ligaments of the knee-pan. _5_. Upper end of the tibia, or shin-bone. _6, 12_. Cartilages.] When protection is required for the organs of the body, or a broad flat surface for the attachment of the muscles, the bones are expanded into plates, as in the cranium and shoulder-blades. The _irregular_ or _mixed_ bones are those which, from their peculiar shape, cannot be classed among any of the foregoing divisions. Their structure is similar to the others, consisting of cancellar tissue, surrounded by a crust of compact matter. The vertebræ, sacrum, coccyx, temporal, sphenoid, ethmoid, malar, two maxillary, palate, inferior turbinated, and hyoid are known as irregular bones. The formation of the joints requires not only bones, but also cartilages, ligaments, and the synovial membrane, to complete the articulation. _Cartilage_ is a smooth, elastic substance, softer than bone, and invested with a thin membrane, called _perichondrium_. When cartilage is placed upon convex surfaces, the reverse is true. The _Ligaments_ are white, inelastic, tendinous substances, softer than cartilage, but harder than membrane. Their function is to bind together the bones. The _Synovial Membrane_ covers the cartilages, and is then reflected upon the ligaments, thus forming a thin, closed sac, called the _synovial capsule._ All the synovial membranes secrete a lubricating fluid, termed _synovia_, which enables the surfaces of the bones and ligaments to move freely upon one another. When this fluid is secreted in excessive quantities, it produces a disease known as "dropsy of the joints." There are numerous smaller sacs besides the synovial, called _bursæ mucosæ_, which in structure are analogous to them, and secrete a similar fluid. Some joints permit motion in every direction, as the shoulders, some in two directions only, as the elbows, while others do not admit of any movement. The bones, ligaments, cartilages, and synovial membrane, are supplied with nerves, arteries, and veins. When an animal is provided with an internal bony structure, it indicates a high rank in the scale of organization. An elaborate texture of bone is found in no class below the vertebrates. Even in the lower order of this sub-kingdom, which is the highest of animals, bone does not exist, as is the case in some tribes of fishes, such as sharks, etc., and in all classes below that of the cartilaginous fishes, the inflexible substance which sustains the soft parts is either shell or some modification of bone, and is usually found on the outside of the body. True bone, on the contrary, is found in the interior, and, therefore, in higher animals, the skeleton is always internal, while the soft parts are placed external to the bony frame. While many animals of the lowest species, being composed of soft gelatinous matter, are buoyant in water, the highest type of animals requires not only a bony skeleton, but also a flexible, muscular system, for locomotion in the water or upon the land. Each species of the animal kingdom is thus organically adapted to its condition and sphere of life. * * * * * CHAPTER III. PHYSIOLOGICAL ANATOMY. THE MUSCLES. [Illustration: Fig. 19. Muscular fillers highly magnified.] The _Muscles_ are those organs of the body by which motion is produced, and are commonly known as _flesh_. A muscle is composed of _fascieuli_, or bundles of fibers, parallel to one another. They are soft, varying in size, of a reddish color, and inclosed in a cellular, membranous sheath. Each _fasciculus_ contains a number of small fibers, which, when subjected to a microscopic examination, are found to consist of _fibrillae_, or little fibers; each of these fibrillae in turn being invested with a delicate sheath. The fibers terminate in a glistening, white _tendon_, or hard cord, which is attached to the bone. So firmly are they united, that the bone will break before the tendon can be released. When the tendon is spread out, so as to resemble a membrane, it is called _fascia_. Being of various extent and thickness, it is distributed over the body, as a covering and protection for the more delicate parts, and aids also in motion, by firmly uniting the muscular fibers. The spaces between the muscles are frequently filled with fat, which gives roundness and beauty to the limbs. The muscles are of various forms; some are longitudinal, each extremity terminating in a tendon, which gives them a _fusiform_ or spindle-shaped appearance; others are either fan-shaped, flat, or cylindrical. [Illustration: Fig. 20. 1. A spindle-shaped muscle, with tendinous terminations. 2. Fan-shaped muscle. 3. Penniform muscle. 4. Bipenniform muscle.] [Illustration: Fig. 21. Striped muscular fibre showing cleavage in opposite directions. 1. Longitudinal cleavage. 2. Transverse cleavage. 3. Transverse section of disc. 4. Disc nearly detached. 5. Detached disc, showing the sarcous elements. 6. Fibrillæ. 7,8. Separated fibrillae highly magnified.] Every muscle has an _origin_ and an _insertion_. The term _origin_ is applied to the more fixed or central attachment of a muscle, and the term _insertion_ to the movable point to which the force of the muscle is directed; but the origin is not absolutely fixed, except in a small number of muscles, as those of the face, which are attached at one extremity to the bone, and at the other to the movable integument, or skin. In most instances, the muscles may act from either extremity. The muscles are divided into the Voluntary, or muscles of animal life, and the Involuntary, or muscles of organic life. There are, however, some muscles which cannot properly be classified with either, termed Intermediate. The _Voluntary Muscles_ are chiefly controlled by the will, relaxing and contracting at its pleasure, as in the motion of the eyes, mouth, and limbs. The fibers are of a dark red color, and possess great strength. These fibers are parallel, seldom interlacing, but presenting a striped or striated appearance; and a microscopic examination of them shows that even the most minute consist of parallel filaments marked by longitudinal and transverse _striae_, or minute channels. The fibers are nearly the same length as the muscles to which they belong. Each muscular fiber is capable of contraction; it may act singly, though usually it acts in unison with others. By a close inspection, it has been found that fibers may be drawn apart longitudinally, in which case they are termed _fibrillae_, or they may be separated transversely, forming a series of discs. The _Sarcolemma_, or investing sheath of the muscles, appears to be formed even before there are any visible traces of the muscle itself. It is a transparent and delicate membrane, but very elastic. The _Involuntary Muscles_ are influenced by the sympathetic nervous system, and their action pertains to the nutritive functions of the body. They differ from the voluntary muscles in not being striated, having no tendons, and in the net-work arrangements of their fibers. The _Intermediate Muscles_ are composed of striated and unstriated fibers; they are, therefore, both voluntary and involuntary in their functions. The muscles employed in respiration are of this class, for we can breathe rapidly or slowly, and, for a short time, even suspend their action; but soon, however, the organic muscles assert their instinctive control, and respiration is resumed. [Illustration: Fig. 22. Unstriated muscular fiber; at _b_, in its natural state; at _a_, showing the nuclei after the action of acetic acid. ] [Illustration: Fig. 23. A view of the under side of the diaphragm.] THE DIAPHRAGM, or midriff, is the muscular division between the thorax and the abdomen. It has been compared to an inverted basin, the concavity of which is directed toward the abdomen. The muscles receive their nourishment from the numerous blood-vessels which penetrate their tissues. The voluntary muscles are abundantly supplied with nerves, while the involuntary are not so numerously furnished. The color of the muscles is chiefly due to the blood which they contain. They vary in size according to their respective functions. For example, the functions of the heart require large and powerful muscles, and those of the eye, small and delicate ones. There are between four hundred and sixty and five hundred muscles in the human body. [Illustration: Fig. 24. A representation of the superficial layer of muscles on the anterior portion of the body.] [Illustration: Fig. 25. A representation of the superficial layer of muscles on the posterior portion of the body.] Very rarely is motion produced by the action of a single muscle, but by the harmonious action of several. There is infinite variety in the arrangement of the muscles, each being adapted to its purpose, in strength, tenacity, or elasticity. While some involuntarily respond to the wants of organic life, others obey, with mechanical precision, the edicts of the will. The peculiar characteristic of the muscles is their contractility; for example, when the tip of the finger is placed in the ear, an incessant vibration, due to the contraction of the muscles of the ear, can be heard. When the muscles contract, they become shorter; but what is lost in length is gained in breadth and thickness, so that their actual volume remains the same. Muscles alternately contract and relax, and thus act upon the bones. The economy of muscular power thus displayed is truly remarkable. In easy and graceful walking, the forward motion of the limbs is not altogether due to the exercise of muscular power, but partly to the force of gravity, and only a slight assistance of the muscles is required to elevate the leg sufficiently to allow it to oscillate. Motion is a characteristic of living bodies. This is true, not only in animals, but also in plants. The oyster, although not possessing the power of locomotion, opens and closes its shell at pleasure. The coral insect appears at the door of its cell, and retreats at will. All the varied motions of animals are due to a peculiar property of the muscles, termed _contractility_. Although plants are influenced by external agents, as light, heat, electricity, etc., yet it is supposed that they may move in response to inward impulses. The sensitive stamens of the barberry, when touched at their base on the inner side, resent the intrusion, by making a sudden jerk forward. Venus's fly-trap, a plant found in North Carolina, is remarkable for the sensitiveness of its leaves; which close suddenly and capture insects which chance to alight upon them. The muscles of the articulates are situated within the solid framework, unlike the vertebrates, whose muscles are external to the bony skeleton. All animals have the power of motion, from the lowest radiate to the highest vertebrate, from the most repulsive polyp to that type of organized life made in the very image of God. The muscles, then, subserve an endless variety of purposes. By their aid the farmer employs his implements of husbandry, the mechanic deftly wields his tools, the artist plies his brush, while the fervid orator gives utterance to thoughts glowing with heavenly emotions. It is by their agency that the sublimest spiritual conceptions can be brought to the sphere of the senses, and the noblest, loftiest aims of to-day can be made glorious realizations of the future. * * * * * CHAPTER IV. PHYSIOLOGICAL ANATOMY. THE DIGESTIVE ORGANS. _Digestion_ signifies the act of separating or distributing, hence its application to the process by which food is made available for nutritive purposes. The organs of digestion are the Mouth, Teeth, Tongue, Salivary Glands, Pharynx, Esophagus, the Stomach and the Intestines, with their glands, the Liver, Pancreas, Lacteals, and the Thoracic Duct. [Illustration: Fig. 26. A view of the lower jaw. _1_. The body. _2, 2_. Rami, or branches. _3, 3_. Processes of the lower jaw. _m_. Molar teeth. _b_. Bicuspids, _c_. Cuspids. _i_. Incisors.] The _Mouth_ is an irregular cavity, situated between the upper and the lower jaw, and contains the organs of mastication. It is bounded by the lips in front, by the cheeks at the sides, by the roof of the mouth and teeth of the upper jaw above, and behind and beneath by the teeth of the lower jaw, soft parts, and palate. The soft palate is a sort of pendulum attached only at one of its extremities, while the other involuntarily opens and closes the passage from the mouth to the pharynx. The interior of the mouth, as well as other portions of the alimentary canal, is lined with a delicate tissue, called _mucous membrane_. The _Teeth_ are firmly inserted in the alveoli or sockets, of the upper and the lower jaw. The first set, twenty in number, are temporary, and appear during infancy. They are replaced by permanent teeth, of which there are sixteen in each jaw; four incisors, or front teeth, four cuspids, or eye teeth, four bicuspids, or grinders, and four molars, or large grinders. Each tooth is divided into the crown, body, and root. The _crown_ is the grinding surface; the _body_, the part projecting from the jaw, is the seat of sensation and nutrition; the _root_ is that portion of the tooth which is inserted in the alveolus. The teeth are composed of dentine, or ivory, and enamel. The ivory forms the greater portion of the body and root, while the enamel covers the exposed surface. The small white cords communicating with the teeth are the nerves. The _Tongue_ is a flat oval organ, the base of which is attached to the os hyoides, while the apex, the most sensitive part of the body, is free. Its surface is covered with a membrane, which, at the sides and lower part, is continuous with the lining of the mouth. On the lower surface of the tongue, this membrane is thin and smooth, but on the upper side it is covered with numerous papillae, which, in structure, are similar to the sensitive papillae of the skin. [Illustration: Fig. 27. The salivary glands. The largest one, near the ear, is the parotid gland. The next below it is the submaxillary gland. The one under the tongue is the sublingual gland.] The _Salivary Glands_ are six in number, three on each side of the mouth. Their function is to secrete a fluid called _saliva_, which aids in mastication. The largest of these glands, the _Parotid_, is situated in front and below the ear; its structure, like that of all the salivary glands, is cellular. The _Submaxillary_ gland is circular in form, and situated midway between the angle of the lower jaw and the middle of the chin. The _Sublingual_ is a long flattened gland, and, as its name indicates, is located below the tongue, which when elevated, discloses the saliva issuing from its porous openings. The _Pharynx_ is nearly four inches in length, formed of muscular and membranous cells, and situated between the base of the cranium and the esophagus, in front of the spinal column. It is narrow at the upper part, distended in the middle, contracting again at its junction with the esophagus. The pharynx communicates with the nose, mouth, larynx, and esophagus. The _Esophagus_, a cylindrical organ, is a continuation of the pharynx, and extends through the diaphragm to the stomach. It has three coats: first, the muscular, consisting of an exterior layer of fibers running longitudinally, and an interior layer of transverse fibers; second, the cellular, which is interposed between the muscular and the mucous coat; third, the mucous membrane, or internal coat, which is continuous with the mucous lining of the pharynx. [Illustration: Fig. 28. A representation of the interior of the stomach. _1_. The esophagus. _2_. Cardiac orifice opening into the stomach. _6_. The middle or muscular coat. _7_. The interior or mucous coat. _10_. The beginning of the duodenum. _11_. The pyloric orifice.] The _Stomach_ is a musculo-membranous, conoidal sac, communicating with the esophagus by means of the cardiac orifice (see Fig. 28). It is situated obliquely with reference to the body, its base lying at the left side, while the apex is directed toward the right side. The stomach is between the liver and spleen, subjacent to the diaphragm, and communicates with the intestinal canal by the pyloric orifice. It has three coats. The peritoneal, or external coat is composed of compact, cellular tissue, woven into a thin, serous membrane, and assists in keeping the stomach in place. The middle coat is formed of three layers of muscular fibers: in the first, the fibres run longitudinally; in the second, in a circular direction; and in the third, they are placed obliquely to the others. The interior, or mucous coat, lines this organ. The stomach has a soft, spongy appearance, and, when not distended, lies in folds. During life, it is ordinarily of a pinkish color. It is provided with numerous small glands, which secrete the gastric fluid necessary for the digestion of food. The lining membrane, when divested of mucus, has a wrinkled appearance. The arteries, veins, and lymphatics, of the stomach are numerous. [Illustration: Fig. 29. Small and large intestines. _1, 1, 2, 2_. Small intestine. _3_. Its termination in the large intestine. _4_. Appendix vermiformis. _5_. Caecum. _6_. Ascending colon. _7_. Transverse colon. _8_. Descending colon. _9_. Sigmoid flexure of colon. _10_. Rectum.] The _Intestines_ are those convoluted portions of the alimentary canal into which the food is received after being partially digested, and in which the separation and absorption of the nutritive materials and the removal of the residue take place. The coats of the intestines are analogous to those of the stomach, and are, in fact, only extensions of them. For convenience of description, the intestines may be divided into the _small_ and the _large_. The small intestine is from twenty to twenty-five feet in length, and consists of the Duodenum, Jejunum, and Ileum. The _Duodenum_, so called because its length is equal to the breadth of twelve fingers, is the first division of the small intestine. If the mucous membrane of the duodenum be examined, it will be found thrown into numerous folds, which are called _valvulæ conniventes_, the chief function of which appears to be to retard the course of the alimentary matter, and afford a larger surface for the accommodation of the absorbent vessels. Numerous _villi_, minute thread-like projections, will be found scattered over the surface of these folds, set side by side, like the pile of velvet. Each _villus_ contains a net-work of blood-vessels, and a lacteal tube, into which the ducts from the liver and pancreas open, and pour their secretions to assist in the conversion of the chyme into chyle. The _Jejunum_, so named because it is usually found empty after death, is a continuation of the duodenum, and is that portion of the alimentary canal in which the absorption of nutritive matter is chiefly effected. The _Ileum_, which signifies something rolled up, is the longest division of the small intestine. Although somewhat thinner in texture than the jejunum, yet the difference is scarcely perceptible. The large intestine is about five feet in length, and is divided into the Caecum, Colon, and Rectum. The _Caecum_ is about three inches in length. Between the large and the small intestine is a valve, which prevents the return of excrementitious matter that has passed into the large intestine. There is attached to the cæcum an appendage about the size of a goose-quill, and three inches in length, termed the _appendix vermiformis_. The _Colon_ is that part of the large intestine which extends from the cæcum to the rectum, and which is divided into three parts, distinguished as the ascending, the transverse, and the descending. [Illustration: Fig. 30. Villi of the small intestine greatly magnified.] [Illustration: Fig. 31. A section of the Ileum, turned inside out, so as to show the appearance and arrangement of the villi on an extended surface.] The _Rectum_ is the terminus of the large intestine. The intestines are abundantly supplied with blood-vessels. The arteries of the small intestine are from fifteen to twenty in number. The large intestine is furnished with three arteries, called the _colic arteries_. The _ileo-colic artery_ sends branches to the lower part of the ileum, the head of the colon, and the appendix vermiformis. The _right colic artery_ forms arches, from which branches are distributed to the ascending colon. The _colica media_ separates into two branches, one of which is sent to the right portion of the transverse colon, the other to the left. In its course, the _superior hemorrhoidal artery_ divides into two branches, which enter the intestine from behind, and embrace it on all sides, almost to the anus. The _Thoracic Duct_ is the principal trunk of the absorbent system, and the canal through which much of the chyle and lymph is conveyed to the blood. It begins by a convergence and union of the lymphatics on the lumbar vertebræ, in front of the spinal column, then passes upward through the diaphragm to the lower part of the neck, thence curves forward and downward, opening into the subclavian vein near its junction with the left jugular vein, which leads to the heart. [Illustration: Fig. 32. _c, c_. Right and left subclavian veins. _b_. Inferior vena cava. _a_. Intestines. _d_. Entrance of the thoracic duct into the left subclavian vein. _4_. Mesenteric glands, through which the lacteals pass to the thoracic duct.] [Illustration: Fig. 33. The inferior surface of the liver. 1. Right lobe. 2. Left lobe. 3. Gall-bladder.] The _Liver_, which is the largest gland in the body, weighs about four pounds in the adult, and is located chiefly on the right side, immediately below the diaphragm. It is a single organ, of a dark red color, its upper surface being convex, while the lower is concave. It has two large lobes, the right being nearly four times as large as the left. The liver has two coats, the _serous_, which is a complete investment, with the exception of the diaphragmatic border, and the depression for the gall-bladder, and which helps to suspend and retain the organ in position; and the _fibrous_, which is the inner coat of the liver, and forms sheaths for the blood-vessels and excretory ducts. The liver is abundantly supplied with arteries, veins, nerves, and lymphatics. Unlike the other glands of the human body, it receives two kinds of blood; the arterial for its nourishment, and the venous, from which it secretes the bile. In the lower surface of the liver is lodged the gall-bladder, a membranous sac, or reservoir, for the bile. This fluid is not absolutely necessary to the digestion of food, since this process is effected by other secretions, nor does bile exert any special action upon, starchy or oleaginous substances, when mixed with them at a temperature of 100° F. Experiments also show that in some animals there is a constant flow of bile, even when no food has been taken, and there is consequently no digestion to be performed. Since the bile is formed from the venous blood, and taken from the waste and disintegration of animal tissue, it would appear that it is chiefly an excrementitious fluid. It does not seem to have accomplished its function when discharged from the liver and poured into the intestine, for there it undergoes various alterations previous to re-absorption, produced by its contact with the intestinal juices. Thus the bile, after being transformed in the intestines, re-enters the blood under a new form, and is carried to some other part of the system to perform its mission. The _Spleen_ is oval, smooth, convex on its external, and irregularly concave on its internal, surface. It is situated on the left side, in contact with the diaphragm and stomach. It is of a dark red color, slightly tinged with blue at its edges. Some physiologists affirm that no organ receives a greater quantity of blood, according to its size, than the spleen. The structure of the spleen and that of the mesenteric glands are similar, although the former is provided with a scanty supply of lymphatic vessels, and the chyle does not pass through it, as through the mesenteric glands. The _Pancreas_ lies behind the stomach, and extends transversely across the spinal column to the right of the spleen. It is of a pale, pinkish color, and its secretion is analogous to that of the salivary glands; hence it has been called the _Abdominal Salivary Gland_. [Illustration: Fig. 34. Digestive organs. _3_. The tongue. _7_. Parotid gland. _8_. Sublingual gland. _5_. Esophagus. _9_. Stomach. _10_. Liver. _11_. Gall-bladder, _14_. Pancreas. _13, 13_. The duodenum. The small and large intestines are represented below the stomach.] Digestion is effected in those cavities which we have described as parts of the alimentary canal. The food is first received into the mouth, where it is masticated by the teeth, and, after being mixed with mucus and saliva, is reduced to a mere pulp; it is then collected by the tongue, which, aided by the voluntary muscles of the throat, carries the food backward into the pharynx, and, by the action of the involuntary muscles of the pharynx and esophagus, is conveyed to the stomach. Here the food is subjected to a peculiar, churning movement, by the alternate relaxation and contraction of the fibers which compose the muscular wall of the stomach. As soon as the food comes in contact with the stomach, its pinkish color changes to a bright red; and from the numerous tubes upon its inner surface is discharged a colorless fluid, called the _gastric juice_, which mingles with the food and dissolves it. When the food is reduced to a liquid condition, it accumulates in the pyloric portion of the stomach. Some distinguished physiologists believe that the food is kept in a gentle, unceasing, but peculiar motion, called _peristaltic_, since the stomach contracts in successive circles. In the stomach the food is arranged in a methodical manner. The undigested portion is detained in the upper, or cardiac extremity, near the entrance of the esophagus, by contraction of the circular fibers of the muscular coat. Here it is gradually dissolved, and then carried into the pyloric portion of the stomach. From this, then, it appears, that the dissolved and undissolved portions of food occupy different parts of the stomach. After the food has been dissolved by the gastric fluid, it is converted into a homogeneous, semi-fluid mass, called _chyme_. This substance passes from the stomach through the pyloric orifice into the duodenum, in which, by mixing with the bile and pancreatic fluid, its chemical properties are again modified, and it is then termed _chyle_, which has been found to be composed of three distinct parts, a reddish-brown sediment at the bottom, a whey-colored fluid in the middle, and a creamy film at the top. Chyle is different from chyme in two respects: First, the alkali of the digestive fluids, poured into the duodenum, or upper part of the small intestine, neutralizes the acid of the chyme; secondly, both the bile and the pancreatic fluid seem to exert an influence over the fatty substances contained in the chyme, which assists the subdivision of these fats into minute particles. While the chyle is propelled along the small intestine by the peristaltic action, the matter which it contains in solution is absorbed in the usual manner into the vessels of the villi by the process called _osmosis_. The fatty matters being subdivided into very minute particles, but not dissolved, and consequently incapable of being thus absorbed by osmosis, pass bodily through the epithelial lining of the intestine into the commencement of the lacteal tubes in the villi. The digested substances, as they are thrust along the small intestines, gradually lose their albuminoid, fatty, and soluble starchy and saccharine matters, and pass through the ileo-caecal valve into the cæcum and large intestine. An acid reaction takes place here, and they acquire the usual fæcal smell and color, which increases as they approach the rectum. Some physiologists have supposed that a second digestion takes place in the upper portion of the large intestine. The lacteals, filled with chyle, pass into the mesenteric glands with which they freely unite, and afterward enter the _receptaculum chyli_, which is the commencement of the thoracic duct, a tube of the size of a goose-quill, which lies in front of the backbone. The lymphatics, the function of which is to secrete and elaborate lymph, also terminate in the _receptaculum chyli_, or receptacle for the chyle. From this reservoir the chyle and lymph flow into the thoracic duct, through which they are conveyed to the left subclavian vein, there to be mingled with venous blood. The blood, chyle, and lymph, are then transmitted directly to the lungs. The process of nutrition aids in the development and growth of the body; hence it has been aptly designated a "perpetual reproduction." It is the process by which every part of the body assimilates portions of the blood distributed to it. In return, the tissues yield a portion of the material which was once a component part of their organization. The body is constantly undergoing waste as well as repair. One of the most interesting facts in regard to the process of nutrition in animals and plants is, that all tissues originate in cells. In the higher types of animals, the blood is the source from which the cells derive their constituents. Although the alimentary canal is more or less complicated in different classes of animals, yet there is no species, however low in the scale of organization, which does not possess it in some form.[2] The little polyp has only one digestive cavity, which is a pouch in the interior of the body. In some animals circulation is not distinct from digestion, in others respiration and digestion are performed by the same organs; but as we rise in the scale of animal life, digestion and circulation are accomplished in separate cavities, and the functions of nutrition become more complex and distinct. * * * * * CHAPTER V. PHYSIOLOGICAL ANATOMY. ABSORPTION. [Illustration: Fig. 35. Villi of the small intestine greatly magnified.] _Absorption_ is the vital function by which nutritive materials are selected and imbibed for the sustenance of the body. Absorption, like all other functional processes, employs agents to effect its purposes, and the _villi_ of the small intestine, with their numberless projecting organs, are specially employed to imbibe fluid substances; this they do with a celerity commensurate to the importance and extent of their duties. They are little vascular prominences of the mucous membrane, arising from the interior surface of the small intestine. Each villus has two sets of vessels. (1.) The blood-vessels, which, by their frequent blending, form a complete net-work beneath the external epithelium; they unite at the base of the villus, forming a minute vein, which is one of the sources of the portal vein. (2.) In the center of the villus is another vessel, with thinner and more transparent walls, which is the commencement of a lacteal. The _Lacteals_ originate in the walls of the alimentary canal, are very numerous in the small intestine, and, passing between the laminae of the mesentery, they terminate in the _receptaculum chyli_, or reservoir for the chyle. The mesentery consists of a double layer of cellular and adipose tissue. It incloses the blood-vessels, lacteals, and nerves of the small intestine, together with its accessory glands. It is joined to the posterior abdominal wall by a narrow _root_; anteriorly, it is attached to the whole length of the small intestine. The lacteals are known as the absorbents of the intestinal walls, and after digestion is accomplished, are found to contain a white, milky fluid, called _chyle_. The chyle does not represent the entire product of digestion, but only the fatty substances suspended in a serous fluid. Formerly, it was supposed that the lacteals were the only agents employed in absorption, but more recent investigations have shown that the blood-vessels participate equally in the process, and are frequently the more active and important of the two. Experiments upon living animals have proved that absorption of poisonous substances occurs, even when all communication by way of the lacteals and lymphatics is obstructed, the passage by the blood-vessels alone remaining. The absorbent power which the blood-vessels of the alimentary canal possess, is not limited to alimentary substances, but through them, soluble matters of almost every description are received into the circulation. The _Lymphatics_ are not less important organs in the process of absorption. Nearly every part of the body is permeated by a second series of capillaries, closely interlaced with the blood-vessels, collectively termed the _Lymphatic System_. Their origin is not known, but they appear to form a _plexus_ in the tissues, from which their converging trunks arise. They are composed of minute tubes of delicate membrane, and from their net-work arrangement they successively unite and finally terminate in two main trunks, called the _great lymphatic veins_. The lymphatics, instead of commencing on the intestinal walls, as do the lacteals, are distributed through most of the vascular tissues as well as the skin. The lymphatic circulation is not unlike that of the blood; its circulatory apparatus is, however, more delicate, and its functions are not so well understood. [Illustration: Fig. 36. A general view of the Lymphatic System.] The _lymph_ which circulates through the lymphatic vessels is an alkaline fluid composed of a plasma and corpuscles. It may be considered as blood deprived of its red corpuscles and, diluted with water. Nothing very definite is known respecting the functions of this fluid. A large proportion of its constituents is derived from the blood, and the exact connection of these substances to nutrition is not properly understood. Some excrementitious matters are supposed to be taken from the tissues by the lymph and discharged into the blood, to be ultimately removed from the system. The lymph accordingly exerts an important function by removing a portion of the decayed tissues from the body. [Illustration: Fig. 37. 1. A representation of a lymphatic vessel highly magnified. 2. Lymphatic valves. 3. A lymphatic gland and its vessels.] In all animals which possess a lacteal system there is also a lymphatic system, the one being the complement of the other. The fact that lymph and chyle are both conveyed into the general current of circulation, leads to the inference that the lymph, as well as the chyle, aids in the process of nutrition. The body is continually undergoing change, and vital action implies waste of tissues, as well as their growth. Those organs which are the instruments of motion, as the muscles, cannot be employed without wear and waste of their component parts. Renovated tissues must replace those which are worn out, and it is a part of the function of the absorbents to convey nutritive material into the general circulation. Researches in microscopical anatomy have shown that the skin contains multitudes of lymphatic vessels and that it is a powerful absorbent. Absorption is one of the earliest and most essential functions of animal and vegetables tissues. The simpler plants consist of only a few cells, all of which are employed in absorption; but in the flowering plants this function is performed by the roots. It is accomplished on the same general principles in animals, yet it presents more modifications and a greater number of organs than in vegetables. While animals receive their food into a sac, or bag called the _stomach_, and are provided with absorbent vessels such as nowhere exist in vegetables, plants plunge their absorbent organs into the earth, whence they derive nourishing substances. In the lower order of animals, as in sponges, this function is performed by contiguous cells, in a manner almost as elementary as in plants. In none of the invertebrate animals is there any _special_ absorbent system. Internal absorption is classified by some authors as follows: _interstitial_, _recrementitial_, and _excrementitial_; by others as _accidental_, _venous_, and _cutaneous_. The general cutaneous and mucous surfaces exhale, as well as absorb; thus the skin, by means of its sudoriferous glands, exhales moisture, and is at the same time as before stated, a powerful absorbent. The mucous surface of the lungs is continually throwing off carbonic acid and absorbing oxygen; and through their surface poisons are sometimes taken into the blood. The continual wear and waste to which living tissues are subject, makes necessary the provision of such a system of vessels for conveying away the worn-out materials and supplying the body with new. * * * * * CHAPTER VI. PHYSICAL AND VITAL PROPERTIES OF THE BLOOD. [Illustration: Fig. 38. Red corpuscles of human blood, represented at _a_, as they are seen when rather _beyond_ the focus of the microscope; and at _b_ as they appear when, _within_ the focus. Magnified 400 diameters.] [Illustration: Fig. 39. Development of human lymph and chyle-corpuscles into red corpuscles of blood. _A_. A lymph, or white blood-corpuscle. _B_. The same in process of conversion into a red corpuscle. _C_. A lymph-corpuscle with the cell-wall raised up around it by the action of water. _D_. A lymph-corpuscle, from which the granules have almost disappeared. _E_. A lymph-corpuscle, acquiring color; a single granule, like a nucleus, remains. _F_. A red corpuscle fully developed.] _Blood_ is the animal fluid by which the tissues of the body are nourished. This pre-eminently vital fluid permeates every organ, distributes nutritive material to every texture, is essentially modified by respiration, and, finally, is the source of every secretion and excretion. Blood has four constituents: Fibrin, Albumen, Salts (which elements, in solution, form the _liquor sanguinis_), and the Corpuscles. Microscopical examination shows that the corpuscles are of two kinds, known as the _red_ and the _white_, the former being by far the more abundant. They are circular in form and have a smooth exterior, and are on an average 1/3200 part of an inch in diameter, and are about one-fourth of that in thickness. Hence more than ten millions of them may lie on a space an inch square. If spread out in thin layers and subjected to transmitted light, they present a slightly yellowish color, but when crowded together and viewed by refracted light, exhibit a deep red color. These blood-corpuscles have been termed _discs_, and are not, as some have supposed, solid material, but are very nearly fluid. The red corpuscles although subjected to continual movement, have a tendency to approach one another, and when their flattened surfaces come in contact, so firmly do they adhere that they change their shape rather than submit to a separation. If separated, however, they return to their usual form. The colorless corpuscles are larger than the red and differ from them in being extremely irregular in their shape, and in their tendency to adhere to a smooth surface, while the red corpuscles float about and tumble over one another. They are chiefly remarkable for their continual variation in form. The shape of the red corpuscles is only altered by external influences, but the white are constantly undergoing alterations, the result of changes taking place within their own substance. When diluted with water and placed under the microscope they are found to consist of a spheroidal sac, containing a clear or granular fluid and a spheroidal vesicle, which is termed the _nucleus_. They have been regarded by some physiologists as identical with those of the lymph and chyle. Dr. Carpenter believes that the function of these cells is to convert albumen into fibrin, by the simple process of cell-growth. It is generally believed that the red corpuscles are derived in some way from the colorless. It is supposed that the red corpuscle is merely the nucleus of a colorless corpuscle enlarged, flattened, colored and liberated by the bursting of the wall of its cell. When blood is taken from an artery and allowed to remain at rest, it separates into two parts: a solid mass, called the clot, largely composed of fibrin; and a fluid known as the _serum_, in which the clot is suspended. This process is termed _coagulation_. The serum, mostly composed of _albumen_, is a transparent, straw-colored fluid, having the odor and taste of blood. The whole quantity of blood in the body is estimated on an average to be about one-ninth of its entire weight. The distinctions between the arterial and the venous blood are marked, since in the arterial system the blood is uniformly bright red, and in the venous of a very dark red color The blood-corpuscles contain both oxygen and carbonic acid in solution. When carbonic acid predominates, the blood is dark red; when oxygen, scarlet. In the lungs, the corpuscles give up carbonic acid, and absorb a fresh supply of oxygen, while in the general circulation the oxygen disappears in the process of tissue transformation, and is replaced, in the venous blood, by carbonic acid. The nutritive portions of food are converted into a homogeneous fluid, which pervades every part of the body, is the basis of every tissue, and which is termed the _blood_. This varies in color and composition in different animals. In the polyp the nutritive fluid is known as _chyme_, in many mollusks, as well as articulates, it is called _chyle_, but in vertebrates, it is more highly organized and is called blood. In all the higher animal types it is of a red color, although redness is not one of its essential qualities. Some tribes of animals possess true blood, which is not red; thus the blood of the insect is colorless and transparent; that of the reptile yellowish; in the fish the principle part is without color, but the blood of the bird is deep red. The blood of the mammalia is of a bright scarlet hue. The temperature of the blood varies in different species, as well as in animals of the same species under different physiological conditions; for this reason, some animals are called _cold-blooded._ Disease also modifies the temperature of the blood; thus in fevers it is generally increased, but in cholera greatly diminished. THE blood has been aptly termed the "vital fluid," since there is a constant flow from the heart to the tissues and organs of the body, and a continual return after it has circulated through these parts. Its presence in every part of the body is one of the essential conditions of animal life, and is effected by a special set of organs, called the _circulatory organs_. * * * * * CHAPTER VII. PHYSIOLOGICAL ANATOMY. CIRCULATORY ORGANS. Having considered the formation of chyle, traced it through the digestive process, seen its transmission into the _vena cava_, and, finally, its conversion into blood, we shall now describe how it is distributed to every part of the system. This is accomplished through organs which, from the round of duties they perform, are called _circulatory_. These are the Heart, Arteries, Veins, and Capillaries, which constitute the _vascular system_. Within the thorax or chest of the human body, and enclosed within a membranous sac, called the _pericardium_, is the great force-pump of the system, the heart. This organ, to which all the arteries and veins of the body may be either directly or indirectly traced, is roughly estimated to be equal in size to the closed fist of the individual to whom it belongs. It has a broad end turned upwards, and a little to the right side, termed its _base_; and a pointed end called its _apex_, turned downwards, forwards, and to the left side, and lying beneath a point about an inch to the right of, and below, the left nipple, or just below the fifth rib. Attached to the rest of the body only by the great blood-vessels which issue from and enter it at its base, the heart is the most mobile organ in the economy, being free to move in different directions. The heart is divided into two great cavities by a fixed partition, which extends from the base to the apex of the organ, and which prevents any direct communication between them. Each of these great cavities is further subdivided transversely by a movable partition, the cavity above each transverse partition being called the _auricle_, and the cavity below, the _ventricle_, right or left, as the case may be. [Illustration: Fig. 40. General view of the heart and lungs, _t_. Trachea, or windpipe, _a_. Aorta, _p_. Pulmonary artery, 1, 2. Branches of the pulmonary artery, one going to the right, the other to the left lung. _h._ The heart.] The walls of the auricles are much thinner than those of the ventricles, and the wall of the right ventricle is much thinner than that of the left, from the fact that the ventricles have more work to perform than the auricles, and the left ventricle more than the right. In structure, the heart is composed almost entirely of muscular fibers, which are arranged in a very complex and wonderful manner. The outer surface of the heart is covered with the pericardium, which closely adheres to the muscular substance. Inside, the cavities are lined with a thin membrane, called the _endocardium_. At the junction between the auricles and ventricles, the apertures of communication between their cavities are strengthened by _fibrous rings_. Attached to these fibrous rings are the movable partitions or valves, between the auricles and the ventricles, the one on the right side of the heart being called the _tricuspid valve_, and the one on the left side the _mitral valve._ A number of fine, but strong, tendinous chords, called _chordæ tendineæ_, connect the edges and apices of these valves with column-like elevations of the fleshy substance of the walls of the ventricles, called _columnæ carneæ_. [Illustration: Fig. 41. 1. The descending vena cava. 2. The ascending vena cava. 3. The right auricle. 4. The opening between the right auricle and the right ventricle. 5. The right ventricle. 6. The tricuspid valves. 7. The pulmonary artery. 8, 8. The branches of the pulmonary artery which pass to the right and the left lung. 9. The semilunar valves of the pulmonary artery. 10. The septum between the two ventricles of the heart. 11, 11. The pulmonary veins. 12. The left auricle. 13. The opening between the left auricle and ventricle. 14. The left ventricle. 15. The mitral valves. 16, 16. The aorta. 17. The semilunar valves of the aorta.] The valves are so arranged that they present no obstacle to the free flow of blood from the auricles into the ventricles, but if any is forced the other way, it gets between the valve and the wall of the heart, and drives the valve backwards and upwards, thus forming a transverse partition between the auricle and ventricle, through which no fluid can pass. At the base of the heart are given off two large arteries, one on the right side, which conveys the blood to the lungs, called the _pulmonary artery_, and one on the left side, which conveys the blood to the system in general, called the _aorta_. At the junction of each of these great vessels with its corresponding ventricle, is another valvular apparatus, consisting of three pouch-like valves, called the _semilunar valves_, from their resemblance, in shape, to a half-moon. Being placed on a level and meeting in the middle line, they entirely prevent the passage of any fluid which may be forced along the artery towards the heart, but, flapping back, they offer no obstruction to the free flow of blood from the ventricles into the arteries. [Illustration: Fig. 42. A representation of the venous and arterial circulation of the blood.] The _Arteries_, being always found empty after death, were supposed by the ancients, who were ignorant of the circulation of the blood, to be tubes containing air; hence their name, which is derived from a Greek word and signifies an _air-tube._ Arteries are the cylindrical tubes which carry blood to every part of the system. All the arteries, except the coronary which supply the substance of the heart, arise from the two main trunks, the pulmonary artery and the aorta. They are of a yellowish-white color, and their inner surface is smooth. The arteries have three coats. (1.) The external coat, which is destitute of fat, and composed chiefly of cellular tissue, is very firm and elastic, and can readily be dissected from the middle coat. (2.) The middle, or fibrous coat, is thicker than the external, and composed of yellowish fibers, its chief property is contractility. (3.) The internal coat consists of a colorless, thin, transparent membrane, yet so strong that it can, it is thought, better resist a powerful pressure than either of the others. Arteries are very elastic as well as extensible, and their chief extensibility is in length. If an artery of a dead body be divided, although empty, its cylindrical form will be preserved. The _Veins_ are the vessels through which the venous blood returns to the auricles of the heart. They are more numerous than the arteries, and originate from numerous capillary tubes, while the arteries are given off from main trunks. In some parts of the body, the veins correspond in number to the arteries; while in others, there are two veins to every artery. The veins commence by minute roots in the capillaries, which are everywhere distributed through the body, and gradually increase in size, until they unite and become large trunks, conveying the dark blood to the heart. The veins, like the arteries, have three coats. The external, or cellular coat, resembles that of the arteries; the middle is fibrous, but thinner than the corresponding one of the arteries; and the internal coat is serous, and analogous to that of those vessels. The veins belong to the three following classes: (1.) The systemic veins, which bring the blood from different parts of the body and discharge it into the vena cava, by means of which it is conveyed to the heart; (2), the pulmonary veins, which bring the arterial, or bright red blood from the lungs and carry it to the left auricle; (3), the veins of the portal system, which originate in the capillaries of the abdominal organs, then converge into trunks and enter the liver, to branch off again into divisions and subdivisions of the minutest character. The _Capillaries_ form an extremely fine net-work, and are distributed to every part of the body. They vary in diameter from 1/3500 to 1/2000 of an inch. They are so universally prevalent throughout the skin, that the puncture of a needle would wound a large number of them. These vessels receive the blood and bring it into intimate contact with the tissues, which take from it the principal part of its oxygen and other elements, and give up to it carbonic acid and the other waste products resulting from the transformation of the tissues, which are transmitted through the veins to the heart, and thence by the arteries to the lungs and various excretory organs. The blood from the system in general, except the lungs, is poured into the right auricle by two large veins, called the superior and the inferior _vena cava_,' and that returning from the lungs is poured into the left auricle by the _pulmonary veins._ During life the heart contracts rhythmically, the contractions commencing at the base, in each auricle, and extending towards the apex. Now it follows, from the anatomical arrangement of this organ, that when the auricles contract, the blood contained in them is forced through the auriculo-ventricular openings into the ventricles; the contractions then extending to the ventricles, in a wave-like manner, the great proportion of the blood, being prevented from re-entering the auricles by the tricuspid and mitral valves, is forced onward into the pulmonary artery from the right ventricle, and into the aorta from the left ventricle. When the contents of the ventricles are suddenly forced into these great blood-vessels, a shock is given to the entire mass of fluid which they contain, and this shock is speedily propagated along their branches, being known at the wrist as the _pulse_. On inspection, between the fifth and sixth ribs on the left side of the chest, a movement is perceptible, and, if the hand be applied, the impulse may be felt. This is known as the throbbing, or beating of the heart. If the ear is placed over the region of the heart, certain sounds are heard, which recur with great regularity. First is heard a comparatively long, dull sound, then a short, sharp sound, then a pause, and then the long, dull sound again. The first sound is caused mainly by the tricuspid and mitral valves, and the second is the result of sudden closure of the semilunar valves. No language can adequately describe the beauty of the circulatory system. The constant vital flow through the larger vessels, and the incessant activity of those so minute that they are almost imperceptible, fully illustrate the perfectness of the mechanism of the human body, and the wisdom and goodness of Him who is its author. Experiments have shown that the small arteries may be directly influenced through the nervous system, which regulates their caliber by controlling the state of contraction of their muscular walls. The effect of this influence of the nervous system enables it to control the circulation over certain areas; and, notwithstanding the force of the heart and the state of the blood-vessels in general, to materially modify the circulation in different spots. Blushing, which is simply a local modification of the circulation, is effected in this way. Some emotion takes possession of the mind, and the action of the nerves, which ordinarily keep up a moderate contraction of the muscular coats of the arteries, is lost, and the vessels relax and become distended with arterial blood, which is a warm and bright red fluid; thereupon a burning sensation is felt, and the skin grows red, the degree of the blush depending upon the intensity of the emotion. The pallor produced by fright and by extreme anxiety, is purely the result of a local modification of the circulation, brought about by an over-stimulation of the nerves which supply the small arteries, causing them to contract, and to thus cut off more or less completely the supply of blood. * * * * * CHAPTER VIII. PHYSIOLOGICAL ANATOMY. THE ORGANS OF RESPIRATION. THE ORGANS OF RESPIRATION are the Trachea, or windpipe, the Bronchia, formed by the subdivision of the trachea, and the Lungs, with their air-cells. The _Trachea_ is a vertical tube situated between the lungs below, and a short quadrangular cavity above, called the _larynx_, which is part of the windpipe, and used for the purpose of modulating the voice in speaking or singing. In the adult, the trachea, in its unextended state, is from four and one-half to five inches in length, about one inch in diameter, and, like the larynx, is more fully developed in the male than in the female. It is a fibro-cartilaginous structure, and is composed of flattened rings, or segments of circles. It permits the free passage of air to and from the lungs. The _Bronchia_ are two tubes, or branches, one proceeding from the windpipe to each lung. Upon entering the lungs, they divide and subdivide until, finally, they terminate in small cells, called the _bronchial or air-cells,_ which are of a membranous character. [Illustration: Fig. 43. An ideal representation of the respiratory organs. _3._ The larynx. _4._ The trachea. _5, 6._ The bronchia. _9, 9, 9, 9._ Air-cells. _1, 1, 1, 2, 2, 2._ Outlines of the lungs.] The _Lungs_ are irregular conical organs rounded at the apex, situated within the chest, and filling the greater part of it, since the heart is the only other organ which occupies much space in the thoracic cavity. The lungs are convex externally, and conform to the cavity of the chest, while the internal surface is concave for the accommodation of the heart. The size of the lungs depends upon the capacity of the chest. Their color varies, being of a pinkish hue in childhood but of a gray, mottled appearance in the adult. They are termed the _right_ and _left_ lung. Each lung resembles a cone with its base resting upon the diaphragm, and its apex behind the collar-bone. The right lung is larger though shorter, than the left, not extending so low, and has three _lobes_, formed by deep fissures, or longitudinal divisions, while the left has but two lobes. Each lobe is also made up of numerous _lobules_, or small lobes, connected by cellular tissue, and these contain great numbers of cells. The lungs are abundantly supplied with blood-vessels, lymphatics, and nerves. The density of a lung depends upon the amount of air which it contains. Thus, experiment has shown that in a _foetus_ which has never breathed, the lungs are compact and will sink in water; but as soon as they become inflated with air, they spread over a larger surface, and are therefore more buoyant. Each lung is invested, as far as its root, with a membrane, called the _pleura_, which is then continuously extended to the cavity of the chest, thus performing the double office of lining it, and constituting a partition between the lungs. The part of the membrane which forms this partition is termed the _mediastinum_. Inflammation of this membrane is called _pleurisy_. The lungs are held in position by the root, which is formed by the pulmonary arteries, veins, nerves, and the bronchial tubes. Respiration is the function by which the venous blood, conveyed to the lungs by the pulmonary artery, is converted into arterial blood. This is effected by the elimination of carbonic acid, which is expired or exhaled from the lungs, and by the absorption of oxygen from the air which is taken into the lungs, by the act of inspiration or inhalation. The act of expiration is performed chiefly by the elevation of the diaphragm and the descent of the ribs, and inspiration is principally effected by the descent of the diaphragm and the elevation of the ribs. [Illustration: Fig. 44. A representation of the heart and lungs. 4. The heart. 5. The pulmonary artery. 8. Aorta. 9, 11. Upper lobes of the lungs. 10, 13. Lower lobes. 12. Middle lobe of the right lung. 2. Superior vena cava. 3. Inferior vena cava.] When the muscles of some portions of the air-passages are relaxed, a peculiar vibration follows, known as snoring. Coughing and sneezing are sudden and spasmodic expiratory efforts, and generally involuntary. Sighing is a prolonged deep inspiration, followed by a rapid, and generally audible expiration. It is remarkable that laughing and sobbing, although indicating opposite states of the mind, are produced in very nearly the same manner. In hiccough, the contraction is more sudden and spasmodic than in laughing or sobbing. The quantity of oxygen consumed during sleep is estimated to be considerably less than that consumed during wakefulness. [Illustration: Fig. 45. View of the pulmonary circulation.] It is difficult to estimate the amount of air taken into the lungs at each inspiration, as the quantity varies according to the condition, size, and expansibility of the chest, but in ordinary breathing it is supposed to be from twenty to thirty cubic inches. The consumption of oxygen is greater when the temperature is low, and during digestion. All the respiratory movements, so far as they are independent of the will of the individual, are controlled by that part of the brain called the _medulla oblongata_. The respiratory, or breathing process, is not instituted for the benefit of man alone, for we find it both in the lower order of animals and in plant life. Nature is very economical in the arrangement of her plans, since the carbonic acid, which is useless to man, is indispensable to the existence of plants, and the oxygen, rejected by them, is appropriated to his use. In the lower order of animals, the respiratory act is similar to that of the higher types, though not so complex; for there are no organs of respiration, as the lungs and gills are called. Thus, the higher the animal type, the more complex its organism. The effect of air upon the color of the blood is very noticeable. If a quantity be drawn from the body, thus being brought into contact with the air, its color gradually changes to a brighter hue. There is a marked difference between the properties of the venous and the arterial blood. The venous blood is carried, as we have previously described, to the right side of the heart and to the lungs, where it is converted into arterial blood. It is now of uniform quality, ready to be distributed throughout the body, and capable of sustaining life and nourishing the tissues. Man breathes by means of lungs; but who can understand their wonderful mechanism, so perfect in all its parts? Though every organ is subservient to another, yet each has its own office to perform. The minute air-cells are for the aeration of the blood; the larger bronchial tubes ramify the lungs, and suffuse them with air; the trachea serves as a passage for the air to and from the lungs, while at its upper extremity is the larynx, which has been fitly called the organ of the human voice. At its extremity we find a sort of shield, called the _epiglottis_, the office of which is supposed to be to prevent the intrusion of foreign bodies. * * * * * CHAPTER IX. PHYSIOLOGICAL ANATOMY THE SKIN. Through digestion and respiration, the blood is continually supplied with material for its renewal; and, while the nutritive constituents of the food are retained to promote the growth of the body, those which are useless or injurious are in various ways expelled. There are, perhaps, few parts of the body more actively concerned in this removal than the skin. [Illustration: Fig. 46: An ideal view of the papillae. 1, 1. Cutis vera. 2.2. Papillary layer. 3, 3. Arteries of the papillae. 4, 4. Nerves of the papillae. 5, 5. Veins of the papillae.] The skin is a membranous envelope covering the entire body. It consists of two layers, termed the Cutis Vera, or true skin, and the Epidermis, or cuticle. The _Cutis Vera_ is composed of fibers similar to those of the cellular tissue. It consists of white and yellow fibers, which are more densely woven near the surface than deeper in the structure; the white give strength, the yellow strength and elasticity combined. The true skin may be divided into two layers, differing in their characteristics, and termed respectively the superficial or papillary layer, and the deep or fibrous layer. Upon the external surface, are little conical prominences, known as _papillae_. The papillae are irregularly distributed over the body, in some parts being smaller and more numerous than in others, as on the finger-ends, where their summits are so intimately connected as to form a tolerably smooth surface. It is owing to their perfect development, that the finger-tips are adapted to receive the most delicate impressions of touch. Although every part of the skin is sensitive, yet the papillae are extremely so, for they are the principal means through which the impressions of objects are communicated. Each papilla not only contains a minute vein and artery, but it also incloses a loop of sensitive nerves. When the body is exposed to cold, these papillae can be more distinctly seen in the form of prominences, commonly known as "goose-pimples." [Illustration: Fig. 47. A section of the skin, showing its arteries and veins. A, A. Arterial branches. B, B. Capillaries in which the branches terminate. C. The venous trunk into which the blood from the capillaries flows.] The internal, or fibrous layer of the skin, contains numerous depressions, each of which furnishes a receptacle for fat. While the skin is supplied with a complete net-work of arteries, veins, and nerves, which make it sensitive to the slightest touch, it also contains numerous lymphatic vessels, so minute that they are invisible to the naked eye. Among the agents adapted for expelling the excretions from the system, few surpass the _Sudoriferous Glands_. These are minute organs which wind in and out over the whole extent of the true skin, and secrete the perspiration. Though much of it passes off as insensible transpiration, yet it often accumulates in drops of sweat, during long-continued exercise or exposure to a high temperature. The office of the perspiration is two-fold. It removes noxious matter from the system, and diminishes animal heat, and thereby equalizes the temperature of the body. It also renders the skin soft and pliable, thus better adapting it to the movements of the muscles. The _Sebaceous Glands_, which are placed in the true skin, are less abundant where the sudoriferous glands are most numerous, and _vice versa_. Here, as elsewhere, nature acts with systematic and intelligent design. The perspiratory glands are distributed where they are most needed,--in the eyelids, serving as lubricators; in the ear passages, to produce the _cerumen_, or wax, which prevents the intrusion of small insects; and in the scalp, to supply the hair with its natural pomatum. [Illustration: Fig. 48. A perspiratory gland, highly magnified. 1, 1. The gland. 2, 2. Excretory ducts uniting to form a tube which tortuously perforates the cuticle at 3, and opens obliquely on its surface at 4.] [Illustration: Fig. 49. A representation of oil-tubes from the scalp and nose.] [Illustration: Fig. 50. Anatomy of the skin. 5, 5. Cutis vera (true skin). 4, 4. Nervous tissue. 3, 3. Sensitive layer in which are seen the nerves. 2, 2. The layer containing pigment cells. 1, 1. Epidermis (cuticle).] The _Epidermis_, or _Cuticle_, so called because it is _placed upon the skin,_ is the outer layer of the skin. Since it is entirely destitute of nerves and blood-vessels, it is not sensitive. Like the cutis vera, it has two surfaces composed of layers. The internal, or _Rete Mucosum,_ which is made up chiefly of pigment cells, is adapted to the irregularities of the cutis vera, and sends prolongations into all its glandular follicles. The external surface, or epidermis proper, is elastic, destitute of coloring matter, and consists of mere horny scales. As soon as dry, they are removed in the form of scurf, and replaced by new ones from the cutis vera. These scales may be removed by a wet-sheet pack, or by friction. The cuticle is constantly undergoing renewal. This layer serves to cover and protect the nervous tissue of the true skin beneath. We may here observe that the cuticle contains the pigment for coloring the skin. In dark races, as the negro, the cuticle is very thick and filled with black pigment. The radiation of animal heat is dependent upon the thickness and color of this cuticle. Thus, in the dark races, the pigment cells are most numerous, and in proportion as the skin is dark or fair do we find these cells in greater or lesser abundance. The skin of the Albino is of pearly whiteness, devoid even of the pink or brown tint which that of the European always possesses. This peculiarity must be attributed to the absence of pigment cells which, when present, always present a more or less dark color. The theory that _climate_ alone is capable of producing all these diversities is simply absurd. The Esquimaux, who live in Greenland and the arctic regions of America, are remarkable for the darkness of their complexion. Humboldt remarks that the American tribes of the tropical regions have no darker skin than the mountaineers of the temperate zone. Climate may _modify_ the complexion, but it cannot _make_ it. [Illustration: Fig. 51. Structure of the human hair. _A_. External surface of the shaft, showing the transverse striae and jagged boundary, caused by the imbrications of the scaly cortex. _B_. Longitudinal section of the shaft, showing the fibrous character of the medullary substance, and the arrangement of the pigmentary matter. _C_. Transverse sections, showing the distinction between the cortical and medullary substances, and the central collection of pigmentary matter, sometimes found in the latter. Magnified 310 diameters.] _Hairs_ are horny appendages of the skin, and, with the exception of the hands, the soles of the feet, the backs of the fingers and toes, between the last joint and the nail, and the upper eyelids, are distributed more or less abundantly over every part of the surface of the body. Over the greater part of the surface the hairs are very minute, and in some places are not actually apparent above the level of the skin; but the hair of the head, when permitted to reach its full growth, attains a length of from twenty inches to a yard, and, in rare instances, even six feet. A hair may be divided into a middle portion, or _shaft_, and two extremities; a peripheral extremity, called the _point;_ and a central extremity, inclosed within the hair sac, or follicle, termed the _root_. The root is somewhat greater in diameter than the shaft, and cylindrical in form, while its lower part expands into an oval mass, called the _bulb_. The shaft of the hair is not often perfectly cylindrical, but is more or less flattened, which circumstance gives rise to waving and curling hair; and, when the flattening is spiral in direction, the curling will be very great. A hair is composed of three different layers of cell-tissues: a loose, cellulated substance, which occupies its center, and constitutes the _medulla_, or pith; the fibrous tissue, which incloses the medulla, and forms the chief bulk of the hair; and a thin layer, which envelops this fibrous structure, and forms the smooth surface of the hair. The medulla is absent in the downy hairs, but in the coarser class it is always present, especially in white hair. The color of hair is due partly to the granules and partly to an inter-granular substance, which occupies the interstices of the granules and the fibers. The quantity of hair varies according to the proximity and condition of the follicles. The average number of hairs of the head may be stated at 1,000 in a superficial square inch; and, as the surface of the scalp has an area of about one hundred and twenty superficial square inches, the average number of hairs on the entire head is 120,000. The hair possesses great durability, as is evinced by its endurance of chemical processes, and by its discovery, in the tombs of mummies more than two thousand years old. The hair is remarkable for its elasticity and strength. Hair is found to differ materially from horn in its chemical composition. According to Vauquelin, its constituents are animal matter, a greenish-black oil, a white, concrete oil, phosphate of lime, a trace of carbonate of lime, oxide of manganese, iron, sulphur, and silex. Red hair contains a reddish oil, a large proportion of sulphur, and a small quantity of iron. White hair contains a white oil, and phosphate of magnesia. It has been supposed that hair grows after death, but this theory was probably due to the lengthening of the hair by the absorption of moisture from the body or atmosphere. The _nails_ constitute another class of appendages of the skin. They consist of thin plates of horny tissue, having a root, a body, and a free extremity. The root, as well as the lateral portion, is implanted in the skin, and has a thin margin which is received into a groove of the true skin. The under surface is furrowed, while the upper is comparatively smooth. The nails grow in the same manner as the cuticle. * * * * * CHAPTER X. PHYSIOLOGICAL ANATOMY. SECRETION. The term _Secretion_, in its broadest sense, is applied to that process by which substances are separated from the blood, either for the reparation of the tissues or for excretion. In the animal kingdom this process is less complicated than in vegetables. In the former it is really a _separation_ of nutritive material from the blood. The process, when effected for the removal of effete matter, is, in a measure, chemical, and accordingly the change is greater. Three elementary constituents are observed in secretory organs: the cells, a basement membrane, and the blood-vessels. Obviously, the most _essential_ part is the _cell_. The physical condition necessary for the healthy action of the secretory organs is a copious supply of blood, in which the nutritive materials are abundant. The nervous system also influences the process of secretion to a great extent. Intense emotion will produce tears, and the sight of some favorite fruit will generally increase the flow of saliva. The process of secretion depends upon the anatomical and chemical constitution of the cell-tissues. The principal secretions are (1), Perspiration; (2), Tears; (3), Sebaceous matter; (4), Mucus; (5), Saliva; (6), Gastric juice; (7), Intestinal juice; (8), Pancreatic juice; (9), Bile; (10), Milk. PERSPIRATION is a watery fluid secreted in minute glands, which are situated in every part of the skin, but are more numerous on the anterior surfaces of the body. Long thread-like tubes, only 1/100th of an inch in diameter, lined with epithelium, penetrate the skin, and terminate in rounded coils, enveloped by a net-work of capillaries, which supply the secretory glands with blood. It is estimated by Krause that the entire number of perspiratory glands is two million three hundred and eighty-one thousand two hundred and forty-eight, and the length of each glandular coil being 1/16 of an inch, we may estimate the length of tubing to be not less than two miles and a third. This secretion has a specific gravity of 1003.5, and, according to Dr. Dalton, is composed of Water, 995.50 Chloride of Sodium, 2.23 Chloride of Potassium, 0.24 Sulphate of Soda and Potassa, 0.01 Salts of organic acids, with Soda and Potassa, 2.02 ------- 1000.00 Traces of organic matter, mingled with a free volatile acid, are also found in the perspiration. It is the acid which imparts to this secretion its peculiar odor, and acid reaction. The process of its secretion is continuous, but, like all bodily functions, it is subject to influences which augment or retard its activity. If, as is usually the case when the body is in a state of repose, evaporation prevents its appearance in the _liquid_ form, it is called _invisible_ or _insensible perspiration_. When there is unusual muscular activity, it collects upon the skin, and is known as _sensible perspiration_. This secretion performs an important office in the animal economy, by maintaining the internal temperature at about 100° Fahr. Even in the Arctic regions, where the explorer has to adapt himself to a temperature of 40° to 80° below zero, the generation of heat in the body prevents the internal temperature from falling below this standard. On the contrary, if the circulation is quickened by muscular exertion, the warmer blood flowing from the internal organs into the capillaries, raises the temperature of the skin, secretion is augmented, the moisture exudes from the pores, and perceptible evaporation begins. A large portion of the animal heat is thrown off in this process, and the temperature of the skin is reduced. A very warm, dry atmosphere can be borne with impunity but if moisture is introduced, evaporation ceases, and the life of the animal is endangered. Persons have been known to remain in a temperature of about 300° Fahr. for some minutes without unpleasant effects. Three conditions may be assigned as effective causes in retarding or augmenting this cutaneous secretion, variations in the temperature of the atmosphere, muscular activity, and influences which affect the nerves. The emotions exert a remarkable influence upon the action of the perspiratory glands. Intense fear causes great drops of perspiration to accumulate on the skin, while the salivary glands remain inactive. TEARS. The lachrymal glands are small lobular organs, situated at the outer and upper orbit of the eye, and have from six to eight ducts, which open upon the conjunctiva, between the eyelid and its inner fold. This secretion is an alkaline, watery fluid. According to Dr. Dalton, its composition is as follows: Water, 882.0 Albuminous matter, 5.0 Chloride of Sodium, 13.0 Mineral Salts, a trace, ------ 1000.0 The function of this secretion is to preserve the brilliancy of the eye. The tears are spread over this organ by the reflex movement of the eyelid, called winking, and then collected in the _puncta lachrymalia_ and discharged into the nasal passage. This process is constant during life. The effect of its repression is seen in the dim appearance of the eye after death. Grief or excessive laughter usually excite these glands until there is an overflow. SEBACEOUS MATTER. Three varieties of this secretion are found in the body. A product of the sebaceous glands of the skin is found in those parts of the body which are covered with hairs; also, on the face and the external surface of the organs of generation. The _sebaceous glands_ consist of a group of flask-shaped cavities, opening into a common excretory duct. Their secretion serves to lubricate the hair and soften the skin. The _ceruminous glands_ of the _external auditory meatus_, or outer opening of the ear, are long tubes terminating in a glandular coil, within which is secreted the glutinous matter of the ear. This secretion serves the double purpose of moistening the outer surface of the membrana tympani, or ear-drum, and, by its strong odor, of preventing the intrusion of insects. The _Meibomian glands_ are arranged in the form of clusters along the excretory duct, which opens just behind the roots of the eyelashes. The oily nature of this secretion prevents the tears, when not stimulated by emotion, from overflowing the lachrymal canal. MUCUS. The mucous membranes are provided with minute glands which secrete a viscid, gelatinous matter, called _mucus_. The peculiar animal matter which it contains is termed _mucosin_. These glands are most numerous in the Pharynx, Esophagus, Trachea, Bronchia, Vagina and Urethra. They consist of a group of secreting sacs, terminating at one extremity in a closed tube, while the other opens into a common duct. The mucus varies in composition in different parts of the body; but in all, it contains a small portion of insoluble animal matter. Its functions are threefold. It lubricates the membranes, prevents their injury, and facilitates the passage of food through the alimentary canal. SALIVA. This term is given to the first of the digestive fluids, which is secreted in the glands of the mouth. It is a viscid, alkaline liquid, with a specific gravity of about 1005. If allowed to stand, a whitish precipitate is formed. Examinations with the microscope show it to be composed of minute, granular cells and oil globules, mingled with numerous scales of epithelium. According to Bidder and Schmidt, the composition of saliva is as follows: Water, 995.16 Organic matter, 1.34 Sulpho-cyanide of Potassium, 0.06 Phosphates of Sodium, Calcium and Magnesium, .98 Chlorides of Sodium and Potassium, .84 Mixture of Epithelium, 1.62 ------- 1000.00 Two kinds of organic matter are present in the saliva; one, termed _ptyalin_, imparts to the saliva its viscidity, and it obtained from the secretions of the parotid, submaxillary and sublingual glands; another, which is not glutinous, is distinguished by the property of coagulating when subjected to heat. The saliva is composed of four elementary secretions, derived respectively, from the mucous follicles of the mouth, and the parotid, the submaxillary, and the sublingual glands. The process of its secretion is constant, but is greatly augmented by the contact of food with the lining membrane. The saliva serves to moisten the triturated food, facilitate its passage, and has the property of converting starch into sugar; but the latter quality is counteracted by the action of the gastric juice of the stomach. GASTRIC JUICE. The minute tubes, or follicles, situated in the mucous membrane of the stomach, secrete a colorless, acid liquid, termed the gastric juice. This fluid appears to consist of little more than water, containing a few saline matters in solution, and a small quantity of free hydrochloric acid, which gives it an acid reaction. In addition to these, however, it contains a small quantity of a peculiar organic substance, termed _pepsin_, which in chemical composition, is very similar to ptyalin, although it is very different in its effects. When food is introduced into the stomach, the peristaltic contractions of that organ roll it about, and mingle it with the gastric juice, which disintegrates the connective tissue, and converts the albuminous portions into the substance called chyme, which is about the consistency of pea-soup, and which is readily absorbed through the animal membranes into the blood of the delicate and numerous vessels of the stomach, whence it is conveyed to the portal vein and to the liver. The secretion of the gastric juice is influenced by nervous conditions. Excess of joy or grief effectually retard or even arrest its flow. INTESTINAL JUICE. In the small intestine, a secretion is found which is termed the _intestinal juice_. It is the product of two classes of glands situated in the mucous membrane, and termed respectively, the _follicles of Lieberkuhn_ and the _glands of Brunner_. The former consist of numerous small tubes, lined with epithelium, which secrete by far the greater portion of this fluid. The latter are clusters of round follicles opening into a common excretory duct. These sacs are composed of delicate, membranous tissue, having numerous nuclei on their walls. The difficulty of obtaining this juice for experiment is obvious, and therefore its chemical composition and physical properties are not known. The intestinal juice resembles the secretion of the mucous follicles of the mouth, being colorless, vitreous in appearance, and having an alkaline reaction. PANCREATIC JUICE. This is a colorless fluid, secreted in a lobular gland which is situated behind the stomach, and runs transversely from the spleen across the vertebral column to the duodenum. The most important constituent of the pancreatic juice is an organic substance, termed _pancreatin_. THE BILE. The blood which is collected by the veins of the stomach, pancreas, spleen, and intestines, is discharged into a large trunk called the portal vein, which enters the liver. This organ also receives arterial blood from a vessel called the _hepatic artery_, which is given off from the aorta below the diaphragm. If the branches of the portal vein and hepatic artery be traced into the substance of the liver, they will be found to accompany one another, and to subdivide, becoming smaller and smaller. Finally, the portal vein and hepatic artery will be found to terminate in capillaries which permeate the smallest perceptible subdivisions of the liver substance, which are polygonal masses of not more than one-tenth of an inch in diameter, called the _lobules_. Every lobule rests upon one of the ramifications of a great vessel termed the _hepatic vein_, which empties into the inferior vena cava. There is also a vessel termed the _hepatic duct_ leading from the liver, the minute subdivisions of which penetrate every portion of the substance of that organ. Connected with the hepatic duct, is the duct of a large oval sac, called the _gall-bladder_. Each lobule of the liver is composed of minute cellular bodies known as the _hepatic cells_. It is supposed that in these cells the blood is deprived of certain materials which are converted into bile. This secretion is a glutinous fluid, varying in color from a dark golden brown to a bright yellow, has a specific gravity ranging from 1018 to 1036, and a slightly alkaline reaction. When agitated, it has a frothy appearance. Physiologists have experienced much difficulty in studying the character of this secretion from the instability of its constituents when subjected to chemical examination. [Illustration: Fig. 52. Section of the Liver, showing the ramifications of the portal vein. 1. Twig of portal vein. 2, 2', 2", 2"'. Interlobular vein. 3, 3', 3", Lobules.] _Biliverdin_ is an organic substance peculiar to the bile, which imparts to that secretion its color. When this constituent is re-absorbed by the blood and circulates through the tissues, the skin assumes a bright yellow hue, causing what is known as the jaundice. _Cholesterin_ is an inflammable crystallizable substance soluble in alcohol or ether. It is found in the spleen and all the nervous tissues. It is highly probable that it exists in the blood, in some state or combination, and assumes a crystalline form only when acted upon by other substances or elements. Two other constituents, more important than either of the above, are collectively termed _biliary salts_. These elements were discovered in 1848, by Strecker, who termed them _glycocholate_ and _taurocholate of soda_. Both are crystalline, resinous substances, and, although resembling each other in many respects, the chemist may distinguish them by their reaction, for both yield a precipitate if treated with subacetate of lead, but only the glycocholate will give a precipitate with acetate of lead. In testing for biliary substances, the most satisfactory method is the one proposed by Pettenkoffer. A solution of cane-sugar, one part of sugar to four parts of water, is mixed with the suspected substance. Dilute sulphuric acid is then added until a white precipitate falls, which is re-dissolved in an excess of the acid. On the addition of more sulphuric acid, it becomes opalescent, and passes through the successive hues of scarlet, lake, and a rich purple. Careful experiments have proved that it is a _constant_ secretion; but its flow is mere abundant during digestion. During the passage through the intestines it disappears. It is not eliminated, and Pettenkoffer's test has failed to detect its existence in the portal vein. These facts lead physiologists to the conclusion, that it undergoes some transformation in the intestines and is re-absorbed. After digestion has been going on in the stomach for some time, the semi-digested food, in the form of chyme, begins to pass through the _pyloric orifice_ of the stomach into the duodenum, or upper portion of the small intestine. Here it encounters the intestinal juice, pancreatic juice, and the bile, the secretion of all of which is stimulated by the presence of food in the alimentary tract. These fluids, mingling with the chyme, give it an alkaline reaction, and convert it into chyle. The transformation of starch into sugar, which is almost, if not entirely, suspended while the food remains in the stomach, owing to the acidity of the chyme, is resumed in the duodenum, the acid of the chyme, being neutralized by the alkaline secretions there encountered. Late researches have demonstrated that the pancreatic juice exerts a powerful effect on albuminous matters, not unlike that of the gastric juice. Thus, it seems that while in the mouth only starchy, and while in the stomach only albuminous substances are digested, in the small intestine all kinds of food materials, starchy, albuminoid, fatty and mineral, are either completely dissolved, or minutely subdivided, and so prepared that they may be readily absorbed through the animal membranes into the vessels. MILK. The milk is a white, opaque fluid, secreted in the lacteal glands of the female, in the mammalia. These glands consist of numerous follicles, grouped around an excretory duct, which unites with similar ducts coming from other lobules. By successive unions, they form large branches, termed the _lactiferous ducts_, which open by ten to fourteen minute orifices on the extremity of the nipple. The most important constituent of milk is _casein_; it also contains oily and saccharine substances. This secretion, more than any other, as influenced by nervous conditions. A mother's bosom will fill with milk at the thought of her infant child. Milk is sometimes poisoned by a fit of ill-temper, and the infant made sick and occasionally thrown into convulsions, which in some instances prove fatal. Sir Astley Cooper mentions two cases in which terror instantaneously and permanently arrested this secretion. It is also affected by the food and drink. Malt liquors and other mild alcoholic beverages temporarily increase the amount of the secretion, and may, in rare instances, have a beneficial effect upon the mother. They sometimes affect the child, however, and their use is not to be recommended unless the mother is extremely debilitated, and there is a deficiency of milk. * * * * * CHAPTER XI. PHYSIOLOGICAL ANATOMY. EXCRETION. The products resulting from the waste of the tissues are constantly being poured into the blood, and, as we have seen, the blood being everywhere full of corpuscles, which, like all living things, die and decay, the products of their decomposition accumulate in every part of the circulatory system. Hence, if the blood is to be kept pure, the waste materials incessantly poured into this fluid, or generated in it, must be as continually removed, or excreted. The principal sets of organs concerned in effecting the separation of excrementitious substances from the blood are the lungs, the skin, and the kidneys. The elimination of carbonic acid through the lungs has already been described on page 66, and the excretory function of the skin on page 70. [Illustration: Fig. 53. View of the kidneys, ureters, and bladder. ] The kidneys are two bean-shaped organs, placed at the back of the abdominal cavity, in the region of the loins, one on each side of the spine. The convex side of each kidney is directed outwards, and the concave side is turned inwards towards the spine. From the middle of the concave side, which is termed the _hilus_, a long tube of small caliber, called the _ureter_, proceeds to the bladder. The latter organ is an oval bag, situated in the pelvic cavity. It is composed principally of elastic muscular fibers, and is lined internally with mucous membrane, and coated externally with a layer of the _peritoneum_, the serous membrane which lines the abdominal and pelvic cavities. The ureters enter the bladder through its posterior and lower wall, at some little distance from each other. The openings through which the ureters enter the bladder are oblique, hence it is much easier for the secretion of the kidneys to pass from the ureters into the bladder than for it to get the other way. Leading from the bladder to the exterior of the body is a tube, called the _urethra_, through which the urine is voided. The excretion of the kidneys, termed the _urine_, is an amber-colored or straw-colored fluid, naturally having a slightly acid reaction, and a specific gravity ranging from 1,015 to 1,025. Its principal constituents are _urea_ and _uric acid_, together with various other animal matters of less importance, and saline substances, held in solution in a proportionately large amount of water. The composition of the urine and the quantity excreted vary considerably, being influenced by the moisture and temperature of the atmosphere, by the character of the food consumed, and by the empty or replete condition of the alimentary tract. On an average a healthy man secretes about fifty ounces of urine in the twenty-four hours. This quantity usually holds in solution about one ounce of urea, and ten or twelve grains of uric acid. In the amount of other animal matters, and saline substances, there is great variation, the quantity of these ranging from a quarter of an ounce to an ounce. The principal saline substances are common salt, the sulphates and phosphates of potassium, sodium, calcium, and magnesium. In addition to the animal and the saline matters, the urine also contains a small quantity of carbonic acid, oxygen and nitrogen. * * * * * CHAPTER XII. PHYSIOLOGICAL ANATOMY. THE NERVOUS SYSTEM. Hitherto, we have only considered the anatomy and functions of the organs employed in Digestion, Absorption, Circulation, Respiration, Secretion and Excretion. We have found the vital process of nutrition to be, in all its essential features, a result of physical and chemical forces; in each instance we have presupposed the existence and activity of the nerves. There is not an inch of bodily tissue into which their delicate filaments do not penetrate, and form a multitude of conductors, over which are sent the impulses of motion and sensation. [Illustration: Fig. 54. The Nervous System.] Two elements, _nerve-fibers_ and _ganglionic corpuscles_, enter into the composition of nervous tissue. Ordinary nerve-fibers in the living subject, or when fresh, are cylindrical-shaped filaments of a clear, but somewhat oily appearance. But soon after death the matter contained in the fiber coagulates, and then the fiber is seen to consist of an extremely delicate, structureless, outer membrane, which forms a tube through the center of which runs the _axis-cylinder_. Interposed between the axis-cylinder and this tube, there is a fluid, containing a considerable quantity of fatty matter, from which is deposited a highly refracting substance which lines the tube. There are two sets of nerve-fibers, those which transmit sensory impulses, called _afferent_ or _sensory_ nerves, and those which transmit motor impulses, called _efferent_ or _motor_ nerves. The fibers when collected in bundles are termed nerve trunks. All the larger nerve-fibers lie side by side in the nerve-trunks, and are bound together by delicate connective tissue, enclosed in a sheath of the same material, termed the _neurilemma_. The nerve-fibers in the trunks of the nerves remain perfectly distinct and disconnected from one another, and seldom, or never, divide throughout their entire length. However, where the nerves enter the nerve-centers, and near their outer terminations, the nerve-fibres often divide into branches, or at least gradually diminish in size, until, finally, the axis-cylinder, and the sheath with its fluid contents, are no longer distinguishable. The investing membrane is continuous from the origin to the termination of the nerve-trunk. [Illustration: Fig. 55. Division of a nerve, showing a portion of a nervous trunk (_a_) and separation of its filaments (_b, c, d, e_.)] In the brain and spinal cord the nerve-fibers often terminate in minute masses of a gray or ash-colored granular substance, termed _ganglia_, or _ganglionic corpuscles_. The ganglia are cellular corpuscles of irregular form, and possess fibrous appendages, which serve to connect them with one another. These ganglia form the cortical covering of the brain, and are also found in the interior of the spinal cord. According to Kölliker, the larger of these nerve-cells measure only 1/200 of an inch in diameter. The brain is chiefly composed of nervous ganglia. Nerves are classified with reference to their origin, as _cerebral_--those originating in the brain, and _spinal_--those originating in the spinal cord. There are two sets of nerves and nerve-centers, which are intimately connected, but which can be more conveniently studied apart. These are the _cerebro-spinal_ system, consisting of the cerebro-spinal axis, and the cerebral and spinal nerves; and the _sympathetic_ system, consisting of the chain of sympathetic ganglia, the nerves which they give off, and the nervous trunks which connect them with one another and with the cerebro-spinal nerves. THE CEREBRO-SPINAL SYSTEM. THE CEREBRO-SPINAL AXIS consists of the brain and spinal cord. It lies in the cavities of the cranium and the spinal column. These cavities are lined with a very tough fibrous membrane, termed the _dura mater_, which serves as the periosteum of the bones which enter into the formation of these parts. The surface of the brain and spinal cord is closely invested with an extremely vascular, areolar tissue, called the _pia mater_. The numerous blood-vessels which supply these organs traverse the pia mater for some distance, and, where they pass into the substance of the brain or spinal cord, the fibrous tissue of this membrane accompanies them to a greater or less depth. The inner surface of the dura mater and the outer surface of the pia mater are covered with an extremely thin, serous membrane, which is termed the _arachnoid_ membrane. Thus, one layer of the arachnoid envelopes the brain and spinal cord, and the other lines the dura mater. As the layers become continuous with each other at different points, the arachnoid, like the pericardium, forms a shut sac, and, like other serous membranes, it secretes a fluid, known as the _arachnoid fluid_. The space between the internal and the external layers of the arachnoid membrane of the brain is much smaller than that enclosed by the corresponding layers of the arachnoid membrane of the spinal column. [Illustration: Fig. 56. Cross-section of spinal cord.] THE SPINAL CORD is a column of soft, grayish-white substance, extending from the top of the spinal canal, where it is continuous with the brain, to about an inch below the small of the back, where it tapers off into a filament. From this nerve are distributed fibers and filaments to the muscles and integument of at least nine-tenths of the body. The spinal cord is divided in front through the middle nearly as far as its center, by a deep fissure, called the _anterior fissure_, and behind, in a similar manner, by the posterior _fissure_. Each of these fissures is lined with the pia mater, which also supports the blood-vessels which supply the spinal cord with blood. Consequently, the substance of the two halves of the cord is only connected by a narrow isthmus, or bridge, perforated by a minute tube, which is termed the _central canal_ of the spinal cord. Each half of the spinal cord is divided lengthwise into three nearly equal parts, which are termed the anterior, lateral, and posterior columns, by the lines which join together two parallel series of bundles of nervous filaments, which compose the roots of the spinal nerves. The roots of those nerves, which are found along that line nearest the posterior surface of the cord, are termed the posterior roots; those which spring from the other line are known as the anterior roots. Several of these anterior and posterior roots, situated at about the same height on opposite sides of the spinal cord, converge and combine into what are called the _anterior_ and _posterior bundles_; then two bundles, anterior and posterior, unite and form the trunk of a spinal nerve. The nerve trunks make their way out of the spinal canal through apertures between the vertebra, called the _inter-vertebral foramina_ and then divide into numerous branches, their ramifications extending principally to the muscles and the skin. There are thirty-one pairs of spinal nerves, eight of which are termed cervical, twelve dorsal, five lumbar, and six sacral, with reference to that part of the cord from which they originate. When the cord is divided into transverse sections, it is found that each half is composed of two kinds of matter, a white substance on the outside, and a grayish substance in the interior. The _gray matter_, as it is termed, lies in the form of an irregular crescent, with one end considerably larger than the other, and having the concave side turned outwards. The ends of the crescent are termed the _horns_, or _cornua_, the one pointing forward being called the _anterior cornu_, the other one the _posterior cornu_. The convex sides of these cornua approach each other and are united by the bridge, which contains the central canal. There is a marked difference in the structure of the gray and the white matter. The white matter is composed entirely of nerve fibers, held together by a framework of connective tissue. The gray matter contains a great number of ganglionic corpuscles, or nerve-cells, in addition to the nerve-fibers. When the nerve-trunks are irritated in any manner, whether by pinching, burning, or the application of electricity, all the muscles which are supplied with branches from this nerve-trunk immediately contract, and pain is experienced, the severity of which depends upon the degree of the irritation; and the pain is attributed to that portion of the body to which the filaments of the nerve-trunk are distributed. Thus, persons who have lost limbs often complain in cold weather of an uneasiness or pain, which they locate in the fingers or toes of the limb which has been amputated, and which is caused by the cold producing an irritation of the nerve-trunk, the filaments, or fibers of which, supplied the fingers or toes of the lost member. On the other hand, if the anterior bundle of nerve-fibers given off from the spinal cord is irritated in precisely the same way, only half of these effects is produced. All the muscles which are supplied with fibers from that trunk contract, but no pain is experienced. Conversely, if the posterior bundle of nerve-fibers is irritated, none of the muscles to which the filaments of the nerve are distributed contract, but pain is felt throughout the entire region to which these filaments are extended. It is evident, from these facts, that the fibers composing the posterior bundles of nerve-roots only transmit sensory impulses, and the filaments composing the anterior nerve-roots only transmit motor impulses; accordingly, they are termed respectively the _sensory_ and the _motor_ nerve-roots. This is illustrated by the fact that when the posterior root of a spinal nerve is divided, all sensation in the parts to which the filaments of that nerve are distributed is lost, but the power of voluntary movement of the muscles remains. On the other hand, if the anterior roots are severed, the power of voluntary motion of the muscles is lost, but sensation remains. It appears from these experiments, that, when a nerve is irritated, a change in the arrangement of its molecules takes place, which is transmitted along the nerve-fibers. But, if the nerve-trunks are divided, or compressed tightly at any point between the portion irritated, and the muscle or nerve-centre, the effect ceases immediately, in a manner similar to that in which a message is stopped by the cutting of a telegraph wire. When the nerves distributed to a limb are subjected to a pressure sufficient to destroy the molecular continuity of their filaments, it "goes to sleep," as we term it. The power of transmitting sensory and motor impulses is lost, and only returns gradually, as the molecular continuity is restored. From what has been said, it is plain that a sensory nerve is one which conveys a sensory impulse from the peripheral or outer part of a nerve to the spinal cord or brain, and which is, therefore, termed _afferent_; and that a motor nerve is one which transmits an impulse from the nerve centre, or is _efferent_. So difference in structure, or in chemical or physical composition, can be discerned between the afferent and the _efferent_ nerves. A certain period of time is required for the transmission of all impulses. The speed with which an impulse travels has been found to be comparatively slow, being even less than that of sound, which is 1,120 feet per second. The experiments heretofore related have been confined solely to the nerves. We may now proceed to the consideration of what takes place when the spinal cord is operated upon in a similar way. If the cord be divided with a knife or other instrument, all parts of the body supplied with nerves given off below the division will become paralyzed and insensible, while all parts of the body supplied with nerves from the spinal cord _above_ the division will retain their sensibility and power of motion. If, however, only the posterior half of the spinal cord is divided, or destroyed, there is loss of sensation alone; and, if the anterior portion is cut in two, and the continuity of the posterior part is left undisturbed, there is loss of voluntary motion of the lower limbs, but sensation remains. REFLEX ACTION OF THE SPINAL CORD. In relation to the brain, the spinal cord is a great mixed motor and sensory nerve, but, in addition to this, it is also a distinct nervous centre, in which originate and terminate all those involuntary impulses which exert so potent an influence in the preservation and economy of the body. That peculiar power of the cord by which it is enabled to convert sensory into motor impulse is that which distinguishes it, as a central organ, from a nerve, and is called _reflex action_. The gray matter, and not the white, is the part of the cord which possesses this power. This reflex action is a special function of the spinal cord, and serves as a monitor to, and regulator of the organs of nutrition and circulation, by placing them, ordinarily, beyond the control of conscious volition. [Illustration: Fig. 57.] If the foot of a decapitated frog is irritated, there is an instant contraction of the corresponding limb; if the irritation is intense the other limb also contracts. These motions indicate the existence, in some part of the spinal cord, of a distinct nerve-centre, capable of converting and reflecting impulses. It has been found by experiment, that the same movements will take place if the irritation be applied to any portion of the body to which the spinal nerves are distributed, thus giving undoubted evidence that the spinal cord in its entirety is capable of causing these reflections. Fig. 57 represents the course of the nervous impulses. The sensory impulse passes upward along the posterior root, _a_, until it reaches the imbedded gray matter, _b_, of the cord, by which it is reflected, as a motor impulse, downward along the anterior root, _c_, to the muscles whence the sensation was received. This is the reflex action of the spinal cord. There is no consciousness or sensation connected with this action, and the removal of the brain and the sympathetic system does not diminish its activity. Even after death it continues for some time, longer in cold-blooded than in warm-blooded animals, on account of the difference in temperature, thus showing this property of the spinal cord. By disease, or the use of certain poisons, this activity may be greatly augmented, as is frequently observed in the human subject. A sudden contact with a different atmosphere may induce these movements. The contraction of the muscles, or cramp, often experienced by all persons, in stepping into a cold bath, or emerging from the cozy sitting-room into a chilly December temperature, are familiar illustrations of reflex movements. It has been demonstrated that the irritability of the nerves may be impaired or destroyed, while that of the muscles to which they are distributed remains unchanged; and that the motor and sensory classes of filaments may be paralyzed independently of each other. The reflex actions of the spinal cord have been admirably summed up by Dr. Dalton, as exerting a general, protective influence over the body, presiding over the involuntary action of the limbs and trunk, regulating the action of the sphincters, rectum, and bladder, and, at the same time, exercising an indirect influence upon the nutritive changes in all parts of the body to which the spinal filaments are distributed. THE BRAIN. The brain is a complex organ, which is divided into the _medulla oblongata_, the _cerebellum_, and the _cerebrum_. The _medulla oblongata_ is situated just above the spinal cord, and is continuous with it below, and the brain above. It has distinct functions which are employed in the preservation and continuance of life. It has been termed the "vital knot," owing to the fact that the brain may be removed and the cord injured and still the heart and lungs will continue to perform their functions, until the medulla oblongata is destroyed. The arrangement of the white and gray matter of the medulla oblongata is similar to that of the spinal cord; that is to say, the white matter is external and the gray internal; whereas in the cerebellum and cerebrum this order is reversed. The fibres of the spinal cord, before entering this portion of the brain, decussate, those from the right side crossing to the left, and those from the left crossing to the right side. By some authors this crossing of the sensory and motor filaments has been supposed to take place near the medulla oblongata. Dr. Brown-Sequard shows, however, that it takes place at every part of the spinal cord. The medulla oblongata is traversed by a longitudinal fissure, continuous with that of the spinal cord. Each of the lateral columns thus formed are subdivided into sections, termed respectively the _Corpora Pyramidalia_, the _Corpora Olivaria_, the _Corpora Restiformia_ and the _Posterior Pyramids_. The _Corpora Pyramidalia_ (see 1, 1, Fig. 58) are two small medullary eminences or cords, situated at the posterior surface of the medulla oblongata; approaching the Pons Varolii these become larger and rounded. The _Corpora Olivaria_ (3, 3, Fig. 58) are two elliptical prominences, placed exterior to the corpora pyramidalia. By some physiologists these bodies are considered as the nuclei, or vital points, of the medulla oblongata. Being closely connected with the nerves of special sensation, Dr. Solly supposed that they presided over the movements of the larynx. [Illustration: Fig. 58.] [Illustration: Fig. 59.] The _Corpora Restiformia_ (5, 5, Fig. 59) are lateral and posterior rounded projections of whitish medulla, which pass upward to the cerebellum and form the _crura cerebelli_, so called because they resemble a leg. The filaments of the pneumogastric nerve originate in the ganglia of these parts. The _Posterior Pyramids_ are much smaller than the other columns of the medulla oblongata. They are situated (4, 4, Fig. 59) upon the margin of the posterior fissures in contact with each other. The functions of the medulla oblongata, which begin with the earliest manifestations of life, are of an instinctive character. If the cerebellum and cerebrum of a dove be removed, the bird will make no effort to procure food, but if a crumb of bread be placed in its bill, it is swallowed naturally and without any special effort. So also in respiration the lungs continue to act after the intercostal muscles are paralyzed; if the diaphragm loses its power, suffocation is the result, but there is still a convulsive movement of the lungs for sometime, indicating the continued action of the medulla oblongata. The _Cerebellum_, or little brain, is situated in the posterior chamber of the skull, beneath the _tentorium_, a tent-like process of the dura mater which separates it from the cerebrum. It is convex, with a transverse diameter of between three and one-half and four inches, and is little more than two inches in thickness. It is divided on its upper and lower surfaces into two lateral hemispheres, by the superior and inferior vermiform processes, and behind by deep notches. The cerebellum is composed of gray and white matter, the former being darker than that of the cerebrum. From the beautiful arrangement of tissue, this organ has been termed the _arbor vitae_. The _peduncles of the cerebellum_, the means by which it communicates with the other portions of the brain, are divided into three pairs, designated as the _superior_, _middle_ and _inferior_. The first pass upward and forward until they are blended with the tubercles of the _corpora quadrigemina_. The second are the _crura cerebelli_, which unite in two large _fasciculi_, or pyramids, and are finally lost in the _pons varolii_. The inferior peduncles are the corpora restiformia, previously described, and consist of both sensory and motor filaments. Some physiologists suppose that the cerebellum is the source of that harmony or associative power which co-ordinates all voluntary movements, and effects that delicate adjustment of cause to effect, displayed in muscular action. This fact may be proved by removing the cerebellum of a bird and observing the results, which are an uncertainty in all its movements, and difficulty in standing, walking, or flying, the bird being unable to direct its course. In the animal kingdom we find an apparent correspondence between the size of the cerebellum and the variety and extent of the movements of the animal. Instances are cited, however, in which no such proportion exists, and so the matter is open to controversy. The general function of the cerebellum, therefore, cannot be explained, but the latest experiments in physiological and anatomical science seem to favor the theory that it is in some way connected with the harmony of the movements. This co-ordination, by which the adjustment of voluntary motion is supposed to be effected, is not in reality a _faculty_ having its seat in the brain substance, but is the harmonious action of many forces through the cerebellum. The _Cerebrum_ occupies five times the space of all the other portions of the brain together. It is of an ovoid form, and becomes larger as it approaches the posterior region of the skull. A longitudinal fissure covered by the dura mater separates the cerebrum into two hemispheres, which are connected at the base of the fissure, by a broad medullary band, termed the _corpus callosum_. Each hemisphere is subdivided into three lobes. The anterior gives form to the forehead, the middle rests in the cavity at the base of the skull, and the posterior lobe is supported by the tentorium, by which it is separated from the cerebellum beneath. One of the most prominent characteristics of the cerebrum is its many and varied _convolutions_ These do not correspond in all brains, nor even on the opposite sides of the same brain, yet there are certain features of similarity in all; accordingly, anatomists enumerate four _orders of convolutions_. The first order begins at the _substantia perforata_ and passes upward and around the corpus callosum toward the posterior margin of that body, thence descends to the base of the brain, and terminates near its origin. The second order originates from the first, and subdivides into two convolutions, one of which composes the exterior margin and superior part of the corresponding hemisphere, while the other forms the circumference of the _fissure of Sylvius_. The third order, from six to eight in number, is found in the interior portion of the brain, and inosculates between the first and second orders. The fourth is found on the outer surface of the hemisphere, in the space between the sub-orders of the second clasp. A peculiar fact relating to these convolutions is observed by all anatomists: mental development is always accompanied by an increasing dissimilarity between their proportional size. The cerebral hemispheres may be injured or lacerated without any pain to the patient. The effect seems to be one of stupefaction without sensation or volition. A well-developed brain is a very good indication of intelligence and mental activity. That the cerebrum is the seat of the reasoning powers, and all the higher intellectual functions, is proved by three facts. (1.) If this portion of the brain is removed, it is followed by the loss of intelligence. (2.) If the human cerebrum is injured, there is an impairment of the intellectual powers. (3.) In the animal kingdom, as a rule, intelligence corresponds to the size of the cerebrum. This general law of development is modified by differences in the cerebral texture. Men possessing comparatively small brains may have a vast range of thought and acute reasoning powers. Anatomists have found these peculiarities to depend upon the quantity of gray matter which enters into the composition of the brain. In the cerebro-spinal system there are three different kinds of reflex actions. (1.) Those of the spinal cord and medulla oblongata are performed without any consciousness or sensation on the part of the subject. (2.) The second class embraces those of the tuber annulare, where the perception gives rise to motion without the interference of the intellectual faculties. These are denominated purely _instinctive_ reflex actions, and include all those operations of animals which seem to display intelligent forethought; thus, the beaver builds his habitation over the water, but not a single apartment is different from the beaver homestead of a thousand years ago; there is no improvement, no retrogression. Trains of thought have been termed a third class of reflex actions. It is evident that the power of reasoning is, in a degree, possessed by some of the lower-animals: for instance, a tribe of monkeys on a foraging expedition will station guards at different parts of the field, to warn the plunderers of the approach of danger. A cry from the sentinel, and general confusion is followed by retreat. Reason only attains its highest development in man, in whom it passes the bounds of ordinary existence, and, with the magic wand of love, reaches outward into the vast unknown, lifting him above corporeal being, into an atmosphere of spiritual and divine Truth. [Illustration: Fig. 60. Section of the brain and an ideal view of the pneumogastric nerve on one side, with its branches, _a_. Vertical section of the cerebrum. _b_. Section of the cerebellum, _c_. Corpus callosum. _d_. Lower section of medulla oblongata. Above _d_, origin of the pneumogastric nerve. 1. Pharyngeal branch. 2. Superior laryngeal. 5. Branches to the lungs. 4. Branches to the liver. 6. Branches to the stomach.] THE CRANIAL NERVES. From the brain, nerves are given off in pairs, which succeed one another from in front backwards to the number of twelve. The _first_ pair, the _olfactory_ nerves, are the nerves of the sense of smell. The _second_ pair are the _optic_, or the nerves of the sense of sight. The _third_ pair are called the _motores oculi_, the movers of the eye, from the fact that they are distributed to all the muscles of the eye with the exception of two. The _fourth_ pair and the _sixth_ pair each supply one of the muscles of the eye, on each side, the fourth extending to the superior oblique muscle, and the sixth to the external rectus muscle. The nerves of the _fifth_ pair are very large; they are each composed of two bundles of filaments, one motor and the other sensory, and have, besides, an additional resemblance to a spinal nerve by having a ganglion on each of their sensory roots, and, from the fact that they have three chief divisions, are often called the _trigeminal_, or _trifacial_, nerves. They are nerves of special sense, of sensation, and of motion. They are the sensitive nerves which supply the cranium and face, the motor nerves of the muscles of mastication, the _buccinator_ and the _masseter_, and their third branches, often called the _gustatory_, are distributed to the front portion of the tongue, and are two of the nerves of the special sense of taste. The _seventh_ pair, called also the _facial_ nerves, are the motor nerves of the muscles of the face, and are also distributed to a few other muscles; the _eighth_ pair, termed the auditory nerves, are the nerves of the special sense of hearing. As the _seventh_ and _eighth_ pairs of nerves emerge from the cavity of the skull together, they are frequently classed by anatomists as one, divided into the _facial_, or _portio dura_, as it is sometimes called, and the _auditory_, or _portio mollis_. The _ninth_ pair, called the _glosso-pharyngeal,_ are mixed nerves, supplying motor filaments to the _pharyngeal muscles_ and filaments of the special sense of taste to the back portion of the tongue. The _tenth_ pair, called the _pneumogastric_, or _par vagum_, are very important nerves, and are distributed to the larynx, the lungs, the heart, the stomach, and the liver, as shown in Fig. 60. This pair and the next are the only cerebral nerves which are distributed to parts of the body distant from the head. The _eleventh_ pair, also called _spinal accessory_, arise from the sides of the spinal marrow, between the anterior and posterior roots of the dorsal nerves, and run up to the medulla oblongata, and leave the cranium by the same aperture as the pneumogastric and glosso-pharyngeal nerves. They supply certain muscles of the neck, and are purely motor. As the glosso-pharyngeal, pneumogastric, and spinal accessory nerves leave the cranium together, they are by some anatomists counted as the _eighth_ pair. The _twelfth_ pair, known as the _hypoglossal,_ are distributed to the tongue, and are the motor nerves of that organ. THE GREAT SYMPATHETIC. A double chain of nervous ganglia extends from the superior to the inferior parts of the body, at the sides and in front of the spinal column, and is termed, collectively, the system of the _great sympathetic_. These ganglia are intimately connected by nervous filaments, and communicate with the cerebro-spinal system by means of the motor and sensory filaments which penetrate the sympathetic. The nerves of this system are distributed to those organs over which conscious volition has no direct control. [Illustration: Fig. 61. Course and distribution of the great Sympathetic Nerve] Four of the sympathetic centers, situated in the front and lower portions of the head, are designated as the _ophthalmic, spheno-palatine, submaxillary_ and _otic ganglia_. The first of these, as its name indicates, is distributed to the eye, penetrates the _sclerotic membrane_ (the white, opaque portion of the eyeball, with its transparent covering), and influences the contraction and dilation of the iris. The second division is situated in the angle formed by the sphenoid and maxillary bone, or just below the ear. It sends motor and sensory filaments to the palate, and _velum palati_. Its filaments penetrate the carotid plexus, are joined by others from the motor roots of the facial nerve and the sensory fibres of the superior maxillary. The third division is located on the submaxillary gland. Its filaments are distributed to the sides of the tongue, the sublingual, and submaxillary glands. The otic ganglion is placed below the base of the skull, and also connects with the _carotid plexus_. Its filaments of distribution supply the internal muscles of the _malleus_, the largest bones of the _tympanum_, the membranous linings of the tympanum and the _eustachian tube._ Three ganglia, usually designated as the _superior, middle_, and _inferior_, connect with the cervical and spinal nerves. Their interlacing filaments are distributed to the muscular walls of the larynx, pharynx, trachea, and esophagus, and also penetrate the _thyroid gland_. The use of this gland is not accurately known. It is composed of a soft, brown tissue, and consists of lobules contained in lobes of larger size. It forms a spongy covering for the greater portion of the larynx, and the first section of the trachea. That it is an important organ, is evident from the fact that it receives four large arteries, and filaments from two pairs of nerves. The sympathetic ganglia of the chest correspond in number with the terminations of the ribs, over which they are situated. Each ganglion receives two filaments from the intercostal nerve, situated above it, thus forming a double connection. The thoracic ganglia supply with motor fibres that portion of the aorta which is above the diaphragm, the esophagus, and the lungs. In the abdomen the sympathetic centers are situated upon the _coeliac_ artery, and are termed, collectively, the _semilunar coeliac ganglion_. Numerous inosculating branches radiate from this center and are called, from the method of their distribution, the _solar plexus_. From this, also, originate other plexi which are distributed to the stomach, liver, kidneys, intestines, spleen, pancreas, supra-renal glands, and to the organs of generation. Four other pairs of abdominal ganglia connected with, the lumbar branches are united by filaments to form the semilunar ganglion. The sympathetic ganglia of the pelvis consist of five pairs, which are situated upon the surface of the sacrum. At the extremity of the spinal column this system terminates in a single knot, designated as the _ganglion impar_. Owing to the position of the sympathetic ganglia, deeply imbedded in the tissues of the chest and abdomen, it is exceedingly difficult to subject them to any satisfactory experiments. A few isolated facts form the basis of all our knowledge concerning their functions. They give off both motor and sensory filaments. The contraction of the _iris_ is one of the most familiar examples of the action of the sympathetic system. In the reflex actions of the nerves of special sense, the sensation is transmitted through the cerebro-spinal system, and the motor impulse is sent to the deep-seated muscles by the sympathetic system. Physiologists enumerate three kinds of reflex actions, which are either purely sympathetic, or partially influenced by the cerebro-spinal system. Dr. Dalton describes them as follows: _First_.--"Reflex actions taking place from the internal organs, through the sympathetic and cerebro-spinal systems, to the voluntary muscles and sensitive surfaces.--The convulsions of young children are often owing to the irritation of undigested food in the intestinal canal. Attacks of indigestion are also known to produce temporary amaurosis [blindness], double vision, strabismus, and even hemiplegia. Nausea, and a diminished or capricious appetite, are often prominent symptoms of early pregnancy, induced by the peculiar condition of the uterine mucous membrane." _Second_.--"Reflex actions taking place from the sensitive surfaces, through the cerebro-spinal and sympathetic systems to the involuntary muscles and secreting organs.--Imprudent exposure of the integument to cold and wet, will often bring on a diarrhea. Mental and moral impressions, conveyed through the special senses, will affect the motions of the heart, and disturb the processes of digestion and secretion. Terror, or an absorbing interest of any kind, will produce a dilatation of the pupil, and communicate in this way a peculiarly wild and unusual expression to the eye. Disagreeable sights or odors, or even unpleasant occurrences, are capable of hastening or arresting the menstrual discharge, or of inducing premature delivery." _Third_.--"Reflex actions taking place through the sympathetic system from one part of the body to another.--The contact of food with the mucous membrane of the small intestine excites a peristaltic movement in the muscular coat. The mutual action of the digestive, urinary, and internal generative organs upon each other takes place entirely through the medium of the sympathetic ganglia and their nerves. The variation of the capillary circulation in different abdominal viscera, corresponding with the state of activity or repose of their associated organs, are to be referred to a similar nervous influence. These phenomena are not accompanied by any consciousness on the part of the individual, nor by any apparent intervention of the cerebro-spinal system." * * * * * CHAPTER XIII. THE SPECIAL SENSES. SIGHT. The eye is the organ through which we perceive, by the agency of light, all the varied dimensions relations, positions, and visible qualities of external objects. The number, position, and perfection of the eyes, vary remarkably in different orders, in many instances corresponding to the mode of life, habitation, and food of the animal. A skillful anatomist may ascertain by the peculiar formation of the eye, without reference to the general physical structure, in what element the animal lives. Sight is one of the most perfect of the senses, and reveals to man the beauties of creation. The aesthetic sentiment is acknowledged to be the most refining element of civilized life. Painting, sculpture, architecture, and all the scenes of nature, from a tiny way-side flower to a Niagara, are subjects in which the poet's eye sees rare beauties to mirror forth in the rhythm of immortal verse. In the vertebrates, the organs of vision are supplied with filaments from the second pair of cranial nerves. In mammalia, the eyes are limited to two in number, which in man are placed in circular cavities of the skull, beneath the anterior lobes of the cerebrum. Three membranes form the lining of this inner sphere of the eye, called respectively the Sclerotic, Choroid, and Retina. The _Sclerotic_, or outer covering, is the white, firm membrane, which forms the larger visible portion of the eyeball. It is covered in front by a colorless, transparent segment, termed the _cornea_, which gives the eye its lustrous appearance. Within the sclerotic, and lining it throughout, is a thin, dark membrane termed the _Choroid_. Behind the cornea it forms a curtain, called the _iris_, which gives to the eye its color. The muscles of the iris contract or relax according to the amount of light received, thus enlarging or diminishing the size of the circular opening called the _pupil_. The _Retina_ is formed by the optic nerve, which penetrates the sclerotic and choroid and spreads out into a delicate, grayish, semi-transparent membrane. The retina is one of the most _essential_ organs of vision, and consists of two layers. A spheroidal, transparent body, termed the _crystalline lens_, is situated directly behind the pupil. It varies in density, increasing from without inward, and forms a perfect refractor of the light received. The space in front of the crystalline lens is separated by the iris into two compartments called respectively the _anterior_ and _posterior chambers_. The fluid contained within them, termed the _aqueous humor_, is secreted by the cornea, iris, and ciliary processes. The space behind the crystalline lens is occupied by a fluid, called the _vitreous humor_. This humor is denser than the other fluids and has the consistency of jelly, being perfectly transparent. "The function of the crystalline lens is to produce distinct perception of form and outline."[3] The transparent humors of the eye also contribute to the same effect, but only act as auxiliaries to the lens. [Illustration: Fig. 62.] The figure on the next page represents the course of the rays of light proceeding from an object _a b_, refracted by the lens, and forming the inverted image _x y_ on the screen. All rays of light proceeding from _b_ are concentrated at _y_, and those proceeding from _a_ converge at _x_. Rays of light emanating from the center of the object _a b_ pursue a parallel course, and form the center of the image. Rays of light passing through a double convex lens converge at a point called the _focus_. In the organ of vision, if perfect, the focus is on the retina, which serves as a screen to receive the image or impression. We have a distinct perception of the outline of a distant hill, and also of a book lying before us. The rays of light we receive from these objects cannot have the same focus. How, then, can we account for the evident accommodation of the eye to the varying distances? Various theories have been advanced to explain this adjustment; such as changes in the curvature of the cornea and lens; a movement of the lens, or a general change in the form of the eyeball, by which the axis may be lengthened or shortened. [Illustration: Fig. 63.] Two facts comprise all the positive knowledge which we possess on this subject. Every person is conscious of a muscular effort in directing the eye to a near object" as a book, and of fatigue, if the attention is prolonged. If, now, the eyes be directed to a distant object, there will result a sense of rest, or passiveness. By various experiments it has been proved that the accommodation or adjustment of the eye for near objects requires a muscular effort, but for distant objects the muscles are in an essentially passive condition. An increase in the convexity of the crystalline lens is now admitted to be necessary for a distinct perception of near objects. We may give two simple illustrations, cited by Dr. Dalton in his recent edition of Human Physiology. If a candle be held near the front of an eye which is directed to a distant object, three reflected images of the flame will be seen in the eye, one on each of the anterior surfaces of the cornea and lens, and a third on the posterior surface of the latter. If the eye is directed to a near object, the reflection on the cornea remains unchanged, while that on the anterior surface of the lens gradually diminishes and approximates in size the reflection on the cornea, thus giving conclusive evidence that, in viewing a near object, the anterior surface of the crystalline lens become _more convex_, and at the same time approaches the cornea. Five or six inches is the minimum limit of the muscular adjustment of the eye. From that point to all the boundless regions of space, to every star and nebulae which send their rays to our planet, human vision can reach. It is the sense by which we receive knowledge of the myriads of worlds and suns which circle with unfailing precision through infinite space. HEARING. [Illustration: Fig. 64. Internal and external ear. 1. External ear. 2. Internal auditory meatus. 3. Tympanum. 4. Labyrinth. 5. Eustachian tube.] Hearing depends upon the sonorous vibrations of the atmosphere. The waves of sound strike the sensitive portions of the ear, and their impressions upon the auditory nerves are termed the sensations of hearing. The ear is divided into three parts, called respectively the External, Middle, and Internal ear. The external organs of hearing are two in number, and placed on opposite sides of the head. In most of the higher order of vertebrates, they are so situated as to give expression and proportion to the facial organs, and, at the same time, to suit the requirements of actual life. The _External ear_ is connected with the interior part by a prolongation of its orifice, termed the _external auditory meatus_. In man, this gristly portion of the auditory apparatus is about one inch in length, lined by a continuation of the integument of the ear, and has numerous hairs on its surface, to prevent the intrusion of foreign substances. Between the external MEATUS and the cavity of the middle ear is the _membrana tympani_, which is stretched across the opening like the head of a drum. The _tympanum_, or ear-drum, communicates with the pharynx by the _eustachian tube_, which is a narrow passage lined with delicate, ciliated epithelium. On the posterior portion it is connected with the _mastoid cells_. Three small bones are stretched across the cavity of the tympanum, and called, from their form, the _malleus, incus_ and _stapes_, or the hammer, anvil, and stirrup. Agassiz mentions a fourth, which he terms the _os orbiculare_. Each wave of sound falling upon the membrana tympani, throws its molecules into vibrations which are communicated to the chain of bones, which, in turn, transmits them to the membrane of the _foramen ovale_. The three muscles which regulate the tension of these membranes are termed the _tensor tympani, laxator tympani_, and _stapedium tympani._ The _Labyrinth_, or _Internal_ ear, is a complicated cavity, consisting of three portions termed the _vestibule, cochlea_, and _semi-circular canals_. The vestibule is the central portion and communicates with the other divisions. The labyrinth is filled with a transparent fluid, termed _perilymph_, in which are suspended, in the vestibules and canals, small membranous sacs, containing a fluid substance, termed _endolymph_ (sometimes called _vitrine auditive_ from its resemblance to the vitreous humor of the eye). The filaments of the auditory nerve penetrate the membranous tissues of these sacs, and also of those suspended at the commencement of the semi-circular canals. These little sacs are supposed to be the seat of hearing, and to determine, in some mysterious way, the quality, intensity and pitch of sounds. The determination of the _direction_ of sound is a problem of acoustics. Some have contended that the arrangement of the semi-circular canals is in some way connected with this sensation. But this supposition, together with the theory of the transmission of sound through the various portions of the cranial bones, has been exploded. From the foregoing description, it will be seen that the labyrinth and tympanum are the most essential parts of the organs of hearing. In delicacy and refinement this sense ranks next to sight. The emotions of beauty and sublimity, excited by the warbling of birds and the roll of thunder, are scarcely distinguishable from the intense emotions arising from sight. It is a remarkable fact, that the refinement or cultivation of these senses is always found associated. Those nations which furnish the best artists, or have the highest appreciation of painting and sculpture, produce the most skillful musicians, those who reduce music to a science. SMELL. [Illustration: Fig. 65. 1. Frontal sinus. 2. Nasal bone. 3. Olfactory ganglion and nerves. 4. Nasal branch of the fifth pair. 5. Spheno-palatine ganglion. 6. Soft palate. 7. Hard palate, _a_. Cerebrum, _b_. Anterior lobes, _c_. Corpus callosum. _d_. Septum lucidum. _f_. Fornix. _g_. Thalami optici. _h_. Corpora striata.] Next in order of delicacy, and more closely allied with the physical functions, is the sense of smell. Delicate perfumes, or the fragrance of a flower, impart an exhilarating sensation of delight, while numerous odors excite a feeling of disgust. The organ of smell is far less complicated in its structure than the eye or the ear. It consists of two cavities having cartilaginous walls, and lined with a thick mucous coat, termed the _pituitary membrane_, over which are reflected the olfactory nerves. Particles of matter, too minute to be visible even through the microscope, are detached from the odorous body and come in contact with the nerves of smell, which transmit the impressions or impulses thus received to the brain. Fig. 65 shows the distribution of the olfactory nerves in the nasal passages. The nose is supplied with two kinds of filaments which are termed respectively nerves of _special_ and nerves of _general sensation_. Compared with the lower animals, especially with those belonging to the carnivorous species, the sense of smell in man is feeble. The sensation of smell is especially connected with the pleasures and necessities of animal life. TASTE. The sense of taste is directly connected with the preservation and nutrition of the body. A delicious flavor produces a desire to eat a savory substance. Some writers on hygiene have given this sense an instinctive character, by assuming that all articles having an agreeable taste are suitable for diet. The nerves of taste are distributed over the surface of the tongue and palate, and their minute extremities terminate in well developed _papillae_. These _papillae_ are divided into three classes, termed, from their microscopic appearance, _filiform_, _fungiform_ and _circumvallate_. The organ of taste is the mucous membrane which covers the back part of the tongue and the palate. The papillae of the tongue are large and distinct, and covered with separate coats of epithelium. The filiform papillae are generally long and pointed and are found over the entire surface of the tongue. The fungiform are longer, small at the base and broad at the end. The circumvallate are shaped like an inverted V and are found only near the root of the tongue; the largest of this class of papillae have other very small papillae upon their surfaces. It is now pretty satisfactorily established that the circumvallate, or fungiform papillae are the only ones concerned in the special sense of taste. The conditions necessary to taste are, that the substance be in solution either by artificial means, or by the action of the saliva; and that it be brought in contact with the sensitive filaments imbedded in the mucous membrane. The nerves of taste are both _general_ and _special_ in their functions. If the general sensibility of the nerves of taste is unduly excited, the function of sensibility is lost for some time. If a peppermint lozenge is taken into the mouth, it strongly excites the general sensibilities of taste, and the power of distinguishing between special flavors is lost for a few moments. A nauseous drug may then be swallowed without experiencing any disagreeable taste. Paralysis of the facial nerve often produces a marked effect in the sensibility of the tongue. Where this influence lies has not been fully explained; probably it is indirect, being produced by some alteration in the vascularity of the parts or a diminution of the salivary secretions. TOUCH. By the sense of touch, we mean the _general sensibility of the skin_. Sensations of heat and cold are familiar illustrations of this faculty. By the sense of touch, we obtain a knowledge of certain qualities of a body, such as form consistency, roughness, or smoothness of surface, etc. The tip of the tongue possesses the most acute sensibility of any portion of the body, and next in order are the tips of the fingers. The hands are the principal organs of tactile sensation. The nerves of general sensibility are distributed to every part of the cutaneous tissue. The contact of a foreign body with the back, will produce a similar _tactile_ sensation, as with the tips of the fingers. The sensation, however, will differ in _degree_ because the back is supplied with a much smaller number of sensitive filaments; in _quality_ it is the same. * * * * * CHAPTER XIV. CEREBRAL PHYSIOLOGY. By means of the nervous system, an intimate relation is maintained between mind and body, for nervous energy superintends the functions of both. The fibres of nervous matter are universally present in the organization, uniting the physical and spiritual elements of man's being. Even the minutest nerve-rootlets convey impressions to the dome of thought and influence the intellectual faculties. We recognize _muscular_ force, the strength of the body, _molecular_ force, molecules in motion, as heat, light, chemical force, electricity, and _nervous_ force, a certain influence which reacts between the animal functions and the cerebrum, thus connecting the conditions of the body with those of the mind. We cannot speak of the effects of mind or body separately, but we must consider their action and reaction upon each other, for they are always associated. There are many difficulties in understanding this relationship, some of which may be obviated by a study of the development of nervous matter, and its functions in the lower orders of organization. Within the plant-cells is found a vital, vegetable substance termed bioplasm, or protoplasm; which furnishes the same nutritive power as the tissues of the polyp and jelly fish. Many families of animals have pulpy bodies, and slight instinctive motion and sensibility, and in proportion as the nervous system is developed, both of these powers are unfolded. Plants have a low degree of sensibility, limited motion, respiratory and circulatory organs. Animals possess quicker perceptions and sensibilities, the power of voluntary motion, and, likewise a rudimental nervous system. Some articulates have no bony skeleton, their muscles being attached to the skin which constitutes a soft contracting envelope. One of the simplest forms of animal life in which a nervous system is found, is the five-rayed star-fish. In each ray there are filaments which connect with similar nerve-filaments from other rays, and form a circle around the digestive cavity. It probably has no conscious perception, and its movements do not necessarily indicate sensation or volition. In some worms a rudimentary nervous system is sparingly distributed to the cavities of the thorax and abdomen, and, as in the star-fish, the largest nerve-filament is found around the esophagus, presiding over nutrition. [Illustration: Fig. 66.] A higher grade of organization requires a more complete arrangement of nervous substance. Stimulus applied to one organ is readily communicated to, and excites activity in another. [Illustration: Fig. 67. A. Nervous system of a Crab, showing its ganglia. B. The nervous system of a Caterpillar.] The nervous system of some insects consists of two long, white cords, which run longitudinally through the abdomen, and are dilated at intervals into knots, consisting of collections of nerve-cells, called ganglia. They are really nerve-centers, which receive and transmit impulses, originate and impart nervous influence according to the nature of their organic surroundings. The ganglia situated over the esophagus of insects correspond to the medulla oblongata in man, in which originate the spinal accessory, glosso-pharyngeal, and pneumogastric nerves. The latter possess double endowments, and not only participate in the operations of deglutition, digestion, circulation, and respiration, but are also nerves of sensation and instinctive motion. The suspension of respiration produces suffocation. In insects, these ganglia are scarcely any larger than those distributed within the abdomen, with which they connect by means of minute, nervous filaments. Insects are nimble in their movements, and manifest instinct, corresponding to the perfection of their muscular and nervous systems. When we ascend to vertebrates, those animals having a backbone, the amount of the nervous substance is greater, the organic functions are more complex, and the actions begin to display intelligence. Man possesses not only a complete sympathetic system, the rudiments of which are found in worms and insects, and a complete spinal system, less perfectly displayed in fishes, birds, and quadrupeds, but, superadded to all these is a magnificent cerebrum, and, as we have seen, all parts of the body are connected by the nervous system. The subtle play of sensory and motor impulses, of sentient and spiritual forces, indicates a perfection of nervous endowments nowhere paralleled, and barely approached by inferior animals. This meager reference to brainless animals, whoso knots of ganglia throughout their bodies act automatically as little brains, shows that instinct arises simultaneously with the development of the functions over which it presides. Here begins rudimentary, unreasoning intelligence. It originates within the body as an inward, vital impulse, is manifested in an undeviating manner, and therefore displays no intention or discretion. While Dr. Carpenter likens the human organism "to a keyed instrument, from which any music it is capable of producing can be called forth at the will of the performer," he compares "a bee or any other insect to a barrel organ, which plays with the greatest exactness a certain number of tunes that are set upon it, but can do nothing else." Instinct cannot learn from experience, or improve by practice; but it seems to be the prophetic germ of a higher intelligence. It is nearly as difficult to draw the dividing line between instinct and a low grade of intelligence, as it is to distinguish between the psychical and psychological[4] functions of the brain. The intimate relation of instinct to intelligence is admirably illustrated in the working honey-bee. With forethought it selects a habitation, constructs comb, collects honey, provides a cell for the ova, covers the chrysalis, for which it deposits special nourishment, and is disposed to defend its possessions. It is a social insect, lives in colonies, chastises trespassers, fights its enemies, and defends its home. It manifests a degree of intelligence, but its sagacity is instinctive. Reason, though not so acute as instinct, becomes, by education, discerning and keenly penetrative, and reveals the very secrets of profound thought. We recall the aptness of Prof. Agassiz's remark: _"There is even a certain antagonism between instinct and intelligence, so that instinct loses its force and peculiar characteristics, whenever intelligence becomes developed."_ Animals having larger reasoning powers manifest less instinct, and some, as the leopard, exercise both in a limited degree. This double endowment with instinct and low reasoning intelligence, is indicated by his lying in ambush awaiting his prey, the hiding-place being selected near the haunt of other animals, where nature offers some allurement to gratify the appetite. Simple reflex action is an instinctive expression, manifesting an intuitive perception, almost intelligent, as shown by the contraction of the stomach upon the food, simply because it impinges upon the inner coats, and thus excites them to action. A better illustration, because it displays sympathy, is when the skin, disabled by cold, cannot act, and its duties are largely performed by the kidneys. Though reflex action is easily traced in the lower organic processes, some writers have placed it on a level with rational deliberation. Undoubtedly, all animals having perception have also what perception implies--consciousness--and this indicates the possession, in some degree, of reason. _Compound_ reflex action extends into the domain of thought. _Simple_ reflex action, or instinct, answers to the animal faculties, such as acquisitiveness, secretiveness, selfishness, reproductiveness, etc., and accomplishes two important purposes; self-preservation and the reproduction of the specie. With many persons, these appear to be the chief ends of life! The psychical functions connect, not only with animal propensities, but also with the highest psychological faculties. Instinct is the representative of animal conditions, just as the highest spiritual faculties are indicative of qualities and principles. The consistent mean of conduct is an equilibrium between these ultimate tendencies of our being. The psychological functions render the animal nature subservient to the rule of purity and holiness, and deeply influence it by the essential elements of spiritual existence. The psychical organs sustain an intermediate relation, receiving the impressions of the bodily propensities, and, likewise, of the highest emotions. Obviously, these extreme influences, the one growing out of animal conditions, the other, the result of spiritual relations, pass into the psychical medium and are refracted by it, or made equivalent to one force. The body requires the qualifying influences of mind. The tendencies of the animal faculties are selfish and limiting, those of the emotive, general, universal. The propensities, like gravity, expend their force upon matter; the emotions pour forth torrents of feeling, and produce rhapsodies of sentiment. The propensities naturally restrict their expression to a specific object of sense; the emotions respond to immaterial being. The tendencies of the former are acquisitive, selfish, gratifying; of the latter, bestowing, expanding, diffusing. The one class is restricted to the orbits of time and matter, the other flows on through the limitless cycles of infinity and immortality. The former is satiated in animal gratification, the latter in spiritual beatification. The one culminates in animal enjoyment, the other expands to its ultimate conceptions in the perfections of Divine Love. In the present life, mind and body are intimately connected by nervous matter. In this dual constitution, the spiritual mental, and animal functions are made inseparable, and modify one another. The ultimate tendencies of each extreme exist, not absolutely for themselves, but for qualifying purposes, to establish a basis for the deeper economy of life. By the employment of reason, animal and spiritual experiences are mutually benefited, and the consciousness rendered accountable. The bodily and mental workings are in many senses one, and help to interpret each other. Every fact of mind has many aspects. A brain force, which results in thought, is simultaneously a physiological force, if it influences the bodily functions. Likewise, spiritual conceptions take their rise in the same blood that feeds the grosser tissues. This vital fluid is momentarily imparting and receiving elements from all the bodily organs, and these, in turn, must influence the process of thought, and, in a degree, determine its quality. The delicate outline, yea, even the substance of an idea, may depend upon the condition of the animal organs. Thought is subject to the laws of biology, and, therefore, is a symbol of health. Morbid conditions of the system hang out their signs in words and utterances. Words which express fear are as true symptoms of functional difficulty as is excessive palpitation. The organ representing fear sustains a special relation to the functions of the heart both in health and disease. Bright hopes characterize pulmonary complaints as certainly as cough. Exquisite susceptibility of mind indicates equally extreme sensibility of body, and those persons capable of fully expressing the highest emotions are especially susceptible to bodily sensations. Tears are physical emblems of grief, and fellow-feeling calls forth sympathetic tears. Excessive anxiety of mind produces general excitability of body, which soon results in chronic disease. Pleasurable emotions stimulate the processes of nutrition, and are restorative. This concomitance of mental and bodily states is very remarkable. Joy and Love, as well as jealousy and anger, flash in the eye and mould the features to their expression. Grief excites the lachrymal, and rage the salivary glands. Shame reddens the ears, drops the eyelids, and flushes the face; but profligacy destroys these expressions. The blush which suffuses the forehead of the bashful maiden betrays her love, and _maternal_ love, stirred by the appeals of an idolized infant, excites the mammary gland to the secretion of milk. The sigh of melancholia indicates hepatic torpor, thus showing a special relation between the liver and respiratory organs. These conditions of mind and body react upon one another. Even the thought of a luscious peach may cause the mouth to water. The thought of tasting a lemon fills the mouth with secretions, and a story with unsavory associations may completely turn the stomach. The relationship of mental and physical functions may be illustrated by entirely removing the spleen of an animal, as that of a dog. An invariable result of its extirpation is an unusual increase of the appetite, for at times the animal will eat voraciously any kind of food. The dog will devour, with avidity, the warm entrails of recently killed animals, and thrive in consequence of such an appetite. Another symptom, which usually follows the removal of the spleen, is an unnatural ferocity of disposition. Without any apparent provocation, the animal will attack others of its own, or of a different species. In some instances, these outbursts of irritability and violence are only occasional, but the experiments show quite conclusively that the spleen moderates combativeness, restrains the appetite, and co-operates with the will and judgment in controlling them. We shall briefly consider the practical question whether the elements of mind can be ideally arranged and presented, so as to more completely reveal their relations to, and disclose their effects upon the bodily functions. Modern philosophers conceive that mind consists of a triad of essentials; _Intellect, Emotion,_ and _Volition_. Physiologists assign to the cerebrum its functions, and neurological, as well as phrenological writers, have located them as represented in Fig. 68. True, there is no structural division between the parts of the cerebrum to indicate this diversity of function, nor is there any perceptible limit between the sensory and motor filaments of the game nerve. As no one has any reason for denying that separate portions of the brain may manifest distinct functions of the mind, we shall assume it as a conceded proposition. The regions of the cerebrum, thus ideally represented, occupy but little more than half of the arc of a circle, whereas it is evident that the base of the nervous mass is not idle, and is equally entitled to our consideration. In the posterior chamber of the skull is the cerebellum, anterior to, and below which, is the medulla oblongata, connecting with the spinal cord and sympathetic system. These various parts are essential to the harmonious blending of mind and body. To this end, two conditions are necessary. (1.) All the nervous forces must be so related that action and reaction may be fully established. (2.) A complete nervous circuit is requisite for the reciprocal influence of mind and body. [Illustration: Fig. 68.] [Illustration: Fig. 69. ] Nature answers to mind in physical correspondences. The planetary system is fashioned after a circle. Life itself springs from a spherule of forces. The perfection of an idea, or the completeness of a conception may be expressed by a circle. The elements of Science, Astronomy, Geology, and Natural History, are pictorially represented in this manner. How appropriately and logically can a fragment of natural history, this epitome of all nature and science--_the mind_--be illustrated by a simple circle! Every element must act and react, and be equal and opposite. Thus may the existence of the opposing energies and functions of each faculty be equally represented. The contrast aids us in understanding their ultimate tendencies, and enables us to correctly value and define their nature. Faculties of kindred qualities may be grouped together, and their antagonisms represented in the opposite arc of the circle. Let us employ a circle to represent mind. The conception of the abstract quality of _good_, requires contrast with one of a converse nature, _bad_, (see Fig. 69). Opposite faculties may be portrayed in the same manner. The functions of the cerebrum and spinal system may be symbolically represented as those of the highest and lowest organs, thus giving rise to the positive and negative extremes of feeling. The writer conceives of no other way in which the widely contrasted facts of human experience can be so perfectly symbolized. _Good_ (Fig. 69) may represent moral faculties, and _bad_, their opposites. Undoubtedly, nature is not so arbitrary in her arrangements as we are in shadowing forth our imperfect conceptions, yet is not this a decided improvement in determining cerebral faculties and their relations? We observe how scholars and philosophers confound the noblest and most exalted emotions with the animal propensities instead of distinguishing between them. "_The emotions are a department of the feelings, formed by the intervention of intellectual processes. Several of them are so characteristic that they can be known only by individual experiences; as Wonder, Fear, Love, Anger_." See Logic: Deductive and Inductive, by Alexander Bain, LL. D., page 508, (1874). This is not an exceptional, but a common example of classifying Love, the highest and purest of the emotions, with Anger, an animal propensity. Is it not more practical and philosophical to group the emotional faculties together, and upon an opposite arc represent their antagonistic energies, the ultimate tendencies of which are criminal? Both groups are mutually modifying and restraining; the one relates instinctively to the bodily wants, the other to the requirements of mind, and each is essential to a consistent life. Accordingly, we deem it philosophical to consider words as symbols of mental faculties, and to classify together such spiritual unities as joy, hope, faith, and love, the tendencies of which are to quicken and transform the ultimates of carnal life into the rudiments of an immortal one, the beginning of heaven on earth. These restrain those opposites, which lead to crime and death. Love and Hate are as antagonistic as heat and cold, and the usefulness of both depends upon their _proper_ temperament. Fig. 70 represents the antagonism of the Intellectual faculties to the Animal, the Emotional to the Criminal, the Volitive to the Enfeebling. It is not essential to discover in the nerve-substance the precise power from which an impulse originates. We may reasonably interpret the functions of the brain, and yet be unable to disclose the duties of any ganglionic corpuscle composing it. We may foretell what each season of the year will bring forth, when we cannot forecast the history of a blade of grass or a single grain of any kind. We may predict the amount of rain for a month, and be unable to prognosticate correctly, the character of any storm, or give the history of a special drop of water. Although we cannot follow the movements of individuals in a battle, yet we may predict the result of the combat; and thus, we judge of the functions of the brain without the ability to reveal the actions of one of the organic molecules of which it is composed. We aim to give a general, reasonable, and popular description of cerebral functions and their bearing upon health and disease. [Illustration: Fig. 70.] REGIONAL DIVISIONS. [Illustration: Fig. 71.] The anterior portion of the cerebrum is devoted to intellectual processes, which freely expend the vital energies. The Intellectual faculties are classified as represented in Fig. 71. The lower portion of the brain, bounded exteriorly by the superciliary ridge, corresponds to the Perceptive, the middle region to the Recollective, and the upper to the Reflective faculties. (See also Fig. 65, _b_.) If we divide the forehead by vertical lines, as shown in Fig. 71, the divisions thus formed represent respectively, the Active, Deliberative, and Contemplative departments of the intellect, all the processes of which are sustained by vital changes, the transformation of organized materials. No mental effort can be made without waste of nervous matter. The gardener's hoe wears by use, and so does every part of the animal organism. Otherwise, nutrition would be unnecessary for the adult. The production of thought wears away the cerebral substance. In ordinary use, the brain requires one-fifth of the blood to support its growth and repair. Great mental efforts are attended by a corresponding expenditure of vital treasures, which are abstracted from the total forces available for the necessities of the system. To repair the losses thus occasioned, materials are appropriated from the blood, which furnishes supplies in proportion to the demands made by the mental activities. The production of thought wears away the gray matter of the cerebrum as surely as the digging of a canal wears away the iron particles of the spade. The brain would soon wear out did not the nutritive functions constantly make good the waste. The intellect, whether engaged in observation, generalization, or profound study consumes the brain and blood, hence intellectual activity implies VITAL EXPENDITURE. _Expenditure_ is an emphatic word because all functions are essential to the production of this nerve-energy, which returns to the system no equivalent. Physical exercise, although attended by structural waste, is advantageous to the circulation of the blood, nutrition, secretion, and, in fact, beneficial to all the organic processes. This is not true of vigorous and prolonged mental labor, which is not attended by any of these incidental advantages. If a child attends a school in which mental development supersedes physical culture, an inordinate ambition sways the youthful mind, and its baneful effects upon the health soon become manifest. Rigorous application of the intellectual faculties consumes the blood, exhausts the vital forces, weakens the organic functions, while pallor covers the face, and the eyes sparkle with a hectic radiance. The family physician pronounces the condition _Anæmia_ (a deficiency of red corpuscles in the blood), and this change in the quality of the blood is owing to the undue appropriation by the brain. Conversely, if the blood be destroyed, or its vitality reduced, in the same proportion will the mental energies be weakened and all the functional powers of the physical system enfeebled. In brief, if the intellect be unduly exercised, the red corpuscles of the sanguine fluid will be gradually destroyed, and the serum allowed to predominate. The blood becomes weak and watery, the subject is nervous, dropsical, consumptive and derangement of the important functions follows almost invariably. Excessive intellectual activity often produces weak state of the system, and the person thus affected becomes languid, spiritless, and an easy prey to disease. This mental cause and its bodily results may be classified in the following order. Mental Cause: EXCESSIVE MENTAL EXERTION, which produces _waste of the brain substance and blood_. / VITAL EXPENDITURE, Bodily results: { ANÆMIA, \ A WEAK CONDITION. This kind of waste is best summed up in the words, VITAL EXPENDITURE. Upon the forehead, as represented in Fig. 72, we will therefore inscribe INTELLECT, ACTIVITY, and VITAL EXPENDITURE. Intellectual employment is usually accompanied by sedentary habits, neglect of healthful exercise, and a deprivation of pure air, to all of which ill health may be attributed. Were the intellectual expenditure arrested, and the forces turned into recuperative channels, many a person would become beautiful with the ruddy glow of health. Without health there is no use for thought; cultivation of the mind is just as natural and essential as the culture of the body, and the trained development of both is needed for mutual improvement. EMOTIVE FACULTIES. [Illustration: Fig. 72.] What results follow the _natural_ and the _excessive_ exercise of the EMOTIVE FACULTIES? AS distinct organs of the body have diverse functions, so, in like manner, different parts of the brain perform the separate operations of the mind. It is easier to discriminate between the products of these dissimilar endowments than to determine the location of the faculties. The intellect deals with concrete subjects, and the emotions with abstractions; the intellect is exercised with material things, the emotions dwell upon attributes; the intellect considers the forces of matter, the emotions, the powers of the soul; the former deliberates upon the truths of science, the latter is concerned with duties, obligations, or moral responsibilities; the first is satisfied only with new truths, original ideas, and rational changes, the last rest securely on fundamental principles, moral certainties, and the absolute constancy of perfect love. The intellectual faculties are wakeful, questioning, mistrustful; the emotions are blind, hopeful, confiding; the one reasoning, exacting, demonstrating; the other, believing, inspiring, devout. The intellect sees, the emotions feel; and, though these functions may blend, the one can never supersede the other. The quality of the emotional faculties is represented by Benevolence, Sympathy, Joy, Hope, Confidence, Gratitude, Love, and Devotion, all of which are the very antitheses of the attributes of animal feeling, described as Melancholy, Fear, Anger, Hate, Malevolence, and Despair. To the emotions we refer the highest qualities of character, while their opposites represent the animal or baser impulses. True, the emotions modify the propensities, as sympathy softens grief. They may subdue and refine the animal feelings, and thus veil them with a delicacy characteristic of their own purity; but the unrestrained influences of grief find vent in loud lamentations, and the bitter disappointments of the selfish faculties are passionate and violent. The _Emotive Faculties_--the organs of spiritual perceptions--are impersonal, outflowing, bestowing. The function represented by Benevolence, is willing, giving. Devotion expresses dedication, consecration; Gratitude manifests a warm and friendly feeling toward a benefactor. "The depth immense of endless gratitude."--MILTON. Love flames toward its object, is out-pouring, blessing; indeed, all the emotions are gushing, effusive, impetuous, and profusely flowing; grand, torrent-like, overwhelming; employing ideal, immaterial, spiritual expressions, developing principles and perfections while aspiring to happiness and immortality. Though beginning with humanity, they embody the Divine. They expand to their ultimate conceptions in the sublime attributes: the perfections of the God of Love; associating with mortality a divine destiny commencing on earth, extending through time, pausing not at the portals of death, the gateway to eternity, but flowing onward into the realms of eternal day. We may consider their counteracting influences, for, without doubt, by checking the selfish tendencies and restraining the animal propensities, they assist in controlling the sensual passions, and thus balance the mind and body. Such an equilibrium we call _happiness_. If the emotions be acute and vehement, they will absorb all other impressions and revel in their culminating and delightful experiences. They exhaust all the bodily energies, and a functional suspension, termed _ecstasy_, follows. It is a swooning, or fainting, a temporary loss of sensation and volition, accompanied by involuntary movements of the arms, smiting of the hands, sighing, and short ejaculatory expressions of rapture. This condition, occasioned by excessive emotion, as in praying, singing, exhortations, and sympathetic appeals, is contagious, often spreading with mysterious rapidity. Its culmination, ecstasy, is popularly termed "_the power_." When gradually induced, it is called _trance_, and each state is regarded by many as supernatural, caused by the immediate influence of the Holy Spirit. The explanation is this: when the emotive faculties are suddenly and powerfully excited, they quickly expend the organic forces, so that the individual swoons from sheer exhaustion. Undue expenditure of this class of brain functions not only consumes the bodily powers, but exhausts and prevents other mental operations. The sudden collapse of all voluntary functions resembles the fainting produced by blood-letting. We may sum up this rapid expenditure of energy in one expressive word, EXHAUSTION, which results in _Ecstasy_, or trance, and which, if carried a degree further, terminates in death. Beginning with the natural exercise of the emotions, we may state the order of sequences thus: Ordinary exercise leads to CALMNESS. Proper exercise " " HAPPINESS. Increased exercise " " ECSTASY. Excessive exercise " " SYNCOPE. Prolonged exercise " " TRANCE. Fatal exercise " " MORTALITY. Their tendencies are EXHAUSTIVE. VOLITIVE FACULTIES. What are the physiological and morbid results attending the ordinary and the immoderate exercise of the VOLITIVE FACULTIES? The generic term _will_, comprehends those faculties, the action of which is termed _volition_. The faculties of the will are Determination, Firmness, Decision, Ambition, Authority, and Vigilance, all of which indicate strength and continuity of purpose. Bordering upon the emotions are Patience and Perseverance, while adjoining the animal faculties are Power, Coarseness, and Love of Display. The former exhibit moral, the latter animal heroism. A sense of power urges forward, whether it be higher or lower, just as the sense of greatness makes a man _great_ by inspiring him with confidence to put forth exertion. Nature is truthful in her aspirations. We know that courage, assurance, and conscious power are necessary for the fulfillment of purpose, because intention precedes action. Will-power is an indication of HEALTH, and the constant exercise of these mental faculties exerts a steady, regular, and strengthening influence over the bodily functions. We translate mental energies into physiological industry. These faculties impart tone to the system, sustain the processes of nutrition, circulation, assimilation, secretion and excretion, and their distinguishing characteristics are vigor, tension, and elasticity. They temper each element of character, as well as every vital act. They infuse the organism with a resisting power which renders it proof against the influence of miasma and malaria, and overcomes that passivity and impressionability so favorable to disease. Firmness expresses a physiological cohesiveness which strongly binds together the fibers of the tissues, and renders the organization compact and powerful. He, who can skillfully employ these energies, is already master of half of the diseases incident to mankind, and wields an indispensable adjunct to medicine, in the practice of the healing art. It is the key to success, for it unlocks difficulties and opens wide the door which leads to favorable results. Surplus energy sustains the circulation, increases capillary action, as if the excess of nerve-power were discharged from the distant extremity of each nerve and pervaded every tissue. The voluntary muscles indicate their participation in this energy, and, indeed, the whole organism is exalted by the influence of the mental faculties. They oppose the tendencies of Feebleness, Relaxation, and Derangement, and modify their proclivities to Disease. The will is the servant of the intellect, emotions, and propensities, and the executive agent of all the faculties. When the volitive faculties are in excess, they may overdo the other functions, prematurely break down the bodily organs, and, by overtaxing the system, subject it to pain and disorder. _VOLITIVE FACULTIES._ The natural effect of FIRMNESS is physiological stability. The exercise of the volitive faculties displays both mental and bodily ENERGY. / TEMPERANCE, Their tendencies are to { SANITY, \ HEALTH. ANIMAL FACULTIES. [Illustration: Fig. 73. is a representation of the cranial conformation of Alexander VI., exhibiting a full development of the conservative faculties. His character, according to history, brought reproach upon the papal chair.] [Illustration: Fig. 74. represents Zeno, a profound thinker and moral philosopher. The contrast in their cranial developments was no greater than that of their lives.] Under this generic term we will group those cerebral powers which are common to the inferior animals, and closely allied to bodily conditions and necessities. As denoting a group of animal faculties they relate not only to the organic functions and self-preservation, but combat the action of the intellect, oppose the evolution of new ideas, resist investigation, and discredit the value of truth. Adhesiveness, being blindly conservative, clings to old ideas and traditionary opinions. The animal faculties tend to stifle investigation, and put authority above truth and science. Having a fixity of nature, a stationary attachment, they treat all intellectual developments as absurd. When these faculties predominate, thought is obscured, intolerance of disposition is manifested, and mental progress is arrested. Thus they evince their conservative nature, and, since they relate to individual interests, they represent the elements of instinct. Such are the functions of Acquisitiveness, Secretiveness, Selfishness, and Combativeness, as well as the Generative powers. If these faculties predominate, all intellectual advancements are treated as experiments or theoretical novelties, and rejected as evanescent and worthless. If the promptings of these be followed, there will be no innovation, and the orthodoxy of the dark ages will remain the standard for all time. The animal faculties coincide with Lethargy, Sleep, and Nutrition, thus favoring organic restoration. The intellectual faculties are wakeful, active, irrepressible, while the animal powers tend to repose, sleep, and renovation, and thus suspend the activities of thought, sense, and motion. The intellect expends the energy of the sensorial centers, induces fatigue and suffering, whereas the animal faculties overcome the vigils of thought, and produce refreshing slumber. Dr. Young styles sleep "tired nature's sweet restorer." Swedenborg declared that, "in sleep the brain folded itself up, and the soul journeyed through the body, repairing the wastes of the previous day." When sleep is natural, the insane are in a fair way to recovery, the sick become convalescent, ulcers granulate, and lesions are made whole. The animal faculties are skeptical, stubborn, and dogmatic, readily combining with those of the violent class, the ultimate tendencies of which are criminal. They are likewise conceited, assuming, and clannish. Any person distinguished by them, will cling to old associations, perpetuate the status of existing parties, be a stickler for creed, ceremonies, and stale opinions, and adhere to ancient orthodoxy in medicine and religion. The animal faculties, since they are staid and regular, are naturally antagonistic to genius, sensibility, and originality. Their mental tendencies have been fairly described and their physiological results may be represented as follows: / RESTRAINT, / SLEEP, The animal faculties produce { NUTRITION, \ RESTORATION, \ CONSERVATION. BASILAR FACULTIES. The ultimate tendencies of the faculties, represented by the posterior base of the cerebrum, are violent and criminal. Being contiguous to the junction of the cerebrum and spinal system, they are subject to the influence of animal experiences. A large development of these faculties is indicated by an unusual breadth and depth of the back part of the base of the brain, and a full, thick neck, both of which denote good alimentary and digestive powers. Active nutrition, plethora of the circulation, vigorous secretion, a well developed muscular system, a large heart and lungs, are accessory conditions. We do not associate corpulence or surplus of vitality with a long, slender neck. The character of cerebral manifestations is represented by the baser faculties of mind, such as Combativeness, Destructiveness, Desperation, Turbulence, Hatred, and Revenge. If unrestrained, these culminate in violent and criminal acts; if _regulated_, they are employed in personal defense. When _unduly excited_, they lead to dissipation, obscenity, swearing, rowdyism, and licentiousness; when _perverted_, they are the source of recklessness, quarrels, frauds, falsehoods, robberies, and homicides. They are unlike instinct, inasmuch as they are not self-limiting. The intimate relation which they sustain to the stomach and nutritive functions is strikingly displayed in the habit of alcoholic intoxication. Spirituous drinks deprave the appetite, derange and destroy the stomach, poison the blood, and pervert all the functions of mind and body; and their injurious influence upon the nerves and basilar faculties is equally remarkable. They excite combativeness, selfishness, irritability, and exaggerate the influence of the animal organs. Intemperance results in disputes, fights, brawls, and murders--the legitimate consequences of which are misunderstandings, suits at law, criminal proceedings, imprisonment, and the gallows. It is, therefore, evident that the ultimate tendencies of these faculties are tyrannical, cruel, violent, and atrocious. They are opposed to the noble, moral faculties--Faith, Love, and Devotion--and, whenever temptation inordinately allures, the course of life is likely to be characterized by dishonorable, deceptive, and treacherous conduct. The pangs of hunger cause soldiers to act more like ravenous beasts, than rational beings. It is animal instinct which impels the soldier to seek first for the gratification of his appetite. Some persons, instigated by carnivorous desires, yearn for raw meat, and will not be satisfied unless their food is flavored with the flesh of animals. Their bodies increase and thrive, even to repletion. Contrast these individuals with pale, lean, anæmic people, who crave innutritious articles of diet, and eat soft stones, slate, chalk, blue clay, and soft coal. Such perversions of the appetite are manifested only when there is either a diminution in the volume of blood, deficient alimentation, defective assimilation, or a general depravity of the nutritive functions. Morbid conditions generate vitiating tendencies and destroy the natural appetite. While alcoholic stimulants affect the medulla oblongata principally, opium acts chiefly on the cerebrum, and excites reverie, dreamy ideality, optical delusions, and the creative powers of the imagination; some of these hallucinations are said to be grotesquely beautiful and enjoyable. The effects of this agent differ from those of alcoholic intoxication by not deadening the moral sensibilities, or arousing the animal propensities. Opium smokers are dreamy and abstracted, not quarrelsome or violent. Those who use ardent spirits lose their moral delicacy, their intellect becomes dull, the reason cloudy, and the judgment is overruled by appetite. It is conceded that the _trophic center_ is principally in the medulla oblongata; the cerebellum and lower cerebral ganglia, however, favorably influence the nutritive functions, and, when these organs are large and active, a plethoric condition is the natural consequence. Redundancy of blood in the body indicates preponderance of the basilar organs. These faculties being vehement in character, an excess of animal characteristics produces those conditions which result in acute and inflammatory diseases. We may express these conditions of the system as follows: The _Animal Faculties_ correspond to the lower instinctive manifestations. / ACQUISITIVENESS, The elements of character are { SELFISHNESS, \ COMBATIVENESS They tend to / TURBULENCE, \ CRIME. / ALIMENTATION, They relate especially to the { SECRETION, functions of \ NUTRITION, \ REPRODUCTION. / VITALITY, A large development of them { PLETHORA, indicates \ HYPERAEMIA (congestion). These naturally give rise to the following diseases: Inflammation, Rheumatism, Gout, Convulsions, etc., which, in these conditions, pursue a violent course. REGION OF FEEBLENESS. Although the middle lobe of the cerebrum, at the base of the brain, does not denote decided force of character, or energy of constitution, yet it has a certain sphere of normal action which is essential to the harmony of mind and body. If this region is largely developed, the constitution is languid, inefficient, sensitive, and abnormally disposed. But if it be deficient, the volitive energies preponderate, and there is a lack of those susceptibilities of constitution, which prevent excessive waste. The cerebral faculties are Fear, Anxiety, Sensibility, Servility, Relaxation, and Melancholy, and their excessive predominance indicates a weak, vacillating, irresolute character, and the existence of those bodily conditions which produce _general excitability_ and chronic derangement. A full development of this portion of the brain indicates that the person is naturally dependent, inferior, and subservient to stronger characters. Such a one is fearful, fretful, complaining, irritable, dejected, morose, and, sooner or later, becomes a fit subject for chronic disease.[5] The ultimate result of excessive fear, excitability, and irritability, is functional or organic derangement,--the morbid conditions represented by the word Disease. The medulla oblongata and portions of the middle lobe of the brain, the functions of which represent Excitability, Anxiety, Fear, and Irritability (symbols of physical profligacy), are located just between the ears (see Fig. 60). Inferior animals distinguished for breadth between the ears are not only cunning and treacherous, but very excitable and irritable. The head of the Fox is remarkable for its extreme width at the region of Fear. He is proverbially crafty and treacherous, always excitable, and so variable in temper that he can never be trusted. He is a very timid thief, exceedingly suspicious, irregular in habits, and frequently driven by hunger into mischievous depredations. [Illustration: Fig. 75. Sly Reynard] The organ of alimentiveness, located directly in front of the ear, indicates the functional conditions of the stomach, which, when aroused by excessive hunger, exerts a debasing influence upon this and all of the adjacent organs, and is demoralizing to both body and mind. In obedience to the instinct of hunger, children will slyly plunder gardens and orchards, displaying profligate, if not reckless tendencies in the gratification of the appetite. In this regional division we include the medulla, the posterior and middle portions of which give rise to the pneumogastric nerve. This nerve receives branches from the spinal accessory, facial, hypoglossal, and the anterior trunks of the first and second cervical, and its filaments are distributed to the lungs, stomach, liver, spleen, pancreas, and gall bladder (see Fig. 60, with explanation) Its agency is necessary to maintain the circulation, and the respiration, since, as the medium of communication, it conveys from the brain large supplies of nervous force to sustain these vital functions. It likewise instantly reports the impressions of these physiological processes to the brain, and especially to those parts which, by analogy of functions. It likewise instantly reports the impressions of these physiological processes of the brain, and especially to those parts which, by analogy of functions, are intimately related to the stomach. Hence, we observe that the conditions of the stomach give rise to reflex impulses, which involuntarily excite the animal faculties to the gratification of the appetite. That the stomach has an intimate connection with the rest of the organism is evident from the fact that when it is inflamed the body is completely prostrated. We have already alluded to the perverting tendencies of alcoholic stimulants. Their peculiar influence upon the cerebellum causes the subject to reel and stagger, as though a portion of that organ were removed; the group of energetic faculties is stupefied, and mental as well as corporeal lethargy is the result. The reaction, which inevitably follows, is almost unbearable, and relief is sought by repeating and increasing the poisonous draughts, the primary influence of which is stimulating, the ulterior, depressing. Alcoholic stimulants unduly excite the nervous centers, the heart, and the arteries, and, consequently, the blood is carried to the surface of the body, where it counteracts the influence of cold and exposure, the frequent attendants upon drunkenness. The use of alcoholic beverages perverts the appetite, interrupts habits of industry and destroys all force of character. Pecuniary, physical, and mental ruin, therefore, are sure to follow as the consequences of habitual, alcoholic intoxication. That ordinary alimentation, which includes the process of digestion, the subsequent vital changes involved in the conversion of food into blood, and its final transformation into tissue, causes mental languor and dullness, as well as bodily exhaustion, is attested by universal experience. A torpid condition of the liver, one of the most inveterate of chronic derangements, is indicated by sullenness, melancholy, despondency, loss of interest in the affairs of life, sluggishness, etc., and the ultimate tendency of this morbid state is towards _suicide_. A broad and deep development of the middle lobe of the brain, shown by a fullness under the chin, and of the adjacent portion of the neck, denotes tendencies to somnambulism, delirium, and insanity. If such characteristics of the organization do not culminate in mental derangement, they exhibit childishness, helplessness, and great dependence. Age abates the vigor of the executive faculties, and old people manifest not only bodily infirmities, but the relaxing and enfeebling influences proceeding from the lower portions of the brain. They totter about in their second childhood, mentally and physically enervated. Those who become dissipated by the use of intoxicating beverages are not only weak, trifling, and foolish, but walk with an unsteadiness which betrays their condition. These illustrations show that this part of the brain is destitute of energy. Diseases of the digestive organs also indicate it. Cholera, whether induced by invisible animalcules in the air, or in water, takes the route of the alimentary canal, opens the vital gates, and myriads of victims are swept down to death. It proves remarkably fatal to those having this cerebral conformation. Perhaps enough has been said to indicate the relaxing and enfeebling tendencies of this region of the brain. They may be classified as follows: _REGION OF FEEBLENESS._ / SERVILITY, / CAUTIOUSNESS, / FEAR, Cerebral Functions: { ANXIETY, \ SENSIBILITY, \ CUNNING, \ PROFLIGACY. / ATONIC, Physiological conditions / EXCITABILITY, and tendencies: { RELAXATION, \ FEEBLENESS, \ DISEASE. This classification shows their tendencies to chronic disease, functional derangement, insanity, and suicide. GENERAL CONSIDERATIONS. Before the structure of the brain was understood, Buffon spoke of it as a "mucous substance of no great importance." Its functional significance was so slightly appreciated that some people hardly suspected they had any brains, until an _accident_ revealed their existence. Latterly, however, it is generally understood that the perfection of an animal depends upon the number and the development of the organs controlled by the nervous system, the sovereign power of which is symbolized by a grand cerebrum, the throne of Reason. That animal which is so low in the scale of organization as to resemble a vegetable, belongs to an ascending series ending in man. The lowest species have no conscious perception, and their movements do not necessarily indicate sensation or volition. Instinct culminates in the _Articulates_, especially in Insects; while created intelligence reaches its acme in man, the highest representative of the _Vertebrates_. "All things by regular degrees arise-- From mere existence unto life, from life To intellectual power; and each degree Has its peculiar necessary stamp, Cognizable in forms distinct and lines."--LAVATER. [Illustration: Fig. 76. Outline of Skulls. 1. European. 2. Negro. 3. Tiger. 4. Hedge Hog. 5. Sloth.] Man, in the faculties of mind, possesses more than a complement for instinct; some of the lower animals, however, seem to share his rational nature, and to a certain degree become responsible to him. Finally, the manifestations of mind bear a relation to the development of cerebral substance, and to the bodily organization which supplies the brain with blood. Fig. 76 shows the relative amount of brain matter in the lower animals, compared with that of man; the peculiarities of each agreeing with its cerebral conformation. It is easier to measure the capacity of skulls in different races than to procure and weigh their brains. The following table has been published. CRANIAL CAPACITY OF HUMAN RACES. Race. CUBIC INCHES. Swedes,................. 100.00 Anglo-Saxons,............ 96.60 Finns,................... 95.00 Anglo-Americans,......... 94.30 Esquimaux,............... 86.32 North America Indians,... 84.00 Native Africans,......... 83.70 Mexicans,................ 81.70 American Negros,......... 80.80 Peruvians and Hottentots, 75.30 Australians,............. 75.00 Gorilla, adult,.......... 34.50 Idiot,................... 22.57 Mr. Davis, of England, having a collection of about eighteen hundred cranial specimens obtained from different quarters of the globe, ascertained the relative volume of brain in different races, by filling the skulls with dry sand. He found that the European averaged 92 cubic inches, the Oceanic 89, the Asiatic 88, the African 86, the Australian 81. Dr. Morton, of Philadelphia, had a collection of over one thousand skulls, and his conclusions were that the Caucasian brain is the largest, the Mongolian next in size, the Malay and American Indian smaller, and the Ethiopian smallest of all. The average weight of brain, in 278 Europeans, was 49.50 oz., in 24 White American soldiers, 52.06 oz., indicating a greater _average_ for the American brain. OUNCES The brain of Cuvier, the celebrated naturalist, weighed 64.33 Ruloff, the murderer and linguist, 59.00 Dr. Spurzheim--phrenologist, 55.06 Celebrated philologist, 47.90 Celebrated mineralogist, 43.24 Upholsterer, 40.91 The weight of the human brain varies from 40 to 70 oz.; that of idiots from 12 to 36 40 oz. The average of 273 male European brains was 49½ oz., while that of 191 females was 44 oz. If we compare the weight of the female brain with that of the body, the ratio is found to be as 1:36.46, while that of the male is as 1:36.50; showing that, relatively, the female brain is the larger. It appears that neither the absolute nor relative size of the cerebrum, but the amount of gray matter which it contains, is the criterion of mental power. Although a large cerebrum is generally indicative of more gray matter than a small one, yet it is ascertained that the grey substance depends upon the number, and depth of the convolutions of the brain, and the deeper its fissures, the more abundant is this tissue. It is this substance which is the source of thought, while the white portion only transmits impressions. We do not wish to underrate any attempt heretofore made to classify the functions of mind and assign to them an appropriate nomenclature. It is not unusual for scientists to give advice to phrenologists and point out the fallacies of their system; but it is hardly worth while to indulge in destructive criticism, unless something better is offered, as the day has passed for ridiculing endeavors to understand and interpret the physiology of the brain. The all important question is, not whether phrenologists have properly located and rightly earned all the faculties of mind, but have their expositions been useful in the development of truth. While endeavoring to connect each mental power with a local habitation in the brain, the system of phrenology may be chargeable with some incongruous classification of the faculties, and yet it has furnished an analysis of the mind which has been of incalculable service to writers upon mental philosophy. Phrenology, in popularizing its views, has interested thousands in their own organizations and powers, who would otherwise have remained indifferent. It has called attention to mental and bodily unities, has served as a guide to explain the physical and psychical characteristics of individuals, and has been instrumental in applying physiological and hygienic principles to the habits of life, thus rendering a service for which the world is greatly indebted. Samuel George Morton, M.D., whose eminent abilities and scholarship are unquestionable, employs the following language: "The importance of the brain as the seat of the faculties of the mind, is pre-eminent in the animal economy. Hence, the avidity with which its structure and functions have been studied in our time; for, although much remains to be explained, much has certainly been accomplished. We have reason to believe, not only that the brain is the center of the whole series of mental manifestations, but that its several parts are so many organs, each one of which performs its peculiar and distinctive office. But the number, locality, and functions of these several organs are far from being determined; nor should this uncertainty surprise us, when we reflect on the slow and devious process by which mankind has arrived at some of the simplest physiological truths, and the difficulties that environ all inquiries into the nature of the organic functions." [Illustration: Fig. 77. Side view of the brain of a Cat. A. Crucial sulcus dividing anterior convolutions. B. Fissure of Sylvius. C. Olfactory bulb.] We may here allude to the recent experimental researches with reference to the functions of various portions of the brain, prosecuted by Dr. Ferrier, of England. He applied the electric current to different parts of the cortical substance of the cerebrum in lower animals which had been rendered insensible by chloroform, and by it could call forth muscular actions expressive of ideas and emotions. Thus, in a cat, the application of the electrodes at point 2, Fig. 77, caused elevation of the shoulder and adduction of the limb, exactly as when a cat strikes a ball with its paw; at point 4, corrugation of the left eye-brow, and the drawing inward and downward of the left ear; when applied at point 5, the animal exhibited signs of pain, screamed, and kicked with both hind legs, especially the left, at the same time turned its head around and looked behind in an astonished manner; at point 6, clutching movement of the left paw, with protrusion of the claws; at point 13, twitching backward of the left ear, and rotation of the head to the left and slightly upward, as if the animal were listening; at point 17, restlessness, opening of the mouth, and long-continued cries as if of rage or pain; at a point on the under side of the hemisphere, not shown in this figure, the animal started up, threw back its head, opened its eyes widely, lashed its tail, panted, screamed and spit as if in furious rage; and at point 20, sudden contraction of the muscles of the front of the chest and neck, and of the depressors (muscles) of the lower jaw, with panting movements. The movements of the paws were drawn inward by stimulating the region between points 1, 2, and 6; those of the eyelids and face were excited between 7 and 8; the side movements of the head and ear in the region between points 9 and 14; and the movements of the mouth, tongue and jaws, with certain associated movements of the neck, being localized in the convolutions bordering on the fissure of Sylvius (B), which marks the division between the anterior and middle lobes of the cerebrum. Dr. Ferrier made similar experiments on dogs, rabbits, and monkeys. The series of experiments made on the brain of the monkey is said to be the most remarkable and interesting, not only because of the variety of movements and distinctly expressive character of this animal, but on account of the close conformity which the simple arrangement of the convolutions of its brain bears to their more complex disposition in the human cerebrum. It is premature to say what import we shall attach to these experiments, but they have established the correctness of the doctrine, advanced on page 105, that thought, the product of cerebral functions, is a class of _reflex actions_. The cerebrum is not only the source of ideas but also of those co-ordinate movements which correspond to and accompany these ideas. Certain cerebral changes call forth mental states and muscular movements which are mutually responsive. They indicate that various functions are automatic, or dependent upon the will, and, as we have seen, experiments indicate that the electric current, when applied to the cerebrum, excites involuntary reflex action. We cannot say how far these experimental results justify the phrenological classification of the faculties of mind, by establishing a _causative_ relation between the physical and psychical states. This short and unsatisfactory account furnishes one fact which seems to support the claim of such a relation: the apparent similarity between the motor center of the lips and tongue in lower animals, and that portion of the human cerebrum in which disease is so often found to be associated with _Aphasia_, or loss of voice. While these experiments are by no means conclusive in establishing a theory, yet they favor it. It is wonderful that nervous matter can be so arranged as not only to connect the various organs of the body, but at the same time to be the agent of sensation, thought, and emotion. It is amazing, that a ray of light, after traversing a distance of 91,000,000 miles, can, by falling upon the retina, and acting as a stimulus, not only produce a contraction of the pupil, but excite thoughts which analyze that ray, instantly spanning the infinitude of trackless space! The same penetrative faculties, with equal facility, can quickly and surely discern the morbid symptoms of body and mind, become familiar with the indications of disease, and classify them scientifically among the phenomena of nature. The symptoms of disease which follow certain conditions as regularly as do the signs of development, and mind itself is no exception to this uniformity of nature. Thoughts result from conditions, and manifest them as evidently as the falling of rain illustrates the effect of gravity. The perceptive and highest emotive faculties of man depend upon this simple, but marvelously endowed nervous substance, which blends the higher spiritual with the lower physical functions. The functions of the body are performed by separate organs, distinguished by peculiar characteristics. To elucidate the distinctions between dissimilar, mental faculties, we have assigned their functions, with characteristic names, to different regions of the head. As they unquestionably influence the bodily organs, we are sustained by physical analogy, in our classification. Our knowledge of the structure and functions of the nervous system is yet elementary, and we are patiently waiting for scientists to develop its facts, and verify them by experimental investigations and such researches as time alone can bring to perfection. While real progress moves with slow and measured foot-steps, the inspirations of consciousness and the inferences of logic prepare the popular mind for cerebral analysis. No true system can contradict the facts of our inner experience; it can only furnish a more complete explanation of their relation to the bodily organs. It should be expected that such careful and pains-taking experiments, as are necessary to establish a science, will be preceded by intuitive judgments and accredited observations, which may be, for a time, the substitutes of those more abstruse in detail. We have, in accordance with popular usage, treated the organs of thought as having anatomical relations. The views which we have presented in this chapter may seem speculative, but the facts suggesting the theory demand attention, and we have attempted to gather a few of the scattered fragments and arrange them in some order, rather than leave them to uncertainty and greater mystery. It is by method and classification that we are enabled to apply our knowledge to practical purposes. Possibly, to some, especially the non-professional, an allusion to the fact that cerebral physiology contributes to successful results in the practice of medicine, may seem to be an exaggerated pretension. None, however, who are conversant with the facts connected with the author's experience, will so regard this practical reference, for the statement might be greatly amplified without exceeding the bounds of truth. Physicians generally undervalue the nervous functions, and overlook the importance of the brain as an indicator of the conditions of the physical system, because they are not sufficiently familiar with its influence over the bodily functions. Pathological conditions are faithfully represented by the thoughts, and words, when used to describe symptoms, become the symbols of feelings which arise from disease. How few physicians there are who can interpret the thoughts, and glean, from the expressions and sentences of a letter, a correct idea of the morbid conditions which the writer wishes to portray! Each malady, as well as every temperament, has its characteristics, _and both require careful and critical analysis_ before subjecting the patient to the influence of remedial agents. In a treatise by Dr. J.R. Buchanan, entitled "Outlines of Lectures on the Neurological System of Anthropology," are presented original ideas pre-eminently useful to the physician. His researches, and those of later writers, together with our own investigations, have greatly increased our professional knowledge. It is by such studies and investigations that we have been prepared to interpret, with greater facility, the indications of disease, and diagnose accurately from symptoms, which have acquired a deeper significance by the light of cerebral physiology. We are enabled to adapt remedies to constitutions and their varying conditions, with a fidelity and scientific precision which has rendered our success in treatment widely known and generally acknowledged. We annually treat thousands of invalids whom we have never beheld, and relieve them of their ailments. This has been accomplished chiefly through correspondence. When patients have failed to delineate their symptoms currently, or have given an obscure account of their ailments, we have been materially assisted in ascertaining the character of the disease by photographs of the subjects. The cerebral conformation indicates the predisposition of the patient, and enables us to estimate the strength of his recuperative energies. Thus we have a valuable guide in the selection of remedies particularly suited to different constitutions. In the treatment of chronic diseases, the success attending our efforts has been widely appreciated, not only in this, but in other countries where civilization, refinement, luxurious habits, and effeminating customs, prevail. This fact is mentioned, not only as an illustration of the personal benefits actually derived from a thorough knowledge of the nervous system, but to show how generally and extensively these advantages have been shared by others. A careful study of cerebral physiology leads us deeper into the mysteries of the human constitution, and to the philosophical contemplation of the relations of mind and body. Self-culture implies not only a knowledge of the powers of the mind, but also how to direct and use them for its own improvement, and he who has the key to self-knowledge, can unlock the mysteries of human nature and be eminently serviceable to the worlds For centuries the mind has been spreading out its treasury of revelations, to be turned to practical account, in ascertaining the constitution, and determining better methods of treating disease. Since comparative anatomists and physiologists have revealed the structure of animals and the functions of their organs, from the lowest protozoan to the highest vertebrate, the physician may avail himself of this knowledge, and thus gain a deeper insight into the structure and physiology of man. An intimate acquaintance with the physical, is a necessary preparation for the study of the psychical life, for it leads to the understanding of their mutual relations and reactions, both in health and disease. Consciousness, or the knowledge of sensations and mental operations, has been variously defined. It is employed as a collective term to express all the psychical states, and is the power by which the soul knows its own existence. It is the immediate knowledge of any object whatever, and seems to comprise, in its broadest signification, both matter and mind, for all objects are inseparable from the cognizance of them. Hence, the significance of the terms, subjective-consciousness and objective-consciousness. People are better satisfied with their knowledge of matter than with their conceptions of the nature of mind. THE NATURE OF MIND. Since this subject is being discussed by our most distinguished scientists, we will conclude this chapter with an extract from a lecture delivered by Prof. Burt G. Wilder, at the American Institute: "There now remains to be disposed of, in some way, the question as to the nature and reality of mind, which was rather evaded at the commencement of the lecture. The reason was, that I am forced to differ widely from the two great physiologists whom I have so often quoted this evening. Most people, following in part early instruction, in part revelation, in part spiritual manifestations, and in part trusting to their own consciousness, hold that the human mind is a spiritual substance which is associated with the body during the life of the latter in this world, and which remains in existence after the death of the body, and forms the spiritual clothing or embodiment of the immortal soul; and that the individual, therefore, lives after death as a spirit in the human form; that of this spiritual man, the soul is the essential being, of which may be predicted a good or evil nature, while the mind, which clothes it as a body, consists of the spiritual substances, affections, and thoughts, which were cherished and formed during the natural life. Together with the above convictions respecting themselves, most people, when thinking independently of theological sublimations, feel willing to admit that animals have, in common with man, fewer or more natural affections and thoughts which make up their minds, but that the inner and immortal soul, which would retain them as part of an individual after death of the body, is not possessed by the beasts that perish. In short, the vast majority of mankind, when thinking quietly, and especially in seasons of bereavement, feel well assured of the real and substantial existence of the human mind, independently of its temporary association with the perishable body. But in antagonism to this simple and comforting faith, stand theological incomprehensibilities on the one hand, and scientific skepticism on the other. The former would have us believe that the soul is a mere vapor, a cloud of something ethereal, of which can be expected nothing more useful than 'loafing around the Throne,' while the latter asks us to recognize the existence of nothing which the eyes cannot see and fingers touch; to cease imagining that there is a soul, and to regard the mind as merely the product of the brain; secreted thereby as the liver secretes bile. Let us hear what the two leading nervous physiologists, of this country, have to say upon this point: 'The brain is not, strictly speaking, the organ of the mind, for this statement would imply that the mind exists as a force, independent of the brain; but the mind is produced by the brain substance; and intellectual force, if we may term the intellect a force, can be produced only by the transmutation of a certain amount of matter; there can be no intelligence without brain substance.'--FLINT. 'The mind may be regarded as a force, the result of nervous action, and characterized by the ability to perceive sensations, to be conscious, to understand, to experience emotions, and to will in accordance therewith. Of these qualities, consciousness resides exclusively in the brain, but the others, as is clearly shown by observation and experiment, cannot be restricted to that organ, but are developed with more or less intensity, in other parts of the nervous system.'--HAMMOND. Thus do the two extremes of theology and science meet upon a common ground of dreamy emptiness, and we who confess our comparative ignorance are comforted by the thought that some other things have been 'hid from the wise and prudent and revealed unto babes.' Yet, while feeling thus, it must be admitted that the existence of spirit and of a Creator do not yet seem capable of logical demonstration. The denial of their existence is not incompatible with a profound acquaintance with material forms and their operations; and, on the other hand, the belief in their existence and substantial nature, and in their powers as first causes, have never interfered with the recognition of the so-called material forces, and of the organisms through which they are manifested. At present, at least, these are purely matters of faith; but although the Spiritualist (using the term in its broadest sense as indicating a belief in spirits), may feel that his faith discloses a beauty and perfection in the union, otherwise imperceptible by him, there is no reason why this difference in faith should make him despise or quarrel with his materialist co-worker, for the latter may do as good service to science, may be as true a man, and live as holy a life, although from other motives. The differences between religious sects are mainly of faith, not of works, and the wise of all denominations are gradually coming to the conviction that they will all do God more service by toleration and co-operation than by animosity and disunion. And so I hold that, until the spiritualist feels himself able to demonstrate to the unbeliever the existence of spirit and of God, as convincingly as a mathematical proposition, there should be no hard words or feelings upon these points. For the present they are immaterial in every sense of the word; and so long as he bows to the facts and the laws of Nature, and deals with his fellow men as he would be done by, so long will I work with him, side by side, knowing, even though I cannot tell him so, that whether or not he joins me in this world, we shall meet in the other world to come, where his eyes will be opened, and where his lips will at least acquit me of bigotry and intolerance." * * * * * CHAPTER XV. THE HUMAN TEMPERAMENTS. Organization implies vital energy, since there can be no organization without it. The sperm cell, as we have previously seen, exists before the initiation of the life of every individual organism. The early history of this fertilizing cell, which is composed of infinitesimal molecules which contain the embryo powers of life, is only partially written. It is a fact, authenticated by Faraday, that one drop of water contains, and may be made to evolve, as much electricity as, under a different mode of display, would suffice to produce a lightning-flash. Chemical force is of a higher order than physical, and vital force is of a still higher order. Within the microscopic compass of the sperm cell are a great number of forces acting simultaneously, which require the answering conditions of a germ cell, and are so blended as to occupy a minimum of space. The union of these subtle elements through the agency of their physical, chemical, and vital forces, constitutes the initiation of life. Elementary matter is transformed into chemical and organic compounds, by natural forces, upon the cessation of which, it is liberated by nature's great destroyer, and re-appears in the world of elements. Thus, man is formed out of the very dust by means of energies which reconstruct the crude, inert matter, and to dust he returns when those energies cease. When we enter upon the consideration of the temperaments, we should bear in mind one peculiarity of life: that it combines, in a small space, many complex powers. In the process of reproduction, there is a complex combination of organic elements. Structures differ as greatly as their functions. So likewise do animals vary in their nature and organization, and individuals of the same species are, in some respects, dissimilar. Yet the characteristics which have distinguished the races of mankind, are fundamental and faithfully maintained. Time does not obliterate them. Within race-limits are found enduring peculiarities, and, although each individual is weaving out some definite pattern of organization, it follows the type of the race, as well as the more immediate, antecedent condition. What then is a _Temperament_ but a _mixing together_ of these determining forces, a certain blending manifested in the constitution by signs, or traits, which we denominate _character_. The different races of mankind must have their several standards of temperament, for the peculiarities of one are not fully descriptive of, and applicable to the other. The term temperament is defined by Dunglison, as being "a name given to the remarkable differences that exist between individuals, in consequence of the variety of relations and proportions between the constituent parts of the body. For its simplicity and scope, we prefer the following definition, suggested by our friend, Orin Davis, M.D.: A TEMPERAMENT IS A COMBINATION OF ORGANIC ELEMENTS SO ARRANGED AS TO CHARACTERIZE THE CONSTITUTION. This leads us to consider some of the elements, conditions and forces which give character to the organization. External circumstances supply necessary conditions to inward activity, for without air, food, or sunlight all living animals would perish. Everywhere, life is dependent upon conditions and circumstances; it is _not_ self-generating. But the conditions of reproduction are very complex. External forces are transformed, and, in turn, become vital or formative powers. Development is a transmutation of physical and chemical forces into vital energy. Although unable to compute the ultimate factors of life, yet we may illustrate their reproductive possibilities and results by comparing them with those of a lower order. Animal structures are mainly composed of four elements: oxygen, hydrogen, nitrogen and carbon. Other constituents, such as phosphorus, sulphur, potassium, sodium, calcium, magnesium, and iron, enter into their composition, but are found in much smaller quantities. From these elements is fabricated an organism which manifests peculiar properties and marvelous functions. If the proportion of these chemical elements be varied, the organic compound will be changed, or, the proportions remaining the same, if the _grouping_ of the elements be altered, different compounds will be produced, showing that the properties of organized substances depend upon the _molecular_ constitution of matter. Rising in the scale of organization, we observe that every variation of the physical and chemical processes implies a corresponding modification of the vital. This is verified by the peculiarities of the several races of mankind. Individual differences are likewise modifications of these processes. Dynamical or vital differentiation depends upon these modifications for the display of vital energy, and is always associated with molecular changes. But it should be borne in mind that an effect may not resemble its cause in _properties_, and the _qualities_ of a chemical compound may be quite different from those of its individual constituents. Organic matter, although more complex, may exhibit properties, both like and unlike its constituent elements. Within certain boundaries, the elements seek to satisfy their affinities. We discover that there are limits between the genera of animals, as well as the races of mankind. Not less really, though perhaps not as absolutely, are there individual precincts within the sphere of the human temperaments, which cannot be passed. If we cannot satisfactorily explain, we can at least discover a reason for temperamental limitation. It is not designed to circumscribe healthful reproduction, but to serve as an effectual hindrance to abnormal deviations. We may state our belief in more positive terms: that the temperamental variations are essential to _genesis_ and _fertility_, and indispensable to _health_ and _normal development_. Every individual is susceptible to impressions which dispose to action. Impressions which excite or increase this disposition, are called _stimuli_. Vital change implies the existence of _stimuli_ and _susceptibility_ to stimulation. The stimulus may not be furnished because the conditions on which it depends are wanting; again, susceptibility may exist at one time and not at another. Stimuli and susceptibility may be present in different degrees, but for the purpose of healthful reproduction they must not be impaired. No single class of foods, albuminous, starchy, saccharine, or mineral, is sufficient for the nutrition of the body, but the food must contain substances belonging to each of the different classes. If an animal be fed exclusively upon albumen, though this substance constitutes the largest part of the bodily mass, exhaustion will rapidly follow, since the food does not contain all the essential, nutritive elements. Again, when the solids of the body have been wasted, they lose their susceptibility to stimuli, and the food does no good. Thus patients become emaciated during acute attacks of disease, upon the cessation of which they are too feeble to recover, simply because they have lost the power to digest and assimilate their food. In inanimate bodies, as in crystals, forces come to rest, but the very idea of life implies action and continual change. Hence diversity of constitutions and different temperaments are essential in order that marriage may result in the reproduction of vigorous beings. VITAL AND NON-VITAL TEMPERAMENTS. [Illustration: Fig. 78.] In the preceding chapter, we attempted to illustrate the unique blending of mind and body by means of the nervous system, and we now propose to exemplify the physical conditions of the organism by certain correspondences, observed in the development and conditions of that system. If nature answer to mind in physical correspondences, she will observe the same regularity in physical development. The simplest classification of the temperaments is represented in Fig. 78. Not only is mental activity dependent upon a vital activity in the brain, but the development of the cerebrum is dependent upon the supply of blood. The growth of the intellect requires the same conditions that aided in the development of Vulcan's right arm: waste and supply; disintegration and reparation of tissue. Our modern iron forges produce many an artisan whose great right arm proclaims him to be a son of power as well as of fire. Thus the fervid intellect, while forging out its thoughts, increases in size and strength. The difference between the development of the two is this; that the exercise of the blacksmith's right arm quickens the activities of all the bodily functions, whereas the employment of the intellect does not offer any healthy equivalent. Physical exercise is a hygienic demand, but intellectual employment exerts no salutary influence on the body, while it is constantly expending the nutritive energies of the blood. The emotions, likewise, make exhaustive draughts upon nutrition to supply the waste of brain substance, just as certainly as physical labor causes muscular change, and demands reparation. One expends cerebral, the other, muscular substance. The one is healthful in its general tendencies, the other, comparatively wasteful and destructive. / DISINTEGRATING, The intellectual faculties are { EXPENDING, \ DERIVING. / ENGROSSING, The emotive faculties are { EXHAUSTING, \ DEVITALIZING. These nervous forces are transformed into spiritual products. The base of the anterior lobes of the brain belong to the atonic region--the source of those languid, deranging influences which coincide with morbidity and disease. A disturbance of the corporeal organs, which especially influence this portion of the brain, naturally tends to the development of insanity or imbecility. Morel has traced, through four generations, the family history of a youth who was admitted to the asylum at Rouen while in a state of stupidity and semi-idiocy. The following summary of his investigations illustrates the natural course of degeneracy as it extends through successive generations: immorality, depravity, alcoholic excess, and moral degradation, in the great-grandfather, who was killed in a tavern brawl; hereditary drunkenness, maniacal attacks, ending in general paralysis, in the grandfather; sobriety, but hypochondriacal tendencies, delusions of persecutions, and homicidal tendencies in the father; defective intelligence in the son. His first attack of mania occurred at sixteen, and was followed by stupidity, and finally ended in complete idiocy. Furthermore, there was probably an extinction of the family, for the son's reproductive organs were as little developed as those of a child of twelve years of age. He had two sisters who were both defective physically and morally, and were classed as imbeciles. To complete the proof of heredity in this case, Morel adds that the mother had a child while the father was confined in the asylum, and that this child exhibited no signs of degeneracy. Statistics show that multitudes of human beings are born with a destiny against which they have neither the will nor the power to contend; they groan under the worst of all tyrannies, the tyranny of a bad organization, which is theirs by inheritance. We may represent the tendencies of the anterior portion of the brain by Fig. 79. The functional exercise of the anterior and superior portions of the cerebrum is _disintegrating_ and _devitalizing_, while the anterior and inferior portions coincide with mental and physical derangement, unless counteracted by opposing forces. It is therefore evident that in any organization, upon which is entailed a perverted or excessive action of this portion of the cerebrum, the tendencies are NON-VITAL, _i.e._, unfavorable to fertility and physical health. If the antagonizing regions are well developed, the tendencies are favorable to life. / SANITY, The volitive organs promote { TEMPERANCE, \ HARDIHOOD. / NUTRITION, The animal organs tend to { RESTORATION, \ CONSERVATION. / SECRETION, The basilar faculties instigate { CIRCULATION, \ VITALITY. / ENERGY, The combined action of these { HEALTH, faculties express \ REPRODUCTION. [Illustration: Fig. 79] If this portion of the brain indicates a full development, we say of such a temperament that it is VITAL, because the functions of its nerve-centers are favorable to evolution. As degeneration observes conditions, so endurance and development conform to certain laws, and it is the duty of all truthful inquirers, who believe not only in the progress of human intelligence, but in physical improvement from generation to generation, to ascertain and comply with these essential conditions. When the anterior and middle lobes of the brain are fully developed at their inferior surfaces, it is regarded as an insane temperament, _i.e._ containing the germs of mental and bodily derangement. How shall we distinguish the combination of organic elements, if not by the manner in which they characterize the constitution? Every human being is distinguished by natural peculiarities, both mental and physical. These are indicated not only by the color of the eyes, hair, and skin, and the mental expressions, but in the conformation and capabilities of the corporeal system. The color, form, size, and texture of a leaf indicate to the expert pomologist the nature of the fruit which the tree will bear, but how much more important is it to understand the harmonies of human development. If Prof. Agassiz could determine the form and size of a fish by seeing its scales, and Prof. Owen outline the skeleton of an unknown animal by viewing a portion of its fossil, why should not the physician understand the language of temperaments, since it opens to him the revelations of human development? The sculptor blends character with form, the artist endows the face with natural expression, the anatomist accurately traces the nerves and arteries, the physiognomist reads character, which the novelist delineates and the actor personates, because there are facts behind all these, the materials wherewith to construct a science. In organization there are permanent forces which operate uniformly, thus revealing the order of nature. THE TEMPERAMENTS CLASSIFIED. [Illustration: Fig. 80] We propose to speak of four constitutional variations entitled to separate consideration; the lymphatic, the sanguine, the volitive, and the encephalic. The brain controls all the voluntary, and modifies the involuntary functions of the body. A particular cerebral development modifies the functions of all the bodily organs, and thus tempers the constitution. We shall, therefore, base our classification of temperaments upon the mental and physiological characteristics, which are portrayed by cerebral development. Such an arrangement is illustrated by Fig. 80. THE LYMPHATIC TEMPERAMENT. The lymphatic temperament predominates when the anterior base of the brain and the middle lobe are developed so as to exert a preponderating influence over the bodily functions. The character of this influence we have described in cerebral physiology. It is difficult to state precisely the normal influences and nerve-forces which arise from these faculties, but it is evident that they are specially related to nutritive attraction, in opposition to volitive repulsion. It is only their excessive influence which produces worthless, miserable, morbid characters. A constitution marked by this development is indolent, relaxative, and an easy prey to epidemics. This treatment is also characterized by a low grade of vitality or resistance. When life is sustained by the volitive powers, it is distinguished by a softness of the bodily tissues, and the prevalence of lymph. The fact that all the organic functions are performed indolently, indicates lack of vital power. An excellent illustration of this temperament is found in Fig. 81, which represents a Chinese gentleman of distinction. In the lower order of animals, as in sponges, absorption is performed by contiguous cells, which are quite as effortless as in plants. Because of their organic indolence, sponges are often classed as vegetables. A body having an atonic or a lymphatic temperament is abundantly supplied with absorbent organs, which are very sluggish in their operations. In the lymphatic temperament, there seems to be less constructive energy, slower elaboration, and greater frugality. Lymph is a colorless or yellow fluid containing a large proportion of water. It is not so highly organized as the blood, but resembles it, when that fluid is deprived of its red corpuscles. In the sanguine temperament, circulation in the blood-vessels is the most active, in the lacteals next, and in the lymphatics the least so, but in the lymphatic temperament, this order is reversed. [Illustration: Fig. 81.] Dr. W.B. Powell has observed that a lymphatic man has a large head, while a fat man has a small one, and also that fat and lymph, are convertible, one following the other, _i.e.,_ "a repletion consisting of fat may be removed, and one of lymph may replace it, and _vice versa_." He could not account for these alternations. The bear goes into his winter quarters sleek and fat, and comes forth in the spring just as plump with lymph, but he loses this fat appearance soon after obtaining food. This simply indicates that, during lymphatic activity, the digestive organs are comparatively quiescent. But when these are functionally employed again, lymphatic economy is not required. It is the duty of the lymphatics to slowly convert the fat by such transformation, that when it reaches the general circulation, it may there unite with other organic compounds, the process being aided by atmospheric nitrogen, introduced during the act of respiration. In this way it may become changed into those chemically indefinite, artificial products, called proteid compounds. This view is supported by the disappearance of fat as an organized product in the lymph of the lymphatic vessels, indicating that such transformation has occurred. In this way, by uniting with other organic compounds, it appears that lymph may serve as a weak basis for blood; that atmospheric nitrogen is also employed in forming these artificial compounds, is indicated by the fact that there is sometimes less detected in arterial than in venous blood. [Illustration: Fig. 82. Judge Green, of the United States Court. ] This temperament is indicated by lymphatic repletion, soft flesh, pale complexion, watery blood, slow and soft pulse, oval head, and broad skull, showing breadth at its base. Fig. 82 illustrates this temperament combined with sanguine elements. In all good illustrations of this temperament, there is a breadth of the anterior base of the skull extending forward to the cheek bones. There is likewise a corresponding fullness of the face under the chin, and in the neck, denoting a large development of the anterior base of the cerebrum. The cerebral conformation of the Hon. Judge Green indicates mental activity, and we have no reason to suppose that lymph was particularly abundant in his brain. [Illustration: Fig. 83.] While this description of the lymphatic temperament is correct, when illustrated by the civilized races of men who are accustomed to luxury, ease, and an abundance of food, it does not apply with equal accuracy to the cerebral organization of the American Indian. His skull, though broad at its anterior base, and high and wide at the cheek bones, differs from the European in being broader and longer behind the ears. Fig. 83 is an excellent representation of a noted North American Indian. While a great breadth of the base of the brain indicates morbid susceptibilities, yet these, in the Indian, are opposed by a superior height of the posterior part of the skull. Consequently, he is restless, impulsive, excitable, passionate, a wanderer upon the earth. The basilar faculties, however, are large, and he is noted for instinctive intelligence. His habits alternate from laziness to heroic effort, from idleness and quiet to the fierce excitement of the chase, from vagabondism to war, sometimes indolent and at other times turbulent, but under all circumstances, irregular and unreliable. In this case, lacteal activity is greater than lymphatic, as his nomadic life indicates. Nevertheless, he manifests a morbid sensibility to epidemic diseases, especially those which engender nutritive disorders and corrupt the blood. Figs. 84 and 85 represent the brain of an American Indian, and that of a European, and show the remarkable difference in their anatomical configuration. Evidently it is a race-distinction. Observe the greater breadth of the brain of the Indian, which according to cerebral physiology indicates great alimentiveness, indolence, morbid sensibility, irritability, profligacy, but also note that it _differs materially in the proportion of all its parts_, from the European brain. Judging the character of the Indian from the aforesaid representation, we should say that he was cunning, excitable, treacherous, fitful, taciturn, or violently demonstrative. His constitution is very susceptible to diseases of the bowels and blood. His appetite is ungovernable, and his love of stimulants is strong. Syphilitic poison, small-pox, and strong drink will annihilate all these tribes sooner than gunpowder. Their physical traits of constitution are no less contradictory than their extremes of habit and character, for while there is evidence of _lymphatic elements_, yet it is contradicted by the color of the hair, eyes, and skin. This peculiar organization will not blend in healthful harmony with that of the European, and this demonstrates that the race-temperaments require separate and careful analytical consideration. [Illustration: Fig. 84. American Indian. Fig 85. European. (FROM MORTON'S CRANIA AMERICANA.) In the American Indian, the anterior lobe, lying between _AA_, and _BB_, is small, and in the European it is large, in proportion to the middle, lying between _BB_ and _CC_. In the American Indian, the posterior lobe, lying between _C_ and _D_ Is much smaller than in the European. In the Indian, the cerebral convolutions on the anterior lobe and upper surface of the brain, are smaller than the European. If the anterior lobe manifests the intellectual faculties--the middle lobe the propensities common to man with the lower animals--and the posterior lobe, the conservative energies, the result seems to be, that the intellect of the American Indian is comparatively feeble--the European, strong; the animal propensities of the Indian will be great--in the European, more moderate; while reproduction, vital energy, and conservation of the species in the Indian is not as great as with the European. The relative proportions of the different parts of the brain differ very materially.] By physical culture and regulation of the habits, the excessive tendencies of this temperament may be restrained. Solid food should be substituted for a watery diet. If it be limited in quantity, this change will not only diminish the size, but increase the strength of the body. The body should be disciplined by daily percussion until the imperfectly constructed cells, which are too feeble to resist this treatment, are broken and replaced by those more hardy and enduring. Add to this treatment brisk, dry rubbing, calisthenic exercises, and daily walks, which should be gradually extended. Continue this treatment for three months, and its favorable effects upon the temperament will surprise the most skeptical; if continued for a year, a radical alteration will be effected, and the hardihood, health, and vigor of the constitution will be greatly increased. This temperament may be improved physiologically, by being blended with the sanguine and volitive. The offspring will be stronger, the structures firmer, the organization more dense. Nutrition, assimilation, and all the constructive functions will be more energetic in weaving together the cellular fabric of the body. The sanguine temperament will add a stimulus to the organic activities, while the volitive will communicate manly, brave, and enduring qualities. When this temperament is united with the encephalic, if such a union does not result in barrenness, it adds _expending_ and _exhaustive_ tendencies to the _enfeebling_'ones already existing, and, consequently, the offspring lacks both physical power and intellectual activity. The peculiarities of this temperament are observed in the diseases which characterize it. It is specially liable to derangements of digestion, nutrition, and blood-making. The blood is easily poisoned by morbid products formed within the body, as well as by those derived from the body of another. This is seen in pyæmia, produced by the introduction of decomposing pus, or "matter," into the blood. This condition is most likely to occur when the vital powers are low and the energies weak, for then the fibrin decreases, the red corpuscles diminish in number, the circulation becomes languid, the pulse grows fluttering and weak, and this increases until death ensues. An individual of this temperament is more easily destroyed than any other "by the poison of syphilis, small-pox, and other contagious diseases. If the blood has received any hereditary taint, the lymphatic glands not only reproduce it but often increase the virulency of the original disease. This temperament indicates a necessity for the employment of stimulating, alterative, and antiseptic medicines. The torpid functions need arousing, the blood needs depuration, i.e., the elimination of corrupting matter, and the system requires alteratives to produce these salutary changes. The secretions need the correcting influence of cleansing remedies for the purification of the blood. Persons of this temperament are more liable to absorption of morbid products within the body, which are in a state of decomposition, producing an infection of the blood, technically termed _septicæmia_. The fatal results which so suddenly follow child-bed fever are thus produced. This kind of poisoning sometimes takes place from the absorption of decomposed exudation in diphtheria, and, though rarely, from decomposing organic products collected in the lungs. Whenever the absorption of poison does take place, fatal consequences usually follow. This passive temperament is more likely to sink under acute attacks of disease, especially alimentary disorders, such as diarrhea, dysentery, and cholera. It quickly succumbs to their prostrating effects, such as depression, congestion, and fatal collapse which rapidly succeed one another. Venesection and harsh purgatives are contra-indicated, and the physician who persists in their employment kills his patient. How grateful are warmth and stimulating medicines! The most powerful, diffusible, and nervous stimulants are required in cholera, when the system is devastated by the disease, as the plain is laid waste by the fierce tornado. THE SANGUINE TEMPERAMENT. Lymph is the characteristic of the lymphatic temperament, and its specific gravity, temperature, and standard of vitality are all lower than that of red blood. In the sanguine temperament all the vital functions are more active, the blood itself has a deeper hue, its corpuscles carry more oxygen, the complexion is quite florid, and the arterial currents impart to every faculty a more hopeful vigor. The blood-vessels are the most active absorbents, eagerly appropriating nutritive materials for the general circulation, while the respiration adds to it oxygen, that agent which makes vital manifestation possible. This temperament exhibits greater sensibility, the conceptions are quicker, the imagination more vivid, the appetite stronger, the passions more violent, and there is found every display of animal life and enjoyment. A full development of the basilar faculties, indicated by an unusual breadth and depth of the base of the brain, accompanies this temperament. Its cerebral area includes the posterior and inferior portions of the cerebrum, the entire cerebellum, and that part of the medulla which connects with the spinal cord, all of which sustain intimate relations to vital conditions. Accordingly, such a development indicates good digestion, active nutrition, vigorous secretion, large heart and lungs, powerful muscles, and surplus vitality. The violent faculties, such as Combativeness, Destructiveness, and Hatred, are natural adjuncts, and their excess tends to sensuality and crime. They are not only secretive, appropriative, selfish, and self-defensive, but when redundant are aggressive and tend to destructiveness, the gratification of animal indulgence, intemperance, and debauchery. The correspondence between the cerebral conformation and the physical development is very obvious. Lower orders of animals possess these faculties, and their spontaneous exhibition is called instinct. They possess the acquisitive, destructive, and propagative propensities, which lead them to provide for their wants and secure to themselves a posterity. The exercise of their bodies causes a continual waste which demands incessant reparation, and they are governed measurably by these animal impulses. All of these lower psychical faculties have a physiological significance. Acquisitiveness functionally expresses assimilation, accretion, animal growth, and tends to bodily repletion. Secretiveness expresses concealing, separating, withdrawing, and functionally signifies secretive action. Secretion is the separating and withdrawing from the blood some of its constituents, as mucus, bile, saliva, etc. This latter process indicates complex conditions of organization, so that the higher and more complex the tissue, the greater the number of secretory organs. Unrestrained selfishness, while it naturally conserves the individual interests, in its ultimate tendencies, is the very essence of human depravity. Without qualification, clearly, it is crime, for blind devotion to the individual must be in utter disregard for the good of others. The ultimate tendencies of these faculties are, therefore, criminal. Exaggerate the faculty of acquisitiveness, and it becomes avariciousness. Develop secretiveness and selfishness, and they become cunning and profligacy, desperation and crime. Their functional development tends to produce physical disorder and violent disease. All of these faculties are vehement, contentious, thriving by opposition. Life itself has been called a forced state, because it wars with the elements it appropriates, and transmutes their powers into vitality. [Illustration: Fig. 86.] We find men and women of this temperament, who are models of character and organization. George Washington is an excellent illustration. The impression that his presence made upon the Marquis de Chastellux, is given in the following words: "I wish only to express the impression General Washington has left on my mind; the idea of a perfect whole, brave without temerity, laborious without ambition, generous without prodigality, noble without pride, virtuous without severity." Gen. Scott, Lord Cornwallis, Dr. Wistar, Bishop Soule John Bright, Jenny Lind Goldsmidt, and Dr. Gall are good representatives of this temperament. Fig. 86 is an excellent illustration of it, finely blended and well balanced, in the person of Madame de Stael. This temperament requires fewer tonics and stimulants than the lymphatic. This constitution is best able to restore vital losses. It is a vital temperament, in other words, it combines favorably with all the others, and better adapts itself to their various conditions. Some regard it as the best adjusted one in all its organs and tissues, and as the most satisfactory and serviceable. [Illustration: Fig. 87.] Excess of nutrition tends to plethora, to animal indulgence, and gross sensuality. Not only do the propensities rouse desire, but they excite the basilar faculties, and portray their wants in the outlines of the face, mould the features to their expression, and flash their significance from the eye. Who can mistake the picture of sensuality represented by Fig. 87? It is enough to shock the sensibility of a dumb animal, and to say that such a face has a beastly look, is an unkind reflection upon the brute creation. A large neck and corresponding development of the occipital half of the brain indicate nervous energy, yet nutrition is not absolutely dependent upon it, for the nutritive processes are active before a nervous system is formed. The lower faculties of the mind exert a remarkable influence over nutrition, secretion, and the molecular changes incident to life. Anger or fear may transmute the mother's nourishing milk into a virulent poison. The following incident, taken from Dr. Carpenter's Physiology, illustrates this statement: "A carpenter fell into a quarrel with a soldier billeted in his house, and was set-upon by the latter with his drawn sword. The wife of the carpenter at first trembled from fear and terror, and then suddenly threw herself between the combatants, wrested the sword from the soldier's hand, broke it in pieces, and threw it away. During the tumult, some neighbors came-in and separated the men. While in this state of strong excitement, the mother took up her child from the cradle, where it lay playing, and in the most perfect health, never having had a moment's illness; she gave it the breast, and in so doing sealed its fate. In a few minutes the infant left-off sucking, became restless, panted, and sank dead upon the mother's bosom. The physician who was instantly called-in, found the child lying in the cradle, as if asleep, and with its features undisturbed; but all resources were fruitless. It was irrecoverably gone. In this interesting case, the milk must have undergone a change, which gave it a powerful sedative action upon the susceptible nervous system of the infant." Anxiety, irritation, hatred, all tend to the vitiation of the disposition and bodily functions, perverting the character and constitution at the same time. Depravity of thought and secretion go together. Degradation of mind and corruption of the body are concomitants. There is a very close affinity between mental and moral perversion and physical prostitution, of which fact too many are unconscious. Nervous influence preserves the fluidity of the blood and facilitates its circulation, for it appears that simple _arrestment_ of this influence favors the coagulation of the blood in the vessels; clots being found in their trunks within a few minutes after the brain and spinal marrow are broken down. Habitual constipation is the source of many ills. Perversion of the functions of the stomach, and of the circulation of the blood, produce general disaster. Diseases which characterize this temperament are acute, violent, or inflammatory, indicating repletion and active congestion; intense inflammation, burning fevers, severe rheumatism, a quick, full pulse, great bodily heat, and functional excitement are its morbid accompaniments. These diseases will bear thorough depletion of the alimentary canal, active, hydragogue cathartics being indicated. Sedatives and anodynes are also essential to modify the circulatory forces, and to relieve pain. Violent disturbance must be quelled, and among the remedial agents required for this duty we may include Veratrum, Ipecac, Digitalis, Opium, Conium, and Asclepias. While equalizing the circulatory fluids, restoring the secretions, and thoroughly evacuating the system, and thus endeavoring to remove disturbing causes, we find that the conditions of this temperament are exceedingly favorable for restoration to health. True, many chronic diseases are obstinate, yet a course of restorative medication persistently followed, promises a fortunate issue in this tractile temperament. Hygienic management of the lymphatic and sanguine temperaments consists in the vigorous toning of the former, while restraint of the latter will greatly exempt it from the anxieties, contentions, and vexations which excite the mind, disturb the bodily functions, and end in chronic disease. People of the latter organization love mental and physical stimulants, are easily inflamed by passion, and their excitability degenerates into irritability, succeeded by serious functional derangements, which prematurely break down the individual with inveterate, deep-seated disorder. Serenity, hope, faith, as well as firmness, are natural hygienic elements. It is a duty we owe ourselves to promptly relinquish a business which corrodes with its cares, and depresses with its increasing troubles. Constant solicitude, and the apprehension of financial disaster, frustrate the bodily functions, disconcert the organic processes, and lead to mental aberration as well as physical degeneracy. Melancholy is chronic, while despair is acute mania, whose impulses drive the victim desperately toward self-destruction. The chronic derangement of these organs exerts with less force the same morbid tendency. Hence the necessity for exercising those hygienic and countervailing influences born of resolution, assurance, and confident trust, and the belief which strengthens all of the vital operations. Doubtless, this temperament is the source of the reproductive powers. It is the corner-stone essential to the foundation of all other temperaments. It has been supposed by some that the cerebellum is the seat of sexual instinct. The fact appears that an ample development of the posterior base of the cerebrum and the cerebellum indicates nutritive activity, which is certainly a condition most favorable to the display of amativeness. In a double sense, then, this temperament is a vital one; both by nutritive repletion, and by reproduction. It is the blood-manufacturing, tissue-generating, and body-constructing temperament, causing growth to exceed waste, and promptly repairing the wear which follows continual labor. While the sleazy structures of the lymphatic temperament are favorable to the functions of transudation, exhalation, and mutual diffusion of liquids, the sanguine, as its name indicates, is adapted to promote the circulation of the blood, to favor nutrition and reproduction. The former temperament does not move the world by its energies, or impress it vividly with its wisdom, and the latter is more enthusiastic, enjoyable, and quickening. Each temperament, however, possesses salient qualities and advantages. THE LIFE LINE. Dr. W.B. Powell, in his work on "The Human Temperaments," announces the discovery of a measurement which indicates the tenacity of life, and the vital possessions of the individual. He has observed that some persons of very feeble appearance possess remarkable powers of resistance to disease, and continue to live until the machinery of life literally wears out. Others, apparently stronger and more robust, die before the usual term of life is half completed. He also noticed that some families were remarkable for their longevity, while others reached only a certain age, less than the average term of life, and then died. He remarked also that some patients sank under attacks of disease, when, to all appearances, they should recover, and that others recovered, when, according to all reasonable calculations, they ought to die. He, therefore, not only believed that the duration of human life was more definitely fixed by the organization than is supposed, but he set himself to work to discover the line of life, and the measure of its duration. He made a distinction between vital vigor, and vital tenacity. _Vital vigor_ he believed to be equivalent to the condition of vitality, which is indicated by the breadth of the brain found in the sanguine temperament; and _vital tenacity_ to be measured by the _depth_ of the base of the brain. Dr. Powell was an indefatigable student of nature, and followed his theory through years of observation, and measured hundreds of heads of living persons, in order to verify the correctness of the hypothesis. His method of measuring the head may be stated as follows: He drew a line from the occipital protuberance on the back of the head to the junction of the frontal and malar bones, extending it to a point above the center of the external orbit of the eye, near the termination of the brow. Then he measured the distance between this line and the orifice of the ear and thus obtained the measure indicating the vital tenacity or duration of, life. Fig. 88 is a representation of the skull of Loper, who was executed for murder in Mississippi. He might have attained a great age, had not his violent and selfish faculties led him into the commission of crime. In this illustration, B represents the occipital protuberance, and A the junction of the frontal and malar bones at the external angle of the eye. The distance between this line (A B) and the external orifice of the ear, is the measure of the life-force of Loper at the time of his: execution. [Illustration: Fig. 88.] [Illustration: Fig. 89.] The tenacity of an individual's life, Dr. Powell determined by the following scale of measurements: three-fourths of an inch from the orifice of the ear to the life-line, is the average length in the adult, and indicates _ordinary_ tenacity of life. As the distance decreases to five-eighths, one-half, or three-eighths of an inch, vital tenacity diminishes. If the distance is more than three-quarters of an inch, it denotes great vital endurance, excellent recuperative powers, and is indicative of longevity. If it measures less than half an inch, it shows that the constitution has a feeble, uncertain hold upon life, and an acute disease is very likely to sunder the vital relations. Dr. Powell contended that "life force and vital force are not equivalent terms, because much more vital force is expended upon our relations, than upon our organization in the preservation of life. Every muscular contraction, every thought, and every emotion requires an expenditure of vital force." He asserted that we _inherit_ our life force or constitutional power, and that we can determine by this _life-line,_ the amount which we so receive. And he believed that it could be increased by _intellectual_ effort, just as we can increase vital force by _physical_ exercise. Fig. 89 represents the skull of a man who died, at nearly the same age as Loper, of consumption, in the Charity Hospital, at New Orleans. The measurement of the skull in this case gives a space between the life-line and the orifice of the ear of one-sixteenth of an inch, showing that the consumptive had lived the full term of his life. Dr. Powell contended that the depth of a man's brain may be increased after maturity; muscular effort, mental activity, and a sense of responsibility being favorable to longevity, while idleness and dissipation are adverse to it. In justice to the Doctor, we have stated fully his theory and his method of determining the hardihood and endurance of the constitution, and we bespeak for it a candid examination. Without doubt it embodies a great deal of truth. Hereafter we shall endeavor to indicate by cerebral configuration, a better system of judging of the vital tenacity, hardihood, and constitutional energies, both inherited and acquired. THE VOLITIVE TEMPERAMENT. By reference to Figs. 72 and 80, the reader will be able to locate the region of the volitive faculties, previously described under the generic term _will_. This temperament is characterized by ambition, energy, industry, perseverance, decision, vigilance, self-control, arrogance, love of power, firmness, and hardihood. These faculties express concentration of purpose and their functional equivalents are power of elaboration, constructiveness, condensation, firmness of fiber, compactness of frame, and endurance of organization. The pulse is full, firm, and regular, the muscles are strong and well marked, the hair and skin dark, the temporal region is not broadly developed, the face is angular, its lines denoting both power of purpose and strength of constitution, with resolution and hardihood blended in the expression. The volitive temperament is distinguished by height of the posterior, superior occipital region, called the crown of the back head, and by corresponding breadth from side to side. The rule given by Dr. J.R. Buchanan applies not only to the convolutions, but to the general development of the brain; _length gives power, or range of action_, and _breadth gives copiousness, or activity of manifestation_. Thus a high, _narrow_ back head indicates firmness and decision, but it is not as constant and copious in its manifestation as when it is associated with breadth. An individual having a narrow, high head, may determine readily enough upon a course of action, but he requires a longer period for its completion than one whose head is both high and broad. Such a cerebral conformation cannot accomplish its objects without enjoying regular rest, and maintaining the best of habits. Breadth of this region of the brain indicates ample resources of energy, both psychical and physical. It denotes greater vigor of constitution, one that continually generates volitive forces, and its persistency of purpose may be interpreted as functional tenacity. Inflexibility of will and purpose impart their tenacious qualities to every bodily function. The _will_ to recover is often far more potent than medicine. We have often witnessed its power in restraining the ravages of disease. The energetic faculties, located at the upper and posterior part of the head, are the invigorating, or _tonic_ elements of the constitution, imparting hardy, firm, steady, and efficient influences, checking excess of secretion, repressing dissipation, and tending to maintain self-possession, as well as healthy conditions of life. Fig. 90 is a portrait of U.S. Grant, which shows a well-balanced organization, with sufficient volitive elements to characterize the constitution. [Illustration: Fig. 90.] The old term _bilious temperament_ might possibly be retained in deference to long usage, did it not inculcate a radical error. _Bilious_ is strictly a medical term, relating to bile, or to derangements produced by it, and it was used originally to distinguish a temperament supposed to be characterized by a predominance of the biliary secretion. In the volitive temperament, the firm, tenacious, toning, and restraining faculties _repress_, rather than _encourage_ biliary secretion, and hence the necessity for administering large doses of cholagogues, remedies which stimulate the secretion of bile. When the system is surcharged with bile, from a congested condition of the liver, we use these agents in order to obtain necessary relief. In this temperament there is moderate hepatic development, lack of biliary activity, deficiency in the secretion of bile, and a sluggish portal circulation. Therefore, to apply the term bilious to this temperament is not only unreasonable, but it is calculated to mislead. The condition of the bowels is generally constipated, the skin dark and sometimes sallow. For these and other obvious reasons, we dismiss the word _bilious_, and substitute one which is more characteristic. We will not dwell upon the volitive as _psychical_ organs, except to show that, when their influence is transmitted to the body, they act as _physiological_ organs, and thus demonstrate that all parts of the brain have their physiological, as well as mental functions. When Andrew Jackson uttered with great emphasis the memorable words, "BY THE ETERNAL," the effect was like a shock from a galvanic battery, thrilling the cells in his own body, and paralyzing with fear every one in Calhoun's organization. This is an illustration of the power or range of action of these faculties. Breadth or copiousness is illustrated in Gen. Grant's reply, "I PROPOSE TO FIGHT IT OUT ON THIS LINE, IF IT TAKES ALL SUMMER." Such a temperament has a profusion of constitutional power, great durability of the life-force, and, in our opinion, the combined height and breadth of this region correctly indicate the natural hardihood of the body and its _retentiveness of life_. No one need doubt its influence upon the sympathetic system, and, through that system, its power over absorption, circulation, assimilation, and secretion, as well as the voluntary processes. Mental hardihood seems wrought into concrete organization. It checks excess of glandular absorption, restrains the impulses of tumultuous passion, tones and regulates the action of the heart, and helps to weave the strands of organization into a more compact fabric. The toning energies of the volitive faculties are better than quinine to fortify the system against _miasma_ or _malaria_, and they co-operate with all tonic remedies in sustaining organic action. Fig. 91 is a portrait of Prof. Tyndall, the eminent chemist, whose likeness indicates volitive innervation, showing great strength of character and of constitution; he is an earnest, thorough, and intense mental toiler; ambitious, but modest; brilliant, because persevering; diligent in scientific inquiry, and who follows the star of truth, whithersoever it may lead him. The expression of his countenance indicates his honest intentions, and displays strength of conscientious purpose; his physical constitution may be correctly interpreted in all of its general characteristics by the analysis of his energetic temperament, the great secret of his strength and success. [Illustration: Fig. 91.] [Illustration: Fig. 92.] We desire to offer one more illustration of a marvelous blending of this temperament with large mental and emotional faculties. Fig. 92 is a representation of the martyred President Abraham Lincoln. During an eventful career, his temperament and constitution experienced marked changes, and while always distinguished for strength of purpose and corresponding physical endurance, he was governed by noble, moral faculties, manifesting the deepest sympathy for the down-trodden and oppressed, blending tenderness and stateliness without weakness, exhibiting a human kindness, and displaying a genuine compassion, which endeared him to all hearts. He was hopeful, patriotic, _magnanimous_ even, while upholding the majesty of the law and administering the complicated affairs of government. The balances of his temperament operated with wonderful delicacy, through all the perturbating influences of the rebellion, showing by their persistence that he was never for a moment turned aside from the great end he had in view; the protection and perpetuation of republican liberty. His life exhibited a sublime, moral heroism, elements of character which hallow his name, and keep it in everlasting remembrance. We have treated the brain, not as a mass of organs radiating from the medulla oblongata as their real center, but as two cerebral masses, each of which is developed around the great ventricle. We have freely applied an easy psychical and physiological nomenclature to the functions of its organs, knowing that there is no arbitrary division of them by specific number, for the cerebrum, in an anatomical sense, is a single organ. The doctrine of cerebral unity is true, and the doctrine of its plurality of function is true also. Whatever effect an organ produces when acting in entire predominance, is regarded as the function of that organ and is expressed by that name. Although our names and divisions are arbitrary and designed for convenience, yet they facilitate our consideration of the psychical, and their corresponding physiological functions. Every cerebral manifestation denotes a _psychical_ organ, and in proportion as these acts are transmitted to the body it becomes a _physiological_ organ. We have ventured to repeat this proposition for the sake of the non-professional reader, that he may be able to distinguish between' the two results of the manifestation of one organ. The transmission of the influence of the brain into the body enables the former to act physiologically, whereas, if its action were confined within the cranium, it would only be psychical. In the language of Prof. J.R. Buchanan, "every organ, therefore, has its mental and corporeal, its psychological and physiological functions--both usually manifested together--_either capable of assuming the predominance_." We have already seen to what degree the _Will_ operates upon the organism, or how "the soul imparts special energy to single organs, so that they perform their functions with more than usual efficiency," and thus resist the solicitations of morbific agents. Doubtless our best thoughts are deeply tinged by the healthful or diseased conditions of such organs as the stomach, the lungs, the heart, or even the muscular or circulatory systems, and these impressions, when carried to the sensorium, are reflected by the thoughts, for reflex action is the third class of functions, assigned to the cerebrum. These reflex actions are either hygienic and remedial, or morbid and pernicious. Hence, it is philosophical not only to interpret the thoughts as physiological and pathological indications, but to consider the cerebrum as exerting real hygienic and remedial forces, capable of producing salutary reparative, and restorative effects. When a boiler carries more steam than can be advantageously employed, it is subjected to unnecessary and injurious strain, and is weakened thereby; so, when the body is overtasked by excessive pressure of the volitive faculties, it is prematurely enfeebled and broken down. There are many individuals who need to make use of some sort of safety valve to let off the surplus of their inordinate ambition; they need some kind of patent brake to slacken their speed of living; they should relieve the friction of their functional powers by a more frequent lubrication of the vital movements, and by stopping, for needed refreshment and rest, at some of the many way-stations of life. THE ENCEPHALIC TEMPERAMENT. The encephalic temperament is distinguished by prominence and breadth of the forehead, or by a full forehead associated with height and breadth at its coronal junction with the parietal bones, and extending toward the volitive region. (See Fig. 10, the space between 1 and 2 represents the coronal region, 1 indicating the frontal bone, and 2 the parietal). Prominence and great breadth of the forehead display _analytical, i.e._, scientific powers applicable to concretes, whereas a fair intellect, associated with a preponderating development of the coronal region, indicates _analogical_ powers, _i.e._, faculties to perceive the relation and the agreement of principles. The former classifies and arranges facts, the latter invests them with moral and spiritual import. The one treats of matter, its physical properties, and chemical composition, the other of thoughts and intentions which involve right and wrong, relating to spiritual accountability. The intellect is employed upon an observable order of things, while the emotive faculties arrange the general laws of being into abstract science. Fig. 93, a portrait of Prof. Tholuck, is a remarkable example of an encephalic organization. Figs. 72 and 79 fairly indicate the effects of undue mental activity, the intellect causing vital expenditure resulting in the devitalization of the blood. While the intellect displays keen penetration, subtle discrimination, and profound discernment, the emotions exhibit intense sensitiveness, acute susceptibility, and inspirational impressibility. The encephalic temperament is characterized by mental activity, great delicacy of organization, a high and broad forehead, expressive eyes, fine but not very abundant hair, great sensitiveness, refined feelings, vividness of conception, and intensity of emotion. If the brain is developed on the sides, there is manifested Ideality, Modesty, Hope, Sublimity, Imagination, and Spirituality. If the brain and forehead project, the Perceptive, Intuitive, and Reasoning faculties predominate. If it rises high, and nearly perpendicularly, Liberality, Sympathy, Truthfulness, and Sociability are manifested. When the emotive faculties are large, Faith, Hope, Love, Philanthropy, Religion, and Devotion characterize the individual. It is an artistic, creative, and aesthetic temperament, beautiful in conception and grand in expression, yet its sensitiveness is enfeebling, and its crowning excellence, when betrayed by the propensities, trails in defilement. Its purity is God-like, its debauchment, Perdition! [Illustration: Fig. 93.] Fig. 94 is the likeness of Prof. George Bush. His forehead is amply developed in the region of Foresight, Liberality, Sympathy, Truthfulness, and Benevolence; his mouth expresses Amiability and Cheerfulness, and the whole face beams with Kindness and Generosity. This philanthropist, who is both a preacher and an author, has published several works upon theology, which distinguish him for great research and originality. [Illustration: Fig. 94.] Fig. 95 represents the sanguine-encephalic temperament, the two elements being most happily blended. The portrait is that of Emmanuel Swedenborg, the great scholar and spiritual divine. The reader will observe how high and symmetrical is the forehead, and how well balanced appears the entire organization. He was remarkable for vivid imagination, great scientific acquirements, and all his writings characterize him as a subtle reasoner. When the encephalic predominates, and the sanguine is deficient in its elements, we find conditions favorable to _waste_ and _expenditure_, and adverse to a generous _supply_ and _reformation_ of the tissues. A child inheriting this cerebral development is already top-heavy, and supports, at an immense disadvantage, this disproportionate organization. The nutritive functions are overbalanced; consequently there is a predisposition to scrofulous diseases and disorders of the blood, various degenerating changes taking place in its composition; loss of red corpuscles, signified by shortness of breath; morbid changes, manifested by cutaneous eruptions; exhaustion from lack of nourishment, etc., until, finally, consumption finishes the subject. [Illustration: Fig. 95.] Harmony is the support of all institutions, and applies with special cogency to the maintenance of health. When the mind dwells on one subject to the exclusion of all others, we call such a condition monomania. If we have an excessive development of mind, and deficient support of body, the result is corporeal derangement. It is unfortunate for any child to inherit unusually large brain endowments, unless he is possessed of a vigorous, robust constitution. Such training should be directed to that body as will encourage it to grow strong, hearty, and thrifty, and enable it to support the cerebral functions. The mental proclivities should be checked and the physical organization cultivated, to insure to such a child good health. Cut off all unnecessary brain-wastes, attend to muscular training and such invigorating games and exercises as encourage the circulation of the blood; keep the skin clean and its functions active, the body warm and well protected, the lungs supplied with pure air, the stomach furnished, with wholesome food, besides have the child take plenty of sleep to invigorate the system, and thus, by regular habits, maintain that equilibrium which tends to wholesome efficiency and healthful endurance. TRANSMISSION OF LIFE. As has been already stated in the chapter on Biology, reproduction of the species depends upon the union of a sperm-cell with a germ-cell, the male furnishing the former and the female the latter. It is a well-known fact that the marriage of persons having dissimilar temperaments is more likely to be fertile than the union of persons of the same temperaments; consanguineous marriages, or the union of persons nearly related by blood, diminish fertility and the vigor of the offspring. Upon this subject Francis Galton has given some very interesting historical illustrations in his well-known work, entitled "Hereditary Genius." The half-brother of Alexander the Great, Ptolemy I, King of Egypt, had twelve descendants, who successively became kings of that country, and who were also called Ptolemy. They were matched in and in, but in nearly every case these near marriages were unprolific and the inheritance generally passed through other wives. Ptolemy II married his niece, and afterwards his sister; Ptolemy IV married his sister. Ptolemy VI and VII were brothers, and they both consecutively married the same sister; Ptolemy VII also subsequently married his niece; Ptolemy VIII married two of his sisters in succession. Ptolemy XII and XIII were brothers, and both consecutively married their sister, Cleopatra. Mr. Galton and Sir Jas. Y. Simpson have shown that many peerages have become extinct through the evil results of inter-marriage. Heiresses are usually only children, the feeble product of a run-out stock, and statistics have shown that one-fifth of them bear no children, and fully one-third never bear more than one child. Sir J.Y. Simpson ascertained that out of 495 marriages in the British Peerage, 81 were unfruitful, or nearly one in every six; while out of 675 marriages among an agricultural and seafaring population, only 65 were sterile or barren, or a little less than one in ten. While the marriages of persons closely related, or of similar temperaments are frequently unfruitful, we would not have the reader understand that sterility, or barrenness, is usually the result of such unions. It is most frequently due to some deformity or diseased condition of the generative organs of the female. In the latter part of this work may be found a minute description of the conditions which cause barrenness, together with the methods of treatment, which have proved most effectual in the extensive practice at the Invalids' Hotel and Surgical Institute. The temperaments may be compared to a magnet, _the like poles of which repel, and the unlike poles of which attract each other._ Thus similarity of temperament results in barrenness while dissimilarity makes the vital magnetism all the more powerful. Marriageable persons moved by some unknown influence, have been drawn instinctively toward each other, have taken upon themselves the vows and obligations of wedlock, and have been fruitful and happy in this relation. Alliances founded upon position, money, or purely arbitrary considerations, mere contracts of convenience, are very apt to prove unhappy and unproductive. Men may unconsciously obey strong instinctive impulses without being conscious of their existence, and by doing so, avoid those ills, which otherwise might destroy their connubial happiness. The _philosophy_ of marriage receives no consideration, because the mind is pre-occupied with newly awakened thoughts and feelings. Lovers are charmed by certain harmonies, feel interior persuasions, respond to a new magnetic influence and are lost in an excess of rapture. If the parties to a marriage are evenly balanced in organic elements, although both of them are vigorous, yet it is physiologically more suitable for them to form a nuptial alliance with an unlike combination. The cause of the wretchedness attending many marriages may be traced to a too great similarity of organization, ideas, taste, education, pursuits, and association, which similarity almost invariably terminates in domestic unhappiness. The husband and wife should be as different as the positive and negative poles of a magnet. When life is begotten under these circumstances we may expect a development bright with intelligence. * * * * * CHAPTER XVI MARRIAGE. LOVE. "Love is the root of creation; God's essence; worlds without number Lie in his bosom like children; he made them for this purpose only. Only to love and to be loved again, he breathed forth his spirit Into the slumbering dust, and upright standing, it laid its Hand on its heart, and felt it was warm with a flame out of heaven." --LONGFELLOW. Love, that tender, inexplicable feeling which is the germinal essence of the human spirit, is the rudimental element of the human soul. It is, therefore, a Divine gift, a blessing which the Creator did not withdraw from his erring children, when they were driven from a paradise of innocence and loveliness into a world of desolation and strife. He left it as an invisible cord by which to draw the human heart ever upward, to a brighter home--the heavenly Eden. Love is the very essence of Divine law, the source of inspiration, even the fountain of life itself. It is spontaneous, generous, infinite. To its presence we are indebted for all that is good, true, and beautiful in Art and Nature. It endows humanity with countless virtues, and throws a mystic veil over our many faults. It is this feeling, this immutable law, which controls the destiny of the race. From its influence empires have fallen, scepters have been lost. Literature owes to Love its choicest gems. The poet's lay is sweeter when Cupid tunes the lyre. The artist's brush is truer when guided by Love. Greece was the cradle of letters and art. Her daughters were queens of beauty, fitted to inspire the Love of her noblest sons. [Illustration: Fig. 96.] The materialism of the nineteenth century has sought to degrade Love; to define it as purely physical. The result has been a corresponding degradation of art, and even literature has lost much of its lofty idealism. Nudity has become a synonym of vulgarity; Love, of lust. "Evil be to him who evil thinks." True Love never seeks to degrade its object; on the contrary, it magnifies every virtue, endows it with divinest attributes, and guards its chastity, or honor, at the sacrifice of its own life. It increases benevolence by opening the lover's heart to the wants of suffering humanity. Ideality is the canvas, and imagination the brush with which Love delineates the beauties of the adored. Love heightens spirituality, awakens hope, strengthens faith, and enhances devotion. It quickens the perceptions, intensifies the sensibilities, and redoubles the memory. It augments muscular activity, and imparts grace to every movement. The desire to love and to be loved is innate, and forms as much a part of our being as bone or reason. In fact, Love may be considered as the very foundation of our spiritual existence, as bone and reason are the essential bases of our physical and intellectual being. Every man or woman feels the influence of this emotion, sooner or later. It is the Kadesh-barnea of human existence; obedience to its intuitions insures the richest blessings of life, while neglect or perversion enkindles God's wrath, even as did the disobedience of the wandering Israelites. The one great fact which pervades the universe is _action_. The very existence of Love demands its activity, and, hence, the highest happiness is attained by a normal and legitimate development of this element of our being. The heart demands an object upon which to lavish the largess of its affection. In the absence of all others, a star, a flower, or even a bird, will receive this homage. The bird warbles a gay answer to the well-known voice, the flower repays the careful cultivator by displaying its richest tints, the star twinkles a bright "good evening" to the lonely watcher, and yet withal there is an unsatisfied longing in the lover's heart, to which neither can respond; the desire to be loved! Hence, the perfect peace of reciprocated love. If its laws are violated, nature seeks revenge in the utter depression or prostration of the vital energies. Thus has the Divine Law-giver engraven His command on our very being. To love is, therefore, a duty, the fulfillment of which should engage our noblest powers. This emotion manifests itself in several phases, prominent among which is filial affection, the natural harmonizer of society. Paternal love includes a new element--protection. Greater than either, and second only in fortitude to maternal affection, is CONJUGAL LOVE. "He is blest in Love alone Who loves for years and loves but one."--HUNT. With Swedenborg, we may assert, "_that there is given love truly conjugal, which at this day is so rare, that it is not known what it is, and scarce that it is_." The same author has defined this relation to be a union of Love and Wisdom. The fundamental law of conjugal love is _fidelity to one love_. God created but one Eve, and the essential elements of paternal and maternal love pre-suppose and necessitate, for their normal development, the Love of _one_ only. Again, Love is the sun of woman's existence. Only under its influence does she unfold the noblest powers of her being. Woman's intuitions should therefore be taken as the true love-gauge. If she desire a plurality of loves, it must be a law of her nature; but is communism the desire of our wives and daughters? No! Every act which renders woman dear to us, denounces such an idea and reveals the exclusive sacredness of her Love. As condemning promiscuity in this relation, we may cite the lovers' pledges and oaths of fidelity, the self-perpetuity of Love itself, the common instincts of mankind, as embodied in public sentiment, and the inherent consciousness that first love should he kept inviolable forever. Again, Love is conservative. It clings tenaciously to all the memories connected with its first object. The scenes consecrated to "Love's young dream" are sacred to every heart. The woodland with its winding paths and arbors, the streamlet bordered with drooping violets and dreamy pimpernel, the clouds, and even "the very tones in which we spoke," are indelibly imprinted on the memory. There is also the "mine and thine" intuition of love. This sentiment is displayed in every thought and act of the lover. Every pleasure is insipid unless shared by the beloved; selfish and exacting to all others, yet always generous and forgiving to the adored. "Mine and thine, dearest," is the language of Conjugal Love. The consummation desired by all who experience this affection, is the union of souls in a true marriage. Whatever of beauty or romance there may be in the lover's dream, is enhanced and spiritualized in the intimate communion of married life. The crown of wifehood and maternity is purer, more divine, than that of the maiden. Passion is lost; the emotions predominate. The connubial relation is not an institution; it was born of the necessities and desires of our nature. "It is not good for man to be alone," was the Divine judgment, and so God created for him "an helpmate." Again, "Male and female created He them;" therefore, sex is as divine as the soul. It is often perverted, but so is reason, aye, so is devotion. The consummation of marriage involves the mightiest issues of life. It may be the source of infinite happiness or the seal of a living death. "Love is blind" is an old saying, verified by thousands of ill-assorted unions. Many unhappy marriages are traceable to one or both of two sources, Physical Weaknesses and Masquerading. Many are the candidates for marriage who are rendered unfit therefor from weaknesses of their sexual systems, induced by the violation of well-established physical laws. We cannot too strongly urge upon parents and guardians the imperative duty of teaching those youths who look to them for instruction, in all matters which pertain to their future well-being such lessons as are embraced in the chapter of this book entitled, "Hygiene of the Reproductive Organs." By attending to such lessons as will give the child a knowledge of the physiology and hygiene of his whole system, the errors into which so many of the young fall, and much of the misery which is so often the dregs of the hymeneal cup, will be avoided. Masquerading is a modern accomplishment. Girls wear tight shoes, burdensome skirts, and corsets, all of which prove very injurious to their health. At the age of seventeen or eighteen, our young ladies are sorry specimens of womankind, and "palpitators," cosmetics, and all the modern paraphernalia of fashion are required to make them appear fresh and blooming. Man is equally to blame. A devotee to all the absurd devices of fashion, he practically asserts that "dress makes the man." But physical deformities are of far less importance than moral imperfections. Frankness is indispensable in love. Each should know the other's faults and virtues. Marriage will certainly disclose them; the idol falls and the deceived lover is transformed into a cold, unloving husband or wife. By far the greater number of unhappy marriages are attributable to this cause. In love especially, honesty is policy and truth will triumph. HISTORY OF MARRIAGE. POLYGAMY AND MONOGAMY. We propose to give only a brief dissertation on the principles and arguments of these systems, with special reference to their representatives in the nineteenth century. Polygamy has existed in all ages. It is, and always has been, the result of moral degradation or wantonness. The Garden of Eden was no harem. Primeval nature knew no community of love. There was only the union of two "and the twain were made one flesh." Time passed; "the sons of God saw the daughters of men that they were fair; and they took them wives of all which they chose." The propensities of men were in the ascendant, and "God repented Him that He had created man." He directed Noah to take into the ark, two of every sort, male and female. But "the imagination of man's heart is evil from his youth," and tradition points to Polygamy as the generally recognized form of marriage among the ancients. The father of the Hebrew nation was unquestionably a polygamist, and the general history of patriarchal life shows that a plurality of wives and concubines were national customs. In the earlier part of Egyptian history, Menes is said to have founded a system of marriage, ostensibly monogamous, but in reality it was polygamous, because it allowed concubinage. As civilization advanced, the latter became unpopular, and "although lawful, was uncommon," while polygamy was expressly forbidden. Solomon, according to polygamous principles, with his thousand women, should have enjoyed a most felicitous condition. Strange that he exclaimed "A woman among all these have I not found." According to the distinguished Rabbi, Maimonides, polygamy was a Jewish custom as late as the thirteenth century. When Cecrops the Egyptian King, came to Athens (1550, B.C.) he introduced a new system, which proved to be another step toward the recognition of Monogamy. Under this code a man was permitted to have one wife and a concubine. Here dawned the era of Grecian civilization, the glory of which was reflected in the social and political principles of Western Europe. During the fourth and fifth centuries B.C., concubinage disappeared, but, under the new regime, the condition of the wife was degraded. She was regarded as simply an instrument of procreation and a mistress of the household, while a class of foreign women, who devoted themselves to learning and the fine arts, were the admired, and often the beloved companions of the husbands. These were the courtesans who played the same role in Athenian history, as did the chaste matron, in the annals of Rome. When Greece became subject to Rome and the national characteristics of these nations were blended, marriage became a loose form of monogamy. In Persia, during the reign of Cyrus, about 560 B.C., polygamy was sustained by custom, law, and religion. The Chinese marriage system was, and is, practically polygamous, for, from their earliest traditions, we learn that although a man could have but one wife, he was permitted to have as many concubines as he desired. In the Christian era the first religious system which incorporated polygamy as a principle was Mohammedanism. This system, which is so admirably adapted to the voluptuous character of the Orientals, has penetrated Western Europe, Asia, and Africa. Hayward estimated the number of its adherents to be one hundred and forty millions. The heaven of the Mohammedan is replete with all the luxuries which appeal to the animal propensities. Ravishing Houris attend the faithful, who recline on downy couches, in pavilions of pearl. On the Western Continent a system of promiscuity was practiced by the Mexicans, Peruvians, Brazilians, and the barbarous tribes of North America. The Mormon Church was founded by Joseph Smith, and professes to be in harmony with the Bible and a special revelation to its leading Saint. According to the Mormon code, "Love is a yearning for a higher state of existence, and the passions, properly understood, are feeders of the spiritual life;" and again, "nature is dual; to complete his organization a man must marry." The leading error of Mormonism is that it mistakes a legal permission for a Divine command. The Mormon logic may be premised as follows: the Mosaic law allowed polygamy; the Bible records it; therefore, the Bible _teaches_ polygamy. A Mormon Saint can have not less than three wives but as many more as he can conveniently support. The eight fundamental doctrines of the Mormon Church are stated as follows: 1. God is a person with the flesh and form of a man. 2. Man is a part of the substance of God and will himself become a god. 3. Man is not created by God but existed from all eternity. 4. Man is not born in sin, and is not accountable for offenses other than his own. 5. The earth is a colony of embodied spirits, one of many such settlements in space. 6. God is president of the immortals, having under Him four orders of beings: (1.) Gods--_i.e._, immortal beings, possessed of a perfect organization of soul and body, being the final state of men who have lived on earth in perfect obedience to the law. (2.) Angels, immortal beings who have lived on earth in imperfect obedience to the law. (3.) Men, immortal beings in whom a living soul is united with a human body. (4.) Spirits, immortal beings, still waiting to receive their tabernacle of flesh. 7. Man, being one of the race of gods, became eligible, by means of marriage, for a celestial throne, and his household of wives and children are his kingdom, not only on earth but in heaven. 8. The kingdom of God has been again founded on earth, and the time has now come for the saints to take possession of their own; but by virtue, not by violence; by industry, not by force. This sect has met with stern and bitter opposition. It was successively located in New York, Ohio, Missouri, and Illinois, from the last of which it was expelled by force of arms, and in 1848 established in Utah. Its adherents number, at the present time, more than two hundred thousand. Another organization, differing from the Mormons, in many of its radical principles, is that of the "Communists," popularly termed "Free Lovers." It is located at Lennox, Madison Co., N.Y. Its members advocate a system of "complex marriage" which they claim is instituted with a conscientious regard for the welfare of posterity. They disclaim "promiscuity," and assert that the tie which binds them together is as permanent and as sacred as that of marriage. Community of property is commensurate with freedom of Love. They define love to be "social appreciation," and this element in their code of civilization, which they deem superior to all others, is secondary to "bodily support." The principles upon which their social status is founded may be briefly summarized as follows: "Man offers woman support and love (unconditional). Woman enjoying freedom, self-respect, health, personal and mental competency, gives herself to man in the boundless sincerity of an unselfish union. State--, Communism." In this, as in all forms of polygamous marriages, love is made synonymous with sexuality, and its purely spiritual element is lost. In every instance this spiritual element should constitute the basis of marriage, which, without it, is nothing more than legal prostitution. Without it, the selfish, degrading, animal propensities run rampant, while the emotions with all their boundless sweetness lie dormant. Woman is regarded as only a plaything to gratify the animal caprice. That Monogamy is a law of nature is evident from the fact that it fulfills the three essential conditions which form the basis of true marriage: (1.) The development of the individual (2.) The welfare of society. (3.) The reproduction of the species. THE DEVELOPMENT OF THE INDIVIDUAL. PHYSICALLY. Reciprocated love produces a general exhilaration of the system. The elasticity of the muscles is increased, the circulation is quickened, and every bodily function is stimulated. The duties of life are performed with a zest and alacrity never before experienced. "It is not possible for human beings to attain their full stature of humanity, except by loving long and perfectly. Behold that venerable man! He is mature in judgment, perfect in every action and expression, and saintly in goodness. You almost worship as you behold. What rendered him thus perfect? What rounded off his natural asperities, and moulded up his virtues? Love mainly. It permeated every pore, so to speak, and seasoned every fiber of his being, as could nothing else. Mark that matronly woman. In the bosom of her family, she is more than a queen and goddess combined. All her looks and actions express the outflowing of some or all of the human virtues. To know her is to love her. She became thus perfect, not in a day or a year, but by a long series of appropriate efforts. Then by what? Chiefly in and by love, which is specifically adapted thus to develope this maturity." But all this occurs only when there is a normal exercise of the sexual propensities. Excessive indulgence in marital pleasures deadens all the higher faculties, love included, and results in an utter prostration of the bodily powers. The Creator has endowed man and woman with passions, the suppression of which leads to pain, their gratification to pleasure, their satiety to disgust. Excessive marital indulgence produces abnormal conditions of the generative organs and not unfrequently leads to incurable disease. Many cases of uterine disease are traceable to this cause. MORALLY AND INTELLECTUALLY. In no country where the polygamous system prevails do we find a code of political and social ethics which recognizes the rights and claims of the individual. The condition of woman is that of the basest slave, a slave to the caprice and tyranny of her master. Communism raises her from the slough of slavery, but subjects her to the level of prostitution. An inevitable sequence of polygamy is a decline of literature and science. The natural tendency of each system is to _sensualism._, The blood is diverted from its normal channels and the result is a condition which may be appropriately termed _mental starvation_. Sensualism is in its very nature directly opposed to literary attainments or advancement. Happily there is a golden mean, an equalization of those elements which constitutes the acme of individual enjoyment. THE WELFARE OF SOCIETY. The general law of ethics, that "whatever is beneficial to the individual, contributed to the highest good of society and _vice versa_," applies with equal force to the hygienic conditions of marriage. Each family, like the ancient Roman household, is the prototype of the natural government under which it lives. Wherever the marriage relation is regarded as sacred, there you will find men of pure hearts and noble lives. Of all foreign nations the Germans are celebrated for their sacred regard of woman, and the duties of marriage, and all scholars from the age of Tacitus to the present day, have concurred in attributing the elevation of woman to the pure-minded Teutons. In America, the law recognizes only Monogamy; but domestic unhappiness is a prominent feature of our national life; therefore, argues the would-be free-lover, monogamy does not accord with the best interests of mankind. The fallacy lies in the first premise. Legally, our marriage system is monogamous but _socially_ and _practically_ it is _not!_ Prostitution is the source of this domestic infelicity. The "mistress" sips the sweet nectar that is denied to the deceived wife. Legislators have battled with intemperance, but have done comparatively little to banish from our midst this necessary (?) evil. They recoil with disgust from this abyss of iniquity and disease. Within it is coiled a hydra-headed monster, which invades our hearthstones, contaminates our social atmosphere, and whose very breath is laden with poisonous vapors, the inexhaustible source of all evil. The perverted appetites of mankind are mistaken for the natural desires and necessities of our being; and, accordingly, various arguments have been advanced to prove that monogamy is not conducive to social developement. It is curious that no one of these arguments refers to the health and well-being of the _individual_, thus overlooking, perhaps willfully, the great law of social economy. Even a few medical writers sometimes advocate the principles of this so-called liberalism. In a recently published work, there are enumerated only _two_ demerits of polygamy and _six_ of monogamy. These six demerits which the author is pleased to term a "bombshell," he introduces on account of his moral convictions no less than humanitarian considerations. The same author terms monogamy a "worm-eaten and rotten-rooted tree." The worm that is devastating the fairest tree of Eden and draining its richest juices is what our contemporary thinks, may be "_plausibly termed, a necessary evil_." It is claimed that monogamy begets narrow sympathies and leads to selfish idolatry. The fallacy of this argument lies in the misapprehension of the term _selfishness_. Self-preservation is literally selfishness, yet who will deny that it is a paramount duty of man. If perverted, it may be vicious, even criminal; but selfishness, in so far as it is generated by monogamy, is one of the chief elements of social economy; furthermore, it favors the observance of the laws of sexual hygiene. As we have said elsewhere, true love _increases benevolence_, and correspondingly expands and develops the sympathies. Selfish idolatry is preferable to social neglect. This argument will not bear a critical examination; for it is asserted that in a happy union, "love is so exclusive that there is hardly a liking for good neighbors, and scarcely any love at all for God." If the "good neighbors" were equally blessed, they would not suffer from this exclusiveness, and it is practically true that there is no higher incentive to love and obey our Maker than the blessing of a happy marriage. THE PERPETUATION OF THE SPECIES. The third essential object of marriage is the perpetuation of the species. The desire for offspring is innate in the heart of every true man or woman. It is thus a law of our nature, and, as such, must have its legitimate sphere. The essential features of reproduction proclaim monogamy to be the true method of procreation. Promiscuity would render the mother unable to designate the father of her children. Among lower animals, pairing is an instinctive law whenever the female is incapable of protecting and nourishing her offspring alone. During at least fifteen years, the child is dependent for food and clothing upon its parents, to say nothing of the requisite moral training and loving sympathy, which, in a great measure, mould its character. Fidelity to one promotes multiplication. It has been argued by the advocates of polygamy that such a system interferes with woman's natural right to maternity. Of the many marriages celebrated yearly, comparatively few are sterile. The statement that many single women are desirous of having children, would apply only to a very limited number, as it is seldom that they would be able to support children without the aid and assistance of a father. Promiscuity diminishes the number and _vitiates_, the quality of the human products. "Women of pleasure never give to the world sons of genius, or daughters of moral purity." * * * * * CHAPTER XVII. REPRODUCTION. Every individual derives existence from a _parent_, which word literally means one who brings forth. We restrict the meaning of the term _reproduction_, ordinarily, to that function by which living bodies produce other living bodies similar to themselves. _Production_ means to bring forth; _reproduction_, the producing again, or renewing. To protract individual existence, nutrition is necessary, because all vital changes are attended by _wear_ and _waste_. Nutrition is always engaged in the work of reparation. Every organism that starts out upon its career of development depends upon nourishing materials for its growth, and upon this renewing process for its development. Nutrition is all the while necessary to prolong the life of the individual, but at length its vigor wanes, its functions languish, and, finally, the light of earthly life goes out. Although the single organization decays and passes away, nevertheless the species is uninterruptedly continued; the tidal wave of life surges higher on the shores of time, for reproduction is as constant and stable as the attractive forces of the planetary system. It is a fact, that many species of the lower order of animals which once existed are now extinct. It has been asserted and denied, that fossil remains of man have been found, indicating that races which once existed have disappeared from the face of the earth. The pyramids are unfolding a wonderful history, embracing a period of forty-five hundred years, which the world of science receives as literally authentic, and admits, also, that fifty-four hundred years are _probably_ as correctly accounted for. The extinction of races is not at all improbable. At the present time, the aboriginal inhabitants of this continent seem to be surely undergoing gradual extinguishment! It, therefore, seems to be possible for a weaker race to deteriorate, and finally become extinct, unless the causes of their decadence can be discovered and remedied. All people are admonished to earnestly investigate the essential conditions necessary for their continuance, for the rise and fall of nations is in obedience to natural principles and operations. Viewed from this standpoint, it is possible that a careful study of the human temperaments and their relations to reproduction may be of greater moment than has hitherto been supposed, and a proper understanding of them may tend to avert that individual deterioration, which, if suffered to become general, would end in national disaster and the extinction of the race. Until recently, even naturalists believed that descendants were strictly like their parents in form and structure. Now it is known that the progeny may differ in both form and structure from the parent, and that these may produce others still more unlike their ancestry. But all these peculiar and incidental deviations finally return to the original form, showing that these changes have definite limits, and that the alterations observe a specific variableness, which is finally completed by its assuming again the original form. (See page 16, Figs. 2 and 3). _Reproduction_ may be _sexual_ or _non-sexual._ In some plants and animals it is non-sexual. The propagation of species is accomplished by buds. Thus the gardener grafts a new variety of fruit upon an old stock. The florist understands how to produce new varieties of flowers, and make them radiantly beautiful in their bright and glowing colors. The bud personates the species and produces after its kind. Some of the _annelides_, a division of articulate animals, characterized by an elongated body, formed of numerous rings or annular segments, multiply by spontaneous division. A new head is formed at intervals in certain segments of the body. (See Fig. 97). Something similar to this process of budding, we find taking place in a low order of animal organization. Divide the fresh water polyp into several pieces, and each one will grow into an entire animal. Each piece represents a polyp, and so each parent polyp is really a compound animal, an organized community of beings. Just as the buds of a tree, when separated and engrafted upon another tree, grow again, each preserving its original identity, so do the several parts of this animal, when divided, become individual polyps, capable of similar reproduction. [Illustration: Fig. 97. An annelid dividing spontaneously, a new head having been formed toward the hinder part of the body of the parent.] The revolving volvox likewise increases by growth until it becomes a society of animals, a multiple system of individuals. There are apertures from the parent, by which water gains a free access to the interior of the whole miniature series. This monad was once supposed to be a single animal, but the microscope shows it to be a group of animals connected by means of six processes, and each little growing volvox exhibits his red-eye speck and two long spines, or horns. These animals also multiply by dividing, and thus liberate another series, which, in their turn, reproduce other groups. Generation requires the concurrence of _stimuli_ and _susceptibility_, and, to perfect the process, two conditions are also necessary. The first is the sperm, which communicates the principle of action; the other is the germ, which receives the latent life and provides the conditions necessary to organic evolution. The vivifying function belongs to the male, that of nourishing and cherishing is possessed by the female; and these conditions are sexual distinctions. The former represents _will_ and _understanding_; the latter, _vitality_ and _emotion_. The father directs and controls, the mother fosters and encourages; the former counsels and admonishes, the latter persuades and caresses; and their union in holy matrimony represents one; that is, the blending of vitality and energy, of love and wisdom,--the elements indispensable to the initiation of life under the dual conditions of male and female,--_one in the functions of reproduction_. Let us consider the modes of Sexual Reproduction, which are _hermaphroditic_ and _dioecious_. HERMAPHRODITIC REPRODUCTION. We have said that two kinds of cells represent reproduction, namely, sperm and germ-cells. These may be furnished by different individuals, or both may be found in one. When both are found in the same individual, the parent is said to be a _natural hermaphrodite_. A perfect hermaphrodite possesses the attributes of both male and female--uniting both sexes in one individual. Natural hermaphroditic reproduction occurs only among inferior classes of animals, and naturalists inform us that there are a greater number of these than of the more perfect varieties. These are found low in the scale of animal organization, and one individual is able to propagate the species. In the oyster and ascidians no organs can be detected in the male, but in the female they are developed. Polyps, sponges, and cystic entozoa, may also be included among hermaphrodites. It is only very low organisms indeed in which it is a matter of indifference whether the united sperm-cells and germ-cells are those of the same individual, or those of different individuals. In more elaborate structures and highly organized beings, the essential thing in fertilization is the union of these cells specially endowed by _different_ bodies, the unlikeness of derivation in these united reproductive centers being the desideratum for perpetuating life and power. In other classes, as _entozoa_, there appear to be special provisions whereby the sperm-cells and germ-cells may be united; _i.e._, the male organs are developed and so disposed as to fecundate the ova of the same individual. Sexual and non-sexual modes of reproduction are illustrated by that well-defined group of marine invertebrate animals, called _cirripedia_ Fig. 98 represents one of this genus. [Illustration: Fig. 98. Pollicipes Mitella.] Some of these are not only capable of self-impregnation, but likewise have what are called _complemental males_ attache to some of the hermaphrodites. In the whole animal kingdom, it may be doubted if there exists another such class of rudimentary creatures as the parasitic males, who possess neither mouth, stomach, thorax, nor abdomen. After exerting a peculiar sexual influence, they soon die and drop off; so that in this class of animals may be found the sexual distinctions of male, female, and perfect hermaphrodites. [Illustration: Fig. 99. Rotiferia; Brachionus Urceolaris; largely magnified. ] There is a class of wheel-animalcules termed _rotifera_, of which the revolving volvox is one example. They have acquired this name on account of the apparent rotation of the disc-like organs which surround their mouths and are covered with _cilia_, or little hairs. They are minute creatures, and can best be viewed with a microscope, although the larger forms may be seen without such assistance. They are widely diffused on the surface of the earth, inhabit lakes as well as the ocean, and are found in cold, temperate, and tropical climates. The rotifera were once supposed to be hermaphrodites, but the existence of sexes in one species has been clearly established. The male, however, is much smaller, and far less developed than the female. In some of these species, germ-cells, or eggs, are found, which do not require fecundation for reproduction or development, so that they belong to the non-sexual class. The third variety of hermaphrodites embraces those animals in which the male organs are so disposed as not to fecundate the ova of the same body, but require the co-operation of two individuals, notwithstanding the co-existence in each of the organs of both sexes. Each in turn impregnates the other. The common leech, earth-worm, and snail, propagate in this manner. _Unnatural hermaphrodism_ is characteristic of insects and crustaceans, in which the whole body indicates a neutral character, tending to exhibit the peculiarities of male or female, in proportion to the kind of sexual organs which predominates. Half of the body may be occupied by male, the other half by female organs, and each half reflects its peculiar sexual characteristics. Some butterflies are dimidiate hermaphrodites; _i.e._ one side of the body has the form and color of the male, the other the form and color of the female. The wings show by their color and appearance these sexual distinctions. The stag-beetle is also an example. We have accounts of dimidiate hermaphrodite lobster, male in one half and female in the other half of the body. Among the numerous classes of higher animals, which have red blood, we have heard of no well-authenticated instance of hermaphrodism, or the complete union of _all_ the reproductive organs in one individual. True, the term _hermaphrodite_ is often applied to certain persons in whom there is some malformation, deficiency, or excess, of the genital organs. These congenital deformities consisting of combined increase or deficiency, supernumerary organs, or transposition of them, which usually render generation physically impossible, have been called _bisexual hermaphrodism_ and classed as monstrosities. We have many published accounts of them, hence, further reference to them here is unnecessary. We would especially refer those readers who may desire to make themselves further acquainted with this interesting subject, to the standard physiological works of Flint, Foster, Carpenter, Bennett, Dalton, and others equally eminent in this particular branch of science. Certain theories have been advanced concerning conditions which may influence the sex of the offspring. One is that the right ovary furnishes the germs for males, the left for females that the right testicle furnishes sperm capable of fecundating the germs of males, and the left testicle, the germs of the left ovary, for females. That fecundation sometimes takes place from right to left and thus produces these abnormal variations. We merely state the hypothesis, but do not regard it as accounting for the distinction of sex, or as causing monstrosities, though it is somewhat plausible as a theory, and is not easily disproved. In the lower order of animals, as sheep and swine, one of the testicles has been removed, and there resulted afterward both male and female progeny, so that the theory seems to lack facts for a foundation. We sometimes witness in the child excessive development, as five fingers, a large cranium, which results in dropsical effusion, or deficient brain, as in idiots; sometimes a hand or arm is lacking, or possibly there is a dual connection, as in the case of the Siamese twins; or, two heads united on one body. It is difficult to give any satisfactory explanation of these abnormal developments. From age to age, the type is _constant_, and preserves a race-unity. The crossings of the races are only transient deviations, not capable of perpetuation, and quickly return again to the original stock. This force is persistent, for inasmuch as the individual represents the race, so does his offspring represent the parental characteristics, in tastes, proclivities, and morals, as well as in organic resemblances. This constancy is unaccountable, and more mysterious than the occasional malformation of germs in the early period of foetal life. If to every deviation from that original form and structure, which gives character to the productions of nature, we apply the term _monster_, we shall find but very few, and from this whole class there will be a very small number indeed of _sexual_ malformations. If the sexes be deprived of the generative organs, they approach each other in disposition and appearance. All those who are partly male and partly female in their organization, unite, to a certain extent, the characteristics of both sexes. When the female loses her prolific powers, many of her sexual peculiarities and attractions wane. DIOECIOUS REPRODUCTION. _Dioecious_ is a word derived from the Greek, and signifies _two households;_ hence, _dioecious reproduction_ is sexual generation by male and female individuals. Each is distinguished by sexual characteristics. The male sexual organs are complete in one individual, and all the female organs belong to a separate feminine organization. In some of the vertebrates, impregnation does not require sexual congress; in other words, fecundation may take place _externally_. The female fish of some species first deposits her ova, and afterwards the male swims to that locality and fertilizes them with sperm. In higher orders of animals, fecundation occurs _internally_, the conjunction of the sperm and germ cells requiring the conjugation of the male and female sexual organs. The sperm-cells of the male furnish the quickening principle, which sets in play all the generative energies, while the germ-cell, susceptible to its vivifying presence, responds with all the conditions necessary to evolution. The special laboratory which furnishes spermatic material is the _testes_, while the stroma of the _ovaries_ contributes the germ-cell. Several different modes of reproducing are observed when fecundation occurs within the body, which vary according to the peculiarities and organization of the female. MODES OF DIOECIOUS REPRODUCTION.--A very familiar illustration of one mode is found in the common domestic fowl, the egg of which vivified within the ovarium, is afterward expelled and hatched by the simple agency of warmth. This mode of reproduction is called _oviparous generation_. The ovaries, as well as all their latent germs, are _remarkably_ influenced by the first fecundation. It seems to indicate monogamy as the rule of higher sexual reproduction. The farmer understands that if he wishes to materially improve his cows, the first offspring must be begotten by a better, purer breed, and all that follow will be essentially benefited, even if not so well sired. Neither will the best blood exhibit its most desirable qualities in the calves whose mothers have previously carried inferior stock. So that there are sexual ante-natal influences which may deteriorate the quality of the progeny. The Jews understood this principle, in the raising up of sons and daughters unto a deceased brother. The fact that the sexual influence of a previous conception is not lost, is illustrated when, in a second marriage, the wife bears a son or daughter resembling bodily or mentally, or in both of these respects the former husband. This indicates a union for life by natural influences which never die out. With some species of fish and reptiles, the egg is impregnated internally, and the process of _laying_ commences immediately, but it proceeds so slowly through the excretory passages, that it is hatched and born alive. This is called _ovo-viviparous generation_. As we rise in the scale of organization, animals are more completely developed, and greater economy is displayed in their preservation. The germ passes from the ovary into an organ prepared for its reception and growth, to which, after fecundation, it becomes attached, and where it remains until sufficiently developed to maintain respiratory life. This organ is called the _womb_, or _uterus_, and is peculiar to most mammalia. This mode of reproduction is termed _viviparous generation_. The kangaroo and oppossum are provided with a pouch attached to the abdomen, which receives the young born at an early stage of development. They remain in contact with the mammæ, from which they obtain their nourishment, until their growth is sufficiently completed to maintain an independent existence. This is called _marsupial generation_. The variety of reproduction which is most interesting, is that of the human species, and is called _viviparous generation_. It includes the functions of copulation, fecundation, gestation, parturition, and lactation. For the full and perfect development of mankind, both mental and physical chastity is necessary. The health demands abstinence from unlawful intercourse. Therefore children should not be allowed to read impure works of fiction, which tend to inflame the mind and excite the passions. Only in total abstinence from illicit pleasures is there moral safety and health, while integrity, peace, and happiness, are the conscious rewards of virtue. Impurity travels downward with intemperance, obscenity, and corrupting diseases, to degradation and death. A dissolute, licentious, free-and-easy life is filled with the dregs of human suffering, iniquity, and despair. The penalties which follow a violation of the law of chastity are found to be severe and swiftly retributive. [Illustration: Fig. 100. Male] [Illustration: Fig. 101. Female] [Illustration: Fig. 102. Outline of the Female Urinary and Generative Organs.] The union of the sexes in holy matrimony is a law of nature finding sanction in both morals and legislation. Even some of the lower animals unite in this union for life, and instinctively observe the law of conjugal fidelity with a consistency which might put to blush other animals more highly endowed. It is important to discuss this subject and understand our social evils, as well as the unnatural desires of the sexes, which must be controlled or they lead to ruin. Sexual propensities are possessed by all, and they must be held in abeyance, until they are exercised for legitimate purposes. Hence parents ought to understand the value of mental and physical labor to elevate and strengthen the intellectual and moral faculties of their children, to develop the muscular system and direct the energies of the blood into healthful channels. Vigorous employment of mind and body engrosses the vital energies and diverts them from undue excitement of the sexual desires. [Illustration: Fig. 103. Outline of the Male Reproductive Organs.] Sexual generation by pairing individuals is the most economical mode of propagating the species. The lower orders of animals possess wonderful multiplicative powers and their faculty for reproduction is offset by various destructive forces. The increased ability for self-maintenance implies diminished reproductive energy; hence the necessity for greater economy and safety in rearing the young. As certain larvae and insects increase, the birds which feed upon them become more numerous. When this means of support becomes inadequate, these same birds diminish in number in proportion to the scarcity of their food. Many have remarked that very prolific seasons are followed by unusual mortality, just as periods of uncommon prosperity precede those of severe disaster. The increased mental and moral cultivation of mankind imposes upon them the necessity for greater physical culture. "Wiser and weaker," is a trite saying, and means that the exercise of the higher nature discloses the equivalent necessity of culturing the body, in order to support the increasing expenditures of the former. Mental and moral discipline are essential for a proper understanding how to provide for the body, for physical training increases the capacity of the individual for self-preservation. Constant vigilance is the price of health as well as of liberty. It is an interesting physiological fact that, while the growth and development of the individual are rapidly progressing, the reproductive powers remain almost inactive, and that the commencement of reproduction not only indicates an arrest of growth, but, in a great measure, contributes toward it. From infancy to puberty, the body and its individual organs, structurally as well as functionally, are in a state of gradual and progressive evolution. Men and women generally increase in stature until the twenty-fifth year, and it is safe to assume that perfection of function is not established until maturity of bodily development is completed. Solidity and strength are represented in the organization of the male, grace, and beauty in that of the female. His broad shoulders represent physical power and the right of dominion, while her bosom is the symbol of love and nutrition. The father encounters hardships, struggles against difficulties, and braves dangers to provide for his household; the mother tenderly supplies the infant's wants, finding relief and pleasure in imparting nourishment, and surrounds helpless infancy with an affection which is unwearied in its countless ministering attentions. Her maternal functions are indicated by greater breadth of the hips. Physical differences so influence their mental natures, that, "before experience has opened their eyes, the dreams of the young man and maiden differ." The development of either is in close sympathy with their organs of reproduction. Any defect of the latter impairs our fair ideal, and detracts from those qualities which impart excellence, and crown the character with perfections. Plainly has Nature marked out, in the organization, very different offices to be performed by the sexes, and has made these distinctions fundamental. Likewise, Nature expresses the intention of reproduction by giving to plants and animals distinctive organs for this purpose. These are endowed with exquisite sensibility, so that their proper exercise produces enjoyment beneficial to both. Excessive sexual indulgence not only prostrates the nervous system, enfeebles the body, and drains the blood of its vivifying elements, but is inconsistent with intellectual activity, morality, and spiritual development. The most entrancing delights and consummate enjoyments are of the emotive order, ideal, abstract, and pure, so inspiring that they overpower the grosser sensual pleasures and diffuse their own sweet chastity and refining influence over all the processes of life. Hence, the gratification of the sexual instincts should always be moderate. It should be regulated by the judgment and will, and kept within the bounds of health. No person has a moral right to carry this indulgence so far as to produce injurious consequences to either party, and he who cannot refrain from it is in no proper condition to propagate his species. In all culture there must be self-control, and the practice of self-denial at the command of love and justice is always a virtue. Self-government is the polity of our people, and we point with pride and laudable exultation to our political maxims, laws, and free institutions. The family is the prototype of society. If self-restraint be practiced in the marital relation, then the principle of self-control will carry health, strength, and morality into all parts of the commonwealth. The leading characteristics of any nation are but the reflection of the traits of its individual members, and thus the family truly typifies the practical morality and enduring character of a people. OVULATION. The _Ovaries_ are those essential parts of the generative system of the human female in which the ova are matured. There are two ovaries, one on each side of the uterus, and connected with it by the Fallopian tubes; they are ovoidal bodies about an inch in diameter, and furnish the _germs_ or ovules. These latter are very minute, seldom measuring 1/120 of an inch in diameter, and frequently are not more than half that size. The ovaries develop with the growth of the female, so that, finally, at the pubescent period, they ripen and liberate an ovum, or germ vesicle, which is carried into the uterine cavity through the Fallopian tubes. With the aid of the microscope, we find that these ova are composed of granular substance, in which is found a miniature yolk surrounded by a transparent membrane, called the _zona pellucida_. This yolk contains a germinal vesicle in which can be discovered a nucleus, called the _germinal spot_. The process of the growth of the ovaries is very gradual, and their function of ripening and discharging an ovum every month into the Fallopian tubes and uterus is not developed until between the twelfth and fifteenth years. This period, which indicates, by the feelings and ideas, the desires and will, that the subjects are capable of procreation, is called _puberty_. The mind acquires new and more delicate perceptions, the person becomes plumper, the mammæ enlarge, and there is grace and perfection in every movement, a conscious completeness for those relations of life for which this function prepares them. The period of puberty is also indicated by MENSTRUATION. The catamenial discharge naturally follows the ripening and liberation of an ovum, and as the ovaries furnish one of these each month, this monthly flow is termed the _menses_ (the plural of the Latin word _mensis_, which signifies a month). The menstrual flow continues from three to five days, and is merely the exudation of ordinary venous blood through the mucous lining of the cavity of the uterus. At this time, the nervous system of females is much more sensitive, and from the fact that there is greater aptitude to conception immediately before and after this period, it is supposed that the sexual feeling is then the strongest. When impregnation occurs immediately before the appearance of the menses, their duration is generally shortened, but not sufficiently to establish the suspicion that conception has taken place. The germ is the contribution of the female, which provides the conditions which only require the vivifying principle of the sperm for the development of another being. The period of aptitude for conception terminates at the time both ovulation and menstruation cease, which, unless brought about earlier by disease, usually occurs about the forty-fifth year of her age. FECUNDATION. Since in the beginning God created male and female, and said unto them, "Be fruitful, and multiply, and replenish the earth," it is evident that what was originated by creation must be continued by procreation. The process of generation the reader will find described on pages 12 and 13. Then commences a wonderful series of transforming operations, rudimentary changes preliminary to the formation of tissues, structures and functions, which finally qualify the organism for independent existence. The ovum, when expelled from the ovary, enters the fimbriated, or fringe-like extremity of the Fallopian tube, to commence at once its descent to the uterus. The process of passing through this minute tube varies in different animals. In birds and reptiles, the bulk of the expelled ova is so great as to completely fill up the tube, and it is assisted in its downward course, partly by its own weight and partly by the peristaltic action of the muscular coat of the canal. In the human subject, however, the ova are so minute that nature has supplied a special agent for their direct transmission; otherwise they might be retained, and not reach their destination. Accordingly, the fimbriated, trumpet-shaped extremity of the Fallopian tubes, which is nearest to the ovaries, and, consequently from the ovary first receives the ovum when expelled; is provided with a series of small hairs, termed _cilia_, forming the lining or basement membrane of the tubes, and, the movements of these cilia being towards the uterus, transmit, by their vibrating motion, the ovum from the ovary, through the Fallopian tubes, to the uterus. The mature ovum, however, is not by itself capable of being converted into the embryo. It requires fecundation by the spermatic fluid of the male, and this may take place immediately on the expulsion of the ovum from the ovary, or during its passage through the Fallopian tube, or, according to Bischoff, Coste, and others, in the cavity of the uterus, or even upon the surface of the ovary. Should impregnation, however, fail, the ovum gradually loses its vitality, and is eventually expelled by the uterine secretions. It occasionally happens that the descent of the impregnated ovum is arrested, and the formation of the embryo commences in the ovary. This is termed _ovarian pregnancy_. Or again, the ovum may be arrested in its passage through the Fallopian tube, causing what is termed _tubal pregnancy_; or, after it has been expelled from the ovary, it may fail to be received by the fimbriated extremity, and escape into the cavity of the abdomen, forming what has been termed _ventral pregnancy_. If the microscopic germ lodges in some slight interstice of fiber, during its passage through the walls of the uterus, it may be detained long enough to fix itself there, and when this occurs, it is termed _interstitial pregnancy_. All these instances of extra-uterine pregnancy may necessitate the employment of surgical skill, in order that they may terminate with safety to the mother. Their occurrence, however, is very rare. The intense nervous excitement produced by the act of coition is immediately followed by a corresponding degree of depression, and a too frequent repetition of it is necessarily injurious to health. The secretions of the seminal fluid being, like other secretions, chiefly under the influence of the nervous system, an expenditure of them requires a corresponding renewal. This renewal greatly taxes the corporeal powers, inducing lassitude, nervousness, and debility. It is a well known fact that the highest degree of mental and bodily vigor is inconsistent with more than a moderate indulgence in sexual intercourse. To ensure strength, symmetry, and high intellectual culture in the human race, requires considerable care. Consideration should be exercised in the choice of a companion for life. Constitutional as well as hereditary ailments demand our closest attention. Age has also its judicious barriers. As before stated, when reproduction commences, growth, as a rule, ceases, therefore, it is inexpedient that matrimony should be consummated before the parties have arrived at mature stature. PREVENTION OF CONCEPTION. Much has been written upon the question whether married people have a right to decline the responsibilities of wedlock. The practice of inducing abortion is not only immoral but criminal, because it is destructive to both the health of the mother and the life of the embryo being. If both the parties to a marriage be feeble, or if they be not temperamentally adapted to each other, so that their children would be deformed, insane, or idiotic, then to beget offspring would be a flagrant wrong. If the mother is already delicate, possessing feeble constitutional powers, she is inadequate to the duties of maternity, _and it is not right to lay such burdens upon her_. Self-preservation is the first law of nature, which all ought to respect. The woman may be able to discharge the duties of a loving wife and companion, when she cannot fulfill those of child-bearing. If the husband love his wife as he ought, he will resign all the pleasure necessary to secure her exemption from the condition of maternity. It seems to us, that it is a great wickedness, unpardonable even, to be so reckless of consequences, and so devoid of all feeling, as to expose a frail, feeble, affectionate woman to those perils which almost insure her death. To enforce pregnancy under such circumstances is a crime. Every true man, therefore, should rather practice self-control and forbearance, than entail on his wife such certain misery, if not danger to life. Undoubtedly, the trial is great, but if a sacrifice be required, let the husband forbear the gratification of passions which will assuredly be the means of developing in his delicate wife symptoms that may speedily hurry her into a premature grave. Before she has recovered from the effects of bearing, nursing, and rearing one child, ere she has regained proper tone and vigor of body and mind, she is unexpectedly overtaken, _surprised_ by the manifestation of symptoms which again indicate pregnancy. Children thus begotten are not apt to be hardy and long-lived. From the love that parents feel for their posterity, from their wishes for their success, from their hopes that they may be useful from every consideration for their future well-being, let them exercise precaution and forbearance, until the wife becomes sufficiently healthy and enduring to bequeath her own vital stamina to the child she bears. From what has been said on this subject, it behooves the prudent husband to weigh well the injurious, nay criminal results which may follow his lust. Let him not endanger the health, and it may be the life, of his loving and confiding wife through a lack of self-denial. Let him altogether refrain, rather than be the means of untold misery and, perhaps, the destruction of the person demanding his most cherished love and protection. On so important a subject, we feel we should commit an unpardonable wrong were we not to speak thus plainly and openly. An opportunity has been afforded us, which it would be reprehensible to neglect. We shall indeed feel we have been amply rewarded, if these suggestive remarks of ours tend in any way to remove or alleviate the sufferings of an uncomplaining and loving wife. Our sympathies, always susceptible to the conditions of sorrow and suffering, have been enlisted to give faithfully, explicitly, and plainly, warnings of danger and exhortations to prudence and nothing remains for us but to maintain the principles of morality, and leave to the disposal of a wise and overruling Providence the mystery of all seemingly untoward events. In every condition of life, evils arise, and most of those which are encountered are avoidable. Humanity should be held accountable for those evils which it might, but does not shun. By a statute of the national government, prevention of pregnancy is considered a punishable offense; whereas every physician is instructed by our standard writers and lecturers on this subject, that not only prevention is necessary in many instances, but even abortion must sometimes be produced in order to save the mother's life. As we view the matter, the law of the national government asserts the ruling principle, and the exceptions to it must be well established by evidence, in order to fully justify such procedure. The family physician may, with the concurrence of other medical counselors, be justified, in rare cases, in advising means for the prevention of conception, but he should exercise this professional duty _only_ when the responsibility is shared by other members of the profession, and the circumstances fully and clearly warrant such a practice. After fecundation, the length of time before conception takes place is variously estimated. Should impregnation occur at the ovary or within the Fallopian tubes, usually about a week elapses before the fertilized germ enters the uterus, so that ordinarily the interval between the act of insemination and that of conception varies from eight to fourteen days. DOUBLE CONCEPTION. If two germs be evolved simultaneously, each may be impregnated by spermatozoa, and a twin pregnancy be the result. This is by no means a rare occurrence. It is very unusual, however, to have one birth followed by another after an interval of three or four months, and each babe present the evidences of full maturity. Perhaps such occurrences may be accounted for on the supposition that the same interval of time elapses between the impregnation of the two germs as there is difference observed in their birth; that after the act of insemination, sperm was carried to each ovary; that one had matured a germ ready for fecundation, then impregnation and conception immediately followed, and the decidua of the uterus hermetically sealed both Fallopian tubes, and thus securely retained the sperm within the other Fallopian canal. The stimulus of the sperm so pent up causes that ovary to mature a germ, although it may do so slowly, and after two or three months it is perfected, fertilized, and a second conception occurs within the uterus. If each embryo observe a regular period of growth and each be born at maturity, there must be an interval of two or three months between their births. But it is far more common for the parturition of the first, displaying signs of full maturity, to coincide with the birth of a second which is immature and which cannot sustain respiratory life. The birth of the latter is brought about prematurely, by the action of the uterus in expelling the matured child. UTERINE PREGNANCY. There are many who manifest a laudable desire to understand the physiology of conception, the changes which take place, and the order of their natural occurrence. When impregnation takes place at the ovaries or within the Fallopian tubes, there is exuded upon the inner surface of the womb a peculiar nutritious substance. It flows out of the minute porous openings surrounding the termination of the Fallopian tube within the uterine cavity, and, thus, is in readiness to receive the germ, and retain it there until it becomes attached. Undoubtedly, the germ imbibes materials from this matter for its nurture and growth. This membranous substance is termed the _decidua_, and disappears after conception is insured. Two membranes form around the embryo; the inner one is called the _amnion_, the outer one the _chorion_. Both serve for the protection of the embryo, and the inner one contains the _liquor amnii,_ in which it floats during intra-uterine life. Immediately after conception, the small glands in the neck of the uterus usually throw out a sticky secretion, filling the canal, or uniting its sides, so that nothing can enter or leave the uterine cavity. The fertilized ovum rapidly develops. After its conception it imbibes nourishment, and there is a disposition in fluids to pass into it, through its delicately-organized membranes. If this process is not involuntary, it is, at all events, at the convenience and use of the developing germ. After three months the embryo is termed the _foetus_. Its fluids are then so much more highly organized, that some of them are tinged with sanguine hues, and thenceforward acquire the characteristics of red blood. Out of red blood, blood-vessels are formed, and from the incipient development of the heart follow faint lines of arteries, and the engineers of nutrition survey a circulatory system, perfecting the vascular connections by supplementing the arteries with a complete net-work of veins and capillaries. THE PLACENTA OR AFTERBIRTH. Whenever conception occurs, a soft, spongy substance is formed between the uterus and the growing ovum, called the _placenta_. It is composed of membrane, cellular tissue, blood-vessels, and connecting filaments. The principal use of this organ seems to be to decarbonate the blood of the foetus, and to supply it with oxygen. It performs the same function for the foetus that the lungs do for the organism after birth. It allows the blood of the foetus to come into very close contact with that of the mother, from which it receives a supply of oxygen, and to which it gives up carbonic acid. This interchange of gases takes place in the placenta, or between it and the uterus, through the intervening membranes. This decarbonating function requires the agency of the maternal lungs, for the purpose of oxygenating the mother's blood. The placenta is attached to the uterus by simple adhesion. True, in some instances, morbid adhesion takes place, or a growing together in consequence of inflammation, but the natural junction is one merely of contact, the membranes of the placenta spreading out upon the cavity of the uterus, so that, finally, the former may be entirely removed without a particle of disturbance or injury to the latter. Formerly, it was supposed that the placental vessels penetrated into the substance of the uterus. We know now there is no such continuation of the vessels of the one into the other. The decarbonation of the blood requires the placental and uterine membranes to be in contact with each other. If the union were vascular, the mother's blood would circulate in the foetal body, and the impulses of the maternal heart might prove too strong for the delicate organism of the embryo. Besides, the separation of the placenta from the uterus might prove fatal to both parent and offspring. The placenta is only a temporary organ, and when its functions are no longer required, it is easily and safely removed. THE UMBILICAL CORD. The foetal blood is transmitted to and fro between the body of the child and the placenta, by a cord which contains two arteries and one vein. This is called the _umbilical cord_, because it enters the body at the middle of the abdominal region, or _umbilicus_. It is composed, also, of its own proper membranous sheath, or skin, and cellular tissues, besides the blood-vessels. Two months after pregnancy, this cord can be seen, when it commences to grow rapidly. QUICKENING. Not until the mother feels motion is she said to be quick with child. That is, the child must be old and strong enough to communicate a physical impulse, which the mother can distinctly perceive, before it is regarded as having received life. This is a fallacy, for the germ has to be endowed with life before organization can begin. The act of impregnation communicates the vital principle, and from that moment it starts upon its career of development. A long period elapses after this occurs before it can make the mother feel its motions. Before quickening, the attempt to destroy the foetus is not considered so grave a crime by our laws, but after this quickening takes place, it is deemed a felony. THE RIGHT TO TERMINATE PREGNANCY. The expediency and the moral right to prematurely terminate pregnancy must be admitted when weighty and sufficient reasons for it exist. Such a course should never be undertaken, however, without the advice and approval of the family physician, and, whenever it is possible, the counsel of another medical practitioner should be obtained. There may be so great a malformation of the pelvic bones as to preclude delivery at full term, or, as in some instances, the pregnant condition may endanger the life of the mother, because she is not able to retain nourishment upon the stomach. In such cases only, is interference warranted, and even then the advice of some well-informed physician should be first obtained, to make sure that the life of the mother is endangered before so extreme a measure is resorted to. Those who are qualified for maternal duties should not undertake to defeat the intentions of nature, simply because they love ease and dislike responsibility. Such persons may be considered genteel ladies, but, practically, they are indifferent to the claims of society and posterity. How such selfishness contrasts with the glorious, heroic, Spartan spirit of the young woman who consulted us in reference to the acceptance of a tempting offer of marriage! She was below medium size and delicately organized. She hesitated in her answer, because she was uncertain as to her duty to herself, and to her proposed husband, and on account of the prospective contingencies of matrimony. After she was told that it was doubtful whether she could discharge the obligations of maternity with safety to herself, and yet that she might prove to her intended husband a true and valuable wife, she quickly answered, her black eyes radiant with the high purpose of her soul: "If I assent to this offer, I shall accept the condition and its consequences also, even if pregnancy be my lot and I know it will cost me my life!" She acceded to the proposal, and years found them one in happiness; then a daughter was born, but the bearing and nursing were too much for her delicate constitution, and she continued to sink until she found rest in the grave. Of all her beautiful and noble sayings, none reflect more moral grandeur of spirit than the one in which she expressed her purpose to prove true to posterity. THE SIGNS OF PREGNANCY. The symptoms which indicate pregnancy are cessation of the menses, enlargement of the mammæ, nausea, especially in the morning, distention of the abdomen, and movement of the foetus. A married woman has reason to suspect that she may have conceived, when, at the proper time, she fails to menstruate, especially when she knows that she is liable to become pregnant. A second menstrual failure strengthens this suspicion, although there are many other causes which might prevent the appearance of the menses, such as disease of the uterus, general debility, or taking cold, and all of these should be taken into account. In the absence of all apparent influences calculated to obstruct the menses, the presumption ordinarily is that pregnancy is the cause of their non-appearance. The evidence is still more conclusive when the mammæ and abdomen enlarge after experiencing morning sickness. Notwithstanding all these symptoms, the audible sound of the heart, or the movements of the foetus, are the only _infallible_ signs of a pregnant condition. THE DURATION OF PREGNANCY. The ordinary duration of pregnancy is about forty weeks, or 280 days. It is difficult to foretell exactly when a pregnancy will be completed, for it cannot be known precisely when it began. Some gestations are more protracted than others, but the average duration is the time we have given. A very reasonable way to compute the term, is to reckon three months back from the day when the menses ceased and then add five days to that time, which will be the date of the expected time of confinement. It is customary, also, for women to count from the middle of the month after the last appearance of the menses, and then allow ten _lunar_ months for the term. This computation generally proves correct, except in those instances in which conception takes place immediately before the fast appearance of the catamenia. A few women can forecast the time of labor from the occurrence of quickening, by allowing eighteen weeks for the time which has elapsed since conception, and twenty-two more for the time yet to elapse before the confinement. With those in whom quickening occurs regularly in a certain week of pregnancy, this calculation may prove nearly correct. The English law fixes no precise limit for the legitimacy of the child. In France a child is regarded as lawfully begotten if born within three hundred days after the death or departure of the husband. There are a sufficient number of cases on record to show that gestation may be prolonged two, and even three, weeks beyond the ordinary, or average term. The variation of time may be thus accounted for: after insemination, a considerable interval elapses before fecundation takes place, and the passage of the fertilized germ from the ovary to the uterus is also liable to be retarded. There are many circumstances and conditions which might serve to diminish its ordinary rate of progress, and postpone the date of conception. This would materially lengthen the _apparent_ time of gestation. It is likewise difficult to determine the shortest period at which gestation may terminate, and the child be able to survive. A child may be born and continue to live for some months, after twenty-four or twenty-five weeks of gestation; it was so decided, at least, in an ecclesiastical trial. We have not the space to describe minutely, or at length, the formation and growth of the foetal structures, and trace them separately from their origin to their completion at the birth of the child. The student of medicine must gain information by consulting large works and exhaustive treatises on this interesting subject. What trifling contingencies defeat vitality! Conception may be prevented by acrid secretions, the result of disease of the reproductive organs. Leucorrheal matter may destroy the vitalizing power of the sperm-cells. There are many ways, even after impregnation, of compromising the existence of the frail embryo. Accidents, injuries, falls, blows, acute diseases, insufficient nutrition and development, in fact, a great variety of occurrences may destroy the life of the embryo, or foetus. After birth, numerous diseases menace the child. By what constant care must it ever be surrounded, and how often is it snatched from the very jaws of death! What, then, is man but simply a germ, evolving higher powers, and destined for a purer and nobler existence! His latent life secretly emerges from mysterious obscurity, is incarnated, and borne upon the flowing stream of time to a spiritual destination--to realms of immortality! As he nears those ever-blooming shores, the eye of faith, illuminated by the inspired word, dimly discerns the perennial glories. Quickened by Faith, Hope, and Love, his spirit is transplanted into the garden of paradise, the Eden of happiness, redeemed, perfected, and made glorious in the divine image of Him who hath said, "I am the Way, the _Truth_, and the LIFE." * * * * * PART II. HYGIENE. CHAPTER I. HYGIENE DEFINED.--PURE AIR. The object of hygiene is the _preservation of health_. Hitherto, we have considered, at some length, the science of functions, or _Physiology_, and now, under the head of _Hygiene_, we will give an outline of the means of maintaining the functional integrity of the system. It is difficult to avoid including under this head Preventive Medicine, the special province of which is to abate, remove, or destroy the many causes of disease. The Greeks bestowed divine honors upon Aesculapius, because he remedied the evils of mankind and healed the sick. The word hygiene is derived from Hygeia, the name of the Greek goddess of health. As male and female are made one in wedlock, so Medicine and Hygiene, restoration and preservation, are inseparably united. Hygiene inculcates sanitary discipline, medicine, remedial discipline; hygiene prescribes healthful agencies, medical theory and practice, medicinal agencies; hygiene ministers with salubrious and salutary agents, medicine assuages with rectifying properties and qualities; hygiene upholds and sustains, medical practice corrects and heals; the one is preservative and conservative, the other curative and restorative. These discriminations are as radical as health and sickness, as distinct as physiology and pathology, and to confound them is as unnatural as to look for the beauties of health in the chamber of sickness. The true physician brings to his aid Physiology, Hygiene, and Medicine, and combines the science of the former with the art of the latter, that restoration may be made permanent, and the health preserved by the aid of hygiene. But when any one makes Hygiene exclusively the physician, or deals wholly in hygienic regulations with little respect for physiology, or lavishly advertises with hygienic prefixes, we may at once consider it a display, not of genuine scientific knowledge, but only of the ignorance of a quack. Some of the modern twaddle about health is a conglomeration of the poorest kind of trash, expressing and inculcating more errors and whims than it does common sense. Many persons dilate upon these subjects with amazing flippancy, their mission seeming to be to traduce the profession rather than to act as help-mates and assistants. We do not believe that there is any real argument going on between the educated members of the medical profession but rather that the senseless clamor we occasionally hear comes only from the stampede of some routed, demoralized company of quacks. In the following pages we shall introduce to the reader's attention several important hygienic subjects, although there are many more that ought to receive special notice. Such as we do mention, demand universal attention, because a disregard of the conditions which we shall enumerate, is fraught with great danger. Our lives are lengthened or shortened by the observance or neglect of the rules of common sense, and these do not require any great personal sacrifice, or the practice of absurd precautions. PURE AIR FOR RESPIRATION. Ordinary atmospheric air contains nearly 2,100 parts of oxygen and 7,900 of nitrogen, and about three parts of carbonic acid, in 10,000 parts; expired air contains about 470 parts of carbonic acid, and only between 1500 and 1600 parts of oxygen, while the quantity of nitrogen undergoes little or no alteration. Thus air which has been breathed has lost about five per cent. of oxygen and has gained nearly five per cent. of carbonic acid. In addition the expired air contains a greater or less quantity of highly decomposable animal matter, and, however dry the atmospheric air may be, the expired air is always saturated with watery vapor, and, no matter what the temperature of the external air may be, that of the exhaled air is always nearly as warm as the blood. An adult man on a average breathes about sixteen times in a minute and at every inspiration takes in about thirty cubic inches of air, and at every expiration exhales about the same amount. Hence, it follows that about 16-2/3 cubic feet of air are passed through the lungs of an adult man every hour, and deprived of oxygen and charged with carbonic acid to the amount of nearly five per cent. The more nearly the composition of the external air approaches that of the expired air, the slower will be the diffusion of carbonic acid outwards and of oxygen inwards, and the more charged with carbonic acid and deficient in oxygen will the blood in the lungs become. Asphyxia takes place whenever the proportion of carbonic acid in the external air reaches ten per cent., providing the oxygen is diminished in like proportion, and it does not matter whether this condition of the external air is produced by shutting out fresh air from a room or by increasing the number of persons who are consuming the same air; or by permitting the air to be deprived of oxygen by combustion by a fire. A deficiency of oxygen and an accumulation of carbonic acid in the atmosphere, produce injurious effects, however, long before the asphyxiating point is attained. Headache, drowsiness, and uneasiness occur when less than one per cent. of the oxygen of the atmosphere is replaced by other matters, and the constant breathing of such an atmosphere lowers vitality and predisposes to disease. Therefore, every human being should be supplied, by proper ventilation, with a sufficient supply of fresh air. Every adult individual ought to have at least 800 cubic feet of air-space to himself, and this space ought to communicate freely with the external atmosphere by means of direct or indirect channels. Hence, a sleeping-room for one adult person should not be less than nine by ten feet in breadth and length and nine feet in height. What occurred in the Black Hole at Calcutta is an excellent illustration of the effect of vitiated air. One hundred and forty-six Englishmen were confined in a room eighteen feet square, with two small windows on one side to admit air. Ten hours after their imprisonment, only twenty-three were alive. VENTILATION OF SCHOOL ROOMS. The depression and faintness from which many students suffer, after being confined in a poorly ventilated school room, is clearly traceable to vitiated air, while the evil is often ascribed to excessive mental exertion. The effect of ventilation upon the health of students is a subject of universal interest to parents and educators, and at present is receiving the marked attention of school authorities. Dr. F. Windsor, of Winchester, Mass., made a few pertinent remarks upon this subject in the annual report of the State Board of Health, of Massachusetts, 1874. One of the institutions, which was spoken of in the report of 1873, as a _model_, in the warming and ventilation of which much care had been bestowed, was visited in December, 1873. He reports as follows: "I visited several of the rooms, and found the air in all, offensive to the smell, the odor being such as one would imagine old boots, dirty clothes, and perspiration would make if boiled down together;" again, in the new _model_ school-house the hot air enters at two registers in the floor on one side, and makes (or is supposed to make) its exit by a ventilator at the floor, on the other side of the room." The master said "_the air was supposed to have some degree of intelligence, and to know that the ventilator was its proper exit_." Thorough ventilation has been neglected by many school officials on account of the increased expense it causes. In our climate, during seven months at least, pure atmospheric air must be paid for. The construction of vertical ducts, the extra amount of fuel, and the attendant expenditures are the objections which, in the opinion of many persons, outweigh the health and happiness of the future generation. It is necessary for the proper ventilation of our school rooms that an adequate supply of fresh air should be admitted, which should be warmed before being admitted to the room, and which should be discharged as contaminated, after its expiration. The proper ventilation of the school room consists in the warming and introduction of fresh air from without, and the discharge of the expired and unwholesome air from within. This may be accomplished by means of doors, windows, chimneys, and finally by ventilators placed, one near the level of the floor, and the other near the ceiling of the room. The ventilators ought to be arranged on the opposite sides of the room, in order to insure a current, and an abundant supply of air. When trustees and patrons realize that pure air is absolutely essential to health, and that their children are being slowly poisoned by the foul air of school rooms, then they will construct our halls of learning with a due regard for the laws of hygiene, and students will not droop under their tasks on account of the absence of Nature's most bountiful gift, _pure air_. VENTILATION OF FACTORIES AND WORKSHOPS. This is a subject which demands the immediate attention of manufacturers and employers. The odors of oil, coal gas, and animal products, render the air foul and stagnant, and often give rise to violent diseases among the operatives. From two to four hundred persons are often confined in workshops six hundred feet long, with no means of ventilation except windows _on one side only_. The air is breathed and re-breathed, until the operatives complain of languor and headache, which they attribute to overwork. The _real_ cause of the headache is the inhalation of foul air at every expansion of the lungs. If the proprietors would provide efficient means for ventilating their workshops, the cost of construction would be repaid with compound interest, in the better health of their operatives and the consequent increase of labor. Our manufacturers must learn and practice the great principle of political economy, namely, that the interests of the laborer and employer are mutual. VENTILATION OF OUR DWELLINGS. Not less important is the ventilation of our dwellings; each apartment should be provided with some channel for the escape of the noxious vapors constantly accumulating. Most of the tenements occupied by the poor of our cities are literally dens of poison. Their children inhale disease with their earliest breath. What wonder that our streets are filled with squalid, wan-visaged children! Charity, indeed, visits these miserable homes, bringing garments and food to their half-famished inmates; but she has been slow to learn that fresh air is just as essential to life as food or clothing. Care should be taken by the public authorities of every city, that its tenement houses do not degenerate into foul hovels, like those of the poor English laborer, so graphically portrayed by Dickens. But ill-ventilated rooms are not found exclusively in the abodes of the poor. True, in the homes of luxury, the effect of vitiated air is modified by food, etc. Men of wealth give far more attention to the architecture and adornment of their houses, to costly decorations and expensive furniture, than to proper ventilation. Farmers, too, are careless in the construction of their cottages. Their dwellings are often built, for convenience, in too close proximity to the barn. Because they do not construct a suitable sewer or drain, the filth and refuse food is thrown out of the back door, where it accumulates and undergoes putrefaction; the vitiated air penetrates the interior of the house, and, there being no means of ventilation, it remains to be breathed by the occupants. The result is, that for the sake of saving a few dollars, which ought to be expended in the construction of necessary flues and sewers, the farmer often sees the child he prizes far more than his broad acres gradually decline, or suddenly fall a victim to fevers or malignant disease. Parents, make your homes healthy, let in the pure, fresh air and bright sunlight, so that your conscience may never upbraid you with being neglectful of the health and lives of your little ones. SITE FOR HOMES. MALARIA. When about to construct our residences, besides securing proper ventilation and adequate drainage, we ought to select the location for a home on dry soil. Low levels, damp surroundings, and marshy localities not only breed malaria and fevers, but are a prolific cause of colds, coughs, and consumption. Care should be taken not to locate a dwelling where the natural currents of air, or high winds, will be likely to bring the poison of decayed vegetable matter from low lands. Certain brooks, boggy land, ponds, foggy localities, too much shade, all these are favorable to the development of disease. Then the walls of a building should be so constructed as to admit air between the exterior and interior surfaces, otherwise the interior of the house will be damp and unwholesome. In the dead of winter in northern latitudes the house ought to be kept slightly tempered with warmth, both night and day, a condition very favorable to the introduction and change of atmospheric currents. The invigorating tendencies of a dry, pure atmosphere are remarkably beneficial, while air charged with moisture and decay is exceedingly baneful, introducing diseases under various forms. Neither should the dwelling be shaded by dense foliage. The dampness of the leaves tends to attract malaria. Trees growing a little distance from the house, however, obstruct the transmission of unhealthy vapors arising beyond them. Malaria generally lurks near the surface of the earth, and seems to be more abundant in the night time. Persons sleeping in the upper story of a house may escape its morbid influence, while those occupying apartments on the lower floor, become affected. DAMP CELLARS. Damp cellars, under residences, are a fruitful cause of disease. Dr. Sanford B. Hunt, in an article in the _Newark Daily Advertiser_, speaking of the recent epidemic of diphtheria in New York City, says: "Pestilences that come bodily, like cholera, are faced and beaten by sanitary measures. Those which come more subtly need for their defeat only a higher detective ability and a closer study of causes, many of which are known, but hidden under the cellars of our houses, and which at last are only preventable by public authority and at public expense in letting out the imprisoned dampness which saturates the earth on which our dwellings are built. Where wood rots, men decay. This is clearly shown in the sanitary map printed in the _Times_. In the great district surrounding Central Park, and which participates in its drainage system, there are no cases. On the whole line of Fifth Avenue there are none. The exempt districts are clearly defined by the character of the soil, drainage, and sewerage, and by the topography, which either has natural or artificial drainage, but most of which is so dry that only surface-water and house-filth--which does not exist in those palaces--can affect the health of the residents. But in the tenement houses and on the made lands where running streams have been filled in and natural springs choked up by earth fillings, diphtheria finds a nidus in which to develop itself. The sanitary map coincides precisely with the topographic map made by Gen. Viele. Where he locates buried springs and water-courses, there we find the plague spots of diphtheria and in the same places, on previous maps prepared by the Board of Health, we find other low types and stealthy diseases, such as typhoid and irruptive fevers, and there we shall find them again when the summer and autumnal pestilences have yielded place to those which belong to the indoor poisoned air in the winter. The experience of other cities, notably London and Dublin, once plague spots and now as healthy as any spot on earth, proves that most of the causations of disease are within the control of the competent sanitary engineer, even in localities crowded beyond American knowledge, and houses built upon soil saturated for centuries with the offal of successive and uncleanly generations. Wet earth, kept wet by the boiling up of imprisoned springs, is a focus of disease. Dry earth is one of the most perfect deodorizers, the best of oxydizers and absorbents, destroying the germs of disease with wonderful certainty. On those two facts rests the theory of public hygiene." DUST AND DISEASE. The air we breathe is heavily loaded with minute particles of floating dust, their presence being revealed only by intense local illumination. Professor Tyndall says: "solar light, in passing through a dark room, reveals its track by illuminating the dust floating in the air. 'The sun,' says Daniel Culverwell, 'discovers atoms, though they be invisible by candle-light, and makes them dance naked in his beams.'" After giving the details and results of a series of experiments in which he attempted to extract the dust from the air of the Royal Institute by passing it through a tube containing fragments of glass wetted with concentrated sulphuric acid, and thence through a second tube containing fragments of marble wetted with a strong solution of caustic potash, which experiments were attended with perfect failure, the Professor continues, "I tried to intercept this floating matter in various ways; and on the day just mentioned, prior to sending the air through the drying apparatus, I carefully permitted it to pass over the tip of a spirit-lamp flame. The floating matter no longer appeared, having been burnt up by the flame. It was, therefore, of _organic origin_. I was by no means prepared for this result; for I had thought that the dust of our air was, in great part, inorganic and non-combustile." In a foot note he says, "according to an analysis kindly furnished me by Dr. Percy, the dust collected _from the walls_ of the British Museum contains fully fifty per cent of inorganic matter. I have every confidence in the results of this distinguished chemist; they show that the _floating_ dust of our rooms is, as it were, winnowed from the heavier matter." Again he says: "the air of our London rooms is loaded with this organic dust, nor is the country air free from its presence. However ordinary daylight may permit it to disguise itself, a sufficiently powerful beam causes dust suspended in air to appear almost as a semi-solid. Nobody could, in the first instance, without repugnance, place the mouth at the illuminated focus of the electric beam and inhale the thickly-massed dust revealed there. Nor is the repugnance abolished by the reflection that, although we do not see the floating particles, we are taking them into our lungs every hour and minute of our lives." "The notion was expressed by Kircher and favored by Linnaeus, that epidemic diseases are due to germs which float in the atmosphere, enter the body, and produce disturbance by the development within the body of parasitic life. While it was struggling against great odds, this theory found an expounder and a defender in the President of this institution. At a time when most of his medical brethren considered it a wild dream, Sir Henry Holland contended that some form of the germ-theory was probably true." Professor Tyndall proposes means by the application of which air loaded with noxious particles may be freed from them before entering the air passages. The following embodies his suggestions on this point: COTTON-WOOL RESPIRATOR. "I now empty my lungs as perfectly as possible, and placing a handful of cotton-wool against my mouth and nostrils, inhale through it. There is no difficulty in thus filling the lungs with air. On expiring this air through a glass tube, its freedom from floating matter is at once manifest. From the very beginning of the act of expiration the beam is pierced by a black aperture. The first puff from the lungs abolishes the illuminated dust, and puts a patch of darkness in its place; and the darkness continues throughout the entire course of the expiration. When the tube is placed below the beam and moved to and fro, the same smoke-like appearance as that obtained with a flame is observed. _In short, the cotton-wool, when used in sufficient quantity, and with due care, completely intercepts the floating matter on its way to the lungs_. The application of these experiments is obvious. If a physician wishes to hold back from the lungs of his patient, or from his own, the germs or virus by which contagious disease is propagated, he will employ a cotton-wool respirator. If perfectly filtered, attendants may breathe the air unharmed. In all probability the protection of the lungs and mouth will be the protection of the entire system. For it is exceedingly probable that the germs which lodge in the air-passages, or find their way with the saliva into the stomach with its absorbent system, are those which sow in the body epidemic disease. If this be so, then disease can be warded off by carefully prepared filters of cotton-wool. I should be most willing to test their efficacy in my own person. But apart from all doubtful applications, it is perfectly certain that various noxious trades in England may be rendered harmless by the use of such filters. I have had conclusive evidence of this from people engaged in such trades. A form of respirator devised by Mr. Garrick, a hotel proprietor in Glasgow, in which inhalation and exhalation occur through two different valves, the one permitting the air to enter through the cotton-wool, and the other permitting the exit of the air direct into the atmosphere, is well adapted for this purpose. But other forms might readily be devised." LIGHT AND HEALTH. Our dwellings ought freely to admit the sunlight. Diseases which have baffled the skill of physicians have been known to yield when the patients were removed from dark rooms to light and cheerful apartments. Lavoisier placed light, as an agent of health, even before pure air. Plants which grow in the shade are slender and weak, and children brought up in dark rooms are pale, sallow, and rickety. It is a bad practice to avoid the sunlight through fear of spoiling the complexion, since the sun's rays are necessary to give to it the delicate tints of beauty and health. Air is necessary for the first inspiration and the last expiration of our lives, but the purity and healthfulness of the atmosphere depend upon the warming rays of the sun, while our bodies require light in order that their functions may be properly performed. We know that without solar light, there can be no proper vegetable growth, and it is equally necessary for the beauty and perfection of animal development. Our dwellings should therefore be well lighted and made as bright and cheerful as possible. Women who curtain the windows, soften the light, and tint the room with some mellow shade, may do so in order to hide their own faulty complexions. The skin of persons confined in dungeons or in deep mines becomes pale or sickly yellow, the blood grows watery, the skin blotches, and dropsy often intervenes. On the other hand, invalids carried out from darkened chambers into the bright sunlight are stimulated, the skin browns, nutrition becomes more active, the blood improves, and they become convalescent. Light is especially necessary for the healthy growth of children. There is nothing more beautiful and exhilarating than the glorious sunlight. Let its luminous, warming, and physiological forces come freely into our dwellings, enter into the chemistry of life, animate the spirits, and pervade our homes and our hearts with its joy-inspiring and health-imparting influences. * * * * * CHAPTER II. FOOD. BEVERAGES. ALCOHOLIC LIQUORS. CLOTHING. The human body is continually undergoing changes, which commence with the earliest dawn of existence and end only with death. The old and worn-out materials are constantly being removed to make room for the new. Growth and development, as well as the elimination of worn-out and useless matter, continually require new supplies, which are to be derived from our food. To fulfill these demands it is necessary that the nutriment should be of the proper quality, and of sufficient variety to furnish all the constituents of the healthy body. In order that food may be of utility, like other building materials, it must undergo preparation; the crude substance must be worked up into proper condition and shape for use, in other words, it must be _digested_. But this does not end the process of supply, each different substance must be taken by the different bands of workmen, after due preparation in the workshop, to its appropriate locality in the structure, and there fitted into its proper place; this is _assimilation_. In reality it becomes a portion of the body, and is advantageous in maintaining the symmetry and usefulness of the part to which it is assigned; this constitutes the ultimate object of food, _nutrition_. EATING is the process of receiving the food into the mouth, _i.e., prehension; mastication and insalivation_--minutely dividing and mixing it with the saliva; _deglutition_--conveying it to the stomach. Plenty of time should be taken at meals to thoroughly masticate the food and mix it with the saliva, which, being one of the natural solvents, favors its farther solution by the juices of the stomach; the healthy action of the digestive powers is favored by tranquility of mind, agreeable associations, and pleasant conversation while eating. It is proverbial of the American people that they bolt their food whole, washing it down with various fluids, thus forcing the stomach to perform not only its own duties, but also those of the teeth and salivary glands. This manner of dispatching food, which should go through the natural process above described, is not without its baleful consequences, for the Americans are called a nation of _dyspeptics_. Eating slowly, masticating the food thoroughly, and drinking but moderately during meals, will allow the juices of the stomach to fulfill their proper function, and healthy digestion and nutrition will result. If the food is swallowed nearly whole, not only will a longer time be required for its solution, but frequently it will ferment and begin to decay before nutritive transformation can be effected, even when the gastric juice is undiluted with the fluids which the hurried eater imbibes during his meal. REGULARITY OF MEALS cannot be too strongly insisted upon. The stomach, as well as other parts of the body, must have intervals of rest or its energies are soon exhausted, its functions impaired, and _dyspepsia_ is the result. Nothing of the character of food should ever be taken except at regular meal times. Some persons are munching cakes, apples, nuts, candies, etc., at all hours, and then wonder why they have weak stomachs. They take their meals regularly, and neither eat rapidly nor too much, and yet they are troubled with indigestion. The truth is they keep their stomachs almost constantly at work, and hence tired out, which is the occasion of the annoyance and distress they experience. EATING TOO MUCH. It should always be remembered that the nutrition of our bodies does not depend upon the amount eaten, but upon the amount that is digested. Eating too much is nearly as bad as swallowing the food whole. The stomach is unable to digest all of it, and it ferments and gives rise to unpleasant results. The unnatural distention of the stomach with food causes it to press upon the neighboring organs, interfering with the proper performance of their functions, and, if frequently repeated, gives rise to serious disease. People more frequently eat too much than too little, and to omit a meal when the stomach is slightly deranged is frequently the best medicine. It is an excellent plan to rise from the table before the desire for food is quite satisfied. LATE SUPPERS. It is generally conceded that late suppers are injurious, and should never be indulged in. Persons who dine late have little need of food after their dinner, unless they are kept up until a late hour. In such cases a moderate meal may be allowed, but it should be eaten two or three hours before retiring. Those who dine in the middle of the day should have supper, but sufficiently early so that a proper length of time may elapse before going to bed, in order that active digestion may not be required during sleep. On the other hand, it is not advisable to go wholly without this meal, but the food eaten should be light, easily digestible, and moderate in quantity. Persons who indulge in hearty suppers at late hours, usually experience a poor night's rest, and wake the next morning unrefreshed, with a headache and a deranged stomach. Occasionally more serious consequences follow; gastric disorders result, apoplexy is induced; or, perhaps, the individual never wakes. FEEDING INFANTS. For at least six or seven months after birth, the most appropriate food for an infant is its mother's milk, which, when the parent is healthy, is rich in all the elements necessary for its growth and support. Next to the mother's milk, that of a healthy nurse should be preferred; in the absence of both, milk from a cow that has recently calved is the most natural substitute, in the proportion of one part water to two parts milk, slightly sweetened. The milk used should be from but one cow. All sorts of paps, gruels, panadas, cordials, laxatives, etc., should be strictly prohibited, for their employment as food cannot be too severely censured. Vomiting, diarrhea, colic, green stools, griping, etc., are the inevitable results of their continued use. The child should be fed at regular intervals, of about two hours, and be limited to a proper amount each time, which, during the first month, is about two ounces. From 11 P.M. to 5 A.M. the child should be nursed but once. As the child grows older the intervals should be lengthened, and the amount taken at a time gradually increased. The plan of gorging the infant's stomach with food every time it cries, cannot be too emphatically condemned. After the sixth or seventh month, in addition to milk, bits of bread may be allowed, the quantity being slowly increased, thus permitting the diet to change gradually from fluid to solid food, so that, when the teeth are sufficiently developed for mastication, the child has become accustomed to various kinds of nourishment. Over-feeding, and continually dosing the child with cordial, soothing syrups, etc., are the most fruitful sources of infant mortality, and should receive the condemnation of every mother in the land. PREPARATION OF FOOD. The production of pure blood requires that all the food selected should be rich in nutritious elements, and well cooked. To announce a standard by which all persons shall be guided in the selection and preparation of their food is impossible. Especially is this the case in a country the inhabitants of which represent almost every nation on the face of the globe. Travelers are aware that there is as much diversity in the articles of food and methods of cookery, among the various nationalities, as in the erection of their dwellings, and in their mental characteristics. In America we have a conglomeration of all these peoples; and for a native American to lay down rules of cookery for his German, French, English, Welsh, and Irish neighbors, or _vice versa_, is useless, for they will seldom read them, and, therefore, cannot profit by them. There are, however, certain conditions recognized by the hygienic writers of every nation. The adequate nutrition of the organic tissues demands a plentiful supply of pure blood, or the digestive apparatus will become impaired, the mental processes deranged, and the entire bony and muscular systems will lose their strength and elasticity, and be incapacitated for labor. DIFFERENT KINDS OF FOOD REQUIRED. The different periods and circumstances of life require their appropriate food, and the welfare of mankind demands that it should supply both the inorganic and organic substances employed in the development of every tissue. The inorganic elements employed in our construction, of which _Phosphorus, Sulphur, Soda, Iron, Lime,_ and _Potash_ are the most important, are not considered as aliments, but are found in the organic kingdom, variously arranged and combined with organic materials in sufficient quantities for ordinary purposes. When, however, from any cause, a lack of any of these occurs, so that their relative normal proportions are deranged, the system suffers, and restoration to a healthy condition can only be accomplished by supplying the deficiency; this may be done by selecting the article of food richest in the element which is wanting, or by introducing it as a medicine. It must be remembered that those substances which enter into the construction of the human fabric, are not promiscuously employed by nature, but that each and every one is destined to fulfill a definite indication. _Lime_ enters largely into the formation of bone, either as a _phosphate_ or a _carbonate_, and is required in much greater quantities in early life, while the bone is undergoing development, than afterwards. In childhood the bones are composed largely of animal matter, being pliable and easily moulded. For this reason the limbs of young children bend under the weight of their bodies, and unless care is taken they become bow-legged and distorted. Whenever there is a continued deficiency of the earthy constituents, disease of the bones ensues. Therefore, during childhood, and particularly during the period of dentition, or teething, the food should be nutritious and at the same time contain a due proportion of lime, which is preferable in the form of a phosphate. When it cannot be furnished by the food, it should be supplied artificially. Delayed, prolonged, and tedious dentition generally arises from a deficiency of lime. With the advance of age it accumulates, and the bone becomes hard, inelastic, and capable of supporting heavy weights. Farther on, as in old age, the animal matter of bone becomes diminished, and lime takes its place, so that the bones become brittle and are easily broken. Lime exists largely in hard water, and to a greater or less extent in milk, and in nearly all foods except those of an acid character. _Phosphorus_ exists in various combinations in different parts of the body, particularly in the brain and nervous system. Persons who perform a large amount of mental labor require more phosphorus than those engaged in other pursuits. It exists largely in the hulls of wheat, in fish, and in eggs. It should enter to a considerable extent into the diet of brain workers, and the bread consumed by them should be made of unbolted flour. _Sulphur, Iron, Soda_, and _Potash_ are all necessary in the various tissues of the body, and deficiency of any one of them, for any considerable length of time, results in disease. They are all supplied, variously arranged and combined, in both animal and vegetable food; in some articles they exist to a considerable extent, in others in much smaller quantities. _Sulphur_ exists in eggs and in the flesh of animals, and often in water. _Iron_ exists in the yolk of eggs, in flesh, and in several vegetables. _Soda_ is supplied in nearly all food, and largely in common salt, which is a composition of sodium and hydrochloric acid, the latter entering into the gastric juice. _Potash_ exists, in some form or other, in sufficient quantities for health, in both vegetable and animal food. CLASSES OF FOOD. All kinds of food substances may be divided into four classes. _Proteids, Fats, Amyloids_, and _Minerals_. Proteids are composed of the four elements, carbon, hydrogen, oxygen, and nitrogen, sometimes combined with sulphur and phosphorus. In this class are included the _gluten_ of flour; the _albumen_, or white of eggs; and the _serum_ of the blood; the _fibrin_ of the blood; _syntonin_, the chief constituent of muscle and flesh, and _casein_, one of the chief constituents of cheese, and many other similar, but less frequent substances. Fats are composed of carbon, hydrogen, and oxygen only, and contain more hydrogen than would be required to form water if united with the oxygen which they contain. All vegetable and animal oils and fatty matters are included in this class. Amyloids consist of substances which are also composed of carbon, oxygen, and hydrogen only; but they contain just enough hydrogen to produce water when combined with their oxygen, or two parts of hydrogen to one of oxygen. This division includes _sugar, starch, dextrine_, and _gum_. The above three classes of food-stuffs are only obtained through the activity of living organisms, vegetable or animal, and have been, therefore, appropriately termed by Prof. Huxley, _vital food-stuffs._ The mineral food-stuffs may, as we have seen, be procured from either the living or the non-living world. They include water and various earthy, metallic, and alkaline salts. VARIETY OF FOOD NECESSARY. No substance can serve permanently for food except it contains a certain quantity of proteid matter in the shape of albumen, fibrin, casein, etc., and, on the other hand, any substance containing proteid matter in a shape in which it can be readily assimilated, may serve as a permanent vital food-stuff. Every substance, which is to serve as a permanent food, must contain a sufficient quantity, ready-made, of this most important and complex constituent of the body. In addition, it must also contain a sufficient quantity of the mineral ingredients which enter into the composition of the body. Its power of supporting life and maintaining the weight and composition of the body remains unaltered, whether it contains fats or amyloids or not. The secretion of urea, and, consequently, the loss of nitrogen, goes on continually, and the body, therefore, must necessarily waste unless the supply of proteid matter is constantly renewed, since this is the only class of foods that contains nitrogen in any considerable quantity. There can be no absolute necessity for any other food-stuffs but those containing the proteid and mineral elements of the body. From what has been said, it will readily be seen that whether an animal be carnivorous or herbivorous, it begins to starve as soon as its vital food-stuffs consist only of amyloids, or fats, or both. It suffers from what has been termed _nitrogen starvation,_ and if proteid matters are withheld entirely, it soon dies. In such a case, and still more in the case of an animal which is entirely deprived of vital food, the organism, as long as it continues to live, feeds upon itself, the waste products necessarily being formed at the expense of its own body. Although proteid matter is the essential element of food, and under certain circumstances may be sufficient of itself to support the body, it is a very uneconomical food. The white of an egg, which may be taken as a type of the proteids, contains about fifteen per cent. of nitrogen, and fifty-three per cent. of carbon; therefore, a man feeding upon this, would take in about three and a half times as much carbon as nitrogen. It has been proved that a healthy, adult man, taking a fair amount of exercise and maintaining his weight and body temperature, eliminates about thirteen times as much carbon as nitrogen. However, if he is to get his necessary quantity, about 4000 grains of carbon, out of albumen, he must eat 7,547 grains of that substance; but this quantity of albumen contains nearly four times as much nitrogen as he requires. In other words, it takes about four pounds of lean meat, free from fat, to furnish 4,000 grains of carbon, the quantity required, whereas one pound yields the requisite quantity of nitrogen. Thus a man restricted exclusively to a proteid diet, must take an enormous quantity of it. This would involve a large amount of unnecessary physiological labor, to comminute, dissolve, and absorb the food, and to excrete the superfluous nitrogenous matter. Unproductive labor should be avoided as much in physiological as in political economy. The universal practice of subsisting on a mixed diet, in which proteids are mixed with fats or amyloids, is therefore justifiable. Fats contain about 80 per cent. of carbon, and amyloids about 40 per cent. We have seen that there is sufficient nitrogen in a pound of meat free from fat, to supply a healthy adult man for twenty-four hours, but that it contains only one-fourth of the quantity of carbon required. About half a pound of fat, or one pound of sugar, will supply the quantity of carbon necessary. The fat, if properly subdivided, and the sugar, by reason of its solubility, pass with great ease into the circulation, the physiological labor, consequently, being reduced to a minimum. Several common articles of diet contain in themselves all the necessary elements. Thus, butchers' meat ordinarily contains from 30 to 50 per cent. of fat; and bread contains the proteid, gluten, and the amyloids, starch and sugar, together with minute quantities of fat. However, on account of the proportion in which these proteid and other components of the body exist in these substances, neither of them, by itself is such a physiologically economical food, as it is when combined with the other in the proportion of three to eight, or three quarters of a pound of meat to two pounds of bread a day. It is evident that a variety of food is necessary for health. Animals fed exclusively upon one class, or upon a single article of diet, droop and die; and in the human family we know that the constant use of one kind of diet causes disgust, even when not very long continued. Consequently, we infer that the welfare of man demands that his food be of sufficient variety to supply his body with all of its component parts. If this is not done the appetite is deranged, and often craves the very article which is necessary to supply the deficiency. After the component parts of the organism have assimilated the nutritious elements of particular kinds of food for a certain length of time, they lose the power of effecting the necessary changes for proper nutrition, and a supply of other material is imperatively demanded. When the diet has been long restricted to proteids, consisting largely of salt meats, fresh vegetables and fruits containing the organic acids, become indispensable; otherwise, the scorbutic condition, or scurvy, is almost sure to be developed. Fresh vegetables and fruits should be eaten in considerable quantities at the proper seasons. VALUE OF ANIMAL FOOD. The principal animal food used in this country consists of _Pork, Mutton, Beef_, and _Fish_. Beef and mutton are rich in muscle-producing material. Although pork is extensively produced in some portions of this country, and enters largely into the diet of some classes, yet its use, except in winter, is not to be encouraged. The same amount of beef would give far greater returns in muscular power. In addition to the meats mentioned, _Wild Game_ furnishes palatable, nutritious, and easily-digested food. _Domestic Fowls_, when young, are excellent, and with the exception of geese and ducks, are easily digested. _Wild Birds_ are considered much healthier food than those which are domesticated. All of these contain more or less of the elements which enter into the composition of the four classes of foods. VEGETABLE FOODS. _Wheat_ is rich in all the elements which compose the four classes, and, when the flour is unbolted, it is one of the best articles for supplying all the elements. _Barley_ stands next to wheat in nourishing qualities, but is not so palatable. _Oats_ are rich in all the elements necessary for nutrition. Oatmeal is a favorite article of diet among the Scotch, and, judging from their hardy constitutions, their choice is well founded. In consequence of the large proportion of phosphorus which they contain, they are capable of furnishing a large amount of nourishment for the brain. _Rye_ is nutritious, but it is not so rich in tissue-forming material. _Indian Corn_ is an article well known and extensively used throughout the United States, and is a truly valuable one, capable of being prepared in a great variety of ways for food. It contains more carbon than wheat, and less nitrogen and phosphorus, though enough of both to be extremely valuable. _Rice_ is rather meagre in nutriment; it contains but little phosphorous matter, with less carbon than other cereals, and is best and most generally employed as a diet in tropical countries. _Beans and Peas_ are rich in nutritious matter, and furnish the manual laborer with a cheap and wholesome diet. The _Potato_ is the most valuable of all fresh vegetables grown in temperate climates. Its flavor is very agreeable, and it contains very important nutritive and medicinal qualities, and is eaten almost daily by nearly every family in North America. Until very recently it, with the addition of a little butter-milk or skim-milk, constituted almost the sole diet of the Irish people. The average composition of the potato is stated by Dr. Smith to be as follows: Water 75 per cent., nitrogen 2.1, starch 18.8, sugar 3.2, fat 0.2, salts 0.7. The relative values of different potatoes may be ascertained very correctly by weighing them in the hand, for the heavier the tuber the more starch it contains. _Turnip and Cabbage_ are 92.5 per cent. water, and, consequently, poor in nutrition, though they are very palatable. The solid portions of cabbage, however, are rich in albumen. It is evident that the quantity necessary to maintain the system in proper condition must be greatly modified by the habits of life, the condition of the organism, the age, the sex, and the climate. The daily loss of substance which must be replaced by material from without, as we have seen, is very great. In addition to the loss of carbon and nitrogen, about four and a half pounds of water are removed from the system in twenty-four hours, and it is necessary that about this quantity should be introduced into the system in some form or other, however much it may be adulterated. Professor Dalton states: "From experiments performed while living on an exclusive diet of bread, fresh meat, and butter, with coffee and water for drink, we have found that the entire quantity of food required during twenty-four hours by a man in full health and taking free exercise in the open air is as follows: Meat, . . . . . . 16 oz., or 1.03 lb. avoir. Bread, . . . . . . 19 " 1.19 " " Butter or fat, . . . 3½ " 0.22 " " Water, . . . . . 52 fluid oz., 3.38 " " That is to say, rather less than two and a half pounds of solid food, and rather over three pounds of liquid food." CLIMATE exerts an important influence on the quantity and quality of food required by the system. In northern latitudes the inhabitants are exposed to extreme cold and require an abundant supply of food, and especially that which contains a large amount of fat. On this account fat meat is taken in large quantities and with a relish. The quantity of food consumed by the natives of the Arctic zone is almost incredible. The Russian Admiral, Saritcheff, relates that one of the Esquimaux in his presence devoured a mass of boiled rice and butter which weighed twenty-eight pounds, at a single meal, and Dr. Hayes states that usually the daily ration of an Esquimau is from twelve to fifteen pounds of meat, one-third of which is fat, and on one occasion he saw a man eat ten pounds of walrus flesh at a single meal. The intense cold creates a constant craving for fatty articles of food, and some members of his own party were in the habit of drinking the contents of the oil-kettle with great apparent relish. DIGESTIBILITY OF FOOD. Unless an article of diet can be digested it is of no value, no matter how rich it may be in nutriment. The quantity of food taken, will influence to a considerable extent, the time consumed in its digestion. The stomachs of all are not alike in this respect, and the subject of time has been a difficult one to determine. The experiments of Dr. Beaumont with the Canadian, St. Martin, who accidentally discharged the contents of a loaded gun into his stomach, creating an external opening through which the process of digestion could be observed, have furnished us with the following table, which is correct enough to show relatively, if not absolutely, the time required for the digestion of various articles: ====================================================== ARTICLES OF DIET. | Mode of | Hours. Min. |Preparation.| ----------------------------|------------|------------ Milk........................|Boiled......| 2 00 " ........................|Raw.........| 2 15 Eggs, fresh.................| " .........| 2 00 " " .................|Whipped.....| 1 30 " " .................|Roasted.....| 2 15 " " .................|Soft boiled.| 3 00 " " .................|Hard boiled.| 3 30 " " .................|Fried.......| 3 30 Custard.....................|Baked.......| 2 45 Codfish, cured, dry.........|Boiled......| 2 00 Trout, salmon, fresh........| " .........| 1 30 Trout, salmon, fresh........|Fried.......| 1 30 Bass, striped, " ........|Broiled.....| 3 00 Flounder, " ........|Fried.......| 3 30 Catfish, " ........| " .........| 3 30 Salmon, salted..............|Boiled......| 4 00 Oysters, fresh..............|Raw.........| 2 55 " " ..............|Roasted.....| 3 15 " " ..............|Stewed......| 3 30 Venison steak...............|Broiled.....| 1 35 Pig, sucking................|Roasted.....| 2 30 Lamb, fresh.................|Broiled.....| 2 30 Beef, fresh, lean, dry......|Roasted.....| 3 30 " with mustard, etc........|Boiled......| 3 10 " " salt only...........| " ......| 3 36 " " " " ...........|Fried.......| 4 00 " fresh, lean, rare........|Roasted.....| 3 00 Beefsteak...................|Broiled.....| 3 00 Mutton, fresh...............| " .....| 3 00 " " ...............|Boiled......| 3 00 " " ...............|Roasted.....| 3 15 Veal, fresh.................|Broiled.....| 4 00 " " .................|Fried.......| 4 30 Porksteak...................|Broiled.....| 3 15 Pork, fat and lean..........|Roasted.....| 5 15 " recently salted.......|Raw.........| 3 00 " " " .......|Stewed......| 3 00 " " " .......|Broiled.....| 3 15 ------------------------------------------------------ ARTICLES OF DIET. |Mode of Preparation. |Hours/Min. ---------------------------|---------------------|---------- Pork, recently salted----- |Fried------------ |4 15 " " " ----- |Boiled----------- |4 30 Turkey, wild ------------- |Roasted---------- |2 18 " tame ------------- | " ---------- |2 30 " " ------------- |Boiled ---------- |2 25 Goose, wild -------------- |Roasted --------- |2 30 Chickens, full-grown ----- |Fricasseed ------ |2 45 Fowls, domestic ---------- |Boiled ---------- |4 00 " " ---------- |Roasted --------- |4 00 Ducks, tame -------------- | " --------- |4 00 " wild -------------- | " --------- |4 30 Soup, barley ------------- |Boiled ---------- |1 30 " bean --------------- | " ---------- |3 00 " chicken ------------ | " ---------- |3 00 " mutton ------------- | " ---------- |3 30 " oyster ------------- | " ---------- |3 30 " beef, vegetables, | | and bread ---------- | " ---------- |4 00 " marrow-bones ------- | " ---------- |4 15 Pig's feet, soused ------- | " ---------- |1 00 Tripe, soused ------------ | " ---------- |1 00 Brains, animal ----------- | " ---------- |1 45 Spinal marrow, animal ---- | " ---------- |2 40 Liver, beef, fresh ------- |Broiled --------- |2 00 Heart, animal ------------ |Fried ----------- |4 00 Cartilage ---------------- |Boiled ---------- |4 15 Tendon ------------------- | " ---------- |5 30 Hash, meat, and vegetables |Warmed ---------- |2 30 Sausage, fresh ----------- |Broiled --------- |3 20 Gelatine ----------------- |Boiled ---------- |2 30 Cheese, old, strong ------ |Raw ------------- |3 30 Green corn and beans ----- |Boiled ---------- |3 45 Beans, pod --------------- | " ---------- |2 30 Parsnips ----------------- | " ---------- |2 30 Potatoes ----------------- |Roasted --------- |2 30 " ----------------- |Baked ----------- |2 30 " ----------------- |Boiled ---------- |2 30 Cabbage, head ------------ |Raw ------------- |2 30 " " with vinegar | " ------------- |2 00 " " ------------ |Boiled ---------- |4 30 Carrot, orange ----------- | " ---------- |3 13 Turnips, flat ------------ | " ---------- |3 30 Beets -------------------- | " ---------- |3 45 Bread, corn -------------- |Baked ----------- |3 15 " wheat, fresh ------ | " ----------- |3 30 Apples, sweet, mellow ---- |Raw ------------- |1 30 " sour ------------- | " ------------- |2 00 " " hard --------- | " ------------- |2 50 Milk is more easily digested than almost any other article of food. It is very nutritious, and, on account of the variety of the elements which it contains, it is extremely valuable an article of diet, especially when the digestive powers are weakened, as in fevers, or during convalescence from any acute disease. Eggs are also very nutritious and easily digested. Whipped eggs are digested and assimilated with great ease. Fish, as a rule, are more speedily digested than is the flesh of warm-blooded animals. Oysters, especially when taken raw, are very easily digested. We have known dyspeptics who were unable to digest any other kind of animal food, to subsist for a considerable period upon raw oysters. The flesh of mammalia seems to be more easily digested than that of birds. Beef, mutton, lamb, and venison are easily digested, while fat roast pork and veal are digested with difficulty. According to the foregoing table vegetables were digested in about the same time as ordinary animal food, but it should be remembered that a great part of the digestion of these is effected in the small intestine. Soups are, as a rule, very quickly digested. The time required for the digestion of bread is about the same as that required for the digestion of ordinary meats. Boiled cabbage is one of the most difficult substances to digest. COOKERY. "Cookery," says Mrs. Owen, "Is the art of turning every morsel to the best use; it is the exercise of skill, thought, and ingenuity to make every particle of food yield the utmost nourishment and pleasure, of which it is capable." We are indebted to this practical woman for many valuable suggestions in this art; and some of our recommendations are drawn from her experience. SOUPS. The nutritious properties, tone, and sweetness of soup depend in the first place upon the freshness and quality of the meat; secondly on the manner in which it is boiled. Soups should be nicely and delicately seasoned, according to the taste of the consumer, by using parsley, sage, savory, thyme, sweet marjoram, sweet basil, or any of the vegetable condiments. These may be raised in the garden, or obtained at the drug stores, sifted and prepared for use. In extracting the juices of meats, in order that soups may be most nutritious, it is important that the meat be put into _cold_ water, or that which is not so hot as to coagulate the albumen (which would prevent it from being extracted), and then, by slow heat and a simmering process, the most nutritious properties will be brought out. BEEF SOUP may be made of any bone of the beef, by putting it into cold water, adding a little salt, and skimming it well just before it boils. If a vegetable flavor be desired, celery, carrots, onions, turnips, cabbage, or potatoes, may be added, in sufficient quantities to suit the taste. MUTTON SOUP may be made from the fore-quarter, in the same manner as described above, thickened with pearl-barley or rice, and flavored to suit the taste. BOILED FISH. Clean the fish nicely, then sprinkle flour on a cloth and wrap it around them; salt the water, and, when it boils, put in the fish; let them boil half an hour, then carefully remove them to a platter, adding egg sauce and parsley. To _bake fish_, prepare by cleaning, scaling, etc., and let them remain in salt water for a short time. Make a stuffing of the crumbs of light bread, and add to it a little salt, pepper, butter, and sweet herbs, and stir with a spoon. Then fill the fish with the stuffing and sew it up. Put on butter, salt, pepper, and flour, having enough water in the dish to keep it from burning, and baste often. A four pound fish will bake in fifty or sixty minutes. BROILED STEAK. Sirloin and porter-house steaks should be broiled quickly. Preserve them on ice for a day or two and their tenderness is much increased. Never broil them until the meal is ready to be served. BOILED HEAT. When meat is to be boiled for _eating,_ put it into boiling water, by which its juices are coagulated and its richness preserved. The slower it boils, the more tender, plump, and white it will be. Meat should be removed as soon as done, or it will lose its flavor and become soggy. PORK STEAKS. The best steaks are cut off the shoulder--ham steaks being rather too dry. They should be well fried, in order to destroy the little living parasites, called Trichinae which sometimes infest this kind of meat. They are introduced into the stomach by eating ham, pork, or sausages made from the flesh of hogs infested by them. Thorough cooking destroys them, and those who will persist in the use of swine's flesh can afford to have it "_done brown._" BAKED MUTTON. To bake mutton well, a person should have a brisk, sharp fire, and keep the meat well basted. It requires two hours to bake a leg of mutton, weighing eight pounds. BREAD. The health and happiness of a family depend, to a certain extent, on good, well-baked bread. At all events, our enjoyment would be greater if it were only better prepared. We make the following extract from an article printed by the State Board of Health, concerning the food of the people of Massachusetts: "As an example of good bread we would mention that which is always to be had at the restaurant of Parker's Hotel, in Boston. It is not better than is found on the continent of Europe on all the great lines of travel, and in common use by millions of people in Germany and France; but with us, it is a rare example of what bread may be. It is made from a mixture of flour, such as is generally sold in our markets, water, salt, and yeast--nothing else. The yeast is made from malt, potatoes, and hops. _The dough is kneaded from one and a half to two hours, and is then thoroughly baked."_ The truth seems to be that the kneading, which in this country takes the housewife's time and muscle, in Europe is done by the help of machinery. So here, in large villages and cities, people might furnish themselves with good bread, by means of co-operative associations, even at a less cost than at present. BEVERAGES. WATER. The importance of water in the economy of nature is obvious to all. It is the most abundant substance of which we have knowledge. It composes four-fifths of the weight of vegetables, and three-fourths of that of animals. It is essential to the continuance of organic life. Water is universally present in all of the tissues and fluids of the body. It is not only abundant in the blood and secretions, but it is also an ingredient of the solids of the body. According to the most accurate computations, water is found to constitute from two-thirds to three-fourths of the entire weight of the human body. The following table, compiled by Robin and Verdeil, shows the proportion of water per thousand parts in different solids and fluids: QUANTITY OF WATER IN 1,000 PARTS. Teeth, 100 Bones, 130 Cartilage, 550 Muscles, 750 Ligaments, 768 Brain, 789 Blood, 795 Synovial fluid, 805 Bile, 880 Milk, 887 Pancreatic juice, 900 Urine, 936 Lymph, 960 Gastric juice, 975 Perspiration, 986 Saliva, 995 THE NATURAL DRINK OF MAN. Water constitutes the natural drink of man. No other liquid can supply its place. Its presence, however, in the body is not permanent. It is discharged from the body in different ways; by the urine, the feces, the breath, and the perspiration. In the first two, it is in a liquid form, in the others in a vaporous form. It is estimated that about forty-eight per cent. is discharged in the liquid, and fifty-two per cent. in the vaporous form; but the absolute as well as the relative amount discharged depends upon a variety of circumstances. Water is never found perfectly pure, since it holds in solution more or less of almost every substance with, which it comes in contact. Rain falling in the country remote from habitations is the purest water that nature furnishes, for it is then only charged with the natural gases of the atmosphere. In cities it absorbs organic and gaseous impurities, as it falls through the air, and flowing over roofs of houses carries with it soot and dust. Water from melted snow is purer than rain-water, since it descends in a solid form, and is therefore incapable of absorbing gases. Rain-water is not adapted to drinking purposes, unless well filtered. All water, except that which has been distilled, contains air, and it is due to this fact, that aquatic animals can live in it; for example, put a fish in distilled water and it will soon die. MINERAL IMPURITIES. Rain-water, which has filtered through the soil and strata of the earth, dissolves the soluble materials, and carries them down to lower levels, until they finally collect in the sea. Common well, spring, and mineral waters contain from 5 to 60 grains to the gallon; sea-water contains 2,000 grains while in some parts of the Dead Sea there are 20,000 grams to the gallon. The principal mineral impurities of well and spring water are lime, magnesia, soda, and oxide of iron, combined with carbonic and sulphuric acids, forming carbonates, sulphates, and chloride of sodium, or common salt. The most general, however, are carbonate and sulphate of lime. Mineral waters are usually obtained from springs which contain a considerable amount of saline matter. Those waters which abound in salts of iron are called _chalybeate_ or _ferruginous_. Those containing salt are termed _saline_. Those in which contain sulphur are termed _sulphurous_. Water derives the quality of hardness from the salts of lime--chiefly the sulphates--which it contains. Hard water, being an imperfect solvent, is unsuitable for washing purposes. There are two varieties of hardness, one of which is temporary, being due to the presence of carbonic acid gas in the water which holds the salts in solution and may be removed by merely boiling the water and thus expelling the gas when the salts are deposited, while the other is permanent and can only be removed by the distillation of the water. It has been ascertained that twelve pounds of the best hard soap must be added to 10,000 gallons of water of one degree of hardness before a lather will remain and, consequently, 0.12 lb. to 100 gallons of water is a measure of one degree of hardness. Since hard water is not so useful in cooking and other domestic purposes, as soft water, causing a great waste of labor and material, it is often highly desirable to soften it, which is effected by the addition of lime in what is known as _Clark's process_. One ounce of quicklime should be added to 1000 gallons of water for each degree of hardness. It should be first slacked and stirred up in a few gallons and then thoroughly mixed with the entire quantity. Then it should be allowed to remain, and will become clear in about three hours, but should not be drunk for twelve hours. The purity of drinking water is a matter of much importance. That which contains a minute quantity of lead will give rise to all the symptoms of lead poisoning, if the use of it be sufficiently prolonged. An account is given of the poisoning of the royal family of France, many of whom suffered from this cause when in exile at Claremont. The amount of lead was only one grain in the gallon. Care should therefore be taken to avoid drinking the water which has been contained in leaden pipes. It should always be allowed to run a few minutes before being used. An excess of saline ingredients, which in small quantities are harmless, frequently produces marked disorders of the digestive organs. A small amount of putrescent matter habitually introduced into the system, as in the use of food, is productive of the most serious results, which can be traced to the direct action of the poison introduced. A case is recorded of a certain locality favorably situated with regard to the access of pure air, where an epidemic of fever broke out much to the astonishment of the inhabitants. Upon observation it was found that the attacks of fever were limited to those families who used water from a neighboring well. The disagreeable taste of the water which had been observed, was subsequently traced to the bursting of a sewer, which had discharged a part of its contents into the well. When the cause was removed, there was no recurrence of the evil effects. ORGANIC IMPURITIES. "Water is liable to organic contamination from a multitude of causes, such as drainage from dwellings, dust, insects, the decaying of vegetable and animal matter. These impurities may be mechanically suspended or held in solution in the water. Although organic impurities, which are mechanically suspended in water, are poisonous, yet they are generally associated with animalculea, and these feed upon, and finally consume them. Good water never contains animalculæ. They are never found in freshly fallen rain-water, remote from dwellings, but abound, to a greater or less extent in cisterns, marshes, ponds, and rivers. These little workers serve a useful purpose since they consume the dead organic matter from the water, and, having fulfilled their mission, sink to the bottom and die. Water which contains organic matter is exceedingly dangerous to health, and its use should be carefully avoided. In low lands where the current of streams is sluggish, and shallow pools abound, the water is apt to be more or less infected with decaying vegetable substances. Many people living in such localities, and wishing to obtain water with as little trouble as possible, dig a hole in the ground, a few feet in depth, and allow the stagnant surface water to accumulate. This water is used for drinking and cooking. The result is that ague prevails in such localities. Care should be taken that wells, from which the water is used for household purposes, are located at a distance from barn-yards, privies, sinks, vaults, and stagnant pools. PURIFICATION OF WATER. There are various methods of purifying water. It may be accomplished by distillation, which is the most perfect method; by filtration through sand, crushed charcoal, and other porous substances, which deprives it of suspended impurities and living organisms; by boiling, which destroys the vitality of all animal and vegetable matters, drives out the gases and precipitates carbonate of lime, which composes the crust frequently seen upon the inside of tea-kettles or boilers; by the use of chemical agents, which may be employed to destroy or precipitate the deleterious substances. Alum is often used to cleanse roily water, two or three grains in solution, being sufficient for a quart. It causes the impurities to settle to the bottom, so that the clear water can be poured or dipped out for use. One or two grains of the permanganate of potassium will render wholesome a gallon of water containing animal impurities. HOW TO USE WATER. Very little if any water should be taken at meal time, since the salivary glands furnish an abundance of watery fluid to assist in mastication. When these glands are aided with water to "wash down" the food, their functions become feeble and impaired. The gastric juice is diluted and digestion is weakened. Large draughts of cold water ought never to be indulged in, since they cause derangement of the stomach. When the body is overheated, the use of much water is injurious. It should only be taken in small quantities. Thirst may be partially allayed, without injury, by holding cold water in the mouth for a short time and then spitting it out, taking care to swallow but very little. Travelers frequently experience inconvenience from change of water. If the means are at hand, let them purify their drinking water, if not, they should drink as little as possible. Persons who visit the banks of the Ohio, Missouri, or Mississippi rivers and similar localities, almost invariably suffer from some form of gastric or intestinal disease. Water standing in close rooms soon becomes unfit to drink and should not be used. A drink of cold water taken on going to bed, and another on rising are conducive to health, especially in the case of persons troubled with constipation. "_Drink water_" said the celebrated Dubois to the young persons who consulted him, "_drink water, I tell you!_" Du Moulin, the great medical authority of his time, wrote, just previous to his death, "_I leave two great physicians behind me--diet and water_." TEA AND COFFEE. These substances are almost universally used as beverages, and when properly employed, serve a four-fold purpose: they quench thirst, excite an agreeable exhilaration, repress the waste of the system, and supply nourishment. In consequence of being generally used at meal times, their stimulant properties are employed to promote digestion, and consequently they are not so objectionable as they might otherwise be. The liquids introduced into the stomach at meal times should not be cold. Tea and coffee are drunk warm, while water, except in a few instances, is always drunk cold, the effects of which have already been shown. That their inordinate use may be injurious no body can deny, but this is equally true of other beverages, even pure, cold water. Scientific investigators inform us that the use of these agents as beverages, when judiciously employed, is not injurious. It has been urged that they are poisonous, but if they are, they are very slow in their operation. When properly prepared, they are very agreeable beverages, and as man will drink more or less at meals, they are allowable; for if their use were excluded, some other beverage would be sought after, and quite likely one of an alcoholic character employed, so of two evils, if this be an evil, let us choose the least. Unlike alcoholic stimulants, they exhilarate without a depressing reaction after their influence has passed off. But one cup should be drunk at a meal, and it should be of moderate strength. The use of large quantities of drink at meals retards digestion by diluting the digestive fluids. The excessive use of large quantities of strong tea or coffee stimulates the brain and causes wakefulness, and produces irritability of the nervous system. When they are productive of such effects, their use is injurious, and should be considerably moderated or wholly discontinued. No criterion can be given by which the amount the system will tolerate can be regulated. What one person may take with impunity, may be deleterious to an other. Individuals differ greatly in this respect. There are some who cannot tolerate them at all, either because of some peculiarity of constitution, or on account of disease. And sometimes when tea is agreeable and beneficial, coffee disagrees with the individual and _vice versa._ Persons of nervous habits whether natural or acquired, are apt to find their wakefulness and irritability increased by the use of tea, particularly if strong, while coffee will have a tranquilizing effect. Persons of a lymphatic or bilious temperament often find that coffee disagrees with them, aggravating their troubles and causing biliousness, constipation, and headache, while tea proves agreeable and beneficial. Whenever they disagree with the system, the best rule is to abandon their use. We find many persons who do not use either, and yet enjoy health, a fact which proves that they are not by any means indispensable, and, no doubt, were it customary to go without them, their absence would be but slightly missed. Tea and coffee are adulterated to a very great extent, and persons using them will be greatly imposed upon. This is an evil we cannot remedy. If people make use of them, their experience in selecting them must be their guide; however, it is believed that the Black and Japan varieties of tea are the least apt to be adulterated, and coffee, to insure purity, should be purchased in the berry, and ground by the purchaser. In preparing tea an infusion should be made by adding boiling water to the leaves, and permitting them to steep for a few minutes only, for a concentrated decoction, made by boiling for a long time, liberates the astringent and bitter principles and drives off the agreeable aroma which resides in a volatile oil. Coffee should be prepared by adding cold water to the ground berry, and raising it slowly to the boiling point. Long-continued boiling liberates the astringent and bitter principles upon which its stimulant effects to a great extent depend, and drives off with the steam the aromatic oil from which the agreeable taste is derived. ALCOHOLIC LIQUORS. These are divided into three classes: malted, fermented, and distilled. They all contain more or less alcohol, and their effects are, therefore, in some respects similar, and, in the words of Dr. B.W. Richardson, the great English authority on hygiene: "To say this man only drinks ale, that man only drinks wine, while a third drinks spirits, is merely to say, when the apology is unclothed, that all drink the same danger. * * Alcohol is a universal intoxicant, and in the higher orders of animals is capable of inducing the most systematic phenomena of disease. But it is reserved for man himself to exhibit these phenomena in their purest form, and to present, through them, in the morbid conditions belonging to his age, a distinct pathology. Bad as this is, it might be worse; for if the evils of alcohol were made to extend equally to animals lower than man, we should soon have, none that were tameable, none that were workable, and none that were eatable." Researches have shown that the proportion of half a drachm of alcohol to the pound weight of the body, is the quantity which usually produces intoxication, and that an increase of this amount to one drachm immediately endangers the life of the individual. The first symptom which attracts attention, when alcohol commences to take effect upon the body, is an increase in the number of the pulsations of the heart. Dr. Parkes and Count Wolowicz conducted a series of interesting experiments on young adult men. They counted the pulsations of the heart, at regular intervals, during periods when the subject drank only water; and then they counted the beats of the heart in the same individual during successive periods in which alcohol was drunk in increasing quantities. The following details are taken from their report: "The highest of the daily means of the pulse observed during the first or water period was 77.5; but on this day two observations were deficient. The next highest daily mean was 77 beats. If instead of the mean of the eight days, or 73.57, we compare the mean of this one day, viz., 77 beats per minute, with the alcoholic days, so as to be sure not to over-estimate the action of the alcohol, we find: On the ninth day, with one fluid ounce of alcohol, the heart beat 430 times more. On the tenth day, with two fluid ounces, 1,872 times more. On the eleventh day, with four fluid ounces, 12,960 times more. On the twelfth day, with six fluid ounces, 30,672 times more. On the thirteenth day, with eight fluid ounces, 23,904 times more. On the fourteenth day, with eight fluid ounces, 25,488 times more. But as there was ephemeral fever on the twelfth day, it is right to make a deduction, and to estimate the number of beats in that day as midway between the twelfth and twenty-third days, or 18,432. Adopting this, the mean daily excess of beats during the alcoholic days was 14,492, or an increase of rather more than thirteen per cent. The first day of alcohol gave an excess of one per cent., and the last of twenty-three per cent.; and the mean of these two gives almost the same percentage of excess as the mean of the six days. Admitting that each beat of the heart was as strong during the alcoholic as in the water period (and it was really more powerful), the heart on the last two days of alcohol was doing one-fifth more work. Adopting the lowest estimate which has been given of the daily work done by the heart, viz., as equal to 122 tons lifted one foot, the heart, during the alcoholic period, did daily work in excess equal to lifting 15.8 tons one foot, and in the last two days did extra work to the amount of twenty-four tons lifted as far. The period of rest for the heart was shortened, though, perhaps, not to such an extent as would be inferred from the number of beats; for each contraction was sooner over. The beat on the fifth and sixth days after alcohol was left off, and apparently at the time when the last traces of alcohol were eliminated, showed, in the sphygmographic tracing, signs of unusual feebleness; and, perhaps, in consequence of this, when the brandy quickened the heart again, the tracing showed a more rapid contraction of the ventricles, but less power than in the alcoholic period. The brandy acted, in fact, on a heart whose nutrition had not been perfectly restored." The flush often seen on the cheeks of those who are under the influence of alcoholic liquors, and which is produced by a relaxed and distended condition of the superficial blood vessels, is erroneously supposed by many to merely extend to the parts exposed to view. On this subject, Dr. Richardson says: "If the lungs could be seen, they, too, would be found with their vessels injected; if the brain and spinal cord could be laid open to view, they would be discovered in the same condition; if the stomach, the liver, the spleen, the kidneys, or any other vascular organs or parts could be laid open to the eye, the vascular engorgement would be equally manifest. In the lower animals I have been able to witness this extreme vascular condition in the lungs, and once I had the unusual, though unhappy opportunity of observing the same phenomenon in the brain of a man who, in a paroxysm of alcoholic delirium, cast himself under the wheels of a railway carriage. The brain, instantaneously thrown out from the skull by the crash, was before me within three minutes after the accident. It exhaled the odor of spirit most distinctly, and its membranes and minute structures were vascular in the extreme. It looked as if it had been recently injected with vermilion injection. The white matter of the cerebrum, studded with red points, could scarcely be distinguished when it was incised, it was so preternaturally red; and the pia mater, or internal vascular membrane covering the brain, resembled a delicate web of coagulated red blood, so tensely were its fine vessels engorged. This condition extended through both the larger and the smaller brain, cerebrum, and cerebellum, but was not so marked in the medulla, or commencing portion of the spinal cord, as in the other portions. In course of time, in persons accustomed to alcohol, the vascular changes, temporary only in the novitiate, become confirmed and permanent. The bloom on the nose which characterizes the genial toper is the established sign of alcoholic action on the vascular structure. Recently, physiological research has served to explain the reason why, under alcohol the heart at first beats so quickly, why the pulse rises, and why the minute blood-vessels become so strongly injected. At one time it was imagined that alcohol acts immediately upon the heart by stimulating it to increased motion; and from this idea,--false idea, I should say,--of the primary action of alcohol, many erroneous conclusions have been drawn. We have now learned that there exist many chemical bodies which act in the same manner as alcohol, and that their effect is not to stimulate the heart, but to weaken the contractile force of the extreme and minute vessels which the heart fills with blood at each of its strokes. These bodies produce, in fact, a paralysis of the organic nervous supply of the vessels which constitute the minute vascular structures. The minute vessels when paralysed offer inefficient resistance to the force of the heart, and the pulsating organ thus liberated, like the main-spring of a clock from which the resistance has been removed, quickens in action, dilating the feebly resistant vessels, and giving evidence really not of increased, but of wasted power." The continued use of alcoholic liquors in any considerable quantity produces irritation and inflammation of the stomach, and structural disease of the liver. Dr. Hammond has shown that alcohol has a special affinity for nervous matter, and is, therefore, found in greater quantity in the brain and spinal cord than elsewhere in the body. The gray matter of the brain undergoes, to a certain extent, a fatty degeneration, and there is a shrinking of the whole cerebrum, with impairment of the intellectual faculties, muscular tremor, and a shambling gait. Large doses of alcohol cause a diminution of the temperature of the body, which in fevers is more marked than in the normal state. In addition to the organic diseases enumerated above, and delirium tremens, the following diseases are frequently the result of the excessive use of alcoholic liquors: epilepsy, paralysis, insanity, diabetes, gravel, and diseases of the heart and blood-vessels. The physiological deductions of Dr. Richardson are so much in accord with our own that we quote them in full: "In the first place we gather from the physiological reading of the action of alcohol that the agent is narcotic. I have compared it throughout to chloroform, and the comparison is good in all respects save one, viz.: that alcohol is less fatal than chloroform as an instant destroyer. It kills certainly in its own way, but its method of killing is slow, indirect, and by disease. The well-proven fact that alcohol, when it is taken into the body, reduces the animal temperature, is full of the most important suggestions. The fact shows that alcohol does not in any sense act as a supplier of vital heat as is commonly supposed, and that it does not prevent the loss of heat as those imagine 'who take just a drop to keep out the cold,' It shows, on the contrary, that cold and alcohol, in their effects on the body, run closely together, an opinion confirmed by the experience of those who live or travel in cold regions of the earth. The experiences of the Arctic voyagers, of the leaders of the great Napoleonic campaigns in Russia, of the good monks of St. Bernard, all testify that death from cold is accelerated by its ally alcohol. Experiments with alcohol in extreme cold tell the like story, while the chilliness of the body which succeeds upon even a moderate excess of alcoholic indulgence leads directly to the same indication of truth. The conclusive evidence now in our possession that alcohol taken into the animal body sets free the heart, so as to cause the excess of motion of which the record has been given above, is proof that the heart, under the frequent influence of alcohol, must undergo deleterious change of structure. It may, indeed, be admitted in proper fairness, that when the heart is passing through these rapid movements it is working under less pressure than when its movements are slow and natural; and this allowance must needs be made, or the inference would be that the organ ought to stop at once, in function, by the excess of strain put upon it. At the same time the excess of motion is injurious to the heart and to the body at large; it subjects the heart to irregularity of supply of blood, it subjects the body in all its parts to the same injurious influence; it weakens, and, as a necessary sequence, degrades both the heart and the body. Speaking honestly, I cannot, by any argument yet presented to me, admit the alcohols by any sign that should distinguish them from other chemical substances of the paralysing narcotic class. When it is physiologically understood that what is called stimulation or excitement is, in absolute fact, a relaxation, a partial paralysis, of one of the most important mechanisms in the animal body, the minute, resisting, compensating circulation, we grasp quickly the error in respect to the action of stimulants in which we have been educated, and obtain a clear solution of the well-known experience that all excitement, all passion, leaves, after its departure, lowness of heart, depression of mind, sadness of spirit. We learn, then, in respect to alcohol, that the temporary excitement it produces is at the expense of the animal force, and that the ideas of its being necessary to resort to it, that it may lift up the forces of the animal body into true and firm and even activity, or that it may add something useful to the living tissues, are errors as solemn as they are widely disseminated. In the scientific education of the people no fact is more deserving of special comment than this fact, that excitement is wasted force, the running down of the animal mechanism before it has served out its time of motion. It will be said that alcohol cheers the weary, and that to take a little wine for the stomach's sake is one of the lessons that comes from the deep recesses of human nature. I am not so obstinate as to deny this argument, There are times in the life of man when the heart is oppressed, when the resistance to its motion is excessive, and when blood flows languidly to the centres of life, nervous and muscular. In these moments alcohol cheers. It lets loose the heart from its oppression; it lets flow a brisker current of blood into the failing organs; it aids nutritive changes, and altogether is of temporary service to man. So far, alcohol may be good, and if its use could be limited to this one action, this one purpose, it would be amongst the most excellent of the gifts of science to mankind. Unhappily, the border line between this use and the abuse of it, the temptation to extend beyond the use, the habit to apply the use when it is not wanted as readily as when it is wanted, overbalance, in the multitude of men, the temporary value that attaches truly to alcohol as a physiological agent. Hence alcohol becomes a dangerous instrument even in the hands of the strong and wise, a murderous instrument in the hands of the foolish and weak. Used too frequently, used too excessively, this agent, which in moderation cheers the failing body, relaxes its vessels too extremely; spoils vital organs; makes the force of the circulation slow, imperfect, irregular; suggests the call for more stimulation; tempts to renewal of the evil, and ruins the mechanism of the healthy animal before its hour for ruin, by natural decay, should be at all near. It is assumed by most persons that alcohol gives strength, and we hear feeble persons saying daily that they are being 'kept up by stimulants.' This means actually that they are being kept down; but the sensation they derive from the immediate action of the stimulant deceives them and leads them to attribute passing good to what, in the large majority of cases, is persistent evil. The evidence is all-perfect that alcohol gives no potential power to brain or muscle. During the first stage of action it may enable a wearied or a feeble organism to do brisk work for a short time; it may make the mind briefly brilliant; it may excite muscle to quick action, but it does nothing substantially, and fills up nothing it has destroyed, as it leads to destruction. A fire makes a brilliant sight, but leaves a desolation. It is the same with alcohol. On the muscular force the very slightest excess of alcoholic influence is injurious. I find by measuring the power of muscle for contraction in the natural state and under alcohol, that so soon as there is a distinct indication of muscular disturbance, there is also indication of muscular failure, and if I wished by scientific experiment to spoil for work the most perfect specimen of a working animal, say a horse, without inflicting mechanical injury, I could choose no better agent for the purpose of the experiment than alcohol. But alas! the readiness with which strong, well-built men slip into general paralysis under the continued influence of this false support, attests how unnecessary it would be to subject a lower animal to the experiment. The experiment is a custom, and man is the subject. The true place of alcohol is clear; it is an agreeable temporary shroud. The savage, with the mansions of his soul unfurnished, buries his restless energy under its shadow. The civilized man overburdened with mental labor, or with engrossing care, seeks the same shade; but it is shade, after all, in which, in exact proportion as he seeks it, the seeker retires from perfect natural life. To search for force in alcohol is, to my mind, equivalent to the act of seeking for the sun in subterranean gloom until all is night. It may be urged that men take alcohol, nevertheless, take it freely, and yet live; that the adult Swede drinks his average cup of twenty-five gallons of alcohol per year and remains on the face of the earth. I admit force even in this argument, for I know under the persistent use of alcohol there is a limited provision for the continuance of life. In the confirmed alcoholic the alcohol is, in a certain sense, so disposed of that it fits, as it were, the body for a long season, nay, becomes part of it; and yet it is silently doing its fatal work. The organs of the body may be slowly brought into a state of adaptation to receive it and to dispose of it. But in that very preparation they are themselves made to undergo physical changes tending to the destruction of their function, to perversion of their structure, and to all those varied modifications of organic parts which the dissector of the human subject learns to recognize,--almost without concern, and certainly without anything more than commonplace curiosity,--as the devastations incident to alcoholic indulgence." The statistics collected from the census of the United States for 1860, and given by Dr. De Marmon, in the _New York Medical Journal_ for December, 1870, must carry conviction to all minds of the correctness of the foregoing deductions: "For the last ten years the use of spirits has, 1. Imposed on the nation a direct expense of 600,000,000 dollars. 2. Has caused an indirect expense of 600,000,000 dollars. 3. Has destroyed 300,000 lives. 4. Has sent 100,000 children to the poorhouses. 5. Has committed at least 150,000 people into prisons and workhouses. 6. Has made at least 1,000 insane. 7. Has determined at least 2,000 suicides. 8. Has caused the loss by fire or violence, of at least 10,000,000 dollars' worth of property. 9. Has made 200,000 widows and 1,000 orphans." If these were the statistics twenty-four years ago, with our greatly increased population, what must they be to-day? We will let the reader draw his own conclusions. MALTED LIQUORS. Under this head are included all those liquors into the composition of which malt enters, such as beer, ale, and porter. The proportion of alcohol in these liquors varies greatly. In beer, it is from two to five per cent.; in Edinburgh ale, it amounts to six per cent.; in porter, it is usually from four to six per cent. In addition to alcohol and water, the malted liquors contain from five to fourteen per cent. of the extract of malt, and from 0.16 to 0.60 per cent. of carbonic acid. They possess, according to Pereira, three properties: they quench thirst; they stimulate, cheer, and, if taken in sufficient quantity, intoxicate; and they nourish or strengthen. The first of these qualities is due to the water entering into their composition; the second, to the alcohol; the third is attributed the nutritive principles of the malt. OBJECTIONS TO THEIR USE AS BEVERAGES. These articles are either pure or adulterated. In their pure state the objection to their use for this purpose lies in the fact that they contain alcohol. This, as we have seen, is a poisonous substance, which the human system in a state of health does not need. Its use, when the body is in a normal condition, is uncalled for, and can only be deleterious. Beverages containing this poison are more or less deleterious to healthy persons, according to the amount of it which they contain. These liquors are frequently adulterated, and this increases their injurious effects. The ingenuity of man has been taxed to increase their intoxicating properties; to heighten the color and flavor, to create pungency and thirst; and to revive old beer. To increase the intoxicating power, tobacco or the seeds of the Cocculus indicus are added; to heighten the color and flavor, burnt sugar, liquorice, or treacle, quassia, or strychnine, coriander, and caraway seeds are employed; to increase the pungency, cayenne pepper or common salt is added; to revive old beer, or ale, it is shaken up with green vitriol or sulphate of iron, or with alum and common salt. FERMENTED LIQUORS. These are cider and wine. Cider contains alcohol to the amount of from five to ten per cent., saccharine matter, lactic acid, and other substances. New cider may be drunk in large quantities without inducing intoxication, but old cider is quite as intoxicating as ale or porter. The composition of wine is very complex, the peculiar qualities which characterize the different varieties cannot be ascertained by chemical analysis. Wine is a solution of alcohol in water, combined with various constituents of the grape. The amount of alcohol in wines ranges from six to forty per cent. As beverages, these are open to the same objections as those manufactured from malt. As a medicine, wine is a useful remedy. Concerning its use in this capacity, Prof. Liebig says: "Wine is a restorative. As a means of refreshment when the powers of life are exhausted--as a means of compensation where a misappropriation occurs in nutrition, and as a means of protection against transient organic disturbances, it is surpassed by no product of nature or art." That an article is useful in medicine, however, is no reason why it should be used as a beverage by those in health. It is rather an argument against such a practice. For it is generally true that the drugs used to restore the diseased system to health, are pernicious or poisonous to it when in a normal condition. DISTILLED LIQUORS. These are whiskey, brandy, and the kindred productions of the still. Whiskey is a solution of alcohol in water, mixed with various other principles which impart to it peculiar physical properties. The amount of alcohol which it contains varies from forty-eight to fifty-six per cent. Old whiskey is more highly prized than the more recent product of the still, from the fact that when kept for some years certain volatile oils are generated which, impart to it a mellowness of flavor. Brandy is a solution of alcohol in water, together with various other substances. It contains from fifty to fifty-six per cent. of alcohol. Pure brandy is distilled from wine, 1,000 gallons of wine yielding from 100 to 150 gallons of brandy, but a very large proportion of the brandy is made with little or no wine. It is made artificially from high wines by the addition of oil of Cognac, to give it flavor, burnt sugar to give it color, and logwood or catechu, to impart astringency and roughness of taste. The best brandy is obtained by distillation from the best quality of white wines, from the districts of Cognac and Armagnac in France. THE CLOTHING. There is no physical agent which exerts a more constant or more powerful influence upon health and life, than the atmosphere. The climate in these latitudes is exceedingly variable, ranging all the way from 110° Fahr. in summer to 40° below zero in the winter season. The body of every individual should be so protected from cold, that it can maintain a mean temperature of 98° Fahr. When the body is warm there is a free and equal circulation of the blood throughout all the structures. When the surface is subjected to cold, the numerous capillaries and minute vessels carrying the blood, contract and diminish in size, increasing the amount of this fluid in the internal organs, thus causing congestion. The blood must go somewhere, and if driven from the surface, it retreats to the cavities within. Hence this repletion of the vital organs causes pain from pressure and fullness of the distended blood-vessels, and the organic functions are embarrassed. Besides, cold upon the surface shuts up the pores of the skin, which are among the most active and important excretory ducts of the system. It is evident, then, that we require suitable clothing, not only for comfort, but to maintain the temperature and functions essential to health and life. The chief object to be attained by dress is the maintenance of a uniform temperature of the body. To attain this end, it is necessary that the exhalations of the system, which are continually escaping through the pores of the skin, should be absorbed or conducted away from the person. These exudations occur in the form of sensible or insensible perspiration, and the clothing, to be healthy, should be so porous as to allow them freely to escape into the air. A substance should also be chosen which is known to be a poor conductor of heat. That generated by the system will thus be retained where it is needed, instead of being dispersed into the atmosphere. We might add that the better the material for accomplishing these purposes, the less will be needed to be worn; for we do not wish to wear or carry about with us any more material than is necessary. It so happens that all of these qualities are found combined in _flannel_. The value of this article worn next to the skin cannot be over-rated, for while it affords protection from cold during the winter months, it is equally beneficial during the heat of summer, because it imbibes the perspiration, and being very porous, allows it to escape. The skin always feels soft, smooth, and pliable, when it is worn; but, when cotton takes its place, it soon becomes dry and harsh. Its natural adaptability to these purposes, shows that it is equally a comfort and a source of health. Where the skin is very delicate, flannel sometimes causes irritation. In such cases a thin fabric of linen, cotton, or silk, should be worn next the skin, with flannel immediately over it. Where there is a uniform and extreme degree of heat, cotton and linen are very conducive to comfort. But they are unsuitable in a climate or season liable to sudden fluctuations in temperature. The value of furs, where people are exposed to extreme cold, cannot be overestimated. They are much warmer than wool, and are chiefly used as wraps on going outdoors. They are too cumbrous and expensive for ordinary wear in this latitude, but in places near the poles they constitute the chief clothing of the inhabitants. The quantity of clothing worn is another important item. The least that is necessary to keep the body well protected and evenly tempered when employed is the rule of health. Some people, instead of wearing flannels next to the body, put on other material in greater abundance, thus confining the perspiration to the skin and making the body chilly. The amount of clothing is then increased, until they are so heavily clad that they cannot exercise. It is far better to wear one thickness of flannel next to the skin, and then cotton, or woolen, for outside garments, and be able to exercise, thus allowing the blood to circulate and to assist in the warming process. One great fault in dress consists in neglecting to properly clothe the upper extremities. Some people do not reflect upon the necessity, while others are too proud to be directed by plain common sense. In the winter season, the feet should be covered with woolen stockings. The next matter of importance, is to get a thick, broad-soled shoe, so large that it will not prevent the free circulation of the blood. Then for walking, and especially for riding, when the earth is wet and cold, or when there is snow on the ground, wear a flannel-lined rubber or "Arctic" over-shoe. _Be sure and keep the feet comfortable and warm at all times._ Our next advice is to keep the legs warm. We were called not long ago, to see a young lady who had contracted a severe cold. She had been to an entertainment where the apartments were nicely warmed, and from thence had walked home late in the evening. We inquired into the circumstances of the case, and ascertained that she wore flannel about her chest, and that she also wore rubbers over her shoes, but the other portions of the lower extremities were protected by cotton coverings. In short, her legs were not kept warm, and she took cold by going out from warm rooms into a chilly atmosphere. A good pair of woolen leggings might have saved her much suffering. The results of insufficient protection of the lower extremities are colds, coughs, consumption, headaches, pain in the side, menstrual derangements, uterine congestion and disorders, besides disablement for the ordinary and necessary duties of life. All these may be prevented by clothing the legs suitably, and wearing comfortable flannels. Young people can bear a low temperature of the body better than old people, because they possess greater power of endurance. But that is no reason for unnecessary exposure. The amount of clothing should be regulated according to the heat-generating power of the individual, and also according to the susceptibility to cold. No two persons are exactly alike in these respects. But it is never proper for young people to reject the counsels of experience, or treat lightly the advice to protect themselves thoroughly against the cold. Many a parent's heart has ached as he has followed the mortal remains of a darling child to the grave, knowing that if good advice had been heeded, in all human probability, the life would have been prolonged. The most deleterious mechanical errors in clothing are those which affect the chest and body. Tight lacing still plays too important a part in dress. It interferes with the free and healthy movements of the body, and effects a pressure which is alike injurious to the organs of respiration, circulation, and digestion. The great muscle of respiration, the diaphragm, is impeded in its motion, and is, therefore, unable to act freely. The large blood-vessels are compressed, and when the pressure is excessive the heart and lungs are also subjected to restraint and thrown out of their proper positions. From the compression of the liver and stomach, the functions of digestion are impeded, a distaste for solid food, flatulency and pain after eating are the unmistakable proofs of the injury which is being inflicted. The evil effects of such pressure are not confined to actual periods of time during which this pressure is applied. They continue after it has been removed and when the chest and trunk of the body have thus been subjected to long-continued pressure they become permanently deformed. These deformities necessarily entail great suffering in child-bearing. The evil effects of mechanical pressure on other parts of the body are not uncommon. The leg is sometimes so indented by a tight garter that the returning flow of blood through the veins is prevented, and a varicose condition of these vessels is produced. Irregular and excessive pressure on the foot by imperfectly fitting shoes or boots produce deformities of the feet and cause much suffering. The high heels which are so common on the shoes of women and children inflict more than a local injury. Every time the body comes down upon the raised heel with its full weight a slight shock or vibration is communicated throughout the entire extent of the spinal column, and the nervous mechanism is thereby injured. Furthermore, displacements of the pelvic organs frequently result from these unnatural and absurd articles of dress. Women of fashion are subjected to much annoyance from wearing long, flowing skirts suspended from their waists to trail uselessly on the floor and gather dust. It is impossible for the wearers of these ridiculous garments to exercise their limbs properly or to breathe naturally. Indigestion, palpitation, shortness of breath, and physical degeneracy are the inevitable consequences of their folly. The skirts should always be suspended from the shoulders and not from the hips. It is especially important that the clothing of children should not fit too tightly. It is very important that the clothing should be kept clean. That which is worn for a long time becomes saturated with the excretions and exhalations of the body, which prevent free transpiration from the pores of the skin, and thereby induce mental inactivity and depression of the physical powers. Unclear clothing may be the means of conveying disease. Scarlet fever has been conveyed frequently by the clothing of a nurse into a healthy family. All of the contagious diseases have been communicated by clothing contaminated in laundries. Certain dyes which are largely used in the coloring of wearing apparel are poisonous, and give rise to local disease of the skin, accompanied in some instances, with constitutional symptoms. The principal poisonous dyes are the red and yellow aniline. A case of poisoning from wearing stockings colored with aniline dyes, in which there were severe constitutional symptoms, came under our observation at the Invalids' Hotel recently. * * * * * CHAPTER III. PHYSICAL EXERCISE. MENTAL CULTURE. SLEEP. CLEANLINESS. A well-developed physical organization is essential to perfect health. Among the Greeks, beauty ranked next to virtue, and an eminent author has said that "the nearer we approach Divinity, the more we reflect His eternal beauty." The perfect expression of thought requires the physical accompaniments of language, gesture, etc. The human form is pliable, and, with proper culture, can be made replete with expression, grace and beauty. The cultivation of the intellectual powers has been allowed to supplant physical training to a great extent. The results are abnormally developed brains, delicate forms, sensitive nerves and shortened lives. That the physical and mental systems should be collaterally developed, is a fact generally overlooked by educators. The fullness of a great intellect is generally impaired when united with a weak and frail body. We have sought perfection in animals and plants. To the former we have given all the degree of strength and grace requisite to their peculiar duties; to the latter we have imparted all the delicate tints and shadings that fancy could picture. We have studied the laws of their existence, until we are familiar with every phase of their production; yet it remains for man to learn those laws of his own being, by a knowledge of which he may promote and preserve the beauty of the human form, and thus render it, indeed, an image of its Maker. When the body is tenanted by a cultivated intellect, the result is a unity which is unique, commanding the respect of humanity, and insuring a successful life to the possessor. Students are as a rule pale and emaciated. Mental application is generally the cause assigned when, in reality, it is the result of insufficient exercise, impure air, and dietetic errors. An intelligent journalist has remarked that "many of our ministers weigh too little in the pulpit, because they weigh too little on the scales." The Greek Gymnasium and Olympian Games were the sure foundations of that education from which arose that subtle philosophy, poetry, and military skill which have won the admiration of nineteen centuries. The laurel crown of the Olympian victor was far more precious to the Grecian youth than the gilded prize is to our modern genius. A popular lecturer has truly remarked, that "we make brilliant mathematicians and miserable dyspeptics; fine linguists with bronchial throats; good writers with narrow chests and pale complexions; smart scholars, but not that union, which the ancients prized, of a sound mind in a sound body. The brain becomes the chief working muscle of the system. We refine and re-refine the intellectual powers down to a diamond point and brilliancy, as if they were the sole or reigning faculties, and we had not a physical nature binding us to earth, and a spiritual nature binding us to the great heavens and the greater God who inhabits them. Thus the university becomes a sort of splendid hospital with this difference, that the hospital _cures_, while the university _creates_ disease. Most of them are indicted at the bar of public opinion for taking the finest young brain and blood of the country, and, after working upon them for four years, returning them to their homes skilled indeed to perform certain linguistic and mathematical dexterities, but very much below par in health and endurance, and, in short, seriously damaged and physically demoralized." We read with reverence the sublime teachings of Aristotle and Plato; we mark the grandeur of Homer and the delicate beauties of Virgil; but we do not seek to reproduce in our modern institutions the gymnasium, which was the real foundation of their genius. Colleges which are now entering upon their career, should make ample provision for those exercises which develop the _physical man._ This lack of bodily training is common with all classes, and its effects are written in indelible characters on the faces and forms of old and young. Constrained positions in sitting restrict the movements of the diaphragm and ribs and often cause diseases of the spine, or unnatural curvatures, which prove disastrous to health and happiness. The head should be held erect and the shoulders thrown backward, so that at each inspiration the lungs may be fully expanded. Physical exercise should never be too violent or too prolonged. Severe physical labor, and athletic sports, if indulged in to an extreme degree, produce undue excitability of the heart, and sometimes cause it to become enlarged. There is a form of heart disease induced by undue exertion which may be called a wearing out or wasting away of that organ. It is common in those persons whose occupations expose them to excessive physical labor for too many hours together. This feebleness of heart is felt but little by vigorous persons under forty years of age, but in those who have passed this age it becomes manifest. However, when any person so affected is attacked by any acute disease, the heart is more liable to fail, and thus cause a fatal termination. Aneurism of the aorta or the large arteries branching off from it, which is a dilatation of the walls of these vessels, caused by the rupture of one or two of their coats, is generally induced by excessive physical strain, such as lifting heavy weights, or carrying weights up long flights of stairs, violent horseback exercise, or hurrying to catch a train or street car. [Illustration: Fig. 104.] AN ERECT CARRIAGE is not only essential to health, but adds grace and beauty to every movement. Although man was made to stand erect, thus indicating his superiority over all other animals, yet custom has done much to curve that magnificent central column, upon the summit of which rests the "grand dome of thought." Many young persons unconsciously acquire the habit of throwing the shoulders forward. The spinal column is weakened by this unnatural posture, its vertebræ become so sensitive and distorted that they cannot easily support the weight of the body or sustain its equilibrium. It is generally believed that persons of sedentary habits are more liable to become round-shouldered than any other class of individuals. Observation shows, on the contrary, that the manual laborer, or even the idler, often acquires this stooping posture. It can be remedied, not by artificial braces, but by habitually throwing the shoulders backwards. Deformed trunks and crooked spines, although sometimes the effects of disease are more frequently the results of carelessness. Jacques has remarked that "one's standing among his fellow-men is quite as important a matter in a _physiological_, as in a _social_ sense." _Walking_ is one of the most efficient means of physical culture, as it calls all the muscles into action and produces the amount of tension requisite for their tonicity. Long walks or protracted physical exercise of any kind should never be undertaken immediately after meals. The first essential to a healthful walk is a pleasurable object. Beautiful scenery, rambles in meadows rich with fragrant grasses, or along the flowery banks of water-courses, affords an agreeable stimulus, which sends the blood through the vital channels with unwonted force, and imparts to the cheeks the ruddy glow of health. Our poets acknowledge the silent influence of nature. Wordsworth has expressed this thought in his own sublime way: "The floating clouds their state shall lend To her: for her the willow bend; Nor shall she fail to see, E'en in the motions of the storm Grace that shall mould the maiden's form By silent sympathy. The stars of midnight shall be dear To her: and she shall lean her ear In many a secret place, Where rivulets dance their wayward round, And beauty, born of murmuring sound, Shall pass into her face." BASE BALL, CRICKET, BOXING, AND FENCING, are all manly exercises when practiced solely with a view to their hygienic advantages and as such have our approval. [Illustration: Fig. 105.] [Illustration: Fig. 109.] THE ART OF SWIMMING was regarded by the Greeks as an important accomplishment. As a hygienic agency, it occupies a high place in physical culture. The varied movements impart strength and elasticity to the muscles. It is as charming a recreation for women and girls as for men and boys. Furthermore, it is not only a means of physical culture, but is often essential for self-preservation. [Illustration: Fig. 110.] THE EXERCISES OF THE GYMNASIUM are especially productive of health and longevity. The most important of these are balancing, leaping, climbing, wrestling, and throwing, all of which are especially adapted to the development of the muscles. In conclusion, we offer the following suggestions, viz: all gymnastic exercises should be practiced in the morning, and in the open air; extremes should be avoided; and it should be always borne in mind, that their chief object is to combine, in a proper proportion, mental and physical development. In every relation of life we should cultivate all those faculties which pertain to our physical, moral, and mental natures, subdue our passions, and nature will bestow upon us her richest rewards of health, beauty, and happiness. CYCLING. [Illustration] If one were asked what athletic exercise deserves to be the most popular in America to-day, the answer would of necessity be cycling. The bicycle is being used by people of all ages and conditions of health in daily life; its hygienic value as a means to healthy exercise cannot be overestimated. In this, as in everything else, immoderation is to be condemned, particularly where persons have not had sufficient training to take long "spins," or attempt racing. Beginners should ride only 10 or 12 minutes at a time--resting then to permit the circulation to become equalized. In all cyclists, at all ages, in veteran riders as well as those not practiced in the art, there is, in the beginning of each attempt, a quickened circulation; the pulse is full and bounding, and rarely falls under a hundred pulsations per minute. So long as the exercise is continued, an increase of cardiac motion is observable, and a vigorous circulation is kept up. This accounts for the astounding journeys a fully trained cyclist can accomplish, and also for his endurance without sleep. In spite of the quickened motion of the heart, rarely have riders been known to grow giddy or show symptoms of cardiac embarrassment. A good rider may climb a hill without trouble, yet be unable to climb a flight of stairs without breathlessness and palpitation. Bicycle riding as a means for acquiring strength and vigor, improving the circulation and developing the respiratory organs, is unexcelled. Fast riding, or "scorching," among those not used to physical exertion, and leaning over the handle-bars so as to ride in a stooping position, are to be heartily condemned. The latter prevents the lungs from getting their full expansion, and cultivates a tendency to round shoulders. Men or women suffering from diseases of the sexual organs should, before riding, consult the physician having their case in charge. [Illustration: Fig. 112.] RIDING ON HORSEBACK is a fine exercise for both sexes. It promotes digestion, improves the circulation, and expands and develops the respiratory organs. The pure, fresh air, pleasant scenery, and pleasurable excitement, impart renewed vigor to the equestrian. In the Southern States it is a universal accomplishment, and children are taught to ride as well as to walk. DANCING. Notwithstanding the fact that dancing has been perverted to the basest purposes, has been made the fruitful source of dissipation, and has often laid the foundation for disease, it is yet capable of being made to minister to health and happiness. As a means of physical culture, it favors the development of the muscular system, and promotes health and cheerfulness. When practiced for this purpose, Jacques terms it "the best of all indoor exercises," as it brings to bear upon the physical system a great number of energizing and harmonious influences. MENTAL CULTURE. The brain, like all other organs of the body, requires alternate exercise and repose; and, in physical endurance, it is subject to general physiological laws. When exercised with moderation it acquires strength, vigor, and an accelerated activity. Excessive mental exertion is liable to result in softening of the brain, and various nervous diseases, sometimes culminating in insanity, and in many instances proving fatal to life. The mere votaries of pleasure who avoid all effort of the mind, fall into the opposite error. In all cases of intellectual activity, the exertions should be directed to some subject interesting to the student. In this manner duty will become a pleasure, which in turn will re-invigorate the mental functions. When the mind in confined to one subject for any considerable length of time together, it becomes fatigued, and requires relaxation, recreation, rest. This may be obtained by directing the attention to some other subject, either study or amusement, the latter of which is preferable. The amusement, however, may be of an intellectual or physical character or both combined, and will, if properly conducted, restore vigor to both mind and body. Prominent among physical phenomena is the mutual relation between the brain and the organs of nutrition. Mental exertion should be avoided for at least one hour after a hearty meal, and all mental labor which requires concentration of thought ought to be accomplished in the earlier portion of the day, when the brain is refreshed and repaired by the night's repose. Mental, like physical endurance, is modified by age, health and development. A person accustomed to concentration of thought, can endure a longer mental strain than one inured to manual labor only. One of the most injurious customs, is the cultivation of the intellect at the expense of the physical powers. MENTAL CULTURE DURING CHILDHOOD. One of the greatest mistakes which people make in the management of their children, is to overtask their mental faculties. Although it is exceedingly gratifying to see children acquire knowledge, and manifest an understanding far beyond their years, this gratification is often purchased too dearly, for precocious children are apt to die young. The tissue of the brain and nerves of children is very delicate; they have not yet acquired the powers of endurance which older persons possess. The greater portion of the nutriment assimilated, is required for growth and organic development, and they can ill afford its expenditure for mental manifestations. They receive impressions easier and learn much more readily than in after life, but it is at the expense of the physical organization. Their mental faculties continue to be developed by the expenditure of brain nutriment, while physical growth and the powers of endurance are arrested. It is much better to give physical development the precedence in order that the mental organism may be well supported and its operations carried into effect; for it must be apparent to all that an ordinary intellect in a healthy body, is capable of accomplishing infinitely more than a strong mind in a _weak_ body. Regularity should be observed in exercising the mental functions. For this reason a fixed order in the pursuit of any literary occupation is very essential. The pursuit of the most abstruse studies will thus become habitual and comparatively easy, a consequence of systematic application. Mental labor should always cease when the train of thought becomes confused, and there is the slightest sensation of depression. All distracting influences should be absent from the mind, in order to facilitate intense study, for the intellect cannot attend perfectly to two subjects at the same time. Painful sensations always have a tendency to paralyze mental exertion. Great care should be taken that the head is not subjected to injury of any kind, as it is almost invariably accompanied by some nervous derangement. Exposure to extreme heat should be carefully avoided. An attack of sun-stroke although it may not be immediately fatal, may occasion tumors in the brain, or some organic disease. SLEEP. For all animated beings sleep is an imperious necessity, as indispensable as food. The welfare of man requires alternate periods of activity and repose. It is a well-established physiological fact, that during the wakeful hours the vital energies are being expended, the powers of life diminished, and, if wakefulness is continued beyond a certain limit, the system becomes enfeebled and death is the result. During sleep there is a temporary cessation of vital expenditures, and a recuperation of all the forces. Under the influence of sleep "the blood is refreshed, the brain recruited, physical sufferings are extinguished, mental troubles are removed, the organism is relieved, and hope returns to the heart." The severest punishment which can be inflicted upon a person, is to entirely deprive him of sleep. In China, a few years since, three criminals were sentenced to be kept awake until they should die. To do this it was necessary to keep a guard over them. The sentinels were armed with sharp, pointed instruments, with which to goad the victims and thus prevent them from sleeping. Life soon became a burden, and, although they were well fed during the time, death occurred sooner than it would have done had starvation been the punishment. SLEEPING ROOMS. The sleeping room should be large and well ventilated, and the air kept moderately cool. The necessity for a fire may be determined by the health of the occupant. Besides maintaining a proper temperature in the room, a little fire is useful, especially if in a grate, for the purpose of securing good ventilation. The windows should not be so arranged as to allow a draught upon the body during the night, but yet so adjusted that the inmate may obtain plenty of fresh air. THE BED should not be too soft, but rather hard. Feathers give off animal emanations of an injurious character, and impart a feeling of lassitude and debility to those sleeping on them. No more coverings should be used than are actually necessary for the comfort of the individual. Cotton sheets are warmer than linen, and answer equally as well. SLEEPING ALONE. Certain effluvia are thrown off from our persons, and when two individuals sleep together each inhales from the other more or less of these emanations. There is little doubt that _consumption_, and many other diseases, not usually considered contagious, are sometimes communicated in this manner. When it is not practicable for individuals to occupy separate beds, the persons sleeping together should be of about the same age, and in good health. Numerous cases have occurred in which healthy, robust children have gradually declined and died within a few months, from the evil effects of sleeping with old people. Again, those in feeble health have been greatly benefited, and even restored, by sleeping with others who were young and healthy. TIME FOR SLEEP. _Night_ is the proper time for sleep. When day is substituted for night, the sleep obtained does not fully restore the exhausted energies of the system. Nature does not allow her laws to be broken with impunity. Children require more sleep than old persons. They are sometimes stupefied with "soothing syrups," and preparations of opium, in order to get them temporarily out of the way. Such narcotics are very injurious and dangerous. We have known a young child to be killed by a _single drop_ of laudanum. This practice, therefore, cannot be too emphatically condemned. HOW TO PUT CHILDREN TO BED. The following characteristic lines are from the pen of Fanny Fern, and contain such good advice that we cannot refrain from quoting them: "Not with a reproof for any of the day's sins of omission or commission. Take any other time than bed-time for that. If you ever heard a little creature sighing or sobbing in its sleep, you could never do this. Seal their closing eyelids with a kiss and a blessing. The time will come, all too soon, when they will lay their heads upon their pillows lacking both. Let them at least have this sweet memory of happy childhood, of which no future sorrow or trouble can rob them. Give them their rosy youth. Nor need this involve wild license. The judicious parent will not so mistake my meaning. If you ever met the man or the woman, whose eyes have suddenly filled when a little child has crept trustingly to its mother's breast, you may have seen one in whose childhood's home 'dignity' and 'severity' stood where love and pity should have been. Too much indulgence has ruined thousands of children; too much love not one." POSITION IN SLEEP. The proper position in sleep is upon the right side. The orifice leading from the stomach to the bowels being on this side, this position favors the passage of the contents into the duodenum. Lying on the back is injurious, since by so doing the spine becomes heated, especially if the person sleeps on feathers, the circulation is obstructed and local congestions are encouraged. The face should never be covered during sleep, since it necessitates the breathing of the same air over again, together with the emanations from the body. THE AMOUNT OF SLEEP. The amount of sleep required varies with the age, habits, condition, and peculiarities of the individual. No definite rule can be given for the guidance of all. The average amount required, however, is eight or nine hours out of the twenty-four. Some persons need more than this, while others can do with less. Since both body and mind are recuperated by sleep, the more they are exhausted the more sleep is required. A person employed at mental labor should have more than one who is merely expending muscular strength. Six hours of unbroken sleep do more to refresh and revive than ten when frequently interrupted. If it is too prolonged it weakens and stupefies both body and mind. If an insufficient amount is taken the flagging energies are not restored. Persons who eat much, or use stimulants generally require more than others. To sleep regularity is desirable. If a person goes to bed at a certain hour for several nights in succession, it will soon become a habit. The same holds true with regard to rising. If children are put to sleep at a stated hour for several days in succession, it will soon become a habit with them. CLEANLINESS. "Cleanliness is next to godliness," and is essential to the health and vigor of the system. Its importance cannot be overestimated, and it should be inculcated early on the minds of the young. "Even from the body's purity, the mind receives a secret sympathetic aid." When we consider the functions of the skin, with its myriads of minute glands, innumerable little tubes, employed in removing the worn-out, useless matter from the system, we cannot fail to appreciate the utility of frequent bathing with soap and water. Unless these excretions are removed, the glands become obstructed, their functions are arrested, and unpleasant odors arise. Many persons think because they daily bathe the face, neck, and hands, dress the hair becomingly and remove the dirt from their clothing that the height of cleanliness has been reached. From a hygienic point of view, bathing the _entire_ body is of much greater importance. Notwithstanding the necessity for cleanliness of the body, we occasionally meet with persons who, although particular about their personal appearance, permit their bodies to be for weeks and even months without a bath. Such neglect should never exceed one week. Plenty of sunlight and at least one or two general baths every week are essential to perfect health. Cleanliness is necessary to health, beauty, attractiveness, and a cheerful disposition. * * * * * CHAPTER IV. HYGIENE OF THE REPRODUCTIVE ORGANS. The structure and functions of organized bodies are subject to continual alteration. The changes of nutrition and growth, which are constantly taking place in the tissues render them at the same time the seat of repair and waste, of renovation and decomposition, of life and death. The plant germinates and blossoms, then withers and decays; animal life, in like manner, comes into being, grows to maturity, fades, and dies. It is, therefore, essential to the perpetuation of life, that new organisms be provided to take the place of those which are passing out of existence. There is no physiological process which presents more interesting phenomena than that of reproduction, which includes the formation, as well as the development of new beings. Since self-preservation is Nature's first law, the desire for food is a most powerful instinct in all living animals. Not inferior to this law is that for the perpetuation of the race; and for this purpose, throughout the animal and vegetable kingdoms, we find the Biblical statement literally illustrated: "Male and female created He them." Health is the gauge by which the prosperity of a people may be measured. Were we to trace the history of nations,--their rise and fall,--we would find that much of the barbarism and crime, degradation and vice, as well as their decline and final extinction, was due to licentiousness and sexual excesses. Since there is an intimate relation between mind and body, when the body is enfeebled the mind becomes enervated. Morbid conditions of the body prevent the highest mental development, and, on the other hand, when the mind is debilitated, general depravity, physical as well as mental, is the result. The highest development of the body results from the equal and harmonious cultivation of all the mental powers. The perfect development and health of the physical organs is therefore essential to the happiness of mankind. But, before health can be insured the nature and general functions of the physical system must be understood. This being done, the question naturally arises: _How can health be best maintained and longevity secured?_ INFLUENCE OF FOOD. We have previously noticed the effects which food, exercise, and other hygienic agencies, have upon digestion, circulation, and respiration; and we find that they exert a not less potent influence upon the health of the generative organs. Excessive stimulation excites the sexual passions. For this reason, children should not be immoderately indulged in highly seasoned foods. Those persons who have great muscular vigor are endowed with violent passions, and unless restrained by moral considerations, are very likely to be overcome by their animal propensities. _Alcoholic stimulants_ have a debasing influence upon the whole system, and especially upon the sexual organs; they excite the animal and debase the moral nature; they exhaust the vitality, and, after the excitement, which they temporarily induce, has passed away, the body is left in a prostrated condition. PHYSICAL LABOR MODIFIES THE PASSIONS. Labor consumes the surplus vitality which a person may possess, and no better protective can be found against the gratification of the passions, unless it be high moral training, than daily toil extended to such a degree as to produce fatigue. Labor determines the blood to the surface and to other parts of the body, and prevents excitement and congestion of the sexual centers. If, by education or association, the passions of children be excited, they will be increased. If, on the contrary, they be taught to avoid these social or solitary evils, they will be abated. Let them be educated to work and the intellectual faculties will assert their sway, the moral powers will be strengthened, and the body better developed, for purity of mind is the result of the perfect development of man. INFLUENCES OF CLIMATE. Individuals possess distinguishing peculiarities characteristic of the nation to which they belong. Climate exerts a powerful influence upon mankind. In tropical regions the inhabitants are enervated, effeminate, and sensual. The rich live in luxury and ease, vice is unrestrained and license unbridled. When the animal propensities are allowed to predominate, the mental faculties are kept in subjection. Hence races that inhabit those latitudes rarely produce scholars or philosophers. A warm climate hastens the development of the reproductive organs. Men and women become mature at a much earlier age in those regions, than in countries where the temperature is lower. In like manner there is a tendency to premature enfeeblement, for the earlier the system matures, the sooner it deteriorates. MAN IS A SOCIAL BEING. History demonstrates that when man is deprived of the society of women, he becomes reckless, vicious, depraved, and even barbarous in his habits, thus illustrating the maxim: "It is not good for man to be alone." Social intercourse promotes mental and physical development. The development of the individual implies the unfolding of every power, both physical and mental. Nothing so regulates and restrains passion as a healthy condition of the organs through which it finds expression. And every organ of the body is powerful in proportion to its soundness. The propensities play a prominent part in the education of the child. When properly disciplined and held in subordination to the higher faculties, they constitute an important factor in the economy of man. Boys are more liable to be morbidly excited when secluded from the society of girls, and vice versa. Again, when the sexes are accustomed to associate, the passions are not apt to be aroused, because of the natural antagonistic constitutional elements. The influence of the one refines, and ennobles the other. Let children be taught to understand their natures, and knowing them, they will learn self-government. "As man rises in education and moral feeling he proportionately rises in the power of self-restraint; and consequently as he becomes deprived of this wholesome law of discipline he sinks into self-indulgence and the brutality of savage life. The passions may be aroused by the language, appearance or dress of the opposite sex. A word spoken without any impure intent is often construed in a very different sense by one whose passions color the thought, and is made to convey an impression entirely unlike that which was intended by the speaker. Also, the dress may be of such a character as to excite the sexual passion. The manner in which the apparel is worn is often so conspicuous as to become bawdy, thereby appealing to the libidinous desires, rather than awakening an admiration for the mental qualities. OBSCENE LITERATURE. Literature is a powerful agent either for good or evil. If we would improve the morals, _choice_ literature must be selected, whether it be that which realizes the ideal, or idealizes the real. Obscene literature, or books written for the express purpose of exciting or intensifying sexual desires in the young, goads to an illicit gratification of the passions, and ruins the moral and physical nature. It not unfrequently happens that a child is born with a vigorous, mental organism which promises a brilliant future, but manhood finds him incompetent, debilitated, and totally incapacitated for mental or manual labor. This may be the result of youthful indiscretion, ignorantly committed, but not unfrequently it is the effect of a pernicious literature which inflames the imagination, tramples upon reason, and describes to the youth a realm where the passions are the ruling deities. Many persons are born into the world with disordered organizations for which they are not themselves responsible. Such individuals are entitled to the sympathy of humanity. Dyspepsia, scrofula, consumption, and a thousand ills to which mankind is heir, are inherited from parents, the results of ill-assorted marriages. Intoxicated parents often produce offspring utterly demented. Children of healthy parents, with good constitutions, are usually healthy and intelligent. There are marked varieties of character in children of the same parents. One manifests great precocity, another is below the average in mental attainments; one is amiable, another irritable in disposition; indeed, there are often as great differences between children of the same, as of different families. This is due to the physical and mental conditions of the parents, more especially the mother, not only at the time of the impregnation but also during the period intervening between conception and the birth of the offspring. The ancients regarded courage as the principal virtue. By us, purity is so estimated. Moral purity is an essential requisite to the growth and perfection of the character. SELF-ABUSE. Untold miseries arise from the pollution of the body. Self-pollution, or onanism, is one of the most prolific sources of evil, since it leads both to the degradation of body and mind. It is practiced more or less by members of both sexes, and the habit once established, is overcome with the greatest difficulty. It is the source of numerous diseases which derange the functional activity of the organs involved, and eventually impair the constitution. This vicious habit is often practiced by those who are ignorant of its dangerous results. Statistics show that insanity is frequently caused by masturbation. Immoderate indulgence in any practice is deleterious to the individual. Emphatically true is this with regard to sexual excesses. Not unfrequently does the marriage rite "cover a multitude of sins." The abuse of the conjugal relation produces the most serious results to both parties, and is a prolific source of some of the gravest forms of disease. Prostatorrhea, spermatorrhea, impotency, hypochondria, and general debility of the generative organs, arise from sexual excesses. The health of the reproductive organs can only be maintained by leading a _temperate_ life. The food should be nourishing but not stimulating. Lascivious thoughts should be banished from the mind, and a taste cultivated for that literature which is elevating in its nature, and the associations should be refining and ennobling. Let these conditions and the rules of hygiene, be observed, and virtue will reward her subjects with a fine physique and a noble character. Woman, from the nature of her organization, has less strength and endurance than man. Much, however, of the suffering and misery which she experiences arises from insufficient attention to the sexual organs. The menstrual function is generally established between the ages of twelve and fourteen. For want of proper instruction, many a girl through ignorance HAS caused derangements which have enfeebled her womanhood or terminated her life. At this critical period the mother cannot be too considerate of her daughter's health. Preceding the first appearance of the menses, girls usually feel an aching in the back, pains in the limbs, chilliness, and general languor. The establishment of this function relieves these symptoms. Every precaution should be taken during the period to keep the feet dry and warm, to freely maintain a general circulation of the blood, to avoid exertion, and to refrain from standing or walking too much. Menstrual derangements should never be neglected, for they predispose to affections of the brain, liver, heart, and stomach, induce consumption and frequently end in death. Young women should, therefore, properly protect themselves, and avoid extremes of heat and cold. * * * * * CHAPTER V. PRACTICAL SUMMARY OF HYGIENE. 1. The first step which should be taken for the prevention of disease, is to make provision for the health of the unborn child. Greater care should be exercised with women who are in a way to become mothers. Those who are surrounded by all the luxuries which health can bestow, indulge too much in rich food, and take too little exercise; while the poor get too little nourishment, and work too hard and too long. A woman in this condition should avoid over-exertion, and all scenes which excite the passions or powerful emotions. She should take moderate exercise in the open air; eat moderately of wholesome food, and of meat not oftener than twice a day; take tea or coffee in limited quantities, and avoid the use of all alcoholic liquors; she should go to bed early and take not less than nine hours sleep; her clothing should be loose, light in weight, and warm. She should take every precaution against exposure to contagious or infectious diseases. 2. There is no better method for preventing the spread of contagious diseases than perfect isolation of the infected, and thorough disinfection of all articles of clothing or bedding which have been in contact with the infected. Many persons erroneously believe that every child must necessarily have the measles, and other contagious diseases, and they, therefore, take no precautions against the exposure of their children. The liability to infection diminishes as age advances, and those individuals are, as a rule, the strongest and best developed who have never suffered from any of the contagious diseases. Although, vaccination is the great safeguard against-pox, yet it should never prevent the immediate isolation of those who are suffering from this disease. 3. To avoid the injurious effects of impure air, the following rules, should be carefully observed. The admission of air which contains anything that emits an unpleasant odor into closed rooms should be avoided. The temperature of every apartment should be kept as near 70° Fahr. as possible, and the air should not be overcharged with watery vapor. Provisions should be made for the free admission into and escape of air from the room at all times. When an apartment is not in use, it should be thoroughly ventilated by opening the windows. Those who are compelled to remain in an atmosphere tilled with dust, should wear a cotton-wool respirator. 4. To insure a healthy condition of the body, the diet of man ought to be varied, and all excesses should be avoided. The total amount of solid food taken in the twenty-four hours should not exceed two and a half pounds, and not more than one-third of this quantity should consist of animal food. Many persons do not require more than one pound and a half of mixed food. To avoid parasitic diseases, meat should not be eaten rare, especially pork. The amount of drink taken should not be more than three pints in twenty-four hours. The excessive use of tea and coffee should be avoided. Pickles, boiled cabbage, and other indigestible articles should never be eaten. 5. To avoid the evil effects of alcoholic liquors, perfect abstinence is the only safe course to pursue. Although one may use spirituous liquors in moderation for a long period of time and possibly remain healthy, yet such an indulgence is unnecessary and exceedingly dangerous. A person who abstains entirely from their use is safe from their pernicious influence; a person who indulges ever so moderately is in danger; a person who relies on such stimulants for support in the hour of need is lost. 6. While the use of tobacco is less pernicious than alcohol in its effects, et it exerts a profound disturbing influence upon the nervous system, and gives rise to various functional and organic diseases. This is the verdict of those who have given the subject the most study, and who have had the best opportunities for extensive observation. Suddenly fatal results have followed excesses in the use of tobacco. Therefore, the habit should be avoided, or if already acquired, it should be immediately abandoned. 7. The clothing should be light and porous, adapted in warmth to the season. It is especially important that persons in advanced life should be well protected against vicissitudes of heat and cold. Exposure is the cause of almost all those inflammatory diseases which occur during winter, and take off the feeble and the aged. The under-garments should be kept scrupulously clean by frequent changes. Corsets or bands which impede the flow of blood, compress the organs of the chest or abdomen, or restrict the movements of the body, are very injurious, and should not be worn. Articles of dress which are colored with irritating dye-stuffs, should be carefully avoided. 8. It matters not how varied a person's vocation may be, change, recreation, and rest are required. It is an error to suppose that more work can be done by omitting these. No single occupation which requires special mental or physical work, should be followed for more than eight hours out of the twenty-four. The physical organism is not constructed to run its full cycle of years and labor under a heavier burden than this. Physical and mental exercise is conducive to health and longevity, if not carried too far. It is erroneous to suppose that excessive physical exertion promotes health. Man was never intended to be a running or a jumping machine. In mental work, variety should be introduced. New work calls into play fresh portions of the brain, and secures repose for those parts which have become exhausted. Idleness should be avoided by all. Men should never retire from business as long as they enjoy a fair degree of health. Idleness and inactivity are opposed to nature. 9. The average length of time which a person ought to sleep is eight hours out of the twenty-four, and, as a rule, those who take this amount enjoy the best health. The most favorable time for sleep is between the hours of 10 P.M. and 6 A.M. All excitement, the use of stimulants, and excessive fatigue tend to prevent sleep. Sleeping rooms should be well ventilated, and the air maintained at a equable temperature of as near 60° Fahr. as possible. An inability to sleep at the proper time, or a regular inclination to sleep at other than the natural hours for it, is a certain indication of errors of habit, or of nervous derangement. 10. Prominent among all other measures for the maintenance of Health, is personal cleanliness. Activity in the functions of the skin is essential to perfect health, and this can only be secured by thoroughly bathing the entire body. Strictly, a person should bathe once every twenty-four or forty-eight hours. The body should be habituated to contact with cold water at all season of the year, so that warm water may not become a necessity. The simplest and most convenient bath, is the ordinary sponge-bath. An occasional hot-air, or Turkish bath, exerts a very beneficial influence. It cleans out the pores of the skin and increases its activity. 11. The emotions and the passions exert a powerful influence over the physical organism. It is important, therefore, that they be held under restraint by the reasoning faculties. This rule applies equally to joy, fear, and grief; to avarice, anger, and hatred; and, above all, to the sexual passion. They are a prolific source of disease of the nervous system, and have caused the dethronement of some of the most gifted intellects. * * * * * PART III. RATIONAL MEDICINE. CHAPTER I. THE PROGRESS OF MEDICINE. During the last half century a great change has taken place in the treatment of disease. Medicine has advanced with rapid strides, from the narrow limits of mere empiricism, to the broader realm of rationalism, until to day it comprehends all the elements of an art and a science. Scientific researches and investigations have added many valuable truths to the general fund of medical learning, but much more has been effected by observation and empirical discovery. It is of little or no interest to the invalid to know whether the prescribed remedy is organic or inorganic, simple, compound, or complex. In his anxiety and distress of body, he seeks solely for relief, without regard to the character of the remedial agents employed. But this indifference on the part of the patient does not obviate the necessity for a thorough, scientific education on the part of the practitioner. Notwithstanding all the laws enacted to raise the standard of medicine, and thus protect the public from quackery, there yet exists a disposition among many to cling to all that savors of the miraculous, or supernatural. To insure the future advancement of the healing art, physicians must instruct mankind in Physiology, Hygiene, and Medicine. When the people understand the nature of diseases, their causes, methods of prevention and cure, they will not be easily deceived, and practitioners will be obliged to qualify themselves better for their labors. The practice of medicine is every year becoming more successful. New and improved methods of treating disease are being discovered and developed, and the conscientious physician will avail himself of _all_ the means, by a knowledge of which he may benefit his fellow-men. The medical profession is divided into three principal schools, or sects. THE ALLOPATHIC, REGULAR, OR OLD SCHOOL OF MEDICINE. This is the oldest existing branch of the profession. To it is due the credit of collecting and arranging the facts and discoveries which form the foundation of the healing art. It has done, and is doing, much to place the science of medicine on a firm basis. To the text-books of this school, every student who would qualify himself for medical practice must resort, to gain that knowledge upon which depends his future success. The early practice of this branch of the profession was necessarily crude and empirical. Conservative in its character, it has ever been slow to recognize new theories and methods of practice, and has failed to adopt them until they have been incontrovertibly established. This conservatism was manifested in the opposition to Harvey when he propounded the theory of the circulation of the blood, and to Jenner when he discovered and demonstrated the beneficial effects of vaccination. Thus has it ever defended its established opinions against innovation; yet out of this very conservatism has grown much real good, for, although it has wasted no time or energy in the investigation of theories, yet it has accepted them when established. In this manner it has added to its fund of knowledge only those truths which are of real and intrinsic value. The history of medicine may be divided into three eras. In the first, the practice of medicine was merely empiricism. Ignorant priests or astrologers administered drugs, concerning the properties of which they had no knowledge, to appease the wrath of mythological deities. In the second or heroic era, the lancet, mercury, antimony, opium, and the blister were employed indiscriminately as the _sine qua non_ of medical practice. The present, with all its scientific knowledge of the human structure and functions, and its vast resources for remedying disease may be aptly termed the liberal era of medicine. The allopathic differs from the other schools, mainly in the application of remedies. In its ranks are found men, indefatigable in their labors, delving deep into the mysteries of nature, and who, for their scientific attainments and humane principles are justly considered ornaments to society and to their profession. HOMOEOPATHY. Although this school is of comparatively recent origin, yet it has gained a powerful hold upon the public favor, and numbers among its patrons very many intelligent citizens. This fact alone would seem to indicate that it possesses some merit. The homeopathic differs from the allopathic school principally in its _"law of cure,"_ which, according to Hahnemann, its founder, was the doctrine of _"similia similibus curantur"_ or "like cures like." Its method of treatment is founded upon the assumption that if a drug be given to a healthy person, symptoms will occur which, if transpiring in disease, would be mitigated by the same drug. While it may be exceedingly difficult for a member of another school to accept this doctrine and comprehend the method founded upon it, yet no one can deny that it contains some elements of truth. Imbued with the spirit of progress, many of its most intelligent and successful practitioners have resorted to the use of appreciable quantities of medicine. This school associates hydropathy with its practice, and usually inculcates rigid dietetic and hygienic regulations. Many homoeopathic remedies are thoroughly triturated with sugar of milk, which renders them more palatable and efficacious. Whether we attribute their cures to the infinitesimal doses which many homoeopathists employ, to their "law of cure," to good nursing, or to the power of nature, it is nevertheless true that their practice is measurably successful. No doubt the homoeopathic practice has modified that of the other schools, by proving that diseases may be alleviated by smaller quantities of medicine than were formerly employed. THE ECLECTIC SCHOOL. This school, founded by Wooster Beach, instituted the most strenuous opposition to the employment of mercury, antimony, the blister, and the lancet. The members of this new school proclaimed that the action of heroic and noxious medicines was opposed to the operation of the vital forces, and proposed to substitute in their place safer and more efficacious agents, derived exclusively from the vegetable kingdom. The eclectics have investigated the properties of indigenous plants and have discovered many valuable remedies, which a kind and bounteous nature has so generously supplied for the healing of her children. Marked success attended the employment of these agents. In 1852, a committee on "Indigenous Medical Botany," appointed by the "American Medical Association," acknowledged that the practitioners of the regular school had been extremely ignorant of the medical virtues of plants, even of those of their own neighborhoods. The employment of podophyllin and leptandrin as substitutes for mercurials has been so successful that they are now used by practitioners of all schools. Although claiming to have been founded upon liberal principles, it may be questioned whether its adherents have not been quite as exclusive and dogmatic as those whom they have opposed. It cannot be denied, however, that the eclectics have added many important remedies to the Materia Medica. Their writings are important and useful contributions to the physician's library. THE LIBERAL AND INDEPENDENT PHYSICIAN. After this brief review of the various medical sects, the reader may be curious to learn to what sect the physicians of the Invalids' Hotel and Surgical Institute belong. Among them are to be found graduates from the colleges of all the different schools. They are not restricted by the tenets of any one sect, but claim the right and privilege, nay, consider it a duty, to select from all, such remedies as careful investigation, scientific research, and an extensive experience, have proved valuable. They resort to any and every agent which has been proved efficacious, whether it be vegetable or mineral. And here arises a distinction between _sanative_ remedial agents and those which are _noxious_. Many practitioners deplore the use of poisons, and advocate innocuous medicines which produce only curative results. We agree with them in one proposition, namely, that improper medicines not only poison, but frequently utterly destroy the health and body of the patient. Every physician should keep steadily in view the final effects, as well as present relief, and never employ any agent without regard to its ulterior consequences. However, an agent which is noxious in _health_, may prove a valuable remedy in _disease_. When morbid changes have taken place in the blood and tissues, when a general diseased condition of the bodily organs has occurred, then an agent, which is poisonous in health, may prove curative. For instance it is admitted that alcohol is a poison; that it prevents healthful assimilation, solidifies pepsin, begets a morbid appetite; that it produces intoxication, and that its habitual use destroys the body. It is, therefore, neither a hygienic nor a sanative agent, but strictly a noxious one; yet, its very distinct antiseptic properties render it valuable for remedial purposes, since these qualities promptly arrest that fatal form of decomposition of the animal fluids which is occasioned by snake-venom, which produces its deadly effects in the same manner as a drop of yeast ferments the largest mash. Alcohol checks this poisonous and deadly process and neutralizes its effects. Thus, alcohol, although a noxious agent, possesses a special curative influence in a morbid state of the human system; but its general remedial effects do not entitle it to the rank of a hygienic agent. We believe that medicine is undergoing a gradual change from the darkness of the past, with its ignorance, superstition, and barbarism, to the light of a glorious future. At each successive step in the path of progress, medicine approaches one degree nearer the realm of an exact science. The common object of the practitioners of all medical schools is the alleviation of human suffering. The only difference between the schools is in the remedies employed, the size of dose administered, and the results attained. These are insufficient grounds for bitter sectarianism. We are all fellow laborers in the same field. Before us lies a boundless expanse for exploration. There are new conditions of disease to be learned, new remedies to be discovered, and new properties of old ones to be examined. We do not deplore the fact, that there are different schools in medicine, for this science has not reached perfection, and they tend to stimulate investigation. The remarks of Herbert Spencer on the "Multiplication of Schemes of Juvenile Culture," may be pertinently applied to the different schools in medicine with increased force. He says: "It is clear that dissent in education results in facilitating inquiry by the division in labor. Were we in possession of the true method, divergence from it would, of course, be prejudicial; but the true method having to be found, the efforts of numerous independent seekers carrying out their researches in different directions, constitute a better agency for finding it than any that could be devised. Each of them struck by some new thought which probably contains more or less of basis in facts--each of them zealous on behalf of his plan, fertile in expedients to test its correctness, and untiring in its efforts to make known its success--each of them merciless in its criticism on the rest--there cannot fail, by composition of forces, to be a gradual approximation of all towards the right course. Whatever portion of the normal method any one of them has discovered, must, by the constant exhibition of its results, force itself into adoption; whatever wrong practices he has joined with it must, by repeated experiment and failure, be exploded. And by this aggregation of truths and elimination of errors, there must eventually be developed a correct and complete body of doctrine. Of the three phases through which human opinion passes--the unanimity of the ignorant, the disagreement of the inquiring, and the unanimity of the wise--it is manifest that the second is the parent of the third." We believe the time is coming when those maladies which are now considered fatal will be readily cured--when disease will be disarmed of its terrors. To be successful, a physician must be independent, free from all bigotry, having no narrow prejudice against his fellow-men, liberal, accepting new truths from whatever source they come, free from restrictions of societies, and an earnest laborer in the interests of the Great Physician. * * * * * CHAPTER II. REMEDIES FOR DISEASE. It will be our aim, throughout this book, to prescribe such remedies as are within the easy reach of all, and which may be safely employed. Many of those of the vegetable class are indigenous to this country, and may be procured in their strength and purity, at the proper season, by those residing in the localities where they grow, while all others advised may be obtained at any good drug-store. We shall endeavor to recommend such as can be procured and prepared with the least trouble and expense to the patient, when it is believed that they will be equally as efficacious as more expensive medicines. PROPRIETARY MEDICINES. Having the invalid's best interests in view, it will often happen that we cannot prescribe better or cheaper remedies nor those which are more effective or easily obtained, than some of our standard preparations, which are sold by all druggists. We are aware that there is a popular, and not altogether unfounded prejudice against "patent medicines," owing to the small amount of merit which many of them possess. The term "Patent Medicine" does not apply to Dr. Pierce's remedies, as no patent has ever been asked or obtained for them, nor have they been urged upon the public as "cure alls." They are simply favorite prescriptions, which, in a very extensive practice, have proved their superior remedial virtues in the cure of the diseases for which they are recommended. From the time of Hippocrates down to the present day, physicians have classified diseases according to their causes, character or symptoms. It has been proved that diseases apparently different may often be cured by the same remedy. The reason for this singular fact is obvious. A single remedy may possess a variety of properties. Quinine, among other properties has a tonic which suggests its use in cases of debility; an antiperiodic, which renders it efficient in ague; and an anti-febrile property, which renders it efficacious in cases of fever. The result produced varies with the quantity given, the time of its administration, and the circumstances under which it is employed. Every practicing physician has his favorite remedies, which he oftenest recommends or uses, because he has the greatest confidence in their virtues. The patient does not know their composition. Even prescriptions are usually written in a language unintelligible to anybody but the druggist. As much secrecy is employed as in the preparation of proprietary medicines. Does the fact that an article is prepared by a process known only to the manufacturer render that article less valuable? How many physicians know the elementary composition of the remedies which they employ, some of which never have been analyzed? Few practitioners know how morphine, quinine, podophyllin, leptandrin, pepsin, or chloroform, are made, or how nauseous drugs are transformed into palatable elixirs; yet they do not hesitate to employ them. Is it not inconsistent to use a prescription the composition of which is unknown to us, and discard another preparation simply because it is accompanied by a printed statement of its properties with directions for its use? Various journals in this country, have at different times published absurd formulae purporting to be receipts for the preparation of "Dr. Sage's Catarrh Remedy" and Dr. Pierce's standard medicines, which, in most instances, have not contained a single ingredient which enters into the composition of these celebrated remedies. In the manufacture of any pharmaceutical preparation, two conditions are essential to its perfection, viz: purity and strength of the materials, and appropriate machinery. The first is insured, by purchasing the materials in large quantities, whereby the exercise of greater care in selecting the ingredients can be afforded; and the second can only be accomplished where the business is extensive enough to warrant a large outlay of capital in procuring proper chemical apparatus. These facts apply with especial force to the manufacture of our medicines, their quality having been vastly improved since the demand has become so great as to require their manufacture in very large quantities. Some persons, while admitting that our medicines are good pharmaceutical compounds, object to them on the ground that they are too often used with insufficient judgment. We propose to obviate that difficulty by enlightening the people as to the structure and functions of their bodies, the causes, character, and symptoms of disease, and by indicating the proper and judicious employment of our medicines, together with such auxiliary treatment as may be necessary. Such is one of the designs of this volume. PROPERTIES OF MEDICINE. It is generally conceded that the action of a remedy upon the human system depends upon properties peculiar to it. The effects produced suggest the naming of these qualities, which have been scientifically classified. We shall name the diseases from their characteristic symptoms, and then, without commenting upon all the properties of a remedy, recommend its employment. Our reference to the qualities of any remedy, when we do make a particular allusion to them, we shall endeavor to make as easy and familiar as possible. DOSE. All persons are not equally susceptible to the influence of medicines. As a rule, women require smaller doses than men, and children less than women. Infants are very susceptible to the effects of anodynes, even out of all relative proportion to other kinds of medicines. The circumstances and conditions of the system increase or diminish the effects of medicine, so that an aperient at one time may act as a cathartic at another, and a dose that will simply prove to be an anodyne when the patient is suffering great pain will act as a narcotic when he is not. This explains why the same dose often affects individuals differently. The following table is given to indicate the size of the dose, and is graduated to the age. YEARS DOSE 21. . . . . . . . . .full 15. . . . . . . . . . 2-3 12. . . . . . . . . . 1-2 8 . . . . . . . . . . 1-3 6 . . . . . . . . . . 1-4 4 . . . . . . . . . . 1-6 2 . . . . . . . . . . 1-8 1 . . . . . . . . . . 1-12 ½ . . . . . . 1-20 to 1-30 The doses mentioned in the following pages are those for adults, except when otherwise specified. THE PREPARATION OF MEDICINES. The remedies which we shall mention for domestic use are mostly vegetable. Infusions and decoctions of these will often be advised on account of the fact that they are more available than the tinctures, fluid extracts, and concentrated principles, which we prefer, and almost invariably employ in our practice. Most of these medical extracts are prepared in our chemical laboratory under the supervision of a careful and skilled pharmaceutist. No one, we presume, would expect, with only a dish of hot water and a stew-kettle, to equal in pharmaceutical skill the learned chemist with all his ingeniously devised and costly apparatus for extracting the active, remedial principles from medicinal plants. Yet infusions and decoctions are not without their value; and from the inferior quality of many of the fluid extracts and other pharmaceutical preparations in the market, it may be questioned whether the former are not frequently as valuable as the latter. So unreliable are a majority of the fluid extracts, tinctures, and concentrated, active principles found in the drug-stores, that we long since found it necessary to have prepared in our laboratory, most of those which we employ. To the reliability of the preparations which we secure in this way we largely attribute our great success in the treatment of disease. Tinctures and fluid extracts are often prepared from old and worthless roots, barks, and herbs which have wholly lost their medicinal properties. Yet they are sold at just as high prices as those which are good. We manufacture our tinctures, fluid extracts, and concentrated, active principles from roots, barks, and herbs which are fresh, and selected with the greatest care. Many of the crude roots, barks, and herbs found in the market are inactive because they have been gathered at the wrong season. These, together with those that have been kept on hand so long as to have lost all medicinal value, are often sold in large quantities, and at reduced prices, to be manufactured into fluid extracts and tinctures. Of course, the preparations made from such materials are worthless. Whenever the dose of fluid extracts, tinctures, and concentrated, active principles, is mentioned in this chapter, the quantity advised is based upon our experience in the use of these preparations, as they are made in our laboratory, and the smallest quantity which will produce the desired effect is always given. When using most of the preparations found in the drug-stores, the doses have to be somewhat increased, and even then they will not always produce the desired effect, for reasons already given. THE LIST OF MEDICINES which we shall introduce in this chapter will be quite limited, as we cannot hope, by making it extensive, that the non-professional reader would be able to prescribe with good judgment any other than the simpler remedies. Hence, we prefer, since we have not space in this volume to waste, to mention only a few of the most common remedies under each head or classification. TINCTURES. Very uniform and reliable tinctures may be made of most indigenous plants, by procuring the part to be employed, at the proper season, while it is green and fresh, bruising it well, and covering it with good strong whiskey, or with alcohol diluted with one part of water to three of alcohol, corking tightly, and letting it stand about fourteen days, when the tincture may be filtered or poured off from the drugs, and will be ready for use. Prepared in this imperfect manner, they rill be found to be much more reliable than any of the fluid extracts found in the drug-stores. An excess of the crude drug should be used in preparing the tincture to insure a perfect saturation of the alcohol with its active principles. HOMOEOPATHIC TINCTURES. The tinctures prepared by several of the German and French pharmaceutists, and called by them "Mother Tinctures," to distinguish them from the dilutions made therefrom, we have found to be very reliable, so much superior to any similar preparations made in this country that we purchase from them all we use of Pulsatilla, Staphisagria, Drosera and several others. They are prepared with great care from the green, crude material, and although high in price, when compared with other tinctures, yet the greater certainty of action which we secure in our prescriptions by their employment more than repays for the expense and trouble in procuring them, for of what account is expense to the true physician when _life_ may depend upon the virtue of the agent he employs? INFUSIONS. These are generally made by adding one-half ounce of the crude medicine to a pint of water, which should be closely covered, kept warm, and used as directed. Flowers, leaves, barks, and roots become impaired by age, and it is necessary to increase or diminish the dose according to the strength of the article employed. DECOCTIONS. The difference between a decoction and an infusion is, that the plant or substance is boiled in the production of the former, in order to obtain its soluble, medicinal qualities. Cover the vessel containing the ingredients, thus confining the vapor, and shutting out the atmospheric air which sometimes impairs the active principles and their medicinal qualities. The ordinary mode of preparing a decoction is to use one ounce of the plant, root, bark, flower, or substance to a pint of water. The dose internally varies from a tablespoonful to one ounce. ALTERATIVES. Alteratives are a class of medicines which in some inexplicable manner, gradually change certain morbid actions of the system, and establish a healthy condition instead. They stimulate the vital processes to renewed activity, and arouse the excretory organs to remove matter which ought to be eliminated. They facilitate the action of the secretory glands, tone them up, and give a new impulse to their operations, so that they can more expeditiously rid the system of worn-out and effete materials. In this way they alter, correct, and purify the fluids, tone up the organs, and re-establish their healthy functions. Alteratives may possess tonic, laxative, stimulant, or diuretic properties all combined in one agent. Or we may combine several alteratives, each having only one of these properties in one remedy. We propose to enumerate only a few alteratives, and give the doses which are usually prescribed; the list which we employ in our practice is very extensive, but it cannot be made available for domestic use. MANDRAKE (_Podophyllum Peltatum_), also called May-apple, is a most valuable alterative. The root is the part used. _Dose_--Of decoction, one to two teaspoonfuls; of tincture, six to eight drops; of fluid extract, three to five drops; of its active principle, Podophyllin, one-twelfth to one-eighth of a grain. POKE (_Phytolacca Decandra_), also called Skoke, Garget, or Pigeon-berry, is a valuable alterative. The root is the part used. _Dose_--Of decoction, one to three teaspoonfuls; of fluid extract, three to ten drops; of concentrated principle, Phytolaccin, one-fourth to one grain. YELLOW DOCK (_Rumex Crispus_), The part used is the root. _Dose_--Of the infusion, one to three fluid ounces three times daily; of fluid extract, ten to thirty drops; of tincture twenty to forty drops. [Illustration: Fig. 113. Tag Alder. ] TAG ALDER (_Alnus Rubra_), This is otherwise known as the Smooth, Common, or Swamp Alder. The bark is the part used. It is excellent in scrofula, syphilis, cutaneous and all blood diseases. _Dose_--Of decoction, one or two tablespoonfuls from three to five times daily; of tincture, one or two teaspoonfuls; of fluid extract, one-half to one teaspoonful; of concentrated principle, Alnuin, one-half to one grain. [Illustration: Fig. 114. Black Cohosh. ] BLACK COHOSH (_Macrotys or Cimicifuga Racemosa_) The part used is the root. Its other common names are Black Snake-root, or Squaw-root. Black Cohosh is an alterative stimulant, nervine, diaphoretic, tonic, and a cerebro-spinal stimulant. It is a useful remedy. _Dose_--Of decoction, one-fourth to one ounce; of tincture, ten to fifteen drops; of fluid extract, five to ten drops; of the concentrated principle, Macrotin, one-eighth to one-half grain. [Illustration: Fig. 115. Blood-root. ] BLOOD-ROOT (_Sanguinaria Canadensis_), is also known as Red Puccoon. The part used is the root. In minute doses Blood-root is a valuable alterative, acting upon the biliary secretion and improving the circulation and digestion. _Dose_--Of powdered root, one-fourth to one-half grain; of tincture, one to two drops; of the fluid extract, one-half to one drop. When given in a fluid form it should be well diluted. BURDOCK (_Arctium Lappa_). The root is the part used. Burdock is a valuable alterative in diseases of the blood. _Dose_--Of tincture, from one teaspoonful to a tablespoonful twenty minutes before meals; of fluid extract, one to two teaspoonfuls. BLUE FLAG (_Iris Versicolor_). The part used is the root. _Dose_--Of the tincture, five to ten drops; of fluid extract, three to ten drops; of concentrated principle, Iridin, one-half to two grains. SWEET ELDER (_Sambucus Canadensis_). Sweet Elder-flowers are a valuable alterative, diuretic, mucous and glandular stimulant, excellent in eruptive, cutaneous, and scrofulous diseases of children. An infusion, fluid extract, or syrup, may be used in connection with the "Golden Medical Discovery." Both will be found valuable for cleansing the blood and stimulating the functions to a healthy condition. _Dose_--Of the infusion of the flowers, from one-half to one ounce, if freely taken, will operate as a laxative; of fluid extract, one-fourth to one-half teaspoonful. The flowers, or inner bark of the root, simmered in fresh butter, make a good ointment for most cutaneous affections. IODINE. This agent, in the several forms of Iodide of Potassium, Iodide of Ammonium, Iodide of Iron, and Iodide of Lime, is largely employed by physicians, and often with most happy results. But for domestic use we cannot advise its employment, as it is liable to injure the invalid, when its action is carried too far, which is apt to be the case, when not administered under the supervision of a competent physician. MERCURY. The various preparations of mercury have a profound, alterative effect upon the system. When taken for some time, they change the quality and composition of the blood; cause a diminution in the number of red blood-corpuscles, and an increase in the various effete materials. In the vast majority of cases we prefer the vegetable alteratives, but in rare instances they exert a beneficial influence, in small doses. None of the preparations of mercury should be taken internally without the advice of a skillful physician, therefore, we shall not give their doses. THE COMPOUNDING OF ALTERATIVES. The efficacy of this class of remedies can be greatly increased by properly combining several of them into one compound. This requires a knowledge of Pharmaceutical Chemistry; i.e., the preparation of compounds founded on the chemical relation and action of their several remedial, active principles. Many practitioners make combinations of remedies which neutralize each other's influence, instead of extending their efficacy and curative power. DR. PIERCE'S "GOLDEN MEDICAL DISCOVERY," or Alterative Extract. This compound is a highly nutritive and tonic preparation, combining the remedial properties of the best vegetable alteratives at present known to the medical profession. In perfecting this alterative compound, and likewise other standard preparations of medicine, we have made an outlay of many thousand dollars for chemical apparatus, and special machinery by the aid of which these remedies have been brought to their present perfection. Great pains are taken to obtain the materials at the right season of the year, properly cured so that none of their remedial qualities may be impaired. We, therefore, can with great confidence recommend Dr. Pierce's "Golden Medical Discovery" as one of the best preparations of the alterative class. Like all others of this type, its action is insensible, producing gradual changes, arousing the excretory glands to remove morbid materials, and at the same time toning the secretory organs. The manufacture of this compound is under the special supervision of a competent chemist and pharmaceutist, and it is now put up in bottles wrapped with full directions for its use. We can confidently recommend this compound whenever an alterative is required to cleanse the blood, tone the system, increase its nutrition, and establish a healthy condition. For these reasons we shall often advise its employment. DR. PIERCE'S PLEASANT PURGATIVE PELLETS. These pellets combine the pure, concentrated, active principles of several vegetable alteratives, and the result is, that within the small compass of a few grains he has most happily blended and chemically condensed these properties so that their action upon the ANIMAL ECONOMY is sanative and universal. They awaken the latent powers, quicken the tardy functions, check morbid deposits, dissolve hard concretions, remove obstructions, promote depuration, harmonize and restore the functions, equalize the circulation, and encourage the action of the nervous system. They stimulate the glands, increase the peristaltic movement of the intestines, tone the nutritive processes, while aiding in evacuating the bowels. All this they accomplish without corroding the tissues or vitiating the fluids. Their assistance is genial, helping the system to expel worn out materials, which would become noxious if retained. Having expended their remedial powers upon the various functions of the body, they are themselves expelled along with other waste matter, leaving behind them no traces of irritation. This cannot be said of mercurials, or of other harsh, mineral alteratives. These Pellets may be safely employed when the system is feeble, frail, and delicate, by giving them in less quantities. _Dose_--As an alterative, only one or two Pellets should be taken daily. ALKALIES. ALKALIES. These constitute an important list of remedial agents, their administration being frequently indicated. The employment of other medicines frequently should be preceded by the administration of an agent of this class, to neutralize excessive acidity in the stomach and bowels. Unless this be done, many medicines will fail to produce their specific effects. SULPHITE OF SODA (_Sodæ Sulphis_). This salt, as well as the Hyposulphite of Soda, is not only generally preferable for administration on account of its unirritating character and the smallness of the dose required, but also because it is a valuable antiseptic agent. The _Sulphite_ should not be confounded with the _Sulphate_ of Soda (Glauber's Salt). _Dose_--This is from three to ten grains. SALERATUS (_Potassæ Bicarbonas_). This is a favorite domestic antacid. _Dose_--Five to fifteen grains is the amount. ACIDS. As alkalies are important and often indicated as remedial agents, acids, so their re-agents, acids, are also frequently necessary to meet opposite conditions of the fluids of the system. HYDROCHLORIC OR MURIATIC ACID. This agent may be administered in doses of from five to ten drops, largely diluted in water or gruel. AROMATIC SULPHURIC ACID, or Elixir of Vitriol, is the most agreeable form of Sulphuric Acid for administration, and may be given in doses of from five to fifteen drops, largely diluted with water. In taking acids, they should be sucked through a straw, and not allowed to come in contact with the teeth, as otherwise the latter organs will be injured by their effects; or should the acid come in contact with the teeth, the mouth should be immediately rinsed with a solution of saleratus or soda, to neutralize the acid. ANODYNES. Anodynes are those medicines which relieve pain by blunting the sensibility of the nerves, or of the brain, so that it does not appreciate the morbid sensation. An anodyne may be a stimulant in one dose, and a narcotic in a larger one. The properties of different anodyne agents vary, consequently they produce unlike effects. The size of the dose required, differs according to circumstances and condition. An adult, suffering acute pain, requires a much larger dose to produce an anodyne effect than one who is a chronic sufferer. An individual accustomed to the use of anodynes, requires a much larger dose to procure relief than one who is not. Doses may be repeated, until their characteristic effects are produced, after an interval of thirty or forty minutes. When the stomach is very sensitive and will not tolerate their internal administration, one-sixth of a grain of Morphia can be inserted beneath the skin, by means of a hypodermic syringe. Relief is more quickly experienced, and the anodyne effect is much more lasting than when taken into the stomach. OPIUM (_Papaver Somniferum)._ Opium is a stimulant, anodyne, or narcotic, according to the size of the dose administered. _Dose_--Of the dry powder, one-fourth to one grain; of tincture (Laudanum), five to fifteen drops; of camphorated tincture (Paregoric), one-half to one teaspoonful; of Morphine, one-eighth to one-fourth grain; of Dover's Powder three to five grains. HYOSCYAMUS (_Hyoscyamus Niger_), commonly known as Henbane. The herb is used. It is a powerful narcotic, and unlike Opium, does not constipate the bowels, but possesses a laxative tendency. Therefore, it may be employed as an anodyne for allaying pain, calming the mind, inducing sleep and arresting spasms, when opiates are inadmissible. _Dose_--Of alcoholic extract, one-half to two grains; of fluid extract, five to ten drops; of the concentrated principle, Hyoscyamin, one-twelfth to one-fourth of a grain. [Illustration: Fig. 116. Poison Hemlock. ] POISON HEMLOCK (_Conium Maculatum_). The leaves are the parts used. Poison Parsley, as it is sometimes called, is an anodyne, narcotic, and an excellent alterative. _Dose_--Of fluid extract, two to six drops; of solid extract, one-fourth to one-half grain. BELLADONNA (_Atropa Belladonna_) or Deadly Nightshade. The herb or leaves are a valuable agent. In overdoses, it is an energetic, narcotic poison. In medicinal doses it is anodyne, antispasmodic, diaphoretic, and diuretic. It is excellent in neuralgia, epilepsy, mania, amaurosis, whooping-cough, stricture, rigidity of the os uteri, and is supposed by some to be a prophylactic or preventive of Scarlet Fever. Its influence upon the nerve centers is remarkable. It relaxes the blood vessels on the surface of the body and induces capillary congestion, redness of the eye, scarlet appearance of the face, tongue, and body. _Dose_--Of fluid extract, one-half to one drop; of tincture, one to two drops; of concentrated principle, Atropin, one-thirtieth to one-sixteenth of a grain; of the _Alkaloid, Atropia_, one-sixtieth of a grain. Even the most skillful chemists are very cautious in compounding these latter active principles, and the danger of an overdose is great. CAMPHOR. This drug is an anodyne, stimulant, and diaphoretic, and, in large doses, a narcotic and an irritant. It is an excellent stimulant for liniments. _Dose_--Of the powder, one to five grains; of the tincture, ten to twenty drops, given in simple syrup. HOPS (_Humulus Lupulus_). This is an excellent remedy in wakefulness, and may be used when opium is contra-indicated. A bag of the leaves, moistened with whiskey and placed as a pillow under the head, acts as an anodyne. _Dose_--Of the infusion of the leaves, from one to four ounces; of the fluid extract, one-fourth to three-fourths of a teaspoonful; of the concentrated principle, Humulin, one to three grains. DR. PIERCE'S COMPOUND EXTRACT OF SMART-WEED. This anodyne compound is made by uniting several of the most valuable agents of this class, and its medicinal qualities are rendered still more efficacious by the addition of certain stimulating articles. It is free from narcotic properties which are liable to produce deleterious results, and has been found to be not only harmless in its action, but very genial and effectual withal, and most reliable as a stimulant and diaphoretic remedy. ANTHELMINTICS. Anthelmintic means "against a worm," and is a term employed to designate those medicines which destroy or expel worms. It means the same as _Vermifuge_. Little is understood concerning the origin of worms. There are five distinct varieties described by authors as being more common than others. There is the long worm, the short, or pin-worm, the thread-worm, the tape-worm, and the broad tape-worm peculiar to some countries of Europe. Irritation of the alimentary canal, from whatever cause usually produces an abundant secretion of mucus, which is thought to be a condition favorable for their production. Therefore, those medicines which remove the cause of this irritation tend to diminish the number, if not to entirely destroy the worms. Some medicines kill the worms, others expel them alive. The remedies which successfully remove one kind of worm, have little effect upon another, and to meet these different conditions, we have a variety of worm-destroying medicines. The pin-worm, inhabits the rectum, and may be destroyed by injecting into it a strong solution of salt, or decoction of aloes, and when it is allowed to pass away, the rectum should be anointed with vaseline, butter, or lard. The eggs of this worm are developed around the orifice of the large intestine, and when this latter precaution is not practiced every time there is a passage from the bowels, they will multiply as rapidly as they can be destroyed. Generally, vermifuge remedies should be taken when the stomach is empty, and should be followed by the administration of a cathartic in two hours after the last dose is administered. SANTONIN. This is decidedly the most reliable anthelmintic known to the medical profession. It is deservedly a popular remedy for worms, and when combined with Podophyllin, is very efficacious in removing the pin-worm. _Dose_--For an adult, two to three grains of the powdered Santonin, repeated every three hours until four or five doses are taken, when it should be followed by a cathartic. SAGE (_Salvia Officinalis_). Sage is a common and excellent domestic remedy for worms. Make an infusion of Sage and Senna leaves, and drink freely until it acts as a cathartic. [Illustration: Fig. 117. Pink Root.] PINK-ROOT (_Spigelia Marilandica_). Pink-root is one of the most active and certain anthelmintics for children. It is indigenous to the United States. When taken in too large quantities, it is apt to purge, give rise to vertigo, dimness of vision, and even to convulsions; therefore, it should be combined with some cathartic. _Dose_--Of the infusion, one ounce at night, followed by physic in the morning. COMMON SALT (_Chloride of Sodium_). Common table salt is an anthelmintic, and may be used in an emergency. Salt water is a very common domestic remedy for worms. _Dose_--In solution, one-quarter to one-half teaspoonful. BALMONY (_Chelone Glabra_). This is also tonic and anthelmintic, and is valuable in debility, dyspepsia, jaundice, and hepatic affections. It also is known as Snake-head. _Dose_--Of the infusion, one to two ounces; of the concentrated principle, Chelonin, from half to one grain. MALE FERN (_Aspidium Filix Mas_). Male Fern is the anthelmintic which is considered especially effectual in removing the tape-worm. _Dose_--Of the powder, one to two drachms, given morning and evening in syrup, followed by a brisk cathartic. The dose of the tincture of the buds in ether is from eight to thirty drops. [Illustration: Fig. 118. Aspen.] POPLAR (_Populus Tremuloides_). The White or Aspen Poplar is a common tree, and contains active principles termed Populin and Salicin, both of which are tonic. An infusion of the bark is a remedy for worms. _Dose_--Of the tea made from the bark, one to four ounces; of Populin, from one-half to two grains. ANTIPERIODICS. It is well understood that malarial diseases are characterized by a periodicity which indicates their nature. Antiperiodics prevent the recurrence of the periodic manifestations, and hence their name. QUININE (_Sulphate of Quinia_). Quinine is a tonic, febrifuge, and antiperiodic. It should generally be administered during the intervals between the febrile paroxysms. It is beneficial also in all diseases accompanied by debility. The dose varies from one to six grains according to indications. Frequently it is given in much larger quantities, but we cannot advise such for domestic use. PRUSSIAN BLUE (_Ferri Ferrocyanidum_). Ferrocyanide of Iron is an excellent tonic and antiperiodic remedy, and often is combined with quinine. _Dose_--From two to five grains. [Illustration: Fig. 119. Boneset. ] BONESET (_Eupatorium Perfoliatum_), or Thoroughwort. This is tonic, diaphoretic, aperient, and possesses some antiperiodic properties; the warm infusion is emetic. _Dose_--Of the infusion, one to four ounces; of the fluid extract, from half to one teaspoonful; of the active principle, Eupatorin, one to three grains. THE "GOLDEN MEDICAL DISCOVERY" has gained an enviable reputation in malarial districts for the cure of ague. From observing its action in the cure of this and other miasmatic diseases, and knowing its composition, we are thoroughly satisfied that it contains chemical properties which neutralize and destroy the miasmatic or ague poison which is in the system, and, at the same time, produces a rapid excretion of the neutralized poisons. One strong proof of this is found in the fact that persons who are cured with it are not so liable to relapse as those in whom the chills are broken with Quinine or other agents. No bad effects are experienced after an attack of ague which has been cured with the "Golden Medical Discovery." This cannot be said of Quinine, Peruvian Bark, Arsenic, and Mercurials, which comprise nearly the whole list of remedies usually resorted to by physicians for arresting ague. The "Golden Medical Discovery" not only has the merit of being a certain antidote for miasmatic diseases, but is pleasant to the taste, a matter of no small importance, especially when administered to children. To break the chills, this medicine should be taken in doses of four teaspoonfuls three times a day, and if this treatment pursued for three days, does not entirely arrest the chills, these doses may be repeated in alternation with five-grain doses of quinine for the three succeeding days. But in no case should more than this amount of the "Golden Medical Discovery" be given. ANTISEPTICS AND DISINFECTANTS. Antiseptics prevent, while disinfectants arrest putrefaction. Oxygen is a natural disinfectant, but a powerful inciter of change. Although this element is the cause of animal and vegetable decay, yet oxidation is the grand process by which the earth, air, and sea are purified. A few substances are both antiseptic and disinfectant. Heat up to a temperature of 140° Fahr. promotes putrescence, but above that point, is a drier or disorganizer, and destroys the source of infection. YEAST (_Cerevisiæ Fermentum_). Yeast is an antiseptic, and is effective in all diseases in which there is threatened putridity. Used externally, it is often combined with elm bark and charcoal, and applied to ulcers, in which there is a tendency to gangrene. _Dose_--One tablespoonful in wine or porter, once in two or three hours. CREASOTE. This is a powerful antiseptic. It is used in a solution of glycerine, oil, water, or syrup. _Dose_--One to two drops, largely diluted. CARBOLIC ACID is a crystalline substance resembling creasote in its properties. It is an antiseptic, and is used both internally and externally. _Dose_--One-fourth to one-half drop of the melted crystals, very largely diluted. Externally, in solution, one to five grains of the crystals to one ounce of the solvent. WHITE VITRIOL (_Zinci Sulphas_). White vitriol is a valuable disinfectant, as it will arrest mortification. In solution it is employed in ulcers and cancers and also as a gargle in putrid sore throat. _Dose_--One-half to two grains in a pill; in solution, one to ten grains in an ounce of water. PERMANGANATE OF POTASH (_Potassæ Permanganas_). This substance is an energetic deodorizer and disinfectant. A solution containing from one to twenty grains in an ounce of water is used as a lotion for foul ulcers. _Dose_--One-eighth to one-fourth of a grain. WILD INDIGO (_Baptisia Tinctoria_). The root is the part used. This plant possesses valuable antiseptic properties. It is an excellent lotion for ill-conditioned ulcers, malignant sore throat, nursing sore-mouth, syphilitic ophthalmia, etc. It is sometimes administered in scarlet and typhus fevers, and in all diseases in which there is a tendency to putrescence. _Dose_--Of the infusion, one-fourth to one-half ounce; of the fluid extract, from three to ten drops, and of the concentrated, active principle of the plant, Baptisin, from one to two grains. ANTISPASMODICS. Antispasmodics are a class of remedies which relieve cramps, convulsions, and spasms, and are closely allied to nervines. Indeed some authors class them together. The following are a few of the most important antispasmodics: ASSAFETIDA (_Assafetida Ferula_). This is a powerful antispasmodic. It is employed in hysteria, hypochondria, convulsions, and spasms, when unaccompanied by inflammation. _Dose_--Of the gum or powder, from three to ten grains, usually administered in the form of a pill; of the tincture, from one-half to one teaspoonful. [Illustration: Fig. 120. Yellow Jessamine.] YELLOW JESSAMINE (_Gelseminum Sempervirens_). The root is the part used. This is a valuable remedy in various diseases when associated with restlessness and a determination of the blood to the brain; also in the neuralgia. _Dose_--Of the fluid extract, three to eight drops; of the concentrated principle, Gelsemin, one-fourth to one grain. The use of this drug by non-professional persons should be attended with great caution. VALERIAN (_Valeriana Officinalis_). The root is the part used. Valerian is an effective remedy in cases of nervousness and restlessness. _Dose_--Of the infusion, (one-half ounce to a pint of water) one-half ounce; of the tincture, one-half to two tablespoonfuls; of the ammoniated tincture of valerian, from one-half to two teaspoonfuls in sweetened water or milk; of the valerianate of ammonia, one-half to three grains. YELLOW LADY'S SLIPPER (_Cypripedium Pubescens_). The root is the part used. This is a useful remedy in hysteria, chorea, and all cases of irritability. _Dose_--Of the powder, fifteen to thirty grains; of the infusion, one ounce; of the fluid extract, fifteen to thirty drops; of the concentrated principle, Cypripedin, one-half to two grains. WILD YAM (_Dioscorea Villosa_). The root is the part used. This is a powerful antispasmodic, and has been successfully used in bilious colic, nausea, and spasm of the bowels. _Dose_--Of the infusion (two ounces to a pint of water), one to two ounces; of the fluid extract, five to fifteen drops; of the concentrated principle, Dioscorein, one-half to one grain. HIGH CRANBERRY (_Viburnum Opulus._) The bark is the part used. It is also known as Cramp Bark. This is a powerful antispasmodic, and is effective in relaxing spasms of all kinds. It is a valuable agent in threatened abortion. _Dose_--Of the infusion, one-half to one ounce; of the fluid extract, one-half to one teaspoonful; of the concentrated principle, Viburnin, one-half to two grains. These doses may be increased if necessary. ASTRINGENTS. Astringents are medicines which condense and coagulate the tissues, thereby arresting discharges. When taken into the mouth, they produce the sensation known as puckering. They are used internally and locally. The term _styptic_ is used as a synonym of astringent, but is generally employed to designate those astringents which arrest hemorrhage, or bleeding. LOGWOOD (_Hæmatoxylon Campechianum_). Logwood is a mild astringent, well adapted to remedy the relaxed condition of the bowels after cholera infantum. _Dose_--Of powdered extract, five to ten grains; of the decoction, one ounce; of the fluid extract, fifteen to thirty drops. BLACKBERRY ROOT (_Rubus Villosus_). This astringent is a favorite, domestic remedy in affections of the bowels. _Dose_--Of the infusion (bruised root), one-half to one ounce, sweetened. [Illustration: Fig. 121. Witch-hazel. ] WITCH-HAZEL (_Hamamelis Virginica_). The parts used are the leaves and bark. This is a most valuable astringent and exerts a specific action upon the nervous system. It arrests many forms of uterine hemorrhage with great promptness, is a valuable agent in the treatment of piles, and is useful in many forms of chronic throat and bronchial affections. _Dose_-Of the infusion, one-fourth to one-half ounce; of the fluid extract, eight to fifteen grains; of the concentrated principle, Hamamelin, one fourth to one grain. [Illustration: Fig. 122. Cranesbill. ] CRANESBILL (_Geranium Maculatum_). The root is used. This plant is also known as Crow-foot, and Spotted Geranium. It is a pleasant, but powerful astringent. _Dose_--Of the fluid extract, ten to thirty drops; of the concentrated principle, Geranin, one to two grains. [Illustration: Fig. 123. Bugle-weed. ] [Illustration: Fig. 124. Hardhack. ] HARDHACK (_Spirea Tomentosa_), Spirea, or Meadow Sweet. The stem and leaves are used. It is a tonic and an astringent, and is used in diarrhea and cholera-infantum. _Dose_--Of the infusion, one-half to one ounce; of the fluid extract, three to six drops. BUGLE-WEED (_Lycopus Virginicus_). This is variously known as Water-hoarhound and Water-bugle. It is sedative and tonic, as well as astringent, and is employed in hemorrhages and in incipient phthisis. _Dose_--Of the infusion, one to two ounces; of the fluid extract, fifteen to twenty-five drops; of the concentrated principle, Lycopin, one-half to one grain. [Illustration: Fig. 125. Canada Fleabane. ] CANADA FLEABANE (_Erigeron Canadense_). The leaves and flowers are used. This plant, sometimes known as Colt's-tail, Pride-weed, or Butter-weed, is astringent, and has been efficiently employed in uterine hemorrhages. _Dose_--Of the infusion (two ounces of the herb to one pint of water), one to two ounces; of the oil, five to ten drops on sugar, repeated at intervals of from one to four hours. CATECHU (_Acacia Catechu_). A tincture of this plant is a pure, powerful astringent, and is especially useful in chronic diarrhea, chronic catarrh, and chronic dysentery. _Dose_--Of the powder, five to twenty grains; of the tincture, one-half to two teaspoonfuls. TANNIN (_Acidum, Tannicum_). This acid has a wide range of application. It is used as an astringent. _Dose_--One to five grains. GALLIC ACID (_Acidum Gallicum_). This remedy is used chiefly in hemorrhages. _Dose_--Three to five grains. In severe hemorrhages, this quantity should be administered every half hour, until the bleeding is checked. CARMINATIVES. Carminatives are medicines which allay intestinal pain, arrest or prevent griping caused by cathartics and exert a general soothing effect. They are aromatic, and to a certain extent, stimulant. ANISE-SEED (_Pimpinella Anisum_). Anise is a pleasant, aromatic carminative, and is used in flatulent colic. _Dose_--Of the powdered seed, ten to fifteen grains; of the infusion (a teaspoonful of seed to a gill of water), sweetened, may be given freely; of the oil, five to ten drops on sugar. FENNEL-SEED (_Anethum Foeniculum_). This is one of our most grateful aromatics, and is sometimes employed to modify the action of senna and rhubarb. _Dose_--Same as that of anise-seed. GINGER (_Zingiber Officinale_). The root is the part used. This is a grateful stimulant and carminative. _Dose_--Of the powder, ten to twenty grains; of the infusion, one teaspoonful in a gill of water; of the tincture, twenty to thirty drops; of the essence, ten to fifteen drops; of the syrup, one teaspoonful. WINTERGREEN (_Gaultheria Procumbens_). The leaves are used. This plant possesses stimulant, aromatic, and astringent properties. The essence of Wintergreen is carminative, and is used in colics. _Dose_--Of the essence, one-half to one teaspoonful in sweetened water; of the oil, three to five drops on sugar. PEPPERMINT (_Mentha Piperita_). Peppermint is a powerful stimulant, carminative, and antispasmodic. It is used in the treatment of spasms, colic, and hysteria. _Dose_--The infusion may be used freely. The essence may be taken in doses of fifteen to thirty drops in sweetened warm water; of the oil, one to five drops on sugar. SPEARMINT (_Mentha Viridis_). The carminative properties of spearmint are inferior to those of peppermint, and its chief employment is for its diuretic and febrifuge virtues. _Dose_--Same as that of peppermint. COMPOUND EXTRACT OF SMART-WEED. Dr. Pierce's Extract of Smart-weed is a valuable carminative and aromatic stimulant, and has been employed with marked success in all diseases in which this class of remedies is required. CATHARTICS. _Cathartics_, or _Purgatives_ are medicines which act upon the bowels and increase the secretions and evacuations. In many parts of the country, these agents are known as purges, or physics. They have been variously divided and subdivided, usually with reference to the energy of their operations or the character of the evacuations produced. _Laxatives_, or _Aperients_, are mild cathartics. Purgatives act with more energy and produce several discharges which are of a more liquid character and more copious than the former. _Drastics_ are those cathartics which produce numerous evacuations accompanied by more or less intestinal irritation. _Hydragogues_ are those purgatives which produce copious, watery discharges. _Cholagogues_ are those purgatives which act upon the liver, stimulating its functions. Cathartics constitute a class of remedies which are almost universally employed by families and physicians. JALAP (_Ipomoea Jalapa_). The root is used. It is a drastic and a hydragogue cathartic. Formerly it was combined with equal parts of calomel. From this fact it received the name of "ten and ten." _Dose_--Of the powder, five to twenty grains; of the fluid extract, ten to fifteen drops; of the solid extract, two to four grains; of the concentrated principle, Jalapin, one-half to two grains. [Illustration: Fig. 126. Culver's-root. ] GAMBOGE (_Gambogia_). The gum is used. Gamboge is a powerful drastic, hydragogue cathartic, which is apt to produce nausea and vomiting. It is employed in dropsy. It should never be given alone, but combined with milder cathartics. It accelerates their action while they moderate its violence. _Dose_--Of the powder, one-half to two grains. This substance combined with aloes and sometimes with scammony, constitutes the basis of the numerous varieties of large, cathartic pills found in the market. CULVER'S-ROOT. (_Leptandra Virginica_). The root is used. This plant, known under the various names of Culver's Physic, Black-root, Tall Speedwell, and Indian Physic, is a certain cholagogue, laxative, and cathartic. _Dose_--Of decoction, one to two fluid ounces; of fluid extract, ten to twenty drops; of tincture, twenty to thirty drops; of the concentrated, active principle, Leptandrin, which is but feebly cathartic, as a laxative, two to five grains. RHUBARB (_Rheum Palmatum_). This is much used as a domestic remedy, and by the profession, for its laxative, tonic, and astringent effects. It is employed in bowel complaints. _Dose_--Of the powder, ten to thirty grains; of the tincture, one-half to two teaspoonfuls; of the fluid extract, ten to thirty drops; of the solid extract, three to five grains; of the syrup, and aromatic syrup, an excellent remedy for children, one-half to one teaspoonful. CASCARA SAGRADA (_Rhamnus Purshiana_), is a very efficient remedy in chronic constipation. _Dose_--Of the fluid extract, from ten to twenty drops taken in a tablespoonful of water. The unpleasant taste may be disguised with the extract of liquorice. CASTOR OIL (_Oleum Ricini_). _Dose_--From one to four teaspoonfuls. It may be disguised by rubbing it with an equal quantity of glycerine and adding one or two drops of oil of anise, cinnamon, or wintergreen. BUTTERNUT (_Juglans Cinerea_). The bark is the part used. Butternut is a mild cathartic, which resembles rhubarb in its property of evacuating the bowels without irritating the alimentary canal. _Dose_--Of the extract, as a cathartic, five to ten grains; of the fluid extract, one-half to one teaspoonful; of the concentrated principle, Juglandin, one to three grains. As a laxative, one-half of these quantities is sufficient. ALOES (_Aloe_) The gum is used. This cathartic acts upon the lower part of the bowels and sometimes causes piles; though some late authors claim that in small doses it is a valuable remedy for piles. _Dose_--In powder or pill, three to ten grains; as a laxative, one to three grains. EPSOM SALTS (_Magnesia Sulphas_). Its common name is "Salts." Much used in domestic practice. _Dose_--One-fourth to one-half ounce. DR. PIERCE'S PLEASANT PELLETS, being entirely vegetable in their composition, operate without disturbance to the system, diet, or occupation. Put up in glass vials. Always fresh and reliable. As _a laxative, alterative,_ or gently acting but searching _cathartic_, these little Pellets give the most perfect satisfaction. Sick Headache, Bilious Headache, Dizziness, Constipation, Indigestion, Bilious Attacks, and all derangements of the stomach and bowels, are promptly relieved and permanently cured by the use of Dr. Pierce's Pleasant Pellets. In explanation of the remedial power of these Pellets over so great a variety of diseases, it may truthfully be said that their action upon the system is universal, not a gland or tissue escaping their sanative influence. Everybody, now and then, needs a gentle laxative to assist nature a little; or, a more searching and cleansing, yet gentle cathartic, to remove offending matter from the stomach and bowels and tone up and invigorate the liver and quicken its tardy action. Thereby the "Pleasant Pellets" cure biliousness, sick and bilious headache, costiveness, or constipation of the bowels, sour stomach, windy belchings, "heart-burn," pain and distress after eating, and kindred derangements of the liver, stomach and bowels. Persons subject to any of these troubles should never be without a vial of the "Pleasant Pellets" at hand. In proof of their superior excellence it can be truthfully said that they are always adopted as a household remedy after the first trial. The "Pleasant Pellets" are far more effective in arousing the liver to action than "blue pills," the old-fashioned compound cathartic pills, calomel or other mercurial preparations, and have the further merit of being purely vegetable in their composition and perfectly harmless in any condition of the system. Furthermore, no particular care is required while using them. Being composed of the choicest, concentrated vegetable extracts, their cost of production is much more than that of most pills found in the market, yet from forty to forty-four of them are put up in each glass vial, as sold through druggists, and can be had at the price of the more ordinary and cheaper made pills. Once used, they are always in favor. Their secondary effect is to keep the bowels open and regular, not to further constipate, as is the case with other pills. Hence, their great popularity with sufferers from habitual constipation, piles and their attendant discomfort and manifold derangements. For all laxative and cathartic purposes the "Pleasant Pellets" are infinitely superior to all "mineral waters," sediltz powders, "salts," castor oil, fruit syrups (so-called), laxative "teas," and the many other purgative compounds sold in various forms. If people generally, would pay more attention to properly regulating the action of their bowels, they would have less frequent occasion to call for their doctor's services to subdue attacks of dangerous diseases. Hence it is of great importance to know what safe, harmless agent best serves the purpose of producing the desired action. DIRECTIONS FOR USING DR. PIERCE'S PLEASANT PELLETS. In all cases, the size of dose to be taken must be regulated somewhat by the known susceptibility of the individual to the action of laxative and cathartic medicines. Some persons' bowels are readily acted upon by small doses, while others require more. As a general rule, the smaller doses which we recommend, are quite sufficient, and produce the best results if persisted in for a reasonable length of time. FOR A GENTLE APERIENT, OR LAXATIVE, take one or not more than two and preferably in the morning, on an empty stomach. FOR A GENTLE CATHARTIC, two or three are generally sufficient, if taken in the morning, on an empty stomach. FOR A VERY ACTIVE, SEARCHING CATHARTIC, four to six may be taken in the morning, on an empty stomach. FOR A CHILD OF TWO TO FOUR YEARS, one-half of a Pellet given in a little sauce of some kind, or soft candy, will be sufficient for a laxative, or one for a mild cathartic. FOR A CHILD OF FOUR TO EIGHT YEARS, one for a laxative or two for a cathartic will act nicely, if given on an empty stomach. AS A DINNER PILL.--To promote digestion and increase the appetite, take only one Pellet each day after dinner. _To overcome the disagreeable effects of a too hearty meal_, take two Pellets as soon as conscious of having overloaded the stomach. IN ALL CHRONIC DISEASES, it is of the utmost importance that the bowels be kept _regular_, yet thorough purgation should be avoided, as it tends to debilitate the system. Small laxative doses of one or at most two Pellets, taken daily and continued for a long time, is the plan that we would recommend to produce the best results. IN DROPSY, an occasional active cathartic dose of the Pellets of say 4 to 6, taken once in a week or ten days, will do good, if, in the interval between these doses, Dr. Pierce's Golden Medical Discovery be taken to invigorate and regulate the system. TO BREAK UP SUDDEN ATTACKS OF COLDS, FEVERS, AND INFLAMMATIONS.--It is only in these sudden and severe attacks of _acute_ diseases that we recommend the Pellets to be taken in active purgative doses, and in these cases _only one_ large or cathartic dose of say 5 or 6 Pellets should be taken. In colds, fevers, and inflammatory attacks, warm sweating teas should be taken freely, and hot foot baths, or a hot general bath, employed to assist in equalizing the circulation of the blood and restoring the equilibrium of the system. SUPPRESSED MENSTRUATION.--This combined treatment of an active dose of Pellets, coupled with the use of a hot bath, foot bath, or, better still, a hot sitz-bath, will bring on _menstruation_, when suppressed from taking cold. In the latter case the effect will be insured if, in addition to the use of the Pellets and baths, a full dose of Dr. Pierce's Compound Extract of Smart-Weed, or Water Pepper, be also used. CAUSTICS. _Caustics_ are substances which have the power of destroying or disorganizing animal structures. By their action they destroy the tissue to which they are applied, and form a crust, which is thrown off by a separation from the parts beneath. Their caustic property may be destroyed by dilution with other substances, to such an extent that they will only irritate or stimulate, and not destroy. Much care is necessary in their employment, and it is not expected that the unprofessional reader will have much to do with them; hence, we have deemed it best not to give a list of these agents. COUNTER-IRRITANTS. _Counter-irritants_ are substances which produce irritation of the part to which they are applied, varying in degree from a slight redness to a blister or pustule. They are applied to the surface with a view of producing an irritation to relieve irritation or inflammation in some other or deeper seated part. They are a class of agents which we very seldom employ, and, hence, we shall notice only a couple of the most simple. MUSTARD (_Sinapis_). The flour of mustard, which is best adapted for domestic use, is employed in the form of a paste spread on cloth. It takes effect in a few moments; the length of time it remains in contact with the skin and the strength of the mustard determine the effect produced. HORSE-RADISH (_Cochlearia Armoracia_). The leaves are the parts used. Let them wilt and bind them on the part affected. They act nearly as energetically as mustard. DIAPHORETICS. _Diaphoretics_ are medicines which increase perspiration. Those which occasion profuse sweating are termed _Sudorifics_. The two terms indicate different degrees of the same operation. They constitute an important element in domestic practice, on account of the salutary effects which generally follow their action. Their operation is favored by warmth externally, and warm drinks, when they are not given in hot infusion. [Illustration: Fig. 127. Pleurisy-root. ] PLEURISY-ROOT (_Asclepias Tuberosa_), is also known as White-root, and Butterfly-weed. It is a valuable remedy, well adapted to break up inflammations and disease of the chest. _Dose_--Of infusion, one to two ounces; of fluid extract, one-fourth to one-half teaspoonful; of the concentrated principle, Asclepin, one to three grains. SAFFRON (_Crocus Sativus_). Golden Saffron. _Dose_--Of infusion (one drachm to a pint of water), one to two ounces. Sage (_Salvia Officinalis_). The warm infusion drunk freely is a valuable, domestic diaphoretic. [Illustration: Fig. 128. Virginia Snake-root. ] VIRGINIA SNAKE-ROOT (_Aristolochia Serpentaria_), is an efficient agent. _Dose_--Of infusion, one to two ounces; of tincture, one-fourth to one teaspoonful; of fluid extract, one-fourth to one-half teaspoonful. JABORANDI (_Pilocarpus Pinnatus_). Jaborandi increases the flow of saliva, causes profuse perspiration, and lowers the temperature of the body. In doses of from twenty to sixty drops of the fluid extract, administered in a cup of warm water or herb-tea on going to bed, we have found it very effectual for breaking up recent colds. We have also found it valuable in whooping-cough, in doses of from three to ten drops, according to the age of the child, given three or four times a day. The fluid extract may be obtained at almost any drug-store. [Illustration: Fig. 129. May-flower. ] MAY-WEED (_Maruta Cotula_), is also known as Wild Chamomile, and Dog-fennel. It is not much used, though it is a powerful diaphoretic. _Dose_--Of infusion, one to two ounces. CATNIP (_Nepeta Cataria_). A deservedly popular, domestic remedy, always acceptable, and certain in its action. The warm infusion is the best form for its administration. It may be drunk freely. GINGER (_Zingiber Officinale_). The hot infusion may be sweetened and drunk as freely as the stomach will bear. DR. PIERCE'S COMPOUND EXTRACT OF SMART-WEED. This is unsurpassed as a diaphoretic agent, and is much more certain in its operation than any simple diaphoretic. DILUENTS. Any fluid which thins the blood or holds medicine in solution is called a diluent. Pure water is the principal agent of this class. It constitutes about four-fifths of the weight of the blood, and is the most abundant constituent of the bodily tissues. Water is necessary, not only for digestion, nutrition, and all functional processes of life, but it is indispensable as a menstruum for medicinal substances. It is a necessary agent in depuration, or the process of purifying the animal economy, for it dissolves and holds in solution deleterious matter, which in this state may be expelled from the body. In fevers, water is necessary to quench the thirst, promote absorption, and incite the skin and kidneys to action. Its temperature may be varied according to requirements. Diluents are the vehicles for introducing medicine into the system. We shall briefly mention some which prove to be very grateful to the sick. VARIOUS VEGETABLE ACIDS AND JELLIES may be dissolved in water, as apple, currant, quince, grape, or cranberry. THE JUICE OF LEMONS, ORANGES, PINE-APPLES, AND TAMARINDS, is also found to be refreshing to fever patients. SASSAFRAS-PITH, SLIPPERY-ELM BARK, FLAX-SEED, AND GUM ARABIC make good mucilaginous drinks for soothing irritation of the bowels and other parts. BREWERS' YEAST mixed with water in the proportion of from one-eighth to one-fourth is a stimulant and antiseptic. THE WHITE ASHES OF HICKORY OR MAPLE WOOD dissolved in water make an excellent alkaline drink in fevers, or whenever the system seems surcharged with acidity. DIURETICS. _Diuretics_ are medicines which, by their action on the kidneys, increase the flow of urine. [Illustration: Fig. 130. Marsh-mallow. ] MARSH-MALLOW (_Althea Officinalis_) is used in irritable conditions of the urinary organs. The infusion may be drunk freely. GRAVEL-PLANT (_Epigea Repens_), is also known as Water-pink, Trailing-arbutus, or Gravel-root. _Dose_--Of decoction of the plant, one to three ounces; of fluid extract, one-fourth to one-half teaspoonful. [Illustration: Fig. 131. Stone-root. ] STONE-ROOT (_Collinsonia Canadensis_), is also known as Knot-root, Horse-balm, Rich-weed, or Ox-balm. This is a mild diuretic, slow in action, yet effective in allaying irritation of the FOXGLOVE (_Digitalis purpurea_) slows the action of the heart, lowers the temperature, and acts indirectly as a diuretic. It is especially valuable in the treatment of scarlet fever and in dropsy. _Dose_--Of infusion, one-half drachm to one-half ounce; of the fluid extract or strong tincture, from two to ten drops. It should be used with caution. A poultice made of the leaves and placed over the kidneys is an effectual method of employing the drug. QUEEN OF THE MEADOW (_Eupatorium Purpureum_), is also known as Gravel-weed, Gravel-root, or Trumpet-weed. This is a most valuable diuretic. _Dose_--Of the infusion, one to three ounces; of fluid extract, one-fourth to one-half teaspoonful; of the concentrated principle, Eupatorin (_Purpu_), one-half to two grains. BUCHU (_Barosma Crenata_). The leaves are used. This agent has been extensively employed, generally in compounds. _Dose_--Of infusion, (steeped for two hours or more) one to two ounces; of fluid extract, the same; of the concentrated principle, Barosmin, one to three grains. PIPSISSEWA (_Chimaphila Umbellata_), or Prince's Pine. This is a tonic to the kidneys, as well as a diuretic and alterative, and is a mild, but very efficient remedy. _Dose_--Of decoction, one ounce from four to six times a day; of fluid extract, one-fourth to one-half teaspoonful; of the concentrated principle, Chimaphilin, one to two grains. WATER-MELON SEEDS (_Cucurbita Citrullus_). _Dose_--Of infusion, the patient may drink freely until the desired effect is secured. PUMPKIN SEEDS (_Cucurbita Pepo_). They are mild, unirritating, yet effective diuretics. An infusion of these may be drunk freely. SWEET SPIRIT OF NITRE (_Spiritus Ætheris Nitros_), is diuretic and anodyne. _Dose_--One-fourth to one-half teaspoonful, diluted in water, every two or three hours. SALTPETRE (_Potassæ Nitras_). _Dose_--Powdered, five to ten grains. ACETATE OF POTASH (_Potassæ Acetas_). _Dose_--Ten to fifteen grains, largely diluted in water. It is more frequently used for this purpose than the nitrate. It is a most valuable diuretic. EMETICS. These are medicines which cause vomiting and evacuation of the stomach. Some of the agents of this class, termed irritant emetics, produce vomiting by a local action on the stomach, and do not affect this organ when introduced elsewhere. Others, which may be termed systemic emetics, produce their effects through the nervous system, and, therefore, must be absorbed into the circulation before they can produce vomiting. In cases of poisoning, it is desirable to empty the stomach as quickly as possible, hence irritant emetics should be employed, for they act more speedily. Draughts of warm water favor the action of emetics. MUSTARD (_Sinapis_) acts promptly and efficiently as an emetic, and may be employed in poisoning. _Dose_--From one to two teaspoonfuls of powdered mustard, stirred up in a glass of tepid water. It should be quickly swallowed and diluents freely administered. SULPHATE OF COPPER (_Cupri Sulphas_) is a prompt, irritant emetic. It should be given in doses of ten grains dissolved in half a glass of water, and its action assisted by the free use of diluents. SULPHATE OF ZINC (_Zinci Sulphas_) is similar in its effects to sulphate of copper, but less powerful, and may be taken in the same manner, and the dose repeated if necessary in fifteen minutes. YELLOW SUBSULPHATE OF MERCURY (_Hydrargyri Sulphas flava_), commonly known as _Turpeth Mineral,_ is an efficient and most desirable emetic in membranous croup. It is an active poison, but, as it is quickly thrown up with the contents of the stomach, there is no danger from its administration. _Dose_--It should be given to a child in doses of from three to five grains, in the form of powder, rubbed up with sugar of milk. IPECAC (_Cephælis Ipecacuanha)._In large doses Ipecac is a systemic emetic. In small doses, it exerts a specific influence upon the mucous membranes, relieves nausea and irritation, and subdues inflammation. In cholera infantum it is an invaluable remedy, if given in very small doses. By allaying irritation of the stomach and restoring tone and functional activity to it and the bowels, it gradually checks the discharges and brings about a healthy condition. It is also valuable in dysentery, and is borne in large doses. As an emetic the dose is, of powder, five to ten grains in warm water; of fluid extract, ten to twenty drops. [Illustration: Fig. 132. Lobelia. ] LOBELIA (_Lobelia Inflata_), sometimes known as Indian Tobacco, or Emetic-weed. The herb and seeds are used. This is a powerful, systemic emetic, but very depressing. _Dose_--Of the powdered leaves, fifteen to twenty grains; of the infusion, one to three ounces; of the fluid extract, ten to fifteen drops. BONESET (_Eupatorium Perfoliatum)._ _Dose_--Of the warm infusion or decoction, two to three ounces; of the fluid extract, one teaspoonful in hot water: of the concentrated principle, Eupatorin, two to five grains. EMMENAGOGUES. Emmenagogue is a term applied to a class of medicines which have the power of favoring the discharge of the menses. We shall mention only a few of those which are best adapted to domestic use. [Illustration: Fig. 133. Pennyroyal. ] PENNYROYAL (_Hedeoma Pulegioides)._ Pennyroyal, used freely in the form of a warm infusion, promotes perspiration and excites the menstrual discharge when recently checked. A large draught of the infusion should be taken at bed-time. The feet should be bathed in warm water previous to taking the infusion. BLACK COHOSH (_Cimicifuga Racemosa)._ Black Cohosh, known also as Black Snake-root, is an effective remedy in uterine difficulties. _Dose_--Of the tincture, twenty drops; of the fluid extract, ten drops. TANSY (_Tanacetum Vulgare)._ Tansy is beneficial in suppressed menstruation. _Dose_--Of the infusion, from one to four fluid ounces. ERGOT (_Secede Cornutum_) in very small doses acts as an emmenagogue, and in large doses it checks hemorrhage. The dose as an emmenagogue, of the fluid extract, is from two to five drops, and to arrest hemorrhage, from half a drachm to two drachms, repeated in from one to three hours. LIFE-ROOT (_Senecio Gracilis._) Life-root exerts a peculiar influence upon the female reproductive organs, and for this reason has received the name of Female Regulator It is very efficacious in promoting the menstrual flow, and is a valuable agent in the treatment of uterine diseases. _Dose_--Of the decoction, four fluid ounces three or four times a day; of the fluid extract, from one-fourth to one-half teaspoonful. MOTHERWORT (_Leonurus Cardiaca_). Motherwort is usually given in warm infusion, in suppression of the menses from cold. _Dose_--Of the decoction, from two to three fluid ounces every one or two hours. DR. PIERCE'S FAVORITE PRESCRIPTION is an efficient remedy in cases requiring a medicine to regulate the menstrual function. Full directions accompany every bottle. DR. PIERCE'S COMPOUND EXTRACT OF SMART-WEED is an excellent emmenagogue. Dr. Eberle, a very celebrated medical writer, and author of a work on medicine which is very popular with the profession, says that he has used the "Extract of Smart-weed" in twenty cases of amenorrhea (suppressed menstruation), and affirms "with no other remedy or mode of treatment have I been so successful as with this." Full directions accompany every bottle. It is sold by all druggists. EXPECTORANTS. Expectorants are medicines which modify the character of the secretions of the bronchial tubes, and promote their discharge. Most of the agents of this class are depressing in their influence and thus interfere with digestion and healthy nutrition. Their application is very limited, hence we shall dismiss them without further consideration. LINIMENTS. Liniments are medicines designed for external application. The benefits arising from their use depend upon their derivative power, as well as upon the anodyne properties which many of them possess, rendering them efficacious for soothing pain. We cannot mention a more valuable agent of this class than DR. PIERCE'S COMPOUND EXTRACT OF SMART-WEED. As an external application this preparation subdues inflammation and relieves pain. For all wounds, bruises, sprains, bee-stings, insect and snake-bites, frost-bites, chilblains, caked breast, swollen glands, rheumatism, and, in short, for any and all ailments, whether afflicting man or beast, requiring a direct external application, either to allay inflammation or soothe pain, the Extract of Smart-weed cannot be excelled. NARCOTICS. A narcotic is a remedy which, in _medicinal_ doses, allays morbid sensibility, relieves pain, and produces sleep; but which, in overdoses, produces coma, convulsions, and death. The quantity necessary to produce these results varies in different individuals. We shall mention a few of those most frequently employed. [Illustration: Fig. 134. Henbane.] HENBANE (_Hyoscyamus Niger_). The leaves and seeds are used. Henbane, in large doses, is a powerful narcotic and dangerously poisonous. In medicinal doses, it is anodyne and antispasmodic; it allays pain, induces sleep, and arrests spasms. _Dose_--Of the fluid extract, five to ten drops; of the solid extract, from one-half to one grain; of the concentrated principle, Hyoscyamin, from one-twelfth to one-fourth of a grain. INDIAN HEMP (_Cannabis Indica_). An East Indian plant. _Dose_--Of the extract, from one-fourth to one-half grain, of the tincture, from three to eight drops; of the fluid extract, from two to five drops. The plant known as Indian Hemp, growing in this country, possesses very different qualities. [Illustration: Fig. 135. Stramonium. ] STRAMONIUM (_Datura Stramonium_). Stramonium, also known as Thorn-apple, in large doses is a powerful narcotic poison. In medicinal doses it acts as an anodyne and antispasmodic _Dose_--Of extract of the leaves, from one-half to one grain; of the fluid extract, from three to six drops. NERVINES. These are medicines which act on the nervous system, soothing excitement and quieting the condition known as "nervousness." HOPS (_Humulus Lupulus_). _Dose_--Of infusion, one to three ounces; of the fluid extract, one-fourth to one-half teaspoonful of the concentrated principle, Humulin, two to three grains. [Illustration: Fig. 136. Scull-cap. ] SCULL-CAP. (_Scutellaria Lateriolia_). The herb is used. It is also known as Mad-dog Weed. This is a valuable remedy. _Dose_--Of infusion, one to two ounces, of the fluid extract, ten to twenty drops; of the concentrated principle, _Scutellarin_, one to two grains. LADY'S SLIPPER (_Cypripedium Pubescens_). The root is used. _Dose_--Of the infusion, one-half to one-ounce; of THE fluid extract, one-fourth to one-half teaspoonful; of the concentrated principle, Cypripedin, one to two grains. PULSATILLA (_Pulsatilla Nigricans)._ We employ the German tincture, prepared from the green herb. In many of the distressing nervous complications to which both males and females are subject in certain diseases of the generative organs, we have found it very effectual. The dose is from two to eight drops. DR. PIERCE'S FAVORITE PRESCRIPTION. This is a tonic nervine of unsurpassed efficacy, combined in such a manner, that, while it quiets nervous irritation, it strengthens the enfeebled nervous system, restoring it to healthful vigor. In all diseases involving the female reproductive organs, with which there is usually associated an irritable condition of the nervous system, it is unsurpassed as a remedy. It is also a uterine and general tonic of great excellence. It is sold by all druggists. SEDATIVES. Sedatives are a class of agents which control excitation of the circulation, and diminish irritability of the nervous system. ACONITE (_Aconitum Napellus_), The parts used are the root and leaves. Aconite slows the pulse, diminishes arterial tension, and lowers the temperature of the body in fevers. It is an effectual remedy in acute inflammation of the tonsils and throat, in acute bronchitis, in inflammation of the lungs, and pleurisy, in the hot stage of intermittent and remittent fevers, in the eruptive fevers, in fever arising from a cold, and in some forms of neuralgia. Acute suppression of the menses from a cold, may be relieved by the tincture of aconite in drop doses every hour. _Dose_--Of the tincture of the root, from one-half of a drop to two drops, in a spoonful of water, in acute fevers and inflammations, from one-half drop to one drop should be administered every half hour or hour, according to the severity of the symptoms. PEACH TREE (_Amygdalus Persica_). Peach tree leaves and bark are slightly sedative, but the chief use which we have found for these articles is to control nausea and vomiting arising from irritability of the stomach. It also possesses mild, tonic properties. _Dose_--Of infusion at the bark of the small twigs or of the leaves, from two to six teaspoonfuls. [Illustration: Fig. 137. American Hellebore. ] AMERICAN HELLEBORE (_Veratrum Viride_) is also known as White Hellebore, Indian Poke, or Swamp Hellebore. The root is the part used. It is a most valuable agent with which to control the frequent, strong, bounding pulse common to many febrile and inflammatory diseases. When the pulse is hard, incompressible, and bounding, this remedy is more effectual than aconite. _Dose_--Of the tincture and fluid extract, from one to two drops, repeated every half hour to two hours, according to the severity of the symptoms. This remedy should be given in very small doses, frequently repeated, if we would secure its best effects. Our favorite mode of administering both veratrum and aconite is to add ten drops of the tincture to ten or fifteen teaspoonfuls of water, of which one teaspoonful may be administered every hour. YELLOW JESSAMINE (_Gelseminum Sempervirens_). The root is the part used. Through its controlling effect over the sympathetic nervous system, this agent exerts a marked influence in controlling morbid excitability of the circulatory organs. It allays irritation, and determination of blood to the brain, indicated by flushed face, contracted pupils, irritability, and restlessness, a frequent condition in diseases incident to childhood. Its concentrated principle, Gelsemin, is an efficient remedy in bloody-flux or dysentery. It should be administered in very small doses to secure the best results. Only one-sixteenth to one-eighth of a grain is required, repeated every two hours. It should be triturated with sugar of milk or with common white sugar, in the proportion of one grain to ten of sugar. _Dose_--Of tincture, from five to fifteen drops; of fluid extract, three to six drops; of Gelsemin, as a sedative, one-fourth to one-half grain. STIMULANTS. Stimulants are medicines which have the power of increasing the vital activity of the body. Some have a very transient action, while others are more permanent in effect. CAYENNE PEPPER (_Capsicum Annuum_). Cayenne Pepper is a powerful stimulant. _Dose_--Of the powder, from one to six grains, administered in milk; of the tincture, from five to ten drops, largely diluted in milk or water. BLACK PEPPER (_Piper Nigrum_). Black Pepper is a warm, carminative stimulant. _Dose_--From five to fifteen grains; of the fluid extract, from ten to fifteen drops. [Illustration: Fig. 138. Prickly-ash. ] PRICKLY-ASH (_Xanthoxylum Fraxineum)._ Prickly-ash bark is a stimulant and tonic. The parts used are the bark and leaves. _Dose_--Of the fluid extract, from five to fifteen drops; of the tincture, ten to twenty drops; of the active principle, Xanthoxylin, one to two grains. ALCOHOL is a powerful stimulant. It is never used in its pure state in medicine, but when diluted forms a useful remedy in many diseases. It is generally employed in the form of whiskey, gin, rum, brandy, and wine. AMMONIA is an excellent stimulant. _Dose_--Of the carbonate, from three to five grains; of the sesquicarbonate, from five to ten grains; this is the same as the carbonate, which has been exposed to the air and slacked (powdered hartshorn); of the aromatic spirit, from one-half to one teaspoonful. The Aqua Ammonia and Liquor Ammonia are of such variable strength that they are seldom employed internally, but may be applied externally and taken by inhalation. DR. PIERCE'S COMPOUND EXTRACT OF SMART-WEED. This quickly diffusible stimulant and genial anodyne we have spoken of under the head of Anodynes. But its medicinal properties equally entitle it to a place and mention under the class of stimulants. As a stimulant it spurs the nervous system and arouses the circulatory forces. Congestion of the lungs, liver, bowels, or uterus, embarrasses the functions of these organs. Frequently this congestive difficulty may be entirely obviated, and the circulation of the blood restored to the surface of the body, by the administration of a few doses of this pleasant remedy. Thus it often acts like magic in giving relief, promoting the circulation, and restoring the organs to their accustomed functional activity. Full directions accompany every bottle. TONICS. Tonics are remedies which moderately exalt the energies of all parts of the body, without causing any deviation of healthy function. While stimulants are transient in their influence, tonics are comparatively permanent. [Illustration: Fig. 139. White Poplar. ] WHITE POPLAR (_Liriodendron Tulipfera_), called also American Poplar, or White Wood. The part used is the inner bark. This is a mild but valuable tonic for domestic use. _Dose_--Of the infusion, from one-half to one ounce; of tincture, from one to two teaspoonfuls. CHAMOMILE (_Anthemis Nobilis_). The part used is the flowers. This is a mild, unirritating tonic. _Dose_--Of infusion (one-fourth ounce of flowers to a pint of water) one-half to one ounce. GENTIAN (_Gentiana Lutead_). The root is the part used. This is a favorite domestic tonic in many localities. _Dose_--Of powdered root, five to ten grains; of the tincture, ten to twenty drops; of the fluid extract, five to ten drops, four or five times a day. NUX VOMICA (_Strychnos Nux Vomica_), or Dog Button. This is a powerful tonic. It increases innervation and is particularly valuable in cases marked by feeble circulation and general impairment of muscular power. In overdoses it is poisonous, and hence must be employed with much caution. _Dose_--Of the tincture, three to five drops; of the fluid extract, ONE TO THREE DROPS. WILLOW (_Salix Alba_). Willow is a tonic and an astringent. _Dose_--Of the decoction, from one to two fluid ounces; of the concentrated principle, Salicin, from two to four grains. [Illustration: Fig. 140. Dogwood.] DOGWOOD (_Cornus Florida_). Dogwood, also known Boxwood, is tonic, astringent, and slightly stimulant. _Dose_--Of the solid extract, from three to five grains; of the infusion, from one to two ounces; of the fluid extract, from ten to twenty drops. WAFER-ASH (_Ptelea Trifoliata_), also called Swamp Dogwood. The bark is used. This is a pure, unirritating tonic. _Dose_--Of tincture, one-half to one teaspoonful; of fluid extract ten to twenty drops; of the infusion, one to two fluid ounces. [Illustration: Fig. 141. Golden Seal. ] GOLDEN SEAL (_Hydrastis Canadensis_). Golden Seal is a powerful and most valuable tonic. It is a valuable local remedy when used as a general injection in leucorrhea. _Dose_--Of the powder, from ten to thirty grains; of the tincture, from one-half to one fluid drachm; of the fluid extract, from ten to twenty drops; of the concentrated principle, Hydrastin, from two to three grains; of the muriate of hydrastia, from one-half to one grain. [Illustration: Fig. 142. American Colombo. ] AMERICAN COLOMBO (_Frasera Carolinensis_). American Colombo is a simple tonic. _Dose_--Of the powdered root, from ten to fifteen grains; of the infusion one-half to one fluid ounce, three or four times a day; of the active principle, Fraserin, one to three grains. [Illustration: Fig. 143. Gold Thread. ] GOLD THREAD (_Coptis Trifolia_). Gold Thread is a pure and powerful, bitter tonic, and is also efficacious as a wash for sore mouth or as a gargle. _Dose_--Of the decoction, from two to six fluid drachms; of the tincture, from one-half to two teaspoonfuls; of fluid extract, from ten to twenty drops. IRON (_Ferrum_). Different preparations of iron are frequently prescribed by physicians. They are particularly valuable in anæmic conditions of the system. The following are a few of the preparations of this metal most generally used: IRON BY HYDROGEN (_Ferri Redactum_). _Dose_--One to two grains. CARBONATE OF IRON (_Ferri Carbonas_). _Dose_--One to three grains. CITRATE OF IRON (_Ferri Citras_). _Dose_--One to three grains. PYROPHOSPHATE OF IRON (_Ferri Pyrophosphas_). _Dose_--One to three grains. TINCTURE OF MURIATE OF IRON (_Tinctura Ferri Chloridi)._ _Dose_--Three to twenty drops. DR. PIERCE'S FAVORITE PRESCRIPTION. The Favorite Prescription, in addition to those properties already described, likewise combines tonic properties. In consequence of the never ceasing activities of the bodily organs, the system requires support, something to permanently exalt its actions. In all cases of debility, the Favorite Prescription tranquilizes the nerves, tones up the organs and increases their vigor, and strengthens the system. Directions for use accompany every bottle. DR. PIERCE'S GOLDEN MEDICAL DISCOVERY. In addition to the alterative properties combined in this compound, it possesses important tonic qualities. While the Favorite Prescription exerts a tonic influence upon the digestive and nutritive functions, the Golden Medical Discovery acts upon the excretory glands. Besides, it tends to retard unusual waste and expenditure. This latter remedy tones, sustains, and, at the same time regulates the functions. While increasing the discharge of noxious elements accumulated in the system, it promptly arrests the wastes arising from debility, and the unusual breaking down of the cells incident to quick decline. It stimulates the liver to secrete, changes the sallow complexion, and transforms the listless invalid into a vigorous and healthy being. At the same time, it checks the rapid disorganization of the tissues and their putrescent change, while it sustains the vital processes. It is, therefore, and indispensable remedy in the treatment of many diseases. * * * * * CHAPTER III. BATHS AND MOTION AS REMEDIAL AGENTS. The remedial effects of bathing are generally underrated. This want of appreciation is more often due to the improper manner in which it is performed than to an insufficiency of curative virtues. The term _bathing_ not only implies a cleaning of the body or certain portions of it, but also the application of water in such a manner as to influence the nervous system, and regulate the functions of the secretory organs. Cleanliness, while it preserves health and promotes recovery, has reference only to the hygienic influences of water and not to its curative effects. There are several kinds of baths, the names of which indicate their character, manner of application, or the part of the body to which they are applied. Among others, we have Cold, Cool, Temperate, Tepid, Warm, Hot, Hot Air, Russian, Turkish, Vapor, Electric, Sea, Shower, Sponge, Douche, Foot, Sitz, Head, Medicated, Alkaline, Acid, Iodine, and Sulphur Baths. Temperature influences the properties of any bath; thus the sponge, sitz, and alkaline baths may be employed warm or cold, according to the effect desired. THE COLD BATH, used at a temperature of from 40° to 60° Fahr., is powerfully sedative, and is employed for its tonic effects. If the vital powers are low, or the individual remains in it too long (two or three minutes should be the limit), the reaction is slow and its effects injurious. While it is highly invigorating to robust persons, those who have a low standard of vitality should be cautions in its employment. A local bath may be followed by beneficial results, when a general bath would be inadmissible. For these reasons we advise the general use of the COOL BATH, at a temperature of from 60° to 75° Fahr. If, in any instance, the _reaction_ is _slow_, we recommend the TEMPERATE BATH, at a temperature of from 75° to 80° Fahr. The time of remaining in the bath should be regulated by the strength of the invalid. As a rule, it should not exceed three _minutes_, and the colder the water the less time should the patient be immersed. Immediately after emerging from any bath, the body should be thoroughly dried and rubbed with a moderately coarse towel until a glow is experienced and reaction is fully established. The attempt to toughen children by exposing them to low temperatures of either air or water, cannot be too emphatically condemned. This caution, however, does not apply to the employment of moderately cool water for ablutions. The cold or cool bath should be taken in the early part of the day, but _never during digestion_. Whenever reaction does not follow bathing, artificial means must be resorted to, as stimulating drinks, dry warmth, or exercise. THE TEPID BATH, the temperature of which is from 85° to 92° Fahr., is generally used for cleansing the body. It is prescribed in fevers and inflammatory affections for its cooling effects. It is usually medicated with some acid or alkali. The latter unites with the oily secretion of the skin and forms a soapy compound easily removed by the water. The temperature should be regulated according to the vitality of the patient; and the bath may be repeated two or three times a day. It removes superfluous heat, and keeps the skin in a condition favorable for excretion. THE WARM BATH, at a temperature varying from 92° to 98° Fahr., is always agreeable and refreshing. It equalizes the circulation and softens the skin, by removing all impurities. It moderates pain and soothes the whole system. It does not weaken or debilitate the person, but is in every way beneficial. It is an efficient, remedial agent in many chronic diseases, convulsions, spasmodic affections of the bowels, rupture, rheumatism, and derangement of the urino-genital organs. It should be employed immediately before going to bed unless urgent symptoms demand it at other times. It may be medicated or not, as circumstances require, but should always be taken in a warm room. THE HOT BATH at a temperature of from 98° to 110° Fahr. is a powerful stimulant. It excites the nerves, and through them the entire system. It causes a sense of heat and a constriction of the secretory organs; but perspiration, languor, and torpor soon follow. In the sudden retrocession of cutaneous diseases, it restores the eruptions to the surface and gives speedy relief. The hot bath may be applied locally when circumstances require. THE RUSSIAN BATH consists in the application of hot vapor, at a temperature varying from 112° to 200° Fahr. The patient is first subjected to a moderately warm temperature, which is gradually increased as he becomes inured to it, the head being surrounded with cloths wet in cold water. Upon emerging from it, the bather is plunged into cold water or receives a cool, shower bath. In rheumatic and cutaneous diseases, chronic inflammations, and nervous affections, the Russian bath is an effective remedy. THE TURKISH BATH is a, dry, hot-air bath. The bather passes from one apartment to another, each one being of a higher temperature than the preceding. He undergoes a thorough shampooing, and, although the person may be scrupulously clean, he will be astonished at the amount of effete matter removed by this process. The bather then returns through the various apartments, and, upon emerging from that of the lowest temperature, he experiences a delightful sensation of vigor and elasticity. As a hygienic agent, the hot-air bath has been' constantly growing in favor. Its value is now recognized by all physicians throughout the world. The judicious use of the Turkish bath serves to secure perfect equalization of the circulation. Glandular activity is increased, elasticity and power given to the muscles, and a permanent, stimulating and tonic influence imparted to the system, a condition at once conducive to the enjoyment and prolongation of life. Dr. Erasmus Wilson, of England, says, in a paper read before the London Medical Association: "The inhabitant of a large city would live as healthy, immured within city walls, as amid the fields and meadows of the country. His bath would be to him in the place of a country house or horse--it would give him air, exercise, freshness, health, and life." "The bath that cleanses the inward as well as the outward man; that is applicable to every age; that is adapted to make health healthier, and alleviate disease, whatever its stage or severity, deserves to be adopted as a national institution, and merits the advocacy of all medical men; of those whose especial duty it is to teach how health may be preserved, and how disease may be averted." The hot, _dry_ atmosphere of the Turkish bath promotes rapid evaporation from the surface of the body, and it is well known that rapid evaporation from the surface is a cooling process. A person's finger may be frozen in one minute's time, by throwing upon it a constant, fine spray of rhigolene or sulphuric ether. The rapid evaporation of the light fluid congeals the liquids of the tissues and a film of ice is rapidly formed upon the part. In a less intense degree the same cooling process is carried on over the whole surface of a person, when in the hot room, or _sudatorium_, of the Turkish bath. The evaporation from the surface is so rapid that one can hardly appreciate the profuseness of the perspiration going on. The evaporation from the surface so rapidly carries off the heat from the body that one finds himself able, with little or no inconvenience, to remain in a room heated to from 180° to 200° or even 220° Fahr. As a hygienic measure to be regularly or occasionally employed by persons in fair health, the Turkish or hot dry-air bath is far superior to the Russian or vapor-bath. (1.) It produces more profuse perspiration, and is therefore more depurating, or cleansing, in its effects. (2.) It does not relax the system, but rather produces a tonic effect, and fewer precautions are, therefore, necessary to guard against taking cold after employing it. (3.) The Turkish bath can be better ventilated than the Russian. While the air is heated to a high temperature, it can be readily kept pure by constant changes. In the Turkish hot-rooms, or _sudatorium_, of the Invalids' Hotel and Surgical Institute, provision is made for bringing underneath the floors a current of fresh air from without. This column of fresh air is carried under the centre of each room where it escapes from the conductor, is warmed, and rises into the room, from which extraction of air is constantly going on through registers opening into tubes, communicating with large ventilated shafts which are kept hot, summer and winter, to insure a draught through them. In this manner, thorough ventilation of our Turkish hot-rooms is insured. The Turkish bath not only combines a most agreeable luxury with a decidedly invigorating and tonic influence, but also, by its stimulating power, induces proper glandular and cellular activity, producing a healthy condition. Sallowness, tan, and freckles, the result of local or general increase of the pigment granules of the skin, soon disappear under the stimulating influence and regular use of the Turkish bath, which causes rapid development of new and transparent cells. The colored granules are thus gradually replaced and the skin assumes a beautiful clearness and purity of appearance, which transcends immeasurably the unhealthy hue that follows the frequent employment of the various cosmetics. The value of an agent which thus improves the general health, insures immunity from coughs, colds, and other diseases, and at the same time produces a healthy and permanent beauty of complexion, is at once apparent. The purity of person, perfect circulation, increase of healthy nutrition and glandular activity produced by the Turkish bath, serve to make it of the most lasting utility. The eminent Dr. Madden has said, and his experience is confirmed by every regular patron of the bath, that, "Wherever the Turkish bath was a national institution the hair of the women was peculiarly luxurious and beautiful. I can vouch for it that the use of the bath rendered the complexion more delicate and brilliant; that the eyes became clearer and brighter; all the personal charms were enhanced. I can recommend no hygienic measure more beneficial or effectual in preserving the health and an attractive personal appearance." Pimples, blotches, eruptions, and other disfigurations of the skin are removed by the frequent use of the Turkish bath, leaving the integument smooth and soft. [Illustration: Fig. 144. First Hot-room of the Turkish Bath. ] HOW THE TURKISH BATH IS ADMINISTERED AT THE INVALID'S HOTEL AND SURGICAL INSTITUTE. The hot-rooms, of which there are two, are exactly similar in every respect except as regards temperature. The first room has a temperature of from 110° to 120° Fahr. The bather is supplied by the attendant every few minutes with copious draughts of cool water. Gradually the relaxing influence of the elevated temperature manifests itself. The capillaries slowly dilate, the veins enlarge under its gentle stimulus, and small points of perspiration appear upon the surface, which assumes a slight, rosy blush. A delightful calm, a feeling of perfect rest and luxurious ease is imparted to the senses. From this room, after an appropriate interval, the bather enters the second room, in which the atmosphere is higher by from 20° to 30°, and it may be made still higher, its regulation requiring but an instant. [Illustration: Fig. 145. One of the Shampooing rooms.] A thorough sweating occurs while the subject remains in these rooms, during a period of from ten to forty minutes. The secretions of the skin, at first impure and loaded with the _débris_ of dead cells and extraneous matter, gradually become purer, and clearer, until, finally, all trace of color disappears and the pearly drops of sweat come full and free. Soon the attendant appears and leads the way to the shampooing-room, where, lying upon a warm marble slab, _massage_ is applied most thoroughly to every portion of the body. By the _massage_, shampooing, or rubbing, the superficial veins are thoroughly emptied of their contents, the muscles are given elasticity and tone, and glandular activity is promoted. Innumerable dead epithelial cells, together with other impurities, are rolled off in flakes under the skillful manipulation of the attendant. After a thorough shampooing, the shower bath is applied, to secure a contraction of the capillaries and a diminution of the perspiration. THE SPIRIT VAPOR-BATH is very effective when employed in the earlier stages of acute, febrile, inflammatory, and painful diseases. In many forms of chronic diseases the administration of a spirit vapor-bath once in from three to fifteen days, is a valuable adjunct to the treatment of these affections. It exerts an exceedingly beneficial influence upon the entire system, and, when habitually employed, may ward off disease. The body should be moistened with an alkaline solution before the administration of a spirit vapor-bath. After the perspiration which it occasions has subsided, which will usually be in from three to four hours, sponge the body with a mixture of the following ingredients: water, three gills; alcohol, one gill; salt, one teaspoonful. By this method the patient experiences none of the unpleasant effects which generally follow the employment of diaphoretics. Various kinds of apparatus have been devised to facilitate the application of the spirit vapor-baths. Most of them are cumbersome and expensive, and, consequently, are seldom used except in hospitals or sanitariums. The following method described by Dr. J. King, may be advantageously employed. "The patient is undressed, ready for getting into bed, having removed the clothing worn through the day and put on a night shirt or other clothing to be worn while sweating, and during the night, if the bath is taken at bed-time. He is then seated on a high Windsor or wooden-bottomed chair, or instead thereof, a bench or board may be placed on a common open-bottomed chair, care being taken that the bottom is so covered that the flame will not burn him. After seating himself, a large coverlet or blanket is thrown around him from behind, covering the back of his head and body, as well as the chair, and another must be passed around him in front, which last is to be pinned at the neck, loosely, so that he can raise it and cover his face, or remove it down from the face from time to time as occasion demands during the operation of the bath. The blankets must reach down to the floor, and cover each other at the side, so as to retain the vapor. This having been done, a saucer or tin vessel, into which is put one or two tablespoonfuls of whiskey, brandy, alcohol, or any liquor that will burn, is then placed upon the floor, directly under the centre of the bottom of the chair, raising a part of the blanket from behind to place it there; then light a piece of paper, apply the flame to the liquor, and as soon as it kindles let down the part of the blanket which has been raised, and allow the liquor to burn until it is consumed, watching it from time to time to see that the blankets are not burned. As soon as consumed, put more liquor into the saucer, about as much as before, and again set it on fire, being careful to put no liquor into the saucer while the flame exists, as there would be danger of setting fire to the blanket, and producing injury to the patient. Continue this until the patient perspires freely, which, in a majority of cases, will be in five or ten minutes." "If, during the operation the patient feels faint or thirsty, cold water must be sprinkled or dashed in his face, or he may drink one or two swallows of it,--and in some cases the head may be bathed with cold water. As soon as free perspiration is produced, wrap the blankets around him, place him in bed, and cover him up warm, giving him about a pint of either some good store tea, ginger, or some diaphoretic herb tea to drink, as warm as he can take it. After two or three hours, remove the covering, piece by piece, at intervals of twenty or twenty-five minutes each, that he may gradually cease perspiring." The above method may be improved by using an ordinary hoop skirt, ten to twelve inches below the bottom of which is suspended a larger and stronger hoop. The upper and smaller hoops should rest upon the patient's shoulders. A woolen blanket, large enough to reach and rest upon the floor, and envelop the whole person, is thrown over the hoops. Unless the bath is employed to diminish the quantity of fluids in the body (as in dropsy), the patient may drink some simple, diaphoretic infusion, to hasten or facilitate perspiration. When he perspires freely, small quantities of cold water may be frequently given. "There is little or no danger of taking cold after this process, if ordinary precaution is observed, and it is easy, agreeable, safe, and effectual." "Occasionally we will meet with patients, upon whom it is almost impossible to produce the slightest moisture, much less perspiration. The skin of such persons is generally dry and harsh, communicating an unpleasant sensation to the touch. In most instances the skin may be restored to its normal condition, by adopting the following course: 1st. Anoint the whole surface of the body and limbs with olive oil every night upon retiring to bed. 2nd. Every morning wash the whole surface with a warm, weak, alkaline solution, employing considerable friction while drying. 3rd. Every two weeks administer a spirit vapor-bath. A perseverance in this course for a few months will accomplish the desired result." Frequent reference to spirit vapor-baths will be made by the author of this work, in speaking of those diseases in which its employment will prove beneficial. SEA BATHING is an excellent, remedial agent in chronic disorders, particularly in those of an atonic character, such as nervous prostration, dyspepsia, and general debility. Much of the benefit attributed to this mode of bathing is undoubtedly due to other influences, such as pure air, exercise, change of scenery, diet, and associations which surround the patient during his sojourn at the sea-shore. At first, the duration of a sea-bath should not exceed three or five minutes, but it may be gradually prolonged to fifteen or twenty minutes. If the patient is very feeble, one or two baths a week are sufficient, and the most robust person should never take more than one a day. They should always be taken in the earlier portion of the day, before breakfast if possible, and _never during digestion_. Before entering this bath, a moderate degree of exercise should always be taken, enough to arouse the vital energies, but not to produce fatigue. Suitably dressed, the patient plunges into the water, in which he remains during the prescribed time. Immediately after emerging from the bath, the patient should be thoroughly dried and dressed and then moderate exercise should be taken to induce reaction. If the reaction is slow, a mild stimulant may be taken and the duration of the bath must be diminished the next time. When sea-bathing is beneficial improvement is soon manifested. The blood becomes richer, the whole system is strengthened and the functions are performed with more regularity. To the rich, sea-bathing is a luxury, but it is a remedy beyond the reach of the poorer classes unless they live near the sea-shore. THE SHOWER BATH produces a shock to the nervous system by suddenly coming in contact with the skin. Numerous streams of cold water fall upon the neck, shoulders, and body of the patient who stands beneath the hose or reservoir. When the patient is plethoric, feeble, or nervous, or when some internal organ is diseased, the cold, shower bath should _not_ be employed. In simple debility unaccompanied by inflammation or symptoms of internal congestion, its use proves advantageous. By moderating the force of the shower, and substituting tepid water, the most delicate persons can endure it and profit thereby. The usual means for inducing a good reaction, friction, and exercise, should be employed. THE DOUCHE BATH consists of a stream of water, dashed or thrown upon the patient from a moderate height or distance, with considerable force. The size, temperature, and force of the stream may be modified to suit the exigencies of the case. It is locally employed as a remedy for sprains, weak or stiff joints, old swellings, etc. The cold, douche bath is more powerful than the shower bath and should be given with the same precautions which govern the application of the latter. THE SPONGE BATH admits of extensive employment in both acute and chronic diseases, and its simplicity renders it of untold value. It consists in a general or local application of water (medicated or not) at any desired temperature. The quantity may be great or small to suit the requirements of the case. If it is applied in acute diseases at a temperature agreeable to the patient, it is exceedingly grateful and may be repeated as often as necessary. It may be rendered alkaline by the addition of some compound of soda, in the proportion of a teaspoonful to a quart of water. A portion of the body may be bathed at a time, and quickly dried, thus avoiding any exposure to cold. It removes excessive animal heat, relaxes the capillaries, equalizes the circulation, and produces comfort, tranquility, and sleep. Nothing is more conducive to the health and comfort of laboring men in summer than a daily bath, and it is a matter of regret that there are so few conveniences for the purpose in most homes, especially those in the country. Farmers in particular need bathing facilities, and yet in most cases they are almost entirely without them. For their benefit we will describe a device which we can recommend to all who want a cheap, convenient, and easily managed apparatus for sponge bathing in the bed-room. The articles required are a piece of rubber-cloth a yard and a quarter square, four slats, two inches wide and three feet long, notched at the ends so as to lock together in the form of a square, and a large sponge. The slats are placed upon the floor and the rubber cloth is spread over them (there is no need of fastening it to the slats), forming a shallow square vessel a yard wide. In this the bather stands and applies the water with a sponge from a basin or bowl on a stand placed conveniently near. There need be no danger of wetting the carpet, or spoiling the furniture. When the bath is finished, gather three corners of the rubber cloth in the left hand, take the fourth corner in the right in such a way as to form a spout when lifted or held over the slop-jar or bucket. The water may be poured out in a moment, when the cloth should be spread over the back of a chair to dry, and the slats unlocked and set away in a closet. THE FOOT BATH is frequently employed, as a means of causing diaphoresis, in colds, attacks of acute diseases, and also to draw the blood from the head or some internal organ. It is a powerful auxiliary in the treatment of those chronic diseases in which inflammation, congestion, and a feeble circulation are prominent symptoms. The water should be as hot as it can be borne and the temperature kept up by additions of hot water. It may be made stimulating by the addition of salt, mustard, ginger, or cayenne pepper. THE SITZ BATH. A tub is so arranged that the patient can sit down in it while bathing. In this manner the lower part of the abdomen, hips, and upper part of the thighs, are immersed in whatever fluid the bath is composed of. It is applicable in diseases of the pelvic organs, and may be hot, warm, cool, cold, or medicated, according to the effect desired. The bath tub should be large enough to permit a thorough rubbing and kneading of the diseased parts, and the patient may remain in it from ten to thirty minutes. The clothing may be wholly or partially removed, as agreeable to the individual. A _warm_, sitz bath is an effective, remedial adjunct in menstrual suppression and in painful menstruation, gravel, spasmodic and acute inflammatory affections generally. The _cold_, sitz bath is used as a tonic in cases of relaxed tissues of the pelvis, in debility of the urino-genital organs, in piles, prolapsus of the rectum, and in constipation. THE HEAD BATH. A shallow basin contains the fluid for the bath; and the patient, assuming a recumbent position, immerses a portion of the head, generally the back part. The temperature may be warm, cool, or cold, as desired. MEDICATED BATHS are infusions of vegetable or other substances in water. They are sometimes applied with the sponge, though generally the patient is immersed. The temperature at which they are usually employed is that of the tepid bath. The nature and strength of the medication depends upon the character of the disease for which it is employed. THE ALKALINE BATH is prepared by dissolving half a pound of carbonate of soda in sixty gallons of water. It is useful in those diseases in which the fluids of the body are abnormally acid, as in rheumatism. THE ACID BATH is prepared by adding two pounds of muriatic or hydrochloric acid to sixty gallons of water. A much smaller quantity of the acid is sometimes used, and in some instances vinegar is substituted. _Scott's Acid Bath_ is composed of nitro-muriatic acid (aqua regia) and water. It should be prepared in a wooden tub, and a sufficient quantity of acid used to give the water a sour taste. It is extensively used in India as a remedy for disorders of the liver. THE IODINE BATH is composed of the following ingredients: tincture of iodine, two drachms; iodide of potassium, four drachms; water, forty gallons. It should be prepared in a wooden tub. It reddens the skin. For children, a much weaker solution must be employed. Its use is generally restricted to scrofulous and tubercular affections. THE SULPHUR BATH is prepared by dissolving eight ounces of sulphuret of potassium and two ounces of dilute sulphuric acid in sixty gallons of water. The acid may be omitted. A SULPHUR VAPOR-BATH is often employed in cities where the necessary apparatus can be procured. It may be improvised by placing sulphur on a shovel over hot coals. The patient should be prepared as in the spirit vapor-bath, and burning sulphur substituted for the liquor. The patient is then enveloped in the fumes of sulphurous oxide. Heating a mixture of sulphur and sulphuric acid, produces the same result. If the gas is inhaled in large quantities it causes irritation of the respiratory passages, and suffocation. It is therefore necessary that the coverings should be securely fastened at the neck, and that the room be one which can be quickly filled with pure air This bath is used in cutaneous, rheumatic, and syphilitic disorders. FOMENTATIONS consist of the general or local application of woolen cloths wrung out of hot water. They should not be so light as to be ineffectual, nor so heavy as to be burdensome. They should not be wet enough to drip, nor applied so as to expose the body to the surrounding air. A fresh cloth should be ready for application before the first one is removed, and the change quickly effected. Fomentations are effectual in relieving congestion and inflammation. THE WET SHEET PACK. As this remedial appliance will be frequently recommended in the pages following, its mode of application is here described. Take a pail half filled with cold water, gather together one end of a common cotton sheet, and immerse it, allowing it to remain while preparing the bed, which may be done as follows: remove all the bed-clothes except a coverlet and the pillows, then spread upon it, in the following order, two ordinary comforters, one woolen blanket, one woolen sheet, (or two woolen sheets if a woolen blanket is not at hand); then wring out one-half or two-thirds of the water from the wet sheet, spread it smoothly upon the blanket, and the patient being undressed, places himself on the sheet, with his arms extended, while an assistant wraps him closely and tightly with it, as quickly as possible. Each arm may be thus covered by the wet sheet, or may lie outside of it, and be covered by wet towels, prepared in the same manner as the sheet. Then quickly and tightly cover with the blankets and comforters, tucking snugly from head to foot. The head should also be covered with a wet towel, and a bottle of warm water placed to the feet, or near enough to keep them warm. After the first shock of the chill is over, the pack is very pleasant and refreshing, and the patient should go to sleep, if possible. The ordinary time for a patient to remain in a pack is about sixty minutes. Thirty or forty minutes is sufficient, if he is in a feeble condition. Never wring the sheet out of warm water, for one of its principal benefits comes from the vigorous reaction induced by its cold temperature. After remaining in the pack from thirty to sixty minutes, allow the patient to stand on his feet, if he is able, and have the whole surface of his body bathed. Rub briskly, and dry with towels, or by throwing over the body a dry sheet and then rubbing him. The dry sheet retains the bodily warmth and is more comfortable, but interferes with the completeness and vigor of the rubbing of the body. Be sure and establish full reaction, which may be known by the warmth of the surface. Frequently, when the patient is released from the pack, and is being bathed, rolls of scales, scurf, and _skin-debris_ come off, thus giving palpable evidence of the utility of the pack in freeing the myriads of pores of the skin of effete matter. It is efficient in fevers, and for breaking up colds, and is a very valuable, remedial agent in most chronic diseases, assisting in removing causes which depress the bodily functions. MOTION IS A REMEDIAL AGENT. The stability of the planetary system depends upon the converted motion of its parts. So in the human system, motion is a fundamental principle which underlies every vital process. Health consists in normal, functional activity. The human system is the arena of various kinds of motions, both of fluids and of solids, and life and health depend upon these physiological movements. There are the movements incident to _respiration_, the expansion and contraction of the walls of the chest, bringing the oxygen of the air into contact with the blood as it circulates through the lungs. Corresponding with the movements of the chest are the _motions of the abdominal walls_, which promote the functions of the organs of the abdominal cavity. There are _motions of the heart and arteries_, which urge the blood out to the extremities and diffuse it through every part of the system, and also _motion of the blood in the capillaries_, by which the blood is circulated through the tissues, that the latter may be built up from its nutritive constituents. Then there is the _motion of the vital current_ in the veins returning towards the heart, and urged forward by the muscular and pump-like action of the chest and abdominal walls. The peristaltic _motions of the stomach and bowels_ urge onward digesting materials, exposing them successively to different solvents and aiding the absorption of nutritive matter. No less essential to life and health are numerous other minute operations or _motions_, on which vital power in all its manifestations of muscular and nervous energy depends. Many other _motions_ are consequent upon decay, growth, and repair. Oxygen, carbonic acid, watery vapors, and other gaseous matter are constantly being exchanged between the system and atmosphere. Then, the human system being a complex, chemical laboratory, there are _motions consequent upon chemical action_, constantly going on within it. _Muscular motion_, under the direction of the will, is also absolutely necessary for the maintenance of good health. Animal heat and muscular and nervous power are dependent upon motions of the minutest particles composing the body. The body is composed of fluid and semi-fluid matter, permitting great freedom of motion. Health requires that there shall be _a constant change of place_, an active transmission of material to and from vital organs and parts, through the medium of blood-vessels, as well as outside such vessels; that is, motion of interstitial fluids. NATURE'S MODE OF SUSTAINING HEALTH. The act of transforming latent, non-vital force which exists pent-up in food, as heat is in coal, into vital energy, requires the simultaneous elimination from the system of a like amount of worn-out matter. Assimilation of nutritive materials is impossible, unless a like amount of matter be eliminated from the system. Muscular and nervous energy are dependent upon activities which cause waste. Not only is this true in a general way, but it is also true that the energy produced by the operations of the vital system has a strict relation to the wasting products--that _full_ energy is only attained by _perfected_ waste. Use, waste, and power, then, sustain definite and dependent or corresponding relations, since waste is as essential to health as is supply. Without waste, disturbance is at once produced in the system similar to that resulting from the introduction of foreign matter. These disturbances constitute disease. The more obvious effects of lack of waste and elimination are mechanical. The circulation is loaded with effete and useless matter, the vessels being thereby weakened and distended, and the circulation retarded. The capillaries become clogged and vital action is diminished. Local congestions, inflammations, effusions, morbid growths, and other pathological results follow. Deranged or suppressed action characterizes, and, indeed, constitutes all departures from health which we call disease. Suffering indicates action, but action which is perverted into wrong channels, or action in one part at the expense of motion in other parts, constituting a disturbance in the equilibrium of forces, from which the system suffers. VALUE OR MECHANICAL MOVEMENTS AND MANIPULATIONS FOR THE TREATMENT OF CHRONIC DISEASES. To correct and restore deranged movements, thereby producing normal, functional activity of every organ and part of the system, must therefore be the chief object of the physician. All remedies, of whatever school or nature, imply motion, and depend for their efficacy upon their ability to excite motion in some one or more elements, organs, or parts of the system. While we do not wish to detract from the real merits of medicine as a curative agent, yet we must admit that the remedial power of motion, transmitted either manually or mechanically, is founded upon rational and physiological principles. All systems of medicine, however much they may differ superficially, propose, as the chief end to be attained by the administration of medicine, or by other treatment, that _motions_ identical with physiological activity should be incited or promoted. How best to accomplish this result, and with least cost to vitality, is an important consideration. Bearing in mind the conservation of forces, that energy or power is as indestructible as matter, that it may be changed into other forms but never lost, it is plain that mechanical force may be applied to the living system and transformed into vital energy; that chemical action, animal heat, and magnetism may represent in the system the mechanical force transmitted to the body. Keeping in view the transformable nature of force, and the need that our systems have of auxiliary power in different departments, when normal activity is impaired by disease, we can readily understand how undoubted, curative effects result from either the manual or the mechanical administration of motion. RUBBING is a process universally employed by physicians of every school for the relief of a great diversity of distressing symptoms, is instinctively resorted to by sympathizers and attendants upon the sick, and constitutes one of the chief duties of the nurse. Uncivilized people resort to this process as their principal remedy in all forms of disease. The difficulty in administering motion as a remedial agent by manual effort, such as rubbing, kneading, oscillating, flexing, and extending the limbs, lies in the impossibility of supplying the _amount, intensity_, and _variety_ of movement required to make it most effective. The power of the arm and the strength of the operator are exhausted before the desired effect is produced. Inventive genius has at last overcome the obstacles to the successful and perfect administration of motion as a curative agent. We have now a series of machines propelled by mechanical power, by the use of which we rub, knead, manipulate, and apply in succession a great variety of movements to all parts of the body. These machines transmit motion to the body from inexhaustible sources, never tire, but are ever ready for new, remedial conquests. The movements administered by their use, _while entirely under the control of the patient_, are never disagreeable, and are far more rapid and intense than can possibly be given by the hands. By the application of short, quick movements of from _twelve to fifteen hundred vibrations a minute_, deep-seated organs and parts are reached, to which motion is transmitted and in which vital energy is thereby generated. The hands have not the power, by kneading, manipulating, or rubbing to impress the system except in a very mild degree, and deep-seated organs and parts are scarcely influenced by the comparatively slow movements thus administered. Among the most important, mechanical inventions devised for administering motion as a remedial agent, is one which has received the name of the _manipulator_. THE MANIPULATOR. With this machine motion can be applied to any organ or part of the system, and intensity of the application regulated to a nicety. The rapidity of motion necessary to produce active exhilaration of any part of the body is easily secured by the use of the manipulator, but is far beyond the power of the hands. The degree of circulation given to the fluids, both inside and outside of the vessels, and of energy imparted to the organs and parts operated upon by the manipulator, is also unapproachable by the application of manual power. EFFECTS UPON THE CIRCULATION AND NUTRITION. The influence of motion on these functions is as follows: The contents of the blood-vessels are moved onward by the pressure and motion transmitted by the manipulator, all backward movement of the blood being prevented by the valves of the veins and by the propelling power of the heart and arteries. Fluids outside these vessels pass through their walls, to take the place of the stagnant blood that has been moved onward. Other blood flows into the part, and thus active and healthy circulation is induced, and nutritive material, capable of affording vital support is also brought to refresh the local part. We have found mechanical movements especially effectual in paralysis, neuralgia, sleeplessness, and other nervous affections; in derangements of the liver, constipation, and dyspepsia; in displacements of the uterus, and congestion, and inflammation of the pelvic organs. For a complete description of the mechanical movements and the machinery employed in the treatment of diseases at the Invalids' Hotel and Surgical Institute, the reader is referred to the appendix to this work. * * * * * CHAPTER IV. HYGIENIC TREATMENT OF THE SICK. There are two essentials requisite to the successful treatment of the sick: (1.) Medical skill; (2.) Good nursing. The former is necessary in order that the condition of the patient be fully understood, and the proper means be employed to effect his recovery. The latter is essential, in order that all influences favoring the production and development of disease may be removed, the tendencies to restoration be promoted by every possible means, and the directions of the physician be properly observed. Success in the treatment of the sick requires good nursing. Without it, the most skillful physicians fail to effect a cure; with it, the most unqualified may succeed. If certain hygienic agencies are essential to the maintenance of health, how much more necessary it is that they be employed in sickness! If certain conditions cause disease, how great the necessity is that such conditions be obviated and hygienic ones substituted! Notwithstanding the importance of good nursing, in the rural districts it is frequently difficult to find a professional nurse, or, if one can be obtained, it is often impossible for the invalid to procure such services, on account of the expense which must necessarily be incurred. Hence, this office usually devolves upon some relative who is considered to be the best qualified for the position; or, as is often the case, necessity demands that the patient be left to a change of nurses. A woman is generally selected for this important position. Her soft hand and soothing voice, her kindly, sympathetic, and provident nature, together with her scrupulous cleanliness, render her man's equal, if not his superior, in the capacity of nurse. There are circumstances, however, in which the services of a man are indispensable; hence the necessity that all should be qualified to care for the sick. A nurse should be attentive to the requirements of physician and patient, for she sustains an intimate relation to both. She should observe the directions of the physician, and faithfully perform them. She should note all the symptoms of the patient, and do everything in her power to promote comfort and recovery. She should anticipate the wishes, and not cause the patient to ask for everything which is desired. So far as practicable, let the wishes be gratified. The senses of the sick often become morbidly acute, and those things which in health would pass unnoticed, in sickness are so magnified as to occasion annoyance and vexation. Sick persons are not all alike, and the peculiarities of each must be studied separately. The nurse must be _kind_, but _firm_, and not yield to such whims of the patient as may be detrimental to recovery; neither must she arouse dislike or anger by opposition, but endeavor to _win_ the patient from all delusions. The feelings of the patient should never be trifled with, for idealities become realities. The nurse should possess an inexhaustible store of patience. Disease affects the mind of the patient and fills it with strange delusions. The sick are often querulous, fretful, and unreasonable, and should be treated with kindness, forbearance, and sympathy. The nurse should always be cheerful, look on the bright side of every circumstance, animate them with encouragement, and inspire them with hope. Hope is one of the best of tonics. It stimulates the flagging, vital energies, and imparts new life to the weak and exhausted forces. Gloom, sadness, and despondency depress the vital forces and lead to death. We have seen patients rapidly sinking, who had given up all hope, and were quietly awaiting the coming of death, snatched, as it were, from its grasp, and restored to health, by words of cheer and encouragement. The nurse should possess _moral principles_, which alone can win the confidence of the patient. She should have judgment, circumspection, intelligence, forethought, alacrity, carefulness, and neatness. In a word she should exercise _common sense_. We deem it but justice to say a word in behalf of the nurse. She, too, is a human being, subject to disease, and, unless hygienic conditions be observed, will soon be stricken low by its presence. She must be relieved occasionally and get rest, or she cannot long withstand the combined influence of fatigue and disease. Her office is an arduous one at best, and the long, weary hours of night-watching should be compensated by exercise in the open air, as well as by sleep during the day. Unless this be done, the system will become exhausted, and sleep will intrude itself upon her at the time when the greatest diligence is required for the welfare of the patient, when the vital powers are at their lowest ebb. She should be supplied with plenty of suitable food during the night, to sustain her and to serve as a safeguard against the invasion of disease. She should be treated with kindness and respect, else her disposition may become morose and reflect itself upon the patient, causing peevishness and despondency. THE SICK-ROOM should be as comfortable, cheerful, and pleasant, as circumstances will allow. Let the room be large and airy, and furnished with a stove, or better still, a fireplace. All articles of clothing and furniture, not necessary to the comfort of the patient, should be removed from the room, and in _malignant_ or _contagious_ diseases the carpets, even, should not be permitted to remain. The surroundings beget happiness or gloom, in proportion as they are pleasant or disagreeable. A tidy attendant, a few flowers and books, wonderfully enhance the cheerfulness of the room. Permit no unnecessary accumulation of bottles, or any thing that can in any way render the room unpleasant. Medicines, drink, or nourishment should never be left uncovered in the sick-room, since they quickly absorb the gaseous emanations from the patient, and become unfit for the purpose which they were intended to serve. Their presence gives the room an untidy appearance, suggestive of filth and slovenliness, and imparts to the patient a feeling of loathing and disgust for articles of diet. THE BED should not be of feathers, on account of their undue warmth, which causes a sensation of languor throughout the system. A husk or sea-grass mattress, or even a straw bed, covered with a cotton quilt, is far preferable. The bedding should be changed frequently. It is better that the bed should be away from the wall, so as to admit of greater freedom of movement about it. PURE AIR. The air in the sick-room should be kept as pure as possible. That which is so necessary in health, is indispensable in sickness. The importance, therefore, of a perfect and free ventilation of the sick-room cannot be too thoroughly impressed; and yet to properly secure this end, may call forth a considerable amount of ingenuity on the part of the nurse. A window should be open, but the current of air must not be allowed to blow directly upon the patient. One window may be raised from the bottom and another lowered from the top. This will permit the entrance of pure air from without, and the exit of the vitiated air from within. The patient, if sufficiently covered in bed, is not liable to take cold from a proper ventilation of the room. Especially is this true, when the bodily temperature is raised by febrile or inflammatory affections. The _temperature_ of a room is no indication of the _purity_ of the air. It is a prevalent, but mistaken notion, that when a room is cold, the air must be pure. Cold air is as readily contaminated with impurities as warm air, therefore, it is not sufficient that the room be kept cool, but the air should be frequently changed. During convalescence, great care is necessary to protect the patient from taking cold. Air which is admitted into the sick-room should not be contaminated by passing over foul drains, privies, or other sources of infection, since, instead of invigorating, it depresses the physical forces and generates disease. LIGHT is as necessary to health as is pure air. Banish either for any continuous period of time, and serious results follow. The strong, robust man, when deprived of light, soon degenerates into a feeble, sickly being, and finally dies. According to the investigations of the Massachusetts Medical Society, it was found that absence of sunlight, together with moisture, not only favor the development of tubercular consumption, but act as an exciting cause. It is well known that persons living in shaded dwellings often suffer from forms of disease which resist all treatment until proper admission of light is secured. The physician to the Emperor of Russia found upon examination that patients confined in well lighted wards, were four times as liable to recover as were those in poorly lighted rooms. Children reared away from the sunlight are apt to be deformed and idiotic, while those partially deformed have been restored by being admitted to the light. Patients sometimes wish to have their rooms darkened, because the light is painful to their weak and sensitive eyes. It is far better to shade the eyes and admit the sunlight into the room, since its rays cause chemical changes to take place, which favor the return of health. Many invalids can ascribe their recovery to the influence of a sun bath. There are, however, conditions in which the patients should be screened from the light. In such cases a little arrangement of the curtains or shutters will accomplish all that is to be desired. Patients convalescing from acute, or suffering from chronic diseases, should receive the influence of light in the open air, and be in it several hours every day. Light and pure air stimulate a healthful development, induce cheerfulness, hope, and recovery, while darkness begets gloom, sadness, despondency, disease, and ultimately death. WARMTH is essential to the well-being of the patient, and it is necessary that a proper temperature be maintained in the room. Except in very warm weather, a little fire should be kept in the room, and at the same time fresh air should be admitted from without, and a uniform temperature thus preserved. This arrangement is especially necessary in localities where great variations in temperature are experienced during the day and night. The normal temperature of the body ranges from 98° to 99° Fahr. The minimum occurs from 2 to 6 A.M.; the maximum, from 1 to 6 P.M. The deviation of a few degrees from this standard indicates disease, and the greater the deviation, the greater is its severity. During the early stages of acute diseases, the animal heat is generally increased, and should be allayed by bathing, and cooling or acidulated drinks. In the latter stages, the temperature becomes diminished and the condition of the system is favorable to congestions, which are most likely to occur between the hours of 2 and 6 A.M., when the vital powers are lowest. The patient then becomes feeble, his extremities grow cold, and he has what is termed a "sinking spell," and perhaps dies. It is during these hours that additional covering, the application of hot bricks to the feet, and bottles of hot water to the limbs and body, friction upon the surface, stimulating drinks, and increased vigilance on the part of the nurse will often save the patient's life. But, unfortunately, at these hours the nurse is apt to get sleepy and inattentive, the demands of the patient go unheeded, and a sacrifice of life is the result. Persons suffering from chronic diseases, or those in feeble health, should preserve their vital energies by dressing warmly, by wearing flannels next to the skin, and by carefully protecting the feet from cold and moisture. CLEANLINESS cannot be too thoroughly impressed upon the minds of those who have the care of the sick. Filthiness is productive of disease and favorable to its development. Bathing at least once a day, with pure, soft water and toilet-soap, is strongly urged, and as this is designed for cleanliness, the temperature of the bath should be made agreeable to the patient. THE CLOTHING AND BEDDING OF THE PATIENT in acute diseases, should be changed frequently and thoroughly aired, if not washed. As soon as removed, these articles should be taken from the room, replaced by others _well aired and warmed._ The hands and face of the patient should be bathed frequently, the hair combed, the teeth brushed, the nails cleaned, the lips moistened, and everything about him kept clean and tidy. These observances, although in themselves trifling, promote comfort and cheerfulness, and contribute largely to the recovery of the sick. All excretions from the patient should be buried, and not committed to privies to communicate disease to those who frequent them. THE DIET contains a very important relation to health. During the process of acute disease, the appetite is generally much impaired, if not entirely absent. It should then be the study of the nurse to devise such articles of nourishment as will be acceptable to the patient and suitable to the condition. The food should be light, nutritious, and easy of digestion. Each individual disease requires a diet adapted to its peculiarities. Those of an inflammatory character require an unstimulating diet, as gruel, barley-water, toast, etc. An exhausted or enfeebled condition of the brain, unattended by irritability, demands a stimulating diet, as beef, eggs, fish, Graham bread, oysters, etc. In wasting diseases, in which the temperature of the system is low, beef, fatty substances, rich milk, sweet cream, and other carbonaceous articles of diet are recommended. In the various forms of chronic ailments, the diet must be varied according to the nature of the disease and the peculiarities of the patient. Deranged digestion is generally an accompaniment of chronic disease. A return to normal digestion should be encouraged by selecting appropriate articles of food, paying due regard to its quantity and quality, as well as to the manner and time of eating. The appearance of food, and the manner in which it is offered, have much to do with its acceptance, or rejection by the patient. Let the nourishment be presented in a nice, clean dish, of a size and shape appropriate to the quantity. More food than can be eaten by the patient should not be placed before him at one time, since a great quantity excites disgust and loathing. In taking nourishment, drink, or medicine, the patient, if feeble, should not be obliged to change his position. MILK is one of the most important foods in fevers and acute diseases attended with great prostration, and in which the digestive powers are enfeebled. It contains within itself all the elements of nutrition. BEEF TEA furnishes an excellent nourishment for the sick, but there are few, even among professional nurses who know how to properly prepare it. We give three good recipes. One method is to chip up lean beef, put it in a porcelain or tin saucepan, cover it with _cold_ water, and bring it up to just below the boiling point, at which temperature _retain it_ for ten minutes, then season and serve. Another method is similar to the foregoing, with this difference, that the juices of the meat are squeezed through a piece of muslin or crash, making the tea richer. Another way, which we consider preferable to either of the above, is to take lean beef, cut it into fine bits, put them in a tightly covered vessel, which is placed in a kettle of water kept boiling. Thus the whole strength of the juice will be obtained from the meat without losing any of its properties. It can be seasoned to the taste, and reduced with water to suit the needs of the patient. SLEEP is "Nature's grand restorer, a balm to all mankind; the best comforter of that sad heart whom fortune's spite assails." It is necessary in health, and doubly so in sickness. During sleep, the vital energies recuperate, the forces are less rapidly expended, and the strength increases. It is the great source of rest and refreshment. Often a day's rest in bed, free from the cares and anxieties of an active life, is sufficient to ward off the approach of disease. If quiet and rest are essential to recuperation in health, their necessity in disease must be apparent. Life frequently depends on tranquility and repose, and the least noise or confusion disturbs the sufferer and diminishes the chances of recovery. Nothing annoys sick or nervous persons more than whispering and the rustling of newspapers. If conversation be necessary, let the tones be modified, but never whisper. In sickness, when the vital forces are low, the more natural rest and sleep the patient obtains, the greater is the prospect for recovery. As a rule, _a patient should never be awakened when sleeping quietly_, not even to take _medicine_, unless in _extreme cases_. If the patient does not sleep, the cause should be ascertained and the appropriate remedies employed; if it arise from rush of blood to the head, cooling lotions should be applied, and warmth to the feet; if, from restlessness or general irritability, a sponge bath, followed by friction should be administered; if the wakefulness is due to noise or confusion, quiet is the remedy. When these means fail, anodynes, or nervines, should be employed. Lying on the side instead of on the back should be practiced. Patients afflicted with chronic diseases, on rising, should take a cold bath, dry the surface quickly with a coarse towel, followed by friction with the hand. Great benefit may be derived by following these suggestions when the nature of the disease is not such as to forbid it. EXERCISE and rest necessarily alternate with each other. Exercise, so necessary to health, in many forms of disease greatly contributes to recovery. It sends the sluggish blood coursing through the veins and arteries with increased force and rapidity, so that it reaches every part of the system, supplying it with nourishment. It increases the waste of old material and creates a demand for new. Convalescing patients, or those suffering from chronic diseases, whenever the weather will permit, should take exercise every day in the open air. This should be done with regularity. The amount of exercise must be regulated by the strength of the patient; never take so much as to produce fatigue, but, as the strength increases, the exercise may be increased proportionately. Some interesting employment, commensurate with the patient's strength, should be instituted, so that the mind may be agreeably occupied with the body. When unable to take active exercise, the invalid, properly protected by sufficient clothing, should ride in a carriage or boat, and each day a new route should be chosen, so that a change of scenery may be observed, thus arousing new trains of thought, which will be exhilarating and prove beneficial to him. SEXUAL INFLUENCES. During the progress of disease or convalescence, entire continence must be observed. It is then necessary that all of the vital energies should be employed in effecting a recovery from disease, without having the additional tax imposed of overcoming the debilitating effects of sexual expenditure. This holds true with regard to all diseases, and especially those of the nervous system and genitourinary organs. VISITING THE SICK may be productive of good or evil results. Mental impressions made upon the sick exert a powerful influence upon the termination of disease. The chances of recovery are in proportion to the elevation or depression of spirits. Pleasant, cheerful associations animate the patient, inspire hope, arouse the vital energies, and aid in his recovery; while disagreeable and melancholy associations beget sadness and despondency, discourage the patient, depress the vital powers, enfeeble the body, and retard recovery. Unless persons who visit the sick can carry with them joy, hope, mirth, and animation, they had better stay away. This applies equally in acute and chronic diseases. It does not matter what a visitor may _think_ with regard to the patient's recovery, _an unfavorable opinion should never find expression in the sick-room_. Life hangs upon a brittle thread, and often that frail support is _hope_. Cheer the sick by words of encouragement, and the hold on life will be strengthened; discourage, by uttering such expressions as, "How bad you look!" "Why, how you have failed since I saw you last!" "I would have another doctor; one who knows something!" "You can't live long if you don't get help!" etc., and the tie which binds them to earth is snapped asunder. The visitor becomes a _murderer!_ Let all persons be guided by this rule: _Never go into the sick-room without carrying with you a few rays of sunshine!_ If the patient is very weak the visitor may injure him by staying too long. The length of the visit should be graduated according to the strength of the invalid. Never let the sufferer be wearied by too frequent or too lengthy visits, nor by having too many visitors at once. Above all things, do not confine your visitations to Sunday. Many do this and give themselves credit for an extra amount of piety on account of it, when, if they would scrutinize their motives more carefully, they would see that it was but a contemptible resort to save time. The sick are often grossly neglected during the week only to be visited to death upon Sunday. THE USE OF TOBACCO AND OPIUM. The recovery of the sick is often delayed, sometimes entirely prevented, by the habitual use of tobacco or opium. In acute diseases, the appetite for tobacco is usually destroyed by the force of the disease, and its use is, of necessity, discontinued; but in chronic ailments, the appetite remains unchanged, and the patient continues his indulgence greatly to the aggravation of the malady. The use of tobacco is a pernicious habit in whatever form it is introduced into the system. Its active principle, Nicotin, which is an energetic poison, exerts its specific effect on the nervous system, tending to stimulate it to an unnatural degree of activity, the final result of which is weakness, or even paralysis. The horse, under the action of whip and spur, may exhibit great spirit and rapid movements, but urge him beyond his strength with these agents, and you inflict a lasting injury. Withhold the stimulants, and the drooping head and moping pace indicate the sad reaction which has taken place. This illustrates the evils of habitually exciting the nerves by the use of tobacco, opium, narcotic or other drugs. Under their action, the tone of the system is greatly impaired, and it responds more feebly to the influence of curative agents. Tobacco itself, when its use becomes habitual and excessive, gives rise to the most unpleasant and dangerous pathological conditions. Oppressive torpor, weakness or loss of intellect, softening of the brain, paralysis, nervous debility, dyspepsia, functional derangement of the heart, and diseases of the liver and kidneys are not uncommon consequences of the excessive employment of this plant. A sense of faintness, nausea, giddiness, dryness of the throat, tremblings, feelings of fear, disquietude, and general nervous prostration must frequently warn persons addicted to this habit that they are sapping the very foundation of health. Under the continued operation of a poison, inducing such symptoms as these, what chance is there for remedies to accomplish their specific action? With the system already thoroughly charged with an influence antagonistic to their own, and which is sure to neutralize their effect, what good can medicine do? Dr. King says, "A patient under treatment should give up the use of tobacco, or his physician should assume no responsibility in his case, further than to do the best he can for him." In our own extensive experience in the treatment of chronic diseases, we have often found it necessary to resort to the same restriction. The opium habit, to which allusion has also been made, is open to the same objections, and must be abandoned by all who would seek recovery. * * * * * PART IV. DISEASES AND THEIR REMEDIAL TREATMENT. INTRODUCTION. Knowledge which is conducive to self-preservation is of _primary_ importance. That great educator, profound thinker, and vigorous writer, Herbert Spencer, has pertinently said that, "As vigorous health and its accompanying high spirits, are larger elements of happiness than any other things whatever, the teaching how to maintain them is a teaching that yields to no other whatever. And therefore we assert that such a course of physiology as is needful for the comprehension of its general truths and their bearings on daily conduct is an all-essential part of a rational education." Believing that the diffusion of knowledge for the prevention of disease is quite as noble a work as the alleviation of physical suffering by medical skill, we have devoted a large portion of this volume to the subjects of physiology and hygiene. These we have endeavored to present in as familiar a style as possible, that they may be understood by every reader. Freely as we have received light upon these subjects have we endeavored to reflect it again, in hopes that a popular presentation of these matters made plain and easy of comprehension to all people, may lead the masses into greater enjoyment of life--the result of a better preservation of health. This we do in part as a public acknowledgment of our obligations to society, to whom every professional man is a debtor. He belongs to it, is a part of its common stock, and should give as well as receive advantages, return as well as accept benefits. We know of no better way to signify our appreciation of the public confidence and patronage, so generously accorded to us, than to offer this volume to the people at a price less than the actual cost for an edition of ordinary size. This we do as a token of the cordial reciprocation of their good will. In giving to the people wholesome advice, by which they may be enabled to ward off disease and thus preserve the health of multitudes, we believe we shall receive their hearty approval, as well as the approbation of our own conscience, both of which are certainly munificent rewards. We believe that good deeds are always rewarded, and that the physician who prevents sickness manifests a genuine and earnest devotion to the common interests of humanity. We have no respect for the motives of those medical men who would withhold that information from the people which will direct the masses how to take care of themselves, and thereby prevent much sickness and suffering. Nor is the diffusion of such knowledge antagonistic to the best interests of the true and competent physician. The necessity for his invaluable services can no more be set aside by popularizing physiological, hygienic, and medical truths, than we can dispense with those of the minister and lawyer by the inculcation of the principles of morality in our public schools. The common schools do not lessen the necessity for colleges or universities, but rather contribute to their prosperity. Nor are we so presumptuous as to anticipate that we could possibly make this volume so instructive as to render "every man his own physician." No man can with advantage be his own lawyer, carpenter, tailor, and printer; much less can he hope to artfully repair his own constitution when shattered by grave maladies, which not only impair the physical functions, but weaken and derange the mental faculties. What physician presumes to prescribe for himself, when suddenly prostrated by serious illness? He very sensibly submits to the treatment of another, because he realizes that sickness impairs his judgment, and morbid sensations mislead and unfit him for the exercise of his skill. If this is true of the physician, with how much greater force does it apply to the unprofessional! If a sick sea-captain is unfit to stand at the helm and direct his ship, how utterly incompetent must the raw sailor be when similarly disqualified! Nor is the physician as competent to treat those near and dear to him, when they are suffering from dangerous illness, as another medical man not similarly situated, whose judgment is not liable to be misled by intense anxiety and affectionate sympathy. Notwithstanding all these facts, however, a knowledge on the part of the unprofessional, of something more than physiology and hygiene, and appertaining more closely to medicine proper, will many times prove valuable. In the first stage of many acute affections which, if unheeded, gradually assume a threatening aspect, endangering life and demanding the services of the most skilled physician to avert fatal results, the early administration of some common domestic remedy, such as a cathartic, or a diaphoretic herb, associated with a warm bath, a spirit vapor-bath, or a hot foot-bath, will very often obviate the necessity for calling a family physician, and frequently save days and weeks of sickness and suffering. So, likewise, are there numerous, acute diseases of a milder character which are easily and unmistakably recognized without the possession of great medical knowledge, and which readily yield to plain, simple, medical treatment which is within the ready reach of all who strive to acquaint themselves with the rudiments of medical science. But in sudden and painful attacks of acute disease, life may be suddenly and unexpectedly jeopardized, and immediate relief prove necessary. While under these circumstances the prompt application of such domestic treatment as good common-sense may dictate, guided by a knowledge of those first principles of medical learning which we shall hereafter endeavor to make plain, may result in speedy and happy relief, yet at the same time there should be no delay in summoning a competent physician to the bedside of the sufferer. Then, and not the least important, there are the various chronic or lingering diseases, from all of which few individuals indeed, who pass the meridian of life, entirely escape. In this class of ailments there is generally no immediate danger, and, therefore, time may be taken by the invalid for studying his disease and employing those remedies which are best suited for its removal. Or, if of a dangerous or complicated character, and, therefore, not so readily understood, he may consult either personally or by letter, some learned and well-known physician, who makes a specialty of the treatment of such cases, and whose large experience enables him to excel therein. In consideration, therefore, of the foregoing facts, we deem it most profitable for our readers that Part Fourth of this volume should be arranged in the following manner: The milder forms of uncomplicated, acute diseases, which may be readily and unmistakably recognized, and successfully managed without professional aid, will receive that attention which is necessary to give the reader a correct idea of them, and their proper remedial treatment. We shall devote only such attention to the severe and hazardous forms of acute diseases as is necessary in order to consider their initial stage, with their proper treatment, not attempting to trace their numerous complications, or portray the many pathological conditions which are liable to be developed. For, even by devoting much space to the latter, we could not expect to qualify our unprofessional readers for successfully treating such obscure and dangerous conditions. We shall devote the largest amount of space to a careful and thorough consideration of those chronic diseases, which, by a little study, may be readily recognized and understood by the masses, and for the cure of which we shall suggest such hygienic treatment and domestic remedies as may be safely employed by all who are in quest of relief. In the more dangerous, obscure, or complicated forms of chronic diseases, the correct diagnosis and successful treatment of which tax all the skill possessed by the experienced specialist, the invalid will not be misled into the dangerous policy of relying upon his own judgment and treatment, but will be counseled not to postpone until too late, the employment of a skillful physician. The apportionment of space which is made in considering the various diseases and their different stages, as well as the course which the people are advised to pursue under the different circumstances of affliction, is not always in accordance with the plans and recommendations which have been made by others who have written works on domestic medicine. Most of these authors have attempted, by lengthy disquisitions, to teach their readers how to treat themselves without the services of a physician, even in the most hazardous forms of disease. In such dangerous maladies as typhoid, typhus, yellow, and scarlet fevers, typhoid pneumonia, and many others, in which life is imminently imperiled, such instruction and advice is decidedly reprehensible, as it may lead to the most serious consequences. We are confident, therefore, that the manner of disposing of the different subjects which are discussed in the succeeding chapters, and the course of action which is advised, will commend themselves to our readers as being such as are calculated to promote and subserve their best interests. MEDICAL DIAGNOSIS. Skill in the art of healing is indicated in three ways: (1.) by ascertaining the _symptoms, seat_, and _nature_ of the disease, which is termed _diagnosis_; (2.) by foretelling the probable termination, which is termed _prognosis_; (3.) by the employment of efficacious and appropriate remedies, which is called _treatment_. Of these three requisites to a prosperous issue, nothing so distinguishes the expert and accomplished physician from the mere pretender as his ready ability to interpret correctly, the location, extent, and character of an affection from its symptoms. By medical diagnosis, then, is understood the discrimination between diseases by certain symptoms which are distinguishing signs. Every malady is accompanied by its characteristic indications, some of which are _diagnostic, i.e._, they particularize the affection and distinguish it from all others. Medical diagnosis is both a _science_ and an _art_; a science when the causes and symptoms of a disease are understood, and an art when this knowledge can be applied to determine its location and exact nature. Science presents the general principles of practice; art detects among the characteristic symptoms the differential signs, and applies the remedy. Da Costa aptly remarks: "No one aspiring to become a skillful observer can trust exclusively to the light reflected from the writings of others; he must carry the torch in his own hands, and himself look into every recess." The critical investigation of symptoms, with the view of ascertaining their signs, is essential to successful practice. Without closely observing them, we cannot accurately trace out the diagnosis, and a failure to detect the right disease is apt to be followed by the use of wrong medicines. General diagnosis considers the surroundings of the patient as well as the actual manifestations of the disease. It takes into account the diathesis, _i.e._, the predisposition to certain diseases in consequence of peculiarities of constitution. We recognize constitutional tendencies, which may be indicated by the contour of the body, its growth, stature, and temperament, since all these facts greatly modify the treatment. Likewise the sex, age, climate, habits, occupation, previous diseases, as well as the present condition, must be taken into account. Auscultation, as practiced in detecting disease, consists in listening to the sounds which can be heard in the chest. Percussion consists in striking upon a part with the view of appreciating the sound which results. The part may be struck directly with the tips of the fingers, but more generally one or more fingers of the other hand are interposed between the points of the fingers and the part to be percussed, that they, instead of the naked chest, may receive the blow; or, instead of the fingers, a flat piece of bone or ivory, called a _pleximeter_, is placed upon the chest to receive the blow. Latterly, improved instruments greatly assist the practitioner of medicine in perfecting this art. The _microscope_ assists the eye, and helps to reveal the appearance and character of the excretions, detecting morbid degenerations; _chemistry_ discloses the composition of the urine, which also indicates the morbid alterations occurring in the system; by percussion we can determine the condition of an internal organ, from the sound given when the external surface is percussed; the ear, with the aid of the _stethoscope_, detects the strange murmurs of respiration, the fainter, more unnatural pulsations of life, and the obscurer workings of disease; with the _spirometer_ we determine the breathing capacity of the lungs, and thus ascertain the extent of the inroads made by disease; the _dynamometer_ records the lifting ability of the patient; the _thermometer_ indicates the morbid variation in the bodily temperature; various instruments inform us of the structural changes causing alterations in the specific gravity of fluids, _e.g_., the _urinometer_ indicates those occurring in the urine; and thus, as the facilities for correct diagnosis increase, the art of distinguishing and classifying diseases becomes more perfect, and their treatment more certain. While physiology treats of all the natural functions, pathology treats of lesions and altered conditions. [Illustration: Fig. 146. Dr. Brown's Spirometer.] By the term _symptoms_ we mean the evidence of some morbid effect or change occurring in the human body, and it requires close observation and well-instructed experience to convert these symptoms into diagnostic signs. Suppose "Old Probabilities" (as we commonly designate the invaluable Signal Department) hangs out his warning tokens all along our lake borders and ocean coasts; our sailors behold the fluttering symbols indicating an approaching storm, but if no one understood their meaning, a fearful disaster might follow. But if these signals are understood, a safe harbor is sought and the mariner is protected. So disease may hang out all her signals of distress, in order that they may be seen, but unless correctly interpreted, and a remedial harbor is sought, these symptoms are of little practical value. Undoubtedly the reason why so many symptom-doctors blunder is because they prescribe according to the apparent symptoms, without any real reference to the nature of the affection. They fail to discover how far a symptom points out the seat, and also the progress of a disease. They do not distinguish the relative importance of the different symptoms. The practical purpose of all science is to skillfully apply knowledge to salutary and profitable uses. The patient himself may carefully note the indications, but it is only the expert physician who can tell the import of each symptom. _Symptoms_ are within every one's observation, but only the physician knows the nature and value of _signs_. We have read an anecdote of Galen, who was a distinguished physician in his day, which illustrates the distinction between sign and symptom. Once, when dangerously ill, he overheard two of his friends in attendance upon him recount his symptoms, such as "Redness of the face, a dejected, haggard, and inflamed appearance," etc. He cried out to them to adopt every necessary measure forthwith, as he was threatened with delirium. The two friends saw the _symptoms_ well enough; but it was only Galen himself, though the _patient_, who was able to deduce the _sign_ of delirium--that is, he alone was able to translate those symptoms into signs. To determine the value of symptoms, as signs of disease, requires close observation. INTERPRETATION OF SYMPTOMS. We shall refer to a few symptoms which any unprofessional reader may readily observe and understand. POSITION OF PATIENT. When a patient is disposed to lie upon his back continually during the progress of an acute disease, it is a sign of _muscular debility_. If he manifests no desire to change his position, or cannot do so, and becomes tremulous at the least effort, it indicates _general prostration_. When this position is assumed, during the progress of continued fever, and is accompanied by involuntary twitching of the muscles, picking of the bed-clothes, etc., then danger is imminent and _the patient is sinking_. Fever, resulting from local inflammation, does not produce muscular prostration, and the patient seldom or never assumes the supine position. If this inflammation is in the extremities, those parts are elevated, in order to lessen the pressure of the blood, which a dependent, position increases. For example, let us change the scene, and introduce a patient with head and shoulders elevated, who prefers to sit up, and who places his hands behind him and leans back, or leans forward resting his arms and head upon a chair. The next week he is worse, and no longer tries to lie in bed, but sits up all the time; note the anxious expression of countenance, the difficult or hurried breathing, the dry and hacking cough, and observe that the least exertion increases the difficulty of respiration and causes palpitation of the heart. These plain symptoms signify thoracic effusion, the collection of water about the lungs. THE COUNTENANCE displays diagnostic symptoms of disease. In simple, acute fevers, the eyes and face are red and the respiration is hurried; but in acute, sympathetic fever, these signs are wanting. We cannot forget the pale, sharp, contracted, and pinched features of those patients whose nostrils contract and expand alternately with the acts of respiration. How hard it was for them to breathe. The contraction and expansion of the nostrils indicate active congestion of the lungs. As a general rule, chronic inflammation of the stomach, duodenum, liver, and adjacent organs, imparts a gloomy expression to the countenance, at the same time the eye is dull, the skin dusky or yellow, and the motions are slow. But in lung diseases, the spirits are buoyant, the skin is fair, and the cheeks flushed with fever and distinctly circumscribed with white, for delicacy and contrast, almost exceed the hues of health in beauty. Note, too, the pearly lustre and sparkling light of the eye, the quivering motion of the lips and chin, all signs of pulmonary disease. THE STORY OF SEXUAL ABUSE is plainly told by the downcast countenance, the inability to look a person fairly in the face, the peculiar lifting of the upper lip and the furtive glance of the eye. The state of the mind and of the nervous system corroborates this evidence, for there seems to be a desire to escape from conversation and to elude society. The mind seems engrossed and abstracted, the individual appears absorbed in a constant meditation, he is forgetful and loses nearly all interest in the ordinary affairs of life. The whole appearance of a patient, suffering from spermatorrhea, is perfectly understood by the experienced physician, for the facial expressions, state of mind, and movements of the body, all unconsciously betray, and unitedly proclaim his condition. TONGUE. Much may be learned from the appearance, color, and form of the tongue, and the manner of its protrusion. If pale, moist, and coated white, it indicates a mild, febrile condition of the system. If coated in the center, and the sides look raw, it indicates gastric irritation. If red and raw, or dry and cracked, it is a sign of inflammation of the mucous membrane of the stomach. If the inflammation is in the large intestine, the tip of the tongue presents a deep red color, while the middle is loaded with a dark brown coating. When the tongue is elongated and pointed, quickly protruded and withdrawn, it indicates irritation of the nerve-centers, as well as of the stomach and bowels. If tremulous, it denotes congestion and lack of functional ability; this may be observed in congestive fevers. PULSE. Usually the pulse beats four times during one respiration, but both in health and disease its frequency may be accelerated or retarded. In adults, there are from sixty-five to seventy-five beats in a minute, and yet in a few instances we have found, in health, only forty pulsations per minute. But when the heart beats from one hundred and twenty to one hundred and forty times a minute, there is reason to apprehend danger, and the case should receive the careful attention of a physician. Irregularity of the pulse may be caused by disease of the brain, heart, stomach, or liver; by the disordered condition of the nervous system; by lack of muscular nutrition, as in gout, rheumatism, or convulsions; by deficiency of the heart's effective power, when the pulse-wave does not reach the wrist, or when it intermits and then becomes more rapid in consequence of septic changes of the blood, as in diphtheria, erysipelas, and eruptive fevers. PAIN. The import of pain depends on its seat, intensity, nature, and duration. An acute, intense pain usually indicates inflammation of a nerve as well as the adjacent parts. Sharp, shooting, lancinating pains occur in inflammation of the serous tissues, as in pleurisy. A smarting, stinging pain attends inflammation of the mucous membrane. Acute pain is generally remittent and not fixed to one spot. Dull, heavy pain is more persistent, and is present in congestions, or when the substance of an organ is inflamed, and it often precedes hemorrhage. Burning pain characterizes violent inflammations involving the skin and subjacent cellular tissue, as in case of boils and carbuncles. Deep, perforating pain accompanies inflammation of the bones, or of their enveloping membranes. Gnawing, biting, lancinating pain attends cancers. The location of pain is not always at the seat of the disease. In hip-disease, the pain is not first felt in the hip, but in the knee-joint. In chronic inflammation of the liver, the pain is generally most severe in the right shoulder and arm. Disease of the kidneys occasionally produces numbness of the thigh and drawing up of the testicle, and commonly causes colicky pains. Inflammation of the meninges of the brain is often indicated by nausea and vomiting before attention is directed to the head. These illustrations are sufficient to show that pain often takes place in some part remote from the disease. In chronic, abdominal affections, rheumatic fevers, gout, and syphilis, the entire system is thrown into a morbid state, the nervous system is disturbed, and wandering pains manifest themselves in different parts of the body. Fixed pain, which is increased by pressure, indicates inflammation. If it be due only to irritation, pressure will not increase it. Some rheumatic affections and neuralgia not only bear pressure, but the pain diminishes under it. Permanent pain shows that the structures of an organ are inflamed, while intermittent pain is a sign of neuralgia, gout, or rheumatism. Absence of pain in any disease, where ordinarily it should be present, is an unfavorable sign. Internal pain, after a favorable crisis, is a bad omen. Or, if pains cease suddenly without the other symptoms abating, the import is bad. If, however, pain and fever remit simultaneously and the secretions continue, it is a favorable sign. A dull pain in the head indicates fullness of the blood-vessels from weakness, low blood, or general debility. It may be caused by taking cold, thus producing passive congestion of the brain. It may proceed from gastric disturbance, constipation of the bowels, or derangement of the liver. Heaviness of the head sometimes precedes inflammation of the brain, or chronic disease of its membranes. A dull, oppressive pain in the head indicates softening of the brain, and is generally accompanied by slowness of the pulse and of the speech. A pulsating pain of the head occurs in heart disease, hysteria, and frequently accompanies some forms of insanity. THE EYE indicates morbid changes and furnishes unmistakable signs of disease. Sinking of the eye indicates waste, as in consumption, diarrhea, and cholera. In fevers it is regarded as a fatal symptom. A dark or leaden circle around the eye, seen after hard work, indicates fatigue and overdoing. If the mucous covering of the inner surface of the lids and the ball of the eye is congested and inflamed, it exhibits redness, and may indicate congestion or even inflammation of the brain. A dilated pupil is often observed in catarrhal consumption, congestion of the brain, low fevers, and chlorosis. The pupil contracts in inflammation of the meninges, when there is increased sensibility and intolerance of light, also in spinal complaints. In some diseases the lustre of the eye increases, as in consumption. But if it decreases with the attack of violent disease, it indicates great debility and prostration. EXAMINATION OF THE URINE. All medical authors and physicians of education, freely admit and even insist upon the importance of critically examining the patient's urine, in all cases in which there is reason to suspect disease of the kidneys or bladder. In chronic affections it is particularly serviceable, especially in derangements of the liver, blood, kidneys, bladder, prostate gland, and nervous system. Many scholarly physicians have sadly neglected the proper inspection of the urine, because they were afraid of being classed with the illiterate "uroscopian" doctors, or fanatical enthusiasts, who ignorantly pretend to diagnose correctly _all_ diseases in this manner, thus subjecting themselves and their claims to ridicule. Nothing should deter one from giving to this excretion the attention it deserves. The urine which is voided when the system is deranged or diseased is altered in its color and composition, showing that its ingredients vary greatly. So important an aid do examinations of the urine furnish in diagnosing many chronic ailments, that at the Invalids' Hotel and Surgical Institute, where many thousands of cases are annually treated, a chemical laboratory has been fitted up, and a skillful chemist is employed, who makes a specialty of examining the urine, both chemically and microscopically, and reporting the result to the attending physicians. His extended experience renders his services invaluable. With his assistance, maladies which had hitherto baffled all efforts put forth to determine their true character, have frequently been quickly and unmistakably disclosed. MICROSCOPICAL EXAMINATION. This method of examination affords a quicker and more correct idea of a deposit or deposits than any other method. The expert, by simply looking at a specimen, can determine the character of the urine, whether blood, mucus, pus, uric acid, etc., are present or not. But when no deposit is present, then it is necessary to apply chemical tests, and in many cases the quantity of the suspected ingredient must be determined by analysis. As a detailed account, of the various modifications which the urine undergoes in different diseases, would be of no practical use to the masses, since they could not avail themselves of the advantages which it would afford for correct diagnosis, except by the employment of a physician who does not ignore this aid in examining his patients, we shall omit all further details upon the subject. For the same reason we shall not often, in treating of the different diseases in which examinations of the urine furnish such valuable aid in forming a diagnosis, make mention of the changes which are likely to have occurred. INFLAMMATION. The term _Inflammation_ signifies a state in which the infected part is hotter, redder, more congested, and more painful than is natural. Inflammation is limited to certain parts, while fever influences the system generally. Inflammation gives rise to new formations, morbid products, and lesions, or alterations of structure. The morbid products of fever, and its modification of fluids are carried away by the secretions and excretions. The susceptibility of the body to inflammation maybe _natural_ or _acquired_. It is natural when it is constitutional; that is, when there is an original tendency of the animal economy to manifest itself in some form of inflammation. We may notice that some children are far more subject to boils, croups, and erysipelatous diseases than others. This susceptibility, when innate, may be lessened by careful medication, although it may never be wholly eradicated. When acquired, it is the result of the influence of habits of life, climate, and the state of mind over the constitution Phlegmonous inflammation is the active inflammation of the cellular membrane, one illustration of which is a common boil. The four principal symptoms are redness, swelling, heat, and pain; and then appears a conical, hard, circumscribed tumor, having its seat in the dermoid texture. At the end of an indefinite period, it becomes pointed, white or yellow, and discharges pus mixed with blood. When it breaks, a small, grayish, fibrous mass sometimes appears, which consists of dead, cellular tissue, and which is called the _core_. There are certain morbid states of the constitution which lead to local inflammation, subsequent upon slight injury; or, in some cases, without any such provocation, as in gout, rheumatism, and scrofula. One of the first results of the inflammation, in such cases, is a weakening of the forces which distribute the blood to the surface and extremities of the body. It is generally admitted that in scrofulous persons the vascular system is weak, the vessels are small, and because nutrition is faulty, the blood is _imperfectly organized_. The result is failure in the system, for if nutrition fails, there may be lacking earthy matter for the bones, or the unctious secretions of the skin; the sebaceous secretion is albuminous and liable to become dry, producing inflammation of the parts which it ought to protect. Disorder of the alimentary canal and other mucous surfaces are sometimes reflected upon the skin. We have occasionally observed cutaneous eruptions and erysipelas, when evidently they were distinct signs of internal disorder. Inflammation may be internal as well as external, as inflammation of the brain, lungs, or stomach, and it is frequently the result of what is called a _cold_. No matter how the body is chilled, the blood retreats from the surface, which becomes pale and shrunken, there is also nervous uneasiness, and frequently a rigor, accompanied with chattering of the teeth. After the cold stage, reaction takes place and fever follows. The sudden change from a dry and heated room to a cool and moist atmosphere is liable to induce a cold. Riding in a carriage until the body is shivering, or sitting in a draft of air when one has been previously heated, or breathing a very cold air during the night when the body is warm, especially when not accustomed to doing so, or exposing the body to a low temperature when insufficiently clothed, are all different ways of producing inflammation. Inflammation may result in consequence of local injury, caused by a bruise, or by a sharp, cutting instrument, as a knife or an axe, or it may be caused by the puncture of a pin, pen-knife blade or a fork-tine, or from a lacerated wound, as from the bite of a dog, or from a very minute wound poisoned by the bite of a venomous reptile. Local inflammations may arise from scalds, burns, the application of caustics, arsenic, corrosive sublimate, cantharides, powerful acids, abrasions of the surface by injuries, and from the occurrence of accidents. The _swelling_ of the part may be caused by an increase of the quantity of blood in the vessels, the effusion of serum and coagulating lymph, and the interruption of absorption by the injury, or by the altered condition of the inflamed part. The character of the _pain_ depends upon the tissue involved, and upon the altered or unnatural state of the nerves. Ordinarily, tendon, ligament, cartilage, and bone are not very sensitive, but when inflamed they are exquisitely so. The heat of the inflamed part is not so great, when measured by the thermometer, as might be supposed from the patient's sensations. TERMINATION OF INFLAMMATION. Inflammation ends in one of six different ways. Inflammation may terminate in _resolution, i.e_., spontaneous recovery; by _suppuration_, in the formation of matter; by _effusion_, as the inflammation caused by a blister-plaster terminates by effusion of water; by _adhesion_, the part inflamed forming an attachment to some other part; by _induration_, hardening of the organ; or by _gangrene_, that is, death of the part. Thus, inflammation of the lungs may terminate by recovery, that is, by resolution, by suppuration and raising of "matter," by hardening and solidification of the lung, or by gangrene. Inflammation of the endocardium, the lining membrane of the heart, may cause a thickening of it, and ossification of the valves of the heart, thus impairing its function. Inflammation of the pericardium may terminate in effusion, or dropsy, and inflammation of the liver may result in hardening and adhesion to adjacent parts. SEVERAL PRINCIPLES FOR TREATMENT OF INFLAMMATION. Remove the exciting causes as far as practicable. If caused by a splinter or any foreign substance, it should be withdrawn, and if the injury is merely local, apply cold water to the parts to subdue the inflammation. If caused by a rabid animal, the wound should be enlarged and cupped, and the parts cleansed or destroyed by caustic. The patient should remain quiet and not be disturbed. The use of tincture of aconite internally, will be found excellent to prevent the rise of inflammation. A purgative is also advised, and four or five of Dr. Pierce's Pleasant Purgative Pellets will be sufficient to act upon the bowels. If there is pain, an anodyne and diaphoretic is proper. Dr. Pierce's Compound Extract of Smart-weed will fulfill this indication. In local inflammation cold water is a good remedy, yet sometimes hot water, or cloths wrung out of it, will be found to be the appropriate application. When the inflammation is located in an organ within a cavity, as the lungs, hot fomentations will be of great service. Bathing the surface with alkaline water must not be omitted. Whenever the inflammation is serious the family physician should be early summoned. FEVER. In fever all the functions are more or less deranged. In every considerable inflammation there is sympathetic fever, but in essential fevers there are generally fewer lesions of structure than in inflammation. Fever occasions great waste of the tissues of the body, and the refuse matter is carried away by the organs of secretion and excretion. The heat of the body in fever is generally diffused, the pulse is quicker, there is dullness, lassitude, chilliness, and disinclination to take food. We propose to give only a general outline of fevers, enough to indicate the principles which should be observed in domestic treatment. Most fevers are distinctly marked by four stages: 1st, the forming stage; 2d, the cold stage; 3d, the hot stage; 4th, the sweating or declining stage. During the first stage the individual is hardly conscious of being ill, for the attack is so slight that it is hardly perceptible. True, as it progresses, there is a feeling of languor, an indisposition to make any bodily or mental effort, and also a sense of soreness of the muscles, aching of the bones, chilliness, and a disposition to get near the fire. There is restlessness, disturbed sleep, bad dreams, lowness of spirits, all of which are characteristic of the formative stage of fever. The next is the cold stage, when there is a decided manifestation of the disease, and the patient acknowledges that he is really sick. In typhus and typhoid fever the chills are slight; in other fevers they are more marked; while in ague they are often accompanied by uncontrollable shaking. When the chill is not so distinct the nails look blue and the skin appears shriveled, the eye is sunken and a dark circle circumscribes it, the lips are blue, and there is pain in the back. The pulse is frequent, small, and depressed, the capillary circulation feeble, the respiration increased, and there may be nausea and vomiting. These symptoms vary in duration from a few minutes to more than an hour. They gradually abate, reaction takes place, and the patient begins to throw off the bed-clothes. Then follows the hot stage, for with the return of the circulation of the blood to the surface of the body, there is greater warmth, freer breathing, and a more comfortable and quiet condition of the system. The veins fill with blood, the countenance brightens, the cheeks are flushed, the intellect is more sprightly, and if the pulse is frequent, it is a good sign; if it sinks, it indicates feeble, vital force, and is not a good symptom. If there is considerable determination of blood to the head it becomes hot, the arteries of the neck pulsate strongly, and delirium may be expected. During the hot stage, if the fever runs high, the patient becomes restless, frequently changes his position, is wakeful, uneasy, and complains of pain in his limbs. In low grades, the sensibility is blunted, smell, taste, and hearing are impaired. The patient in the hot stage is generally thirsty, and if he is allowed to drink much, it may result in nausea and vomiting. Moderate indulgence in water, however, is permissible. There is aversion to food, and if any is eaten, it remains undigested. The teeth are sometimes covered with dark _sordes_ (foul accumulations) early in the fever, and the appearance of the tongue varies, sometimes being coated a yellowish brown, sometimes red and dry, at other times thickly coated and white. The condition of the bowels varies from constipation to diarrhea, although sometimes they are quite regular. The urine is generally diminished in quantity, but shows higher color. The sweating stage in some fevers is very marked, while in others there is very little moisture, but an evident decline of the hot stage, the skin becoming more natural and soft. The pulse is more compressible and less frequent, the kidneys act freely, respiration is natural, the pains subside, although there remains languor, lassitude, and weariness, a preternatural sensibility to cold, an easily excited pulse, and a pale and sickly aspect of the countenance. The appetite has failed and the powers of digestion are still impaired. DOMESTIC MANAGEMENT OF FEVERS. It is proper to make a thorough study of the early, insidious symptoms of fever, in order to understand what ought to be done. If it arises in consequence of malaria, the treatment must be suited to the case. If from irritation of the bowels and improper articles of diet, then a mild cathartic is required. If there is much inflammation, a severe chill, and strong reaction, then the treatment should be active. If the fever is of the congestive variety and the constitution is feeble, the reaction imperfect, a small, weak pulse, a tendency to fainting, a pale countenance, and great pain in the head, apply heat and administer diaphoretics, and procure the services of a good physician. As a general rule, it is proper to administer a cathartic, unless in typhoid fever, and for this Dr. Pierce's Purgative Pellets answer the purpose, given in doses of from four to six, according to the state of the bowels. If these are not at hand, a tea of sage and senna may be drunk until it produces a purgative effect, or a dose of Rochelle salts taken. In nearly all fevers we have found that a weak, alkaline tea, made from the white ashes of hickory or maple wood, is useful, taken weak, three or four times daily, or if there be considerable thirst, more frequently. Some patients desire lemon juice, which enters the system as an alkali and answers all purposes. Diaphoretic medicines are also indicated, and the use of Dr. Pierce's Extract of Smart-weed will prove very serviceable. Drinking freely of pleurisy-root tea, or of a strong decoction of boneset is frequently useful. After free sweating has been established, then it is proper to follow by the use of diuretic teas, such as that of spearmint and pumpkin seed combined, or sweet spirits of nitre, in doses of twenty to thirty drops, added to a teaspoonful of the Extract of Smart-weed, diluted with sweetened water. To lessen the frequency of the pulse, fluid extract or tincture of aconite or veratrum may be given in water, every hour. During the intermission of symptoms, tonic medicines and a sustaining course of treatment should be employed. If the tongue is loaded and the evacuations from the bowels are fetid, a solution of sulphite of soda is proper; or, take equal parts of brewer's yeast and water, mix, and when the yeast settles, give a tablespoonful of the water every hour, as an antiseptic. Administering a warm, alkaline hand-bath to a fever patient every day, is an excellent febrifuge remedy, being careful not to chill or induce fatigue. If there is pain in the head, apply mustard to the feet; if it is in the side, apply hot fomentations. The symptoms which indicate danger are a tumid and hard abdomen, difficult breathing, offensive and profuse diarrhea, bloody urine, delirium, or insensibility. Favorable symptoms are a natural and soft state of the skin, eruptions on the surface, a natural expression of the countenance, moist tongue, free action of the kidneys, and regular sleep. If the domestic treatment which we have advised does not break the force of the disease and mitigate the urgency of the symptoms, it will be safer to employ a good physician, who will prescribe such a coarse of treatment as the case specially requires. It is our aim to indicate what may be done before the physician is called, for frequently his services cannot be obtained when they are most needed. Besides, if these attacks are early and properly treated with domestic remedies, it will often obviate the necessity of calling upon a physician. If, on the other hand, fevers are neglected and no treatment instituted, they become more serious in character and are more difficult to cure. To recapitulate, our treatment recommends evacuation through nature's outlets, the skin, kidneys, and bowels, maintaining warmth, neutralizing acidity, using antiseptics, tonics, and the hand-bath, and the fluid extract or tincture of aconite, or veratrum to moderate the pulse by controlling the accelerated and unequal circulation of the blood. It is a simple treatment, but if judiciously followed, it will often abort a fever, or materially modify its intensity and shorten its course. FEVER AND AGUE. (INTERMITTENT FEVER.) The description of fever already given applies well to this form of it, only the symptoms in the former stage are rather more distinct than in the other varieties. Weariness, lassitude, yawning, and stretching, a bitter taste in the mouth, nausea, less of appetite, the uneasy state of the stomach and bowels are more marked in the premonitory stages of intermittent fevers. The cold stage commences with a chilliness of the extremities and back, the skin looks pale and shriveled, the blood recedes from the surface, respiration is hurried, the urine is limpid and pale, sometimes there is nausea and vomiting, and towards the conclusion of the stage, the chilly sensations are varied with flushes of heat. The hot stage is distinguished by the heat and dryness of the surface of the body and the redness of the face; there is great thirst, strong, full, and hard pulse, free and hurried respiration and increased pain in the head and back. The sweating stage commences by perspiration appearing upon the forehead, which slowly extends over the whole body, and soon there is an evident intermission of all the symptoms. In the inflammatory variety of intermittent fever, all these symptoms are acute, short, and characterized by strong reaction. Gastric fever, the most frequent variety of intermittent fever, is marked by irritation of the stomach and bowels, and a yellow appearance of the white of the eye. CAUSES. The cause of the malarial fevers, intermittent, remittent, and congestive, is supposed to be _miasm_, a poisonous, gaseous exhalation from decaying vegetation, which is generally most abundant in swamps and marshes, and which is absorbed into the system through the lungs. TREATMENT. During the entire paroxysm the patient should be kept in bed, and in the cold stage, covered with blankets and surrounded with bottles of hot water. The Compound Extract of Smart-weed should be administered in some diaphoretic herb-tea. During the hot stage, the extra clothing and the bottles of hot water should be gradually removed and cold drinks taken instead of warm. During the sweating stage the patient should be left alone, but as soon as the perspiration ceases, from two to four of the Purgative Pellets should be administered, as a gentle cathartic. A second paroxysm should, if possible, be prevented. To accomplish this, during the intermission of symptoms, the Golden Medical Discovery should be taken in doses of from two to three teaspoonfuls every four hours in alternation with three-grain doses of the sulphate of quinine. If the attack is very severe, and is not relieved by this treatment, a physician should be summoned to attend the case. REMITTENT FEVER. (BILIOUS FEVER.) The distinction between _intermittent_ and _remittent_ fever does not consist in a difference of origin. In the former disease there is a complete intermission of the symptoms, while in the latter there is only a remission. TREATMENT. The treatment should consist in the employment of those remedial agents advised in intermittent fever, the Golden Medical Discovery and quinine being taken during the remission of symptoms. During the height of the fever, tincture of aconite maybe given and an alkaline sponge-bath administered with advantage. As in intermittent fever, should the course of treatment here advised not promptly arrest the disease, the family physician should be summoned. CONGESTIVE FEVER. (PERNICIOUS FEVER.) This is the most severe and dangerous form of malarial fever. It may be either intermittent or remittent in character. In some instances the first paroxysm is so violent as to destroy life in a few hours, while in others it comes on insidiously, the first one or two paroxysms being comparatively mild. It is frequently characterized by stupor, delirium, a marble-like coldness of the surface, vomiting and purging, jaundice, or hemorrhage from the nose and bowels. In America this fever is only met with in the Mississippi valley, and in other localities where the air contains a large quantity of malarial poison. TREATMENT. This fever is so dangerous that a physician should be summoned as soon as the disease is recognized. For the benefit of those who are unable to obtain medical attendance, we will say that the treatment should be much the same as in intermittent fever, but more energetic. Quinine should be taken in doses of from five to fifteen grains every two or three hours. If it be not retained by the stomach, the following mixture may be administered by injection: sulphate of quinine, one-half drachm; sulphuric acid, five drops; water, one ounce; dissolve, and then add two ounces of starch water. CONTINUED FEVERS. The symptoms of these fevers do not intermit and remit, but _continue_ without any marked variation for a certain period. They are usually characterized by great prostration of the system, and are called _putrid_ when they manifest septic changes in the fluids, and _malignant_ when they speedily run to a fatal termination. _Typhoid_ and _typhus_ fevers belong to this class. We shall not advise treatment for these more grave disorders which should always, for the safety of the patient, be attended by the family physician, except to recommend some simple means which may be employed in the initial stage of the disease, or when a physician's services cannot be promptly secured. TYPHOID FEVER. (ENTERIC FEVER.) In typhoid fever there is ulceration of the intestines and mesenteric glands. This diseased condition of the bowels distinguishes this fever from all others, and is readily detected by sensitiveness to pressure, especially over the lower part of the abdomen on the right side. The early disposition to diarrhea is another characteristic symptom of it, and there is also no intermission of symptoms as in intermittent fever. The disease comes on insidiously, with loss of appetite, headache, chilliness, and languor. It is usually a week or more before the disease becomes fully developed. CAUSE. Typhoid fever is a specific form of fever developed from the action of a specific germ upon a susceptible system. The poison of typhoid fever is eliminated mainly through the bowels. The germs of typhoid can maintain life for months in water, and thus it happens that ponds, lakes, rivers and streams which receive sewage can spread the germs of typhoid fever. Well water often swarms with these poisonous germs. In some cases it has been found that privies, though twenty or forty feet away from a well, have yet drained into it--through a clay soil covered with gravel--and carried the germs to those drinking the water from the well. Next to water, milk is the most prominent carrier of contagion. Milk is apt to get infected with the germs if cooled in tanks of water which may receive drainage from outhouses and barns. TREATMENT. Scientific support has been given the treatment by cold tub baths (70° Fahrenheit) and it is advised by many physicians. Experience has proved that sponge baths and tub baths are of the utmost importance, when the temperature of the patient is at or above 102.5° Fahrenheit. Every three hours the tub bath is given for twenty minutes at 70° Fahrenheit. These may be tepid at first, gradually cooling to 70°. Frictions are applied to patient in the bath, and he is wrapped in blankets when taken out to avoid danger of chill, and then given a warm drink or stimulant. Treatment should be directed by an experienced physician to suit the symptoms. The evacuations from the bowels should be thoroughly disinfected with chloride of lime or carbolic acid, that they may not convey the disease to others. All the sewerage and drain pipes in the house should likewise be disinfected. SCARLET FEVER. (SCARLATINA.) This fever takes its name from the scarlet color of the eruption on the surface of the body. Sometimes it is comparatively mild, and is then called _Scarlatina Simplex_; when it is accompanied by a sore throat, it is termed _Scarlatina Anginosa_; and when the disease is of a low, putrid type, it is called _Scarlatina Maligna._ This disease has three distinct stages: (1), the stage of invasion; (2), the stage of eruption; and (3), the stage of desquamation. In the first stage there is pain in the head, increased heat of the skin, redness and soreness of the throat, and sometimes nosebleed, diarrhea, or vomiting. The average duration of this stage is twenty-four hours. The eruptive stage generally begins on the second day, though sometimes it is delayed longer, and the scarlet rash rapidly diffuses itself over the whole body. The redness is vivid and has been compared to the appearance of a boiled lobster. The stage of eruption reaches its maximum of intensity on the third day, and it is important that it does not recede. Redness of the tonsils and throat is one of the early symptoms which precedes any cutaneous eruption. The tongue also is finely spotted with numerous red points which mark its papillae, presenting an appearance which has been compared to that of a strawberry. The thirst is urgent, there is no appetite, and vomiting and mild delirium are common. This stage continues from four to six days, and sometimes longer. Desquamation (scaling off of the skin) commences at the decline of the eruption, in the form of minute, branny scales. The duration of this stage is indefinite, and may end in five or six or may continue ten or twelve days. If the inflammation in the throat is very severe, it may terminate in an abscess, which may also occur in the glands of the neck, and sometimes the inflammation extends to the lips, cheeks, and eyelids. Gangrene within the throat occurs in rare instances. The disease is easily communicated, and usually develops in two to five days after exposure. It occurs most frequently in the third and fourth years of life. There is no other disease so simple, and yet so often liable to prove fatal, as scarlet fever; and for this reason we shall advise the attendance of the family physician. Domestic treatment may be given as follows, until a physician can be obtained: Catnip, pennyroyal, or pleurisy-root tea, containing one teaspoonful of the Extract of Smart-weed, may be given, to drive the rash to the surface. Cold drinks are suitable to allay the thirst, nausea, and fever. The sick-room should be kept at a temperature of about 65° Fahr., and fresh air admitted freely. The patient ought not to be overloaded with bed-clothes; and the skin should be sponged over twice daily with tepid water, different parts being exposed successively, and carefully dried with soft cloths. Soda may be added to the water, but no soap should be used. The diet should consist of milk, extract of beef, and soups. Injections may be employed to relieve constipation, but purgatives should be avoided. We repeat that this disease is one which requires the attendance of the family physician, and great care should be exercised during recovery, that no bad results may follow. SMALL-POX. (VARIOLA.) Small-pox is produced by a specific poison, which is reproduced and multiplied during the progress of the disease. It is contained in the pustules, and in the excretions and exhalations of affected individuals. It is established after a period of incubation varying from nine to thirteen days after infection. There are two varieties of this disease, known as _confluent_ and _distinct_ variola; in the former, the vesicles run together, in the latter, they are separate. This fever has three stages. The first is that of _invasion_, distinctly marked by a chill or a series of chills, which alternate with flushes of heat. In this stage the tongue becomes coated, there is also nausea and vomiting, pain in the limbs, back, and particularly in the loins, the latter symptom being of diagnostic importance. This stage continues about two days, and if the symptoms are light, it may be expected that the disease will be comparatively mild, and of the _distinct_ variety. _The stage of eruption._ The eruption begins to appear on the skin, generally on the third day following the attack, though in the throat and mouth may be discovered round, whitish, or ashy spots, several hours previous to the appearance of vesicles on the surface of the body. These are first seen on the face and neck, then on the trunk and upper extremities, and, lastly, on the lower extremities. The eruption at first appears in the form of small, red or purple spots, which change the texture of the skin by becoming more hard, pointed, and elevated. On the fifth day of the eruption they attain their full size, being softened and depressed in the center, and hence are called _umbilicated_. Now a change takes place, and the vesicles fill with "matter" and become pointed, and there is a rise in the fever. _The stage of suppuration_ commences thus: the pulse quickens, the skin becomes hotter, and in many cases of the confluent variety, swelling of the face, eyelids, and extremities occurs. Frequently there is passive delirium in this stage, and if diarrhea sets in, it is an unfavorable sign. The duration of this stage of the eruption is four or five days. _The stage of desication_, or of the drying of the pustules, commences between the twelfth and fourteenth day of the disease. In the confluent variety, patches of scab cover all the space occupied by the eruption, and the skin exhales a sickening odor. THE TREATMENT should have reference to the determination of the eruption to the surface. If there is thirst, allow cold drinks, ice-water, or lemonade. Bathing the surface with cold water, breathing plenty of fresh air, using disinfectants in the room, and taking antiseptic medicine internally, are proper. Add one part of carbolic acid to six parts of glycerine, mix from two to three drops of this with an ounce of water, and of this preparation administer teaspoonful doses frequently. A few drops of carbolic acid and glycerine may be rubbed up with vaseline, and the surface anointed with it to prevent pitting. The malady is so grave that it should be intrusted to the care of the family physician. VARIOLOID. (MODIFIED SMALL-POX.) Varioloid is a modified form of small-pox. There is less constitutional disturbance, and very little or no pitting of the skin. Varioloid generally occurs in persons who have not been fully protected by vaccination. A person suffering from this modification of the disease may, by contagion, communicate to another genuine small-pox. The _treatment_ is the same as that recommended in variola. VACCINIA. (COW-POX.) The important discovery of vaccination is due to Dr. Jenner, who ascertained that when the cow was affected by this disease and it was then communicated to man, the affection was rendered very mild and devoid of danger, and at the same time it proved a very complete protection against small-pox. Like most other valuable discoveries introduced to the world, it encountered bitter prejudice and the most unfair opposition. Now its inestimable value is generally known and admitted. In a few cases, in which the quality of the vaccine virus was deteriorated, its effect is only to slightly-modify small-pox, and then the disease resembles that caused by inoculation. The operation of infecting the blood with the _kine virus_ is called _vaccination_. All that we know is that when the cow becomes affected with this disease, and it is then transferred to man, it loses its severity and serves as a protection against small-pox. In a great majority of cases this protection is absolute, and only in a very few does it leave the subject susceptible to small-pox, materially modified. The protection it affords against small-pox is found to diminish after the lapse of an indefinite number of years, and hence it is important to be re-vaccinated once or twice, for instance, after an interval of five years. Between the second and third months of infancy is the best period for vaccination, and the place usually selected is the middle of the arm above the elbow-joint. CHICKEN-POX. (VARICELLA.) Chicken-pox is an eruptive disease, which affects children, and occasionally adults. It is attended with only slight constitutional disturbance, and is, therefore, neither a distressing nor dangerous affection. The eruption first appears on the body, afterwards on the neck, the scalp, and lastly on the face. It appears on the second or third day after the attack, and is succeeded by vesicles containing a transparent fluid. These begin to dry on the fifth, sixth, or seventh day. This disease may be distinguished from variola and varioloid by the shortness of the period of invasion, the mildness of the symptoms, and the absence of the deep, funnel-shaped depression of the vesicles, so noticeable in variola. TREATMENT. Ordinarily very little treatment is required. It is best to use daily an alkaline bath, and, as a drink, the tea of pleurisy-root, catnip, or other diaphoretics, to which may be added from one-half to one teaspoonful of the Extract of Smart-weed. If the fever runs high, a few drops of aconite in water will control it. MEASLES. (RUBEOLA.) This is generally a disease of less severity and importance than the other eruptive fevers, but it is sometimes followed by serious complications. The stage of invasion is marked by the symptoms of a common cold, sneezing, watery eyes, a discharge from the nostrils, a dry cough, chilliness, and headache. This stage may last four days. Then follows an eruption of red dots or specks, which momentarily disappear on pressure. On the fourth day of the eruption the redness of the skin fades, the fever diminishes, and the vesicles dry into scales or little flakes. The eyes may be inflamed and the bowels may be quite lax at this stage. TREATMENT. The great object in the treatment is to bring out the eruption. To effect this, sweating teas are beneficial. The free use of the Extract of Smart-weed is recommended, and the skin should be bathed every day with tepid water. Sometimes when warm drinks fail to bring out the eruption, drinking freely of cold water and keeping warmly covered in bed, will accomplish the desired result. FALSE MEASLES (_Rose Rash_) is an affection of very little importance and may be treated similarly to a case of ordinary measles. ERYSIPELAS. There are few adult persons in this country who have not, by observation or experience, become somewhat familiar with this disease. Its manifestations are both constitutional and local, and their intensity varies exceedingly in different cases. The constitutional symptoms are usually the first to appear, and are of a febrile character. A distinct chill, attended by nausea and general derangement of the stomach is experienced, followed by febrile symptoms more or less severe. There are wandering pains in the body and sometimes a passive delirium exists. Simultaneously with these symptoms the local manifestations of the disease appear. A red spot develops on the face, the ear, or other part of the person. Its boundary is clearly marked and the affected portion slightly raised above the surrounding surface. It is characterized by a burning pain and is very sensitive to the touch. It is not necessary for the benefit of the popular reader that we should draw a distinction between the different varieties of this malady. The distinctions made are founded chiefly upon the _depth_ to which the morbid condition attends, and not on any difference in the _nature of the affection_. Suppuration of the tissues involved is common in the severer forms. Should the tongue become dark and diarrhea set in, attended with great prostration, the case is very serious, and energetic means must be employed to save life. A retrocession of the inflammation from the surface to a vital organ is an extremely dangerous symptom. The disease is not regarded as contagious, but has been known to become epidemic. TREATMENT. The treatment during the initial stage of this disease should correspond with the general principles laid down for the treatment of fever. The spirit vapor-bath, with warm, diaphoretic teas, or the Compound Extract of Smart-Weed may be given to favor sweating. The whole person should be frequently bathed in warm water rendered alkaline by the addition of saleratus or soda. The bowels should be moved by a full dose of the Purgative Pellets. Fluid extract of aconite in small and frequent doses will best control the fever. The specific treatment, which should not be omitted, consists in administering doses of ten drops of the tincture of the muriate of iron in alternation with teaspoonful doses of the Golden Medical Discovery, every three hours. As a local application, the inflamed surface may be covered with cloths wet in the mucilage of slippery elm. Equal parts of sweet oil and spirits of turpentine, mixed and painted over the surface, is an application of unsurpassed efficacy. DIPHTHERIA. This is an exceedingly grave, constitutional disease characterized by a rapid breaking down of the powers of life, together with a peculiar affection of the throat, in which a disposition to the formation of false membranes is a prominent feature. The formation of these membranes, however, is not limited to the throat, but may occur on mucous surfaces elsewhere. CAUSE. Infection with the specific germ of the disease by contagion or inoculation. It can be carried in milk or water, and the germs can attach themselves to furniture, walls, clothing, etc. A person with chronic diphtheretic sore throat can infect children or susceptible persons with the disease in its most acute type by kissing. All persons with sore throat should avoid kissing--as this disease is commonly spread in this way. SYMPTOMS. The symptoms vary in different cases. In some the disease comes on gradually, while in others it is malignant from the first. The throat feels sore, the neck is stiff and a sense of languor, lassitude, and exhaustion pervades the system. Sometimes a chill is experienced at the outset. Febrile disturbance, generally of a low, typhoid character, soon manifests itself. The skin is hot; there is intense thirst; the pulse is quick and feeble, ranging from 120 to 150 per minute. The tongue is generally loaded with a dirty coat, or it may be bright red. The odor of the breath is characteristic, and peculiarly offensive, and there is difficulty in swallowing and sometimes in breathing. Vomiting is sometimes persistent. If we examine the throat, we find more or less swelling of the tonsils and surrounding parts, which are generally bright red, and shining, and covered with a profuse, glairy, tenacious secretion. Sometimes the parts are of a dusky, livid hue, and, in rare instances, pallid. The false membrane, a peculiar tough exudation, soon appears and may be seen in patches, large or small, or covering the entire surface from the gums back as far as can be seen, its color varying from a whitish yellow to a gray or dark ashen tint. When it is thrown off, it sometimes leaves a foul, ulcerating surface beneath. The prostration soon becomes extreme, and small, livid spots may appear on the surface of the body. There may be delirium, which is, in fatal cases, succeeded by stupor, or coma. The extremities become cold; diarrhea, and in some cases convulsions, indicate the approach of death. Sometimes the patient dies before the false membrane forms. TREATMENT. The extremely dangerous character of this disease demands that the services of a skillful physician be obtained at once; and that his efforts should be aided by the most thorough hygienic precautions, good fresh air, bathing, and a supporting diet. Prior to the arrival of the physician, lose no time in using plenty of good brandy or whiskey to offset the extremely weakening effect of the disease. The employment of alcoholic stimulation in this disease is almost always used by physicians. Control the vomiting and allay the thirst by allowing the patient to suck small pieces of ice every five or ten minutes. Hot fomentations or spirits of turpentine should be applied to the throat. If the physician does not take charge of the patient by this time, the use of permanganate of potash, triturated, in strength of one grain to the ounce, in a mixture of fine sugar of milk and gum acacia, and blown over the parts with an insufflater every few hours, brings the best results if thoroughly carried out; or the throat can be swabbed out with the following mixture: chlorate of potash, four drachms; tincture of muriate of iron, three drachms, syrup of orange, two ounces; water sufficient to make four ounces; administered every two or three hours. Inhaling steam or lime-water from a steam atomizer is especially good. The use of blisters, caustics, active purges, mercurials, or bleeding, should be condemned. Throughout the whole course of the disease the strength must be supported by the most nourishing diet, as well as by tonics and stimulants. Beef tea, milk, milk punch, and brandy should be freely administered. A competent physician should be called in as early as possible. The general results of the treatment with antitoxin, if given on the first, second or third day of the disease, are usually favorable. There are rarely any immediately bad results from the injections, and the published testimony of careful observers would tend to prove that recovery has followed its use in a larger percentage of cases than under former methods of treatment. QUINSY. (TONSILLITIS.) This is an acute inflammation of the tonsils, which generally extends to, and involves adjacent strictures, and is attended with general febrile disturbance. Its duration varies from four to twenty days. It sometimes terminates by a gradual return to health (resolution); or by the formation of "matter" within the gland (suppuration.) When this latter is the case, the swelling sometimes becomes so great before it breaks as to require lancing. CAUSES. It most frequently results from a cold. In some persons there is a predisposition to it, and the individual is liable to recurring attacks. Persons of a scrofulous diathesis are more liable to it than others. SYMPTOMS. Difficulty of swallowing, soreness, and stiffness of the throat, are the first monitions of its approach. There is fever, quick, full pulse, and dryness of the skin; the tongue is furred, and the breath offensive. The tonsils are intensely red, swollen, and painful, the pain often extending to the ear. Sometimes but one tonsil is affected, though generally both are involved. In severe cases the patient cannot lie down, in consequence of the difficulty of breathing. TREATMENT. In the early stage of the disease, the spirit vapor-bath is invaluable. The sweating which it produces should be kept up by the use of the Compound Extract of Smart-weed in some diaphoretic infusion. Hot wet-packs to the throat, covered with dry cloths, are useful. The inhalation of the hot vapor of water or vinegar, or peppermint and water, is beneficial. A carthartic should be given at night. When the disease does not show a disposition to yield to this treatment, the services of a physician should be obtained. When pus, or "matter," is formed in the tonsil, which may be known by the increased swelling and the appearance of a yellowish spot, the services of a physician will be required to lance it. ENLARGED TONSILS. [Illustration: Fig. 147. _A A._--Enlarged Tonsils. B.--Elongated Uvula.] Chronic enlargement of the tonsils, as shown in Fig. 147, _A A_, is an exceedingly common affection. It is most common to those of a scrofulous habit. It rarely makes its appearance after the thirtieth year, unless it has existed in earlier life, and has been imperfectly cured. Both tonsils are generally, though unequally enlarged. A person affected with this disease is extremely liable to sore throat, and contracts it on the slightest exposure; the contraction of a cold, suppression of perspiration, or derangement of the digestive apparatus being sufficient to provoke inflammation. CAUSES. Repeated attacks of quinsy, scarlet fever, diphtheria, or scrofula, and general impairment of the system, predispose the individual to this disease. SYMPTOMS. The voice is often husky, nasal or guttural, and disagreeable. When the patient sleeps, a low moaning is heard, accompanied with snoring and stentorian breathing, and the head is thrown back so as to bring the mouth on a line with the windpipe, and thus facilitate the ingress of air into the lungs. When the affection becomes serious, it interferes with breathing and swallowing. The chest is liable to become flattened in front and arched behind, in consequence of the difficulty of respiration, thus predisposing the patient to pulmonary disease. On looking into the throat, the enlarged tonsils may be seen, as in the figure. Sometimes they are so greatly increased in size that they touch each other. TREATMENT. The indications to be carried out in the cure of this malady are: (1.) To remedy the constitutional derangement. (2.) To remove the enlargement of the tonsil glands. The successful fulfillment of the first indication may be readily accomplished by attention to hygiene, diet, clothing, and the use of the Golden Medical Discovery, together with small daily doses of the Pleasant Purgative Pellets. This treatment should be persevered in for a considerable length of time after the enlargement has disappeared, to prevent a return. To fulfill the second indication, astringent gargles may be used. Infusions of witch-hazel or cranesbill should be used during the day. The following mixture is unsurpassed: iodine, one drachm; iodide of potash, four drachms; pure, soft water, two ounces. Apply this preparation to the enlarged tonsils twice a day, with a probang, or soft swab, being careful to paint them each time. A persevering use of these remedies, both internal and local, is necessary to reduce and restore the parts to a healthy condition. Sometimes the enlarged tonsils undergo calcareous degeneration; in this case, nothing but their removal by a surgical operation is effectual. This can be readily accomplished by any competent surgeon. We have operated in a large number of cases, and have never met with any unfavorable results. ELONGATION OF THE UVULA. Chronic enlargement or elongation of the uvula, or palate, as shown at B, Fig. 147, may arise from the same causes as enlargement of the tonsils. It subjects the individual to a great deal of annoyance by dropping into and irritating the throat. It causes tickling and frequent desire to clear the throat, change, weakness, or entire loss of voice, and difficulty of breathing, frequently giving rise to the most persistent and aggravating cough. TREATMENT. The treatment already laid down for enlarged tonsils, with which affection, elongation of the uvula is so often associated, is generally effectual. When it has existed for a long time and does not yield to this treatment, it may be removed by any competent surgeon. ANÆMIA. When the blood contains less than the ordinary number of red corpuscles, the condition is known as _anæmia_, and is characterized by every sign of debility. A copious hemorrhage, in consequence of a cut, or other serious injury, will lessen the quantity of blood and may produce anæmia. After sudden blood-letting, the volume of the circulation is quickly restored by absorption of fluid, but the red corpuscles cannot be so readily replaced, so that the blood is poorer by being more watery. This is only one way in which the blood is impoverished. The blood may be exhausted by a drain upon the system, in consequence of hard and prolonged study. Severe mental employment consumes the red corpuscles, leaving the blood thin, the skin cool and pale, and the extremities moist and cold. Anæmia may arise from lack of exercise, or it may be occasioned by mental depression, anxiety, disappointment, trouble, acute excitement of the emotions or passions, spinal irritation; in fact, there are many special relations existing between the red corpuscles of the blood and the various states of the mind and the nervous system. The latter depends directly upon the health and quantity of these red corpuscles for its ability to execute its functions. Anæmia may arise in consequence of low diet, or because the alimentary organs do not properly digest the food, or when there is not sufficient variety in the diet. No matter how anæmia is occasioned, whether by labor and expenditure, by hemorrhages, lead poisoning, prolonged exposure to miasmatic influences, deprivation of food, indigestion, imperfect assimilation, frequent child-bearing, or lactation, the number of the red corpuscles in the blood is materially diminished. The diagnostic symptoms of anæmia are pallor of the face, lips, tongue, and general surface, weakness of the vital organs, hurried respiration on slight exercise, swelling or puffiness of the eyes, and a murmur of the heart, resembling the sound of a bellows. This disorder of the blood tends to develop low inflammation, dropsical effusion, tubercular deposits, Bright's disease, derangements of the liver, diarrhea, leucorrhea, and is a precursor of low, protracted fevers. This condition of the blood predisposes to the development of other affections, providing they are in existence, and often it is found associated with Bright's disease, cancer, and lung difficulties. TREATMENT. (1.) Prevent all unnecessary waste and vital expenditure. (2.) Place the patient under favorable circumstances for recovery, by regulating the exercise and clothing entertaining the mind, and furnishing plenty of pure air. (3.) Prescribe such a nutritious diet as will agree with the enfeebled condition of the patient. (4.) Regular habits should be established in regard to meals, exercise, recreation, rest, and sleep. (5.) The use of tonics and stimulants, as much as the stomach will bear, should be encouraged. Bathe the surface with a solution of a drachm of quinine in a pint of whiskey. (6.) Iron, in some form, is the special internal remedy in anæmia. Meantime, it is proper to treat the patient with gentle, manual friction, rubbing the surface of the body lightly and briskly with the warm, dry hand, which greatly stimulates the circulation of the blood. Anæmia occurs more frequently in the female than in the male, because her functions and duties are more likely to give rise to it. APNOEA. Apnoea, or short, hurried, difficult respiration, is occasioned by certain conditions of the blood. When anything interferes with the absorption of oxygen, or the elimination of carbonic acid, the blood is not changed from venous to arterial, and becomes incapable of sustaining life. This morbid condition is termed _asphyxia_. We often read of persons going into wells where there are noxious gases, or remaining in a close room where there are live coals generating carbonic acid gas and thus becoming asphyxiated, dying for want of oxygen. Deficiency of oxygen is the cause of apnoea, and sometimes the red corpuscles themselves are so few, worn out, or destroyed, that they cannot carry sufficient oxygen, and the consequence is that the patient becomes short of breath, and when a fatal degeneration of the corpuscles ensues, he dies of asphyxia. Many a child grows thin and wan and continues to waste away, the parents little dreaming that the slow consumption of the red corpuscles of the blood is the cause which is undermining the health. Sometimes this disease is the result of starvation, irregular feeding, improper diet, want of care, and, at other times, want of fresh air, proper exercise, and sunlight. TREATMENT. The first essential to success in the treatment of this disease, is the removal of the exciting cause. Exercise in the outdoor air and sunlight, with good, nutritious food, and well-ventilated sleeping apartments, are of the greatest importance. The bitter tonics, as hydrastin, with pyrophosphate of iron, should be employed to enrich the blood and build up the strength. LEUCOCYTHÆMIA. This term is used to designate a condition in which there is an excess of colorless blood-corpuscles. In health, the colorless corpuscles should exist only in the proportion of one, to one or two hundred of the red corpuscles. These colorless corpuscles increase when there is disease of the lymphatic glands, but whether this is the cause of their increase or perversion is not known. They have been found abundant in the blood in diseases of the spleen and of the liver. Diarrhea usually attends this complaint, together with difficult breathing, loss of strength, gradual decline, fever, diminution of vital forces, and finally death. The recovery of a well-marked case of this disease is very doubtful. Its average duration is about one year. DROPSIES. _Transudation_ is the passage of fluid through the tissue of any part of the body without changing its liquid state, while _exudation_ means, medically, the passage of matter which coagulates and gives rise to solid deposits. When transudations are unhealthy, they may accumulate in serous cavities or in cellular structures, and constitute _dropsy_. Exudation is the result of inflammation, and the product effused coagulates and becomes the seat of a new growth of tissue. Exosmosis means the passage of fluid from within outward, and is a process constantly taking place in health; while transudation takes place because the blood is watery and the tissues are feeble and permeable, permitting the serum and watery elements of the blood to pass into certain cavities, where they accumulate. The cause of dropsies may be low diet, insufficient exercise, indigestion, hemorrhages, wasting diseases, in fact, any thing which impoverishes the blood and increases the relative amount of serum. The tardy circulation of blood in the veins, or its obstruction in any way, is a condition highly favorable to the development of dropsy. General dropsy is called _anasarca_, and is readily distinguished by bloating or puffiness of the skin all over the body. This condition is also called _oedema_. The skin is pale, yields under the finger without pain, and preserves the impression for some time. The oedema usually appears first in the lower extremities, next in the face, and from thence extends over the body. General dropsy is commonly due to an impoverished condition of the blood, and this may be the result of _albuminuria_, a disease of the kidneys. Albuminuria is frequently the sequel of scarlatina. Hence, the utmost care should be taken against exposure of a patient recovering from scarlatina, and the same caution should be exercised during convalescence from measles, erysipelas, and rheumatism. Dropsies may be general, as in anasarca, or local, as dropsy of the heart, called _cardiac_ dropsy: dropsy of the peritoneum, the serous membrane which lines the abdominal cavity, called _ascites_; dropsy of the chest, called _hydrothorax_; dropsy of the head, called _hydrocephalus_; dropsy of the scrotum, called _hydrocele_. Dropsy is not, therefore, of itself a disease, but only the symptom of a morbid condition of the blood, kidneys, liver, or heart. Thus disease of the valves of the heart, may obstruct the free flow of blood and thus retard its circulution. In consequence the pulse grows small and weak, and the patient cannot exercise or labor as usual, and finally the lower limbs begin to swell, then the face and body, the skin looks dusky, the appetite is impaired, the kidneys become diseased, there is difficulty in breathing, and the patient, it is said, dies of dropsy, yet dropsy was the result of a disease of the heart, which retarded the circulation and enfeebled the system, and which was actually the primary cause of death. TREATMENT. Dropsy being only a symptom of various morbid conditions existing in the system, any treatment to be radically beneficial must, therefore, have reference to the diseased conditions upon which the dropsical effusion, in each individual case, depends. These are so various, and frequently so obscure, as to require the best diagnostic skill possessed by the experienced specialist, to detect them. There are, however, a few general principles which are applicable to the treatment of nearly all cases of dropsy. Nutritious diet, frequent alkaline baths to keep the skin in good condition and favor excretion through its pores, and a general hygienic regulation of the daily habits, are of the greatest importance. There are also a few general remedies which may prove more or less beneficial in nearly all cases. We refer to diuretics and hydragogue cathartics. The object sought in the administration of these is the evacuation of the accumulated fluids through the kidneys and bowels, thus giving relief. Of the diuretics, queen of the meadow, buchu, and digitalis generally operate well. As a cathartic, the Purgative Pellets accompanied with a teaspoonful or two of cream of tartar, will prove serviceable. Beyond these general principles of treatment it would be useless for us to attempt to advise the invalid suffering from any one of the many forms of dropsy. The specialist skilled by large experience in detecting the exact morbid condition which causes the watery effusion and accumulation, can select his remedies to meet the peculiar indications presented by each individual case. Sometimes the removal of the watery accumulation by tapping becomes necessary, in order to afford relief and give time for remedies to act. We have found it necessary to perform this operation very frequently in cases of _hydrocele_, and also quite often in cases of abdominal dropsy. The chest has also been tapped and considerable quantities of fluids drawn off, and this has been followed by prompt improvement and a final cure. CASES TREATED. CASE I. A Canadian gentleman, aged 68, applied at the Invalids Hotel and Surgical Institute, for examination and treatment. He had been dropsical for over two years, and had become so badly affected as to be unable to lie down at night. His legs were so filled with water and enlarged as to render it almost impossible for him to walk, and there was a general anasarca. The least exertion was attended with the greatest difficulty of breathing. He had been under the treatment of several eminent general practitioners of medicine in Canada but found no relief. They were unable to discover the real cause of his ailment, but to the specialist who has charge of this class of diseases at our institution, and who annually examines and treats hundreds of such cases, it was at once apparent that the dropsy was caused from a weakened condition of the heart, which rendered it unable to perform its functions. He was put upon a tonic and alterative course of treatment, which also embraced the use of such medicines as have been found to exert a specific, tonic action upon the muscular tissues of the heart. He improved so rapidly that in less than two months he was able to lie down and sleep soundly all night. The bloating disappeared, his strength improved, and in three month's more he was discharged perfectly cured. CASE II. A man aged 42, consulted us by letter, stating that he was troubled with general bloating which had made its appearance gradually and was attended by general debility and other symptoms which have been enumerated as common to general dropsy. He had been under the treatment of several home physicians without receiving any benefit; he had steadily grown worse until he felt satisfied that if he did not soon get relief he could not live very long. He was requested to send a sample of his urine for examination, as we had suspicions, from the symptoms which he gave, that the cause of his dropsy was _albuminuria_, or Bright's disease of the kidneys. On examination of the urine, albumen in very perceptible quantities was found to be present. We had, about this time, come into possession of a remedy said by very good authority, to be a specific in degeneration of the kidneys when not too far advanced, and we determined to test it upon this well-marked case. We accordingly prescribed it, together with other proper tonics and alteratives, at the same time giving the patient important hygienic advice, which must be complied with if success is attained in the management of this very fatal malady. Our patient gradually improved, and in a few months' time was restored to perfect health, which he has continued to enjoy ever since. From our subsequent experience, embracing the treatment of quite a large number of cases of Bright's disease of the kidneys, we are satisfied that it is, in its early stage, quite amenable to treatment. CASE III. A man aged 35, single, consulted us for what he supposed to be enlargement of the testicles. The scrotum was as large as his head, and it was with difficulty that he could conceal the deformity from general observation. The disease was immediately recognized by the attending surgeon as hydrocele. The liquid was promptly drawn oft by tapping, and a stimulating injection was made into the scrotum to prevent re-accumulation. We mention this case only because it is one among a very large number who have consulted us supposing that they were suffering from enlargement of the testicles, cancer, or some other morbid growth within the scrotum, when a slight examination has shown the affection to be hydrocele, a disease which is speedily cured by tapping, with a little after treatment. The operation is perfectly safe and almost entirely painless. CASE IV. A lady, aged 24, consulted us by letter enumerating a long list of symptoms which clearly indicated abdominal dropsy, resulting from suppression of the menses. A well-regulated, hygienic treatment was advised, and medicines to restore the menstrual function by gradually toning up and regulating the whole system, were forwarded to her by express. After four months' treatment, perfect recovery resulted. Cases like this latter are very common and generally yield quite readily to proper management. No harsh or forcing treatment for restoring the menstrual function should be employed, as it will not only fail to accomplish the object sought, but it is also sure to seriously and irreparably injure the system. The most difficult cases which we have had to deal with, have been those which had been subjected by other physicians to the administration of strong emmenagogues in the vain effort to bring on the menses. RHEUMATISM. Prominent among constitutional diseases is the one known as _rheumatism_. It is characterized by certain local symptoms or manifestations in fibrous tissues. This term has been applied to neuralgic affections and to _gout_, but it differs from each in several essential particulars. Rheumatism may be divided into (1) _Acute_, (2) _Chronic_, (3) _Muscular_. ACUTE ARTICULAR RHEUMATISM. Acute articular rheumatism implies an affection of the articulations or joints. It usually commences suddenly; sometimes pain or soreness in the joints precedes the disclosure of the disease. The symptoms are pain in the joints, tenderness, increased heat, swelling and redness of the skin. The pain varies in its intensity in different oases, and is increased by the movement of the affected parts. Swelling of the joints occurs, especially those of the knee, ankle, wrist, elbow, and the smaller joints of the hands and feet. The swelling and redness are generally in proportion to the acuteness of the attack. Acute articular rheumatism is always accompanied with more or less fever. Sweating is generally a prominent symptom, being strongly acid and more profuse during the night. The appetite is impaired, the tongue is coated, the bowels are constipated, or there is diarrhea. THE DURATION OF THIS DISEASE. Unlike fevers, its course is marked by fluctuations; frequently after a few days the pain subsides, the fever disappears, and convalescence is apparently established, when, suddenly, all the symptoms are renewed with even greater intensity than before. This disease rarely proves fatal, unless the heart is involved. CAUSES. Rheumatism is frequently supposed to be occasioned by a suppression of the functions of the skin, and is generally attributed to the action of cold upon the surface of the body. But this acts only as an exciting cause. It is a disease of the blood. This form of rheumatism usually occurs between the age of fifteen and thirty, and prevails most extensively in changeable climates. Acute articular rheumatism seldom terminates in the chronic form. CHRONIC ARTICULAR RHEUMATISM. Articular rheumatism, in the subacute or chronic form, is frequently observed in medical practice. The symptoms are pain and more or less swelling of the joints, although not of as grave a character as in acute rheumatism. There is frequently an absence of increased heat and redness. As in the acute form, the different joints are liable to be affected successively and irregularly, until, after a time, the disease becomes fixed in a single joint, and the fibrous tissues entering into the ligaments and tendons are liable to be affected. The appetite, digestion, and nutrition are often good, and, in mild cases, patients are able to pursue their daily vocations. The disease is supposed to be the same as in the acute form, but milder, and, strange to say, more persistent. A diseased condition of the blood is supposed to be involved in both instances, but this morbid state is less extended, and, at the same time, more obstinate in the chronic than in the acute form. Sub-acute articular rheumatism is not always chronic, and may disappear in a shorter time than in the acute form. Chronic articular rheumatism is not generally fatal, but there is danger of permanent deformities. MUSCULAR RHEUMATISM. This affection is closely allied to _neuralgia_, and may properly be called _myalgia_. It exists under two forms, acute and chronic. In acute muscular rheumatism, there is at first a dull pain in the muscles, which gradually increases. When the affected muscles are not used the pain is slight, and certain positions may be assumed without inducing it constantly; but in movements which involve contraction of the muscles the pain is very violent. In some cases, the disease is movable, changing from one muscle to another, but usually it remains fixed in the muscle first attacked. The appetite and digestion are not often impaired, and there is no fever. The duration of this form of rheumatism varies from a few hours to a week or more. In subacute or chronic muscular rheumatism, pain is excited only when the affected muscles are contracted with unusual force, and then it is similar to that experienced in the acute form. The chronic form is more apt to change its position than the acute. The duration of this form is indefinite. In both the acute and chronic forms some particular parts of the body are more subject to the affection than others. The muscles on the posterior part of the _neck_ are subject to rheumatic affection. It is termed _torticollis_ or _cervical_ rheumatism in such cases, and should be distinguished from ordinary neuralgia. When the muscles of the loins are affected, it is commonly known as _lumbago_. In case the thoracic muscles are affected, it is known as _pleurodynia_. In coughing, sneezing, and the like, the pain produced is not unlike that in pleuritis and intercostal neuralgia. One of the most marked features of muscular rheumatism, is the cramp-like pain, induced by the movements of the affected muscles, whereas the pain is slight when those muscles are uncontracted. This feature is very serviceable in distinguishing muscular rheumatism, or myalgia, from neuralgic affections. Another trait which distinguishes muscular rheumatism from neuralgia, is that the former is characterized by great soreness, while the latter is not. There is also a distinction between inflammation of the muscles and muscular rheumatism. In the case of the former, there is continued pain, swelling of the parts, occasional redness, and the presence of more or less fever, which conditions do not exist in the latter. Persons subject to rheumatism of the muscles, are apt to suffer from an attack, after exposure of the body to a draught of air during sleep, or when in a state of perspiration. TREATMENT OF ACUTE RHEUMATISM. Administer the spirit vapor-bath to produce free perspiration, which should be maintained by full doses of the Compound Extract of Smart-weed. The anodyne properties of the latter also prove very valuable in allaying the pain. Tincture or fluid extract of aconite root may also be employed, to assist in equalizing the circulation, and also to secure its anodyne action. Black cohosh seems to exert a specific and salutary influence in this disease, and the tincture or fluid extract of the root of this plant may be advantageously combined with the aconite. Take fluid extract of aconite-root, thirty drops; fluid extract of black cohosh, one drachm; water, fifteen teaspoonfuls; mix. The dose is one teaspoonful every hour. The whole person should be frequently bathed with warm water, rendered alkaline by the addition of saleratus or soda. The painful joints may be packed with wool or with cloths wrung from the hot saleratus water, and the patient kept warm and quiet in bed. The acetate of potash taken in doses of five grains, well diluted with water, every three or four hours, is very valuable in acute rheumatism. Its alkaline qualities tend to neutralize the acid condition of the fluids of the system, and it also possesses diuretic properties which act upon the kidneys, removing the offending blood-poison from the system through these organs. If the joints are very painful, cloths wet with the Compound Extract of Smart-weed and applied to them, and covered with hot fomentations, very frequently relieve the suffering. The majority of cases yield quite promptly to the course of treatment already advised, if it is persevered in. The disease, however, sometimes proves obstinate and resists for many days the best treatment yet known to the medical profession. TREATMENT OF CHRONIC RHEUMATISM. The general alkaline baths recommended in the acute affection are also valuable in the chronic. The spirit vapor-bath, the Turkish, as well as the sulphur vapor-bath, are all worthy of a trial in this obstinate and painful disease. Alternatives are a very valuable class of agents in chronic rheumatism. The following mixture, in teaspoonful doses three times a day, in alternation with the Golden Medical Discovery, has proved very successful in this disease: acetate of potash, one ounce; fluid extract of black cohosh, one ounce; fluid extract of poison hemlock, two drachms; simple syrup, six ounces. This thorough alterative course, if well persevered in, together with the use of alkaline and vapor-baths, will generally prove very successful. The specialist, however, dealing with chronic diseases exclusively, will occasionally meet with a case which has been the rounds of the home physicians without benefit, that will tax his skill and require the exercise of all his perceptive faculties to determine the exact condition of the patient's system, upon which the obstinacy of the disease depends. When this is ascertained, the remedies will naturally suggest themselves, and the malady will generally yield to them. But, although the treatment of this disease has entered largely into our practice at the Invalid's Hotel, and has been attended by the most happy results, yet the cases have presented so great a diversity of abnormal features, and have required so many variations in the course of treatment, to be met successfully, that we frankly acknowledge our inability to so instruct the unprofessional reader as to enable him to detect the various systemic faults common to this ever-varying disease, and adjust remedies to them, so as to make the treatment uniformly successful. If the several plans of treatment which we have given do not conquer the disease, we can not better advise the invalid than to recommend him to employ a physician of well-known skill in the treatment of chronic diseases. If such a one is not accessible for personal consultation, a careful statement of all the prominent symptoms, in writing, may be forwarded to a specialist of large experience in this disease, who will readily detect the real fault, in which the ailment has its foundation. Particularly easy will it be for him to do so, if he be an expert in the analysis of urine. A vial of that which is first passed in the morning, should be sent with the history of the case, as chronic rheumatism effects characteristic changes in this excretion, which clearly and unmistakably indicate the abnormal condition of the fluids of the body upon which the disease depends. * * * * * DISEASES OF THE SKIN. ECZEMATOUS AFFECTIONS. Eczematous affections constitute a very important class of skin diseases, the prominent characteristics of which are _eruption_ and _itching_. They are progressive in character, passing through all the successive stages of development, from mere redness of the skin to desquamation, or thickening of the cuticle. The affections belonging to this group are _eczema, psoriasis, pityriasis, lichen, impetigo, gutta rosacea,_ and _scabies_, or _itch_. A careful examination of each of these diseases shows it to be a modified form of eczema, and, therefore, they demand similar treatment. ECZEMA. (_Humid Tetter, Salt-rheum, Running Scall_, or _Heat Eruption_.) The term _eczema_ is used to designate the commonest kind of skin diseases. In this disease, the minute blood-vessels are congested causing the skin to be more vascular and redder than in its natural state. There is an itching or smarting in the affected parts. The skin is raised in the form of little pimples or vesicles, and a watery lymph exudes. Sometimes the skin becomes detached and is replaced by a crust of hardened lymph, or it may be partially reproduced, forming _squamæ_, or scales. There are three stages of this disease; the inflammatory, accompanied by swelling, and the formation of pimples or vesicles; that of exudation, which is succeeded by incrustation; and that of desquamation, in which the skin separates in little scales and sometimes becomes thickened. Rarely, if ever, does the disease pass through these successive stages, but it is modified by its location and the temperament of the patient. The many varieties of eczema are designated according to their predominating characteristics. Thus, when pimples or vesicles are abundant, it is termed, respectively, _eczema papulosum_ and _eczema vesiculosum,_ a fine illustration of which may be seen in Colored Plate I, Fig. 1. Again, when characterized by the eruption of pustules, it is termed _eczema pustulosum_, a representation of which may be seen in Plate I, Fig. 2; and, when the prominent feature is the formation of scales, it is termed _eczema squamosum_. Eczema may be general or partial; in other words, the eruption may appear in patches or be distributed over the entire surface of the body. The latter form often appears in infants, but rarely occurs in adults. Two or more varieties of the eruption may be associated, or one form may gradually develop into another. [Illustration: Plate I. Fig. 1. Fig. 2. Fig. 3. Fig. 4. Fig. 5.] Infants and young children are peculiarly subject to this disorder, and, if the disease be not promptly arrested, it will assume the severest form and eventually become chronic. The muscles are soft, the eyes are dull and expressionless, and the little sufferer experiences the most excruciating torments. Frequently the whole body is covered with patches of eczema, the secretions are arrested, and, where the scales fall off, the skin is left dry and feverish. Eczema has no symptoms proper, since the morbid feelings are due to constitutional debility, of which eczema is the result. The _signs_ of eczema are redness, heat, an itching or smarting sensation, the formation of pimples or vesicles, exudation, incrustation, the separation of the cuticle into scales and a gradual thickening of the skin. CAUSES. Three forms of constitutional derangement predispose the system to eczema; nutritive, assimilative, and nervous debility. In the former, there is a diminution of nutritive power, so that the patient becomes weak and emaciated. Assimilative debility is indicated by an impaired digestion and a consequent suppression, or an abnormal state of the secretions. Eczema occasioned by nervous debility, is accompanied by all the morbid conditions incident to irritation and exhaustion of the nervous system. Eczema may be excited by a violation of the rules of hygiene, as undue exposure, or sudden transition from heat to cold, deficient or excessive exercise, impure air, or improper clothing. PSORIASIS. Psoriasis may be defined as a _chronic form of eczema_. The transition of the last stage of eczema into psoriasis is indicated by a tendency of the inflamed, thickened, scaly skin to become moist when rubbed. It usually appears in patches on various portions of the body. The skin is parched and highly discolored. The hairs are harsh and scanty. The patient is constantly tormented by an unbearable itching sensation and, if the skin is rubbed, it exudes a viscous or sticky fluid. These are the characteristic signs of psoriasis. It generally appears on the flexures, folds and crooks of the joints, the backs and palms of the hands, the arms, and the lower portions of the legs. PITYRIASIS. (_Branny Tetter_, or _Dandruff_.) This affection is a mild form of psoriasis, from which it may be distinguished by a more superficial congestion or inflammation of the affected parts, the absence of swelling, and the formation of smaller scales, having the form and appearance of _fine bran_. It generally appears on the scalp, sometimes extends over the face, and, in rare instances, affects the entire surface of the body. The signs peculiar to this disease are slight inflammation, itching, and the formation of minute scales. CAUSES. Pityriasis is caused by nutritive debility, and is often associated with erysipelas, rheumatism, and bronchitis. LICHEN. (_Papular Rash_.) Lichen is a term used to designate an eruption of minute conical pimples, which are more or less transparent, red, and occasion great annoyance. The eruption is attended with a severe, hot, prickling sensation, as if the flesh were punctured with hot needles. The pimples contain no pus, but if opened, they exude a small quantity of blood and serum. This disease more frequently occurs between the ages of twelve and fifty, but occasionally appears during dentition, when it is called "tooth rash." The lichen pimples are sometimes dispersed singly over the skin and gradually subside, forming a minute scale, corresponding in position with the summit of the pimple. When the pimples appear in clusters, there is a diffused redness in the affected part, and, if they are irritated, minute scabs will be formed. Lichen generally appears on the upper portion of the body, as on the face, arms, hands, back, and chest. The various forms of lichen are designated according to their causes, signs, location, manner of distribution, and the form of the pimples. _Lichen Simplex_ is the simplest form of this disorder, and is indicated by the appearance of minute pimples, which, when the distribution is general, are arranged like the blotches of measles. Sometimes the eruption is local and bounded by the limits of an article of clothing, as at the waist. In eight or ten days, the cuticle separates into minute scales, which are detached and thrown off; but a new crop of pimples soon appears and runs the same course, only to be succeeded by another, and thus the affection continues for months and even years. _Lichen circumscriptus_ is an aggravated form of _lichen simplex_, and is characterized by a circular arrangement of the pimples. The circumference which marks the limit of the patch is sharply defined. This form of lichen usually appears on the chest, hips, or limbs, and is not unfrequently mistaken for ringworm. _Lichen strophulosus_ is a variety peculiar to infants. Dermatologists recognize several subdivisions of this species, but the general characteristics are the same in all. The pimples are much larger than in the other forms of lichen, of a vivid red color and the duration of the eruption is limited to two or three weeks. _Lichen urticatus_ is also an infantile affection and begins with inflammation, which is soon succeeded by the eruption. In a few days the pimples shrink, the redness disappears, and the skin has a peculiar bleached appearance. The eruption is attended by an intense itching sensation and, if the skin is ruptured, a small quantity of blood is discharged and a black scab formed. This variety of lichen is very obstinate and of long duration. _Lichen tropicus_, popularly known as _prickly heat_, is an affection which attacks Europeans in hot climates. It is characterized by the appearance of numerous red pimples of an irregular form, distributed over those portions of the body usually covered by the clothing. It is attended with a fierce, burning, itching sensation, which is aggravated by warm drinks, friction of the clothing, and the heat of the bed. The eruption indicates a healthy condition of the system; its suppression or retrocession is an unfavorable symptom, denoting some internal affection such as deranged nutrition. [Illustration: Plate II. Fig. 6. Fig. 7. Fig. 8. Fig. 9. Fig. 10. Fig. 11. Fig. 12. Fig. 13.] In _lichen planus_, as the term indicates, the pimples are flattened. There is no sensation of itching or formation of scabs. The pimples are solitary and have an angular base, and the fresh pimples formed appear on the spaces between the former eruptions. This affection usually attacks some particular region, such as the abdomen, hips, or chest. Instances are recorded in which it has appeared on the tongue and the lining membrane of the mouth. Sometimes it appears in patches, but even then, the margin of each pimple can be discerned. _Lichen pilaris_ and _lividus_ are modifications of lichen simplex, the former being so named to describe the location of the pimples, _i.e._, surrounding the minute hairs which cover the body, especially the lower limbs. The term _lichen lividus_ indicates the dark purplish hue caused by a torpid circulation and the consequent change of arterial into venous blood before leaving the pimples. _Lichen circinatus_ is a modified form of _lichen circumspectus_. The pimples in the center of the circular patch subside and a ring is formed which gradually increases in size. When the rings become broken or extend in regular forms, the affection is termed _lichen gyratus_. CAUSES. Constitutional debility predisposes the system to this eruption. The exciting causes are irritation of the skin, strumous diathesis, dentition, and any violation of hygienic rules. Although lichen is not a fatal disease, yet it tends to reduce the vitality of the system. IMPETIGO. (_Crusted Tetter_ or _Scall_.) Impetigo is a term applied to an inflammation of the skin, more severe and energetic in its character than the preceding affection. We have found the predominating characteristics of eczema and lichen to be the presence of exudation in the former, and the absence of it in the latter. Impetigo is marked by the formation of yellow pus, which raises the cuticle into pustules. There is a slight swelling, redness, and the pus gradually dries up, forming an amber-colored crust, a representation of which is given in Colored Plate I, Fig. 5. It soon falls, leaving the skin slightly inflammed, but with no scar. The pustules are sometimes surrounded by a cluster of smaller ones. The varieties of impetigo are designated according to the distribution of the pustules. _Impetigo figurata_, is characterized by the appearance of large clusters upon an inflamed and swollen surface, generally upon the face, but sometimes upon the scalp. This form is represented in Colored Plate I, Fig. 4. In _impetigo sparsa_ the pustules are scattered over the whole body. CAUSES. The predisposing cause of impetigo is nutritive debility, and the exciting causes are irritation, impure air, and errors of diet. GUTTA ROSACEA is a _progressive_ disease, and its successive stages of development mark the several varieties, such as _gutta rosacea, erythematosa, papulosa, tuberculosa, pustulosa_, according as they are characterized by redness, pimples, tubercles, or pustules. This affection is attended with heat, itching, and throbbing. The pustules contain serous lymph, which exudes if the cuticle be broken, and forms a crust at the summit of the pustule. This eruption often appears on the face of persons addicted to intemperate habits, and has thus received the name of "_rum blossom_." CAUSE. It is essentially a chronic affection, and depends upon constitutional causes. SCABIES. (_Itch_.) This disease is characterized by a profuse scaliness of the skin, by an eruption of pimples, vesicles, and, in rare instances, of pustules. Its prominent feature is an intense itching, so aggravating that, in many instances, the skin is torn by the nails. Unlike other diseases of the skin, it is not due to inflammation, but is caused by animalculæ, or little parasites, termed by naturalists the _acarus scabiei_. This minute animal burrows in the skin, irritating it, and thus producing the scaliness and itching. The vesicles are comparatively few in number, and contain a transparent fluid. The pustules are only present in the severest forms or when the skin is very thin and tender. It is then termed _pustular itch_. The parts usually affected are the hands, flexures of the joints, and the genital organs. Cases are recorded, in which scabies appeared upon the face and head, but they are of rare occurrence. The activity of the animalculæ, is modified by the vitality of the victim. In persons of a vigorous constitution, they will rapidly multiply, and, in a few days after their first appearance, will be found in almost every part of the body. Scabies is not confined to any age or sex, but chiefly affects persons of filthy habits. This disease can only be communicated by contact, or by articles of clothing worn by an infected person. There are certain indications which predispose the system to infection, such as robust health, a hot climate, and uncleanliness. TREATMENT. In all the varieties of eczematous affections, except scabies, the treatment of which will hereafter be separately considered, remedies employed with a view to the removal of the constitutional fault are of the greatest importance. The eruption upon the skin is but a local manifestation of a functional fault, which must be overcome by alterative remedies. All the excretory organs should be kept active. To open the bowels, administer a full cathartic dose of Dr. Pierce's Pleasant Pellets. Afterwards they should be used in broken doses of one or two daily, in order to obtain their peculiar _alterative_ effects. The use of Dr. Pierce's Golden Medical Discovery is also necessary to secure its constitutional remedial benefits. As a local corrective to relieve the itching and disagreeable dryness of the skin, add half an ounce of blood-root to half a pint of vinegar, steep moderately for two hours, strain and paint the affected parts once or twice daily with the liquid. Every night before retiring, apply glycerine freely to all the affected parts, or dissolve one drachm of oxalic acid in four ounces of glycerine and anoint the skin freely. The white precipitate ointment, obtainable at any drug store, is an excellent application is most forms of eczema. A tea, or infusion, of black walnut leaves, applied as a lotion to the affected parts, has also proved beneficial. The surface of the body should be kept clean by frequent bathing, and thus stimulating its capillary vessels to healthy activity. The eczematous surfaces should not be bathed frequently, and never with harsh or irritating soaps. All varieties of eczematous affections, except scabies, are only temporarily relieved by external applications, while the _radical cure_ depends upon a protracted use of alterative, or blood-cleansing medicines. Therefore, we would again remind the reader of the necessity of keeping the bowels regular, and removing all morbid taints of the blood and faults of the secretory organs by the persistent use of Dr. Pierce's Golden Medical Discovery. _The successful treatment of scabies_, or common itch, generally requires only local applications, for the object to be obtained is simply the destruction of the little insects which cause the eruption. Happily, we possess an _unfailing specific_ for this purpose. Numerous agents have been employed with success, but _Sulphur_ enjoys the greatest reputation for efficacy, and, since it is perfectly harmless, we advise it for this class of disease. Take a quantity of pulverized sulphur and mix with sufficient vaseline or lard to form an ointment. Having first divested the body of clothing, anoint it all over freely, and rub the ointment thoroughly into the pores of the skin while standing before a hot fire. The application should be made at night before retiring, and the patient should wear woolen night-clothes or lie between woolen blankets. In the morning after the application, the patient should take a warm bath, washing the skin thoroughly and using _plenty of soap_. This treatment should be repeated two or three times to be _certain_ of a _perfect eradication_ of the disease. After this course of treatment, the wearing apparel as well as the bed-clothes should be thoroughly cleansed, as a precaution against a return of the disease. * * * * * ERYTHEMATOUS AFFECTIONS. The prominent features, eruption, and itching of _eczematous_ affections are purely local. _Erythematous_ affections are, however, remarkable for their symptoms of constitutional disorder. Each of these affections is preceded by intense febrile excitement and nervous debility. In brief, the local manifestations are simply signs of general internal disorders; hence, the treatment should be directed to the restoration of the system. This group includes _erythema, erysipelas_, and _urticaria_. ERYTHEMA. A vivid and partial flushing of the face is produced by a superficial inflammation of the skin, termed _erythema_. There are many stages of this disease, from the instantaneous transient flush caused by emotional excitement, to the protracted inflammation and swelling of _erythema nodosum_. The affection is characterized by a flush which is at first a bright vivid scarlet, but which changes to a deep purplish tint. There is a slight elevation of the skin, sometimes accompanied by itching. In the second stage of development, the flush subsides, the skin has a yellowish or bruised appearance, and a few minute scales are formed. In _erythema papulosum_, a fine representation of which is given in Colored Plate III, Fig. 18, there is an eruption of red pimples or pustules. The prominent feature of _erythema nodosum_, a variety of erythema which affects those portions of the skin exposed to the sun, is the appearance of a large swelling, usually lasting four or five days and attended by constitutional symptoms, such as nausea, fever, languor, and despondency. The disease is associated with the symptoms incident to a disordered nervous system and sometimes results fatally, in other cases, it terminates in melancholy and mania. CAUSES. The predisposing causes of erythema are constitutional debility, changes of climate and temperature, and irritating food or medicines. Locally, it may be produced by friction and the heat of the sun. [Illustration: Plate III. Fig. 14. Fig. 15. Fig. 16. Fig. 20. Fig. 17. Fig. 19. Fig. 18.] ERYSIPELAS. There are few adult persons in this country who have not, by observation or experience, become somewhat familiar with this disease. Its manifestations are both constitutional and local, and their intensity varies exceedingly in different cases. The constitutional symptoms are usually the first to appear, and are of a febrile character. A distinct chill, attended by nausea and general derangement of the stomach is experienced, followed by febrile symptoms more or less severe. There are wandering pains in the body and sometimes a passive delirium exists. Simultaneously with these symptoms the local manifestations of the disease appear. A red spot develops on the face the ear, or other part of the person. Its boundary is clearly marked and the affected portion slightly raised above the surrounding surface. It is characterized by a burning pain and is very sensitive to the touch. It is not necessary for the information of the general reader that we should draw a distinction between the different varieties of this malady. The distinctions made are founded chiefly upon the _depth_ to which the morbid condition extends, and not on any difference in the _nature of the affection_. Suppuration of the tissues involved is common in the severer forms. Should the tongue become dark and diarrhea set in, attended with great prostration, the case is very serious, and energetic means should be employed to save life. A retrocession of the inflammation from the surface to a vital organ is an extremely dangerous symptom. The disease is not regarded as contagious, but has been known to become epidemic. URTICARIA. (_Hives, or Nettle-Rash._) This word is derived from _urtica_, signifying a nettle; it is a transient affection of the skin, indicated by a fierce, burning, itching sensation and a development of pustules, or white blotches of various forms. A representation of this eruption is given in Colored Plate III, Fig. 17. It is appropriately named nettle-rash, from its resemblance to the irritation caused by the sting of a nettle. There is the same sharp, tingling sensation and a similar white wheal or blotch, caused by the muscular spasm of the corium, a layer of the skin. Urticaria may be either acute or chronic. Acute urticaria is always preceded by febrile symptoms and the attack is indicated by a sudden congestion of the skin, followed by a slight swelling or elevation of the affected part. When the congestion subsides, the skin has a bruised appearance. In chronic urticaria, the febrile symptoms are absent. CAUSES. The exciting causes of urticaria are gastric disorder, irritation of the mucous membrane, or a sudden nervous shock. The predisposing causes are conceded to be assimilative and nervous debility. Hence, it frequently accompanies purpura or land scurvy and rheumatism. The skin in some persons is so susceptible to irritation that urticaria can be kindled at any moment by excitement, as an animated conversation, or by the simple pressure of the hand. TREATMENT. The proper treatment for simple erythema consists in applying to the affected parts a little lime-water, or sweet-oil, or glycerine, with the use of warm baths and mild cathartics. This is generally sufficient to effect a cure, if followed up with the persistent use of Dr. Pierce's Golden Medical Discovery taken three times a day. In _erysipelas_ a hot bath, with warm, sweating teas, or, better still. Dr. Pierce's Compound Extract of Smart-weed may be given to favor sweating. The whole person should be frequently bathed with warm water rendered alkaline by the addition of saleratus or soda. The whole should be moved by a full dose of the "Pleasant Pellets." Fluid extract of veratrum viride, in doses of a drop or two every hour will best control the fever. The specific treatment, that which antidotes the poison in the blood, consists in administering fifteen-drop doses of the tincture of the muriate of iron in one teaspoonful of the "Golden Medical Discovery," every three hours. As a local application, the inflamed surface may be covered with cloths wet in the mucilage of slippery elm. A preparation of equal parts of sweet oil and spirits of turpentine, mixed and painted over the surface, is an application of great efficacy. _For urticaria_, the "Pleasant Pellets" should be administered in sufficient doses to move the bowels, the skin bathed with warm water rendered alkaline by the addition of common baking soda or saleratus, and, if there be any febrile symptoms, a little tincture of aconite or veratrum may be administered in one drop doses once each hour. In the chronic form of the disease, the diet should be light, unstimulating, and easily digested, the skin kept clean by frequent bathing, and fresh air and outdoor exercises freely taken. The somewhat protracted use of Dr. Pierce's Golden Medical Discovery will result in the greatest benefit in this form of disease. BULLOUS AFFECTIONS. The distinguishing feature of this group of cutaneous affections is the formation of _bullæ_, or blebs, which are defined as "eminences of the cuticle, containing a fluid." HERPES is an inflammation of the skin in which the eruption appears in patches of a circular form. On the second day, minute, transparent vesicles appear and gradually develop, becoming opalescent. On the succeeding days, they shrink and produce reddish brown scabs, which soon become hard and fall off, leaving deep, purplish pits. In adults, these vesicles sometimes terminate in painful ulcers, caused by an irritation of the eruption. By some practitioners, herpes is regarded as a purely nervous disorder, from the fact that it is frequently accompanied by severe neuralgic pains. These pains are not _constant_, but _occasional_, and do not appear at any definite stage of the disease. Sometimes they precede and accompany the eruption. Other instances are recorded in which they remained many years after the disease had disappeared. The local and constant pain of herpes is a severe burning, prickling, itching sensation, which remains after the scabs fall. The three _general_ forms of this disease are _herpes zoster_, _phlyctoenodes_ and _circinatus_. In _herpes zoster_, or _shingles_, the clusters of vesicles encircle one-half of the body, frequently at the waist; hence, it has received the name of _zona_ or _girdle_. The vesicles often develop into bullæ, and sometimes ulcerate. In _herpes phlyctoenodes_, the vesicles are small, round, and irregularly distributed over the face, neck, arms, and breast. This form is accompanied by febrile symptoms and offensive excretions. In _herpes circinatus_, or _ringworm_, the vesicles appear in circular patches, or rings. This is the mildest form of herpes, and is not attended by symptoms of constitutional disorder. The various forms of herpes are represented in Colored Plate I, Fig. 3. CAUSES. Herpes is not contagious. It is caused by vicissitudes of heat and cold, violent emotions, excessive exertion, irritation of the skin, and a general atony of the system. MILIARIA is the name given to an eruption of vesicles which are larger than those of eczema, but smaller than the bullæ of herpes. At first, the serum contained in the vesicles is perfectly transparent, and reflects the red tint of the underlying skin, hence the name _miliaria rubra._ But gradually it becomes milky and opalescent, hence, the term _miliaria alba_. The vesicles of miliaria are generally solitary, and appear on those portions of the body most liable to become heated and to perspire. The eruption is preceded by chills, languor, slight fever, intense thirst, a sharp prickling sensation of the skin, and profuse perspiration. The vesicles soon desiccate and are replaced by a new crop. CAUSES. Miliaria is almost universally an accompaniment of febrile disease, and all disorders in which there occurs a profuse perspiration. The causes to which it may be traced in each instance are improper diet, impure air, burdensome clothing, or strong emotions. PEMPHIGUS is a peculiar eruption which appears upon the limbs and abdomen. The affected part is of a bright red color, and, in a few hours, small vesicles appear containing a transparent fluid. The vesicles soon develop into bullæ, entirely covering the inflamed portion. The fluid becomes opaque and in a few hours escapes. The patch is then covered with a yellow scab. Pemphigus may be either acute or chronic. The acute form is subdivided according to the degree of inflammation, as _pemphigus pompholyx_ in which it is severe, and _pemphigus benignus,_ when it is mild. The bullæ of pemphigus are illustrated in Colored Plate III, Fig. 19. CAUSE. Pemphigus is always caused by a vitiated state of the system. RUPIA is indicated by an eruption as large as a chestnut containing a watery fluid, which desiccates into a yellowish-brown crust. A fine representation of rupia vesicles in both stages of development, is given in Colored Plate II, Fig. 13. TREATMENT. In all forms of herpes, the administration of a small dose of Dr. Pierce's Pleasant Pellets, with the use of his "Golden Medical Discovery" in one to two teaspoonful doses three times a day, will be followed by the happiest results. The skin should be kept clean by the use of the sponge-bath, rendered alkaline by the addition of common baking soda or saleratus. The portion of the body covered by the eruption, should be bathed with a solution of sulphate of zinc, one ounce to a pint of water. Miliaria is generally associated with certain febrile diseases, and its proper treatment consists in overcoming the febrile and other constitutional symptoms which accompany the disease. A hot foot-bath and small doses of tincture of aconite, say one drop in water each hour, will suffice to remove the fever. If the stomach and bowels are in a vitiated condition, as they are apt to be, a mild cathartic dose of "Pellets" should be given. _The treatment of pemphigus_ should consist in frequent alkaline sponge-baths, and in covering the affected parts with poultices of slippery elm, which should be kept moist with vinegar, The constitutional treatment should embrace the persistent use of the "Golden Medical Discovery." When the disease occurs in children, it is most generally dependent upon deficient nutrition, and special attention should be given to the diet of the patient, which should be nutritious. Fresh air and outdoor exercise ought not to be neglected. The proper treatment of rupia does not differ from that suggested for pemphigus. NERVOUS AFFECTIONS OF THE SKIN. In nervous affections of the skin, the natural sensibility may be increased, diminished, or perverted. These morbid impressions arise from the nervous system. Although there are several varieties of these affections, yet, being of minor importance, we shall omit their consideration and only speak of one of them in this work. PRURIGO affects the entire surface of the body and imparts to the skin a parched, yellowish appearance. It is characterized by pimples, and an intense burning, itching sensation. Rubbing and scratching only irritate the skin, which becomes covered with thin black scabs. A good representation of _prurigo_ may be seen in Colored Plate II, Fig. 6. The itching sensations are sometimes caused by chilling the body, by violent exercise, and heat; allowing the mind to dwell upon the affection aggravates it. Prurigo is recognized under two forms; _vulgaris,_ which is a mild form, and _senilis_, which chiefly occurs in old age, and is more severe. The external genital parts of females are frequently affected with this disease, and it is aggravated by menstruation and uncleanliness. This affection may be due to a vitiated condition of the blood, and is common among those who are greatly debilitated. It is frequently occasioned by uncleanliness, intemperance, the use of unwholesome food, or by an impure atmosphere. TREATMENT. To allay the itching, take glycerine, one ounce, add to it one drachm of _sulphite_ of soda, and one ounce of rose-water, and apply this to the affected parts. A solution made with borax, two drachms, and morphine, fire grains, dissolved in six ounces of rose-water, makes an excellent lotion to allay the itching. If the disease be severe, it will be necessary to correct the vitiated condition of the blood by a protracted use of Dr. Pierce's Golden Medical Discovery, and to aid its effects, give one "Pleasant Pellet" every day, not to operate as a cathartic, but only to exert an alterative influence. ALPHOUS AFFECTIONS. (SCALY SKIN DISEASES.) Differences of opinion exist with regard to the proper classification of these affections. We shall briefly consider _alphos_, which is sometimes confounded with _lepra_. ALPHOS, which from its Greek derivation signifies _white_, is characterized by circular, slightly raised white spots. These eruptions vary in size from one line to two inches in diameter, and may be scattered over the entire surface of the body, although they most frequently appear upon the elbows and knees. Alphos may consist of a single tubercle, or of large clusters constituting patches. The scales vary in color and thickness. In Colored Plate III, Figs. 14 and 15, are fine illustrations of alphos. When a person begins to recover from this affection, the scales fall off, leaving a smooth red surface, which gradually returns to its natural color. This disease is more liable to occur in winter than in summer, although in some cases the reverse holds true. It may disappear for a time, only to return again with renewed vigor. It is not regarded as contagious. TREATMENT. Thorough and protracted constitutional treatment is required to overcome this disease. Dr. Pierce's Golden Medical Discovery should be taken internally and also applied locally to the affected parts. To every other bottle of the "Discovery" which is taken, one-half ounce of the iodide of potash may be added. One or two of the "Pellets" taken daily will prove a useful adjunct to the "Discovery." Locally, we have sometimes applied a lotion made of oxide of zinc, one-half drachm; benzoic acid, two drachms; morphine, five grains; glycerine, two ounces. Tincture of the chloride of iron, one drachm in one ounce of glycerine, makes an excellent local application. Whatever the local treatment may be, however, we chiefly rely upon the _persistent_ use of the best alteratives, or blood-cleansing medicines. AFFECTIONS OF THE HAIR-FOLLICLES. FAVUS (_Scald Head_) is a disease peculiar to the hair-follicles, and is indicated by the formation of small yellow crusts, having the form of an inverted cup. The eruption has a very offensive odor. When it appears in isolated cups, it is termed _favus dispersus_, but it often occurs in large clusters, as represented in Colored Plate II, Fig. 12, and is then termed _favus confertus_. It generally affects the scalp, but sometimes extends to the face and neck. CAUSE. Favus is caused by nutritive debility, which results in a perverted cell-growth. SYCOSIS (_Barber's Itch_) is an inflammatory affection of the hair follicles of the face. The prominent features of the disease are redness and the formation of scales. It is peculiar to males. It has received various names, according to its predominating characteristics, such as _sycosis papulosa, tuberculosa_, and _fungulosa_. Colored Plate II, Fig. 10, is a line illustration of sycosis as it appears on the cheek. CAUSES. Various causes induce the appearance of sycosis. The general causes are nutritive debility, vicissitudes of heat and cold, and an exhausted state of the nervous system. It may also result from various chronic diseases, such as syphilis and dyspepsia. COMEDONES, or _grubs_, are due to a retention of the sebaceous matter in the follicles. The sebaceous substance undergoes a change, becoming granular and somewhat hardened. It gradually extends to the mouth of the follicle, where it comes in contact with the atmosphere, and assumes a dark color, as represented in Plate II, Fig. 8. This fact, together with its peculiar form when squeezed out of the skin, has caused it to be termed _grub_. They often appear in great numbers on the face of persons whose circulation is not active, or those who are of a particularly nervous temperament. Stimulating baths and friction will prove very efficacious in removing these cylinders of sebaceous matter. If they are allowed to remain, they will produce an irritation of the skin causing an inflammatory disease known as acne, or stone-pock. ACNE OR STONE-POCK. In the earliest stage of congestion, acne is characterized by minute hardened elevations of the skin, as shown in Plate II, Fig. 9, and is termed _acne punctata_. As the affection progresses, a bright red pimple, Plate II, Fig. 11, appears, having a conical form, hence the name _acne coniformis_. The pimple develops into a pustule containing yellow "matter," and is then known as _acne pustulosa_. This is followed by a thickening of the tissues, termed _acne tuberculata_. When the thicker skin is removed, it leaves a deep scar, hence the term _acne indurata_. CAUSES. The remote cause of acne is nutritive debility. The immediate causes are rapid growth, anæmia, improper food, errors of hygiene, mental exhaustion, and various chronic diseases. TREATMENT. The treatment of favus or scald-head should be commenced by shaving the hair off close to the scalp and washing the head thoroughly with soap and water. In some severe cases, it may be necessary to soften the incrustations with poultices, following these with a free use of soap and water. Having thus exposed the scalp and thoroughly divested it of incrustations, apply to it the ointment of iodide of sulphur, which may be procured at any good drug store. It should be gently rubbed over the parts night and morning. The scalp ought to be kept perfectly clean throughout the treatment. Instead of the foregoing, the following may be applied: Take oxalic acid, ten grains; creosote, twenty drops; water, two ounces; mix. Half an hour after using this lotion, anoint the head freely with butter or lard; it will add greatly to the efficacy of the treatment. But while local applications will relieve many skin diseases and mitigate suffering, we cannot too strongly impress upon the minds of our readers the importance, in this as in all other chronic diseases of the skin, of perseverance in the use of the best alteratives. In this class of agents Dr. Pierce's Golden Medical Discovery stands pre-eminent. Its efficacy may be increased in this disease by adding to each bottle one ounce of the acetate of potash, and, when thus modified, it may be administered in the same manner as if no addition had been made to it. _The Treatment of Sycosis_ should be essentially the same as that suggested for favus, and it will result in prompt relief and a permanent cure. _Treatment of Acne._ In the treatment of this, as in that of other diseases, we should seek to ascertain the cause, and, when possible, remove it. Outdoor exercise, a spare, unstimulating diet, and perfect cleanliness are of the first importance. The affected parts should be bathed with warm water and Castile, or, what is better, carbolic soap. Washing the face in cold water generally aggravates the disease. As a local application to the pustules, we have used with good results the following lotion: Oxide of zinc, twenty grains; morphine, five grains; glycerine, two ounces: mix. First having washed the affected parts thoroughly, apply this compound. Our chief reliance, however, as in the preceding diseases, should be upon the persistent use of alteratives and mild cathartics or laxatives. FURUNCULAR AFFECTIONS. (BOIL-LIKE AFFECTIONS.) Under this head properly belong boils, carbuncles, and styes. BOILS. These annoying affections are hard, prominent, circumscribed, inflamed, suppurating tumors, having their seat in the cellular tissue beneath the skin. They vary in size from a pea to a hen's egg, and may occur on any part of the body. The color of a boil varies from deep red to mahogany. It is painful, tender, advances rapidly to maturity, becomes conical, and finally bursts and discharges bloody "matter." Through the opening, and filling the cavity, may be seen a piece of sloughing cellular tissue which is called the _core_. In from four to fifteen days, it is all expelled and the sore rapidly heals. The causes are an impure condition of the blood, which generally arises from imperfect action of the liver or kidneys. TREATMENT. Spirits of turpentine applied to a boll _in its earliest stage_ will almost always cause it to disappear; but when suppuration has commenced it should be favored by the application of poultices. Next purify the blood to prevent subsequent returns to other parts of the body. For this purpose take Dr. Pierce's Golden Medical Discovery. One or two "Pleasant Pellets" each day will aid in the cure. CARBUNCLE. (ANTHRAX.) These are more violent, larger, and more painful than boils, which they resemble. They may spring from several small pimples which extend deep into the tissues, and on the surface frequently several small vesicles appear and break. They may discharge, through one or several openings, a thin acrid, bloody, or dark-colored fluid. They most frequently appear upon the back of the neck, back, back part of the limbs, and under the arms. Their presence is evidence of a depressed condition of vitality. These tumors vary in size from one-half an inch to six inches in diameter, and rapidly proceed to a gangrenous condition, a grayish slough being detached from the healthy tissue. TREATMENT. Invigorate the system by every possible means. The bitter tonics, such as Golden Seal, Gentian, or Willow, together with quinine and iron should be used. Nutritious diet, pure air, etc., are necessary. Purify the blood to remove the causes of the disease. For this purpose, give the "Golden Medical Discovery" in as large doses as can be borne without acting too freely on the bowels. Anodynes may be necessary to overcome the pain. Poultices are useful to encourage the separation of the dead from the living tissues. Antiseptic dressings are beneficial, of which carbolic acid is to be preferred; yeast, however, may be employed. Sometimes powerful caustics or free incisions are productive of gratifying results, if followed by appropriate dressings, but these extreme measures should only be resorted to by the direction of a physician. For a considerable time after the urgent symptoms have subsided, the "Golden Medical Discovery" should be used, to purify and enrich the blood, and the bitter tonics and iron may be alternated with it, or be used conjointly to good advantage. * * * * * SCROFULA. It is estimated that about one fifth of the human family are afflicted with scrofula. A disease so prevalent and so destructive to life, should enlist universal attention and the best efforts of medical men in devising the most successful treatment for its cure. It varies in the intensity of its manifestation, from the slightest eruption upon the skin (scrofulous eczema), to that most fatal of maladies, pulmonary consumption. THE SCROFULOUS DIATHESIS. The existence of a certain disposition or habit of body designated as the _scrofulous_ or _strumous diathesis_, is generally recognized by medical practitioners and writers as a constitutional condition predisposing many children to the development of this disease. Enlargement of the head and abdomen, fair, soft and transparent or dark, sallow, greasy or wax-looking skin, and precocious intellect are supposed to indicate this diathesis. The characteristic feature of this disease, in all the multifarious forms that it assumes, is the formation of tubercle, which, when the malady is fully developed, is an ever-present and distinguishing element. _Tuberculous_ is therefore almost synonymous with _scrofulous_, and to facilitate an acquaintance with a large list of very prevalent maladies, we may generalize, and classify them all under this generic term. As _tubercle_ is frequently spoken of in works treating on medicine and surgery, playing, as it does, a conspicuous part in an important list of diseases, the reader may very naturally be led to inquire: WHAT IS TUBERCLE? As employed in pathology, the term is usually applied to a species of degeneration, or morbid development of a pale yellow color, having, in its crude condition, a consistence analogous to that of pretty firm cheese. The physical properties of tubercle are not uniform, however. They vary with age and other circumstances. Some are hard and calcareous, while others are soft and pus-like. The color varies from a light yellow, or almost white, to a dark gray. It is almost wholly composed of albumen united with a small amount of earthy salts, as phosphate and carbonate of lime, with a trace of the soluble salts of soda. The existence of tubercular deposits in the tissues of the body, which characterizes scrofula, when fully developed, must not, however, be regarded as the primary affection. Its formation is the result of disordered nutrition. The products of digestion are not fully elaborated, and pass into the blood imperfected, in which condition they are unable to fulfill their normal destiny--the repair of the bodily tissues. Imperfectly formed albuminous matter oozes out from the blood, and infiltrates the tissues, but it has little tendency to take on cell-forms or undergo the vital transformation essential to becoming a part of the tissues. Instead of nutritive energy, which by assimilation produces perfect bodily textures, this function, in the scrofulous diathesis, is deranged by debility, and there is left in the tissues an imperfectly organized particle, incapable of undergoing a complete vital change, around which cluster other particles of tubercular matter, forming little grains, like millet seed, or growing, by new accretions of like particles, to masses of more extensive size. As tubercle is but a semi-organized substance, of deficient vitality, it is very prone to disintegration and suppuration. Being foreign to the tissues in which it is embedded, like a thorn in the flesh, it excites a passive form of inflammation, and from lack of inherent vital energy it is apt to decompose and cause the formation of pus. Hence, infiltration of the muscles, glands, or other soft parts with tuberculous matter, when inflammation is aroused by its presence, and by an exciting cause, give rise to abscesses, as in lumbar or psoas abscesses. When occurring in the joints, tubercles may give rise to chronic suppurative inflammation, as in white swellings and hip-joint disease. Various skin diseases are regarded as local expressions of, or as being materially modified by, the scrofulous diathesis, as eczema, impetigo, and lupus. The disease popularly known as "_fever-sore_" is another form of scrofulous manifestation, affecting the shafts of the bones, and causing disorganization and decay of their structure. Discharges from the ear, bronchitis, chronic inflammation of the intestinal mucous membrane, and chronic diarrhea are frequently due to scrofula, while pulmonary consumption is unanimously regarded as a purely scrofulous affectation. Scrofula shows a strong disposition to manifest itself in the lymphatic glands, particularly in the superficial ones of the neck. The most distinguishing feature of this form of the disease is the appearance of little kernels or tumors about the neck. These often remain about the same size, neither increasing nor diminishing, until finally, without having caused much inconvenience, they disappear. After a time these glands may again enlarge, with more or less pain accompanying the process. As the disease progresses, the pain increases, and the parts become hot and swollen. At length the "matter" which has been forming beneath, finds its way to the surface and is discharged in the form of thin pus, frequently containing little particles or flakes of tubercular matter. During the inflammatory process there may be more or less febrile movement, paleness of the surface, languor, impaired appetite, night sweats, and general feebleness of the system. The resulting open ulcers show little disposition to heal. SYMPTOMS. There is a train of symptoms characteristic of all scrofulous disease. The appetite may be altogether lost or feeble, or in extreme cases, voracious. In some instances there is an unusual disposition to eat fatty substances. The general derangement of the alimentary functions is indicated by a red, glazed or furrowed appearance of the tongue, flatulent condition of the stomach, and bloated state of the bowels, followed by diarrhea or manifesting obstinate constipation. Thirst and frequent acid eructations accompany the imperfect digestion. The foul breath, early decay of the teeth, the slimy, glairy stools, having the appearance of the white of eggs, and an intolerable fetor, all are indicative of the scrofulous tendencies of the system. CAUSES. Scrofula may be attributed to various causes. Observation has shown that ill-assorted marriages are a prolific source of scrofula. Both parents may be not only healthy and free from hereditary taints, but robust, well-formed physically, perfectly developed, and yet not one of their children be free from this dire disease. It may present itself in the form of hip disease, white swelling, "fever-sore" suppurating glands, curvature of the spine, rickets, ulcers, pulmonary consumption, or some skin disease, in every case showing the original perversion of the constitution and functions. Scrofula is hereditary when the disease, or the diathesis which predisposes to its development, is transmitted from one or both parents who are affected by it, or who are deficient in constitutional energy, showing feeble nutrition, lack of circulatory force, and a diminished vitality. All these conditions indicate that a few exposures and severe colds are often sufficient to produce a train of symptoms, which terminate in pulmonary or other strumous affections. Whatever deranges the function of nutrition is favorable to the development of scrofula, therefore, irregularities and various excesses tend to inaugurate it. Depletion of the blood by drastic and poisonous medicines, such as antimony and mercurials, hemorrhages and blood-letting, syphilis, excessive mental or physical labor, as well as a too early use and abuse of the sexual organs, all tend to waste the blood, reduce the tone of the system, and develop scrofula. [Illustration: Fig. 1. A Scrofulous Tumor] Scrofula may be the consequence of insufficient nourishment, resulting from subsisting upon poor food, or a too exclusively vegetable diet, with little or no animal food. Want of exercise and uncleanliness contribute to its production. It is much more prevalent in temperate latitudes, where the climate is variable, than in tropical or frigid regions. The season of the year also greatly influences this disease, for it frequently commences in the winter and spring, and disappears again in the summer and autumn months. TREATMENT. The skin should be kept clean by means of frequent baths. These assist the functional changes which must take place on the surface of the body, permit the stimulating influence of the light and air and facilitate the aeration of the blood, as well as the transpiration of fluids through the innumerable pores of the skin. All exposure to a low temperature, especially in damp weather, and the wearing of an insufficient amount of clothing should be avoided. Then the food should be generous and of the most nourishing character. Steady habits and regular hours for eating and sleep must be observed, if we would restore tone and regularity to the functions of nutrition. Moderate exercise in the open air is essential, in order that the blood may become well oxygenated, that the vital changes may take place. It is no doubt true that the occasion of the prevalence of scrofula among the lower classes may be ascribed to frequent and severe climatic exposures, irregular and poor diet, or want of due cleanliness. Every well-regulated family can avoid such causes and live with a due regard to the conditions of health. The proper treatment of scrofula is important, because we meet with its symptoms on every side, showing its slow actions upon different parts of the body and its influence upon all the organs. After this disease has been existing for an indefinite length of time, certain glands enlarge, slowly inflame, finally suppurate, and are very difficult to heal. These sores are very liable to degenerate into ulcers. All of these symptoms point to a peculiar taste of the blood, which continually feeds and strengthens this morbid outbreak. All authors agree that the blood is not rich in fibrinous elements, but tends to feebleness and slow inflammation, which ends in maturation. Thus we may trace back this low and morbid condition of the blood to debility of the nutritive organs, defective digestion, which may be induced by irregular habits, a lack of nourishing food, or by the acquirement of some venereal taint. The matter that is discharged from these glands is not healthy, but is thin, serous, and acrid; a whey-like fluid containing little fragments of tuberculous matter, which resembles curd. The affected glands ulcerate, look blue and indolent, and manifest no disposition to heal. We have thus traced this disorder back to weak, perverted and faulty nutrition, to disordered and vitiated blood, the products of which slowly inflame the glands, which strain out unhealthy, irritating, poisonous matter. The medicines to remedy this perverted condition of the blood and fluids must be alteratives which will act upon the digestive organs and tone the nutritive functions, thus enriching and purifying the blood. As this affection is frequently a complication in chronic diseases, it is eminently proper for us to refer to a few considerations involved in its general treatment. An alterative medicine belongs to a class which is considered capable of producing a salutary change in a disease without exciting any sensible evacuation. In scrofula, remedies should be employed which will improve digestion and also prevent certain morbid operations in the blood. It is well known to medical men that nearly all medicines belonging to the class of alteratives, are capable of solution in the gastric and intestinal secretions, and pass without material change, by the process of absorption, through the coats of the stomach and intestines, as do all liquids, and so gain an entrance into the general circulation; that these same alteratives act locally to tone and strengthen the mucous surfaces, and thus promote and rectify the process of digestion before being absorbed; that alterative medicines, when in the blood, must permeate the mass of the circulation, and thus reach the remote parts of the body and influence every function; that these medicines, while in the blood, may combine with it, reconstruct it, and arrest its morbid tendencies to decomposition. We should use those alteratives which give tone to the digestive and nutritive functions, in order to curtail the constant propagation of scrofula in the system; which alter and purify the blood through the natural functions, thus reconstructing it; and which check the septic, _disorganizing_ changes which are evinced by the irritating and poisonous matter discharged from the ulcers. These are the three ways in which medicines operate upon the nutritive functions and the blood. Thus alteratives may be specifics, in so far as they are particularly useful in certain disorders, and the combination which has been made in Dr. Pierce's Golden Medical Discovery, excels all others with which we are acquainted, for scrofulous diseases, particularly in fulfilling the foregoing indications. It works out peculiar processes in the blood, not like food, by supplying merely a natural want, but by strengthening the nutritive functions and counteracting morbid action, after which operations it passes out of the system by excretion. From what has been said upon the importance of blood medicines and their modes of action, the reader must not infer that we account for all diseases by some fault of the humors of the body, for we do not. But that scrofula, in its varied forms, results from imperfect nutrition and disorders of the blood, is now universally conceded. It is for this reason that neither time nor pains have been spared in perfecting an alterative, tonic, nutritive, restorative, and antiseptic compound, to which Dr. Pierce has given the name of "Golden Medical Discovery." Not only is it an alterative and a nutritive restorative, acting upon the secretions, but it opposes putrefaction and degenerative decay of the fluids and solids. Hence its universal indication in all scrofulous diseases. It will intercept those thin, watery discharges which are the result of weakness, degeneration, and putrescent decay of the blood, perpetuated by a low grade of scrofulous inflammation. By an adult it can be taken in doses of from one to two teaspoonfuls three or four times per day. The bowels should be properly regulated. When constipation exists one or two of Dr. Pierce's Pleasant Pellets taken daily, will fulfill the indication. The patient ought not to neglect to carry out all the hygienic recommendations heretofore given. The treatment of running sores is very simple. Cleanse them every day with Castile-soap and water, being careful not to rub or touch the surface of the sores. Use a clean sponge or a piece of clean muslin and saturating it with the warm water, hold it a few inches above the affected part, and squeeze out the fluid, allowing the cleansing stream to fall gently upon the open sore. After thoroughly cleansing the sore, apply to it Dr. Pierce's All-Healing Salve. 25 cents in postage stamps sent to us will secure a box by return post if your druggist does not have it in stock. HIP-JOINT DISEASE. (COXALGIA.) _Hip-joint disease_, also known as Coxalgia, is frequently a scrofulous affection of the hip-joint. It usually attacks children, but may occur at any period of life. The causes of this affection are imperfectly understood, yet all the indications point to a scrofulous state of the system. Dampness, cold, improper diet, severe injuries from blows or falls are all numbered among the exciting causes which are conducive to the establishment of this disease. THE SYMPTOMS are usually developed gradually; at first there is severe pain in the knee, but finally it is located in the hip-joint. Occasionally it is noticed in the hip and knee at the same time. As the disease progresses, the general health becomes impaired, there is wasting of the muscles, wakefulness, disturbed sleep, high fever, profuse and offensive perspiration, the hair falls out, and there is an inability to move the limb without producing excruciating pain. Frequently pus will be formed and discharged at different points, and the limb will become greatly emaciated. Since pain in the knee-joint may mislead as to the location of the disease, to determine the seat of the affection, place the patient in a chair and percuss the knee lightly, by giving it a slight blow with the knuckle; if the hip be affected, the pain will be readily felt in that joint; if it be simply neuralgia of the knee-joint, it will excite no pain whatever. If the disease be allowed to progress and dislocation of the joint takes place, the affected limb becomes shortened. TREATMENT. The treatment of this disease should consist in rest for the hip-joint, cleanliness of the person and plenty of fresh air and light, a nutritious diet and the use of tonics and sustaining alterative, or blood-cleansing medicines. Dr. Pierce's Golden Medical Discovery has, unaided by other medicines, cured many cases of this disease. This class of medicines should be persistently employed, in order to obtain their full effects. It is a disease which progresses slowly and which is not easily turned from its course, and its fatality should warn the afflicted to employ the best treatment. Many poor, unfortunate victims know too well, from sad experience, that the course of treatment frequently recommended and employed by physicians and surgeons is ineffectual, and cruel; they deplete the system, apply locally liniments, lotions, iodine, and hot applications; confine the patient in bed and strap his hips down immovably, thus preventing all exercise; then they attach that cruel instrument of torture, the weight and pulley, to the diseased limb. After many years of practical experience in the treatment of hundreds of cases, we have developed a system of treatment for this terrible malady which is based upon common sense. Instead of depleting, we, by proper constitutional treatment, strengthen and fortify the system. We do not confine the patient in bed, but permit him to go around and take all necessary exercise. We adjust an ingeniously devised and perfectly fitting appliance or apparatus, by which a gentle extension of the limb is maintained, thereby relieving the tension of the muscles, and preventing the friction and wearing of the inflamed surfaces of the joint, which, without the use of our new and improved appliance, are a source of constant irritation. The appliances required in the successful treatment of this disease are numerous and varied in their construction, and require skill and experience on the part of the surgical mechanic as well as on the part of the surgeon, to take accurate and proper measurements of the diseased limb, and to construct the appliances so that they will be adapted to the various requirements of different cases. There are no definite rules for taking these measurements, and only a thorough examination of the case can indicate to the eye of the experienced surgeon what measurements are required, and what kind of an appliance is suitable for each individual case. At the Invalids' Hotel and Surgical Institute these measurements are all taken by the surgeon in person, and each appliance is constructed under his immediate supervision. It is utterly impossible for physicians who have but a limited experience in the treatment of such cases to take correct measurements and send off for an apparatus which fulfills the requirements of the case. In the light of our vast experience at the Invalids' Hotel and Surgical Institute, we feel that we cannot too strongly urge the employment of a suitable apparatus for supporting the hip-joint, giving it perfect rest, and enabling the patient to exercise and get the outdoor air. As much of the pain in this disease is due to the pressure of the head of the _femur_, or thigh-bone, in the _acetabulum_, or socket, steadily-applied mechanical extension, to relieve the inflamed and sensitive joint of the pressure, is of the greatest importance. By such application the patient is enabled to move about without pain, while the joint is kept perfectly at rest--a condition favorable to the reduction of inflammation within it. The surgeon specialist of the Invalids' Hotel and Surgical Institute is frequently sent for to visit cases of this disease hundreds of miles away and by the employment of suitable apparatus he has been enabled, in scores of cases, to relieve the suffering at once. In cases in which the head of the thigh bone, or the bony socket of the joint has become so diseased as to cause it to ulcerate and break down, all portions of diseased bone should be _thoroughly removed_ by a surgical operation. If this be neglected or delayed, a fatal termination of the disease may be expected. Parents should not put off the employment of a competent specialist in this terrible, distressing, and fatal disease. As treated by general practitioners, it very often proves fatal; or, after causing intense suffering for a series of years, if the active condition of the disease subsides, the patient is left with a ruined and broken constitution, a result which more prompt and earlier relief would have prevented. The records of practice at the Invalids' Hotel and Surgical Institute abound in reports of cases, demonstrating the fact, that by careful and judicious management, hip-joint disease in its earlier stages, may be promptly arrested, and that cures may be effected even when the bony structure of the joint is seriously diseased. WHITE SWELLING White Swelling, otherwise known as _Hydrarthrus_, or _Synovitis_, more frequently affects the knee-joint than any other part. The joints of the elbow, wrist, ankle, or toes, may, however, be affected with this disease, but we shall speak of it in this connection as affecting only the knee-joint. Synovitis may be acute or chronic. The latter form is sometimes induced by blows, sprains, falls, etc., or from exposure to cold; more frequently it is the result of rheumatism or scrofula. THE SYMPTOMS of this affection are generally slow in their appearance, being sometimes months in manifesting themselves. The joint at first presents only a slight degree of swelling, which gradually increases. Pain is soon felt, mild at first, but augmenting until it becomes severe. The skin has a smooth, glistening appearance, and there is an increased amount of heat in the parts. The affected limb becomes wasted, and is sometimes permanently flexed. There is more or less fever about the body, impairment of the digestive organs, and sleeplessness. The pulse is low but quick, and night-sweats and diarrhea often appear. Under this irritation, the patient is liable to waste away and finally die. A _post-mortem_ examination reveals the effects of the disease upon the parts attacked. The cartilages of the joint are soft, the synovial membrane is thickened, the ligaments are inflamed and often destroyed, the synovial fluid is increased in amount, sometimes normal in appearance, at others thick and viscous. If the bones be diseased, their articular extremities may be distended and fatty matter deposited in them. The conditions depend upon the form, severity, and duration of the disease. Synovitis may be considered under three heads; Rheumatic, Scrofulous, and Syphilitic. _Rheumatic Synovitis_ may arise from exposure to cold, from some injury, or from intemperance in eating. The beginning of the disease may be distinctly marked, or it may come on so gradually that the time of its commencement cannot be noted. The pain is of a dull, steady character, and less severe in the night. This form of the disease sometimes terminates favorably, but in scrofulous systems it is liable to end in the destruction of the joint. It is more common in early life, rarely occurring after the thirtieth year. _Scrofulous Synovitis_, or _Tuberculosis of the Knee-joint_, when of a chronic character, shows a wasting of the limb, and the swelling is of a pulpy consistence. This form of the disease is more liable to occur in children, though occasionally it is met with in adults. But little pain accompanies this form, although the limb is liable to become permanently affected. In its earlier stages this disease may be checked. _Syphilitic Synovitis_ is the result of syphilis. The pain is more severe during the night. It, however, generally terminates unfavorably, especially in scrofulous constitutions. THE TREATMENT of white swelling should be both constitutional and local. Alterative medicines are indicated to purify the blood. Doctor Pierce's Golden Medical Discovery is unequaled for this purpose. As local treatment, in the active stage of the disease, the knee-joint should be steamed, and hot fomentations applied. This should be followed by applications over the joint of solid extract of stramonium or belladonna, mixed with glycerine. The joint should be wrapped in cotton or wool to keep it uniformly warm. If there are openings about the joint, discharging pus, syringe them out once a day with Castile soap-suds, which may be improved by adding a little bicarbonate of potash (common saleratus). See that the bowels are kept regular, and that the diet is nourishing. Cases of this disease which have been treated at the Invalids' Hotel and Surgical Institute with uniform success might be cited to the extent of filling a very large number of pages like these. When treated by a skilled specialist, this otherwise formidable and dangerous disease is readily amenable to treatment, and good and serviceable limbs can be promised, even in the extreme cases in which amputation is usually advised by general practitioners and surgeons, who desire the glory that they imagine they will receive by performing a capital operation. RICKETS. (RACHITIS.) Rickets is a scrofulous disease, in which there is derangement of the entire system, and it finally manifests itself in disease of the bones. It is characterized by a softening of the bony tissue, due to a deficiency of earthy or calcareous matter in their composition. It appears to be a disease incident to cold, damp places, ill-lighted and imperfectly ventilated rooms, and it especially attacks those who are uncleanly in their habits. THE SYMPTOMS of rickets are severe pains in the bones, especially during the night, febrile excitement and profuse perspiration, paleness of the face, a sallow and wrinkled appearance of the skin, and derangement of the digestive organs. After a time the body becomes emaciated, the face pale, and the head unusually large. The bones become soft and unable to support the body; various distortions appear; the extremities of the long bones are enlarged, while the limbs between the joints are very slender. Rickets is a disease peculiar to childhood, though it may not be developed until a more advanced period of life. It rarely proves fatal, unless the lungs, heart, or other vital organs, become involved. In some instances the softening and other symptoms continue to increase until every function is affected, and death ensues. _Post-mortem_ examinations of those who have died of rickets have disclosed morbid changes in the brain, liver, and lymphatic glands. The lungs are often compressed or displaced, and the muscles of the body become pale and wasted. Sometimes the bones are so soft, on account of the deficiency of the calcareous deposit, that they can be easily cut with a knife. TREATMENT. The use of Dr. Pierce's Golden Medical Discovery is indicated in this affection. It is a disease usually developed during childhood, in consequence of insufficient exercise, deprivation of the sunlight, low, innutritious diet, and lack of cleanliness. Therefore, it is essential to obviate all known causes, and, at the same time supply the patient with food rich in those elements which the system seems to demand. Under any plan of treatment the general directions given for the hygienic management of scrofula should be followed. We might cite many cases that have entirely recovered from this disease, under our advice and the use of "Golden Medical Discovery." We shall merely say, for the encouragement of the afflicted, that this form of scrofula yields readily to this medicine. OLD SORES. (CHRONIC ULCERS.) Under this head we may properly consider that class of affections known as Fever-sores, Running-sores, Ulcers, etc. These sores have common characteristics, yet each possesses certain peculiarities, which have led to their division into _irritable, indolent_, and _varicose_. These peculiarities are not constant, one form of ulcer often changing into another. One feature common to all, however, is their slowness in healing, which has sometimes led to the belief that they are incurable. Another popular notion is that their cure is detrimental to the health of the patient. With equal propriety we might say that it is dangerous to cure diarrhea, dysentery, consumption, or cancer. As a result of these erroneous impressions, many people suffer from chronic ulcers for years, and even for a life-time, without attempting to obtain relief. Chronic ulcers usually appear upon the lower extremities. The depth and appearance of the ulcer depend upon its character and the thickness of the tissues where it is situated. Fig. 2 shows a chronic ulcer, or fever-sore, as it appears upon the ankle. [Illustration: Fig. 2. A Chronic Ulcer.] THE IRRITABLE ULCER is painful and tender, the slightest injury causing it to bleed. It is of a dark purplish hue, and filled with spongy, sensitive granulations. It discharges a thin, bloody matter which is sometimes very fetid and acrid, and excoriates the tissues if it comes in contact with them. The edges of this species of ulcer are shelf-like and ragged, and turn inward. The adjacent structures are red and swollen. Very often they are attended by severe constitutional disturbances, such as chills, fever, and great nervous prostration and irritability. IN THE INDOLENT ULCER the edges are not undermined, but turned outward, and are rounded, thick, glossy, and regular. The granulations are broad, flat, pale, insensible, and covered with a grayish, tenacious matter. The surrounding parts are not very sensitive, but the limb on which it is located is apt to be swollen. This is the commonest form of ulcer, and often remains for years. VARICOSE ULCER. This species of ulcer occasions a swollen or enlarged condition of the neighboring veins, which are very much enfeebled. It almost invariably appears below the knee, and may be either indolent or irritable. It is generally sensitive to the touch, and sometimes excessively painful. Knots of superficial veins may often be seen beneath the skin. As we have before remarked, these various species of ulcers are merely modifications of one form of chronic sore. The patient may assert that he enjoys excellent health, but if we question him closely, we find that the sore irritates him, and that there is sufficient constitutional disturbance to prevent the healing powers of nature from effecting a cure. TREATMENT. The cure of these sores is necessarily slow, and who ever expects to obtain _immediate_ relief will be disappointed. Constitutional treatment is of the utmost importance, and should, therefore, be thoroughly and persistently applied. The nutritive system, especially the absorbents, should be kept active, as these are the channels by which the broken-down tissue surrounding the sore is replaced by that of a higher grade of vitality. For this purpose, the best alteratives or blood cleansing remedies are required. If secretion and excretion are not normally performed, the blood becomes poisoned by the absorption of unhealthy "matter" from the sore, and various constitutional disturbances occur. If, at any time during treatment, constitutional disturbances are manifested by fullness or disagreeable sensations in the head, nausea, pain, cough, chills, or fever, a thorough cathartic should be given. If the patient be robust, a repetition of the same once a week will be very beneficial. Dr. Pierce's Golden Medical Discovery, and "Pellets" will be productive of the best results. The local treatment should depend upon the character of the ulcer. If the sore be _irritable_ or painful, soothing applications, such as warm poultices or steaming in a vapor of bitter herbs, as hops, boneset or smart-weed or water pepper, will be found highly beneficial. A poultice of powdered slippery elm is also very soothing, and hence well adapted to this purpose. If the ulcer be _indolent_, a stimulating application is necessary. The hardened, callous state of the edges should be removed by alkaline applications. A strong solution of saleratus, or even a caustic, prepared by boiling the lye from hard-wood ashes to the consistence of syrup, will prove of great utility. One or two applications of the latter are generally sufficient. The foregoing course of treatment is intended to put the open sore or ulcer in what is known to surgeons as a healthy condition--a condition most favorable for the healing process. But the open surface of the sore needs something more. It needs the cleansing or antiseptic and soothing influence of such a dressing as is found in Dr. Pierce's All-Healing Salve. If your dealer in medicines does not have this Salve in stock, 25 cents in stamps sent to World's Dispensary Medical Association, Buffalo, N.Y., will secure a box of this unequaled dressing. It will be sent to your address by return post. Therefore, do not allow the dealer to put you off with some inferior preparation. If he has not the All-Healing Salve in stock you can easily obtain it by sending to us as above directed. No matter how good the local dressing applied to the open sore, or ulcer, do not discontinue the internal use of the "Golden Medical Discovery" until the affected parts are completely healed. FEVER-SORE. (NECROSIS.) By the term _necrosis_ we mean mortification, or the state of a bone when it is deprived of life. Dunglison says: "This condition is to the bone what _gangrene_ is to the soft parts." It is popularly known as _fever-sore_, there being no distinction made between this species of sore and those ulcers which affect only the soft tissues of the body. When any part of a bone becomes _necrosed_, it is treated as a foreign body. Nature makes an effort for its removal, and at the same time attempts to replace it with new and healthy materials. In consequence of this process, the dead portion is often inclosed in a case of new, sound bone, termed the _involucrum_; when this is the case the dead portion is termed the _sequestrum_. If, however, it be superficial, and separate from the parts beneath, it is called an _exfoliation_. This healing process, by which the involucrum is formed, cannot be completed while the dead portion remains. Hence, numerous openings are made through the involucrum, to permit the escape of the sequestrum. When a surgical operation is performed for the removal of the necrosed bone it is called _sequestrotomy_. The instruments which our specialists usually employ for this practice are represented in Figs. 3, 4, and 5. [Illustration: Fig. 3. Hand drill for boring bone. ] [Illustration: Fig. 4. The osteotrite, for enlarging openings and cutting carious bone.] [Illustration: Fig. 5. Gouge forceps for excavating bone.] CAUSES. Fever-sore may be due to inflammation, injuries, working in phosphorus, or from the inordinate and protracted use of mercury. SYMPTOMS. The pain frequently commences in the night, and all the different stages succeed, until, finally, the result is frequently mortification or death. The entire bone, or only a part of it, may be affected; the parts become swollen, "matter" forms, and unless it be artificially evacuated, it will in time work its way out through a fistulous opening. As the disease progresses, the adjacent tissues become thickened and numerous openings are formed, which communicate with the bone, and often with each other, so that a probe may be passed from one to another, as represented in Fig. 6, copied from a drawing by Dr. Howe. The discharge from fever-sores varies in character, and usually has a fetid odor. The surgeon can readily distinguish between healthy and unhealthy bone by the use of a probe. The pus discharged in necrosis contains minute particles of bone, which may be felt by rubbing it between the fingers. Sometimes large pieces present themselves at the openings. The general health is seriously impaired, and the patient becomes debilitated, anæmic, and hectic. [Illustration: Fig. 6. Necrosis of the tibia. A common probe is passed through the sinuses, or openings.] TREATMENT. The process of repair is necessarily tedious, and nature should be assisted to remove the old bone and promote the formation of the new. An alterative course of treatment is indicated and must be persistently followed. Give Dr. Pierce's Golden Medical Discovery and Pleasant Pellets in sufficient doses to keep the bowels regular. However, all efforts to heal the sores, as long as dead bone remains, will prove fruitless. The sores should he throughly cleansed with injections of an alkaline solution, after which bandages, moistened with glycerine, may be applied. If they emit a fetid odor, add a few drops of carbolic acid to the glycerine. The dead bone can be but slowly removed by suppuration, therefore time, and, indeed, sometimes life itself, may be saved by removing it with surgical instruments. In the operation of sequestrotomy, the surgeon must exercise great judgment. Carelessness may prolong the disease and subsequently necessitate another operation, or, perhaps, an amputation. Usually the dead bone is easily removed by the skilled specialist surgeon, and, when thoroughly taken out, the parts readily heal and the patient rapidly recovers. The removal, therefore, of the dead bone which is a constant source of irritation, and the cause of protracted suffering, should not be delayed, for very rarely indeed can it be removed at all without the assistance of the surgeon. Besides, delay often results in the loss of the limb, and not unfrequently occasions the death of the patient. Under the influence of a reliable local _anæsthetic_, carefully applied, the operation of removing the decayed and offensive bone is speedily and painlessly performed, the use of chloroform or ether not generally being required. * * * * * TESTIMONIALS. If the following letters had been written by your best known and most esteemed neighbors they could be no more worthy of your confidence than they now are, coming, as they do, from well known, intelligent and trustworthy citizens, who, in their several neighborhoods, enjoy the fullest confidence and respect of all who know them. Out of thousands of similar letters received from former patrons, we have selected these few at random, and have to regret that we can find room only for this comparatively small number in this volume. BLOOD DISEASE. RAW SORES FROM KNEE TO ANKLE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Master Amasa Peck] _Dear Sirs_--My little boy, Amasa Claude Peck, was severely stricken with what the doctors called erysipelas. We had employed two doctors for months without any effect, until he commenced taking your Dr. Pierce's Golden Medical Discovery. Two bottles effected a cure. His leg was raw from his knee to his ankle; it has never broken since, which has been several years. The same medicine also did great things for my now deceased husband in a case of erysipelas of long standing. Respectfully yours, MRS. A.B. PECK, Ranger, Eastland Co., Texas. My daughter Mrs. Jennie Rice, was cured of catarrh in her head by using the "Discovery" with Dr. Sage's Catarrh Remedy. She derived great benefit from your medicines and gives the privilege of using her name. A.B.P. ANÆMIA--IMPOVERISHED BLOOD. WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St.. Buffalo, N.Y.: [Illustration: Mrs. Knight.] _Dear Sirs_--Ten or twelve years ago I had a combination of diseases. Our family physician said I was bloodless and there was no hopes of my recovering. My mother advised me to consult you, which I did. After one month's treatment I was on foot again; it was truly astonishing how speedily I found relief after taking your preparations. I have also used your "Favorite Prescription" and "Golden Medical Discovery," which proved very beneficial. MRS. ADDIE R. KNIGHT, Carapeake, Gates Ce., North Carolina. ERYSIPELAS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J. Smith, Esq.] _Gentlemen_--I am glad to say that the use of your medicine has saved me many doctors' bills, as I have for the past eleven years been using it for the erysipelas and also for chronic diarrhea, and am glad to say that it has never failed. I have also recommended it to many of my neighbors, as it is a medicine worth recommending. I give you the privilege of using my name Yours truly, JOSEPH SMITH Mineral Point, Tuscarawas Co., O BLOOD AND KIDNEY DISEASE. DR. R.V. PIERCE, Buffalo, N.Y.: [Illustration: Mr. Edmundson.] _Dear Sir_--I had been an invalid for nineteen years and had all the doctors in our country prescribe for me, but they could not say just what ailed me. When I wrote you giving the history and symptoms, you diagnosed my case as disease of the blood and kidneys, and advised me to try your "Golden Medical Discovery" and "Pellets" and I feel confident your medicines _saved my life_, and I hope all sufferers from kidney and blood diseases will try your valuable medicine. Respectfully yours, T.H. EDMUNDSON, Postmaster, Home, Marshall Co., Kans. ECZEMA--SUFFERINGS INTENSE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y. [Illustration: J.P. Delano, Esq. ] _Gentlemen_--About five years ago I was taken with a discoloration of the skin on my legs and arms, which in a short time terminated in the most aggravated eczema. My sufferings were intense, and no relief did I experience, until I commenced the use of your preparations. I have taken five bottles of the "Golden Medical Discovery," and more than that number of the "Pellets," and believe that I am entirely cured. I never feel the least itching, or burning, which was at one time so unbearable. My appetite and digestion are splendid, and, although I will be seventy years old my next birthday, I am as hearty and strong as most men of fifty. Very truly yours, JOSEPH P. DELANO, Warsaw, Richmond Co., Va. Mr. G. MILTON SYDNOR, Druggist, of _Warsaw, Richmond Co., Va._, writes: "My friend, Mr. J.P. Delano, has requested me to write you in confirmation of his statement, which I cheerfully do. I know Mr. Delano well personally, and can testify to the correctness of his statement. His case of eczema was the worst that I had ever seen. I saw him often during the time he was afflicted, as he came to my store often after medicine. He purchased the "Discovery" and "Pellets" from me, and has been one of the strongest champions of your medicines, and thus aided me very much in their sale. I am quite sure that he has been the means of my selling several dozens of that preparation." BOILS CURED. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Wm. Ramich, Esq.] _Gentlemen_--I was troubled with boils for thirty years. Four years ago I was so afflicted with them that I could not walk. I bought Dr. Pierce's Pleasant Pellets, and took one "Pellet" after each meal. The boils soon disappeared and have had none since. I have also been troubled with sick headache. When I feel the headache coming on, I take one or two "Pellets," and am relieved of it." Respectfully yours, WILLIAM RAMICH, Minden, Kearney Co., Neb. A TERRIBLE SKIN DISEASE. Jackson, N.C. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Dear Sirs_--I had been troubled with skin disease all my life. As I grew older the disease seemed to be taking a stronger hold upon me. I tried many advertised remedies with no benefit, until I was led to try your "Golden Medical Discovery." When I began taking it my health was very poor; in fact, several persons have since told me that they thought I had the consumption. I weighed only about 125 pounds. The eruption on my skin was accompanied by severe itching. It was first confined to my face, but afterwards spread over the neck and head, and the itching became _simply unbearable_. This was my condition when I began taking the "Discovery." When I would rub the parts affected a kind of branny scale would fall off. For a while I saw no change or benefit from taking the "Discovery," but I persisted in its use, keeping my bowels open by taking the "Pellets," and taking as much outdoor exercise as was possible, until I begun to gain in flesh, and gradually the disease released its hold. I took during the year somewhere from fifteen to eighteen bottles of the "Discovery." It has now been four years since I first used it, and though not using scarcely any since the first year, my health continues good. My average weight being 155 to 160 pounds, instead of 125, as it was when I began the use of the "Discovery." Many persons have reminded me of my improved appearance. Some say I look younger than I did six years ago when I was married. I am now forty-eight (48) years old, and stronger, and enjoy better health than I have ever done before in my life. Yours truly, J.A. Buxton. BAD CASE OF ECZEMA OR SALT-RHEUM. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Foster.] _Gentlemen_--I was troubled with eczema, or salt-rheum, seven years. I doctored with a number of our home physicians and received no benefit whatever. I also took treatment from physicians in Rochester, New York, Philadelphia, Jersey City, Binghamton, and received no benefit from them. In fact I have paid out hundreds of dollars to the doctors without benefit. My brother came to visit us from the West and he told me to try Dr. Pierce's Golden Medical Discovery. He had taken it and it had cured him. I have taken ten bottles of the "Discovery" and am entirely cured and if there should be any one wishing any information I would gladly correspond with them. If they enclose return stamped envelope. Very truly yours, MRS. JOHN G. FOSTER, 83 Chapia Street, Canandaigua, N.Y. ERYSIPELAS AND WOMB DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: Mrs. White.] _Gentlemen_--I am forty-eight years old, and have had four children. Three years ago the doctor said I had womb trouble, which was accompanied with backache and a tired and miserable feeling all over; left side hurt me very much, and could not lie on that side, and the doctor said it came from affection of the spleen; had a great deal of headache; was costive, and suffered terribly from erysipelas; it nearly set me crazy, so great was the burning and itching; sometimes experienced severe burning in the stomach. I took twelve bottles of your medicines, six bottles of Dr. Pierce's Golden Medical Discovery and the same amount of his "Favorite Prescription." Was using them for about six months, and can say that they did their work well. I have ever since felt like another person, and do not think I can say enough in their praise. I have no more weakness, and all evidence of erysipelas has disappeared. Respectfully yours, MRS. SARAH E. WHITE, Kennon, Belmont Co., Ohio. ECZEMA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss Harris. ] _Gentlemen_--About four years ago my daughter, Helen G. Harris, was afflicted with Eczema in a distressing form. She tried medicines too numerous to mention, but they did no good. I told her that I would write to Dr. Pierce, which I did, and after a few months' use of his medicines she was entirely cured. I believe your medicines unequaled. MRS. JNO. H. RICHARDSON, a widow living near Wakefield, Va., a few years ago, was in extremely bad health, and used your proprietary medicines with entire success. Respectfully yours, THOMAS HARRIS, Wakefield Station, Sussex Co., Va. SALT-RHEUM--FLESH CRACKED OPEN AND BLED. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss Clark. ] _Gentlemen_--It gives me pleasure to express my faith in the virtue of Dr. Pierce's Golden Medical Discovery. Having suffered for three years from salt-rheum and after having been unsuccessfully treated by a good physician, I began the use of the "Discovery." The humor was in my hands. I was obliged to keep a covering on them for months at a time, changing the covering morning and night. The stinging, burning and itching sensation would be so intense that at times it seemed as if I would go crazy. When I bent the fingers the flesh would crack open and bleed. It is impossible for me to describe the intense pain and suffering which I endured night and day. After taking six bottles of the "Discovery" I was entirely cured. Respectfully yours, MISS LOTTIE CLARK, River Falls, Pierce Co., Wis. INVETERATE SKIN DISEASE WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: M. Allen, Esq.] _Gentlemen_--I desire to state that I am perfectly well and very thankful to you for curing me. The medicines which I used for two months only have effected a perfect and permanent cure of my case. My face looks as well as ever. I was six weeks under treatment at the Invalids' Hotel and Surgical Institute, and I got first-class accommodation. The case was a strange one. The pimples did not break out on my chin where I had let my beard grow, they broke out on my cheeks, forehead and nose. A doctor in San Francisco told me it was blood poison and said it was very hard to cure it. I think if it were blood poison it would run all through my system. When I first felt the disease coming on in winter--my face used to be very cold. I worked under the sun fourteen years every summer. I wore no hat--nothing but a skull cap. I thought I was sun-proof. The doctor in San Francisco stopped the disease for one year but it came back again. I had it for five years. It came on from hard work and exposure in the sun. When my face would break out in the fall it got so itchy, and then little pimples would break out on my face, nose and forehead. I think parasites were in my face. If I would drink a glass of beer, I would feel the effects of it in my face, and tobacco would affect me just the same. My face, nose and forehead would be spotted all over like a "fiddler's note book," every fall for five years. I never saw a case like mine. The doctor said if I would get tanned with the sun I would be all right. In the kind of work I had to do, I could wear no hat. Respectfully yours, MICHAEL ALLEN, Oro Fino, Siskiyou Co., Cal. CURES BROWN SPOTS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.: [Illustration: Mrs. Johnson. ] _Gentlemen_--I can say that my health is better now than for the last fifteen years. I cannot say what my disease was, but I was as spotted as a leopard with brown spots; I was so miserable and nervous, and could not sleep. I took Dr. Pierce's Golden Medical Discovery one year, and the brown spots all disappeared and I am well. Have not taken any medicine in two years. I think the "Golden Medical Discovery" a splendid medicine for stomach, liver and skin disease. I got no help from the other doctors. I used only the "Golden Medical Discovery." Yours truly, MRS. WILLIAM JOHNSON, P.O. Box 188, Owosso, Shiawassee Co., Mich. SCROFULOUS DISEASE. [Illustration: Mrs. Nichols. ] WORLD'S DISPENSARY MEDICAL ASSOCIATION, No. 663 Main St., Buffalo, N.Y.: _Dear Sirs_--I was sick eight long years with the scrofulous humor and I used Dr. Pierce's Golden Medical Discovery and it cured me. I used five bottles and I have used it since for other troubles. It has helped me wonderfully, in fact cured me, and I recommend it to all my friends Yours most gratefully, MRS. MARY E. NICHOLS Bay Shore, Suffolk Co., N.Y. "HEART-RENDING TO BEHOLD". Terrible Suffering from Skin Disease. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration] _Gentlemen_--My baby when about three months old began to have little sores come out on his face; did not amount to much until six months old, then they began to spread all over his face and head until his face, head and ears were one solid sore. Our family physician was summoned at the early stages of the disease and tried everything he knew of for the cure of the same, but nothing did him any good. The disease baffled the skill of the doctor in every way, and I was advised by friends to try certain remedies, which I did, with very little effect. The child by this time was a heart-rendering sight to behold, and suffered unknown agonies with the torturing itching and burning of the sores, and so things ran on until my brother, who resides in Buffalo, visited me. As soon as he saw the child he advised me to have him treated at the Invalids' Hotel and Surgical Institute in Buffalo. I wrote to them stating my baby's case, asking them if they could help him, and they thought they could, so began their treatment at once by using salves externally and medicine internally and as soon as they began their treatment the child began to improve and continued so until he was entirely cured in six months' time. He is now two years and six months old and is as tough as any child you ever saw; weighs thirty-five pounds and is perfectly well, thanks to Dr. Pierce and his wonderful medicines. Yours truly, MRS. A.L. PAYNE, Box 147; Oxbow, Jefferson Co., N.Y. SCROFULOUS ABSCESSES. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y. [Illustration: Mrs. Sweeney.] _Gentlemen_--About four years ago I took scrofula, and did everything that doctors and others prescribed, but only got worse. Several abscesses formed about my neck and breast, discharging a quantity of matter. I got so weak I could scarcely walk about the house. I read all the medical works I could get hold of, and, among the rest, read some of your works. You described my case, and recommended Dr. Pierce's Golden Medical Discovery with his "Pleasant Pellets." So I procured some and commenced using them and soon began to mend. In six months my sores were all healed up, and in twelve months _I was entirely well_. I am forty-five years old and believe I am as stout as I ever was in my life. I used about one dozen bottles of the "Golden Medical Discovery" with the "Pellets," and used nothing else after I began using your medicines. So I must give your medicine all the praise for curing me, and I am bound to recommend it. Yours truly MRS. BELLE SWEENEY, Flat Top, Mercer Co., W. Va. CROSS EYES. CONVERGENT STRABISMUS. INSTANT AND PAINLESS CURE. [Illustration: D. Crane, Esq.] WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I am happy to certify to your skill. I had been afflicted with badly crossed eyes from my birth, and my sight was impaired, and I was badly disfigured. By a painless operation my eyes were instantaneously restored to a proper position and my sight much improved. Your Hotel and skillful surgery merit every recommendation. Yours truly, DAVID CRANE, Spring Creek, Warren Co. Pa. SCROFULOUS SORE EYES. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: Miss Gardner.] _Gentlemen_--When I was two years old my eyes broke out in little white pimples and itching all the time in the mornings; when I awakened my eyes would have to be washed open; I could not see and when they were washed open the corruption would run down my face and drop off. I have tried all of our physicians and their medicine did me no good. A physician attended them from Ellicott City and did them no good. He said it was the running scrofula in the eyelids and could never be cured; it had continued fourteen years, and I had given up all hopes of ever being cured until I saw your advertisement of the "People's Common Sense Medical Adviser," and I sent and got one, and I saw a great deal in it about the eyes. I wrote to you about them and you prescribed for me. Now my eyes are quite well. Some advised me to wear glasses, but you said not. I have been a great sufferer but am glad to say you did me all the good that I have received. Respectfully yours, MISS VIRGINIA M. GARDNER, Mayo, Anne Arundel Co., Md. WEAK AND SORE EYES. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: John Casserly. ] _Gentlemen_--After taking Dr. Pierce's Golden Medical Discovery for four weeks, at a cost of only $1.50, I am more than pleased to announce that my eyes are perfectly well and strong as ever. I doctored and fussed with quack medicines for about one year and a half and found no relief. Finally I consulted your "Medical Adviser" and found a case similar to mine so I wrote and got a speedy reply. I followed directions, which resulted in a speedy cure as above. Yours truly, JOHN CASSERLY, JR., Westline, Redwood Co., Minn. RUNNING SCROFULOUS SORES. [Illustration: H.M. Holleman, Esq.] DR. R.V. PIERCE: _Dear Sir_--When about three years old I was taken with mumps, also had fever, finally I had that dreaded disease Scrofula. The most eminent physicians in this section treated me to no avail. I had running scrofulous sores on left side of neck and face. I was small and weakly when eight or nine years old, and in fact was nearly a skeleton. Six bottles of Dr. Pierce's Golden Medical Discovery wrought marvelous changes. Although the sores were healed in eight months, I did not quit taking it until I was sure it had been entirely routed from my system. The only signs left of the dreadful disease are the scars which ever remind me of how near death's door I was until rescued by the "Discovery." I am now eighteen years old and weigh 148 pounds; and have not been sick in five years. Respectfully, HARVEY M. HOLLEMAN, Wilmington, Newbern & Norfolk Railway Co., Wilmington, New Hanover Co., N.C. "FEVER SORES." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration] _Gentlemen_--My daughter who is now 18 years of age was attacked with a severe pain and swelling in her ankle, which soon caused her to have high fever. We employed some of the best physicians in this locality who pronounced it rheumatism, did everything for her they could do, but she kept getting worse from day to day, and in about five weeks after she was first taken sick her ankles and legs came open and discharged a lot of yellow matter and finally slivers of bones came out of the openings in her ankles. All the doctors we consulted said that we would have to have an operation performed on her and have the dead bones taken out, or else she could not get well, with the exception of one of the doctors who said that if her health could be improved the dead bones would come out and be replaced with new ones, for the dead pieces would brake loose from the sound bone and come out through the opening with the matter; but he could not do anything to improve her health. After doctoring her three months she was reduced to a mere skeleton and had to be tended to like a mere baby and have her feet elevated, or else she would scream with pain. We commenced giving her Dr. Pierce's Golden Medical Discovery. After using it for one month we could see, for the first time, that she was getting no worse, and after using about five bottles her health began to improve a little; but she still suffered with pain and could not have her feet down until she had taken twelve bottles. When she had taken fifteen bottles--she began to walk on crutches, and later with a cane, for about two or three months, when she could walk without a crutch or cane. The diseased bones gradually came out in pieces, some of them an inch to two inches long and one-fourth of an inch thick; the sores healed as soon as the last dead bone was out. She is now a strong healthy young lady as her photograph plainly shows. Respectfully yours, D.R. SCHROER. Holstein, Warren Co., Mo. GENERAL DECLINE, RUNNING SORE ON LEG. Fort Coulonge, Pontiac Co., Quebec. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Thanks be to God, and you, I have the best of health since I have taken your special medicine and one bottle of "Favorite Prescription." I was as weak as any person could be without dying, and I am as healthy as any person can be to-day, and I have gained ten pounds since, and a great many people remark to me how much better I look. Also, I can mention to you another person who was cured by your "Golden Medical Discovery." His name is John McCoy. For near two years he never walked. He suffered from a running sore on his leg, and after using twelve bottles, he could walk all right and is well to-day The doctors wanted to have it taken off. You say in your letter you would like to have a photograph. I have none and there is no photograph gallery in this village or I would have one taken. Yours truly, Mrs Isaac Brady ECZEMA. DR. R.V. PIERCE, Buffalo, N.Y.: _Dear Sir_--When I was married I weighed 125 pounds. I was taken sick with a disease which my doctor said was eczema. He failed to do me any good, and I fell away to 90 pounds. I had dyspepsia so bad that I could not eat anything. My husband got me "sarsaparillas" and "cures" and "bitters," and nothing did me any good. Finally he got two bottles of Dr. Pierce's Golden Medical Discovery. I began using it, and, thank God and you, I improved; now I weigh 140 pounds, and my skin is as smooth as a baby's. My husband says I look younger than I did the first time he saw me. I have better health than ever, and I owe it all to you. It is a miracle that I am cured. I cannot say too much about the medicine. Very respectfully, Rebecca F. Gardner "FEVER SORES" OR INDOLENT ULCERS--DROPSY AND TORPID LIVER. Dr. R.V. PIERCE, Buffalo, N.Y.: [Illustration: Mr Fred Pestline.] _Dear Sir_--I write in regard to your great "Golden Medical Discovery." I cannot be thankful enough to you for what it has done for me. As a result of the grippe I had dropsy, and ulcers formed on my legs with a most intolerable itching at night after going to bed. My circulation was very poor and liver inactive. I feel perfectly well since I took the medicine. The old sores on my legs are all healed up, and I feel like a new man. I highly recommend your "Golden Medical Discovery" to any inquiring person, for it has saved my life. Yours very truly, FRED. PESTLINE, Alexander, Genesee Co., N.Y. RUNNING SORE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Kuhn.] _Gentlemen_--It pleases me to state that I had a running sore up on my neck, and had it operated upon three times, and still it was not cured. I was also run down very much. There was a decided change after using Dr. Pierce's Golden Medical Discovery. I took a few bottles and was soon cured Later my husband had a lump behind his ear; he tried your medicine, and one bottle cured him. I shall always recommend your medicines. Yours respectfully, MRS. L. KOHN, No. 618 E. 16th St., New York City. "OLD SORES" ON LEGS. Alexander, N.C. DR. R.V. PIERCE, Buffalo, N.Y.: _Dear Sir_--Your "Golden Medical Discovery" has proven a blessing to me. It was recommended to me by Rev. P.A. Kuykendall. I have been a sufferer with old sores on my legs for four years. I used three bottles of it, and my legs are sound and well and my health is better than it has been for some time. I had THE best doctors of this country treat my case and they failed to effect a cure. Yours respectfully, J.N. Kery Kendall HIP-JOINT DISEASE. PHYSICIANS FAIL TO BENEFIT. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: E.J. Rush.] _Gentlemen_--At the age of eight years I became afflicted with "Hip-joint Disease." For a year I suffered as much as it was possible for a human being to suffer. My physicians told me I would have to wait patiently, but my father procured me some of Doctor Pierce's Golden Medical Discovery, and I found my falling health restored. I can cheerfully say that I believe I owe my life to the use of that valuable medicine. Your true friend, EDWARD J. RUSH, Elizabeth, Harrison Co. Ind. HIP-JOINT DISEASE CURED. [Illustration: Mrs. Ridgley.] MISS MARY E. RIDGLEY, of _Gales Creek, Washington Co., Oregon_, when only three years old, had lameness in one of her lower limbs but the use of liniment and Dr. Pierce's Pellets relieved her, and she got better. When six years old the trouble developed into hip-joint disease, so pronounced by her physician. She lost the use of the limb. Was three months under the doctors, but got no better. She complained of great pain in the limb, especially in the knee and hip. The limb wasted away, becoming small and short, and her back became crooked. She had no appetite; was very weak. Hip and knee were very tender to the touch. Physician's treatment not helping her, her mother began to give her "Golden Medical Discovery." Four months afterwards she wrote Dr. Pierce as follows: "She is growing fast, and never complains of any pain or ache. She sleeps well, and eats heartily. Her leg has filled up, and is as big as the other. She plays around all day with the other children. Everybody is astonished to see how she has improved." In the margin we print Miss Ridgley's picture as she appears twelve years after this treatment, at the age of eighteen. The young lady herself, writes Dr. Pierce as follows: "Your medicines are worth their weight in gold. I was cured of hip-joint disease by the "Golden Medical Discovery" and "Pellets," and I feel sure that they can cure the worst cases if given a chance." HIP-JOINT DISEASE OF 11 YEARS' STANDING. P.O. Box 128, Gagetown, Tuscola Co., Mich. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--When I began taking your medicines I was in bed, nothing would relieve me, my hip being swelled seemingly ready to burst. When I began to take Dr. Pierce's Golden Medical Discovery and "Pellets," the swelling gradually decreased; when I had taken one bottle I was able to be up. I don't know how long I will remain well, but I am satisfied that it is the medicine that did the work: I take it right along; as long as I can keep the way I am now, I am satisfied. I have recommended your remedies, and will continue to do so. Yours truly, H.F. Giron THICK NECK (GOITRE). WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: Master Sumner.] _Gentlemen_--I am willing and pleased to have you publish anything I have written in regard to the cure of my little son of Goitre (that a surgeon of N. Adams said could never be cured). I do hope that by so doing some little one may escape the misery my little one suffered for over a year until I began the use of the "Golden Medical Discovery." I followed your directions found in the little book around the bottles. Before the first bottle was gone, he could eat and sleep without that coughing and choking that, before the use of the "Discovery," was impossible. The tumor began to lessen in size, and after the third bottle I would never have known he ever had a tumor there. He is now hearty and healthy. Sleeps as good as any child and is full of life. He does not take anything to prevent a return, and has not for over a year. I have one of your Common Sense Medical Advisers, and found it worth five times what I gave for it; I have helped others to get it and the "Medical Discovery" and "Favorite Prescription" have brought relief to many through me I use the "Prescription" off and on; it has given me strength; I think I should have been an invalid long ago without it. Every one here knows the truth of this letter, and I would tell it to the world if I could. Respectfully, MRS. ANNIE SUMNER, Heartwellville, Bennington Co., Va. THICK NECK (GOITRE), NERVOUS DEBILITY AND WEAKNESS CURED. [Illustration: Miss Rachel Mann.] Miss ELLA A. HOUGHTON, of _Theresa, Jefferson Co., N.Y._, was cured of Thick Neck, Nervous Prostration, Weakness and a complication of ailments by Dr. Pierce's "Discovery" and "Favorite Prescription." She says: "My health is now as good as it was before I was sick. The swelling (goitre) has all gone from my neck. I don't have any bad feelings. My gratitude for the benefit I have received from your treatment has induced me to recommend you to all whom I know to be sick." "I have known of two or three middle aged ladies residing near here, who have been cured by your 'Favorite Prescription.'" GOITRE CURED. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss Rachel Mann.] _Dear Sirs_--I can say that your medicine has done its work well in the case of my sister, Miss Rachel Mann. She is entirely well of Goitre and throat trouble. I am glad to say that we can recommend your medicines very highly. Very truly yours, MARY J. MANN, for sister Rachel Mann, Romola, Center Co., Pa. CARBUNCLES LARGE AS HEN'S EGGS! EIGHT OR TEN YEARS AFFLICTED. TWO BOTTLES ONLY, CURE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Col. T.U. Fogg.] _Gentlemen_--For about eight or ten years my father was laid up with carbuncles, the worst that I ever saw. He tried everything he heard of, and his doctor did everything he could for him, but nothing did him any good. Had six or seven carbuncles at a time, as large as a hen's egg; he got so weak and suffered so much he could not walk a step. It was in the summer of '72 or '73 that he had his bed put in the middle of his chamber and got on it to die. No one expected him to get well. Looking over the newspapers, he saw your "Golden Medical Discovery" advertised, and the good it had done. There was not any sold then in the country, so he sent to Richmond--forty-five miles--and got a bottle. When he began to take it he was nearly covered with carbuncles--little and big together. Before he had taken half-a-bottle they began to go away. Before he had taken two bottles he was entirely cured, and he has never been bothered with them since. Every time he sees any sign of them, he gets a bottle of "Golden Medical Discovery" and it cures them. My father, Col. T.U. Fogg, lives in West Point, King William Co., Va. He is now seventy-eight years old, and enjoys good health. Yours truly, Mrs. NANNIE GOULDMAN, Beulahville, King William Co., Va. * * * * * THICK NECK. (GOITRE.) Thick neck, or goitre, also sometimes called bronchocele, consists of an enlargement of the thyroid gland, which lies over and on each side of the trachea, or windpipe, between the prominence known as "Adam's apple" and the breast bone. The tumor gradually increases in front and laterally, until it produces great deformity, and often interferes with respiration and the act of swallowing. From its pressure on the great blood-vessels running to and from the head, there is a constant liability to engorgement of blood in the brain, and to apoplexy, epilepsy, etc. When the enlargement once makes its appearance, it continues to increase in size as long as the person lives, unless appropriate treatment be resorted to. It never disappears spontaneously. These tumors are much larger than those not familiar with them would suppose from their outward appearance, as they extend under and are bound down by the muscles on each side of the neck, so that they become embedded in the cellular tissues underneath, while the sides of the neck retain, to a considerable extent, their round and even appearance, whereby the real magnitude of the tumor is not apparent. Figure 7 represents the appearance of the neck of a person afflicted with this disease. The form of protuberance varies materially with different persons, that shown in the engraving being the shape which it ordinarily assumes. [Illustration: Fig. 7.] The causes of the affection are not well understood. The use of snow-water, or water impregnated with some particular saline or calcareous matter, has been assigned as a cause. It has also been attributed to the use of water in which there is not a trace of iron, iodine, or bromine. A writer in a Swiss journal, _Feuilles d' Hygiene_, states that the disease is often due to an impeded circulation in the large veins of the neck, from pressure of the clothing, or from the head being bent forward, a position which is often seen in school children, when the muscles of the back of the neck have become fatigued. TREATMENT. We have obtained wonderful results by a new method of treatment, which consists in the employment of electrolysis in conjunction with other therapeutic means. There is scarcely a case in which this treatment, properly carried out, will not effect a radical cure. It is attended with no danger whatever. Those who are afflicted with this disease and unable to avail themselves of special treatment, cannot do better than to take Dr. Pierce's Alterative Extract, or Golden Medical Discovery, and apply to the skin over and around the tumor, night and morning the following solution which may be prepared at any drug store: iodine, one drachm; iodide of potassium, four drachms; dissolve in three ounces of soft water. Apply to the tumor twice a day, with a feather or hair pencil. MUMPS. (PAROTITIS.) This is an inflammation of the parotid glands and generally occurs in childhood. It is often epidemic, and is manifestly contagious. It usually, though not always, appears on both sides of the neck at the same time. SYMPTOMS. An external, movable swelling, just below and in front of the ear, near the angle of the jaw, is the prominent symptom. The enlargement is not circumscribed, but hard and painful, and attended with more or less fever, derangement of the secretions, and difficulty in swallowing. The swelling increases until the fourth and fifth day, when it gradually diminishes, and by the eighth or tenth is entirely gone. Sometimes the disease is accompanied by swelling of the breasts in the female, or the testicles in the male. TREATMENT. Usually but little treatment is necessary. Exposure to cold should be avoided. If severe or painful, with febrile symptoms, a hot foot-bath and small doses of the "Compound Extract of Smart-Weed," in some diaphoretic infusion, to induce sweating, together with small doses of aconite, will produce good results. If swelling of the testicles threatens (which seldom happens except on taking cold), resort should be had to mild cathartics, the spirit vapor-bath, stimulating liniments to the neck, and warm fomentations to the part attacked If delirium occurs, a physician should be summoned. INFLUENZA, OR LA GRIPPE. This is an infectious disease, characterized by depression, and usually associated with a catarrhal condition of the mucous membrane. It may affect the respiratory organs or the intestinal canal. There is a marked liability to serious complications, of which pneumonia is the most dangerous. The disease is evidently due to a specific virus of great infectiveness, and is more active and contagious at certain seasons and under certain conditions of the atmosphere. By some it has been supposed that it is due to a miasma in the air, but the character of its infection indicates that the true virus is of a germinal nature. Uncomplicated cases recover, but in the aged and in the delicate we may see fatal results, due usually to the profound depression or the high temperature to which the individual is subjected. There is much redness and swelling of the mucous membranes of the nose and throat--a bronchitis--and a catarrhal state of the stomach and intestines. These may all be present, or the disease may center upon one particular portion of the animal economy, and manifest its ravages there alone. SYMPTOMS. The attack usually resembles an ordinary catarrh of cold. In some cases the nasal catarrh is absent, or very mild, and the infection invades the general system, with much fever. A very striking manifestation of the disease is the severe nervous troubles which are present at the outset, consisting of headache, pain in the back and legs, and a general soreness of the muscles and bones as if bruised or beaten. The pulse is usually feeble and small--intermittent. The disease may center in the brain, producing delirium. Mental disorders are not uncommon, and there is usually following the disease more or less inaptitude for mental work and a tendency to depression of spirits. In many cases there is a severe diarrhea, and the individual suffers much from pain and discomfort in the abdomen. This is a gastro-intestinal irritation, and apparently favors an early recovery, and usually there are less severe sequels in such cases. The most dangerous complication is pneumonia. These cases may follow bronchitis, or the grip may begin with well-characterized symptoms of this disease, for which see the chapters upon this trouble. The sputa may not be rusty until after several days. The crisis is usually slow, and a considerable proportion recover, the disease frequently showing a sudden change for the better, and the patient being up and around in a few days. Cases complicated with pneumonia are the most indefinite in their symptoms, and require the closest attention. TREATMENT. In every case the disease must be regarded as a dangerous one, and the patient be confined to bed and indoors until all fever has disappeared, otherwise sudden and serious manifestations are liable to appear at any time. The patient must be well fed and nourished from the outset. The bowels should be acted upon by mild laxatives, such as castor oil or Dr. Pierce's Pleasant Pellets, using from one to three. It is also of advantage afterward to move them twice each day, by the injection of warm water, to which has been added a teaspoonful of table salt to each pint. This injected into the rectum, using the water slightly tepid, or cool if the patient is feverish, will tend to soften the actions from the bowels and favor the escape of poisonous matter. The cool water has also a soothing effect upon the fever and nervous system. If the fever is high, and there is delirium, small doses of aconite, with water, should be used every half hour or hour, but all depressing agents of this kind must be used with caution, as profound prostration sometimes develops. Warm baths, repeated frequently, and followed by hot lemonade, are of the greatest benefit in reducing the feverish condition and quieting the patient. The bed should be warmed after these are administered and the patient given hot lemonade to bring on free action of the skin, kidneys, and bowels. Where the pulse is weak, the free use of stimulants, as wine, coffee, tea, and brandy or whiskey, are required, as the great danger of the disease is a depression of the heart. In severe bronchitis, pneumonia, and other complications, appropriate treatment should be applied. * * * * * ACUTE NASAL CATARRH. Acute Nasal Catarrh, or cold in the head, is an acute inflammation of the mucous membrane lining the nasal passage which may confine itself to these parts or extend to the pharynx, larynx, and air-passages below, or affect the auxiliary sinuses or cavities communicating with the nasal passages. The most frequent cause of cold in the head is exposure to sudden changes in temperature, or draughts of cool air, without taking proper precaution to protect the body so as to prevent the rapid radiation of animal heat. In most cases there is an inherited tendency or acquired weakness, which frequently may be associated with a scrofulous condition of the whole system, that render these points less resistant, and consequently invite the morbid changes which result from exposure and cold. Acute Catarrh also occurs during the initial stage of such eruptive diseases as measles, typhus, typhoid, erysipelas, etc. Seldom do we meet with an otherwise healthy individual, who is subjected to a frequent cold in the head. Impure blood, inherited scrofulous taints, enfeebled circulation, debility, either general or nervous, are all advance agents, inviting catarrhal disease, and preventing rapid recovery from an acute attack, so that a low grade of Chronic Catarrh is generally the sequence. SYMPTOMS. The attack is visually ushered in by a chill, or chilly sensation, feeling of lassitude, followed by a slight fever. These symptoms are not as distressing as the sense of fullness about the eyes and frontal region, and prickling dry heat, with more or less obstruction in the nostrils. A few hours later follows a copious, acrid watery discharge, which gradually becomes thick and yellow. Often the inflammatory action may extend to the orifice of the eustachian tube, causing obstruction with temporary deafness, or ringing in the ears. Severe facial neuralgia may be caused by the pressure from the swollen parts upon the branches of sensitive nerves. TREATMENT. In the mild forms of acute catarrh, or coryza, only simple treatment is required. A hot foot-bath on retiring at night, with a full dose of Dr. Pierce's Compound Extract of Smart-weed, to produce free perspiration will generally break up the attack. Should the discharge from the nostrils continue, Dr. Sage's Catarrh Remedy should be freely used four to six times each day, until the symptoms are controlled. In case the bowels do not act, a full dose of Dr. Pierce's Pleasant Pellets may he taken at bed-time. Avoidance of exposure to cold, and light vegetable diet, are advisable. In the more severe attacks, especially when complicated by laryngeal or bronchial symptoms, the most decisive measures should be employed. The Compound Extract of Smart-weed should be taken freely, together with hot drinks, or a hot general bath. The patient should be warmly covered in bed to encourage a continued perspiration, to equalize the circulation, and subdue the inflammation. Dr. Pierce's Golden Medical Discovery should be taken in teaspoonful doses four times each day in all cases that are complicated or protracted. Individuals suffering from frequent colds will do wisely to fortify their systems by taking a few bottles of the "Golden Medical Discovery" to improve nutrition, purify the blood, and thus aid nature in overcoming such inherited tendency or required weakness as may be their misfortune to possess. Remember frequent attacks of Acute Catarrh prepare fertile soil for the chronic form which oftentimes is so loathsome and destructive. * * * * * CHRONIC NASAL CATARRH. OZAENA. In consequence of repeated attacks of acute catarrh, or "cold in the head," as it is usually termed, the mucous membranes of the nose and the air-passages of the head become permanently thickened, the mucous follicles or glands diseased, and their functions either destroyed or very much deranged. Although chronic catarrh is most commonly brought on in the manner above stated, it sometimes makes its appearance as a sequel of typhoid fever, scarlet fever, measles, or other eruptive fevers, or shows itself as a local manifestation of scrofulous or syphilitic taints in the system. Injury to the nose may result in a displacement of one or more of the bony structures, setting up a chronic inflammation with catarrh at that point. In the early stages of the disease, the patient may be annoyed with "only a slight dropping into the throat," as many express it, the amount of the discharges from the air-passages of the head at this stage of the disease being only slightly in excess of health. In some cases the discharge is thick, ropy, and tough, requiring frequent and strong efforts in the way of blowing and spitting, to remove it from the throat, in which it frequently lodges. In other cases, or in other stages of the same case, the discharge is thin, watery, acrid, irritating, and profuse. The nose may be "stopped up" from the swollen and thickened condition of the lining mucous membrane, so as to necessitate respiration through the mouth, giving to the voice a disagreeable nasal twang. From the nature of the obstruction in this condition, it is useless for the sufferer to endeavor to clear the passage by blowing the nose; this only tends to render a bad matter worse, by increasing the irritation and swelling of the already thickened lining membrane. The swelling of the mucous membrane does not in all cases become so great as to cause obstruction to respiration through the affected passages. In some cases, the patient suffers from head ache a great portion of the time, or experiences a dull, heavy, disagreeable fullness or pressure in the head, with a confusion of his ideas, which renders him quite unfit for business, especially such as requires deep thought and mental labor. Memory may be more or less affected, and the disposition of those who are otherwise amiable is often rendered irritable or morose and despondent. The mental faculties suffer to such an extent in some cases as to result in insanity. The sense of smell is in many cases impaired, and sometimes entirely lost, and the senses of taste and hearing are not unfrequently more or less affected. OZÆNA. The ulcerous or more aggravated stage of the disease, from the offensive odor that frequently attends it, is denominated _Ozæna_. The secretion which is thrown out in the more advanced stages of chronic catarrh becomes so acrid, unhealthy, and poisonous, that it produces severe irritation and inflammation, which are followed by excoriation and ulceration of the delicate membrane which lines the air-passages in the head. Although commencing in this membrane, the ulceration is not confined to it, but gradually extends in depth, until it frequently involves all the component structures of the nose--cartilage and bone, as well as fibrous tissues. As the ulceration extends up among the small bones, the discharge generally becomes profuse and often excessively fetid, requires the frequent use of the handkerchief, and renders the poor sufferer disagreeable to both himself and those with whom he associates. Thick, tough, brownish incrustations, or hardened lumps, are many times formed in the head, by the evaporation of the watery portion of the discharge. These lumps are sometimes so large and tough that it is with great difficulty that they can be removed. They are usually discharged every second, fourth, or fifth day, but only to be succeeded by another crop. Portions of cartilage and bone, or even entire bones, often die, slough away, and are discharged, either in large flakes, or blackened, half-decayed, and crumbly pieces; or, as is much more commonly the case, in the form of numerous minute particles, that escape with the discharge and are unobserved. It is painfully unpleasant to witness the ravages of this terrible disease, and observe the extent to which it sometimes progresses. Holes are eaten through the roof of the mouth, and great cavities excavated into the solid bones of the face; in such cases only the best and most through treatment will check the progress and fatal termination of the disease. COMPLICATIONS. Catarrh, or ozaena, is liable to be complicated, not only by the system, blood, and fluids, suffering from scrofulous or other taints, as has already been pointed out, but also by an extension of the diseased conditions to other parts beyond the air-passages of the head. Occasionally deformities of the septum or other internal structures also polypi or tumors, are sources of constant irritation and accelerate catarrhal disease. DISEASE OF THE THROAT. The acrid, irritating and poisonous discharge, which, in some stages of disease, almost constantly runs down over the delicate lining membrane of the _pharynx_ (throat), is liable to produce in this sensitive membrane a diseased condition similar to that existing in the air-passages of the head. The throat may feel dry, husky, and at times slightly sore or raw; or, from the muco-purulent discharge that is almost constantly dropping down over its surface, the patient may feel very little inconvenience from the disease of the throat until it is far advanced--the moistening and lubricating effect of the matter that drops on the surface tending to blunt the sensibility of the parts. (_See pharyngitis for symptoms and treatment_.) THE EXTENSION OF THE DISEASE TO THE LARYNX. The larynx, situated directly below the pharynx (throat), is subjected to the influence of the same irritation from acrid and poisonous discharges dropping into the throat from the head. More or less of it is removed by hawking and spitting, but some remains and is drawn into the larynx, or still lower into the trachea (windpipe), with the inspired air. Thus the disease creeps along the continuous mucous surfaces of the air-passages, the acrid poisonous discharge arousing in its track the irritation, inflammation, ulceration, and thickening of the lining membrane which characterize the disease in other portions of the air-passages. The symptoms and treatment of laryngitis will be found under its appropriate classification. BRONCHITIS AND CONSUMPTION. We have already detailed the manner in which the throat, larynx, and trachea, in succession, become affected from catarrh, or ozaena. By the same process of extension, the bronchial tubes, and lastly, the _parenchyma_, or substance of the lungs, in their turn, become diseased, and bronchitis and consumption are firmly established. Tightness in the chest, with difficulty of breathing; soreness; darting, sharp, or dull, heavy pain, or a prickly, distressing sensation, accompanied with more or less cough and expectoration--are evidences that the bronchial tubes have become affected, and they should admonish the sufferer _that he is now standing on the stepping-stone to_ CONSUMPTION, over which thousands annually tread, in their slow journey to the grave. [Illustration: Fig. 8. Internal and external ear. _1_, External ear. _2_, Internal auditory meatus. _3_, Tympanum. _4_, Labyrinth. _5_, Eustachian tube.] DEAFNESS. By means of a small canal, called the _eustachian tube_, an air-passage and communication between the throat and middle ear is formed. (See Fig. 8.) This passage is lined by a continuation of the mucous membrane which covers the throat and nasal passages. The catarrhal inflammatory process, by continuity of surface, follows the mucous membrane, thickening its structure, until the eustachian tube is closed, and the beautiful mechanism of the internal ear is rendered useless. While the thickening of the mucous membrane is going on, and the passage is gradually becoming closed (and the process sometimes extends through several years), the patient will occasionally, while blowing the nose, experience a crackling in one or both ears, and hearing becomes dull, but returns suddenly, accompanied with a snapping sound. This may be repeated many times, until, finally, hearing does not return, but remains permanently injured. In other cases the hearing is lost so gradually that a considerable degree of deafness may exist before the person is really aware of the fact. Either condition is often accompanied with noises in the head of every conceivable description, increasing the distress of the sufferer. The delicate bones of the ear are sometimes detached from their articulations, the drum is ulcerated and perforated, and through the orifice thus made, the bones or small _spiculæ_ may escape with the thick, purulent, and offensive discharge. CLOSURE OF THE TEAR DUCT. The lachrymal duct, or passage (tear duct), which, when in a healthy condition, serves to convey the tears from the eye into the nose, may be closed by the same inflammatory and thickening process which we have already explained. This condition is usually attended with watery and weak eyes, the tears escaping over the cheeks, and sometimes producing irritation and excoriation. The nasal branch of the ophthalmic nerve sometimes participates in the ulceration going on in the head, so that the eyes are sympathetically affected. They sometimes become congested or inflamed, and sharp pain in the eyeballs may be experienced. INDIGESTION, DYSPEPSIA, ETC. A large portion of the acrid, poisonous, purulent discharge, which drops into the throat during sleep, is swallowed. This disturbs the functions of the stomach, causing weakness of that organ, and producing indigestion, dyspepsia, nausea, and loss of appetite. Many sufferers complain of a very distressing "gnawing sensation" in the stomach, or an "all gone," or "faint feelings," as they often express it. SYMPTOMS. Dull, heavy headaches through the temples and above the eyes; indisposition to exercise; difficulty of thinking or reasoning, or concentrating the mind upon any subject; lassitude; indifference respecting business, lack of ambition or energy; obstruction of nasal passages; discharges voluntarily falling into the throat, sometimes profuse, watery, acrid, thick and tenacious, mucous, purulent, muco-purulent, bloody, concrete blood and pus, putrid, offensive, etc. In others, a dryness of the nasal passages: dry, watery, weak, or inflamed eyes; ringing in the ears, deafness, discharge from the ears, hawking and coughing to clear the throat, ulcerations, death and decay of bones, expectoration of putrid matter, _spiculæ_ of bones, scabs from ulcers leaving surface raw, constant desire to clear the nose and throat, voice altered, nasal twang, offensive breath, impairment or total deprivation of the sense of smell and taste, dizziness, mental depression, loss of appetite, nausea, indigestion, dyspepsia, enlarged tonsils, raw throat, tickling cough, difficulty in speaking plainly, general debility, idiocy, and insanity. All the above symptoms, as well as some others which have been previously given, and which it is not necessary here to repeat, are common to this disease in some of its stages or complications; yet thousands of cases annually terminate in consumption or chronic bronchitis, and end in the grave, without ever having manifested one-half of the symptoms enumerated. VARIETIES. People often suppose that there are a great many varieties or species of catarrh. This is an error. The nature of the disease is the same in all cases, the symptoms only varying with the different stages of the disorder, and the various complicated conditions which are liable to arise, and which have already been pointed out. CAUSES. Anything which debilitates the system, or diminishes its powers of evolving animal heat and withstanding cold or sudden changes of atmospheric temperature, and other disease-producing agencies, renders the individual thus enfeebled very liable to catarrh. Among the most common debilitating agencies are a scrofulous condition of the system, or other impurities of the blood, exhaustive fevers, and other prostrating acute diseases, or those badly treated; exhaustive and unnatural discharges, intemperance, excessive study, self-abuse, adversity, grief, want of sleep, syphilitic taints of the system, which may have been contracted unknowingly, or may have been inherited, having perhaps been handed down even unto the third or fourth generation, to an innocent posterity from infected progenitors; too sudden rest after great and fatiguing exercise, and living in poorly-ventilated apartments. These are among the most fruitful causes of those feeble, deranged, or impure conditions of the system to which catarrh so frequently owes its origin. Although the immediate or exciting cause is generally repeated attacks of "cold in the head," which, being neglected or improperly treated; "go on from bad to worse," yet the predisposing or real cause of the disease is in the majority of cases, an enfeebled, impure, or otherwise faulty condition of the system, which invites the disease, and needs only the irritation produced in the nasal passages by an attack of cold, to kindle the flame and establish the loathsome malady. Some people are convinced with difficulty that there exists in their system a weakness, impurity, or derangement of any kind, which permitted the disease to fasten itself upon them. They may not feel any great weakness, may not have any pimples, blotches, eruptions, swellings, or ulcers, upon their whole person; in fact, nothing about them that would, except to the skilled eye of the practical and experienced physician, indicate that their system is weakened or deranged with bad humors; and yet such a fault may, and GENERALLY DOES, exist. As an ulcer upon the leg, or a "fever-sore," or an eruption upon the skin, may be the only outward sign of a fault in the system, so frequently chronic catarrh is the only sign by which a bad condition of the system manifests itself in a manner that is perceptible to the sufferer himself, or to the non-professional observer. The finely-skilled physician, whose constant practice makes his perceptive faculties perfect in this direction, would detect the constitutional fault, as an experienced banker detects a finely-executed and dangerous bank-note which the unpracticed eye would pronounce genuine. [Illustration: Fig. 9. Examination of the Nasal Passages by means of the Rhinoscope and Head Mirror.] TREATMENT. If you would remove an evil _strike at its root_. As the predisposing or real cause of catarrh is, in the majority of cases, some weakness, impurity, or otherwise faulty condition of the system, in attempting to cure the disease our chief aim must be directed to the removal of that cause. The more we see of this odious disease, the more so we the importance of combining; with the use of a local, soothing and healing application, a thorough and persistent internal use of blood-cleansing and tonic medicines. As a local application for healing the diseased condition in the head, Dr. Sage's Catarrh Remedy is beyond all comparison the best preparation ever invented. It is mild and pleasant to use, producing no smarting or pain, and containing no strong, irritating, or caustic drug, or other poison. Its ingredients are simple and harmless, yet when scientifically and skillfully combined, in just the right proportions, they form a most wonderful and valuable healing medicine. Like gunpowder, which is formed of a combination of saltpeter, sulphur, and charcoal, the ingredients are simple, but the product of their combination is wonderful in its effects. The Remedy is a powerful antiseptic, and speedily destroys all bad smell which accompanies so many cases of catarrh, thus affording great comfort to those who suffer from this disease. The reader's mind cannot be too strongly impressed with the importance of combining thorough constitutional with the local treatment of this disease. Not only will the cure be thus more surely, speedily, and permanently, effected, but you thereby guard against other forms of disease breaking out, as the result of humors in the blood or constitutional derangement or weakness. In curing catarrh and all the various diseases with which it is so frequently complicated, as throat, bronchial, and lung diseases, weak stomach, catarrhal deafness, weak or inflamed eyes, impure blood, scrofulous and syphilitic taints, the wonderful powers and virtues of the "Golden Medical Discovery" cannot be too strongly extolled. It has a specific effect upon the lining mucous membranes of the nasal and other air passages, promoting the natural secretion of their follicles and glands, thereby softening the diseased and thickened membrane, and restoring it to its natural, thin, delicate, moist, healthy condition. As a blood-purifier, it is unsurpassed. As those diseases which complicate catarrh are diseases of the lining mucous membranes, or of the blood, it will readily be seen why this medicine is so well calculated to cure them. The "Golden Medical Discovery" is the natural "helpmate" of Dr. Sage's Catarrh Remedy. It not only cleanses, purifies, regulates, and builds up the system to a healthy standard, and conquers throat, bronchial, and lung complications, when any such exist, but, from its specific effects upon the lining membrane of the nasal passages, it aids materially in restoring the diseased, thickened, or ulcerated membrane to a healthy condition, and thus eradicates the disease. When a cure is effected in this manner it is permanent. The system is so purified, regulated, and strengthened, as to be strongly fortified against the encroachments of catarrh and other diseases. The effects of the "Golden Medical Discovery" upon the system will be gradual, and the alterative changes of tissue and function generally somewhat slow. They are with however, less complete, radical, and lasting; and this constitutes its great merit. Under its influence all the secretions are aroused to carry the blood-poisons out of the system, the nutrition is promoted, and the patient finds himself gradually improving in flesh; his strength is built up, his lingering ailments dwindle away, and by and by he finds his whole person has been entirely renovated and repaired he feels like a new man--a perfect being. [Illustration: Fig. 10. Atomizer. ] THE CLOTHING. With most persons suffering from chronic nasal catarrh, there is a great disposition to take cold, even slight cause being sufficient to produce an acute attack, which greatly aggravates the chronic affection and operates to render it permanent. To obviate the bad effects that are liable to result from this predisposition, great attention should be paid to the clothing, that it thoroughly protects the person from sudden changes of temperature. For more particular and practical suggestions in regard to this matter, the reader is referred to the article on Clothing, in Part Two, Chapter II, of "The People's Common Sense Medical Adviser." THE DIET has an important influence with this disease, as with consumption and many other chronic ailments. It should be largely composed of those articles rich in the non-nitrogenized or carbonaceous elements. Fat meats, rich, sweet cream, good butter, and other similar articles of food, should comprise a large part of the diet. These elements, which are prolific in the production of animal heat counteract the predisposition to take cold, and thus become most valuable remedial agents--not less essential than the medical treatment that has been advised. The patient, suffering from chronic catarrh, should study well the hygienic teachings to be found in Part Two of "The People's Common Sense Medical Adviser," and govern himself accordingly. TREATMENT OF COMPLICATIONS. There are various complications of this disease that require modifications of the treatment to meet them successfully. The rules cannot be made that would enable non-professional readers to vary the treatment to suit peculiarities of constitution, or complications of the disease. When consulted, either the person or by letter, we have been able to so modify the treatment as to be adopt it to peculiar individuals which rejected the ordinary treatment, and have thus cured hundreds who had otherwise failed to find relief. [Illustration: Fig. 11. Steam Atomizer, illustrating position of head during treatment.] TIME REQUIRED IN EFFECTING A CURE. Reader, if you suffer from chronic nasal catarrh, do not expect to be very speedily cured, especially if your case is one of long standing. Unprincipled quacks and charlatans, who possess no knowledge of disease, or medicine either, and whose sole design is to palm off upon you a bottle or two of some worse than worthless strong, caustic solution, irritating snuff, or drying "fumigator," "dry up," "annihilator," "carbolated catarrh cure," "catarrh specific," or other strong preparation, will tell you that the worst cases can be _speedily_ cured by these unreasonable means. It is true that such strong, irritating, and drying preparations will many times suddenly arrest the discharge from the nose, but the thickened or ulcerated condition of the lining mucous membrane, which really constitutes the disease, is not removed by such treatment, and the discharge soon comes on again. Besides, there is danger attending the employment of such strong, irritating, or drying preparations. The disease, by their use, is frequently driven to the throat, bronchial tubes, lungs, or brain, and thus a bad matter is made worse. Not less irrational and unsuccessful is the plan of treating the disease with inhalations of "carbolized iodine," and other drags, administered through variously-devised pocket and other inhalers. Such treatment may mask or cover up catarrh for a time; but, by reason of the constitutional nature of the disease, it cannot effect a perfect and permanent cure. Dr. Sage's Catarrh Remedy, on the other hand, cures the disease on common-sense, rational, and scientific principles, by its mild, soothing, and healing properties, to which the disease gradually yields, when the system has been put in perfect order by the use of "Golden Medical Discovery." This is the only perfectly safe, scientific, and successful mode of acting upon and healing it. Without, we trust, being considered egotistical, we can say that this opinion is based upon a large experience and a perfect familiarity with the nature and curability of the disease. For many years our whole time and attention has been given to the study and cure of catarrh and other chronic diseases treated of in "The People's Common Sense Medical Adviser." Cases of catarrh have been treated by thousands, and our medicines for the cure of this loathsome disease, and of other chronic diseases, have met with an extensive sale in all parts of the United States, and have found their way into many foreign countries. The universal satisfaction with which their use has been attended, and the grateful manifestations received from the cured, have afforded one of the greatest pleasures of our lives. Scarcely a mail arrives that does not bring new testimony of cures effected by the treatment here recommended. DIRECTIONS FOR USING DR. SAGE'S CATARRH REMEDY. To prepare the medicine ready for use, put the whole quantity of powder contained in the package, as put up for sale, into a bottle; pour into it one pint of cool, soft water. Rain water or melted snow is good. Ordinary lake, river, well or spring water will do if only _slightly_ hard. Cork the bottle tightly and shake it thoroughly, after which allow it to stand six or eight hours to settle. Two of the ingredients of which the remedy is composed do not entirely dissolve, but their medicinal properties are completely and speedily extracted and taken up by the water. These settlings have lost their medicinal properties and should not be allowed to enter the nasal cavity. It should be kept tightly corked, not allowing it to freeze in winter, or be kept where it is very warm in summer. This we term the "Catarrh Remedy Fluid." Use the fluid, prepared according to the above directions, not less than three or four times a day, the last time just before retiring, in the following manner: Without shaking the bottle to roll the fluid, pour out a teaspoonful or more into the hollow of the hand, hold it there until warmed; first gently, and afterwards forcibly, snuff the fluid up one nostril and then the other, until the nose is well filled and it passes back into the throat. No fears need be entertained that it will produce strangling or any unpleasant effect in thus using it, for, unlike any other fluids (simple tepid water not excepted), it does not produce the slightest pain or disagreeable feeling, but, on the contrary, leaves such a cooling, pleasant sensation that its use soon becomes a pleasure rather than a task. In a few minutes after thus using the remedy, it should be blown out gently (never forcibly), to clear the nose and throat of all hardened crusts and offensive accumulations, if any such exist. Never blow the nose violently, as it irritates the passages and counteracts, to some extent, the curative effects of the remedy. This process should be repeated until the remedy has been thoroughly applied two or three times, not blowing it out the last time of using it, but retaining the medicine in contact with the affected parts for a considerable length of time. No harm can result if the fluid be swallowed, as it contains nothing poisonous or injurious. A BETTER WAY. The manner of using Dr. Sage's Catarrh Remedy, advised above, is somewhat imperfect and not nearly so thorough a mode as the one to which the reader's attention will now be directed. In a very large number of bad cases of catarrh, or those of long standing, the disease has crept along and extended high up in the nasal passages, and into the various sinuses or cavities, and tubes communicating therewith. The act of snuffing the fluid _carries it along the floor of the nose and into the throat_, but does not carry it _high enough_, or fill the passages _full enough_, to reach all the chambers, tubes, and surfaces, that are affected with the disease. The fluid may seem, from the sensation produced, to pass high up between the eyes, or even above them, but it does not. It is only a sensation transmitted to these parts by nerves, the filaments of which are distributed to that portion of the mucous membrane which the fluid does not reach, just as a sensation is transmitted to the little finger by a blow upon the elbow. Now, in order to be most successful in the treatment of catarrh, it is necessary that _the remedy should reach and be thoroughly applied to all the affected parts_. This can be accomplished in only one way, which is by _hydrostatic pressure_. The anatomy of the nasal passages, and the various chambers and tubes that communicate therewith, is such that they cannot be reached with fluid administered with any kind of syringe or inhaling tube, or with any instrument, except one constructed to apply it upon the principle above stated. Such an instrument is Dr. Pierce's Nasal Douche. By the use of this instrument, the fluid enters every portion of the air-passages of the head by its own weight, no snuffing being required. DIRECTIONS FOR USING DR. SAGE'S CATARRH REMEDY WITH THIS INSTRUMENT. [Illustration: Fig. 12. This cut illustrates the manner of using Dr. Pierce's Nasal Douche.] To cleanse out the passages previous to applying the Catarrh Remedy fluid, take one quart of soft water, add to it two large tablespoonfuls of common salt, and shake it up occasionally until all is dissolved. Before use heat it until blood warm, or, in other words, until it gives a pleasant, mild warmth to the inserted finger. Put the reservoir on a shelf, or hang it up, so that it will be a little higher than the head: fill the reservoir with salt and water, pressing the tube between the thumb and finger so as to prevent the fluid from escaping through it; introduce the nozzle at the end of the tube into one nostril, pressing it in far enough to close the entrance of the passage so that no fluid can escape by the side of the tube, breathe through the mouth, avoid swallowing, and allow the fluid to flow. The soft palate, by the act of breathing through the mouth, is elevated so as to completely close the passage into the throat, and thus the fluid is made to flow up one nostril in a gentle stream, to pass into and thoroughly cleanse all the sinuses, or cavities, connected with the nasal passages, and to flow out of the other nostril. The douche should not be employed unless both nostrils are open and the flow is free. If the head is "stopped up," snuff up the warm liquid from the hand occasionally, until the passages are open and you can breathe freely through both nostrils. Do not forget that the instrument will not work properly unless you _breathe through the mouth and avoid swallowing_ while the fluid flows. Fill the reservoir a second time with the simple salt and water, and, inserting the nozzle into the nostril out of which the fluid flowed on using it the first time, pass the current through in the opposite direction; that is, so that it will flow out of the nostril into which it flowed the first time of using it. After having thus thoroughly cleansed the passages, fill the instrument half full or more with the "Catarrh Remedy Fluid," prepared as heretofore directed, and warmed to a moderate temperature, and pass this through the nose in the same manner as directed for the salt water. The salt water is not curative, but is milder than simple water, and is, therefore, preferable for cleansing the passages. On first commencing the use of the instrument, it is best to hang it only a very little higher than the forehead, but after using it a few times, put it up about as high as the length of the tube will admit. Let no one entertain any feeling of timidity on commencing the use of this instrument, as its operation is perfectly simple and harmless, and, with the fluids which we recommend, is never attended with any strangling, choking, pain, or other disagreeable sensations. The medicine should be applied with the Douche at least twice a day, in the morning and at night on retiring. There is no advantage in using the medicine oftener than three times a day, when used with the instrument, but a _sufficient_ quantity should be used each time to medicate all the diseased parts. If any remains in the Douche it may be poured back into the stock solution for subsequent use, but a liquid that has once passed through the nasal cavity contains the germs of the disease and must not be used a second time. * * * * * NASAL POLYPUS. The term Nasal Polypus is usually given to a variety of growths which are met with in the nasal passages far more frequently than any other tumors. They are thus designated because of their fancied resemblance to the aquatic polypus. They occur singly, or in clusters, as illustrated in Fig. 13. In the early stages the mucous membrane is swollen and irregularly dilated, presenting a rough and mottled appearance not unlike chronic catarrh with which they are usually associated. Gradually these mound-like tumors enlarge, usually becoming pendulant, and presenting a grayish opaque glistening surface, similar to the pulp of a grape. Occasionally they become massive at the point of attachment, and assimilate a warty or cauliflower growth. The latter variety is better supplied with blood vessels and presents a red or dark pink surface and may bleed on slight irritation. The favorite location is beneath or behind the middle or superior turbinated bodies, oftentimes nearly or quite concealed. However, no portion of the mucous membrane lining the upper air passages is exempt. Sometimes they grow from the roof of the nostril and pharnyx in pendulous masses, assuming the shape of the cavities, filling the entire nostril and upper portion of pharnyx. The mucous membrane covering the turbinated bodies may become dilated and swollen, finally developing by catarrhal processes into a polypus at that point. (See _H_, Fig. 13.) [Illustration: Fig. 13. NASAL POLYPI. _A_. Anterior opening of the nostril. _B_. Soft Palate, _C_. Orifice of the Eustachian tube. _D, D_. Superior and inferior turbinated bodies. _E_. Large Polypus. _F_. Several small Polypi. G. Throat. _H_. Polypoid growth on turbinated body.] CAUSES. Nothing definitely is known regarding their causation. They are generally supposed to originate in some constitutional derangement, impairing the nutrition of the mucous membranes. Other cases are closely associated with chronic nasal catarrh, and frequent attacks of cold in the head. SYMPTOMS. These may vary considerably in different cases due to the character and location of the polypus. In the early stages before the tumor is well developed, the symptoms may be those of nasal catarrh, and the diagnosis of polypus be possible only after a personal examination by a skillful specialist. Neither is the size of the polypus always in proportion to the severity of the symptoms. The nasal discharge is generally increased and of a variable character. As the tumors enlarge they cause a sense of fullness and weight between and below the eyes, with more or less headache and facial neuralgia. There is partial or complete obstruction of one or both nostrils. In some cases the obstruction changes from one nostril to the other when lying down; the stoppage generally being on the side toward the pillow. A polypus located at the junction of the nasal passages and throat by force of gravity always causes obstruction to the lower nasal cavity when lying down. Polypi often attain considerable size and by pressure upon and displacement of the surrounding structures occasion hideous facial deformity. Changes in the weather often aggravate the symptoms. By blowing the nostril the tumor sometimes may be forced forward, so that it may be seen a short distance from the anterior opening of the nostril. The _voice_ is often affected, being muffled or harsh in tone, similar to that which accompanies a cold in the head. _Respiration_ may be considerably embarrassed, due to the obstruction in the nasal passages, and the patient necessarily resorts to mouth breathing. In advanced cases the Larnyx is usually much congested, being constantly irritated, not only reflexly through the nervous system, but directly by the inspired air, and excoriating discharges dropping in the throat from behind the palate. Thus it is plain to understand how chronic Pharyngitis, Laryngitis, Bronchitis, and Asthma may result from a small polypus in the nasal cavity. TREATMENT. In mild cases correcting the constitutional derangement may check the morbid process in the nostrils and cause absorption of the polypus growth. For this purpose Dr. Pierce's Golden Medical Discovery is unequaled. The removal of the polypus may sometimes be accomplished by snuffing powdered blood-root. When these measures fail it is necessary to seek surgical assistance. After the removal of the polypus Dr. Sage's Catarrh Remedy should be used to prevent a recurrence. OUR OPERATION FOR NASAL TUMORS. Having operated with unvarying success upon a very large number and variety of nasal tumors at the Invalids' Hotel and Surgical Institute we are positively assured that the means and methods which we employ are neither severe or dangerous; _no pain_, consequently _no shock_; recovery rapid and permanent. Many forms of injection and local treatment are in use for the removal of nasal polypi, none of which have proven to be curative; recurrence of the tumor many times following such treatment. Many cases have presented themselves after having been treated by the heroic method of seizing the polypus with a pair of forceps and forcibly tearing it loose, bringing with it segments of healthy tissue, leaving bone exposed, and a ragged, uneven surface of diseased membrane. It is much easier to properly treat a case from the beginning than to undertake it in such a rendition. Owing to the fact that these nasal tumors grow directly from the lining membranes it is necessary not only to thoroughly remove the tumor but to treat the diseased membrane at the point from which the polypus springs; otherwise another tumor may develop at the same point. The nasal passage having been thoroughly anæsthetized, or benumbed, by the use of cocaine, the nasal speculum is introduced, and by means of reflected light from the head mirror worn by the operator, the interior of the nostril is brought into view. (See Fig. 9, p. 479.) Often the attachment of the growth is entirely hidden behind the irregular bony structures of the nostril so that it requires the skill of an expert specialist, deft in the manipulation of these parts, to operate properly. Many styles and shapes of delicately devised instruments are necessary to completely remove the growth without doing injury to the adjacent structures. By our newly devised operation the tumor is at once removed, without pain, and with the loss of only a few drops of blood. Further, because the tumor is entirely removed and the base properly treated there is not the offensive discharge for a long time afterward and the danger from infection and blood-poison to which the patient is subjected in other forms of treatment. In conclusion we would say that we claim for our operation the following points that are worthy of the careful consideration of every one who may be so unfortunate as to require the services of a specialist for the removal of growths in the nasal or upper air passages. 1st. Our operation is absolutely painless. 2d. No chloroform or ether is required. 3d. We insure perfect removal of growth. 4th. There is no injury to other adjacent structures. 5th. The operation is bloodless. 6th. The recovery is rapid. 7th. There is no slough to produce pus that may be absorbed and cause blood-poisoning. * * * * * DEFORMITY OF THE NASAL SEPTUM. In health the nasal septum is a bony or cartilaginous plate, as shown in _A_, Fig. 14, dividing the nasal passages into two cavities of the same size and shape. This plate or partition is also a support to which the flexible structures which form the tip of the nose are attached. In early life the septum is flexible and may be bent or doubled by injury to the nose; but owing to its elasticity usually resumes its natural position and shape. After maturity any dislocation or change in this bony plate usually remains permanent unless some means are employed for its correction. In a limited number of cases supposed to be chronic nasal catarrh, we have found upon examination that one or both nasal cavities were more or less obliterated and obstructed by the deformed and thickened septum. (See _A_, Fig. 15.) Many of these cases date from an injury to the external parts, causing only bleeding from the nose and a slight pain for a short time. Chronic inflammation develops at the point where the bone is bent or cracked, resulting in thickening, often producing nodules or spur-like projections which not only interfere with nasal breathing, but also act as irritants to the adjacent delicate membranes and produce many of the symptoms common to nasal catarrh. [Illustration: Fig. 14. Anterior view of the healthy nasal passages as seen with the projecting portion of the nose removed. _A._ Vertical septum or bony plate separating nostrils. _B, B._ Turbinated bodies. _C, C._ Nasal passages.] Among other common causes are unequal or imperfect development of the nasal bones, due to an inherited strumous tendency and local ulcerative disease, weakening or destroying the bone. SYMPTOMS. The location and extent of the deformity of the nasal septum necessarily gives opportunity for a variety of symptoms. In aggravated cases the nose appears to be bent toward one side. In the earlier stages there is an excess of mucous secretion, often dropping into the throat from behind the palate. The discharge is variable as in nasal catarrh with more or less difficult nasal breathing, the stoppage changing from one nostril to the other. Sneezing and frequent attacks of nose bleed are often common symptoms. The tendency of the disease is to extend backward often causing headache, deafness, roaring in the ears and post-nasal disease which results in a chronic sore throat, the latter disease often being the one for which the patient seeks advice. If allowed to progress uninterruptedly the throat gradually becomes more irritable, associated with an annoying cough, and the voice becomes harsh and has a nasal tone. The general health is impaired, the nervous system excitable; laryngitis, asthma, and lung disease become complications, which render the existence of the individual miserable. TREATMENT. In mild cases where the deformity is slight, and the obstruction is not a constant symptom, the nasal cavities should be cleansed (See treatment of nasal catarrh) after inhaling dust, and special attention given to the prompt treatment of cold in the head. Should there be irritability, sneezing, or a constant discharge, it is advisable to use Dr. Sage's Catarrh Remedy as directed on p. 483 to soothe the excitability and lessen the inflammatory action in and about the thickened and deformed septum. As an auxiliary to promote the absorption of the thickened tissues and restore them to a healthy activity, a number of bottles of the "Golden Medical Discovery" should be taken while using the local treatment. Any dormant condition of the liver or digestive tract may be corrected by taking Dr. Pierce's Pleasant Purgative Pellets. In advanced cases after the structures are so diseased and thickened that it renders local treatment hopeless, only surgical interference can prove curative. OUR PAINLESS OPERATION. By the application of a few drops of a solution of cocaine in the nostril, at the point to be treated, we are now able to produce such local anæsthesia as to render the operation entirely painless without the administration of either chloroform or ether. This is an important consideration as many are adverse to taking chloroform or ether, and now that we possess an agent that produces, locally, complete insensibility to pain, we are very glad to dispense with their use in all such minor operations. There is no pain caused even by the application of the cocaine to deaden the sensibility of the part. Many examinations of the upper air-passages heretofore very annoying and even painful to the patient and sometimes unsatisfactory, are rendered entirely painless, and carried out with a thoroughness that would be impossible without the use of this wonderful agent. Not only in surgery of the nose and throat, but alike in other departments, our surgeon-specialists employ the same local anæsthetic in all minor operations, none of which are attended with the least pain. Our specialists were among the first surgeons in this country to employ this newly-discovered anæsthetic. We regard it as a great boon to our patients, and never withhold it in any case where it can be employed to prevent suffering. Its use is attended with no danger, nor is it followed by bad or disagreeable results. OUR OPERATION. [Illustration: Fig. 15. Anterior view of deformed nasal passages as seem with the projecting portion of the nose removed. _A._ Deformed and thickened septum or bony plate separating nostrils. _B,B._ Irregular and obstructed nasal passages. _C._ Diseased and swollen turbinated body. _D,D._ Turbinated bodies crowded back by septum.] The nostrils being the entrance to and the beginning of the air passages no dexterity and skill can be spared in treating and properly correcting any deformity that may exist. Mutilation of these sensitive structures is sure to be followed by serious reflex symptoms in adjacent parts. Consequently cases of this nature should only be entrusted to the care of a competent and experienced specialist. Our resources and appliances are unlimited and seldom do we use the surgeon's knife in a case of this nature. As in the treatment of other pathological growths in the upper air passages the rhinoscope is indispensable. The parts can only be brought into the view of the operator by means of this instrument and sets of mirrors to reflect light on all sides of the deformed and hidden parts. By our operation both nasal cavities are restored to their normal size and contour (compare Figs. 14, 15), unhealthy and diseased tissues are removed, and free nasal respiration established. All treatments are carried out under strict aseptic precautions, thus reducing the danger from absorption of poisonous secretions to the minimum. By our skillful and ingenious management of these cases we never have had a single patient manifest any serious symptoms after operation. In such cases we consider this the only safe, practical, and permanent cure. Every year hundreds pass out of existence the victims of incurable disease of the air-passages resulting from morbid nasal conditions, who might be saved by proper and timely treatment. * * * * * PHARYNGITIS AND POST-NASAL CATARRH. [Illustration: Fig. 16. Use of the Post-nasal Syringe in the treatment of Post-nasal Catarrh. _A_. Tongue. _B_. Epiglottis. _C_. Soft palate. _D_. Anterior opening of the nostril. _E,E,E._ Turbinated bodies. _F_. Junction of the nasal passage and throat. _G_. Diseased and roughened mucous membrane. _H_. Throat or Pharynx. _I, I_. Interior of nasal passage.] Simple chronic pharyngitis seldom exists alone and uncomplicated; most cases being the result of previous existing disease of the nasal or post-nasal passages. Many cases are associated with hypertrophy, or enlargement, of the tonsils. Usually the disease is located in the upper part of the pharynx, or throat, behind and above the uvula and soft palate, and is thus hidden from view when looking into the throat through the mouth. When not associated with nasal catarrh the common symptoms are dropping of tenacious mucous in the throat, causing a constant desire to hawk and spit; sense of dryness in this region; cough and expectoration on rising in the morning, which is due to the irritability of the throat, and may invade the lower air-passages. The throat may be studded with red and thickened patches of its mucous membrane. Respiration may be embarrassed, the voice affected and the general health gradually decline. The membrane above and behind the palate is angry, reddened, thickened and roughened, as represented in _G_, Fig. 16. TREATMENT To rationally treat a disease, attack the cause. Therefore, in an uncomplicated case of post-nasal disease of the pharynx the medicine should be applied at this point. For this purpose we recommend the regular and continuous use of Dr. Sage's Catarrh Remedy administered preferably by means of the post-nasal syringe as illustrated in Fig. 16. The efficacy of Dr. Sage's Catarrh Remedy as a curative agent in catarrh of mucous membranes is unequaled if the medicine be properly and thoroughly applied. The Catarrh Remedy fluid should be prepared as directed in the pamphlet which accompanies the medicine. Warm enough of the medicine to fill the syringe twice. After the syringe is filled with the warm medicine, introduce the curved tip behind the soft palate, holding the syringe as seen in Fig. 16, then incline the head forward over a wash bowl and empty the syringe by pressing the plunger quickly. The medicine will immediately come in contact with the diseased surfaces and pass out through the nostrils, thoroughly medicating, disinfecting and cleansing the upper part of the throat and the posterior region of the nostrils. Two syringes of the medicine should be used for each treatment, and two or more applications made every day until a cure is effected. At the same time the local treatment is being used, Dr. Pierce's Golden Medical Discovery should be taken to act through the blood upon the diseased tissues. The Catarrh Remedy may be administered by means of the Nasal Douche, if the case is complicated by nasal catarrh. Should tumors or deformities exist, it is advisable to consult a specialist. * * * * * ENLARGED TONSILS. Chronic enlargement of the tonsils, as shown in Fig. 17, _A A_, is an exceedingly common affection. It is most common to those of a scrofulous habit. It rarely makes its appearance after the thirtieth year, unless it has been imperfectly cured. Both tonsils are generally, though unequally enlarged. A person affected with this disease is extremely liable to sore throat, and contracts it on the slightest exposure; the contraction of a cold, suppression of perspiration, or derangement of the digestive apparatus being sufficient to provoke inflammation. CAUSES. Repeated attacks of quinsy, scarlet fever, diphtheria, or scrofula, and general impairment of the system, predispose the individual to this disease. SYMPTOMS. The voice is often husky, nasal or guttural, and disagreeable. When the patient sleeps, a low moaning is heard, accompanied with snoring and stentorian breathing, and the head is thrown back so as to bring the mouth on a line with the windpipe, and thus facilitate the ingress of air into the lungs. When the affection becomes serious it interferes with breathing and swallowing. The chest is liable to become flattened in front and arched behind, in consequence of the difficulty of respiration, thus predisposing the patient to pulmonary disease. On looking into the throat, the enlarged tonsils may be seen, as in the Fig. 17. Sometimes they are so greatly increased in size that they touch each other. [Illustration: Fig. 17. _A. A._ Enlarged Tonsils. _B_. Elongated Uvula.] TREATMENT. The indications to be carried out in the cure of this malady are: (1.) To remedy the constitutional derangement. (2.) To remove the enlargement of the tonsilar glands. The successful fulfillment of the first indication may be readily accomplished by attention to hygiene, diet, clothing, and the use of Dr. Pierce's Golden Medical Discovery, together with small daily doses of his "Pleasant Pellets." This treatment should be persevered in for a considerable length of time after the enlargement has disappeared, to prevent a return. To fulfill the second indication, astringent gargles may be used. Infusions of witch-hazel or cranesbill should be used during the day. The following mixture is unsurpassed: iodine, one drachm; iodide of potash, four drachms; pure, soft water, two ounces. Apply this preparation to the enlarged tonsils twice a day, with a probang, or soft swab, being careful to paint them each time. A persevering use of these remedies, both internal and local, is necessary to reduce and restore the parts to a healthy condition. Sometimes the enlarged tonsils undergo calcareous degeneration; in this case, nothing but their removal by a surgical operation is effectual. This can be readily accomplished by any competent surgeon. We have operated in a large number of cases, and have never met with my unfavorable results. The method we adopt at the Invalids' Hotel and Surgical Institute for the removal of diseased tonsils is, like other minor operations, painless. The patient is not required to take chloroform or ether. When the enlarged gland is once thoroughly removed the disease seldom returns. ELONGATION OF THE UVULA. Chronic enlargement, or elongation of the uvula or soft palate, as shown at _B_ in Fig. 17, may arise from the same causes as enlargement of the tonsils. It subjects the individual to a great deal of annoyance by dropping into or irritating the throat. It causes tickling and frequent desire to clear the throat, also change, weakness and loss of voice, and often gives rise to a very persistent and aggravating cough. Constriction of the throat, cough and difficult breathing are more prominent symptoms in complicated cases. TREATMENT. The treatment already laid down for enlarged tonsils, with which affection, elongation of the uvula is so often associated, is generally effectual. When it has existed for a long time, and does not yield to this treatment it may be removed by any competent surgeon. * * * * * CHRONIC LARYNGITIS. This is of much more frequent occurrence than the acute form, and is often associated with tubercular affections, and constitutional syphilis. It is characterized by an inflammatory condition, ulceration, or hardening of the mucous membrane of the larynx, most frequently the latter. There is also a chronic form, known as _follicular laryngitis_, or _clergymen's sore throat_, to which public speakers are subject. THE CAUSES of chronic laryngitis are various, as prolonged use of the vocal organs in reading or speaking; using them too long on one pitch or key, without regard to their modulation; improper treatment of acute diseases of the throat; neglected nasal catarrh; the inordinate use of mercury; syphilis; repeated colds which directly cause sore throat, injuries, etc. It is also frequently due to tubercular deposits, and in these cases it generally terminates in consumption. SYMPTOMS. The affection often comes on insidiously. There is soreness of the throat, noticeable particularly when speaking, and immediately thereafter; a "raw" and constricted feeling, leading to frequent attempts to clear the throat, in order to relieve the uneasy sensation. The voice becomes altered, hoarse, and husky, and there is a slight, peculiar cough, with but little expectoration. At first, the matter expectorated is mucus, but as the disease advances, and ulceration progresses, it becomes muco-purulent, perhaps lumpy, bloody, or is almost wholly pure pus. The voice becomes more and more impaired, and is finally lost. In the latter stages, it resembles consumption, being attended with hectic fever, night-sweats, emaciation, cough, profuse expectoration, and sometimes hemorrhage. TREATMENT. The patient should avoid using his voice as much as possible. At the same time, attention should be paid to the diet, the bathing, and the clothing. Every thing should be done that is calculated to build up and improve the general health. Dr. Pierce's Golden Medical Discovery is well adapted to remove morbid states of the disease, in consequence of its direct action on the mucous membranes of the air-passages, and its efficacy in allaying irritation of the laryngeal, pharyngeal, and pneumogastric nerves. It should be perseveringly employed. Iodine inhalations, administered with the pocket inhaler, illustrated by Fig. 3, and the application of tincture of iodine to the forepart of the neck, are efficacious in many cases. Inhalations of chloride of ammonia, administered with a steam-atomizer, Fig. 11, in the form of spray, are frequently of great benefit. _Perseverance_ is necessary, and the afflicted are cautioned against discontinuing the treatment too soon, for the disease is very liable to return. * * * * * CONSUMPTION. PHTHISIS PULMONALIS. By this we understand a constitutional affection, characterized by a wasting away of the body, attended by the deposition of tubercular matter into the lung tissue. Hence the appellations, _Phthisis Pulmonalis; Pulmonary Tuberculosis; Tubercular Consumption_. Tubercles may form in other organs and result in a breaking down of their tissues, but the employment of the term _Consumption_ in this article is restricted to the lungs. The general prevalence, the insidious attack, and the distressing fatality of this disease, demand the special attention and investigation of every thinking person. It preys upon all classes of society. Rich and poor alike furnish its victims. Some idea of its prevalence may be formed when we consider that, of the entire population of the globe, one in every three hundred and twenty-three persons annually dies of consumption. It may not be definitely known just what proportion of all the deaths in this country and Europe occurs from this one disease. Those who have gathered statistics differ somewhat, some claiming one-fourth, while others put the ratio at one-sixth, one-seventh, and even as low as one-ninth. A fair estimate, and one probably very near the truth, would be one-sixth or one-seventh of the whole number. In New York City, for five consecutive years, the proportion was three in twenty. In New England, about twenty thousand annually succumb to this destroyer, and in the State of New York as many more. These figures may appear to be exaggerations, but investigations of the subject prove them to be the simple truth. Epidemics of cholera, yellow fever, and other diseases of similar character, so terrible in their results, occasion wide-spread alarm, and receive the most careful considerations for their prevention and cure, while consumption receives scarcely a thought. Yet the number of their victims sinks into insignificance when compared with those of consumption. Like the thief in the night, it steals upon its victim unawares. In a large proportion of cases, its approach is so insidious that the early symptoms are almost wholly disregarded; indeed, they excite but little, if any, attention, and perhaps for a time disappear altogether. Thus the patient's suspicions, if they have been aroused, are allayed and appropriate measures for his relief are discontinued. This may be the case until renewed attacks firmly establish the disease, and before the patient is fully aware of the fatal tendency of his malady, he is progressing rapidly towards that "bourne from which no traveler returns." As has already been stated, consumption is a constitutional disease, manifested by feeble vitality, loss of strength, emaciation--symptoms which are too often classed under the name of _general debility_, until local symptoms develop, as _cough, difficult breathing_, or _hemorrhage_, when examination of the chest reveals the startling fact that tubercular deposits have been formed in the lungs. Invalids are seldom willing to believe that they have consumption, until it is so far advanced that all medicine can do is to smooth the pathway to the grave. Another characteristic of this disease is _hope_, which remains active until the very last, flattering the patient into expectation of recovery. To the influence of this emotion, the prolongation of the patient's life may often be attributed. NATURE OF THE DISEASE. It is an error to suppose that the disease under consideration is confined to the lungs. "Pulmonary Consumption," as has been remarked, "is but a _fragment_ of a great constitutional malady." The lungs are merely the stage where it plays its most conspicuous part. Every part of the system is more or less involved, every vital operation more or less deranged; especially is the _nutritive_ function vitiated and imperfect. The circulation is also involved in the general morbid condition. Tubercles, which constitute a marked feature of the disease, are composed of unorganized matter, deposited from the blood in the tissue of the lungs. They are small globules of a yellow, opaque, friable substance, of about the consistency of cheese. After their deposition, they are increased in size by the accretion of fresh matter of the same kind. They are characteristic of all forms of scrofulous disease. The most plausible theory in regard to them is, that they are the result of imperfect nutrition. Such a substance cannot be produced in the blood when this fluid is perfectly formed. It is an unorganized particle of matter, resulting from the imperfect elaboration of the products of digestion, which is not, therefore, properly fitted for assimilation with the tissues. The system being unable to appropriate it, and powerless to cast in off through the excretory channels, deposits it in the lungs or other parts of the body. There it remains as a foreign substance, like a splinter or thorn in the flesh, until ejected by suppuration and sloughing of the surrounding parts. It might be supposed by some that when the offending matter was thus eliminated from the lungs, they would heal and the patient recover; but, unfortunately, the deposition of tubercular matter does no cease. Owing to the morbid action of the vital forces, it is formed and deposited as fast or faster than it can be thrown off by expectoration. Hence arises the remarkable fatality of pulmonary consumption. CAUSES. The causes of consumption are numerous and varied, but may all be classed under two heads, viz: _Constitutional_, or _predisposing_, and _local_, or _exciting_. Of just what tubercular matter consists, is still a subject of controversy, but that its existence depends upon certain conditions, either _congenital_ or _acquired_, is generally conceded; and one of these conditions is impaired vitality. Constitutional predisposition must first give rise to conditions which will admit of the formation of tubercular matter, before any cause whatever can occasion its local deposition. It must modify the vitality of the whole system, when other causes may determine in the system thus impaired, the peculiar morbid action of which tubercular matter is the product. The general division of causes into predisposing and exciting, must ever be more or less arbitrary. Individuals subject to predisposing causes may live the natural term of life and finally die of other disease. Indeed, when predisposing causes are known to exist, they should constitute a warning for the avoidance of other causes. Again, among the so-called exciting causes, some may operate in such a manner, with some individuals, as to predispose them to consumption, and the result will be the same as if the disposition had been congenital. The causes which in one individual are _exciting_, under other circumstances and in other individuals, would be _predisposing_, because they act so as to depress the vitality and impair the nutritive processes. THE PREDISPOSING CAUSES, then, are hereditary predisposition, scrofula, debility of the parents, climatic influences, sedentary habits, depressing emotions, in fact, _anything_ which impairs the vital forces and interferes with the perfect elaboration of nutritive material. THE EXCITING CAUSES are those which are capable of arousing the predisposing ones into activity, and which, in some instances, may themselves induce predisposition; as dyspepsia, nasal catarrh, colds, suppressed menstruation, bronchitis, retrocession of cutaneous affections, measles, scarlatina, malaria, whooping-cough, small-pox, continued fevers, pleurisy, pneumonia, long-continued influence of cold, sudden prolonged exposure to cold, sudden suspension of long-continued discharges, masturbation, excessive venery, wastes from excessive mental activity, insufficient diet, both as regards quantity and quality, exposure to impure air, atmospheric vicissitudes, dark dwellings, dampness, prolonged lactation, depressing mental emotions, insufficient clothing, improper treatment of other diseases, exhaustive discharges, tight lacing, fast life in fashionable society, and impurity and impoverishment of blood from any cause. This list might be greatly extended, but the other causes are generally in some manner allied to those already named. SYMPTOMS. The symptoms of consumption vary with the progress of the disease. Writers generally recognize three stages, which so gradually change from one to the other that a dividing line cannot be drawn. As the disease progresses, new conditions develop, which are manifested by new symptoms. Prior to the advent of pulmonary symptoms, is the latent period, which may extend over a variable length of time, from a few months to several years; and, indeed, may never be developed any farther. Until sufficient tubercular matter has been deposited in the lungs to alter the sounds observed on auscultation and percussion, a definite diagnosis of tubercular consumption cannot be made, even though there may have been hemorrhage. Nevertheless, when we find _paleness, emaciation, accelerated and difficult breathing, increased frequency of the pulse, an increase of temperature_, and _general debility_ coming on gradually without any apparent cause, we have sufficient grounds for grave suspicions. These are increased if tenderness under the collar-bone, with a slight, hacking cough is present. These symptoms should be sufficient to warn any individual who has the slightest reason to believe that he is disposed to consumption, to lose no time in instituting the appropriate hygienic and medical treatment, for it is at this stage that remedies will be found most effective. Unfortunately, this period is too apt to pass unheeded, or receive but trifling attention; the patient finds some trivial excuse for his present condition, and believes that he will soon be well. But, alas for his anticipations! The disease goes onward and onward, gradually gaining ground, from which it will be with great difficulty dislodged. The cough now becomes sufficiently harassing to attract attention, and is generally worse in the morning. The expectoration is slight and frothy; the pulse varies from ninety to one hundred and twenty beats in a minute, and sometimes even exceeds this. Flushes of heat and a burning sensation on the soles of the feet and palms of the hands are experienced. A circumscribed redness of one or both cheeks is apparent. These symptoms increase in the afternoon, and in the evening are followed by a sense of chilliness more or less severe. The appetite may be good, even voracious; but the patient remarks that his food "does not seem to do him any good," and, to use a popular expression, "he is going into a decline." As the strength wanes the cough becomes more and more severe, as if occasioned by a fresh cold, in which way the patient vainly tries to account for it. Expectoration increases, becomes more opaque, and, perhaps, yellow, with occasionally slight dots or streaks of blood. The fever increases, and there is more pain and oppression of the chest, particularly during deep respiration after exercise. Palpitation is more severe. There may now be night-sweats, tire patient waking in the morning to find himself drenched in perspiration, exhausted, and haggard. Bleeding from the lungs occurs, and creates alarm and astonishment, often coming on suddenly without warning. The hemorrhage usually ceases spontaneously, or on the administration of proper remedies, and in a few days the patient feels better than he has felt for some time previously. The cough is less severe, and the breathing less difficult. Indeed, a complete remission sometimes occurs, and both patient and friends deceive themselves with the belief that the afflicted one is getting well. After an indefinite length of time, the symptoms return with greater severity. These remissions and aggravations may be repeated several times, each successive remission being less perfect, each recurrence more severe, carrying the patient further down the road toward the "dark valley." Now the cough increases, the paroxysms become more severe, the expectoration more copious and purulent, as the tubercular deposits soften and break down. The voice is hollow and reverberating, the chest is flattened, and loses its mobility; the collar-bones are prominent, with marked depression above and below. Auscultation reveals a bubbling, gurgling sound, as the air passes through the matter in the bronchi, with the click, to the air cells beyond. Percussion gives a dull sound or if there are large cavities, it is hollow, and auscultation elicits the amphoric sound, as of blowing into a bottle. Hectic fever is now fully established; the eye is unusually bright and pearly, with dilated pupils, which gives a peculiar expression; the paroxysms of coughing exhaust the patient, and he gasps and pants for breath. The tongue now becomes furred, the patient thirsty, the bowels constipated, and all the functions are irregularly performed. Another remission may now occur, and the patient be able to resume light employment, for an indefinite length of time, which we have known to extend over three or four years, when the symptoms again return. If the patient is a female, and deranged or suppressed menstruation has not marked the accession of pulmonary symptoms, the flow now becomes profuse and clotted, or is scanty and colorless, sometimes ceasing altogether. In the male, the sexual powers diminish, and copulation is followed by excessive and long-continued prostration. From this time onward, the progress of the disease is more rapid. The liver and kidneys are implicated. In addition to the pallor, the complexion becomes jaundiced, giving the patient, who is now wasting to a mere skeleton, a ghastly look. The urine is generally copious and limpid, though occasionally scanty and yellow. The pulse increases to one hundred and thirty or one hundred and forty beats in the minute, and is feeble and thread-like. The cough harasses the patient so that he does not sleep, or his rest is fitful and unrefreshing; whenever sleep does occur, the patient wakes to find himself drenched with a cold, clammy perspiration. The throat, mouth, and tongue now become tender, and occasionally ulcerate. Expectoration is profuse, purulent, and viscid, clinging tenaciously to the throat and mouth, and the patient no longer has strength to eject it. The hair now falls off, the nails become livid, and the breathing difficult and gasping; the patient has no longer strength to move himself in bed and has to be propped up with pillows, and suffocates on assuming the recumbent position. Drinks are swallowed with difficulty. Diarrhea takes the place of constipation. The extremities are cold, swollen, and dropsical; the voice feeble, hollow, grating, husky, the patient gasping between each word; the respiration is short and quick. A slight remission of these symptoms occurs. The patient is more comfortable, lively, cheerful, and perhaps forms plans for the future. But it is the last effort of expiring vitality, the last flicker of the lamp of life, the candle burns brilliantly for a moment, and with one last effort goes out, and death closes the scene. The duration of the active stage of consumption varies from a few weeks to several years, the average time being about eighteen months. _Cough_ is always a prominent symptom throughout the entire course of the disease, varying with its progress. _Expectoration_, at first scanty, then slightly increased, colorless, frothy, and mucous, is also a characteristic. After a time it becomes opaque, yellow, and more or less watery; then muco-purulent and finally purulent, copious, and viscid. When tubercular matter is freely expectorated, with but little mucus, it sinks in water. This symptom continues to the very last. _Haemoptysis_ (bleeding from the lungs) may occur at any stage of the disease, often being the first pulmonary symptom noticed, again being delayed until late; and there are cases in which it does not happen at all. It seldom occurs in any other disease. _Night-sweats_ may occur at any stage, though they are rarely experienced until the disease is pretty well established, and are very exhausting. _Hectic Fever_ generally occurs soon after the pulmonary symptoms are developed, and increases in intensity with the progress of the disease. There are usually two paroxysms in twenty-four hours, one of which occurs towards evening and is followed by night-sweats. _Dyspnoea_ (difficult breathing) is at first slight, except after exertion, amounting to only a sense of oppression; but it becomes more and more severe as the disease advances, until the very last, when it is agonizing in the extreme. _Aphthæ_, sometimes extending to the pharynx and larynx, generally occurs towards the last. The mouth and throat become so very sore and tender that nourishment and medicine are taken with difficulty. _Emaciation and Debility_ are characteristic of the disease. They fluctuate as the disease advances or is retarded, increasing to the very last. _Auscultation and Percussion_ constitute valuable means of diagnosis from the time tubercular matter begins to be deposited to the very last, and, when correctly practiced, reveal the extent and progress of the disease. As a knowledge of the sounds elicited can only be acquired by practical experience with proper instruments, they will not be described here. The only diseases with which consumption is likely to be confounded are general debility in the early stage, bronchitis, chronic pleurisy, chronic pneumonia, and abscess in the lungs, after the advent of pulmonary symptoms. CURABILITY. Notwithstanding the prevailing opinion that consumption is incurable, there exists ample, incontrovertible evidence to the contrary. Its curability is established beyond the shadow of a doubt. Individuals have recovered in whom there was extensive destruction of pulmonary tissue, and, indeed, entire destruction of one lung. Numerous instances are on record in which persons have suffered from all the symptoms of confirmed consumption, and have regained their health and subsequently died of other diseases. The case of the late Dr. Joseph Parish, of Philadelphia, affords a striking example of this kind. In early life, he manifested all the symptoms of confirmed consumption, including frequent hemorrhages, yet he fully regained his health, and, after a very useful life, died at an advanced age of another disease. Post-mortem examination revealed the existence of cicatrices, or scars, in his lungs where tubercular matter had been deposited. Dr. Wood, in his Practice of Medicine, mentions another instance of a medical gentleman in Philadelphia, who in early life suffered from consumption with hæmoptysis, from which he recovered, and afterwards died, at an advanced age, of typhoid fever, when the knife revealed the presence of cicatrices. Post-mortem examinations of individuals who have died of other diseases, have revealed, in numerous instances, the presence of consumption at some period of their existence. In these cases the lungs were perfectly healed by cicatrization, or by the deposit of a chalky material. A French physician made post-mortem examinations of one hundred women, all of whom were over sixty years of age, and who had died of other diseases, and in fifty of them he found evidences of the previous existence of consumption. Professor Flint says that consumption sometimes terminates in recovery, and that his observations lead him to the conclusion that the prospect of recovery is more favorable in cases characterized by frequent hemorrhages. Drs. Ware and Walshe are also led to the same conclusion. Professor J. Hughes Bennett, of Edinburgh, has thoroughly investigated the subject, and adds his testimony to that of others, citing numerous cases that have resulted in perfect recovery. If such testimony is not sufficient, we may mention the following, whose names are well known and respected in professional circles, and all of whom declare that consumption is a curable disease. The list includes Laennec, Andral, Cruveilhier, Kingston, Presat, Rogée, Boudet, and a host of others. No farther back than 1866, on page 145, of the proceedings of the Connecticut Medical Society, we find "Observations, Ante-mortem and Post-mortem, upon the case of the late President Day by Prof. S.G. Hubbard, M.D., New Haven," from which we learn that Jeremiah Day, LL. D., who was for twenty-nine years President of Yale College, was, while a mere youth, a victim of pulmonary consumption. During his infancy and boyhood his vitality was feeble. He entered Yale College as a student in 1789, "but was soon obliged to leave the institution on account of pulmonary difficulty, which was doubtless the incipient stage of the organic disease of the lungs which subsequently developed itself." He remained in feeble health for two years, but returned to college, and graduated in 1797. For the next six years his lung difficulties were quite severe, and he repeatedly bled in large quantities, but he had so far recovered in 1803, as to accept a Professorship. He was afterwards chosen President of the college, which office he held for many years, in the enjoyment of good health. He died from "old age," as we are told, in 1867, aged 94 years. Statistics show that under the improved methods of treating this disease, the mortality, as compared with previous years, has been greatly reduced. Clinical observation proves that injuries to the lungs are not so fatal as was once supposed. TREATMENT. The earlier the treatment of this disease is undertaken, the greater is the probability of success. The reason of this is obvious; at first the disease is general or constitutional, but as it advances, by the deposit of _tubercular matter_, it becomes both constitutional and local. Hence the treatment must be both _general_ and _local_. The occurrence of certain prominent and distressing symptoms, either from the natural progress of the disease, or from complications with other affections, often renders it difficult, even for physicians, to determine how far their treatment should be general and how far local. Treating the symptoms instead of the general disease, or treating the constitutional disease without regard to the symptoms which arise from it, is an error into which many physicians have fallen. The constitutional affection, the local manifestations and complications, and the circumstances and individual peculiarities of the patient, must all be carefully considered; bearing in mind all the while, that tubercular matter is the product of a morbid action, which, in every case, must exist before its deposition in the lungs, or any other tissue, can take place. In every case in which curative treatment is to be instituted, the hearty and persistent co-operation of both patient and friends is absolutely necessary; and the treatment, which is both hygienic and medical in character, should have in view the following aims: (1.) The avoidance of the causes concerned in the production and perpetuation of the disease. (2.) The restoration of healthy nutrition, in order to stop the formation of tuberculous matter. (3.) The arrest of the abnormal breaking down of the tissues, and the prevention of emaciation. (4.) The relief of local symptoms, and the complications arising from other diseases. The fulfillment of the first indication, the avoidance of causes, is of the utmost importance, for if they have been sufficient to _produce_ the disease, their continued operation must certainly be sufficient to _perpetuate_ it. A single individual is very often subjected to the operation of several of the causes already enumerated, some of which, in consequence of circumstances and surroundings, are unavoidable. Of these, the one most difficult to overcome is climate; _i.e._ the frequent variations of temperature. Upon the subject of climate much has been written. But that which is best adapted to the cure of consumption, is that which will enable the patient to pass a certain number of hours every day in the pure open air, without exposure to sudden alterations of temperature. There are very few persons who change their place of residence, except as a last resort, when the disease is in the last stage. It is then productive of little or no good. This is one reason why so many people having consumption die in Florida, and other warm countries. If a change of climate is to be effected at all, it should be made early. The most powerful stimulant to health is well-regulated exercise. It assists the performance of every function, and is of paramount importance to promote good digestion and proper assimilation, conditions essential for recovery. It should not, however, be carried beyond the powers of endurance of the individual, so as to exhaust or fatigue. Everything that can invigorate should be adopted; everything that exhausts should be shunned. To fulfill the second indication, to restore healthy nutrition, requires not only a proper diet, both as regards quantity and quality, but demands that the integrity of the organs concerned in the process of digestion and assimilation, shall be maintained at the highest standard of perfection possible. That the diet be sufficient in quantity should be obvious to all. It is also necessary that it be nutritious, and that it should contain carbonaceous elements. Food of a starchy or saccharine character is apt to increase acidity, and interfere with the assimilation of other elements, therefore, articles, rich in fatty matters, should enter largely into the diet. The articles of food best adapted to the consumptive invalid are milk, rich cream, eggs, bread made from unbolted wheat-flour, and raised with yeast, cracked wheat, oatmeal, good butter, beef, game, and fowls. These contain the necessary elements for assimilation. Oily food is of great importance, and the beef eaten should contain a good proportion of fat. Plenty of salt should always be eaten with the food, and a desire for it is often experienced. Over-eating should be avoided, lest the stomach be induced to rebel against articles of diet rich in important elements. Derangement of the process of nutrition requires careful attention, and, if necessary, correction. For this purpose, nothing can excel Dr. Pierce's Golden Medical Discovery. It increases the appetite, favors the nutritive transformation of the food, enriches the blood, and thus retards the deposition of tubercular matter. It is so combined that, while it meets all these indications, it relieves or prevents the development of those distressing symptoms so common in this disease. The "Golden Medical Discovery" is adapted to fulfill the third indication in the management of this disease, which is to check the abnormal breaking down and waste of tissues, which constitute such a prominent feature in this malady. The antiseptic properties of the "Discovery" are unmistakably manifested in preventing such abnormal decomposition. The emaciation, excessive expectoration, profuse perspiration, diarrhea, and hectic fever, common to consumption, are all due to a too rapid disintegration and waste of the tissues. It is in this condition of the system that this medicine, by its powerful antiseptic properties, manifests its most wonderful curative ability. When, as in this disease, the vital forces of the system have, in a degree, lost their restraining influence over the processes of disintegration, waste, and decay, which goes on so rapidly that nutrition cannot compensate for the loss to the system, then it is that the "Golden Medical Discovery," by its antiseptic influence, checks this rapid waste of the tissues, and thus arrests the disease. To the lack of employment of such a remedy in the treatment of consumption, the unparalleled fatality of the disease is largely due. In their anxiety to improve digestion and nutrition, and thus build up the tissues, physicians often lose sight of the no less important indication of restraining the destructive waste going on in the system, which overbalances the supplies furnished by absorption. The gradually increasing emaciation and loss of strength render perpetuity of the organism impossible. The fulfillment of the fourth indication, to relieve local symptoms, and the complications with other diseases, is often attended with no little difficulty. _The Cough_ is a secondary symptom, arising from the irritation caused by the tubercular deposits. Medicated inhalations may give temporary relief, but cannot cure it. They strike at the branches of the disease, while the root is left to flourish and develop new branches. Expectorants have been employed to a great extent, and the theories, which have been advanced in favor of their use, are sometimes very ingenious. That they modify the cough, we do not attempt to deny; but it is usually at a great expense, for they derange the stomach and interfere with digestion and assimilation. Improvement of the general health is always attended with amelioration of the cough. If the patient did not cough at all, the lungs would soon fill up with broken-down tissue, and death from suffocation would result. Irritation of the nerves supplying the lungs sometimes occurs, and causes the patient to cough immoderately, when it is not necessary for the purpose of expectoration. This condition is readily controlled by Dr. Pierce's Golden Medical Discovery, which exerts a decidedly quieting and tonic influence upon the pneumogastric nerve, which, with its ramifications, is the one involved. An infusion of the common red clover, in tablespoonful doses, will also be found a valuable adjunct in overcoming this condition. _Hoemoptysis_. Hemorrhage from the lungs is generally sudden and unexpected in its attack, though sometimes preceded by difficulty of breathing, and a salty taste in the mouth. Although it _very rarely_ destroys life, it often occasions alarm. Common table salt, given in one-fourth to one-half teaspoonful doses, repeated every ten or fifteen minutes, is generally sufficient to control it. Ligatures applied to the thighs and arms, sufficiently tight to arrest the circulation of blood in the veins, but not tight enough to impede it in the arteries, is a useful proceeding. Ergot, in teaspoonful doses of the fluid extract, hamamelis, and gallic acid, all are valuable for this purpose. _Night-sweats_ can only be regarded as a symptom of weakness, and are to be remedied by an improvement of the general health. Bathing in salt water is sometimes attended with good results. The practice of giving acids for this symptom can only be regarded as irrational. It may arrest the sweating, but it will do harm in other ways. Belladonna, given at bed-time, is an effectual remedy. _Frequency of the pulse_ is generally a prominent symptom in this disease. It sometimes points to a condition of sufficient importance to require a remedy. Although the "Golden Medical Discovery" is combined to meet this condition, its value may be greatly enhanced by adding one-half to one teaspoonful, according to the urgency of the case and the frequency of the pulse, of the fluid extract of _Veratrum Viride_ to each bottle. The benefit of this, when persisted in, will be apparent in the amelioration of all the symptoms, and in the general improvement. This fluid extract can be had at any drug store. _Diarrhea_ is sometimes a troublesome symptom, and particularly so in the latter stages of the disease. It is generally due to acidity of the alimentary canal, to which the treatment must be directed. Great care should be taken in the selection of the diet to improve the quality and avoid everything which disagrees with the patient. Improve digestion by every possible means. Carbonate of soda and rhubarb, in the form of a syrup, are sometimes excellent. The Compound Extract of Smart-weed, in small doses, will generally diminish the frequency of the discharges. _Derangement of the Liver_ is often a complication requiring attention, and the timely relief of which goes very far in ameliorating the general condition of the patient. The "Golden Medical Discovery" is generally sufficient to relieve this complication. Its influence, however, may be considerably increased in this direction by the use of Dr. Pierce's Pleasant Pellets, according to the directions which accompany them. They should only be taken in the smallest doses, one or two "Pellets "every day, just enough to produce a natural movement of the bowels each day. _Uterine Derangements_. In the female, derangement of the menstrual function is generally an early complication of consumption, if indeed it does not occur at the outset. It deserves early attention, and, in addition to the remedies already advised, Dr. Pierce's Favorite Prescription is so compounded as to meet the requirements of this condition, and at the same time exert a favorable influence upon the constitutional disease. The numerous reports of cures of well-developed cases of Consumption to be found in the back portion of this little treatise must be sufficient, it seems to us, to convince the most skeptical of the wonderful power which Dr. Pierce's Golden Medical Discovery exercises over this terribly fatal malady. As will be noted, many of the cases there reported had long been unsuccessfully treated with cod liver oil emulsion and all the other usual remedies employed by the profession and were fast running down. "Golden Medical Discovery" aroused the stomach and liver, and started all the nutritive functions into action, whereby digestion and nutrition were promoted and both the strength and flesh steadily built up. The reader will bear in mind, that most of the cases hereinafter reported, were pronounced Consumption by their attending physicians as well as by us. It cannot be said, therefore, that we exaggerate the malady and that the cases were merely bad, lingering coughs. Thousands, whose maladies have been pronounced genuine Tubercular Pulmonary Consumption, (Phthisis Pulmonalis) by eminent physicians have been _perfectly_ and _permanently_ cured by the use of Dr. Pierce's Golden Medical Discovery. It can, therefore, no longer be doubted that this wonderful compound is far superior as a remedy for Consumption to cod liver oil, compound Hypophosphites, and the many other agents so highly extolled, and so generally prescribed for this fatal malady by even the more progressive and advanced of the medical profession of our day. Read the letters received from grateful patients who have been cured and note how many commend the use of "Golden Medical Discovery," as a "last resort," after their home physicians had exhausted all their skill and resources in vain. * * * * * CHRONIC BRONCHITIS. This is a subacute or chronic form of inflammation of the mucous membrane of the bronchial tubes, of a very persistent character and variable intensity. There are few diseases which manifest a greater variety of modifications than this. SYMPTOMS. The symptoms of this disease vary greatly with its violence and progress. Cough is always present, and is very often the first symptom to attract the patient's attention. It is usually increased by every slight cold, and with each fresh accession becomes more and more severe, and is arrested with greater difficulty. The cough is always persistent, sometimes short and hacking, at other times deep, prolonged, and harsh. Sometimes it is spasmodic and irritating and particularly so when it is associated with affections of the larynx, or with asthma, involving irritation of the branches or the filaments of the pneumogastric nerve. When the chronic follows the acute form of the disease, or follows inflammation of the lungs, the expectoration may be profuse from the first, and of a yellowish color and tenacious character. When the disease arises from other causes, the expectoration is generally slight at first, and the cough dry or hacking. This may continue some time before much expectoration occurs. The expectorated matter is at first whitish, opaque, and tenacious, mixed sometimes with a frothy mucus, requiring considerable coughing to loosen it and throw it off. As the disease progresses, it becomes thicker, more sticky, of a yellowish or greenish color, mixed with pus, and sometimes streaked with blood. In the latter stages, it becomes profuse and fetid, and severe hemorrhage may occur. Sometimes the cough and expectoration disappear when the weather becomes warm, to appear again with the return of winter, which has gained for it the appellation of _winter cough_. The sufferers feel as if something was bound tightly round them, rendering inhalation difficult. Soreness throughout the chest is often a persistent symptom, especially when the cough is dry and hard. Behind the breast-bone there is experienced a sense of uneasiness, in some cases amounting to pain, more or less severe. As the disease progresses, the loss of strength is more and more marked, the patient can no longer follow his usual employment, his spirits are depressed, and he gradually sinks, or tubercular matter is deposited in the lungs, and consumption is developed. TREATMENT. Thorough attention to hygiene, with the avoidance of the causes concerned in the production and perpetuation of the disease, is necessary. The patient must be protected from the vicissitudes of the weather by plenty of clothing; flannel should be worn next to the skin, with a pad of flannel or buckskin over the chest, and the feet should be kept warm and dry. Exercise in the open air is essential. When the weather is so cold as to excite coughing, something should be worn over the mouth, as a thin cloth, handkerchief, muffler, or anything which will modify the temperature of the atmosphere before it comes into contact with the mucous lining of the lungs. Good ventilation of sleeping-rooms is all-important; not that the air should be cold, but that it should be as pure as possible. The diet must be nutritious, cabonaceous, and of sufficient quantity. Beef, milk, rich cream, plenty of good butter, eggs, fish, wheat bread from unbolted flour, supply the appropriate alimentary substances for perfect nutrition and the maintenance of animal heat. To overcome the modified form of inflammation in the bronchial tubes, all sources of irritation should be avoided, as the inhalation of dust, or excessively cold air. It is in the cure of severe and obstinate cases of this disease that Dr. Pierce's Golden Medical Discovery has achieved unparalleled success, and won the highest praise from those who have used it. Its value will generally be enhanced in treating this complaint by adding one-half a teaspoonful of the fluid extract of _Veratrum Viride_ to each bottle. This can be added by any respectable druggist. Especially should it be thus modified if the pulse be accelerated so as to beat ninety or a hundred times in a minute. The "Golden Medical Discovery" should be taken in teaspoonful doses, repeated every two hours. When the cough is dry and hard, with no expectoration, it arises from irritation of some of the branches of the pneumogastric nerve, which this remedy will relieve. It may, however, be aided by inhaling the hot vapor of vinegar and water, or vapor from a decoction of hops, to which vinegar has been added. The use of Dr. Pierce's Golden Medical Discovery should be _persisted_ in, taking it in frequent doses, every two or three hours, and keeping up its use until the disease yields and is perfectly stamped out. Do not expect a formidable disease of perhaps weeks' or months' duration to be _speedily_ cured. Chronic diseases are generally slow in their inception and development and can only be cured by gradual stages. Perseverance in treatment is required. Many invalids do not possess the strength of purpose--the will power--to continue the use of the "Golden Medical Discovery" long enough to receive its full benefits. It is worse than useless for such to commence its use, for without persistency it cannot be expected to cure such obstinate maladies as chronic bronchitis. * * * * * ASTHMA. PHTHISIC. One of the most distressing ailments with which the human family is afflicted is asthma. Its symptoms are not to be mistaken. Suddenly and without apparent provocation the patient experiences the greatest difficulty in breathing. When warning is given, there is usually a sense of fullness in the stomach, flatulence, languor, and general nervous irritability. The countenance is a picture of anxiety and horror. The difficulty of breathing increases and the struggle for air commences. Windows and doors are thrown open, fans used, and, utterly regardless of consequences, the sufferer passes the whole night in exposure and torture, even though the temperature be below zero. Fearing suffocation, the patient dare not lie down; he rushes to the window for air, rests his head upon a table or chair, or upon his hands, with the elbows upon the knees, jumps up suddenly and gasps and struggles for air. The eyes are prominent and the veins of the forehead distended with blood; sometimes the bowels are relaxed. The urine is colorless and is passed in copious quantities. This symptom indicates great excitement of the nervous system. The voice is hoarse, articulation difficult, breathing limited, noisy and wheezy. The _wheezing_ is pathognomonic of the disease. It can only be confounded with croup, and then only in the young. In croup there is pain and difficulty in swallowing, fever and cough, which are usually absent in asthma. A severe paroxysm of asthma is very distressing to witness, and one unused to it might well suppose the sufferer to be in his last agonies. No definite limit can be assigned to the duration of the attack or of the disease. It may last but a few minutes, may endure for hours, or with slight remission continue for days. The condition of the patient may be for years as changeable as the pointings of the weather-vane. In fact, the atmosphere has much to do with the disease. With every approaching storm, with every cloud of dust, even the dust from sweeping a room, with every foul odor, and, in some more sensitive organizations, with even the perfume of flowers, a paroxysm is provoked. Truly he is a "child of circumstances," a veritable football upon the toes of every atmospheric disturbance. UNPARALLELED SUCCESS. Persons affected with asthma or phthisic are numerous. With such an amount of suffering in our midst is it not a marvel, if not a disgrace, that the medical profession of to-day endorse the opinions of a half century ago and pronounce it incurable, rather than make stupendous and laudable efforts to discover plans of medication that will result in certain and permanent cure? Almost single handed we undertook this field of investigation, and we take pleasure in reporting that our labors have been crowned with success. The large experience furnished us has led to the discovery of remedies for this distressing malady of more than ordinary efficacy. Through the agency of these means we have been enabled to cure hundreds, who had suffered untold tortures for twelve, fifteen, or twenty-five years. Some whom we have been successful in curing had suffered from childhood to middle and even old age. The treatment of asthma, or phthisic, still continues to be a prominent specialty at the Invalids' Hotel and Surgical Institute. NATURE OF THE DISEASE. As to the exact pathological condition in this malady, opinions differ. Some physicians consider it a disease of the nervous system, others, of the blood, others, of the bronchial tubes, while not a few believe it to be dependent upon some disease of the stomach, heart, liver, kidneys, or due to urinary affections, or "female weakness." Respecting all these diseases of special organs, it is evident that any complication, and particularly one that is debilitating or causes irritation of the nervous system will increase its severity. This important fact we keep constantly in view in our treatment, and prescribe remedies to remove all complications. In heart disease there is often dyspnoea, or difficult breathing, but this is not of the nature of asthma, or phthisic. The condition of the lungs is readily understood. There being an obstruction to the free passage of the blood through the heart, any excessive muscular exertion, or anything, in fact, which increases the action of the heart, is very apt to produce congestion of the lungs, and then the blood becomes surcharged with carbonic acid, which causes increased efforts to take more air into the lungs. A NERVOUS DISEASE. A sudden fright, unfavorable news, grief, loss of property, etc., circumstances which affect the mind and nervous system, almost invariably throw the phthisical into a paroxysm. Nervines are demanded, particularly if the case be a chronic one, and we see that they are carefully and properly prepared and supplied, and in such a form as to be exactly fitted to the temperament and constitution. POPULAR REMEDIES USED FOR SELF-TREATMENT OF ASTHMA. There are numerous remedies that may be used to _relieve paroxysms_ of asthma. Among them we will notice a few that are most frequently employed by the profession. They can be easily and inexpensively prepared by any patient or druggist: 1. Equal parts of the tinctures of lobalis capsicum and skunk cabbage root. _Dose_.--Take a half teaspoonful in a little water every ten or fifteen minutes until relieved. NOTE.--This is an antispasmodic and relaxant. In considerable quantities it will produce sickness at the stomach and perhaps vomiting. It should not be used when there is disease of the heart. 2. Chloroform. _Dose_.--A small quantity (say thirty drops), may be poured upon a handkerchief or napkin, held about one inch from the nostrils and the vapor inhaled. It is quite unnecessary to use this until insensibility follows; in fact, such an effect would be hazardous to life in the hands of the inexperienced. 3. Sulphuric ether. _Dose_.--The same as No. 2, and with the same precaution. Either of them should be used promptly upon the beginning of the paroxysm. 4. Take four ounces of stramonium leaves and strip from the stems, rubbing between the hands to partly pulverize. To this add one ounce of saltpetre, finely powdered. _Dose_.--Place a half teaspoonful upon a very hot shovel. Inhale the rising smoke. If the first few inspirations cause coughing, the smoke should not be evaded as the coughing incites deeper inspiration. 5. Stramonium and saltpetre as in No. 4. Dampen with water and make into balls or cones. These are more easily handled and are fired in the same way as the powder and used in the same way. 6. Take of sunflower leaves, stramonium leaves, mullein leaves, one ounce each; of lobelia leaves, half an ounce; of powdered nitre, one ounce; and benzoic acid, two drams. Mix thoroughly. _Dose_.--A pipeful, to be smoked the same as tobacco. 7. A cup of hot coffee or several of hot water. This is especially effective in cases arising from checked perspiration, from rheumatism, etc. These recipes are given to the public as being the principal agents employed by the medical profession throughout the world. It must be distinctly understood that they are not _curative_ but merely _palliative_, and used to relieve paroxysms. We object to them wholly and unqualifiedly because they contain NARCOTICS. It is a fundamental principle in our treatment not to use this class of remedies. They stupefy the brain, debilitate the nervous system, and have, in not a few instances, formed an unfortunate appetite and habit, most difficult to overcome. We are of the opinion that one of the chief reasons why this malady has been considered incurable is the fact that physicians have almost universally relied upon narcotic drugs. With such medication a cure is the exception. A cure can only be effected under such circumstances when the _powers of nature are sufficient to overcome both the_ NARCOTIC _and the_ DISEASE. That they will _relieve_ we do not deny, but _they will never cure_. It reminds us of an old country doctor who advised a lady to smoke tobacco to cure acid dyspepsia. She followed the prescription for over thirty years and at last accounts was not cured yet. In all seriousness we ask would any other remedy except a narcotic or stimulant be used with such persistency for anything like this length of time? Is it not apparent that such agents form a habit which is often worse than the disease, and yet fail to effect a cure? We appreciate the necessity for relief, and do not blame sufferers for availing themselves of any means for this purpose. But they should not be satisfied with relief only, but should look about for such a system of medication as will rid them of the disease completely and permanently. If a week's or a month's exemption is a "foretaste of heaven," how incomparable are the comforts and happiness to be derived from a life-time immunity? MILLIONS OF DOLLARS are annually spent upon the advice of physicians, in traveling expenses, and hotel bills, by sufferers from asthma, or phthisic, in seeking a change of climate that will be advantageous. It is the last expedient of the doctor who is annoyed by the continued complaint of his unrelieved patient, and can only be made available by the wealthy. In some instances the change is beneficial, but to be effectually so a permanent change of residence is required. Most patients are unable or unwilling to do this. In some cases change only affords temporary relief, the attacks returning after a few months. Even the wealthy dislike to take such chances. The less opulent cannot think of such methods, and hence are compelled to bear their sufferings as best they can. In the majority of instances the "change of climate" is only an illusion, or only temporarily beneficial at best. We can tell them a better way, and if they are wise they will follow it. * * * * * HAY ASTHMA, OR HAY FEVER. This affection, known also as Hay Catarrh, Hay Fever, or Rose Cold differs but little in its manifestations, from coryza, or cold in the head, save in its _inciting cause_, and in its element of periodicity. In this latitude there are persons who, during summer or early fall, are invariably attacked with acute congestion or inflammation of the upper air-passages, giving rise to sneezing, watery discharges from the nose and eyes, difficult respiration, fever, and general prostration. These symptoms are supposed to be induced by the inhalation of pollen or odors from grasses or flowers, which at that time are supposed to give off certain exhalations of an Irritating character. Unless arrested by medical treatment, the disease lasts until cool weather, or the occurrence of a hard frost rids the atmosphere of the exciting influence. Some feather beds give off an odor which excites all the aggravated symptoms of this disease. Thus it appears that certain emanations have the power of inciting these inflammatory conditions in certain sensitive constitutions. In all individuals suffering from this disease there is an over sensitiveness of the nervous system which admits of the appearance of such sudden and severe manifestations. Many cases suffering only mild symptoms for the first few seasons, annually become aggravated until severe spasmodic asthma is a regular, and sometimes continuous complication. A case or two are on record in which the odor from the body of a horse so induced these symptoms that the individual could never ride or drive him. TREATMENT. In mild cases, or when the attack first appears, the daily use of Dr. Sage's Catarrh Remedy fluid will neutralize and wash away the poisonous particles which have found lodgment in the nasal passages. The Remedy is best applied with Dr. Pierce's Nasal Douche. When the disease has existed the previous season it is necessary that the patient begin both constitutional and local treatment four or six weeks prior to an expected return of the disease. The nervous system should be strengthened, and the resistance of the patient to the irritating influence of these pollens and odors so increased, that even though he may be exposed, no severe symptoms will follow. Dr. Pierce's Golden Medical Discovery will be found invaluable as an alterative, blood purifier, and nerve tonic, and should be taken regularly while Dr. Sage's Catarrh Remedy is being used locally for its antiseptic and curative properties. The action of the "Discovery" is especially desired in cases that are so far advanced as to be attended with asthmatic symptoms, such as difficult breathing, headache, and a feeling of lassitude and prostration. In very obstinate or distressing cases our specialists have been able to prescribe and send, by mail or express, special courses of treatment which have proven so effective as to cure the disease _permanently_, so that it has not reappeared the following season. The treatment seems to have produced such an impression upon the system as to have fortified the individual against a return of the disease. In rare cases morbid growths in the upper air-passages are of such a nature as in themselves to be a source of sufficient excitement to unbalance the nervous equilibrium so that the individual is thus rendered more susceptible to this disease. In such, or exceedingly obstinate cases a personal examination by our specialist is desirable, and often results in the use of such measures as give permanent relief. * * * * * TESTIMONIALS. If the following letters had been written by your best known and most esteemed neighbors they could be no more worthy of your confidence than they now are, coming, as they do, from well known, intelligent, and trustworthy citizens, who, in their several neighborhoods, enjoy the fullest confidence and respect of all who know them. Out of thousands of similar letters received from former patrons, we have selected these few at random, and have to regret that we can find room only for this comparatively small number in this volume. BLEEDING FROM LUNGS, CONSUMPTION WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: (Before) C.H. HARRIS, ESQ.] [Illustration: (After) C.H. HARRIS, ESQ.] _Gentlemen_--I wish to say to you that Doctor Pierce's Golden Medical Discovery saved my life and has made me a man; my home-physician says I am good for forty years yet. You will remember that my case was a case just between life and death, and all of my friends were sure it was a case of death, until I commenced taking a second bottle of "Golden Medical Discovery," when I was able to sit up and the cough was very much better, and the bleeding from my lungs stopped, and before I had taken six bottles of the "Golden Medical Discovery" my cough ceased and I was a new man and ready for business. And now I feel that it is a duty that I owe to my fellow-men to recommend to them the "Golden Medical Discovery" and Dr. Sage's Catarrh Remedy, which saved my life when doctors and all kinds of medicines failed to do me any good. I will send to you with this letter two of my photographs; one was taken a few weeks before I was taken down sick in bed, and the other was taken after I was well. Yours respectfully, C.H. HARRIS, No. 1622 Second Avenue, Rock Island, Ill. SEVERE CHRONIC COUGH. Wilbar, Wilkes Co., N.C. DR. R.V. PIERCE, 663 Main Street, Buffalo, N.Y.: _Dear Sir_--I cannot recommend your "Golden Medical Discovery" too highly. I had a severe chronic cough and I began to use that medicine and took only one bottle, and I have not been sick a day since. When I began to use your "Golden Medical Discovery" my weight was 104 pounds, and now I weigh 125 pounds. Yours very truly, Mrs. Anna Parsons SPITTING OF BLOOD. LUNG DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J.M. Hite, Esq.] _Gentlemen_--I can gladly recommend Dr. Pierce's Golden Medical Discovery to all suffering from diseases for which you recommend it. In the summer of 1888 I took a severe cold, which settled on my lungs and chest, and I suffered intensely with it. I tried several of our best physicians here and they gave up all hopes of my recovery, and my friends thought I would have to die, and I thought so myself, as the doctors did not know what was the matter with me. In the morning, on rising, I would cough and spit blood for two hours, and I was pale and weak and not able to work any. I then ran across Dr. Pierce's advertisement and I came to the conclusion I would try the "Golden Medical Discovery," as it was so highly recommended. I was greatly discouraged when I began the use of the "Discovery," but after I had taken four or five bottles I then noticed I was getting better, and I could stand it to work some, and kept on taking it till I took about twenty or twenty-five bottles. It has been five years since I took it and have had no return of that trouble since. I gladly recommend your medicine for I know it saved my life. Yours respectfully, JOHN M. HITE, Audubon, Audubon Co., Iowa. LUNG DISEASE. [Illustration: Mrs. McGill.] Blue Rock, Muskingum Co., Ohio. DR. R.V. PIERCE, Buffalo, N.Y.: _Dear Sir_--I feel like taking you by the hand and saying, "thank God, you have saved my wife," for we had given her up. We had sat by her, when the doctor said she could not live till morning; so bad was her lung disease. Dr. Pierce's Golden Medical Discovery cured her. MR. THOMAS McGILL. When her case was reported to the specialist of the Invalids' Hotel, Mrs. McGill was suffering from pain in the chest, struggling for breath, hard dry cough; jarring hurt the chest; short breath, backache; uterine disease, leucorrhea, menstruation scanty and painful; feet and ankles swollen; was confined to house most of the time; was given up by her home physician. Her disease began six years before with "lung disease" which was followed by bleeding from lungs. CURES WHEN COD LIVER OIL FAILS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--My wife a few years ago had hemorrhages of the lungs, and we summoned our home physician. He checked the hemorrhage but failed to cure her. She had also a terrible cough and expectorated a great deal. She wanted to see another doctor so I called one and he examined her. She asked him whether she had consumption, and his answer was, "Madam, it is very near consumption." He advised her to use cod liver oil, but this gave but little relief. I happened to get hold of one of your little books that comes with each bottle of Dr. Pierce's medicines and I read some cases about like my wife's. I went to the drug store and procured a bottle of Dr. Pierce's Golden Medical Discovery and my wife commenced using it according to directions. She began to get better right away and her cough has left her. She used about ten bottles. She is in her fifty-fifth year and can walk ten or twelve miles without any trouble. We are satisfied that her life and health have been saved by the use of "Golden Medical Discovery." As soon as she takes any cold she insists upon having a bottle of her medicine, as she calls it, and that is the last we hear of her cold. Yours respectfully, Joseph D. Wiles West Point Street, Frederick, Md. MALARIA, CHILLS, AND LUNG DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: R. Williams, Esq. ] _Gentlemen_--It has been about eight months since I quit using Dr. Pierce's Golden Medical Discovery. When I commenced using it I only weighed 130 pounds. I had been suffering with malarial fever, chills, and lung disease for four years. I took treatment from many doctors, and tried many different kinds of patent medicines and all seemed to do no good. Since I have used four bottles of "Golden Medical Discovery" and one bottle of Dr. Pierce's Pleasant Pellets I feel well in every respect _and weigh 160 pounds instead of only 130_, my weight when I began its use. Yours truly, ROBERT WILLIAMS, Hazelton, Barber Co., Kas. CONSUMPTION. ALMOST RAISED FROM THE GRAVE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: MRS. VANSICKLIN.] _Gentlemen_--I have long felt it my duty to acknowledge to you what your "Golden Medical Discovery "and "Pleasant Pellets" have done for me. They almost raised me from the grave. I had three brothers and one sister die of consumption, and I was speedily following after them. I had severe cough, pain, copious expectoration, and other alarming symptoms, and my friends all thought I had but a few months to live. At this time I was persuaded to try your "Discovery," and the first bottle acted like magic. Of course I continued on with the medicine, and as a result I gained rapidly in strength. My friends were astonished. When I commenced the use of your medicines, six years ago, I weighed but 120 and was sinking rapidly. I now weigh 135, and my health continues perfect. I have a copy of your "People's Common Sense Medical Adviser," and neither money nor friends could ever induce me to part with it. Twelve years later, Mrs. Vansicklin writes: "My health still continues _perfect_. I now weigh 148 pounds. Your book--the Common Sense Medical Adviser is a treasure in our home." Yours truly, MRS. H.H. VANSICKLIN, Brighton, Ont. CONSUMPTION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J.A. Henson, Esq. ] _Gentlemen_--Two years ago I thought I had consumption, and was continually coughing day and night, and not able to work. I bought six bottles of Dr. Pierce's Golden Medical Discovery and it did me more good than all the other medicine I ever took, and now I am feeling all O.K., and I weigh 165 pounds. Two years ago I weighed 145 pounds. I can fully recommend Dr. Pierce's Golden Medical Discovery to any person that has consumption. I remain, Yours truly, JOHN A. HENSON, South Bosque, McLennan Co., Texas. IT "FILLS THE BILL." LUNG DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: A.D. Simmons, Esq.] _Gentlemen_--In 1872, when living in New York State, my health was very poor. I was clear "run down." Pain in my lungs, right side and in my bowels; had been ailing for nearly two years; my feet swelled during the day so I could hardly stand it till night, as I was on my feet the most of the time. I wrote you and you sent me special medicines, which brought me around all right. I have weak lungs, and when I get run down I usually take a few bottles of Dr. Pierce's Golden Medical Discovery, which always builds me up. We have used your "Discovery" in our family with the best results. When living at Blue Mound I was very sick with inflammation of the lungs from taking cold. When I took cold I was at Clinton, Missouri. Was confined to my bed for a few days. I said to the doctor that I must go home; he advised me to stay where I was, but I started for Blue Mound with my pulse at 140. When I arrived home I was glad to get in bed, and called in Dr. ----. He said my lungs were in a bad condition. Well, I was very sick for three weeks or more, and when I got around I was not well, and at that time Dr. ---- came to Blue Mound, stopped there two weeks, gave free lectures and had lots of patients. He examined me and said I needed treatment, and he could cure me. I was suffering all the time with pain in my right lung. He wanted $50.00 for treatment, and would cure. So I let him pass along and wrote to your Association for advice, which was to take the "Discovery," and I took one-half dozen bottles which "filled the bill." Yours respectfully, A.D. SIMMONS, Emporia, Lyon Co., Kansas. CONSUMPTION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Smith.] _Gentlemen_--It is my pleasant duty to you and to suffering humanity to acknowledge the benefit I received from Dr. Pierce's Golden Medical Discovery. About seven years ago I became troubled with my lungs--consumption in its first stage. Some of my friends in Ontario had been using your medicine before I knew anything of it; and after coming to this country, I commenced taking it, and I think it has done wonders for me. I am positive, that if any one will persist in taking it, it will do all you say. It has done so much for me that I feel it my duty to testify to its wonderful curative properties. Respectfully, MRS. JESSE K. SMITH, Baldur, Selkirk Co., Manitoba. DYSPEPSIA AND NASAL CATARRH. DR. PIERCE, Buffalo, N.Y.: [Illustration: J. Larson, Esq.] _Dear Sir_--I had been very badly troubled for many years with dyspepsia, also nasal catarrh, and got so bad and weak that I could not work. I could hardly eat anything without vomiting; had a pain in the stomach and a burning sensation coming into the throat. I took Dr. Pierce's Golden Medical Discovery and "Pleasant Pellets," and can truly say these medicines have helped me wonderfully. I improved right along from the very beginning. I stopped taking medicine in the latter part of May and then felt as well as ever in my life. I am pretty well now, for a man of sixty-three years. I can eat all kinds of food and it doesn't cause me any pain in the stomach as it always did before I took Dr. Pierce's medicines. I can cheerfully say to the public that they need not hesitate in taking Dr. Pierce's Golden Medical Discovery for dyspepsia; it will eradicate and cure the disease if anything will. Yours truly, JOHN LARSON, Ashby, Grant Co., Minn. LUNG DISEASE. Dr. R.V. PIERCE, Buffalo, N.Y.: [Illustration: J.J. Hume, Esq.] _Dear Sir_--I cheerfully make the following statement: In February, 1893, I was attacked with a severe illness. It came on very gradually, and was attended with a severe cough and expectoration; also had pain in the lungs; had chills and night-sweats; was much reduced in strength. After trying for relief in different directions without success, I was induced to apply to your eminent Staff of Physicians at 603 Main St., Buffalo, N.Y., and I am happy to say that my improvement began as soon as I began the use of the medicines which were prescribed for me at that time. The improvement has been continuous, until I now feel my lungs are entirely cured; have no cough, no expectoration in the last month, and my usual weight of 183 pounds has been restored. Have been able to do a fair day's work any time during the past two mouths without unusual fatigue. I can cheerfully recommend your Institution to persons similarly affected, and will authorize you to refer any one making inquiry to me. Yours respectfully, J.J. HUME, Corfu, Genesee Co., N.Y. A BAD COUGH. Vanburen, Kalkaska Co., Mich. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Your medicine is the best I have ever taken, I was not able to do hardly any work at all; had pain in my left side and back, and had headache all the time. I tried your medicine and it helped me. Last spring I had a bad cough; got so bad I had to be in bed all the time. My husband thought I had consumption. He wanted me to get a doctor, but I told him if it was consumption they could not help me. We thought we would try Dr. Pierce's Golden Medical Discovery and before I had taken one bottle the cough was stopped and I have had no more of it returning. Respectfully yours, Jennie Dingman SEVERE COUGH. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Jewell.] _Gentlemen_--I want to say a word in favor of your medicine. I can not do it justice by mere words. I was taken sick the 5th of July; I called a doctor but did not receive any benefit from him. I was going into quick consumption. Had a terrible cough, raised a great deal of phlegm; had pain through chest, was very weak and all run-down." I told my husband to get a bottle of "Golden Medical Discovery;" he did so; I commenced taking it and I began to get better. I was not outside of the door yard, from July 5th, until August 22d. I only took two bottles, and the first of September I was able to do the work for boarders, and have had boarders ever since. It is the grandest medicine ever invented. Respectfully, Mrs. CHARLES JEWELL, (P.O. Box 89), Rockford, Kent Co., Mich. SPITTING OF BLOOD. Olanta, Clearfield Co., Pa. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I can truly say that your "Golden Medical Discovery" and "Pleasant Pellets" have been the means of saving my life. When I began taking your medicines I thought my time was short. I have not spit up blood now for about four months, and am feeling much better. Our home doctor says my temperature and pulse are all right now; and that I do not need further medicine, and that I will get all right again. I feel that your medicine has done wonders for me. I would have written sooner, but I was waiting to see if the improvement Would be permanent. Yours truly, D.Y. Rowles DESPONDENCY. NERVOUS PROSTRATION--THREATENED WITH CONSUMPTION. WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.: [Illustration: H. Cummins, Esq.] _Gentlemen_--I have felt inclined to say to you, and your whole staff of physicians, and now do convey to you, my heart-felt gratitude for your able and skillful assistance rendered me in my afflictions. I had been for years a sufferer, and at times nearly despondent. I had been treated by the most able and skillful physicians that this north-western country could provide. I had paid them large sums of money and was finally given to understand that there was no hope for my cure. Your advertisements fell into my hands, which treated upon my case. I read and compared my case with the insight you so ably explained, so I was satisfied you understood your profession well. I started full of hope and as I reached Buffalo, after three days' travel by rail, some 1,500 miles, there was something that cheered me on. I made my way to your Invalids' Hotel. I was examined and pronounced curable. I was operated upon for a local affection that caused much of my suffering, the same day I arrived, and in ten days was discharged permanently cured. I have felt perfectly well ever since. I was nicely treated by the able nurses and attendants who were always gentle and kind. I can cheerfully say to the public, that they need not hesitate in throwing themselves into your kind care in every case that is curable by the hand of man, and you will treat them honestly. Hoping this may be of some benefit to some afflicted persons who may feel some diffidence in trusting themselves in your hands. Yours respectfully, H. CUMMINS, Eagle Lake, Blue Earth Co., Minn. LUNG DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Fisher.] _Gentlemen_--I am much better, and believe it was through your medicine and advice that I am as well as I am. I might have been entirely well if I had been able to have kept the medicine to take as directed. I have taken only four bottles, and it would be four or five months from the time I would take one bottle till I could get another one. I can talk better, and feel almost like a new person to what I did two years ago. I weigh more and can do any kind of work. Dr. Pierce's Golden Medical Discovery is the only medicine that did me any good. Your friend, MRS. RACHEL D. FISHER, Silver Point, Putnam Co., Tenn. CHILLS AND LINGERING COUGH WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: H. Dietzel, P.M.] _Gentlemen_--In 1879 I wrote you after suffering eighteen months. I had tried three doctors--took over one dozen bottles of patent medicines, without relief. I had chills with hacking cough; my friends said I had consumption; was reduced in flesh and nerve till the least work or exercise would exhaust me completely. Thanks for the day I wrote you, for I sent you ten dollars, and received four bottles of medicine which I took, and have been able to do hard work. I have never had any symptoms of those dreaded chills since. My weight got as low as 135 pounds; now I weigh 175 pounds. I would advise any one affected with chronic disease to consult you, as your treatment is genuine. Yours truly, HENRY DIETZEL, P.M. Ernst, Clark Co., Ill. HEREDITARY CONSUMPTION. HOME DOCTORS OPPOSED HIS COMING TO US (THEY OFTEN DO) ALTHOUGH UNABLE TO HELP HIM THEMSELVES. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J.F. Jones, Esq. ] _Gentlemen_--For the benefit of the afflicted, I wish to say, that I visited your Institution in 1889, completely broken down in health and suffering, as I thought, from heart disease and consumption. I had spent money with many of our home physicians, but they only gave me partial relief and I would soon be worse than ever. When I spoke of coming to you, the doctors here cried "humbug," but I told them I had been humbugged at home and if I staid I would surely die, and if I went could do no worse. I spent thirty days at your Invalids' Hotel and Surgical Institute, and came away like a new man, comparatively speaking. I found the Institution all it had been represented, and I may truthfully say, that the time spent there was to me as an oasis in a desert to a weary and thirsty traveler; for those were among the happiest days of my life. No pains were spared to make each patient comfortable and at home. I cannot recommend your Institution too highly, for I feel that to your treatment I owe my life. I have sold a great deal of your medicines, and recommend them with the same faith I would water to the thirsty. They, the "Pellets," "Golden Medical Discovery" and "Favorite Prescription," give universal satisfaction. You are at liberty to use this as you desire, for my only motive in writing is to benefit the afflicted, by pointing out to them a place of cure; for, no matter what their disease, I am confident that if medical skill can avail, they can be cured at the Invalids' Hotel and Surgical Institute. Yours truly, J.F. JONES, Raleigh C.H., Raleigh Co., W. Va. ABSCESS OF LUNG. REDUCED ALMOST TO A SKELETON. Bisbee, Cochise Co., Ariz. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I had been confined to my bed four months, had tried the skill of four doctors and all the patent medicines that were recommended for my case, which was an abscess on the lung. My physicians and friends had given me up to die; I was reduced to a perfect skeleton; my strength was gone; my eyesight was so dim I could scarcely see at all, and I had no appetite--could not eat anything at all when I commenced using Doctor Pierce's Family Medicines. I have taken sixteen bottles of the "Golden Medical Discovery," twelve bottles of "Pellets" and three bottles of "Favorite Prescription," and to-day I am well and strong and weigh 128 pounds--two pounds more than I ever before weighed in my life. Your true friend, Mrs. Sarah A. Kelly LUNG DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Sickles.] _Gentlemen_--My daughter had pneumonia and it left her with a horrible cough and one lung was almost gone; our doctor seemed to think there could be nothing more done, and said to go South; but not having the means at that time, I began giving her Dr. Pierce's Golden Medical Discovery, which she took steadily for two years. During that time she gained rapidly in strength; the lungs became normal, the cough leaving her entirely. We are never without this medicine in the house, and have recommended it to all our friends, and I am positively certain that if Dr. Pierce's medicine is used in time, it will cure in other cases as well as in this one. Yours respectfully, MRS. RUTH A. SICKLES, Ocean Port, Monmouth Co., N.J. (Box 33.) REDUCED TO A SKELETON. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Mills.] _Gentlemen_--Having felt it a duty to write of the good I received by taking your medicine, I now would say, that one year ago I was given up by my family physician and friends; all said I must die. My lungs were badly affected, and body reduced to a skeleton. My people commenced to give me your "Medical Discovery" and I soon began to mend. It was not long before I became well enough to take charge of my household duties again. I owe my recovery to Dr. Pierce's Golden Medical Discovery. Respectfully yours, MRS. MIRA MILLS, Sardis, Big Stone Co., Minn. COUGH AND NIGHT SWEATS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: H.M. Detels and Wife.] _Gentlemen_--In regard to your medicines I will say that they are always in the house. I shall never forget those nights when I was down with pneumonia. Had it not been for Dr. Pierce's Golden Medical Discovery I would not be a well man to-day. One bottle stopped the cough and night sweats. My wife was troubled with leucorrhea so bad that we did not know what to do until Dr. Pierce's Favorite Prescription was brought into the house and gave her rest. Yours truly, H.M. DETELS, Traver, Tulare Co., Cal. PULMONARY DISEASE. A WONDERFUL CURE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Chas. E. Lees, Esq. ] _Gentlemen_--I am 29 years old. During the winter of '84 I contracted a severe cold, which settled on my lungs. Each succeeding winter my cough grew worse, and in the winter of '85 I had chicken-pox, and taking cold, drove them in causing me a severe spell of sickness. The following summer I had congestion of the lungs and hemorrhage and a severe spell of fever. My physician advised me to go West in search of health. My friends thought I had consumption of the lungs, I coughed so much. In September, 1889, I left Carthage, Mo. (where I then lived), for Phoenix, Ariz. After I had been there about four months I had a severe attack of "_La Grippe_" and with this I coughed myself almost (I thought), to death; and to add to my distress I had an almost intolerable attack of pleurisy. A doctor was summoned and after an examination said I had Empyemia, and said he could do me but very little good until he removed the pus. He and his partner came and by the use of an aspirator drew off nine pints of pus; after about a week he drew off two pints. After a few days I told my doctor I could hear the pus gurgle as I had before he drew it off. Strange to say, but nevertheless true, my heart was crowded over on the opposite side for three months. I knew it was there for I could feel the pulsations there, and I was so short of breath for a long time I could not stoop down to tie my shoes. The doctor told me it would be useless again to use the aspirator, but that he would be obliged to make an incision in my side and treat it till I got well. On the 28th day of March. 1890, my doctor and his partner and three other doctors undertook the operation, and, after removing about two inches of one of my ribs, withdrew 16 pints of pus. This came near being too much for me though I slowly recovered and in three months the doctors thought I was able to come home. I arrived home in June and was very poorly all summer, and did not sit up but _very little_, and had fever every day. In the latter part of the summer of '90 I commenced to take "Golden Medical Discovery" and although my side had been discharging for TWENTY-THREE MONTHS it healed up sound and well. I am now able to do considerable hard work. I would advise all who are afflicted as I was, to give your medicine a trial. I am glad I have out-lived my friends' expectations. Yours truly, CHARLES E. LEES, P.O. Box 2, Winslow, Washington Co., Ark. THROAT AND LUNG DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. White. ] _Gentlemen_--I was troubled with throat and lung disease for about two years and lost strength so that I was unable to do much work. I took four bottles of Dr. Pierce's Golden Medical Discovery, and can say that it did more good than any other medicine that I ever took. I am now able to do my work, and enjoy good health. Yours truly, MRS. JULIA WHITE, Willow Creek, Blue Earth Co., Minn. WEAK LUNGS, COUGH, PROFUSE EXPECTORATION AND CATARRH. [Illustration: A. Kratz, Esq. ] MR. ANTON KRATZ, of _Crawford, Dawes Co., Neb._, had weak lungs, cough and catarrh, with profuse expectoration; difficult breathing, lasting from one to eight hours. He writes: "I took sick and went to the doctors. They gave me medicine, but it did not help me, so I got two or three bottles of 'Golden Medical Discovery' and some 'Pellets.' After awhile I got better, until three winters ago I got sick again so I could not do anything, and I wrote to you giving my symptoms on one of your question blanks, and asked you about my case. You told me to take your 'Golden Medical Discovery.' I took four bottles and got well and have been well ever since." LUNG DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION: Buffalo, N.Y.: [Illustration: Mrs. Lincoln. ] _Gentlemen_--Before taking the "Discovery" I would have four or five bad coughing spells every day and would cough up mouthfuls of solid white froth, and before I took one bottle it stopped it. I could not walk across the room with the pain in my back and sides; but soon the pain was all gone, and I could sleep well at night. My general health is much better since I have taken the "Golden Medical Discovery" although I have been obliged to work hard on a farm. Respectfully yours, MRS. JOHN LINCOLN, Glen Annan, Huron Co., Ont. CONSUMPTION AND GENERAL DEBILITY. CURED BY SPECIAL HOME TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. F. Nienhuis. ] _Gentlemen_--I had pain in lungs and across the chest; had been spitting blood for the past six years. Menstruation was scant and caused great prostration. Suffered from constipation; cutting pains about the stomach and rumbling in the bowels; exceedingly nervous; indigestion. She writes as follows: "I wish to inform you that I am well. I never can praise you or your ways of treatment enough. I shall bring you all the patients that I can. I feel so rich to get my health back. I can eat well and sleep well, and work all day. I suppose you will think it took a long time to pull me up, but I was very low, much worse than I ever told you of at the time. I was not able even to feed myself any more. My husband had to undress me. I could not wash my own face, or stand alone. I did not lie down to sleep for eleven months; I always had to sit up, because I would choke if I laid my head down. _I have not raised a drop of blood since your treatment_, and I did it always for five years before. Our minister said this spring that he had never thought I could live, and says that he advises every one that is sick to go to you. He was so surprised to see how strong and well I was. My relatives all think that you ought to write my case up for the papers in Chicago. I can never repay you for what you have done for me. A thousand thanks is but empty words. My husband was telling a man just last week, "do not spend all your money in Chicago, as we did, and then write to Buffalo, but go and write now, and your wife will soon be well." My father was saying that he wished the doctors that gave me up could see me now. I think they could not believe their own eyes. I am astonished when I think back how I was six years ago; I could not walk across the room alone for three years, and after taking your treatment for eighteen months, I am _completely_ well. I can hardly believe it myself when I read over those letters that I received from you. I work hard every day. There is never a day that you are not remembered. I hope that you may live many years to do for others what you have done for me. I had this taken so that you might have my picture as I am now; I wish you could have seen me as I was then, and I wish to thank you for those little notes of inquiry that you used to send to find out how I was getting along, which showed that I was remembered not only while the money lasted, but that you cared for me after that." Respectfully yours, MRS. F. NIENHUIS, Crawford, Cook Co., Ill. "COMPLETELY WRECKED." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Lindsey. ] _Gentlemen_--Last August I was taken sick of a fever and was confined to bed for nearly six months. I had four doctors to see me, but it just seemed to me that they could relieve me for only a short while. I had a bad cough and all thought I was going into consumption. After being sick for so long, my nerves were nearly exhausted and my stomach, liver and bowels refused to act, in fact, my whole system was completely wrecked. I could not rest nor sleep, unless influenced by some drug and at last, mother concluded to try your medicines on me. She had taken them about a year before and had been greatly benefited by their use, so she said I will try the last resort--for I had been given up to die. I began taking your "Golden Medical Discovery" and "Pleasant Pellets." I improved rapidly--was soon able to be up in my room, and to my surprise, I could eat a little of nearly everything I desired. Before I began the use of your medicines, I could eat nothing in peace; I would almost cramp to death, even when I took a little cold water. But after the use of four and a half bottles of your "Golden Medical Discovery," and two vials of "Pellets," with God's help, I have almost risen from the dead. I will cheerfully recommend your remedies to my afflicted friends, for I am to-day, well and strong as ever. You can use this among your testimonials, if you choose, with my greatest approval. Very Respectfully yours, Miss LOULA LINDSEY, Ringgold, Pittsylvania Co., Va. BRONCHITIS OF TWENTY YEARS' STANDING. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: B.F. Wiley, Esq.] _Gentlemen_--I had bronchitis for twenty years and over, and I could not work without coughing so hard as to take all my strength away. I took five bottles of Dr. Pierce's Golden Medical Discovery, and give you my word and honor that I can do any work that there is to do on my "ranch" without coughing. Sometimes in the winter when exposed to the change in the weather, I have a slight attack of coughing. Remember, I have not taken any of the "Golden Medical Discovery" for a year. Yours, B.F. WILEY, Box Elder, Converse Co., Wyo. BRONCHITIS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: M.M. Alexander, Esq.] _Gentlemen_--I was troubled with bronchitis for over two years, had severe cough and great difficulty in breathing; appetite was poor and suffered from indigestion, became very weak and despondent. My age (I am now 71) was against me. I was treated by two physicians but they did me no good. I then used four bottles of your "Golden Medical Discovery" and was entirely cured, for which I am very thankful. Yours truly, M.M. ALEXANDER, Hedrick, Alexander Co., N.C. LUNG DISEASE. Schuylersville, Saratoga Co., N.Y. (P.O. Box 396). WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Something over a year ago I wrote to you about my lungs. I used Dr. Pierce's Golden Medical Discovery besides using Iodine and mustard paste. That pain in my lung entirely left me, and I have not felt it at all since last August. The doctor who lives here and who has always treated me thinks it is a great cure. Words cannot express my gratitude to you. I am now able to do a good day's work. Yours gratefully, Lulu E. Baugs CHRONIC SORE THROAT, COUGH HOARSENESS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Traphagen.] _Gentlemen_--I am feeling well at the present time; I took fourteen bottles of Dr. Pierce's Golden Medical Discovery. I had chronic sore throat, hoarseness, sore chest, rheumatism in my arms, and was very much run down. The doctor here at home said one lung was affected and that I had symptoms of consumption. I know that your "Golden Medical Discovery" was the cause of regaining my health. I remain, Respectfully yours, MRS. MARY TRAPHAGEN, NO. 6 Front Street, Poughkeepsie, N.Y. CONSUMPTION. BAD COUGH, SPIT UP BLOOD. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: K.C. McLin, Esq.] _Gentlemen_--When I commenced taking your "Discovery" I was very low with a cough, and at times spit up much blood. I was not able to do the least work, but most of the time was in bed. I was all run-down, very weak, my head was dizzy, and I was extremely despondent. The first bottle I took did not seem to do me much good, but I had faith in it and continued using it until I had taken fifteen bottles, and now I do not look nor feel like the same man I was one year ago. People are astonished, and say, "well, last year this time I would not have thought that you would be living now." I can thankfully say I am entirely cured of a disease which, but for your wonderful "Discovery," would have resulted in my death. Yours truly, K.C. McLIN, Kempsville, Princess Anne Co., Va. LUNG DISEASE. COUGHED DAY AND NIGHT. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Steinmann.] _Gentlemen_--Three years ago I was so sick I could not eat, sleep or walk, for I coughed all day and night. My weight was reduced from 150 to 127 pounds. The first night that I slept four hours at one time, was after I had taken three doses of Dr. Pierce's Golden Medical Discovery. The offensive matter expectorated grew less every day and when I had taken the whole of one bottle I could sleep all night without coughing, and have been well ever since and weigh 178 pounds. Respectfully yours, MRS. LOUISA STEINMANN, 67th St., near 15th Ave., Lefferts Park, Brooklyn, N.Y. BILIOUSNESS, CONSTIPATION, BAD COUGH. [Illustration: G.I. Wilder, Esq.] WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Some twenty-five years since I was feeling very miserable all summer; I was very bilious; sometimes my bowels would not move once in sixty or seventy hours, and then almost impossible. I would take some bitters, which would help to move the matter, but as soon as the bitters were gone, I had to buy more or I would be as bad as before, and sometimes worse; but none of them appeared to do me any good except to move the bowels, until thirty years since a druggist called my attention to Dr. Pierce's Golden Medical Discovery, and before I had taken half a bottle of the "Golden Medical Discovery" I felt much better and by the time I had taken all, I could eat three hearty meals per day and had not felt so well for a long time. Soon after I was called to do a job some miles from home, and one night the old lady there was speaking about her daughter, (Mrs. Brooks) who had been under the doctor's care for five months and did not get any better, and I learned by asking a few questions that she had no appetite, and no ambition to do anything. Then I told her what the "Golden Medical Discovery" had done for me. The next day the old lady drove down to her daughter's, and got Mr. Brooks to send to Rutland--ten miles away--for two bottles of the "Golden Medical Discovery," and the next day the doctor came, and when about to take leave, Mr. Brooks told the doctor he did not want him any more at present and would send for him if necessary. I saw the old lady about ten days later and her daughter was improving, and Mr. Brooks had great faith in the "Golden Medical Discovery," and had not sent for the doctor, but had gone to Rutland for more of the "G.M.D." When I commenced taking the "Golden Medical Discovery." I thought I was going into consumption as had a cough for three years or more and my weight decreasing. My weight before taking the "G.M.D." was 133 pounds; last March it was 147 pounds, and I give the credit to the "Discovery." Yours respectfully, GEORGE I. WILDER, East Wallingford, Rutland Co., Vt. THROAT AND LUNG DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Bringer. ] _Gentlemen_--I had complicated chronic disease for several years--throat and lung and other affections, which almost resulted in consumption. Our doctors could do me no good. I happened to get hold of some of Doctor Pierce's books, and was induced to try his treatment. To the surprise of myself and family, I was, in a short time, changed almost to a new person--from pale sallow complexion to the bloom of health again. Many thanks for restoring me from an untimely grave. I will say to the public it is not always necessary to go to the Institute; I was treated at home with success. I cannot speak in too high praise of Dr. Pierce's Golden Medical Discovery, "Pellets" and "Favorite Prescription." I think they will do all that is claimed for them. Respectfully, MRS. ALMEDA BRIGNER, Oxford, Furnas Co. Neb,. SEVERE LUNG AND BRONCHIAL DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: E. Campbell, Esq. ] _Gentlemen_--For some time I have been troubled with a severe lung and bronchial disease, following a severe attack of pneumonia. Was raising a great amount of pus, had severe night-sweats and was very much prostrated, when I was induced to visit Dr. Pierce's Invalid's Hotel and Surgical Institute for examination. After having a full statement of my case, I paid for one month's treatment in the Sanitarium and during that time was fully restored to health. I can not speak too highly of the physicians, and this famous Institution. I take great pleasure in making my cure public and in highly recommending this Institution to all afflicted. The Staff of Physicians and Surgeons is skillful and of large experience, and I feel confident that all the benefit that can possibly be obtained from medical treatment, can be obtained at the Invalids' Hotel and Surgical Institute. Yours truly, EUGENE CAMPBELL, New Cumberland, Hancock Co., W. Va. DYSPEPSIA AND CONSUMPTION. DR. R.V. PIERCE, Buffalo, N.Y.: [Illustration: Mrs. Ferguson.] _Dear Sir_--I was not able to do my work for nearly two years, and I tried four different doctors and grew worse all the time. Then I began on your medicine and took twelve bottles of "Golden Medical Discovery" and one of "Favorite Prescription," and am able to do my work and feel as well as I have felt in years. Physicians called my disease Dyspepsia and Consumption. Respectfully yours, MRS. R. FERGUSON, Ink, Shannon Co., Mo. LUNG DISEASE CURED. [Illustration: Miss M.H. Snead.] Will you please accept a few lines from me thanking you for your skill in preparing your medicines and placing them within reach of the suffering. I have a daughter, Miss M.H. Snead, who has been very low, was almost given up by two physicians, who treated her with their best skill, and did not receive much benefit. She was first attacked with pneumonia and pleurisy in very bad form and was then taken with a very bad cough, which kept growing worse and worse, until finally it seemed as though she had consumption very bad. The physicians prescribed Cod liver oil, but to no benefit. Mrs. Miller, a neighbor of ours, recommended Dr. Pierce's Golden Medical Discovery to me with very strong faith, as she had been in the same condition and was cured by its use. I procured two bottles and she grew better. She hasn't felt any return of lung disease in over twelve months. She was nothing but a skeleton when she took the first dose, and to-day she weighs 135 pounds. I thought it my duty to write to you in regard to her case, as so many other medicines had failed, and it has acted like a charm. Respectfully yours, MRS. SARAH E. SNEAD. Clio, Iredell Co., N.C. DISEASE OF LUNGS AND STOMACH. Locust Lane, Scott County, Va. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I am happy to inform you that after consulting you by letter and two months' trial of Dr. Pierce's Golden Medical Discovery, I am enjoying a better state of health than I have for some time. I have had weak lungs for several years--at times spit up blood. In January, 1893, I took a severe cold, which settled on my lungs--had a very bad cough, it seemed as if my lungs were swollen; could not expectorate much at a time, very hard to get up; suffered much with pains in my chest; was reduced in flesh and became very weak. Physicians prescribed for me but I found no relief until I consulted you. It seemed I was going into consumption very fast. I have as good health now as could be expected. I am fifty-seven years of age and able to work on my farm, and feel under many obligations for your kind advice. Also my stomach was out of order, suffered with burning in my stomach and chest. I have no burning nor pains in my stomach and chest now. Yours truly, Milton Ramry DOCTORS ENDORSE IT. AN EMINENT PHYSICIAN OF ARKANSAS TELLS OF SOME REMARKABLE CURES OF CONSUMPTION. [Illustration: Mrs. Rogers.] Dr. PIERCE:--I will say this to you, that Consumption is hereditary in my wife's family; some have already died with the disease. My wife has a sister, Mrs. E.A. Cleary, that was taken with consumption. She used your "Golden Medical Discovery," and, to the surprise of her many friends, she got well. My wife has also had hemorrhages from the lungs, and her sister insisted on her using the 'Golden Medical Discovery." I consented to her using it, and it relieved her. She has had no symptoms of consumption for the past six years. People having this disease can take no better remedy. Yours truly. W.C. Rogers, M.D. Stamps, La Fayette Co., Ark. CHRONIC BRONCHITIS AND DYSPEPSIA. WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.: [Illustration: A. Rosenberger, Esq.] _Gentlemen_--Several years ago I spent many dollars for medicine, but in vain, and expected to die with consumption. But hearing of your Invalids' Hotel and Surgical Institute, I visited you. To your advice and treatment I owe my life and present good health. Hoping that you and your eminent faculty may be spared many years to cure the afflicted, I send you my best wishes. Yours truly, ALBERT ROSENBERGER, Laotto, Noble Co., Ind. "SORE THROAT." Palatka, Putnam Co., Florida. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--About seven years ago I was taken with sore throat and tried some home remedies, and it grew worse; and then I went to a doctor here in town, and after trying his remedies for three or four months, which did me no good, then I tried Dr. ---- remedies; and still I grew worse for two years when I wrote you about it. You advised me to take Dr. Pierce's Golden Medical Discovery and his "Pellets," according to directions, and they would cure me, and so they did after taking eight bottles of the "Discovery," and the "Pellets" to keep my bowels regular. We now take the "Discovery" and "Pellets" for all our aches and pains, and think there are no medicines half so good. We use no other. Yours Truly, Mrs. Ellen Calvert LUNG AND WOMB DISEASE, DROPSY, SICK HEADACHE, DYSPEPSIA AND BLOODY PILES. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Knavel. ] _Gentlemen_--In the winter of 1881, I became irregular in my monthly courses. Of course at first I paid but little attention to it, hoping it would amount to nothing and probably wear away. But I slowly but surely grew worse, and at last resolved to apply to the doctors for help. My water came often, and in small quantities, and with great pain, and with red brick-dust deposit. I was attacked with severe womb trouble, bloody piles and dropsy of the ovary. I was treated by five different doctors. I was compelled to wear an inside support for a year, but it still seemed impossible for me to get well and I began to feel exceedingly alarmed and very uneasy, not knowing what course to pursue, or what the consequences might be. I had heard of Dr. Pierce, and concluded to make one more trial, so I sat down and wrote a letter to him, stating matters as near as I could, and in due time I received a favorable reply; then I commenced with his medicine. I commenced somewhere in February 1891 with the "Golden Medical Discovery" and "Favorite Prescription," in alternate doses. A strange occurrence followed. My limbs felt like what we call "asleep," and I felt as if I were in a strange land and wondered what was going to take place. I kept on till I took nine bottles. The first relief I felt was from sick headache, which I had been troubled with for many years; I was also cured of a very bad cough which I had been troubled with for many years, and of dyspepsia of long standing. I was entirely cured of a very singular and severe itching on my back, between my shoulders, which our doctor's called winter itch and which they pronounced incurable. I had suffered with this for twenty years; it would come in the winter and go away in the summer. I was also cured of the worst form of bloody piles and of womb disease. At present I feel like a new person. When I first commenced with Dr. Pierce's medicines, I could not walk half a mile without a pain. The other day I walked to Mercersburgh post-office, a distance of twelve miles, and the next day walked back again, and felt no bad results from the Journey. I am now 51 years old. Mrs. Knavel further writes, that "To any person desiring to know more concerning my case and its wonderful cure, and who will enclose to me a return self-addressed and stamped envelope for reply, I will be pleased to write further information." Yours respectfully, SARAH A. KNAVEL, Indian Springs, Washington Co. Md. BRONCHITIS AND LUNG DISEASE. [Illustration: Mrs. Neal.] Mrs. Neal, of Crockett Mills, Tenn., had an attack of measles, followed by _bronchitis_ and _pneumonia_. Her husband writes: "I feel gratified with the effect of your wonderful medicine. I can recommend it to anybody, and feel I am doing them justice. My wife was not able to perform her household duties for six months. She has used two bottles of 'Golden Medical Discovery,' and is now able to do all her work. I think it the finest medicine in the world, and I am, gratefully, Your life-long friend, J.B. NEAL." BLEEDING FROM LUNGS; CHRONIC CATARRH; VERY LOW. CURED BY SPECIAL HOME-TREATMENT WORLD'S DISPENSARY MEDICAL ASSOCIATION: Buffalo, N.Y.: [Illustration: G.R. Sprinkle.] _Gentlemen_--I was very low--almost given up by two physicians who treated me with their very best skill and did not receive much benefit. I was attacked with "La Grippe" in December, 1891, and pleurisy, and was taken with a very bad cough, which kept growing worse. The physicians prescribed Emulsion of Cod Liver Oil, but no benefit. In June, 1892, I bled from the lungs; everybody thought I would die. A friend told me to try Dr. Pierce's medicines. I did so, and after taking six months' home-treatment I was cured. When I commenced taking his treatment I only weighed 130 pounds, now I weigh 175, and can do as good a day's work as I ever could. I can cheerfully say that I believe I owe my life to his valuable medicines. Yours truly, G. RILEY SPRINKLE, California Creek, Madison Co., N.C. LUNG DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Van Baskirk.] _Gentlemen_--I was troubled with my lungs and stomach for five years. I could do no work hardly until I used Dr. Pierce's Golden Medical Discovery. After using five bottles of the "Golden Medical Discovery" and three vials of the "Pleasant Pellets" I was cured, and now I am doing the work for a family of nine. I tried other medicines and nothing would do me any good, and if I had not gotten your medicine I would have been in my grave. I could not recommend it too highly for the good it did me; it is the best medicine I ever got hold of. MRS. E.C. VAN BOSKIRK, Selin's Grove, Snyder Co.,Penn. "COMPLETELY BROKEN DOWN" FROM DYSPEPSIA, CATARRH, SPINAL DISEASE--NERVOUS PROSTRATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: C.M. Niles, Esq.] _Gentlemen_--I wish to express my heartfelt thanks to you for the wonderful cure that your special remedies performed in my case. In the Spring of 1891, I had a severe attack of La Grippe, which left me in bad shape. I consulted as good a physician as there was in the county, and he told me that I was suffering from enlargement of the heart and that I must be very careful about taking: any violent exercise, and I must not allow myself to get excited, as excitement of any kind might prove fatal. He gave me remedies for my trouble which made me feel some better; but being a farmer I was obliged to work hard and soon began to run down. I began to have spells of a terribly deathly sinking feeling at my stomach and a terrible pressure at the heart--in the region of the heart, and sometimes I would fall prostrate and although I was conscious all the time I could not speak aloud. The last of October, 1891, while doing my chores in the morning, I had one of those bad spells and upset my lantern, which resulted in my losing my buildings by fire. My wife was out of health at that time--she, too, was suffering from the effects of La Grippe. Having lost everything eatable for ourselves and stock, I was forced to work very hard to get through the winter. The next February, 1892, we had another attack of La Grippe, which resulted in the death of my beloved wife. The next May, this terrible affliction together with hard work completely broke me down and although I was doctoring all the time I kept steadily growing worse. I got so bad that I could not sleep more than two or three hours any night and very often I would go all night without closing my eyes at all. The last of September, I had to give up work almost entirely. I got so that I _could not walk one-fourth of a mile without being completely exhausted_. One physician whom I consulted said I was suffering with nervous prostration and gave me medicine for it, but I got no better. My food distressed me terribly and after eating, it would sour and I would have to vomit up the most that I had eaten. At last, I got so I had to live on bread made of wheat middlings and for about three months I could not eat anything else, although it seemed as though I should starve to death. I thought I would give anything if I could eat a hearty meal of anything that I wanted, but did not dare to because every kind of food distressed me so. My bowels became badly constipated and for three months I did not have a natural operation of the bowels; and I suffered very much with catarrh, and there was such a pressure across my forehead that it seemed sometimes as though it would burst. I became very despondent. I did not want to go anywhere, neither did I want to see any one, everything looked dark and gloomy to me. When well, I was naturally or a lively disposition and a great hand to joke with my friends, but no one could say anything funny enough to get a smile out of me then. I was always very fond of music too, but I could not bear to hear a bit of music, neither vocal nor instrumental. About the first of February, 1893, some of my friends prevailed upon me to consult a physician who made a specialty of treating chronic nervous troubles; he said I had no organic trouble of the heart and that it was caused by my stomach being out of order; he said that I had a bad kidney trouble and that my spine was affected, and that unless I got help it would end in "Locomotor Ataxia." He said he could help me but it would probably take a year to cure me. He let me have a month's treatment and gave me advice in regard to diet, etc. I thought for awhile that it was helping me but soon I began to go down hill again, and as a last resort I began to take some of the cure-alls (patent) with which the country is flooded; but I soon became disgusted with them and made up my mind there was no help for me. I had to use about all the strength I had to walk; I could not lift my left foot up to step over anything--had to draw it after me; I could hardly sleep; neither could I transact any business, in fact I did not take any interest in any of my affairs. It seemed to me as though I did not have a friend on earth, and I longed for death to come to put me out of my misery. My son, with whom I was living, had been trying for a long time to get me to send to you for treatment, but I had paid out so much money and received no benefit from it, that I did not believe there was any help for me. At last I thought I would write you what I could of my symptoms, and get your opinion of my case, but it took me about two days to write the letter. My head felt so bad that I could not collect myself enough to describe my feelings. You wrote me that my trouble was caused by indigestion, dyspepsia, catarrh, and spinal affection, and that you could cure me, and in fact, make a new man of me if I would send for your special treatment and follow your advice. My son sent for the medicine for me. I took it and followed your directions as near as I could; the first week I could not see much of any change--the second week I could see that I was improving some, the third week I could look back and see that I had gained considerable. I could sleep better; the bloating in my bowels did not trouble me so bad; my stomach did not distress me so much and I could eat different kinds of food and my digestion seemed to be improving fast; and by using your Special Catarrh Remedy my nose began to run (it had been nearly six months that my nose was perfectly dry) and one day it felt as though something gave way in my head--it seemed to be back, in behind my eyes, and I blowed a large amount of filth out of my head that looked like the yolk of an egg, and it was nearly as thick as jelly; after that my head began to improve rapidly and I began to gain in flesh and strength, and the best of all is, I have kept right on gaining until at the present time _I feel as well as I ever did in my life_. Sleep well, can eat three hearty meals every day and digest them too, and eat anything I want, and seven days in a week. To look back now I don't see why I did not apply to you when I was first taken sick. For about ten years ago. I had treatment of you for catarrh, liver and kidney trouble, and you helped me then; also, about eight years ago my wife had two months' treatment from you which helped her of the troubles from which she was suffering at that time. All the reasons that I can give, is, that owing to financial troubles and having to pay out so much for sickness, I could not seem to get the money (that I could spare) to pay for the treatment. Gentlemen, I wish I could express my thanks to you for what you have done for me, but I cannot do it. I am a poor hand to express myself, but I consider my restoration to health almost a miracle, and I firmly believe that I owe my life to you, for I do not believe that I should have lived till the present time had it not been for your Special Treatment. Now, if there is any part of this letter that you would wish to publish, you are at liberty to do so: and if it would be the means of directing any suffering fellow being to a place where they can get relief, I shall be very thankful. Respectfully, C.M. NILES, East New Portland, Somerset Co., Maine. CATARRH, INDIGESTION, AND NERVOUSNESS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: E.A. Baldwin, Esq.] _Gentlemen_--For a long time I was suffering from indigestion, catarrh and nervousness. I was so run down that I could not go to school, and, as the various remedies I tried did me no good, I applied to you, and was advised to try a course of special treatment. After taking only two months' medicines from your noble institution, I feel perfectly restored to health. I have, moreover, recovered my lost flesh, and I am pleased to say need no further medicines. Yours truly, E.A. BALDWIN, Proctorsville, Windsor Co., Vermont. NASAL CATARRH. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss Pollak.] _Gentlemen_--My daughter had for many months severe nasal catarrh with sores forming on the inside of nose; if not attended promptly the sores would come out on bridge of nose and also in the corner of nose and upper lip. We had several physicians attending her, but they gave her only temporary relief. We were advised by a friend who had used your remedies to try them. After using thirteen bottles of Doctor Sage's Catarrh Remedy, and at the same time two bottles of Doctor Pierce's Golden Medical Discovery my daughter was completely cured of the dreaded disease and in the past three years has had no symptoms of the disease ever coming back. I am satisfied the above medicines will cure any kind of catarrh. Yours truly, JOSEPH POLLAK, McPherson, McPherson Co., Kan. CHRONIC NASAL CATARRH RESULTED IN LUNG DISEASE. DESPAIRED OF OBTAINING RELIEF. DR. R.V. PIERCE, 663 Main Street, Buffalo N.Y.: [Illustration: H.J. Converse, Esq.] _Dear Sir_--Without solicitation from you, I feel it my duty to suffering humanity, to make known the virtues of your medicine in curing catarrh. About ten years ago, I first began to realize that I was the victim of nasal catarrh; I tried every known remedy, but gradually grew worse. My ears would gather and break; nights of restlessness would succeed days of agony. The disease finally attacked my left lung, and I despaired of obtaining relief. About six years since I began the use of Dr. Sage's Catarrh Remedy, in connection with the "Golden Medical Discovery," and by the persistent use of the above remedies I feel that I am completely cured of this loathsome disease. For attacks of biliousness, coughs and colds, I think there is nothing equal to the "Discovery," and I bless the day that I first began the use of your remedies. Very respectfully, HOWARD J. CONVERSE, Civil Engineer, Plain City, Madison Co., Ohio. A TERRIBLE CASE OF CATARRH. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Lansing.] _Gentlemen_--I suffered for two years with catarrh in the head, having very severe pains in the top of my head. A hunch came on the side and back of my head--my whole head and face were so sore and sensitive that a pillow of down felt hard, and I was obliged to change my position often. I could not breathe through my nose at all and was obliged to keep my bed fully one half of the time, and could not collect my thoughts to think steadily on any subject--I was really afraid of losing my reason. I got all run-down and was "out of sorts" in general; then I commenced using Dr. Sage's Catarrh Remedy and Dr. Pierce's Golden Medical Discovery. To-day my health is good and I have no catarrh. Yours truly, MRS. JAMES LANSING, Fort Edward, Washington Co., N.Y. CATARRH AND GENERAL DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Thos. Lewis, Esq.] _Gentlemen_--Being an invalid for many years and trying home physicians without benefit, I went to the Invalids' Hotel and Surgical Institute, and can most highly recommend this place to all sufferers. I had a severe attack of catarrh and general debility, and after a short stay at this Institute, my whole system was toned up and I was soon enjoying perfect health. I can truthfully say that this institution fully merits all the praise that could be given it. I never lose an opportunity to recommend all my suffering friends to the Faculty of this Association, for I believe it is in advance of its kind in the world. The physicians and surgeons are skillful and of wide experience, the nurses kind and thoughtful, the rooms large and pleasant, and everything is done to make the visit of any one pleasant as well as beneficial in the highest degree. I do not hesitate to urge all invalids, no matter what their trouble, to place themselves under the care of the eminent physicians of this institution, being confident that they can give them all the relief that possibly can be obtained from medical treatment and skill. Truly yours, THOMAS LEWIS, Kamas, Summit County, Utah. CATARRH AND LIVER COMPLAINT. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Wm. King, Esq.] _Dear Sirs_--After suffering for several years with nasal catarrh and liver complaint, and having become greatly reduced in health, as a last resort I placed myself in your hands for treatment My improvement began almost immediately after entering your institution. I was enabled to leave at the end of one month, having experienced great benefit. The treatment was continued at home for a few months, after which my cure was complete. At the present time, I am able for office work, and feel that I am completely cured of the catarrh and have but little if any trouble with my liver. I shall lose no opportunity to recommend your institution or your medicines to the afflicted. I do most unhesitatingly recommend chronic sufferers to visit your institution or take your remedies at home. Sincerely yours, WILLIAM KING, Rose Bud, Pope Co., Ills. CATARRH, BRONCHITIS, LIVER COMPLAINT AND DYSPEPSIA. Ely, White Pine Co., Nevada. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--For ten years I was greatly afflicted with Catarrh, Bronchitis, Liver Complaint, and Dyspepsia. I tried many doctors and remedies to see if I could not obtain relief, but I grew constantly worse instead of better. I heard much concerning the Invalids' Hotel and Surgical Institute at Buffalo. I concluded to go there and try and obtain some benefit. I staid a month in this famous Institution, and during that time made fine improvement, and when I left felt like another man. I can truthfully recommend this world-renowned Institution to all the afflicted. The Institution itself, in all its appointments, is far in advance of the age. It is more like a home than a hospital; the rooms are large and pleasant; the table the very best; the nurses kind and considerate, and the doctors skillful and of wide experience. While there I saw and talked with a great number of people who had come to this Institution as a last resort, and they were all unanimous in their praise. I cannot say too much in favor of the World's Dispensary Medical Association and its Staff of skilled attendants, nor can I too strongly urge all sufferers to go there, being confident that all within the power of medical science and skill can be done for them there. Would send you my photograph as requested, but there is not a photograph gallery within a hundred miles of here. Yours truly, D.D. Phillips BRONCHITIS; CATARRH. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: Mrs. Osborne.] _Gentlemen_--I was troubled for several years with bronchial disease, having a severe cough a good share of the time. Some of my friends thought I had consumption; I got so weak I could scarcely walk across the floor, and raised a good deal. I commenced taking Dr. Pierce's Golden Medical Discovery and my cough soon got better, and I have not been troubled with it since. That was four years ago; I took only three bottles. I would recommend it to all having throat or lung trouble. I have also used Dr. Sage's Catarrh Remedy with equally good results. I believe that no one need suffer long with chronic catarrh who is within reach of this remedy. Yours respectfully, MRS. LENA OSBORNE, Ripley, Chautauqua Co., N.Y. NASAL CATARRH, LUNG DISEASE, INDIGESTION, ETC. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: H.A. Milne, Esq.] _Gentlemen_--Five years since my family physician pronounced my case Pulmonary Consumption. Since that time I nave taken various treatments, some of which have given relief. One treatment that was administered for nasal catarrh, from which I continued to be affected, caused erosion of the mucous membrane, and destruction of the bony septum which separates the two nostrils. Took cold quite easily, suffered from considerable nasal catarrh, with discharges passing posteriorly dropping into the throat; occasional cough with some shortness of breath on exertion. A deep inspiration caused a dizzy sensation in the head; eyesight was impaired as well as the memory. After sitting for a time, and then quickly rising I suffered from blindness as well as a dizzy feeling in the head. I never felt that I was entirely cured of my lung trouble, having many of the symptoms which are common to those in the incipient stage of consumption. I also suffered from indigestion, torpidity of the liver, and constipation of the bowels. Upon consulting at your Institution, was advised at once to begin the course of specially prepared medicines as indicated in my case. In all, I have only taken two months' special treatment, and it has now been six months since I have required any medicine; all symptoms of disease have entirely disappeared, and I desire to thank you for the interest you have taken in my case, and the treatment prescribed. I have no objection to your publishing my testimony, if by so doing others may be induced to place themselves under your care for treatment at your Institution, or have medicines sent to their homes. Respectfully yours, H.A. MILNE, Mekinock, Grand Forks Co., North Dakota. CONSUMPTION. Ashland, Middlesex Co., Mass., (Box 171). DR. E.V. PIERCE, Buffalo, N.Y.: _Dear Sir_--It is now eight years since I took Dr. Pierce's Golden Medical Discovery. I had a very bad cough, also night-sweats, and was almost in my grave, as we thought, with consumption, when a friend of mine who died with consumption came to me in a dream and told me to take Dr. Pierce's Golden Medical Discovery, and, thank the Lord, I did so. By the time I had taken half of the first bottle I felt so much better, I kept on till I had taken three bottles, that was all I needed. I got well and strong again. Sincerely yours, Clura McIntyre CHRONIC NASAL CATARRH. DR. R.V. PIERCE, NO. 663 Main St., Buffalo, N.Y.: [Illustration: Mrs. Flemming.] _Dear Sir_--I had been troubled with chronic nasal catarrh for a year; could not sleep at night or rest in the day, because I could not breathe through my nose. I tried everything I was told of, and all failed to cure. I read about Dr. Pierce's remedies and thought I would try them. I used three bottles of Dr. Pierce's Golden Medical Discovery, four of Dr. Sage's Catarrh Remedy, and I was relieved within two weeks. I continued these medicines for four weeks, and am perfectly cured. I would advise any one who is troubled with catarrh to use Dr. Pierce's medicines. I am very thankful for the remedies." Yours respectfully, MRS. M. FLEMMING, 698 17th Ave., Milwaukee, Wis. NASAL CATARRH AND DYSPEPSIA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Nuckolls.] _Gentlemen_--Twenty years ago I was nearly dead with nasal catarrh. I had it several years before I knew what it was, then I read Dr. Pierce's description of catarrh. I felt as he described. No one else had ever been able to tell me anything of the symptoms he described. I simply concluded that if he could so minutely describe, he could also relieve, and I immediately placed myself under his treatment--by correspondence. In a few months I was entirely relieved and have not suffered from it since. At the time I placed myself under his care I could not breathe with my mouth closed. My friends thought I could live only a few months more. I have had no return of catarrh and enjoy good health. I believe Dr. Pierce's treatment will cure any case of catarrh. Nine years ago I was under Dr. Pierce's treatment (by correspondence) for dyspepsia. After a few months' treatment I was entirely cured of that terrible disease. Yours respectfully, MRS. HENRY NUCKOLLS, Rockville, Hanover County, Va. CATARRH OF TWENTY YEARS' STANDING. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J. Weaver, Esq.] _Gentlemen_--My catarrh was of about twenty years' standing; my left nostril closed, I could not breathe through it; had a constant pain above my left eye night and day. I commenced using Dr. Sage's Catarrh Remedy, at the same time using the "Golden Medical Discovery"; I used one package and one bottle of "Golden Medical Discovery" and I found great relief; after using the second I thought all was right, but I began to feel the effects of it again, so I got the third and fourth packages, and I am satisfied I am rid of it. Since I commenced using your medicines, I have taken six bottles of Dr. Pierce's Golden Medical Discovery. Yours respectfully, JOHN WEAVER, West Carrollton, Montgomery Co., Ohio. CHRONIC NASAL CATARRH CAUSES GREAT SUFFERING. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Crocker.] _Gentlemen_--I had been a great sufferer from nasal catarrh for a number of years which greatly debilitated my system, and in consequence, have been in poor health for the last five years. Slight exposure would cause bronchial trouble, but kept up under it until a little more than two years ago when I was taken with "La Grippe," which greatly aggravated my other troubles; and for more than six months before consulting you was scarcely able to do anything; _could not breathe through my nostrils_ only a little while at a time either day or night; I suffered _dreadfully_, having at times _terrible pains in my head_ being unable to sleep some nights more than two hours and then not without dreaming, and when I awoke my head felt worse then when I retired. Had indigestion, chronic constipation and stomach trouble. A little more than a year ago, while reading in one of your Memorandum Books I decided to try your Dr. Pierce's Golden Medical Discovery, "Favorite Prescription" and "Pellets;" and after using several bottles, I began to get better and to get some strength, but my catarrh remained about the same until I consulted you by letter and the remedy prescribed proved effectual; after three months' treatment, I am able to do most of my house work. Yours respectfully, MRS. SARA M. CROCKER. P.O. Box 332. Niantic, New London Co., Ct. CHRONIC NASAL CATARRH. THOUGHT HIS CASE HOPELESS--TWO BOTTLES CURE. WORLD'S DISPENSARY-MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: A.G. Meise, Esq. ] It gives me great pleasure to testify to the merits of Dr. Sage's Catarrh Remedy. I can say honestly and candidly that it is the grandest medicine ever compounded for catarrh. I suffered terribly with that dreadful disease and thought my case a hopeless one. I have expended on my case about forty dollars for different remedies guaranteed to cure catarrh in its worst form, but received no benefit therefrom. I also received treatment from two physicians, but they did me no good. Having read a great deal about Dr. Sage's Catarrh Remedy, I concluded to try it. The first bottle gave the most pleasing results, and the second bottle completely cured my case, which I considered hopeless. I most heartily recommend Dr. Sage's Catarrh Remedy to all suffering from catarrh, with the assurance that it will surely cure. It is a great boon to suffering humanity. Hoping that this humble testimony may be the means of leading many sufferers to try your most valuable medicine with the same happy results as I experienced, and wishing you the best of success, I am, Yours sincerely, AUGUST G. MEISE, Vincennes, Ind. NASAL CATARRH. Naples, Uinta Co., Utah. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I have been using Dr. Sage's Catarrh Remedy and have been taking "Golden Medical Discovery" since I last wrote to you. I am well pleased with the result. I feel better than I have for years. The "Golden Medical Discovery" caused a very unpleasant sensation to pass through my body at first but I do not feel it much now. I have recommended it to others and the only complaint I hear now is that our druggist cannot keep a supply on hand. I take pleasure in reporting my case to you, and I feel that the interest you have taken in my case has been a blessing unto me. My mother has suffered with bad legs for over twenty years and last fall they got so bad she was unable to walk. She has taken "Golden Medical Discovery" all winter and is now able to walk a little. She says she feels better in body than she has for years. She has spent the most of her life among the sick and speaks very highly of your medicines. Yours truly, Geo A. Slough IMPURE BLOOD AND CATARRH. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: Rev. J.H. Tate. ] _Gentlemen_--My health is better now than it has been in ten years. I used six bottles of "Golden Medical Discovery," and three bottles Doctor Sage's Catarrh Remedy, and since using your medicines I have been able to do more work than before. I have been teaching school since my health got better and last year I was able to travel and preach fifty-nine sermons, besides my work of teaching. For four years I suffered with catarrh in my head, and impure blood, until my health was very feeble. Dr. Pierce's Golden Medical Discovery I found to be the best blood-purifier I ever used. Had I not used your remedies I believe that I would have been dead to-day, or at least not able to say anything. But instead of that I am able to walk one and one-half miles and teach school every day. Yours truly, REV. J.H. TATE, Wahoo, Sullivan Co., Tenn. CATARRH AND DYSPEPSIA CURED BY SPECIAL HOME-TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: B. Eberhardt, Esq.] _Gentlemen_--I am happy to inform you that my catarrh and dyspeptic symptoms have all vanished. I am no longer troubled with headache and stoppage of the nose, my stomach is in good order, and I enjoy three hearty meals daily without any bad feelings. I have gained in almost every respect, particularly in weight and strength, since beginning the use of your specially prepared medicines. By continuing to follow your special hygienic rules, I believe no relapse will occur. Yours respectfully, BERTHOLD EBERHARDT, N.E. Cor. 10th and Callowhill Streets, Philadelphia, Pa. NASAL CATARRH. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: M.D. Ingram, Esq. ] _Gentlemen_--I have used your Dr. Sage's Catarrh Remedy and Dr. R.V. Pierce's Golden Medical Discovery and they cured me of a severe Catarrh in the Head. I can honestly recommend them to all who may suffer from that distressing disease. Yours truly. M.D. INGRAM, Ingram, Bell Co., Ky. Mr. Ingram had suffered for many years from the most distressing symptoms, such as profuse offensive discharge from nose, stopping up of nose, sneezing, weak eyes and frequent headache. CHRONIC NASAL CATARRH AND LUNG DISEASE. Marlow, Baldwin Co., Ala. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I had catarrh in the head for years, and trouble with my left lung at the same time. You put so much faith in your remedies that I concluded to try one bottle or two, and I derived much benefit therefrom. I used up three bottles of Dr. Sage's Catarrh Remedy, five bottles of your "Golden Medical Discovery," and in four months I was myself again. I could not sleep on my left side, and now I can sleep and eat heartily. So long as I have your medicines on hand I have no need of a doctor; I do not think my house in order without them. Yours truly, A.H. Heard A DEBT OF GRATITUDE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Prof. W. Hausner, Famous Mesmerist.] _Gentlemen_--Some ten years ago I suffered untold agony from chronic nasal catarrh. My family physician gave me up as incurable, and said I must die. At this time I weighed 110 pounds. My case was such a bad one, that every day, towards sunset, my voice would become so hoarse I could barely speak above a whisper. In the morning my coughing and clearing of my throat would almost strangle me. By the use of Dr. Sage's Catarrh Remedy in three months I was a well man; the cure has been permanent, and I now weigh 148 pounds. Yours truly, PROF. W. HAUSNER, Ithaca, Tompkins Co., N.Y. CATARRH, DEAFNESS AND OTHER COMPLICATIONS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: M.C. Weaver, Esq.] _Gentlemen_--I take pleasure in announcing to you that I have been greatly benefited by your medicines; my trouble began with nasal catarrh and extended to my throat and ears; my bowels were inactive and my general health became impaired; my worst trouble, however, was dullness of hearing. I had an uncomfortable, bad feeling in my ears--akin to earache; I had a watery discharge from the nose; I had to hawk and spit a great deal at times; my mind was greatly affected also and had a great deal of pain in the head. Upon advice of friends to try your medicines I resolved to do so. Have used six bottles of your "Golden Medical Discovery" and two bottles of Sage's Catarrh Remedy. The pain in my head is gone and my health is greatly improved and am working every day, something I could not do before. My appetite is good. Yours truly, MORRIS C. WEAVER, No. 171 E. Genesee St., Buffalo, N.Y. BRONCHIAL DISEASE. Clifford, Susquehanna Co., Penna. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--The doctors said I had bronchitis, and I doctored with five different physicians before taking your medicines. My throat would bleed from three to five times a day--half a dozen mouthfuls perhaps--as fresh as if you had cut your finger, and I was in a generally weakened state although able to be about the house, but the least exertion would make me tremble. Finally I purchased one of Dr. Pierce's Common Sense Medical Advisers, and read it a good deal, and so was induced to take your medicines. I took in all seven bottles of the "Golden Medical Discovery," one of the "Favorite Prescription," and one bottle of Dr. Sage's Catarrh Remedy, and some of the "Pellets," and they did everything for me--more than anything else I ever tried. In about six months' time I was well. Now, my throat does not trouble me unless I take cold. It has been about six years since I took your medicines, and I think they cured me. I think there are no medicines equal to your medicines, and would recommend them to all suffering ones. Yours truly, Mrs. Lewis Johnson CATARRH. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: D. Miner, Esq.] _Gentlemen_--I had the catarrh in the head for about fifteen years; my head was always stopped up and I had pains almost constantly. My nose would run, and stuff would fall into my throat whenever I would lie down, and at other times it seemed dry and crusty, and then my head would become stopped up and I would suffer again. I used cubebs and glycerine for a long time; they only relieved me while I was using them. I used several other kinds of stuff, but I received no benefit from them. I had nearly given up in despair. At last I came across one of your advertisements of Dr. Sage's Catarrh Remedy in one of your Memorandum Books, and I thought I would try it. It is the grandest thing on earth. I was thankful to God I found something at last to stop my suffering. May God bless you, dear friends, for saving my life. I used your medicine about eight weeks: it only took two bottles to cure me sound and well after all the rest had failed. Yours truly, DAVID MINER, Bridgeport, Marion Co., Ind. CHRONIC NASAL CATARRH. HALF A DOZEN BOTTLES OF DR. SAGE'S CATARRH REMEDY WITH DR. PIERCE'S GOLDEN MEDICAL DISCOVERY CURES PERMANENTLY A BAD CASE OF CHRONIC NASAL CATARRH. WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.: [Illustration: N.M. Hodges.] _Gentlemen_--I was suffering from chronic catarrh, and bought a half-dozen bottles of your Dr. Sage's Catarrh Remedy, also some of Dr. Pierce's Golden Medical Discovery to purify my blood and I am happy to say I am permanently cured of that disease. Years after this letter was written Mr. Hodges informs us that his cure has remained permanent. Yours truly, N.M. HODGES, Laketown, Rich Co., Utah. CHRONIC NASAL CATARRH. STARTED WITH LA GRIPPE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: E.W. Thomas, Esq.] _Gentlemen_--I think it is time I reported my case to you, as it is five months since I began using your medicines. I have taken five bottles of Dr. Sage's Catarrh Remedy, and used it with Dr. Pierce's Golden Medical Discovery. I have no signs of catarrh now, and can say I never felt better in my life, then while taking your medicine. Two years later Mr. Thomas says: I nave not been troubled with catarrh since taking the "Catarrh Remedy." I am a tenor singer and my voice almost left me when I had the catarrh but now my voice has come back. Yours respectfully, E.W. THOMAS, Box 18, Garden City, Miss. CATARRH AND OTHER COMPLICATIONS. North Berne, Fairfield Co., Ohio. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--My health is good. I am restored from weak eyes, weak stomach, catarrh, also female trouble. I took two bottles of Dr. Pierce's Golden Medical Discovery, one bottle of Dr. Sage's Catarrh Remedy. It took wonderful effect. I have recommended your medicines a great deal, and have done a great deal of work for you. I have been the cause of selling quite a quantity of medicine in this county, and I will do all I can for you. Yours truly, Sarah Campfield CATARRH OF EIGHT YEARS' STANDING. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: E.M. Baily, Esq.] _Gentlemen_--I write this to let you know that I am well of that disease called catarrh of the head. Three years ago this fall I had catarrh in its worst form, till from three gills to one and one-half pints of corruption would be expectorated in twenty-four hours. Then I noticed your advertisement. Six months after taking your medicines I thought it too soon to tell you, but I can now say that my money was well spent in buying your medicine, for it resulted in a permanent cure. The catarrh was of eight years' standing. Yours respectfully, EDWARD M. BAILEY, Taggart, Harrison Co., Mo. DREADFUL COUGH. ABSCESS OF LUNG. Brookeland, Sabine Co., Texas. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: F. Berryman, Jr.] _Gentlemen_--Seven years ago I was on the verge of the grave, with what the physician pronounced an abscess of the right lung. It lingered on for three years. During that time my side discharged large quantities of pus and I had a dreadful cough. I was so weak that I could not walk fifty yards without being completely exhausted. I had taken every kind of medicine that was recommended for similar maladies, such as cod liver oil, sarsaparillas, iron tonic and syrup of hypophosphites, without any relief. I was about discouraged when I commenced taking Dr. Pierce's Golden Medical Discovery. I took six bottles and it completely restored me to health. The discharge stopped from my side, and the cough has ceased. I am now able to follow my profession, which is a teacher of penmanship. I can walk ten miles any day without the least worry. If any one doubts this statement they can write me and I will verify the above statement. Trusting that this may be the means of assisting some one else who is suffering untold miseries, as I did before using the "G.M.D." I am, fraternally thine, F. Berryman, Jr. CATARRHAL DEAFNESS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: S.P. Gray, Esq.] _Gentlemen_--I was nearly deaf on the right side of my head. I used three or four bottles of Dr. Pierce's Golden Medical Discovery and four bottles of Dr. Sage's Catarrh Remedy with the Nasal Douche, in the first trial. Cold weather coming on I had to stop, as I could not use the Injector in freezing weather, but I was greatly benefited. Along towards spring I found it was coming back, from taking cold, and, after several trials of other remedies, I again began the use of your medicines, taking two bottles of the "Golden Medical Discovery" and three bottles of Dr. Sage's Catarrh Remedy, and I feel safe in believing I am cured as I feel no signs of its return. My health is very good for a man of 74 years of age and I am satisfied that Dr. Pierce's Medicines did it. I recommend them whenever I have a chance. Yours respectfully, S.P. GRAY, Graham, Nodaway Co., Mo. BRONCHITIS. LIVER COMPLAINT. 318 E. 83rd St., New York City, N.Y. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I am extremely sorry not to have informed you sooner of the magnificent result I obtained from your most valuable medicines. When, sometime ago, I consulted you in regard to my affliction, bronchitis, I was indeed fearing the worst. But I had so much confidence in your medicines, which I had previously used for colds and liver complaint with good results, that I strictly followed your kind advice and continued taking it until I was assured of perfect health. I took five bottles of your Dr. Pierce's Golden Medical Discovery, using the "Pellets" combined as directed, and _the effect was magical_. I am now healthy and hearty. Heartily thanking you for your kind advice and assistance, I remain, gentlemen. Yours most respectfully, Paolo Bedesing LINGERING COUGH. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y. _Gentlemen_--I contracted a cough during the winter of 1889 and tried many different kinds of cough medicines, but none did me any good. I at last became alarmed, and wrote to Dr. R.V. Pierce to know if he could prepare a medicine that would cure me, and I was advised to try his "Golden Medical Discovery," which I did, and am glad to say that only two bottles cured me after letting the cough run on from the winter of 1889 until the spring of 1893. Yours respectfully, MORGAN. C. LILLY, Holston, Washington Co., Va. NERVOUS DEBILITY AND CATARRH. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Hoffman.] _Gentlemen_--I have enjoyed good health since I took your treatment. I suffered intense agony for five months, and after taking one month's medicine I found very much relief--so much I was surprised. Many thanks for the good your medicines have done me, and my prayers are that God may help you in your good work, and that you may live long and prosper. Yours respectfully, MRS. ALICE HOFFMAN, Box 183, Clarksville, Butler Co., Iowa. NERVOUS DEBILITY AND CATARRH. Big Piney, Pulaski Co., Mo. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I was treated by you eleven years ago for nervous debility and chronic catarrh of eight years' standing and of a very aggravated nature. I was considered near my grave by many of my friends when I commenced treatment. I used eight months' special treatment, after while I used some 12 or 15 bottles of your Sage's Catarrh Remedy, and have had excellent health ever since. Yours truly, B.P. Dake. CURE OF DEAFNESS DUE TO CATARRH. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: T.J. Williams, Esq.] _Gentlemen_--For several years I was troubled with catarrh and deafness of the right ear--the hearing becoming more and more defective until I could scarcely hear at all. There was a constant ringing, roaring noise in my ear, and finally the disease assumed a very painful form. The ear became very sensitive to the touch, and the pain and inflammation extended into the eustachian tube and down into the throat. I could scarcely sleep at night, and during the day I suffered constantly. I finally decided to consult Dr. Pierce, and acting under his advice, I began the use of "Golden Medical Discovery" and Sage's Catarrh Remedy by means of Dr. Pierce's Nasal Douche. I soon began to improve and after using three bottles each of the above named remedies the pain and soreness left my ear, my hearing returned and I considered myself completely cured, and indeed there has been no recurrence of the trouble since. Sincerely yours, T.J. WILLIAMS, Byrneville, Harrison Co., Ind. ASTHMA AND CATARRH. [Illustration: G. Berner, Esq.] WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--For some months I suffered from a shortness of breath and dryness in the throat which usually came on at night, and these symptoms gradually became aggravated until it was impossible for me to procure enough sleep so that I could perform my daily duties about the farm. Deriving no relief from such treatment as I was taking I came to your Institution, was examined by your specialist, who pronounced my case asthma, complicated with nasal catarrh. After using the special medicines which he prepared for me for a few days I commenced to feel better, the shortness of breath gradually disappearing; the paroxysms of asthma were less frequent and not so severe. After taking only two months' treatment I was completely restored to my previous good health, and for five months it has not been necessary for me to use any medicine, and I feel that I am perfectly well. I give you this testimonial in order that others who are similarly afflicted may know of your skill in treating cases of this nature, and seek relief from your Institution. Respectfully, GOTTLIEB BERNER, Cheektowaga, Erie Co., N.Y. ASTHMA COMPLICATED WITH BRONCHITIS. [Illustration: T.E. Stanton, Esq.] WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--It is five weeks to-day since I was at your place for medical treatment for a bronchial and asthmatic difficulty; it had got so bad that it was hard work for me to breathe if I moved around any; I have sat up many a night for when I laid down I could not get my breath. I had six different doctors to aid me--all the good they did me was to get my money. Can say, of a truth, that you have done mo more good than all other doctors. One doctor said I would not live two years; that is four years ago and I am yet alive. I am sure I am now on the safe road to recovery with your treatment. Yours, etc., T.E. STANTON, Manlius, Onondaga Co., N.Y. ASTHMA, OR PHTHISIC. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: A.F. Buttles.] _Gentlemen_--In gratitude to yourselves as well as to give my fellow sufferers the benefit of my experience I wish to say, that immediately after receiving your courteous reply to my letter, describing the difficulty in breathing after any extra exertion, I began taking Dr. Pierce's Golden Medical Discovery, and before I had finished the first bottle I was greatly relieved. I have taken less than one-half dozen bottles, and although the disease was of about three years' standing, I can now do as big a day's work as any of my neighbors and as many of them, for all of which I am indebted to the "Golden Medical Discovery." Yours respectfully, AVERY F. BUTTLES. Norden, Keyapaha County, Nebr. NASAL POLYPI. WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.: [Illustration: G.H. Bailey, Esq.] _Gentlemen_--It is with pleasure that I can testify to your skillful operation in removing a number of nasal tumors. I had been a great sufferer from acute headaches, caused by the tumors, for years. I cannot speak too highly of the benefit I received at your Institution the two months I stayed with you. I feel sure of a permanent cure as I do not have the headaches as formerly. Yours respectfully, GEORGE H. BAILEY, Hinsdale, Cheshire Co., N.H. ASTHMA CURED. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Kyker.] Gentlemen--My wife was afflicted with asthma for twenty years: as she grew older she grew worse. Her case was treated by three eminent doctors, but all failed; they told me there was no cure for it. Discouraged as I was, I resolved to try Dr. Pierce's Golden Medical Discovery; she used five bottles and two vials of your "Pleasant Pellets," which has made a permanent cure. She has gained twenty pounds in weight since the cure was effected. Yours truly, D.R. KYKER, English, Cocke Co., Tenn. COMPLICATION OF DISEASES. A GRATEFUL PATIENT'S WORDS OF PRAISE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main Street, Buffalo, N.Y. [Illustration: W. Henkel, Esq. ] _Gentlemen_--Having been in your Institution as a sufferer from two distinct chronic diseases of years' standing, and having been placed under the charge of your specialists, I was speedily relieved of my afflictions. The Invalids' Hotel is a place as much like home as it is possible for such an institution to be. The physicians and surgeons are all expert specialists and thoroughly efficient; the nurses are very competent, attentive and kind; and, in fact, the whole _personnel_ of the Invalids' Hotel endeavor to do their best to make the patients feel like being at home. I always felt while there as if I was one of the family. I gladly recommend your Institution to all persons who are afflicted with any kind of chronic disease, for from my own experience I _know_ the professional staff will do all which they promise to do. Please accept my thanks for the speedy benefits and perfect cure of my diseases, and I think your Institution is worthy of the highest endorsement. Yours truly, WILLIAM HENKEL, No. 1917 Congress Street, St. Louis, Mo. LUNG TROUBLE. WORLD'S DISPENSARY MEDICAL ASS'N, Buffalo, N.Y.: [Illustration: Mrs. Sunderland.] _Gentlemen_--When I commenced taking your medicines, eighteen months ago, my health was completely broken down. At times I could not even walk across the room, without pains in my chest. The doctor who attended me said I had lung-trouble and that I would never be well again. At last I concluded to try Dr. Pierce's medicines. I bought a bottle of "Golden Medical Discovery," took it and soon commenced to feel a little better, then you directed me to take both the "Golden Medical Discovery" and the "Favorite Prescription," which I did. Altogether I have taken eighteen bottles of "Golden Medical Discovery," twelve of the "Favorite Prescription" and five vials of "Pellets." I am now almost entirely well and do all my work without any pain whatever, and can _run_ with more ease than I could formerly _walk_. Yours truly, MRS. CORA L. SUNDERLAND, Chaneyville, Calvert Co., Md. ASTHMA, OR PHTHISIC. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Owen.] _Gentlemen_--For six or seven years I have been a great sufferer from asthma, being for weeks so I had to sit in my chair night and day; and to all people suffering with the disease, I am glad to recommend your medicines of which I have taken only a few bottles. I now call myself cured, for I have not had asthma for a long time. Yours respectfully, MRS. EMILY OWEN, Hinsdale, Cheshire Co., N.H. NERVOUS PROSTRATION FOLLOWING GRIP. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: W.S. Nicholson, Esq.] _Gentlemen_--In January of '90 took the "grippe," went to work before I was well, was caught in a rain which gave me a very bad relapse, resulting in lung fever and complete prostration; was on my bed two months, and when I did get out, the strength to walk any more than just a few rods did not come back. My family doctor and two prominent physicians of Sioux City, did me no good. Late in the fall I got a bottle of Dr. Pierce's Golden Medical Discovery, which quieted my trembling nerves and gave me an appetite to eat. I then concluded to try the Doctor, personally. Up to this time I was in a pitiable condition. Sometimes I could not sleep until I felt almost wild, then sleep so much I would be stupefied. I could not digest any food and my whole system was wasting and failing fast. I doubt if any one who saw me expected me to get well. I took the treatment sent me by the World's Dispensary Medical Association for more than a year. The medicine never gave me any distress as other medicines had done before. I began to improve from the start, but the change from one extreme to the other was like the growth of a child. To any one suffering from nervous prostration I would say, "don't be impatient." It takes a long time for weakened nerves to grow strong. I have at last become strong and well, thanks to the Giver of all good and the grand Institution at Buffalo. I nave since married a noble-hearted young woman, and when I am playing with our sweet, healthy, baby girl, I give way to the thought that at last the long, Bad chapter of my life is ended; at such times her merry laugh sounds like a song of triumph of life over death. Gratefully yours, W.S. NICHOLSON, Willow Creek, Clay Co., Iowa. * * * * * DISEASES OF THE HEART. Diseases of the heart are classified as either _functional_ or _organic_ We shall dwell only briefly upon purely _functional_ derangements of the heart; as _increased_, or excited action, _defective_, or enfeebled action, and _irregular_ action. Increased action of the heart, indicated by palpitation, or increased number of the beats, may be caused _mechanically_, as by distention of the stomach, which, by preventing the descent of the diaphragm, excites the action of this organ. Or it may be a _sympathetic_ disturbance produced through the nervous system; thus the emotions and passions may suddenly arouse the heart to excessive action; or the presence of worms in the intestines, improper food, and masturbation, may be the cause. The use of tea, tobacco, and alcoholic drinks excites the heart. We have found that the excessive use of tobacco is very frequently the cause of functional derangement of this organ. Deficiency of the blood, as in anæmia, may be the cause of palpitation of the heart. Functional disturbance of the heart's action is manifested by palpitation, irregularity, intermissions, a rolling or tumbling movement, and a feeling as if the heart were in the throat. These symptoms often give rise to great apprehension, anxiety, fear, and depression of mind. TREATMENT. The curative treatment of functional derangement of the heart must have reference to the causes producing it. If it is in consequence of indigestion, the appetite and digestion should be improved by observing regularity in the time of taking the meals, and eating very easily-digested food. The use of strong tea, coffee, tobacco, and spirits, should be interdicted, and regular exercise, rest, and sleep should be enjoined. In all cases, the domestic management should include daily bathing, exercise in the open air, regular habits, and the avoidance of all causes which tend to excite the heart's irregularity. _The remedial treatment_ of these functional affections ought to be confided to some experienced physician, as the remedies are not within the ordinary reach of all families, nor if they were, would they have sufficient experience and knowledge to select and properly administer them. ORGANIC DISEASE OF THE HEART. By organic disease we mean disease pertaining to the structure of the heart itself, in contradistinction to _functional_ disease, which has reference merely to the _action_ of the heart. The heart is subject to various organic diseases, but we have only space to consider, in the briefest manner, those which are the most common. It is essential that the reader should have some knowledge of the anatomy and functions of the various parts of the heart in order that its diseases and their effects may be comprehended; therefore the anatomy and physiology of this organ, given in Part I, Chapter VII, of this work, should be carefully studied. It is very evident that any disease which affects the structure and function of any part of the heart must, necessarily, give rise to certain modifications of the pulse, sounds, etc. It is through the observation and study of these modifications and changes that we arrive at a correct diagnosis as to the precise location and character of the disease. [Illustration: Fig. 1. Pond's Sphygmograph.] Until within comparatively recent years, physicians were very much in the dark regarding diseases of the heart. Now, however, with a thorough knowledge of the anatomy, physiology, and pathology of the heart and the parts surrounding it, and with the aid of instruments which modern ingenuity has given us, we are able to diagnosticate with precision the slightest lesions of any part of this important organ, and, knowing their nature, to map out an appropriate course of treatment. With the aid of the stethoscope, invented by Laennec and improved upon by Camman, we are able to distinguish the slightest deviation from the normal sounds, and, by noting the character of the sound, the time when it occurs, the area over which It is heard most distinctly, and the direction in which it is transmitted, to locate the lesion which produces it. By the aid of the sphygmograph, first invented by Herrisson, and afterward improved upon by Ludwig, Vierordt, Marey, and lastly by Pond, of our own country, the pulsations at the wrist are registered, and thus made perceptible to the eye. We herewith give a cut, Fig. 1, of Pond's instrument, and two tracings made by it. The first is a healthy tracing, and the second indicates enlargement, technically called hypertrophy, of the heart PERICARDITIS, or inflammation of the membranous sac which surrounds the heart, may be either acute or chronic. The symptoms in acute pericarditis are made up from co-existing affections, and are frequently associated with articular rheumatism, Bright's disease of the kidneys, or pleuritis The intensity of the pain varies in different individuals. The action of the heart is increased, the pulse is quick, and vomiting sometimes takes place. When this disease is developed in the course of rheumatism, it is known as rheumatic pericarditis, and is almost always associated with endocarditis. In some cases acute pericarditis is very distressing, in others it is mild. The fatality is not due so much to the disease itself, as to co-existing affections. When it does not prove fatal, it sometimes becomes chronic. In chronic pericarditis, pain is seldom present. The heart is generally more or less enlarged, its sounds are feeble, the first being weaker than the second. ENDOCARDITIS, or inflammation of the membrane lining the cavities of the heart, is one of the most frequent forms of heart disease. It is almost invariably associated with acute rheumatism, or some of the eruptive fevers, as small-pox, scarlet fever, etc., and is due to the irritation of the unhealthy blood passing through the heart. The disease is generally attended with little or no pain, and, consequently, if the attending physician be not on the alert, it will escape his observation. When associated with acute rheumatism, the disease is only in rare instances directly fatal, but in the great majority of cases it leaves permanent organic changes, which sooner or later develop into valvular affections, and these may eventually destroy life. When the disease occurs, however, as the result of pyæmia (blood-poisoning produced by the absorption of decomposing pus or "matter") or of diphtheria, or when it is associated with any other septic conditions, it constitutes a very grave element. Collections of matter formed on the membrane lining the heart and covering its valves, are liable to be detached and carried by the circulation to the brain, spleen, or liver, where they plug up some artery, and thus cause death of the parts which it supplies with blood. Chronic endocarditis generally occurs in rheumatic subjects, unassociated with any acute disease, It may exist without any marked symptoms, except, perhaps, a sense of oppression and uneasiness in the chest, with palpitation. It produces a thickening and hardening of the membrane lining the heart, and generally causes a retraction, adhesion, and degeneration of some of the valves of the heart, thus bringing on valvular disease. VALVULAR LESIONS are, as we have seen, very frequently the result of endocarditis. They are of two kinds. First, those which prevent the valves from flapping back close to the walls of the ventricles, or arteries, thus diminishing, to a greater or lesser extent, the size of the valvular orifices, and offering an obstruction to the free flow of blood through them; and which consist of a thickening and retraction, or adhesion of the valves, chalky deposits, morbid growths, etc. Secondly, those which prevent complete closure of the valves, and thus permit a return of the blood into the cavity from which it has just been expelled. These latter consist of retractions, perforations, and partial detachments of the valves, chalky deposits around the base of the valves and in them, and rupture of the chordæ tendineæ. These two forms of lesions are usually co-existent, one generally being more extensive than the other. Thus, the regurgitation may be slight, and the obstruction great, or _vice versa_. The symptoms and disturbance of the circulation are altogether dependent upon the location and form of the lesion, or lesions. Each valvular lesion has its characteristic sound, or murmur, which is heard at a particular period in the cycle of the heart's action, and it is, as before stated, from these sounds, from tracings of the pulse, and from the many other indications, that we arrive at a diagnosis. Thus, in obstruction of the orifice at the junction of the aorta with the left ventricle, one of the most frequent of valvular lesions, a murmur, generally harsh in character, is heard with the first sound of the heart, with greatest intensity directly over the normal position or the aortic semilunar valves. This is conveyed along the large arteries, and may be heard, less distinctly, over the carotids. In the sphygmographic tracing, the line of ascent is less abrupt than in the normal tracing (Fig. 2), and not nearly so high, and it is rounded at the top. In aortic regurgitation, the line of ascent is similar to that of the healthy tracing, but the line of descent is very sudden. The left side of the heart is almost invariably the primary seat of these affections, but in the latter stages of their course, the right side also is liable to become involved, and, as a consequence, there then exists great disturbance of the venous circulation, with a damming back of the blood in the veins, and passive congestion of the liver, kidneys and brain, followed by dropsy, albumen in the urine, etc. [Illustration: Fig. 2. The above is a representation of a tracing of a healthy pulse as made with the Sphygmograph.] HYPERTROPHY OF THE HEART consists of a thickening of the muscular walls of this organ. It may be confined to one portion of the heart, or it may affect the entire organ. The affection has been divided into the following three forms: _Simple hypertrophy_, in which there is an increase in the thickness of the walls of the heart, without any augmentation in the capacity of the cavities, and which is usually the result of chronic Bright's disease, or great intemperance; _eccentric hypertrophy_, in which there is an increase in the thickness of the walls of the heart, together with increase in the capacity of the cavities, and which is generally the result of some valvular lesion; and _concentric hypertrophy_, in which there is an increase in the thickness of the walls of the heart, with a decrease in the capacity of the cavities. Valvular lesions, obstructions in the large arteries, or, in fact, any thing which calls upon the heart to constantly perform an undue amount of labor must, necessarily, produce hypertrophy of its muscular walls, just as the undue amount of labor which the blacksmith's arm is called upon to perform produces hypertrophy of its muscles. With this condition, the pulse is hard and incompressible, and the line of ascent in the sphygmographic tracing (Fig. 3) is higher than in health. [Illustration: Fig. 3.] DILATATION OF THE HEART is a condition which is closely allied to hypertrophy of the heart, and which consists of an increase in the capacity of the cavities of the heart, with diminished contractile power. In simple dilatation, there is an increase in the capacities of the cavities, without any marked change in the walls of the organ. It is usually the result of some disease which has produced great muscular prostration, and which has interfered materially with nutrition. More frequently, however, dilatation is the result of valvular lesions, and is associated with hypertrophy, there being an increase in the thickness of the walls with a diminution of the contractile power. The hypertrophy from valvular lesions goes on increasing until it reaches a certain stage, when dilatation commences, the two conditions then being associated. ATROPHY of the heart is the opposite to hypertrophy, and signifies a wasting away of the muscular substance, and a diminution in the thickness of the walls of the heart. Its power is diminished in proportion to the degree of atrophy. FATTY DEGENERATION of the heart consists in the deposition of particles of fat within the _sarcolemma_ (the sheath which invests the fibrils), which are substituted for the proper muscular tissue. If the fatty degeneration exists to any extent the muscular walls present a yellowish color, and the heart is soft and flabby. This may be confined to one ventricle, or it may affect the inner layer of fibres, the outer layer remaining unchanged. Degeneration of the left ventricle occasions feebleness of the pulse. Difficulty in breathing is one symptom of this disease, especially when the right ventricle is affected. There is pallor, feeble circulation, cold extremities, and frequently dropsy. Fatty degeneration is more liable to occur in corpulent persons, and between the ages of forty and fifty years. ANGINA PECTORIS, also termed _neuralgia of the heart_, might be included among the diseases of the nervous system, but as it is usually associated with a derangement in the action of the heart, it may be properly considered in this connection. The pain varies in intensity, sometimes being very acute, at others assuming a milder form. The action of the heart is more or less disturbed. The beats are irregular, at times being strong, while again they are feeble. A feeling of numbness is experienced in those parts to which the pain penetrates. These paroxysms _usually_ continue but a few minutes, although they sometimes last several hours. Persons suffering from angina pectoris are liable to sudden death. It is connected with ossification, or other organic changes of the heart. Usually these paroxysms, if the life of the patient continues, become more and more frequent. The danger is not to be measured by the intensity of the pain, but by the co-existing organic disease. Although it is not absolutely certain that organic disease is present in all cases of angina pectoris, yet the exceptions are so rare that when the signs of organic disease cannot be detected, it may be inferred that angina is not the real affection, or that the existing lesions escape observation. Those who suffer from this disease are, in the great majority of cases, of the male sex, and rarely under the age of forty. TREATMENT. In the foregoing consideration of organic diseases of the heart, we have omitted to speak of their remedial management, for the obvious reason that unprofessional readers are unable to correctly distinguish between the various diseases of this vital organ; and it would, therefore, be useless for us to attempt to instruct them as to the medicinal treatment of the different cardiac affections. In the vast majority of instances, diseases of the heart are not necessarily speedily fatal. Persons have been known to live twenty years or more with very extensive organic disease of this organ. It is _very important_, however, that a correct diagnosis be made in the early stages of these diseases, in order that an appropriate course of hygiene and treatment may be adopted, which will check their progress. While we cannot cure extensive organic diseases of the heart, we _can_ check their progress, and prolong life, and render the condition of the subject comparatively comfortable. Since we are able to diagnosticate with the utmost precision the various affections of the heart, and since the discovery of certain specific medicines which exert most beneficial effects, we are enabled to treat this class of maladies with the most gratifying results. Thus we have seen a case in a very advanced stage of the disease, with the breathing so difficult that the subject had been compelled to remain almost constantly in the sitting posture, in the greatest agony, for so long a time that immense bed sores had formed on the seat; in which the dropsy had become so extensive that the skin of the legs had burst open; and yet this patient, through the influence of a specific course of treatment, was speedily relieved, and enabled to live in a comparatively comfortable condition for many months. One afflicted with heart disease should abstain from the use of all kinds of stimulants, tobacco, and whatever tends to lower vitality. His life should be an even one, free from all excitement of any kind whatsoever. He should avoid severe physical exertion, and everything which causes the heart to beat with undue frequency. There are certain symptoms, the result of _chlorosis_ (the green sickness), a deficiency of blood, dyspepsia, uterine disease, and certain nervous affections, which may simulate those of real organic disease, but the physician of education and experience, with a trained ear, is able to detect the difference speedily. SORE MOUTH. (STOMATITIS.) Stomatitis, or inflammation of the mucous membrane of the mouth, may include the entire surface of the gums, tongue, and cheeks, or appear only in spots. Vesicles are formed, having swollen edges and a white or yellow center, which finally ulcerate. When mild, the affection is confined to these parts. If the inflammation is acute, the mouth is dry and parched, or as is more frequently the case, the flow of saliva is abundant and acrid, and, when swallowed, irritates the stomach and bowels, producing fever, diarrhea, griping pains, and flatulency. The tongue is either coated white or red, and is glossy, and the sense of taste is considerably impaired. Digestion and nutrition are then disturbed, and the patient becomes rapidly emaciated. THRUSH, OR CANKER, is that form of stomatitis in which white ulcers locate on the inner side of the upper lip, the tongue, or roof of the mouth; the irritation which they cause not only interferes with eating, but produces fever, together with the symptoms previously mentioned. APTHÆ, or follicular inflammation, is distinguished by very painful little ulcers, single or in clusters, scattered over the surface of the tongue and lining of the mouth. Sometimes it is complicated with little lumps in the tongue. These form ulcers and denote scrofulous inflammation. Fissures and cracks in the tongue indicate derangement of the stomach. THE CAUSES of stomatitis, in nursing infants, are unhealthy milk, or effete matter, which, for lack of proper care and cleanliness, accumulates upon the nipple. In older children, improper diet, irritants, debility of the digestive functions, or hereditary syphilitic taint, disorder the blood and induce local inflammation. TREATMENT. Locally, use a wash of golden seal or gold thread sweetened with maple-sugar, and rendered slightly alkaline with borax or saleratus. Also use a very weak, alkaline tea, or one of slippery-elm flour, to obviate the acridity of the secretions. If the sores do not heal, constitutional treatment may be required, as the use of the Golden Medical Discovery. The family physician should be consulted if the sore mouth resists all these remedial measures. NURSING SORE MOUTH. (STOMATITIS MATERNA.) During the period of nursing, and sometimes in the latter months of pregnancy, women are liable to a peculiar variety of sore mouth. The soreness is sometimes so great that, although the appetite may be ravenous, the patient cannot eat. When this condition extends to the stomach and bowels, symptoms of a very grave character appear, and the disease, by interfering with the process of nutrition, causes emaciation and debility, and in extreme cases, death. It is a strange affection, nearly always disappearing upon weaning the child, though this course is not absolutely necessary. It appears to depend upon a hepatic, or gastric derangement, in connection with a vitiated condition of the blood, but how this is brought about is unknown. SYMPTOMS. The disease sometimes comes on suddenly, at others more slowly. The fact that the woman is either pregnant or nursing, is of importance in forming a diagnosis. At first there is a severe, scalding sensation of the tongue, mouth, and fauces, with pain, which is sometimes intense. The color of the tongue is often pink, or a light red, while the mouth is generally of a deeper hue. This stinging, biting sensation is accompanied by a profuse, watery discharge from the mouth, which seems extremely hot and acrid, causing excoriation whenever it comes in contract with the face or chin. The appetite is good, sometimes ravenous, but food or drinks, except of the blandest character, occasion such intense pain that the patient avoids their use. Ulceration occurs after a little time. The bowels are generally constipated, but when the disease extends to the stomach or intestines, diarrhea occurs. There is generally anæmia, debility, and impairment of the vital powers. TREATMENT. The indications for treatment in this affection are to overcome the vitiated condition of the blood, and to sustain the vital powers. The remedies for this purpose are alteratives, antiseptics, and tonics. Give the Golden Medical Discovery, the value of which may be greatly enhanced by adding one-half ounce of the fluid extract of baptisia to each bottle, in doses of a teaspoonful four times a day. Chlorate of potash, half an ounce in a pint of water, used as a wash and gargle, is of great value. A teaspoonful of the same may be swallowed several times a day. This will not interfere with other medicines. As a tonic, the tincture of the muriate of iron, in five to ten-drop doses, diluted with water, may be taken three or four times daily. Quinine, in one or two-gram doses, should be given with the iron if the debility be extreme. When there is great acidity of the stomach, which may be known by heart burn, saleratus may be taken in water, to neutralize it, but should not be drunk within an hour of the time for taking other medicines. If constipation exists, use the Pleasant Pellets. This course of treatment, thoroughly carried out, will seldom fail to effect a perfect cure, without weaning the child, yet this latter course may sometimes become advisable to promote the recovery of the patient. Should the treatment advised not produce the desired result, a skillful physician's services should be secured, as he may, in individual cases, distinguish other important indications which may enable him to modify the treatment to advantage. DIARRHEA, CHOLERA INFANTUM, OR SUMMER COMPLAINT, AND DYSENTERY. These diseases are usually considered separately by medical writers but, as they are closely related, a simple diarrhea not unfrequently running into a _cholera infantum_ or a dysentery, we shall consider them together. DIARRHEA is an affection characterized by unnaturally frequent evacuations from the bowels of a liquid of morbidly soft consistency. It may be simple or inflammatory, and acute or chronic. A diarrhea is said to be bilious when the discharges are composed principally of serum, highly colored with yellow or green bile; catarrhal, when they are of a semi-transparent, mucous character; serous, when the dejections are thin and watery, sometimes mixed with blood, bile, or ingesta. The symptoms of the affection are usually at first those of indigestion, a fullness of the stomach, flatulency, and colicky pains. The pains, which precede each evacuation, are intermittent in character. There may be an unpleasant sinking sensation in the abdomen, and, with the discharge, exhaustion, a feeble pulse, and a cool skin. In the inflammatory variety, there is more or less fever. CHOLERA INFANTUM, or summer complaint, is a disease peculiar to the warm season, and more prevalent in cities, and among those children who do not nurse at the breast. It is characterized by great irritability of the stomach, and persistent vomiting and purging, the discharges from the bowels being copious and watery, and sometimes containing specks of curd, yellowish-green matter, and mucus. The limbs of the little sufferer are usually drawn up, indicating pain in the bowels, and there is great prostration with cold extremities. The invasion may be so sudden, and the disease so violent as to destroy life in a few hours. DYSENTERY, also known as _bloody-flux,_ consists of an inflammation of the mucous membrane of the large intestine, with ulceration of the affected surfaces. The disease is accompanied with much nervous prostration, and is distinguished by severe pains in the abdomen of a griping nature, followed by frequent scanty and bloody stools, and much straining. Occasionally the attack is ushered in with a chill and aching pains in various parts of the body, with copious fecal dejections. In other cases the attack is preceded by loss of appetite, a sense of uneasiness with dull pains in the abdomen, and weariness. The disease, like diarrhea, may be either acute or chronic. THE CAUSES of these affections of the bowels are many and varied. They may be brought on by exposure to cold and wet, or by improper and indigestible articles of food, such as unripe fruits, salads, pastries, and, in fact, anything which interferes with the normal operations of the digestive apparatus. One of the most fertile sources of diarrhea in infants, and of _cholera infantum_, is the administration of unsuitable food, the ill effects of which are greatly increased by exposure to heat or cold. Uncleanliness, and the inhalation of impure air, are prolific causes Of these diseases. Epidemics have been supposed to be due to some peculiarity in the condition of the atmosphere, or to some impalpable germ of a vegetable or animal nature. TREATMENT. In the treatment of these diseases, one should first endeavor to ascertain the cause of the trouble, and then, if possible, effect its removal. Attention should be given to the hygienic surroundings of the individual afflicted; if he reside in a miasmatic district, or in a location in which the atmosphere is contaminated by the decomposition of animal or vegetable matter, or filled with noxious gases, his abode should be changed. A pure, dry air is most beneficial in these cases. Only the least irritating and most easily digestible articles of food should be taken. Healthy cow's milk is slightly alkaline, but that of cows fed on slops is usually acid, and unfit for infants. It is, therefore, well to test all milk with blue litmus paper before feeding it to young children. If found to be strongly acid, that is if it turns the paper red, it should be rejected, but if only slightly so, sufficient lime water may be added to render it slightly alkaline. For adults and older children, the diet should consist of such starchy foods as arrow-root, sago, corn starch, and rice, and of ripe grapes, freed from the skins and seeds, peaches, and boiled milk, or milk and lime water. In some cases the animal broths are beneficial, especially mutton broth. To quench the thirst, crust coffee, rice coffee, and lemonade, in small quantities, may be taken. Rest is important in these diseases. In severe cases, the patient should be kept in bed. At the onset of an attack of diarrhea or dysentery, if there be reason to believe that the intestinal tract contains irritating matter, a dose of castor oil, with a few drops of anise oil added to render it palatable, should be administered. After all irritating ingesta have been removed, Dr. Pierce's Compound Extract of Smart-weed should be given in doses proportionate to the age of the patient, and the severity of the case. Being composed of the extract of smart-weed, or water pepper, Jamaica ginger, camphor, and genuine French grape brandy, it exerts a most wonderful effect not only in those diseases but in cholera morbus and intestinal colic. It allays the irritation and inflammation of the affected mucous surfaces, and soothes the nervous system. In the great majority of cases, the above course of treatment will be found sufficient, but in the more severe forms of these diseases additional remedies may be required. In dysentery, accompanied with severe pain and straining, injections of starch water and laudanum, from two to four ounces of the former to from twenty to fifty drops of the latter should be used. Hot fomentations applied to the abdomen are beneficial. If the discharges contain much blood, a flannel cloth moistened with the spirits of turpentine should be laid over the lower part of the abdomen, and kept there until slight irritation is produced. Lime water, bicarbonate of soda, bicarbonate of potash (saleratus), chalk, and the subnitrate of bismuth are valuable agents to correct the secretions, and allay irritation of the diseased mucous surface. The above-named preparations of soda, potash, and bismuth may be taken in doses of from five to twenty grains every few hours. Blackberry root and cranesbill (_Geranium Maculatum_), in the form of fluid extract or infusion, are beneficial in acute cases in which the discharges are profuse and watery, and in the chronic forms of these affections. In _cholera infantum_ subnitrate of bismuth should be given in doses of from five to ten grains at intervals of from two to four hours. If the discharges are very profuse, the fluid extract of cranesbill may be administered in from two to ten-drop doses alternately with the bismuth. The camphorated tincture of opium (paregoric) is required in doses of from two to twenty drops, depending upon the age of the child and the severity of the case, if there is much pain, but great caution should be exercised in administering the preparations of opium to children. A single drop of laudanum given to a young infant has caused convulsions, coma, and death in more than one instance. To check the vomiting of _cholera infantum_, mild irritation over the stomach is sometimes effectual. For this purpose a weak mustard plaster, or a cloth moistened with turpentine, may be laid over the stomach for a few minutes at a time. If the child is old enough to suck pellets of ice, these are beneficial, or a piece can be wrapped in a cloth and sucked. COLIC. _Colic_ is a term applied to griping pains in the abdomen, which are sometimes accompanied with nausea and vomiting. The derangement is recognized in several forms, some of which we shall briefly describe. BILIOUS COLIC. This may be the result of a morbid condition of the liver. SYMPTOMS. It is characterized by severe pain occurring in paroxysms, which may be relieved by pressure upon the bowels. The pulse is quick, the tongue coated, and the skin harsh and dry; there is headache, impaired appetite, acrid taste in the mouth, thirst, nausea, attended with vomiting and general chilliness, followed by febrile symptoms. CAUSE. It may be induced by exposure to cold, in consequence of which the circulation is impeded, the pores of the skin obstructed, and all of the vitiated matters having to be expelled through the liver, stomach, and intestines. It may also be due to malaria in the atmosphere. It most commonly occurs during the autumn, after a season of hot weather. FLATULENT COLIC. Flatulent or "wind" colic is one of the results of indigestion. SYMPTOMS. A sense of fullness in the pit of the stomach, attended with pain, which is transferred from one part of the bowels to another. There is fever, a quick pulse, nausea, and the presence of gas; by the latter feature it may be detected from the other forms. CAUSES. Cold or atmospheric changes, the eating of unripe fruits, uncooked vegetables and those articles of diet which ferment easily, are the principle causes. PAINTER'S COLIC. This form is also known by various names, such as _colica pictonum, saturnine_, or _lead colic_. Those persons who are engaged in the manufacture of lead, and painters, are the most frequent victims of this affection. SYMPTOMS. Impaired appetite, fetid breath, thickly coated tongue, obstinate constipation, a dry skin, scanty urine, languor, severe pain in the umbilical region, and general derangement of the functions of the system. CAUSES. From the term applied to this form, the cause may be inferred. It is induced by the absorption of lead through the lungs, stomach, and skin. TREATMENT. The indication to be fulfilled in _bilious_ colic is to relieve the intestinal spasm. This may be done by drinking freely of a decoction of yam-root, or _dioscorea villosa_, which is an effectual remedy in this affection. If this be not at hand, the spasm may be relieved by administering freely of Dr. Pierce's Extract of Smart-Weed. If the stomach be irritable, a tablespoonful of laudanum and one of tincture of lobelia, in four ounces of starch water, administered as an injection, is effectual. If simple means do not promptly arrest the attack, no time should be lost in summoning the family physician. In _flatulent_ colic, the treatment should depend upon the cause. If it be occasioned by cold, a teaspoonful or two of the Extract of Smart-weed, in warm water or catnip tea, repeated a few times, will be sufficient. If it result from overloading the stomach, a dose of the Pleasant Pellets will answer the purpose. If the pain in the abdomen is severe, apply hot fomentations. Assist the action of physic, by giving an injection of senna and catnip tea, or if the stomach is very sour, take internally some mild alkali, such as common saleratus. In _painters'_ colic, the following cathartic mixture is an effectual remedy: sulphate of magnesia (epsom salts), twelve ounces; nitrate of potassa (saltpeter), half an ounce; sulphuric acid, one drachm; boiling water, one quart. Of this remedy give a teaspoonful every thirty minutes or every hour, until the bowels move. An injection of some diaphoretic tea, or of alum water, is a good remedy. Castor oil and molasses, containing a teaspoonful of spirits of turpentine, will add to the efficiency of an injection. If the colic be not promptly relieved, a physician should be employed. To eliminate the lead from the system, and thus prevent a return of the colic, or other injurious effects, two drachms of iodide of potassium should be added to a bottle of the Golden Medical Discovery, and a teaspoonful of this taken four times a day. JAUNDICE. (ICTERUS.) This affection is generally regarded as a symptom of disordered liver, since it frequently occurs during the progress of diseases of that organ. When the disease imparts a greenish tinge to the skin, it is termed _green jaundice,_ and, when it imparts a blackish color, it is known as _black jaundice._ Jaundice is undoubtedly due to the presence of biliary elements in the blood. CAUSES. In consequence of the varied conditions from which it arises, Professor Da Costa has aptly remarked: "With the _recognition_ of jaundice, the difficulty in diagnosis may be said to begin." He considers the causes of jaundice to be (1) diseases of the liver; (2) disease or the bile ducts; (3) diseases remote from the liver, or general disease leading to a disorder of that viscus; (4) certain causes acting upon the blood. SYMPTOMS. It is characterized by a yellowish color of the skin and of the white of the eyes. The skin is usually dry and harsh; if it be moist, the linen will be tinged yellow from the perspiration. The tongue is coated yellow, the mouth is dry, and the appetite impaired; there is headache, nausea, and sometimes vomiting; there is pain in the abdomen after eating, and in the region of the liver, and it is also felt in the right shoulder, and between the shoulder-blades. In severe cases, there is fever, accompanied with chills, despondency and loss of flesh. The stools are generally of a light clay color, and very offensive; the urine is thick and yellow. When the disease terminates fatally, there is delirium followed by stupor. TREATMENT. The first step should be to eliminate from the system, as speedily as possible, all noxious materials. For this purpose, the spirit-vapor bath should be used. If the urine is scanty or voided with difficulty, take acetate of potash or queen of the meadow. These may be taken in connection with the Golden Medical Discovery and Purgative Pellets, the efficacy of which has already been described in the treatment of chronic inflammation of the liver. They are indeed valuable agents in this disease, since they increase the action of all the excretory glands, and rapidly remove those matters, which, if retained, would poison the system. In some cases, acids are of great value; good hard cider or hydrochloric acid and the acid bath are frequently valuable agents. In other cases the employment, both internally and externally, of alkalies in addition to the Golden Medical Discovery answers the purpose much better. Again, there are persons who, in addition to alteratives and baths, require tonics. In the treatment or this affection, whatever may be the nature of the case, the use of _alteratives_ must not be forgotten, for _without_ them, the auxiliary treatment with acids, alkalies, and tonics, will not produce the desired effect. The employment of drastic remedies is sometimes resorted to; but, although they may give temporary relief, the patient soon relapses into his former condition, while if the treatment above given be adopted, the recovery will be permanent. GALL-STONES. (BILIARY CALCULI.) These are concretions found in the gall-bladder or bile duct, and vary from the size of a pea to that of a hen's egg. There may be no indication of their existence in the gall-bladder until they begin to pass through the duct. CAUSES. The formation of gall-stones is undoubtedly due to an unhealthy condition of the bile. Corpulent persons, and those indulging in over-stimulating diet, or in the habitual use of fermented drinks, are most liable to be troubled by them. SYMPTOMS. The patient is suddenly seized with excruciating pain in the right side. After a time it subsides, but is again renewed with as great severity as before. There is nausea, with vomiting, which is often excessive and severe. The pulse is sometimes slower than is natural, the extremities are cold, there is great exhaustion, together with perspiration and spasmodic contraction of the abdominal muscles. As soon as one stone has passed through the duct into the intestine, immediate relief is experienced until another commences to pass, and the larger the concretion, the greater is the pain. If the stools be washed, the gall-stones may be seen floating on top of the water. TREATMENT. This consists chiefly in relieving the patient of pain and vomiting during the passage of the gall-stones. Hot fomentations made with stramonium leaves and lobelia, and applied over the painful parts, are beneficial. Small doses of lobelia may be taken, but not in sufficient quantities to produce vomiting. Doses of opium should also be taken; this anodyne must, however, be used with care. Gelseminum is often useful. Chloroform, ether, or the spirit vapor-bath generally allays the pain. Carbonate of soda, dissolved in water, often relieves the vomiting. These distressing symptoms are apt to recur until the removal of all the gall-stones is effected. To aid in removing them, take the Golden Medical Discovery rather freely for a day or two, and continue its use with lobelia, in doses sufficiently large to produce nausea, but not vomiting. From four to eight ounces of sweet oil may be given, and, if the bowels do not respond within three hours, repeat the dose, and the gall-stones will generally be evacuated. To prevent the formation of these concretions take the Golden Medical Discovery, together with alkaline drinks made with carbonate of soda. Tone and energy will thereby be imparted to the liver, the free flow of bile will be insured and the subsequent formation of gall-stones prevented. INTESTINAL WORMS. We have not the space to discuss the numerous theories which have been offered to account for the presence of these parasites in the human body. We shall enumerate the principal species, describe the symptoms indicating their presence, and indicate the proper remedies. There are five species of intestinal worms, sufficiently common to merit a description. (1.) The round worm, termed by naturalists, _ascaris lumbricoides_, varies from six inches to a foot in length, and resembles the common earth-worm. It infests the small intestines, and seldom migrates into the stomach or large bowel. Instances are recorded, however, in which it has crept upward in the esophagus, larynx, nostrils, and eustachian tube; but their presence in these parts is of comparatively rare occurrence, and is generally caused by some local irritation which compels their migration. The fact that they have been found in the peritoneal sac, gave rise to the opinion that they perforate the intestine; but careful observations have proved that they can only escape through openings made by ulcers. This species has been found in adults, but is more common in children from three to twelve years of age. The number of this species existing in a human body is variable. Sometimes only two or three are found. At other times a hundred, and even twice that number, are voided in a few days. (2.) The _ascaris vermicularis_, thread, pin, or seat-worm, is round, very slender, and about half an inch in length. The habitation of this species is the rectum, and they are often found matted together in the excrement. They are very active, even after ejection, and have been known to cause great local irritation by entering the vagina and urethra. Their presence is an occasional cause of masturbation. It is impossible to estimate the number of these parasites that may exist in the human rectum. Great numbers, sometimes, are voided at a single evacuation. (3.) The _tricocephalus dispar_ is a third variety of the round worm, and is said to infest the bodies of almost every species of mammalia. As its name indicates, the upper portion of its body is slender, hair-like, and terminates at the lower extremity in a thick, spiral portion. It is from one to two inches in length, and is found attached by its head to the mucous membrane of the cæcum, and, in rare instances, in the colon and small intestine. They are rarely numerous. _Tæceniæ_ or _tape-worms,_ are hermaphrodites, of a flat, ribbon-like form, and are composed of numerous segments, each of which is provided with a complete set of generative organs, and contains ova for the production of thousands of individuals. Some authors have supposed that each segment, or joint, is a distinct individual, but the existence of one head for the whole precludes this theory. There are two species of _tæniæ_ developed in the human intestine; the _tænia solium_ and the _tænia lata_. (4.) The _tænia solium_ is the species commonly found in America and all the countries of Europe, except France, Russia, and Switzerland. In France, both species are found, but the tænia lata seems to be indigenous to Russia and Switzerland. The _tænia solium_ varies in length from four or five to thirty, thirty-five, or even forty feet. The head is hemispherical and armed with a double row of twenty or thirty hooklets. The genital organs are alternate and placed upon the outer edges of each segment. It inhabits the small intestine, and is usually solitary. (5.) The _tænia lata_, or broad tape-worm, is distinguished by the greater breadth of its segments, and the location of the genital organs, which are found in the centre of each segment. Its small elongated head is unarmed, and has a longitudinal fissure on each side. It usually attains a greater length than the _tænia solium_. SYMPTOMS. The symptoms which the long worms occasion, are frequently somewhat obscure. Thirst, irregular appetite, colicky pains, excessive flow of saliva, enlargement of the abdomen, itching of the nose, pallor of the face, offensive breath, disturbed sleep, and grinding of the teeth, all are common symptoms. Occasionally, convulsions and other nervous affections are produced by the presence of the _ascaris lumbricoides,_ but generally they produce less constitutional disturbance than the other varieties. The passage of this species of worms from the bowels, or their ejection from the stomach, is the only positive evidence of their presence. The _ascaris vermicularis_, thread, pin, or seat-worm, gives rise to most of the symptoms produced by the long worms, but in addition produces intense itching at the anus, and, not unfrequently, an eruption upon that part. The itching is particularly distressing at night. When the little sufferer is well covered, the warmth occasioned by the bed-clothes causes these little parasites to crawl out upon the anus, and produces such paroxysms of itching and pain as to cause the child to kick the covering oft and lie naked. The persistent manifestations of a disposition to lie naked, should excite the parents' suspicions of seat-worms, and lead them to investigate all the symptoms. By examining the child's stools the worms may he found adhering to the feces, and they may also be seen on the anus. Thousands of children suffer untold agony from these little seat-worms, which are left unmolested to torment them, because the parents are unfamiliar with the meaning of the symptoms manifested, and therefore pay no heed to them. We have been thus particular in describing the symptoms indicating the presence of these pestiferous parasites, in order that they may be readily detected. _The Symptoms_ produced by the tape-worm are dizziness, ringing in the ears, increased secretion of saliva, indigestion, ravenous appetite, sharp abdominal pains, and emaciation. The only positive sign of the presence of these parasites, is the passage of pieces of them in the feces. The nervous and other symptoms produced by the ordinary long worms are also caused by the tape-worm. CAUSES. Careful observations have proved that there are certain causes which favor the generation or development of intestinal worms. Among others, we may mention fatty or farinaceous articles of food, gormandizing, constant exposure to a moist atmosphere, and sedentary habits. It is now generally conceded that the development of tape-worms is due to the swallowing of an egg or germ-cell, which is contained in many kinds of animal food, and which the process of cooking has failed to destroy. People living near low marshes, lakes, or the seacoast, are liable to _tæniæ_. TREATMENT. The expulsion of the _ascaris lumbricoides_ may be very easily and pleasantly effected. Santonin is an effectual remedy for this variety of worms. For a child three years old, take santonin, six grains; podophyllin, one grain; white sugar, thirty grains; mix, triturate, and divide into twelve powders, and give one every three or four hours, until they act upon the bowels; or take santonin, ten grains; white sugar, twenty grains; mix, triturate, and divide into ten powders, and give one every night at bed-time, and after giving two or three in this way, administer a mild cathartic. As santonin is almost entirely tasteless, if not combined with other medicines which are unpalatable, no difficulty will be experienced in administering it to children. By reference to the article on anthelmintics in this volume, other valuable vermifuges may be selected, and directions found for their employment. In the removal of thread or pin-worms, anthelmintic medicines taken into the stomach are of little or no value. An injection of a strong solution of salt, is a very efficient remedy. A teaspoonful of turpentine in half a pint of milk makes a good injection. Strong coffee has been recommended as an injection. The anus should be well anointed with vaseline, lard, oil, or fresh butter, after each movement of the bowels. Whatever injection or remedy is used, it should be followed by the application of some ointment to the anus, otherwise they will continue to deposit their eggs about that orifice and multiply there. Various remedies have been used to destroy tape-worms. Among others we may mention the old and time-honored remedy, which consists of two or three ounces of the oil of turpentine, taken in castor oil or some aromatic tincture. A decoction made by boiling two or three ounces of freshly powdered pomegranate bark in a pint of water was used by the ancients, and is now highly recommended as a remedy. Some American physicians have used an emulsion of pumpkin seeds with marked success. Twenty or thirty grains of the extract of male fern, followed by a cathartic is highly recommended for the destruction and removal of tæniæ. TRICHINA SPIRALIS. In 1835, Owen discovered a peculiar parasite, which sometimes infests the human body, and is termed the _trichina spiralis_. The presence of these parasites has given rise to morbid conditions of the system, followed by the most serious results. They are developed in the alimentary canal, and then perforate its tissues and enter the muscles. Twelve trichinæ have been found in a section of human muscle only one-twelfth of an inch square and one-fifth of an inch in thickness. The early symptoms of trichinæ are very uncertain, being the same as those of some other disease. The patient complains of severe pain in the abdomen and is troubled with diarrhea. When the trichinæ pass into the muscles, they occasion great suffering. There are sharp pains in the muscles, the perspiration is profuse, and the patient becomes exhausted. CAUSE. Nearly every case of trichinæ, which has been brought to the notice of the profession, has been attributed to the eating of raw or improperly cooked pork. The parasites can only be detected with a microscope. TREATMENT. The impossibility of removing the trichinæ after they have passed into the muscles is apparent; and, as yet, no special remedy has been recommended to remove them from the alimentary canal. The only safety lies in prevention. Hence raw or imperfectly cooked pork should never be eaten. * * * * * DYSPEPSIA. It is generally conceded that a multitude of human ailments arise from _indigestion_, and in its various forms it taxes the skill of the physician to prescribe the proper remedies. It is undeniable that the closest intimacy exists between happiness and good digestion. A healthy digestion aids materially in making a cheerful disposition, and the "feast of reason and flow of soul" is due as much to the functional integrity of the stomach as to a strong and generous mental organization. Dr. Johnson severely said: "_Every man is a rascal as soon as he is sick._" We all know that a morbid condition irritates the individual and excites sarcastic and disagreeable remarks. And, likewise, an irritable temper and, suddenly aroused passions may not only turn and disturb the stomach, but even poison the secretions. Anxiety, excitability, fear, and irritability frequently cause the perversion of physiological processes. The slightest functional disturbance of the stomach deranges, more or less, all the succeeding operations of digestion and tends to the vitiation and impairment of the delicate processes of nutrition. Dyspepsia may commence and proceed so insidiously as not to excite the suspicion of friends, although the patient generally desires active treatment, such as cathartics, emetics, and medicines to act upon the liver. When the disease becomes confirmed, it presents some of the following symptoms: Weight, uneasiness, and fullness in the region of the stomach, attended by impatience, irritability, sluggishness, anxiety, and melancholy; there is impairment of the appetite and taste, also sourness, flatulency, and, perhaps, frequent attacks of colic, loss of hope, courage, and energy; apathy, drowsiness, and frightful dreams are also symptoms common in the different stages of this disease. There are, furthermore, the accompanying symptoms of a coated tongue, bitter taste in the mouth, unpleasant eructations, scalding of the throat from regurgitation, offensive breath, sick headache, giddiness, disturbed sleep, sallow countenance, heart-burn, morbid craving after food, constant anxiety and apprehension, fancied impotency, and fickleness. The subjects of dyspepsia frequently imagine that they require medicines to act upon the liver, desire active treatment, are endlessly experimenting in diet, daily rehearse their symptoms, and are morbidly sensitive. CAUSES. Overtasking the body or mind, overloading the stomach, the use of improper food, such as stale vegetables and meat, unripe fruits, indigestible articles, improperly prepared food, irregular meals, disorderly habits, the use of alcoholic stimulants, loss of sleep, masturbation irritability of temper, anxiety, or grief may all give rise to indigestion. If the functions performed by the skin are embarrassed by cold, tight clothing, or lack of cleanliness, the nutritive changes cannot properly take place throughout the body, and consequently the digestive functions are embarrassed, as the revolutions of a water-wheel are impeded by the backset of the water. When food is not thoroughly masticated, it is not properly mixed with saliva of the glands of the mouth, and is not prepared for digestion by the acids of the stomach. Whatever diminishes the general strength, impairs the health, or encroaches upon the functions of life, also hinders the perfect solution of food and disturbs in a measure the function of digestion. Whatever diminishes the normal amount of the digestive secretions or perverts their quality, deteriorating their solvent properties, is a cause of dyspepsia. This should be borne in mind in selecting remedies. TREATMENT. The hygienic treatment consists in the regulation of the daily habits, proper selection and preparation of the food, cultivation of cheerfulness, diversion of the mind, and cleanliness of person. We cannot give particular directions as to the kind of diet, as there are no established rules for guidance. Generally, a dyspeptic knows best, from experience, what articles of diet can be taken with the least injury. The directions applicable to the condition of one patient, are not suited to those of another. In dyspepsia, animal food is, as a rule, preferable. Foods rich in starchy matter often ferment and produce distress. Sometimes alkalies may be given with beneficial effect, when there seems to be an excess of acid in the gastric secretions. In some cases, the digestive fluids are weak and fermentation results, giving rise to flatulency and belching. An antiseptic, which may be prepared by mixing a teaspoonful of hydrochloric acid with four ounces of water, of which a teaspoonful may be taken after each meal, will prove beneficial to check the fermentation and aid digestion. The addition of one or two drops of a mixture of one part of carbolic acid and six of glycerine, to the above solution of hydrochloric acid improves its antiseptic properties. Or, Dr. Pierce's Golden Medical Discovery will stop undue fermentation, and from its tonic and invigorating effect upon the lining membranes of the stomach will generally overcome the indigestion. Some people are afraid to take it, when suffering from indigestion, because it has a sweet taste. But the sweet is not saccharine, or sugar sweet, but an entirely different sweet principle which prevents fermentation instead of promoting it. Acidity of the stomach and the attendant irritation may be allayed by the following mixture: Calcined magnesia, one drachm; refined sugar, one drachm; subnitrate of bismuth, one-half drachm; oil of cajeput, ten drops. The dose is half a teaspoonful an hour after every meal. Any dispensing druggist can put it up. It is frequently difficult to prevent the patient from over-distending the stomach, and thus impairing the tone of the muscular coats and prolonging the process of digestion. In consequence of debility, over-exertion, anxiety, or chronic inflammation of the stomach, there is not a proper secretion, in quantity or quality, of digestive solvents, and it matters not whether it be a deficiency of the fluids of the stomach, or of the intestines, or of the pancreas and liver, the result is indigestion. The question of what important agent is lacking, naturally presents itself to the physician. Is it _pepsin_, the active principle of the gastric juice, which converts proteids into peptone, that is wanting, or is there a deficiency of _pancreatin_? Of course the principle which is lacking should be supplied; but has the physician the remedial agents properly prepared, and ready for prescribing? The specialist, having more cases of dyspepsia to treat than the general practitioner, is more likely to have the latest and most approved remedies applicable to loss of appetite, indigestion, impoverished blood, imperfect assimilation, and all diseases arising from faulty nutrition. In ordinary practice, the physician's time is divided in his consideration of acute, chronic, surgical, and obstetrical cases; in fact, much of it is occupied in riding to reach his patients. His attention is continually diverted from one class of cases to another, effectually preventing investigation in any particular direction. His patronage does not warrant him in the outlay of time required for the investigation of particular diseases, and the expense necessary to obtain the latest and best remedial agents for their treatment. In the multiplicity of his cares and arduous duties by night and by day, obstinate chronic cases become an annoyance to him, and whenever he can be otherwise professionally employed, he avoids them, disliking to undertake their treatment. With plenty of time for scientific investigation, ample facilities to meet the demands upon his skill, and each succeeding case presenting some new phase, the treatment becomes a matter of absorbing interest to the specialist, and each success inspires greater confidence. We not only use in the treatment of indigestion, solvent remedies, like pepsin, which act only upon proteids, but also other remedies of recent discovery, which exert a remarkable curative influence in diseases of the digestive organs. The chemistry of digestion and of life is becoming better understood. Any of the free acids may serve to dissolve a precipitated phosphate; but it is only the investigating therapeutist and experienced practitioner who understands which of them is the _most_ and which is the _least_ efficacious. Alkalies may dissolve lithic deposits, but who, unless he be an experienced physician, can detect the fault of nutrition which leads to their formation, or rightly interpret the symptoms indicating it? These simple illustrations of the complications which attend dyspepsia, are mentioned merely to show that they must be anticipated and taken into account in the treatment. The number of cases of dyspeptic invalids treated by the staff of the Invalids' Hotel and Surgical Institute within file past few years, is so large as scarcely to be credited by those unacquainted with the prevalence of this disease. For this reason we have taken unusual pains to investigate the causes of the disease, and have spared no expense to provide the most approved digestive solvents, and stomachic tonics, which invigorate the mucous membrane of the stomach, and materially assist in reducing the food to a liquid condition. Some of these, without being purgative, increase the activity of the liver, and stimulate the intestinal secretions, two very important indications which should be fulfilled by remedies which cause no real depression. The recent important discoveries made in obtaining the active principles from indigenous plants, has opened the way to the use of a few of the most important of these remedial agents, hitherto almost wholly unknown to the medical profession, and the encouraging results attending our practice have amply repaid us for the investigation and originality in our treatment of this affection. A careful chemical and microscopical examination of the urine often discloses the actual morbid conditions which perpetuate this functional disease. CHRONIC DIARRHEA. On account of the frequency and importance of chronic diarrhea, we deem it worthy of special consideration. It is frequently the sequel of the acute form of the affection. The urgent and severe symptoms of acute diarrhea are often abated, but the disease is not completely cured. The bowels are left in an irritable condition, perhaps in a state of chronic ulceration, which perpetuates morbid discharges. The most noticeable symptom is the tendency to frequent and unhealthy discharges from the intestines. The evacuated matter varies much in appearance and character in different cases. The precise location of the morbid conditions which give rise to the discharges, as well as to their extent, modifies the color, consistency, and ingredients of the stools. Most frequently they are dark colored and of very offensive odor. They are of a more liquid character than is natural, except when, as is sometimes the case, periods of constipation alternate with periods of unnatural looseness. Tormina, or griping, is usually present, but not so severe as in the acute affection. Tenesmus, or straining, often accompanies it. The appetite is impaired, there is general debility, and the patient is nervous and irritable. The complexion becomes sallow, the skin dry and rough, the tongue dark colored, and the body emaciated. The affection may be the sequel of neglected or badly treated acute diarrhea, may arise from the injudicious use of powerful purgative medicines, may result from dissipation, unwholesome food, bad air, absence of light, long continued exposure to dampness and cold, overwork, and extreme mental anxiety. Sometimes it is associated with other diseases, such as Bright's disease of the kidneys, scurvy, or some of the various forms of scrofulous disease. The more prominent symptoms are so apparent and so characteristic that the most unskilled may be able to decide whether the patient has chronic diarrhea; but to determine in what portion of the intestinal canal the affection is chiefly seated, to decide upon the extent of its ravages, to ascertain what peculiar shade or type the affection has taken on, to investigate its complications and modifications, to ferret out its producing or aggravating causes, and above all, to nicely and skillfully adjust remedies to meet the depraved conditions, is by no means an easy task, even for the educated and experienced physician. It should be borne in mind that this is a dangerous malady, and one which should not be trifled with or neglected. Its tendency is to corrode and destroy the bowels, a process which if unchecked, must sooner or latter result in death. There is little tendency to spontaneous recovery, nor is a removal of the exciting cause often followed by recovery. The disease becomes so firmly seated, and the powers of life so debilitated, that nature cannot rally. TREATMENT. A warm, salt bath, several times a week, taken at bed-time, is beneficial. Flannel should be worn next to the skin, and the sleeping-room should be warm and well ventilated. As will be seen from testimonials hereinafter inserted, Dr. Pierce's Golden Medical Discovery has achieved great success in curing chronic diarrhea. Its use should be persisted in for a considerable time to strengthen and tone up the bowels. To relieve the discharges, take Dr. Pierce's Compound Extract of Smart Weed, as needed from time to time. CHRONIC INFLAMMATION OF THE LIVER. (CHRONIC HEPATITIS.) This is what is ordinarily termed _liver complaint, torpid liver, and bilious disorder_. Under this head may be considered all those chronic affections known as congestion, induration, and enlargement of the liver, and which result in deficient action, functional derangement, morbid secretion of bile, and various chronic affections. SYMPTOMS. Owing to the liability of other organs to become diseased during the progress of chronic affections of the liver, great precision in diagnosis is required to determine, by the symptoms, the organ which is _primarily_ diseased and those secondarily affected. This requires not only familiarity with the signs of a complicated disease, but also thorough anatomical knowledge of the diseased organ, of the morbid changes which occur in its structure, and their influence on its own functions, as well as on those of other organs. The symptoms may differ according to the circumstances, temperament, sex, age, or constitution of the individual, and the complications of the disease. The local indications are fullness of the right side, thus denoting congestion of the liver; a dull, heavy pain, which is increased by pressure or by lying on the left side; a sense of fullness, weight, and oppression about the stomach; an aching in the right shoulder-blade; a dull, disagreeable pain in the shoulder-joint, which may extend down the arm, and which is sometimes felt in the wrist and joints of the hand Not unfrequently the complexion becomes pale and sallow, and there is puffiness under the eye, headache, a bitter taste in the mouth, tongue coated white or covered with a brown fur, and hardness of the gums; there is frequent sighing, a hacking cough, fever, restlessness, and loss of sleep; sometimes an unnatural, greasy appearance of the skin, at others, it is dry and harsh, has scaly or branny eruptions, pimples, dark blotches, and troublesome itching. The urine is frequently scanty and high-colored, but variable as to quantity and appearance; it often produces a scalding sensation when voided, and, if allowed to stand, deposits a sediment which sometimes contains albumen. The pulse is very slow, particularly when the elements of the bile are not eliminated from the blood. The pulsations of the heart are easily quickened, and palpitation is excited if the subject be low and anæmic. There is depression of spirits, and a decided tendency to be discouraged and despondent. The functional powers of the stomach are impaired; there is loss of appetite, or it becomes capricious; uneasiness is felt in the region of the stomach, oppression, sometimes nausea and water-brash, or there is indigestion, flatulency, and acid eructations; the bowels become irregular, usually constipated, and occasionally subject to obstinate diarrhea attended with colicky pains; the stools are of a light clay color, sometimes hard and dark, again thin and very offensive, and occasionally green or black. As the disease progresses, during the day the circulation is sluggish, the feet and hands are cold, but at night the pulse is accelerated, and a burning sensation is felt in the palms of the hands and the soles of the feet. The foregoing symptoms are not all present in one case, nor are any two cases alike in every respect. They vary according to the organs most implicated in the hepatic derangement. Thus, when chronic inflammation of the liver is associated with _heart_ disease, the subject may have palpitation, excessive or defective action of the heart, attended with more or less pain and shortness of breath. If the _lungs_ be specially influenced, then, in addition to the ordinary hepatic symptoms, there may be a dry cough, asthma, hurried respiration, bronchitis, hoarseness, and pain in the chest. If the _stomach_ be the sympathizing organ, the tongue is coated white or brown, there is nausea, loss of appetite, flatulency, acidity, dyspepsia, fullness, and oppression, amounting, sometimes, to pain in the stomach after taking food; the food ferments and gives rise to eructations and various other manifestations of disorder. If the _bowels_ are morbidly influenced by this affection, there is constipation or diarrhea, griping pain, distension of the abdomen, piles, and pain just within the points of the hips, thus indicating irritation of The colon. If the _brain_ or _nervous system_ sensitively responds, there is headache, dizziness, disturbed sleep, depression of spirits, peevishness, capriciousness, lack of energy, irritability, and congestive symptoms. When the _skin_ is involved the surface is dry, harsh, and scaly, displaying dark "moth-spots," blotches, or numerous little sores, and the countenance has a dull, tawny look. If the _kidneys_ be disturbed by it, there may be pain and a sensation of weight in the back, while the urine may be scanty and high-colored, or abundant, pale, and limpid, frequently charged with sedimentary products of disease, and voided with difficulty. If the _womb_ be implicated in this chronic affection, the menstrual function may be deranged, and result in an excessive or a deficient monthly flow, and be followed by profuse leucorrhea. The preceding allusion to the complications of chronic inflammation of the liver shows the necessity of clearly distinguishing between the symptoms of this disorder and those reflected by the organs which sympathetically respond. To discriminate more effectually, and place the correctness of the diagnosis beyond doubt, we make a chemical and microscopical examination of the urine, and thereby detect the morbid products which it contains, and direct our attention to the diseased organs furnishing them. These examinations together with a complete history of the case, enable us to make a correct and definite diagnosis of the disease, and the extent to which it has affected the other organs. Before entering upon the consideration of treatment, let us briefly enumerate the functions of the liver: _First_, it removes matter, which, if allowed to remain in the blood, would become noxious and unfit it for the further support of the body. _Secondly_, by secreting bile, it furnishes to the digestive organs a fluid which assists in converting the food into chyle, stimulates the intestine to action, and then is itself transformed and absorbed with the chylous products, after which it circulates with the blood and assists in nutrition until, becoming injurious and pernicious, it is re-secreted and re-elaborated to serve again, as described. For its growth and nourishment, the liver is furnished with blood by the hepatic artery; but for the purpose of secretion and depuration, it is abundantly supplied with venous blood by the portal system, which is made up of veins from the spleen, stomach, pancreas, and intestines. This impure, venous blood, surcharged with biliary elements, which must be withdrawn from it, is freely poured into the minute network of this glandular organ. In a healthy condition of the liver, the carbonaceous elements of the blood are converted into sugar, and the constituents of the bile are liberated by the liver, and set apart for further duties. When it fails to eliminate these noxious elements from the blood, it is itself thoroughly vitiated by them. TREATMENT. Food must be rich in carbon in order that it may build up the tissues and keep the body warm, but carbonic acid, the result of the combustion, must be removed from the blood, or death will ensue. So bile is necessary to digestion, nutrition, and life; yet, if it be not separated from the blood by the secreting action of the liver, it will as surely poison the system and destroy life as carbonic acid. Although the constituents of the bile exist in the blood, they must be removed in order that the blood may be rendered more fit to support the body, while the secreted bile is destined to assist in digestion, and the mysterious process of nutrition. Therefore, we should induce a secretion of bile, and restore the normal activity of the liver. This should be done, not by administering stimulants, but by relieving it of all contingent embarrassments as far as possible. Would any one think of giving to a weak, debilitated man large portions of brandy to enable him to work? Does not every one know that, when the unnatural stimulus is removed, he fails? Apply this principle in the treatment of the liver. When harsh, unnatural stimulants and "bile-driving" medicines are administered for a time and then withheld, the liver relapses into a more torpid and debilitated condition than before treatment was begun. Is not this true of nine-tenths of all who suffer from this malady, and have recourse to this class of remedies? Then how can we remedially fulfill the preceding indications? We answer in the language of a distinguished author and standard medical writer, "by using a class of agents which should never be overlooked in the treatment of long-standing liver diseases, chiefly addressed to the blood and denominated '_alteratives._'" _Alteratives, tonics_, and _restorative catalytics_ are required not only in diseases of the liver, but in a large number of ailments in which the blood becomes charged with morbid materials. The active remedial properties of the most efficient agents of the above classes of medicine now known, are scientifically combined in the "Golden Medical Discovery," which acts _especially_ upon the blood, and hence influences the system generally. It is also powerful in eliminating those morbid humors which are afterwards subjected to excretion through various organs. Its action is radically different from most medicines employed in chronic diseases, for the reason, that what is usually prescribed, is something corrosive. Unless the disease be temporary, it may return with increased violence. We have been very minute in the description of the remedial properties of the "Golden Medical Discovery," and have relied upon the reason and intelligence of our patrons, believing that they can, in a degree, understand why we deem it so applicable to the system. It does not debilitate the liver by over-stimulation, nor irritate the stomach and bowels by disturbing the delicate processes of digestion, neither does it act with severity upon the blood, but it operates so gently, insensibly, and yet with so much certainty, that it excites the surprise and admiration of the patient. From the careful detail of its various properties, there is abundant reason for its favorable action upon all of the excretory organs, which co-operate in the removal of morbid materials from the system. If, however, the bowels are unusually sluggish or obstinately constipated, it is advisable, in conjunction with the "Golden Medical Discovery," to use the "Pleasant Pellets," which are also powerfully alterative, besides being mild and unirritating in their operation. They are the natural assistants of the "Discovery," working harmoniously together. They should be taken in small doses, and their use perseveringly followed, until the bowels are properly regulated by the use of the "Discovery" alone. It has been customary to resort to powerful drastic cathartics, followed by bitters prepared in dilute alcohol. The habit is unscientific, for it is well known that alcohol deranges the functions of the digestive organs and depraves the blood, besides creating a morbid appetite. It has been repeatedly demonstrated that the use of such bitters has led to a life of drunkenness, with all the woe and untold misery which attend it. Medicines to be strictly remedial, should exert a tonic influence upon all the vital processes. Those organs which are contiguous to the liver, or connected by sympathy with it, should be assisted in the performance of their functions. Persons who are habitually subject to "bilious" attacks are pleased to find that the use of the "Discovery" and "Pellets" furnishes immunity from such onsets, and prevents their usual recurrence. Thus these remedies are _preventive_ as well as _curative_. What we have thus far recommended for the treatment of this chronic affection is within the reach of every family. Patients laboring under this disease, when complicated with other affections, require special consideration and treatment, and all such are counseled to employ only those physicians whose experience and success entitle them to confidence. Health is one of the greatest of blessings, and how to restore it when lost, is a question of vital importance. Having successfully treated thousands of invalids who have suffered from this chronic affection, we possess abundant evidence of the curability of the disease, but we have only space to publish a few letters from persons who have been under our care, or who have used our medicines, purchased from druggists. CONSTIPATION. (COSTIVENESS.) Health depends very largely upon the regularity of the bowels. There should be proper alvine evacuations every day. There are few persons who have not suffered at some period of their lives from constipation of the bowels. Inattentive to the calls of nature, or a neglect to regularly attend to this important duty, sooner or later, produces disastrous results. Furthermore, it is essential to the comfort of every individual, for, when this function is not performed, there is derangement of the mental as well as of the bodily organs. Constipation, or _costiveness_, as it is sometimes termed, is a functional derangement of the large intestine. This intestine is about five feet in length, and consists of the cæcum, colon, and rectum. It serves as a temporary reservoir for the excrementitial residue of alimentary matter, and for the effete materials excreted by the glands contained in its mucous coats. It is distinguished as the _large_ intestine, because of its great size. Habitual constipation produces many derangements, resulting from _sympathy, irritation_, or _mechanical obstruction_. By referring to Figs. 4 and 9, the reader may observe the anatomical relations which the large intestine sustains to the other abdominal organs. The ascending colon arises in the cæcum (Fig. 4), at the lower part of the abdomen, and passes over the kidney on the right side, where it begins a circuitous route around the abdominal cavity, comes in contact with the inferior surface of the liver, proceeds behind and below the large curvature of the stomach, emerges on the left side, and passes downward in front of the left kidney, where it dips into the pelvic cavity, and ends in the rectum. If fecal matters are retained until they are decomposed, great injury follows, since the fluid portions are absorbed, conveyed into the blood, and, of necessity, corrupt it with their impurities. In this way, constipation may be the source of general derangement, but _such_ disorder is seldom attributed to the torpid state of this intestine. There is little doubt but that it thereby imposes a great tax upon the functions of the liver, and, frequently, the fault is attributed to that organ instead of the large intestine. Sometimes the blood becomes so charged with fecal matter that its odor can be detected in the breath of the subject. An overloaded condition of the large intestine may cause inflammation of the liver or dropsy of the abdomen. When the colon is distended, it becomes a mechanical impediment to the free circulation of the blood in other organs, and causes congestion of the portal system, predisposing to chronic inflammation or cirrhosis of the liver. This latter is a structural affection, and may, in turn, give rise to abdominal dropsy. In a word, the accumulation of feces in the colon irritates both the large and small intestines, thus causing congestion of the bowels, liver, or stomach. The protracted presence of feculent matter deadens the sensibility of the intestine, so that great stimulation is required to provoke it to action. The contents become dry, solid, knotty, and hard, and very difficult to evacuate. If drastic, irritating physic be taken, only _temporary_ relief is afforded, and it must be repeatedly resorted to, and the dose increased, to obtain the desired effect. SYMPTOMS. One diagnostic symptom of a loaded state of the colon, is an abundant secretion of urine, as limpid as water. The direct symptoms relate to the hardness of the feces and the great difficulty of voiding them. The influence of constipation upon the functions of the liver, is indicated by the sympathy displayed between that organ and the mind. The patient manifests apprehension, mental depression, taciturnity, and melancholy, all indicative of hypochondriac dejection, induced by constipation. We have treated patients, who, from this cause, had renounced their bright hopes, lost their buoyant spirits, and, becoming subject to superstitious fears, had given themselves up, night and day, to devotions and penance. It often happens that the victims of this deep dejection and morbid feeling of self-abasement, are persons not only of good moral character, but of high religious attainments, and their painful exhibitions of fear, distrust, and gloom, originate in _physical_ rather than in spiritual causes. It is interesting to witness this strange perversion of the imagination, this morbid debasement of the religious faculties, and dejection of mind, due to causes disturbing the functions of the liver and other vital organs. Young girls, as they approach the age of puberty, seem possessed with the idea that the unfrequent action of the bowels is a desirable habit. They do not associate with the duty a proper regard for health, but consider it as an inelegant and repugnant practice. The consequence is, that at this susceptible period, constipation, induced by neglect, arouses a latent hepatic or pulmonary disease which has been lurking in the system. How many girls illustrate the truth of this statement by their complaints of dizziness, throbbing pain in the forehead and temples, flushing of the face, transient flushes of heat over the body, while at the same time the extremities are cold. At other times, they manifest the evils of such a course by their stupor, drowsiness, and deep sleep, although upon arising in the morning, they are still tired and unrefreshed. The constipated condition of the bowels, often leads to congestion of the uterus and leucorrhea, followed by uterine debility, prolapsus, excessive menstruation, anteversion or retroversion of that organ. The infrequency of the habit, incorrectly supposed to be desirable by a young woman, becomes nearly, if not quite disastrous to all her desires and bright prospects. Complications arise, and neither the inexperienced girl nor her solicitous and afflicted parents know where to look for remedial aid. If they seek an asylum from these sufferings, they find many private institutions, where flattering expectations of speedy recovery are aroused. At such institutions, these uterine disorders are generally treated merely as local diseases, while the causes are overlooked, and, consequently, a permanent cure is not effected. Having spent nearly all the money at her command, the patient returns home utterly disheartened. After such failures, many of these unfortunate individuals have applied to us and received treatment, and by persistently following our directions, have in due time been restored to health, amid all the comforts of home, and among friends, who rejoiced with them in the unexpectedly favorable turn of affairs, accomplished at a comparatively trifling expense. We have seen infants, and also young children, in whom constipation was obstinate. It therefore seems that it is often hereditary. In some persons, this affection continues from childhood, with but little variation, until bleeding pile tumors are developed. Habitual constipation of the bowels for a long period of years will generate a class of diseases, which are often very serious in their results. CAUSES. We have already alluded to a sense of false modesty which prevents a response to the calls of nature, and we may mention other reasons, equally trifling, which deter many from fulfilling its demands. Some are in the habit of temporarily postponing their visits to the water closet, until, when they do go, they find themselves unable to evacuate the bowels. Sometimes the closet is a damp, uncomfortable out-house, situated at a distance from the dwelling, or the access is too public, and, hence, there is an unwillingness to visit it at the proper time. Some appear to be too indolent to attend to this duty. Others are too energetic, and think they cannot take the time, until they have finished some self-imposed task or attended to a pressing engagement. Inactive life and sedentary occupations are also causes of constipation. Active exercise promotes all the bodily functions, and helps to regulate the bowels. Those who are engaged in literary pursuits, find that mental occupation determines the blood to the brain, thus drawing it from the extremities; the temperature falls below the natural standard, and there is almost invariably congestion of the bowels. The inmates of boarding-schools, factory girls, seamstresses, milliners, employés in manufacturing establishments, and all who sit and toil almost unremittingly twelve hours in the day, do not get sufficient exercise of all the muscles of the body, and are often troubled with obstinate constipation. Food prepared according to the modern modes of cookery, is one of the causes which favors the developement of this derangement. People live too exclusively upon bolted wheat flour. The branny portion of a kernel of wheat consists of various nutritive elements, with more than five times the amount of phosphate of lime contained in fine bolted flour. Those who daily use boiled cracked wheat are not troubled by constipation. There is no dryness or hardness of the feces, and the bowels are evacuated without discomfort. TREATMENT. Prevention is always better than cure; hence, a few hygienic directions may not be amiss. Do not disregard the intimations of nature, but promptly respond to her calls. If there is constipation, overcome it by establishing the habit of making daily efforts to effect a movement of the bowels. Taking regular exercise by walking, and lightly percussing or kneading the bowels for five minutes daily, help to increase their activity. The habit of early rising favors the natural action of the bowels. Drinking a glass of water on rising exerts a beneficial influence. The food should be such as will excite the mucous secretion of the large intestines, and arouse its muscles to action. For this purpose, there is no one article that excels coarsely-cracked boiled wheat. Graham bread, mush, cakes, gems, and all articles of diet made from unbolted wheat flour are valuable auxiliaries, and may be prepared to suit the taste. Take the meals at stated hours; be punctual in attendance, regular in eating, and thoroughly masticate your food. Irregularity in the intervals between eating, disturbs the functions of the intestine. The use of ripe fruits, such as apples, pears, grapes, figs, and prunes, in proper quantities, is sometimes very beneficial. Trivial or unimportant as these hygienic suggestions may appear, yet were they observed, constipation, as well as most of the diseases incident to it, would be obviated. A large proportion of the cases will yield to the foregoing hygienic treatment without the employment of medicines. Should it be necessary, however, to employ an aperient to relieve the constipation, Dr. Pierce's Golden Medical Discovery will act most congenially, and will be followed by no constipating reaction, which invariably occurs when drastic cathartics are employed. Its operation is mild, bringing about a healthy action by promoting the biliary and other secretions, thus aiding nature in establishing normal functional activity in the bowels. Recourse should be had to it before employing any thing more strongly cathartic. However, should it prove too mild in its aperient effects, small doses of Dr. Pierce's Pleasant Pellets may be employed daily to assist it. Unlike other cathartics, they produce a secondary tonic effect upon the bowels, which renders their influence more lasting than that of other purgatives. We cannot too strongly discourage the injurious custom which many people have of frequently _scouring_ out their bowels with strong cathartics. It is a bad practice, and cannot fail to do injury. The greatest benefit is derived, not from cathartic doses, but from taking only one or two of the "Pellets" per day, or enough to keep the bowels regular, and continuing their use for several weeks, in connection with Dr. Pierce's Golden Medical Discovery, strictly carrying out the hygienic treatment heretofore advised. The medical treatment of individual cases sometimes involves many considerations relative to the particular circumstances and complications presented. The peculiar susceptibility of the constitution, as well as the diseases incident to constipation, must be taken into account. Symptomatic derangement should not be treated as primary, although it is by inexperienced physicians. If the patient be afflicted with uterine disease, piles, nervous affections, falling of the lower bowel, or fistula, they should be treated in connection with this disease. For these reasons, we would advise our readers to submit all complicated cases, or those that do not yield to the course heretofore advised, to a physician of large experience in the management of chronic diseases, and not assume the great responsibility and the dire consequences which are very liable to arise from the improper treatment of such cases. We have been called upon to treat thousands of cases of this troublesome affection, and as a result of our vast experience, and in consequence of our original and improved methods of diagnosis, it is not generally necessary that we should see and examine the patient in person. We can almost always determine the exact nature of the patient's malady, and its stage of advancement, without seeing the subject in person. PILES. (HEMORRHOIDS.) There are few maladies more common than this, and few which are more annoying. Piles consist of tumors formed within the rectum and about the anus, by dilatation of the hemorrhoidal veins and thickening of their walls. Sometimes, when attended by considerable inflammation, or when the attacks are very frequent, there is thickening of the adjacent cellular and mucous tissues. There are two general forms of this disease, the external or blind piles, in which the tumors are outside the anus, and the internal or bleeding piles, in which the tumors are formed within the sphincters, although after their formation they may protrude. The external piles are commonly made up of thick tissues; upon one side, the skin forms the covering, while on the inner surface is the mucous membrane of the bowel. It is this surface which is most tender and irritable and liable to inflammation. The internal form of the disease is situated from a half an inch to two and a half inches above the sphincter muscle of the anus. The tumors are usually round, oval or cylindrical in form. They may be scattered over the surface of the bowel, or clustered together. The illustrations (Figs. 1 and 2) show the two forms of the disease. The two protruding tumors in Fig. 2, illustrate the usual form of prolapsing internal piles, whilst the one highest up in the bowel shows the form most commonly met with. It is seldom that one pile tumor is found alone, there usually being two or three, and sometimes as many as five or six, in a cluster. Fig. 3 shows the manner of distribution of the veins in the rectal region. The small venous loops, or bulb-like terminations of the veins H. _i_., are the points at which the piles most frequently occur. [Illustration: Fig. 1. Swollen External Piles.] CAUSES. Whatever tends to favor an undue accumulation of blood in the hemorrhoidal veins predisposes to piles. For this reason the affection is frequently a result of diseases of the heart and liver, which cause an obstruction in the circulation of the blood through the portal vein. Mechanical pressure from tumors in the abdomen, pregnancy, or an enlarged or misplaced uterus, is not infrequently a cause of the disease, by keeping the hemorrhoidal veins over-distended. Those diseases which provoke much straining, as stricture, inflammation or enlargement of the prostate gland, and stone in the bladder are also active causative agents. The most common cause of all, however, is constipation; and persons of indolent, sedentary and luxurious habits of life are the ones most frequently affected with this derangement. The following are also prolific causes of piles, viz.: pelvic tumors, violent horseback exercise, indigestion, pregnancy, habitual use of drastic cathartics, diarrhea, dysentery, sitting on heated cushions, long-continued standing posture, diseases of the liver, worms, the wearing of tight corsets, eating highly seasoned or indigestible food, and the use of alcoholic stimulants. No age is exempt from piles, nor is the disease peculiar to either sex. Aside from the serious inconvenience and pain which are experienced with most forms of piles, there is a tendency to fistula, and to cancer in the rectal region. It is important, therefore, that the disease should not be allowed to run on unchecked. [Illustration: Fig. 2. Piles: internal and protruding. ] SYMPTOMS. The most common symptoms at first are slight uneasiness, such as a little soreness or itching at the verge of the anus, and at times lancinating pains. These sensations are more severe as a rule if the bowels are constipated. If the piles are external they frequently become inflamed, swollen and painful, and in some instances they suppurate, which usually results in relief. When internal piles have increased to any considerable extent, or have become inflamed, they produce not only itching at the extremity of the bowel, pain in the back, etc., but also a sensation of fullness in the rectum, as though some foreign body were present, and, on action of the bowels, there is a sensation as though a portion of the fæces had not been expelled. When the internal piles become large, they frequently come down with fæcal matter from the bowel, as illustrated in Fig. 2, and this prolapsus becomes more and more marked with the progress of the disease, until, in many cases, the tumors are forced down at each action of the bowels, causing excruciating pain until they are properly replaced. Usually, in the early stages, they recede spontaneously; however, after a time it becomes necessary for the sufferer to press them back, but in some instances this is impossible. Frequently during the protrusion one of the hemorrhoidal veins gives away, and this is followed by a free escape of blood, and ulceration may ensue. Not infrequently with this disease the patient loses strength and flesh, and the face becomes pale and puffy, assuming a waxy appearance. Many times there is nausea, with vertigo. Is consequence of the relaxation, the bowel may descend when on the feet, or with some extra muscular effort, especially when stooping. These symptoms may not all be present in one person, and, indeed, sometimes are somewhat obscure; when such is the case, an examination by a competent physician will always determine the true character of the complaint at once. [Illustration: Fig. 3. H. _i._ Internal hemorrhoidal veins. H. _m._ Middle hemorrhoidal veins. H. _e._ External hemorrhoidal veins. S. _i._ Internal sphincter muscle, S. _e._ External sphincter muscle. ] TREATMENT. Notwithstanding the well established fact that piles are readily cured by the appropriate treatment, hundreds of thousands of people suffer untold tortures from them because of the popular impression that they cannot be cured. All cases are not, however, amenable to the same form of treatment, for various unhealthy conditions of the system are often concerned in their production and perpetuation, and must, of necessity, be remedied by appropriate treatment, before a cure of the piles can be expected. It will, therefore, become apparent that the avoidance of causes is of paramount importance. Some of these causes are external, and wholly under the control of the patient, while others depend upon diseases that are curable; it frequently happens that while other diseases are being remedied, the piles disappear Without any special attention. Diseases of the urinary apparatus, as stricture of the urethra, enlargement of the prostate gland, and stone in the bladder, dysentery, diarrhea, and constipation,--all cause piles, by the irritation, and determination of blood, which they induce; these difficulties must be removed by appropriate treatment. Some years since, we ascertained that we were using in our practice remedies which, in addition to other virtues, possessed a direct specific influence upon the vessels concerned in the formation of piles. These agents enter into the composition of Dr. Pierce's Golden Medical Discovery, which, consequently, will be found exceedingly efficacious in the treatment of this disease. This remedy, therefore, in removing the disease upon which the piles depend, as a congested or torpid liver, constipation, etc., and in exciting a direct curative control over the piles themselves, exerts a double influence. It may be aided, when the bowels are badly constipated, by the use of Dr. Pierce's Pleasant Pellets, taken in the morning, to secure a regular and easy evacuation of the bowels each day. All stimulating food and alcoholic drinks should be abstained from. The cold bath is beneficial in these cases, provided there is not great debility. The affected parts should be bathed frequently with cold water, and, if prolapsus exists, it is well to inject a little cool water into the rectum, and allow it to remain a few minutes. As a soothing, astringing and healing application to the affected parts we prepare an Ointment that has acquired great fame for the prompt relief which it affords in all ordinary cases. This we do not sell through druggists but can send by mail, on receipt of price, $1.00 per large box, postage prepaid. The persistent use of this Ointment, at the same time keeping the bowels regular by the use of "Golden Medical Discovery," with an occasional laxative dose of "Pellets," will generally cure all ordinary cases of piles. THE RADICAL CURE OF LARGE PILE TUMORS. In cases in which the tumors have become indurated and very large it is impossible to effect cures by the foregoing or any other medical treatment. Various methods have been in use by the profession for the relief of the most severe cases. The most common is excision with the knife or scissors. Reference to the large vessels, shown in Fig. 3, which are affected in this disease, will at once show the sufferer the dangers of this method. The sudden removal of a tumor, which is connected with one or more of the large hemorrhoidal veins, is sure to be followed by severe hemorrhage, and many times painful ulceration, and a fatal result. To avoid this it has been the practice of many physicians to apply caustics or to burn off the base of the tumors with a red-hot iron. A more barbarous and painful method could not be devised. When it is considered that in many cases, this severe and painful treatment is followed by ulceration, and occasionally by the developement of cancer, the matter should be carefully weighed before any such dangerous procedure is attempted. Another common method of treatment is to crush the base of the pile with a clamp, and then cut off the tumors with scissors. After this it is also necessary to apply the hot iron to prevent hemorrhage. Formerly, applications of nitric acid were in common use by physicians as a means of cure, but it was found that while this treatment would give temporary relief, yet in no severe case would it effect a cure. By what we term palliative treatment alone more cures are effected than by the old process of treatment with nitric acid. Still another form of treatment is strangulation of the pile by means of a ligature, and this is often more painful than the application of hot irons, inasmuch as in cutting off the return flow of blood from the piles, a large tumor is left for days fully distended and extremely painful. It does not slough off for a considerable time, and we have seen the strongest men suffer intensely, to whom the use of scissors in removing the tumors was a positive relief in comparison with the torture of the ligature. A treatment that has been highly recommended by some physicians and condemned by others, is the process of injection with carbolic acid. This method of treatment is not very painful but, unfortunately, it is dangerous. The injection of the tumors with a fluid which causes coagulation of the blood, and which does not completely shut off the return current of the circulation through the tumors, has proved fatal in a small percentage of cases. The clots which are formed by this treatment become detached and are carried into the general circulation and conveyed to the liver, lungs and even to the brain, where, by plugging up the vessels of those organs, they cause abscesses which terminate life. Serious inflammation of the veins is another accident which often follows the injection of carbolic acid. This treatment is, therefore, now seldom resorted to except by physicians who do not appreciate its dangers. A MORE SUCCESSFUL METHOD. Fortunately for suffering humanity, a method of treatment has been perfected and thoroughly tested in our institution, in which all such trouble and danger as above described are avoided. This consists in bringing down the tumors, cleansing them and making application, of certain chemical preparations, that cause the tumors to speedily shrivel up, and in a very short time, say ten to fourteen days, disappear entirely. These treatments and applications cause _no pain whatever_, for by first applying a weak solution of cocaine to the parts they are speedily rendered entirely insensible, so that the most sensitive, nervous lady experiences not the slightest suffering from the application of our remedies. Having now at our command means so positively certain in their action upon pile tumors, we do not hesitate to say that the very worst cases, no matter of how long standing, can be promptly cured, if we can only have the patient for a few days under our personal care. Considering the very distressing character of pile tumors, it is a great boon that we have at last found safe, painless, and positively certain means for their cure. The news will be hailed with joy by a large class of sufferers. Probably no other discovery in modern science is destined to be the means of conferring greater blessings on a large class of sufferers than that of a painless and positive method of curing the largest pile tumors in the brief time required by our system of treating them. It seems to us that there is no longer an excuse for any one to endure the tortures inflicted by pile tumors, provided the afflicted one can command the little time and moderate amount of means necessary to secure the treatment indicated. Piles are not only in and of themselves very painful and annoying, but often greatly aggravate and even cause other grave and painful affections, and should, therefore, not be neglected. When large, they never get well without proper treatment. We have seen many cases in which the long train of diverse and distressing symptoms caused by piles led the sufferer, and even the family physician, to suppose that other diseases existed, but all of which annoying symptoms were speedily dispelled by the cure of the piles. We have no doubt that neglected piles, fistulæ, and other morbid conditions of the lower bowels, frequently degenerate into cancerous disease. We have the eminent authority of J. Hughes Bennett, of Edinburg, and many other close observers, for saying that benign or ordinary tumors often degenerate into real cancerous disease, and our own extensive observation convinces us that this is not infrequently a result of neglected rectal disease, as piles, fistulæ and fissures. How important, then, to give prompt attention and skillful treatment to disease of these parts. When the ordinary palliative treatment, with ointments and with laxative agents to keep the bowels soluble, does not _completely and perfectly_ subdue the malady, lose no time in securing the most skillful appliances, that every vestige of the affection may be promptly removed. We have treated many thousands of cases with uniform success, and our patients write to us expressing the greatest degree of satisfaction, and recommending our method most highly. Reports of a few cases, selected at random from the large number which we have cured, are given below to illustrate our success in curing them. ANAL FISTULA. (FISTULA IN ANO.) This disease is _more dangerous_ than piles, though, after once formed, not so painful. It sometimes commences with intense itching about the anus, accompanied with a little discharge; or the first symptom may be a painful abscess, like a boil, which finally breaks. The soreness then in a measure subsides, leaving a fistulous opening, with a continuous discharge of matter. This unnatural opening, with its constant drain upon the system, sooner or later is certain to ruin the health or develop consumption or other maladies, and destroy life. Fistula in Ano may exist in three conditions: First, complete fistula--when the opening is continuous from the cavity of the rectum or bowel to the surface of the skin, so that liquids, gases, etc., escape; secondly, internal incomplete fistula, when the opening extends from the inside of the rectum into the tissues surrounding it, but not through the skin. A few cases of this kind exist, while the sufferers are unconscious of the nature of the difficulty, supposing it to be piles or some trouble--they know not what. Thirdly, external, incomplete fistula, when the opening extends through the skin into the tissues around the rectum, but does not enter the bowel. Other complications, such as pendulous tits or projections, from one-fourth to one and a half inches in length, are attendant upon fistula. Two or more openings may appear in the skin, all communicating with the same sinus, or opening into the rectum. Sometimes only a small external opening is seen, while a large abscess exists internally. In any case, the discharge is not only reducing to the system, but it is disgusting and offensive. CAUSES The causes are a constitutional predisposition, constipation, piles, or the presence of foreign bodies in the rectum, causing an abscess or ulcer. Some authors have contended that fistula always originates from an ulcer in the rectum, which gradually makes its way through the cellular tissue to the surface. Others contend that the cause of this disease consists in an abscess, which burrows in the tissues and makes its exit into the rectum, or through the skin, or both. No doubt it may originate in both ways. It can readily be seen that when an internal opening is once established, the _foeces_ which enter into it must sooner or later work their way to the surface, burrowing through those parts which offer the least resistance, until a place of exit is reached. DIAGNOSIS. The disease may be suspected, if there has been an abscess in the parts involved, or if the patient has been subject to pain in the rectum, and the parts are tender, tumid, or indurated. When the fistula opens externally, the linen will be moistened and soiled with pus, or a bloody fluid, and when the tract is large, the _foeces_ may pass through it. A careful exploration with a probe, passed into the external opening while the finger is in the rectum, generally reveals the direction of the tract; but, sometimes, in consequence of the tortuous course of the canal, the probe cannot he made to follow it. When the fistula is incomplete, and opens internally, the probe is passed into the rectum and directed outwards, when it may be felt externally. In such cases, a tumor, caused by the contents of the fistula, may generally be seen protruding near the anus, and the pain will be considerably increased during defecation, by the _foeces_ passing into it and disturbing its walls. The examination should be made with the greatest possible care, for it is attended with more or less pain. TREATMENT. When constitutional derangement exists, it must be rectified, or any treatment will be liable to result in failure. The comfort of the patient may be greatly promoted by attention to the bowels, keeping their contents in a soluble condition, and the liver active, so as to prevent congestion of the rectum and adjacent structures. This can best be done by careful attention to hygiene, and the use of "Golden Medical Discovery" and "Pellets," in sufficient quantities to produce the above named effects. A _radical cure_, however, cannot be accomplished except by surgical means, for which we have the _knife, ligature, caustic, stimulating injections, etc.,_ which may be varied to suit the emergency, but which should never be employed except by a competent surgeon. Constitutional conditions materially influence the cure, no matter what procedure is adopted; the greater the constitutional derangement and the poorer the general health, the longer is the cure delayed. The great secret of our success in treating this disease consists in applying appropriate constitutional treatment at the same time. The use of the knife is becoming obsolete, and has, to a great extent, given way to other measures which are equally successful. Indeed, other means will succeed in cases in which the knife fails or is for any reason inapplicable. One great objection to the knife is not only the dread which patients entertain of it, but the great liability of its use to result in paralysis of the sphincters of the anus, the consequence of which is loss of control over the bowels; and another is that it sometimes entirely fails to result in cure. By the means which we employ, these objections are entirely overcome, and, while the general system is being renovated, the fistula is healed, without any complications. Fistula is much more common than has generally been supposed. It is apt to be associated with pulmonary diseases. Heretofore, it has been supposed that to heal the fistula, during the progress of the lung affection, would result in fatal consequences, and the patient has been left to suffer and die under the combined influence, of the _two_ diseases. Observation, based upon an extensive experience in the management of such diseases, has proved that supposition to be fallacious in every respect, and we would urge all persons afflicted with fistula to have the affliction cured, no matter what complications may exist. The fact underlying this erroneous opinion is, that when grave constitutional troubles have co-existed the use of the knife has resulted in failure, and the fistula has refused to heal. Having had ample facilities for observing the relative merits of the various methods of treating this complaint, in hundreds of eases, in our own practice and that of others, we feel justified in saying that the plan which we have adopted is far superior to that in general use. The local treatment which we employ depends upon the nature of the fistula; in some instances the ligature is best, in others caustics, and again injection, etc., while still others require a combination of two or more methods, or a modification of them. In cases in which it is impossible for the patient to come to our hotel for a radical and speedy cure of the fistula, we employ constitutional treatment, with, the use of a medicated crayon, which is similar in shape to a small slate pencil. This crayon is made of gelatine with the remedial agents thoroughly incorporated through it, and in an easily soluble form. They are very flexible and readily used, and where the fistulous track is sufficiently large to admit of their insertion, the most decided improvement invariable follows their application. One is oiled and gently introduced into the track every two or three days, and by its solution the unhealthy tissues which line the track are removed. They are thrown off, and a healthy action is induced. With careful constitutional treatment, decided improvement soon follows, and the discharge is gradually lessened. The most satisfactory improvement occurs in the general health and strength of the patient, and gradually the fistula closes. Sometimes it is necessary to pursue this course of treatment for many months, but the result obtained is sufficient reward for the trouble. A large percentage of cures follow this treatment, and we recommend it when it is impossible for the patient to leave home, or when the general health is greatly reduced by severe constitutional disease. * * * * * TESTIMONIALS. While we have a great cloud of witnesses testifying to the efficacy of our treatment of the diseases described in this volume, yet for lack of space we can here introduce only the few following: "LIVER COMPLAINT." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J.H. May, Esq. ] _Gentlemen_--In the year 1889 I was taken with disease which the doctors called "liver complaint." I tried three different doctors. They did me no good. They tried about one year; I was not able to work for two years. At last I thought I would try Dr. Pierce's medicines, and I wrote to Dr. Pierce, and he wrote to me to take his "Golden Medical Discovery," and I bought two bottles, and when I took it, I saw it was improving me, and I got five more, and before I had taken all I was well, and I haven't felt the symptoms since. I had a continued hurting in my bowels for about two years. I feel as if the cure is worth thousands of dollars to me. Yours truly, J.H. MAY, Potts' Station, Pope Co., Ark. DYSPEPSIA AND WOMB DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Ransom. ] _Dear Sirs_--When first taking Dr. Pierce's Favorite Prescription I was nervous and would have sour stomach and distress after eating, and when I would rise after stooping over everything would turn dark before me and I would feel dizzy. I suffered a great deal of pain at each monthly period. I took one bottle and a half of the "Favorite Prescription," one teaspoonful three times a day, and the "Pellets" as directions called for. I gained in health and strength so rapidly that I have been able to work very hard the past summer, and my back never troubles me; and when I have my monthly periods I never feel the least bit of pain. In fact I consider myself in excellent health. Very truly yours, MRS. INEZ V. CARR RANSOM, Panama, Chaut. Co., N.Y. INFLAMMATION OF LIVER. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: T.J. Bentley, Esq. ] _Gentlemen_--I was taken sick with inflammation of the liver and could get no relief from the doctors of this place--Randolph, N.Y. I was induced to use Dr. Pierce's Golden Medical Discovery, and "Pleasant Pellets," and after using five bottles of the medicine, I regained my health, and now I am a well man. I weighed 185 pounds before taken sick, and I was reduced to 135 pounds in sixty days' time. I suffered greatly from headache, pain in my right shoulder, poor appetite, constipation and a sleepy feeling all the time. My health is now very good, and I weigh 170 pounds, and I am able to do a good day's work without any trouble at all. Thanks to these valuable medicines. Yours truly, THOMAS J. BENTLEY, Randolph, Catt. Co., N.Y. LIVER DISEASE AND DYSPEPSIA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Hart. ] _Dear Sirs_--I am enjoying excellent health. After taking a bottle of Dr. Pierce's Golden Medical Discovery and several bottles of "Pellets," I am a different person. Only weighed 119 pounds when I began taking your medicine, now weigh 160. My symptoms were pain under the left shoulder, distress after eating, headache, dizziness, constipation, and, in fact, my system was "out of sorts generally." I tell every one your medicine has done more for me than any other. I remain, yours truly, MRS. CHARLES H. HART, San Ardo, Monterey Co., California. LIVER COMPLAINT AND CATARRH. [Illustration: Wm. King, Esq. ] _Dear Sirs_--After suffering for several years with nasal catarrh and liver complaint, and having become greatly reduced in health, as a last resort I placed myself in your hands for treatment. My improvement began almost immediately after entering your institution. I was enabled to leave at the end of one month, having experienced great benefit. The treatment was continued at home for a few months, after which my cure was complete. At the present time, I am able for office work, and feel that I am completely cured of the catarrh and have but little if any trouble with my liver. I shall lose no opportunity to recommend your institution or your medicines to the afflicted. I do most unhesitatingly recommend chronic sufferers to visit your institution or take your remedies at home. Sincerely yours, WILLIAM KING, Rose Bud, Pope Co., Ills. A COMPLICATED CASE OF STOMACH, LUNG, AND UTERINE DISEASE. [Illustration: Mrs. Rademaker. ] _Dear Sirs_--Some six years ago I was taken sick with chills; I would have a very bad chill and then I would begin to sweat and vomit; I had no appetite; I had the catarrh very bad; I had inward troubles of different kinds; my back ached all the time; I had sores gather and break inside; I had a lung trouble; I was very bad off; I could sit up only long enough to have my bed made; my husband sent for our family doctor; he came three times a week for three months; I was not so well at the end of three months as when he first came, but kept growing worse; he gave me up to die, and said I had consumption. I had heard of Dr. Pierce's medicines doing a good deal of good, so I made up my mind to try them. I sent and got one bottle of "Favorite Prescription" and one bottle of "Golden Medical Discovery"; also one bottle of "Pellets," and commenced taking them. In a few days I commenced to gain, and In two weeks' time I could sit up most all day, and in five weeks' time I could do my work with the help of two small girls. After taking four bottles of "Favorite Prescription," six bottles of "Discovery," and three of "Pellets," I was well enough to get along without any medicine. I can do a good day's work, and I owe my life to Dr. Pierce. With God's will and the use of Dr. Pierce's medicine I am still alive and well. Yours respectfully, Mrs. CLARA A. RADEMAKER, Addison Point, Washington Co., Me. LIVER COMPLAINT AND DROPSY. WORLD'S DISPENSARY MEDICAL ASSOCIATION. Buffalo, N.Y.: [Illustration: Mrs. Dennis. ] _Gentlemen_--About two years ago I was confined to my bed for several weeks with liver complaint. I became dropsical, my limbs swelled to twice their usual size and I could scarcely move them. I commenced using Dr. Pierce's Golden Medical Discovery; one bottle helped me so I could sit up; two bottles gave me strength enough to be able to do part of my household work; six bottles cured me, and to-day I am enjoying good health. The "Medical Discovery" should be in every household, and in gratitude for what it has done for me I have recommended it to many friends. For nine years I have suffered from deafness, and while taking the "Discovery" my hearing became much improved. Very truly yours, MRS. I.C. DENNIS, Burson. Calaveras Co., Cal. INDIGESTION, CONSTIPATION, VARICOCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mr. Hodges.] _Dear Sirs_--In regard to my condition of health, will say, although I am not entirely well, yet I have received much and lasting good from your treatment. My digestion was improved greatly, so that little trouble is experienced after eating; my liver seems to act reasonable well, and my bowels are much better. My varicocele I consider entirely cured, as I have not used the bandage for one half day for more than six months, and do not experience any inconvenience from that source. Yours truly, HARLAN HODGES, Keota, Keokuk Co., Is. CASE OF CHRONIC DIARRHEA CURED BY HOME TREATMENT. [Illustration: Mrs. Gwin. ] At the time the case was first submitted to us the bowels were moving six or eight times a day. In addition to the diarrhea, the patient had suffered from indigestion and womb trouble for eight years. There was almost continual pain from the top of the head to the hips and through the shoulders. There was weakness, soreness and numbness in the arms, hands, back and hips; the bladder was irritable, urine being passed frequently, or occasionally scanty, dark, thick, with a brick-dust deposit. There was a dragging sensation in the region of the womb. Menstruation was irregular, and she had frequent trembling spells lasting for hours. There was difficulty in fixing the attention, even for a sufficient length of time to write a brief letter. In fact, she was so weak and nervous she could scarcely write at all. Sleeplessness was a prominent feature of the case. The principal diet consisted of light bread and hot milk; could not use Graham bread. A course of special treatment was supplied to her about the first of January, 1890, but soon after commencing the treatment she had an attack of pneumonia. In due time the treatment was resumed, and then followed an attack of the epidemic influenza, or grip, so that, although the treatment was carried on at intervals during a year, there were but few occasions when our specialist had what he considered full control of the case. A year after the case was discharged the following communication was received: February 15, 1893. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I should have written sooner, but I waited to see if there would be any return of my old disease. After suffering over eight years with severe chronic diarrhea, you have cured me; I have had no return of it for over a year. It is with gratitude I write to you to tell you the great good you have done me, for I am sure I would have been in my grave before this had it not been for your treatment; My stomach troubles me very little any more. Occasionally I use a bottle of "Golden Medical Discovery" and a bottle of "Pellets." Hoping that the kind Father may spare your lives for many years to do good to suffering humanity, I am, Very gratefully yours, MRS. R.S. GWIN, Peck's Run, Upshur Co., W. Va. LIVER COMPLAINT, DYSPEPSIA, AND CONSTIPATION. CURED BY HOME TREATMENT. [Illustration: J. Fleener.] Received his first disability in the war; complains of getting very weak; bowels move only in three or tour days; stomach so painful that nothing passes through it digested; back so weak cannot sit up; had the first attack of dyspepsia fifteen years ago, and has spent hundreds of dollars trying to get well; kidneys badly affected, urine highly colored, and burns in passing; has pains around the heart and fluttering sensations at times, says: "I am not able to travel; all the doctors have given me up as beyond medical aid. Reports after two months' treatment: "I am happy to say that I am almost well; suffer with no pain in my stomach after eating; my appetite is good; my bowels move once a day and very often twice a day, and the urine is natural; do not have that dizziness in the head any more: rest well at night and feel rested in the morning Have gained flesh all the time; weigh 178 pounds, and work every day on the farm. Have taken no medicine from any other physician, and give you and your medicine all the credit for the health I now enjoy. My wife has taken your "Golden Medical Discovery" for goitre (thick neck). She has taken it for about six weeks and she is getting better." JOHN FLEENER, Brooklyn, Indiana. DYSPEPSIA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: G.R. Kenyon, Esq. ] _Gentlemen_--Your letter was received, and I am glad to say that I am perfectly well, and have been since I took your last medicine. I think I am better than I ever was, if such a thing could be. I am twenty pounds heavier than I ever was before, weighing 155 pounds. I have not had a pain or an ache since, for which fact I am thankful to you for looking after my case as promptly as you did, as, in looking over your catalogue of diseases, I thought that I had every thing ailing me that was in the book. I have told dozens if they were sick to call on you. With my best wishes, and hoping that all of your patients will receive as much benefit as I did, I remain, Very truly yours, GEORGE R. KENYON Batavia, Ill. DYSPEPSIA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J.P. McAdams, Esq. ] _Gentlemen_--"A few of my symptoms were: Heartburn and fullness after eating, sometimes pain in my bowels, headache, poor appetite and bad taste in my mouth. At night I was feverish, with hot flushes over skin. After taking Dr. Pierce's Golden Medical Discovery I was relieved of all these symptoms, and I feel perfectly well to-day." Very truly yours, J.P. MCADAMS, Elon College, North Carolina. OBSTINATE AND COMPLICATED DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: John H. Smith, Esq. ] _Gentlemen_--Yours of July 12th to hand. I am only too glad to comply with your request. Having suffered for many years with a complication of diseases and feeling conscious that they were rapidly making serious inroads upon my constitution, and that I was speedily becoming unable and incapacitated to attend to my ordinary business. I resolved, after reading a number of testimonials from your patients, to place myself under your treatment at the Invalids' Hotel and Surgical Institute. With heart-felt gratitude I can truthfully say I am relieved of my trouble. I most cheerfully and earnestly recommend this Institution to all who are afflicted with chronic and painful diseases, no matter of what nature. During my stay there I saw some wonderful cures and surgical operations. Yours truly, JOHN H. SMITH, Deckertown, Sussex Co., N.J. COMPLICATION OF DISEASES. [Illustration: Andrew Holes, Esq.] Without solicitude or hope of pecuniary reward, with heart-felt gratitude and a desire to aid my fellow-man to health and happiness, allow me to state, that as an inmate for more than a month of the Invalids' Hotel and Surgical Institute at No. 663 Main Street, Buffalo, N.Y., I feel warranted in its highest recommendation. While there I saw and talked with a great number of people who came there as a last resort, to be cured of almost every chronic disease to which flesh is heir, and they were unanimous in their praise of the Institution and the skilled specialists who constitute its professional staff. ANDREW HOLES, Moorhead, Minn. NERVOUS DEBILITY, DYSPEPSIA, KIDNEY AND LIVER DISEASE--CURED. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: B.V. Wright, Esq. ] Gentlemen--I take pleasure in informing you that the treatment you gave me for the relief of an affection of the spine and nervous system, disease of the digestive organs, kidneys and liver, has been entirely successful. I had feared that my health was gradually being undermined, prior to entering your institution, and I can testify to the perfect appointment that you have, the excellent apparatus for the administration of electrical and other massage treatment and baths. My relief was most satisfactory, and the cure has remained permanent. I take pleasure in recommending your institution to the afflicted, believing that you have the very best treatment for chronic diseases known, and I have had an opportunity to satisfy myself, from conversation with other invalids in your Institution, of the care and skillful treatment that you administer, and its excellent effects. I believe that it is fully abreast of the times, and equal to any institution in the world. With many good wishes and thanks for my cure, I remain, Yours truly, B.V. WRIGHT, Graniteville, Middlesex Co., Mass. PROLAPSING PILES (HEMORRHOIDS), ASTHMA, TORPID LIVER AND CONSTIPATION. CURED AT THE AGE OF 62--NOW 73 YEARS OF AGE--AND CONTINUES IN GOOD HEALTH. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Plummer. ] _Dear Doctors_--It is with the greatest pleasure that I add my own experience to that of the many that you have cured. I am now seventy-three years of age, and enjoy very good health for my years, and as you can see by the photograph I send you, time has dealt very considerately with me so far as my activity and enjoyment of life are concerned. To this I feel that in large measure my thanks are due to you, for eleven years ago when I was sixty-two years of age you treated the pile tumors so successfully. They had been the source of greatest discomfort. I think that they were caused first by chronic diarrhea, which had troubled me many years prior to their appearance. I was also afflicted with asthma, torpid liver and constipation. These conditions produced in time some pile tumors that were the source of much suffering, and seemed to continually annoy me. As is usual with such difficulties, I believe, I would be free from discomfort for a time, and then the piles would get sensitive and irritable, come down at stool, and gave rise to severe pain that seemed to affect my general health. The nervous symptoms that resulted from their presence were such as to lead me to fear that I would break down in health unless they were relieved. From information obtained from others who had been relieved at your hands, I applied to your institution, and can thankfully assert that the tumors were permanently cured, as it has been eleven years since your specialist treated me, and I have had no trouble of the kind, and for an old lady I am pretty well. I had such good treatment and nice care at your institution that I cannot express in my testimony the thanks that I owe you. Wishing you every success in the treatment of others, and that you may be able to relieve the sufferings of many hundreds as you have mine, I remain. Very respectfully and thankfully yours, MRS. MOSES PLUMMER, Groton, Caledonia Co., Vt. BILIOUSNESS, CONSTIPATION, BAD COUGH. WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.: [Illustration: George Wilder, Esq. ] _Gentlemen_--Some twenty-five years since I was feeling very miserable all summer; I was very bilious; sometimes my bowels would not move once in sixty to seventy hours, and then almost impossible. I would take some bitters, which would help to move the matter, but as soon as the bitters were gone, I had to buy more or I would be as bad as before, and sometimes worse; but none of them appeared to do me any good except to move the bowels, until thirty years since a druggist called my attention to your "Golden Medical Discovery," and before I had taken half a bottle of the "Golden Medical Discovery," I felt much better, and by the time I had taken all, I could eat three hearty meals per day and had not felt so well for a long time. Soon after I was called to do a job some miles from home, and one night the old lady there was speaking about her daughter (Mrs. Brooks) who had been under the doctor's care for about five months and did not get any better, and I learned by asking a few questions that she had no appetite and no ambition to do anything. Then I told her what the "Golden Medical Discovery" had done for me. The next day the old lady drove down to her daughter's and got Mr. Brooks to send to Rutland, ten miles away, for two bottles of the "Golden Medical Discovery," and the next day when the doctor came and was about to take his leave, Mr. Brooks told the doctor he did not want him any more at present, and would send for him, if necessary. I saw the old lady about ten days later and her daughter was improving, and Mr. Brooks had great faith in the "Golden Medical Discovery," and had not sent for the doctor, but had gone to Rutland for more of the "Golden Medical Discovery." When I commenced taking the "Golden Medical Discovery" I thought I was going into consumption, as I had a cough for three years or more and my weight decreasing. My weight before taking the "Golden Medical Discovery" was 133 pounds; last March it was 147 pounds, and I give the credit to the "Discovery," GEORGE I. WILDER, East Wallingford, Rutland Co., Vt. LIVER DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Bosworth. ] _Gentlemen_--I suffered greatly for thirteen years. Not one moment during that time had I rest from pain or weakness. I consulted six of our best physicians, taking medicines from each for a good long time. I became completely discouraged, as I had been many times before. A letter from the World's Dispensary Medical Association with questions to be answered, fell into my hands; these I carefully answered. As soon as a letter could go and come I received another saying I had the Liver Disease. I could hardly believe it, for it had never entered my mind that that was my trouble. I read the pamphlet sent me in the next mail, describing my feelings much better than I could myself. I accepted their advice, strictly followed it. I found complete relief in taking the "Golden Medical Discovery." For years I could not ride a mile nor walk to my nearest neighbor's without feeling worse for it, and most of the time could not go at all. The day this picture was taken I rode eighteen miles, walking up and down two long hills. To the afflicted and discouraged I would say consult the World's Dispensary Medical Association; accept their advice, strictly follow it, and if there be help for you I believe you will find it in so doing. Respectfully yours, MRS. HELEN C. BOSWORTH, Money Creek, Houston Co., Minn. DYSPEPSIA, AND OTHER COMPLICATIONS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Stephen Ogden, Esq.] _Gentlemen_--In reply to yours of the 7th instant, I would say that I can cheerfully recommend your medicines, as I have tried them and found them just as represented. I am enjoying splendid health at the present time. Yours truly, STEPHEN OGDEN, Twin Mound, Douglas Co., Kansas. DYSPEPSIA AND CONSTIPATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss. Helfer. ] _Gentlemen_--I have been troubled with dyspepsia and constipation for the last six years, and have tried all medicines that I could think of; and I got so low in health that I thought I would once more try the "Golden Medical Discovery" and Dr. Pierce's Pleasant Pellets. After taking it for three months I began to feel better, especially the gas and sour rising off my stomach at night. Formerly it was a terrible distressed feeling, could not rest nor sleep. I am very thankful to the World's Dispensary Medical Association, and thankful to God who put the great _power_ in your medicine that cured me. I will say a good word for your medicines to all friends I meet. With many thanks, I remain, Respectfully. Miss M.A. ELIZABETH HELFER, Moreton Farm, Monroe Co., N.Y. COMPLICATION OF DISEASES. A GRATEFUL PATIENT'S WORDS OF PRAISE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: William Henkel, Esq. ] _Gentlemen_--Having been in your Institution as a sufferer from two distinct chronic diseases of years' standing, and having been placed under the charge of your specialists, I was speedily relieved of my afflictions. The Invalids' Hotel is a place as much like home as it is possible for such an institution to be. The physicians and surgeons are all expert specialists and thoroughly efficient; the nurses are very competent, attentive and kind; and, in fact, the whole _personnel_ of the Invalids' Hotel endeavor to do their best to make the patients feel like being at home. I always felt while there as if I was one of the family. I gladly recommend your Institution to all persons who are afflicted with any kind of chronic disease, for from my own experience I _know_ the professional staff will do all which they promise to do. Please accept my thanks for the speedy benefits and perfect cure of my diseases, and I think your Institution is worthy of the highest endorsement. Yours truly, WILLIAM HENKEL, No. 1917 Congress Street, St. Louis, Mo. DYSPEPSIA AND GENERAL DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Rev. A.H. Mevs. ] _Gentlemen_--Having suffered for a number of years with dyspepsia, torpid liver and general debility, and having tried several physicians with little or no benefit, I resolved, as a last resort, to consult your specialists at the World's Dispensary. Being advised by them to use Dr. Pierce's Golden Medical Discovery, I did so, and after using several bottles, I feel entirely restored to health. Now, I take great pleasure in recommending your medicines to suffering humanity everywhere. Yours very gratefully, REV. A.H. MEVS, Friar's Point, Coahoma Co., Mississippi. "LIVER COMPLAINT." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J. Gaughan, Esq. ] _Gentlemen_--When I commenced taking "Golden Medical Discovery," I was suffering badly from "Liver Complaint." I had been out of health for three years. I suffered terribly from "heart-burn," had bad coat on tongue, and was often troubled with diarrhea. Three bottles of the "Discovery" cured me. Had I not commenced taking it when I did, I should have been dead long ago. You have my heartfelt gratitude for my cure. Yours truly, JAMES GAUGHAN, Braidwood, Will Co., Ill. P.S.--There are lots of people here whom I have recommended to use your Golden Medical Discovery," and each and every one says it is a good medicine. One woman in particular, told me she was getting better every day by the use of your medicines. J.G. NERVOUS DYSPEPSIA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Taylor.] _Gentlemen_--I had a dead aching in my head and down the back of my neck and in my left ear, and my tongue was so stiff at night and dry, and I had no taste, or appetite to eat anything. I also had such a dead aching in the small of my back; it just felt as if I would break, and such aching between my hips. I had been having the "change of life," and if I worked hard I got a pain between my shoulders and a kind of aching in the abdomen. I doctored a good deal and never got any relief. I was very nervous. I took two bottles of Dr. Pierce's Golden Medical Discovery and two of his "Favorite Prescription," and I am perfectly cured. MRS. ELLEN TAYLOR, Clarion, Clarion Co., Pennsylvania. DYSPEPSIA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Rev. Prosser.] _Dear Sirs_--I was a great sufferer from dyspepsia, and I had suffered so long that I was a wreck; life was rendered undesirable and it seemed death was near! but I came in contact with Dr. Pierce's Golden Medical Discovery and "Pellets." I took twelve bottles of the "Discovery," and several bottles of the "Pellets," and followed the hygienic advice of Dr. Pierce, and I am happy to say it was indeed a cure, for life is worth living now. A thousand thanks for your treatment. I enclose my photo. Yours respectfully, REV. CHAS. PROSSER, Mount Carmel, Northumberland Co. Pa. LIVER DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Winter.] _Dear Sirs_--It is with pleasure that I tell you what your "Discovery" has done for my mother. She was in poor health for a long time, coughing and weak, and thought she had consumption; she had such palpitation of the heart and could not rest at night because of the palpitation sometimes, and then the right arm pained her so at times that she hardly knew what to do; If we would put on hot applications, it would drive it to the heart, and the doctor did her no good; so finally, as a last resort, we happened to get hold of some of Dr. Pierce's pamphlets and were constrained to write to him and send a small bottle of urine for examination. He immediately wrote back, saying it was liver trouble, and to take the "Golden Medical Discovery" according to directions. She took it for two months, when the pain in her arm gradually left her and she could comb her own hair, and began to be more cheerful, for she was melancholy before. The palpitation grew less and less, and she rested at night, and is now doing her own work for a family of five, and is sixty-one years old. I have taken delight in recommending to others this wonderful medicine for heart and liver trouble; she took a dozen bottles to effect the desired end. Respectfully yours, Miss LU WINTER, Dakota, Winona Co., Minn. TORPID LIVER, SUPPRESSED MENSTRUATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Fitzgerald. ] _Gentlemen_--I had suffered so much for years from "Liver Complaint" that I did not care whether I got well or not, but my husband urged me to take your "Golden Medical Discovery." I had not had my courses for six months; after I had taken your medicine about two months, I was well. When one of my daughters with a baby two weeks old was in so much pain that she could not rest day or night, I went to her as quickly as I could, and commenced giving her your "Favorite Prescription." The next morning the pains were all gone. She said, "oh, mother, I would have died if you had not come. I do feel so good." Your medicine makes people feel like they wanted to live. There is a woman at Verdi who had several children who died with consumption of the bowels and _chronic diarrhea_. She had another one who was going the same way. The doctor said it was bound to die. I went there and gave it five drops of Dr. Pierce's Extract of Smart-Weed, and increased the dose every time its bowels moved, until I got to a half teaspoonful. The next morning the child was almost well. That woman says I saved her baby's life. I could write a week and not tell half the good your medicines have done through my hands. Two weeks ago, a young man at my house was taken with _cholera morbus_. He thought he was surely going to die, but as quickly as I could get some hot water, I put hot applications on his stomach and bowels, and gave him a few doses of your Extract of Smart-Weed. He got well immediately. MRS. MARY ISABELL FITZGERALD. Reno, Washoe Co., Nev. LIVER DISEASE AND NERVOUS DYSPEPSIA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: I. Rhue, Esq. ] _Gentlemen_--I was weak, nervous, dizzy, with a fainting sensation when walking; could not walk any distance, always feeling hungry but always felt bad; after eating felt as though my victuals were sticking in my throat; could not rest well at night; I was not well all winter. In 1891 took sick and quit work; in March doctored with three different doctors with very little benefit for a good deal over a year, then began taking your "Golden Medical Discovery." Took ten bottles of that, and one bottle of your "Pleasant Pellets," and steadily improved all the time I was taking your medicine and have worked all this summer; did not work for two years. My case was liver disease and nervous dyspepsia of which your medicine has cured me, for which receive my sincere thanks. Respectfully yours, ISRAEL RHUE, Morrisdale Mines, Clearfleld Co., Pa. TORPID LIVER. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--From early childhood I have suffered from a sluggish liver with all the disorders accompanying such a condition. Doctors' prescriptions and patent medicines I have used in abundance; they only afforded temporary relief. I was recommended to try Dr. Pierce's Pleasant Pellets. I did so, taking three at night and two after dinner every day for two weeks. I then reduced the dose to one 'Pellet' every day and continued this practice for two months. I have in six months increased in solid flesh, twenty-six pounds. I am in better health than I have been since childhood. Drowsiness and unpleasant feelings after meals have completely disappeared. Respectfully yours, U.S. Inspector of Immigration, Buffalo, N.Y. John H.M. Berry LIVER DISEASE, CONSTIPATION. DR. R.V. PIERCE, Buffalo, N.Y.: [Illustration: Mrs. McDaniel.] _Dear Sir_--I enclose you my photograph as you requested; also, state that I have taken your "Pellets" and "Golden Medical Discovery" for chronic "liver complaint" attended with constipation of the bowels, and after using six bottles of "Discovery" and same of "Pellets," I am greatly benefited. You can use my name in advertising your medicines and I can warrant them to do all you claim for them. Respectfully yours, Mrs. M.F. McDANIEL, Bee Branch, Van Buren Co., Ark. TORPID LIVER, DYSPEPSIA, NERVOUS AND GENERAL DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J.F. Hudson, Esq.] _Dear Sirs_--Having suffered severely, for a long time, from a torpid liver, indigestion, constipation, nervousness and general debility, and finding no relief in my efforts to regain my health, I was induced to try your "Golden Medical Discovery" and "Pleasant Pellets." Under this treatment I improved very much, and in a few months was able to attend to my professional duties. I now feel very grateful for the benefits I have received from the use of your valuable medicines, and recommended them to many of my friends and neighbors. Respectfully yours, J.F. HUDSON, Witcherville, Sebastian Co., Ark. "TROUBLESOME COMPLAINTS." WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 683 Main Street, Buffalo, N.Y.: [Illustration: Miss Cheney.] _Gentlemen_--After using five bottles of Dr. Pierce's Golden Medical Discovery, four bottles of Dr. Pierce's Favorite Prescription, and about half-a-dozen packages of his "Pellets," I am convinced that I am thoroughly cured of that dread disease, known as dyspepsia, and other troublesome complaints. Very sincerely yours, MISS HATTIE L. CHENEY, Sac City, Sac County, Iowa. LIVER AND KIDNEY DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Ray.] _Gentlemen_--Your kindness to me I can never forget, I cannot express half my feelings of gratefulness to you. I had despaired of ever getting well. I had been in bad health twenty years--liver and kidneys, all out of order and aches all through me; numb hands and cold feet. Everything I ate distressed me, bowels constipated, was very nervous, depressed and despondent; in fact I can't express half my bad feelings to you. When I first wrote to you, I thought I would not live to get an answer from you. I have taken twenty bottles of "Golden Medical Discovery" and "Pellets." My health is now very good. You have my honest recommendations to all sufferers. Thankfully yours, MRS. REBECCA RAY, DeAnn, Hempstead Co., Ark. LIVER AND KIDNEY DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: G.W. Sweeney, Esq.] _Gentlemen_--I was for years hardly able to go about. I suffered from liver and kidney trouble, six different Doctors treated me during that time but could do me no good. I give your "Medical Discovery" the praise for my cure. Then, too, my wife had a bad case of Asthma which was cured by the use of that wonderful blood-purifier. Yours truly, GEO. W. SWEENEY, Haydentown, Pa. TORPID LIVER. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Bransford.] _Gentlemen_--I can truthfully say that I believe your "Golden Medical Discovery" saved my life. When I began your treatment two years ago, I had been given up by the Doctor, and my friends had lost all hope of my recovery. I had suffered for years with torpid liver; I had chronic pleurisy and catarrh in a very bad form, attended with hemorrhages--was confined to my bed two months. In a few days after beginning your medicine I could perceive a slight change for the better; in three months I felt almost like a new person. Yours very gratefully, MRS. MAGGIE E. BRANSFORD, Williamsburg, W. Va. DYSPEPSIA, UTERINE DISEASE. [Illustration: Mrs. Martin. ] MRS. J.A. MARTIN, of _Cleburne, Texas_, had not had good health since the birth of her child, eight years before; had a headache with burning and throbbing sensations; and a hurting in her stomach; there was a dead aching and gnawing or drawing of the stomach as she described it; sharp pain in the stomach extending to her right breast and shoulder. Weighed in health 125 pounds, but was reduced to 95 pounds; was weak; could scarcely walk at all, was sick at stomach a great deal; when her monthly sickness came on had much pain and the sickness of the stomach remained until menstruation stopped. She writes: WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--"I have taken about six bottles of your 'Golden Medical Discovery' and 'Favorite Prescription,' and am glad to say that I feel better and stouter than I have felt in a long time. I can work all day now and not be tired at night. My head don't trouble me now. When I commenced the use of the medicine I weighed 89 pounds, and to-day I weigh 98 pounds. I feel better than I have for months." DYSPEPSIA AND CONSUMPTION. DR. R.V. PIERCE, Buffalo, N.Y.: [Illustration: Mrs. Ferguson. ] _Dear Sir_--I was not able to do my work for nearly two years, and I tried four different doctors and grew worse all the time. Then I began on your medicine and took twelve bottles of "Golden Medical Discovery" and one of "Favorite Prescription," and am able to do my work and feel as well as I have felt in years. Physicians called my disease Dyspepsia and Consumption. Respectfully yours, MRS. R. FERGUSON, Ink. Shannon Co., Mo. DYSPEPSIA, COSTIVENESS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Wickline. ] _Gentlemen_--I suffered a great deal with headache and dizziness in my head and costiveness. My food would sour on my stomach and I would spit it up. I also suffered with my back a great deal; in fact, I was entirely broken down. Had different doctors but none seemed to do me any good and I began to take your medicine--the "Golden Medical Discovery." I have been enjoying better health since I have taken your medicine than I had for years before. I have recommended it to my friends; I believe it to be the best medicine in the world. My sister has taken more of your medicine than I have; her husband has also taken it; she thinks there is no medicine in the world so good as Dr. Pierce's. Yours truly, MRS. MAGGIE WICKLINE, Box 95, Pulaski City, Pulaski Co., Va. DYSPEPSIA OF FIFTEEN YEARS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Strawderman. ] _Gentlemen_--Dr. Pierce's Golden Medical Discovery and "Favorite Prescription" cured me of dyspepsia after fifteen years' suffering. I doctored a great deal without receiving any benefit. About four years ago my attention was called to Dr. Pierce's Favorite Prescription, which was highly recommended for dyspepsia and I used three bottles of "Prescription" and eight bottles of "Golden Medical Discovery," and they have done me more good than all other medicines I ever used. Yours truly, MRS. ANGELINE STRAWDERMAN, Philippi, Barbour Co., W. Va. DYSPEPSIA, SHORTNESS OF BREATH. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: W. Goodwin, Esq. ] _Gentlemen_--I was in bad health when I commenced your treatment; I was troubled with my stomach, and with shortness of breath. Everything I ate distressed me. I lost flesh and strength and became very nervous and despondent. I took eight bottles of "Golden Medical Discovery," and six bottles of "Pellets," and they cured me. I would advise all suffering people to go under your treatment. Respectfully yours, WRIGHT GOODWIN, Gaylord, Beaufort Co., N.C. DYSPEPSIA IN ITS WORST FORM. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: E. Dieterly, Esq.] _Gentlemen_--Only those who have had dyspepsia in its worst forms know what it really can be. What such a case needs I have found in your kindly encouragement, and your "Golden Medical Discovery." Although I can now claim, if any one can, that I have a cast iron stomach, I always keep your "Golden Medical Discovery" and the "Pellets" on hand when settling down from an active summer's vacation, to quiet student life. I heartily recommend these medicines to every one whose suffering is of the nature that mine was. Yours truly, ERVIN DIETERLY, Gettysburgh, Pa. DYSPEPSIA AND "FEMALE WEAKNESS." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Hutchinson.] _Gentlemen_--Words fail to describe my sufferings before I took your "Golden Medical Discovery" and "Favorite Prescription." I could not walk across the room without great suffering, but now I am able to do my own work, thanks to your wonderful medicines, I am a well woman. I suffered all the time with a weight in the bottom of my stomach, and the most severe bearing-down pains, low down, across me, with every step I attempted to take. I also suffered intense pain in my back and right hip. At times I could not turn myself in bed. My complexion was yellow, my eyes blood-shot, and my whole system was a complete wreck. I suffered greatly from headaches, and the thought of food would sicken me. Now I can eat anything, and at anytime. My friends are all surprised at the great change in me. Every one thought I would not live through the month of August. Two of my neighbors are using your medicines, and say they feel like new beings. Truly yours, MRS. ANNIE HUTCHINSON, Cambridge, Dorchester Co, Md. INDIGESTION AND NERVOUSNESS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Livingston.] _Gentlemen_--I am a woman of fifty-six years of age. Had been troubled with Indigestion for three years, which, I think, resulted from "change of life" and overwork. An eminent physician informed me I had no organic disease. But I had distress after eating and was troubled with gas in parts affected, an unpleasant taste in my mouth in the morning. I was weak and nervous and had to live on a very light diet. After taking your "Golden Medical Discovery" I was relieved of these symptoms. I believe the results warrant me in recommending it to others. Yours respectfully, MRS. CHARLES LIVINGSTON, Livingston, Grant Co., Wis. INDIGESTION AND TORPID LIVER. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: E.M. Seavolt, Esq. ] _Gentlemen_--I can heartily recommend your "Golden Medical Discovery" to any one who is troubled with indigestion and torpid liver; I was that bad it was about chronic with me. All the other medicines could give me no relief; but at last, what came to my relief was that wonderful medicine, the "Golden Medical Discovery." I could scarcely eat anything--it would put me in terrible distress in my stomach; I had a dull aching and grinding pain in my stomach with pain in my right side and back, and headache, bad taste in my mouth; at night I was feverish and the soles of my feet burned. I took four bottles of the "Discovery" and two vials of the "Pellets." I am well and hearty and can eat as well as any body can,--thanks to your "Discovery." Yours truly, E.M. SEAVOLT, No. 427 Sandusky St., Mount Vernon, Knox Co., Ohio. DISEASE OF STOMACH. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: A. Lewis, Esq.] _Gentlemen_--Yours of the 4th instant was duly received. I take great pleasure in recommending to the public your system of home-treatment for chronic diseases. I am thankful to say I am in perfect health and have worked every day since I last wrote to you and have not taken a particle of medicine of any kind and am weighing about one hundred and eighty pounds. I have taken your "Golden Medical Discovery" with very satisfactory results, and "Pleasant Pellets" also. Yours respectfully, ARTHUR LEWIS, Schoharie, Schoharie Co., N.Y. RHEUMATISM. WHAT A MINISTER SAYS. CURED FOR $4. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Rev. W. Williams.] _Gentlemen_--In the fall of last year I suffered from rheumatism in my left shoulder and elbow. I tried a great many remedies, recommended to me by friends, but they all failed to afford relief. From that time I began Dr. Pierce's Golden Medical Discovery, until I felt that I was cured, was a period covering four or five months. While the attack lasted, I suffered a great deal, and could not dress or undress myself. Although I am 73 years old, I now regard my health as splendid. I had spent a great deal of money previously, in various kinds of medicine, but the "Discovery," from the day I commenced until I was well, cost only FOUR DOLLARS. Accept my gratitude, and I beg to subscribe myself, Sincerely yours, Rev. WILSON WILLIAMS, Trinity Station, Morgan Co., Ala. HEADACHE AND CONSTIPATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss Wolfe.] _Gentlemen_--I suffered from loss of appetite, constipation, neuralgia, and great weakness, and had terrible attacks of sick headache very frequently; also nose bleed. My health was so poor that I was not able to go to school for two years. I took Doctor Pierce's Pleasant Pellets and "Golden Medical Discovery," and in a short time I was strong and well. Many friends are taking your medicines seeing what they have done for me. Respectfully yours, Miss BERTHA WOLFE, Markham, Cattaraugus Co., N.Y. AS LIVER PILLS, NOTHING CAN COMPARE WITH DR. PIERCE'S PLEASANT PELLETS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mr. S. Baker, Sr.] There is nothing that can compare with Dr. Pierce's Pleasant Pellets, as Liver Pills, They have done me more good than any other medicine I have ever taken. Respectfully yours, SAMUEL BAKER, No. 161 Summit Ave., Phillipsburg. N.J. ULCERATION OF BOWELS. SEVERE BLEEDING. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Aurelia Vanzile. ] _Gentlemen_--My friends said I would never be any better, for I had ulceration of the bowels. By the time I had taken a bottle and a half of Dr. Pierce's Golden Medical Discovery, the bleeding had almost stopped. My appetite was good, nothing seemed to hurt me that I ate. My improvement was wonderful. Several years have passed and my cure is permanent. Yours respectfully, Mrs. AURELIA VANZILE, Hamilton, Ind. BILIOUS ATTACKS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: I.C. Seely, Esq.] _Gentlemen_--Nine years ago I was taken with severe pains in my stomach and bowels which the usual home remedies failed to relieve; after several days it passed off, leaving me very sore and weak but in the course of a few weeks it came on again. I called in a doctor--he treated me for biliousness; I occasionally went several months without any attack and then it would come more severe than ever; I could scarcely bear the weight of my clothes on my stomach and bowels. I grew thin, weak and despondent,--could do no work without bringing on terrible pain. Doctors treated me for catarrh of the head and stomach, indigestion, dyspepsia, but all was of no avail; the suffering gradually increased in severity and I despaired of any relief. In 1892 I had a spell that was so severe I cramped from feet to neck. The Doctor said I must die--he couldn't do any thing for me. After about five weeks in bed I could again sit up, but the pain had settled in my right groin and limb. Relatives persuaded me to try "Golden Medical Discovery." Two thirds of the bottle was gone when I felt a change for the better; I had one very light attack after the first bottle; that has been seventeen months ago and I have had no more trouble. I have taken ten bottles of Dr. Pierce's Golden Medical Discovery and I am now well and able to support my family. To any one with stomach and bowel trouble I will recommend Dr. Pierce's Medicine. I am never without it in the house. I remain, yours, I.C. SEELY, Lindsborg, McPherson Co., Kans. DYSPEPSIA--CONSTIPATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 653 Main St., Buffalo, N.Y.: [Illustration: Mrs. A.L. Pierce.] _Gentlemen_--Three years ago I was suffering from constipation, distress in the stomach, bowels, feet and ankles bloated, kidney and heart trouble, loss of appetite, bad taste in the mouth, sour risings in the stomach, and indigestion. I was under the treatment of three physicians seven months. One gave me up to die. This was my condition when I was prevailed upon to take Dr. Pierce's Golden Medical Discovery and "Pleasant Pellets." I am well, your medicines have cured me permanently. Had I the power and language to herald to the whole world the good qualities of your medicines, I would most gladly do so, as they have saved my life and brought health and happiness to me. Yours most sincerely, MRS. A.L. PIERCE, Stillwater, Penobscot Co., Me. SORES IN MOUTH DUE TO INDIGESTION. [Illustration: C.K. Turney, Esq.] CHAS. KELLOGG TURNEY, ESQ., a prominent contractor and builder, also well known as one of the accomplished singers at the Chautauqua Assembly, and who does business at _Room 6, Bernard Block, Collinwood, Cuyahoga County, Ohio_, writes: "I was troubled with little watery blisters which would form on the under side of my tongue, and which proved very sore and troublesome. Becoming alarmed at the frequency of their appearance, and having much faith in Dr. Pierce and his associates, I wrote to them for advice. They recommended me to take Dr. Pierce's Golden Medical Discovery, which I did, and after using two bottles my trouble entirely disappeared." GAINED THIRTEEN POUNDS; CATARRH OF STOMACH. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Powell. ] _Gentlemen_--Two years ago I was pale and emaciated, food fermented in my stomach. A physician pronounced my case "Catarrh of the Stomach," but he could not help me. I lived a month without solid food and when I tried to eat I would vomit. At this time I began taking Dr. Pierce's Pleasant Pellets, and in two weeks I was decidedly better. I am now in good health, and never felt better in my life. I have a better color, eat more, and have no distress after eating--having gained thirteen pounds since I began taking them. Yours respectfully, MRS. MARY POWELL, Glen Eaton, Marshall Co., W. Va. CHRONIC DIARRHEA--DYSPEPSIA. [Illustration: T.L. HALL, ESQ.] THOMAS L. HALL, of _Creek, Westmoreland County, Pa.,_ had chronic diarrhea, which his physician called dysentery. He had been troubled more or less for five years; had very severe attack fifteen months before writing us; had not been able to work steadily for twelve months. Food sometimes passed undigested; some days had three to six passages; had watery and sour risings from the stomach; backache; was drowsy upon rising in the morning; pain about the heart; itching all over body and limbs. He had three months' treatment at home--the special medicines being sent him by express. He writes that he "was greatly benefited by first week's treatment," but continued and "in three months was entirely well." DYSPEPSIA--LOSS OF FLESH. WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main Street, Buffalo, N.Y.: [Illustration: B. MAKSON, ESQ.] _Gentlemen_--Three years ago I commenced taking Dr. Pierce's Golden Medical Discovery; I weighed 140 pounds, and now I weigh 175 pounds, so you see how I have gained in health and weight. Dr. Pierce's Pellets are the best pills I ever took for the liver. All my friends say they do them the most good. Respectfully yours, ROBERT MANSON, West Rye, Rockingham Co., N.H. TERRIBLE DYSPEPSIA CURED. [Illustration: MRS. LUKE COOK.] Mrs. LUKE COOK, of _Grove, Newaygo Co., Michigan_, writes: "I had been ill for five years. My symptoms were pain in the stomach and bowels; could eat nothing but stale bread and tea or coffee. Meat and vegetables passed through the bowels undigested in about two hours, causing great pain. I was all "run-down." Tongue looked like a piece of raw meat. One doctor pronounced my case cancer of the stomach. I took treatment from five different physicians with but very little benefit--only temporary relief. I got so weak I could scarcely walk around, and suffered terrible agony. After taking fifteen bottles of Dr. Pierce's Golden Medical Discovery, I am well and able to do my own work, and frequently walk two miles and back the same day. I am now sixty-eight years old." INDIGESTION, CATARRH, AND NERVOUSNESS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.: [Illustration: E.A. BALDWIN, ESQ.] _Gentlemen_--For a long time I was suffering from indigestion, catarrh and nervousness. I was so run down that I could not go to school, and, as the various remedies I tried did me no good, I applied to you, and was advised to try a course of special treatment. After taking only two months' medicines from your noble institution, I feel perfectly restored to health. I have, moreover, recovered my lost flesh, and I am pleased to say need no further medicines. Yours truly, E.A. BALDWIN, Proctorsville, Windsor Co., Vermont. GENERAL DEBILITY, MALARIA, SICK HEADACHE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: T.L. Hall, Esq. ] _Gentlemen_--I am happy to say that your valuable medicine has been a great benefit to me. I was suffering from general debility, malaria and nervous sick headaches, and after my third child was born (a beautiful baby boy of ten pounds) I only recovered after a long illness; I barely gained strength enough in two years' time so that I was able to crawl about to accomplish the little housework that I had, by lying down to read many times each day; had sick headaches very often; and many pains and aches, all the time complaining of getting no better. I finally asked my husband to get a bottle of Dr. Pierce's Favorite Prescription, which he promptly did. After I had taken one bottle I could see a great change in my strength, and fewer sick headaches. I continued taking the medicine until I had taken eight bottles--seven of the "Favorite Prescription" and one of the "Golden Medical Discovery." For some time past I have not used it, but I am now able to do the housework for myself, husband and two children (aged nine and five years). I also take in dressmaking, and enjoy walking a mile at a time, and I think it is all due to the medicine, for I know I was only failing fast before I commenced to take it. I take great pleasure in recommending the "Favorite Prescription" to all women who suffer from debility and sick headache. Respectfully yours, MRS. J.H. LANSING, Fort Edward, Washington Co., N.Y. MALARIAL FEVER. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss McConell.] _Gentlemen_--My little girl, eleven years old, took malarial fever and lay 22 days in fever. Our family doctor was tending her twice a day; she got no better; I sent unbeknown to the doctor and got one bottle of Dr. Pierce's Pellets, and one bottle of his "Golden Medical Discovery," and commenced to give them to her as directed; after taking the medicine three days, the fever began to go down, and the doctor came in and said: "what's the matter?" "Ida, you have no fever this morning," and laughed. Then I told him I had been giving Dr. Pierce's medicines. He didn't say a word--he was beaten. My oldest daughter is improving by taking Dr. Pierce's Favorite Prescription. Yours respectfully, MRS. ELIZABETH McCONELL, Payne, Paulding Co., O. GENERAL DROPSY. TAPPING AND MEDICATION CONQUERS THE DISEASE AFTER IT HAD RUN 22 YEARS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: E.L. Waters, Esq.] _Gentlemen_--I wish to acknowledge that you have cured me of the worst dropsy that ever came within my knowledge, it having afflicted me twenty-two years. After I had suffered much from other surgeons without any cure being effected, and with only relief for a short time, you performed a not only painless but very scientific operation, and with medicine completed the cure. It is now five years since you treated me and no symptoms of the disease have shown themselves. I will also add that while with you at the Invalids' Hotel I received the best of care and attention from the well trained nurses in your employ, for all of which I feel grateful. With respect and best wishes, EDWIN L. WATERS, ATHOL CENTRE, MASS. REDUCED TO A SKELETON. CHRONIC DIARRHEA--DYSPEPSIA CURED BY TWO MONTHS' SPECIAL HOME-TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J.T. Yerby, Esq.] _Gentlemen_--To all sufferers from chronic diseases I want to say that I suffered for six years, and was under fourteen different doctors in city and country. They could not reach my case; I was given up to die; my sufferings were _indescribable_; I could not retain food on my stomach; could not control my bowels at times; suffered great pain; could not sleep at night; I was reduced to a _skeleton_; in health I weighed 180; then only 111; I now weigh as much as I did before I was sick. I am sixty years old, but feel young and active; I owe it to the medicines you sent to me. After taking it two months I was out of bed attending to my work; my friends could hardly believe it was I when they would meet me out away from home. I consider my cure as almost miraculous. Respectfully, JOS. T. YERBY, White Stone, Lancaster Co., Va. CHRONIC DIARRHEA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: I.G. Hamilton, Esq.] _Gentlemen_--It is now nine years since I was afflicted with the above disease, which reduced me to a mere skeleton, and my friends had very little hope of my recovery. After trying different doctors, and many other remedies for a year, from which I received little or no benefit, I was advised to try Dr. Pierce's special treatment, which I did, and after two months I was a well, strong, healthy man, and have been ever since. Yours, etc., ISAAC G. HAMILTON, Baie Verte, Westmoreland Co., N.H. DYSPEPSIA OR INDIGESTION. KIDNEY DISEASE AND RUPTURE. [Illustration: A.N. Kingsley, Esq.] The following is from the widely-known and popular proprietor of the Kingsley House at Ashuelot, N.H.: "It may seem useless to add testimony to the overwhelming mass already given of the many remarkable cures performed at your Institution, but I deem it a pleasure and a duty to add mine to your long list as _very remarkable_. I had a rupture of twenty-seven years' standing, with hemorrhage of the kidney for six months, preceding my visit to your Institute, and was also troubled badly with indigestion, all of which ailments had reduced me in strength and flesh to a mere skeleton. Had been treated by many local physicians, who failed to do me any good. I could walk but a very short distance when I left my home on the 8th of July, 1892, for treatment at your Institution, with but little faith or hope of ever being any better. But through your skillful treatment I was able to return to my home on the 9th of August, 1892, and consider myself permanently cured, having had to take no medicine since. Considering my case _almost a miracle_, I cannot speak too highly of your Institute and skillful treatment, to which I feel that I am indebted for my continued existence. You are at liberty to refer to me, and to use this as you see fit. Very respectfully, A.N. KINGSLEY, Ashuelot, Cheshire Co., N.H." DYSPEPSIA, RHEUMATISM, NERVOUS PROSTRATION, SLEEPLESSNESS. [Illustration: J.T. Townsend, Esq. ] Mr. J.T. TOWNSEND, of _Noah, Coffee County, Tenn_., consulted us by letter. He was suffering from great nervous prostration; could not walk without tottering; was troubled greatly with inability to sleep; poor appetite; did not relish food; suffered much pain and stiffness in the joints; was overcome with neat working on a thresher, followed by persistent nausea, confusion of ideas, his memory being very defective. After taking a single course of treatment, the medicines being sent by express, he writes as follows: "The medicine you sent me lasted me five weeks, and proved very beneficial indeed. I believe it, under God, was the means of saving me from a premature grave. When I received the medicine, I had just gotten rid of an attack of bilious fever, which left me in a deplorable condition. I was very week and nervous, but my improvement commenced with the first dose of your medicine, so by the time my medicine was out I felt better than I had for years, and now have no indication of a return of my trouble." A month later he writes: "I continue to enjoy the most perfect health. Every organ of my body, and every faculty of my mind, is in splendid condition, which makes life worth living. I have gained twenty-one pounds since I have been able to attend to business. Please accept my profound thanks for your promptness in sending me my medicines." NERVOUS DEBILITY. PILES, CATARRH, HEART SYMPTOMS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J. Talbott, Esq. ] _Gentlemen_--The effect of your remedies is little short of a miracle. My general make-up and appearance are astonishing; my cheeks rosy, eyes bright, circles nearly all gone from under eyes; am fleshier, stronger, more active, and an entirely different man. No piles, catarrh, heart trouble; no chills and fever; no despondency, no anything. Yours truly, JOHN TALBOTT, Pennsylvania Agricultural Works, York, York Co., Penn. DYSPEPSIA AND CATARRH CURED BY SPECIAL HOME-TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: B. Eberhardt, Esq. ] _Gentlemen_--I am happy to inform you that my catarrh and dyspeptic symptoms have all vanished. I am no longer troubled with headache and stoppage of the nose, my stomach is in good order, and I enjoy three hearty meals daily without any bad feelings. I have gained in almost every respect, particularly in weight and strength, since beginning the use of your specially prepared medicines. By continuing to follow your special hygienic rules, I believe no relapse will occur. Yours respectfully, BERTHOLD EBERHARDT, N.E. Cor. 10th, and Callowhill Streets, Philadelphia, Pa. INDIGESTION, CONSTIPATION, AND UTERINE DISEASE. WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss Joslyn.] _Gentlemen_--Some months ago I consulted your specialist concerning my health, which had at that time become very much impaired from the effects of uterine disease, indigestion and chronic constipation. I was also troubled with frequent attacks of nervous headache which rendered me very miserable. A line of treatment was outlined by your specialist, which I followed closely, and I immediately began to improve under the use of the medicine advised. The benefits wore so marked that within two or three months I was able to discontinue the use of the medicine, and have since that time been enjoying good health. I attribute my cure to the use of your medicines, and I heartily thank you for the benefits received, as well as for the kind attention given me by your specialist. Respectfully yours, IDA M. JOSLYN, Groton, Conn. CHRONIC BRONCHITIS AND DYSPEPSIA. WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.: [Illustration: A. Rosenberger, Esq.] _Gentlemen_--Several years ago I spent many dollars for medicine, but in vain, and expected to die with consumption. But hearing of your Invalids' Hotel and Surgical Institute, I visited you. To your advice and treatment I owe my life and present good health. Hoping-that you and your eminent faculty may be spared many years to cure the afflicted, I send you my best wishes. Yours truly, ALBERT ROSENBERGER, La Otto, Noble Co., Ind. A COMPLETE COLLAPSE. STOMACH TROUBLES WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: J.L. Warner, Esq.] _Gentlemen_--Fifteen years ago I felt the first effect of a diseased stomach. It was very light at first, but as time went on it gradually grew worse. I did not suffer much at first--say for the first five years; but after that it was continual suffering all the time (and growing worse all the time), until just two years ago, when I completely collapsed, and had to give up all thoughts of work. I have not done a day's work since, but am now ready to go to work again. During the last five years I have been doctoring with as many as six different doctors here and in San Francisco. I was with one specialist here in my city five months, but none of the doctors gave me even temporary relief. The main symptoms of my disease were that my food would sour on my stomach and give me an awful heart-burn. I would bloat and have sour risings, and an awful burning sensation in my chest which would bring the tears. I have felt many times that I would like to leave this world. In looking over the ads. in the San Francisco Examiner, I ran across yours--stating that any one who would send twenty-one one-cent stamps to the address given would receive The People's Common Sense Medical Adviser I did as requested, and read a copy, and I now owe my life and present good health to Dr. Pierce and his noble staff of physicians. I have now taken fourteen bottles of the "Golden Medical Discovery" and four bottles of the "Pleasant Pellets," and will say that I am entirely well of all my stomach troubles. Can sleep nine hours every night. A word to those who are taking or contemplating taking this grand remedy. Do not give up with one or two bottles, but continue on, and it will cure you as sure as the sun shines above. Gratefully yours, J.L. WARNER, 1005 Fourth Street, Sacramento, Cal. NERVOUS DYSPEPSIA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J. Smith, Esq.] _Gentlemen_--For over twelve years I was a great sufferer from nervous indigestion and acidity of the stomach. I tried some of the best doctors, both in England and this country, but did not find permanent relief until I went to the Invalids' Hotel and Surgical Institute. The medicine prepared for me by the specialist at this famous institution was so effectual that I feel that I am perfectly cured. I cannot speak in too high praise of the Invalids' Hotel and Surgical Institute. The Staff of Physicians is skillful and of large experience, and the institution itself, in all its appointments, excellent and in advance of the age. I highly recommend it to all the afflicted, feeling confident that all the benefit to be derived from medical or surgical treatment can be had at that institution. JOSEPH SMITH, No. 200 Eighth Street, Olean, N.Y. BAD CASE OF DYSPEPSIA, CURED BY SPECIAL HOME-TREATMENT. [Illustration: Mrs. Johnson. ] Mrs. JOHANNA JOHNSON, of _Big Springs, Union Co., South Dak_., forty-six years old. A pain began in the stomach, a sort of cramp; extended to the chest, shoulders and arms, also affecting the spinal column opposite the location of pain; had a hard lump that felt like lead in the pit of her stomach. Pain was brought on sometimes by eating something that at other times she could eat with impunity. Attacks of pain lasted usually about three days. After the pain would leave, she was weak and sore. Sometimes attacks would come on every day. Had two months' special treatment. Reports five months afterwards as follows: "Since taking your medicine, I am a new person; at least I feel so. I have used only one-half of the last set of medicines, and think I will not need to continue. A lady similarly afflicted is trying some of my medicine, and will order from you direct. I am glad to know where to direct the sick, and where the most good can be had for one's money. I am feeling well, and can work as formerly." INDIGESTION AND CONSTIPATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: O.F. Sinigar, Esq.] _Gentlemen_--I was troubled with chronic indigestion and constipation. Had to be constantly taking physic, and finally was compelled to resort to hot water injections regularly to move my bowels. This got to be a great drudge to me. I took treatment from the leading physicians of this part of the country for my stomach and bowel troubles, and spent over one hundred dollars in this way, but they did me no good whatever. I got so bad that I began to think my time on earth was short, and did not care if I lived or died. I had to stop work; everything was a burden to me, until at last I tried your Institution. I went there, and you said you could help me, and those words sounded so good to me, as I thought I never could get well again. After taking your special home-treatment for five months, I was in the enjoyment of perfect health. This was two years ago, and ever since my bowels have moved regularly, and I have not taken any medicine to make them move. I cannot find words in which to express my sincere thanks for the almost immediate relief. I received from your specialists, and will say I am now enjoying the very best of health. Yours with respect, ORWIG F. SINIGAR, No. 71 Feather St., Canton, Ohio. FISTULA IN ANO, PILES, PROLAPSE OF RECTUM. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: N.T. Roberts, Esq.] _Gentlemen_--For more than twelve years I have been a sufferer with a complication of rectal troubles; pile tumors, prolapsus and fistula in Ano. I have been under the treatment of our most skilled practitioners, by ligature, carbolic acid, constitutional treatment, change of climate and the celebrated Brinkerhoff treatment, and also tried all of the local guaranteed nostrums, from all of which I have been only temporarily relieved. The old troubles would in a short time return, and with seemingly renewed vigor. With fast failing health and terrible nerve prostration, I left home the 1st day of October last, to take a two weeks' trip, hoping for some temporary relief. On the trip I stopped over at Buffalo, and having several years before been in correspondence with the Infirmary, concluded to consult you. I did so with little hope of a beneficial result. From the manner in which I was received and the satisfactory diagnosis of my case, I placed myself under your treatment. On the 16th day of October you operated upon me with such complete and satisfactory success, that I am now a sound and happy man, and am confident that had I been treated by you ten years ago that I would now be twenty years younger in feeling and thousands of dollars better off. It affords me pleasure, doctors, to recommend the Invalids' Hotel and Surgical Institute to all of the afflicted, and to assure them of the most skillful treatment, honest and polite attention, and with the assurance of my kindest and most grateful remembrance, I am, Yours truly, N.T. ROBERTS, Pine Bluff, Ark. RECTAL FISTULA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Lothrop. ] _Gentlemen_--Having been a great sufferer for years and receiving little or no benefit from other physicians, I determined to try your Institution, and with grateful results. Having a successful operation for a fistula (of five years' standing) without the knife, while other home-physicians advised me there were no other means. And my troubles are yielding slowly but surely; my general health is better than for twelve years--all of which I owe to Dr. Pierce, and his skillful physicians and surgeons. Please accept my sincere thanks for the kindness shown me while an inmate by all connected with the Invalids' Hotel. I shall heartily recommend your Institution to all sufferers. Yours gratefully, MRS. M.B. LOTHROP, Villa Park, Orange Co., Cal. UTERINE AND RECTAL DISEASE. HOME PHYSICIANS FAILED. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Clawson.] _To whom it may concern_--I was greatly afflicted with Uterine and Rectal disease. My disease was of very long standing and had baffled the skill of our home physicians. I went to the Invalids' Hotel and Surgical Institute, and received treatment of their specialist. Under his skillful care and kind attention I soon regained my strength and felt that my former life and ambition were again restored to me. I cannot speak in too high praise of this famous Institution; the rooms are large and cheerful, the food of the very best, the nurses kind and attentive, and the staff of physicians and surgeons skillful and of large experience. Yours respectfully, MRS. CHAS. CLAWSON, Middlesex, Yates Co, N.Y. RECTAL FISTULA WITH BLOOD-POISONING, CURED BY A SAFE AND PAINLESS METHOD. A PROMINENT MERCHANT TESTIFIES TO THE SUPERIOR METHODS EMPLOYED AT THE INVALIDS' HOTEL AND SURGICAL INSTITUTE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J.F. Saton, Esq. ] It is with pleasure that I testify to the cure of the Fistula, for which you treated me. I had suffered from it for a long time, and felt that it was likely to seriously undermine my health and poison my system. I had deterred having it treated from the fears of the cutting operation in common use by physicians in the large hospitals and by surgeons in general practice. My fears were grounded on the fatal results that had followed in cases in my knowledge. I am thankful that I placed my case in the hands of your experienced specialists for treatment. The result has been a perfect cure. The treatment of the blood-poison that you gave me was successful in eliminating it all from my system, and I have since enjoyed perfect health, and no recurrence whatever of the fistula. It has been now many years since I was cured, and I thank you most sincerely for the good results that were brought about in my case. I can recommend your institution as one in which all the requirements of an invalid are fully met. Yours truly, J.F. EATON, Auburn, Mo., Box 806. RECTAL FISTULA AND NERVOUS PROSTRATION-RUPTURE. [Illustration: M.L. Stigers, Esq.] _To the afflicted public_: It becomes my pleasant duty to recommend the Invalids' Hotel, Buffalo, N.Y., as an Institution for the successful treatment of surgical cases and chronic ailments of every description. It is with especial pleasure that I recommend the surgeon-in-chief of the Hotel, who is a skilled surgeon, one who stands at the head of the profession. The appointments of the Hotel are excellent. I was afflicted with an Anal Fistula (a very bad one it proved to be). I went to the Invalids' Hotel for treatment. Was placed under the care of your surgeon, who treated my case with such skill, that the parts are healed soundly. I recommended a friend of mine, who had a rupture, to go to you for treatment. He did so and was soundly healed of his trouble. I will cheerfully answer all communications relative to my stay at the Invalids' Hotel, provided a stamp is enclosed for return postage. Yours truly, M.L. STIGERS, Menlo, Iowa. ANAL FISTULA. COMPLICATED CASE OF HEART DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: N.S. Johnson, Esq. ] _Gentlemen_--I feel that it is my duty to suffering humanity to let them know of your great success with me. I had a chronic disease that I had suffered with for sixteen years, and last November, owing to a fall, the disease doubled on me. I was confined to my bed for months, and the best surgeons of our city attended me daily. I continually grew worse. After consultation they decided that the knife must be used, which is attended with great pain and danger. I wrote you and stated my case; you said you could entirely cure me without pain, also without the use of the knife. I determined to go to Buffalo. Arrived there the 18th of March, and on the 20th of April I was at home entirely cured, and have enjoyed better health than for years. You also treated my wife for heart trouble, and greatly benefited her. The thoroughness of your methods, preparing the system, etc., greatly adds to your success, as well as your skillful treatment. I shall ever hold the surgeons at the Invalids' Hotel and Surgical Institute as a green spot in my memory. Yours respectfully, N.S. JOHNSON, Bloomfield, Iowa. HERNIA AND PILES CURED WITHOUT PAIN. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J.J. App, Esq.] _Gentlemen_--I have been successfully treated at your institution for piles and also rupture of the left side. Your institution is all it claims to be, and the treatment of my case was accomplished without pain and apparently any risk. Your method of using locally cocaine as an anæsthetic is such a decided improvement. I did not have to take any dangerous ether or chloroform, but had a small quantity of medicine injected that made the operation as painless as though it was being done on some one else. At the same time I knew everything and could see what was being done. You have my kindest thanks for the good care and many attentions given me. Your nurses and physicians all give kind and skillful care. Yours very truly, J.J. APP, Bolivar, Tuscarawas Co., Ohio. LARGE PILE TUMORS. [Illustration: J.C. Bagley, Esq. ] WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I was afflicted with piles for many years, brought on by heavy lifting during the war. My suffering was extreme, and the pile tumors gradually increased in size, notwithstanding the fact that I tried many different kinds of treatment. After becoming physically incapacitated and unable to do any work at all, and after much hesitation, I visited your institution as the last resort. I am happy to state that my visit there has resulted in a complete and permanent cure. A year or more has now elapsed since I placed myself under the care of your specialist, and I wish to thank you most heartily, for the attention which I received while there, and for the cure which has been accomplished in my case. I cannot say enough in favor of you and your staff of physicians who gave every attention, and whose treatment has been so successful. All suffering has entirely vanished, and I have gained about 35 pounds in flesh. Respectfully yours, J.C. BAGLEY, Watts Flats, Chaut. Co., N.Y. LARGE PILE TUMORS; CHRONIC INFLAMMATION OF BLADDER. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: P. Crump, Esq. ] I was troubled with piles for thirty years. These were very mild at first but gradually increased in severity, and I was unable to get anything which would relieve them. They gradually increased in size, and for a good many years past have caused me a great amount of pain. The tumors became of large size and protruded whenever I lifted anything heavy or strained in the least; also bled copiously at times. This, together with chronic inflammation of the bladder, with which I have also suffered for some years, rendered my life miserable. Physicians at home gave up my case as hopeless, and said that they did not think I could be benefited, and certainly not cured. I visited your Institution, hoping to obtain relief, but with very little faith, and am happy to say that the treatment which I obtained there has resulted in a permanent cure of the piles, and the inflammation of the bladder has been so greatly relieved that at present I have no suffering of any kind. The cure is complete and I feel like a new person. In fact I have not experienced such comfort in many years. I shall always appreciate the kindness and attention shown me by your staff of physicians, and also by the nurses in your Institution, and shall advise my afflicted friends to make you a visit. Very respectfully, PETER CRUMP, Dennison, Goodhue Co., Minn. PILE TUMORS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: S.H. Crosby, Esq. ] Since the spring of 1872, I have been troubled with pains in head, the result of sun-stroke while in the U.S. army, and pile tumor growth. For the last named disease I was treated at the Invalids' Hotel and Surgical Institute, in June of 1887, and the growth, as I believe, is killed, and the result has been a great benefit to my general health. I am quite comfortable and with strength to look after my little work and superintend the same, much better than before treatment, for which benefit please accept my thanks. Yours respectfully, S.H. CROSBY, Manito, Mason Co., Ill. BAD CASE OF PILES CURED BY HOME-TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I received a few days ago a communication from you requesting a photo, of myself. I will say that I am sorry, but I have had no photograph of myself taken since I was a child, but will gladly give you a testimonial and I will answer by letter any skeptical ones that you refer to me, provided they send a return addressed and stamped envelope for reply. Just one year ago, I was suffering untold agonies from internal piles and prolapsus of the rectum: my bodily pain was so great that the mental strain was almost more than I could stand. I was useless to myself and family and had about persuaded myself it would be better to take my life, and I think I should have done so had not a copy of the Common Sense Medical Adviser happened to fall into my hands. I was not certain just what my trouble was, at least what to call it. I began the Chapter treating on Pile Tumors, and then I realized just what my trouble was. I wrote you and received encouragement. I sent for a month's treatment and it was certainly the best investment I ever made. I received the medicines at noon--read the directions carefully and commenced at once to carry them out. I seemed better the next day. I suffered less, and in a few days there was a decided change for the better. I continued the medicine until I had taken all of it; I have not taken any since, except occasionally a few of Dr. Pierce's Pellets, just enough to act as a mild laxative. I am perfectly well. I was always more or less constipated all my life. I now understand that by keeping the bowels open and in good order, I could have avoided all of the suffering that I have gone through; my friends all think my recovery almost a miracle. I feel, Oh, so grateful to you, I shall never fail to speak a word in your favor to suffering humanity. Respectfully, Mrs. J.W. Heist Fayette, Howard Co., Mo. PILES AND CHRONIC DIARRHEA. DR. R.V. PIERCE, Buffalo, N.Y.: [Illustration: J.J. Bradford, Esq. ] _Dear Sir_--I was a great sufferer for thirty years from piles, and take great pleasure in bearing testimony to the fact, that since you treated me, seven years since, I _have not had a symptom of piles_. At the above stated period I had also been a sufferer from diarrhea, in its most aggravating form, for three and a half years, and I was completely and radically cured of that, also. I beg to assure you, and your noble associates, of my lasting gratitude, and feel no hesitancy in expressing the opinion that but for your great skill in treating me, I should have been in my grave. I state for the benefit of all those who may be similarly afflicted that if they will place themselves in your hands, you will goon effect radical cures. JOHN J. BRADFORD, Augusta, Perry Co., Miss. LARGE PILE TUMORS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: L.H. Esety, Esq.] _Gentlemen_--Allow me to thank you for the kind attention and skillful treatment I received while at your Institution for five weeks' treatment. I cannot speak too favorably of your Institution. You have my best wishes for your continued success. Respectfully yours, L.H. ESTEY, Hinsdale, Cheshire Co., N.H. HEADACHE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: E. Vargason, Esq. ] _Gentlemen_--I have used your medicines for a number of years, and know that they do for me all that is claimed for them. I am employed mostly at my desk, and not infrequently have an attack of the headache. It usually comes on in the forenoon. At my dinner I eat my regular meal, and take one or two of Doctor Pierce's Pleasant Pellets immediately after, and in the course of an hour my headache is cured and no bad effects. I feel better every way for having taken them--not worse, as is usual after taking other kinds of pills. Your "Pleasant Pellets" are worth more than their weight in gold, if for nothing else than to cure headache. Very respectfully, E. VARGASON, Otter Lake, Lapeer Co., Mich. DYSPEPSIA, NEURALGIA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss Gwin.] _Gentlemen_--Before using your medicines, my food would not digest; then neuralgia set in, and I suffered severe pain through my sides, shoulders, breast and stomach. Bilious attacks were frequent; then my flesh began stinging and my heart began beating badly and making me so that I could not lift a chair, and all together threw me into a cramp and a numbness, and the family thought I was dying, and sent for another doctor who said it was hard to do anything for me; he visited me almost six years and did not help me; the pain was so great I had to scream; I said to my doctor, "can you give me something" and he said, "yes, but it will not do you any good." I told him he had not done me any good in six years, and I would quit him. I saw I was almost gone, very pale and weak and did not eat anything. I began your "Golden Medical Discovery," and one-half bottle helped me so much I began work and improved fast; it helped me so I got 10 bottles. While using them my friends said when I quit I would be just as bad as ever. It has been five years and no need of a doctor yet, and I will say that I think it cannot be beat, and I will still believe in it, for if it had not been for the "Golden Medical Discovery" I would have been in my grave. Your medicines have helped my brother, and father is using it now and it is helping him. I remain. Your true friend, Miss C.B. GWIN, Cowardin, Bath Co., Va. BLOATING OF BOWELS, CAUSED BY LIVER DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: MR. G.S. WATRING] _Gentlemen_--My son, aged fourteen years, was taken with bloating of the abdomen; this would go down leaving the parts so sore he could scarcely stand. We had three different doctors to treat him, but he grew steadily worse. We then commenced giving him Dr. Pierre's Golden Medical Discovery, and after using it three days he commenced to improve. Last summer he had so fully recovered his health as to make a full hand in the harvest field. He took, in all, only six bottles of the "Golden Medical Discovery," and it saved his life. Respectfully yours, J.B. WATRING, Lead Mine, Tucker Co., W. Va. NERVOUS DYSPEPSIA; UTERINE AND SPINAL WEAKNESS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo. N.Y.: [Illustration: MRS. NAY.] _Gentlemen_--I had nervous dyspepsia for twenty years, followed by uterine and spinal weakness with irritation of the same. In the Spring of 1890 I became so exhausted that I was compelled to keep to my bed with symptoms of paralysis in the lower limbs, and many other distressing symptoms. I accidentally obtained one of Dr. Pierce's Medical Advisers from a friend, and finding my ailments so well described therein, I wrote to Dr. Pierce for his advice, which he sent by return mail. For my recovery he requested me to use his "Golden Medical Discovery," his "Favorite Prescription," and his "Pleasant Pellets." He also gave me some directions for every-day living. These means accomplished my complete cure. I am thankful that we can have such reliable medicines brought into our homes without great expense. Yours truly, MRS. AMERICA NAY, Volga, Jefferson Co., Ind. DYSPEPSIA, TORPID LIVER--TERRIBLE SUFFERING. [Illustration: MRS. O'BANNON] DR. R.V. PIERCE: _Dear Sir_--When I commenced your medicines, had headache all the time, indigestion, pain in my back and loins, soreness and stiffness in my joints, my limbs ached so I could not sleep at night: I could not lie in bed more than two or three hours any night; when I would lie my head on the pillow I would have to rise immediately to get breath, sit up and walk the floor very near all night. I could not eat anything that would digest; I would do the cooking for the family, but I was in so much pain the tears were in my eyes all the time I would get a meal ready. I would take one mouthful of bread and then go off and sit down and cry with hunger, but dare not eat any more, and then would have to vomit from that one mouthful of bread--I would have such weak spells I could not stand on my feet. I had tried five doctors, they had done me no good; I had given up--never to take anything more, only to lull the pain. I had given up to die when I received a pamphlet and some papers from you. I decided to try once more and I have been improving ever since I commenced your treatment; my health is better than it has been for fifteen years; I weighed one hundred pounds when I began taking your medicines; now I weigh one hundred and thirty, as much as I ever weighed. I have taken ten bottles of "Favorite Prescription" and still more of "Golden Medical Discovery," and several vials of the "Pellets." Your sincere friend, MRS. M.H. O'BANNON, Lameta, Leake Co., Miss. * * * * * [Illustration: Fig. 1. Nervous System.] * * * * * THE NERVOUS SYSTEM. The nerves of the human body are not unlike the vast telegraph system of this continent. The millions of nerve filaments are similar to the network of wires that keep all the cities in close sympathy and communion. The nerves have to deal with organs instead of villages, and with cells in place of individuals. Commerce is regulated and train loads of food supplies dispatched here and there by telegraph, while in the body the nerves send their analogue, increased blood and nourishment, where it is required. [Illustration: View on roof of Western Union Telegraph Company's Central Station, Buffalo, N.Y., showing net-work of wires leading to all parts of the country.] The various organs of sense receive manifold impressions of conditions to be met, food required and dangers to be avoided and the nerves transmit these impressions telegraphically to the brain. The structure of the brain, spinal cord and sympathetic nerves, is not unlike a gigantic and complicated galvanic battery. The number of cells in the brain and spine are more numerous, by many millions, than those supplying any telegraph system. As the blood supplies each cell with its necessary nourishment and removes its used up or waste materials, so does the workman give each cell of his battery fresh chemicals from time to time, and removes the used up waste. The wires that lead from this battery to every part of the country are like the nerve filaments that go to each part of the human body and make them all--no matter how minute--perform their functions in a proper manner, and, when done, permit them to retire to rest. With the complicated human structure, when disease takes hold, we have the same troubles that would be presented were the telegraph operators suddenly to become ill. What confusion and discord would prevail! If the sickness is severe enough to cause delirium, it would be as though madmen were at the telegraph keys dispatching trains of passenger cars which could hardly fail to bring injury and destruction to unwary travelers. In health, we are unaware of the work of the nerves. The wheels of life move without noise. Few realize that the cavities of the heart (auricles and ventricles) are contracting steadily and alternately under the guidance of nerve cells. By this means the stream of blood, laden with nourishment, is sent to every part of the body. Silently the stomach pours out, under nerve influence, its juices that dissolve and change parts of the food, that it may pass into the blood in condition to nourish. In a similar way, the pancreas pours out a fluid that digests the fats. The muscular fibres of the intestines are caused to contract rhythmically and force along the bolus of digested food, so that its soluble parts may be taken up by the minute absorbent vessels to enrich the blood. All these things of most vital importance we know least about. They go on, from day to day, without our being aware of the work done. Let something interfere with the process, and how quickly is the sensation changed. Few there are who have not felt the agony of colic pain, due to stoppage of digestion. What suffering is greater than the sense of awful suffocation from a heart that is not acting well? These are only familiar illustrations of a thousand and one distressing derangements and symptoms that come from exhaustion and prostration of the nervous system. * * * * * NERVOUS DEBILITY OR EXHAUSTION. This affection, also popularly known as Nervous Prostration, or Nervous Weakness, and, to the medical profession, as Neurasthenia, or Nervous Asthenia, is becoming alarmingly prevalent. The wear, tear and strain of modern life are concentrated upon the nervous system. The care and consequent fret, worry and labor of this age are greater than ever before known. The result of this extreme activity, is exhaustion and weakness. Physical bankruptcy is the result of drawing incessantly upon the reserve capital of nerve force. We extract the following from an article which recently appeared In the New York _Tribune_: AN AGE OF NERVOUSNESS. The stone age, the bronze age and the iron age, we have heard of; likewise of the Dark Ages, and other self-marking eras in human history. As for the present, it might with fitness be known as the age of engineering, or of electricity, both of which proud titles it has won by its achievements. Yet there is also a less roseate view to be taken of it, and another title to be given to it, based upon its too-evident frailties; namely, that it is an age of nervousness. Such is the view taken by the famous psychologist, Dr. William Erb, of the University of Heidelberg. Nervousness, he says, meaning nervous excitement, nervous weakness, is the growing malady of the day, the physiological feature of the age. Hysteria, hypochondria and neurasthenia are increasing with fearful rapidity among both sexes. They begin in childhood, if not indeed inherited. Minds are overburdened in school, with too much teaching or misdirected teaching. The pleasures of social life follow, overexerting the already enfeebled nervous system. Business life is made up of hurry and worry and shocks and excitements. Society, science, business, art, literature, even religion, are all pervaded by a spirit of unrest, and by a competitive zeal which urges its victims on remorselessly. No man knows repose. The result is, wreckage. The pharmacopoeia is overcrowded with nerve tonics, nerve stimulants, nerve sedatives. The medical profession devotes its best energies to the treatment of neuropaths. And as a people we are, or are becoming, excitable, irritable, morbid, prone to sudden collapse through snapping of the overtense chord of the nervous vitality. Nowhere are the rush and hurry and overstrain of life more marked than in this much-achieving Nation. The comparative youth and freshness and vigor of the American people enable them to do and to endure what would be beyond the power of an older and more worn-out community. Yet there is no disguising the fact that the pace tells even here, and often tells to kill. True, all the tendencies of the age are in that direction. Inventions, discoveries, achievements of science, all add to the sum of that which is to be learned, and widen the field in which there is work to be done. What we need to learn is, however, that all these things are for man, not man for them. If knowledge has increased, we should take more time for acquiring it, knowing that, with the consequent increase of power, we shall be able to achieve as much afterward in the shorter time as our predecessors did in the longer time their briefer study afforded. Greater ability should mean not only greater results wrought, but fuller repose as well. For it would be a sorry ending of this splendid age of learning and of labor to be known as an age of unsettled brains and shattered nerves. A distinguished medical authority says: "It is proved beyond any dispute that nervousness is the characteristic malady of the American Nation, growing upon them in a frightfully accelerated ratio every year, and threatening them with disasters at no distant date which the mind shrinks from contemplating." He continues as follows: "The number of deaths from this cause is already appalling and is steadily and rapidly increasing. In some of the busy centres the tables of mortality show that the proportion of nerve deaths has multiplied more than twenty times in the last forty years, and that now the nerve deaths number more than one-fourth of all the deaths recorded. What is most shocking in these returns, this fearful loss of life occurs mainly among young people of both sexes." "This means that the Americans are fast becoming a very short-lived people; and that if they were shut in on themselves for only a few years, without any influx of vitality by immigration, the publication of the census would send a pang of horror and alarm throughout the land." The annual report of the State Board of Charities of the State of New York for 1894, shows that while the increase in the State's population from 1880 to 1892 was 28 per cent., the increase of the insane in State institutions for the same period was 83 per cent.! The enjoyment of the fruits of fortune, earned at the expense of the nerve cells, is an impossibility. The quiet and harmony of the nerve centres and nervous system are gone. Rest is impossible, continuance of work only causes increased jarring and discord of that many stringed and wonderful mechanism. SYMPTOMS. It is well nigh impossible to give the symptoms of this disease in an orderly manner, as the affection gives rise to a thousand and one varying and ofttimes vague symptoms. The particular part of the nervous system affected, and also the cause and character of the attacks modify the symptoms. The eminent Dr. Wood says: "Nervous exhaustion may, in the beginning, affect the whole of the nervous system, or it may be at first purely local, and co-exist with lack of general nervous strength." SPERMATORRHEA furnishes many examples of the local form of neurasthenia, or exhaustion, the sexual centres being primarily affected. In these cases, however, sooner or later, the whole nervous system becomes Involved. So in other forms of the disorder, the exhaustion at first local, finally, if neglected, implicates the whole organism. Often, in brain exhaustion, the symptoms are at first purely local. Almost always the cause of a local neurasthenia, or exhaustion, is excessive use of the part. Thus, cerebral or brain exhaustion, or debility, is usually the result of mental overwork, while sexual asthenia, or weakness is generally due to abuse of the sexual organs or to sexual excesses. When to the brain fatigue, or exhaustion, are added the depressing effects of excessive anxiety, or allied emotions, the symptoms from the first are more general, and the exhaustion may effect chiefly a single function of the brain. In pure brain exhaustion, the loss of a disposition to work, is usually the first symptom, the sufferer finding that it constantly requires a more and more painful effort of the will to perform the allotted task. At first, there is loss of the power of fixing the attention, and this, by and by, is accompanied by a weakness of the memory; disturbances of sleep are frequent; various abnormal sensations in the head are complained of. In most cases there is not absolute headache, but a feeling of weight or fullness, or an indescribable distress, usually aggravated by mental effort. It is true that in some cases of very dangerous brain tire, mental labor is performed with extraordinary vigor and ease; the power of work, is, for the time, markedly increased, and even the quality of the product may be raised. The patient may glory in a wild intellectual exaltation, a sense of mental power, with an almost uncontrollable brain activity. It is probable, however, that these cases are not instances of pure neurasthenia, or brain exhaustion, but that there is active congestion of the gray matter of the brain. In these cases the disease is very prone to end in serious organic affection of the brain. [Illustration: Melancholy. ] Severe brain exhaustion may be associated with good spirits, but usually there is marked depression, and this perversion of function generally goes on, if the disease be not checked, to decided melancholy. The will power, like all the other functional activities of the brain, is prone to be weakened, morbid fears may finally develop, and at last, that which was at the beginning a single brain exhaustion, may end in persistent hypochondria, followed by insanity. Peculiar sensations are common in neurasthenia, such as chilliness, unnatural itching, a feeling as though ants or other insects were crawling on the skin. Eruptions are common. Attacks of neuralgia are often frequent and sometimes severe, being usually worse in those persons of nervous ancestry. In some cases there is a lack of proper sensation, in others an unnatural sensitiveness. There is also in many cases a peculiar tenderness over some portion of the spinal column, especially in women. IN WOMEN, with nervous disturbance of the sexual organs, there is frequently great pain felt during menstruation; in others, ovarian irritation and a so-called "irritable," or sensitive uterus, giving rise to manifold nervous and hysterical symptoms, sometimes culminating in convulsions or "fits." In not a small proportion of the uterine diseases which are generally only locally treated by physicians, the local disease is largely and sometimes solely the expression of a general weakness of nervous origin. SELF-ABUSE AND EXCESSES. It is well known that Onanism, or masturbation, as well as sexual excesses, produce an exhaustion of the nerve centres presiding over the sexual functions. This is the common history of spermatorrhea or loss of the virile fluid by nightly emissions, accompanied by lascivious dreams. GENERAL NEURASTHENIA, or nervous exhaustion, may also produce a local weakness of the sexual centres of the brain and spinal cord, with symptoms at least resembling those of partial impotency and great irritability of the sexual organs, or a complete impotence, with premature seminal discharge whenever coition is attempted. Many times this condition results from excessive intellectual labor, even with no sexual excesses or abuses. Nocturnal, or nightly emissions, are not always experienced in these cases. When they do occur, the debilitating losses of vital fluid react upon the brain, robbing the victim of courage and manliness and exciting various phases of morbid fear and sensitiveness. Many cases of nervous debility, or exhaustion, are the result of long continued malarial poisoning, diarrhea, Bright's disease, exhausting fevers or other debilitating affections. Numerous are the cases in which the patient is able to trace the origin of the malady back to an attack of influenza, or grip. An epidemic of the latter disease is sure to be followed by numerous cases of nervous prostration, or exhaustion. CARE SHOULD BE EXERCISED. In all cases, it is necessary to make careful examinations in order to detect any obscure chronic disease which may exist. In women, nervous prostration often develops without perceptible cause at the age of puberty or at the "change of life." Overwork, especially overwork combined with worry, are fruitful causes of nervous exhaustion in both sexes. AN OVERWORKED NERVOUS SYSTEM is always an exhausted nervous system. The nerve cells have been robbed of their vital forces. All the nutritive organs of the body suffer from the lack of nerve control, and the blood-vessels that supply the nerve centres are not in proper tone. Hence the supply of blood and the action of the heart are greatly interfered with. Many times, the most troublesome symptom, early in the disease, is an excessive perspiration of the hands and feet. IMPOVERISHED OR POOR BLOOD. A badly nourished nervous system is irritable. Many of the symptoms of weakness and lack of nutrition resemble those found in congestion, or stimulation from excess of blood. Then, too, we find sometimes that poor, thin, watery blood, not suitable for nourishment although sent in large amount to the brain, does not properly nourish that organ. There will still be brain exhaustion, as the nervous structures have lost their power of absorbing the nutrient materials from the blood which, being poor in quality, does not vitalize and strengthen the nerve centres as it should. In such cases thought is an effort and sustained mental exertion is impossible; the memory is uncertain, and the patient drowsy. Occasionally, after rest, there may be flashes of brilliancy, but generally they are brief. DANGER OF CONTRACTING INTEMPERANCE. The patient often learns that a small amount of wine or spirits is a temporary aid, and sometimes its habitual use is begun in this way. Stimulants only make a bad matter worse when their use is continued for any considerable length of time. The sufferer becomes more and more dependent upon them and the nervous exhaustion is much aggravated as large quantities are taken to satisfy the morbid craving that has been acquired. WAKEFULNESS, OR INSOMNIA, is present in many cases; in others, there is unusual drowsiness but sleep gives neither rest nor strength; often it is disturbed by dreams that exhaust the vitality and leave the patient more tired than when rest was sought. HEADACHE is one of the most annoying symptoms and sometimes is very persistent. It may incapacitate the patient for the ordinary duties of life. After laying down awhile and being quiet, the headache may be relieved, but recurs on attempting to go about. FRETFULNESS. Sometimes, owing to the discomfort experienced, there is likely to be a change of disposition, irritability of temper, fretfulness and peevishness; a tendency to an irascibility all out of proportion to the real provocation. In many cases there is dizziness, and frequently noises in the head, ringing in the ears, spots before the eyes, twitching of the muscles, eyelids or eye muscles, and at times dimness of vision, or sudden spells when the sight is not satisfactory. At times there is a feeling of discomfort, as if the quantity of good air were not sufficient to aerate the blood, and there is sighing or a desire to sit in an open window, or a strong desire to be fanned. The pulse and temperature are usually normal, or a little below, but may rise if any local irritation exists. At times the face is flushed and at others pale. The skin may be dry, or in other cases bathed in perspiration on slight exertion or mental worry. When there is weakness of the nervous system, the disease manifests itself through various organs. Hence, the palpitation of the heart, dyspepsia or acute attacks of indigestion, with colicky pains and heaviness after meals, with eructations or belchings of gas, or local discomfort and unnatural action affecting, at different times, almost every organ of the body. It is well known that insanity may result from the loss of sleep and constant brooding over the symptoms that the patient fails to properly understand. TREATMENT. In no class of diseases is greater care, scientific knowledge and skill more necessary than in the treatment of nervous affections. Almost every case is a law unto itself, and must receive careful consideration, pains-taking advice and specially prescribed treatment suited to the peculiarities of the individual. Hereditary influences, causes of the disease and constitutional peculiarities of the patient must all be taken into account. VALUE OF EXPERIENCE. Only through extensive experience can the medical practitioner become expert at detecting and successfully meeting, by rational scientific and carefully adapted treatment, the many phases and complications incident to the different forms and stages of this very prevalent malady. For more than a quarter of a century, the Specialists of the Invalids Hotel and Surgical Institute having charge of this department of practice, have been actively engaged battling with diseases of the nervous system. As a result of this long time and vast experience, they have naturally developed and thoroughly tested many valuable remedial agencies for the relief and cure of this class of sufferers. Many of these can be successfully prescribed and used at the patients' homes without a personal consultation; while others can only be brought into use at our Institution. TREATMENT AT HOME. Many cases, especially when the exciting cause of the malady can be easily ascertained, as in spermatorrhea from self-abuse, or sexual excesses, or in women when arising from uterine affections, can be very successfully managed and cured at home. This is also true when the disease is due to the excessive use of tobacco, opium and other narcotics. CONSULTATION BY LETTER. The patient has thought over his symptoms hundreds of times. The location of every discomfort has been carefully noted. These matters are stated with accuracy, common sense and good judgment when writing to us. The people are far more intelligent in these matters than physicians are generally willing to admit. A patient is often confused while being personally examined by a physician and gives imperfect or incorrect answers. After he has left the presence of the physician, he finds that he has failed to enumerate many of the most important symptoms. In consulting by letter, the patient is not embarrassed, states the exact symptoms and carefully reads over the letter, to see if it is a complete and accurate description of his sufferings. In this way he often conveys a much better idea of the case than if present in person, and subject to the most thorough questioning and "cross-examination." The timid lady and nervous young man write just as they feel and one reason why we have had such success in treating intricate and delicate diseases, is because we have obtained such true and natural statements of the cases from these letters, many of which are perfect pen pictures of disease. As bank tellers and cashiers, who daily handle large quantities of currency, can unmistakably detect spurious money by a glance at the engraving or touch of the paper, so the experienced physician, by his great familiarity with disease, becomes equally skilled in detecting the nature and extent of a chronic malady, from a written description of its symptoms. To aid the patient in giving a clear and intelligible history of his case we send, when requested, a very complete question blank. EXAMINATION OF THE URINE. A careful, microscopical examination and chemical analysis of the urine is a valuable aid in determining the nature of these diseases of the nervous system. This important fact is not overlooked at the Invalids' Hotel and Surgical Institute, where experienced chemists are employed to make such examinations and report the result to the attending physicians. Persons consulting us and desiring to avail themselves of the advantages afforded by these examinations, can send a sample of their urine by express. The bottle should be thoroughly cleansed and should contain from two to four ounces of that first passed after arising in the morning. It should be carefully packed in saw-dust or paper and inclosed in a light wooden box. All express charges must be prepaid through and a complete history of the case, including the age and sex of the patient, should accompany every package, or it will receive no attention. This saves valuable time by directing the examination into the channels indicated and thus avoiding a lengthy series of experiments. As we are daily receiving numerous bottles of urine, every sample, to prevent confusion, should be labeled with the patient's name. By the postal regulations, all liquids are excluded from the mails, unless packed in accordance with our printed directions, which will be sent free on request being received for them. WE AIM TO CURE, not merely to palliate as is so often done by practitioners in dealing with these distressing maladies. We do not prescribe coca mixtures, whiskey, malt extracts, so-called celery compounds or other nerve stimulants, which only spur the already weakened nervous system on as a man would urge his jaded horse to renewed efforts when the animal should be refreshed by proper food and rest. Neither have we any faith, in lasting good resulting from prescribing such nerve sedatives as put the nerves to sleep and so, by simply blunting sensibility, delude the patient into the false belief that he is being benefited. To effect a radical cure of the weakness, the nerve centres must be restored to a normal condition by improving the nutrition of the nerve cells. To do this the causes of the difficulty must be understood and any local weakness or disease of any organ, be it the liver, kidneys, lungs, stomach, rectum, bladder, or generative organs, must be understood, properly treated and overcome. The desire for alcoholic stimulants is a most common and dangerous tendency of the disease. To gratify the morbid appetite for stimulants is to do the patient lasting injury. IMPOVERISHED BLOOD. In some cases the nervous affection is the result of an impure, or impoverished, condition of the blood. In such cases the use of Dr. Pierce's Golden Medical Discovery has, in the great majority of cases, resulted in an immediate benefit and gradually in a permanent restoration of the nerve centres to a normal condition. This remedy, particularly if assisted by the use of Dr. Pierce's Pleasant Pellets, when constipation is present, unloads the liver, and their combined action tends to remove from the blood the poisons which it is the function of the liver to take from that fluid. The cells of the brain, after performing their function, throw into the blood certain poisonous materials which it is the function of the liver to remove. If this is not done, the cells become clogged, and can only be restored to a natural and healthful condition by increasing the activity of the liver. This treatment gives rise to an immediate improvement, and a continuance of the remedies results in a gradual toning up of the nervous system and relief from the unpleasant symptoms. "FEMALE WEAKNESS." Many women suffer from nervous prostration, or exhaustion, owing to congestion of the uterus and ovaries, caused by over-indulgence; again by overwork, the strain of too many household cares, or too frequent childbirths. In these cases, the use of Dr. Pierce's Favorite Prescription is of the greatest benefit, tending to restore the uterus and ovaries to a normal condition. Its wonderful restorative effects, tonic and nerve invigorating properties, especially adapt it to the cure of these cases. Digestion and assimilation of food are promoted by its use. When the liver or blood is not in healthful condition, as previously referred to, the "Golden Medical Discovery" should be used in conjunction with the "Prescription." If menstruation be scanty, Dr. Pierce's Pellets will have a beneficial influence in increasing the flow, and overcoming the headache and congestion of internal organs that is the result of scanty menstruation, especially if their use be accompanied with full doses of Dr. Pierce's Compound Extract of Smart-Weed. LOCAL CAUSES. In the great majority of cases, when nervous prostration has made its appearance at intervals, with periods of prolonged good health intervening, but in which, as a rule, slight excesses, over-exertion or the attacks of some acute disease, produces a nervous exhaustion, we have found that local derangement is the cause of the whole trouble. This cause may often be readily removed and a perfect and permanent restoration of the health will follow. IN MEN, we have often found a varicocele to be the cause of nervous prostration. In others rupture, or urethral stricture, sometimes of a character so mild as hardly to give serious inconvenience, has been the cause. IN WOMEN,, ulceration of the uterus, stricture of the cervix, congestion or other diseases of the ovaries, such as cysts, abscesses, etc., inflammation of the Fallopian tubes, characterized with more or less periodical discomfort and attacks of leucorrhea, or "whites," are common causes. In all cases in which the nervous disease depends upon local causes, we find that the relief of the local source of irritation, which tends to reduce the general health and interfere with perfect nervous tone, is all that is necessary to give the invalid a perfect restoration to health, vigor and activity. It is like removing the burden from a tired horse who has fallen prostrate under an excessive load. The removal of the burden puts the individual under a favorable condition for the immediate restoration to health and strength, and permanent relief is only a matter of a few days' or weeks' time, with appropriate nourishment and restorative nerve tonics. ALCOHOL, OPIUM AND TOBACCO affect different individuals according to their several susceptibilities. Some are able to withstand, with apparent impunity, an amount of these that can not be tolerated by others without great injury. No one, however, is wholly proof against these unwholesome agents which are in such common use. The sad results of their excessive use are seen in thousands of cases of shattered nerves and wasted vigor. The excessive use of tea and coffee is also a prolific cause of nervous affections. Happily, we have now at our command remedies which exercise a most potent controlling influence over the acquired, morbid appetite for these narcotics and stimulants. Of course we have to depend, to some extent, upon the will power of the patient, but where this is not wholly lost, we have in all our later experience, been able to realize a degree of success which has been alike gratifying to both physician and patient. THE INVALIDS' HOTEL AND SURGICAL INSTITUTE SPECIALLY EQUIPPED FOR THE CURE OF NERVOUS AFFECTIONS. Private institutions, well supplied with the numerous and costly aids to the work of the specialist treating nervous diseases, are now a recognized necessity. Physicians and sufferers alike appreciate this fact. Public hospitals do not answer this purpose, owing to the fact that they are more especially intended for the alleviation of the sufferings of the poor, and the greater part of the work done is in affording relief from acute diseases and emergencies requiring surgical aid. Attention is thus detracted from delicate nervous affections and is almost wholly engrossed in caring for sufferers from other diseases and injuries. Besides, association with the charity cases that abound in such places and the evidences of suffering present on every hand, are enough to prevent all improvement in sensitive and sympathetic invalids. Perfect equipment is an important part of the battle in the cure of nervous affections. ELECTRICITY IN NERVOUS AFFECTIONS. [Illustration: Fig. 4. Our large 40 cell Galvano-Faradic Battery with Switch-board.] Electrical applications, to be beneficial, require, on the part of the attendant, a technical knowledge of the highest character with costly apparatus and special appliances. There can be little doubt that electricity is convertible into nerve force. [Illustration: Fig. 5. Our Franklin, or Static Electricity, Machine.] In treating cases in the Invalids' Hotel, a large variety of batteries, dynamos and other electrical appliances are brought into use. These consist of cell batteries, such as is illustrated by Fig. 4, dynamos, operated by power, Franklin, or static electrical machines illustrated in Fig. 5, and other electrical apparatus, the choice of the particular machine or battery being determined by the nature of the case. CARE AND SKILL REQUIRED. Electricity, like other powerful agencies, in order to prove remedial must be used of proper strength and in proper quantity. The potential, or strength, as well as the volume, or amount, of current has to be carefully measured for that purpose. To accomplish this, we employ an instrument called a galvanometer, or amperemeter, illustrated in Fig. 6, which indicates the exact amount of current being applied. For the want of such instruments to measure the current, physicians often fail to get beneficial results, as they are not able to administer either the proper quantity or quality of current. Ofttimes, for like reasons, their hap-hazard way of employing this powerful agent does positive injury to the patient. [Illustration: Fig. 6. The Galvanometer, or Amperemeter.] Of course, in treating cases at a distance, we cannot avail ourselves of all the great variety of apparatus brought into use at our Invalids Hotel, yet we have some forms of machines well adapted for home use, and so simple that, by sending plain printed directions with the machines, our patients are able to use them effectively without the aid of the physician. Especially is this true in the milder forms of nervous disease, and when great exactness and nicety of application is not so important. We show in Fig. 7 and Fig. 8, two forms of such batteries which are often furnished our patients for use at their homes. Many times, after cases are under treatment here for a while, we are able to educate them in the use of the battery so that by taking one of these home with them they can continue the treatment with good results after leaving the Institution. ORGANIC, OR ANIMAL, EXTRACTS AS REMEDIES. The experience of Pasteur, Brown-Sequard, and our own specialists, in the use of extracts of nerve substance and of certain glands and organs by hypodermic or subcutaneous injection of these fluids, has, in a vast number of cases, been most gratifying to both physicians and patients. Many wonderful cures have thus been obtained. Injected subcutaneously these animal extracts are immediately assimilated and we are often able to stop, at once, the progress of disease and turn the tide towards recovery. Thus the cells receive the special stimulants upon which their life and activity depend. [Illustration: Fig. 7. A small Battery for home use.] The animal extracts employed in our Institution are all scientifically and carefully produced in our chemical laboratory under the direct supervision of an experienced chemist, and are believed to be superior in quality. They are turned out fresh, as wanted, which is important, as all such preparations, no matter how carefully made and put up, deteriorate with age. These extracts are made from the glands and organs of the lower animals, as from the brain, spinal cord, heart, testicles, ovaries and some other organs and parts of bullocks, rabbits, guinea pigs and other animals. That they possess properties which exert most potent tonic, or invigorating, influences upon those organs and parts of the human system corresponding to the organs and parts of the lower animals from which they have been extracted, no longer admits of doubt. In cases of partial and even complete impotency, especially in elderly men, attended with nervous exhaustion, most astonishingly favorable results are obtained by our specialists through the administration of our extracts obtained from the nerve tissue of the spinal cord, associated with the use of the expressed juices from animal testes. We do not, however, prescribe these extracts to the exclusion of other well tested remedial agents, but do regard them, especially in the more confirmed and obstinate cases, as among our most positive curative agents. [Illustration: Fig. 8. A small Battery for home use.] We must confess that when first proclaimed by Brown-Sequard as Valuable remedial agents, we regarded the use of these extracts with good deal of skepticism, but experience is, after all, the best teacher and we were forced, after numerous successful tests, to admit their great efficacy. We have always endeavored to keep up with the vanguard of the army of medical reform, and so took early occasion to introduce these agents into our practice and made preparations to produce them in our laboratory. From an article written by an eminent specialist in nervous diseases, and recently published in the New York _Medical Journal_, we extract the following: "Organic beings possess the power of assimilating from the nutritious matters they absorb the peculiar pabulum which each organ of the body demands for the development and sustenance. The brain, for instance, selects that part which it requires, the heart the material necessary for its growth and preservation, and so on with the liver, the lungs, the muscles, and the various other organs of the body. No mistake is ever committed. The brain never takes liver nutriment, nor the liver brain nutriment; but each selects that which it requires. There are, however, diseased conditions of the various organs in which this power is lost or impaired, and, as a consequence, disturbance of function, or even death itself, is the result." "Now, if we can obtain the peculiar matter that an organ of the body requires and inject it directly into the blood, we do away with the performance of many vital processes which are accomplished only by the expenditure of a large amount of vital force." "Let us suppose a person suffering from an exhausted brain, the result of excessive brain-work. Three hearty meals are eaten every day, but, no matter how judiciously the food may be arranged, the condition continues. Now, if we inject into that person's blood a concentrated extract of the brain of a healthy animal, we supply at once the pabulum which the organ requires. Then, if under this treatment the morbid symptoms disappear, we are justified in concluding that we have successfully aided Nature in doing that which, unassisted, she could not accomplish." "That is the system. I believe it is applicable not only to the brain, but to all the other organs of the body." The writer of the above is, very probably, a little over sanguine in his opinion that the plan of treatment will prove efficacious in all organic diseases, but certainly, from our experience, we can endorse his belief as to its great efficacy in many forms of organic weakness, especially those of the generative organs, nervous system, heart and some other parts of the body. We believe that we are placing a conservative estimate upon the remedial value of these animal juices, or extracts, when we say that they are destined to fill an important place in the curative resources of the specialist in chronic diseases. Under the head of epilepsy, also in connection with our consideration of locomotor ataxia, we shall have occasion to refer to the use of these extracts as applicable to the cure of those maladies. Most cases of nervous diseases that come to us, for examination and treatment, do so after having tried, without success, treatment by baths, enforced seclusion, as well as unskillfully applied electrical treatment and massage. Prolonged medication has frequently aroused digestive disorders and made the patient hate the sight of the medicine bottle. In such cases our improved methods, as applied in the Institution and also prescribed for patients at a distance, enable our specialists to give relief and effect cures with a minimum of medicine. They also enable us to treat many cases of nervous diseases heretofore regarded as almost hopeless, such as locomotor ataxia, paralysis, epilepsy and spinal affections, with a degree of success which has been very gratifying alike to physicians and patients. * * * * * HEADACHE AND NEURALGIA. There is no ill to which flesh is heir that is the source of a greater degree of discomfort to the human race than headache. The farmer, housewife, banker, merchant and laborer seem to be equally prone to the affliction and all who suffer have a great number of days rendered uncomfortable and unhappy by the presence of this most unpleasant affection. Pain is the warning finger of disease--the threatening indication of coming trouble. In headache, we have an indication that the system is subjected to some strain or injurious impression. It may be that the eyes have been overworked or the brain unnaturally taxed; or that the nervous and physical systems have not been properly refreshed by sufficient sleep, and have used up the residue of reserve power. Many suffer from headache only after they have been subjected to sudden changes of temperature and have taken cold; others only when the bowels have become inactive, the liver torpid and the blood vitiated with retained poisons. All appreciate the discomfort that results from this malady and earnestly seek for permanent relief. Headaches may be divided in two classes: (1) those due to the presence of poisons in the blood, and (2) those due to irritation of various organs, as of the eyes, stomach, liver, and intestines. Of the first form, or variety, of headache, influenza, or grip, and acute "cold in the head," are the most common causes. These give rise to most excruciating pain. There is congestion, followed by inflammation in the nasal passages and cavities communicating therewith. The membranes of these passages throw out a thin, watery, irritating discharge, which gradually thickens and becomes pus-like and offensive in character, if the disease continues. Poisonous matters are absorbed from the affected surfaces into the blood. These poisons, circulating in the blood, produce great irritation of the nerve cells, so much so, that the severity of the attack is felt in the nervous centres, the brain and spinal cord, with pain varying from the most acute and sharp, to a dull, numb ache. The temples, eyes, neck and small of the back, are in their order, the usual locations of greatest pain. Such attacks vary in frequency and severity. One attack is usually followed by an early recurrence, which may be more or less severe, while the period of active pain varies from a few hours to several days. Such attacks leave an exhausted state of the nerve centres and general weakness of the system that often lasts for weeks and may permanently impair the system, except such results be prevented by appropriate treatment. Every recurrence of the attack leaves the system in a worse condition, until profound nervous prostration; ensues. Malarial headache, sometimes termed "brow ague," is a common form of the malady with those residing in malarial regions. The pain rapidly develops, usually over one eye. It lasts from five to ten hours, and is often of frightful intensity. Other forms are rheumatic and gouty headache; usually a heavy aching pain appearing on the approach of storms, but at times almost continuous, made worse by improper diet. Uræmic headache is due to kidney disease, and alcoholic to direct irritation of the brain membranes from the use of alcoholic beverages. The latter is accompanied with much irritation of the stomach and intestines. Headaches of a similar character result from the presence in the blood of an excess of the active principles of coffee and tea. Overindulgence in these agents, as with alcohol, affects the nerve cells and membranes, often causing severe attacks of headache. Nervous headache is another common affliction. This seems to arise from several causes, such as impoverished blood and exhaustion from overwork of the brain. Hysterical headache is not uncommon. There is a severe kind of headache, the attacks of which appear first at early puberty and continue at intervals more or less frequent in women up to the change of life and in men to about the fortieth year. The periodical headache is usually preceded by yawning, chilliness, languid, exhausted feelings, in others by peculiar emotional or mental activity. This is followed by unusual drowsiness, in which the night's rest is broken by dreams, and from which the patient awakes tired. Gradually, during the day, the headache develops, beginning in the eyes or bones over them. It gets more and more severe, shooting into the jaws and neck or extending to the back of the head and spine. As the pains get most severe, nausea or vomiting, often repeated, follow, in which the contents of the stomach, with mucus and bile, is ejected. The whole paroxysm lasts from five hours to two or even three days. NEURALGIC HEADACHE is a common variety; often the pain is not confined to the head, in fact neuralgia may affect almost any part of the system. NEURALGIA. Neuralgia is an affection of the nerves, of which the chief symptom is pain. This is of variable intensity and character. It follows the course of the affected nerve and its branches, and occurs in paroxysms, of agonizing pain with periods of intermission during which the pain may be very slight, and cause but little discomfort. The severe pain is described as lancinating, cutting, tearing, burning, boring and pressing. Patients use different words in describing the attacks, and there is probably a difference in the character of the pain, though in a severe paroxysm one is scarcely able to make a very nice distinction. We have known cases in which the pain occurred suddenly and overwhelmed the patient's fortitude by its severity and unexpected onset. Between the paroxysms there may be less severe pain, which is then more frequently of an aching, burning or pricking character. In some, paroxysm after paroxysm succeed each other with almost lightening-like rapidity, and even in the intervals the pain is very intense. At another time there is only one sharp sting of pain, which attacks recur several times an hour or day, or may be absent for days or months. An extended freedom from all pain is rare in a patient very much affected. The first attacks in all forms of neuralgia are often comparatively light, and the severity of the pain gradually increases as the attacks multiply. We have frequently had patients unacquainted with anatomy, map out the distribution of a nerve very perfectly, simply describing the portion of the body in which the pain was experienced. For convenience, the neuralgia has been named with reference to the nerve most seriously attacked; lumbago to the spasms of pain affecting the small of the back; tic-douloureux is a term applied to neuralgia of the fifth nerve, that supplying the side of the face, with branches to the eyes, jaw, and teeth. Neuralgia of the testicles, ovaries, stomach, heart, are frequently met with. That affecting the large nerve supplying the thigh and leg is termed sciatica. These nerve affections often prove a most grave disorder, rendering the life of the sufferer a burden. TREATMENT. Contrary to opinions frequently expressed by members of the medical profession, we find that most cases present some removable, or remediable, cause for attacks of headache and neuralgia. The temporary relief that is obtained by the use of "headache powders," various bromide combinations, caffeine and other anodyne and narcotic medicines, is sometimes necessary in order that the excruciating sufferings may be borne for the time, but as a rule such remedies only react unfavorably by interfering still further with the natural restoration of the affected organs, or protract the removal of the cause of the disease. Hence, the next attack is usually earlier in its appearance and more severe and lasting when such agents are employed. The great majority of headaches and neuralgias are due to the presence of poisons in the blood. This may be due to affections of the blood-making, or blood-purifying organs. For the correction of inactive blood-making glands, or a lack of purification of the blood, due to such cause, the use of Dr. Pierce's Golden Medical Discovery is particularly beneficial. It has no equal in its direct effect upon the liver, the great purifying organ of the body. Through this natural gateway, it removes from the system poisonous materials which are the waste from the nerve cells. The accumulation of these waste materials irritates the cells and causes them to cry out with pain. The blood, being properly purified by the use of "Golden Medical Discovery" supplies to the nerves, and to the nerve cells, what they crave--a healthy and rich blood that furnishes proper nourishment. Hence the headache disappears, and the neuralgic pains are overcome. When the liver is engorged and torpid, the intestines become overloaded with fecal matters that putrefy and give rise to gases and consequent distention. Deleterious poisons are formed and absorbed by the blood from such hardened and irritating lumps in the intestines. When the bowels are thus constipated, Dr. Pierce's Pleasant Pellets are necessary as an adjunct to the "Golden Medical Discovery." The "Pellets" remove from the intestinal canal all irritating materials and thus enhance the alterative, or blood-cleansing, action of the "Golden Medical Discovery." In women, when there is a nervous affection, dependent upon some unnatural state of the ovaries or uterus, and complicated with an imperfect or unnatural circulation in those parts, we have noted that most satisfactory results invariably follow the use of Dr. Pierce's Favorite Prescription. This agent improves the tone of the nervous system, and by its direct restorative tonic effects, lessens, or overcomes, any congestion of the womb or its appendages, regulates menstruation and promotes a condition of health and vigor. In a vast experience, our specialists have thoroughly tested a great many specific remedies which we prescribe for home-treatment, sending the necessary remedies to our patients by express or mail, carefully adapting them to each individual case. Many sufferers have been, by a brief course of our home-treatment, relieved permanently from excruciating sufferings that had been a source of annoyance and loss of time for many years prior to the use of our remedies. Our treatment is intended to effect permanent cures. We do not use those narcotics and compounds of antipyrine and other similar agents which are very depressing in their effects, and, like morphine and other preparations of opium, give only temporary relief, and interfere with the action of the heart, but we use treatment that builds up the system, removes the cause of the difficulty and restores the nervous system and all the organs of the body to a normal and healthful condition. In some cases we advise treatment in our Institution, where we have every facility in the way of electrical appliances and many other aids that can only be employed by the personal attention of a skillful physician. These aids are more fully described under the head of nervous exhaustion and a reference is also suggested to what we have to say under the heads of paralysis and locomotor ataxia. Headaches or neuralgic pains, due to local irritations, as uterine disease, stricture, neurotic or nerve tumors, pressure of trusses, eye strain from weakened eye muscles, or lenses that need the help of proper spectacles, require for a permanent cure the removal of the cause. Sciatic neuralgia, one of the most common and painful forms of nerve irritation, is particularly amenable to treatment by the modern means of cure used in our practice at the Invalids' Hotel. We find, as a rule, that severe headaches and neuralgias are but the forerunners of more serious conditions, and are therefore deserving of special attention. They should be corrected as early as possible, before any organic changes have occurred. * * * * * PARALYSIS OR PALSY; LOCOMOTOR ATAXIA AND KINDRED AFFECTIONS. Paralysis is an affection characterized by loss of muscular power or by the sense of touch, taste, sight or smell becoming impaired from injury to a nerve by accident or disease. The disease is sometimes due to simple lack of nerve force or power. This may come from interference with the blood supply of the nerve centres, as in hysterical palsy and reflex paralysis. Frequently the power of speech is affected in this way, ability to remember and difficulty in pronunciation of certain words being the most common. Certain affections of the womb and its appendages, in women, and, in men, stricture of the urethra, adherent prepuce, or foreskin, with wounds and injuries, many times of nerves and organs remote from the paralyzed points, cause the loss of power. THE CAUSES OF PARALYSIS are very numerous. Whatever destroys, or impairs the natural structure of nervous matter, or whatever interferes materially with the conducting power of nerve-fibre, or the generating power of the nerve-centres, will produce a paralysis, the extent of which will depend upon the amount of nervous matter affected. Thus paralysis may be due to disease of the brain arising from apoplexy; to abscess, softening, syphilitic or other tumors, or epilepsy; to disease of the spinal cord, or marrow; to disease of the structures which surround the spinal cord, producing pressure upon it; to injury or compression of a nerve, by which its conducting power it impaired; to the effects of diphtheria, hysteria, or rheumatism. It may also be due to poisoning of nervous matter with opium, lead, arsenic, or mercury; or to the retention of poisonous substances which are generated in the living body and which should pass off through the excretory organs, as the elements of the urine and bile. Members of consumptive families are very prone to paralysis. We also find that the disease is often the result of some nervous strain, or over excitement The over indulgence of the passions is particularly a fruitful source of injury to the brain and spinal centres. An angry man or woman uses up more nerve energy in a few minutes than would be sufficient to serve the muscles with stimulus through hours of toil. The young, in unnatural indulgence of the sexual passions, waste the vigor and energy of maturity. Sexual excesses must be put down as among the most prolific causes of this terrible malady. Ignorance shields no one from the consequences of violations of the laws of health. The passion for wealth with its ceaseless toil, continuous strain, and rapid exhaustion of the nerve forces, usually brings its devotee into the same condition of discord as does the abuse of a stimulant. For a time the system will repair and bolster up the weakness, but the longer the day of reckoning is postponed, the more serious and terrible is the collapse. Such individuals need only an exposure to cold, or an over indulgence of some kind, to suddenly precipitate a paralysis. GENERAL PARALYSIS. This term is applied to paralysis affecting the arms and legs. In this form of paralysis there is generally more loss of motion than of sensation, and the mind is usually more or less affected. HEMIPLEGIA, or paralysis of one side of the body, is generally spoken of as a "stroke of palsy." Sometimes only one extremity, the arm, is affected. Only occasionally is the face involved. In the majority of cases the mind is affected, the memory being poor, the sufferer becoming melancholy, peevish, and fretful. In paralysis of the right side, there is sometimes a curious forgetfulness or misplacement of language, the patient being unable to think of words to express his thoughts. This condition is called _aphasia_. It is usually the result of some injury or disease of the brain, almost invariably the side of the brain opposite the affected half of the body. In some cases it is due to a wasting, or softening, of the brain substance, on account of insufficient nourishment, a deficient supply of blood; whilst in others, it is due to just the opposite condition, an excess of blood, producing rupture of some blood-vessel, transudations, and pressure. PARAPLEGIA, or paralysis of the lower half of the body, is the result of disease of the spinal marrow. The paralysis may occur suddenly, but, in the majority of cases, it comes on slowly and insidiously, with weakness and numbness of the feet and legs, or with tingling and a sensation resembling that produced by ants creeping on the surface of the skin. By degrees the weakness increases, until there is complete loss of both motion and sensation in the feet and legs. The lower bowel and bladder are generally involved, and as a result, the patient suffers from constipation, and retention and dribbling of urine. Although completely paralyzed, the patient is often tormented with involuntary movements and cramps in the affected muscles. Paraplegia may be caused by various injuries of the spinal cord; by congestion, degeneration, or hemorrhage; by pressure from thickening of the sheath of the cord, or from tumors, or from disease of the bones and cartilages of the spinal column. Paraplegia may also be produced through reflex action, by an irritation, or injury to some organ or part of the body distant from the spinal cord; thus, irritation of the skin, or of the bowels from the presence of worms, or disease of the bladder or of the womb, may produce paraplegia. LOCOMOTOR ATAXIA. Locomotor ataxia, or creeping palsy, is also called progressive paralysis. This affection consists of a disease of the nervous matter in the posterior columns of the spinal cord. It usually affects first the lower part of the cord, and those portions of the nerve matter that supply the muscles of the legs. In other cases it first affects the portions of the spinal cord that supply the arms. In most cases of this disease there is an early stage in which the patient suffers from "lightning pains," as they are called. These are of a severe, stabbing, boring character, very sudden in their onset, and at times so serious as to have induced suicide. These paroxysms, in the milder form of the disease, are not so severe, and are readily controlled by anodynes. They may affect the stomach, and be mistaken for dyspepsia, or the rectum, and be taken for fissure or piles. At times they affect the bladder, when the symptoms are not unlike those of stone or cancer. In many cases we find the patient has been treated for a long period of years for rheumatism, sciatica, or neuralgia, when the real disease has been this progressive paralysis in its earlier stage. Sometimes the disease takes the form of spermatorrhea or impotency; in other cases it is manifested in weak eyes, disturbances of vision, or cross-eyes. Sooner or later, there appears the peculiar paralysis of the disease, which consists of more or less numbness of the feet and legs, and, in the later stages, of the hands and arms, sometimes of the face. As a rule, however, the patient finds difficulty in properly maintaining his balance, and in walking his movements are tottering, like a man partially intoxicated. It is difficult for him to maintain his balance and walk with his eyes closed. If the arms are affected, their movements are uncertain. In guiding a needle or in buttoning or unbuttoning the clothing, there is an inability to move the hand with rapidity and certainty, or to any portion of the face or body if the eyes be closed. The eyes and attention must be constantly directed to the motion that is about to be performed, or it is imperfectly done. The brain centres in this case supply the weakened action of the spinal cord, and the stimulus to the muscles is directed by the intelligence instead of being automatic, as in health, and due to spinal action. Still later, the voluntary movements become spasmodic or jerking. The neuralgic pains often become very distressing; there is often a sense of constriction around the limbs or body, as if they were encircled with tight cords. In extreme cases locomotion becomes impossible, the patient is unable to bring the hand to the mouth, and the speech may become impaired, articulation being difficult and imperfect. In all cases there is more or less loss of sensation in the lower limbs, the patient generally being usable to distinguish between two points and one, even when the two, are a considerable distance apart. The inability to feel the contact of the ground or floor with the feet occasions the difficulty in walking. THE CAUSES of this disease are somewhat obscure, but unquestionably exposure to cold and dampness, and over-mental work, are largely instrumental in its production. Scrofula and syphilis favor its development, while abuse of the nervous system, such as results from over-indulgence of the animal and reproductive instincts, are frequent sources of the nervous changes that lead to ataxia. SHAKING PALSY. _Shaking Palsy, or Paralysis Agitans_, is an affection dependent upon degenerative changes in the nervous centres. It is characterized by a tremulous agitation, or continual shaking, beginning in the hands, arms or head, and gradually extending itself over the entire body. The disease progresses slowly, but when far advanced the agitation is violent, and the patient swallows and masticates his food with great difficulty. In an advanced stage of the disease, the body becomes bent forward, and the chin almost touches the breast-bone. The tremor, which early in the disease only occurred during the time the patient was awake, now continues during sleep, and not infrequently the agitation becomes so violent as to waken the sufferer. GENERAL TREATMENT OF PARALYSIS. The indications of treatment for the various forms of paralysis are to remove the causes, if these can be determined, and rouse the functions of the paralyzed parts. Measures should be adopted to remedy the morbid conditions upon which this affection depends. Keep the skin clean and healthy, promote the circulation of the blood, especially in the paralyzed limbs, and encourage healthy nutrition. These ends may be best attained by the daily employment of stimulating baths and frictions upon the surface. As much regular exercise as the patient can bear without fatigue should be taken in order to favor the preservation of the appetite and strength. Care should also be taken that the bowels are evacuated regularly every day. The circulation through, and consequently the nutrition of, the palsied muscles may be aided by having a strong healthy person knead and manipulate them. These manual movements upon the surface of the body will often excite muscular sensibility, similar to that awakened by a weak Faradic current. The internal medicines should be such as to regulate the general functions of the system. The use of these remedies must be directed by the skill and experience of those who are professionally qualified to administer hem. When the patient has been able to be under our personal care at the Invalids' Hotel, we have found the employment of mechanical movements and manipulations, applied by means of a variety of machinery, employed in this Institution, together with the use of the equalizer, or large dry cupping, or vacuum apparatus, to be of the greatest benefit. These several machines and apparatus furnish a perfect system of physical training, thus rendering valuable aid in the cure of many forms of obstinate chronic diseases. A few of these machines are shown in Figs. 9, 10, 11, 12, 13, and 14; also see page 32 of Appendix. [Illustration: Fig. 9. Manipulator Extended.] [Illustration: Fig. 10. Manipulator Folded.] The general practitioner often endeavors to overcome the inertia of the nerve-centers and nerves by means of specific irritants, with the view of exciting the power-producing function, of compelling the weakened and disabled centers to evolve more power. By such stimulation and forcing, he places a burden on the weakest parts. The compulsory and ineffectual endeavor of the weak parts to act in response to such stimulation is very liable to make undue drafts upon the capacity to act, which only end in exhaustion of the little remaining power instead of its re-enforcement. Cases which were previously curable by direct and appropriate means, are thus forever placed beyond the reach of remedies. No powerful stimulating or depressing medicines are indicated in any of the various forms of the affection. In paralysis it should be our aim to improve local and general nutrition, to relieve local congestions and inflammations, to produce absorption of deposited matters, and to force an abundance of blood through palsied muscles, from which they may derive a proper supply of nutriment, and to which they may give up the products of waste. All this can be accomplished by massage, mechanical movements, regulation of the atmospheric pressure on the body, baths, and proper physical culture. In paralysis, there is a diminution or total loss of the contractile property of the muscles to which the affected nerve fibers are distributed; consequently the capillaries and small veins are not compressed, as in health, and the blood is not forced on through them towards the heart; hence there is a backing-up of the circulation, passive congestion, and all the evils incident to that condition ensue. [Illustration: Fig. 11. Oscillating the Arms and Chest.] _Mechanical movements_ properly applied to the affected limbs, or parts of the body, accomplish the same results as contraction of the muscles. They compress the capillaries and veins and thus force the blood on through these vessels towards the heart. There is a constant pressure in the arteries, hence the flow of blood in the capillaries is always towards the veins, and, when it gets into the veins, it is prevented from flowing back by the valves in those vessels. A proper circulation of the blood through the disordered parts is thus effected, and, as the result, they receive an abundance of nutriment, and their waste products are promptly carried away to the excretory organs, by which they are separated from the body; the deposits of fatty matter between the muscular fibers are absorbed, and the agglutinated fibers are separated. [Illustration: Fig. 12. Rubbing the Legs.] As proof of these statements, it has been found by experiment and observation that there is an increase of temperature in the parts subjected to this action, which _must_ be due mainly to an increase in the chemico-vital changes that are superinduced by the nutritious elements of the arterial blood, particularly that element which is supplied to it by the inspired air, oxygen. All the products of waste are increased. The skin becomes more soft and moist, showing that the amount of matter eliminated by it is increased. The urine becomes more abundant, and the relative amount of urea, its most important constituent, becomes greatly increased. The amount of carbonic acid gas exhaled is increased, and further evidence in the same direction is furnished by the very marked increase in the inspiratory acts, necessitated by the increased demands for oxygen. [Illustration: Fig. 13. Oscillating the Legs.] The local increase of the circulation incident to properly applied mechanical movements, must produce a corresponding diminution of blood in other, even in remote, regions of the body. Thus this treatment, by its revulsive effects, is capable of relieving various disorders of the head, chest, digestive organs, and pelvis. Nowhere, however, is the effect more satisfactory than in affections of the brain and spinal cord, whether characterized by loss of power, of sensation, or by neuralgic pain. Any portion of these nerve centres suffering from congestion, will find prompt relief in mechanical vibratory movements. THE MOVEMENT CURE which we advocate is not a "Swedish Movement Cure," nor anything akin to it. It is the application of remedial forces by complex structures, which combine a variety of mechanical powers. The inventions are solely American. [Illustration: Fig. 14. Apparatus for Rubbing in a Recumbent Position.] By means of this machinery, which is driven by steam power with great velocity, we are able to apply _soft, pleasant, rapid vibrating movements_ over the surface of the body, and thereby increase the circulation of blood through the parts, raise the temperature, and excite pleasant sensations. The movements can be applied by our ingeniously-devised machinery to any part of the body through the clothing and _without the least exposure of the person._ They can be administered in a great variety of ways, by light, quiet persuasions, by gentle frictions, by rubbing, by oscillations, by kneadings, by circular movements, in fact, by an almost _endless variety_ of reciprocating and alternating motions, which, if described, would convey to the mind of the reader but a faint conception of their remedial value. VIBRATORY MOTION not only establishes activity of the circulation through the skin and muscles, but it also affects profoundly the circulation in the important and vital organs of the body; it is thus capable of overcoming torpidity or congestion of the liver, spleen, and other deep-seated organs, without the depressing effects which sometimes follow the administration of powerful medicines. It has not been our purpose to literally explain, in detail, the methods of applying vibratory motion in the treatment of paralysis for popular experiment, since to be successful one should become an expert, not only in this mechanical treatment, but also in the diagnosis of the various forms of paralysis, as well as familiar with their causes, pathology, and remedial requirements. Thus, to be successful in the treatment of paralysis and other nervous diseases, by the application of motor forces with our ingeniously-contrived machinery, the cost of which is beyond the means of most invalids, one must exercise great discretion. GRATIFYING SUCCESS. Not only is vibratory motion as a remedial agent rational and philosophical, but our experience has fully demonstrated its marvelous effects in the treatment of paralysis in its various forms, and also in the cure of other chronic diseases. We have cured cases of infantile paralysis which had resisted the skill of the most renowned physicians in our country. We have treated those who could not stand or bear the weight of the body, but who have been so far restored as to be able to walk and run without assistance. Writer's and telegraph operator's paralysis, or cramp, we have cured in a few weeks' time. Club-feet, spinal curvature, and other deformities resulting from paralysis, have been successfully treated in our Institution. In short, our success has been most flattering in all curable cases of paralysis, and it is such experience that induces us to hold out encouragement to those who are afflicted with paralysis and other nervous affections. Vibratory motion is a desideratum of priceless value to those who are afflicted with diseases of the nervous system, as well as to all others who need a gentle stimulus to call forth their latent energies and improve their physical condition. RECAPITULATION. Motion, properly transmitted to the human system by mechanical apparatus, is transformed into other forms of force identical with vital energy, by which the ordinary processes of the system are greatly promoted. It increases animal heat and nervous and muscular power to the normal standard. It removes engorgement or local impediments to the circulation. The electrical induction produced, renders it a most efficacious remedy for paralysis of all kinds. It removes interstitial fluids and causes rapid absorption and disappearance of solid and fluid accumulations. It is a powerful alterative, or blood-purifier, increasing oxidation and stimulating excretion. It diminishes chronic nervous irritability and promotes sleep. It hardens the flesh by increasing muscular development and improves digestion and nutrition. ANIMAL JUICES, OR EXTRACTS. The use of animal, nerve and gland extracts has proven of surprising efficiency in the treatment of paralysis and locomotor ataxia. They furnish a pabulum in concentrated form for the nourishment and restoration of the weakened nerve cells and fibres. In the vast majority of cases, we have been able, by the use of these recently discovered curative agents, when assisted by other means at our command at the Invalids' Hotel and Surgical Institute, to arrest the progress of these nervous affections, hitherto so generally considered incurable, and bring about restoration of the paralysed functions and a renewal of lost power. These comparatively new remedial agents have been very thoroughly tested by us. Their merits are more fully considered in a preceding chapter of this treatise, under the head of treatment for Nervous Exhaustion, or Debility. * * * * * EPILEPSY ("FITS"). Epilepsy, or falling sickness, is a disease which is characterized by attacks of sudden loss of consciousness, together with convulsive movements of the muscles. The paroxysms occur at irregular intervals, the periods between them, in some cases, being only a few minutes or hours, while in others, several months elapse. There are two classes of Epilepsy: 1st. The general form, with a convulsion that usually involves all the muscles of the body simultaneously. It begins suddenly with little or no warning, commonly with a cry or scream. The convulsion may last several minutes and is followed by a deep sleep for some hours. 2nd. The local or Jacksonian form in which the attack begins with a peculiar sensation in some particular region of the body, either in one extremity or one half of the face. This sensation is followed by a twitching of the muscles of the part. The sensation and spasm extend or advance gradually to other parts. Consciousness is not usually lost, though it may be when the spasms culminate in a general convulsion. Great weakness generally follows in the parts convulsed, gradually passing away. When the attack begins on the right side of the face it is associated with an immediate inability to speak. SYMPTOMS. In the severe forms of the disease, the subject suddenly loses consciousness and falls; there is rigidity of the muscles, which causes a twitching of the face and limbs; the eyes are turned up, and there is foaming at the mouth. In the severe form of the disease, the respiration is arrested, while in the milder attacks, the breathing is difficult, slow, deep, and snoring. With the commencement of the spasm, the tongue is sometimes caught between the teeth and severely bitten. During the paroxysm, the countenance changes from a livid hue to dark purple. The convulsion continues from one to three minutes, and is followed by a deep, sighing inspiration; the subject then sinks into a deep sleep, which continues for half an hour or longer. When consciousness is first regained, the subject appears confused, stupid, and usually complains of headache. He has no recollection of what has occurred during the attack, he pronounces words indistinctly, and if he attempts to walk, he staggers like a drunken man. Sometimes, several attacks occur so closely together that there is no interval of consciousness between them. In some cases, there are premonitory symptoms, such as giddiness, drowsiness, headache, and irritability of temper, which warn the subject of an approaching paroxysm. Occasionally, a wave of cold commencing at the feet and proceeding to the head, is experienced. This is called an _aura_. When it reaches the brain, the subject becomes unconscious, falls, and the convulsion commences. If the disease be allowed to proceed unchecked, it almost invariably leads to great impairment of mind, insanity, or paralysis. CAUSES. The _predisposing causes_ are an hereditary tendency to the disease, and everything which impairs the constitution and produces nervous prostration and irritability. Syphilis, phimosis, sexual abuses, uterine disease, and the use of alcoholic liquors are prominent predisposing causes. Many of the causes treated by us have been brought on by masturbation. Others are the results of injury to the head. Often fracture of the skull is followed by epileptic attacks. _The exciting causes_ include everything which disturbs the equilibrium of the nervous system. Indigestible articles of food, intestinal worms, loss of sleep, great exhaustion, grief, anger, constipation of the bowels, piles, and uterine irritation may be enumerated among such causes. Convulsions of an epileptic character may also be induced by a poisoned condition of the blood, from malaria and disease of the kidneys or liver. TREATMENT. When the time of an expected paroxysm approaches, great care should be exercised that the patient be not suddenly attacked while carrying a lighted lamp, or that he does not fall in some dangerous place, strike upon a heated stove, or in some similar way inflict great injury. If there be warning symptoms before the attack, the subject should carry a vial of the _nitrite of amyl_ in the pocket, and, when the premonitory symptoms are felt, two or three drops should be poured on a handkerchief and held about an inch from the nose and inhaled, until flushing is produced, or a burning sensation is felt in the face. During the paroxysm, the subject should be laid on the back, with the head slightly elevated, and the clothing about the neck and waist, if tight, should be loosened. If there be sufficient warning, a folded napkin, or a soft pine stick covered with a handkerchief or cloth, should be placed between the double teeth, to prevent the tongue from being bitten. During the fit, the head may be bathed with cold water. A person who suffers from this disease should avoid everything which tends to excite the nervous system, or increase to any great extent the action of the heart. The sufferer should go to bed at regular hours, and take at least eight hours sleep. The sleeping-room should be large and well ventilated, and the patient should lie with the head elevated. All indigestible articles of food should be avoided and the diet should consist principally of bread, vegetables, milk, and fruits. Meat should be taken but once a day, and then in very small quantities. The use of alcoholic liquors and coffee should be avoided, and tea only taken in small quantities. The bowels should be regulated with Dr. Pierce's Pleasant Pellets and injections, if necessary. A thorough bath should be taken once or twice a week. If the attacks occur at night, the body should be sponged before going to bed with tepid water, to which should be added sufficient tincture or infusion of capsicum, or red-pepper, to render it stimulating to the skin. The causes, if they can be determined, should be removed, and those remedies administered which relieve nervous irritability and cerebral congestion. If due to worms, the proper remedies should be given; if to phimosis, the subject should be circumcised; if to pressure on the brain, from fracture of the skull, trephining should be practiced, and the depressed bone raised. There are no _specifics_ for this disease; each individual case must be treated according to the condition presented. The nostrums advertised extensively over the country as specifics for this disease, while they may, in some instances, prevent the attacks for a short time, irritate the stomach, impair digestion, lower vitality, and permanently injure the system, often rendering the disease incurable. They deceive the sufferer, leading him to think that his disease is being cured, until it progresses so far that he is beyond the reach of any treatment. As a rule, the longer the disease progresses, the more difficult it is to cure. Epilepsy has by many physicians been regarded as incurable, but our extensive experience has convinced us that by an appropriate course of treatment, the _vast majority_ of cases can be cured. The animal extracts, or juices, herein more fully described under the head of treatment for Nervous Exhaustion, have proven curative in some cases that have resisted other remedies. This treatment requires the personal attention of a physician skilled in its employment. It is also of first importance that the extracts be properly made. We have discovered several new remedies, which undoubtedly exert a powerful curative influence over this disease, but it is necessary to vary the treatment so much in different cases, that it would be useless to enter further into details in this treatise. SURGICAL TREATMENT. A considerable proportion of those cases of epilepsy, termed Jacksonian, have been found to be caused by new growth upon, or in, the substance of the brain. Sometimes cysts form as a result of small hemorrhages, or of spots of softening from clots in the cerebral arteries. Other cases are due to a small spot of hardened tissue or an inflamed centre of irritation in the outer gray matter of the brain. The majority of these forms of disease can be exactly localized in a small area of the brain, and may usually be traced to a blow or fall on the head, or to fracture of the skull without depression. The discovery of the fact that such results of injury will produce localized spasm has naturally lead to the conclusion that similar products anywhere in the brain may give rise to epilepsy. In these cases trephining of the skull and the removal of irritation from the brain has been followed by the most successful results. It is seldom a serious or dangerous operation, but very few deaths having resulted in the practice of good surgeons in many hundreds of cases, and these were individuals who were not favorable for operation, and in whom it was undertaken as a last resort In these cases of epilepsy, due to injury, the operation is fairly safe, and in carefully selected cases that have not been allowed to run so long as to bring upon the brain a general epileptic tendency, the results of operation are good and the procedure warrantable. SEE TESTIMONIALS FROM A FEW OF THE MANY CURES EFFECTED BY OUR SPECIALISTS. * * * * * CHOREA (ST. VITUS'S DANCE). This disease is an affection of the nervous system, which is characterized by spasmodic contractions of certain muscles. It may affect the entire body, although it is usually confined to the left side, or to a special group of muscles. SYMPTOMS. Twitchings of the muscles of the face are the most conspicuous symptoms. They are at first comparatively slight, but as the disease progresses, these spasms become more decided, and the face is twisted into various shapes and forms. The head, in some cases, is constantly jerking. It is with great difficulty that the tongue is thrust out of the mouth, and then, with a sudden jerk, it is quickly withdrawn. These spasms or contortions, may affect the extremities in a similar manner, the hands and arms cannot be kept quiet, the gait may be unsteady, and one foot is merely dragged after the other. If one limb be forcibly held, to keep it quiet, some other limb will involuntarily move. Strange as it may appear, these contractions, which cannot be controlled by the will during wakefulness, are very much lessened or arrested by sleep. Prior to the development of the spasmodic affection, there is usually a period in which the sufferer notes a want of appetite, languidness, with disinclination towards mental or bodily pursuits, headache, restlessness, pains in the limbs and joints, with irritable temper and weakness of memory. There are many other symptoms in special cases. As the disease develops, the patient gradually begins to exhibit an awkwardness of movement in the extremities, and objects frequently fall from the grasp. Children thus afflicted, spill their food while eating, and it becomes difficult for them to stand still. Attempts to write, sew, or draw are imperfectly performed. Such children are very often punished for supposed ill-behavior or careless habits. Later on the symptoms become more unmistakable, and the presence of the disease is readily recognized. The patient may become incapable of dressing, and the limbs and face are no longer under the control of the will. Uncontrollable movements of the fingers, hands, shrugging of the shoulders, dancing of the legs, grimaces of the face, and distortions of the body, become more or less constant. Speech and swallowing may be seriously embarrassed. Any unusual excitement of the mind or body is apt to intensify the muscular twitchings. Severe mental application, the reading of exciting books, the witnessing of entertainments, and excessive indulgence in sports, have to be discontinued. THE MOST COMMON CAUSES seem to be exhaustion of the nerve centres, due to the appearance of the second teeth in children and the development common to the age of puberty. Other causes may be briefly mentioned as follows: rheumatic affections, constipation, a morbid state of the blood, suppression of the menstrual function, uterine difficulties, masturbation, or self-abuse, blows, injuries, or any cause which would give rise to nervous debility. Sometimes it is caused by obstruction in the alimentary canal, or by intestinal worms. TREATMENT. The disease is one in which there is a debility of the nerve centres, complicated with a lack of assimilation and digestion. There is no affection more amenable to treatment in its early stages than this. We are daily in receipt of correspondence from sufferers, or their parents, or friends, in which the most gratifying relief and a cure has resulted from the use of Dr. Pierce's Favorite Prescription used in conjunction with Dr. Pierce's Golden Medical Discovery. These two remedies should be used alternately, the dose being suited to the age of the patient. A large majority of the cases of chorea occur in females and at the period of life when the nervous system is subjected to unusual requirements. In these cases the "Favorite Prescription" effects a gradual restoration of nervous energy, and improvement in the tone of the nerve centres, and by its direct effect upon the circulation in the ovarian region, eliminates the most potent causes of debility. In young people, we usually advise a dose of three drops for each year of the age. For instance, children of eight years of age should take twenty-four drops; those of twelve, thirty-six drops; those of fifteen, forty-five drops, which is about two-thirds of a teaspoonful. A similar dose of Dr. Pierce's Golden Medical Discovery should be administered, taking it before meals, and the "Prescription" after meals. Under their administration the patient will rapidly improve in health and strength; the circulation is materially bettered, the blood is purified, enriched, vitalized. The remedies effect a complete removal, from the blood, of the impurities that represent nerve waste, and as a consequence the nerve cells are properly nourished. The disease is gradually controlled, and when the favorable influences of quiet, nourishing food, with plenty of outdoor air, and not too active exercise is added, the progress is most gratifying. The patients, in a few weeks, are able to control much of the spasmodic movements, and gradually their restoration to a normal condition is accomplished. In occasional cases, where there is some complication, as rheumatism or other severe affection, complicating and preventing their recovery, special treatment is required. We are always ready to advise in regard to such cases when consulted either by mail or in person. * * * * * TESTIMONIALS. If the following letters had been written by your best known and most esteemed neighbors they could be no more worthy of your confidence than they are now, coming, as they do, from well known, intelligent and trustworthy citizens, who, in their several neighborhoods, enjoy the fullest confidence and respect of all who know them. Out of thousands of similar letters received from former patrons, we have selected these few at random, and have to regret that we can find room only for this comparatively small number in this volume. NERVOUS AND GENERAL DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: T.M. Carson, Esq.] _Gentlemen_--I am thankful to-day that I can honestly say, that as a result of your few weeks' treatment, I feel better now in both body and mind than I have for fifteen years. Before I consulted you I felt more like taking my own life to end my miserable feelings than I felt like living; I had given up all hopes of ever being any good to myself or anybody else, but, thank God, your encouragement, and kind words, and skillful treatment have made a different man of me. Before I consulted you, I took no interest in business nor any thing else in the world, which the wise Creator has placed in this world for all mankind to enjoy; but now my mind is clear, and I take an interest in business and enjoy life better than I ever did before. Now, may God bless you for your good and skillful treatment of me; and, also, may this be the means of inducing others who are to-day suffering from the same complaint to at once consult you, as I can assure them that they will receive full benefit of your kind attention, for moderate charges. Yours respectfully, T.M. CARSON, P.O. Box 145, Swissvale, Allegheny Co., Pa. NERVOUS DEBILITY. SPECIAL TREATMENT, FOLLOWED BY USE OF "GOLDEN MEDICAL DISCOVERY." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Ltd., 3, New Oxford Street, London, W.C.: [Illustration: F. Macey, Esq. ] _Gentlemen_--I now write to describe the benefit which I have received from your treatment. For some time I had been suffering from nervous debility, and before placing myself under your treatment my trouble was very severe; and not understanding the nature of my disease, I did not know what to do until I saw a few testimonials of your wonderful cures, when I was led to at once communicate with you; and after two months' special treatment from you, I was greatly relieved, and was advised to then use Dr. Pierce's Golden Medical Discovery, which I did for a time, and am happy to say that I now feel like another man, and am troubled no longer with the old symptoms, and I thank God, and also the kind gentlemen that have been conducting my case, for the treatment and advice which I have received. I also think the "Golden Medical Discovery" is a most wonderful medicine, and I shall feel it my duty to speak well of your medicines and treatment to all fellow sufferers I may meet. I am, Yours truly, F. MACEY, Faversham, Kent, England. NERVOUS DEBILITY. [Illustration: A.E. Norcross, Esq.] WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: _Gentlemen_--Two and a half years ago, after seeking in vain for health at the hands of local doctors, I began treatment with you for "Nervous Debility of a complicated nature. Ag a result thereof I now give this testimonial, having been changed from a person of rapidly declining health--often despondent and with no inclination to work of any kind, to one of sound constitution who enjoys life and is once more able to battle his way to success in life; and it is now about two years since the change occurred, showing it to be permanent. I cannot say too much in praise of your methods, and careful, courteous attention which myself and others have enjoyed at your hands; and that the good work may go on to an unlimited extent is my earnest wish. Yours sincerely. A.E. NORCROSS, (General Delivery), Detroit, Mich. NERVOUS DEBILITY, DYSPEPSIA, HEART DISEASE. [Illustration: Miss Greenwell. ] WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I feel very grateful to you, and to our all-wise Creator for restoring my health. When I first wrote to you I was a miserable sufferer with nervous debility, dyspepsia, heart disease, also female weakness. I was so nervous and low-spirited I could not sleep, in fact I was just about as weak and low as I could be, and could scarcely drag around; but, after persevering for about twelve months, occasionally with the help of your kind treatment and advice, I once more begin to feel like myself again. Words cannot tell how I do appreciate my health. Thank you, gentlemen! I shall never forget the kind business-like manner in which you have treated me. May God bless you, inasmuch as your heart's desire is to do good to suffering humanity. Very truly, Miss K. GREENWELL, No. 253 Twenty-second St., Ogden, Utah. NERVOUS DEBILITY--RESULT OF INDISCRETION. [Illustration: C.H. Goodsell, Esq. ] WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--For the last year and a half I was troubled with Nervous Debility. I tried some medicine that I bought from the druggist, which did me little or no good; so, hearing of the World's Dispensary Medical Association, of Buffalo, I wrote them about my case, and in reply, they said they were sure they could cure me. At that time I was weak in my arms and legs, had poor sight and, worst of all, I was very nervous and bashful. I could not sleep at night and feel refreshed in the morning. I could not look any one in the eye without feeling ashamed. I have now taken two months' treatment and I feel sound in mind and body; but to be sure I am going to take another month's treatment from these same doctors in Buffalo. I recommend all men who are afflicted with any disease similar to the one of which I have just been cured to apply to the World's Dispensary Medical Association, and if they take treatment from these doctors they will surely be cured. I cannot praise them too much for what they have done for me. Yours truly, C.H. GOODSELL, No. 151 S.W. Temple St. Salt Lake City, Utah. NERVOUS AND GENERAL DEBILITY. WORLD'S DISPENSARY MEDICAL, ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: T.W. Knapp, Esq. ] _Gentlemen_--I had been out of health for a period of about three years. Suffered with pains in the head, catarrh, chills, fever, nervousness, and general debility. Spent about all the money I had in order to obtain relief, but received little, if any good. I was scarcely able to work, when in July, 1887, I wrote to your Association, describing my case. You replied, advising me, and prescribing a course of treatment, which you sent to me. After taking but a part of these medicines I began to feel a great deal better; could sleep very much better and was able to resume work as usual, but still suffered some pain in head, and my buck was lame and weak. I continued treatment for some three or four months, until all remaining symptoms of distress and weakness had disappeared. At the end of about eight months I found I felt as well as I ever did. My weight had increased fully twenty pounds, and I could safely say that you had effected a perfect cure in my case. Respectfully yours, THOMAS WESLEY KNAPP, Myhart, Allen Co., Ind. NERVOUS AND UTERINE DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: Mrs. Williams. ] _Gentlemen_--I was sick for over three years with nervous complaint, with blind dizzy spells, palpitation of the heart, pain in the back and head, and at times would have such a weak tired feeling when I first got up in the morning, and at times nervous chills. At other times, I would feel as if there were a tight bandage around my forehead. The first physician I went to said I had nervous dyspepsia; the next one did not say what he thought ailed me; the third said I had dyspepsia, but none of them did me any good. As soon as I commenced taking Dr. Pierce's Favorite Prescription, I began to get better; could sleep well nights, and that bad nervous feeling and the pain in my back soon left me. I can walk several miles without getting tired. I took in all, three bottles of the "Favorite Prescription" and two of Dr. Pierce's Golden Medical Discovery. Yours truly, MRS. JENNIE WILLIAMS, Mohawk, Lane Co., Oregon. NERVOUS AND GENERAL DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.: [Illustration: W.C. Dillon, Esq.] _Gentlemen_--When I applied to you for medical treatment I was in a very bad state. Your suggestion that I use Dr. Pierce's Golden Medical Discovery was followed with good results, and I can say I felt the effects of it before the first bottle was finished. The dull pains in my back were leaving me very fast. I used three bottles of the "Golden Medical Discovery." I had a dull pain in the back, restless sleep followed by very trying dreams, appetite poor, weakness, consequently very easily tired. Now I can go about my work, walk twelve or fifteen miles a day and not feel tired. When I commenced to use your "Golden Medical Discovery" I only weighed 125 pounds; now have increased to 150. Yours respectfully, W.C. DILLON, Box 63, Woburn, Middlesex Co., Mara. NERVOUS DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: M.H. Moore, Esq.] _Gentlemen_--I had been ailing for months and did not know what was the matter. I had a heavy and languid feeling; dimness of sight, spots and flashes before my eyes; an "all gone" feeling in my stomach as if the bottom had fallen out; was nervous and irritable and felt like sinking down when at work. I could hardly get up in the morning; it seemed as if I were more tired then I was when I went to bed. My appetite at times was ravenous, and at other times the smell of food made me sick; I would often go from the dinner table and vomit. I would have spells when it seemed that every man was my foe and would be melancholy, and think that something was going to happen to me; was easily upset, could not get my mind to stay on anything long at a time. When I read about your remedies, I made up my mind to try them. After taking one month's treatment I felt better, and kept on until I had taken three months' treatment and was made a new man. I would advise any one who is in bad health to do the same, and will assure them that Dr. Pierce is a gentleman, and will do Just what he says, as he did in my case. Yours truly, MARIS H. MOORE, Ocean City, Cape May Co., N.J. NERVOUS AND GENERAL DEBILITY. Dr. R.V. PIERCE, Buffalo, N.Y.: [Illustration: Mrs Linn.] _Dear Sir_--My case was a complication of diseases--a general break-down, lasting three years. I placed myself under the treatment of four different physicians. At last, giving up all hope of recovery at home, I was making arrangements to go to a Sanitarium in Michigan for special treatment. One of your small books with blank enclosed was handed to me; I filled out the blank, and thought I would try rather than leave home and little ones,--"Happy decision;" two months' special treatment and I was well and happy, and to-day, I have the very best of health. Yours respectfully, MRS. LOMA LINN, Ladoga, Montgomery Co., Ind. NERVOUS AND GENERAL DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J. Thomas, Esq. ] _Gentlemen_--Had vertigo, or dizziness. Pain over right eye. Vomiting sometimes, severe pains in arms, from elbows to shoulders, pain in left side. Numbness of the fingers. His home physician said "will run into paralysis." Analysis of the urine shows phosphatic deposits. Began treatment with specialists of Invalids' Hotel and Surgical Institute, in August, '87; used the remedies interruptedly for about six months. Writes May 11th, '89, "have not had a dizzy spell for a year." In October,'90, writes, "the dizzy spells have gone for good, I hope." November 9th, '93, reports, "I most willingly recommend your medicines for they cured me of those dizzy spells of long standing, after four doctors in this county had treated my case for three years, without benefit." Respectfully yours, JASPER THOMAS, Alamosa, Conejos Co., Col. IRRITABILITY AND EXHAUSTION OF THE NERVOUS SYSTEM, RHEUMATISM AND HEART DISEASE. CURED BY SIX BOTTLES OF THE "GOLDEN MEDICAL DISCOVERY." [Illustration: C.A. Roberts, Esq. ] Mr. C. Allison Roberts, of Cassville, White Co., Tenn., suffered a great deal from rheumatism, he says: "Legs ached more like toothache than anything I can think of, the thigh bones throbbing and paining; had pains in hips, back, arms and shoulders." His symptoms also showed that the heart was affected. Had chills, headache often and sometimes sick headache. Bowels were costive and irregular. Food distressed and could not eat meat; urine milky; coughed in early part of night, and feet and legs would become numb. Had difficulty in getting to sleep before midnight, and was restless through the night and dreamed much. Had sinking spells which lasted for thirty minutes. Turned pale, became trembly and sometimes vomited his food. Almost immediately after beginning the use of the "Golden Medical Discovery" the headache ceased. After using four bottles, reported that he had been benefited by the remedy. Later he reported: "I have been in reasonable health for some time. I took six bottles of the 'Golden Medical Discovery' and it cured the rheumatism entirely. I had suffered with it for several years and found no relief until I used your medicine. Have no weak nor nervous symptoms now, and no spells of turning sick at the stomach, or of bad action of the heart, palpitation, etc." NERVOUSNESS, "FEMALE WEAKNESS," NASAL CATARRH. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Sanderson. ] _Gentlemen_--My health was utterly gone. Was suffering from nervousness, female troubles and nasal catarrh; life was almost a burden to me, but a glorious change came, due solely to Dr. Pierce's Favorite Prescription and Dr. Sage's Catarrh Remedy. I have suffered more than tongue can ever tell. I have been treated by good physicians but they only help me temporarily. I have taken a great many patent medicines with the same result. In 1890, I began taking Dr. Pierce's Favorite Prescription and Dr. Sage's Catarrh Remedy, which gave me immediate relief and a permanent cure. Respectfully, MRS. BELLE SANDERSON, Sprout, Nicholas Co., Ky. NERVOUS DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 603 Main St., Buffalo, N.Y.: [Illustration: J.F. Ritter, Esq.] _Gentlemen_--It is now about six months since I discontinued your treatment, and as I have had no return of the old symptoms, I consider it unnecessary to take more medicine. When I visited your Institution some two years ago, I had but faint hopes of ever being restored to health, as I was suffering from a complication of diseases. My case was an unusually obstinate one, yet I am satisfied that a cure could have been accomplished in half the time, had I been able to follow your directions in regard to diet more closely. I hereby tender you my sincerest thanks for the kind treatment received while at your Institution. Those days will always be the happiest in my memory. I will close by giving your faculty my sincere thanks, and hope success will crown your business. Yours very gratefully, J.F. RITTER, Medford, Jackson Co., Oreg. NERVOUS DEBILITY. SPECIAL TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Ltd., 3, New Oxford Street, London, W.C.: [Illustration: W. Trumbetta, Esq. ] _Dear Sirs_--In reply to your kind inquiries regarding my health, I am only too glad to say that I am better than I ever was. Before taking your medicines, I experienced great nervousness, loss of appetite, restless nights, taking no interest in my work; had pale complexion, with hollow checks, sunken eyes and loss of memory. I only took your special treatment for about two months, and received great benefit from taking it, but still go on taking your "Pellets" when required. I am sorry to say that I have not got a photograph before taking your medicines, or I should have been glad to send it to let you have seen them both before taking your medicines and after. I remain Yours sincerely, W. TRUMBETTA, 84, Essex Street, South Heigham, Norwich, Eng. NERVOUS PROSTRATION. WORLD'S DISPENSARY MEDICAL, ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: Mrs. E.A. Northrop.] _Gentlemen_--It is now sixteen years since I suffered from that terrible disease, nervous prostration. I suffered untold agony and thought I would go insane. Had a terrible burning sensation across my shoulders, and my head felt large as two, and as if there was a hole from one ear to the other and all sounds passed right through. I could not see, nor sleep, nor scarcely eat, and was that nervous the least thing made me angry. I was treated by our home physician and given up as incurable. At that time I saw your Memorandum Book and thought I would write you, and the result of it was you took my case. After one month of your valuable remedies I felt like a new person, and after six months was restored to good health again after suffering nearly one year of untold agony. I would heartily recommend all and every one suffering from any chronic disease to place their case in the hands of the World's Dispensary Medical Association, of Buffalo, N.Y., as I cannot praise your treatment too highly. Words are inadequate to express the gratitude I owe you in so successfully treating my case. Respectfully yours, MRS. E.A. NORTHROP, South Main Street, Newark, Wayne Co., N.Y. GENERAL AND NERVOUS DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J.W. Stocking, Esq.] _My Dear Sirs_--I believe that I am free from all the troubles that you have been treating me for. The pain in my back is gone--my digestion is good. In all truth I can say _I am a man again_! I can stoop without pain--can labor without that weak and tired feeling. I am truly grateful to you for the good that you have done me, and may you reap a rich reward for the good you have done for suffering humanity, is my sincere wish. Truly yours, J.W. STOCKING, Panama. Lancaster County, Nebr. NERVOUS DEBILITY AND VARICOCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: D.A. Walton, Esq.] _Gentlemen_--I commenced treatment, I think, in July or August, of 1888, and continued four months. My case was nervous debility of fifteen years' standing. I tried home doctors but found they were only aggravating my case. I also tried the Remedy Company, then of St. Louis, who claimed to perform wonderful cures with their "Pastiles," but they proved utterly worthless. Having come in possession of Dr. Pierce's little book and circulars, a perusal of the same convinced me that my health would not be trifled with at his Institution. I was a poor man and could not afford much experimenting. I ordered one month's treatment, and at the end of this first month, I found, to my surprise, that I was feeling different. The second month, still more surprised at my returning health. Third month thought I was cured, and engaged myself to a young lady, and wrote you to that effect, and you advised me with your congratulations to marry, and to order another month's treatment; and at the end of the fourth month I was a _man_, something I did not know what it would be like to be before. I have now been married five years, and have two healthy children--a boy and a girl. I would never have dared to marry had it not been for your medicines. I must add that during this treatment I was troubled with varicocele on left side. I wrote you this at third month of treatment, and you sent without extra charge, a Suspensory and Lotion, and two months' treatment cured me sound and well of this distressing malady; I have not felt the least symptoms of its return. I want the world to know what a competent and honorable firm the World's Dispensary Medical Association is. I would love to shake you by the hand. May God let you continue to be a help to mankind is my prayer. Yours truly, D.A. WALTON, Marion, Grant County, Ind. NERVOUS DEBILITY AND VARICOCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J.L. Ridings, Esq.] _Gentlemen_--I can bear testimony to the removal of varicocele, for which you treated me. I had been in the habit of getting out with the boys and trying to see which could kick the highest with one foot on the ground, and it caused me to have varicocele. I went to my home doctor and he treated me with no success. It was getting worse all the time and I got out of shape all over. My health got bad and I thought my case hopeless. I had tried two doctors and received no benefit. I had one of your little Memorandum Books in my pocket, and one day, looking through it I saw you treated such cases, and wrote you and received word in a few days that you would treat me, so I sent off for one month's treatment; and in five months I had gained my weight back, and that was eight years ago and I feel sound and well and my health has been good ever since. You are at liberty to use my testimony in whatever way it may be of most benefit to you. I also enclose a photograph of myself that was taken soon after your treatment. With feelings of much gratefulness, I am. Very truly yours, J.L. RIDINGS, Clarence, Shelby County, Missouri. NERVOUS DEBILITY. INDIGESTION. WORLD'S DISPENSARY MEDICAL ASSOCIATION. Buffalo, N.Y.: [Illustration: R,M. Bascom, Esq.] _Gentlemen_--It is now about thirteen months since I discontinued your treatment, and I have no return of the old symptoms, I consider it unnecessary to continue treatment. When I commenced taking your medicine I was suffering from nervous debility, indigestion, dyspepsia, etc. After using your medicine one month I am perfectly healthy, and cheerfully recommend your Institution to suffering humanity. Yours truly, R.M. BASCOM, Sunfield, Eaton County, Mich. NERVOUS DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION. Buffalo, N.Y.: [Illustration: F. Zerbe, Esq.] _Gentlemen_--It is now about five years since I received a two months' treatment for my case and I have had no return of the symptoms, I consider it unnecessary to take more medicines because I am gaining strength every day. I am healthier than I have been in fifteen years, and I thank you for the kind favor you have done me in my case, and I wish that all sufferers would send to you for treatment. Yours respectfully, FRANKLIN ZERBE, De Turksville, Schuylkill Co., Penna. NERVOUS DEBILITY, DYSPEPSIA, CONSTIPATION. Blackstone, Nottoway Co., Va. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Dr. Pierce's Golden Medical Discovery and "Pleasant Pellets" made a perfect cure of me. I increased in weight from 120 pounds to 150 pounds and my strength increased in proportion. It improved me so rapidly that my friends inquired what produced such a change in my general appearance and health. Some accused me of dissipation. When I told them it was your medicine, the drug stores found a ready market for it, and continue to sell it with increased sales. Yours truly, R.E. Jones NERVOUS AND GENERAL DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: O.A. Conklin, Esq.] _Gentlemen_--I was a great sufferer from nervous and general debility. I applied to you by letter for advice and received from you medical treatment for three months, which completely restored me to health; the course of treatment did not interfere with my usual vocation and was not difficult to follow. I am a well man to-day and take pleasure in advising all the afflicted to consult you at once, and feel sure they will, like myself, be well pleased with your treatment. Yours truly, O.A. CONKLIN, Ravenna, Muskegon Co., Mich. NERVOUS DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: H. Culver, Esq.] _Gentlemen_--After taking the two months' treatment which you sent me by mail for that broken-down condition, usually styled "Nervous Debility," attended by the usual symptoms such as headache, sleeplessness, confusion of ideas, etc., the above symptoms have so entirely disappeared that I do not consider it necessary to continue the treatment longer. I would say further that I am satisfied that you understand your business, and would advise anybody suffering from any chronic disease to avail themselves of your skill in preference to resorting to any other source known to me. Yours respectfully, HERMAN CULVER, Port Angeles, Clallam Co., Wash. GENERAL AND NERVOUS DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Wm. H. Coon, Esq.] _Gentlemen_--I am very thankful for what you have done for me. The treatment which you furnished me a year ago gave me great relief. I had been suffering for many months with general and nervous debility, with headache, languor, sleeplessness, indigestion, constipation, etc., which were increasing upon me. One month's treatment gave me perfect relief, and I am now like a new person. I can heartily recommend all young men to consult your staff when in need of medical advice. Respectfully yours, WM. H. COON, Medina, N.Y. NERVOUS DEBILITY AND CATARRH. Big Piney, Pulaski Co., Mo. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I was treated by you eleven years ago for nervous debility and chronic catarrh of eight years' standing and of a very aggravated nature. I was considered near my grave by many of my friends when I commenced treatment. I used eight months' special treatment, after which I used some 13 or 15 bottles of your Sage's Catarrh Remedy, and have had excellent health ever since. Yours truely B.P. Dake. NERVOUS DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: G. Rankin, Esq.] _Gentlemen_--For about five years I was troubled with Nervous Debility. I was weak and nervous, and my appetite poor. I saw your advertisement in a newspaper and concluded to write to you. I took your medicine for nine months, and at the end of that time, I had gained thirteen pounds, was much stronger, my nervousness had left me and I felt well and strong. I am sincerely thankful for the great help I received from you. Yours very truly, GEORGE RANKIN, New Castle, Lawrence Co., Pa. NERVOUS DEBILITY. Richville, St. Lawrence Co., N.Y. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--After two years of perfect health I write to you thanking you for your treatment. I had suffered several years from Nervous Debility, and had tried various remedies, and been treated by different physicians, but received no benefit from them. I ventured to write to you, and after taking a month's treatment and following your Hygienic rules, I am now fully recovered and never felt better in my life. May God spare you for many more years, for the sake of suffering humanity. Yours respectfully, Evan P. Jones. NERVOUS DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Edw'd Uelbrick, Esq. ] _Gentlemen_--In 1887, I had occasion to visit your Invalids' Hotel and Surgical Institute for a course of treatment. I am happy to state that my case was cured to my entire satisfaction, and that I always think with gratitude of the kind treatment received from the hands of doctors and nurses. While there I became acquainted with many undergoing treatment for various chronic and surgical diseases, and all were unanimous in their praise of the Institution. Respectfully yours, EDWARD UELBRICK, White Oaks, N.M. NERVOUS PROSTRATION; RHEUMATISM; CONSTIPATION. Colebrook, Litchneld Co., Ct. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I desire to express my heartfelt thanks for the great benefit you have done me. About ten years ago I contracted rheumatism, from which I suffered dreadfully at times. Was also troubled with chronic constipation; had been from boyhood. Had doctored more or less for years without any great benefit until I consulted you and commenced taking your Special Remedies. After taking three courses of your medicines I was so far improved in health and strength that I considered it unnecessary to continue it longer. Wishing you much success in your great work. Yours truly, W.H. LOVELAND NERVOUS DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: L. Rakes, Esq.] _Gentlemen_--So much of my good health is due to the excellent treatment I received from the Invalids' Hotel and Surgical Institute, that I take the greatest pleasure in recommending all the afflicted to this famous Institution. I was run down and a great sufferer from nervous debility. The remedies put up by the specialist of this Institute so suited my case, and so improved my health, that I soon felt like a new man. My gratitude is so heartfelt that I cannot speak to my friends and to all the afflicted in too high praise of the skill of the physicians of the World's Dispensary Medical Association and of the great benefit to be derived from their treatment. Yours, truly, LEVI RAKES, Plattemouth, Cans Co., Neb. NERVOUS DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: T.J. Carder, Esq.] _Gentlemen_--I was suffering with a very severe nervous debility and general weakness, and after using your splendid treatment for four months, I find myself perfectly cured. Respectfully yours, T.J. CARDER, Pacific Grove, Monterey Co., Cal. NERVOUS PROSTRATION. Severe Palpitation of the Heart. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Moore.] _Gentlemen_--I am feeling quite well. I have taken Dr. Pierce's Golden Medical Discovery and "Pellets," and I can truly say they have done me more good than anything I have ever taken. I keep the "Pellets" in the house all the time. Respectfully, MRS. LAURA E. MOORE, Wolfborough, Carroll County, N.H. NERVOUS DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: G. Posson. Esq.] _Gentlemen_--My health had been gradually failing for years. I could not sleep nights and was very nervous, and I was depressed in spirits and was entirely unfit for business. The principal cause was over-work. Through the influence of friends I began your treatment and continued it three months, and at the end of that time I felt so much better that I did not continue it longer. And I can cheerfully recommend your mode of treatment to every sufferer. Sincerely yours, GEORGE POSSON, Middleburgh, Schobarie Co., N.Y. NERVOUS DEBILITY AND CATARRH. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y,: [Illustration: Mrs. Hoffman.] _Gentlemen_--I have enjoyed good health since I took your treatment I suffered intense agony for five months, and after taking one month's medicine I found very much relief--so much I was surprised. Many thanks for the good your medicines have done me, and my prayers are that God may help you in your good work, and that you may live long and prosper. Yours respectfully, MRS. ALICE HOFFMAN, Box 183, Clarksville, Butler Co., Iowa. "A NERVOUS WRECK." NERVOUS DEBILITY, EXHAUSTION, THREATENED INSANITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: F. Moffat, Esq.] _Gentlemen_--About six years ago, I had tried all the doctors in my part of the country with no satisfactory benefit. They did not understand my case. I was a nervous wreck--unable to sleep--could not eat, and underwent the usual horrors that one endures where there is loss of control of the nerves. A few months more would have made me insane. My cure has remained permanent. The relief was something that I cannot describe. It has enabled me to pursue my work steadily ever since, and I am more than happy to testify to the excellent skill and honorable dealings of your faculty and the fine appointments of your Institution. Respectfully yours, FAYETTE MOFFATT, Hendrum, Norman Co., Minn. NERVOUS DEBILITY, KIDNEY DISEASE, NIGHT-EMISSIONS, SEVERE HEADACHES, INDIGESTION, RHEUMATISM, COULD NOT SLEEP NOR REST. FOUND RELIEF AFTER FIVE OR MORE YEARS OF AGONY. Elstonville, Lancaster Co., Pa. WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I am not able to express my thanks to you for the benefit of your special treatment. I had no hope of ever being restored to health again, having tried several home physicians, and having found no relief. I had little faith of ever being relieved of the dizzy spells and black spots before my eyes. Some of my friends told me it was nothing but a fake and a humbug. Thank God I did not listen to them. The first month's special treatment gave me such relief that I continued five months, and to-day can do heavy work without that troublesome pain in my back, and can stoop down without dizziness in my head. I would advise any one that is afflicted with any of these diseases to at once consult the practical and skillful physicians at the World's Dispensary Medical Association, at Buffalo, N.Y. I cannot think of words that will half express my gratitude. Thanks to God that he has granted you such skill. I am. Yours truly, John M. Ellinger. GENERAL DEBILITY OF FIFTEEN YEARS' STANDING. CURED BY SPECIAL HOME-TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Lt'd: [Illustration: G.W. Whitrod, Esq.] _Gentlemen_--After being a sufferer from debility and general weakness for fifteen years, I found a radical cure in the treatment I received from you at my own home. The first supply of medicine seemed to start me on the road, and the wheel was kept turning till I reached the happy condition of health. I hope this will meet the eyes of some of my old comrades, who have been to the eastern countries, and there lost their health, as I did, and as many others do. Gentlemen, I wish again to thank you most kindly for your good treatment and thoughtful attention. I will enclose my photograph. I am, Yours truly, G.W. WHITROD, Rockland, St. Andrews, Attleboro, Norfolk, Eng. NERVOUS DEBILITY. WORLDS DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: C.M. Gates, Esq.] _Gentlemen_--About a year ago I found myself a victim of Nervous Debility. For some time I hardly knew what course to pursue, nearly every paper I might pick up contained some advertisement that would cure me. But believing in the old adage, "never expect to get something for nothing," I decided to write to an Association that _I knew_ was reliable. Acting accordingly, I took a course of four months' treatment, which I am pleased to state has given me in return a perfect cure. Thanks to the medical skill of your Faculty. Yours truly, C.M. GATES, Girard, Macoupin Co., Ill. NERVOUS AND GENERAL DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: A. Crowl, Esq.] _Gentlemen_--After taking your second months' treatment I feel as though I am entirely cured. The trouble with my back is entirely removed; have gained in strength right along and have been working hard for the last two months. I cannot fully express my appreciation of your kindness and beneficial treatment. Yours truly, A. CROWL, Oneida Mills, Carroll Co., Ohio. NERVOUS DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: T.M. Hutchison, Esq.] _Gentlemen_--Your letter inquiring about my health, came duly to hand a few days ago. In answer permit me to say that the three months' course of treatment effected a cure. Now my general health is good, body strengthened, mind clear, memory revived, and energy to work restored; cheerfulness and bright hopes, once lost, are now fully regained. My case was a complicated one of Liver disease and general effects of bad habits and usage, yet I was not too far gone to be restored by your wonderful treatment. My prayer is that you will ever prove a blessing to mankind. Yours respectfully, T.M. HUTCHISON, Forest Hill, Summers Co., W. Va. NERVOUS DEBILITY. PILES, CATARRH, HEART SYMPTOMS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J. Talbott, Esq.] _Gentlemen_--The effect of your remedies is little short of a miracle. My general make-up and appearance are astonishing; my cheeks rosy, eyes bright, circles nearly all gone from under eyes; am fleshier, stronger, more active, and an entirely different man. No piles, catarrh, heart trouble; no chills and fever; no despondency, no anything. Yours truly, JOHN TALBOTT, Pennsylvania Agricultural Works, York, York Co., Pens. NERVOUS DEBILITY RESULTING FROM INJURY TO SPINE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Geo. W. Benham, Esq.] _Gentlemen_--I take pleasure in saying that the Invalids' Hotel is the best institution in the world for the cure and treatment of all kinds of chronic diseases. I was afflicted for a long time before I went to your Institution for treatment, and I tried many doctors, but without avail. After being in your Institution two months, I was restored to health, and I am a well man to-day, and take pleasure in giving you many thanks. My difficulty was the result of injury received early in life, and it has been permanently and perfectly cured. With many good wishes and highest recommendations. Respectfully yours, GEORGE W. BENHAM, P.O. Box 227, Seymour, Conn. NERVOUS DEBILITY, DYSPEPSIA, AND OTHER COMPLICATIONS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, No. 663 Main St., Buffalo, N.Y.: [Illustration: D.H. Poff, Esq.] _Gentlemen_--I am now through with your last month's treatment. I have taken in all three months' treatment. When I first wrote to you I thought I was gone beyond the reach of recovery, but, thanks to God, I am to-day a sound man, heartier than I have been for years, and your Institution deserves the credit of it. I will forever remember you, and want you to publish this testimonial for the benefit of others, as there are thousands in the same fix that I was in. Yours truly, D.H. POFF, Raleigh, Raleigh Co., W. Va. NERVOUS PROSTRATION. Everson, Whatcom Co., Wash. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--As regards your medicines I can truthfully say that I consider them good. Three years ago, I was much run-down with indigestion and nervous prostration. I purchased about four bottles of "Golden Medical Discovery" and "Favorite Prescription," and after taking them along with the "Pellets", I felt much improved. Indeed, my friends told me I looked like another woman. Yours truly, Mrs. Rob't Burns NERVOUS DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: W. Slattery, Esq.] _Gentlemen_--I am pleased to send you a testimonial regarding the perfect and permanent cure which you have effected in my case. I suffered from Nervous Debility. The symptoms were prostration, sleeplessness, exhaustion, over-fatigue from mental trouble, overstudy and anxiety, indigestion, dyspepsia, constipation, headache, inability to concentrate the mind, general lassitude, melancholia, backache and pains from the top of my head to the sole of my feet. You treated me about twelve months and effected a _perfect cure_. Yours respectfully, WILLIAM SLATTERY, Garden City, Finney Co., Kan. HERNIA--LEFT INGUINAL--PRESENT EIGHT YEARS WITH NERVOUS PROSTRATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: A.J. Kidder, Esq.] _Gentlemen_--I take greatest pleasure in making public the most wonderful cure I received at the Invalids' Hotel and Surgical Institute of Buffalo. I had suffered severely for eight years with a left inguinal hernia; had tried many physicians and medicines, but found only temporary relief. I was greatly run-down, and my nervous system considerably shattered. My friends persuaded me to go to the Invalids' Hotel and Surgical Institute. While there I was operated on by their specialist, and in a few weeks began to gain strength and energy so that I could return home, and have since felt entirely well. Words could not do justice to my feeling in regard to this institution. There is no place like it for medical aid, and I would urge all invalids to go there, feeling confident that they could no where receive more skillful treatment or more kind attention and care. Respectfully, A.J. KIDDER, North Yam Hill, Yamhill Co., Oreg. THICK NECK (GOITRE), NERVOUS DEBILITY AND WEAKNESS CURED. [Illustration: Mrs. Houghton.] Miss ELLA A. HOUGHTON, of _Theresa, Jefferson Co., N.Y._, was cured of Thick Neck, Nervous Prostration, Weakness and a complication of ailments by Dr. Pierce's '"Discovery" and "Favorite Prescription." She says: "My health is now as good as it was before I was sick. The swelling (goitre) has all gone from my neck. I don't have any bad feelings. My gratitude for the benefit I have received from your treatment has induced me to recommend you to all whom I know to be sick." "I have known of two or three middle aged ladies residing near here, who have been cured by your 'Favorite Prescription.'" NERVOUS DEBILITY, CURED BY SPECIAL HOME-TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Lt'd, 3, New Oxford Street, London, W.C.: [Illustration: G. Dancy, Esq.] _Dear Sirs_--It is now over two years since I first began to feel something the matter with me. I gradually got worse, with a nervous and despondent feeling. I went to a doctor, who said I was suffering from debility and ordered me away. I got a little better and returned to work, but only to get worse again. I then had very restless nights with terrible dreams, and would wake up all in a perspiration. I often wished I was dead. At last, I had to give up work again, and thought that I should never return to it. I was then under several doctors, but they did me no good. I then came across a little book from your Association, and seeing cases like mine cured, I determined to come to London and see you. I was then under your treatment for three months at my home, taking your medicines and adhering to your rules. I felt a change the first week, and after three months' treatment I was restored to health. It is now four months since I took any of your medicine, and have not had any symptoms return. I am now at work again, and enjoying life the same as anyone else. I thank you very much for your kind attention. I remain, Yours truly, G. DANCY, 25, Merton Road, Stanford Road, Kensington, W. London. "LIFE MISERABLE AT TIMES." NERVOUS EXHAUSTION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: J.W. Durham, Esq.] _Gentlemen_--For several years I was a sufferer from some constitutional disease, or combination of diseases, which rendered life miserable at times. Dyspepsia, headache, dizziness, irritability and gloomy forebodings were among the symptoms I suffered. By chance, one of the pamphlets you publish fell into my hands, and I was induced to write you, describing my condition as best I could, and consequently I was treated by your Specialists. When I had been treated for two months I felt so well and the symptoms were so far gone that I felt I was cured and quit taking medicine. As this was more than two years ago time has proved that I was correct, for I am a healthy, robust man to-day--thanks to you and to your associates in the noble Institution which you have established for suffering humanity. Yours respectfully, J.W. DURHAM, Parkland, Jefferson County, Ky. NERVOUS AND GENERAL PROSTRATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss Morrison.] _Gentlemen_--It is with pleasure that I add my testimony to your list, hoping it may contribute to your success and induce others to avail themselves of the benefit of your invaluable medicines. In June, 1890, I took typhoid fever of malignant type; for two months I hovered between life and death; at length the fever left me in a prostrated condition. Then I was taken with a severe pain in my back and general nervous prostration; could not move myself in bed nor bear to be moved by the most careful nurses without experiencing excruciating pain. I had the best medical attention in the community, but they failed to give relief. My friends wrote to Dr. Pierce, stating my condition and requesting treatment for me. He treated me for two months; by that time I had so much improved that I did not think it worth while to continue the treatment longer, and my health has been such that I have not had occasion to lie in bed two days together since. I feel under lasting obligations to Dr. Pierce, and thank God for blessing the world with so able a physician. Very respectfully, MISS MAGNOLIA MORRISON, Abernethy, Iredell Co., N.C. NERVOUSNESS, CATARRH, AND INDIGESTION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 683 Main St., Buffalo, N.Y.: [Illustration: R.A. Baldwin, Esq.] _Gentlemen_--For a long time I was suffering from indigestion, catarrh and nervousness. I was so run down that I could not go to school, and, as the various remedies I tried did me no good, I applied to you, and was advised to try a course of special treatment. After taking only two months' medicines from your noble institution, I feel perfectly restored to health. I have, moreover, recovered my lost flesh, and I am pleased to say need no further medicines. Yours truly, E.A. BALDWIN, Proctorsville, Windsor Co., Vermont. LOSS OF FLESH AND STRENGTH. NERVOUS PROSTRATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: C. Holmstedt, Esq.] _Gentlemen_--I was run down entirely, losing my flesh and getting weak and nervous, and had hard work to draw a long breath; could hardly breathe at all, and came nearly dying once or twice. Had tried many kinds of patent medicines--many doctors, all in vain. One day I saw an advertisement in a newspaper, about "If you are run down and losing flesh, use 'Golden Medical Discovery.'" I, like a drowning man, would grab at anything on sight. So I went to my druggist and asked him for "Golden Medical Discovery," and he had it and I bought one bottle and followed the directions and it did me good at first start; so I bought two bottles every month until I had used about six bottles, then I had my strength back and could draw my breath and felt like a new man. Yours truly, CHARLES HOLMSTEDT, Newtonville, Baraga County, Mich. NERVOUS EXHAUSTION. A PROMINENT NURSE AND STUDENT IN DISEASES OF FEMALES. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Sarah Barnhardt.] _Gentlemen_--One could scarcely discharge a more pleasant duty to a suffering fellow being than to direct them to a place of relief. Hence, I desire to state that a short time ago, life was almost a burden to mo until I began taking treatment for nervous exhaustion from Dr. Pierce of the Invalids' Hotel and Surgical Institute, at Buffalo, N.Y., and can conscientiously say at the end of six weeks, I feel like another being. I have also consulted Dr. Pierce on numerous occasions during the past eight years, and at no time whatever have I known his remedies to fail, more especially, his "Favorite Prescription," (which I have used in my practice), and the "Golden Medical Discovery," when taken according to directions. These remedies will in no event disappoint. I am now In the enjoyment of perfect health--a blessing which I attribute to the kind Providence which directed me to the World's Dispensary Medical Association. Yours gratefully, SARAH BARNHARDT, Grand Rapids, Mich. NERVOUS EXHAUSTION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: W.E. Dixon, Esq.] _Gentlemen_--It is over a year now since I applied to you for help and it is more than six months since I reported myself as well. I have worked very hard since then, and still have continued well all the time. When I called upon you for treatment I was in a terrible condition. I was subject to severe headaches; was troubled with a tired, an almost lifeless feeling, and although I slept, _I could not get rest_. I was nervous and fretful, and could not do as much work as I wanted to do. To tell it all in a few words _I was all run down_. I had never wholly recovered from the grip, which left me in a very poor condition; and that, together with over-work and insufficient physical exercise, had put me in such a condition that I was almost unfit to teach my school. After five months' treatment (one month intervening in which I received none) I considered myself well, and I think that I was right. I feel very grateful to you for your treatment of me, and shall ever be willing to speak a good word for you. Yours respectfully, WILLIAM E. DIXON, Harwich Port, Barnstable County, Mass. NERVOUS EXHAUSTION. DR. R.V. PIERCE, Buffalo, N.Y.: [Illustration: Geo. S. Wilson, Esq.] _Dear Sir_--After being troubled with my head for two years and taking treatment with ten different doctors and getting no help, I started for your city, but allowed myself to be talked out of seeing you by a man on the train; stopped off at Lancaster and saw Dr. ----, took one month's treatment with no benefit--grew worse. After that, started once more, did not tell where I was going. I was a complete wreck--had to be helped on board of the cars. You looked me over carefully--you seemed to know just what the trouble was. Gave me medicine for a month's treatment. I came back homo and took the medicine. Well, I was surprised the first week and have been ever since--gained right along. Have been well ever since and all for one month's treatment, for which I thank you very much. Respectfully, GEO. S. WILSON, Perry, Wyoming Co., N.Y. NERVOUS EXHAUSTION. Cayuga, Vermilion Co., Ind. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--It is now about eighteen months since I discontinued the use of your medicines. I can truly say I feel like a new man. I have none of that wakefulness at night, or the tired feeling when I get up of a morning. Now, I can work hard all day, go to bed at night tired, wake up the next morning rested and refreshed, though I took but two months' treatment; its value to me I am not able to estimate; before and during treatment I weighed about 160 pounds, and now I weigh 185 pounds. With many thanks and good wishes, I am, Yours truly, Geo. F. Howard SEVERE NERVOUS PROSTRATION. "OUT OF DARKNESS INTO LIGHT." WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main Street, Buffalo, N.Y.: [Illustration: Mrs. Austin.] _Gentlemen_--About eighteen years ago, after the birth of one of my children I was left in a weak, run-down condition; it seemed to me that my nerves were unstrung very bad: I did not suffer much pain, but I think I suffered everything any one could suffer with nervousness; my life was a misery to me. I doctored with seven different doctors and got no relief; then I took almost all kinds of patent medicines and got no relief from them, but got worse all the time, when I chanced to get one of your little pamphlets. I thought I would write to you, and waited as I thought to hear that there was no help for me; when my answer came and you said you could cure me great was my joy. I had taken your medicine about a month when I began to improve and in a few months was entirely cured. My recovery was like coming out of the dark into the light, so great was the change. I will advise all sufferers to go to you for relief--I don't think they will be disappointed. When I commenced taking your medicine I weighed 94 pounds, now I weigh 125 pounds. I do not know how to thank you for all the good your remedies did me, With heart-felt thanks I am. Sincerely yours, MRS. AMANDA C. AUSTIN, Burden, Cowley Co., Kansas. P.S.--I have a lady friend who is taking Dr. Pierce's Favorite Prescription now, and last summer every one thought she was going with consumption; four of her father's family had died with it in five years: she has taken one bottle of "Favorite Prescription," and now she is better in health than she has been in three years. Her address is Mrs. Laura Paugh, Burden, Cowley Co., Kas. A.C.A. NERVOUS EXHAUSTION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.: [Illustration: C. Gaul, Esq.] _Gentlemen_--For the last five years I have tried many leading doctors in this country but without avail. I gave up every hope. Your advertisement fell into my hands; at the time I did not know what to do because all my money had gone for medicine, but money was no object to me. I could not rest till I was cured. Your treatment, which I received, cured me in a short time, and I am just as good as ever. I come before the public to advise anyone in need of treatment to give you the first chance, and he will find relief for I believe that nowhere can one obtain more skillful care or more kindly attention. Hoping that success will crown your business, I am, Very truly yours, CHARLES GAUL, Muskegon, Muskegon Co., Mich, care of "Warwick House." NERVOUS PROSTRATION, SLEEPLESSNESS, DYSPEPSIA, AND RHEUMATISM. [Illustration: T. TOWNSEND, ESQ.] Mr. J.T. TOWNSEND, of _Noah, Coffee County, Tenn_., consulted us by letter. He was suffering from great nervous prostration; could not walk without tottering: was troubled greatly with inability to sleep; poor appetite; did not relish food; suffered much pain and stiffness in the joints; was overcome with heat working on a thresher, followed by persistent nausea, confusion of ideas, his memory being very defective. After taking a single course of treatment, the medicines being sent by express, he writes as follows: "The medicine you sent me lasted me five weeks, and proved very beneficial indeed. I believe it, under God, was the means of saving me from a premature grave. When I received the medicine, I had just gotten rid of an attack of bilious fever, which left me in a deplorable condition. I was very week and nervous, but my improvement commenced with the first dose of your medicine, so by the time my medicine was out felt better than I had for years, and now have no indication of a return of my trouble." A month later he writes: "I continue to enjoy the most perfect health. Every organ of my body, and every faculty of my mind, is in splendid condition, which makes life worth living. I have gained twenty-one pounds since I have been able to attend to business. Please accept my profound thanks for your promptness in sending me my medicines." NERVOUS PROSTRATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.: [Illustration: G.W. Colquitt, Esq.] _Gentlemen_--It gives me pleasure to testify to your skill in the treatment of my case. When I applied to you last June, I was suffering all the horrors of nervous prostration, which was brought on by over-work and constant anxiety. I had no energy and no interest in business; rather an aversion to anything like work. My appetite was poor, indeed food seemed to distress rather than nourish. I felt tired and drowsy mornings; irritable and despondent; suspicious of every body and everything. After two months' treatment these unpleasant symptoms disappeared, and my health is better than it has been for twenty years. I can never express to you my gratitude for your kindness, and would cheerfully recommend your Institution to all sufferers. Yours truly, GEORGE W. COLQUITT, Palmetto, Campbell Co., Ga. BAD CASE OF UTERINE DISEASE AND NERVOUS PROSTRATION, CURED BY HOME TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Glass.] _Gentlemen_--It is with pleasure that I write to let you know the great benefit I have received from your medicines and self-treatment at home, which you kindly sent me, advising me to take your Dr. Pierce's Favorite Prescription and "Pleasant Pellets" and "Golden Medical Discovery" for my troubles. I did take your advice as near as I could; when I wrote my first letter to you, I had been treated by different doctors for twelve months and received but very little or no benefit, but had spent one hundred dollars for treatment and medicines. My husband, and little boy twelve years old, did all the family sewing and washing and work in general, and I could not walk across the room without help or stand on my feet one minute at a time; at night I could not sleep, nor day time either; nothing I ate tasted well--I had no desire to eat anything; my bowels were costive all the time, and after following your advice and using about fourteen dollars worth of your medicines altogether, I now feel like a new person. I am not bothered with that nervousness, where it used to be that I could not stand a sudden rush of horses feet, or a quick halloo from one's boys, or a sudden sound of anything would cause me to take sudden nervous spells of some kind, as if I were smothering or dying, or something of the kind--I can't tell just how I did feel. Now I do all my washing, sewing and house work in general for a family of seven--five children, my husband and self, and help my husband in the field some besides. I can truthfully say, ii it had not been for Dr. Pierce's medicines and the kind advice to me, with self-treatment at home, I would have been dead long ago, and I never can feel that I can say enough for his skill and medicine nor thank him enough for the good he has done me. I use no other medicines in my family but these and never will, for they do all that is claimed for them and more too. I have one of the "Advisers," and I would not be without it for fifty times its cost. May God be with you throughout your life is my prayer. Respectfully yours, MRS. ADDIE GLASS, Bandera, Bandera Co., Texas. NERVOUS PROSTRATION FOLLOWING GRIP. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: W.S. Nicholson, Esq.] _Gentlemen_--In January of '90 I took the "grippe," went to work before I was well, was caught in a rain which gave me a very bad relapse, resulting in lung fever and complete prostration; was on my bed two months, and when I did get out, the strength to walk any more than just a few rods did not come back. My family doctor and two prominent physicians of Sioux City, did me no good. Late in the fall I got a bottle of Dr. Pierce's Golden Medical Discovery, which quieted my trembling nerves and gave me an appetite to eat. I then concluded to try the Doctor, personally. Up to this time I was in a pitiable condition. Sometimes I could not sleep until I felt almost wild, then sleep so much I would be stupefied. I could not digest any food and my whole system was wasting and failing fast. I doubt if any one who saw me expected me to get well. I took the treatment sent me by the World's Dispensary Medical Association for more than a year. The medicine never gave me any distress as other medicines had done before. I began to improve from the start, but the change from one extreme to the other was like the growth of a child. To any one suffering from nervous prostration I would say, "don't be impatient." It takes a long time for weakened nerves to grow strong. I have at last become strong and well, thanks to the Giver of all good and the grand Institution at Buffalo. I have since married a noble-hearted young woman, and when I am playing with our sweet, healthy, baby girl, I give way to the thought that at last the long, sad chapter of my life is ended; at such times her merry laugh sounds like a song of triumph of life over death. Gratefully yours, W.S. NICHOLSON, Willow Creek, Clay Co., Iowa. NERVOUS PROSTRATION COMPLICATED WITH KIDNEY AND BLADDER DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: M. Manheim, Esq.] _Gentlemen_--Having been a patient in your Invalids' Hotel for several weeks, I take great pleasure in telling other sufferers of my treatment which I received under your efficient staff of physicians, surgeons and nurses, and I will say with clear conscience that every care and comfort was given me that I wished for. I am sure that your Institution is far in advance of the age, and would wish that every invalid could avail himself of the treatment that I received in your most, excellently kept Invalids' Hotel. I cheerfully give this as my testimonial to individuals, friends and sufferers. My health is so fully restored that I look upon life with pleasure and comfort, whereas before I was a suffering nervous invalid, unable to sleep and much of the time in torment. Wishing you success I am your friend and well wisher, M. MANHEIM, Georgetown, S.C. NERVOUS EXHAUSTION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.: [Illustration: A.D. Christie, Esq.] _Gentlemen_--I was troubled with nervous exhaustion; my legs and back ached, and I could not sleep hardly any, and could not rest at night for about three months, and, reading in one of your Memorandum Books a case that suited mine and having taken medicines without any good results, I concluded to try your medicines. I explained my case carefully and got one month's medicines, of which I did not take all as I thought I did not need it, as I felt like another man--could sleep well and work without having that "all-gone feeling." Yours respectfully, A.D. CHRISTIE, Maple Creek, Forest Co., Penn. NERVOUS AND GENERAL PROSTRATION. "LIFE IS NOW SWEET." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss Moyers.] _Gentlemen_--Six years ago I had an attack of measles, which left my health in a precarious condition. I was placed under the treatment of a good physician who did all in his power to restore my health, but all in vain. I had dyspepsia and could not eat meat, vegetables nor fruit of any kind. I suffered alternately from cold and heat. At times my feet and knees would feel like ice to the touch, and at other times I would suffer the most excruciating torture, seeming as though every nerve in my body was being seared with a hot iron. My left hip and knee would become so affected that I could scarcely walk across the room. I slept very little. On one occasion I remained awake four days and four nights, and then was put to sleep by repeated doses of morphine. My nervous system became so shattered that words spoken by any person in my room fell like pebbles on my brain; and nights I would often have to be raised in bed to prevent smothering to death. It is impossible for me to describe my sufferings at that time but I know that if it had not been for Dr. Pierce's Favorite Prescription I would to-day have been in my grave. I began the use of the "Favorite Prescription" in March--three years ago, as well as I can remember. Continued till summer when I wrote to you--received your advice and a few simple prescriptions which I had filled at the drug store. I also began the use of the "Golden Medical Discovery." My nerves became quiet: I slept well; my stomach began to heal; my strength returned and I began to feel like a new person. And, to-day, while I am not as strong as the strongest, I can do any kind of work that other women do, and each season I can say I am stronger than I was the last. I used thirty bottles of your medicines. Some may say that was a great deal, but I will never regret the money and patience it took to cure me. It has enabled me to once more enter school where I am trying to make up for those lost years of my life, and as I join the girls in their romps, I can say that "life is now sweet." Any one desiring particulars may address me. Respectfully, MISS LUCY MOYERS, Kelso, Lincoln Co., Tenn. NERVOUS EXHAUSTION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: W.H. Keesler, Esq.] _Gentlemen_--I was thought to be beyond all help and had but very little hope myself, but at the urgent entreaty of my wife I let her write to you for me and began taking special treatment from you. I could eat but very little and could keep nothing on my stomach, and was vomiting up bile once or twice every day; muscles all gone and too weak to get about. But to-day I think I am a sound healthy man. I owe it all to your treatment, and a loving Saviour who blessed the means in your hands to the healing of this body of mine. And I gladly recommend the sick and suffering to try Dr. Pierce, and pray God to bless you and your work. Yours respectfully, W.H. KEESLER, P.O. Box 185, Harriman, Roane Co., Tenn. NERVOUS EXHAUSTION. Farina, Fayette Co., Ill. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--It gives me great pleasure to add my testimony to that of many others in behalf of the great success of your Institution. I had been breaking in general health for years and had got so that I could not properly attend to my business. Was very forgetful and easily irritated and excited, and was unable to attend to my business a good part of my time. I doctored with country and city M.D.'s., and took patent medicine, but without any permanent good. I was induced to write to you, which resulted in my taking about one and one-half months' treatment from you, when I felt so much better that I discontinued the treatment. For the last six months I have felt like my old natural self again, and am able to attend strictly to business all the time for which I am very thankful. Yours truly, C.H. West. KIND WORDS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J. Hurst, Esq.] _Gentlemen_--Having spent four weeks in your Institution, it gives me great pleasure to state that during that time I received the most courteous and faithful care and treatment, and I bear willing testimony to the skill and ability of the surgeons and the faithful care of the nurses. Wishing you continued success, I recommend all persons suffering from chronic diseases to give you a trial. Respectfully yours, JOHN HURST, Marquette, Bighorn Co., Wyo. SICK HEADACHE, GENERAL DEBILITY, MALARIA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. J.H. Lansing.] _Gentlemen_--I am happy to say that your valuable medicine has been a great benefit to me. I was suffering from general debility, malaria and nervous sick headaches, and after my third child was born (a beautiful baby boy of ten pounds) I only recovered after a long illness; I barely gained strength enough in two years time so that I was able to crawl about to accomplish the little housework that I had, by lying down to read many times each day; had sick headaches very often; and many pains and aches, all the time complaining of getting no better. I finally asked my husband to get a bottle of Dr. Pierce's Favorite Prescription, which he promptly did. After I had taken one bottle I could see a great change in my strength, and fewer sick headaches. I continued taking the medicine until I had taken eight bottles--seven of the "Favorite Prescription" and one of the "Golden Medical Discovery." For some time past I have not used it, but I am now able to do the housework for myself, husband and two children (aged nine and five years). I also take in dressmaking, and enjoy walking a mile at a time, and I think it Is all due to the medicine, for I know I was only failing fast before I commenced to take it. I take great pleasure in recommending the "Favorite Prescription" to all women who suffer from debility and sick headache. Respectfully yours, MRS. J.H. LANSING, Fort Edward, Washington Co., N.Y. HEADACHE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: E. Vargason, Esq.] _Gentlemen_--I have used your medicines for a number of years, and know that they do for me all that is claimed for them. I am employed mostly at my desk, and not infrequently have an attack of the headache. It usually comes on in the forenoon. At my dinner I eat my regular meal, and take one or two of Doctor Pierce's Pleasant Pellets immediately after, and in the course of an hour my headache is cured and no bad effects. I feel better every way for having taken them--not worse, as is usual after taking other kinds of pills. Your "Pleasant Pellets" are worth more than their weight in gold, if for nothing else than to cure headache. Very respectfully, E. VARGASON, Otter Lake, Lapeer Co., Mich. HEADACHE AND CONSTIPATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss Wolfe.] _Gentlemen_--I suffered from loss of appetite, constipation, neuralgia, and great weakness, and had terrible attacks of sick headache very frequently; also nose bleed. My health was so poor that I was not able to go to school for two years. I took Dr. Pierce's Pleasant Pellets and "Golden Medical Discovery," and in a short time I was strong and well. Many friends are taking your medicines seeing what they have done for me. Respectfully yours, Miss BERTHA WOLFE, Markham, Cattaraugus Co., N.Y. TERRIBLE PAIN IN HEAD AND FAINTING SPELLS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Jacobs.] _Gentlemen_--When I commenced taking your medicine I was very sickly. I had frequent spells of fainting, terrible pain in my head, and life was a burden to me. I was attended by one of the best physicians in our town, but with no good results. At last a neighbor advised me to try Dr. Pierce's Favorite Prescription, which I did, and after taking one bottle I felt greatly benefited. I would advise all ladies similarly afflicted to try "Favorite Prescription." Yours truly, MRS. SAMUEL A. JACOBS, Mechanicsburgh, Cumberland Co., Penn. SICK HEADACHE, BOILS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.: [Illustration: Wm. Ramich, Esq.] _Gentlemen_--I was troubled with boils for thirty years. Four years ago I was so afflicted with them that I could not walk. I bought Dr. Pierce's Pleasant Pellets, and took one "Pellet" after each meal. The boils soon disappeared and have had none since. I have also been troubled with sick headache. When I feel the headache coming on, I take one or two "Pellets," and am relieved of it. Respectfully yours, WILLIAM RAMICH, Minden, Kearney Co., Neb. SICK HEADACHE. WORLD'S DISPENSARY MEDICAL ASSOCIATION. Lt'd: [Illustration: Mrs. Baker.] _Gentlemen_--Having suffered several years with very bad bilious attacks and all kinds of headaches, I tried different kinds of medicines but found nothing to cure me. Having read about Dr. Pierce's Pleasant Pellets, I commenced taking them. Before I had finished one phial I found benefit; they have done me great good. I have recommended them to all my friends and will continue to do so where I have the chance. Yours truly, MRS. JAMES BAKER, Furneaux, Pelham, Nr. Buntingford, Herts. OBSTINATE NEURALGIA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main St., Buffalo, N.Y.: [Illustration: A. Habenicht, Esq.] _Gentlemen_--This is to certify that I had the neuralgia several years, and was not able to perform labor nor attend to business. I was induced to try your medicines, which I took and they effected a permanent cure. I am now well and hearty, and able to do a good day's work, and weigh one hundred and eighty pounds,--and thanks to you for it. I used your medicines three months and was cured. Yours truly, AUGUST HABENICHT, Fort Pierce, Brevard Co., Fla. PARALYSIS AND UTERINE DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 603 Main St., Buffalo, N.Y.: [Illustration: Mrs. Mann.] _Gentlemen_--I will say that your Institute is all that you claim for it, and more too. The Doctors are courteous gentlemen and the best Physicians I have ever met with in my life. My treatment while at the Institute did me more good in one month than all the doctors everywhere else combined. My ailment was Paralysis and Female Weakness. Your treatment did me good while at the Institute, and I have also been greatly benefited by the home-treatment I have received from you since. I am much better than I was; I am able to do considerable work now. When I came to you I could not do anything. I herewith send you my heartfelt thanks for all you have done for me, and should I need more treatment I will write you as before. I would advise all people who have chronic diseases to go to the Invalids' Hotel and Surgical Institute for help, for it is a grand place and prices are reasonable. We use your Family Medicines--your "Pellets" and Golden Medical Discovery--and find they are all you claim for them. Again I thank you and remain, your friend, MRS. S.B. MANN, Sutton, Clay Co., Neb. PARTIAL PARALYSIS FROM UTERINE DISEASE. Buffalo, La Rue County, Ky. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I am still having very good health. I value Dr. Pierce's Golden Medical Discovery and his "Favorite Prescription" very highly and often recommend them to others. I do not think I would ever have got well if it had not been for your medicines. I was in a sad condition. My bowels and half of my body (the left side), was nearly paralyzed, besides nearly my whole system was out of order. I suffered all the time; but after taking six bottles of "Golden Medical Discovery" and the same of "Favorite Prescription," and using two bottles of Sage's Catarrh Remedy as an injection, I felt like a new person. I have never seen anyone suffering in the same way as I did. If anyone with female trouble of any kind will use your medicines I am satisfied they will help them. Yours truly, Mary A. Sallee. LOCOMOTOR ATAXIA. SPECIAL TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Ltd., No. 3 New Oxford Street, London, W.C.: [Illustration: C.F.G. Castleman, Esq.] _Gentlemen_--In the latter part of 1890, I was struck down with that terrible--and by many members of the medical profession pronounced to be, incurable disease, locomotor ataxia. My family doctor declared that nothing could be done for me, but for the sake of satisfaction advised me to go to London, and see an expert, whom he named. I did so, with the result of being told as above. This was in November, 1890. The symptoms were first numbness in hands and feet, which soon extended as far as the thighs, joined with the most intense feeling of cold that it can be possible to imagine. For six months I felt as though I had stood in ice up to my thighs. I soon became unable to walk or to stand, and crawled up stairs on my hands and knees, I thought for the last time, as I then thought I should die. Stomach troubles then set in, and for more than three months, I endured the utmost agony. Night and day sweats absorbed my little remaining strength, and I became helpless. I had taken leave of my family, not expecting to last the day out, when I was seen by a young doctor, who is fast becoming an eminent man, who said he thought he could alleviate my sufferings--though he did not expect to cure me. He commenced to treat me, and in about one month I began to improve, though very slowly. This was in February, 1891, and before the end of the year I was able to walk down stairs again. It was in March, 1892, that I began taking Dr. Pierce's Golden Medical Discovery, and on sending to you for a bottle in reply to your inquiry, I began your special treatment, with the happy result that I gradually improved in health and strength; and on the 26th of October, 1892, I was able to call on you in London, and you advised me to continue your treatment, and use a battery as well, which I did until April, 1893, when I could walk about quite nicely, and I now enjoy better health than for the past eight years. I am thankful too, that my eldest daughter has derived the greatest benefit from Dr. Pierce's Favorite Prescription. She took it for painful menstruation, and is now well and healthy. I am Yours very truly, C.F. GOODWIN CASTLEMAN, Bursledon, Southampton, England. PARALYSIS, NERVOUS PROSTRATION, ETC. From the records of the WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: F.M. Brasher, Esq.] This gentlemen had a severe attack of grip in January, 1890. His health gradually declined until June, at which time he was taken very much worse. Had nervous shocks three or four times a day. Slight paralysis of lower limbs. Respiration and pulse slow and irregular. Bowels constipated and tongue coated. Indigestion. Ringing in the ears. Legs wasting. Dimness of vision. Lost flesh rapidly and reduced to "skin I and bones." Chills and sweats; dizzy. Had great distress in bowels. Pain about the heart. Had been confined to his bed 46 days, at the time the case was submitted to us. We sent only one month's course of special medicines. He writes us afterwards: "I am at regular farm work, after my doctor here having told me that I must die and that Dr. Pierce was a gigantic humbug." Yours truly, F.M. BRASHER, Homer, Logan Co., Ky. EPILEPTIC "FITS." WORLD'S DISPENSARY MEDICAL ASSOCIATION, No. 663 Main St., Buffalo, N.Y.: [Illustration: Miss Swinehart.] _Gentlemen_--My daughter, Sadie, is eighteen years old; has been afflicted with that dreaded disease, Epilepsy, for fourteen years. She received treatment from seven different doctors without any material benefit. She has only had one spasm after commencing with your treatment, now almost two years. Three boxes of epilepsy medicine, followed up with your "Favorite Prescription" cured her. She took about six months' treatment in all. This places us under a world of obligation to you as the instrument of our great relief under a kind Providence. Should there be any signs of it returning we would with unshaken faith send for more medicine. You can use her or my signature as you wish. Yours truly, GEORGE SWINEHART, Lake, Stark Co., Ohio. EPILEPSY. CURED BY SPECIAL TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Ltd., No. 3 New Oxford St., London.: [Illustration: G.H. Plumbstead, Esq.] _Gentlemen_--I have great pleasure in announcing to you my heartfelt thanks for the benefit derived from your treatment, having suffered from epileptic fits for six years. I have experienced as many as five and seven fits a day, some lasting two hours at a time. I am glad to say since trying your medicine which is now five months, I have not had one. Thanking you for your kindness. Gratefully yours, GEO. HERBERT PLUMSTEAD, 67 Fishgate Street, St. Edmunds, Norwich, England. SPASMS OR FITS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: Master Johnnie Maxwell] _Gentlemen_--I desire to express my gratitude for the wonderful results of your treatment with my little son John. He was very bad, as we thought, for the physician could do nothing for him any more, and I got discouraged and went to my daughter, Mrs. D.T. Knappenberger, of Jeannette, Pa., (who has been a terrible invalid and was cured at your Institute), for advice. 'Oh, father,' she said, 'don't doctor here, but go to Dr. Pierce. So the result was I gave her money and she sent for medicines. You sent two bottles of medicine and he never has taken a drop since and is perfectly well and never had a spell since. I do not know what you call the disease, but we called it spasms or fits. With my experience I can heartily recommend the Invalids' Hotel, and think if a case can be cured at all, you can cure it. And unless they can cure or greatly benefit the patient, they will not undertake it; this is my experience with the World's Dispensary. My daughter, Mrs. D.T. Knappenberger, and my son Johnnie, feel very grateful toward the Dispensary for their cure. Yours truly, D.A. MAXWELL, Greensburgh, Westmorland Co., Pa. EPILEPSY, "FITS." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss McCarty.] _Gentlemen_--My little girl was delicate from birth, nervous and irritable. When three and one-half years old we discovered she had that terrible disease "epilepsy," inherited from her father's family; she had spasms or fits once in two or three days, and grew worse so rapidly that in four months she had from four to eight fits in twenty-four hours. Home physicians did no good, and just then one of your little pamphlets came to me as they had come often before. As my need was great I wrote a description of her case, and though your answer did not seem very encouraging, I did not dare to lose any chance of saving my child, so I commenced the treatment. On November 6, 1891, she had seven fits; November 7th gave her your medicines; she had four fits that day, and never one since. She took your medicines less than four months. She is nearly six years old, a strong, hearty, bright child, attending school every day. What more can I say than that I thank Dr. Pierce and the Faculty of the World's Dispensary Medical Association for having saved the life of my child, and I thank God that he gave them the knowledge and skill to do so. Respectfully yours, MRS. J. MCCARTY, Gouldsville, Washington Co., Vt. ST. VITUS'S DANCE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Master Ira D. Ponsler.] _Gentlemen_--My boy had been in bad health for a long time. We called our home doctor, but he got no better. Finally he had the St. Vitus's Dance, and our doctor did not know what to do. So I wrote to you and did as you told me; I got two bottles of your "Favorite Prescription," and one bottle and a half did the work all right. At that time, eighteen months ago, his weight was 85 pounds, now it is 135 to 140; he is fourteen years old. Yours truly, JEREMIAH PONSLER, Zenas, Jennings County, Ind. EPILEPSY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss Thulin.] _Gentlemen_--My daughter, Josephine E. Thulin, is now six and a half years old. She had been afflicted with epilepsy for three and a half years, and received treatment from three different doctors, and from one especially, for the space of two years steady, without any benefit. Before taking your treatment she had as many as six or seven spells a day. The child could not have stood it much longer. After taking your treatment one month the spells stopped. With four months' special treatment from you, and two months' use of Dr. Pierce's Favorite Prescription she was entirely cured. In one year and three months she has not had a drop of medicine, and she is in the best of health and vigor. I would say to any sufferer from obstinate or chronic disease, and especially epilepsy, that we have a living witness. You can come and see for yourself that the doctors connected with the World's Dispensary Medical Association _do_ understand how to prescribe. You can use this as a testimonial from me, of what you have done for us. I remain, Yours truly, JOHN THULIN, (for daughter,) Kearney, Buffalo Co., Nebr. A STRONG ENDORSEMENT. [Illustration: H.E. Bankston, Esq.] _To whom it may concern_: This is to certify that I took treatment at the Invalids' Hotel and Surgical Institute, Buffalo, N.Y., and I was cured of a chronic trouble that had been maltreated by other physicians. While there I saw a man who had been cured by the specialists, who had before been given up to die by the best doctors in Troy, N.Y. Of course, the case must have been a very stubborn one. I afterwards saw a man here, in Georgia, die, who, if he had been in Pierce's Surgical Institute under the treatment and care of his skilled doctors and nurses, I know would have most assuredly got well. Why? Because it was only a case of _stone in the bladder_, and they are easily cured at Dr. Pierce's Surgical Institute. I think almost any chronic disease can be cured there, if taken in time, judging from my observations while an inmate of that Institution. H.E. BANKSTON, Barnesville, Pike Co., Ga. COMPLICATION OF DISEASES. [Illustration: A. Holes, Esq.] Without solicitude or hope of pecuniary reward, with heart-felt gratitude and a desire to aid my fellow-man to health and happiness, allow me to state, that as an inmate for more than a month of the Invalids' Hotel and Surgical Institute at No. 663 Main Street, Buffalo, N.Y., I feel warranted in its highest recommendation. While there I saw and talked with a groat number of people who came there as a last resort, to be cured of almost every chronic disease to which flesh is heir, and they were unanimous in their praise of the Institution and the skilled specialists who constitute its professional staff. ANDREW HOLES, Moorhead, Minn. * * * * * [Illustration: OUTLINE OF THE FEMALE URINARY AND GENERATIVE ORGANS. The above cut is introduced here to assist in conveying a correct idea of the Urinary and Generative Organs of Woman, their form and relative positions, together with the bones, muscles and other tissues forming the cavity of the pelvis in which the organs rest, and by which they are protected. By dividing that portion of the body directly through the middle from before backward, we first cut through the cushion of fat (mons veneris) covering the pubic bone, then in succession the bone, bladder, womb, vagina, rectum, front half of spine, spinal marrow, rear half of spine, and lastly the muscles and skin. Just underneath the bone in front is revealed that sensitive organ, the clitoris, a facsimile of the male organ in miniature, the head of which protrudes, while the body is covered with tissue, but is readily traced with the finger. Further back is the urethra, or water passage, which is one and a half inches long. Next is the vagina. When closed, its mucous lining is folded in upon itself, and requires dilating in order to be cleansed and to apply remedies. On the vagina rests the hollow, pear-shaped womb, the small end of which protrudes into the vagina, and in which is a small opening, leading through the neck into the cavity of the organ. On either side of the womb, near its top, are the Fallopian tubes leading to the ovaries, situated between the womb and hip bones. At every menstruation these organs throw off a germ-cell, which passes through the Fallopian tubes into the uterine cavity.] THE DOOR OF LIFE. [Illustration] The fear of pain and the dangers of childbirth fill many a woman's breast with dismay. In the olden days of leeches and witchcraft, it was considered sacrilegious to lessen the pains of labor. Latterly, anæsthetics have been used at the time of parturition, and now people are beginning to find out that pain and danger can be almost wholly avoided. Proper preparation during gestation will make both as rare as they used to be common. There is no reason why childbirth should be fraught with danger and distress. It is a perfectly natural function, and should be performed in a natural way without undue suffering. Nature never intended that women should be tortured when doing the one thing which makes them wholly womanly. The perversion of nature's laws has brought this suffering about, and a return to right living will stop it. Nine out of ten women are troubled more or less by weakness and diseases peculiar to their sex. It is so because they do not take proper care of themselves--because they neglect little ills and little precautions. A woman in perfectly hearty health goes through her time of trial with comparative ease. The thing to do then, is to make all pregnant women healthy--to strengthen them generally and locally. The medicine and tonic to do it with is Dr. Pierce's Favorite Prescription. It is a powerful invigorant and nervine. It soothes and strengthens the nerves and acts directly on the feminine organism in a way which fits it for the proper and regular performance of all its functions at ill times. Taken during gestation it robs childbirth of its dangers to both mother and child, by preparing the system for delivery, thereby shortening labor, lessening pain and abbreviating the period of confinement. The Favorite Prescription also promotes the secretion of an abundance of nourishment for the child, if taken after confinement, besides building up the mother's strength and making her recovery more perfect. ABORTION. (MISCARRIAGE.) The term _abortion_ is used to denote the premature expulsion of the foetus. If the expulsion takes place within four months after impregnation, it is termed _abortion_; if between the fourth and seventh month, _miscarriage_; if after the seventh month, but before the completion of the full period of gestation, _premature labor_. Abortion may be due to those agents which act directly upon the uterus and cause the expulsion of the foetus; to those which occasion the death of the foetus, thereby effecting its ejection; and it may be _criminal_, that is, produced intentionally by direct agencies intended for that purpose. SYMPTOMS. The premonitory symptoms are pain in the loins and lower part of the back, a dull pain in the abdomen and thighs, nausea, chills, and palpitation. The membranes and blood-vessels of the uterus become lacerated, causing profuse hemorrhage. The discharge of blood from the vagina is sometimes attended with excessive pain. THE CAUSES which act directly upon the uterus to produce abortion may be violent exercise, lifting, accidents, or injuries from blows or falls. Nervous susceptibilities, a plethoric condition of the system, anæmia, exhaustive discharges, use of improper food, uterine displacements, congestion caused by excessive sexual excitement, general debility or muscular irritability, which is sometimes so great as to produce contractility of the uterus before the term of pregnancy is completed, inflammation of the cervix, ulcerations of the uterus, or any previously existing disease may produce abortion. When it has once taken place, it is apt to recur at about the same time in subsequent pregnancies. The death of the foetus may be occasioned by a diseased condition of the embryo, amnion, or placenta, and also by convulsions or peritoneal inflammation. CRIMINAL ABORTION is secretly practiced by women who desire to rid themselves of the evidence of immorality, and by those in wedlock who wish to avoid the care and responsibility of rearing offspring. Statistics show that it is very prevalent, undermining the health of women and corrupting the morals of society. We cannot pass over this subject in silence. Those who frustrate the processes of nature by violating the laws of life incur just penalties. All the functions of life and body are vitally concerned in reproduction. Any infraction of the Divine law, "Thou shalt not kill," is inevitably followed by punishment. The obligations to nature cannot be evaded without inevitable penal effects. Furthermore, all such transgressors carry with them the consciousness of guilt and the feeling of secret woe. "O God! that horrid, horrid dream Besets me now awake! Again, again, with dizzy brain. The human life I take, And my red right hand grows raging hot, Like Cranmer's at the stake."--HOOD. What shall we say concerning abortionists, men and women who are willing to engage in the murder of innocents for pay? True, there may be circumstances in which it is not right to continue in the pregnant condition, such as when the children of an unfortunate marriage are idiots, or the pelvis of the woman is so deformed that she cannot bear a living child. All such cases should be submitted to the _family_ physician, who ought to be made acquainted with all the circumstances and facts relating to the case, when he can summon other physicians for counsel, and their deliberations may determine the propriety or necessity of bringing on an abortion. Parties have written to us and others have made personal application under circumstances when it might have been right for their _family physician_ to have induced abortion. We wish to have it distinctly understood that we will not under any circumstances prescribe medicines or perform any operation to relieve women of pregnancy. Mechanical means are resorted to by abortionists, and many women produce abortion upon themselves. It always terminates in lasting injury and sometimes in speedy death. Certain medicines will sometimes produce abortion but they are very unsafe. An opinion is very prevalent that if abortion be produced before the movements of the foetus are felt, there is no crime committed. It should be remembered that _life begins with conception_, and, at whatever period of pregnancy abortion is committed, _life is destroyed_. Whoever disobeys the Divine injunction cannot escape his own consciousness of the deed, and the anguish and bitter remorse which ever after disturb the soul. TREATMENT. In threatened abortion, there is pain in the back or lower part of the abdomen, and later some flow of blood. The first object is to obtain perfect rest and quiet, and assume the recumbent position. By lying down, the blood will be more easily diverted to the surface of the body. Gallic acid, in doses of five grains every two or three hours, is often a valuable agent to arrest the hemorrhage, but opium in some form should be relied upon principally. A Dover's powder, ten grains, may be administered, to assist in determining the blood to the surface and extremities of the body and to allay irritation. The room should be cool, the patient should lie on a hard bed, and all company should be avoided, for excitement favors abortion. If the flow of blood equals a gill in amount, there is little hope of preventing abortion, and the treatment of the case should be entrusted to the family physician. * * * * * WOMAN AND HER DISEASES. An imaginative poet avers that woman is the link connecting Heaven and earth. True it is, we see in her the embodiment of purity and heavenly graces, the most perfect combination of modesty, devotion, patience, affection, gratitude and loveliness, and the perfection of physical beauty. We watch with deep interest the steady and gradual development from girlhood to womanhood, when the whole person improves in grace and elegance, the voice becomes more sonorous and melodious, and the angles and curvatures of her contour become more rounded and amplified, preparatory for her high and holy mission. The uterus, or womb, and ovaries, with which her whole system is in intimate sympathy, render her doubly susceptible to injurious influences and a resulting series of diseases, from which the other sex is entirely exempt. By their sympathetic connections they wield a modifying influence over all the other functions of the system. Physically and mentally, woman is man modified, perfected,--the last and crowning handiwork of God. When, therefore, this structure so wonderfully endowed, so exquisitely wrought, and performing the most delicate and sacred functions which God has ever entrusted to a created being, is disturbed by disease, when the nicely-adjusted balance of her complex nature deviates from its true and intended poise, the most efficient aid should be extended, in order that the normal equilibrium may be regained, her health restored, and her divine mission, on which human welfare so largely depends, be fulfilled. Its importance should elicit the best efforts of the highest type of mind, the ripe development of genius, and the most scientific administration of the choicest, rarest, and purest medicinal elements in the whole range of nature. A VAST EXPERIENCE. As the remedial management of diseases of women has, for many years, entered very largely into our practice at the Invalids' Hotel and Surgical Institute, located at 663 Main Street, Buffalo, N.Y., comprising the treatment of many thousands of cases annually, we have been afforded great experience in perfecting and adapting remedies for their cure, enabling us to meet their requirements with increased _certainty_ and _exactness_. TREATING THE WRONG DISEASE. Our improved and perfected system of diagnosing, or determining, the _exact_ nature and extent of chronic affections, which, in most cases, we are able to do at a distance, and without a personal examination of the patient, as will be more particularly explained in the appendix, or latter part of this little book, has enabled us to avoid the blunders so often committed by the general practitioner, who not infrequently treats those afflicted with chronic ailments peculiar to women, for long weeks, and perhaps months, without ever discovering their real and true disease, or condition. Thus, invalid women are often uselessly subjected to treatment for dyspepsia, heart disease, liver or kidney affections, sick headaches, and various aches and pains, as if they were _primary_ diseases, when in reality, they are only so many local manifestations, or _symptoms_, of some overlooked derangement, or disease, of the womb. For, as we have already intimated, every organ of the system is in _intimate_ sympathy with the uterus, or womb. Any disease, either functional or organic, of this organ, is at once manifest through several, if not all, the sympathizing organs of the system. When we receive a sharp blow upon the elbow, the pain is felt most keenly in our little finger. Just so in diseases of the womb; often the most distress is felt in organs or parts of the system quite distant from the real seat of disease. On this account, thoughtless, easy-going and ignorant physicians are misled, and very commonly mistake the invalid's disease for some affection of the stomach, heart, liver, kidneys, or other organ, when really it is located in the uterus. Cure the disease of the womb, and all these disagreeable manifestations, or symptoms, vanish. Their cause being removed, the various dependent derangements, and disagreeable nervous sensations and sufferings rapidly give way, and vigorous health is firmly re-established. TIME AND PERSEVERANCE IN TREATMENT REQUIRED TO CURE. Most chronic diseases of women are slow in their inception, or development, and their removal or cure must necessarily be gradual. Disease that has been progressing and becoming more firmly established for months, or perhaps years, cannot, except in rare cases, be hastily dislodged, and the system restored to perfect health. The process of cure, like the development and progress of the disease, must be a gradual one, accomplished step by step. Often, too, the use of medicines that, if _persisted_ in, will prove beneficial and curative, will, for a considerable time, arouse in the system very disagreeable sensations, and many times this leads unthinking persons to become frightened or discouraged, and to quit the treatment best adapted to their cases if only faithfully carried out. In many forms of womb disease, their are organic lesions or changes, that can be repaired only by a gradual process, just as an external wound would heal,--not suddenly, but by a constant, slow filling in and building up, or by the gradual development or growth of one cell upon another. Just as a great breach in a wall would be repaired by filling in brick upon brick, until the defect is effaced, so must these lesion's be removed by gradual processes. When fully repaired, the dependent, sympathetic derangements, disagreeable sensations, and all the long train of consequential symptoms are, one by one, abolished. NOT LIMITED IN OUR REMEDIAL RESOURCES. It should be borne in mind that, while we recommend, in this little volume, certain courses of treatment for ordinary cases, the remedies mentioned do not by any means embrace all our resources in the way of medicines and other curative agencies, especially for complicated, difficult, or very obstinate cases. In many of the latter class we can send medicines that are exactly adapted to the case, if the invalid will fill out one of our "Applications for Treatment," which may be found folded in the latter part of this book, or which will be sent to any address, on application, by mail. In most womb diseases, the chemical and microscopical examination of the urine also furnishes valuable aid in determining the exact condition of the patient, as well as the precise stage of the local organic disease. Full directions for putting up and sending such samples may be found in the "Appendix" of this little volume. Every case submitted to us, either by letter or in person, receives the careful and deliberate consideration of a full Council of specialists before a decision as to the nature of the malady, or the proper course of treatment to be employed, is determined upon. The great advantage of this system of practice must be obvious to every intelligent, thoughtful person. No experimenting is ever resorted to. The treatment is _specially_ and _exactly_ adapted to each individual case, which requires such judgment, skill, and nicety of discrimination, as has only been acquired by our specialists through long and diligent study, and an experience embracing the treatment annually of many thousands of cases of those chronic diseases which are peculiar to women. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main Street, Buffalo, N.Y. * * * * * MENSTRUATION AND ITS DISORDERS. The function of the ovaries is to furnish ova or germs, and the functions of the uterus or womb are to secrete mucus; to exude the menses; to secrete the decidua; to contain and nourish the foetus and to effect its expulsion. Menstruation, or the menses, monthly visitation, catamenia, menstrual flow, courses, or periods, usually makes its appearance in the female between the twelfth and fifteenth years, at which time the reproductive system undergoes remarkable changes. A marked characteristic of menstruation is its regular return about every twenty-eight days. The menstrual flow usually continues from three to six days, and the discharge seems to be ordinary blood, which, during its vaginal passage, becomes mixed with mucus, and is thereby deprived of the power of coagulation. The quantity exuded varies from two to eight ounces, but the amount consistent with the health of one person, may be excessive and weakening in another. This function is regarded as "being regular when its effect upon the system is favorable, for whatever organic process directly contributes to the health should be considered as normal. It occurs at regular intervals for about thirty years, when menstruation and the aptitude for conception simultaneously cease. The departures from healthy menstruation are numerous. The most important of these are _amenorrhea, dysmenorrhea_, and _menorrhagia_. AMENORRHEA. The term _amenorrhea_ signifies the absence of menstruation when it should occur. It may be considered under two general heads: when it fails to be established at the proper age, and when, after having made its appearance, it ceases to return at the usual periods. The term _retention_ has been applied to the first, and that of _suppression_ to the latter. Menstruation may fail to be established in consequence of organic defects, or from some abnormal condition of the blood and nervous system. MALFORMATION OF THE VAGINA. Retention of the menses may result from malformation of the vaginal canal, which sometimes terminates before it reaches the womb, being simply a short, closed sac. If the uterus and ovaries are perfect, all the feminine characteristics are manifest, and a vaginal exploration discloses the nature of the difficulty. If, however, the sides of this passage adhere in consequence of previous inflammation, they may be carefully separated by a surgical operation, and this function restored. ABSENCE OR MALFORMATION OF THE WOMB. The uterus may be deformed or entirely absent, and yet there be an inclination, or symptoms indicative of an effort, to establish this function. The individual may be delicate in organization, graceful in bearing, refined and attractive in all feminine ways, and yet this organ may be so defective as to preclude the establishment of the menstrual function. Sometimes there is merely an occlusion of the _mouth_ of the uterus, the perforation of which removes all difficulty. In others, the _neck_ of the womb is filled with a morbid growth, or the walls of its canal are adherent, as the result of inflammation, and may be separated by a small silver or ivory probe, and the menses be thus liberated. IMPERFORATE HYMEN. The hymen is a circular, or semilunar membrane, which imperfectly closes the outer orifice of the vagina in the virgin. When of a semilunar shape, it usually occupies the lower or posterior portion of the canal, leaving an opening in the upper or anterior portion, varying from the size of a quill to that of a thimble, through which the menstrual fluid exudes. This membrane is usually ruptured and destroyed by the first sexual intercourse, and, hence, its presence has been considered evidence of virginity. Its absence, however, must not be considered a conclusive evidence of sexual intercourse, for, as Dr. Dunglison says, "many circumstances of an innocent character may occasion a rupture or destruction of this membrane. It is often absent in children soon after birth; while it may remain entire after copulation. Hence, the presence of the hymen does not _absolutely_ prove virginity; nor does its absence prove incontinence, although its presence would be _prima facie_ evidence of continence." Sometimes this membrane, when not imperforate, is so thick and strong as to render sexual intercourse impossible, and requires a cutting operation to open the vagina. Several such cases have been operated upon at the Invalids' Hotel and Surgical Institute. It occasionally happens that the hymen is entire, or imperforate, at birth. This may not be discovered before puberty. But when this period arrives and the menstrual discharge takes place into the vagina, the female will suffer from the retention and accumulation of this secretion, and ultimately a tumor or a protrusion of the membrane which closes the vagina will occur, giving rise to severe pain and other serious symptoms. The retained menstrual fluid, increasing in quantity at every monthly period, dilates the womb as well as the vagina, and even the Fallopian tubes become distended, presenting at length an urgent necessity for relief. TREATMENT. This condition admits of relief only by operative surgery. The operation consists in dividing the hymen by a crucial incision, thus allowing the accumulated fluid to be discharged, after which the vagina is cleansed by syringing it with warm water. ABSENCE OF THE OVARIES. Let us suppose the case of a young woman who has fully reached the period of puberty without having menstruated. All the organs which we have described, are manifestly developed, she is healthy, vigorous, robust, and able to exercise freely or to engage in laborious occupations. But we notice that her voice is not sweetly feminine, nor is her presence timid, tender, and winning; there is wanting that diffident sexual consciousness, which gently woos, and, at the same time, modestly repels, and tends to awaken interest, curiosity, and desire. Considering also that she has never manifested any inclination to menstruate, we are irresistibly led to the conclusion that the ovaries are wanting; the delicate mustache upon the upper lip, the undeveloped breasts, the coarse features, and her taste for masculine pursuits, all concur in this diagnosis. Thus we account for the harshness of the voice, fitted for command rather than to express the mellow, persuasive cadences of love. Such a malformation cannot be remedied. RETENTION AND SUPPRESSION FROM MORBID CONDITIONS OF THE BLOOD. Non-appearance, as well as suppression of the menses, may result from an abnormal state of the blood. The first condition which demands our attention under this head is _plethora_. In robust, plethoric females the menses are sometimes very tardy in their appearance, and every month the attempt to establish this function is attended with pain in the head, loins, and back, chilliness, nausea, and bloating of the abdomen. Sometimes there is intolerance of light or sound, and cerebral congestion, amounting almost to apoplectic symptoms. The pulse is full and strong, the blood abundant and surcharged with red corpuscles. Such persons may be accustomed to luxurious living, and there is evidently a predisposition to abnormal activity of the alimentary functions. TREATMENT. We may briefly suggest that such subjects should engage in laborious physical exercise in order to expend the surplus of vitality, and should lessen the daily amount of food taken, and use that which is light and unstimulating. We should also prevent the determination of blood to the head, by keeping it cool and the feet warm, and by increasing the flow of blood to the extremities. The volume of the circulation may be diminished by acting upon the natural outlets, such as the skin, kidneys, and bowels. The proper means and appliances for quickening the circulation of the blood are indicated, and friction upon the surface, bathing, the daily use of such cathartics as Dr. Pierce's Pleasant Pellets, and, finally, the use of some general uterine stimulant, such as Dr. Pierce's Favorite Prescription, will generally prove successful in cases of amenorrhea resulting from plethora. RETENTION AND SUPPRESSION FROM ANÆMIA. To describe the condition of the patient whose blood is low and deprived of the richness, warmth, and bloom, it once possessed when it kindled admiration and enthusiasm in others, is but to give a picture of a numerous class of female invalids. It is sad to see beauty fading, vigor waning, and Bright's disease or consumption slowly wasting the blood and consuming the vital cells, until the spirit can no longer dwell in its earthly abode and death claims the skeleton for dust. CHRONIC DECLINE, with its attendant anæmia, may be induced by bad habits, destitution, or constitutional depravity. Sickly forms, wrecks of health, address our senses on every side. All these subjects evidently once had a capital in life, sufficient, if properly and carefully husbanded, to comfortably afford them vital stamina and length of days. Alas! they have squandered their estate, perchance in idleness and luxurious living, or have wasted it in vanities or misdirected ambition. Having become bankrupts in health, there is necessarily a failure of the menstrual function, and then follows a _panic_. All the blame of the insolvency and general derangement, is unjustly attributed to the non-performance of the duties of the uterus. Thus, this organ is altogether _dependent_ Upon the general health for its functional ability, yet frequently treatment is instituted to compel menstruation, regardless of the condition of the system. Thus the enfeebled uterus is wrongfully held responsible for general disorder, because it ceases to act, when _by acting_ it would further deplete the blood and thus materially contribute to the already existing chronic decline. No matter what are the causes of this decline, whether they are the follies of fashion, the effect of indolence, debility in consequence of insufficient food, perversion of nutrition by irregular habits, lack of exercise, or the taking of drastic medicines, the result is anæmia and amenorrhea. TREATMENT. We would suggest in such cases a nutritious diet, increased exercise, cleanliness, regular habits, hard beds, and useful employment. The diet may be improved by animal broths, roasted meats, fresh beef, mutton, chicken, or eggs, and the dress should be comfortable, warm, and permit freedom of motion. The patient should indulge in amusing exercises, walking, swinging, riding, games of croquet, traveling, singing, percussing the expanded chest, or engage in healthful calisthenic exercises. The hygienic treatment of this form of amenorrhea, then, consists in physical culture, regular bathing, and the regulation of the bowels, if constipated, as suggested in this volume under the head of constipation. The _medical treatment_ should be directed to enriching the blood, improving nutrition, toning up the generative organs, and the health of the whole system. This requires the employment of uterine and general tonics, and Dr. Pierce's Favorite Prescription, which is sold by druggists, happily combines the properties required. It improves digestion, enriches the blood, exercises a tonic and gently stimulating effect upon the uterus and ovaries, and thus promotes the function of menstruation. It is not a strong emmenagogue, but operates slowly, yet surely, and in accordance with physiological laws, being eminently congenial in its effects upon the female system, and, hence, not liable to do harm. There is danger in employing active driving medicines, besides, no emmenagogue, however powerful, can establish the menstrual function so long as the system is in a debilitated condition and the blood reduced. The restorative effects of the "Favorite Prescription" should be secured by administering it regularly, in from one to two teaspoonful doses, three or four times a day, for several weeks, and as the system is built up and those symptoms appear which indicate a return of the menses, their visitation may be encouraged by the use of hot foot and sitz-baths, and free doses of Dr. Pierce's Compound Extract of Smart-weed. But the latter should only be used when symptoms of approaching menstruation are manifested. By following out this course of treatment, a soft flush will gradually take the place of the pallor of the cheeks, the appetite will return and the health will be restored. ACUTE SUPPRESSION OF THE MENSES may be caused by _strong emotions,_ as excessive joy, or by violent _excitement_ of the _propensities_, as intense anger, sudden fright, fear, or anxiety. Suppression may result from sudden exposure to cold, immersion of the hands or feet in cold water, drinking cold water when the body is heated, sitting on the cold ground or damp grass, or from a burn or wound. It is not uncommon for women to labor in the heated wash-room, pounding, rubbing, and wringing soiled linen, thereby overtaxing the delicate physical system. While feeling tired and jaded, all reeking in perspiration, they rinse and wring the clothes out of cold water and hang them upon the line with arms bare, when the atmosphere is so freezing that the garments stiffen before they finish this part of the task. Is it any wonder that acute suppressions occur or that inflammations set in? The symptoms which naturally follow are a quick pulse, hot skin, thirst, fever, headache, and dizziness, and the inflammation may locate in the ovaries, uterus, lungs, bowels, brain, or other parts. No matter what organs are attacked the menses are suppressed. The suppression can generally be attributed to an adequate cause, resulting in constitutional disturbance. The severity and duration of the attack and the power of the constitution to resist it, must determine the gravity of the consequences. TREATMENT. As acute suppression of the menses is due to derangement of the circulation of the blood, caused by taking cold, by violent excitement of the propensities or excessively strong emotional experience, the prominent indication is to secure its speedy equalization. Give a hot foot, a warm sitz, or the spirit vapor-bath and administer full doses of Dr. Pierce's Compound Extract of Smart-weed, to produce free perspiration. Dr. Eberle, a very celebrated medical author, says that he used the Extract of Smart-weed in twenty cases of amenorrhea, and affirms, "with no other remedy or mode of treatment have I been so successful as with this." Our experience in the use of the Extract has been equally satisfactory. Should this treatment not establish the function, Dr. Pierce's Favorite Prescription should be given three times a day until the system is invigorated, say for twenty-eight days, when the above course may be repeated, and generally with success. Should the case be complicated with inflammation of the lungs, brain, or other vital organs, manifesting alarming symptoms, the family physician should be called. The treatment should be active and suited to the indications of each particular case. When the disease becomes chronic, the active stage of symptoms having passed, and it continues to linger without making the desired improvement, all the means suggested for the treatment of suppression from anæmia should be employed. Their use will be followed by the most gratifying results. It should be borne in mind, however, that when we have suggested any treatment in this volume, it is generally such as the family may institute and apply, and does not, by any means, represent the variety or extent of the remedial resources which we employ when consulted in person or by letter. We refer our readers to only a few of the safe and reliable remedies which we have prepared and placed within their reach, and give them just such hygienic advice as we think will best serve their interests. * * * * * DYSMENORRHEA. (PAINFUL MENSTRUATION.) _Dysmenorrhea_, from its Greek derivation, signifies a _difficult monthly flow,_ and is applied to menstruation when that function becomes painful and difficult. Menstruation, like other healthy operations of the body, should be painless, but too frequently it is the case, that discomfort and distress commence twenty-four hours before the flow appears, and continue with increasing pain, sickness at the stomach, and vomiting, until the patient has to take to the bed. When the discharge does occur, speedy relief is sometimes obtained, and the patient suffers no more during that menstrual period. With others, the commencement of the function is painless, but from six to twenty-four hours after, the flow is arrested and the patient then experiences acute suffering. Pain may be felt in the back, loins, and down the thighs. Sometimes it is of a lancinating, neuralgic kind, at others, it is more like colic. Frequently the distress causes lassitude, fever, general uneasiness, and a sense of lethargy. There are those who suffer more or less during the entire period of the flow, while the distress of others terminates at the time when a membranous cast is expelled. For convenience of description, dysmenorrhea has been divided into the following varieties: _neuralgic, congestive, inflammatory, membranous_, and _obstructive_. _The neuralgic variety_ of dysmenorrhea, sometimes called _spasmodic_ or _idiopathic_, occurs when there is excessive sensibility of the ovaries and uterine nerves, which sympathetically _respond_, especially to cutaneous, biliary, and sexual irritation, and when ovarian or uterine irritation is communicated to distant nerve-centres. In the first class, usually comprising lean persons of an encephalic temperament, whatever disorders the functions of the general system, instantaneously reflects upon the ovaries and uterine nerves, and the menstrual function Is correspondingly disturbed, and, instead of being painless, the flow becomes spasmodic, with paroxysms of distress. In the second class, which includes those persons who are plethoric, the ovarian and uterine nerves seem to be the origin and centre of irritation, which is sometimes so severe as to cause indescribable pain. We have known women who affirmed that the severity of labor pains was not so great as that from this cause. In one instance, the subject suffered thus for eleven years, and then became a mother, and has ever asserted that her periodic suffering was far more intense than the pain experienced during her confinement. These neuralgic pains fly along the tracks of nerves to different organs, and capriciously dart from point to point with marvelous celerity, producing nausea, headache, and sometimes delirium. IN THE CONGESTIVE VARIETY of dysmenorrhea, the menstrual period may be ushered in without pain; after a few hours, the pulse becomes stronger and more rapid, the skin grows hot and dry, the menses stop, there is uneasiness, restlessness, and severe pelvic pains. Evidently, the mucous membranes of the Fallopian tubes and uterus have become congested, and the pain results from the arrest of the functional process, the exudation of blood. THE CAUSES are plethora, exposure to cold, excitement of the emotions or passions, and a morbid condition of the blood. Sometimes congestion arises in consequence of a displacement of the uterus. IN THE INFLAMMATORY VARIETY, the mucous membrane of the uterus is the seat of irritation. The blood flows into the capillary vessels in greater abundance than is natural, and those vessels become over-dilated and enfeebled and so altered in their sensibility as to produce local excitement and pain. It may be associated with inflammation of the ovaries, peritoneum, or bladder. Upon the return of the menses, there is a dull, heavy, fixed pain in the pelvis, which continues until the period is completed. There is generally tenderness of the uterus, and also leucorrhea during the intervals between each monthly flow. IN THE MEMBRANOUS VARIETY of dysmenorrhea, the entire mucous membrane which lines the cavity of the uterus, in consequence of some morbid process, is gradually detached and expelled at the menstrual period. SYMPTOMS. There are steady pains at the commencement of the menstrual flow, and they increase in violence and become decidedly expulsive. The mouth of the uterus gradually dilates, and finally, the membrane is forced out of the uterus, attended with a slight flow of blood and an entire subsidence of the pain. THE TREATMENT, in all the preceding varieties of dysmenorrhea, should consist of measures to determine the circulation of the blood to the surface, and increase the perspiratory functions. Congestion and inflammation of the internal organs are generally induced by exposure to cold or from insufficient clothing. Sometimes they follow from neglect of the skin, which is not kept clean and its excretory function encouraged by warm clothing. The domestic treatment at the monthly crisis should be commenced by the administration of hot foot, and sitz-baths, after which the patient should be warmly covered in bed, and bottles of hot water applied to the extremities, back, and thighs. Dr. Pierce's Compound Extract of Smart-weed should be given in full doses, frequently repeated, to secure its diaphoretic, emmenagogue, and anodyne effects, which, for this painful affection, is unsurpassed. For the radical cure of this disease, whether of a congestive, inflammatory, or neuralgic character, Dr. Pierce's Favorite Prescription, which is sold by druggists, is a pleasant and specific remedy, which will most speedily correct the abnormal condition that produces the trouble, and thereby obviate the necessity of passing this terrible ordeal at every monthly period. The patient should take two teaspoonfuls of the medicine three times a day, and keep up its use in these doses for weeks. Frequently, one month will suffice to cure, but in most cases, a longer season is required. In the end, the suffering patient will not be disappointed, but will become a new being, ready for the enjoyment and duties of life. The bowels should be kept regular throughout the treatment by the use of Dr. Pierce's Pleasant Pellets, if necessary. A hand or sponge-bath should be used daily to keep the skin active, and be followed by a brisk rubbing of the surface with a rough towel or flesh-brush. A wet sheet pack will cleanse the pores of the skin and invite the blood into the minute capillaries of the surface, and thus prove of great benefit. It should be repeated after an interval of seven days, but ought to be omitted if near the approach of a menstrual period. The clothing should be warm, to protect the system against changes of temperature; especially should every precaution be taken to keep the feet dry and warm. The patient should walk in the open air, and the distance should be regularly lengthened at each succeeding walk. If the course of treatment which we have suggested be faithfully pursued, a permanent cure will be effected. IN THE OBSTRUCTIVE VARIETY of dysmenorrhea, some organic impediment hinders the exit of the menstrual blood from the uterus, which, consequently, becomes distended and painful. The pain may be constant, but is most acute when the uterus makes spasmodic efforts to discharge the menstrual blood. If these efforts prove successful, there is an interval of relief. Flexion or version of the womb may produce partial occlusion of the canal of the neck of the uterus, thus preventing the free flow of the menstrual fluid through it. Tumors located in the body or neck of the uterus often cause obstruction to the free discharge of the menses. Imperforate hymen and vaginal stricture also sometimes cause obstruction and give rise to painful menstruation. As these several abnormal conditions and diseases will be treated of elsewhere in this volume, we omit their further consideration here. Partial adhesion of the walls of the neck of the womb may result from inflammation of the mucous lining, and prevent a free and easy exit of the menstrual fluid. In many cases, the contracted and narrowed condition of the canal of the cervix seems to be a congenital deformity, for we can trace it to no perceptible cause. It is also true that contraction and partial, or even complete, stricture of the cervix, or neck of the womb, often results from the improper application of strong caustics to this passage by incompetent and ignorant surgeons. Every person has observed the contraction of tissue caused by a severe burn, which often produces such a distortion of the injured part as to disfigure the body for life. A similar result is produced when the neck of the womb is burned with strong caustics. The tissues are destroyed, and, as the parts heal, the deeper-seated tissues firmly contract, forming a hard, unyielding cicatrix, thus constricting the neck of the womb, through which the menses pass into the vagina. [Illustration: Fig. 3. THE UTERINE DILATOR. This instrument is introduced into the canal of the uterine neck with its blades closed. By means of the thumb-screw the blades are then separated as shown in this illustration, the cervical canal being thereby dilated to the required extent.] TREATMENT. From the nature of this malady, it will readily be seen that no medical treatment can effect a radical cure. We must therefore resort to surgery. In a small proportion of cases, the stricture may be cured by repeated dilations of the constricted part of the cervical canal. This may be accomplished by using a very smooth probe which is fine at the point, but increases in size, so that its introduction will widen and expand the orifice and canal. The stricture may be overcome in many cases by using different sized probes. In some instances, we have employed the uterine dilator, represented by Fig. 3. We have also introduced sea-tangle and sponge tents into the neck of the womb, and allowed them to remain until they expanded by absorbing moisture from the surrounding tissues. The latter process is simple, and in many cases preferable. By means of a speculum (see Figs. 15 and 16), the mouth of the womb is brought into view, and the surgeon seizes a small tent with a pair of forceps and gently presses it into the neck of the womb, where it is left to expand and thus dilate the passage. If there seems to be a persistent disposition of the circular fibers of the cervix to contract, and thus close the canal, a surgical operation will be necessary to insure permanent relief. In performing this operation, we use a cutting instrument called the hysterotome (see Figs. 4 and 5). By the use of this instrument, the cervical canal is enlarged by an incision on either side. The operation is but slightly painful, and, in the hands of a competent surgeon, is perfectly safe. We have operated in a very large number of cases and have never known any alarming or dangerous symptoms to result. After the incision, a small roll of cotton, thoroughly saturated with glycerine, is applied to the incised parts, and a larger roll is introduced into the vagina. The second day after the operation, the cotton is removed, the edges of the wound separated by a uterine sound or probe, and a cotton tent introduced into the cervix, and allowed to remain, so that it will expand and thus open the wound to its full extent. This treatment must be thoroughly applied, and repeated every alternate day, until the incised parts are perfectly healed. [Illustration: Fig. 4. WHITE'S HYSTEROTOME. In operating, this instrument is introduced into the canal of the neck of the womb, when a thumb screw in the end of the handle is turned, by which a small blade is thrown out from each side, and as the instrument is withdrawn from the canal an incision is made on each side, thus enlarging the passage. The upper figure illustrates the instrument closed, ready for introduction; the lower one, with the blades projected for cutting.] Many times patients cannot understand why it is that the operation of cutting the constricted cervix causes no pain; they often being entirely unconscious of the making of the incision. The explanation is easy. The cervix uteri, or neck of the womb, is supplied with but few nerves of sensation, and is almost as destitute of sensation as the finger or toe nails, the paring of which causes not the slightest pain. On this account we never find it necessary to administer chloroform or any other anæsthetic when undertaking this operation. If the patient be extremely sensitive the application to the cervix of a weak solution of cocaine is quite sufficient to completely benumb or anesthetize the parts so as to entirely avoid all pain from the operation. [Illustration: Fig. 5. STOHLMAN'S HYSTEROTOME. This instrument has two cutting blades which shut past each other, as seen in the lower figure, so as not to cut when introduced into the canal of the uterine neck. After introduction, the cutting blades are separated, as shown in the upper figure, the extent of the incision being regulated by the thumb-screw attached to the handles, as represented in the lower figure.] * * * * * MENORRHAGIA. (PROFUSE MENSTRUATION.) The word _Menorrhagia_, which is of Greek derivation, literally means _monthly breaking away_, and is employed to designate profuse menstruation. This disorder must not be confounded with those hemorrhages which are not periodical, and which are due to other causes. The term _menhorrhagia_ is restricted to an immoderate monthly flow. The menstrual flow may occur too often, continue too long, or be too profuse. It induces a feeble pulse, cold extremities, weak respiration, general debility, and may occur in opposite states of the system, _i.e._, in women who have a plethoric and robust habit, or in those of flaccid muscles and bloodless features. When the menstrual discharge is natural, it is so gradual that by mixing with the vaginal secretions it is prevented from coagulating, while in this disease, clots are often formed. SYMPTOMS. In women of a _plethoric_ habit, it is ushered in by itching and heat in the vagina, pain and a feeling of weight in the loins and lower part of the abdomen, and, at times, the breasts become hot and painful. There is considerable thirst, headache, and giddiness. At last, the blood appears and flows profusely, and all the violent symptoms at once subside. The rest of the period is marked by an inordinate flow, leaving the system weak from the loss of blood. It oftener occurs, however, in persons who are naturally weak and delicate, in which case the periods are more frequent and continue longer, and after a time they are renewed by any bodily exertion or mental emotion, so that a constant drain exists. If the flow of blood is not continuous, leucorrhea intervenes. The patient gradually loses strength and becomes languid, her face is pale and usually bloated, livid circles appear around the eyes, the appetite is impaired, the bowels are constipated, and the feet and ankles swollen. Lack of blood in the brain is indicated by headache, ringing in the ears, and dizziness. The patient is nervous and irritable, being disturbed by the slightest noise, and the heart palpitates after the least exertion. CAUSES. The _first_ form is caused by eating too much rich and highly-seasoned food, drinking wine, porter, ale, or beer, want of exercise, in brief, whatever induces plethora; the _second_ results from an insufficient or poor diet, leucorrhea, frequent abortions, want of ventilation, inherent feebleness, and whatever depresses the vital powers. Either form may be due to syphilitic taints, excessive sexual indulgence, accidents of pregnancy, or organic diseases of the womb. The morbid affections of the womb most likely to induce menorrhagia, are granular ulceration of its mouth and neck, fungous degeneration of its lining membrane, and tumors within that organ. As these subjects will be severally considered hereafter, we shall here dismiss them with this brief notice. Profuse menstruation is very prone to occur in young women of a lymphatic temperament, whose organs are sleazy in texture. TREATMENT. To control the excessive flow, the patient should remain in her bed, and assume the recumbent position until the period is passed. If circumstances prevent strict compliance with this rule, it should be observed as nearly as possible. Warmth should be applied to the feet, and cold cloths, which ought to be removed as soon as they become warm by the heat of the body, should be repeatedly placed upon the back and abdomen. A strong tea made from cinnamon bark, or witch-hazel leaves or bark, taken freely, will prove very efficacious in checking the flow. The fluid extract of ergot, in doses of from half a teaspoonful to a teaspoonful, in a little water or cinnamon tea, is one of the most effectual remedies in this affection. Another valuable remedy for arresting menorrhagia is an infusion of Canada fleabane; or the oil of this plant may be administered in doses of from five to ten drops on sugar. Gallic acid is also a good styptic to employ in these cases. If there is febrile excitement, a hard pulse, frequent and throbbing, and if there is headache, thirst, parched lips, hot and dry skin, as is sometimes the case, then menorrhagia is due to an augmented action of the heart and arteries, and the indication of treatment is to diminish vascular action. This may be temporarily accomplished by the use of veratrum viride, which should be continued until the flow is sufficiently diminished. The means already suggested will generally prove effective in controlling the inordinate flow at the time. Treatment that will produce permanent relief should then be adopted. The condition of the skin, kidneys, and bowels, requires attention for noxious elements should not be retained in the system. To give tone to weakened pelvic organs we know of nothing more specific in its effects than Dr. Pierce's Favorite Prescription, which is sold by druggists. It should be taken continuously for weeks, in order to fully correct the extremely weakened condition of that organ. It also aids nutrition, and thus tones up the general system, so that in the form of profuse menstruation, resulting from debility, the patient is strengthened, her blood enriched, and her nervousness quieted, which constitutes the necessary treatment to make the cure permanent. As women approach the critical age, and menstruation ceases, if they are anæmic, their condition is pitiable. This period is popularly denominated the _turn of life_. Under favorable circumstances, the vitality is decidedly enhanced, and the decline of this function is attended with a revival of the bodily powers. But when this crisis has been preceded by excessive labor, when intemperance or excesses of any kind have deranged the bodily functions and perverted nutrition, when the mind has been long and deeply depressed, or when the insidious progress of disease of the heart, liver, or other Important organs, occurs in consequence of irregularities of living, then there is danger of congestion of the uterus and a protracted and profuse menstrual flow, which favors a decline. The treatment of this form of menorrhagia does not differ from that already suggested. The diet should be light and nourishing, and daily exercise, such as walking, riding, change of air and scenery, all will contribute to restoration. Especial attention should be directed to the condition of the bowels and liver. If the latter be deranged, Dr. Pierce's Golden Medical Discovery will be a most efficacious remedy. When there is a diminution of vital force, resulting in impaired nutrition and disorders of blood, an alterative is required which will insensibly and gradually restore activity by removing the causes of derangement. Impairment of nutrition is very frequently associated with functional or organic disease of the liver, and curative measures consist of the use of alteratives, friction baths, exercise, nutritive diet, and diversion of the mind. Whenever innutrition depends upon deprivation of the blood or torpor of any of the secretory organs, the "Golden Medical Discovery" will prove to be an invaluable remedial agent, for it is an alterative and at the same time a blood restorative. If the bowels be costive small laxative doses of Dr. Pierce's Pleasant Pellets should be employed. The "Favorite Prescription" regulates the menstrual function by toning up the tissues of the uterus and restraining the escape of the menses from the orifices of the blood-vessels. While the diet should be nourishing, consisting of wild game, mutton, chicken, and wine, the patient ought not to debilitate the stomach by the use of strong tea or coffee. The circulation of the blood should be quickened by riding, walking, exposure to sunlight, and fresh air. The patient ought to engage in some light occupation, in which the mind will be constantly as well as agreeably employed, but not overtaxed. By pursuing the course of treatment, invalids suffering from menorrhagia may be permanently restored to health. * * * * * THE TURN OF LIFE. (CESSATION OF THE MENSES.) Menstruation commonly occurs at regular monthly intervals, during a period of about thirty years. The time for its cessation depends somewhat upon the date of its first appearance. In the temperate zones it commences at about the fifteenth year, and, consequently should terminate at the forty-fifth year. Instances are common, however, in which it has been prolonged until the fiftieth and even to the fifty-fifth year. In warm climates it commences and terminates at an earlier age. As women approach the critical period of life, if the general health and habits be good, the discharge may gradually diminish, and, at length, totally disappear, without producing any particular inconvenience, but this seldom happens. More frequently, the discharge is entirely absent for six or seven weeks, and when it does return, it is more copious than usual. In some cases, the flow is not only too profuse, but too frequent. Many months may elapse before the menses return, and, even then, they are apt to be very pale and deficient in quantity. The fluctuations of this function occasion irregularities and disturbances of the general health. When the flow of blood is diverted from the uterus, it is liable to be directed to the head or some other part of the body. In fact, there appears to be constitutional agitation, and disorders of all the organs. Perhaps one reason for calling this a critical period is, that if there is a morbid tendency in the system, a disposition to develop tumors of the breast or uterus, these are very liable to make rapid progress at this time, since they are not relieved by the customary, local exudation of blood. It is a time favorable to the awakening of latent disorder and morbid growths, for, at the decline of the menstrual function, the uterus is not so capable of resisting vitiating influences. There is greater liability to irritation of the bladder and rectum, and the menstrual flow may be superseded by a white, acrid discharge, caused by an inflammation of the mucous membrane of the vagina. Even if the system be not enfeebled by excessive losses of blood, debility may result from a continued irritation of the uterine organs, and cause the morbid discharge. The nervous system sympathetically responds, becoming exceedingly irritable, and thus implicating in this derangement every bodily organ. In some constitutions, the change of any habit is almost impossible, particularly if it is improperly acquired, or detrimental to health; and so we have sometimes thought respecting this function, that the more it has been abused and perverted during the time of Its natural activity, the greater is the disturbance occasioned when it ceases. TREATMENT. There should be regularity in all the habits of life. Women are too apt to approach this important period without due care and consideration. When the physical system is about to suspend a function, it is folly to endeavor to perform the labor or assume the responsibilities which were permissible when the constitution was more robust. How the duties of each day and hour weigh upon the energies of the mother! What intense solicitude and yearning she experiences! How unselfish is that mother who each day works steadily and faithfully for others, and who is conscious of the hidden dangers that lurk around her pathway! With confiding faith and love, she commends the interests of her children to Him who doeth all things well. She anticipates the wants of her family and strives to supply the desired comforts, thus wasting her strength in the labors prompted by her loving nature. Would it not be a greater comfort to those children to have the counsel of their dear mother in later years, than to have the bitter reflection that she sacrificed her health and life for their gratification? Unconsciously, perhaps, but none the less certainly, do women enter upon this period regardless of the care they ought to bestow upon themselves. Without sufficient forethought or an understanding of the functional changes taking place, they over-tax their strength, until, by continuous exertion, they break down under those labors which, to persons of their age, are excessive and injurious. Is it strange, when woman has thus exhausted her energies, when her body trembles with fatigue and her mind is agitated with responsibilities, that the menses capriciously return, or the uterus is unable to withstand congestion, and capillary hemorrhage becomes excessive? If the physical system had not been thus exhausted, it would have exercised its powers for the conservation of health and strength. It is better to be forewarned of the ills to which we are liable, and fortify ourselves against them, rather than squander the strength intended for personal preservation. Let every woman, and especially every _mother_, consider her situation and properly prepare for that grand climacteric, which so materially influences her future health and life. The general health should be carefully preserved by those exercises which will equalize the circulation of the blood, and the regular action of the bowels should be promoted by the use of those articles of diet which contribute to this end. Relieve the mind of responsibility, keep the skin clean, and enrich the blood with tonics and alteratives. For the latter purpose, use Dr. Pierce's Favorite Prescription and "Golden Medical Discovery." If these remedies fail, seek professional advice. A careful regulation of the habits, strict attention to the requirements of the system, and the use of tonic medicines, will very frequently render the employment of a physician unnecessary * * * * * LEUCORRHEA. ("WHITES.") Leucorrhea is the symptomatic manifestation of some uterine or vaginal affection, vulgarly called "whites." We say _symptomatic_, for the white or yellowish discharge, which we term leucorrhea, is not a disease, but a symptom of some uterine or vaginal disorder. We call it a _white_ discharge to distinguish it from the menses and uterine hemorrhages. It varies, however, in color and consistency from a white, glairy mucus to a yellow or greenish, purulent, fetid matter. Sometimes it has a curdled appearance, at others, it is of the consistency of cream. Leucorrhea is the most common symptom of uterine derangement, and there are few females who are not affected by it at some period of life. It may originate either in the vagina or uterus, and it is accordingly termed either vaginal or uterine leucorrhea. The nature of leucorrhea is analogous to that of nasal catarrh. In a healthy state, the lining membrane of the genital organs secretes sufficient mucus to moisten them; but, if the mucous membrane is temporarily congested or inflamed, the secretion becomes profuse, irritating, and offensive. Vaginal and uterine leucorrhea are essentially different in character, the former being an acid, and the latter an alkaline secretion, and, while the first is a creamy, purulent fluid, the latter is thick and ropy, like the white of an egg. In fact, the latter discharge is rich in albuminous matter and blood-corpuscles, hence, its great debilitating effect upon the system, and, if not promptly arrested it is likely to produce _vaginitis, pruritus vulvce_, or _vulvitis_. VAGINITIS is indicated by intense inflammation of the mucous membrane of the vagina. When this affection is present the patient experiences a sense of burning heat, aching and weight in the region of the vagina, violent and throbbing pains in the pelvis, and the discharge is profuse and very offensive. There is also a frequent desire to urinate, and the passage of the urine causes a sensation of scalding. PRURITUS VULVAE. The discharge irritates the nerves of the external genital parts, thus producing an almost unendurable itching. Scratching or rubbing the parts only aggravates the affection. The patient is tormented night and day, is deprived of sleep, and naturally becomes despondent. Pruritus vulvae, in its severest forms, is often developed when the discharge is scarcely noticeable. It is the most common result or accompaniment of leucorrhea. VULVITIS. This term indicates an inflammation of the lining membrane of the external genital parts. Sometimes the inflammation extends to the deeper tissues, causing great pain, and even suppuration, resulting in the formation of an abscess. The attack is indicated by redness, swelling, and a feverish state of the affected parts, which is quickly followed by a profuse flow of yellow pus, and, in some instances, small ulcers are formed on the affected parts. SYMPTOMS. The sufferer from leucorrhea becomes pale and emaciated, the eyes dull and heavy, the functions of the skin, stomach and bowels become deranged, more or less pain in the head is experienced, sometimes accompanied with dizziness, palpitation is common, and, as the disease progresses, the blood becomes impoverished, the feet and ankles are swollen, the mind is apprehensive and melancholy, and very frequently the function of generation is injured, resulting in complete sterility. Exercise produces pain in the small of the back and the lower portion of the spine, and, owing to a relation of the vaginal walls, the womb falls far below its natural position, or turns in various directions, according to the manner in which the weight above rests upon it. Ulcers are apt to appear upon the mouth of the womb, the matter from which tinges the discharge and stains the linen. Hysteria is often an attendant of this disease. CAUSES. The immediate cause of leucorrhea is either congestion, or inflammation of the mucous membrane of the vagina or womb, or both. The exciting causes are numerous. Among others, deranged menstruation, prolonged nursing of children, pregnancy, abortions, excessive indulgence in sexual intercourse, uncleanliness, piles, uterine ulcers, and displacement of the womb, are the most common. In brief, it usually accompanies every uterine disorder which vitiates and reduces the system. During childhood, particularly in scrofulous children, discharges from the vagina are not unfrequent, owing to worms or other intestinal irritation. Among the organic causes of leucorrhea, are ulceration of the mouth or neck of the womb and tumors. These will be considered hereafter. TREATMENT. We have dwelt upon leucorrhea because of its prevalence and in order to exhibit the various forms it may assume. These reasons long ago prompted us to investigate it; and, ascertaining the derangement to consist in a relaxation of the walls of the vagina, attendant upon depressed vitality, for many years we experimented with various medicines to find those that would exercise specific properties in restoring the tissues involved to a natural condition, thereby arresting the abnormal discharge. Our efforts in that direction have been very successful, and our expectations more than realized. The treatment which we shall recommend is rational, based upon the pathological conditions of the disease, and has been attended with the greatest success. It embraces the use of those general restoratives and specific uterine tonics, so harmoniously combined in Dr. Pierce's Favorite Prescription, a remedy which has achieved unparalleled success in the cure of this affection and won the highest praise from thousands of grateful women. It many cases, it is well to accompany its use with alterative treatment, for which the "Golden Medical Discovery" will be found especially effective. It is an absurd practice to arrest the discharge with astringent injections _alone_. The weak and lax walls of the vagina, as well as the other tissues of the system, require strength, and this can be gained only by the use of general and special tonics. Appropriate injections as _auxiliary_ treatment will very much _assist_ in the cure. The "Favorite Prescription" is a special tonic for the affected parts, and the "Golden Medical Discovery" is the best general alterative of which we have any knowledge. They may be taken in alternate doses every day. If the patient is very pale and anæmic, one drachm of the carbonate, or two drachms of the citrate or pyrophosphate of iron, may be advantageously added to each bottle of the "Favorite Prescription." If the carbonate be employed, as it is insoluble, the bottle should be well shaken every time before using. The functions of the skin should be kept active by frequent baths, and the patient, if able, should walk or ride in the open air, and freely expose herself to the sunshine. If the invalid be too weak to exercise much, she should go out in warm weather and sit in the open air. Sunshine is no less important in maintaining animal, than in supporting vegetable growth and health. The human being, like the plant, sickens and grows pale, weak and tender, if secluded from the sunlight. The apartments occupied should be thoroughly ventilated. Many women are sickly and feeble because they live in badly ventilated rooms. We cannot too strongly urge in this, as in all other chronic diseases peculiar to women, that the bowels be kept regular. Frequent, but small doses of Dr. Pierce's Pleasant Pellets will prove most beneficial. If the vaginal passage is tender and irritable, an infusion, or tea of slippery-elm bark is very soothing, and may be used freely with a vaginal syringe. Whatever injection is employed, should be preceded by the free use of Castile soap and warm water, to thoroughly cleanse the parts. One part of glycerine to six parts of water is a soothing lotion when there is much tenderness, heat, and pain in the vagina. If there be no great tenderness in the vagina, or if the acute, inflammatory symptoms have yielded to the lotions already suggested, then a tonic and astringent injection should be employed. For this purpose a wash made by dissolving one of DR. PIERCE'S PURIFYING AND STRENGTHENING LOTION TABLETS, in one pint of hot water is a superior application and will not fail to be of great benefit in controlling the disagreeable drain. If your medicine dealer is not supplied with these, mail 25 cents in one-cent stamps to us and we will forward a box of the Lotion Tablets by return post. These Lotion Tablets have for many years been used in the treatment of obstinate cases of leucorrhea at the Invalids' Hotel and Surgical Institute, and their efficiency has been alike gratifying to both patient and physician. If _pruritus_ or severe itching, be also a symptom, the itching will readily yield if the parts be cleansed with Castile or other fine soap and warm water, followed by the application of a compound composed of two ounces of glycerine, one ounce of rose-water, and one drachm of sulphite of soda; or, for the sulphite of soda, two drachms of borax may be substituted. The following lotion is a good one to relieve pruritus: sugar of lead, two drachms; carbolic acid, half a drachm; laudanum, four ounces; glycerine, four ounces; water, four pints; mix. This may be applied to the itching parts, and also injected into the vagina. [Illustration: Fig. 6. FOUNTAIN SYRINGE.] HOW TO USE VAGINAL INJECTIONS. We usually recommend the Fountain Syringe illustrated in Fig. 6, as the most convenient instrument for administering vaginal injections. The fountains supplied by us are of soft rubber, and have extra nozzles, with which to make rectal, nasal or ear irrigations. There is also a large, long nozzle for vaginal injections. [Illustration: Fig. 7. SOFT RUBBER-BULB SYRINGE] It is channeled so is to permit the free clearing away of the secretions as the Douche is employed. The Fountain Syringe can he used without assistance, the flow of fluid is gradual, and with a force that can be varied, by raising or lowering the reservoir, yet is never so great as to be liable to produce injurious effects. The syringes usually sold with small nozzles or pipes are of little or no value for vaginal injections. In many instances so small a tube will pass readily into the canal of the uterus, and hence there has frequently resulted an injection of a portion of the fluid into the uterus itself, producing severe pain. It is important, therefore, in using the Vaginal Douche to employ only a large tube that has grooves in its surface for the free clearing away of the fluid as it runs from the fountain. Where it is desired to obtain relief from a congested, inflamed or sensitive and irritable state of the mucous surface, the employment of a large quantity of water as hot as it can be borne, is of the greatest remedial value. It rapidly diminishes the size of the blood vessels, and aids in bringing about a normal circulation in the parts. As a rule, in taking the Douche with the Fountain Syringe the rubber bag is filled, and suspended from a nail or hook at a height of from two to five feet above the patient, and the fluid passes through the tube by force of gravity, thus requiring no muscular exercise. The force of the stream depends upon the height of the fountain above the outlet nozzle. It is only necessary that the patient should assume a comfortable position where the fluid which comes from the vaginal canal can flow into a water closet, or any convenient vessel. After a thorough cleansing of the vaginal surfaces of mucus, by means of the warm or hot water, it is sometimes advisable to inject remedial fluids. These injections may readily be made with the fountain or bulb syringe, introducing not less than from two to four ounces. This may be retained sufficiently long to exert its remedial effects upon the mucous surface, which usually takes from five to eight minutes. The hips should be elevated, and the nozzle of the syringe surrounded by a napkin or other similar material, upon which moderate compression can be made so as to retain the fluid in the vagina for the necessary period. When suffering from any uterine trouble, it is necessary to avoid severe fatigue. The amount and character of exercise should be suited to the condition of the patient; while, most important of all, the strictest abstinence from sexual intercourse should be observed. To those who are unable readily to obtain the Fountain Syringe above recommended we can send by mail, post-paid, one of these instruments on receipt of $2.00. A Soft Rubber-bulb, or Pump Syringe (illustrated in Fig. 7), not so good for making vaginal injections, can be sent by us, post-paid, for from 75cts. to $1.50, the price varying with the quality and size. * * * * * STERILITY. (BARRENNESS.) Real sentiment and interest center in fecundity, since the desires and happiness of mankind are consummated in marriage and procreation. How dreary would life be without love, companionship, and the family! How precious are the ties that bind our hearts to father, mother, daughter, and son! The love of children is innate in the heart of every true man and woman. Each child born supplements the lives of its parents with new interest, awakens tender concern, and unites their sympathies with its young life. How dreary is the thought that one may attain a ripe old age with neither son nor daughter to smooth the decline of life, or sorrow for his or her departure! How many women desire a _first-born_ of love, the idol of their waiting hearts, a soul, which shall be begotten within, clothed with their own nature, and yet immortal! It is a natural instinct, this yearning of the heart for offspring; and yet little is said upon this subject, in which so much is experienced. All that is beautiful and lovely in woman, finds its climax in motherhood. What earthly being do we love so devotedly as our mother? [Illustration: Fig. 8.] Men and women exhibit but little concern, mere idle curiosity, perhaps, on this subject, unless, perchance, there is no evidence of their own reproductive powers. If, however, these appear to be deficient, then few topics are more deeply interesting or investigated with greater personal solicitude. Such persons will seldom submit their condition to the family physician, for it is a delicate subject, involving personal considerations, and, therefor, they prefer to consult with one who cannot connect their unfortunate situation with any of the incidents which enter into the history of their lives. This is very natural, and sometimes is the only way to keep private matters profoundly secret. Being widely known as specialists, devoting our undivided attention to chronic affections, and having unusual facilities for the investigation and management of such cases, we have been applied to in innumerable instances, to ascertain the causes of barrenness and effect its removal. It is admitted that the question of a woman's sterility is practically decided in the first three years of married life, for statistics show that less than ten out of a hundred women who do not indicate their fertility in the first three years of wedlock ever bear children. We have treated many who gave no evidence of fertility for a much longer period of married life, and who afterwards gave birth to children. We are unable to state the proper ratio of the number of the married who are childless; much less have we the right to assume that all who decline the responsibilities of motherhood are necessarily barren. CAUSES. The causes of barrenness may be obliteration of the canal of the neck of the womb, sealing up of its mouth, or inflammation resulting in adhesion of the walls of the vagina, thus obstructing the passage to the uterus. In the latter case, the vagina forms a short, closed sac. In some instances, the vaginal passage cannot be entered in consequence of an imperforate hymen. Again, the cause of barrenness may either be a diseased condition of the ovaries, preventing them from maturing healthy germs, or chronic inflammation of the mucous membrane of the neck of the uterus, which does not render conception impossible, but improbable. It is one of the most common causes of unfruitfulness, because the female seldom, if ever, recovers from it spontaneously. It has been known to exist for twenty or thirty years. Chronic inflammation of the vagina also gives rise to acrid secretions, which destroy the vitality of the spermatozoa. Suppression of the menses, or any disorder of the uterine functions, may disqualify the female for reproduction. Flexions of the uterus, displacements, congestions, and local debility, may likewise prevent fertility. Sterility may result from impaired ovarian innervation or undue excitement of the nerves, either of which deranges the process of ovulation. Even too frequent indulgence in marital pleasures sometimes defeats conception. Prostitutes who indulge in excessive and promiscuous sexual intercourse, seldom become pregnant. Any thing that enfeebles the functional powers of the system is liable to disqualify the female for reproduction. TREATMENT. An extensive observation and experience in the treatment of sterility, convinces us that, in the majority of cases, barrenness is due to some form of disease which can be easily remedied. If the passages through the neck of the uterus be closed or contracted, and this is the most frequent cause of sterility, a very delicate surgical operation, which causes little if any pain or inconvenience to the patient, will remove the impediment to fertility. In many of these cases, we have succeeded in removing the contraction and stricture of the neck of the womb by dilatation. When the vaginal walls are so firmly united as to prevent copulation, a surgical operation may be necessary to overcome their adhesion. When the hymen obstructs the vaginal orifice, a similar operation may be necessary to divide it. Vaginismus, which will be treated elsewhere, sometimes causes sterility. It is proper that we should suggest to the barren, that if sexual intercourse be indulged in only very abstemiously, conception will be more likely to occur than if moderation be not exercised. We may also very properly allude to the fact that there is greater aptitude to fecundation immediately before and soon after the menstrual periods than at other times. In fact, many medical men believe that it is impossible for conception to occur from the twelfth day following menstruation up to within two or three days of the return of the menses. ELONGATION OF THE NECK OF THE WOMB. An elongated condition of the neck of the womb, illustrated by Fig. 9, is frequently a cause of sterility. If this part is elongated, slim and pointed, as shown in the illustration, it is apt to curve or bend upon itself, thus constricting the passage through it and preventing the transit of seminal fluid into the womb. An eminent author says, "Even a slight degree of elongation, in which the cervix, or neck, has a conical shape, has been observed to be frequently followed by that condition [sterility]." Our own observations, embracing the examination of hundreds of sterile women annually, lead us to believe that this condition is among the common causes of barrenness. But, fortunately, it is one of those most easily overcome. [Illustration: Fig. 9. Conoid Neck.] TREATMENT. If the neck is only slightly elongated, this consists in dividing the slim projecting part, by the use of the _hysterotome_, If it be a more aggravated case, a portion of the womb must be removed. This operation is perfectly safe and simple, and, strange as it may seem to those who are not familiar with operations upon the womb, is not painful. We have never seen any bad results follow it, but have known it to be the means of rendering numerous barren women fruitful. [Illustration: Fig. 10. Flexion, u, Uterus, B, Bladder.] [Illustration: Fig. 11. Version, u, Uterus, B, Bladder.] FLEXIONS AND VERSIONS OF THE WOMB. Flexion of the uterus, in which it is bent upon itself, as illustrated in Fig. 10, produces a bending of the cervical canal, constricting or obliterating it, and thus preventing the passage of spermatozoa through it. Version of the uterus in which its top, or _fundus_, falls either forward against the bladder (anteversion), as illustrated in Fig. 11, or backward against the rectum (retroversion), may close the mouth of the uterus by firmly pressing it against the wall of the vaginal canal, and thus prevent the passage of spermatozoa into the womb. 'The treatment of these several displacements will be considered hereafter. We may here remark, however, that they can be remedied by proper treatment. Our mechanical movements, manipulations, and kneadings are invaluable aids in correcting these displacements. DISEASE OF THE OVARIES. Sterility may be due to disease of the ovaries. Chronic inflammation of the ovaries may result from uterine disorders or peritonitis, and is commonly attended with a sense of fullness and tenderness, and pain in the ovarian region. These symptoms are more apparent upon slight pressure, or during menstruation. This disease is curable, although it may require considerable time to perfectly restore the health. When this chronic affection is the result of other derangements, the indications are to restore health in the contiguous organs, and to relieve excessive congestion and nervous excitement in the ovaries. The patient should be very quiet during the menstrual period and avoid severe exercise or fatiguing occupations, not only at those periods, but during the intervals. All measures calculated to improve the general health should be adopted. Use injections of warm water, medicated with borax, soda, and glycerine, in the vagina every night and morning. The surface of the body should be kept clean by the daily employment of hand-baths, followed by brisk friction. The bowels, if constipated, should be regulated as suggested for constipation. The system should be strengthened by Dr. Pierce's Favorite Prescription, and, if the blood be disordered, no better alterative can be found for domestic use than Dr. Pierce's Golden Medical Discovery. If the patient does not in a few months improve under this treatment, the case should be placed under the immediate care of some physician well qualified by education and experience to critically examine and successfully treat this affection. CHRONIC INFLAMMATION AND ULCERATION OF THE UTERUS, A CAUSE OF STERILITY. When enumerating the causes of barrenness we mentioned that chronic inflammation of the mucous membrane of the mouth and neck of the womb was the most common affection that defeats conception. Of all diseases of female organs, this is, without doubt, the most common, and, since it does not at first produce great inconvenience or immediately endanger life, it does not excite the attention which its importance demands. It is overlooked, and, when the attention is directed to the existence of this long-neglected disease it appears so trivial that it is not regarded as being the real cause of infertility in the patient. When this disease has existed for a long time, the very structure of the parts involved becomes changed. The glands of the cervical membrane secrete a glairy mucus, resembling the white, or albuminous part of an egg. The secretion is thick and ropy, and fills the entire mouth and neck of the uterus, thus preventing the entrance of the spermatozoa. The mucous membrane becomes thickened, the inflammation extends to the deeper structures, and, on examination through the speculum, we find the mouth of the uterus inflamed, hardened, and enlarged, as represented in Fig. 22, Colored Plate IV, or in Fig. 23 of same plate. Fig. 25, Plate IV, shows the mucous follicles just as they are found all along the neck of the womb, in a state of inflammation and enlargement, and filled with a fluid resembling honey, giving rise to ulceration and a thick discharge, as illustrated in Fig. 23, Colored Plate IV. Feebleness of the constitution, impoverishment of the blood, a scrofulous diathesis, want of exercise, uncleanliness, tight lacing, disappointment, excessive excitement of the passions, the use of pessaries for displacement of the uterus, overwork, and taking cold, all predispose the cervical membrane to chronic ulceration. The inflammation may be so mild, and the discharge so trifling in quantity, as scarcely to attract attention. But after it obtains a firmer hold, and, in most cases, it is aggravated by exposure or neglect, the patient experiences dragging sensations about the pelvis, and pain in back and loins, accompanied with a bearing-down sensation and numbness or pain extending to the thighs. The discharge is thick, starch-like, and generally irritating. The patient becomes irascible, capricious, querulous, and sometimes moody and hysterical. She is easily discouraged, her appetite and digestion become impaired, and she grows thin and does not look or act as when in health. TREATMENT. In offering a few hints for the domestic management of these abnormal conditions, we would at the same time remark, that, while health may be regained by skillful treatment, recovery will be gradual. We especially wish to guard the patient against entertaining too strong expectations of a speedy recovery. Although she may employ the best treatment known, yet from three to five months may elapse before a perfect cure can be effected. In persons of scrofulous diathesis, in whom the recuperative forces are weakened, it is very difficult to effect a radical cure. It is equally true, however, that under domestic management alone, thousands have been restored to perfect health and fruitfulness. Hygienic management consists in toning the functions of the skin by daily bathing the surface of the body, and quickening the circulation by brisk friction. The patient should rise early in the morning, and exercise in the fresh and invigorating air. Those who sleep in warm rooms, or spend much of their time in bed, will continue to have congestion of the uterus, and habitual discharges from this enfeebled organ. The patient should take daily walks, increasing the length of the excursion from time to time, but not to the extent of producing fatigue. The bowels, if constipated, should be regulated. Strengthen the system by using Dr. Pierce's Favorite Prescription, to each bottle of which add two drachms of citrate or pyrophosphate of iron. The mouth and neck of the uterus should be thoroughly cleansed by the use of the syringe, as suggested for the treatment of leucorrhea. The use of the solution of Dr. Pierce's Purifying and Strengthening Lotion Tablets there advised will also be beneficial, if thoroughly applied. A most valuable course of local treatment, which may be adopted by any intelligent lady without the aid of a physician, and one that will result in the greatest benefit when there is morbid sensibility, congestion, inflammation, or ulceration about the mouth or neck of the womb, consists in applying to those parts a roll of medicated cotton or soft sponge, allowing it to remain there for twelve hours at a time. A piece of fine, soft, compressible sponge, as large as a hen's egg, or a roll of cotton batting of two-thirds that size, is thoroughly saturated with pure glycerine. Securely fasten to it a stout cord a few inches long. The vagina and affected parts having been thoroughly cleansed with warm water and Castile soap, as advised in the treatment of leucorrhea, the sponge or cotton should be passed up the vagina with the finger, and pressed rather firmly against the mouth and neck of the womb, which, being enlarged, and, consequently falling below its natural position, will generally be low down in the vagina, and so hardened as to be unmistakably distinguished from the surrounding parts by the sense of touch. The glycerine, having a very strong affinity for water, will absorb large quantities of the _serum_, which has been effused into the affected tissues in consequence of their congestion and inflammation, and thus reduce the inflammation and enlargement. This is the cause of the profuse, watery discharge which follows the application. In twelve hours after the sponge or cotton has been applied, it should be removed by means of the attached thread, one end of which has been purposely left hanging out of the vagina. Then thoroughly cleanse the vagina with warm water, use the solution of Dr. Pierce's Lotion Tablets as suggested for the treatment of leucorrhea, and repeat the glycerine application the following day or every other day. If there is no irritation or tenderness of the vagina, add one drachm of tincture of iodine to each ounce of the glycerine, alternating the use of this with that of pure glycerine; or, the iodine and glycerine may be used every third day, and the glycerine alone on the two intervening days. As the iodine will color the finger somewhat, it is well to know that this unpleasant effect may be almost or entirely avoided by coating that member with lard, sweet oil, or vaseline. The stain may be readily removed with a solution of iodide of potassium. The use of Dr. Pierce's Antiseptic and Healing Suppositories as advised on an other page under the head of Ulceration of the Uterus will aid greatly in effecting a cure. If your medicine dealer does not have these Suppositories in stock, mail 25 cents in stamps to Dr. R.V. Pierce, Buffalo, N.Y., and a box will be sent you by return post. It is well to alternate Dr. Pierce's Golden Medical Discovery with Dr. Pierce's Favorite Prescription, taking of each three times a day. By persevering in this course of treatment, nine-tenths of those who are thus afflicted will improve and be fully restored to health, fruitfulness and happiness. If barrenness continue, the case should be unreservedly submitted, either in person or by letter, to a physician skilled in the diagnosis and treatment of these affections. From the foregoing remarks, the reader will perceive that there are a variety of diseased conditions, any one of which may produce sterility. It is equally true that nearly all these conditions may be easily cured by proper medical or surgical treatment. A frequent cause of barrenness is stricture of the neck of the uterus. No medicine that a woman can take or have applied will remove this unnatural condition. Fortunately, however, the means to be employed cause no pain, are perfectly safe, and the time required to effect a cure is short, rarely over twenty or thirty days. * * * * * DISPLACEMENTS OF THE WOMB. The relative positions of the womb and surrounding organs, when in a state of health, are well illustrated by Fig. 1, page 680. The womb is supported in its place by resting upon the vaginal walls, and by a broad ligament on either side, as well as by other connective tissues. By general debility of the system, the supports of the womb, like the other tissues of the body, become weakened and inadequate to perfectly perform their duty, thus permitting various displacements of that organ. PROLAPSUS, OR FALLING OF THE UTERUS, is a common form of displacement. It has been erroneously regarded as a local uterine disease, requiring only local treatment instead of being considered as a symptom of general derangement, and, therefore, requiring constitutional treatment. Hence, variously devised supporters have been invented to retain the womb in position after its replacement. It is a law of physiology, that the muscular system is strengthened by use, and that want of exercise weakens it. The blacksmith's arm is strengthened and developed by daily exercise. Support his arm in a sling, and the muscles will be greatly weakened and wasted. So when artificial supports are used to retain the womb in position, thereby relieving the supporting ligaments and tissues of their normal function, the _natural_ supports of the uterus are still further weakened, and the prolapsus will be worse than before when the artificial support is removed. Besides, all these mechanical contrivances are irritating to the tissues of the womb and vagina, and frequently produce congestion, inflammation, and even ulceration, thus rendering the patient's condition much worse than before their employment. These worse than useless appliances should never be resorted to for the temporary relief which they sometimes afford. Constitutional treatment together with appropriate applications is the only effectual method of remedying this morbid condition. SYMPTOMS. When the displacement is sufficient to cause any serious disturbance, the prominent symptoms are a sensation of dragging and weight in the region of the womb, pain in the back and loins, inability to lift weights, great fatigue from walking, leucorrhea, a frequent desire to urinate, irritation of the lower bowel, and derangement of the stomach. The womb may protrude from the vaginal orifice; in very rare cases, wholly protrudes, and may be inverted. CAUSES. As we have already stated, general debility favors prolapsus of the womb, but various general and local circumstances and conditions also favor its occurrence. Wearing heavy garments supported only by the hips, compressing the waist and abdomen with tight clothing, thus forcing the abdominal organs down upon the womb, are fruitful causes of this affection. Excesses in sexual intercourse give rise to leucorrhea, producing a relaxed condition of the vagina, upon which the womb rests, and, in this way, one of its supports is weakened. Enlargement of the uterus from congestion, and inflammation or tumors also favor prolapsus. Abortion may leave the womb enlarged, its supports weakened, and result in this displacement. [Illustration: Fig. 12. Retroflexion, U, Uterus (Womb), B, Bladder.] FLEXIONS AND VERSIONS. Instead of sliding down into the vagina, as in prolapsus, the uterus is liable to fall or be forced into other unnatural positions. When the uterus is bent upon itself, it is called _flexion_. If the bending is backward, it is called _retroflexion_; if forward, _anteflexion._ Fig. 12, represents the former condition, the uterus being flexed backward so that the fundus, or upper part of the womb, is pressed against the rectum, while the neck of the uterus remains in its natural position. This is a common form of displacement, and generally occurs between the ages of fourteen and fifty. SYMPTOMS. The prominent symptoms of retroflexion of the uterus are a sense of weight in the region of the rectum, difficulty in evacuating the bowels, and, sometimes a retention of the feces. There may be suppression of the urine and the menses may be diminished in quantity. If retroflexion is due to a chronic enlargement of the uterus, caused by abortion or parturition, the patient suffers from an immoderate menstrual flow. CAUSES. The principal causes of retroflexion are congestion, enlargement and tumors of the uterus. Congestion is liable to occur in women possessing an extremely active temperament, as well as in those of sedentary and indolent habits. Retroflexion is a common displacement in both married and unmarried women; it is a secondary affection, and, when it is caused by congestion, the menses are painful and reduced in quantity, and there is pain in the back and a sense of weight in the region of the rectum. In some instances, there is a reflex irritation of the mammary glands, and a consequent secretion of milk. There may also be nausea and vomiting, which often lead to the erroneous opinion that the patient is pregnant. _Anteflexion_ of the uterus denotes a bending forward of the body and fundus of the uterus, while the neck remains in its natural position. In versions of the uterus, neither the body nor the neck of the womb is bent upon itself, but the whole organ is completely turned backward or forward. [Illustration: Fig. 13. Retroversion. B, Bladder. U, Uterus (Womb).] _Retroversion_ of the uterus, illustrated by Fig. 13, signifies a change in the position of the womb, so that the upper, or fundal portion of the organ drops back toward the concavity of the sacrum, while the neck preserves a straight line in the opposite direction. The fundus presses forcibly against the rectum, while the upper part of the vagina bends abruptly and forms an acute angle near the mouth of the uterus. SYMPTOMS. Retroversion is indicated by bearing-down pains in the loins and difficulty in evacuating the bowels. The feces may accumulate in the rectum, because they cannot pass this obstruction. CAUSES. Jumping, falling, or undue pressure from the contents of the abdomen, may suddenly cause retroversion of the uterus. Sometimes retroversion results from obstinate constipation. _Anteversion_. This term designates another unnatural position of the uterus, in which the fundus, or upper part of the organ, falls forward, as illustrated by Fig. 14, while the neck points towards the hollow of the sacrum. This position of the womb is the reverse of that of retroversion. In its natural position, the fundus of the uterus is slightly inclined forward, and any pressure, or forward traction, is liable to cause it to fall still further in that direction. [Illustration: Fig. 14. Anteversion, U, Uterus, B, Bladder.] SYMPTOMS. One of the most common symptoms of anteversion is a frequent desire to urinate, in consequence of the pressure of the uterus upon the bladder. The free flow of the menses is sometimes obstructed. CAUSES. The causes are tight lacing, prolapse of the abdominal organs, weakness of the supporting ligaments, and enervating habits. TREATMENT. In treating all the various displacements of the uterus, the prominent indication is to tone up the general system, for by so doing we also strengthen the uterine supports. Digestion should be improved, the blood enriched, and nutrition increased, so that the muscles and ligaments which retain the womb in position may become firm and strong. The womb will thus be gradually drawn into position by their normal action and firmly supported. It is a great mistake, made by physicians as well as patients, to consider a displacement of the uterus a _local_ disease, requiring only local treatment. A restoration of the general health will result in the cure of these displacements, the uterus will regain its tone and muscular power, and the local derangement, with its attendant pain and morbid symptoms, will disappear. It is true that displacements of the womb may be associated with inflammation and ulcers, which require local treatment, as elsewhere suggested; but simple displacement of the uterus may be remedied by pursuing the following course of sanitary and medical treatment. Sleep on a hard bed, rise early, bathe, and take a short walk before breakfast. Dress the body warmly and allow sufficient space for the easy and full expansion of the lungs. Eat moderately three meals a day, of those articles which are nutritious and readily digested. Keep the bowels regular by the use of proper food. If they are constipated, use Dr. Pierce's Pellets to keep them open and regular. Avoid retaining the standing position too long at a time, especially when the symptoms are aggravated by it. Many energetic women disregard their increasing pains, and keep upon their feet as long as possible. Such a course is extremely injurious and should be avoided. As a general restorative and uterine tonic, nothing surpasses Dr. Pierce's Favorite Prescription, which is sold by druggists and accompanied with full directions for use. If leucorrhea is an attendant symptom, the treatment suggested for that condition should be employed. The use of Dr. Pierce's Antiseptic and Healing Suppositories, applying one every third night After having first cleansed the vagina and neck of the womb thoroughly by the use of warm water and soap as an injection, will prove of great benefit in giving strength to the supports of the womb and its appendages. [Illustration: Fig. 22. Fig. 21. Fig. 23. Fig. 24. Fig. 25. Fig. 26.] By persevering in the rational treatment which we have suggested for the various displacements of the womb, nearly all who suffer from such derangements may be fully restored to health. The patient should not expect _speedy_ relief. Considerable time will be necessary to bring the general system up to a perfect standard of health, and, until this is accomplished, no great improvement in the distressing symptoms can be expected. Mechanical movements are especially effective in this class of cases. We have successfully treated many obstinate cases in which the displacements were very serious. * * * * * ULCERATION OF THE UTERUS. Ulceration is the process by which ulcers, or sores, are produced. It is characterized by the secretion of pus or some fetid discharge, and is continued as a local disease through the operation of constitutional causes. Ulcers are generally symptoms of other morbid conditions. Ulcers may form in the _mouth_ or _neck_ of the uterus, and, omitting cancerous ulcers and those of a syphilitic character, which are considered elsewhere, may be classified as _Granular_ and _Follicular_. [Illustration: Fig. 15. The Ferguson Speculum.] GRANULAR ULCER. This variety of ulcerative degeneration is the most frequent, and may exist for some time without exciting any suspicion in the mind of the patient that she is afflicted with any such morbid condition. There is local inflammation, and the mouth of the uterus is uneven, rough, and granular. If an examination be made with the speculum, the mouth of the uterus is often found in the condition represented in Fig. 22, Colored Plate IV. Figs 15 and 16 represent two different forms of specula. The one represented by Fig. 15 consists of a tube of glass coated with quicksilver and covered with India rubber, which is thoroughly varnished. That represented by Fig. 18 is made of metal and plated. By using one of these instruments, the condition of the mouth of the womb can be distinctly seen. [Illustration: Fig. 16. An Expanding Uterine Speculum.] FOLLICULAR ULCER. When the mucous follicles of the neck of the uterus are inflamed they enlarge and become filled with a fluid having the color and consistency of honey, presenting the appearance illustrated by Fig. 25, Colored Plato IV. This secretion, because of the presence of the Inflammation, is not discharged. The follicles, therefore, continue to enlarge until they burst, and we then see in their place the red, elevated, angry-looking eminence, which is called a _follicular ulcer_. SYMPTOMS. The severity of the symptoms depends upon the character of the ulceration. It may be simple or associated with purulent leucorrhea and hemorrhage. If ulceration be slight and local, few symptoms will be present; but if it be associated with uterine debility, congestion and inflammation of the mucous membrane of the uterus, the discharge will be profuse, and there will be fixed pain in the back and loins, a bearing-down sensation, and great difficulty in walking. The discharge is weakening, as it impoverishes the blood, and thus reduces the strength. CAUSES. Ulceration may be induced by any thing that excites inflammation of the lining membrane of the mouth and neck of the uterus. The use of pessaries, excessive sexual indulgence, injuries occasioned by giving birth to children, congestions, enlargements and displacements, may all operate as causes. TREATMENT. We cannot too strongly condemn the practice so popular at the present time with physicians generally, of indiscriminately burning all uterine ulcers with strong caustics, such as nitrate of silver, chromate of potassium, and other similar escharotics, regardless of the condition of the general system. Ulcers of the womb must be healed in the same manner as those upon any other part of the body. It is an irrational practice to repeatedly cauterize them, expecting thereby to promote healing, while the system is vitiated and the vitality far below the standard of health. Enrich the blood, tone up the system, keep the ulcers cleansed by the frequent use of lotions, and they will generally heal. Caustics often aggravate the irritability and interfere with the healing processes of nature. Ladies should not unnecessarily submit to the exposure of their persons. If they perseveringly employ the treatment which we shall suggest, other local treatment will _very rarely_ be found necessary. This modern warfare which physicians are waging upon the unoffending womb is a most irrational practice. Our grandmothers got along very well without exposing themselves to the humiliation and tortures of this new-born empiricism. We do not wish to be understood as undervaluing or denying the necessity, in rare cases, of examinations of the uterus, or as being unappreciative of the aid afforded in such investigations by the speculum, and the beneficial effects of local applications made directly to the womb through that instrument. What we affirm is, that such examinations and applications are, in the practice of most modern physicians, made unnecessarily frequent, resulting many times in lasting injury to the patient. GENERAL MEANS. As has already been indicated, constitutional treatment should be principally relied upon to cure ulceration of the neck of the womb. Put the system in perfect order and the local ulceration cannot fail to heal. If you have a sore or ulcer upon the leg you very naturally reason that there is a fault in the system at large or in the blood. You do not apply caustics to the sore, but you go to work to restore the blood and system to a normal or healthy condition and as soon as this is accomplished the open and rebellious sore, or ulcer, heals of its own accord. All you have to do locally, to stimulate the ulcer to heal, is to keep it well cleansed by the use of Castile soap and warm water. Just so with ulceration of the womb. Thoroughly cleanse the vagina and neck of the womb once a day by the use of warm water and a little soap, applying this _thoroughly_, as directed on page 704, under the head of treatment for leucorrhea, and using a solution of Dr. Pierce's Purifying and Strengthening Lotion Tablets as there directed. After thus thoroughly cleansing and purifying the parts, a piece of soft sponge as large as a hen's egg, to which a bit of cord or strong thread is attached to facilitate removing it, may be thoroughly wet in pure glycerine and introduced into the vagina, pressed against the mouth of the womb, and allowed to remain there for twelve hours, when it should be gently removed by pulling on the attached string. The cleansing lotion of soap and warm water should be used daily and followed by the glycerine application. Every third night instead of the glycerine tampon apply one of Dr. Pierce's Antiseptic and Healing Suppositories, pressing it well up against the mouth of the womb, and letting it remain there to slowly dissolve. This will give far better curative results than the application of nitrate of silver or other caustics so generally used by physicians. Besides it has the great advantage of being entirely harmless in any condition of the parts to which it is applied. These Suppositories are powerfully antiseptic, destroying all offensive odors and have a soothing and at the same time tonic or strengthening effect upon the neck of the womb and the vagina. In cases where there is prolapsus or falling of the womb, or Anteversion or Retroversion, or other displacements the use of the Antiseptic and Healing Suppositories will be found to be of great benefit in giving strength to the supports of the womb and its appendages. If your dealer is not supplied with the Suppositories, inclose 25 cents in one-cent stamps to us at Buffalo, N.Y., and a package will be sent you, post-paid. We are fully aware that this thorough and _systematic_ course of treatment is slightly troublesome in its application, but what system of treatment that can promise similar success is not? This course of treatment must be _rigidly_ adhered to for several weeks before we can expect a complete cure of the ulcers and the arrest of the consequent leucorrheal discharge. THE SHEET ANCHOR OF HOPE. Do not fail to bear in mind that no difference how good the lotions and other local applications may be, your _chief_ reliance in all cases of ulceration of the womb, as well as in those of simple leucorrhea, must be upon _thorough constitutional_ treatment. To this end Dr. Pierce's Golden Medical Discovery should be taken three times a day in doses of from one to one-and-a-half teaspoonfuls one hour before each meal, and in the middle of the forenoon, in the middle of the afternoon, and just before retiring for the night, a like amount of Dr. Pierce's Favorite Prescription should be taken. The use of these blood cleansing and invigorating tonic medicines should be kept up _persistently_ for several weeks; for you must not expect a perfect cure too soon in a malady that has become chronic and seated. The disease does not become established hastily, but is slow in its inception and progress, and will only gradually and slowly yield to the best of treatment, which we believe we have already pointed out. Followed _earnestly, faithfully_ and _persistently_, the use of the means which we have suggested will rarely, if ever, fail. * * * * * URINARY FISTULA. A fistula, or false passage, is sometimes formed between the bladder and the vagina, between the bladder and the uterus, or between the urethra and the vagina. This passage allows the urine to escape through it into the vagina, and is a source of great annoyance and suffering. This affection is most commonly due to sloughing, caused by severe and long-continued pressure upon the parts during child-labor. It is also sometimes produced by the unskillful use of forceps and other instruments employed by midwives. Syphilitic and other ulcerations may so destroy the tissues as to form a urinary fistula. TREATMENT. The treatment is purely surgical, and consists in paring the edges of the opening so as to make them raw, bringing them together and holding the parts thus by means of stitches until they heal. By the aid of a speculum, properly curved scissors, needles with long handles, fine silver wire, and a few other instruments and appliances, the skillful surgeon can close a urinary fistula with almost as much ease as he can close a wound on the surface of the body. * * * * * DISORDERS INCIDENT TO PREGNANCY. While some women pass through the whole period of pregnancy without inconvenience, others suffer from various sympathetic disturbances, as "morning sickness," impaired appetite, constipation, diarrhea, headache, "heart-burn," fainting fits, difficult breathing, and sometimes convulsions. A strong nervous sympathy exists between the uterus and every part of the system and this sympathy is greatly intensified by pregnancy, causing the distressing symptoms above mentioned. TREATMENT. By proper treatment, most of these evils can be obviated and the patient made comfortable. By the moderate use of such a nervine and uterine tonic as Dr. Pierce's Favorite Prescription, this nervous irritability may be controlled or subdued, and the disagreeable symptoms thus avoided. While the female is pregnant, she should avoid all compression of the waist and abdomen. For this reason tight clothing, stays, or corsets must be discarded. She should also carefully regulate her diet, selecting that which is most nutritious and easily digested. The nausea which occurs in the morning may generally be avoided by partaking of a little light food and a cup of tea or coffee before leaving the bed. If vomiting occurs, and the ejected matter be very acid, carbonate of magnesia, taken in tablespoonful doses, or some alkali with aromatics, or pulverized charcoal, which can be obtained at any drug store, will afford relief. If constipation or diarrhea be experienced, small doses of Dr. Pierce's Pellets should be employed--one or two only at a time. Want of appetite, headache, or a tendency to convulsions, can be generally overcome by a persistent use of Dr. Pierce's Favorite Prescription, which should be taken in teaspoonful doses three or four times each day. Indeed, this valuable medicine not only relieves the distressing symptoms which frequently attend the pregnant state, but also prepares the system for the ordeal of parturition (delivery). One or two bottles of this nervine and tonic used previous to confinement, will, in many cases, save hours of terrible suffering, besides regulating the system, and thus insuring a speedy recovery. We have received the heartfelt thanks of hundreds of grateful mothers for the inestimable benefit thus conferred. The Favorite Prescription is perfectly safe and harmless to use _at all times_ and under all circumstances in the doses above prescribed. * * * * * OVARIAN AND UTERINE TUMORS. We have space only to give a brief outline of the characteristics and treatment of the most frequent classes of tumors which affect the ovaries and uterus. OVARIAN TUMORS generally consist of one or more cysts or sacs, developed within the ovary, and filled with a fluid, or semi-fluid matter, which is formed in their interior. The cysts vary in size, in some instances being not larger than a pea, while in others they are capable of containing many quarts of fluid. In one case operated upon at the Invalids' Hotel and Surgical Institute, thirty-five pints of fluid were taken from three cysts. The effect of ovarian tumors on the duration of life is shown by the statistics of Stafford Lee. Of 123 cases, nearly a third died within a year, more than one-half within two years from the first development of reliable symptoms, while only seventeen lived for nine years or upwards. FIBROID TUMORS of the uterus are composed of fibrous tissue, identical in structure with that of the uterine walls. They are met with in all sizes, from that of a small shot to that of a mass capable of filling the entire cavity of the abdomen. Cases are on record in which these tumors have attained the weight of seventy pounds. The manner in which fibroid tumors terminate life is generally by prostration and debility produced by pressure on, and consequently, interference with, the function of some one or more of the organs essential to life; or by anæmia and debility, produced by the severe hemorrhages, which the intra-uterine or sub-mucous form not infrequently induces. POLYPI OR POLYPOID TUMORS of the uterus are of three kinds, cystic, mucous and fibrous. They vary greatly in size, sometimes being as large as a tea-cup; and their point of attachment may be extensive or consist only of a small pedicle. The cystic and mucous varieties may spring from any portion of the mucous surface of the uterus, but they are more frequently met with growing from the mucous membrane lining the cervical canal, and pendent from the mouth of the womb, as represented in Fig. 21 and in Fig. 26, Colored Plate IV; while the fibrous variety generally grows from the sub-mucous tissue at or near the fundus, or upper portion, of the uterus. The most prominent symptoms of polypoid growths are hemorrhage, which is almost invariably present, leucorrhea, pain, backache, and a sense of weight and dragging in the pelvis. The best method of treatment, and, in fact, the only effectual one, is removal with the _écraseur_, polypus forceps, or galvano-cautery. The operation is usually attended with little or no pain. FOR MORE THAN TWENTY-FIVE YEARS the physicians of the Invalids' Hotel and Surgical Institute, have been successfully treating tumors by means of electricity. More recently, the medical profession has quite generally adopted electrical applications in response to the advice of Apostoli, of Paris. The plan used however is crude. It does not compare in results with the successful and safe procedure that our surgeons have invented and pursued. Electrical treatment will destroy the life of ovarian and fibroid tumors if applied early and after the improved methods so long used at our Institution. The destructive effect of electricity is modified by the introduction of certain electro-chemical applications so that it attacks and kills only the cells of the tumor. THE VERY LARGE OVARIAN TUMORS, however, are not amenable to treatment by this process. The walls of their cysts become so thin and weak, while the pressure of the fluid from within is so great, that sudden and spontaneous rupture is liable to occur at any time and produce death. Removal by a cutting operation is necessary in such cases. Fortunately this procedure, as skillfully modified and perfected by experience, has, in the hands of our surgeons, proven free from the dangers and hazard common to Ovariotomy. This is due to skillful operation and to the fact that in our Institution the sanitary arrangements are as perfect as it is possible to make them. Everything is at hand in the way of instruments and appliances likely to be required, and the entire procedure is conducted upon the principles of perfect cleanliness and antisepsis, which obviate the risk of inflammation and blood-poisoning. Furthermore, our nurses have had such fine training and such a vast experience in their attendance upon such cases, that wants are anticipated, and details, that would escape those not so well qualified, are looked after so thoughtfully and vigilantly that the convalescence is rapid, as well as being in every way comfortable and safe. Under such conditions OUR SURGEONS HAVE COMPLETED A LONG LIST OF REMOVALS OF OVARIAN TUMORS WITHOUT A SINGLE DEATH! We are, therefore, _warranted_ in stating that THE DANGERS DUE TO THE PRESENCE OF THESE TUMORS ARE FAR GREATER THAN THE SLIGHT RISKS OF REMOVAL BY THE SKILLFUL METHODS EMPLOYED BY OUR SURGEONS. Owing to a change made in the anæsthetic used, the painful and persistent vomiting that often follows abdominal operations is prevented. This does away with the greatest of all the dangers attendant upon the operation of Ovariotomy, and favors speedy recovery. Food, as administered in the form of artificially digested and concentrated nourishment, is readily retained. The strength is thus rapidly restored, and the healing process hastened. It is generally supposed that the size of the opening made through the abdominal walls is large, proportionate to the size of these tumors. This is an error. Even in the largest cystic tumors where the development is immense, a small incision only, is made--simply sufficient to bring the walls of the tumor in view and admit, perhaps, two or three fingers. The tumor is then rapidly emptied of its contents by means of a powerful suction apparatus. Adhesions, if any exist, are then carefully removed, and hemorrhage therefrom prevented; after which the large sac of the tumor, which when collapsed is like a thin bag, is readily drawn out through the small opening in the abdomen and removed. The small pedicle or cord-like mass of vessels that supplies the tumor, are then carefully treated after a plan invented by, and peculiar to, ourselves, which effectually prevents any bleeding, and, at the same time, does not leave any irritating substance, such as burned and charred flesh, rubber, silk, or any other unabsorbable material, within the abdomen. The parts are left unbruised and without any poisonous germs in contact. Our surgeons have met with phenomenal success in removing Ovarian Tumors, by the operation of Ovariotomy. Thus far, in a career extending over a long period of time and embracing the removal of a long list of these morbid growths, they have not had a single fatal case. The following cases illustrate our method of treatment in a few of the many cases that have been under our care. Each case is typical of a class: [Illustration: Fig. 17. The shape and position of the Tumor are shown by the dotted line.] CASE I A married woman, aged 38. Had never given birth to a child. About four years before coming under our observation, she discovered a small bunch, as she expressed it, in the left ovarian region, which gradually increased in size until, when she consulted us, it caused considerable pain in the region of the liver from pressure, and interfered with respiration. Her general health was becoming much impaired. She stated that she had consulted a prominent gynecologist in this city, who had told her that the attachments of the tumor were so extensive that ovariotomy (removal with the knife) was out of the question, and that, therefore, he could only give her palliative treatment. This unfavorable prognosis only added mental anguish and despair to her physical suffering. On examination, we found a large multilocular cystic tumor, represented by Fig. 17, with very thick walls, extending from the left ovarian region obliquely upwards and to the right, so that it pressed more upon the short ribs on the right side than it did upon the left, but which filled the entire cavity of the abdomen. The attachments, as the doctor whom she had previously consulted had stated, were so extensive that its removal with the knife could not be thought of. We were not disposed, however, to give the case up as hopeless. We told her that we would do what we could for her, but as to what the result of our treatment would be, we could not definitely say. She placed her case in our hands, and we resorted to the above described treatment. She was treated two and three times per week for more than two months, at the end of which time, the tumor had decreased in size fully two-thirds. It has ever since remained stationary, and has given her no trouble or inconvenience whatever. It is now seven years since we treated her. [Illustration: Fig. 18. U, Uterus. B, Bladder. R, Rectum. T, Tumor.] CASE II. A young lady of 23; unmarried. About six months previous to consulting us, she had discovered a tumor of about the size of an egg, In the region of the left ovary, which had been gradually increasing in size. On examination, we found the morbid growth to be about the size of a quart bowl, and evidently composed of several cysts with thick walls. She experienced no pain, and but slight inconvenience from its presence, but she was in great mental distress. She was an only daughter, and her mother had died a few years previously from the shock and hemorrhage resulting from an operation for the removal of a large ovarian tumor, performed by the late lamented Dr. Peaslee, of New York. The same course was pursued in this case, and at the end of six weeks' treatment, the tumor was reduced to the size of an egg, and has remained so ever since, now more than three years. CASE III. A woman,37 years of age; married six years; no children. She had suffered for eight years from profuse menstruation and dysmenorrhea, with a membranous discharge, and, for several months before consulting us, she had experienced severe pain and a soreness in the pelvic organs. Her bowels were obstinately constipated, it being next to impossible for her to have an evacuation, and she possessed a pale and careworn countenance. Upon examination, we discovered a hard, incompressible tumor, represented in Fig. 18, attached to the posterior wall of the uterus, which caused anteversion of the womb, and which pressed upon the rectum so as to produce great obstruction. She was treated by means of electrolysis, with injections into the substance of the growth, for one month, at the end of which she resumed home, with the tumor reduced from the size of a pint bowl to the size of an egg, and her health greatly improved. After going home the tumor continued to grow less until, at the end of a few months, her home physicians could detect no trace of it, and she has remained well since, for more than five years. [Illustration: Fig. 19. U, Uterus. T, Tumor.] CASE IV. A lady aged 36: married 13 years; no children. She complained of severe pain in the back and a frequent desire to urinate. Menstruation was profuse, and the bowels were constipated. On examination, we found an inter-mural fibroid tumor, represented in Figs. 19, developed in the anterior wall of the uterus, and pressing upon the bladder. The womb was enlarged, measuring three inches in depth, and was slightly anteflected. A month's treatment, with electrolysis and injections into the tumor, arrested the growth and diminished the size more than one-half, and caused the unpleasant symptoms to disappear. [Illustration: Fig. 20. U, Uterus. T, Tumor.] CASE V. A married lady, 26 years of age; had borne no children, but had had several abortions, brought about intentionally. Six months before consulting us, a tumor, about the size of an egg, was discovered by her home physician. It grew steadily from the time of its discovery until, when we made an examination, it was found to be about the size of an ordinary tea-cup. It was developed in the posterior wall of the womb, as represented in Fig. 20. Three weeks' treatment reduced the tumor two thirds. [Illustration: Fig. 21. U, Uterus. P, Polypus.] CASE VI. A widow lady, aged 52. She was examined ten years ago by two of the most distinguished physicians of New Haven, Conn., who pronounced her sufferings due to cancer of the uterus. She was then suffering from repeated hemorrhages, and other symptoms. They gave her palliative treatment, and told her that to interfere with the morbid growth would only shorten her life, and that by leaving it alone she might live several years. By and by the hemorrhages ceased and she passed the change of life, but she continued to be troubled with a sensation of fullness in the pelvis, pains in the back, and frequent headaches. On examination we found not a cancer, but a large polypus, as represented in Fig. 21, which had caused all the trouble. It was quickly removed, without pain, and her health restored. Thus, through an error of diagnosis, she was made to suffer physically and mentally for ten, long years of her life, in constant dread of a horrible death. * * * * * TESTIMONIALS. While we have a great cloud of witnesses testifying to the efficacy of our treatment of the diseases described in this volume, yet for lack of space we can here introduce only the following: LARGE FIBRO-CYSTIC TUMOR. [Illustration: Miss Duke.] PRONOUNCED INCURABLE BY MANY EMINENT SURGEONS. HEALTH RESTORED AND TUMOR REMOVED WITHOUT CUTTING. WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I cheerfully send you the following testimonial, and hope it may induce some sick person to seek relief where it is sure to be found. We never truly appreciate health until it forsakes us. For six years, I suffered all the tortures and fears attendant on the growth and development of a fibro-cystic tumor. I tried to have the tumor removed, but found it impossible. I had the very best medical advice the South affords, but every physician rendered the same verdict, 'incurable.' How that word, for months, rang in my ears--'INCURABLE.' It seemed stamped on my mind in letters of fire. What I suffered, both in mind and body, cannot be imagined. But for my unbounded faith in God's goodness and mercy, I doubt not, I would have given up and died. But I trusted in Him to direct me in the way to find relief. One hope stood out before me like a beacon light; and that was to find the means to go to Buffalo, N.Y., to Dr. Pierce's famous Invalids' Hotel and Surgical Institute. At last the opportunity came, and I bid my loved ones a sad farewell, (not one of them ever expected to see me again, alive) and with a sister to relieve me of every care on the journey, we started for the Institute. On arriving at the Invalids' Hotel, I was too sick and fatigued to treat with civility the sweet-faced, lady-like housekeeper who received me, or the gentle nurses who tried so patiently and kindly to minister to my wants. I had read a good deal about the Invalids' Hotel, and expected to see wonderful things; but like Sheba's Queen, I could truthfully say, 'the half had never been told.' The many ways, means, and appliances, for the relief of poor sufferers surpassed a thousand fold anything I had ever imagined could come within the scope of human skill. The skilled physicians were not only able and attentive, but on meeting one, if it were every day, they always had a ready smile, a warm hand clasp, and an encouraging word, which alone, would make one feel better and at home. The trained nurses were attentive and kind. Every department was cleanliness itself, and kept at such an even temperature, even to the halls, that during my four months' stay, I never had the slightest cold. Not only the comforts of life, but every luxury that the most exacting could demand, were fully supplied. I saw many poor sufferers, from various diseases, made well and happy, and I too, with the other happy ones, found relief, and that without the use of the knife or an anæsthetic of any kind. I would urge all poor chronic sufferers, it matters not what the trouble may be, to go to Dr. Pierce's Institute and be cured. If any one similarly afflicted cares to know more of my case, I will gladly answer any questions, if she will only write me, and enclose addressed and stamped envelope in which to reply. During my stay at the Invalids' Hotel I never lacked for anything that willing hands and warm hearts could supply, and I came away feeling that I was leaving a sweet, luxurious home and many warm friends, but with a new lease of life and perfect confidence in the ability of the physicians, for I know I could not possibly have lived two months longer, had I not found relief. To-day I am well, rosy and happy, with a heart full of lasting gratitude for the kind treatment and cure which I received at the Invalids' Hotel and Surgical Institute. Yours truly. Miss DELAINE DUKE, Clanton, Chilton Co., Ala. POLYPOID TUMOR OF UTERUS WEIGHING OVER FIVE POUNDS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss Bolin.] _Gentlemen_--After many trials my doctors here had given up all efforts to cure me. A tumor that had existed almost from my childhood was gradually killing me. From frequent hemorrhages, I had become as pale and bloodless as a ghost, and so weak as to be scarcely able to stand or walk. Frequently the loss of blood was so great as to cause such long fainting spells that my family thought me past mortal help. How I lived to get to your place is yet a matter of wonder. We appreciated the fact that in the skill of your surgeon lay my last and only hope. The result proved his abilities. The restoration of my health, when it was so generally and for so long despaired of, was miraculous, and I cannot sufficiently express my gratitude and thanks. The comfort that was given by the kindly attention of your nurses is one of the very agreeable memories of your home-like and pleasant Institution. With much gratitude, I am, Respectfully yours, Miss ANNIE BOLIN, Leon, Kan. NOTE--The above case had been pronounced cancer of the womb by home physicians. FIBROID TUMOR. CURED WITHOUT CUTTING. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Drennen.] _Gentlemen_--I cheerfully give a testimonial of my treatment at your Institution, hoping it may induce others to avail themselves of your skill. In December, 1890, I went to you, after suffering five years with two fibroid tumors of the uterus. The tumors had grown rapidly for six months prior to my going to you for treatment, and had become quite painful. Under your treatment they entirely disappeared and my health was entirely restored. The treatment I received from your able corps of physicians and nurses was all that could be desired, and I would further state that your Hotel and Surgical Institute possess all the requirements for making invalids comfortable and happy. Yours truly, VANIA E. DRENNEN, Nelson, Portage Co., O. OVARIAN TUMOR OF 62 POUNDS WEIGHT REMOVED. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Matson. ] _Gentlemen_--I hereby certify that I had safely removed, without realizing any pain, a large cyst, or Multilocular Tumor (ovarian) weighing 62 pounds, by your surgeons. Then, with kind and watchful treatment, the care of good and faithful nurses, and by the blessing of an all-wise Providence, I was sitting up in twelve days from that time; had no inflammation or fever, kept gaining, and in five weeks returned home. I am feeling better than I have for two or three years. I cheerfully and truthfully recommend the Invalids' Hotel and Surgical Institute to all afflicted as I was--with tumors, or any chronic disease. The rooms are large and pleasant, the best of food is served, and everything possible is done by the physicians, nurses, and attendants connected with the Institution, to render the visits of the afflicted pleasant and desirable. Accept the grateful thanks of my husband and myself for your good care and great kindness to me during my stay at your Hotel, and I wish you all great success. Very respectfully, MRS. ELISHA MATSON, Watte Flats, Chautauqua Co., N.Y. UTERINE FIBROID TUMOR. THE FOLLOWING IS FROM THE EMINENT LADY PHYSICIAN AND POPULAR LECTURER, MRS. JENNIE V.S. WILCOX, MD WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Jennie V.S. Wilcox, M.D. ] _Gentlemen_--The _least_ return one can render for an invaluable service, the saving of a life, is an acknowledgment of the same. Mine was a long-standing, stubborn, constitutional difficulty; chronic, and defying _all_ previous treatment. Under the care of the doctors of the elegantly appointed Invalids' Hotel and Surgical Institute the disease yielded. Could I persuade some of my fashionable friends to spend a summer or winter at Dr. Pierce's rather than at "resorts" more or less unsuited to weary or sick people, there might rise up an improved generation. The electrical appliances at the Invalids' Hotel are probably the finest in the world. With them the administration of electricity for the absorption and removal of all abnormal growths, especially in my sex, is an _assured science_, and no experiment. I cordially commend all my fellow sufferers to the tender care of the Invalids' Hotel. Yours very respectfully, JENNIE V.S. WILCOX, M.D. Saratoga Springs, N.Y. OVARIAN ABSCESS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Keach.] _Gentlemen_--It is with pleasure that I can testify to the skillful treatment received at the hands of your surgeon specialists. I had been given up to die, with an abdominal tumor and abscess. My case was not understood, before coming to you. Although operated upon twice unsuccessfully by others, my life was despaired of. I am happy to state that after a few weeks' stay in your Institution, with a skillful operation which owing to my extreme feebleness, was performed without any Chloroform or Ether (local anæsthesia only being employed), and which resulted in the removal of the tumor and abscess, I was perfectly cured, and have since enjoyed excellent health. I am now restored to my children and family, and have much to thank you for. The kindness and attention received from your physicians and nurses while in the hotel could not be better, and I wish to praise them all highly. Very truly yours, MRS. ANNA KEACH, 60 Bissell Ave., Buffalo. SUFFERED FOR 20 YEARS. OVARIAN DISEASE WITH INFLAMMATION OF ABDOMINAL ORGANS AND GREAT NERVOUS PROSTRATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Gibbons.] _Gentlemen_--I most gladly express my appreciation of the treatment I received at the Invalids' Hotel and Surgical Institute at Buffalo. When I first applied to you for treatment I could sit up but a few minutes each day, and my physician had told me I never could be any better. I began to improve very soon after receiving and commencing to use your medicines. I continued to use them for some months, following the special instructions faithfully as I could, and steadily improved in health. My trouble was of such a nature that it was necessary for me to receive personal treatment, and I spent six weeks at your Institute. The kindness of physicians and attendants is everything that can be wished. It is now two years since I have had any of your medicines, and I have taken no others since, and my health is very good indeed. I can hardly realize that I am the same person that used to suffer so much for twenty years or more. Very respectfully, MRS. M. GIBBONS, Franklin, Delaware Co., N.Y. DISEASED OVARY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 683 Main St., Buffalo, N.Y.: [Illustration: Mrs. Tanner.] _Gentlemen_--In the Autumn of '88, I had an ovary removed at the Invalids' Hotel and Surgical Institute, Buffalo. The operation was performed with consummate skill. The Hotel is first-class in every respect, being at once a Christian Hospital and Home. The skill of man, as exercised there, seems all that God designed it to be. I cheerfully add my testimonial as I consider the Institution first class in every respect. Yours truly, MRS. ELLEN F. TANNER, Leavenworth, Kans. FIBROID TUMOR OF UTERUS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Sleeper.] _Gentlemen_--There is no endorsement that the faculty of your Institute could ask that I would not willingly give. I fully realize that I owe not only my good health, but my life to the wonderful treatment received at the Invalids' Hotel and Surgical Institute, and would earnestly recommend any person needing the best medical or surgical attention to go for relief and cure to your Institution at Buffalo, N.Y. Words are inadequate to express the gratitude I owe you in so successfully treating my case. Very truly yours, Mrs. C.B. SLEEPER. Brainerd, Minn. OVARIAN TUMOR MADE UP OF SMALL CYSTS (MULTILOCULAR). [Illustration: Mrs. Crissman.] It grew to enormous size in but five months. The patient, a young unmarried woman, left home expecting to die. She had several physicians. None of them could give her any definite information as to the nature of the growth or other than unfavorable expectations as to its probable effects. It was successfully removed. The patient being able to be up and around in about two weeks with no unfavorable symptoms. Cure perfect. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _My Dear Doctors_--Many months have passed since I have written you concerning my health. I have remained perfectly well, and, in fact, my health was never better than since the tumor was removed. You will remember my case: The tumor had only grown about five months, but it was of immense size, and I had despaired of life, and my family thought that I would not return alive from your Institution. Your skillful operation and removal of the tumor, which weighed over thirty pounds, with the kind nursing and good attention given me afterwards, brought me through sound and well. To you I feel that I owe all thanks. My prayer is for the success of the World's Dispensary Medical Association. You saved my life after I had given up all hope. The kind care that all gave me was something that could not be paid for with money. It was like being at home. I send you my picture, which will give you some idea of the change for the better in my looks. I am now married and am very happy. Very respectfully, MRS. P.S. CRISSMAN. Montrose, Henry Co., Mo. OVARIAN TUMOR. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Ortez.] _Gentlemen_--I am pleased to inform you that I have had no trouble since the removal of the tumor five years ago--that my general health is perfectly restored, and I grow stronger and stronger. And since that time I have two boys, healthy, and growing as strong as can be, and I feel very well satisfied with the care of the good and faithful nurses and physicians. I cheerfully and truthfully recommend the Invalids' Hotel and Surgical Institute to all afflicted as I was with tumors, or any chronic disease. I send you my picture which will give you some idea of the change for the better in my looks. Accept the grateful thanks of my husband and myself for your good care and great kindness to me during my stay at your hotel and our wishes for your best success. Respectfully, MRS. J. NESTOR ORTIZ, Ortiz, Conejos Co., Colo. FIBROUS TUMOR. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Dean.] _My Dear Doctors_--My husband had to carry me into your place but in thirty days I walked out of the Invalids' Hotel sound and well. The tumor that caused my sufferings had gradually developed during a period of several years. The trouble induced an inflammation of the bladder and I had to endure that torment in addition. There were times when I could not touch my feet to the floor. Walking was an agony that I could hardly bear. I faithfully tried good physicians and the various remedies and treatments that were recommended to me without any satisfactory relief. So I made up my mind to go to your institution. I am now very thankful. Every one I met with in your place seemed to help me to get well. You have got not only the most skillful physicians and nurses but they are also the kindest and most agreeable that I have ever met. Your hotel is comfortable, home-like and perfectly clean. The treatment was wonderfully successful in my case. The removal of the tumor was accomplished without pain. I can highly endorse local anesthesia instead of using chloroform or ether. My recovery was rapid and I continue in good health and think of you all with thanks and good wishes. Very truly yours, MRS. ADELAIDE DEAN, 246 Garden Street, Lockport, N.Y. FIBROID TUMOR OF THE UTERUS INVOLVING BOTH BODY AND NECK OF THE WOMB. [Illustration: Mrs. Johnson.] The tumor was of many years' standing; had grown within a few months till it was about the size of a child's head. From anxiety and worry, the patient had grown nervous and generally miserable. It was successfully removed by electrolysis, no knife nor other cutting instrument being employed. In ten days the patient was able to be about and to return home. _Yanceyville, N.G_. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I have thought of you and prayed for your welfare ever since I left your Institution. I am perfectly well and enjoying as good health as ever I did. The treatment you so skillfully applied has completely restored my health, and I feel that I owe you a debt of gratitude that I can never repay. I am constantly sounding your praise among my friends, and know that I can never speak of you in too high terms. I once despaired of ever feeling well,--to-day, I am jolly and like another being. May you long be spared to minster to the afflicted. Very respectfully, MRS. HANNAH JOHNSON. NERVOUS PROSTRATION; DEBILITY; DYSPEPSIA; "FEMALE WEAKNESSES," CURED BY SPECIAL HOME-TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Nicholson.] _Gentlemen_--For a number of years I suffered with a complication of female troubles; I tried various remedies from physicians but nothing seemed to do me any permanent good. About three years ago, I suffered an attack of nervous prostration, being the result of repeated miscarriages; this was a severe shock to my nervous system, resulting in a complication of other troubles among which was nervous dyspepsia. Words fail to express what I endured at this time. Only those who have passed through a similar experience can imagine the distressing symptoms accompanying this disease; I could neither eat nor sleep, was growing very thin in flesh and life seemed a burden to me. This was my condition when I wrote to your Institution for help. I received a very encouraging letter and commenced treatment at once. I had not used their remedies a week before I began to feel better, and as I continued the treatment my health gradually improved. All the distressing symptoms have disappeared and my general health is restored. Accept my sincere thanks for the interest manifested in my case and the happy results obtained. I am now the mother of a fine baby girl, and I shall ever remember to whom I owe my present health and good fortune. Yours truly, MRS. J.D. NICHOLSON, La Hoyt, Henry Co., Iowa. BED FAST FROM WOMB DISEASE AND URINARY TROUBLES. DR. R.V. PIERCE, Buffalo, N.Y.: [Illustration: Mrs. McClain.] _Dear Sir_--When I began your treatment, I was unable to be up any at all, being troubled with womb and urinary diseases; but I can gladly say that had it not been for your medicine I could not have lived a great while longer. I hereby give your medicine a high recommendation for the marvelous work it has wrought. Yours respectfully, MRS. PHEBE MCCLAIN, Earnest, Jefferson Co., Ala. UTERINE AND RECTAL DISEASE. HOME PHYSICIANS FAILED. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Clawson.] _To whom it may concern_--I was greatly afflicted with Uterine and Rectal disease. My disease was of very long standing and had baffled the skill of our home physicians. I went to the Invalids' Hotel and Surgical Institute, and received treatment of their specialist. Under his skillful care and kind attention I soon regained my strength and felt that my former life and ambition were again restored to me. I cannot speak in too high praise of this famous Institution; the rooms are large and cheerful, the food of the very best, the nurses kind and attentive, and the staff of physicians and surgeons skillful and of large experience. Yours respectfully, MRS. CHAS. CLAWSON, Middlesex, Yates Co., N.Y. FALLING OF THE WOMB, LEUCORRHEA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Covell.] _Gentlemen_--I was sick two years with "Falling of the Womb" and leucorrhoea or whites, previous to taking your medicines. I took six bottles of your "Favorite Prescription," and was entirely cured of both in six months; it is four years this month, since I was entirely well of both those diseases and have never had any signs of their appearance since, and I am satisfied the "Favorite Prescription" saved my life, for I could hardly walk around, when I commenced taking your medicine, and I think it is a God's blessing to me, and a great credit to you that I ever took your medicine, for had I not taken it, I think I would have been in the grave now, and I can highly recommend it to all who suffer from these two complaints. I was pronounced incurable by the best doctors here in the West. I gave up all hopes and made up my mind that I was to be taken away from my husband and baby of two years old. I was sick all of the time--could not eat anything at all. In one week, after beginning the use of your medicine, my stomach was so much better that I could eat anything; I could see that I was gaining all over, and my husband then went and got me six bottles: I took three of them and my stomach did not bother me any more. We sent to you and got the People's Common Sense Medical Adviser, and found my case described just as I was; we did what the book told us, in every way; in one month's time I could see I was much better than I had been; we still kept on just as the book told us, and in three months I stopped taking medicine, only three times a day, and continued for some time in that way, and to-day, I can proudly say I am a well woman. Yes, am well, strong and healthy. I am so glad and thankful to you, Doctor, for my good health, for well do I know you are the one that cured me. When I began to take your medicine my face was poor and eyes looked dead. I could not enjoy myself any where, I was tired and sick all the time. I could hardly do my housework, but now I do that and tend a big garden, help my husband and take in sewing. Yours respectfully, MRS. MARY F. COVELL, Scotland, Bon Homme Co., So. Dak. SEVERE NERVOUS PROSTRATION. "OUT OF DARKNESS INTO LIGHT." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Austin.] _Gentlemen_--About eighteen years ago, after the birth of one of my children I was left in a weak, run-down condition; it seemed to me that my nerves were unstrung very bad: I did not suffer much pain, but I think I suffered everything any one could suffer with nervousness; my life was a misery to me. I doctored with seven different doctors and got no relief; then I took almost all kinds of patent medicines and got no relief from them, but got worse all the time, when I chanced to get one of your little pamphlets. I thought I would write to you, and waited as I thought to hear that there was no help for me; when my answer came and you said you could cure me great was my joy. I had taken your medicine about a month when I began to improve and in a few months was entirely cured. My recovery was like coming out of the dark into the light, so great was the change. I will advise all sufferers to go to you for relief--I don't think they will be disappointed. When I commenced taking your medicine I weighed 94 pounds, now I weigh 125 pounds. I do not know how to thank you for all the good your remedies did me, With heart-felt thanks I am, Sincerely yours, MRS. AMANDA C. AUSTIN, Burden, Cowley Co., Kansas. P.S.--I have a lady friend who is taking Dr. Pierce's Favorite Prescription now, and last summer every one thought she was going with consumption; four of her father's family had died with it in five years: she has taken one bottle of "Favorite Prescription," and now she is better in health than she has been in three years. Her address is Mrs. Laura Paugh, Burden, Cowley Co., Kas. A.C.A. MONTHS OF SUFFERING AND TORTURE. "LEFT TO DIE A HOPELESS WRECK." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Moody.] _Gentlemen_--A grateful heart and an appreciation of your medical skill prompts me to make a statement of my case. At the birth of my last baby (a boy weighing 14 pounds at his birth), I contracted womb disease. And for three years previous to treatment, I had been a great sufferer from prolapsus. Owing to a more serious injury than prolapsus, received at childbirth, my physicians told me that "I could never hope for recovery." After delivery, I kept my bed for seven weeks. At the expiration of that time I tried to walk. I found that I could not even stand straight; there seemed to be a "tight cord" or "drawing" from my left side extending down into my groin, accompanied by great soreness. After repeated attempts, with my body inclined to that side and yielding to the drawing, I finally succeeded in walking--a violent trembling all the while in the parts affected. Three months after the birth of my baby, I tried to take hold of my household duties--then my troubles increased, and with them came a series of "Doctors' bills." I consulted two of the best physicians, besides trying all the medicines I heard tell of, that were recommended for such diseases; but failed in obtaining a cure from any of them; my relief was only temporary. My condition was growing worse each day; the womb was so low and the "bearing down" weight so great that I could scarcely stand on my feet at all. I was irritable and nervous with a dull headache and constipation; hands and feet cold and clammy, except the palms and soles; a burning on top of my head. At this stage of my disease my bladder was badly affected--the "neck" becoming enlarged and the water collecting there caused a protrusion to over half the size of a tea cup, leaving it so dry and harsh, that it was with the greatest difficulty I could walk at all; a sudden jar, sneeze, or even the slightest pressure, would force the water out, leaving me in a spasm of pain. At this stage (22 months after confinement) menstruation returned for the first time since the birth of my baby. I had already suffered as much as I thought it possible to bear, and live, but my sufferings were even greater after this; my womb was ulcerated and inflamed; nervousness increased to violent shaking, over which I had no control; circulation so feeble that the extremities were scarcely supplied with blood, they were constantly cold and clammy. My sleep broken and disturbed, life was fast becoming a burden to me, For months, however, I endured this torture; I had abandoned work altogether; I could be up but a few moments at a time and could not walk across the floor without excruciating pain. There was no sleep, no rest, and after a week and even more, would pass during which I would never close my eyes in sleep, even when morphine, opium and chloral, were administered. My body seemed a dead weight, while my mind was alive to all my sufferings. There seemed to be a burning pressure about my head all the while. I would have shaking spells frequently, leaving me perfectly exhausted, my heart the while beating so rapidly, I could not count the pulsations; it seemed to cease altogether after that, with a sinking, fainting feeling over me, making it difficult to breathe at all. During my menstrual periods I suffered a "thousand deaths." My appetite was gone, mind and sight impaired, strength and flesh all gone. I was a pitiable object to look at, divested of all that made life endurable for me. I had baffled the skill of two physicians, and was left, after three years of agony, to die, a "hopeless wreck," worse than death. Such was my condition when I applied to you for treatment. After using medicines only six days I began to improve; my nerves were steadier; circulation better, hands and feet warm. Nine days after taking your medicines they restored the function again. I will confess I expected to suffer death again--I did not think the medicines had had time to effect a change within so short a time. Imagine my joy and surprise upon waking next morning to find it had "stolen like a thief upon me in the night," I knew not when. I spent the day in grateful tears--how could I help it? It passed off as quietly as it came, leaving my head clear of that _dreadful, burning pressure_! My nerves were steady; indeed, my improvement was so remarkable, that it seemed almost a delusion. My appetite had returned, and I was hungry for the first time in over a year. I slept well--awoke refreshed and feeling stronger. After two weeks, I was able to walk around the house and yard without support; a day or two after that I walked a hundred yards, visiting and spent the day. In three weeks time I went home (I had gone to my mother's before treatment, as I and many others thought, to die). At the end of one month there was no symptom, nor sign, of the old disease. I was able to be up all day, resting a short time at noon. To be sure of permanent results I continued treatment for one month longer, and have never had a return of the disease nor any symptom of it since. Before the end of the second month, I was able to be about the house, helping the children with the cooking, and milking. My weight increased fourteen pounds in five months after treatment. I have taken no medicine since except one bottle of Dr. Pierce's Favorite Prescription, four years ago. At this time (nine years after treatment), I find my health still good, having no aches nor pains, a splendid appetite, sleep well, no headache, no backache and no womb trouble. I am able to do my house work and everything; can do a day's work with less fatigue than I have for years before treatment. I feel sure that I would have been in the grave years ago if it had not been for your medicines. I advise all other ladies who are troubled with the same disease to apply to you for treatment. Be assured, that whenever I have it in my power I shall recommend your invaluable remedies. I thank you a thousand times for what you have done for me, and for the kindness which you have extended to me throughout. Wishing you long life and continued success, I am, with much gratitude, Very truly yours, Mrs. JENNIE S. MOODY, Isney, Choctaw Co., Ala. COMPLICATED CASE OF WOMB DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Knappenberger.] _Gentlemen_--When I went to the Invalids' Hotel for treatment I was in a very critical condition. I could scarcely walk for inward troubles--but I cannot stop to speak of one disease, for I had such a complication of diseases. Now I am doing my own housework and in the past four weeks I have entertained forty-seven people, and I think I certainly am doing well. It is with the greatest pleasure that I recommend all who are afflicted to go to the Invalids' Hotel and Surgical Institute. The Surgeons are honorable, trustworthy gentlemen, who will do all they promise; and, being men of large experience, they know just what course of treatment to pursue from first to last, so that an invalid can rest assured that no experimenting will be done. For seventeen years I was an invalid and never had better health than at the present day, for which I am grateful to your Institute. Yours respectfully, Mrs. D.T. KNAPPENBERGER, Jeannette, Westmoreland Co., Pa. UTERINE DISEASE. [Illustration: Mrs. Reel and Daughters.] _Gentlemen_--For eight years I was a sufferer from female derangements. I have been permanently cured by your specialist, and with only thirty days' treatment. I am happy to say there is no return of the old trouble, and all my friends were so surprised to see me so well after being an invalid so long. I shall never regret the day I went to the Invalids' Hotel. You ought to see me now--I am so healthy, I shall never forget your kind treatment of me, and the nurses too were so kind and attentive--I cannot say too much in their praise. Respectfully, MRS. J.W. REEL, Idaho City, Boise Co., Idaho. PAINFUL MENSTRUATION AND CONSTIPATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss Doran.] _Gentlemen_--In April, 1891 I came to your Invalids' Hotel for examination and treatment. I was at that time suffering from profuse and painful menstruation, complicated with obstinate constipation, from which I had suffered many years. I cannot speak too highly of your treatment of my case, as it was both prompt and thorough and resulted in a radical cure of the above named diseases, and I desire to recommend all who are thus afflicted to apply to your eminent staff of physicians for relief, as they cure when others fail. My advice to all who are afflicted is, if you wish to get well, go where they make such diseases a specialty. I hope that many others may be as thoroughly cured as I have been. Yours truly, Miss ELLA DORAN, Tiffin, Seneca Co., O. COMPLICATION OF DISEASES CURED BY SPECIAL HOME-TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Sheen.] _Gentlemen_--I suffered from female complaint; my kidneys, stomach and nerves were also affected. My physician told me I had Bright's Disease of the Kidneys. I suffered a great deal in various ways, at times. I felt as if life were a burden to me; about that time Dr. Pierce's Common Sense Medical Adviser came into my possession. I read it carefully, and I thought if Dr. Pierce can not cure me perhaps he can give me some relief. I wrote to him, describing my symptoms and feelings as well as I could, and asked him if he could cure me. He said he thought he could, but it would take a long time for my disease was deep seated. He sent me a box of medicines enough to last one month, especially prepared for my case. I continued taking his medicines for about thirteen months, and at the end of that time I felt like a new woman; that has been almost seven years now and my health is still good. The benefits derived from Dr. Pierce's Medicines are lasting, and I advise all women suffering as I did, to give his medicines a fair trial. Gratefully yours, MRS. MARY SHEEN, Council Bluffs, Iowa. PARALYSIS AND UTERINE DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Mann.] _Gentlemen_--I will say that your Institute is all that you claim for it, and more to. The Doctors are courteous gentlemen and the best Physicians I have ever met with in my life. My treatment while at the Institute did me more good in one month than all the doctors everywhere else combined. My ailment was Paralysis and Female Weakness. Your treatment did me good while at the Institute, and I have also been greatly benefited by the home-treatment I have received from you since. I am much better than I was; I am able to do considerable work now. When I came to you I could not do anything. I herewith send you my heartfelt thanks for all you have done for me, and should I need more treatment I will write you as before. I would advise all people who have chronic diseases to go to the Invalids' Hotel and Surgical Institute for help, for it is a grand place and prices are reasonable. We use your Family Medicines--your "Pellets" and "Golden Medical Discovery"--and find they are all you claim for them. Again I thank you and remain, your friend, MRS. S.B. MANN, Sutton, Clay Co., Neb. BARRENNESS CURED. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: A.H. Bain, Wife and Child.] _Gentlemen_--With pleasure I can recommend your medicines and treatment. At the time of my treatment I was barren, and had no signs of ever having any children until after the time of your treatment. We now have two little boys, and we are happy. This picture shows my husband, myself and our eldest child. I pray for your continued success, and thank you for your skill. Very truly yours, MRS. A.H. BAIN, Cozad, Dawson Co., Neb. INDIGESTION, CONSTIPATION, AND UTERINE DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss Joslyn.] _Gentlemen_--Some months ago I consulted your specialist concerning my health, which had at that time become very much impaired from the effects of uterine disease, indigestion and chronic constipation. I was also troubled with frequent attacks of nervous headache which rendered me very miserable. A line of treatment was outlined by your specialist, which I followed closely, and I immediately began to improve under the use of the medicine advised. The benefits were so marked that within two or three months I was able to discontinue the use of the medicine, and have since that time been enjoying good health. I attribute my cure to the use of your medicines, and I heartily thank you for the benefits received, as well as for the kind attention given me by your specialist. Respectfully yours, IDA M. JOSLYN, Groton, Conn. NERVOUS AND GENERAL PROSTRATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss Morrison.] _Gentlemen_--It is with pleasure that I add my testimony to your list, hoping it may contribute to your success and induce others to avail themselves of the benefit of your invaluable medicines. In June, 1890, I took typhoid fever of malignant type; for two months I hovered between life and death; at length the fever left me in a prostrated condition. Then I was taken with a severe pain in my back and general nervous prostration; could not move myself in bed nor bear to be moved by the most careful nurses without experiencing excruciating pain. I had the best medical attention in the community, but they failed to give relief. My friends wrote to Dr. Pierce, stating my condition and requesting treatment for me. He treated me for two months; by that time I had so much improved that I did not think it worth while to continue the treatment longer, and my health has been such that I have not had occasion to lie in bed two days together since. I feel under lasting obligations to Dr. Pierce, and thank God for blessing the world with so able a physician. Very respectfully. MISS MAGNOLIA MORRISON, Abernethy, Iredell Co. N.C. GENERAL DECLINE. "FEMALE WEAKNESS," HEART DISEASE AND RHEUMATISM. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Ashman.] _Gentlemen_--For years I had been a great sufferer from general declining health--female weakness, heart disease and rheumatism--and despaired of ever getting well. Physicians afforded me only temporary relief. It was not until I commenced doctoring with Dr. R.V. Pierce that I experienced any decided benefit. My health has gradually improved until now I feel like a new being. Language fails to express my gratitude for this cure, which is due wholly to your life-saving and life-giving medicines. Respectfully, MRS. CALEB ASHMAN, Du Bois, Clearfleld Co., Pa. NERVOUS AND GENERAL DEBILITY. DR. R.V. PIERCE, Buffalo, N.Y.: [Illustration: Mrs. Linn.] _Dear Sir_--My case was a complication of diseases--a general break-down, lasting three years. I placed myself under the treatment of four different physicians. At last, giving up all hope of recovery at home, I was making arrangements to go to a Sanitarium in Michigan for special treatment. One of your small books with blank enclosed was handed to me; I filled out the blank, and thought I would try rather than leave home and little ones,--"Happy decision;" two months' special treatment and I was well and happy, and to-day, I have the very best of health. Yours respectfully, MRS. LOMA LINN, Ladoga, Montgomery Co., Ind FEMALE WEAKNESS; LEUCORRHEA. DR. R.V. PIERCE, Buffalo, N.Y.: [Illustration: Mrs. McClure.] _Dear Sir_--I was troubled with "female weakness" and leucorrhea for three years before I applied to you. I had tried several doctors but they did me no good, and I grew worse all the time. Finally I wrote to you for special treatment, and thanks to Dr. Pierce for being the means of my recovery. I am forty-five years old and do all my housework. I remain, MRS. MARTIN J. MCCLURE, Thomasville, Oregon Co., Mo. "FEMALE WEAKNESS." Dr. R.V. PIERCE, Buffalo, N.Y.: [Illustration: Mrs. Moses.] _Dear Sir_--Having been treated by one of your associate physicians, at the Invalids' Hotel and Surgical Institute, and greatly benefited, I do not hesitate to recommend you and your Faculty to all who may need the services of honest and skillful physicians. Yours truly, MRS. D.S. MOSES, Fremont, Ohio. "FEMALE WEAKNESS." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Fitch.] _Gentlemen_--I have been taking Dr. Pierce's Favorite Prescription--three bottles of it and am getting well fast; I can do my own work, which I have not done for almost two years; I do my own washing and all of my house work; I have gained about six pounds taking your remedy. You cannot know how glad I am that I tried your "Favorite Prescription." Yours truly, MRS. ANNIE B. FITCH, Johnstown, Cambria Co., Pa. WOMB DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Ulrich.] _Gentlemen_--I enjoy good health thanks to Dr. Pierce's Favorite Prescription and "Golden Medical Discovery." I was under doctors' care for two years with womb disease, and gradually wasting in strength all the time. I was so weak that I could sit up in bed only a few moments, for two years. I commenced taking Dr. Pierce's Favorite Prescription and his "Golden Medical Discovery," and by the time I had taken one-half dozen bottles I was up and going wherever I pleased, and have had good health and been very strong ever since--that was two years and a half ago. Yours truly, MRS. ANNA ULRICH, Elm Creek, Buffalo Co., Neb. A MOST WONDERFUL CURE. TERRIBLE ULCERATION AND FALLING OF WOMB. DROPSY AND OTHER COMPLICATIONS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Smith.] _Gentlemen_--I am a farmer's wife. My husband hired hands to work on his farm--I had them to cook for--to wait upon, and my family to care for. I worked very hard till my health and strength gave way. Six years ago the "turn-of-life" began in the worst form with other disease which I knew not; I had a severe misery in my back, pain in my head; the monthly flow became so excessive--came on too often; lasted eleven days. When the flow would stop then there would be yellow discharge of thick mattery appearance. I had bearing down in the lower portion of the womb--great pain all through my body: the pain in my womb was more like "labor-pain" than anything I can compare it to; I had palpitation of the heart, light chills, hay fever; had pain in my stomach like colic. My womb was very low down; the mouth was a large hard knot--was so sore I was compelled to have a soft seat to sit on; severe pains in my thighs; pain down the sides of the abdomen; pain in my breast, pain between my shoulders; my bowels costive; my nervous system prostrated; my digestion impaired; I had a desire to urinate all the time, could not pass only a few drops at a time; on standing a few hours, it would form a crust on the chamber--red, grainy substance; I was bloated all over my body. My feet and legs were swelled tight, and I was in so much pain day and night I could not sleep; I could not eat any food only a little sweet milk and a little corn-bread; I lived in this way for four years; I could not walk across the room. I was treated by four of the best doctors in the land; the first three gave me no relief--the fourth built up my health to some extent; none of them could cure me--none of the four could regulate the menstrual flow, they could not cure those offensive discharges. I was given up to die by all four of them; my family and friends expected every day I would die. I got one of your Memorandum Books; I read it carefully, and I was hoping all this time for some relief--I hoped all the time for relief. My husband decided to write to you--ask your advice, believing you could give me relief; though I felt ashamed to tell a gentleman, a doctor I never saw, those things concerning my afflictions; but I was suffering terribly. I hoped for relief and I found it. I am happy to tell you I am well. I was spared to be cured by your good advice and good medicine and to spread your fame. When I received the book you sent me and a letter telling me what to take, and what it would do for me, I was very feeble; I had just got up from one of those bad spells--so weak that I could not sit up for more than an hour at a time. My husband went and got the medicine and a syringe. I began its use, as you advised, and took the medicine as you directed; I have taken your medicine seven months; the first month my improvement was slow; I began to have strength; my pain began to banish; my appetite began to come; I commenced to sleep sound and the bloating began to go down; the pain in my head was gone; palpitation of the heart, also the misery in my back disappeared; the pain in my womb began to banish; the first time the monthly flow appeared, it was controlled--it was regulated--it went so light with me that I could go all the time without a cane. I have not had one spell to confine me to bed in seven months; I have done all the cooking for my family all the year; the pain in my stomach disappeared; the yellow discharge also--the bearing down banished. I have no pain, no aches, no bad feelings. I feel better to day, than I have in ten years. I now enjoy life, enjoy my family, enjoy my friends. I enjoy the pleasure of telling my friends who cured me, and what medicine it was that cured me; he should have the honor. It is Dr. Pierce! I was at death's door when I began to take his medicine, and followed his advice. It was his "Favorite Prescription," "Golden Medical Discovery" and the "Pleasant Pellets" that cured me. I also used the lotion, or wash advised, with a syringe. Now, I wish you to accept my best wishes, and hearty thanks for what you have done for me. Last winter I gave my sick friends the pamphlets which were around the bottles of medicine; some of them are going to take it; it gives great satisfaction here; I will take no other myself; it will come the nearest to raising the dead of any medicine I ever saw in my life; it saved my life, when four doctors gave me up to die. My God bless you in your work, as He has done in my case. Yours truly, MRS. MARY SMITH, Oakfuskee, Cleburne Co., Ala. SEVERE FLOWING. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs Clark.] _Gentlemen_--I suffered terribly with leucorrhea, my monthlies would nearly always send me to bed; I would lose from two to four quarts of blood. I had womb trouble pretty bad and my bladder would trouble me nearly all the time, by continually wanting to urinate, with smarting, burning pains. My husband got me a bottle of Dr. Pierce's Favorite Prescription. I took nineteen bottles and now feel very well indeed. Your friend, MRS. LULU CLARK, No. 208 West 3d Street, Sioux City, Ia. Mr. Homer Clark, the husband, writes: "My wife was troubled with leucorrhea and female weakness, and ulcers of the womb. She has been doctoring with every doctor of any good reputation, and has spent lots of money in hospitals, but to no purpose. She continued to get worse. She was greatly prejudiced against patent medicines, but as a last resort we tried a bottle of Dr. Pierce's Favorite Prescription. We had seen some of your advertisements, and Mr. Cummings, a west-side druggist, advised us to try a bottle. We tried it with the following results: The first bottle did her so much good that we bought another, and have continued until she has been cured." INFLAMMATION AND "FALLING OF WOMB." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Camfield.] _Gentlemen_--I deem it my duty to express my deep, heart-felt gratitude to you for having been the means, under Providence, of restoring me to health, for I have been by spells unable to walk. My troubles were of the womb--inflammatory and bearing down sensations and the doctors all said they could not cure me. Twelve bottles of Dr. Pierce's wonderful Favorite Prescription has cured me. Yours, MRS. FRANK CAMFIELD, East Dickinson, Franklin Co., N.Y. GENERAL DECLINE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Duncan.] _Gentlemen_--I believe I owe my life to Doctor Pierce's remedies. Six or seven years ago, my health began to gradually fail; some of my friends as well as myself thought I was going into consumption. I began taking Dr. Pierce's Favorite Prescription, "Golden Medical Discovery" and his "Pellets," and was greatly benefited; took half a dozen bottles at that time, did not take any more for several years, when I began to go down again. I was married November, 1889. The next September had a miscarriage. The summer following my health was very bad; I then got one dozen bottles and took as directed. My health was much improved and am now the proud mother of a healthy boy 22 months old. My health is now much better than I thought it ever would be. Yours truly, MRS. ALICE V. DUNCAN, Rees Tannery, Mineral Co., W. Va. ERYSIPELAS AND WOMB DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. White.] _Gentlemen_ I am forty-eight years old, and have had four children. Three years ago the doctor said I had womb trouble, which was accompanied with backache and a tired and miserable feeling all over; left side hurt me very much, and could not lie on that side, and the doctor said it came from affection of the spleen; had a great deal of headache; was costive, and suffered terribly from erysipelas; it nearly set me crazy, so great was the burning and itching; sometimes experienced severe burning in the stomach. I took twelve bottles of your medicines, six bottles of Dr. Pierce's Golden Medical Discovery and the same amount of his "Favorite Prescription." was using them for about six months, and can say that they did their work well. I have ever since felt like another person, and do not think I can say enough in their praise. I have no more weakness, and all evidence or erysipelas has disappeared. Respectfully yours, MRS. SARAH E. WHITE, Kennon, Belmont Co., O. FALLING OF WOMB. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Givens.] _Gentlemen_--Having suffered for years with what my doctor called "Falling of the Womb" I was advised to try Dr. Pierce's Favorite Prescription. The effect has been simply marvelous; a single bottle relieved me of all pain and enabled me to sleep at night, which I had not been able to do for a long time. For three months I have not had any return of the complaint above named. I feel as well as I ever did. I shall heartily recommend "Favorite Prescription" to all afflicted as I was. Yours truly, MRS. SAMUEL GIVENS. Leesburg, Harrison Co., Ky. DYSPEPSIA, UTERINE DISEASE. [Illustration: Mrs. Martin.] MRS. J.A.MARTIN, of _Cleburne, Texas_, had not had good health since the birth of her child, eight years before; had a headache with burning and throbbing sensations; and a hurting in her stomach; there was a dead aching and gnawing or drawing of the stomach as she described it; sharp pain in the stomach extending to her right breast and shoulder. Weighed in health 135 pounds, but was reduced to 95 pounds; was weak; could scarcely walk at all, was sick at stomach a great deal; when her monthly sickness came on had much pain and the sickness of the stomach remained until menstruation stopped. She writes: WORLD'S DISPENSARY MEDICAL ASSOCIATION Buffalo, N.Y.: _Gentlemen_--"I have taken about six bottles of your 'Golden Medical Discovery' and 'Favorite Prescription,' and am glad to say that I feel better and stouter than I have felt in a long time. I can work all day now and not be tired at night. My head don't trouble me now. When I commenced the use of the medicine I weighed 89 pounds, and to-day I weigh 98 pounds. I feel better than I have for months." COUGH AND NIGHT SWEATS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: H.M. Detels and Wife. ] _Gentlemen_--In regard to your medicines I will say that they are always in the house. I shall never forget those nights when I was down with pneumonia. Had it not been for Dr. Pierce's Golden Medical Discovery I would not be a well man to-day. One bottle stopped the cough and night sweats. My wife was troubled with leucorrhea so bad that we did not know what to do until Dr. Pierce's Favorite Prescription was brought into the house and gave her rest. Yours truly, H.M. DETELS, Travor, Tulare Co., Cal. "CHANGE OF LIFE." WORLD'S DISPENSARY MEDICAL, ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. M.E.E. Prichard.] _Gentlemen_--It was four years ago that I applied to you for treatment. My family physician did me no good. When I began your treatment I was nearly bed-fast; my life was a misery to me. I have taken eight bottles of your medicine and it has cured me. If I could tell the whole world of your medicine I would do it. If any woman undergoing the "change of life" will take Dr. Pierce's Golden Medical Discovery and his "Favorite Prescription," according to directions, they will cure her. When I began taking them I could scarcely do anything and now I can do all my housework and pick two hundred pounds of cotton a day. Yours truly, MRS. M.E.E. PRICHARD, Thornton, Limestone Co., Texas. COMPLICATION OF DISEASES. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Robertson.] _Gentlemen_--For twenty years, I suffered with womb disease and most of the time I was in constant pain which rendered life a great burden. I cannot express what I suffered. I had eight doctors and all the medicine I had from them failed--the one after the other. I was nervous, cold hands, feet, palpitation, headache, backache, constipation, leucorrhoea and no appetite, with bearing down pains. I got so weak I could not walk around. I had to keep my bed, thinking I would never get any better. One day my husband got one of your little books and read it to me. He said there was nothing doing me any good. I said I would try Dr. Pierce's Favorite Prescription. I did try it. After the first few weeks my appetite was better; I was able to sit up in bed. I wrote to the World's Dispensary Medical Association, at Buffalo, N.Y., and described my case; they sent me a book on woman's diseases. I read carefully and followed the directions as near as I could, and took the medicine for two years, With the blessing of God and your medicines I am entirely cured. That was three years ago: Yours most respectfully, MRS. ALEX. ROBERTSON, Half Rock, Mercer Co., Mo. VAGINITIS--IRREGULAR MENSTRUATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Parker.] _Gentlemen_--I was married in April, 1893. Soon after I discovered that I was a sufferer from a very painful condition of the vagina and from irregular menstruation. In fact the latter was true from its first appearance. I consulted our family physician but he gave me no relief. At last I applied to Dr. Pierce for aid: he advised me to take his "Favorite Prescription," which I did faithfully. I bought seven bottles of it and one of the "Golden Medical Discovery." After I had taken two bottles of the "Favorite Prescription," my menses began to be more regular and I was also relieved of the other diseases. Before I began taking the medicine, I felt great lassitude and weakness at times, but I now feel quite strong. I can confidently recommend Dr. Pierce's Favorite Prescription to any one suffering as I did. Yours truly, MRS. MARIA L. PARKER, Aten, Cedar Co., Neb. CONSUMPTION. DR. R.V. PIERCE, Buffalo, N.Y.: New London, Union Co., Ark. _Dear Sir_--Some five or six years ago I had a bad cough and got so low with it that I could not sit up long at a time. We called our family physician, and he said I had consumption. All our neighbors thought so too. I had pains through my chest and spit up blood. I commenced with your "Golden Medical Discovery" and had only taken it two or three days when I felt like a different person. I took four bottles of the medicine and it cured my cough. Have not been bothered since, until a short time ago I took cold and commenced to cough again; I got a bottle of the "Discovery" and it relieved me at once. I think it is the best medicine in the world. It saved my life. I don't think any one would die of consumption if they would take Dr. Pierce's Golden Medical Discovery. I recommend it to all my friends, and tell them what it did for me. Yours respectfully, Mittie Gray LEUCORRHEA, "FEMALE WEAKNESS." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Jones.] _Gentlemen_--I have used your "Favorite Prescription" and must acknowledge to you and the public also, the benefits I received from the use of a half dozen bottles of it. My condition was pitiful before I was persuaded to use it. I had leucorrhea, no appetite, cold feet, weakness, fainting spells, melancholy. I felt that I would soon leave my children motherless. I fell off in flesh to a pitiful looking object. My friends around said I must be consumptive. My family doctor gave me nearly all kinds of blood medicine for over a year--all kinds of tonics to build up flesh, but nothing seemed to benefit me. Last September--one year ago, I began using Dr. Pierce's Favorite Prescription, being convinced that my disease was female weakness. I had only used it three days when I began to feel better and, after using three bottles accompanied by the "Discovery," I felt as though I was well, and continued its use until I had used half a dozen bottles for fear of a relapse. Was a living picture of surprise to my friends. They had all expected my death. I have given birth two months ago to a baby and no return of my old disease. I hope that all females, dragging about with pain and weakness, dyspepsia, melancholy feelings, restlessness at night, and not feeling like getting up in the morning, may commence the use of Dr. Pierce's Favorite Prescription, and be well again. Yours respectfully, MRS. ANNIE H. JONES, No. 316 Effingham Street, Portsmouth, Norfolk Co., Vt. FEMALE WEAKNESS, ASTHMA, SEVERE COUGH. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Monroe.] _Gentlemen_--I had been ailing for a year or more, being troubled with "Female Weakness" and leucorrhoea, when I took a severe cold which settled on my lungs, and I had a very severe attack of asthma, which was so bad that for three weeks I could not lie down in bed at all. I had a terrible cough, in fact, every one thought I had consumption and nothing gave me relief until I took your medicines, using two bottles of "Favorite Prescription" and two of "Golden Medical Discovery." They cured me and I have had no return of the dreadful cough since, and that has been two years now and I have had good health ever since. I am in possession of a copy of the Common Sense Medical Adviser, which I would not part with for anything. Respectfully yours, MRS. S.A. MONROE, 315 S. Regester Street, Baltimore, Md. LEUCORRHEA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Chapel.] _Gentlemen_--I have been troubled with falling of the womb for years, and was hardly able to drag around. The doctors said I had ovarian tumors and leucorrhea; the treatment they gave me only produced temporary relief. I grew worse with leucorrhea all the time until I chanced to see your remedies. I consulted you; you pronounced my trouble leucorrhea, and advised Dr. Pierce's Favorite Prescription. You sent me some prescriptions to have filled here, which I used with great success. I am entirely free from my old trouble--leucorrhea. I only used three bottles of "Favorite Prescription." I could not thank you enough for the cure. When I commenced with your remedies I weighed one hundred and nine pounds; I now weigh one hundred and forty-six. Respectfully, MRS. MATTIE L. CHAPEL, Dawson, Hopkins County, Ky. "FEMALE WEAKNESS," THE RESULT OF GRIP. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y. [Illustration: Mrs. Speer.] _Gentlemen_--I was taken sick with the grip on the first day of January, 1892. I employed a doctor, until in May I was some better, but could not do any work. The Grip left me with a weakness, my head felt very badly and I would get so discouraged and despondent. It affected my back, hips, and legs, and made me miserable indeed. My stomach was very bad; it soured and burned after eating. My heart, also, gave me much distress by beating so fast and loud at times. In May I commenced using Dr. Pierce's Favorite Prescription; took seven bottles of that, and then, by your advice, began taking Dr. Pierce's Golden Medical Discovery. I took five bottles of that, making twelve bottles in all. My niece lives with me, and she, also, took the "Favorite Prescription," which did her a great deal of good. Yours respectfully, MRS. E.J. SPEER, North Barton, Tioga Co., N.Y. "FEMALE WEAKNESS" PERMANENTLY CURED. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Ramsey.] _Gentlemen_--My trouble was "female weakness" and womb disease. I suffered greatly for twelve years. Four years ago my health became so poor I was confined to my bed most of the time from May until September. I was treated by our family physician but received no benefit; I then consulted Dr. R.V. Pierce, of Buffalo. Through his good advice I began using his "Favorite Prescription," having taken in all eight bottles of "Prescription" and two of his "Golden Medical Discovery." I am at present enjoying better health than I have for twelve years. As it is now three years since I quit using those medicines and I have no return of my old trouble. I consider myself permanently cured. Yours truly, MRS. MOLLIE L. RAMSEY, Liberal, Barton County, Mo. TORPID LIVER, SUPPRESSED MENSTRUATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs Fotzgerald.] _Gentlemen_--I had suffered so much for years from "Liver Complaint" that I did not care whether I got well or not, but my husband urged me to take your "Golden Medical Discovery." I had not had my courses for six months; after I had taken your medicine about two months, I was well. When one of my daughters with a baby two weeks old was in so much pain that she could not rest day or night, I went to her as quickly as I could, and commenced giving her your "Favorite Prescription." The next morning the pains were all gone. She said, "oh, mother, I would have died if you had not come. I do feel so good." Your medicine makes people feel like they wanted to live. There is a woman at Verdi who had several children who died with consumption of the bowels and _chronic diarrhea_. She had another one who was going the same way. The doctor said it was bound to die. I went there and gave it five drops of Dr. Pierce's Extract of Smart-Weed, and increased the dose every time its bowels moved, until I got to a half teaspoonful. The next morning the child was almost well. That woman says I saved her baby's life. I could write a week and not tell half the good your medicines have done through my hands. Two weeks ago, a young man at my house was taken with _cholera morbus_. He thought he was surely going to die, but as quickly as I could get some hot water, I put hot applications on his stomach and bowels, and gave him a few doses of your Extract of Smart-Weed. He got well immediately. MRS. MARY ISABELL FITZGERALD, Reno, Washoe Co., Nev. SUPPRESSED MENSTRUATION AND NERVOUS DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Clark.] _Dear Sirs_--My health is quite good, so I have been able to do all my own work, and I know Dr. Pierce's Favorite Prescription is what helped me. We never think of doing without Dr. Pierce's Pleasant Pellets in the house. I give them to my children when they need anything of the kind, and they never fail to do good. Gratefully yours, MRS. WARREN CLARK, Mount Pleasant, Isabella Co., Mich. DISEASE OF WOMB. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Wilson.] _Gentlemen_--I cannot say too much for Dr. Pierce's Favorite Prescription. I feel it my duty to say to all women who are suffering from any disease of the womb that it is the best medicine on earth for them to use; I cannot praise it too highly for the good it did me. If any one doubts this, give them my name and address. Respectfully, MRS. CORA S. WILSON, Carlisle, Sullivan Co., Ind. "HER FAVORITE". WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y. : [Illustration: Mrs. Collines.] _Gentlemen_--Dr. Pierce's Favorite Prescription is my favorite medicine. I recommend it highly to my friends. Mrs. James Grant of Fort Fairfield, Maine, one year ago was a very sick woman. I told her what your medicine had done for me and others whom I know, and I think it raised her from the death-bed; her husband thinks it a miracle that she got better. My health at present is good. Respectfully yours, MRS. GEORGE A. COLLINES, Maysville Centre, Aroostook Co., Maine. WORDS OF PRAISE. UTERINE DISEASE. DR. PIERCE, Buffalo, N.Y.: [Illustration: Mrs. Pierce.] _Dear Sir_--Years ago you sent a box of medicine to my sister, Mrs. Cynthia P. Freer in New Albion, N.Y., which did so much for her that after I was married I used them in my own family. Two different times I have used the "Discovery" when physicians told me they could only patch me up--I was so bad and getting steadily worse. I sat down and wrote to you; even after the letter was written I felt so worthless it seemed foolish to try, so kept my letter for some time thinking it better not to trouble you with it, but finally mailed it little thinking your advice and the "Discovery" could so speedily restore me to my usual health. A near neighbor used it for a cough occasioned by a sudden cold, and less than one bottle stopped the cough. We use the "Pellets" for malaria and the numberless ills and epidemics that go the rounds, always with happy results; it saves us physicians' bills and much suffering. We consult your Common Sense Medical Adviser as our family physician. It saves much anxiety and fruitless journeyings after a physician, perhaps to find them gone or unwilling to breast the storm or heat, to say nothing of the delay and danger of being too late. Both my sister and myself have used your "Favorite Prescription" and know it to be what it is represented by you to be. I can conscientiously recommend those of your remedies we have used. I am willing to answer letters of inquiry, if stamps are enclosed for reply. Respectfully. MRS. ABBIE J. PIERCE, Box 22, Waterbury, Dixon Co., Nebraska. "FEMALE WEAKNESS". DR. R.V. PIERCE, Buffalo, N.Y.: [Illustration: Mrs. Hoover.] _Dear Sir_--I had been a great sufferer from "female weakness;" I tried three doctors; they did me no good; I thought I was an invalid forever. But I heard of Dr. Pierce's Golden Medical Discovery and his "Favorite Prescription," and then I wrote to him and he told me just how to take them. I commenced last Christmas and took eight bottles. I now feel entirely well. I could stand on my feet only a short time, and now I do all my work for my family of five. My little girl had a very bad cough for a long time. She took your "Golden Medical Discovery" and is now well and happy. Yours respectfully, MRS. WILLIAM HOOVER, Bellville, Richland Co., Ohio. STERILITY CURED WORLD'S DISPENSARY MEDICAL. ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. King.] _Gentlemen_--I will always recommend Dr. Pierce's Favorite Prescription, it cured me when all 'other' medicines failed. For ten years I suffered untold misery. I commenced taking your medicines and found relief before finishing one bottle. After using your medicine eleven months, I made my husband the present of a twelve pound boy. I think it is the best medicine in the world. Yours truly, MRS. CAROLINE KING, New Boston, Scioto Co., O. "WOMB TROUBLE." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Demby.] _Gentlemen_--For three years I suffered from what my doctor called womb trouble. I cannot find language to describe the tortures I suffered. Sixteen weeks ago I began to use your medicine and now feel better and stronger than I have felt for years, in fact my health is thoroughly restored and there are no signs of any return of my former trouble. I owe it all to your wonderful "Favorite Prescription" which I shall always praise wherever I go. Yours truly, MRS. MAMIE DEMBY, 1503 Saratoga St., Baltimore, Md. UTERINE DEBILITY CURED AFTER SIXTEEN YEARS OF SUFFERING. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Hards.] _Gentlemen_--I must tell you that I have enjoyed better health since I began treatment with Dr. Pierce's Favorite Prescription, for Leucorrhea and Uterine Debility than I have for sixteen years. I am cured of my trouble and now weigh one hundred and sixty-six pounds, whereas my weight for many years stood at one hundred and twenty-five pounds. With pleasure, I remain, Yours truly, HARRIET HARDS, Montpelier, Idaho. FEMALE WEAKNESS, NERVOUSNESS AND DYSPEPSIA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Ross] _Gentlemen_--I suffered everything from bearing-down sensations, headaches, cold feet and hands, leucorrhea, backache, and general weakness. Was exceedingly nervous and very gloomy and despondent; had poor appetite, constipation, distress in stomach after eating, and could not sleep well. Began using "Favorite Prescription" alternately with "Golden Medical Discovery" in April, and by July was cured. Respectfully, MRS. S.F. ROSS, No. 200 Market Street, Amesbury, Mass. THREATENED MISCARRIAGE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Miller.] _Gentlemen_--I cannot say enough in praise of Dr. Pierce's Favorite Prescription, as it has done me a world of good and undoubtedly saved my baby's life, as I came near losing him twice before the proper time. Respectfully, MRS. C.P. MILLER, No. 1638 Frederick Ave., St. Joseph, Mo. WAS A GREAT SUFFERER. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Kempson.] _Gentlemen_--When I began to take your medicine I could not do any work to speak of. I was in such misery that many times, as I lay down for the night, have I prayed that I might never see the rising of another sun. It was almost death to me to stand on my feet. When I began using your medicines, I weighed 103 pounds. I have taken in all, ten bottles of your Dr. Pierce's Favorite Prescription, six of "Golden Medical Discovery," and some of your "Extract of Smart-Weed." To-day I am well, and weigh 148½ pounds, and am doing the work for my family of nine. Respectfully, MRS. FRED KEMPSON, Cambria, Hillsdale Co., Mich. TROUBLES INCIDENT TO "CHANGE OF LIFE." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Carpenter.] _Gentlemen_--I can testify to the efficacy of Dr. Pierce's medicines. I have been using his "Golden Medical Discovery," "Favorite Prescription," and "Pellets" for several years, for troubles incident to the "turn of life." I have found them to be of very great benefit to me, and cheerfully recommend them to all similarly afflicted. Respectfully, Mrs. M.C. CARPENTER, Berlin, Sangamon Co., ID DYSPEPSIA AND "FEMALE WEAKNESS." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Hutchinson.] _Gentlemen_--Words fail to describe my sufferings before I took your "Golden Medical Discovery" and "Favorite Prescription." I could not walk across the room without great suffering, but now I am able to do my own work, thanks to your wonderful medicines, I am a well woman. I suffered all the time with a weight in the bottom of my stomach, and the most severe bearing-down pains, low down, across me, with every step I attempted to take. I also suffered intense pain in my back and right hip. At times I could not turn myself in bed. My complexion was yellow, my eyes blood-shot, and my whole system was a complete wreck. I suffered greatly from headaches, and the thought of food would sicken me. Now I can eat anything, and at any time. My friends are all surprised at the great change in me. Every one thought I would not live through the month of August. Two of my neighbors are using your medicines, and say they feel like new beings. Truly yours, MRS. ANNIE HUTCHINSON, Cambridge, Dorchester Co, Md. WOMB DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y. [Illustration: Mrs. Cummings.] _Gentlemen_--I am now entirely cured by the use of your medicines. I think, and so do my relations, that if it had not been for your medicines that I could never have lived. I had many physicians before but got no relief until I began to take Dr. Pierce's Favorite Prescription and his "Golden Medical Discovery." I then commenced to get better right away. I kept getting better and am now entirely cured. They are the best remedies for women and all their ailments. I suffered from severe pain in back and region of womb, frequent headache, was pale and sallow, with dark circles around eyes, was very nervous, cross, fretful, had spells of crying, and was out of sorts generally. Respectfully, MRS. SUSAN CUMMINGS, Shawano, Shawano Co., Wis. "FEMALE WEAKNESS." PERIODICAL PAINS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Tanner.] _Gentlemen_--I was sick for four years. For two years I could do no work. I had five different physicians, who pronounced my case a poor or impoverished condition of the blood, and uterine trouble. I suffered a great deal with pain in both sides, and much tenderness on pressing over the womb. I bloated at times in my bowels and limbs. Was troubled with leucorrhea. I could not sleep, and was troubled with palpitation of the heart. Suffered a great deal of pain in my head, temples, forehead and eyes. I had a troublesome cough, and raised a great deal, and at times experienced a good deal of pain in my chest and lungs. My voice at times was very weak. I suffered excruciating monthly, periodical pains. Since taking seven bottles of your "Favorite Prescription" some time ago, I have enjoyed better health than I have for more than four years previously; in fact, for several months past I have been able to work at sewing. I have gained in weight thirty-nine pounds since taking your medicines; the soreness and pain, of which I formerly complained so much, have disappeared. Yours truly. Miss MARY TANNER, North Lawrence, St. Lawrence Co., N.Y. FALLING OF WOMB. WORLD'S DISPENSARY MEDICAL ASSOCIATION. Buffalo, N.Y.: [Illustration: Mrs. Lewis.] _Gentlemen_--I cannot tell you how my wife has improved since she began the use of your "Favorite Prescription," coupled with "Golden Medical Discovery." She has no more trouble with falling of the womb, and she never feels any pain unless she stands too long. She has no bearing-down pains since she began the use of your remedies. She does nearly all of her own housework now, but before she commenced taking your remedies, she could hardly walk across the room. I do not know now to thank you for all the good your remedies have done her, for the best doctors had given her case up as incurable. Yours truly, ALFRED LEWIS, Fairport Harbor, Lake Co., Ohio. UTERINE DEBILITY. PERMANENTLY CARED, AFTER TAKING FIVE BOTTLES OF "PRESCRIPTION." _Dep't of Photography, U.S. Artillery School_, Fortress Monroe, Va. WORLD'S DISPENSARY MEDICAL ASSOCIATION: [Illustration: Mrs. Sargent.] _Gentlemen_--My wife cannot speak too highly of your Dr. Pierce's Favorite Prescription, it having completely cured her of a serious womb trouble of long standing. She took five bottles altogether, and she has borne a large, healthy child since. There has been no return of the complaint. She only wishes every poor, suffering woman should know of the inestimable value your "Favorite Prescription" would be to them, and thanks you, gentlemen, from the bottom of her heart, for the benefit she has received. Yours very truly, EDWARD F.F. SARGENT. "FEMALE WEAKNESS." DR. R.V. PIERCE, Buffalo, N.Y.: [Illustration: Mrs. Davis.] _Dear Sir_--I am enjoying good health, and I deem it my duty to send you my testimonial. I can conscientiously recommend your medicines to any suffering woman. I think they are indeed the best medicines for "female complaint" that has ever been invented. Had it not been for them I surely would have died. I tried numbers of remedies from doctors but without getting any relief; I then took Dr. Pierce's Golden Medical Discovery and his "Favorite Prescription" and I feel confident that I am permanently cured. I told my mother to try it; she has taken four bottles--two of the "Golden Medical Discovery" and two of the "Prescription." She says it is the best medicine she has ever tried for her case; she is in better health than she has been for fifteen years. Mrs. Shelton also used it, says it has done her more good than all the doctors' medicine ever did; she has "female complaint." Yours respectfully, MRS. NORA DAVIS, Noble, Ozark County, Missouri. UTERINE DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Coventry.] _Gentlemen_--I had "Female Weakness" very bad--in bed most of the time, dragging down pains through my back and hips; no appetite; no energy. The family physician was treating me for liver complaint. I did not get any better under that treatment so I thought I would try Dr. Pierce's Favorite Prescription and "Golden Medical Discovery." I felt better before I used one bottle of each. I continued their use until I took six bottles of each. In three months' time I felt so well I did not think it necessary to take any more. In childbirth it does what Dr. Pierce recommends it to do. I would like to recommend Dr. Pierce's Extract of Smart-weed to those who have never tried it; it surely is the best thing for cholera morbus, or pain in the stomach I ever used; it WORKS like a charm. I try never to be without it. Yours respectfully, MRS. IDA COVENTRY, Huntsville, Logan Co., O. LEUCORRHEA, IRREGULAR MENSTRUATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Kenison.] _Gentlemen_--After years of suffering I have been cured by your wonderful medicine, when I commenced your medicines I could neither eat nor sleep; my hands and feet were constantly cold. I had leucorrhea for twenty years and my monthly periods were never regular, occurring about once in three weeks. I used three bottles of Dr. Pierce's Prescription and two of his "Golden Medical Discovery," and am a well, hearty woman to-day--thanks to your kind advice and excellent medicine. Our family doctor said to-day, "I can't beat Dr. Pierce's Favorite Prescription; it is a wonderful medicine." Yours respectfully, MRS. MARY KENISON, Catlin, Otero County, Colorado. "CHANGE OF LIFE," ORGANIC HEART DISEASE, WOMB TROUBLE. Dr. R.V. PIERCE, Buffalo, N.Y.: _Dear Sir_--I feel that I would be doing an injustice to you and to suffering humanity if I did not write you a statement of my case. I have been a constant sufferer all my life, and for the past five years have been under the care of many good physicians, who, I must say, have only given me relief for a short time. I cannot describe the constant pain and torment to which I was subjected every moment of my life, and I was so reduced in flesh and strength that I could scarcely walk across the floor and had little hope of ever being any better. I was induced, by the advice of a friend, to take your "Favorite Prescription," as she had been cured after taking several bottles of it. My physicians said I was suffering from the effects of "change of life," organic heart disease and womb trouble. I sent for your Common Sense Medical Adviser and then wrote to you. You advised me to take six bottles more of the "Favorite Prescription," which I did, and in a reasonable length of time after taking it, I felt very grateful for the happy relief I obtained. I do not suffer near so much with my heart as I did before taking the "Favorite Prescription." I had not been able to do any kind of work at all for two years, and I am now able to attend to my household duties without suffering any pain. I have two daughters--17 and 19 years old, that have been in very bad health for twelve months or more. I gave them each several bottles of the "Favorite Prescription," and it entirely cured them. I would send you my photo., as you request, but have none, and there is no place nearer than Natchez, Miss., thirty miles distant, where I could have one taken. I now thank you most kindly for the happy relief and cure which myself and daughters received from taking your "Favorite Prescription." With many thanks and wishing you success, I am. Yours respectfully, Mrs N.E. Reily, Bougere, Concordia Parish, La. ULCERATION OF THE WOMB. [Illustration: Mrs. McAllister.] _Gentlemen_--This is to let you knew what your medicine is doing here. I was In bad health; age was working upon me, and had ulceration of the womb; I could not get about; I took Dr. Pierce's Favorite Prescription and it cured me; I felt ten years younger. I have not had any return of my trouble. I am the mother of thirteen children and I am fifty-three years old, have never seen a better woman's friend than your medicine. I have recommended it to my friends here, and it has never failed in any case, so let me thank you for the good it did me. Yours, MRS. M.A. MCALLISTER, Lim Rock, Jackson County, Ala. REV. W.J. WALKER'S PRAYER. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Rev. W.J. Walker.] _Gentlemen_--I wish to inform you of the benefit my wife has received from the use of your medicines. I must say that your "Favorite Prescription" is the best female regulator on earth; my wife has been cured by the timely use of it. I have been using the "Golden Medical Discovery" and "Pleasant Pellets," and I am fully satisfied they are all you claim them to be; so I wish you abundant success, and hope that the Almighty God will continue His blessings toward you in your noble work. Respectfully, REV. W.J. WALKER, Vancleave; Jackson Co., Miss. TERRIBLE PAIN AND FAINTING SPELLS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Jacobs.] _Gentlemen_--When I commenced taking your medicine I was very sickly. I had frequent spells of fainting, terrible pain in my head, and life was a burden to me. I was attended by one of the best physicians in our town, but with no good results. At last a neighbor advised me to try Dr. Pierce's Favorite Prescription, which I did, and after taking one bottle I felt greatly benefited. I would advise all ladies similarly afflicted to try "Favorite Prescription." Yours truly, Mrs. SAMUEL A. JACOBS, Mechanicsburgh, Cumberland County, Pennsylvania "WAS THE PICTURE OF DEATH." PHYSICIANS FAILED. [Illustration: Mrs. Loyd.] DR. R.V. PIERCE: _Dear Sir_--My daughter has been sick all her life, and the older she grew, the worse she was until she was the picture of death: the physicians could not do her any good. I heard of your "Favorite Prescription," for women, and I gave her three bottles, and now she is a perfectly healthy girl. Have recommended it to a great many sufferers from "female complaints," and it has cured them. I think it is the greatest medicine in the world, and I have never found anything to compare with it. Yours truly, MRS. M.J. LOYD, Wesson, Copiah Co., Miss. UTERINE DISEASE OF YEARS' STANDING. SUFFERED FOR TWELVE YEARS. [Illustration: Mrs. Wilson and Child] _Oreide, (formerly Enterprise,) Taylor County, W. Va._ _Gentlemen_--A heart overflowing with gratitude prompts me to write you. Twelve long weary years I suffered greatly from Uterine derangement and at last was given up by my physician to die, besides spending almost all we had. After five months' treatment with your Doctor Pierce's Favorite Prescription, I now enjoy most excellent health. I would, to-day, have been in my grave, and my little children motherless, had it not been for you and your medicine. I will recommend your medicine as long as I live. If any one doubts this, give my name and address. Yours sincerely, MRS. MALVINA WILSON. ST. VITUS'S DANCE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: St. Vitus's Dance.] _Gentlemen_--My boy had been in bad health for a long time. We called our home doctor, but he got no better. Finally he had the St. Vitus's Dance, and our doctor did not know what to do. So I wrote to you and did as you told me: I got two bottles of your "Favorite Prescription," and one bottle and a half did the work all right. At that time, eighteen months ago, his weight was 85 pounds, now it is 135 to 140; he is fourteen years old. Yours truly, JEREMIAH PONSLER, Zenas, Jennings County, Ind. "FALLING OF WOMB." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Sharrard and Son.] _Gentlemen_--I take great pleasure in recommending Doctor Pierce's Favorite Prescription for "Falling of the Womb." I was troubled with bearing down pains and pains in my back whenever I would be on my feet any length of time. I was recommended to try Dr. Pierce's Favorite Prescription, which I did with happy results. I feel like a new person after taking three bottles of it. Respectfully, MRS. ALLEN SHARRARD, Hartney, Selkirk Co., Man. UTERINE DISEASE, "CHANGE OF LIFE." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Fletcher.] _Gentlemen_--I am happy to say that my health remains good since my sickness four years ago. I took several bottles of "Pellets," one of "Golden Medical Discovery," and two of "Favorite Prescription" and gained right along after I had been taking them. I am at a loss to give my sickness a name, as my physician called it a "Complication of Diseases," resulting from change of life and over-work. I take great pleasure in recommending your remedies to suffering women. May you live many years to administer to the suffering and afflicted is the wish of your sincere friend. Yours, etc., MRS. J.T. FLETCHER, Pony, Madison Co., Montana. MAKES CHILDBIRTH EASY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Guthrie.] _Gentlemen_--I never can thank you enough for what your treatment has done for me; I am stronger now than I have been for six years. When I began your treatment I was not able to do anything. I could not stand on my feet long enough to wash my dishes without suffering almost death; now I do all my housework, washing, cooking, sewing and everything for my family of eight. Your "Favorite Prescription" is the best medicine to take before confinement that can be found; or at least it proved so with me. I never suffered as little with any of my children as I did with my last, and she is the healthiest we have. I recommend your medicines to all of my neighbors, and especially "Favorite Prescription" to all women who are suffering. Have induced several to try it, and it has proved good for them. Very respectfully, MRS. DORA A. GUTHRIE, Oakley, Overton Co., Tenn. SHORTENS LABOR. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Baker.] _Gentlemen_--I began taking your "Favorite Prescription" the first month of pregnancy, and have continued taking it since confinement. I did not experience the nausea or any of the ailments due to pregnancy, after I began taking your "Prescription." I was only in labor a short time, and the physician said I got along unusually well. We think it saved me a great deal of suffering. I was troubled a great deal with leucorrhea also, and it has done a world of good for me. Yours truly, MRS. W.C.BAKER, South Bend, Pacific Co., Wash. "FEMALE WEAKNESS." DR. B.V.PIERCE, Buffalo, N.Y.: [Illustration: Mrs. Shepherd.] _Dear Sir_--My wife was hardly able to walk about the house when she began using Dr. Pierce's Favorite Prescription, and by the time she had used one bottle of it and one bottle of his "Pellets," she could walk a half a mile with more ease than she could walk across the house before she began to take it; she says she thinks it is just what all weakly women ought to have. Yours truly, GEORGE W. SHEPHERD, Sigman, Putnam Co., W. Va. "FEMALE WEAKNESS." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Inman.] _Gentlemen_--I began taking "Favorite Prescription" about a year ago. For years I have suffered with falling and ulceration of the womb, but to-day, I am enjoying perfect health. I took four bottles of the "Prescription" and two of the "Golden Medical Discovery." Every lady suffering from female weakness should try the "Prescription" and "Golden Medical Discovery." Yours respectfully, Mrs. F.L. INMAN, Manton, Wexford Co., Mich. "FEMALE WEAKNESS". "COULD SCARCELY DRAG AROUND." [Illustration: Mrs. Baker.] DR. R.V.PIERCE: _Dear Sir_--Several years ago I took your "Favorite Prescription." At that time, I was so miserable (and had been so for many years) that I could scarcely drag myself around. Concluded to try your medicine. I took half a dozen bottles and I have not had a return of my old trouble. Hoping others will be benefited as I have been, I remain, Sincerely, MRS. C.H. BAKER, Freytown, Lackawanna Co., Pa. OBSTINATE CHRONIC DISEASE CURED. MINISTERS ENDORSE IT. [Illustration: Mrs. Stimpson.] DR. R.V. PIERCE: _Dear Sir_--For some six or seven years my wife had been an invalid. Becoming convinced that it was her only hope, we bought six bottles of Dr. Pierce's Favorite Prescription and "Golden Medical Discovery." To the surprise of the community and the joy of myself and family, in one week my wife commenced to improve, and long before she had taken the last bottle she was able to do her own work (she had not been able to do it before for seven years), and when she had taken the last of the medicine she was soundly cured. Yours truly, REV. T.H. STIMPSON, Donnoha, Forsyth Co., N.C. NERVOUS DYSPEPSIA; UTERINE AND SPINAL WEAKNESS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Nay.] _Gentlemen_--I had nervous dyspepsia for twenty years, followed by uterine and spinal weakness with irritation of the same. In the Spring of 1890 I became so exhausted that I was compelled to keep to my bed with symptoms of paralysis in the lower limbs, and many other distressing symptoms. I accidentally obtained one of Dr. Pierce's Medical Advisers from a friend, and finding my ailments so well described therein, I wrote to Dr. Pierce for his advice, which he sent by return mail. For my recovery he requested me to use his "Golden Medical Discovery," his "Favorite Prescription," and his "Pleasant Pellets." He also gave me some directions for every-day living. These means accomplished my complete cure. I am thankful that we can have such reliable medicines brought into our homes without great expense. Yours truly, MRS. AMERICA NAY, Volga, Jefferson Co., Ind. THICK NECK (GOITRE), NERVOUS DEBILITY AND WEAKNESS CURED. [Illustration: Miss Houghton.] MISS ELLA A. HOUGHTON, of _Theresa, Jefferson Co., N.Y._, was cured of Thick Neck, Nervous Prostration, Weakness and a complication of ailments by Dr. Pierce's "Discovery" and "Favorite Prescription." She says: "My health is now as good as it was before I was sick. The swelling (goitre) has all gone from my neck. I don't have any bad feelings. My gratitude for the benefit I have received from your treatment has induced me to recommend you to all whom I know to be sick." "I have known of two or three middle aged ladies residing near here, who have been cured by your 'Favorite Prescription.'" SUPPRESSED MENSTRUATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--It is almost two years ago that my little girl was taken with a spasm which frightened me so that my menses became suppressed. I suffered severely with pressure on the brain so that I often thought I should go insane. I also had severe pain in the ovaries, and bearing down pain. I consulted a physician, who treated me for awhile till I began to feel worse, and consulted another physician whom I knew had treated several women for like ailments. He gave me medicine which did me no more good than that prescribed by the first physician. Finally, after an examination, the doctor said that he should have to operate on me in order to have my health restored. As my husband and I had heard and read so much about Dr. Pierce's medicines we decided to try them. We had Dr. Pierce's Common Sense Medical Adviser. I took three or four bottles of Dr. Pierce's Favorite Prescription and one bottle of "Golden Medical Discovery" and one vial of "Pellets." After using these I felt perfectly cured. As I am always troubled more or less with biliousness, I keep your little "Pellets" on hand and find relief by using them. One of them taken after meals acts splendidly for indigestion. Respectfully, MRS. B.H. KAMFERBECK, Holland, Ottawa County, Michigan. THICK NECK (GOITRE). WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: Master Sumner.] _Gentlemen_--I am willing and pleased to have you publish anything I have written in regard to the cure of my little son of Goitre (that a surgeon of N. Adams said could never be cured). I do hope that by so doing some little one may escape the misery my little one suffered for over a year until I began the use of the "Golden Medical Discovery." I followed your directions found in the little book around the bottles. Before the first bottle was gone, he could eat and sleep without that coughing and choking that, before the use of the "Discovery," was impossible. The tumor began to lessen in size, and after the third bottle I would never have known he ever had a tumor there. He is now hearty and healthy. Sleeps as good as any child and is full of life. He does not take anything to prevent a return, and has not for over a year. I have one of your Common Sense Medical Advisers, and found it worth five times what I gave for it; I have helped others to get it and the "Medical Discovery" and "Favorite Prescription" have brought relief to many through me. I use the "Prescription" off and on; it has given me strength; I think I should have been an invalid long ago without it. Every one here knows the truth of this letter, and I would tell it to the world if I could. Respectfully, MRS. ANNIE SUMNER, Heartwellville, Bennington Co., Vt. DROPSY, SICK HEADACHE, DYSPEPSIA AND BLOODY PILES. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Knavel.] _Gentlemen_--In the winter of 1881, I became irregular in my monthly courses. Of course at first I paid but little attention to it, hoping it would amount to nothing and probably wear away. But I slowly but surely grew worse, and at last resolved to apply to the doctors for help. My water came often, and in small quantities, and with great pain, and with red brick-dust deposit. I was attacked with severe womb trouble, bloody piles and dropsy of the ovary. I was treated by five different doctors. I was compelled to wear an inside support for a year, but it still seemed impossible for me to get well and I began to feel exceedingly alarmed and very uneasy, not knowing what course to pursue, or what the consequences might be. I had heard of Dr. Pierce, and concluded to make one more trial, so I sat down and wrote a letter to him, stating matters as near as I could, and in due time I received a favorable reply; then I commenced with his medicine. I commenced somewhere in February 1891 with the "Golden Medical Discovery" and "Favorite Prescription," in alternate doses. A strange occurrence followed. My limbs felt like what we call "asleep," and I felt as if I were in a strange land and wondered what was going to take place. I kept on till I took nine bottles. The first relief I felt was from sick headache, which I had been troubled with for many years; I was also cured of a very bad cough which I had been troubled with for many years, and of dyspepsia of long standing. I was entirely cured of a very singular and severe itching on my back, between my shoulders, which our doctors called winter itch and which they pronounced incurable. I had suffered with this for twenty years; it would come in the winter and go away in the summer. I was also cured of the worst form of bloody piles and of womb disease. At present I feel like a new person. When I first commenced with Dr. Pierce's medicines, I could not walk half a mile without a pain. The other day I walked to Mercersburgh post-office, a distance of twelve miles, and the next day walked back again, and felt no bad results from the journey. I am now 51 years old. Mrs. Knavel further writes, that "To any person desiring to know more concerning my case and its wonderful cure, and who will enclose to me a return self-addressed and stamped envelope for reply, I will be pleased to write further information." Yours respectfully, SARAH A. KNAVEL, Indian Springs, Washington Co. Md. WOMB DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: MRS. GUNEKEL.] _Gentlemen_--I have been a sufferer from womb trouble for eight years, having doctored with the most skillful physicians, but finding only temporary relief from medicines prescribed by them. I was advised by a friend to take the "Favorite Prescription," which I did, and found, in taking six bottles of the "Prescription" and two of the "Discovery," that it has effected a positive cure, for which words cannot express my gratitude for the relief from the great suffering that I so long endured. Respectfully, MRS. W.O. GUNEKEL, No. 1461 South 7th St., Terre Haute, Ind. GENERAL DEBILITY. "FEMALE WEAKNESS." DR. R.V. PIERCE, Buffalo, N.Y.: Hardy, Cascade Co., Mont. _Dear Sir_--I have enjoyed pretty good health for the past three years. Before I took your "Golden Medical Discovery" and your "Favorite Prescription" I was so weak that I could hardly do my housework. I took seven bottles in all of the two medicines; they did me a world of good; I do not think I should have been here to-day were it not for your medicines. I would send you my photograph, but I have none, and live sixty miles from a photographer. Gratefully yours, Mr. Thomas Prewett TUMOR OF BREAST AND WOMB DISEASE. [Illustration: MRS. GOLDEN. ] Mrs. Jane Golden, of Durand, Pepin Co., Wis., writes Dr. R.V. Pierce, Chief Consulting Physician, at the Invalids' Hotel and Surgical Institute at Buffalo, N.Y., as follows: "It is my heart's desire to write to you of what your medicines have done for me. I was in a very bad state when I wrote to you, and you prescribed for me and I took your medicines according to directions and am a well woman again. I had uterine disease and tumor in the breast. The doctors said they could do nothing for me any more and must resort to the knife. I would not consent and so wrote to you, and followed your advice. I took two dozen bottles of your 'Favorite Prescription,' seven bottles of your 'Golden Medical Discovery' and my health is now better than it had been in twenty years; my neighbors said I could not live three months, and I know that your treatment and medicine cured." ULCERATION OF WOMB. IRREGULAR MENSTRUATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Spicer.] _Gentlemen_--Please accept my heartfelt thanks for your medicines, which I have every reason to believe have cured me. I was afflicted for more than five years with falling of the womb and ulceration of the same, connected with very painful and irregular menstruation with chills during the same. Rush of blood to the head, sometimes falling down in insensibility and remaining so for several hours; and part of the time could not bear my weight on my limbs to stand up or walk at all for several days at a time. I was a burden to myself when I commenced taking Dr. Pierce's Favorite Prescription and "Golden Medical Discovery," and his "Pleasant Pellets" and "Smart-weed;" I used the glycerine and iodine as you prescribed for me also. I think I used one dozen bottles of "Prescription," half a dozen "Discovery" one dozen "Pills," one-half dozen "Smart-weed," at first and some more afterwards, only a few bottles, I don't remember how many. I am now well, doing my own work, and do not suffer any more pain, and don't need any more medicine. Respectfully, MRS. MARY J. SPICER, Boulder, Boulder Co., Colo. SAVE DOCTORS' BILLS. DR. R.V. PIERCE, Buffalo, N.Y.: Arcadia, Manistee Co., Mich. _Dear Sir_--We received your kind letter, with the "Pellets," and are very much obliged for the same. We know they are just what you recommend them to be. We have used your medicines for about seven years and have depended almost entirely on them for five years. Before we began the use of your medicines, we used to have to employ a doctor every little while; now we do not have to. We have four children. We give them Dr. Pierce's Golden Medical Discovery when they take cold and I think it is far better than most cough medicines, for the "Discovery" helps the appetite and the cough medicines make one sick. I like your idea of keeping the blood pure and the "Discovery" is the medicine for that. I take a bottle twice a year, in the spring and fall, and I have recommended it to several other ladies who have tried it and they all think highly of it. I have bought thirteen bottles of the "Discovery" and three bottles of Dr. Pierce's Favorite Prescription and nine bottles of the "Pellets" in five years, so you see our doctor-bill has not been very large. Our oldest boy hurt himself, lifting, and I depended upon Dr. Pierce's Compound Extract of Smart-weed for external application, and it cured him. I bought two bottles of that. Yours truly, Mrs. S. Keillor "FEMALE WEAKNESS." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Cummings.] _Gentlemen_--I took your Dr. Pierce's Favorite Prescription when I was run-down and through the warm weather. It worked like a charm on my system and I am a good deal heavier in flesh now. It is the best medicine in the world for "female troubles," for I took almost all kinds of Patent Medicines, and doctors' prescriptions without benefit. There is hardly a day passes but that I recommend it to some of my lady friends. Yours truly, Mrs. CORA CUMMINGS, No. 74 E. Yates St., Ithaca, N.Y. CHILDBIRTH MADE EASY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Johnson.] _Gentlemen_--Your medicines have my greatest praise as they did me a great deal of good. I was sick for nearly three years. Sometimes I thought I would go crazy I was so weak, nervous, and down hearted, and sour in spirits, that I was afraid I would die every day, and such mean feelings I could not describe to any one. I remained in this stage for nearly three years, doctoring with every home doctor and trying every medicine that I thought would help me, and I could get no relief. I could not sleep at times and had palpitation of the heart so that I would have to get up, for my heart would beat so fast I thought every minute I would die. The misery I went through no one could describe. A lady friend handed me Dr. Pierce's Common Sense Medical Adviser, and I wrote to you about myself, and you told me to take "Favorite Prescription" and "Golden Medical Discovery." I commenced in the spring and took three bottles of each of your medicines, and I felt so much better I thought that was enough, and ever since I have had my health. I grew stronger, and could run and skip about like a child, and was happy all day long. I felt so well I could hardly believe it was myself. I just used the two kinds of medicines--"Golden Medical Discovery" and "Favorite Prescription," and followed the "Common Sense Medical Adviser," took regular baths, and dieted for about a year, and the result was a bright baby boy which brightens our home. I took the "Favorite Prescription" before, and the result was a few hours' labor and got along splendidly; my baby weighed twenty-four pounds at seven months--a brighter, healthier baby than he is there never was. Respectfully yours, MRS. MINA JOHNSON, Riverside, Ravalli Co., Mont. PARTIAL PARALYSIS FROM UTERINE DISEASE. Buffalo, Larue County, Ky. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I am still having very good health. I value Dr. Pierce's Golden Medical Discovery and his "Favorite Prescription" very highly and often recommend them to others. I do not think I would ever have got well if it had not been for your medicines. I was in a sad condition. My bowels and half of my body (the left side), was nearly paralyzed, besides nearly my whole system was out of order. I suffered all the time; but after taking six bottles of "Golden Medical Discovery" and the same of "Favorite Prescription," and using two bottles of Sage's Catarrh Remedy as an injection, I felt like a new person. I have never seen anyone suffering in the same way as I did. If anyone with female trouble of any kind will use your medicines I am satisfied they will help them. Yours truly, Mary A. Sallee IRREGULARITY AND UTERINE DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss Henderson.] _Gentlemen_--I cannot say enough for your Dr. Pierce's Favorite Prescription. For years I suffered from irregularity and uterine debility, but now I feel as well as I ever did in my life. Thanks to you for your "Favorite Prescription," for it has performed a permanent cure of me. With gratitude, I remain, Yours, L.M. HENDERSON, Springfield, South Dakota. WOMB DISEASE. DR. R.V. PIERCE, Buffalo, N.Y.: [Illustration: Mrs. Sprigs.] _Dear Sir_--I think your "Favorite Prescription" was the preservation of my life. I was under the doctor's care for three months with womb disease and a gradual wasting all the time. I was so weak that I could not be raised in bed when I commenced taking the "Prescription," and by the time I had taken three bottles I was up and going wherever I pleased, and have had good health and been very strong ever since. That was four years ago. I have recommended it to a good many of my friends, and they have taken it and are highly pleased. Yours truly, G.A. SPRIGGS, Long Savannah, James Co.. Tenn. ULCERATION OF WOMB. St. John, Whitman Co., Wash. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--For three months I was almost prostrated with ulceration of the womb. I began the use of Dr. Pierce's Favorite Prescription and his "Golden Medical Discovery," and other remedies that are prescribed in his treatise on womb diseases. After three months' use of same I was cured. I have implicit faith in their medicines and can recommend them to others who are similarly afflicted. Yours truly, Mrs. Geo. Thornton. LESSENS MISERY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Lindsey.] _Dear Sirs_--I think Dr. Pierce's Favorite Prescription the best medicine in the world for females; I consider myself entirely well. I can do as much work as any woman. I gave birth to a healthy girl; your medicine is the best in the world for pregnant ladies--_it lessens the misery of that critical period_. I cannot praise it too much. I have gained ten pounds since I began using your valuable remedy. Yours respectfully, MRS. MARY LINDSEY, Williams Station, Escambia Co., Ala. OVARIAN DISEASE. Bridgeport, Putnam Co., Fla. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I received the Common Sense Medical Adviser and I am well pleased with it. I return many thanks to you for your kindness. My complaint was pain in my back, and in my side, that moved from the right side to the left; shortness of breath and pain in the lower part of the stomach, and my doctor said I had ovaritis and I took two bottles of the "Favorite Prescription" and one bottle of the "Golden Medical Discovery," and I am relieved of all pains in the back and sides, and of womb complaint. I shall always speak good words for you. I suffered with those pains for five years. Yours truly, Mrs Nancy Brooks LEUCORRHEA. Brooklyn, Jackson Co., Mich. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Parker] _Gentlemen_--I am more than willing to say your most valuable medicine has cured me of a very disagreeable complaint, leucorrhea. I suffered for years with pain in my back, never a night was I free. At your request I commenced a course of Dr. Pierce's Favorite Prescription and "Golden Medical Discovery." I could not sleep on a mattress; it seemed as though it would kill me. Since taking the medicine I can sleep anywhere; I am perfectly well. I would not be placed in my former condition for any money. I bought six bottles, or $5.00 worth. I took but four, my husband took the "Golden Medical Discovery." At this time I had a servant girl who suffered badly from pain at the time of her monthly periods; she took the other bottle of "Favorite Prescription," which was a great help to her. Gratefully yours, Mrs. J.H. Parker SEVERE FLOWING (MENORRHAGIA.) Lewistown, Mifflin Co., Penn's. _Gentlemen_--Seven years ago this month, I was taken sick--was bed-fast six months, and during that time, many times, was not able to eat alone. I had the best doctor that could be got. I would have sinking spells. My nerves were prostrated and I had female weakness and ulceration of the womb, which caused such excessive flowing that they thought I would die; then I would take sinking spells. My stomach was too weak, the medicine could not do its part as it should have done. I had torpid liver and right side of lungs affected; catarrh of the throat and piles; palpitation of the heart, and kidneys were somewhat affected. My doctor got me up and able to walk through the house, but the flowing would still be so bad that I would have to take the bed; then would be able to be up again and learn to walk a little again till the time would come again. My doctor treated me for the ulcers. A lady came to see me. She told me to try Dr. Pierce's Favorite Prescription. I got it but did not tell my doctor. He soon remarked the improvement and I then told him what I was using; he told me to use it, that it would be good for me. I used eleven bottles of the "Favorite Prescription," and two of the "Golden Medical Discovery." The flowing was not so bad. I got so I could sit up and be about at all times, and walk about in the house. I am still improving, and can do light house work. I am able to walk out to church every Sunday. Yours truly, Mrs Abner Knepp "FEMALE WEAKNESS." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Danard.] _Gentlemen_--A few years ago my health failed. I was troubled with female disease in its worst form having been afflicted about fifteen years. I was also troubled with constipation, loss of appetite, dizziness and ringing in my head, nervous prostration, hysteria, loss of memory, palpitation of the heart together with "that tired feeling" all the time. I consulted several physicians--no one could clearly diagnose my case and their medicine failed to give relief. After much persuasion I commenced taking Dr. Pierce's Favorite Prescription--have taken five bottles and am a well woman doing all my housework; from a run down condition I have been restored to health. I feel it my duty to recommend your "Favorite Prescription" for ladies afflicted with female diseases as I have been. Gratefully yours, MRS. BYRON DANARD, Milford, Prince Edward Co., Ont., Canada. INDIGESTION, IMPOVERISHED BLOOD. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss Sampson.] _Gentlemen_--After suffering for over a year with indigestion and low condition of the blood I was advised to try Dr. Pierce's Favorite Prescription. I had hardly finished the first bottle when I felt a great change, so I continued on until I had taken three bottles, and at the end of that time I was completely cured. My health was so much impaired that I feel I owe a great deal to your wonderful medicine. Thanking you for the advice which you so kindly gave me while taking your medicine, I am, Most gratefully. Miss CASSIE SAMPSON, No. 347 McHaren Street, Ottawa, Ottawa County, Ontario. "FEMALE WEAKNESS." DR. R.V. PIERCE, Buffalo, N.Y.: Nixon, Hardin Co., Tenn. _Dear Sir_--I am in very good health now. I think your "Favorite Prescription" is wonderful. I brought forth a fine son the first day of December--the fattest baby I ever saw, and that is why I think your medicine is such a fine one for poor sickly females. I know I never would have become pregnant, if I had not got in better health. I feel it my duty to do all that I can to praise you and your wonderful "Favorite Prescription." I can highly recommend it to all females who are suffering with leucorrhea, for I don't think any one suffered any worse than I did when I made my case known to you. May God bless you, and your great medicine--the "Favorite Prescription." Yours truly, _Sallie L. Howard_ ULCERATION AND FALLING OF WOMB. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Lyon.] _Gentlemen_--I had been suffering from ulceration and abscess in the womb, and falling of the womb, for several years or since the birth of my youngest child. I consulted all the physicians around here and they gave me up and said there was no help for me. At last, almost discouraged, I found in a little book your medicines advertised. I did not have any faith in them--I had tried so much and failed to get relief. But I began taking Dr. Pierce's Golden Medical Discovery and his "Favorite Prescription," and took five bottles of each, and used two bottles of your Sage's Catarrh Remedy for vaginal injections. It is three years since and I have not had any return of the trouble. I feel very grateful, and in fact, owe you my life, for I do not think I should have been alive now if I had not taken your remedies. Respectfully, Mrs. ABRAM LYON, Lorraine, Jefferson County, N.Y. BARRENNESS, DYSPEPSIA, "LIVER COMPLAINT." Basin, Cassia Co., Idaho. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I first had dyspepsia and "liver complaint" for five years, and I took six bottles of Dr. Pierce's Golden Medical Discovery and his "Pleasant Pellets," which Entirely cured me of that complaint. I also had painful menstruation, and took about eight bottles of Dr. Pierce's Favorite Prescription and two bottles of his Compound Extract of Smart-weed, which cured me. The symptoms of this disease were very severe, pain in the region of the womb, back and thighs, Chilliness and nausea; this disease was so severe that I was barren for two years of married life, and after taking the "Favorite Prescription," I became the mother of a boy. Yours respectfully, Mrs Emma Mcintosh GENERAL DEBILITY, MALARIA, SICK HEADACHE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. J.H. Lansing.] _Gentlemen_--I am happy to say that your valuable medicine has been a great benefit to me. I was suffering from general debility, malaria and nervous sick headaches, and after my third child was born (a beautiful baby boy of ten pounds) I only recovered after a long illness; I barely gained strength enough in two years' time so that I was able to crawl about to accomplish the little housework that I had, by lying down to read many times each day; had sick headaches very often; and many pains and aches, all the time complaining of getting no better. I finally asked my husband to get a bottle of Dr. Pierce's Favorite Prescription, which he promptly did. After I had taken one bottle I could see a great change in my strength, and fewer sick headaches. I continued taking the medicine until I had taken eight bottles--seven of the "Favorite Prescription" and one of the "Golden Medical Discovery." For some time past I have not used it but I am now able to do the housework for myself, husband and two children (aged nine and five years). I also take in dressmaking, and enjoy walking a mile at a time, and I think it is all due to the medicine, for I know I was only failing fast before I commenced to take it. I take great pleasure in recommending the "Favorite Prescription" to all women who suffer from debility and sick headache. Respectfully yours, MRS. J.H. LANSING, Fort Edward, Washington Co., N.Y. OVARIAN PAINS. Ligonier, Westmoreland Co., Pa. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--The doctors never gave any name for my disease except that one doctor said it was severe pain in the ovaries. His medicine did me no good; but whatever ailed me I was in such misery I could not describe what I suffered. The first thing that gave me any relief was Dr. Pierce's Favorite Prescription. The first half bottle made me feel much better. I used two or three bottles and thought I was cured, but it came back in three or four months, and as soon as I began to take the medicine again I got better. I took two or three bottles again, and never felt anything of it since; and that is nearly four years ago, and I give all thanks to Dr. Pierce's Favorite Prescription. I use no other medicine at all for stomach trouble but Dr. Pierce's Golden Medical Discovery. I have been troubled some with rheumatism, when nothing else would do any good, "Golden Medical Discovery" cured me; I had not taken more than one-half bottle when I felt like another woman, and I would advise any who has any trouble with his stomach, or who has rheumatism, to try it as there is not its equal to be found. Yours truly, Mrs S.A. Beatty "GIVES A NEW LEASE OF LIFE." Jamestown, Chautauqua Co., N.Y. DR. R.V. PIERCE, Buffalo, N.Y.: [Illustration: Miss Crowley.] _Dear Sir_--Both your communications have been received. I have neglected to answer them. I am glad to say in this letter that my sister is very much improved in health, and says she feels as if she had a new lease of life. She feels so much better since she commenced taking your medicine. I think it was just the medicine she needed, and am more than thankful to you for the kindly interest you have taken, and hope that others will find the same benefit from your valuable books and medicines, that my sister has. I will close with gratitude to you. Yours respectfully, Miss MOLLIE M. CROWLEY, (for sister) care Sherman House, Jamestown, N.Y. MOTHERS' RELIEF. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Simmons.] _Gentlemen_--Doctor Pierce's Medicines have been our family medicines for twenty years. They are all they have been represented to be, and untold benefits have been derived from them. Have been treated by you with your Special Remedies, and cured of difficulties that our family doctor failed to cure; and when ailing, by the use of a few bottles of "Golden Medical Discovery," have been always benefited. I recommend Dr. Pierce's Favorite Prescription to every one who is having a family--taken as directed, it works like a charm in confinement. Respectfully, MRS. A.D. SIMMONS, Emporia, Lyon Co., Kas. "FALLING OF WOMB." Clover Hill, Coahoma Co., Miss. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I cannot tell you how I have improved since I have used Dr. R.V. Pierce's Favorite Prescription and his "Golden Medical Discovery." I had been suffering for four years and I began to get worse and worse until I commenced using these medicines, and then I began to get better, and now I feel like a new woman. I suffered much from "falling of the womb," and headache, and pains in my back, and I thank you kindly for the good your medicines done me. I can do my housework now and not feel bad from it. I hope others will find the same benefit from your valuable books and medicines that I have. Gratefully yours, Eliza Allen. "WOMAN'S ILLS." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Bates.] _Gentlemen_--A few years ago I took Dr. Pierce's Favorite Prescription, which has been a great benefit to me. I am in excellent health now. I hope that every woman, who is troubled with "women's ills," will try the "Prescription" and be benefited as I have been. Yours truly, MRS. W..R. BATES, Dilworth, Trumbull Co., Ohio. AN OLD LADY'S TRIBUTE. BETTER THAN CALOMEL. Clinton, Hinds Co., Miss. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--It gives me much pleasure to say that I have been greatly benefited by Dr. Pierce's Pleasant Pellets. They act on the stomach and liver, and clear the complexion better than calomel, and you are relieved of that awful sickness and constipation which other medicines produce. Dr. Pierce's Golden Medical Discovery is the greatest tonic in the world, to build up the broken-down constitution. I am an elderly lady, sixty-six years old. I feel that my days are of short duration and would not give a word of recommendation if I did not feel it my duty to suffering humanity. Yours truly, Mrs. N.A. Watts. A YOUNG LADY'S ADVICE TO INVALIDS. "A SURE AND CERTAIN CURE." DR. R.V. PIERCE, Buffalo, N.Y.: [Illustration: Miss Fugate.] _Dear Sir_--Please accept my thanks for the good your medicines have done me. I truly believe the "Favorite Prescription" saved my life; it is a sure and certain cure. I am having perfect health; I am stout and can do all my housework. Every invalid lady should take Dr. Pierce's Favorite Prescription and "Golden Medical Discovery." Yours respectfully, ROZZIE FUGATE, Madisonville, Hopkins Co., Ky. BETTER THAN "SUPPORTERS." Leesville Cross Roads, Crawford Co., Ohio. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Four years ago, I became afflicted with womb trouble--knew nothing but pain and suffering. Began doctoring right away with our home doctor. He not doing me any good, I went to another doctor who advised me to wear an inside supporter, _which really did me more harm than good_. Last spring was taken down sick and laid on my back for ten weeks; when I heard of Dr. Pierce's wonderful Favorite Prescription. The first bottle helped me. I have now taken four bottles and feel perfectly cured. I cannot find language to express my gratitude for being restored to perfect health from a condition worse than death. Yours truly, Mrs F. Holmes. SUPPRESSED MENSTRUATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss Burk.] _Gentlemen_--When I was fourteen years old I took a bad cold and there resulted internal troubles. I was a great sufferer for four years. I had tried two physicians but neither gave me any relief. After taking Dr. Pierce's Favorite Prescription I can't say enough for it. It cured me so I have no more pains. I am now nineteen years of age. Respectfully, Miss MAMIE BURK, Everett, Bedford Co., Pa. HOW TRAVELING INVALIDS MAY BE IMPOSED UPON. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--It is now about five years since I spent eight days at the Invalids' Hotel and Surgical Institute, under treatment for a chronic disease of eighteen years' standing. I had given up to die. Going to your Dispensary was a last resort with me; I had undergone a surgical operation at the hands of my family physician from which I grew worse every day for eight months, so that I very despondently started for your institution; and when I had traveled eleven hundred miles I was made more despondent by inquiring of a man how far I had to travel to reach Buffalo, N.Y.: He answered, "Just one hundred miles." I then inquired of him if he had ever been in Buffalo, N.Y. He replied, "Many a time." I then asked him, what about Dr. Pierce's world-famed Surgical Institute? "Oh, it's a humbug. They have some drawings or pictures taken from some government buildings, that's where they get that fine building you see pictured in their books and pamphlets." I don't suppose there ever was a sadder heart entered the door of the Invalids' Hotel than that heart of mine; but it was soon made glad to be glad ever since. During the first night in the Invalids' Hotel I met and talked with patients afflicted as I was. Many of them were cured and talking of going home next day, and sure enough, they went; but I never missed them in number for others kept coming. I can honestly and truthfully say that the World's Dispensary Medical Association of Buffalo, N.Y., is anything else than a humbug. The reason why they are not humbugs is plain. They continue to perform wonderful cures and treat their patients with unsurpassed nursing, and a kinder lot of physicians, surgeons and nurses I don't believe can be found in the world. I cheerfully advise all persons suffering from chronic diseases not to stop to count the distance from where they live to Buffalo, N.Y., but go straight to the Invalids' Hotel and Surgical Institute without delay, for it is by the will of God and their skill that I am living to-day. Yours truly, L.M. McPhail, Autun, Anderson County, S.C. NERVOUSNESS, "FEMALE WEAKNESS," NASAL CATARRH. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Sanderson.] _Gentlemen_--My health was utterly gone. Was suffering from nervousness, female troubles and nasal catarrh; life was almost a burden to me, but a glorious change came, due solely to Dr. Pierce's Favorite Prescription and Dr. Sage's Catarrh Remedy. I have suffered more than tongue can ever tell. I have been treated by good physicians but they only help me temporarily. I have taken a great many patent medicines with the same result. In 1890, I began taking Dr. Pierce's Favorite Prescription and Dr. Sage's Catarrh Remedy, which gave me immediate relief and a permanent cure. Respectfully, MRS. BELLE SANDERSON, Sprout, Nicholas Co., Ky. MADE HER "STRONG AND WELL." DR. R.V. PIERCE, Buffalo, N.Y.: West Liberty, Ohio. _Dear Sir_--I can cheerfully recommend your valuable medicine, the "Favorite Prescription," to suffering females. Three years ago my health became so poor that I was scarcely able to help with the household duties. I was persuaded to try your medicine, and purchased six bottles. That, with the local treatment you advised, made me strong and well. My sister has used it in the family with like results. Yours truly, L.E. Johnson MADE LIFE A BURDEN. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss Crawford.] _Gentlemen_--For years I suffered monthly from periodic pains which at times were so acute as to render life a burden. I began using Dr. Pierce's Favorite Prescription. I used seven bottles in as many months and derived so much benefit from it and the home-treatment recommended in his Treatise on Diseases of Women, that I wish every women throughout our land, suffering in the same way, may be induced to give your medicines and treatment a fair trial. Gratefully yours, Miss G.F. CRAWFORD, Limestone, Me. "FEMALE WEAKNESS," LEUCORRHEA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration] _Gentlemen_--I will write you a few lines to-day and feel thankful that I can say I enjoy good health most all the time. When I first commenced using your medicine I was suffering from female weakness, leucorrhea, bearing-down pains and a soreness across me that at times I could hardly stand up straight when I would get up off of my chair to walk across the room. I got a bottle of your "Favorite Prescription" and by the time I had used half of it, the soreness began to get better. I used three bottles altogether, and since that, you might say I am enjoying the best of health most of the time. I have had two baby boys since--both healthy, although the baby is only three weeks old, and I am doing all of my own work since he was two and one-half weeks old. I always speak highly and recommend your medicine because I know it deserves a good name; and I feel certain it will cure female diseases if they give it a fair trial. Yours respectfully, MRS. RICHARD REED, Springfield, Kings Co., N.B. FEMALE IRREGULARITIES. Cuscowilla, Mecklenburg Co., Va. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I take pleasure in adding my testimonial to the great list, and hope that it will be of interest to suffering humanity. I tried three doctors and none of them seemed to do me any good. When at last I almost despaired of health any more, I saw in a paper one of your advertisements, and I sent for and got two bottles of Dr. Pierce's Golden Medical Discovery, and I improved so rapidly that I sent for and got three bottles of your "Favorite Prescription," and now I am as well as I have been since I was a child. I had been a sufferer for three years when I commenced taking Dr. Pierce's medicines. When I commenced taking it, I was not able to walk across my room without help, or rise from my chair. I suffered from nervousness very much, and with the least excitement I would faint; and I think, in short, I suffered with female irregularities and that your medicine has brought me through. I don't think I can say enough for it. I have used five bottles of your medicine in all. If any one wishes to know what I have to say, they can address me in person, enclosing stamps. With respect, I am, Yours, Sarah E. Ineker "JUST A MERE SKELETON." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Roberts. ] _Gentlemen_--If I had not taken your medicine I would not be here now. The doctors did me no good, I was just a mere skeleton, could not eat. I would have awful pain in my stomach--pain in my side, bowels and chest; soreness in my back and womb; was weak, nervous and could not sleep. After I took your "Favorite Proscription" and "Golden Medical Discovery," I commenced to improve. In two weeks could walk about the house--could eat--did not have any more pain in my stomach--threw away my morphine powders. When I first commenced taking the medicine it made me feel worse. I was hoarse, could not speak aloud for three days; as I got better my pains and bad feelings left me and I could sleep good; my nerves got better. Before I took your medicine I kept my bed four months--got worse all the while. I am now quite fleshy and can work all day. Respectfully, MRS. WILLIAM ROBERTS, Bridgeport, N.Y. CONSTANT SUFFERER FOR MANY YEARS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Scott.] _Gentlemen_--For many years my wife has been a constant sufferer from indigestion, sick headache, nervous prostration and all other complaints that the female sex is heir to, and, after trying many remedies and doctors with but little or no relief, I persuaded her to try Dr. Pierce's Favorite Prescription and "Golden Medical Discovery." She was so out of heart, she returned the answer that it would be like all the rest--of no good; but on my account, she said she would try it, so I got one bottle each; and before she had used half of a bottle she felt that it was benefiting her, and she has continued to improve ever since, and now thinks it the most wonderful remedy on earth for her sex, and recommends it to all suffering females. She has not been so well in ten years. I write this without any solicitation and with a free, good will, so that you may let all who may suffer know what it has done for her. Yours truly, M.W. SCOTT, U.S. Marshall's Office, Atlanta, Ga. A MOTHERS' FRIEND. Tanks, Cottle Co., Texas. DR. R.V. PIERCE, Buffalo, N.Y.: _Dear Sir_--I took your "Favorite Prescription" previous to confinement and never did so well in my life. It is only two weeks since my confinement and I am able to do my work. I feel stronger than I ever did in six weeks before. Yours truly, Corda Culpepper BED FAST. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: Mrs. Tappan.] _Gentlemen_--For about two years I was a constant sufferer from diseases peculiar to my sex. I had to be carried from my bed, had horrible dreams, sinking sensations, was very nervous and had little or no appetite. In short, my whole body was racked with pain. I had frequent attacks of hysteria, and was completely discouraged, for I found no medicine did me any good. At last I determined to give your "Favorite Prescription" a trial. I had taken but two bottles before I felt so much better! I took eleven bottles. To-day I am well. I have never felt the least trace of my old complaint in the last six years. We use the "Golden Medical Discovery" whenever we need a blood-purifier. By its use, eruptions of all kinds vanish and the skin is rendered clear and soft, almost as an infants. Respectfully, MRS. HARRY TAPPAN, Reynolds, Neb. AT DEATH'S DOOR. Abita Springs, La. DR. R.V. PIERCE, Buffalo, N.Y.: _Dear Sir_--My wife suffered from laceration of the womb and inflammation--she was completely bed-ridden and lingered about one year at death's door. Local applications were given her and Dr. Pierce's Favorite Prescription; she gradually regained strength and continued to do so until she recovered. I am convinced that any case of womb disease can be certainly and permanently cured by the use of your remedies. M. Green Agt. Southern Exp. Co. HEART, LIVER, AND STOMACH DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mrs. Landrum.] _Gentlemen_--About nine years ago my health began to fail; had a continual pain and aching under my right shoulder and in or under my right breast; I could not eat anything but a little milk or bread, and even that made my stomach pain and hurt me so I could not rest; I kept getting weaker all the time and I could no longer sit up; I sent for our family physician; he said I had dyspepsia and inflammation of the liver, and gave me medicine two or three months, but I kept getting weaker all the time; it seemed to me that I was diseased all over; thought I had heart disease; had the doctor examine my heart several times. I became so discouraged that I gave up all hope of ever getting well, but consented to send to Dr. Pierce for medicine. I commenced taking it and in a short time I was able to sit up; continued to take his medicine three months and felt like a new person--didn't need any more medicine and have not yet. I can eat anything I wish; am sixty-three years old; can walk a mile without any trouble, and I can truly say that I believe it was Dr. Pierce's medicines that saved my life. Respectfully yours, MRS. VIRGINIA LANDRUM, Merino, Logan Co.. Col. UTERINE DISEASE. Creston, Iowa. DR. R.V. PIERCE, Buffalo, N.Y.: _Sir_--My wife improved in health gradually from the time she commenced taking "Favorite Prescription" until now. She has been doing her own housework for the past four months. When she began taking it, she was scarcely able to be on her feet, she suffered so from uterine debility. I can heartily recommend it for such cases. Yours truly, H.H. Snyder THE PICTURE OF HEALTH. DR. R.V. PIERCE, Buffalo, N.Y.: [Illustration: Mrs. Meeker.] _Dear Sir_--My daughter, Miss MEEKER, was sick and we called in one of the best doctors here. She got so weak that I had to help her out of bed and draw her in a chair. She then tried some of Dr. Pierce's Favorite Prescription. In less than a week she was out of bed and has been working about five weeks now, and looks the picture of health. As for myself I am much better of my female complaint. Before taking the "Favorite Prescription," I suffered most of the time from catarrhal inflammation. Yours respectfully, MRS. NANCY MEEKER, Dunraven, Delaware Co., N.Y. LIFTED THE BURDEN. Nye, Putnam Co., W. Va. DR. R.V. PIERCE, Buffalo, N.Y.: _Dear Sir_--Mine is a case of eleven years' standing, which baffled the skill of the best medical aid procurable. I obtained no good effect, until I began the use of the "Favorite Prescription," which lifted the burden which was seeking my life. My gratitude I owe to the "Prescription." I hope that all suffering humanity (as in my case) may profit by the result of my experience. Yours truly, Evoline Neil * * * * * SPERMATORRHEA (SEMINAL WEAKNESS), or emission of semen without copulation, is generally induced by the early habit of masturbation. It is one of the evidences that passion, instead of prudence, has held sway. Passion may aptly be termed the voice of the body, by which, if we listen, we are enchanted and led astray. Conscience is the voice of the soul, which remonstrates, and if we obey, we shall be guided aright. We cannot reconcile these conflicting voices, and if we indulge the passions when conscience forbids gratification, the remembrance of the wrong remains forever, and constant fear is an everlasting punishment. WRECKED MANHOOD. Man possesses few powers which are more highly prized than those of virility, which is the very essence of manhood. "He is but the counterfeit of a man, who hath not the life of a man." THE SEMEN is a milky fluid of the consistency of mucus. It is secreted by the testicles and is intermixed with the fluids secreted by the prostate and by Cowper's glands. Its fertilizing property depends on the presence of minute bodies, termed _spermatozoa_. These consist of little polliwig-shaped bodies (Fig. 3), having large heads and long filaments or tails. Under the microscope these little bodies are seen to describe movements not unlike those of polliwigs. WHY EMISSIONS OF THE VITAL FLUID DEBILITATE. The seminal fluid consists of the most vital elements in the human body. It not only assists in maintaining the life of the individual, but communicates the essential, transforming principle which generates another mortal having an imperishable existence. Its waste is a wanton expenditure, which robs the blood of its richness and exhausts the body of its animating powers. No wonder that its loss enfeebles the constitution, and results in impotency, premature decline, St. Vitus's dance, paralysis, epilepsy, consumption, softening of the brain, and insanity. No wonder that conscience and fear become tormenting inquisitors, and that the symptoms are changed into imaginary specters of stealthily approaching disease. "There is no future pang Can deal that justice on the self-condemned He deals on his own soul." THE PRACTICE OF ONANISM squanders the vitality and bankrupts the constitution. Indigestion, innutrition, emaciation, shortness of breath, palpitation, nervous debility, are all symptoms of this exhaustion. Subsequently, the yellow skin reveals the bones, the sunken eyes are surrounded by a leaden circle, the vivacious imagination becomes dull, the active mind grows insipid--in short, the spring, or vital force, having lost its tension, every function wanes in consequence. Excessive lustful enjoyment produces feebleness, and finally terminates in disease and impotency. SEMINAL WEAKNESS may be the result of marital excesses. A _proper_ sexual gratification contributes to the health and happiness of both parties. On the other hand, intemperate indulgence not only prevents fruitfulness, but ultimately, if persisted in, renders the husband entirely impotent, and undermines and destroys the constitution of the wife. Spermatorrhea may be induced by spinal irritation, intestinal worms, or piles. It may also result from inherited, as well as acquired, constitutional weakness. NOCTURNAL OR NIGHT EMISSIONS. Involuntary emissions of semen most frequently occur during amorous dreams at night, and are therefore termed _nocturnal emissions_. Although they are at first occasioned by lascivious dreams, attended by erections and pleasurable sensations, yet, as the disease progresses, the erections become less perfect and the losses are only revealed by the depression of spirits experienced the following morning, and by the stiffened and stained spots on the linen. At first, these emissions may occur but once in two or three weeks, unless the patient be excited by company, stimulation, food, drinks, or other causes; but, at a later stage of the disease, they sometimes take place every night. In aggravated cases, the seminal sacs are so weakened that the warmth of the bed, friction of the clothing, reading obscene literature, viewing indecent pictures, indulging in lewd conversation, or even being in the presence of women, produces a waste of semen--many times unattended by erections. When there is great weakness, seminal discharges may be induced by lifting heavy weights, pressure upon the genital organs, horseback riding, straining at stool, or even upon urinating, as observed when muscular efforts are made to expel the last drops, which appear thick and viscid. If the urine be allowed to stand for a few hours, the seminal discharge will be precipitated, and will form a light-colored deposit at the bottom of the vessel. If the sediment be examined with a microscope, spermatozoa can readily be detected in it. WASTING AWAY OF THE TESTICLES. Masturbation not only occasions loss of semen, but frequently the testicles and other generative organs waste and become reduced in size as a result of the abuse. Fig. 1 shows the testicle in a healthy condition, while Fig. 2 represents one much reduced, as a result of self-abuse. The celebrated Dr. Drewery, of London, speaking of the reason why masturbation is so extremely injurious in its effects upon both body and mind, says: "This is a question which I have often been asked by patients, and it is one which is rather difficult to explain to any one not acquainted with the phenomena of reflex nervous action. "Perhaps the simplest mode of putting it is to say that the effects produced by the excitement of the parts are not the direct result of the stimulation, but that the excitement of the extremities of the nerves is conveyed through them to the spinal cord and brain, and that the emission which occurs, when sufficient stimulus has been applied, is the result of nervous force reacting upon the parts from the spinal cord back again. This action is termed reflex, and is similar to that of vomiting, which is only produced through the medium of the great nervous centres; so that if the nervous communication between the stomach and spinal cord and brain is cut off, nothing in the stomach could possibly cause vomiting, whereas if the communication remains intact, this action can be immediately produced by irritation of nerves far away from the stomach, viz., by tickling the fauces, as every drunkard is well aware who has ever put his finger down his throat for the purpose of emptying his stomach of the contents which are poisoning him, but which without the additional stimulus he is unable to expel. It will be seen, therefore, from this that the act of emission is only produced through the agency of the spinal cord, and not by any direct nervous action between the parts which are stimulated, and those which are concerned in the emission. [Illustration: Fig. 1. The Testicle in a healthy condition.] [Illustration: Fig. 2. A Testicle wasted by Masturbation.] "The brain is also concerned to the fullest extent in the production of these phenomena, as are all the senses of the body; this is proved by the fact that emissions occur during sleep, without any excitement beyond the engorgement of the parts with blood, produced by the cerebellar congestion of the brain, usually found to follow lying upon the back during sleep. This, however, is unnatural and unhealthy, and is usually the result, as before pointed out, of masturbation. But these two important points must be remembered--that emission may be produced by friction merely as a purely spinal reflex action, and it may be caused by the action of the brain without any friction whatever. Both these results are unhealthy and injurious. A true natural and healthy act of sexual intercourse demands the excitement of brain, spinal cord, and every nerve in the body simultaneously, and resembles the lightning flash which restores the equilibrium of electric force disturbed during a thunderstorm. "It is useless to endeavor to describe the marvelous actions of nervous force, but from what has been said it is not difficult to comprehend that if a convulsive action is produced in any part of the body by the sole excitement of the spinal cord, when it is necessary for its healthy and natural production that the brain and senses generally should be equally excited, the balance of nerve power is destroyed, which fact alone is proved by the effects upon the nervous system always following masturbation, which is the irritation of the spinal cord without the assistance of the brain." VARIOUS COMPLICATIONS are likely to arise in the progress of this malady. STRICTURE of THE URETHRA, or water passage, is a very common complication and, even when quite slight, generally interferes very seriously with the cure of the spermatorrhea when overlooked by the attending physician, as is very commonly done, especially when the constriction of the water passage is only slight. Very often it occurs in our practice that on examining a case of this disease that has been the rounds of the doctors, we find a stricture, which had been entirely overlooked by other practitioners, being so slight as not to occasion serious obstruction to the flow of urine but yet sufficient to interfere very much with the cure of the spermatorrhea. The size of the urethra, or water passage, should bear an exact and proportionate relation to that of the penis, and when from any cause the urethra is contracted below this normal size, it should receive attention, as otherwise the stricture is likely to increase and the passage becomes so constricted as to produce serious disease of the bladder, and not fail to perpetuate spermatorrhea, when this disease exists. HYDROCELE (_Dropsy of the Scrotum_) consists of an undue secretion of the fluid which moistens the _tunica vaginalis_, and may arise from an irritation of the testicle, produced by masturbation. This subject is fully considered in the Medical Adviser. VARICOCELE is a dilatation of the veins of the spermatic cord and scrotum, and is frequently a result of masturbation. It is readily distinguished under the form of a soft, doughy, compressible, knotty, and unequal enlargement of the veins, and a tumid condition of the adjacent parts. One writer, speaking of the enlargement of the spermatic vessels, describes them as "feeling like a coiled up bundle of worms." DISEASE OF THE PROSTATE GLAND is frequently caused by solitary indulgence. Venereal excesses produce congestion and the gland is overnourished. It becomes greatly enlarged, a condition called _hypertrophy_. This affection gives rise to a heavy feeling or pressure in the region below the bladder, and often interferes seriously with urination, and gives great pain and uneasiness, and often results in grave and dangerous complications. PROSTATORRHEA consists of an unnatural flowing or wasting of the prostatic secretion, which may be known by its mucous-like appearance, and, when placed within the field of the microscope, by the absence of _spermatozoa_ or fecundating germs. It is often mistaken for spermatorrhea, or for gleet, by inexperienced and careless physicians. For a full consideration of diseases of the prostate gland, see Part IX of our Dime Series of pamphlets, which will be sent on receipt of ten cents in postage stamps. Again, the habit of self-pollution weakens all the structures of the genital organs, and induces seminal waste, which may lead to a morbid diminution in the size of the prostate gland. This condition, which is exactly the opposite of the one above described, is _atrophy_. Any disease which renders the circulation in the prostate gland languid and feeble interferes with the nutrition of that organ and impairs its function. IMPOTENCY (_Loss of Sexual Power_). Masturbation prevents the excitability of the nervous system and sexual organs and causes debility, which is indicated by the premature discharge of semen during sexual intercourse. These premature emissions indicate not only partial impotency, but also that the nerve-centres have become morbidly sensitive by the practice of solitary vice, or marital excesses. At length the powers of the erectile tissues are diminished, and there is weakness which prevents the act of copulation, or the erection may be slow and not last long enough, on account of a faulty functional condition of the spinal cord. A PECULIAR FORM OF IMPOTENCY is associated with certain abnormal nutritive changes which give rise to a lymphatic or fat condition of the system. Not that the temperament in all these cases is originally lymphatic, but the system degenerates in consequence of nutritive perversion. With the loss of sexual ardor, there is also apathy of mind, loss of manliness, and the victim becomes cold, dispassionate, and treacherous, devoid of any admiration or love for the opposite sex. He acquires rotundity of person, the face is fat, smooth, often beardless, and the voice is feminine. The victims of this disease represent two distinct classes, viz.: (1) those who are fearfully tormented by the consciousness that they are losing their virile powers, and become irritable, jealous and often desperate; and (2) those who are completely indifferent to this deprivation. (1.) Patients of the former class are readily restored to health by proper treatment, for they are willing to make an effort for the recovery of their manly powers. There is not complete loss of sexual desire, yet their disappointment is so great that they may entertain suicidal thoughts. They are moody, fickle, discontented, excitable, and remarkably impulsive. With proper treatment, they regain tone of body, vigor of mind, an increase of sexual desire, and become more attentive to business affairs, and less indifferent to the gentler sex. With the restoration of the general health and the sexual functions, remarkable constitutional changes occur. It is often the case that their intimate friends hardly recognize them by looks or acts. (2.) It is equally true that those who are wholly indifferent to the loss of virile power, uninterested in the evidences of their manhood, are sometimes incurable. In fact, it is useless to treat the latter class, because they will neither co-operate with the physician, nor persist in the treatment necessary to effect a radical and constitutional change. Masturbation perverts and finally destroys the secretory functions of the testicles. It sometimes causes chronic inflammation, which may result in obliteration of the minute seminal canals, or obstruction of the conveying ducts. The sperm is imperfectly elaborated and totally unfit for procreative purposes. Sometimes the spermatozoa are entirely absent, and, when present, are very few in number, incomplete in structure, diseased, and deficient in power as well as in organization. Fig. 3 represents the spermatozoa in a healthy condition, and Fig. 4, when they are sickly, deficient and inanimate. The husband may appear to be healthy, and _his_ inability to procreate may be erroneously considered a defect in his wife. SYMPTOMS OF SPERMATORRHEA. The indications of abuse of the sexual organs are loss of nervous energy, dullness of the mental faculties, and delight in obscene stories. The expression of the face becomes coarse, and the movements slow; the eye is sunken, the face bloated and pale, and the disposition is fretful and irritable; the appetite is capricious, the throat irritated, and the patient makes frequent attempts to clear it, in order to speak distinctly. There are pains in the chest, wakefulness, and during the night lascivious thoughts and desires. The relish for play or labor is gone, and a growing distaste for business is apparent; there is a determination of blood to the head, headache, noises and roaring sounds in the ears, the eyes may be blood-shot and watery, weak or painful, the patient imagines bright spots or flashes passing before them, and there may be partial blindness. There is increasing stolidity of expression, the eye is without sparkle, and the face becomes blotched and animal-like in its expression. The victim is careless of his personal appearance, not unscrupulously neat, and not unfrequently a rank odor exhales from the body. There are troublesome sensations, as of itching and crawling, in and about the scrotum. Subsequently, there is obstinate constipation, and all the symptoms of dyspepsia follow. Gradually the pallor deepens, the patient becomes emaciated. There is a shortness of breath, palpitation after even moderate exercise, trembling of the knees, and eruptions on the skin. There may also be cough, hoarseness, stitch in the side, loss of voice. The sleep is not refreshing, the patient has frequent nightmare, or the dreams are lascivious, and the involuntary emissions of semen become more frequent. The weakness increasing, the sufferer experiences a weakness in his legs and staggers like a drunken man, his hands tremble and he stammers. [Illustration: Fig. 3. Microscopic appearance of healthy semen.] [Illustration: Fig. 4. Microscopic appearance of semen which will not fecundate.] The victim is unable to concentrate his thoughts, cannot remember what he reads, and is mentally indolent. He begins to be suspicious of his friends, has less confidence in others, and desires to be alone, is despondent and has suicidal thoughts. He has pain in the back, does not like to walk, and is inclined to lie down. The semen is prematurely discharged upon attempting coition, and if there be offspring, it is apt to be feeble or subject to scrofula, consumption, or convulsions. The genital organs, especially the penis and testicles, diminish in size, as the disease progresses, lose their energy, and the glands of the penis become cold and flaccid. There is frequent desire to urinate, chronic irritation in the neck of the bladder, and pain in the spermatic cord and testicle, and sometimes in the end of the penis. The microscope shows that semen involuntarily discharged may be devoid of spermatozoa, or if present, they are defective, their heads being without tails. The urine is loaded with mucus or bears up a filmy, membranous, transparent matter, or it may be covered with a thin fluid having an oily appearance, but in rare cases is clear. Again, it may hold substances in solution, which are deposited in crystals or incrust the urine, or it may precipitate a material having the appearance of brick-dust, and sometimes semen tinged with blood. The dyspeptic symptoms when present are followed by diarrhea. The limbs are cramped and rigid, the feet bloated, and the patient becomes melancholy and relinquishes all hope of recovery. As the disease progresses, the patient lacks firmness and is absent-minded. When the erections are imperfect and the semen is prematurely discharged, or when a lengthy coition is required before the sperm can be ejected, it is evident that the patient is rapidly becoming impotent; the virile powers are vanishing and manhood is surrendering sway to a merciless foe. We frequently witness this condition in men, even at the age of thirty-five, when the summit of vigor and strength should only have been reached. How often are we solicited to restore these lost hopes and powers! To what tales of ignorance and recklessness, or submission and remorse, do we repeatedly listen from these unfortunate sufferers! In patients of this class, sexual intercourse prevents spontaneous emissions, but it does not remove the functional and organic derangements of the nerve-centres; hence, at a time when the victims of this disease should be in the prime of life, they are impotent, and epilepsy, apoplexy, paralysis, softening of the brain, or insanity, frequently results. EPILEPSY (OR FITS). This dread disease is one of the most common and serious complications of the more advanced stages of spermatorrhea. The injury done to the nerve-centres by the practice of masturbation is manifested in epileptic convulsions, more or less frequent. If proper treatment be early adopted, and faithfully pursued, the case is not yet hopeless; though, in the majority of cases, the patient never recovers after the disease assumes this phase. PARALYSIS. Paralysis, or Palsy, when occurring as a complication of spermatorrhea, may be preceded by an attack of apoplexy, in which the patient loses consciousness, and lays in a condition of profound stupor for a time, and on recovery from his unconscious state, finds himself unable to use one or more of his limbs, or the disability and loss of power, which may also be accompanied by more or less loss of sensation, may come on gradually, without any premonition or marked manifestation of its approach. In either case, its appearance is to be regarded as a matter of serious importance. Paralysis, when occurring as a consequence of masturbation or sexual excesses, is usually difficult of cure; yet, now and then, cases are cured at our Institutions even after this grave malady has appeared as a complication. SOFTENING OF THE BRAIN. This malady, although less common as a result of masturbation than the complications mentioned in the preceding paragraphs, is of sufficiently frequent occurrence to entitle it to a passing notice here. This condition usually results ultimately in complete dementia, or loss of reason. It is an incurable disease. INSANITY. This deplorable malady is not a very uncommon result of masturbation and its various resultant morbid conditions, as the records of the many institutions for the unfortunate class of sufferers from this disease bear abundant witness. Sometimes it manifests itself in the milder forms of hallucination, or monomania, but in the majority of cases, the patient sinks into a despondent hypochondria, which is many times followed, sooner or later, by a raving mania. In cases of monomania resulting from masturbation, the mental derangement is often so slight as to escape detection by the patient's friends, the peculiar freaks of disposition being regarded rather as eccentricities of character than as symptoms of serious disease. Fits of despondency are usually common with such sufferers. The mental derangement is not always accompanied or preceded by spermatorrhea or frequent seminal emissions, the injury done to the nervous system by the practice of self-abuse, or sexual excesses, being first noticeable in various phantasms or imaginings on the part of the patient. These are, in different cases, so various, both in character and degree, as not to admit of any classification, each case presenting phases peculiar to itself. In many cases, the patient imagines that his best friends are conspiring to injure him, or that some great calamity is about to befall him. In most cases there is danger of the patient's committing suicide, if not closely watched. Especially is this true of those who suffer from fits of hypochondria. Except in its milder forms, insanity resulting from masturbation and sexual excesses, is rarely curable. DON'T BE ALARMED. A nocturnal seminal emission now and then, or at long intervals is not, in and of itself, evidence of the existence of spermatorrhea or other serious disease. A full blooded, strong, passionate man, in vigorous health, and who has never abused himself, may now and then, at long intervals, if his sexual passions be not gratified naturally, or if he permit his mind to run much upon lascivious subjects, experience an emission while asleep and dreaming. As to whether such occurrences are evidence of disease or not, in any given case, depends upon their frequency, and as to whether they are the result of a weakness of the organs and are followed by more or less depression and debility, or are merely the overflow of a robust system, or the outburst of restrained, pent-up, and ungratified passions. In the latter case, and when only occurring at long intervals, the emissions are not followed by any perceptible enervating or weakening effects. QUACKERY RAMPANT. This country is flooded with cheap circulars and pamphlets, circulated openly and broadcast, wherein ignorant, pretentious, blatant quacks endeavor to frighten young men who may never have practiced self-abuse, or been guilty of excesses in any way, and yet who experience, now and then at long intervals, nocturnal seminal emissions. In such cases, it is the duty of the conscientious, honest, and sympathetic practitioner of the healing art to give assurance, and not to unnecessarily alarm those who experience nothing inconsistent with a state of fairly good health. To frighten such young men into believing themselves diseased, when in reality they experience nothing but what may occasionally occur in the experiences of any robust, healthy man, is the most detestable, downright quackery. TREATING THE WRONG DISEASE. Not only are many men subjected to useless treatment by general practitioners who overlook the real disease, caused by pernicious youthful habits pursued in solitude, or later excesses in venery, but the female sex are also quite as often subjected to treatment for diseases which do not exist, the real trouble being nervous debility and other weaknesses that have resulted from the youthful pernicious practices common to both sexes, or later excesses in marital pleasures. MORAL CONSIDERATIONS. Masturbation is a habit which tyrannizes over the mind, perverts the imagination, and forces upon the victim venereal desires, even while he is forming the strongest resolutions to reform. It constrains into its service the higher faculties, such as friendship, confidence, love, reason, and imagination, to make its ideal graceful and beautiful. SENSUAL LUST. The fancy creates an attractive partner, possessed of girlish beauty, a perfect type of goodness, blended with sexuality, and whom the subject worships with all the ardor of passion. Around this _beau ideal_ all his affections are clustered; to her the purest of his blood is offered in sacrifice, and it is no wonder that female associates seem tame and unattractive when such imaginary and consummate divinity is courted. In the sensual delirium is conceived an elysium of carnal bliss, where half-nude nymphs display their charms and invite to sensual enjoyments. Thus we see how this habit makes the spiritual faculties subservient to morbid passion, and by what means elevating influences are prostituted to vulgar and base-born creations. SYMPTOMS VARY IN DIFFERENT CASES. We can only partially delineate the terrible effects resulting from the abuse of the sexual organs. The symptoms are multitudinous, but, as we have before stated, no two persons are similarly influenced by this disease. The symptoms will vary according to the severity of the affection, the age of the patient, and his constitutional peculiarities. The presence of only a few of the symptoms which we have enumerated is evidence of abnormal weakness, which demands treatment. Montaigne says: "We must see and get acquainted with our sins if we expect to correct them." Virtue presupposes trials just as much as victory implies warfare. The triumph of virtue is to defeat morbid or excessive passion, for virtue is only realized when it is a conquering force. Innocence is passive but virtue is an active quality, purified in the fiery furnace of temptation. As men have in all ages been influenced by passions, so temptation has ever found its victims. It is an obligation that one owes to himself to overcome every evil passion or weakness to which he is subject, and the discharge of this personal duty requires moral courage. THE REWARD OF VIRTUE. Our Saviour invited all erring mortals to enter upon a higher life when He said, "Come unto Me, all ye that labor and are heavy laden, and I will give you rest." The invitation is accompanied with a promise. To all who are weary of excess and bowed down by passion, rest and restoration are promised, if they will but reform and employ proper means to that end. THE SUFFERERS MUST REFORM. Just as there is no spiritual restoration without obeying the Saviour, so there can be no physical restoration unless we fulfill nature's imposed conditions. There can be no salvation unless sin be discarded, and so there can be no redemption from the bad effects of a practice, so long as it is continued. It is no easy task to master a despotic passion. Appetite is often stronger than the will. The treatment must begin with moral reformation. Every manly impulse, and all the higher qualities of the patient's nature, must be enlisted in the struggle for virtue and health. If the passions are restrained, then the capital of health increases, for the saving of the vital secretions is equal to compound interest. This illustrates the truth of the Latin proverb: "_No gain is so certain as that which proceeds from the economical use of what you have"!_ The patient actually acquires confidence and manly courage by the retention of the seminal fluid, which directly increases his virile powers. HYGIENIC ADVICE TO PATIENTS. Daily physical exercise and regular habits must be established. It is important that the mind, as well as the physical powers, be directed into active and wholesome channels. There must be restraint and discipline. It is useless to begin medical treatment while the patient continues to read exciting, amorous stories and obscene books, which are suggestive of lewd thoughts. Something practical ought to occupy the thoughts and engage the hands. Regular and vigorous physical exercise is necessary to assist the circulation of the blood, and compel its determination into the minute and extreme parts of the vascular system. When the blood is thus directed, nutrition is more vigorous and the activity of all the functions is augmented. Not only should there be regularity in eating, but sound discretion should be exercised in selecting a plain, wholesome diet, consisting of such articles of food as best favor a daily and free evacuation of the bowels. Avoid the use of those articles of food which produce excessive acidity of the stomach. Hearty or late suppers are not allowable. The patient should use no alcoholic beverages, and should abstain from such stimulants as tea, coffee, beer, wine, and tobacco. We cannot even recommend their _moderate_ use, for total abstinence is the better plan. The patient should sleep in a well-ventilated room, on a hard bed, and have only sufficient covering for warmth and comfort. He should not lie upon the back, because in this position nightly emissions are more likely to occur. The patient should go to bed when he feels sleepy, and not resist the inclination until wakefulness is induced. He should rise early in the morning and immediately take a cold hand bath. For this purpose a quart or two of water and a common hand towel only are required. After bathing, rub the surface of the body with the dry hand or a crash towel, and continue the friction until the skin is red and a reaction is established. Do not excuse yourself from following these hygienic suggestions. A refreshing bath changes the morbid sensibilities to a more healthful state by the reaction of the nervous system. It is beneficial to apply a towel saturated with cold water to the genital organs fifteen minutes before leaving the bed. Douching, or showering the genital organs with cold water once or twice a day will also be beneficial. It should not be practiced, however, just before going to bed. It is well to bathe the head with cold water, and this can be done much better if the hair be kept closely cut. Horseback riding, climbing, and all exercises which rub, chafe, or excite the genital organs, should be avoided. Even the clothing should be loose, so that walking will not produce friction or cause any excitement of these organs. The calls of nature should receive prompt attention, and the urine be voided at any time (especially during the night) when there is an inclination. If there be irritation of the bladder and lower bowels, the patient will receive decided benefit from the daily use of an injection of cold water into the bowels. From a half pint to a pint of cold water may be used at one time, and the injection should be retained for a few minutes before going to bed. The bowels will thus be relieved, the heat and irritation subdued, and the liability to seminal emissions lessened. Patients afflicted with spermatorrhea should not allow their thoughts to dwell upon their ailments, for they are apt to become moody, self-deceived, and even insane upon this subject. To avoid this, harmless amusements should be indulged in, and good moral company cultivated. They become suspicious, skeptical, and believe that they are victims of imposture. When they lose self-reliance, their faith and trust in others begins to waver, especially if their health does not improve so rapidly as they had anticipated: As much depends upon the faithful observance of the hygienic rules as upon the constant and proper use of medicines. The rapidity of recovery depends upon the constitutional energies and the vigor of the vital resources. If the blood be greatly impoverished, or the nervous system much impaired, recovery will be necessarily slow. Time, patience, and perseverance, are just as essential to a recovery from the effects of these abuses as the best medical treatment that can be employed. THE MEDICAL TREATMENT OF SPERMATORRHEA AND IMPOTENCY. Few diseases require so many modifications of treatment, to suit the peculiarities of individual cases as spermatorrhea, because it is attended with so many complications and morbid functional and structural changes. Every complication must be considered, and great judgment exercised in the selection of remedies. As this selection must depend upon the peculiarities of the case involved, it is impossible to impart to the non-professional readers sufficient medical knowledge to enable them to choose the appropriate remedies for these intricate disorders. Hence it would be useless to specify the various medicines which our specialists employ in treating them. It would only lead to many fruitless experiments, which might result in great harm to the afflicted. For remedies powerful enough to effect cures of spermatorrhea and impotency are capable, when improperly employed, of doing great harm. Especially should all ready-made, proprietary or put-up medicines, such as are sold in drug stores and chemists' shops, be avoided, for reasons already mentioned. Great harm, also, often results from the employment of "galvanic belts," "galvanic batteries and pads," and other catch-penny devices, with which the too confiding are not only duped and swindled, but terribly injured. They are all worse than useless, and often render the mildest case very difficult to cure by inducing serious complications. It is better to take no medical treatment, but rely solely on the hygienic advice we have given, rather than to resort to any of the so-called "_specifics"_ found in the drug shops, or to any such silly, good-for-nothing trash as the various "Pastilles," "Boluses," "Curative Rings," "Voltaic Belts," or other quackish medicines and contrivances. IMPORTANCE OF HYGIENIC DISCIPLINE. The invalid should restrict his attention to hygiene, and learn that patient endurance and heroic perseverance are necessary, even when taking the most efficient remedies. His entire system having gradually become deranged, corrective medicines must necessarily be _chronic_ in their operations; in other words, they must act insensibly, slowly, and progressively. Some of the symptoms of sexual weakness will, under proper hygienic and medical treatment, generally begin to disappear within a month. If the nervous system be very much impaired, however, a longer time will elapse before the restorative effects of treatment will be observed. Neither the physician nor the patient should expect that a broken-down constitution can be immediately repaired. The day of miracles is past. The most rational method of treating the sick promises nothing supernatural, nothing which is not in accordance with science. Diseases of this character are always slow in their inception, or development and progress, and must be cured in like manner, step by step. Nature never hurries; atom by atom, little by little, she achieves her work. OUR IMPROVED TREATMENT. Tears ago our specialists resolved to pay particular attention to the investigation and treatment of these diseases, which are not only alarmingly prevalent, but sadly neglected and mistreated by the general practitioner of medicine. UNFAILING REMEDIES. Having successfully treated many thousands of cases, we can safely say of our remedies that they are very positive in their remedial effects. The great success which has attended the employment of these remedies has led us to rely upon them with implicit faith. By their persistent use, spermatorrhea and threatened impotency can be cured as readily as other chronic or lingering diseases. We particularly solicit those cases which have heretofore been regarded as incurable. The patient is subjected to no surgical operation, and he can safely and accurately follow the directions given, while the treatment does not interfere with any ordinary occupation in which he may be engaged. These delicate diseases should not be intrusted to physicians who advertise under fictitious names, or to those of ordinary qualifications. The general practitioner may be thoroughly read in these diseases, but he cannot acquire the skill of a specialist who annually treats thousands of cases, while the former seldom, if ever, has occasion to prescribe for them. SIGNS OF IMPROVEMENT WHEN UNDER TREATMENT. Under our peculiar and improved system of treatment, gradual improvement in the patient's condition will be manifested. The eye becomes more brilliant and sparkling, the patient is less morose, his digestion improves, he is less listless and despondent, takes more interest in business and other affairs, his sleep is less disturbed and more refreshing, the strength improves, and, if the sexual organs had become wasted in size, weak in function, and flaccid and soft, they begin, by and by, to have more tone and firmness, and to develope and increase in size, as their nutrition is restored, by the checking of the exhausting drain which they have sustained. If nocturnal emissions occur occasionally, the discharge will, under the microscope, be found to be less watery, and to contain increased numbers of _spermatozoa_, with heads and filaments perfect. The patient now begins to gain in self-confidence, courage, and other manly attributes, and, instead of the bashful, retiring, nervous, languid hypochondriac, we see a man of ambition and energy, competent to battle with the adversities of life. Who can estimate the value of such a transformation from nervousness and despondency to vigorous manhood? Who would begrudge all their earthly goods and treasures when thus afflicted, to be so restored to health and enjoyment for of what avail are the greatest riches when health and manhood itself are lost? OUR TERMS BUSINESS-LIKE AND FAIR. Occasionally persona solicit us to undertake the cure of these ailments, and, in case of failure, receive no compensation. They write: "If you will _warrant_ that your prescriptions will result in a _perfect restoration to health_, we will gladly pay the fees that you ask." The absurdity of such a request is apparent, and therefore we answer: "We cannot _warrant_ that you will live even for the next twenty-four hours. We do not bet, play for stakes, or wager our skill for money. Personal responsibility cannot be shifted or evaded, and life and health, with all their momentous considerations, are necessarily individual affairs. Therefore a proposal to make the conditions of health a subject of speculation is a challenge to gamble." The patient may not comply with the specified conditions, and the physician's success depends upon a faithful application of the prescribed treatment. For these reasons only a quack will be a party to any such transaction. Ours is not a trading, hazardously speculative profession. Besides, thousands of our patients reside long distances away and we cannot know of their responsibility or honesty, nor spend time inquiring after their financial standing. EVIDENCES OF THE CURABILITY OF SPERMATORRHEA AND IMPOTENCY. Many individuals afflicted with spermatorrhea and impotency, particularly those who have been swindled by some of the many charlatans who are to be found in nearly every city, are incredulous, and doubt our ability to cure these maladies. Others are skeptical, because their physician, who may be a very skillful general practitioner, but who has had very little or no experience in treating these delicate maladies, has failed to relieve them, and, perhaps, has told them the disease is incurable. We therefore beg the indulgence of our readers for here offering some indisputable evidence of the extraordinary success which we have achieved, by our peculiar methods of treating these affections, as pursued at the World's Dispensary and Invalids' Hotel and Surgical Institute. This evidence is introduced for the encouragement of an unfortunate class of invalids, for many of whom existence has ceased to possess any charms. The grateful manifestations which we have received from this class of sufferers have afforded us one of the greatest pleasures of our lives, and have alone been a rich remuneration for the diligent study and arduous labors devoted to the investigation of these diseases and to the perfecting of our peculiar and successful methods of treating them. SACREDLY CONFIDENTIAL. In introducing the following extracts from our extensive files of letters, the names of the writers will be omitted, as we regard all such correspondence, as well as facts communicated to us in personal consultations, as _sacredly confidential._ Lack of space and fear of wearying the reader, prevent us from introducing more than a few extracts; but these are only fair samples of _thousands_ that have been received. Those given, present cases in almost every stage of treatment, some soon after commencing, others further advanced, and still others which are cured. If we could devote the space, and had we time to select them, we could insert an almost unlimited number of those received from patients who have been perfectly cured; but we think the reader will be more interested in expressions coming from patients in all stages of treatment, as they are daily received. Therefore, without regard for literary excellence, we append a number chosen miscellaneously, and given _verbatim_. They express the sentiments of persons in all stages of life, and illustrate the views and feelings generally entertained by those whom we have been called upon to treat. The following extracts are spontaneous acknowledgments, and are, therefore, more valuable and truthful than if obtained by solicitation, a practice contrary to our sense of propriety, and, hence, one in which we never indulge. Although ofttimes less expressive of satisfaction and gratitude than if the communication were presented in full, yet only sufficient space can be spared for a brief quotation from each letter. * * * * * TESTIMONIALS CASE 175,827. IMPOTENCY, CONSTIPATION, AND SEMINAL LOSS AT STOOL AND WITH THE URINE. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Since I have taken the remainder of a third month's treatment that you gave me I have been relieved of my trouble. The emissions have ceased and the losses at stool and in the water have left me. Eighteen months ago I was almost a complete wreck; now I take an Interest in business and am in excellent health. Respectfully, S., Waveland, Ind. CASE 177,068. SPERMATORRHEA. LOSS OF VITAL STRENGTH. CARED WITH SEVEN MONTHS' TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--You have undoubtedly wondered at my long silence. Since last I wrote you there has been a marked change in my life (of which I will speak further on), under your skillful treatment. I improved so rapidly, notwithstanding the many interruptions which misfortune on my part occasioned, that six months ago I considered myself cured. I have been married three months and a half to a worthy woman, who should have gained for herself a husband who never deviated from a virtuous path as much as I; but the attachment formed was so strong that no misfortune seemed powerful enough to sever it. The barrier which seemed insurmountable, and which I had erected myself by early indiscretions and excesses, has given way, thanks to your superior medical knowledge and skillful treatment. Again I can hold up my head and say, "I am a man. I never fail to call the attention of my friends to your Institution as the best in the world, for I have reason to know that it is truly so. I have recommended two friends of mine to you, who are under your treatment, and are getting well. One has tried all the local physicians, and many firms, but with no success. May God bless you, and may your Institution meet with all the success it so richly deserves, is the prayer and wish of one you have caved. J., Leadville, Colo. CASE 178,666. EMISSIONS, AND LOSS OF WEIGHT AND STRENGTH. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have had no emissions now for some time, and feel well in every way. I am gaining in strength and weight, and find I shall not need further medical treatment. The four months' medicines that you have sent me have effected a radical regeneration in my health, and I thank you for it. M., Hartford, Conn. CASE 111,477. SPERMATORRHEA AND IRRITABLE BLADDER; CURED BY TWO MONTHS' TREATMENT. This was a badly complicated case of spermatorrhea, the patient being also troubled with frequent urination, partial impotency, mucous discharges from the urethra, and a burning sensation in the testicle and groin. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I took the two months' treatment sent me by you as directed. After taking the first month's treatment the emissions ceased entirely, my appetite increased, and I slept much better. Eight months ago I finished the second month's treatment and have since been in perfect health. I am fully convinced that you do every thing that you promise. I am, gentlemen, yours respectfully, R., Fort Totten, Dakota. CASE 266,080. SPERMATORRHEA. THREATENED IMPOTENCY. A SEVERE CASE, CURED BY SIX MONTHS' TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have received the last medicine sent me, and have taken all with the best results. I have so improved in health that I think it unnecessary for me to take any more medicine. It is now several days since I took the last of the medicine, and have not had any return of the disease. The desire to masturbate seems to have left me, and I feel well, happy and strong. When I look back to the time before I commenced to take your medicine, the change that has taken place seems wonderful. I had lost all hope of being restored from the ruinous habit I had practiced for many years without knowing how fatal it was to health. I tried hard to stop the practice, but it had grown so strong on me that I would always practice it again, and was fast becoming impotent. Had emissions at night; was nervous, downhearted; and I lost flesh, and felt miserable in many ways too numerous to mention. But now I feel healthy and well. If I had been more careful, and had not stopped treatment so soon before, I might have been cured in four or five months. Nevertheless, I am well satisfied, and thankful that I am restored to health in six months; and I wish to express my sincere thanks to you and your Institution, for I owe my restoration to health and happiness to you. If in the future I need any medical skill, I shall always apply to your Institution, being certain of receiving the best attention. Yours thankfully, S., Pittsburgh, Pa. CASE 62,365. VERY BAD CASE OF SPERMATORRHEA AND IMPOTENCY. CURED WITH SIX MONTHS' TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--It has now been nine months since I stopped your treatment, and as there has been no return of former symptoms, I judge there can be no doubt as to my cure being permanent. I must confess that, having been duped and swindled by so many previous to visiting you, I had not much confidence when I went to Buffalo to see you. But your specialists, and your Manager, seemed to talk so straightforwardly and without making any of those extravagant promises that I have become so used to, that I became convinced of your skill before I had been long in your wonderful Institution. I think almost any invalid who will visit your Hotel, and see for themselves the wonderful appliances that you have accumulated for the cure of disease, must soon become convinced that if there can be any hope of relief it can be secured there, if anywhere. There I saw those who told me they had been brought there on beds or couches for hundreds of miles, and that they had not been able to walk for two to four years, and yet with two or three months' treatment were able to go about everywhere, and were about ready to return home. Such experiences as these established my confidence, and to-day I bless the day I first visited the Invalids' Hotel. True, it took six months to cure me, but I presume you seldom have cases to equal in severity the condition I was in when I applied to you. I was so bad, as you will remember, though I do not suppose you rely upon any thing but your records in referring to cases, having so many under treatment at all times, at all events, if you will turn to the record of my case, which is "File No. 62,365," you will see that I had discharges of semen every time my bowels moved and without erections. In fact, I was completely impotent. I am now as strong and vigorous as any man. You told me it would probably take a year to cure me, but as you accomplished it in five months, though I continued to take medicine a month longer to insure against a relapse, I think myself very fortunate. Should any of your staff have occasion to come this way, I should be only to glad to do any thing I can to entertain them. Gratefully yours, C., St. Louis, Mo. CASE 183,998. GENERAL DEBILITY. EMISSIONS AND LOSS OF ENERGY. URINARY IRRITATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--The reason for my not continuing treatment further than the fourth month, is the fact that my health is so much improved that I do not need it. I feel like a new being. All of my bad symptoms are gone, and I feel that I am cured. For eight months my health has continued to improve all the time. I owe you and your staff a debt of gratitude that I can never pay. Yours with thanks, H., Johnson's Bayou, La. CASE 152,504. SPERMATORRHEA. Mr. S., of Bagwell, Texas, writes as follows: "language fails to express my gratitude for what your treatment has done for me. I have gained forty-two pounds since coming under your care. My cure is perfect." CASE 174,628. SPERMATORRHEA. EXTREMELY BAD CASE. LOSS OF VOICE; THREATENED WITH CONSUMPTION. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am thankful to say that as a result of eight months' treatment you have given me, the symptoms of my disease have been entirely removed. My voice has got strong and clear, and my breathing is easy and natural. My weight is increased, and in every way I am feeling well. I cannot refrain from penning a few lines. H., Port Hope, Ont. CASE 113,274. SPERMATORRHEA. Mr. K., of Kalamazoo, Mich., writes: "I feel that you have proven to be the best friend I have on earth. It is about three weeks now since I finished the last month's medicines, and I feel as strong as I ever did in my life. When I commenced taking your medicines I only weighed 155 pounds, but now I weigh 170 pounds. I feel strong and rugged; my step is firm and bold; and I feel altogether a new man, for which I return you my sincere thanks." CASE 173,399. EMISSIONS. LOSS OF WEIGHT AND APPETITE; DYSPEPSIA. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--I write to let you know that my health is improved, and to thank you for the same. The emissions occur only at intervals of several months, and I do not have any more polluting dreams. I am better in every way. My appetite is improved, and my digestion is perfect. Have gained in weight, and sleep well. I have not required all of the last supply of medicine, the sixth month, and I think I will pull through all right. Please accept my thanks for the benefit effected. D., Valparaiso, Ind. CASE 45,757. SPERMATORRHEA. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Received yours dated Oct. 27th, and am happy to say that I have so far recovered as to believe further treatment unnecessary. I feel like a new man; am able to do a full day's work without pain or laziness. I am very thankful for the benefits I have received through your skill, and should I think it necessary at any time for me to renew the treatment, I will be glad to call on you. Yours with great respect. A., Zanesville, O. CASE 175,315. SPERMATORRHEA; DIZZINESS AND BILIOUSNESS; DYSPEPSIA. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am in good health, and can say that I am cured. The emissions have stopped, and I have no unnatural discharges, nor dizziness in the head. My health is good in general, and I work hard every day. Physically, I have a good appetite and digestion, which is a great change from what it was when you first treated me. Although I continued the treatment for eight months, owing to the complications and severity of my case, yet I am thankful for the great relief. D., Newport, Ark. CASE 39,625. SEMINAL AND NERVOUS DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--My case was one of long standing, and had brought me to think and meditate more of dying a consumptive's death, than living. The ill success I had met in trying to recover my lost manhood, had put me in such a constantly low-spirited condition, that nothing was interesting or pleasurable. I am highly pleased to report the improvement in my condition. My voice, weak and hoarse when I commenced treatment, is now strong and masculine. Hope and self-confidence have returned, and my countenance is firm and resolute. The dull, heavy, pressing pain under my left shoulder, is entirely gone, long ago. The pain and weakness in hips, back, and side, are never felt. I am in every way fully restored to perfect health and manhood. Yours sincerely, O. Sheboygan, Mich. CASE 67,546. SPERMATORRHEA. CURED IN FOUR MONTHS. [EXTRACT FROM LETTER.] WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--It is with great pleasure that I write you. I have taken but one month's treatment from you, and if I should just give you a full history of my case before and since I have taken your medicine, you would not believe the improvement could be true. I feel better every way. I am without language to express my thanks to you for the great work you have done for me. Your ever true friend, B., Blountville, Sullivan Co., Tenn. CASE 22,511. IMPOTENCY. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--Accept my thanks for the great benefit received from your treatment. I never thought I could be so fully restored. G., Peru, Ind. CASE 450,422. SPERMATORRHEA, SEMINAL DEBILITY, MUSCULAR RHEUMATISM. CURED WITH SIX MONTHS' TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am thankful to say that, as the result of the six months' treatment you have given me, that I am cured of my trouble. Since the beginning of the treatment the losses became less and less frequent, and now I am entirely relieved, and desire to return my sincerest thanks to you for the good you have done and the kind attention that you gave me. Sincerely yours, G., Milverton, Ont. CASE 48,927. NERVOUS DEBILITY AND IMPOTENCY. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--My head is clear and I feel like myself again, and now only wish that the money I spent for useless medicines and experimenting doctors, had at once found its way to you. By recommending you to others suffering as I did, I hope to assist in your honorable work. For my restoration to health and manhood, I am deeply grateful. Truly yours, B., Philadelphia, Pa. CASE 154,136. SEMINAL WEAKNESS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I see no further use in continuing your medicines, as I now feel perfectly well and the emissions have stopped entirely. I used to feel dizzy, exhausted, and irritable on arising in the morning, but now I feel nothing of the kind. Respectfully, K., Johnstown, Pa. CASE 175,391. SPERMATORRHEA, WITH SYMPTOMS OF BRIGHT'S DISEASE AND TORPID LIVER. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--When I applied to you for treatment, although a man of apparently perfect health, yet I was subject to an exhausting drain, and felt myself gradually declining in vigor of intellect and constitution. The five months' treatment that you have sent me has effected a very remarkable change in my health. My kidneys (which had troubled me so that I feared Bright's disease) and torpid liver have become natural, and I feel like a new man. The only precaution I now take is not to sleep on my back; and I feel that I am cured. I send you the names of some other patients, and close by saying that I thank you sincerely for the cure, and the great benefit in my health that has resulted from your treatment. M., Manhattan, Kans. CASE 110,837, STRICTURE AND SPERMATORRHEA. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--My seminal trouble was cured long since, and I had forgotten it. Your medicines relieved me of that in a short time, and I am satisfied that it will cure the worst cases in a few weeks. I am also satisfied that you and your faculty accomplish more in the healing art than any other in the country, and I cannot say too much in recommendation of your institution. I have tried your institution, and have found your words true in every sense, and take pleasure in authorizing you to use my name in any way to suit yourself. My appetite is good, and I have no pain or trouble whatever. The neuralgia in the lungs, the tough phlegm, weakness, etc., have all disappeared. A. CASE 111,571. SPERMATORRHEA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Under the influence of your last course of medicine my health has improved so greatly that I feel any further treatment to be unnecessary. My health is better now than at any other period for years. The night emissions have ceased entirely, I not having had one now for many months. I feel better in every way. Respectfully, P. Pittsburgh, Pa. CASE 57,757. LOST SEXUAL POWER REGAINED. [EXTRACT FROM LETTER.] WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--While taking your medicine I labored physically. I am cheerful, hopeful, joyous, glad, and grateful for my restoration to sound and vigorous health. My friends daily express surprise at the great change in my personal appearance, and declare that I appear younger than I did fifteen years ago. I always reply that I obtained my new lease of life from the World's Dispensary Medical Association, Buffalo, N.Y. With sincere gratitude and great respect, I subscribe myself W., Canyon City, Grant Co., Oregon. CASE 3,508. SEMINAL AND NERVOUS DEBILITY OF THIRTY YEARS' STANDING. CURED IN TWO MOUTHS. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _My kind Benefactors_--Inclosed find the case of my daughter-in-law, whom I desire you to treat, believing that you can cure her. I feel assured that if you fail in the cure of her case, now so chronic, that no human skill will be of benefit. Some four or five years ago you treated me for general debility and premature decay, with severe attacks of vertigo. The first month's medicines, which were sent by express, effected a relief of my case. Owing to the long standing of my trouble (twenty-five or thirty years), I concluded to continue the treatment another month. My order was promptly filled by mail. By these two months' treatment I was perfectly cured, my whole system renovated and invigorated. I have been repeatedly asked what I had been doing to cause such an improvement in my personal appearance, and activity, for an old man. With profound gratitude, adding love, I am your obedient servant, W., Rusk, Texas. CASE 250,336. SPERMATORRHEA; LOSS OF STRENGTH AND WEAKNESS OF MEMORY. CURED WITH SEVEN MONTHS' TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have not taken any medicine since last December, at which time I had closed the seventh months' treatment. I am happy to say that, as a result, my mind is clear and easy. I am steadily gaining in strength, and feel better than I have for many years, and owe it all to your treatment and advice. I hope you will live long and prosper, and continue to dispense a balm for suffering humanity. I will close by giving your faculty my greatest devotion and sincere thanks, and hope success will crown your business. W., Pickens, Miss. CASE 82,127. SPERMATORRHEA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Your last month's treatment has entirely cured me. I have been married three weeks and am happy, thanks to your unexampled skill. B., Blackberry, Kane Co., Ill. CASE 88,736. SPERMATORRHEA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Sure enough I am well, and I desire to thank you for your medical skill. My strength is very greatly increased, my digestion and appetite are perfect. I sleep well and awake refreshed, and, in fact, feel better every way. My eyesight, which was weak, is wonderfully improved, and my physical condition is now perfect in every way. All the emissions have ceased. Respectfully, B., Fayette, Howard Co., Mo. CASE 144,241. SEMINAL DEBILITY. CURED WITH FOUR MONTHS' TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am happy to say that your treatment, which I have taken four months, has effected a radical cure of my trouble, and you are at liberty to use my name and address as a reference. Your treatment has effected a cure in my case. Very truly yours, M., Trout Creek, N.Y. CASE 71,250. SPERMATORRHEA OF THIRTEEN YEARS' STANDING. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I can honestly say, as the result of your treatment, that I feel better now than at any time previous for years. My disease is under complete control, and I have no fear of any further trouble in that direction. In a word, I feel that I am cured and well; and you may rest assured that I shall take great pains to avoid in the future the cause that brought me to my former condition. I am, indeed, thankful to you, as your treatment has made it possible for me to lead a better life, and effectually to resist those passions which so long dominated over me. I remain, very respectfully yours, H, Council Bluffs, Iowa CASE 142,842. SPERMATORRHEA CURED. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--it is with great thankfulness to you that I pen these few lines. I am to-day a strong and healthy man, which I never would have been but for your kind and skillful attention. My health was completely broken down by the effects of self-abuse, and I doctored with other physicians for two years, but with no success. However, after a few months of your treatment I find my health fully restored. I am now in a condition to enjoy the world and take comfort wherever I am; in a word, I am "a man among men." I most cordially invite all persons requiring skillful medical treatment to apply to the World's Dispensary. M., Fredericville, Mich. CASE 174,937. SPERMATOZOA. THREATENED WITH IMPOTENCY. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I finished your three months' course of treatment some weeks ago, and am glad to say that I am a well man. A thousand thanks to you. K., Warm Springs, Mont. Ter. CASE 52,272. SEMINAL DEBILITY. LOSS OF MANHOOD. GENERAL WEAKNESS FROM EXCESSES. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--I took your medicines according to directions, and I feel that I am fully restored to health and the enjoyment of my manly powers. My health is better than it has been for years, and is improving all the time. The headache and dizziness have entirely left me. You have my honest recommendations to all sufferers. Thankfully yours, M., Hudson, N.Y. CASE 44,573. IMPOTENCY. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--As a result of your three months' treatment, I am feeling better than I have for twenty years,--more of a man in every way. S., Prairie Star, Neb. CASE 56,811. NERVOUS DEBILITY. AFFECTION OF SEVERAL YEARS' STANDING, PERMANENTLY CURED BY ONE MONTH'S TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--Five years have elapsed since my case was cured by you with one month's treatment. Since that time I have not had the first symptom of the disease. I know I am cured. Yours with thanks, C., Kalamazoo, Mich. CASE 175,579. EMISSIONS, YELLOW COMPLEXION, BLACK HEADS AND ERUPTIONS ON THE FACE. WORLD'S DISPENSARY MEDICAL ASSOCIATION:, _Gentlemen_--I am happy to say that I have not used all of the last month's medicine. The five months' treatment that I have had from you has effected my entire cure. I have had no losses for many weeks, and my complexion is restored to its natural clearness and purity. The black heads and pimples have all disappeared. K., Neillsville, Wis. CASE 21,437. IMPOTENCY. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--I have, as a result of your treatment, been more of a man than before in six years. I have felt, worked, and eaten better than ever before. My strength is in every way fully restored. C., Jordanville, N.Y. CASE 38,005. IMPOTENCY. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--When I first wrote you I had given up all hope of ever getting well. I had not worked for two years. I had not been under your treatment three months before I went to work, and have been at it ever since. I gain every day. C., Hinsdale, N.H. CASE 53,578. SPERMATORRHEA. GREAT LOSS OF STRENGTH AND FLESH, APPETITE REGULAR, SOMETIMES RAVENOUS AND THEN VERY POOR. INTELLECT AND MEMORY MUCH ENFEEBLED, THE RESULT OF LOSSES THROUGH THE URINE. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--The condition of my health is highly satisfactory, thank Heaven and you as the instrument. It has often been a cause of astonishment to me, to think now admirably your medicines controlled my cage; it seems wonderful even now. I say, with all my heart, God bless your noble work, for the cure of my disease and perfect restoration of my health and strength. A., Shongo, Allegany Co., N.Y. CASE 52,920. SPERMATORRHEA, RESULTING IN DYSPEPSIA AND HEART DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am gratified to be able to report my cure. My case was a severe one, the insidious drain upon my system producing general debility, attacks of severe palpitation of the heart, and obstinate dyspepsia. Since using your medicines, I have been cured of these troubles. I have no palpitation, digestion good, not easily worried, able to work hard without undue fatigue, strength greatly increased. My weight is now 163. I am thankful to God and to you for the evidence of my final cure. Yours devotedly, R. CASE 51,002. SPERMATORRHEA. RHEUMATIC PAINS, GENERAL LOSS OF MEMORY, STRENGTH, MANLINESS, AND INTELLECTUAL POWER. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--When I sent to you for medicines, I little expected the remarkable benefit that has resulted. The rheumatic pains that have so long troubled me, ceased within a week. I am now able to attend to my business with my former ability and energy. You have my gratitude for the cure effected in my case. Very respectfully, P., Bloomington, Ill. CASE 146,406. SPERMATORRHEA, WITH DYSPEPSIA, CATARRH, AND BACKACHE. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am happy to say that as a result of five months' treatment, the weakness of my urinary and generative organs has been entirely relieved. My catarrh is so much better. The difficulty in the head is now gone, and I have no discomfort. The weakness in the back, and pain in the kidneys, has all left me, and I rest well at night. There are now no unnatural discharges, and I am happy to say that your medicines have effected such a change in my condition that now I continue to improve all the time. D., Medusa, N.Y. CASE 52,121. SPERMATORRHEA. SYMPTOMS: DIURNAL AND NOCTURNAL EMISSIONS, LOSS OF SEXUAL POWER AND WASTING OF THE ORGANS, GENERAL DEPRESSION AND EMACIATION. MOST SEVERE FORM OF THE DISEASE. CURE WITH THREE MONTHS' TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--I have waited several months and find my cure perfect and permanent. Thanks to you my health and manhood have been perfectly restored, and I am as fat as a bullock. S., Millbrook, Ont. CASE 4,100. SPERMATORRHEA. ENTIRELY BROKEN DOWN. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Over eight years ago I visited you at your office this present month, very melancholy and thinking perhaps that in six months I would be lying in my cold and silent grave, and now I am strong and healthy. I never was so healthy in my life. Am married, and we have two of the nicest children you ever saw. I am the happiest man in town, and hope to ever be so. My sickness was contracted through ignorance and self-abuse. I am glad to say that I have had a permanent cure, and thank God. I feel grateful to you and thank you kindly. Yours very truly, L., Barnes' Corners, N.Y. CASE 52,004. EMISSIONS. LOSS OF WEIGHT, STRENGTH, AND MENTAL POWER. WORLD'S DISPENSARY MEDICAL, ASSOCIATION: _Dear Sirs_--I received the month's treatment sent for, and took it. It worked like a charm. I have no more emissions, and my weight, energy and strength, are fully restored. R., Fort Collins, Colo. CASE 53,859. SPERMATORRHEA. FIVE YEARS' STANDING. SYMPTOMS: FREQUENT NOCTURNAL EMISSIONS, LOSS OF MEMORY, NERVOUS, NO ENERGY OR STRENGTH. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--Pardon me for not sending you a report of my condition before this. Have been waiting to see if there would be any relapse. I am assured that my cure is complete and perfect. None of the symptoms of the disease remain. Your medicines I can recommend as the most powerful and direct to accomplish good I have ever taken. I feel it my duty now to give you my heart-felt acknowledgment for the good done me. Respectfully, H. Goshen N.Y. CASE 38,973. SPERMATORRHEA. EXTREMELY BAD CASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--You have cured me sound and well of the terrible effects of early indiscretion. My case was worse than any I have ever read, and I never expected to get well. With eight months treatment taken at my home, I have been fully restored. You have my sincere and hearty thanks. C., Halifax, N.S. CASE 70,648. SPERMATORRHEA AND THREATENED IMPOTENCY. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _My Dear Benefactors_--Please accept my sincere thanks. Words at my command are inadequate to express my feelings when I realize the great beneficial features of your most excellent remedy. I have spoken to several of my most intimate friends who are similarly affected, and after I took the first dose I was completely relieved, and the flesh I gained was in such abundance that I was scarcely identified by them. I gave part of your _par excellence_ medicine to a bosom companion of mine, named ----. He became convalescent, but desires another bottle. Write to him at once. Your name will be held in the highest esteem by these invalids, and by Yours respectfully, H., Cincinnati, Ohio. CASE 143,838. SPERMATORRHEA, WITH PARALYSIS AND DYSPEPSIA. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Sirs_--Your treatment worked like a charm with me. Before I sent to you I consulted my family doctor, and asked him what he thought of my case. To give you his own words, he said. "J., I think you will be an entire cripple." I then thought I would write to you. I had not taken more than three months' medicine when I was out in the harvest field. I sleep all night, have a good appetite, my back has got well, and I can lay all night. My limbs are stronger, and my nerves are again all right. Upon the whole I am a new man, and my mental powers are much relieved. In eighteen months from the time I placed my case under your treatment, I was better than I had been in ten years, and feel like myself. Yours truly, J., Peru Mills, Pa. CASE 93,264. SEMINAL WEAKNESS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Allow me most sincerely to thank you for the great benefit I have derived from your two months' treatment. When I first wrote to you I felt as if my life on earth was short, indeed; but, thank God, through His help and yours, I have been saved from filling an early grave as the results of self-abuse. Before I began treatment I was pale and sickly; I had palpitation of the heart so bad that I often expected to drop dead in the street; I had loss of voice; always felt tired; I had involuntary emissions of semen in the night, which always made me feel weak through the next day; whilst quite often my mind was filled with suicidal thoughts. Such was the price I was compelled to pay for violating the laws of God and nature. Now every thing is changed. I thank you a thousand times, Doctor, for the great good you nave done me. May God bless you. I shall always be pleased to recommend your treatment to everybody, and I will cheerfully answer any communication that I may receive in relation to this. W., Lynn, Mass. CASE 140,948. SPERMATORRHEA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Dear Sirs_--I believe myself to be free of the trouble for which you have been treating me. It seems too good to be true, yet I feel satisfied that I am more of a man than ever before in my life. I have not the time nor ability to thank you in the high-flown language peculiar to testimonial writers, but suffice it to say that I am. Most gratefully yours, S. CASE 44,464. NERVOUS PROSTRATION. This gentleman, engaged as the head of a large academy, suffered severely from mental depression, weakened memory, nervous exhaustion, and lack of intellectual power, the result of the delicate drain upon the nervous system and his severe labors. We append his letter after four months' treatment: WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--My friends all notice and speak of my decided improvement. My health and faculties are again as they were years ago. Yours, H., Philadelphia, Penn'a. CASE 33,928. SPERMATORRHEA, RESULTING IN CONSUMPTION. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--I would have been beyond the reach of aid now but for your treatment. I am now enjoying perfect health. Yours gratefully. H., Gillie's Hill Ont. CASE 42,921. SPERMATORRHEA, RESULTING IN DYSPEPSIA AND DECIDED LOSS OF STRENGTH. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am deeply indebted to you. The disagreeable head symptoms, dyspepsia and weakness are all gone. I can now eat and digest as hearty a meal as any one, and feel well, healthful and energetic. Never have any losses. I was very sick when I commenced treatment, but was speedily relieved. Yours truly, S., Charles River Village, Mass. CASE 44,866. SPERMATORRHEA, WITH MARKED LOSS OF MEMORY, HEALTH, AND TONE OF SYSTEM. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I took treatment of you last summer. The improvement was marked, and I have continued to grow healthier and stronger, notwithstanding I have been busy all the time and nave studied very hard. Do not get fatigued as before. I read six orations of CICERO in seven weeks and passed with honor a very close examination. My limbs are solid and strong, whereas before I was weak, and my flesh cold, soft, and clammy. I am in college working hard. Truly, P. CASE 147,411. APPROACHING IMPOTENCY. RENEWED HEALTH AFTER FIVE MONTHS' TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I can gratefully say I am feeling like a new man since taking your prescription for seminal weakness. While I was in the West two months, my wife received two months' treatment from you, and on my return home, to my greatest satisfaction, her cheeks were as red as roses and her health greatly improved, for which accept our profound thanks. May your honored President live long and do good unto the sons and daughters of afflicted humanity, is our prayer. W., Aral, Va. CASE 44,198. NERVOUS PROSTRATION, CAUSED BY SELF-ABUSE. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Your kindness to me I can never forget. I cannot express half my feelings of gratefulness to you. I had despaired of ever getting well. Thanks to your skill I am now a new being. Yours very truly, B., Steuben County, N.Y. CASE 53,816. NERVOUS DEBILITY, CAUSED BY SELF-ABUSE. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--My health has improved so that I no longer need treatment. You have my heart-felt thanks for the good you have done me, and may you have as good success in treating the hundreds of others as you have had in mine. I remain yours very truly, K., Hartford, Conn. CASE 53,913. NERVOUS DEBILITY AND IMPOTENCY. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I shall ever remember you with gratitude. My relief is perfect and permanent. I feel _so_ much better. I remain yours truly, J., Jacksonville, Ill. CASE 254,484. SPERMATORRHEA; GENERAL DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am happy to say that your medicines and treatment are always ahead of what they are represented, and I hope you will accept my deep and sincere thanks for the good you have done me. My weakness and debility have entirely disappeared, and I can say that the expense of the six months' treatment I received from you, has been repaid a hundredfold, by the benefits it has effected in my condition. F., Starkey, N.Y. CASE 54,803. NERVOUS DEBILITY AND IMPOTENCY. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have taken the last of the medicine which you sent me, and feel satisfied it has entirely cured me. I return my thanks to you for the good you have done me. F., East Liverpool, Ohio. CASE 69,116. SEMINAL WEAKNESS, WITH CANCEROUS TESTICLE. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--It has now been over two years since you treated me and found it necessary to remove one testicle on account of cancerous disease, that must soon have destroyed life had the operation not been performed. T feel myself a strong, healthy man, having had no symptoms of the seminal weakness for months past. Yours, P., Pittsburgh. Penn's. CASE 51,417. IMPOTENCY. I am getting along so well with the medicine that I am a standing wonder to my friends, and I shall not cease, while life lasts, to praise the skill that has brought about such miraculous results. Yours truly, K., Chillicothe, Ohio. CASE 67,004. IMPOTENCY. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am only too happy to say that I have fully recovered my powers in every particular since placing myself under your treatment. I would not take $5,000 for the good you have done me. I am only sorry that I did not go to you before wasting time and money on the quacks connected with that "Museum of Anatomy" in New York. T., Philadelphia, Penn'a. CASE 67,208. SPERMATORRHEA. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--When placing myself under your treatment, I was told that my case being an exceedingly bad one, it would probably require six months in which to effect a perfect cure. After taking your remedies four months I found myself in perfect health, and have remained so ever since. I cannot express the gratitude I feel for you, and can never half repay the debt of gratitude I owe you. I have given your pamphlet,-"Abuse of the Male Generative Organs and the Diseases to which it Gives Rise," to quite a number of young men whom I had reason to suspect it might benefit. Gratefully yours, T., Norfolk, Virginia. CASE 67,070. SPERMATORRHEA. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have now returned home a now man, after four months' treatment from you. I need no more medicines now. I would urge all suffering to go to you for help. Thanking you for your services, I remain yours truly, R., Bunch, Iowa. CASE 431,637. IMPOTENCY, WITH NERVOUS DEBILITY AND LIVER DISEASE. This gentleman applied for the relief of the following symptoms: Exhausting and frequent seminal emissions, losses in the urine, want of manly strength, nervous prostration, indigestion, torpid condition of the liver, headache, nausea, and constipation. After a course of five months' treatment he writes: WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I am very grateful to you for the good you have done me, and I feel like a man now. It is sometime since I left off medicine. I have continued to improve, and I feel better than I have for years before treatment. I am happy at the restoration of my health and vigor. I shall recommend you to all sufferers. Hoping you will continue to be successful. I remain, Yours truly, P., Canaan, Conn. CASE 111,489. SEMINAL EMISSIONS, LOSS OF MEMORY AND GENERAL DECLINE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Inclosed please find money for my last supply of medicines. You seem to understand my condition thoroughly. My color, appetite, and strength have improved wonderfully, and my sleep is sound, undisturbed and refreshing. Under the influence of your medicines I have completely recovered my mental and physical powers, and I feel that I am able to discontinue further treatment. The emissions have become less and less frequent until now they do not trouble me at all. I remain, yours truly, H., Eagle Springs, Coryell Co., Tex. CASE 51,203. SPERMATORRHEA. PERFECT CURE. HIS LETTER BEFORE TREATMENT, AND AFTER. (First letter.) WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Dear Sirs_--It was my pleasant privilege to read concerning your skill in the treatment of all kinds of diseases, and concerning your reputation, which is most justly merited. Encouraged by these facts to place explicit confidence in you. I beg leave to state my own case as clearly as I may be able. It is as sad as it is fatal if no thorough cure can be effected. I have from my twelfth year onward been practicing, though not excessively, the evil, _self-abuse._ Although I have been led to abandon the pernicious habit for several years, my age being twenty-four, the horrible effects have not disappeared. The serious result is that I am suffering from spermatorrhea. An involuntary discharge of the seminal fluid occurs invariably once, not infrequently twice, every week during sleep. The genital organs have become diminished in size. I will proceed to state the symptoms which I have been able to observe. They are--disposition to solitude, inaptitude for study, indolence, forgetfulness, melancholy, weakness in the back (especially perceptible after standing), a lack of confidence in my own ability, want of energy, sometimes pain in the chest, elbow, arm, knees, and loins. Uneasy nights, disturbed and highly disagreeable dreams becoming more and more irritating as the time for the discharge of the seminal fluid draws nearer, also a desire to lie longer in bed in the morning. Now, dear Doctors, permit me to ask your kind advice as to what means are to be taken. I have tried numerous remedies for more than a year, but to no effect. My suffering grows severer. Please reply as speedily as you may be able. If you be so kind as to honor me with an answer, please state the amount of money needed for your services, which shall be forwarded at once. Please find inclosed one dollar, remuneration for your kind services. Very respectfully, M., Wheeling, Cook Co., Ill. (At the close of treatment.) WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--I have finished the eight months' treatment; had I been able to follow the directions more closely, three months' treatment would have effected a permanent cure of my case. Now I am well, body strengthened, mind invigorated, memory revived, energy to work restored, cheerfulness and bright hopes, once altogether lost, are now fully regained. Indeed, I feel like a new being. And now, dear Doctors, in closing our important correspondence, permit me to render my heart-felt thanks for your kindness to me, and for the benefit received from your invaluable treatment. Adieu; may God grant you a long life, that you may benefit many an afflicted one. Very truly yours, M., Wheeling, Cook Co., Ill CASE 464,255. MASTURBATION. LOSS OF FLESH AND MENTAL POWER. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--After three months of your treatment, I find myself cured of one of the worst habits that it has ever been the lot of man to fall into. My whole system is invigorated; I have no more weak back nor legs; no more emissions; my strength is greatly increased, and my weight is more than it has ever been before. The dull, heavy feeling in my head is entirely past, and I can truly say that I feel like a new man. Hoping you will do as much good in the future as you have in the past, is the wish of, Yours truly, B., Holyoke, Mass. CASE 91,656. SPERMATORRHEA. OBSTINATE CASE OF EIGHT YEARS' STANDING. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I have taken seven months' treatment from you, and to-day I am a well man. My friends are surprised at the great change which has taken place in me. The emissions have ceased entirely, and I am strong and well. I am a thousand times obliged to you for the good your treatment has done for me. Respectfully yours, U., Topeka, Kansas. CASE 461,306. ONANISM. MELANCHOLIA; CONTEMPLATED SUICIDE. WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Having waited several weeks after finishing the last medicine, to see if there would be any relapse, I now send you a report of treatment. I believe I am thoroughly cured, not only of poor health, but of all desire to abuse myself. I have regained health, spirits, and confidence. Am married, something I have long desired, but never before dared to attempt. Please accept my sincere thanks, gentlemen. Your medicine has saved me from a suicide's grave. H., Denver, Col. CASE 110,838. SEMINAL WEAKNESS AND FISTULA IN ANO. A case of anal fistula that had been unsuccessfully treated by Prof. ----, of Nashville, who had operated with the knife. He had also been unsuccessfully treated by several home physicians who stated that his symptoms of spermatorrhea were all that could be described, and more too. The sensations of crawling and itching in the rectum were very severe, and as a result of weakness there was a serious palpitation of the heart, and general debility. The generative organs were unduly excitable and weak. He complained of weakness in the rectum and loins, with irregularity of the bowels, trembling and weakness of the entire system. There was profuse discharge from the fistula and also from the urethra. We undertook his case without making any promises of a radical cure, as it seemed that the disease had progressed so that it would be impossible to effect more than satisfactory improvement in his general condition, and a palliation of the symptoms of disease. At the end of seven months' treatment he writes as follows: WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--The result of the treatment you have sent me is a permanent cure of the fistula beyond a doubt, and in a magical manner. My heart is very much improved, so that it does not trouble me in the least. My health is perfect in every way. It is unnecessary for me to order any more medicines, but should I think at any time that a little is required to keep me in good health, I will order at once. I think that I am entirely through with the fistula and sympathetic weakness, and I can truly say that your remedies delivered me from the jaws of death. With sincere thanks to you, I am, yours for ever. D. CASE 140,056. SPERMATORRHEA. The following long-standing and aggravated case of seminal debility began to yield at once under the specific influence of our medicines. Frequent nocturnal emissions were present, and the semen also passed off, unobserved and unsuspected, in the urine; of course a ceaseless vital drain of this character began quickly and profoundly to impress the constitution, so that when the patient under consideration applied to us for relief, the most unmistakable symptoms of commencing organic disease of the heart and lungs had plainly declared themselves to be present. Like many hundreds, of similar cases which we cure annually, the disease yielded promptly and perfectly to the well-directed efforts of our specialist in this important branch of practice; indeed, so easy, swift and perfect was the cure that the patient failed to realize the necessity of continuing the treatment a few weeks in order to insure himself against the possibility of a relapse, and discontinued his correspondence with us, whereas it is in precisely such cases that we recommend the treatment to be not too abruptly discontinued. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Your kind favor, thoughtfully inquiring after my health, came duly to hand. In answer, permit me to say that it was not my intention to take further treatment as I considered my cure to be perfect, all local and general symptoms having wholly subsided before I had finished the month's course, and thus far manifesting no disposition to return. However, in the light of your wisdom and experience, I have reconsidered the matter and now believe with you that another month's course of treatment is advisable, in order effectually to guard against the possibility of a relapse. I accordingly inclose you the price of the additional month's course. The second morning after commencing the use of your medicines I awoke refreshed in body and mind, and this experience has been repeated every morning since. The emissions were arrested at once, and I have not had a single unnatural discharge since, except once when I experienced a slight nocturnal emission, which, however, was followed by no depressing after-effects, but altogether the reverse. I feel so much stronger and better in all respects that It is a positive pleasure for me to do a hard day's work now. Respectfully, B., Crystal Lake, Wis. CASE 86,291. This gentleman had suffered during eleven years from seminal weakness as the result of indiscretions in youth; nocturnal emissions were present, and there was also a seminal loss with the urine, and at stool; the patient's memory was greatly impaired and his mind otherwise affected from the vital drain; he was dyspeptic, his bowels were costive, and threatening symptoms of consumption had already begun to manifest themselves when he came under our care. Two months of our special treatment, at the patient's home, effected a perfect and permanent cure, and completely arrested all abnormal seminal losses. The following grateful letter is from the gentleman in question: WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Permit me to say that, six months after having discontinued your treatment, my cure remains perfect. This great permanent and enduring benefit was secured to me through only two months of your skillful treatment and careful management of my case. Your medicines had a wonderful control over my disease, driving away its terrible symptoms as if by magic; they imparted to me a new power, filled my body and mind with unusual vigor, and transformed me from one racked with pain and living death or worse, to a full measure of health and happiness. I feel that if I had not been opportunely and successfully treated by you, that my life would have been permanently blighted, and that the happy and contented mind that now inspires these lines would ere this have been dethroned of reason. I feel that you have been my savior. I have not had a single nocturnal emission since leaving your treatment, six months ago. Thanking you, gentlemen, from the depths of a grateful heart, I remain. Your obedient servant, G., Cayuta, Schuyler Co., N.Y. * * * * * Did the interest of our readers demand it, we could add to the preceding list an almost endless number of extracts from letters written by grateful patients, expressing their heart-felt thanks for having been cured of spermatorrhea and impotency by our treatment. But we have we trust given sufficient to illustrate our great success in dealing with these maladies. A CAUTION TO THE AFFLICTED. We are daily consulted by persons suffering from spermatorrhea and impotency who have been victimized by ignorant charlatans. Some seek to dupe and swindle the unwary by claiming to have themselves been cured of spermatorrhea or impotency by some prescription, which they offer to send free to any sufferer. When the prescription is obtained it is found to consist of a few articles well-known to every druggist, coupled with certain arbitrary and fictitious terms, unknown to everybody and not to be found in any medical work extant. Following the prescription is a modest suggestion that if it cannot be filled by the home druggist, the benevolently-disposed party furnishing the prescription will be pleased to send the medicine, already prepared, for from three to five dollars. Of course, the whole scheme from beginning to end being a swindle, when the "medicine" is obtained and taken it proves entirely useless. Skill and genuine merit do not go begging. Men who spend hundreds of dollars for the publication of advertisements offering to give away valuable information can always be safely set down as swindlers. In the public prints will be found advertised various ready prepared, "put-up," or proprietary, so-called "remedies," "Specifics," "Boluses," "Pastiles," "Rectal Pearls," "Urethral Crayons," "Voltaic Belts," "Galvanic Belts," "Batteries," and "Pads," all recommended as infallible remedies for spermatorrhea and impotency. A vast experience in the treatment of these affections has satisfied us that each case must be studied and treated according to the symptoms manifested, and that medicines that are adapted to one stage of the disease are entirely unsuited to other stages of the same case. No "Pad" or "Battery and Pad," "Galvanic" or "Voltaic Belts," "Battery," "Bolus," or "Soluble Crayon," ever did or can help a case of this disease, except it be in the imagination. Although the proprietors of the most popular proprietary medicines in the market, medicines carefully adapted to the cure of the diseases for which they are recommended, yet, should we attempt to get up a general remedy to cure spermatorrhea and kindred maladies, we are certain it would be an utter failure, and this is entirely true of all such preparations now and heretofore offered for sale, and, from the very nature of the diseases they are recommended to cure, ever must be. Each case must have medicines carefully prepared to meet the conditions present, and when these conditions, from the effects of treatment or other causes, change, the treatment must be varied accordingly. POSITIVE INJURY instead of benefit often results from the employment of some of the nostrums advertised for the cure of spermatorrhea, impotency and kindred affections. Especially have we found that the use of "Soluble Urethral Crayons," "Boluses," "Pastiles", and kindred contrivances, which are so extensively advertised, are exceedingly injurious, and often render otherwise moderate and simple cases, complicated and incurable. Although of pretended French origin, they are evidently the invention of an ignoramus, who knows nothing of the delicate anatomy of the generative organs or of the proper treatment of the diseases incident thereto, for none other would have thought of such a preposterous plan of treatment. No man should insert such absurdly devised and mischief breeding contrivances into his urethra (urinary canal), for thereby he is almost sure to do himself a permanent injury. So far from having been invented by an eminent French surgeon, as claimed, such treatment is entirely unknown in France, and ever has been, as the writer well knows from personal observation and enquiry while sojourning in that country and visiting its most noted hospitals and medical institutions. All the various "Troches," "Boluses," "Wafers," "Suppositories," "Pearls," "Rectal Pearls," "Rectal Capsules," and other contrivances which are recommended for the cure of Spermatorrhea and kindred weaknesses, and which are designed to be employed by inserting them into the lower bowel (rectum), and there permitting them to dissolve, are only so many irrational and filthy devices for duping the ignorant and innocent sufferers from these maladies. AN ALLURING SWINDLE. A still more enticing, and hence more dangerous, device for swindling unfortunate sufferers, is the widely advertised "Vacuum Treatment" or "appliance" so loudly and plausibly recommended for "Developing weak and wasted organs." A simple, little, brass air pump, connected with a glass tube, or cylinder, fitted with a valve at one end, which costs not to exceed one dollar and a half, is the worthless device palmed off on the confiding ones _at from fifteen to thirty dollars_. This is done under the _false pretense_ that its daily use to pump blood into the weak or wasted organs, will cause their development and growth. Thousands have invested their hard earned cash in this worse than worthless, injurious, contrivance. In fact the head of the concern putting out this alluring device is said to have amassed a fortune out of the nefarious business. So far from benefiting any one, out of several hundreds of cases that have come under our personal observation, in which this apparatus has been faithfully used for a long period of time, we have never met with a single case that had derived the slightest benefit therefrom. On the contrary, we have been called upon to examine many who had been _seriously injured_ by its use. The sudden congestion or filling and over-distention of the delicate blood-vessels of the organ operated upon, caused by placing it in a vacuum, is liable to rupture these minute vessels, causing the infiltration of blood into the tissues and giving rise to inflammation, and in some cases, to _suppuration, mortification, sloughing_ and _death_. In other cases, the blood-vessels of the organ and adjacent parts are so weakened by the _strain_ put upon them as to induce varicocele and other diseased conditions. In spermatorrhea, it is the worst possible thing that can be applied, for by forcing an undue amount of blood into the part the sensitiveness of the organ is increased, irritation is set up in the deep urethra, and the emissions are increased in frequency. In this, and other ways, hundreds of men but slightly out of health have been permanently injured. But this is only a small part of the story connected with the reprehensible business of palming off "The Vacuum Developing and Strengthening Appliance." The precious rascals, not content with making from a thousand to fifteen hundred per cent. profit on the miserable device furnished, while advertising fifteen dollars ($15.00) as the price of the "appliance" and "accompanying preparations," for "_ordinary cases_," make a general practice, when they have secured the fifteen dollars ($15.00), of sending it by express _with a bill to be collected on delivery_ FOR FIFTEEN DOLLARS ($15.00) MORE. With this bill they send an explanation, that "on re-examining the case" they "found it necessary, or thought it advisable, to send their stronger and more expensive preparations and appliances _for the worst cases_ AND SO HAVE CHARGED FIFTEEN DOLLARS ($15.00) MORE TO COVER THE EXTRA EXPENSE." It is astonishing that there are those who can be induced to part with their money for such claptrap devices, and still more so that having been duped and swindled out of their hard earned money through false pretenses and promises of benefit held out to them, they should submit quietly to such extortion and not have the swindlers arrested and prosecuted for obtaining money under false pretenses as they richly deserve. For what crime can be more deserving of punishment than the holding out of false hopes and pretenses to the unfortunate? Employing the United States mails for swindling is a pretty dangerous business, and sooner or later these rascals will, we predict, find it out to their sorrow. They are pretty sure to get hold of some men, ere long, who will invoke the aid of the United States District Attorney to bring them to justice. YOUNG MAN, if you have, through ignorance, fallen into practices that have arrested your physical growth and development in any of your organs or parts, shun all such unscientific and worse than worthless contrivances as you would shun a pestilence. No matter how plausible the web of arguments woven to entrap you, be assured, they are the utterance of knaves who care not what false hopes they encourage so they secure your money. Consult only those whose well known skill, experience and integrity will insure honest dealings and the most scientific treatment known to the "healing art," and who supply the latter at reasonable cost. Be assured also, that when, through proper treatment, your weakness and functional derangements are overcome, the parts that have suffered therefrom, will regain all the strength and development possible to impart to them through the aid of the physician's skill. Nature often accomplishes wonders in this direction, when aided by the skillful practitioner. * * * * * VARICOCELE; _OR, ENLARGED VEINS OF THE SCROTUM SOMETIMES CALLED FALSE RUPTURE_ Probably no affection of the generative organs has been given more attention by surgeons than this. Its great frequency, being present in about one-third of all cases of spermatorrhea, and its disposition to result in impotency and wasting away of the testicles, bring it constantly before the profession. [Illustration: Fig. 1. A healthy testicle.] [Illustration: Fig. 2. Testicle wasted from Varicocele. The enlarged and torturous veins are shown to be about as large as the testicle.] CAUSES.--Varicocele commonly results from long continued fatiguing exercise, in the upright position, heavy lifting, jumping, straining, severe constipation, injuries from horseback riding, bicycle riding, especially the latter, or any obstruction or obstacle to the free return of blood through the spermatic veins. Self abuse and excessive sexual indulgence are also prolific causes of varicocele. When the spermatic veins are over-distended to such an extent that their tonicity is impaired, they gradually lose their capacity for transmitting the blood, and a slowly increasing enlargement and tortuously of veins results. This goes on, becoming steadily more marked, until the pressure of the engorged vessels upon the spermatic cord impedes the full circulation of blood in the testicle and causes a wasting and softening of this gland. A loss of sexual power and increasing weakness of the generative organs generally follow this gradual destruction of the testicle, and sometimes total and incurable impotency results. This affection is also designated by the terms _circocele_ and _spermatocele_. It consists of an enlargement or varicose condition of the veins of the scrotum or spermatic cord, and affects the left side more frequently than the right. This is due to the fact that the spermatic veins of that side are longer, more dependent and tortuous, and, consequently, support a greater column of blood than the other side. The enlarged veins feel like a bundle of earth-worms. The knotty and tortuous vessels sometimes form quite a large tumor, which is, now ever, but rarely sensitive to the touch, yet sometimes causes a feeling of weight in the scrotum and loins, and sometimes produces a sensation of numbness in the thighs. [Illustration: Fig. 3. Well developed Varicocele.] When varicocele of an aggravated or largely developed type is present, associated with any weakness of the generative organs, as spermatorrhea or impotency, it must be cured before the organs can regain a healthy condition, as by the constant pressure of the abnormal quantity of blood and enlarged veins upon the spermatic cord, arteries, and testicles, the irritability, weakness, and wasting, are increased. The use of suspensory bandages, with strongly astringent lotions, will, in mild cases, produce relief and many times cure. Except in the worst cases, it is well to try these means before resort is had to operative surgical treatment, unless the patient is anxious to be cured in a more speedy manner. The treatment by suspensory bandage and lotions is necessarily somewhat slow in producing remedial results; yet, many quite well marked cases have, in our experience, been cured by such means perseveringly applied. Although many who have been unable to come to us for an operation, have been cured by suspensory bandages and our improved lotions applied to the affected parts, in all cases in which the veins are very much enlarged, we recommend the sufferers to come here and undergo our surgical treatment, which is painless in its execution and radical in its results. It has been recognized by physicians and surgeons for over a century, that in bad cases of varicocele a cure can only be certainly and permanently effected by operation. Many have been the methods of operation advanced by the prominent surgeons of every age, but all have met with such an alarming mortality, that they have been one by one abandoned, except as a last resort in extremely bad cases. A late author gives the percentage of deaths from the various old operations, now in general use throughout this country and Europe, as varying from seven to fifteen per cent. of all cases. In contrast to this, we point with pride to our records, by which we are shown to have operated upon over a thousand cases by our original method, obtaining in each and every instance a perfect cure, without a single alarming symptom or a death ensuing. This we think is sufficient evidence of the perfect safety of the operation and its superiority over every other method. So every sufferer with the disease, we would recommend it as a positive means of securing a permanent cure. Various worse than useless devices are advertised by quacks, who, as a class, are afraid to undertake surgical treatment for the cure of varicocele. One has what he calls a "varix clamp," or "clasp," to be worn upon the enlarged veins. Many "compressors" and other equally useless devices are advertised and sold for the same purpose. These are not only perfectly worthless, but positively dangerous in their application. The pressure they make upon the spermatic cord, nerves, and artery, is very apt to result in impotency and a rapid wasting away of the testicles. Patients should avoid all the catch-penny devices recommended for varicocele, as none of them are worth a moment's consideration. Even a moderate degree of morbid enlargement of the spermatic veins will sometimes cause such engorgement and obstruction to the free circulation of the blood in the testicle, as to cause gradual wasting or shriveling of that organ. In some cases the morbid condition will give rise to seminal weakness, or spermatorrhea. Many of these cases that can only be cured by surgery, are trifled with by quacks, who attribute the spermatorrhea, or loss of semen, to everything else than its true cause--varicocele. To illustrate, Mr. B., of Colorado, applied at the Invalids' Hotel and Surgical Institute, a few years ago, and said he had for five years been troubled with nightly emissions of semen and his testicles were gradually wasting away. He had been under the treatment of men making great pretensions as specialists, to whom he had paid several hundred dollars in the vain hope of getting cured of spermatorrhea. They treated him with medicines only, and did him no good whatever. On examination, we found a very varicose or enlarged condition of the left spermatic veins, and gave it as our opinion that the seminal loss was wholly due to this abnormal condition and could only be cured by an operation that would remove the varicocele. The operation was promptly performed. In two days he was able to leave his bed, and in a week started home to Colorado. Some months thereafter we received a letter from him wherein he said: "The enlarged veins continued to absorb and grow less and less, until, in a few weeks' time, all unnatural enlargement had disappeared. With a steady improvement in the condition of the veins, I experienced corresponding improvement in my general health, and the seminal losses grew less and less, and finally, long ago, disappeared entirely. I feel that my manhood, with all the powers that should belong thereto, are mine to enjoy. In other words, my restoration to health is complete. Had I saved the large amount of money that I fooled away on those quacks, and given it all to you, I feel that you would then have been only fairly paid for the great good you have done me." The foregoing is but a fair sample of letters that we are almost constantly receiving from those who have pursued useless treatment for spermatorrhea, dependent upon varicocele, and have been speedily cured by our never-failing operation for this malady. Among the great variety of operations in surgery for various diseased conditions, performed by our surgeons, none have been attended with more uniform satisfaction, and perfect success, than has our operation for varicocele. A PAINLESS OPERATION. By the injection of a few drops of a medicated solution under the skin, at the point where the incision is to be made, we are now able to produce such complete local anæsthesia as to render the operation _entirely painless_ without the administration of either chloroform or ether. This is an important consideration, as many are averse to taking chloroform or ether, and now that we are possessed of an agent that produces, locally, _complete insensibility to pain_, we are very glad to be able to dispense with their use in all such minor operations. Many examinations heretofore very painful, as of the bladder for stone, and of the deep urethra for strictures, are now rendered _entirely painless_ by the use of this wonderful agent. A great variety of surgical operations are now performed by our surgeon specialists, without any suffering on the part of our patients, by the local use of an anæsthetic solution injected into the parts to be operated upon. Formerly we were obliged either to administer chloroform or ether, or subject our patients to a great deal of suffering. Our specialists were among the first surgeons in this country to employ local anæsthesia successfully. We regard it as a great boon to our patients, and never withhold it in any case where it can be employed to prevent suffering, its use being attended with no danger and followed by no bad or disagreeable results. OUR PAINLESS OPERATION. Having operated with unvarying success, during the past twenty-five years, upon several thousand cases of varicocele, at the Invalids' Hotel and Surgical Institute, we now invite special attention to the results of our peculiar operation, which is neither severe nor dangerous, and from which the patient makes a much more rapid, and in every respect more satisfactory, recovery than from other operations in use by surgeons generally. In our practice we have never failed to secure the happiest results from our operation. The saving of time is also of importance to the laboring man as well as to the millionaire. Instead of being confined to his bed for ten to twenty days, and to his room for a month or more, as is the case following other operations, the patient is not confined to bed at all, and can generally return home in a week or ten days at the longest. The only precaution necessary is that he should, for a reasonable time after the operation, wear a well-fitting suspensory bandage. This can, in a little time, be entirely dispensed with. When we contrast these results with those obtained from ligation, graduated pressure by "clamps," suture pins, or the slicing off of a part of the scrotum, and suturing, or stitching, the wide gaping wound so caused, as is practiced to-day by other surgeons, the marked superiority of the results obtained, through our superior method of operating on this affection, must be apparent. A very large part of those cured by our treatment have previously spent far more money for worthless "electric suspensories," "equable scrotal compressors," "scrotal clamps," various "rings," and other "jim cracks," than was paid us _for a radical and permanent cure_. Some of these instruments are so formidable as to suggest the racks and thumbscrews of the middle ages. Such useless appliances often weaken the scrotal muscles by the unnatural compression which they produce and make the discomfort far worse when they are discontinued than before their use. For such cases as cannot come to us at once for an immediate and _perfect cure_, we have a common sense method of treatment, comparatively inexpensive, that gives relief and comfort in all cases, and in mild cases often effects a complete cure. This treatment leaves the scrotum and its contents in an improved, strengthened and more healthful state. * * * * * TESTIMONIALS. If the following letters had been written by your nearest, most respected and trustworthy neighbors, they could not be entitled to more confidence than they now are, coming, as they do, from intelligent citizens, each one of whom, in his own neighborhood, enjoys the full confidence of all his acquaintances. These letters are taken at random from among hundreds of similar ones, received from former patients of ours, residing in all parts of the United States and Canada, and if it would add anything to the endorsement in the way of giving greater confidence in our ability to treat successfully the malady under consideration, we could multiply the letters which we here introduce many times over. To publish more, however, would seem to be tedious repetition, for there necessarily must be a sameness in all such letters testifying to our skill, and we must, therefore, be content to rest our case with the limited number of endorsements which we have room for only in this volume. VARICOCELE. A PERFECTLY PAINLESS OPERATION. PATIENT SMOKES A CIGAR AND TALKS WITH THE SURGEONS WHILE OPERATION IS BEING PERFORMED. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: A.J. Seth, Esq.] _Gentlemen_--I suffered with varicocele at the age of nine years, caused by a fall, and doctored for same about fifteen years, and obtained no relief. Renowned surgeons of Pittsburgh, New York, and other cities pronounced my case incurable. I heard of the Invalids' Hotel, No. 663 Main Street, Buffalo, N.Y., and entered it as a last resource. On the third day after entering the Institution I was treated, and during the operation (which was a painless one), I smoked a cigar and talked with the operating surgeons, feeling _no pain whatever_. I remained in the Hotel one week, and during that time I never once was unable to walk to the elevator and have my meals in the dining room. The tables were laden with the best the country can produce. It is truly "The Invalids' Hotel" (or rather _home_), as the clerks and nurses are very kind, attentive and social. Will add, that I am permanently cured, and advise any person thus afflicted not to hesitate entering the Invalids' Hotel for treatment. Respectfully, A.J. SETH, Lucinda, Clarion Co., Penna. VARICOCELE. Fair View, Sanpete Co., Utah. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: W.F. Petts, Esq.] _Gentlemen_--I feel it my duty to thank you for the benefit I received at your Institution during the month of December, 1892. I was afflicted with varicocele on the left side, which caused me a great deal of trouble and almost made me feel at times that I did not want to live any longer if I could not be restored to soundness again. Hearing of your skill in the treatment of varicocele I determined to give you a trial, which I accordingly did, and with gratifying results for now I am as sound and well as a gold dollar. The operation which was performed on me at your Institution for the permanent cure of varicocele was, to my great surprise, entirely painless and performed in a much briefer time than I expected. I only remained at your noble Institution ten days after the operation, at the end of which time I returned to my home at Chatham Hill, Smyth Co., Va. When I got home I experienced very little soreness from the operation and I felt that I could enjoy life fully. About six months after, I got married and came to Utah where I now reside, and I am very much pleased to say that I am now as sound and well as ever, and very happy in my married state. When I went to your Institution I was surprised to see such a great number of young men from almost every State in the Union, who had come there to be operated upon for varicocele; and they all told me that the operation was painless to them, as it also was to me, and they said they were fast improving and were glad they had come there for treatment. I never experienced such great and unprecedented kindness as I did during the ten days I was at the "Invalids' Hotel." I had an excellent room--well furnished, plenty to eat, and was treated with the kindness of a mother by the nurses and attending physician. I advise all who are afflicted with varicocele to go to your Institution at once for an operation, which I assure them they will never regret. Trusting that those who require an operation of any kind, or who are afflicted in any way, may go to your Institution and be restored to health, and again thanking you for my restoration to health and YOUR great kindness and good treatment of me while I was with you, I remain, Yours very truly, William F. Petts P.S.--My sister's life was saved by your "Favorite Prescription," W.F.P. VARICOCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: A. Ebsary, Esq.] _Gentlemen_--It is with great pleasure I recommend those suffering from varicocele to your skillful hands. I suffered with varicocele for seven years, caused by standing behind the counter at business from seven in the morning until ten and twelve o'clock at night. In 1888 a friend gave me a copy of your Common Sense Medical Adviser. After perusing its pages I was convinced of the genuineness of its doctrine. I immediately started for Buffalo--a distance of 1,900 miles. During my stay of ten days at your Institution I was treated with the utmost kindness by the nurses and surgeons, all of whom are expert specialists. The equipment of the Institution is something immense. I often think of the appetite those healthy exercises in the treatment room gave me when dinner time came. After being in the Institution three days I underwent an operation for varicocele--an injection of medicine locally making the operation _absolutely free from pain_. The operation was performed in about thirty minutes, immediately after which I could walk to my room, and, after resting an hour, descended to the dining room and took my dinner as usual. While at the Institution I met numerous persons suffering from varicocele, and it was quite pleasing to contrast their happy looks as they wished you "goodbye" with the haggard appearance they had upon entering. After leaving the Institution I traveled about 1,400 miles by rail and 500 miles by water without the least inconvenience, which I consider a fair test of the operation. Five years have passed since that time, and I now feel as sound as it is possible to feel. In conclusion, let me say to those suffering from varicocele that it is impossible for them to do better than follow my example. Respectfully yours, ARTHUR EBSARY, (Care of Hon. Jas. Baird.) Water Street, St. John's, Newfoundland. VARICOCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: F.H. Jenkins, Esq.] _Gentlemen_--I am a carpenter and some years ago, I fell from a scaffold which in time almost killed me. I wasn't hurt very much at the time, but a dull aching pain seemed to take me in the left side of the scrotum, and after I could stand it no longer, I went to my doctor. He said that I had a rupture of the blood veins of the left testicle, and it was incurable. I gave up in despair; but at last, a friend handed me some of your advertising papers, and I saw the Common Sense Medical Adviser advertised and sent for the book and studied its contents carefully, and came to the conclusion that I was suffering from varicocele. I found on consulting you that my suspicions were right. I at once wrote you for particulars, and in less than a week I was at the Invalids' Hotel for treatment. At that time no one knows how I suffered; but I hadn't long to suffer. In ten days after _an entirely painless operation_ I was a well man and returned home. I cannot say too much in regard to the treatment and care from both Surgeons and Nurses. Nothing was left undone to promote comfort and good care. It is the only place on earth that I would feel safe to trust my life for a severe operation. There were, I think, over 100 patients at the Invalids' Hotel and Surgical Institute, at the time I was there, and as I had a good chance to be with them, I found that they were all doing remarkably well. At the date of my operation which was the 7th of March, 1893, I weighed just 165 pounds; to-day I weigh 189. I have gained in health, strength and vigor every day, I believe. I would just say, in conclusion, that I can give my word as an honest man to any sufferer that I believe he can be cured of almost any chronic malady at the Invalids' Hotel and Surgical Institute. Respectfully yours, F.H. JENKINS, (Box 13), Ascot Corner, Sherbrooke Co., P.Q., Canada. VARICOCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: R.C. Martin, Esq.] _Gentlemen_--Having been operated upon at the Invalids' Hotel and Surgical Institute. Buffalo, N.Y., for the radical cure of a varicocele of the left side from which I had suffered for four years, I take pleasure in certifying to the speedy and certain relief afforded me, and the painless nature of the operation, as performed by the surgeons of the World's Dispensary Medical Association. Fourteen days from the time of the operation I returned home cured, and went to work. I desire to express my thanks to the Medical Staff for their skill and attention. I met several patients while at the Sanitarium, and they all reported as getting along favorably and well. Respectfully, R.C. MARTIN, Gambril, Scott Co., Iowa. VARICOCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Chas. Dove, Esq.] _Gentlemen_--I can heartily say that the operation was a great success. I had rupture of the veins, or Varicocele, ten years. I never thought that I could be cured so easily. The operation was entirely painless, and I was only nine days away from home. I am now as well as ever and I recommend the Invalids' Hotel and Surgical Institute to any one who is suffering from any chronic disease. Yours, CHARLES DOVE, 33 John St., Wilkes Barre, Pa. VARICOCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J.F. Singrey, Esq.] _Gentlemen_--I was successfully treated for varicocele at the Invalids' Hotel. The operation was made painless by local application, previously applied, which made the parts insensible, and I returned home the ninth day. While there I met with patients from all parts of the country, and all spoke in the highest terms of the treatment received from the surgeons and nurses and all connected with the Institution. Yours respectfully, J.F. SINGREY, Maryville, Nodaway Co., Mo. VARICOCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: H.P. SMITH, ESQ.] _Gentlemen_--I feel very thankful to the Association for the benefit received--due to an operation performed for the cure of a varicocele of many years' standing. All traces of the disease have disappeared. I was surprised to know that so little pain was connected with the operation. Will say to those who think of visiting the Invalids' Hotel, that they will be treated well, and their visit will be made as pleasant as possible during their stay. Yours respectfully, HENRY P. SMITH, Warren, Huntington Co., Ind. VARICOCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: G.R. Southern, Esq.] _Gentlemen_--Having been operated upon at the Invalids' Hotel and Surgical Institute, Buffalo, N.Y., for varicocele of ten years' standing, I take pleasure in certifying to a speedy and perfect cure. The operation was made painless by local applications previously applied, which made the parts insensible to such a degree that the operation was performed without any suffering on my part. Time of stay, after operation, was ten days. I cannot speak too highly of the care and attention I received from the surgeons and nurses while there; everything that was provided was of the best--the best of food, clean apartments and pleasant rooms. I would recommend your Institution to any one suffering from any kind of chronic or surgical disease; and if they will only go to your Institution, they will meet with patients cured and others on the way to recovery from the same difficulty they have themselves--no matter what it is, if curable at all. I wish you success, Yours truly, GEORGE R. SOUTHERN, Morris, Otsego Co., N.Y. VARICOCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y. [Illustration: B.T. Stone, Esq.] _Gentlemen_--It is with pleasure that I certify to the success of the operation performed upon me for varicocele at your Institution some months ago. This operation was performed by one of your specialists in a skillful and painless manner. I found the Invalids' Hotel just what it is represented to be, and all patients who were there were well satisfied with the treatment. I was not confined to bed at all after the operation, and was able to leave at the end of ten days in an excellent condition. I am unable to express the great relief which your treatment has given me and I cannot say too much in praise of your Institution. I take great pleasure in recommending you whenever I get a chance, and cannot thank you enough for what you have done for me. With kindest regards, I am sincerely yours, B.T. STONE, Fellowsville, Preston Co., W. Va. LARGE VARICOCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: C.W. Kelly, Esq.] _Gentlemen_--It gives me much pleasure to state that during my stay at your Sanitarium I was treated with the utmost kindness, and found everything there just as represented in your pamphlet, if not indeed better. Your Institution is the best of the kind that I have ever seen and if it is possible for a person to be cured your specialists will accomplish it. A visit there convinced me that you do not make promises which you do not fulfill. After being there and having a surgical operation successfully performed, I heartily recommend all invalids to give your place a trial. Much to my surprise the operation which was performed was perfectly painless, no anæsthetic was given, and I was not confined to my bed for an hour. I was able to leave your Institution at the end of ten days completely cured. I can heartily commend your efforts in the cause of suffering humanity, and shall be pleased to offer my personal testimony at any time. With best wishes to the World's Dispensary Medical Association, I am, Sincerely yours, C.W. KELLY, Riverside, Riverside Co., Cal. VARICOCELE. THE RESULT OF INJURY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: C.F.L. DeHaven, Esq.] _Gentlemen_--Nine years ago I was struck with a springing pole, causing the spermatic cord to swell badly. I applied for medical aid and was told that no harm would result. But I grew worse, and spent over one hundred dollars with quacks and received no help. Four years ago while reading a chapter in Dr. Pierce's Common Sense Medical Adviser, I noticed that no hesitation was made in stating that a permanent and radical cure of varicocele could be made at the Invalids' Hotel and Surgical Institute. I went to the Hotel and the result was I returned home in eleven days permanently cured. I cannot speak in too high praise of the surgeon, and his delicacy and kindness in performing a painless operation; or of the nurses, who almost hourly visit the invalids and minister to their comfort. The Institution is fully equipped and nothing is left undone that can relieve suffering. I conversed with a great many patients while at the Invalids' Hotel and language could not express their delight at their treatment there. I earnestly urge all invalids to save time and suffering by being treated at the Invalids' Hotel and Surgical Institute where the latest and most improved methods are used, and operations are made painless and where everything is delightful and comfortable. I owe my life to the tenderness and skill of the surgeon and nurses at the Invalids' Hotel and Surgical Institute. Very truly yours, CLARENCE F.L. DEHAVEN, Haynes, Hocking Co., Ohio. VARICOCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: F. Brooks, Esq.] _Gentlemen_--I can say that while in your Institution I received the best of care and attention both by doctors and nurses; that your operation was almost entirely without pain; that my virility has increased since then as well as the tone of my general health; that your Institution is as commodious and cheerful as one could wish. Your patients with whom I became acquainted while there nearly all seemed to be well pleased with the ease and comfort of their surroundings as well as the manner in which they were treated for varicocele. Respectfully, FLAVIUS BROOKS, Sinnamahoning, Cameron Co., Pa. BAD VARICOCELE OF MANY YEARS' STANDING. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: D.E. Moorefield, Esq.] _Gentlemen_--I take pleasure in recommending your Invalids' Hotel and Surgical Institute as first-class in every respect. Some four years ago I was there and had an operation performed on me for a very bad varicocele with which I had been troubled some 15 or 20 years. The operation was made painless by the use of local applications. After staying at your place about twenty days (longer than is generally necessary) I was able to make my long trip home. The operation was a very successful one, considering the long time my trouble had been neglected, as I have suffered little or no inconvenience since. I saw a very large number of patients at the Invalids' Hotel from all parts of the United States and Canada, and all of them seemed to have a very high opinion of the treatment they were receiving from your Specialists, and I know personally, of several remarkably successful operations performed by your skillful surgeons while I was there. Respectfully, D.E. MOOREFIEID, Nathalie, Halifax Co., Va. VARICOCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: D.H. Miller, Esq.] _Gentlemen_--Having been operated upon at the Invalids' Hotel and Surgical Institute for the cure of Varicocele, which was caused from heavy lifting, I take pleasure in informing you that it is entirely cured; it was a varicocele of a number of years' standing and a bad case. It has been three years since I was operated upon and I have not experienced any trouble from it since; in fact, I feel that I am now entirely cured. _The operation is painless_ and gives entire satisfaction in every respect. I advise all who are suffering from this or any other chronic disease to take treatment at the Invalids' Hotel and Surgical Institute and they will be well rewarded by so doing. Yours respectfully, DAVID H. MILLER, Markle, Huntington Co., Ind. VARICOCELE OR FALSE RUPTURE--DUE TO STRAINING AND OVERWORK. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo. N.Y.: [Illustration] _Gentlemen_--I can bear testimony to the removal of the difficulty for which you treated me, for I had been to experts in Philadelphia and they did not know how to perform the operation, and said I could not be cured. I was treated by experts in Albany and other cities, but all for no use. I went to the Invalids' Hotel and Surgical Institute and was operated upon and find I am cured. The treatment in every other respect was good; everything was done to make patients happy and pleasant; the best of care and attention was paid to all. Yours truly, W. McGOWAN, Orbisonia, Huntingdon Co., Pa. VARICOCELE OR FALSE RUPTURE--TWELVE YEARS' STANDING--CURED IN TEN DAYS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: N.H. Sharitz, Esq.] _Gentlemen_--Having been operated upon at the Invalids' Hotel and Surgical Institute, Buffalo, N.Y., for the radical cure of a Varicocele of the left side, from which I had suffered for twelve years, I take pleasure in certifying to the speedy and certain relief afforded, and the painless nature of the operation as performed by the surgeon of the World's Dispensary Medical Association. Ten days from the time of the operation, I returned home radically and permanently cured. I desire to express my thanks to the medical staff for their skill and attention. Gratefully yours, N.H. SHARITZ, Box 22. Rural Retreat, Wythae Co., Va. VARICOCELE AND RESULTANT WEAKNESSES. WASTING OF STRENGTH AND MANLY VIGOR--NOW STRONG AND WELL. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Robert B. Wills, Esq.] _Gentlemen_--I am unable to find words to express my feelings of gratefulness and gratitude that I owe to your Institution, for the able and gentlemanly treatment that I was favored with during my stay with you, by officials and attendants in their respective capacities, in every department. Nothing was left undone that could possibly be of benefit to me or add to my comfort, and to your Institution, your treatment, which in my own experience I have found to be marvelously wonderful, I feel to-day as if I owe my health, my strength, my life; for I firmly believe if it had not been for your timely and painless treatment, instead of writing to you at this time, being in the enjoyment of health and strength, I would be filling a place in an insane asylum or an invalid's grave. And it may not be more than just to your wonderful treatment to say that the Varicocele and resultant weaknesses was of about fifteen years' standing, during which time I had spent time and money with both physicians and quacks, without any result for the better, and when my life blood was daily wasting away, and the powers of manly strength and vigor were completely gone, by an act of Providence I went to your Institution as a last resort, for life or death. I was painlessly operated upon by you for my complaint, from which time I have steadily improved in health, strength, weight and vigor, until I have gone from 135 pounds, my weight when operated upon, to 174, at which I tip the balance as I write to you to-day. If the afflicted everywhere could only realize that so many lives may be spared by your wonderful treatment, none would stay away. You are at liberty to give my testimony to the world in whatever way it may be of most benefit to you. I also enclose a photograph of myself that has been taken since the effects of your treatment have been shown. With feelings of much gratefulness, I am, Very truly yours, ROBERT B. WILLS, No. 23 Elizabeth St., Hagerstown, Md. RUPTURE OF SPERMATIC VEINS. VARICOCELE (FALSE RUPTURE)--PREVIOUS OPERATOR LEFT PART OF SURGEON'S NEEDLE IN FLESH; SUCCESSFULLY EXTRACTED AT INVALIDS' HOTEL. [Illustration: Chas. P. Morse, Esq.] "WHAT I THINK OF THE INVALIDS' HOTEL AND SURGICAL INSTITUTE:" The Invalids' Hotel and Surgical Institute is an Institution first-class in every respect, presided over by a capable, honest and pleasant lot of medical experts who certainly know their business. I cannot speak of it too highly. I was treated there in the summer of 1887, for Rupture of the Spermatic Veins, previous to which I had been operated on two different times, with no relief, by a doctor here in this place cracked up to be one of the best in Northern Illinois, and an officer of the Chicago Eye and Ear Infirmary. The operation at the Invalids' Hotel was perfectly painless, did not have to take any anæsthetic, neither was I confined to my bed at all, and the result a perfect success; while in the two previous operations I had here at home, I was confined to my bed a week each time and another week scarcely able to move about, be sides getting worse each time with pain enough to drive one crazy. But the half has not been told. About two and a half years after I had been cured of my difficulty at Buffalo, I commenced having terrible pains in my leg and abdomen, for which I could not account, and after standing it until it seemed as though I would be glad to die, I again consulted the Invalids' Hotel; after a thorough investigation they operated on me where my pain seemed the most apparent, and dug out a piece of a surgeon's needle something over half an inch in length, that had been broken off in the first operation I had by the doctor here at home, and so admitted by him when confronted with it. I have spent lots of money and nearly six years of the worst pain man ever stood getting relief, while had I known of this place on the start, an operation with no pain whatever and scarcely more discomfort than a sore mouth after having a tooth removed, would have ended it all. In conclusion, I will say to any poor sufferer, don't do as I did and put your trust in the would-be greatest doctor you have at home, but go to this place at Buffalo, where you will have proof of their ability, and where you will surely meet patients about to leave, cured; others on their way to recovery for the same difficulty you may have yourself, no matter what it is, if curable at all; a place where you will have the kindest of attention, the best of medical and surgical skill, and where you can see sufferers going away every day with hearts full of gratitude and happy. Respectfully, CHAS. P. MORSE, 311 North Avon St., Rockford, Ills. VARICOCELE-FALSE RUPTURE CAUSED BY INJURY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: G.W. McCollom, Esq.] _Gentlemen_--In the year 1866, sometime in July, I jumped from a load of lumber to the ground, and at once felt a sharp severe pain along the spermatic cord of left side of scrotum, preventing my walking to the house without help. The veins near the cord filled to such extent that they seemed solid, and could not be reduced for some time. I went to a good doctor and by him was advised to "pay no attention to it, it will not amount to much." From that time I suffered continually, and will not try to describe what I endured until I was relieved by a surgical operation performed on me by the surgeon-specialist of the Invalids' Hotel and Surgical Institute, of Buffalo, N.Y. After working-hard for several years my suffering increased and I was advised to consult Prof. L., of Chicago Hahnemann College (of Homeopathic School) and by him was informed an operation of tieing the veins (choking them off) could be performed but 90 per cent (if I remember rightly) of the operations proved fatal. I decided not to try it. By accident I learned of your great skill, and though my case was of twenty-one years' time, and my health and strength gone, I considered the method plausible and reasonably safe. I had the operation performed, and now after six years have passed, I can say with satisfaction, there is little to be noticed or remind me of the past years of misery. The parts are of healthy-color. Urine has assumed a natural appearance, both sides of scrotum seem in size alike. No bandage is worn and for two years has been discarded. My weight increased and for two years prior to the taking of my photo, I did the work of handling a third-class post office, doing a money order business of $50,000, not losing a day in that time, and at the present time in this hot climate, I have been doing outdoor work, some of it hard, and with mercury at 100 degrees. I have worked and found no need of a bandage; and no unnatural relaxation of the scrotum or veins is noticed. If anyone wishes to write me, they are at liberty to do so. If my experience can be of benefit to any, I will answer all enquiries, and in a general way will now say no one should delay attending to such difficulty, for if the blood is in a reasonably healthy condition your surgeon will operate in such a way that the result will be all right in time. I send photo taken in 1891. Respectfully, GEORGE W. McCOLLOM, Monrovia, Los Angeles Co., Cal. VARICOCELE. Sanborn, Barnes Co., N. Dak., Aug. 9th, 1895. PROPRIETOR INVALIDS' HOTEL AND SURGICAL INSTITUTE, Buffalo, N.Y.: _Dear Sir_--Having been afflicted with varicocele and loss of manhood and having heard so much of the cure for these troubles at the Invalids' Hotel. Buffalo. N.Y., I went there and was operated upon. The operation itself is nothing to bear. It is painless and the result is a radical cure. For this you have my sincere thanks. I take pleasure in recommending your Institution to all sufferers and know that it is in every respect just as claimed to be. I would say to all who suffer from this trouble: go to the Invalids' Hotel and Surgical Institute, at Buffalo, N.Y., and you will get relief. You will receive kind attention from all. Very truly yours, George Bignall. VARICOCELE AND GENERAL DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J.L. Ridings, Esq.] _Gentlemen_--I can bear testimony to the removal of varicocele, for which you treated me. I had been in the habit of getting out with the boys and trying to see which could kick the highest with one foot on the ground, and it caused me to have varicocele. I went to my home doctor and he treated me with no success. It was getting worse all the time and I got out of shape all over. My health got bad and I thought my case hopeless. I had tried two doctors and received no benefit. I had one of your little Memorandum Books in my pocket, and one day, looking through it I saw you treated such cases, and wrote you and received word in a few days that you would treat me, so I sent off for one month's treatment; and in five months I had gained my weight back, and that was eight years ago and I feel sound and well and my health has been good ever since. You are at liberty to use my testimony in whatever way if may be of most benefit to you. I also enclose a photograph of myself that was taken soon after your treatment. With feelings of much gratefulness, I am, Very truly yours, J.L. RIDINGS, Clarence, Shelby County, Missouri. VARICOCELE AND NERVOUS DEBILITY. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: D.A. Walton, Esq.] _Gentlemen_--I commenced treatment, I think, in July or August, of 1888, and continued four months. My case was nervous debility of fifteen years' standing. I tried home doctors but found they were only aggravating my case. I also tried the Remedy Company, then of St. Louis, who claimed to perform wonderful cures with their "Pastiles," but they proved utterly worthless. Having come in possession of Dr. Pierce's little book and circulars, a perusal of the same convinced me that my health would not be trifled with at his Institution. I was a poor man and could not afford much experimenting. I ordered one month's treatment, and at the end of this first month, I found, to my surprise, that I was feeling different. The second month, still more surprised at my returning health. Third month thought I was cured, and engaged myself to a young lady, and wrote you to that effect, and you advised me with your congratulations to marry, and to order another month's treatment; and at the end of the fourth month I was a _man_, something I did not know what it would be like to be before. I have now been married five years, and have two healthy children--a boy and a girl. I would never have dared to marry had it not been for your medicines. I must add that during this treatment I was troubled with varicocele on left side. I wrote you this at third month of treatment, and you sent without extra charge, a Suspensory and Lotion, and two months' treatment cured me sound and well of this distressing malady; I have not felt the least symptoms of its return. I want the world to know what a competent and honorable firm the World's Dispensary Medical Association is. I would love to shake you by the hand. May God let you continue to be a help to mankind is my prayer. Yours truly, D.A. WALTON, Marion, Grant County, Ind. BAD VARICOCELE OF LONG STANDING. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J.M. Elam, Esq.] _Gentlemen_--I feel many obligations to your noble skill, as physicians. I was treated with much kindness by physicians and nurses. I was surprised to find such a speedy cure of such a bad case of varicocele of long standing; the operation was entirely painless and I felt a great change in myself, as a result of it. Am so glad to tell any sufferer of that terrible disease to apply to you at once and be cured, for I am sure I could not have lived long as the pressure and burden was so great _I could scarcely be on my feet at all_; any work in an upright position was impossible. Now it has been five years since I was operated upon and I feel well of that disease--varicocele attended with impotency or weakness of the generative organs, caused by varicocele. Thanks to the good physician who relieved me--hope he may live long and be able to relieve all that submit themselves to him for treatment, as I did. I found everything that had been described to be just so in regard to the Staff and Institution. Gratefully yours, J.M. ELAM, Flat Rock, Scott Co., Va. DOUBLE VARICOCELE AND STRICTURE OF URETHRA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: C. Hanson, Esq.] _Gentlemen_--I have taken treatment from you for several months for nervous debility, and although I am not quite fully cured as yet, I have been greatly benefited, and believe, if I had come to you before I was duped and swindled by different quacks and was more dead than alive, I would to-day be a thoroughly well man. I have also been to your Institute twice for surgical operations, and cannot too highly praise the Hotel, or the skill and care of the attending surgeons and nurses. They are gentlemen in every way and the Invalids' Hotel is just as represented. I shall advise all suffering from chronic diseases to go to you for relief, as I have never seen any one there who was not cured or greatly benefited. Very truly yours, CHRISTIAN HANSON, Austin, Mower Co., Minn. INDIGESTION, CONSTIPATION, VARICOCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mr. Hodges.] _Dear Sirs_--In regard to my condition of health, will say, although I am not entirely well, yet I have received much and lasting good from your treatment. My digestion was improved greatly, so that little trouble is experienced after eating; my liver seems to act reasonably well, and my bowels are much better. My varicocele I consider entirely cured, as I have not used the bandage for one half day for more than six months, and do not experience any inconvenience from that source. Yours truly, HARLAN HODGES, Keota, Keokuk Co., Ia. BAD VARICOCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: W.H. Dellinger, Esq.] _Gentlemen_--Having been operated upon at the Invalids' Hotel and Surgical Institute for the radical cure of a bad varicocele, from which I had suffered for eight years, I desire to express my thanks to you for your kindness and skill. And I would advise all persons, needing surgical or medical treatment, to go to the World's Dispensary Medical Association. Respectfully yours, WILLIAM H. DELLINGER, Vincennes, Knox Co., Ind. VARICOCELE. Cambridge, Furnas Co., Nebr. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--With great gratitude toward your most valuable Institute, I feel indebted to you for the cure of varicocele. I was troubled ten years with this annoying disease, caused, I think, by being thrown from a horse. My case was of a very obstinate character. I was treated by a leading specialist of Omaha, Nebr., without success and without being in the least benefited. I expended the neat little sum of $500, and then sank back in despair, losing all hopes of a cure. I had previous to my treatment in Omaha noticed a little hand or Memorandum Book of the World's Dispensary, and again one came to my notice. I mustered up courage to write to you, and in June, 1892, I visited your Institute for treatment. I was treated by the best skilled surgeons and given best attention by experienced nurses. I met a number of patients while under treatment troubled with various and complex diseases, who expressed their gratitude to the Faculty of the Invalids' Hotel and Surgical Institute. The operation performed was rendered painless, owing to local applications previously applied. After the operation, which was about 11 o'clock, A.M., I rested until 12, noon, and responded to the dinner call as usual. I was required to remain but ten days, then returned home, a distance of some twelve hundred miles. I wore a neat fitting support for about six months, and then abandoned it and have gone as nature created me. Oh, what a relief. I had worn a "suspensory" for about six years. I have had no return of former trouble, it being now about two years since the operation. To any suffering with varicocele I must say, "don't delay, but place yourself under treatment at the Invalids' Hotel and Surgical Institute, Buffalo, N.Y., and you will say as I do, 'The half has never been told.'" With earnest wishes for your future success, I am, Yours truly, E.L. Brown VARICOCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: D.E. Righetti, Esq.] _Gentlemen_--I wish to inform you of the success of your treatment of me for varicocele on the left side and its attendant weakness, etc. I am now happy to say that through the agency of your surgical skill and the efficacy of your medicine, I am healthy, strong, and a perfect man. I suffered for about two years previous to the operation with acute pain in the parts, and continued mental anxiety. I desire to express my entire satisfaction that, during the ten days that I remained in the Invalids' Hotel, I never experienced such uniform kindness and attention as I did from the attending surgeon and from all the attachees, and that I recommend all persons similarly afflicted to consult you, and they can be sure to find the way to happiness. Respectfully yours, D.E. RIGHETTI, Cayucos, San Luis Obispo Co., Cal. VARICOCELE OF TWENTY YEARS' STANDING--CURED "WITHOUT PAIN. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: C.H. Boyle, Esq.] _Gentlemen_--I take great pleasure in recommending the Invalids' Hotel and Surgical Institute. After trying my home physicians without obtaining any permanent relief, and growing constantly worse, I went to this famous Institution and submitted to an operation for varicocele. This was a perfect success, and soon I felt like a new man, and as strong as I ever did. I feel that nothing I could say would do justice to this renowned Institution. In every way, it is kept in advance of the age. The staff of physicians and nurses spare no pains to make the visit of every one pleasant as well as beneficial in the highest degree. I would urge all sufferers afflicted as I was, or with any chronic disease, to avail themselves, without delay, of the skillful treatment to be obtained of the specialists of the World's Dispensary Medical Association, for I am confident that they will receive all the benefit that can be obtained from medical or surgical treatment and care. Yours truly, CHAS. H. BOYLE, Fort Benton, Choteau Co., Montana. VARICOCELE. SPENT $500 WITH OTHER DOCTORS TO NO PURPOSE. Bryson, Jack Co., Texas. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--I had been troubled with varicocele for nine years, and had given up ever being cured. After spending $500.00, with medical quacks I then went to the World's Dispensary Medical Association as a last resort. One of their skillful surgeons performed an operation upon me which was entirely painless. I conversed with several other patients, who had the same disease. They seemed happy to know that there was such an Institution that could relieve suffering humanity. The surgeons and nurses were so good and kind to us and gave us the best of attention and even the patients had a very fraternal feeling toward each other. Your Institution is finely equipped and has the best of accommodations. Accept my thanks. Yours truly, A.D. Bryson A BAD CASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: H.C. Decker, Esq.] _Gentlemen_--I have been cured of an almost life-long difficulty by the skill of your specialist, and heartily thank you for the successful manner in which the operation was performed in my case. The result is complete and perfect relief, and as time advances I can each day more fully appreciate the value of your Institution. The time spent there I shall never forget, as it was a time of extreme pleasure to me. The operation was _perfectly painless_ and did not confine me to my bed, and this taken with the extreme kindness of every one connected with the Institution, made the time pass in a very happy manner. I consider your Hotel first-class in every respect, and would heartily advise all sufferers from chronic ailments to visit you before giving up their cases as hopeless. Respectfully yours, H.C. DECKER, Dresbach, Winona Co., Minn. VARICOCELE-CAUSED FROM STRAIN. Montague, Sussex Co., N.J. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--In reply to your inquiry concerning my treatment, I cheerfully give you the following testimonial: "I was troubled for many years with a very bad varicocele, which I received when a boy while jumping. The complaint troubled me exceedingly. I tried almost every known means to effect a cure, but with no avail, for the more I doctored the more aggravated became the disease. After thus suffering for many years and knowing of the fame your Institution had attained in curing such diseases, I at last consulted your specialist in that class of diseases--was operated upon and returned home in ten days, a sound and well man. I can recommend your Institution to all suffering humanity as the most home-like, your nurses the most attentive and specialists the most skillful the world can offer. May you long be the benefactors of mankind." Yours truly, F.L. Van Etten VARICOCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: E.H. MAHNKEN, ESQ.] _Gentlemen_--The result of your operation, performed one year and a half ago for a case of varicocele of twelve years' standing, and which had troubled me very much, has cured me entirely. I am thankful to God that He put it into my mind to visit your Surgical Institute. I cannot recommend your skill too highly. Yours truly, ED. H. MAHNKEN, Smithton, Pettis Co., Mo. VARICOCELE. Medora, Billings Co., N. Dak. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Having been operated upon at the Invalids' Hotel and Surgical Institute, Buffalo, N.Y., for the radical cure of a varicocele on the left side from which I suffered four years, I take pleasure in certifying to the speedy and certain relief afforded, and the painless operation, as performed by the surgeon of the World's Dispensary Medical Association. Ten days from the time of the operation I returned home permanently cured. I desire to express my thanks to the Medical Staff for their skill and attention. Gratefully yours, Geo. O. Reid A STRONG ENDORSEMENT. _To whom it may concern_: [Illustration: H.E. Bankston] This is to certify that I took treatment at the Invalids' Hotel and Surgical Institute, Buffalo, N.Y., and I was cured of a chronic trouble that had been maltreated by other physicians. While there I saw a man who had been cured by the specialists, who had before been given up to die by the best doctors in Troy, N.Y. Of course, the case must have been a very stubborn one. I afterwards saw a man here, in Georgia, die, who, if he had been in Pierce's Surgical Institute under the treatment and care of his skilled doctors and nurses, I know would have most assuredly got well. Why? Because it was only a cage of _stone in the bladder_, and they are easily cured at Dr. Pierce's Surgical Institute. I think almost any chronic disease can be cured there, if taken in time, judging from my observations while an inmate of that Institution. H.E. BANKSTON, Barnesville, Pike Co., Ga. * * * * * HYDROCELE, OR DROPSY OF THE SCROTUM. This malady consists of a collection of water in the _tunica vaginalis_, or membranous sac which contains the testicles. It may affect either one or both sides. In health the sac-like covering, or investing membrane, of the testicle secretes a limpid fluid which lubricates its inner surface. When secreted in excess, it accumulates and constitutes _hydrocele_. The tumor commences at the bottom of the scrotum and grows very gradually, while hernia, or rupture, with which it is often confounded, progresses from above downwards and makes its appearance suddenly. We were recently consulted by an aged gentlemen, whose disease a distinguished surgeon had pronounced _double hernia_. On examining the enlargement, we found the disease to be dropsy of the scrotum, complicated with varicocele. CAUSES. Injuries from blows or bruises are among the most common causes of this disease. It may also result from inflammation of the testicle or from excited action in those parts. It has been known to result from stricture of the urethra, or water-passage, and also from local irritation along that passage. HYDROCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: H.H. Williams, Esq.] _Dear Sirs_--In answer to inquiries will say, that any person afflicted as I was, I would advise them not to listen to any ordinary doctor, but leave at once for the Invalids' Hotel and Surgical Institute, Buffalo, N.Y., where he could get the best of treatment and attendance that money could procure. The table also is loaded with the best of fruits, vegetables, and the finest meats of the markets. Respectfully, H.H. WILLIAMS, St. Augustine, Florida. HYDROCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: D. Flynn, Esq.] _Gentlemen_--Without solicitation, but simply to aid suffering humanity, I take pleasure in recommending your place to any suffering from Hydrocele. I was cured in a short time, after having the Hydrocele for eighteen years. Your new process is painless, no knife being used and is certain, sure and safe. With many good wishes of success, I am, Yours truly, DAVID FLYNN, (Engineer, S.F. & W. Ry.,) Way Cross, Ware Co., Ga. HEMATOCELE OR RUPTURED VEINS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: D. Parker, Esq.] _Gentlemen_--I was afflicted with Hematocele of large size, caused by an injury, for which home-treatment gave me no relief. Hearing of your Invalids' Hotel I went there and had an operation performed for its cure. I have the greatest confidence in your Specialists, as the operation was a perfect success. It was perfectly painless, and I was able to go home in less than two weeks with the cure complete. I take pleasure in certifying to the good work you are doing. With the best of feeling toward the Invalids' Hotel, I am, Yours truly, DON PARKER, P.O. Box 155, Oakfield, Genesee Co., N.T. HYDROCELE WITH VARICOCELE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: D. Huntington, Esq.] _Gentlemen_--About five years ago, having been a patient at, the Invalids' Hotel and Surgical Institute and undergone a painless operation for the cure of hydrocele and varicocele--which was performed to my entire satisfaction. I desire to express my thanks to the Medical Stuff for their skillful treatment of my case. Two weeks from the time of the operation I returned home, radically and permanently cured. I recommend all similarly afflicted to consult the World's Dispensary Medical Association. Yours truly, DANIEL HUNTINGTON, Huron, Beadle Co., So. Dak. TWENTY-TWO YEARS' STANDING--UNSUCCESSFULLY TREATED BY OTHERS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: E.L. Waters, Esq.] _Gentlemen_--I wish to acknowledge that you have cured me of the worst case that ever came within my knowledge, it having afflicted me twenty-two years. After I had suffered much from other surgeons without any cure being effected, and with only relief for a short time, you performed a not only painless but very scientific operation, and with medicine completed the cure. It is now five years since you treated me and no symptoms of the disease have shown themselves. I will also add that while with you at the Invalids' Hotel I received the best of care and attention from the well trained nurses in your employ, for all of which I feel grateful. With respect and best wishes, EDWIN L. WATERS, Athol Centre, Mass. * * * * * THE URINARY ORGANS: THEIR ANATOMY, PHYSIOLOGY AND PATHOLOGY. By reference to Fig. 1 the reader will get a good understanding of the relative positions of the kidneys, bladder, and adjacent organs. THE KIDNEYS. It is hardly necessary to discuss the minute structure of these organs in a book intended for the non-professional reader. The function of the kidneys is to remove certain waste materials from the blood. As fast as excreted by the kidneys, the urine passes through the ureters, of which there are two,--one leading from each kidney, into the bladder. The ureters are lined with a continuation of the mucous membrane, reflected from the bladder upwards, and this lining also extends to the cavities of the kidneys. Calculi or gravel, and stones, forming, as they sometimes do, in the kidneys, and passing down through these delicate and sensitive canals, cause excruciating pain. The symptoms of renal calculi passing from a kidney to the bladder are, as already indicated, severe cutting pain in the loins, and along the ureter, attended with considerable fever. A very rough stone, such, for instance, as a mulberry calculus, passes with considerable difficulty, and the patient is often suddenly seized with excruciating agony in the loins and in the groin, the pain also shooting down into the testicle of the corresponding side, often causing it to retract. There is usually, also, sympathetic pain shooting down the thigh. We have seen patients roll on the floor in the greatest agony, cold sweat meanwhile pouring down their faces, when thus suffering. The patient may also vomit violently, through nervous sympathy. The urine is apt to be bloody, and there is a constant desire to pass it. There is pain in the end of the penis, and also in the lower portion of the abdomen. THE BLADDER. This is a sac, or reservoir, to receive and hold the urine as it comes from the kidneys through the ureters. Its walls are partly composed of muscle, and partly of a lining mucous membrane. The muscular coating is external, and it is by its contraction that the urine is expelled. When empty, the bladder shrinks down to a small size, as compared with its distended condition. When filled, it is capable of holding about one pint. If it is distended by the retention of urine much beyond this capacity, the muscular coats lose their force, and often the urine cannot be passed naturally. In health, when the bladder becomes filled and distended, there is a consequent desire to empty it by passing water. [Illustration: Fig. 1.] The voiding of the urine should not be attended with the slightest pain or disagreeable sensations, and the desire to pass it should not be frequent. When there is frequent desire to pass it, or when its passage is attended with pain, there is irritation, or inflammation, in the coats of the bladder, or in the urethra. This may arise from an excessively acid or irritating condition of the urine, as well as from various other causes. Gonorrhea, or clap; stricture of the urethra, which impedes the free flow of the urine; enlargement or inflammation of the prostate gland; gravel, and stone in the bladder, are all capable of creating a frequent desire to pass water. Whatever the unhealthy condition may be which gives rise to this troublesome symptom, it calls for prompt and skillful treatment, for the most trivial affections of these organs often pass into those that are exceedingly intractable, if not incurable. THE EXAMINATION OF THE URINE. The urine itself, when subjected to microscopical or chemical examination, as we shall hereafter more fully explain, offers the best means of determining the exact nature of these distressing affections. When normal, the urine is of a pale straw-color, and throws down no deposits on cooling. In passing it no difficulty or pain should be experienced, and it should spurt from the urethra in a full, round, and regular stream, until the bladder is entirely emptied. If the stream is forked, checked, or interrupted in any way before the bladder is completely emptied, it is evidence that something is wrong. Stricture of the urethra, prostatic disease, and gravel, or stone in the bladder, are all capable of producing obstruction to the free flow of the urine. HOW SLIGHT AILMENTS BECOME DANGEROUS DISEASES. As we have before stated, the mucous membrane lining the bladder is reflected upwards into the ureters, lining these canals. By reason of this continuity of mucous surfaces, patients suffering from urethral, prostatic, and bladder affections, often die from disease of the kidneys. It must not be supposed that because stricture of the urethra does not co-exist with _Brights_ disease, that the latter may not have been caused by the obstruction in the urethra due to stricture. Pulmonary consumption, for instance, often begins in the form of nasal catarrh, but, by the continuity of the mucous membrane, it travels, so to speak, into the throat, or pharnyx; from the pharnyx into the larnyx, and then into the lung structure itself. The disease is transferred from the nose into the lung tissue. What occurs in the nasal, laryngeal, and pulmonary tract of mucous membrane, happens, also, in the urinary tract. A gonorrhea, which is a specific acute inflammation of the urethral canal, leaves behind it a slight gleet, or chronic inflammation of the mucous membrane of the urethra. This may give little inconvenience for a number of years, but gradually it culminates in a stricture, or, implicating the prostatic portion of the urethra, occasions inflammation of the prostate gland, and, perhaps, enlargement of this organ. This gradually gives rise to cystitis, or inflammation of the bladder. From the bladder, the disease travels up the ureters into the kidneys, and finally _Brights_ disease is established in these organs. The mucous membrane lining the bladder also extends through the urethra. Throughout the interior of the body, whether it be in the stomach, lungs, or other parts, this lining mucous membrane serves as a protection to the parts beneath, just as the skin on the exterior of the body serves as a protection to the sensitive true skin and the tissues underneath it. THE CAUSE OF CERTAIN DISTRESSING SYMPTOMS. Close to the neck of the bladder is a triangular space, on which the mucous membrane is smoother, and devoid of folds, or rugae, and which is far more sensitive and vascular than other portions of the mucous membrane lining this organ. It is called the _trigone vesical_. This _trigone_ is the most depending part of the bladder. If there be stone in the bladder, it naturally gravitates and rests on this sensitive space, so that, when the bladder is empty, the foreign body occasions inconvenience, until the urine, trickling down through the ureters, and intervening between the mucous membrane and the stone, serves as a temporary protection to the mucous surface. Hence the pain becomes less as the urine is secreted, until the water is again passed, and the intervening fluid thereby removed, when the stone again presses upon, and irritates, the sensitive _trigone_, by coming into more immediate contact with it. The greater ease with patients afflicted with stone experience in a recumbent position in bed, or on a sofa, compared with being in an erect posture, is easily explained. The foreign body, when the patient is standing, walking, or riding, falls by its own gravity on this sensitive spot; when in a recumbent position, it rolls away from this sensitive _trigone_ into the back part of the bladder, where the mucous membrane is less sensitive; consequently, the patient suffering from stone in the bladder is more easy at night, whereas, one suffering from prostatic disease, whether it be inflammation of the prostate gland, or enlargement of that organ, is usually worse in bed. HOW BLADDER DISEASES COME TO BE CONFOUNDED WITH OTHER DISEASES. The bladder is largely supplied with blood-vessels, lymphatics, and nerves, given off from the same systems that supply the rectum or lower bowel, and in females the uterus or womb, and the ovaries. This accounts, in a great measure, for the symptoms of bladder disease in those afflicted with piles, or other diseases of the lower bowel, or of diseases of the uterus or womb in the female. We have frequently been consulted by patients who had erroneously supposed themselves to be suffering from disease of the bladder, or of the prostate gland, but whom we found, on examination, to be suffering from hemorrhoids, or piles. In these cases, by removal of the pile tumors, the frequent desire to urinate, and all pain in the region of the bladder, are promptly relieved. Sometimes, ulcers located in the rectum, give very little unpleasant sensation in the bowel, but produce pain in the bladder, with frequent desire to urinate. Enlargement of the uterus, the womb, or displacements of that organ, as prolapsus, or anteversion, and all capable of producing symptoms of bladder disease. A frequent desire to urinate and more or less sharp pain in the region of the bladder are usually experienced in these cases. Disease of the bladder, in like manner, often produces an apparent disease of other organs through sympathy, and without great care in diagnosticating each case, the _effect_ may be taken for the _cause_, and the patient treated for a disease which does not really exist. THE URETHRA. The urethra, in the male, is the canal extending from the bladder to the end of the penis, through which the urine is passed. This canal starts from the base of the bladder, passes through the prostate gland, and, entering the penis, continues of about uniform size along the under part of the penis until it reaches the glans, or head of that organ, where it expands somewhat into a bulb-like fossa, or cavity, and becomes reduced again at the orifice. At a short distance from the bladder it receives the outlets of the seminal ducts. The urethra is a most delicate and sensitive canal, and is surrounded by tissues of like delicacy, and is lined with a mucous membrane which is highly vascular, and filled with sensitive nerves. The introduction of any instrument into this canal is to be undertaken only when absolutely required, and when necessary. It should be so skillfully and carefully effected that no pain or irritation can result. The slightest awkwardness is liable to cause an unnoticeable injury, which may result in a false passage, or an effusion of plastic lymph around the canal, which, organizing, forms the most troublesome kind of organic structure. By proper and early treatment all danger and pain is avoided, and a cure effected in a very short time. In an extensive practice, in which we yearly treat thousands of cases, we have never yet failed to give perfect and permanent relief from stricture, or disease of the prostrate gland, without the necessity of using cutting instruments of any kind, when we have been consulted before injury to the urethra has been produced by the improper use of instruments. Having specialists who devote their entire time and attention to the study of these diseases, we are able to relieve and cure a large number painlessly and speedily, in which the awkward manipulations of physicians or surgeons, whose hands, untrained by constant and skillful use, not only fail to effect any benefit, but set up new, or aggravate existing, disease. This subject will receive a more full and complete consideration in another part of this treatise. THE PROSTATE GLAND. The prostate is a gland of about the size and shape of a large chestnut, lying just in front of the bladder, and surrounding the urethra. The size of the prostate gland varies considerably with the age of the person. In early life it weighs but a few grains. As puberty approaches it becomes larger, and in the adult weighs from half an ounce to an ounce. In old age it enlarges considerably, and sometimes presses upon the bladder so as to impede the flow of urine. This condition is often confounded with stricture, gravel, or stone in the bladder, by inexperienced physicians. Hypertrophy, or enlargement of the prostate gland, is not an unfrequent disease in the adult or middle-aged man. Being in close contact with the bladder, when it enlarges it encroaches on the bladder, pressing on it, and it has the effect of interfering with the function of urination. As before indicated, enlargement or hypertrophy of the prostate gland, is often confounded with stricture, gravel, and stone in the bladder, by inexperienced physicians, and treated accordingly. The true condition of this gland is readily determined by an examination through the rectum or lower bowel, the finger of the expert surgeon being able to determine at once whether it is enlarged or not. THE DANGER OF BAD TREATMENT. In disease of the prostate gland, as well as in inflammation of the kidneys and bladder, stricture of the urethra, and many other forms of urinary disease, the use of stimulating diuretics, and the much-advertised "kidney cures," "buchus," and similar preparations, which largely increase the flow of urine, simply aggravate, and do positive harm. In fact, the most difficult cases that we have had to deal with have been those that, through such treatment, either taken on their own account or prescribed by inexperienced physicians, have been rendered so much worse as to make their cases very intractable, and tedious to relieve and cure. REQUIRE NICELY ADAPTED TREATMENT. As we have heretofore indicated, there is no class of diseases that require nicer adaptation of medicines to each individual case, than those of the urinary organs. Medicines which, in one stage of these diseases are beneficial and curative, in another stage are often exceedingly injurious. Hence it is that we claim it to be impossible for any one to put up any set prescription, or proprietary medicine, that will meet the wants of a large percentage of this class of cases. The only rational course to be pursued is to examine carefully each case as it is presented; find out the exact condition and stage of the disease with which the patient is afflicted, and then prescribe for it such special medicines as are nicely and exactly adapted to the patient's condition. These, in many cases, will have to be changed from time to time, to suit the ever-changing condition of the disease, as it is modified by the treatment. Not only have the manufacturers of "buchus," "kidney cures," etc., committed grave errors by prescribing stimulating diuretics for almost all kidney and bladder diseases, under the impression that, as the patient passes only a small quantity of urine at a time, the kidneys should be stimulated to secrete more, but physicians in general practice have been very prone to commit the same error in their practices. When the bladder and kidneys are in a weak and diseased condition, incapable of efficient action, the bladder being already unable to dispose of the diminished quantity of urine secreted, it is simply outrageous practice to administer medicines calculated to stimulate the kidneys to perform more work. By being thus forced, these organs become seriously diseased. It would appear most unreasonable to whip and spur a horse already jaded from overwork. Common sense would dictate rest, which always does good; but, as the bladder is weak, the doctor whips up the kidneys with drugs, thus endeavoring to force them to secrete more urine, and thereby the poor, crippled bladder, which is incapable of disposing of even the diminished quantity secreted, is actually made to do more work in a diseased and feeble condition, than it would perform in a sound, strong, and healthy state. The results of this pernicious practice are _Bright's_ disease of the kidneys, cystitis or inflammation of the bladder, and numerous other grave maladies. * * * * * KIDNEY DISEASE. Diseases of the kidneys are generally very slow in their inception, coming on gradually and manifesting no special symptoms of their presence until they have assumed a formidable character. For this reason they are the more dangerous. Simple derangement of the urinary secretion is no evidence of disease of these organs, as changes in the color, quantity and specific gravity of the urine are often produced by changes of temperature, active or sedentary habits, mental emotion, and sometimes by articles of diet, or drink, as well as by the use of different drugs. The existence of disease of the kidneys in the early stages can only be positively determined by a microscopical and chemical examination of the urine, which reveals to us the presence of casts, epithelia, blood, pus, etc. The microscope informs us not only of the presence of disease, but very often of the particular portion of the kidney in which it is located, as well as of the stage which the disease has reached. We are also aided by chemistry in determining the exact abnormal condition of the kidneys by the detection of albumen, sugar, etc. These examinations, by aid of the microscope and chemical re-agents, should never be neglected by the physician. Without them his diagnosis, or judgment of the patient's condition, is simply guess-work. With them he is enabled to base his treatment upon certain and positive knowledge of the patient's real and true condition. The usual symptoms of chronic disease of the kidneys, but which vary materially with the age, constitutional peculiarities and temperament, are weakness in the small of the back, pains in the region of the loins and groins, numbness of the thigh on the side of the affected kidney (for often only one organ is affected), high-colored and often scalding urine, many times depositing a sediment, sometimes white or milky urine, bloody urine, frequent desire to pass the urine, partial impotency, pains in the testicles and shooting into the loins, suppression or inability to pass the urine, gravel, stone in the bladder, dropsical swellings, swelling of the testicles, irritability and pain in the bladder, mucous and sometimes seminal discharges oozing from the urethra. WHEN THE BLADDER IS AFFECTED the prominent symptoms usually complained of are irritability of the bladder, accompanied by a frequent desire to urinate, inability to retain more than a small quantity of urine, and this for a short time only, pain in the region of the bladder, extending into the back, thighs, etc., hot scalding sensations in passing the urine, sediment in the urine, and sometimes bloody urine. The appetite is usually diminished, there is a depression of spirits, the urine is often passed only by drops, and is irregular in quantity and quality, frequent inability to pass the urine at all, in males partial impotency, with dull disagreeable pain in the testicles and irritation of the urethra, attended with mucous and sometimes seminal discharges oozing from the urethra. Some of these symptoms may be present as the result of functional or organic disease of other organs than the kidneys or bladder, and to distinguish them with positive certainty is impossible without the aid of a microscopical and chemical examination of the urine. * * * * * BRIGHT'S DISEASE. This affection may appear in either an acute or chronic form. The acute form is frequently a complication, or sequel of scarlet fever, diphtheria, cholera, typhoid fever, erysipelas or measles, and is frequently developed by intemperance. The acute form of the disease is very rapid in its progress, often destroying life by uraemic poisoning--the retention of urea in the system. The symptoms of the acute form are diminution or suppression of urine, dry skin, chills, thirst, pains in the loins, and a general dropsical, puffy condition of the system, especially manifesting itself in the earlier stages under the eyes, but gradually showing itself in the oedema, or swelling of the feet, and lower extremities generally. Unless promptly relieved, the patient dies of coma (stupor), or from convulsions. No person should be so rash as to attempt the treatment of this dangerous affection without the aid of the best medical skill that can be procured. IT IS THE CHRONIC FORM OF BRIGHT'S DISEASE that we propose principally to discuss in this article. True Bright's disease of the kidneys is an insidious and most fatal form of organic disease. We venture to assert that less than one per cent. of those who imagine they have "Bright's," have this disease at all. We find that most of those who, as one of our Faculty puts it, _insist upon having_ Bright's disease, base their "diagnosis" upon the ever-changing condition of the urinary secretion, and especially upon the copiousness of the deposit; whereas, in true Bright's, deposits of any kind are rarely met with. Perhaps the form of deposit most commonly mistaken for Bright's disease, is that known to medical men as the _urates_. When the urates are in excess they form a heavy pinkish deposit of a flocculent nature within from five to thirty minutes after the urine has been passed--that is, after it has been passed sufficiently long to cool. To prove that the deposit is urates, heat the specimen to the temperature of the blood, when the deposit in question will disappear. Excess of urates has now been definitely traced, in the majority of instances, to functional torpidity of the liver. Another common form of deposit is that in which the reaction of the urine, instead of being acid, as in health, is either neutral or alkaline, and in which the earthy phosphates are precipitated for this reason. The earthy phosphates, when thrown down by a neutral or an alkaline condition of the urine, appear as a heavy white deposit, which, though usually devoid of clinical significance, is certainly calculated to frighten timid patients who read of the "terrible ravages of Bright's" in the advertisements of various popular "kidney cures." To prove that the precipitate is phosphatic in its nature, add a few drops of vinegar and it will disappear; whilst, if, after the vinegar has been added, the specimen be brought to the boiling point, not only both the urates and phosphates remain in solution, but there is only one single substance known to pathological chemistry that can form a deposit under these conditions--and that substance is albumen, which, if present in quantity, is always indicative of serious disease. The papers are filled with the plausible but unwarranted statements of the manufacturers of various "kidney cures," who anxiously desire that every one should be impressed with the idea that all their troubles arise from kidney disease in order to sell large quantities of their medicines. In many cases the unfortunate patient is rendered much worse by the use of remedies that are not suited to his condition, and which will not cure the real trouble with which he is affected. Daily we are consulted by persons in whose cases these errors have been made. In reality, true Bright's disease is not a common affection, and nine out often individuals who think that they suffer from it, or the early stages of the trouble, in fact have something more curable. In some cases it is an affection of the liver, which forces an excretion of unnatural salts by the kidneys, and thus renders the urine acrid and irritating, or they may be suffering from some other disease, such as a deformity or enlargement of certain glands, as the prostate; unnatural position of the organs, as with women who suffer from weakness, the uterus pressing forward on the bladder and urethra, and thus showing every evidence of disease in the urinary canal. It is as common for persons to suffer from deformity of the urinary canal as from misshapen limbs, or from noses and ears not of proper size and proportion. The urinary canal, from the bladder outward, is narrow and delicate. Any disease or injury therein is liable to result in gradual contraction, which may be manifested long years after the cause has been forgotten, or has disappeared. These affections, to the inexperienced, or the physician who is not particularly alert and cautious in his diagnosis, are liable to cause error, and he will pronounce a given case Bright's disease, when in reality there is some simple cause for the irritation of the urinary canal, and the pains in the kidneys, etc., all of which frequently result from a slight damming up of the flow of water, and the prevention of free expulsion from the system of the salts of which the body is relieved by the kidneys. They cannot work under pressure. When, from any cause, the flow of water is checked, and, as it were, dammed up so that a slight pressure is put upon the kidneys below, their secretion is most materially interfered with, and the many trains of symptoms that usher in disease of the kidneys, appear. The true, and only sure way to relieve these conditions, as can be understood by any one, is to remove the real cause. The use of any medicine that stimulates the kidneys to an irritable action, under such pressure, is to be avoided, as it only makes the trouble worse, increases the amount of water that is dammed up, and results in more serious manifestations of constitutional disease; whereas, by merely relieving the choked outlet, the flow of water becomes free, and the kidneys are speedily restored to their natural condition. This is well illustrated by the following: Case 113,396. As recorded at the Invalids' Hotel. L.C.K., farmer, age 41, married. For a period of nearly ten years, as a result of slight injury, he had suffered from cloudy and unhealthy-looking water, with some burning on passing it; frequent calls to urinate; swelling of the limbs, loss of energy and strength; headache, etc.; gradually there appeared severe pain in the back, at times recurring with a sense of fullness in the abdomen. For a period of nearly eight years he had been constantly treated by physicians at his home, all of whom had investigated his case. He had made several long journeys to consult the manufacturers of a much-advertised "kidney cure," who, after pretending to examine his urine, scientifically (none of the proprietors are physicians), assured him that, without the shadow of a doubt, his disease was Bright's, and that he might be cured by their "kidney cure," which was for sale at all drug stores. For a period of eighteen months he steadily took this "cure," which, he states, he is sure aggravated his disease, as, although his sufferings at times were less, he felt that he was not improving in the least, and that his disorder was not being properly controlled. His home physician went with him on several occasions, consulted with the owner of the proprietary medicine, and was equally mistaken in his diagnosis. After consulting many doctors, all of whom assured him they could give him treatment that would prolong his life somewhat, and make his condition comfortable, but that no treatment would affect his cure, he was induced, by reading our article, heretofore referred to, to consult us. A very thorough examination of the case was made, which resulted in finding two contractions of the urethra, which admitted only the smallest sized probe, and which, necessarily, prevented the free flow of the urine. These were speedily removed, when, much to the surprise of his family physician, who accompanied him, over thirty-seven ounces of fluid were drawn from the bladder. This gave him immediate and perfect relief. The pains and aches in the region of the kidneys, the weakness and tenderness, and the many other uncomfortable symptoms with which he was troubled, all disappeared. From a feeble and irritable invalid, in a few weeks he was converted into a happy and cheerful man. The symptoms of congestion and irritability of the kidneys gradually disappeared, and in thirty days after visiting us he writes that he feels himself entirely sound and well. This gentleman states that he will be pleased to correspond with any one who wishes to learn the particulars of his case, and his full name and address will be furnished to any inquirer. Bright's disease when fully established is characterized by degeneration of the kidneys. Submitted to examination, after death by this disease, these organs present various appearances. Hence, the degeneration that characterizes the disease has been designated as waxy degeneration. Some pathologists contend that the disease consists of several different renal maladies, all of which, however, agree in the one ever-present symptom of a more or less albuminous condition of the urine. As to the causes of kidney disease, it may be said that any thing which will give rise to a greater or less degree of congestion of the kidney will induce either a temporary albuminous condition of the urine, or a true Bright's disease of the kidneys. Suppression of perspiration, by exposure to cold and wet, want of cleanliness, deficiency of nutritious diet, liver disease, certain poisons in the system, as of scarlet fever, measles, erysipelas or diphtheria, taken in conjunction with sedentary habits, bad air, excessive mental labor or worry, may each occasion an albuminous urine, and finally result in Bright's disease, but of all causes that appear to produce this disease, none are so prolific as intemperance. A scrofulous diathesis, or habit of body, may strongly predispose to the disease, and chronic kidney disease frequently follows acute rheumatism and the practice of masturbation. In some instances the chronic form of Bright's disease follows an acute attack, but is more often developed slowly and insidiously without any known cause. THE SYMPTOMS of this fatal malady generally appear so gradually that they excite but little or no concern until it has reached its more advanced and dangerous stages. Frequently, a puffy, watery or flabby condition of the face, particularly under the eyes, is the first symptom noticed, and the patient may observe that his urine is diminished in quantity. The urine is sometimes abundant, but generally more scanty than in health, is acid in its reaction, and generally of a low specific gravity. The countenance is generally somewhat pale and bloodless, which, taken with the dropsical condition of the system, and the constant albuminous condition of the urine, points the expert specialist to Bright's disease of the kidneys. Various circumstances and conditions may give rise to the temporary presence of albumen in the urine, and, although albumen may be temporarily absent from the urine even when Bright's disease exists, yet this is not common. There are certain indirect symptoms which point clearly and almost unmistakably to the presence of this disease. These are deep-seated pain or weakness in the back, gradual loss of flesh, red, brown, or dingy urine, more or less drowsiness, and as the disease advances, a smothering sensation, or difficulty in breathing, with dropsical puffiness or swelling. Occasional attacks of nausea and vomiting are common; pains in the limbs and loins, which are often mistaken for rheumatism. Irregularity of the bowels is also common. The skin becomes harsh and dry, not perspiring even under active exercise. Sometimes these symptoms are years in their development, being very obscure at first, and in some cases the disease has been known to prove fatal without the patient having experienced any extraordinary symptoms. With those whose systems are enfeebled by want, intemperance, exposures or disease, as scrofula or syphilis, the first symptoms usually observed will be a frequent desire to urinate, occasional attacks of diarrhea, flatulency, dropsical swelling of the face, especially under the eyes, and afterwards of the extremities, paleness and increasing debility. Stupor, apoplexy and convulsions are the forerunners of a fatal termination. Microscopical and chemical examinations of the urine are the only reliable means of diagnosis, and should be often repeated. (See Urinary Signs, in Appendix.) As albumen is often present in the urine without the existence of Bright's disease, it is impossible, except by the aid of the microscope, to distinguish true Bright's from other affections of the kidneys. In both purulent urine, and that containing blood, albumen will be found by the usual tests, but in smaller quantity than in Bright's disease. Albumen, with disintegrated epithelia, hyaline, and large granular casts, as well as waxy casts, are peculiar to, and characteristic of, this disease. In the treatment of this malady, our specialist's experience has been very great, and attended with marvelous success. Of course, after the substance of the kidney has degenerated and broken down, and become destroyed to any great extent, a cure is impossible. But that we now possess remedies of great value, and specific power over this terrible disease, we have the most positive evidence in the remarkable success attended in its treatment. Most cases that are curable can be managed successfully at a distance, the necessary medicines being sent either by mail or express. Our specialists have cured many in this way who were so bloated from dropsical effusion as to weigh twenty-five to forty pounds more than usual. In our Sanitarium, where we have had the advantage of our Turkish baths and other appliances, we have cured some cases in which the removal of the dropsical effusion reduced the patient's weight sixty pounds. We cannot, In conclusion, too strongly condemn the general resort to strong diuretics so often prescribed by physicians for all forms of renal maladies, but which, by over-stimulating the already weak and delicate kidneys, only aggravate and render incurable thousands of cases annually. Not less harmful are the many advertised "kidney cures," "kidney remedies," "buchus," and kindred preparations. They all contain powerful, stimulating diuretics, and, while they may appear for a short time to do good, invariably render the case worse and far more difficult to cure. The cases of Bright's disease reported cured by these preparations are cases of far less dangerous maladies, made to appear, by exaggerated accounts of them, as true Bright's disease. The use of these general, ready-made or proprietary remedies in any case of true Bright's disease is hazardous in the extreme. In no disease is there greater necessity for treatment nicely adapted to the exact condition of the patient (which should always be carefully ascertained by microscopical and chemical examinations of the urine) than in this. As it is a disease that runs a slow course, there is always time to send samples of the urine for examination by expert specialists, and no other physician than a specialist of large experience should be entrusted with the treatment of a malady so dangerous in its character, and in the diagnosis and treatment of which general practitioners commit such frequent, and often fatal, errors. (SEE TESTIMONIALS.) DIABETES. (POLYURIA AND GLYCOSURIA.) There are two essentially different varieties of this disease, one of which is called _Diabetes Insipidus_, or _Polyuria_, and the other _Diabetes Mellitus_, or _Glycosuria_. The first is characterized by an increase in the amount of urine excreted, and yields readily to proper treatment. The second is characterized by the presence of sugar in the urine, and under ordinary treatment often proves fatal. The _causes_ are obscure, and are therefore not very well understood by the profession. SYMPTOMS. A notable increase of the quantity of urine excreted is the first symptom which attracts the patient's attention. Frequently, several quarts, or even gallons, of urine are daily excreted, and it is paler than natural. The patient experiences extraordinary thirst, and has an almost insatiable appetite, though at the same time he loses flesh and strength. The tongue may be either clammy and furred or unnaturally clean and red. The bowels become constipated, and a peculiar odor is observed in the patient's breath and exhales from his body. The skin becomes harsh, dry, and scurfy. There are dizziness, headache, dejection, lassitude, and not unfrequently blindness, caused by cataract, is developed in one or both eyes. The intellect is blunted, and, as the disease progresses, the emaciation and debility increase, and pulmonary diseases develop; or, perhaps, an uncontrollable diarrhea sets in, and the patient dies from exhaustion. In this disease, as in Bright's, we have many medicines that produce specific curative effects, enabling our specialists to treat it with greatly increased success. The disease is readily diagnosticated, or determined, by chemical examination of the urine, so that we have been enabled to treat this class of cases very successfully at a distance, and without personal examinations. Great attention should be paid to the diet in these cases. It should be highly nutritious, but anything of a sweet or starchy nature must be avoided. The following articles are wholesome and afford sufficient variety, viz.: of animal food--beefsteak, game, poultry, fish, eggs, cheese, cream, butter; of vegetables--spinach, dandelion greens, turnip tops, watercresses, lettuce, celery, and radishes; of drinks--tea, coffee, claret, water, brandy and water, beef-tea, mutton-broth, or water acidulated with tartaric, nitric, citric, muriatic, or phosphoric acid. The _forbidden_ articles are oysters, crabs, lobsters, sugar, wheat, rye, corn or oatmeal cakes, rice, potatoes, carrots, bests, peas, beans, pastry, puddings, sweetened custards, apples, pears, peaches, strawberries, currants, etc., also beer, sweet wines, port, rum, gin, and cider. (SEE TESTIMONIALS.) CHRONIC INFLAMMATION OF THE BLADDER. (CHRONIC CYSTITIS.) This affection, also called _catarrh of the bladder_, is an inflammation of the mucous lining of this organ. It may occur at any period of life, but it oftenest appears in the aged, and is usually associated with some obstruction to the flow of urine. CAUSES. It may be due to colds, injuries, irritating diuretics, injections, extension of disease from the kidneys or adjacent organs, intemperance, severe horseback riding, recession of cutaneous affections, gout, rheumatism, etc.; but it more frequently results from stricture of the urethra, enlarged prostate gland, gravel, and gonorrhea. It is also caused by an habitual retention of the urine, and sometimes results from masturbation or self-abuse. SYMPTOMS. There is an uneasy sensation in the bladder, and heaviness and sometimes pain and weakness in the back and loins. The urine is scanty, and, although there is a desire to void it frequently, it is passed with difficulty. If allowed to stand, it deposits more or less mucus, which is sometimes mistaken for semen. As the disease progresses, the quantity of the mucus increases. It is very viscid, and adheres to the sides of the vessels, so that if an attempt be made to pour it out, it forms long, tenacious, ropy threads. Sometimes the quantity of mucus is so great that on exposure to cold the whole mass becomes semi-solid, and resembles the white of an egg. The excreted urine is alkaline, acrid, exhales a strong odor of ammonia, and soon becomes exceedingly fetid. Sometimes the urine becomes so thick that great difficulty is experienced in expelling it from the bladder. Nocturnal emissions, impotency, and loss of sexual desire are apt to ensue. Occasionally there will be a spasmodic contraction of the bladder, with straining and a sensation of scalding in the urethra, and sometimes the patient is unable to urinate. When ulceration occurs in the progress of the disease, as it is apt to in its advanced stages, blood will occasionally be seen in the urine. In the advanced stages of the disease the system becomes greatly debilitated, emaciation supervenes, with hectic fever, nervous irritability and, finally, death. TREATMENT. A strict observance of the rules of hygiene is essential to a cure. We must ascertain the cause if possible, remove it, and thus prevent it from perpetuating the disease. The various causes and conditions involved in different cases demand corresponding modifications of treatment; hence, it is useless for us to attempt to teach the non-professional how to treat this complex disease. We have succeeded in curing many severe cases without seeing the patient, being guided in prescribing by indications furnished by microscopical and chemical examinations of the urine. (See Urinary Signs in Appendix.) In fact, nearly all cases can be cured at their homes, and without a personal examination being made. In the worst cases, we have found it best to have our patients at our institution, where we can wash out the bladder with soothing, healing lotions, and thus make direct applications to the diseased parts. (SEE TESTIMONIALS.) GRAVEL. When the solid constituents of the urine are increased to such an extent that they cannot be held in solution, or when abnormal substances are secreted, they are precipitated in small crystals, which, if minute, are called _gravel_. Another cause of the precipitation of these salts is a stricture of the urinary canal which, by interfering with the free expulsion of all the fluid from the bladder, results in the retention of a portion, which gradually undergoes decomposition. Salts from the urine are thus precipitated in the same way that they are thrown down in urine which is allowed to stand in a vessel. Any one can illustrate this, by allowing a small quantity of the urinary secretion to stand for a few days either in an open or a closed bottle. Soon a white, flaky deposit will be observed, which will become more and more dense, and finally fine grains will be seen precipitated at the bottom of the bottle. Similar grains, lodging in the folds of the bladder, gradually increase in size, by the precipitation of more salts around them, and ultimately become a source of much irritation. When of large size, they are termed _calculi_ or stones. When these formations occur in the kidneys they are termed _renal calculi_; when in the bladder, _vesical calculi_. There are several varieties of gravel, each depending upon different conditions of the system for its formation. The two prominent varieties are the red, containing uric acid, and the white, or phosphatic, gravel. SYMPTOMS. When the deposits are in the kidneys, there is pain in the back and loins, occasionally cutting and severe; sometimes it darts down the course of the ureter to the bladder, and extends even to the thighs. When the deposits are in the bladder, there is a frequent desire to urinate, with a bearing-down, straining pain; also a cutting or scratching sensation in the urethra during micturition. In the male, intense pain is often experienced at the end of the penis. When the urine is voided in a vessel and allowed to settle, a gravelly deposit is seen, generally of a red or a white color, and the particles varying in size. TREATMENT. These urinary deposits indicate a general derangement of the system, as well as a local disease. Nutrition is imperfect and some of the excretory organs are not properly performing their functions, or, perhaps, some portion of the body is being too rapidly wasted. Very frequently we find these gravelly formations as the result of a rheumatic or a gouty diathesis. It is also a well-known fact that torpidity of the liver throws an excessive amount of work on the kidneys. These organs then, in part, perform the function of the liver, and hence unnatural activity is required of them, and the secreting of such substances as uric acid, which precipitates readily and gives rise to severe irritation of the urinary canal. In order to treat these cases rationally and successfully, it is first necessary to ascertain by microscopical and perhaps chemical examinations, the character of the deposit. By such an examination, the exact condition of the system which gives rise to these abnormal products may be definitely determined, and the remedies to be employed indicated. As the non-professional are not qualified to make such examinations, it would be useless for us to suggest specific treatment for the various forms of this affection. Samples of the urine may be sent to us with a brief description of the symptoms experienced, and the proper medicines to cure can be returned by mail or express. Our specialists are treating, with uniform success, large numbers of cases in this way. (SEE TESTIMONIALS.) STONE IN THE BLADDER. Few affections to which the human flesh is heir are more painful than this terrible affliction. The cutting operation heretofore required to remove it, is considered one of the most dangerous operations that the surgeon is ever called upon to perform. The death of the Emperor Louis Napoleon, of France, from an operation for the removal of a stone, at the hands of surgeons renowned for their skill, gave new impetus to the efforts of surgeons to invent some method that would be less dangerous than that which has been heretofore commonly employed. The cutting operations have been the rule. Of these the operation by median-section is the safest, and is most commonly employed for the removal of stones that are not too large, while the lateral operation is used where the stone is more than about one inch in its smallest diameter. As will be seen by the consultation of any hospital record, the deaths in these various operations have been, in adults, from one in three to one in every four cases--a very large percentage, and sufficient to deter any sufferer from undergoing an operation except for the relief of a condition which is in itself worse than death. Even when this alarming death-rate is explained to sufferers, they willingly undergo the operation, feeling that they would rather die than longer continue in their pain and anguish. Our specialists, not satisfied with the results of these operative measures, in their studies of the disease endeavored to perfect some other means by which these foreign bodies could be removed from the bladder without such great danger and pain. The operation by crushing, and removal without cutting, appeared to them to present the most practicable advantages, and they therefore devote their entire time to the improvement of this method for the removal of stone. The method of crushing was first invented by a French surgeon many years ago; but, owing to his crude instruments, and the difficulty that was experienced in expelling the pieces of stone, the operation was seldom employed by surgeons. The improvements in these methods at the hands of Bigelow and Sir Henry Thompson, with those that have been made by our specialists, have resulted in our being able to present to sufferers with this disease, a means of cure which is, we are assured, the most successful known to modern medical science. There have been so far in the history of the treatment of this malady by the new method of cure, one hundred and twenty-odd cases operated upon at the hands of prominent surgeons, all of which were with less perfect methods than that of our specialists, and there were but four deaths in this large number. By the advantages which are the result of further improvements by our specialists, we can assure you that this mortality is even less in our hands; in fact, approaches, as near as possible, to a perfect method of cure. We think that in a moderately healthy subject, one in which the kidneys are not badly diseased as the result of irritation from the calculus, the operation is almost absolutely safe. The method consists in the crushing of the stone, and its removal from the bladder by means of small silver catheters attached to an apparatus which gently and perfectly removes, by suction, all the pieces which are thrown to the bottom of the bladder. This operation has now been performed in our institution in a very large number of cases with uniform success, and the cures have been effected in from six to eight weeks without a single unpleasant symptom arising during their progress. By this method it is not necessary to remove the entire calculus at one operation, if it is a large one. By the old cutting operation this was required, as the bleeding was great, and what was to be done had to be done immediately, or the patient would die from the _hemorrhage_. With the new method a part of the large calculus, or when several exist, one or two of them, may be removed at a time, after which the patient can rest and gain strength for the second; or, if necessary, for the third operation. The largest stone removed by us in this way was one weighing between seven and eight hundred grains, for which three operations were required. It is necessarily performed under a mild anæsthetic, which prevents suffering and secures the perfect relaxation of the patient. In the case in which this large amount of stone was removed we feel certain that a cure could not possibly have resulted from a cutting operation, as the heart was seriously affected, and the physical condition of the patient so low, as the result of years of suffering, that death would have occurred while undergoing the operation. By carefully pursuing the new method, and not prolonging the sittings more than a few minutes each time, the entire stone was evacuated. The health of the patient constantly improved during the interval of three operations, which covered a space of seven weeks. This stone was as large as a hen's egg. Small calculi or gravel are readily removed in a few moments' time by the new method. In no case is there any bleeding. Instead of a large, gaping wound being left after the operation, from which secondary hemorrhage may take place, or poisoning result from the irritation of decomposing urine, the parts are left in a healthy state with the surface unbroken. The stone, a constant source of irritation, is removed, and the health is speedily restored. When it is impossible for the patient to visit us, a careful examination of the urine is made, and if gravel have been passed, these are carefully examined also. An idea of the composition of the stone is arrived at by this means, and treatment is directed to dissolve it. Success has commonly followed this method of treatment, when the stone has not been very large. With the gradual reduction of the size of the stone the irritation subsides, and the general health of the patient improves. (SEE TESTIMONIALS.) CHRONIC ENLARGEMENT OF THE PROSTATE GLAND. (HYPERTROPHY.) The prostate gland lies just in front of the base of the bladder, and surrounding the urethra, or urinary canal. Enlargement, therefore, of this body, if it be of considerable extent, causes it to encroach and press upon the base of the bladder, and to more or less constrict the urinary canal near the base or outlet of the bladder. The enlargement may be only slight, or the dimensions of the gland may be increased from the size of a large chestnut, its normal dimension, to the volume of a pullet's egg, or even to the size of an orange. Hypertrophy of the prostate generally arises from causes which operate in a slow and permanent manner. Whatever has a tendency to produce a determination of blood to, and an engorgement of, this organ, is capable of producing the affection, an augmented flow of blood to the the part having the effect to increase the nutrition. Among the most frequent causes of this affection, are excessive venery, masturbation, disease of the bladder, stricture of the urethra, horseback exercise, gonorrhea, and the employment of strong, stimulating diuretics. Some of the worst cases that we have had to deal with have occurred in old men, and, in fact, the malady is more common to those advanced in life; but it is frequently produced in those of middle age by the causes enumerated. Among the earliest symptoms of the disease is an uneasy feeling in the region of the base of the bladder. There is a more frequent desire to urinate than usual, and, in the course of time, this frequency becomes more urgent; still no particular notice may be taken of it, it being considered as "only a slight inconvenience." After several months, or it may be years, the discomfort increases, and nightly calls to empty the bladder become habitual. By and by the patient begins to find the discomfort of getting out of his warm bed very troublesome; still no notice to taken of it. He does not consider it worth his while to consult a doctor for "such a trifle." In the course of time the patient is obliged to get out of bed twice during the night instead of once. Afterwards, the calls become still more frequent and urgent; the inconvenience more evident; finally, pain is substituted for inconvenience, and then the doctor is consulted. Unless a specialist of experience be consulted, the bladder will most probably be examined, and medicine will be prescribed only to excite the kidneys to secrete more urine, which does harm instead of good; the disease slowly, but surely progressing. Patients often write us that they have had something wrong with the bladder for a number of years, having to urinate more frequently than they ought; sometimes having to do so three and four times during the night; in extreme cases even every half hour or so, and that they are not able to pass it freely, but only in small quantities, and attended with much pain. These symptoms are not always constant, but let up for a few weeks and then appear again. Things go on in this way for a year or two, perhaps, when the passage of the urine is completely shut off for several hours, and the patient is in great agony until the bladder is relieved by the use of the catheter. After such instrumental relief, for a day or two the urine may be natural again, coming at first, perhaps, in very small quantities, but by and by more freely. Then, after a week or two intervening, there may be another complete stoppage, attended, as before, with intense suffering, which will have to be again relieved by the use of an instrument. The foregoing is a fair account of the usual progress of the disease and its symptoms. As the prostate gland becomes more irritated and inflamed from the natural progress of the disease, or from the irritation caused by the passage of instruments, or the employment of strong, harsh, stimulating diuretics, the urine becomes cloudy, and still later is found to have deposited during the night in the chamber utensil a quantity of thick, tenacious, and usually offensive mucus. There is apt to be more or less discomfort in the rectum, or lower bowel, produced by the pressure of the enlarged prostate upon it. Rarely, the first intimation of a large prostate occurs through a sudden retention of the urine, and the patient being under the impression that there was nothing wrong with the organ previously. Closely questioned, however, the information is elicited that there has been a long train of mild symptoms, similar to those that we have described, preceding the attack of retention of the urine. This shows the importance of early attention and proper treatment when such symptoms are manifested. However slight the inconvenience experienced, it should not be neglected. The disease should be brought under control at the outset by skillful and nicely-adapted treatment. Usually before a person suffers from toothache, the decay occasioning it has been gradually progressing without pain for from five to eight years. Just as the decay of the tooth may be arrested by the early attention of the dentist, so may prostatic disease by early attention be not only promptly relieved, but permanently cured. Disease of the prostate being slow in its inception and progress, is also slow to yield even to the most skillful treatment. Being slow to develop, patients rarely seek assistance until the organ has become so large as to be seldom restorable to a size where mechanical means can be wholly dispensed with for relieving the bladder. Most surgeons are too much in the habit of depending on the catheter for the relief of the patient, and usually instruct the sufferer how to use it, telling them that this, the catheter, is to be their only doctor for life. Great as is the relief afforded by the catheter, which has often saved life, yet it is a fact that its frequent and prolonged use often renders disease of the prostate very intractable and often wholly incurable. Frequent use of the catheter, without any treatment to prevent the further enlargement of the diseased gland, or to reduce its size, permits the part to go on enlarging, and, besides, the constant use of the catheter irritates the prostatic portion of the urethra, causing thickening of the lining membrane, and sooner or later a more or less complete organic stricture of this canal, depending upon thickening of the lining mucous membrane, as well as upon the encroachment of the gland itself upon this canal. Besides, when the use of the catheter is once commenced, even when the enlargement is not very great, it is with the utmost difficulty that we have been able to induce patients to leave off its use. The bladder, becoming accustomed to its use, refuses to obey the will without this help. The irritation set up in the parts by the friction of the catheter causes inflammation and exudation in the lining membrane. This extends to the structure of the prostate itself and increases the hypertrophy or enlargement. It will, therefore, be seen how important it is to early resort to treatment to relieve the first manifestations of this affection. A disease of so delicate a nature, and one so often confounded with other maladies by inexperienced physicians, should only be intrusted for treatment to expert specialists of large experience in the management of this and kindred maladies. * * * * * STRICTURE OF THE URETHRA. Stricture of the urethra generally results from some specific disease of the urethra, but may be caused by sexual excesses, exposure, or strain, or by the practice of masturbation or self-abuse. It runs a course varying in time from a few days to many weeks or months, during which time the patient is often unaware of the real cause of his sufferings. Commonly, the attention is first called to a stricture by a slight discharge, or smarting sensation, or the appearance of an undue amount of mucous deposit in the urine. Occasionally, some difficulty in starting the water, or a diminution in the size and force, or a twisting of the stream as it flows, is the first symptom. This passive stage is of variable duration. When skillful treatment is instituted at this stage of the disease, a speedy cure is easily effected without pain or danger. Any exposure, improper use of instruments, or irritating cause, may speedily give rise to the alarming symptoms due to closure of the urethra, from which fatal consequences may suddenly ensue. [Illustration: Fig. 2. A Single Stricture of the Urethra.] This condition is illustrated in Fig. 2, which shows the hard and tough stricture which surrounds the soft mucous membrane that lines the urinary canal. When irritated or inflamed, as the result of a cold or other cause, the mucous membrane becomes swollen and thickened, and, as the stricture will not yield and enlarge, the result is that the urethra is almost completely closed, and it becomes impossible to pass the urine. Great pain is experienced, and the surgeon has to be called to draw off the urine with a catheter, which, at best, is a very difficult and painful operation, when the urethra is so irritable and constricted. TREATMENT. In the earlier stages of the malady, relief is given by the skillful use of instruments for dilating the canal, or, where this fails by the operation of urethrotomy, for which we employ an improved and ingenious instrument, by which the stricture is readily and almost painlessly divided. IMPROVED METHODS. Our surgeons have operated upon many hundreds of bad cases by a very ingenious and almost painless method, that requires no use of bougies in the after-treatment. This saves the patient an immense amount of pain and annoyance, and enables him to go home almost immediately after the operation. The ordinary after-treatment, by dilatation with bougies, is very tedious, and often more painful than the operation itself, so that our peculiar method of treatment has been hailed with joy by those familiar with the old and unnecessarily-painful systems of treatment. Besides, our more improved method has been followed by far more perfect cures in every case operated upon. In many of the cases coming under our observation and treatment, there have been several strictures, as illustrated in Fig. 3, which shows the urethra constricted at three different points, besides a congenital contraction at its mouth or meatus. [Illustration: Fig. 3. Condition of the Urethra with three Strictures and a congenital contraction at the meatus or outlet.] SPERMATORRHEA not infrequently results from stricture of the urethra, even when the affection is quite slight. Our attention was first called to this subject by the consideration of the numerous cases in which epileptic convulsions or "fits," and other serious diseases of the nervous system in children, have resulted from an unnatural contraction of the prepuce or foreskin, constituting what is termed _phimosis_. Every surgeon of experience has met with many of these cases of reflex irritation. It occurred to us, that, inasmuch as these contractions of the foreskin give rise to nervous diseases of an alarming nature, may not an unnatural narrowing of the urethral canal, which must have exactly the same effect in retarding the flow of the urine, give rise to irritable nervous affections in adults. May not unnatural irritation and excitement of the sexual organs, so set up, cause loss of semen to occur during sleep, and consequent nervous and general debility? It is a well recognized fact that the urethral canal should bear a certain definite and proportionate size to that of the penis, just as the length of the arm should naturally bear a certain proportion to the length of the body. In the case of some parts of the body, disproportionate development of the part may not give rise to anything further than unsightliness; but when we find the small size of the urethra retarding the free passage of the urine, then we may expect, if this condition is long continued, to find more or less irritation of the urethra and, perhaps, of the bladder, also. When there is a contraction of the urethra at its external orifice, or at any point along its course, unnatural pressure is put upon the urinary canal behind the constricted portion, and these parts must bear an undue strain during the passage of the urine. It is a well established fact that improper diet, cold, exposure, and over-work exert a very powerful modifying influence upon the urinary secretion, frequently causing an acrid and irritating condition of this fluid. This condition, when associated with a contracted urethra, must result in irritation of the mucous membrane lining this canal back of the stricture, if long continued or frequently repeated. As an illustration, we have a hose pipe from which, by means of a small nozzle, water is expelled a considerable distance, but a great tension is put upon the hose behind the nozzle. If the pressure is increased greatly the hose will burst; but, if the small nozzle be replaced with a larger one, the projection of the stream will be quite as great, but all undue tension of the pipe is overcome and the danger of bursting is done away with. We have, in an unnaturally contracted urethra, a favorable condition for the development of disease in the urinary canal and adjacent parts of the generative organs. Irritation is set up in the urethra behind the stricture by undue strain in passing water, and the frequent reoccurrence of acrid urine, as the result of any of the causes we have already mentioned, this irritation keeps gradually increasing. It will be felt more during the periods when the urine is acrid, but may pass unnoticed even at such times. The seminal sacs and the prostate and Cowper's glands communicate with the deeper portions of the urethra by means of canals or ducts, lined with mucous membrane which is continuous with the urethral mucous membrane. Hence we can readily see that not only by reflex nervous irritation are those parts debilitated, through the contraction of the urethra, but the affection is apt to extend by continuity of the mucous membrane, and thus become more and more manifest, through symptoms of disease of the testicles, prostate gland and seminal vesicles, and these disorders become more and more seated the longer the morbid condition of the urethra is allowed to run on, until there may be an entire loss of the sexual functions, occurring at an age when there should be present the most vigorous manhood. From no other cause can we explain the common prevalence of disease of the deeper portions of the urethral canal and bladder, many times confounded with other diseases of the urinary and generative organs. The following is the history of a case that fully illustrates the foregoing statements: CASE 112,289. MR. O.C.E., SINGLE, 32 YEARS OF AGE. [Illustration: Fig. 4. Condition of the urethra in Case 112,289; permanently cured at the Invalids' Hotel and Surgical Institute.] He applied to us suffering from entire loss of the sexual function, with great nervous debility, and there was a thin slimy discharge from the urethra, and the usual symptoms of melancholia and weakness. He had lost all taste for business, and was extremely nervous, from the fact that he was engaged to be married, and felt that his condition would not permit it. On examination a contraction of the urethra was found at the point shown in Fig. 4, which had probably been present for years. He stated that he never had been just right in those parts, but had lived a virtuous life, had never had any venereal disease, and, hence, the true nature of his trouble had not been suspected. With the removal of the stricture there was an immediate improvement in his condition, which became more and more rapid, as his system gained strength and reaction became manifest. At the end of two months he wrote that he felt sound and well, and that he had experienced the most wonderful improvement in every way. His vital strength was fully restored, and he was most profoundly grateful. Chronic inflammation of the bladder, sometimes called catarrh of the bladder, an affection that is elsewhere herein fully treated of, and chronic inflammation of the kidneys, and true Bright's disease, as well as prostatic disease, are all liable to result from strictures of the urethra. Hence, it behooves one suffering from this malady to have it promptly and skillfully treated. FALSE PASSAGES. In very rare cases of impassable stricture, or in which fistulous openings, or false passages, have formed, through which the urine flows or dribbles away, we have resorted to the operation of perineal section with the most gratifying results. The cases requiring this operation are rare ones, in which death must generally result but for the relief afforded by the operation. DANGEROUS USE OF INSTRUMENTS. The worst and most dangerous cases of stricture with which we have met, in a long and extensive experience, were rendered thus by the careless or unskillful use of bougies, catheters, or sounds. Many surgeons and physicians are most recklessly careless or unskilled in the use of these most dangerous instruments, as the many cases of false passage or stricture of the most painful and dangerous kind, caused or aggravated by their ignorant or improper use, sorrowfully testify. DELAY DANGEROUS. By proper treatment of stricture in its early stages, all danger and pain are avoided, and a cure is effected in a very short time. In an extensive practice, in which we yearly treat hundreds of cases, we have never yet failed to give perfect and permanent relief from stricture, or diseased prostate or urethra, without the necessity of cutting instruments of any kind, when we have been consulted before injury of the urethra has been produced by improper use of instruments. Having specialists who devote their entire time to the study and cure of these diseases, we are thereby enabled to attain the highest degree of skill in the management of these cases. GREAT SKILL REQUIRED. The urethra is a sensitive and delicate canal, and is surrounded by tissues the most delicate, and lined with mucous membrane which is highly vascular and filled with sensitive nerves. The introduction of any instrument is to be undertaken only when absolutely required, and, when necessary, it should be so skillfully and carefully effected that no pain or irritation can result. The slightest awkwardness is liable to cause an unnoticeable injury, which results in false passage or an effusion of plastic lymph around the canal, and as it organizes, the formation of the most troublesome organic stricture. The attention not only of sufferers, but also of the profession, is called to the remarkable success of our operation, perineal section, by which a cure of extremely bad cases of impassable stricture and false passages, or urinary fistulas, is effected in from thirty to forty days, and with very little suffering. That we have been successful in such cases must be considered as conclusive evidence that no case of stricture, false passage, or urinary fistula, is beyond the reach of our skill. * * * * * TESTIMONIALS. In a practice embracing the treatment of a vast number of cases of diseases of the Urinary Organs, it has been our good fortune to effect many remarkable cures. The experience gained in this field of practice has made our specialists skilled experts, and hence hundreds consult them as a last resort. In fact we seldom get a case, in this line, that has not been the rounds of the home physicians before applying to us for relief and cure. The cures, therefore, which we shall introduce here are the more remarkable because of the failure, in nearly every case, of other medical men to benefit or cure. They are not the every-day, ordinary cases met with in the general practitioner's rounds, but complicated, obstinate ones, which had generally been given up as hopeless before coming to us. CASE 4A-3431. "WASTED TO A SHADOW." BLEEDING FROM KIDNEYS. A SEVERE CASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: T.S. Bailey, Esq.] _Gentlemen_--I think it my duty to write to you concerning my case. In the year 1886 I was seized with inflammation of the bladder and passed nothing but thick blood, owing to heavy work, and I consulted a doctor and he said there was no cure for such a bad case; but he gave me medicine and it relieved me at the time I used it; and I took 16 bottles and I got worse and wasted to a shadow. I quit taking the medicine, and other complaints came, as rupture in the spermatic cord, for which I applied to you and soon got relief. And in 1891 the bladder disease made its appearance, and I wrote to the Invalids' Hotel and Surgical Institute and got no reply as our mails were stopped on account of snow drifts. I sent for the best doctor in Listowell and I still got worse, and he said I might live three or four weeks, but there was no stoppage of the disease. And I got so weak that I had to support myself by the furniture in my room; and I wasted down to 100 lbs. in two weeks; and I applied to your Institute and I received my medicine in a few days, and in two weeks I began to gather strength and now I am hearty and well and my weight is 145 lbs. I feel so thankful to the Medical Association and its Staff of skilled men. It is 15 months since I quit taking your medicines and no signs of the disease returning. Yours gratefully, THOMAS S. BAILEY, Dorking, Wellington Co., Ont. CASE 23A-877. INFLAMMATION OF THE BLADDER, WITH OTHER COMPLICATIONS. SUFFERED EXCRUCIATING PAIN IN URINATING. [Illustration: G.W. Heffner, Esq.] For many years I suffered with inflammation of the Prostrate Gland and Bladder. It became gradually worse and I endured extreme pain, so much so that I was laid up for weeks at a time, and almost gave up in despair. I was persuaded to go to the Invalids' Hotel and Surgical Institute. I have never regretted following this advice. While there I submitted to an operation by their specialist. This was entirely painless and the result perfectly satisfactory. I left in a short time delighted, and have since been strong and well. I cannot speak in too high praise of this famous Institution; the rooms are large and pleasant, the food the very best, the attendants kind and attentive and the staff of physicians skillful and of large experience. I highly recommend all invalids to the World's Dispensary Medical Association. I feel confident that all the benefit to be derived from medical treatment is to be received at this Institution. Yours truly, GEO. W. HEFFNER, Chicago, Ills. CASE 2A-103. INFLAMMATION OF BLADDER, COMPLICATED WITH KIDNEY DISEASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: M. Manheim, Esq.] _Gentlemen_--Having been a patient in your Invalids' Hotel for several weeks, I take great pleasure in telling other sufferers of my treatment which I received under your efficient staff of physicians, surgeons and nurses, and I will say with clear conscience that every care and comfort was given me that could be wished for. I am sure that your Institution is far in advance of the age, and would wish that every invalid could avail himself of the treatment that I received in your most excellently kept Invalids' Hotel. I cheerfully give this as my testimonial to individuals, friends and sufferers. My health is so fully restored that I look upon life with pleasure and comfort, whereas before I was a suffering, nervous invalid, unable to sleep and much of the time in torment. Wishing you success, I am your friend and well wisher, M. MANHEIM, Georgetown, S.C. CASE 859,143. BLADDER, RECTAL, KIDNEY AND LIVER DISEASE. "ENTIRE URINARY ORGANS ONE MASS OF SORES." "DESPAIRED OF CURE." [Illustration: S.C. Tracy, Esq.] My disease was caused by the roughness and exposure incidental to the life of a miner, working in the gold mines of California and Montana. I had much of the time to work in water, with my clothes wet, which finally brought on a severe pain In my kidney, which ere long completely prostrated me. I employed and was treated by six different physicians, the best I could obtain in my section of country, and who while seeming to understand the nature of my disease, yet gave me no remedy that afforded me any real relief. I grew worse under the treatment of them all. The pain in the kidney left me, but immediately located in the bladder. My bladder became very painful and commenced to ulcerate and fill up. It seemed from the excruciating agony I suffered, that there must have been an abscess in either the kidney or bladder, and from the large amount of pus discharged at one time, it appeared to me that my kidneys, bladder and the entire urinary organs were one mass of sores and pus mixed with blood. I had to use injections of laudanum daily in the lower bowels to ease the pain and live. Was reduced by long suffering, looking for each day to be my last. I felt that no human power on earth could help me. No language can describe, and God only knows, the agony I suffered. From what I have already written, you may form some faint conception of my physical condition at the end of six years' treatment by the best medical aid I could get in the section where I was living. I also used for some time (with no benefit), "Warner's Safe Cure," and in fact, tried every means that I could hear of, but to no permanent relief. Such was my condition when I was led finally to consult and be treated by your Association, though I had but faint hope of obtaining any relief from any one. With the very best description I could give in writing of my case, and all the information you got from me, you would not undertake the case until you were further informed, and for which caution I sincerely thank you. You wrote me--"we are at a loss to definitely determine your condition. We have an opinion based upon the facts before us, but we feel that we must have a personal examination." In the condition I was then in, I could not have been kept alive to reach the first railroad station, which was only six miles from my house, and much less to travel to Buffalo. Indeed I wrote you, that if you would cure me for nothing, I was unable to go to you. In reply, you then advised me to take your "Special Remedies" until I could improve sufficiently to go to Buffalo for examination. Now this frank answer of yours, removed every doubt from my mind, and convinced me that you were _honorable physicians_. On March 10th, 1883, I began taking your "Special Remedies," as you prescribed them, and at the end of three years' constant treatment, I was improved sufficiently to go to Buffalo to your Institute, where I was examined as you required of me. When I reached your Institute, I was there carefully examined and received a month's treatment. When I reflect on my condition and my suffering when I first began to use your specifics, and see what I am now, I feel that no words can too glowingly express my gratitude to your Association for the physical benefits you have conferred upon me by your treatment of my despaired-of case. SAMUEL C. TRACY Platteville, Wis. DOUBLE VARICOCELE AND STRICTURE OF THE URETHRA. [Illustration: C. Hanson, Esq.] WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: _Gentlemen_--I have taken treatment from you for several months for nervous debility, and although I am not quite fully cured as yet, I have been greatly benefited, and believe, if I had come to you before I was duped and swindled by different quacks and was more dead than alive, I would to-day be a thoroughly well man. I have also been to your Institute twice for surgical operations, and cannot too highly praise the Hotel, or the skill and care of the attending surgeons and nurses. They are gentlemen in every way and the Invalids' Hotel is just as represented. I shall advise all suffering from chronic diseases to go to you for relief, as I have never seen any one there who was not cured or greatly benefited. Very truly yours, CHRISTIAN HANSON, Esq. Austin, Mower Co., Minn. CASE 23A-890. DISEASE OF THE URINARY ORGANS. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: F.A. Empsall, Esq.] _Gentlemen_--I feel it my duty to give my testimonial in behalf of your grand Institution. I had an operation performed at your place two years ago for the relief of a very painful disease of urinary passage, and, thanks to your skill, I was cured, and have enjoyed the best of health since. I earnestly recommend your Institution to all who are suffering, and still further let me thank you for the kindness I received at the hands of everybody connected with the Institution. I am, Respectfully yours, FRANK A. EMPSALL, P.O. Box 980, Pittsfield, Berkshire Co., Mass. CASE 2A-208. RETENTION OF URINE. SUFFERED INTENSE PAIN. [Illustration: P.J. Hamill, Esq.] WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Dear Sirs_--To your favor of the 20th ult., would say that I can only speak in the highest terms of your Institution. After suffering for ten or twelve years with retention of the urine, and bladder difficulties, I can say that I found immediate relief at your hands. When going to your place, about six years ago, I was suffering with intense pain, loss of appetite, and unable to eat a good meal. I now weigh 170 lbs., do a good day's work and feel well in every respect. I am only too glad that I am able to praise your Institution, and can highly recommend it to any one who is suffering as I was. With great respect, I remain. Yours very truly, P.J. HAMILL, Utica, N.Y. CASE 80,115. ENLARGED PROSTATE AND CHRONIC CATARRHAL INFLAMMATION OF BLADDER. [Illustration: Abraham Schell, Esq.] Several years ago I had occasion to become an inmate of the Invalids' Hotel and Surgical Institute, No. 683 Main Street, Buffalo, N.Y. I was afflicted with an enlarged prostate and chronic Inflammation, or catarrhal condition of the bladder. I was largely benefited by the treatment I received there, and had I remained a little longer, as I was advised to do by the doctor who attended me, I should have fully recovered. I was so nearly cured that I did not think it necessary to remain longer, as I supposed nature would do for me what remained to be done, to effect a perfect cure. My business was urgent. I could not well remain longer. In this I made a mistake, I should have remained longer. I was seventy-two years old at the time. I bear willing testimony to the ability of the medical staff and the interest the doctors take in the welfare of their patients. The nurses and all the subordinates were very kind and seemed to vie with each other to contribute to the pleasure and happiness of the inmates of the Institute. One will find the Institute equipped with all the improvements known to modern science, for the promotion and restoration of health. It is impossible to do justice to its merits in a short article of this kind. Persons must go there and see and judge for themselves, of the wonders of this extraordinary medical establishment. If they cannot recover their health there, in my Judgment, it is of no use to go elsewhere. ABRAHAM SCHELL, Knight's Ferry, Cal. CASE 820,804. OBSTINATE AND COMPLICATED DISEASE. [Illustration: John H. Smith, Esq.] WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--Yours of July 12th to hand. I am only too glad to comply with your request. Having suffered for many years with a complication of diseases and feeling conscious that they were rapidly making serious inroads upon my constitution, and that I was speedily becoming unable and incapacitated to attend to my ordinary business. I resolved, after reading a number of testimonials from your patients, to place myself under your treatment at the Invalids' Hotel and Surgical Institute. With heart-felt gratitude I can truthfully say I am relieved of my trouble. I most cheerfully and earnestly recommend this Institution to all who are afflicted with chronic and painful diseases, no matter of what nature. During my stay there I saw some wonderful cures and surgical operations. Yours truly, JOHN H. SMITH, Deckertown, Sussex Co., N.J. CASE 520,425. COMPLICATION OF DISEASES. [Illustration: Andrew Holes, Esq.] Without solicitude or hope of pecuniary reward, with heart-felt gratitude and a desire to aid my fellow-man to health and happiness, allow me to state, that as an inmate for more than a month of the Invalids' Hotel and Surgical Institute at No. 663 Main Street, Buffalo, N.Y., I feel warranted in its highest recommendation. While there I saw and talked with a great number of people who came there as a last resort, to be cured of almost every chronic disease to which flesh is heir, and they were unanimous in their praise of the Institution and the skilled specialists who constitute its professional staff. ANDREW HOLES, Moorhead, Minn. CASE 654,500. DISEASE OF KIDNEYS AND OTHER COMPLICATIONS CAUSED BY EXPOSURE AND MALARIA. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J.W. Dean, Esq.] _Gentlemen_--Having spent a short period of time at the Invalids' Hotel and Surgical Institute, No. 663 Main Street, Buffalo, N.Y., I must say I found it fully equal in every respect to the claims made for it by the proprietors. It was filled with invalids who were under the care of a corps of physicians and surgeons and the fact that all the sick people appeared to be improving, and that they were both cheerful and hopeful, and that they all spoke well of the Institution and of its doctors, was calculated to inspire confidence in one who went there himself to be treated. The greater number of these cases, as far as I was able to learn, were chronic and of a complicated character. They represented a wide range of the States and Territories of the Union, and had in each exhausted the resources of the home physicians. Having myself been treated by your Faculty for a complication of troubles induced by exposure and malaria, I feel that I owe my restoration to health to your skill and devotion, at a time when I was unable to perform labor and was much discouraged, and had failed to obtain relief elsewhere. You are at liberty to make any use you may desire of this communication. Very respectfully yours, J.W. DEAN, Chariton, Putnam Co., Mo. CASE 620,230. DIABETES AND INFLAMMATION OF BLADDER, GIVEN UP BY HIS HOME DOCTORS AS SURE TO DIE IN A FEW WEEKS. RESTORED TO ACTIVE WORK ON HIS FARM. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J.D. Parks, Esq.] _Gentlemen_--I received your kind letter the 12th, and was glad to hear from you and have no objection to your making use of my name in any way to help the sick and suffering, for I know what it is to be sick. I was sick for seven years; could not do anything; was visited by seven doctors and was treated by four, and was given up to die by one of the best doctors of Russellville. He said I could not live longer than fall. He treated me for Sugar Diabetes, while the rest said I had inflammation of the bladder. After giving up all hopes of being cured at home, a friend got me to write to Dr. Pierce's Institution and after corresponding: awhile I decided to go and be treated. I was there one month and I never was cared for or treated more kindly by any one. No parents could have been better to their sick children. I cannot speak too highly of the Institution, and I believe I would have been in my grave to-day if I had not gone and been treated. I feel great pleasure in expressing to you my sincere thanks for the cure that has been effected in my case, by your very skillful treatment, whereby I am now entirely and I trust permanently cured from a dangerous disease, which had defied the utmost skill of all former medical attendants for the past five years, and from which I had despaired of being: relieved. I am happy to state that my health is so good since taking the month's course of treatment at your Institute, and, the home treatment since my return, that I am now able to carry on the work of my farm. I would cheerfully recommend all persons requiring medical or surgical aid to consult you at the earliest possible opportunity, as I know by personal experience that the facilities cannot be surpassed for treatment of all classes of chronic diseases. Most gratefully yours, J.D. PARKS, Homer, Logan Co., Ky. P.S.--I have always recommended my neighbors to your Institution and was the cause of F.M. Brasher taking treatment, who was cured after two doctors gave him up. J.D.P. CASE 820,426. COMPLICATION OF DISEASES. A GRATEFUL PATIENT'S WORDS OF PRAISE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: William Henkel, Esq.] Gentlemen--Having been in your Institution as a sufferer from two distinct chronic diseases of years' standing, and having been placed under the charge of your specialists, I was speedily relieved of my afflictions. The Invalids' Hotel is a place as much like home as it is possible for such an institution to be. The physicians and surgeons are all expert specialists and thoroughly efficient; the nurses are very competent, attentive and kind; and, in fact, the whole _personnel_ of the Invalids' Hotel endeavor to do their best to make the patients feel like being at home. I always felt while there as if I was one of the family. I gladly recommend your Institution to all persons who are afflicted with any kind of chronic disease, for from my own experience I _know_ the professional staff will do all which they promise to do. Please accept my thanks for the speedy benefits and perfect cure of my diseases, and I think your Institution is worthy of the highest endorsement. Yours truly, WILLIAM HENKEL, No. 1917 Congress Street, St. Louis, Mo. "_A question of life or death!_" CASE 2A-107. STONE IN BLADDER. CASE SIMILAR TO THAT OF COL. ELLIOTT F. SHEPARD, WHO DIED IN NEW YORK WHILE UNDERGOING AN OPERATION. [Illustration: David S. Clark, Esq.] _Gentlemen_--I am seventy-seven years of age and have resided in Erie for sixty-two years, and for thirty-six years have been an elder in the First Presbyterian Church. During four or five years I suffered from a painful affection of the bladder; the severity permitted neither freedom from pain by day nor calm repose by night. Meanwhile, I consulted leading physicians and visited numerous health resorts. Neither time, means nor effort were spared that I might be free from pain. Relief came unexpectedly. A signal act of Providence, that should be acknowledged daily, brought your Institution to my notice, though I had then no acquaintance with any one connected with it. With me it was a question of life or death. Up to last March I was in a condition of unendurable torture. I knew that at my age, after the months of pain already borne, that any operation would be serious, perhaps fatal. Accordingly, I arranged my temporal affairs and carefully "set my house in order." On the 13th of March last, I started for Buffalo to your Institution. Still uninformed as to the cause of my trouble, I submitted to a searching examination, as to my habits, constitution, parentage, the age and cause of death of my parents, and other facts, from which a tolerable biography could have been prepared. All was kindly intended. Their aim was to locate my ailment and then to determine my ability to undergo an operation. Having found a stone in the bladder, they advised that it be crushed and extracted. By a strange coincidence as this was announced, I learned of Col. Elliott F. Shepard's death under an operation for the same disease. He was many years my junior, and seemingly far better able to undergo the operation. Still, in my desperation, I determined to go on. During five days, I was under treatment for the coming operation. On the 18th of March the stone was crushed and extracted. It was a complete success. Of the consideration, tenderness and skill of the surgeon and his assistants, I cannot too strongly speak. Of the gentle and assiduous nurses, the system and completeness of the whole establishment, as it moved along as one harmonious whole, in all its departments, I cannot sufficiently express my admiration. I am now relieved of a state of torture, and restored to health and happiness equal to any period of my life. This I say with sincerity and emphasis. Since then I have gained twenty-two pounds in flesh. I wish my words could reach the ear of every one similarly affected, throughout our land, to banish all doubts and take advantage of the science, skill and pleasant surroundings so happily blended in your Institution, for the removal of pain and the mitigation of distress. DAVID S. CLARK, Erie, Pa. CASE 520,123. STONE IN BLADDER. 1200 GRAINS OF STONE REMOVED WITHOUT CUTTING. PASSED BLOOD IN GREAT QUANTITIES FROM THE BLADDER. DOCTORS AT HOME (AS USUAL) DISCOURAGED HIM FROM COMING TO US. WORLD'S DISPENSARY MEDICAL ASSOCIATION: [Illustration: James Vine, Esq.] _Gentlemen_--I am glad to make public the wonderful cure that you accomplished in my case. For ten years I was a sick man, and during three years I suffered so much that life was a burden. My business had to be given up and the torments were something that could not be described. Every little while I had to urinate, and each time suffered a spasm of pain, like a knife thrust; the use of a catheter was painful and often it took long and painful trials before the water could be drawn off. I passed blood, in quantities at times. When I went to your place we had given up hope of a cure, and relief was all that I looked for. My doctors at home discouraged me. I spent four weeks in your Invalids' Hotel, and now at the age of sixty-seven years am sound and hearty as any one, work from five in the morning until seven at night. I manage a large and active business and enjoy life. I cannot express my high praise of your Institution. Your doctors are skillful and the nurses all kind and good. All understand their business and attend to it. I came home a new man and cannot say enough for your praise, and to express my thanks for the wonderful cure and comfort I have enjoyed. Yours, JAMBS VINE, SR. P.S.--You removed a stone that weighed over 1200 grains from my bladder, without cutting. The operation gave me complete relief. While there and since, I have seen a great many skillful cures done by you. J.V., SR., St. Catherines, Out. CASE 620,610. STONE IN BLADDER--WEIGHT 530 GRAINS--SUCCESSFULLY REMOVED WITHOUT CUTTING. NEIGHBORS TOLD HIM HE WOULD BE "BROUGHT HOME IN A BOX." WORLD'S DISPENSARY MEDICAL ASSOCIATION: [Illustration: C.A. CHURCH, ESQ.] _Gentlemen_--Seeing the picture of the Invalids' Hotel and Surgical Institute in our local newspapers, called to my mind the treatment I received there in 1887. I had been suffering for ten or twelve years with bladder trouble, and our home physicians did not seem to understand the cause or the trouble, and I finally corresponded with your faculty, and their advice was to come and have an examination. I had been a great sufferer and was so weak that I could hardly walk from the hotel to the depot, and those who saw me start said that I would be brought home in a box. Soon after my arrival an examination revealed a stone in my bladder. After a few days' treatment to strengthen up the system, the stone was taken out, weighing 530 grains. Four or five others were afterwards taken out of smaller size, and I am still alive. Will soon be seventy-six years old, and I cannot speak too highly of the care and attention I received from the physicians and nurses while there. Everything that was provided was of the best; good food, glean apartments; and no better place can be found for treatment of the many diseases they advertise to cure. Anyone suffering from bladder or kindred trouble can find relief at the Invalids' Hotel, Buffalo, N.Y. Respectfully, C.A. CHURCH, New Berlin, N.Y. CASE 620,258. STONE IN THE BLADDER--GREAT SUFFERING FOR YEARS--HEART-FELT GRATITUDE. [Illustration: Wm. H. Miller, Esq.] WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: I would not be a true man If I did not acknowledge at this time (as I should have done long ago), with words of gratitude, the wonderful relief I received at your Institution five years ago. It affords me the greatest pleasure to say to you and to the world at large, that the treatment and operation I received at your Institution was an entire success and a miraculous cure. After twenty-five long years of suffering such as few people endure, caused from exposure while in the military service of the United States, I contracted kidney and bladder disease, which shortly afterwards resulted in the formation of a calculus or stone. I experimented with medicines. Special Prescriptions, etc., from some of the most eminent physicians in the world, in fact everything that promised relief and help for my kidneys was used, but received no relief, until the bladder discomfort became unendurable. As a last resort, knowing full well that life with me would be very short unless I could receive immediate relief, I went to your famous Institute, where I was treated and operated upon and a large stone was removed from the bladder. The old method of cutting, which is so dangerous, was not employed, but the new and painless process of crushing; this process was an agreeable surprise to me, no pain and no risk, as in the old method of cutting. From the day of the operation I began to improve, and in a few weeks thereafter I returned home to my wife, family and friends, a well and happy man, and I have spent the last five years with ease, comfort and pleasure--a living, walking testimonial for your renowned Institute. Believe me, when I say that words fail me to express to you my sincere gratitude for your marvelous and almost miraculous cure effected in my case. I feel sure no invalid could receive more skillful and kindly attention anywhere in the world. I would urge every sufferer to take treatment at the Invalids' Hotel and Surgical Institute, believing it to be the most skillful, and feel sure that it is the most advanced of the age. Sincerely and gratefully yours, WM. H. MILLER, Stoyestown, Somerset Co., Penna. CASE 720,402. STONE IN BLADDER ONE AND A HALF INCHES IN DIAMETER SUCCESSFULLY REMOVED WITHOUT CUTTING OR PAIN. [Illustration: Thos. Daltry, Esq.] From severe exposure when in the army, I brought upon myself an acute attack of rheumatism, from which I suffered terrible pain. Following this I began to be troubled with my bladder and kidneys. For three years I experienced considerable discomfort. There was severe burning and scalding, and urination caused much pain. I passed two pieces of gravel and became convinced that I had stone in the bladder. Was examined by my home physician, who said there was no stone. I was not satisfied, however, and went to the Invalids' Hotel and Surgical Institute. I was examined by their specialist. After an injection of cocaine and carefully cleansing out the bladder, a stone was found about one inch and a half in diameter, probably similar in its composition to the pieces already passed. I was advised to have it operated upon and removed, which I arranged to do. The process used was their new and painless one of crushing, no knife or other cutting instrument being employed. The stone was readily grasped by the crusher and reduced to small fragments. The evacuator was then introduced and the stone entirely removed. After a few weeks' careful attention my health was entirely restored and I was able to leave for home. I take great pleasure in making public my wonderful cure. I could not speak in too high praise of those who took charge of my case, nor recommend too highly this famous Institution. It is about three years since I was operated on, and pave not felt any bad effects since. THOS. DALTRY, Huntington, Huntington, Co., Ind. CASE 820,539. GRAVEL OR STONE WITH CHRONIC KIDNEY AND BLADDER DISEASE. CURED NINE YEARS AGO AFTER BEING GIVEN UP TO DIE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Mr. O. Thompson.] In 1884, at the age of fifty-four years. I was prostrated with Kidney and Bladder complaint and told by the best physicians that I was but ten days out of the grave. I applied to your Institute for help and received treatment, and now after nearly nine years am in comparatively good health. All this time I have been able to do much work and to oversee my farm. Two stones or gravel were passed while under home treatment. No further formations have developed. The many cases I have recommended to you have all been more than satisfied with the results of their treatment. I wish to thank you for the great benefit and care I received at your hands. Yours truly, ORVILLE THOMPSON, Avoca, Steuben Co., N.Y. CASE 859,612. A STRONG ENDORSEMENT. [Illustration: H.E. Bankston, Esq.] _To whom it may concern:_ This is to certify that I took treatment at the Invalids' Hotel and Surgical Institute, Buffalo, N.Y., and I was cured of a chronic trouble that had been maltreated by other physicians. While there I saw a man who had been cured by the specialists, who had before been given up to die by the best doctors in Troy, N.Y. Of course, the case must have been a very stubborn one. I afterwards saw a man here, in Georgia, die, who, if he had been in Pierce's Surgical Institute under the treatment and care of his skilled doctors and nurses, I know would have most assuredly got well. Why? Because it was only a case of _stone in the bladder_, and they are easily cured at Dr. Pierce's Surgical Institute. I think almost any chronic disease can be cured there, if taken in time, judging from my observations while an inmate of that Institution. H.E. BANKSTON, Barnesville. Pike Co., Ga. CASE 820,260. COMPLICATION OF DISEASES. WORLD'S DISPENSARY MEDICAL ASSOCIATION: [Illustration: J.F. Ritter, Esq.] _Gentlemen_--It is now about six months since I discontinued your treatment, and as I have had no return of the old symptoms, I consider it unnecessary to take more medicine. When I visited your Institution some two years ago, I had but faint hopes of ever being restored to health, as I was suffering from a complication of diseases. My case was an unusually obstinate one, yet I am satisfied that a cure could have been accomplished in half the time, had I been able to follow your directions in regard to diet more closely. I hereby tender you my sincerest thanks for the kind treatment received while at your Institution. Those days will always be the happiest in my memory. I will close by giving your faculty my sincere thanks, and hope success will crown your business. Yours very gratefully, J.F. RITTER, Medford, Jackson Co., Oreg. Stricture, the result of injury from falls and accidents, is particularly difficult of permanent cure. The following gratuitous recommendations are from cases belonging to this class who entirely approve of the publication, with full name, photo-gravure and address. CASE 820,507. STRICTURE CURED AFTER MANY OPERATIONS BY OTHER SURGEONS HAD PROVEN TO BE FAILURES. WORLD'S DISPENSARY MEDICAL ASSOCIATION: [Illustration: Archie Ritchie, Esq.] I would state that I am an architect, fifty-two years of age, that about seventeen years ago I fell from a scaffold, a distance of eighteen feet, across a beam, striking upon the perineum. A physician was immediately called and I was treated by him for about eight or ten weeks. A catheter was introduced into the bladder, but caused such intense pain and anguish that it had to be withdrawn. It was tried again but could not be introduced on account of the lacerations in the urethra, caused by the violence used. A consultation was held and an operation recommended. An anæsthetic was used and a cut made through the perineum from the outside into the bladder. A catheter was inserted into the bladder, tied in place and left in position for about eight weeks. After eight or nine weeks the catheter was removed, but it was four or five weeks before the wound in the perineum healed. After a few months I began to have a urinary difficulty, and symptoms of urethral stricture. This condition continued until the urethra was entirely closed, and it was impossible to make water. A physician attempted to pass a catheter, but could not do so. He continued to treat me by the process of dilation for five or six months. I began to feel more comfortable, but the symptoms of stricture would manifest themselves again. I then went to a hospital at Toronto. There I was treated also by the dilating method. The treatment was continued for about four weeks, but became so very painful, and there was so much irritation in the urethra, that it was impossible to endure it longer. They then called an electrical specialist and he began treatment by electrolysis. In about three weeks I went home, but in a short time the stricture again manifested itself; the contraction was very marked, and micturition very difficult. It grew gradually worse and I could not receive any comfort or benefit. I returned to Toronto to take further treatment from the electrical specialist. During the operations of dilation of the urethra, I passed some gravel. After four weeks treatment I returned home, but in about two months was as bad as ever, and last October went back to Toronto and was again treated by the electrical method. The doctor had much difficulty in inserting the smallest catheter, and it caused intense pain and suffering. The last time he attempted to insert a catheter, there seemed to be something give way, and a large amount of pus and fluid passed from the rectum. The physician told me an abscess had formed. I returned home and tried to keep as comfortable as possible, but could not micturate with any degree of satisfaction or comfort. I gradually began to grow worse and there was a return of the stricture with inflammation of the bladder. In March, 1892, there began to be formed gravel in the bladder. They would at times obstruct the flow of urine entirely. I kept going from bad to worse, until the urethra appeared to be entirely closed. The physician I called found it impossible to pass a catheter Into the bladder, and advised me to go to some hospital where I could receive proper treatment, and where proper appliances for this class of cases were used, as he felt satisfied nothing could be accomplished for me at home. I then came to the Invalids' Hotel and Surgical Institute in Buffalo to receive treatment, and the treatment has been so successful that the urethral stricture as well as the gravel have been removed. After I returned home I felt as if a great load had been lifted from my shoulders. I have no irritation at all as I used to have, and I can keep my water for six or seven hours without any trouble, and the water seems to be clear and free from sediment of any sort, and in general I feel as I never expected to again. The doctors here were dumb-founded at the short time I was in getting fixed at your Institution, and feel ashamed to ask any questions as to treatment. Many months have passed and I continue well and active in my profession. Any one I can send the way of your Institution you may be sure I shall do so, and thanking you personally for your kind and successful treatment of my case, I remain ever your well-wisher, ARCHIE RITCHIE, Architect, Mount Forest, Ont. GRATEFUL LETTER FROM A PROMINENT ARCHITECT. TO THE WORLD'S DISPENSARY MEDICAL ASSOCIATION: _Gentlemen_--It is again with the greatest of pleasure that I write you after twelve months since I was treated in your Institution, to add to my former testimonial. With the blessing of good health I have been able to attend to my business as well as ever, and have the greatest of comfort in every respect, and feel about ten years younger than I was when I came to your Institution for treatment, and I have still again to thank you, gentlemen, for the kind and courteous attention I received from every one I came in contact with in your Institution, while under treatment, and shall ever remember my visit to your Hotel with pleasure, and shall advise any one suffering under the same trouble, with whom I may come in contact, to come to your valuable Institute for treatment, where they can have the best of attention and skill. Again thanking you, gentlemen, for what you have done for me, I hope that your Institute may long be kept up to minister to suffering humanity. God bless your staff of physicians, and may success attend you, is the wish and prayer of ever your well-wisher and grateful patient, ARCHIBALD RITCHIE, Mt. Forest, P.O., Ont. [_See Mr. Ritchie's former communication, on page 857._] CASE 2A-126. PAINFUL IMPEDIMENT TO THE ACTION OF URINARY ORGANS. [Illustration: Edward Compton, Esq.] WORLD'S DISPENSARY MEDICAL ASSOCIATION: This is to certify that I have been to the Invalids' Hotel and Surgical Institute, at Buffalo, N.Y., for treatment, and cannot speak in too high terms of the staff of physicians and surgeons, or of the treatment which I received. I consider the Hotel one of the best in the country, the table being excellent, and the treatment the very best to be found in the land. It is a most pleasant place to stay. The attention which is given by the nurses could not be better. As surgeons I think your specialists possess the finest skill that can be found. Any person suffering should not delay, but go at once and be treated and get well. You are at liberty to use this endorsement in any way that will do the most good. With gratitude, I remain, EDWARD COMPTON, Chillicothe, Ill. CASE 620,380. STRICTURE, THE RESULT OF INJURY--CURE PERMANENT. [Illustration: Mr. Fay Sawdy.] The stricture, which resulted from an injury, had been greatly aggravated by uric acid crystals which were continually forming in the urine. Patient had rheumatism, causing this acid state of the system. He had been a great sufferer for many years, continually experiencing the nervousness, smarting, pain and burning, with occasional attacks of urethritis, common to the malady in this form. This made the stricture almost unbearable, and he was practically incapacitated for his labor at the time that treatment was undertaken in our Institution. He had been to the Hot Springs and in the care of other physicians with no satisfactory results. The relief of the stricture by our new and painless method was followed by very great improvement in his condition, after which appropriate remedies for the rheumatism were administered, and the result was a very gratifying and satisfactory relief from his difficulty. Patient afterwards embarked in business as a proprietor of a hotel of his own, and has been ever since very active in carrying on the business, and extremely successful. The stricture showed no tendency to recur, as is commonly the case where it is cured by other methods than employed by us. Many years elapsed from the time that it was treated before the testimonial appended was written. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Dear Doctors_--I want to thank you, but words cannot express my gratitude, for your treatment white at your Institution, but I will say for the benefit of persons afflicted with stricture, that I was entirely cured by you, and after several years have not seen any signs of its returning. Yours truly, FAY SAWDY, Proprietor Hotel Sawdy, Earlville, Madison Co., N.Y. CASE 551,864, URETHRAL STRICTURE--NASAL CATARRH--CURED IN TWENTY DAYS--A PREVIOUS OPERATION BY A NASHVILLE (TENN.) SURGEON UTTERLY FAILED. [Illustration: S.A.D. Smith, Esq.] WORLD'S DISPENSARY MEDICAL, ASSOCIATION. Buffalo, N.Y.: In September, 1886, I was examined by one of your able staff of physicians and was found to be suffering with a bad form of nasal catarrh and with two strictures in the urethra (water passage). After a few days' general treatment, I was operated upon and turned over to be cared for by the nurse, from whom I received all the attention that was necessary. To my utter astonishment I was dismissed in twenty days from the Surgical Institute, cured of the stricture. I had been operated on by one able surgeon of Nashville, Tenn., and was worse after the operation than before. I have never had a symptom of the stricture since I was dismissed from the Invalids' Hotel and Surgical Institute, and have been in better health than ever before in my life. Very truly, S.A.D. SMITH, Laurel Hill, Tenn. CASE 820,201. STRICTURE OF THE URETHRA OF THREE YEARS' STANDING--COULD PASS URINE ONLY IN DROPS AND WITH GREAT PAIN. WORLD'S DISPENSARY MEDICAL ASSOCIATION: [Illustration: Frank Brendell, Esq.] _Gentlemen_--Wishing to add my testimony as to your great skill in surgery, I will say that I suffered with stricture of the urethra, due to an injury, for about three years. It became so bad that at times I could pass water only in drops and with great pain. I went to a doctor here, who used sounds which helped me for a time, but in less than six weeks I was worse than ever. Hearing of your place, I came to you and had a painless operation performed, and have ever since been thoroughly cured. I experience no trouble or pain. It is three years since I had the operation, and the cure has proved permanent. You have my deepest gratitude. Yours truly, FRANK BRENDELL, Olean, Catt. Co., N.Y. CASE 820,472. COMPLICATED AFFECTION OF NERVOUS SYSTEM AND URINARY ORGANS. [Illustration: E.J. Archer, Esq.] _To the afflicted with chronic Diseases:_ It is with great pleasure that I refer to the successful treatment, together with the kind care and attention received at the hands of the professional staff, both physicians and nurses, of the world-renowned Invalids' Hotel and Surgical Institute. In every way It verifies their statement--"Not a hospital but a pleasant remedial home," and as such I add my name to the thousands who know and recommend it to the afflicted. Not only was this true in my own case, but in many which came under my observation while there, so I say to the afflicted--visit them if you can and if your case (no matter of what character) is Within human skill, you will never have to regret it. Very sincerely yours, EDWARD J. ARCHER, Plainwell, Mich. CASE 520,408. STONE IN THE BLADDER. WORLD'S DISPENSARY MEDICAL ASSOCIATION: [Illustration: Rob't Worthington, Esq.] _Gentlemen_--For six years I had been a great sufferer from stone in the bladder. The discomfort increased, until it almost became unbearable. Hearing of the universal success of the specialist at the Invalids' Hotel and Surgical Institute, in similar cases, I went there and submitted to an operation. The method employed was their new and painless one of crushing, no knife or cutting instrument being used. I felt no pain afterward, there was no fever, and I could have gone home the day after. The operation was witnessed by one of my friends, who says it was very artistic and done with skill. It was a complete success, for I have not been troubled in the least, although nearly seven years have passed. I feel that I cannot speak in too high praise of this renowned Institution and its staff of skilled physicians. No invalid need fear to place himself under the skillful treatment and kindly care to be received there, for I am confident that all the benefit known to medical science, can be obtained at the Invalids' Hotel and Surgical Institute. ROBERT WORTHINGTON, Staunton, Fayette Co., Ohio. CASE 114,747. NERVOUS DEBILITY, DYSPEPSIA, KIDNEY AND LIVER DISEASE--CURED. WORLD'S DISPENSARY MEDICAL ASSOCIATION: [Illustration: B.V. Wright, Esq.] _Gentlemen_--I take pleasure in informing you that the treatment you gave me for the relief of an affection of the spine and nervous system, disease of the digestive organs, kidneys and liver, has been entirely successful. I had feared that my health was gradually being undermined, prior to entering your institution, and I can testify to the perfect appointment that you have, the excellent apparatus for the administration of electrical and other massage treatment and baths. My relief was most satisfactory, and the cure has remained permanent. I take pleasure in recommending your institution to the afflicted, believing that you have the very best treatment for chronic diseases known, and I have had an opportunity to satisfy myself, from conversation with other invalids in your Institution, of the care and skillful treatment that you administer, and its excellent effects. I believe that it is fully abreast of the times, and equal to any institution in the world. With many good wishes and thanks for my cure, I remain, Yours truly, B.V. WRIGHT, Graniteville, Middlesex Co., Mass. CASE 790,698. DIABETES CURED BY HOME TREATMENT. [Illustration: Mrs. Woodruff.] _To whom it may concern_: This is to certify that for a number of years I was a constant sufferer, and what was many times termed a hopeless victim of that terrible disease, diabetes. The symptoms were indeed alarming; my strength being so completely exhausted that my walking from room to room was attended with difficulty. My nerves were in a constant tremor, and in fact no other words than that, "I was completely out of fix all over," will express my condition. Having purchased a bottle of Dr. Pierce's Favorite Prescription for my daughter, and in looking over the directions of the accompanying circular and finding my own case so thoroughly described, I decided at once to give his special home treatment a trial, which I did during the three months that followed. This proved to be all that was required for the restoration of my usual health, and during the four years which have since elapsed I have had not the slightest reason for believing otherwise than that a perfect cure has been effected, and can most heartily recommend Dr. Pierce's medicines and treatment to any or all who may be suffering with kidney complaint in any form. Very sincerely yours, MRS. MARY A. WOODRUFF, Columbus Junct., Louisa Co., Ia. CASE 795,590. INCONTINENCE OF URINE--CURED BY SPECIAL HOME TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: Miss Richman.] _Dear Sir_--I consider myself duty-bound to you and suffering humanity to acknowledge the benefit that I have received from your treatments. From babyhood till I was twenty years old I was continually bothered with a weakness of the muscles of the bladder, that gave me much trouble, both by night as well as day. I doctored with several physicians and tried all patent medicines, but could not get any relief until I took your medicine about six months, and now I am sound and well. It has been over two years since I quit taking your medicine, and have had no symptoms of the disease returning. Yours most gratefully. Miss MOLLIE RICHMAN. North Cove, Pacific Co., Wash. CASE 4A-2,226. BRIGHT'S DISEASE AND GRAVEL CURED BY SPECIAL HOME TREATMENT. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J.W. Thompson, Esq.] _Dear Sir_--You have my thanks and best wishes for your success, as you cured me of what the doctors here called Bright's Disease and Stone in the Bladder. They did me no good, so I concluded to write to you, which I did, and am happy to say your medicine worked like a charm. God and myself only know how I suffered. I lost fifty-six pounds of flesh in six weeks and I thought my time had come, but when I commenced taking your medicine, in three days I saw a change for the better was taking place, and in one month I considered myself cured. I am still in good health and can do as hard a day's work as any man. Again I thank you. Your charges were reasonable and any one suffering as I was should write you at once. Any person writing to me must send stamped addressed envelope if wanting an answer. J.W. THOMPSON, St. John, Whitman Co., Wash. CASE 2A-223. INFLAMMATION OF THE BLADDER. RETENTION OF URINE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: E.A. Brown, Esq.] _Gentlemen_--I had been a terrible sufferer for many years with Bladder trouble. I had experienced the greatest discomfort, and tried in vain to find relief. I was persuaded to go to the Invalids' Hotel and Surgical Institute, I went and while there submitted to a course of treatment that gave me relief, and was entirely satisfactory. Three years have elapsed and I continue well. I take the greatest pleasure in making public my cure. No sufferer going there can fail to receive all the benefit to be derived from medical treatment. The staff of physicians are skillful and of large experience; the attendants kind and attentive, and the Institution, in all its appointments, not to be excelled in the country. I had been told by other physicians, Jealous at your success, not to go to your place, but I am now more than pleased that I disregarded their advice. E.A. BROWN, Corfu, N.Y. * * * * * RUPTURE. (BREACH OR HERNIA.) By the term _Hernia_, we mean a tumor, which is formed by the displacement of the intestines, the omentum (covering of the bowels), or both, and which protrudes from the abdominal cavity. The most common varieties are _umbilical, inguinal_ and _femoral_ hernia. Children are most subject to umbilical, males to inguinal, and females to femoral, hernia. [Illustration: Fig. 1. Indirect Inguinal Hernia. Sketched from a case subsequently cured by our improved method of treatment. ] CAUSES. These are either _predisposing_ or _exciting_. Any thing which occasions general or local muscular debility, as dropsy, pregnancy, abscesses, wounds, obstructions to natural evacuations, etc., is a predisposing cause of hernia. The exciting cause is pressure applied to the contents of the abdomen, as straining in evacuating the bowels and bladder, lifting heavy weights, or violent physical exertion. SYMPTOMS. The only characteristic symptom of hernia is the presentation of an elastic, or doughy tumor of variable size, which either gradually or suddenly makes its appearance. There is flatulence, uneasiness, and sometimes pain in the abdomen. Sharp and dull pains frequently recurring and confined to the locations where ruptures appear should receive attention. Examination will not infrequently reveal a small enlargement. If a hernia, this will usually disappear after a night's rest and may not be again noticed until the next day, or for several days. On coughing, with the finger applied to the enlargement, a sensation of an impulse (succussion), or slight additional protrusion will be felt The trouble appears at any time of life, an analysis of seventy thousand cases indicating that it is most common in debilitated persons, and that there is a constant decrease in the frequency of the affection from the first to the thirteenth year, after which rupture is more and more frequently met with as age advances. [Illustration: Fig. 2. This figure illustrates a case of Femoral Hernia which was radically cured by our improved method. This tumor is a little lower on the thigh than in cases of inguinal hernia. Femoral Hernia is most common to females, and inguinal in males.] INGUINAL HERNIA (see Fig. 1) is more common than all other forms of rupture. It is more frequently met with in men, and when severe there is usually a mass of intestine which falls into the scrotum and has an evil effect, by pressing upon the testicle. The protrusion follows the spermatic vessels and hence it usually appears low down in the abdomen and on one or both sides of the pubic bone. FEMORAL HERNIA (see Fig. 2), most common in women of mature life, is felt as a lump below the strong ligament in the groin which forms the line of separation between the thigh and the abdomen. On its outer side and close to it can be felt the beating or pulsation of the large artery of the thigh. UMBILICAL HERNIA (see Fig. 3) appears at or near the navel and is most common in children. It may be present from birth, or it may result from fretting and crying at any period of childhood. [Illustration: Fig. 3. UMBILICAL HERNIA. Sketched from a case subsequently cured by our new method.] Sufferers from any form of rupture are constantly subject to the danger of strangulation. This occurs when, from any cause the free return of the contents of the protruded part of the intestine is prevented. It is an accident of a serious nature, inasmuch as nearly fifty per cent. die if not carefully operated upon, and with the most skillful treatment, one in four cases terminates in death. Every individual should guard against rupture by maintaining, by proper exercise, diet, and rest, a condition of vigor and tonicity of the muscular system. When debilitated, all strains and exertions should be care fully avoided until the health is built up, and the relaxation overcome. TREATMENT. The palliative treatment of hernia is by _reduction_ and _retention_. Reduction consists in returning the protruding intestine to its proper place through the opening by which it escaped. This is accomplished either by manipulation or by a surgical operation. Retention is effected by wearing a mechanical appliance called a _truss_. As soon as the tumor protrudes, or the "bowel comes down," the patient should assume the recumbent posture, with his shoulders and feet elevated. The patient or an attendant should grasp the hernia, and with gentle, but gradually increasing pressure upon the tumor attempt to replace it. At the same time let the patient knead the bowels upward by pressing upon the integument, so that the intestine may, as far as possible, be pushed away from the point of protrusion. Sometimes the contraction of the muscular fibres at a point where the hernia makes its exit is so great that the tumor cannot be replaced. In this case the system should be relaxed with lobelia (not given in doses to produce vomiting), and as soon as the patient is thoroughly under its influence, the manipulations may be resumed. When there is any difficulty experienced in putting back the "breach," or rupture, professional assistance should be promptly summoned. After the reduction of the rupture, a truss should be properly adapted, applied, and constantly worn, to prevent the protrusion of the intestine. [Illustration: Fig. 4. The above cut fairly illustrates a case of Double Inguinal Hernia, complicated with Hydrocele, cured at the Invalids' Hotel and Surgical Institute.] Of the latter instruments there are several hundred varieties for sale throughout the country. With the exception of about one-half dozen forms, which embody the true principles of a proper truss, they are, without exception, harmful. Unless proper support be given to the walls of the abdomen, and that without constant pressure, a truss does harm; then, too, the shape of the pad must be such as to avoid pressure where it is not required; otherwise, as in the case where a small ring is worn upon a finger, there is a gradual loss of strength and a depression formed in the healthy tissue, which can be plainly seen and felt. In this way trusses do harm, and such evil consequences may follow the _improper_ application of a _good_ truss. SURGICAL TREATMENT. When the hernia has become strangulated and cannot be returned by manipulation, a surgical operation is necessary. Whenever the necessity for such a procedure is apparent, it should be performed _immediately_, for the greater the delay the greater the liability to fatal results. The operation consists in cutting down upon the strangulated bowel, thus relieving it of its constriction and facilitating its replacement. It is a delicate operation, and must be skillfully performed. After the operation, the patient requires appropriate hygienic treatment. [Illustration: Fig. 5. This figure illustrates a Double Inguinal Hernia, of large size, which was permanently cured by our improved method of treatment. The left side (_b_) shows the _direct_ descent of the bowel into (_c_) the scrotum, while on the right side (_a_) the rupture is indirect, the bowel descending through the internal ring and inguinal canal.] THE RADICAL CURE. A small percentage of cures will follow the proper use of a good truss, and the advertisements of the so-called rupture cures are founded upon such cases. These impostors pretend that the use of some vaunted salve, ointment, or styptic lotion, applied on the outside, will heal and cure the deep-seated separation of the muscular fibres. The truss in these cases is the curative means in the small number that are relieved, and for it but few dollars should be charged instead of the exorbitant prices demanded by these impostors. Improvements in surgery in this age of wonders, have kept apace with the advances in electricity and other branches of science. Diseases and deformities which only a few years ago were considered incurable are now overcome and cured with certainty and without risk or suffering. Especially is this true with reference to hernia or rupture. Our specialists have devoted much attention to the radical cure of rupture, or breach, with the most gratifying results. Formerly we employed and advocated the use of the injection treatment only. This method was tested and brought to a most efficient and practical stage, so that we now apply it in the treatment of over eighty percent. of the cases that are presented at our Institution. This plan of cure, as used by us, is a great advance over that of any similar one in use, throughout the country. Our fluid is much more safe in its effects, never gives rise to the troublesome abscesses and inflammation that is common to the use of the injection fluids that have been advised on the Heatonian method. The fluid we use is a bland and healing agent, which produces an exudation behind the cords that surround the inguinal rings, and forms a well defined truss pad of moderate size in such position that the rupture cannot pass by it and appear externally. It causes also an adhesive inflammation limited to the hernial sac, that completely closes it. This treatment is rendered _entirely painless_ by the use of a solution which is injected underneath the skin with a fine hollow needle attached to a small syringe, and which tends to produce complete local anæsthesia, or loss of feeling so that the procedure is thoroughly and carefully carried out without any risk or discomfort. The needle used by us for the treatment of the hernia is so perfected that any possible injection of the fluid into the abdominal cavity, or upon the coating of the intestine, is an impossibility, and in no way can an injection be made into a blood vessel or nerve so as to produce any discomfort or trouble. We thus avoid all the risks that pertain to the usual plan of injection. There is a small percentage of cases, as before stated, in which this form of treatment is not likely to give a permanent cure, from the fact that the omentum or intestine has become adherent externally, to the sac, or in the scrotum, to the coverings of the testicle. This makes the complete replacement of the rupture without cutting an impossibility, and in such cases even where the hernial opening is closed, treatment by injection only would not result in a permanent cure. Our aim is to treat all cases of rupture that we undertake in such a manner that _by no possibility can the deformity return_. We therefore have for the cure of these cases another method, by which with our local anæsthetic fluid, we are able to perform a surgical operation without any distress whatever to the patient. The greatest risk of the old operation for rupture was the danger of general anæsthesia with chloroform or ether, or some similar agent. The great majority of individuals cannot bear the inhalation of the large quantities of these anæsthetics necessary to secure loss of feeling without consequent nausea, and at times an effect upon the heart that often results seriously. The risk from the anæsthetic is much greater than from the surgical procedure. By our method, this risk is entirely done away with. The pain dispelling fluid enables our operator to pursue his method WITHOUT GIVING THE PATIENT ANY PAIN OR DISCOMFORT WHATEVER. During the operation he is in full possession of all his faculties, and can assist in any way desired by coughing, or straining, in order, at any time, to complete the protrusion of the rupture and show its entire extent of surface when the sac is laid bare. We then replace the rupture completely; suture the sac so that the rupture will have no pocket into which to descend, and then firmly unite the rings by a plan that we have invented, and BY WHICH THEY ARE MADE MORE STRONG AND FIRM THAN IN THEIR ORIGINAL STATE. Early in our experience, and while using the plan of treatment that is usually employed for the radical cure of rupture, we had occasional relapses of the difficulty, but since using our improved method we have had no such trouble. We can assure our patients that there is less risk of the appearance of the rupture at the point where the operation is performed than there is of a new breach forming. The success of this treatment has been invariable. None of the plans of treatment that we pursue for the cure of rupture tend to keep the patient in bed more than a few hours. There is little or no pain, after either of our plans of treatment, and out of the many hundreds which we have treated and perfectly cured, in no instance have we had any inflammation or serious manifestation--there being no fever or general reaction. It is a matter of great surprise to our patients, who undergo our treatment for the radical cure of rupture, that by our varied methods, the object is accomplished with so little discomfort and with no pain whatever. From two to three weeks' personal attention of our specialist, is usually all that is required even in the worst cases. NO TRUSS IS NEEDED AFTER OUR TREATMENT. WE CONSIDER A CASE CURED ONLY WHEN THE PATIENT IS ABLE TO DO WITHOUT A TRUSS OR SUPPORT IN ALL THE USUAL WALKS AND VOCATIONS OF LIFE. * * * * * TESTIMONIALS. The testimonials that we append are but a small number out of the great mass that we have received. A very large percentage of individuals who have been treated by us for rupture desire that their disability be held a matter of sacred confidence and with all such we take pleasure in guarding their confidence with the greatest care. Others are quite willing that their experience may be made public in this manner for the benefit of similar sufferers. If the following letters had been written by your best known and most esteemed neighbors they could be no more worthy of your confidence than they now are, coming, as they do, from well known, intelligent and trustworthy citizens, who, in their several neighborhoods, enjoy the fullest confidence and respect of all who know them. A LOCOMOTIVE ENGINEER TESTIFIES TO HIS CURE OF RUPTURE. THE CONSTANT JAR OF A LOCOMOTIVE IS ONE OF THE SEVEREST TESTS THAT CAN BE APPLIED TO A RECENTLY CURED CASE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: F.W. Frost, Esq.] _Gentlemen_--After suffering a number of years from a painful Rupture, I went to the Invalids' Hotel and Surgical Institute, at Buffalo. While there, I submitted to an operation which was not painful. It was done without chloroform, ether or any dangerous anæsthetic. Under the skillful treatment of your specialists and the very close and kind attention of your nurses, in less than a month, I left the Institution feeling like a new man. I have every reason to believe that the Hernia will never return, and that I am permanently cured. It it a great relief to go without a truss. Very respectfully, F.W. FROST, Rotterdam June, Schenectady Co., N.Y. A LOCOMOTIVE ENGINEER'S ADVICE TO SUFFERERS FROM RUPTURE. THE CONSTANT JAR OF A LOCOMOTIVE IS ONE OF THE SEVEREST TESTS THAT CAN BE APPLIED TO A RECENTLY CURED CASE. THROW AWAY TRUSSES. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: F.S. Auchenpaugh, Esq.] _Gentlemen_--I am an engineer--running an engine on the Western Division of the Fitchburg Railroad. I had a severe case of double Hernia; still, have always worked along with them until this winter. One side was of twenty-five years' standing--the other of about eight years. This winter I was laid up sick with pneumonia; in coughing so much, which of course was made necessary by that terrible disease, I strained myself so that after getting up from my sick-bed, I was not able to go to work, as I could get no truss that would hold the rupture. I was talking with Brother Stagg one day. He asked me "why I did not go to the Invalids' Hotel and Surgical Institute, at Buffalo, N.Y., and get cured?" I went, and in three weeks was cured, so that I could dispose of my truss entirely. I wish to say this comes from me direct; it was my own proposition that this letter be made public. Yours respectfully, F.S. AUCHENPAUGH, Rotterdam, N.Y. RUPTURE FROM BOYHOOD. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: A. Sauvain, Esq.] _Gentlemen_--I am glad to say that I was cured at the World's Dispensary Medical Association after suffering from boyhood until the age of twenty-five from a hernia, or rupture, by a treatment of twenty days. It is now five years since I was cured, and can say that I was permanently cured. You have my most sincere gratitude for your skillful operation and the good care received in your Institution while there. I can recommend your nurses and physicians most highly, and I think your Institution unequaled in this country. Yours truly, ALBERT SAUVAIN, Silverton, Marion Co., Oreg. HERNIA--LEFT INGUINAL--PRESENT EIGHT YEARS WITH NERVOUS PROSTRATION. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: A.J. Kidder, Esq.] _Gentlemen_--I take greatest pleasure in making public the most wonderful cure I received at the Invalids' Hotel and Surgical Institute of Buffalo. I had suffered severely for eight years with a left inguinal hernia; had tried many physicians and medicines, but found only temporary relief. I was greatly run-down, and my nervous system considerably shattered. My friends persuaded me to go to the Invalids' Hotel and Surgical Institute. While there I was operated on by their specialist, and in a few weeks began to gain strength and energy so that I could return home, and have since felt entirely well. Words could not do justice to my feeling in regard to this institution. There is no place like it for medical aid, and I would urge all invalids to go there, feeling confident that they could no where receive more skillful treatment or more kind attention and care. Respectfully, A.J. KIDDER, North Yam Hill, Yam Hill Co., Oreg. HERNIA. CURED SEVERE PAIN. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J.H. Riemer, Esq.] _Dear Sirs_--Your favor received and found that you would like to have me give you a testimony of my case I will say in reply that I was treated at the Invalids' Hotel and Surgical Institute, for Hernia on the left side. It was not large but it gave me severe pain while working. I wore a truss but it did not relieve the pain very much. I read in the paper one night your advertisement and a week after I started for the Invalids' Hotel, and took the treatment for rupture and went home sound and happy, like a new man, and I can work harder than ever and can assure anyone interested that it is no humbug. With the best wishes, JOHN H. RIEMER, Zion, Wis. P.S.--If any one would like to inquire about my case give them my full address and I will inform them about it, if they enclose return stamped and addressed envelope for reply. J.H.R. "SOUND AS A DOLLAR." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: B.F. Hook, Esq.] _Gentlemen_--Am greatly pleased to report that the operation for the radical cure for rupture received at your Institution in May, 1889, has proved entirely successful. I am sound as a dollar. My case was an extremely troublesome and dangerous one. Many times I required the assistance of a surgeon to reduce it. No truss would hold it a whole day. My two weeks' stay with you was worth thousands of dollars to me. Will gladly answer any inquiry and would advise any one suffering from hernia to take the radical cure. Very truly yours, B.F. HOOK, Holmesville, Holmes Co., Ohio. RUPTURE, DYSPEPSIA OR INDIGESTION, AND KIDNEY DISEASE. [Illustration: A.N. Kingsley, Esq.] The following is from the widely-known and popular proprietor of the Kingsley House at Ashuelot, N.H.: "It may seem useless to add testimony to the overwhelming mass already given of the many remarkable cures performed at your Institution, but I deem it a pleasure and a duty to add mine to your long list as _very remarkable_. I had a rupture of twenty-seven years' standing, with hemorrhage of the kidney for six months, preceding my visit to your Institute, and was also troubled badly with indigestion, all of which ailments had reduced me in strength and flesh to a mere skeleton. Had been treated by many local physicians, who failed to do me any good. I could walk but a very short distance when I left my home on the 8th of July, 1892, for treatment at your Institution, with but little faith or hope of ever being any better. But through your skillful treatment I was able to return to my home on the 9th of August, 1892, and consider myself permanently cured, having had to take no medicine since. Considering my case _almost a miracle_, I cannot speak too highly of your Institute and skillful treatment, to which I feel that I am indebted for my continued existence. You are at liberty to refer to me, and to use this as you see fit. Very respectfully, A.N. KINGSLEY, Ashuelot, Cheshire Co., N.H. RUPTURE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: H. Keifer, Esq.] _Gentlemen_--About four years ago, when working on a scaffold it gave way, and I fell a few feet and the strain and jar caused a rupture in the right side. I did not pay very much attention to this until I noticed that it was enlarging. It finally grew so that I could not work. I used several kinds of trusses that did me no good. I went to the Invalids' Hotel and Surgical Institute, and submitted to an operation which was entirely painless and proved most satisfactory in every respect. Since then I have been well and able to do hard work for a man of my age (72). I feel no inconvenience from the rupture. I take pleasure in recommending the Institute to all who are in need of help. I can highly recommend the physicians and nurses and the kind attention I received while there. I am now well and sound as ever. Yours truly, HENRY KEIFER, Spring Green, Sauk Co., Wis. HERNIA AND PILES CURED WITHOUT PAIN. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: J.J. App, Esq.] _Gentlemen_--I have been successfully treated at your institution for piles and also rupture of the left side. Your institution is all it claims to be, and the treatment of my case was accomplished without pain and apparently any risk. Your method of using locally cocaine as an anæsthetic is such a decided improvement. I did not have to take any dangerous ether or chloroform, but had a small quantity of medicine injected that made the operation as painless as though it was being done on some one else. At the same time I knew everything and could see what was being done. You have my kindest thanks for the good care and many attentions given me. Your nurses and physicians all give kind and skillful care. Yours very truly, J.J. APP, Bolivar, Tuscarawas Co., Ohio. HERNIA OR RUPTURE. LARGE PROTRUSION OF SIXTEEN YEARS' STANDING. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: M.G. Hartzell, Esq.] _To the afflicted_: For sixteen years I was troubled with Hernia, caused by heavy lifting. It was on the right side and the protrusion sufficient to extend into the scrotum. I purchased trusses, but none of them could be worn with comfort, and I suffered very much. I concluded to go to the Invalids' Hotel and Surgical Institute and see if I could not obtain relief. While there I submitted to an operation. The result was entirely satisfactory. The pain in my back subsided; my general health began to tone up, and in a short time, thanks to the skill of their specialist and the kind attention of their nurses, I felt like a new man. I take pleasure in highly recommending the Institution to all the afflicted. I feel confident that all the benefit to be derived from medical or surgical treatment is to be received at the Invalids' Hotel and Surgical Institute. Yours respectfully, M.G. HARTZELL, Deadwood, So. Dakota. DOUBLE RUPTURE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--It is with much pleasure that I write you this testimonial of the wonderful cures you have performed for me. [Illustration: D. Hartley, Esq.] In the year 1883, I became ruptured on the _left_ side. I immediately wrote you (having heard of your fame in curing all kinds of diseases) for your terms of treatment which I received by return mail, you also stating you were positive you could cure me. Through unavoidable circumstances I was unable to come to your Institution until December, 1886. During this time I had tried wearing a truss, which only made it worse, and very much aggravated my complaint as it was impossible to hold the rupture in its place. However I arrived at the Invalids' Hotel on December 8th, 1886. On being examined by one of your staff, I was pronounced a bad case, but by your mode of treatment you could cure it. I was therefore, operated upon by one of your specialists, without any cutting however and comparatively little pain, by your scientific method, and in thirty days returned home cured. The time I had to remain there, I believe, was much longer than most persons treated for the same complaint. Since then I have worked very hard sometimes (my occupation being that of a farmer,) so much so that I became ruptured on the _right_ side three years ago,--the other side remaining perfectly sound without any protection. I considered myself very unfortunate in being in this position again, fortunate in knowing where to go for relief, and very soon was back in your Institution where I was successfully treated and perfectly cured and am to-day a sound man and able to do any kind of work on my farm. I write this testimonial for the sake of suffering humanity, and wish you to use it in any way that the greatest number of persons may read it. As for myself, I would not be in the condition I once was and not know of your Institution for all I could see. I not only recommend your Institution for the complaint of which I was cured but for all chronic diseases or anything requiring a skillful surgical operation, believing your Staff of Physicians and Surgeons to be second to none anywhere. Your nurses and attendants, and every accommodation, also, being all that is necessary to make your Institution everything that its name implies--a complete Invalids Hotel and Surgical Institute. Respectfully yours, DAVID HARTLEY, P.O. Box 84, Wyoming, Out. P.S.--I have also received much benefit from taking your "Golden Medical Discovery" for dyspepsia and liver complaint, and being broken down generally. A few bottles worked wonders, and I have been well ever since, and that was quite a number of years ago. D.H. RUPTURE. A GRATEFUL PATIENT'S WORDS OF PRAISE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main Street, Buffalo, N.Y.: [Illustration: W. Henkel, Esq.] _Gentlemen_--Having been in your Institution as a sufferer from two distinct chronic diseases of years' standing, and having been placed under the charge of your specialists, I was speedily relieved of my afflictions. The Invalids' Hotel is a place as much like home as it is possible for such an institution to be. The physicians and surgeons are all expert specialists and thoroughly efficient; the nurses are very competent, attentive and kind; and, in fact, the whole _personnel_ of the Invalids' Hotel endeavor to do their best to make the patients feel like being at home. I always felt while there as if I was one of the family. I gladly recommend your Institution to all persons who are afflicted with any kind of chronic disease, for from my own experience I _know_ the professional staff will do all which they promise to do. Please accept my thanks for the speedy benefits and perfect cure of my diseases, and I think your Institution is worthy of the highest endorsement. Yours truly, WILLIAM HENKEL, No. 1917 Congress Street, St. Louis, Mo. STRANGULATED RUPTURE OR BREACH IN A CHILD TWO YEARS OLD, CURED. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: Rev. R. Krause, Esq.] _Dear Sirs_--Our boy is, since the operation, quite well and healthier than ever before, so that I presume, the rupture, or a part of it, may have existed since his birth. Even that small lump in the groin has, as much as I can feel by touching, completely disappeared. I take this opportunity of expressing my heart-felt thanks for the kind and christian-like treatment my wife and boy experienced from you and the nurses. God bless you and let you live long for the welfare of suffering men. Dr. Pierce's Invalids' Hotel of Buffalo, N.Y., deserves to be recommended to every sufferer of whatever disease. Eight years ago I underwent a successful operation, saving my body a member. The dangerous outgrowth, which made the operation a necessity, never returned. In regard to your specialist, I wish to remark, that his skillful way of performing operations reminded me very much of Bernard von Langenbeck, professor of surgery in the University of Berlin, where I was a student. He is just as tender and sympathetic with his patients as that famous director of the Prussian Royal Clinical Hospital has been. As to the medicines of Dr. Pierce, I recommended them to members of my congregation, who told me that they did them good. Dr. Bastian, of Dansville, N.Y., a druggist, told me that your medicines are bought by the same persons again and again. I consider this to be the best recommendation. A medicine which is of no effect will not be bought a second time by the same person. Yours, REV. RICHARD KRAUSE, Portway, N.Y. [Illustration: Mrs. Krause.] [Illustration: Master H. Krause.] Mrs. Mary Krause, the mother of the little boy whose case is above reported, writes: "In respect to your medicines I can only say that they have done me and others much good, especially when I suffered with chronic catarrh and doctored with your physicians. I shall never forget the kind treatment I received from your physicians and nurses during the time I had to stay in your house, while our Herman had to go through that dangerous operation which was necessary to cure his strangulated rupture. I can recommend your Institute and medicines to all suffering people." HERNIA OR RUPTURE [Illustration: B. Galland, Esq.] OF FOURTEEN YEARS CURED "SOUND AS A DOLLAR." WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Dear Sirs_--In reply to yours of the 29th ult., in which you kindly make inquiry in regard to my physical condition, I would say, that I am now, I think, as sound as a dollar, and consider that after I had bad fourteen years of suffering with Hernia, and being cured as I was last winter at your Institute, makes me under great obligations to the science and skill of the World's Dispensary Medical Association. Very respectfully yours, ROBERT GALLAND, Orangeville Mills, Barry Co., Mich. IRREDUCIBLE HERNIA. PRESENT FROM BOYHOOD--PROTRUSION OF ENORMOUS SIZE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: [Illustration: D. Nitschke, Esq.] _Gentlemen_--I take pleasure in reporting that I have not worn the truss for a long period, and that I have been at work steadily at my business of binding and printing, running a large establishment, for over four years, without any trouble whatever from the rupture. It has remained permanently and perfectly cured. You will remember my case as a most severe one. I am a man of sixty years of age, and the disease had been the source of serious discomfort to me since childhood. The protrusion was the size of a man's head, and could not be replaced. I was forced to give up all exercise, and suffered much at my daily work from inconvenience and pain. Any injury upon the protrusion, which could not always be protected, was followed with much discomfort, and my general health was seriously affected. The passage of the food through the confined intestines was a painful process often times, and kept me in great misery. I am thankful to state that since your operation the rupture has remained sound and well, and I have been relieved of all difficulty of the kind. I now enjoy excellent health, and am at my business daily from twelve to sixteen hours, and on my feet constantly, yet without any manifestations whatever of the re-appearance of the rupture. You have my most sincere gratitude for the skillful operation and the good care received in your Institution while there. I can recommend your nurses and physicians most highly, and think your Institution is unequaled in this country. With many good wishes, I am, Very truly yours, DANIEL NITSCHKE, 2067 Franklin Ave., Toledo, Ohio. COMPLICATION OF DISEASES. [Illustration: A. Holes, Esq.] Without solicitude or hope of pecuniary reward, with heart-felt gratitude and a desire to aid my fellow-man to health and happiness, allow me to state, that as an inmate for more than a month of the Invalids' Hotel and Surgical Institute at No. 663 Main Street, Buffalo, N.Y., I feel warranted in its highest recommendation. While there I saw and talked with a great number of people who came there as a last resort, to be cured of almost every chronic disease to which flesh is heir, and they were unanimous in their praise of the Institution and the skilled specialists who constitute its professional staff. ANDREW HOLES, Moorhead, Minn. HERNIA OR RUPTURE OF 11 YEARS' STANDING. [Illustration: L. Crist, Esq.] WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.: _Gentlemen_--Allow me to express my thanks to you for the attention and benefits received at the hands of your skillful staff of surgeons and nurses. I had been a sufferer from Hernia for eleven years and tried everything, but was no better. I finally went to the Invalids' Hotel and Surgical Institute, and am now entirely cured and enjoy splendid health. I heartily recommend yours to be the most skillful treatment of the age. With best wishes, LEWIS CRIST, No. 67 Frankston Ave., Pittsburgh, Pa. RUPTURE, AGGRAVATED BY OCCUPATION AS A LOCOMOTIVE ENGINEER--COULD NOT BE HELD IN PLACE--AFTER TREATMENT SUBJECTED TO THE TRYING TEST OF THE CONSTANT JAR OF THE LOCOMOTIVE YET PROVES RELIABLE. WORLD'S DISPENSARY MEDICAL ASSOCIATION, NO. 663 Main Street, Buffalo, N.Y.: [Illustration: J.M. Keach, Esq.] _Gentlemen_--It has long been my desire to make a statement of my cure for the benefit of all those persons who have suffered in like manner. I had a rupture that was very large and difficult to hold in place. Trusses of all kinds were tried. They were painful and would not hold it. The rupture would come down constantly when at my engine and give me fearful pain. I was cured at the Invalids' Hotel and Surgical Institute, Buffalo, N.Y., by a treatment that is safe and certain. My cure has been permanent, although I have worked steadily. Yours sincerely, JAMES M. KEACH. No. 68 Bissell Ave., Buffalo, N.Y. FEMORAL HERNIA. [Illustration: Miss M.V. Thomas.] This patient, aged thirty-four years, was always delicate; suffered from malarial fever each year for ten years past. The hernia was caused by lifting her father, who was on his sick-bed, during five different times, causing terrible suffering. The hernia was treated by our Specialist, and in eighteen days the lady was able to return home. She reports: _Gentlemen_--I am grateful to you for a permanent cure of the hernia, and happy to inform you that I have felt no signs of rupture since I was at your Institution. Respectfully yours, Miss MATTIE V. THOMAS, Albion, Noble Co., Ind. "A LIVING DEATH FOR YEARS." WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.: [Illustration: H. Wood, Esq.] _Gentlemen_--In the hope that some sufferer from hernia may be induced to take your treatment for that disease, I send you this certificate, containing a synopsis of my case and cure of the same. My life was a living death for years. I had almost lost all hope of ever being cured, and was plunged in despair, as I had tried so many trusses, appliances and remedies, each one in successive repetition, a failure. In January and February of the year '89, I entered your Institution for treatment, my malady being an inguinal hernia on the right side, of twenty years' standing--from childhood. I was then impressed with the feeling that it was my last chance, and that it would be my last effort, and to be candid I had very little hope that a cure would be effected. To me my condition seemed appalling, as I dare not eat, drink, laugh, exercise or perform any of the functions of life without having to reduce my rupture, frequently as often as forty or fifty times _per diem_, while on occasions the reduction would occupy hours of untold agony. No truss or appliance that I could get would retain the rupture, and I had tried all sorts as fast as they came to my knowledge. Marvelous as it may appear to all sufferers from this distressing affliction, I was discharged from your Institute in thirty days, a well and sound man, and only from memory and the record do I know that I was ever ruptured. I have at times since performed some of the hardest kinds of work for long periods, but no sign of weakness has ever appeared. I do not consider the necessary operation performed as attended with any danger; it is no comparison to the chances a person takes who in the daily walks of life is tortured with a rupture. While an inmate of your Institution, I was accorded the kindest and most considerate treatment from all members of your staff and employees with whom I came in contact. I consider the appointments and cuisine of the establishment as perfection. You are at liberty to make the fullest and freest use of this testimonial you may see fit in your judgment, and I will cheerfully answer any communication from any sufferer referred to me for more explicit testimony. I am, Sincerely yours, HENRY WOOD. Mason Valley, Nev. * * * * * CROUP, MEMBRANOUS AND SPASMODIC. [Illustration: Fig. 1. False Membrane in Croup. From a specimen in Dr. Gross' cabinet.] Every family should be made acquainted with the symptoms and treatment of this disease. Especially is this true in the case of those living remote from a physician. From the lack of this knowledge on the part of parents, many a little one has perished before medical assistance could be obtained. In some of its forms its progress is very rapid, and, unless relief is obtained in a few moments, or hours at the most, death ensues. There are several quite distinct pathological conditions of the vocal and respiratory organs which have, in popular parlance, been designated as croup. But two of these are worthy of consideration here. These are _true_ or _membranous_ croup, in which a false, semi-organized membrane is formed, and _spasmodic croup_. Both may result fatally, but the former is much the more dangerous. MEMBRANOUS CROUP is supposed to originate in the trachea, from which, as it progresses, it often extends upward to the larynx, and downward to the bronchial tubes. It is the result of severe inflammation of the mucous membrane, and is characterized by the formation of a false membrane, which covers or lines the inner surface of the true structure (see Fig. 1). It is formed of a coagulable, semi-fluid exudation from the mucous membrane. On being brought to the surface and into contact with the inspired air, this substance grows thick and tough, or leathery, as we find it. It is the obstruction in the respiratory canal which this foreign matter causes that gives rise to the labored breathing, and the ringing, brassy cough, together with the crowing or whistling inspiration characteristic of croup. Before recovery can take place this membrane must be detached and expelled. The cough is nature's effort to accomplish this work. The formation of this adventitious membrane in the larynx is attended with more danger than when it is confined to the trachea. In most cases in which the disease has had a very speedily fatal termination, an examination has shown that the larynx was its chief seat. SYMPTOMS. True croup is generally preceded by what is known as "a cold." The child coughs, sneezes, and is hoarse. It is the hoarseness and the peculiar _character_ of the cough which indicate the tendency to croup. This has been already described. In addition, the child is restless, fretful and feverish. The disease makes rapid strides. Finally the cough ceases to be loud and barking, and is very much suppressed; the voice is almost gone; the face is very pale; the head thrown back; the nostrils dilated and in perpetual motion, the pulse at the wrist very feeble, great exhaustion, more or less delirium, and, finally, death comes to the relief of the little sufferer. Convulsions sometimes occur in the last stages, and soon terminate fatally. TREATMENT. No time should be lost in commencing treatment. Hot fomentations should be applied to the throat and upper portions of the chest. The free inhalation of steam should be employed early. The following treatment has been found very effectual in membranous croup, and is recommended by the highest authorities: Yellow subsulphate of mercury, or turpeth mineral, three to five grains, depending upon the age of the child, for one dose. If it does not cause vomiting in fifteen minutes, give a second dose. This, however, is seldom necessary. If the turpeth mineral cannot be obtained, sulphate of copper or sulphate of zinc may be given instead, as directed under the head of Emetics, in Part III, Chapter II. If there be a quick pulse, hot skin, a hurried breathing, and an occasional ringing cough, the child should be kept in bed, comfortably covered, but not overloaded with clothes, and the tincture or fluid extract of veratrum viride administered as follows: Take fluid extract of veratrum, five drops; sweet spirits of nitre, one teaspoonful; pure water, twenty teaspoonfuls; mix, sweeten with white sugar, and give a teaspoonful of the mixture every half-hour to two hours, according to the age of the child and the severity of the case. If there be great prostration, with cold extremities, the carbonate of ammonia should be administered, in doses of from one to two grains, every second hour, in gum arabic mucilage. Quinine is a valuable remedy, and is tolerated in large doses. The patient's body should be frequently sponged with warm water in which a sufficient quantity of saleratus or ordinary baking-soda has been dissolved to render it quite strongly alkaline. If the bowels be constipated they should be moved by an injection of starch-water. Beef tea and other concentrated, supporting diet should be administrated. In those cases in which there is a tendency to croup, the Golden Medical Discovery, together with iron and the bitter tonics, should be given to build up the system and counteract such tendency. The treatment which we have advised has been put to the severest tests in the most severe forms of the disease, and has resulted most successfully. If, however, in any case it does not give prompt relief, our advice is to lose no time in summoning a physician who is known to be skilled in the treatment of diseases of children. SPASMODIC CROUP. In this affection no false membrane is formed. It seems to have a nervous origin. Most frequently the child is awakened in the night by a sense of suffocation. He may cry out that he is choking. The countenance is livid, the breathing is hurried and each respiration is attended by a crowing sound. The child has fits of coughing or crying, and makes vehement struggles to recover his breath. This complaint, unlike croup, is unattended by fever, it being of a purely spasmodic character with no inflammation. Apply hot fomentations to the throat, and give frequent small doses of tincture or fluid extract or syrup of lobelia, to produce slight nausea; or, better still, an acetic syrup of blood-root, made by adding one teaspoonful of the crushed or powdered root to one gill of vinegar and four teaspoonfuls of white sugar. Heat this mixture to the boiling point, strain, and administer from one-fourth to one teaspoonful every half-hour or hour. Slight nausea should be kept up, but it is unnecessary to produce vomiting. This is usually all the treatment that is required. WHOOPING-COUGH. (PERTUSSIS.) This is primarily a disease of the nervous system, involving the respiratory organs through the medium of the pneumogastric nerve. It is considered a disease of childhood, though we have met with it in _old age_. It is eminently a contagious affection, and occurs generally but once during life. SYMPTOMS. It is at first manifested by a catarrhal cough, gradually developed. After a while it becomes paroxysmal, generally worse at night. The cough is severe, and long-continued; when a prolonged inspiration occurs, it is accompanied by a peculiar shrill sound, the characteristic _whoop_, which, when once heard, is never forgotten. The cough is attended by a copious secretion of glairy mucus, which is brought up at the latter part of the paroxysm. During, or at the end of the paroxysm, vomiting frequently occurs, and sometimes nosebleed. The cough is so severe at times, that the patient turns purple, gasps for breath, and presents all the symptoms of suffocation. Bronchitis sometimes is a troublesome complication. Immediately preceding a paroxysm of coughing a sense of impending danger appears to seize the child, and it runs to its mother, or grasps some support, as if for protection. Until the paroxysmal character and peculiar _whoop_ is developed, the disease is diagnosed with difficulty. TREATMENT. We have found the Golden Medical Discovery to modify the disease and cut it short. The philosophy of its action can be readily understood by its effect on the pneumogastric nerve, as explained under consumption and bronchitis. Jaborandi, described under the head of diaphoretics, often speedily arrests this disease. The employment of an infusion of red clover blossoms, in small doses, is of undoubted value in modifying the irritation of the air-passages, and may be used to good advantage with, or in alternation with the Golden Medical Discovery. Exposure to cold and wet should be avoided. NOSEBLEED. Hemorrhage from the nose is commonly the result either of a catarrhal or an inflammatory condition of the nasal mucous membrane. Individuals are susceptible to it who are oppressed by fever or constitutional diseases that reduce the strength. There is also a condition of the nervous system in which there is congestion of the nerve centres which favors manifestations of this somewhat troublesome difficulty. CAUSES. In some instances an examination of the nose will reveal the presence of a small point of congested vessels, usually about the size of a split pea. Upon this portion of the mucous membrane small scabs form, and at any time when they may be dislodged, by accident or otherwise, a hemorrhage will ensue. The constitutional conditions that produce the tendency to hemorrhage are most important. In individuals of a debilitated condition, it results from the lack of a proper amount of fibrin in the blood. Where the blood becomes thin, or loses a large share of its red corpuscles, the individual is pale, and hemorrhages are frequent from the mucous surfaces of any portion of the body, the nasal mucous surface being especially liable to such attacks. TREATMENT. This is local and constitutional. Where there is constitutional imperfection, it should be remedied. Usually in young women there is some difficulty with the ovarian or uterine circulation, and the attack of hemorrhage from the nose is reflex in its character, appearing just before or at the time of the menstrual flow, accompanied with troublesome headache. The correction of this form is by the use of the "Favorite Prescription" and "Golden Medical Discovery," using of each a teaspoonful three times a day, taking the "Prescription" before meals and the "Discovery" after meals. If the bowels are constipated, the "Pellets" should be employed, in order to overcome any congestion of the liver which favors the manifestation of nosebleed. In children there is usually a debilitated state of the system, which is best remedied by the use of a half teaspoonful dose of the "Discovery," taken three times a day, after meals, with sweetened water. This treatment should be continued for a month or six weeks. By this means the blood-making organs rapidly improve in their activity and functions, the blood becomes rich in corpuscles and fibrin, thus strengthening the walls of the blood-vessels and tending to prevent a hemorrhage following undue excitement or injury. With men the use of laxatives is of great importance. One or more of the "Pellets," taken on retiring at night, are most beneficial. Where the blood is not up to the standard of purity, even though the individual be fleshy, the "Discovery" should be used, a teaspoonful or two, three times a day, after meals, in conjunction with plenty of outdoor exercise and the best of food. Where the hemorrhages occur in those having too much blood, the diet must be corrected by the use of vegetables and fruit, diminishing the amount of meat and pastries to a minimum. The amount of fibrin should also be increased by the use of the "Golden Medical Discovery." LOCAL TREATMENT. Of those applied directly to the membrane, Dr. Sage's Catarrh Remedy, used according to the directions which wrap the bottle, is excellent in bringing about a normal condition of the mucous surfaces. Following this, a small amount of Subnitrate of Bismuth may be snuffed into each nostril. Usually the amount required to cover a three-cent silver piece is sufficient. The powder dries the surface and favors the speedy formation of a coagulum, or clotted covering, which effectually checks any further hemorrhage. The application of a firm compress to the upper lip will also diminish the flow of blood through the arteries that run to the anterior portion of the mucous surface. Good effects often follow the use of a small piece of ice applied to the nape of the neck. This, with a reclining posture, will cause contraction of the blood-vessels. If the Subnitrate of Bismuth is not to be readily obtained, the use of any other powder such as starch, finely divided and baked so as to be free from a tendency to form starch paste when applied to a mucous surface, is equally good. Well-browned flour is also serviceable. The use of the contents of a puff-ball, which contains many millions of fine spores, has been employed from time immemorial. The use of such drying powders tends to favor the speedy formation of clots. Where the small points of engorged vessels are to be readily reached, use a solution of the Tincture of Chloride of Iron, one part in four of water, applying with a small pledget of soft cotton wrapped about, or fastened to, the end of a pencil or stick. In this way the solution may be applied in very small amount to the spot where the hemorrhage appears, and will give immunity from future attacks. Any of the styptics (see pages 320-325) can be called into service. Those who have the advantage of the city drug store may use a solution of basic ferric sulphate (Monsell's solution), or the spray of a three or four percent. solution of cocaine. The latter is one of the most pleasant and effective remedies in these emergencies. Before its administration the nasal cavity should be cleansed by snuffing up the nostrils salt and warm water. When washed, immediately apply the spray. If the constitutional condition which led to the hemorrhage continues, the general remedies--of which the "Golden Medical Discovery" is the most efficacious--should be administered. This agent increases the number of red blood corpuscles, and enriches the blood in fibrin, so that the relief obtained is absolutely permanent. INFLAMMATION OF THE STOMACH. (GASTRITIS.) Gastritis is generally defined as an inflammation of the mucous membrane of the stomach. However, the cellular, muscular, and serous tissues are all liable to be more or less affected. Gastritis may be either _acute_ or _chronic_. Either form is a distinct modification of disease, manifesting peculiar symptoms and requiring special remedies. _Acute Gastritis_ generally occurs as a result or complication of other diseases. It is an occasional feature In scarlatina, serious cases of bilious fever, and in cutaneous affections of every description. The mucous membrane of the stomach is placed in intimate communication with all the vital organs, by means of the nerves of the solar-plexus, hence the sympathy between the stomach and skin, and the morbid condition of the stomach occasioned by disease of other organs. THE EARLY SYMPTOMS of acute gastritis are a burning sensation in the stomach, accompanied by nausea and frequent vomiting. The respiratory movements are rapid and shallow, the pulse is hard and short, and as the disease progresses, becomes small, frequent, and thready. The tongue usually retains its natural appearance, but it is sometimes dry and tinged with a vivid scarlet at the tip and edges. Intense thirst and hiccough are occasional symptoms. The facial expression is haggard, and indicative of the most intense suffering. The stomach will not retain the mildest liquids. In the early stages of the disease, the ejections consist of chyme and mucus, streaked with blood. As it progresses, the vomiting becomes a sort of regurgitation, the contents of the stomach being ejected without any apparent nausea or effort. The ejections then consist of a dark-colored granular matter, resembling what is known in yellow fever as _black-vomit_. CAUSES. Formerly it was supposed that this was a very common disorder, and the term _acute gastritis_ was applied to every development of symptomatic fever. But late clinical and pathological investigations clearly indicate that acute gastritis is of rare occurrence. It may be caused by the excessive and habitual use of alcoholic drinks, especially if taken without food, by copious draughts of cold water, or by intense emotions. But its _general_ cause is the ingestion of irritating and corrosive poisons. Where the former causes are known not to exist, the presence of poison should always be suspected. As the cause sometimes becomes a matter of legal investigation, it is very important that the practitioner should be able to determine the _real_ origin. If caused by poison, the disease is very suddenly developed, the patient complaining of a very intense burning sensation in the throat and the lining membrane of the mouth, which will generally show the action of the poison. A diarrhea is also more apt to accompany the disease. If inorganic or vegetable poisons are known or suspected irritants, the appropriate antidotes should be promptly administered. For a list of the principal poisons and their antidotes, with practical suggestions for treatment, the reader is referred to the article in this volume, on Accidents and Emergencies. TREATMENT. The inflammation should be allayed, and a tea made of peach-tree leaves is very serviceable. Small pieces of ice, swallowed, will generally allay the thirst and vomiting, and a mucilage of slippery-elm is very soothing to the inflamed mucous membrane. This is an important disease, and its management should be entrusted to a skillful physician. CHRONIC INFLAMMATION OF THE STOMACH. _Chronic Gastritis_ is sometimes mistaken for dyspepsia or gastralgia. It is very necessary to discriminate between these diseases, as the appropriate remedies of the latter will often only aggravate and augment the former. A chronic inflammation of the stomach is a very common affection and has many phases, but the term chronic gastritis is applied only to that species of inflammation occasioned and accompanied by irritation. It is seldom a result of the _acute_ form. THE SYMPTOMS of chronic gastritis are various and sometimes vague. Among those which are prominent we may mention an irregular appetite. At times it is voracious and the patient will consume every available article of diet, while at others he will experience nausea and disgust at the sight of food. Even when very hungry, one mouthful of food will sometimes produce satiety and cause vomiting. The appearance of the tongue is variable, sometimes natural, at others thickly coated. The desire for drink is capricious, varying from intense thirst to indifference. Another prominent symptom is a sense of heaviness and heat in the epigastric region, after partaking of food. Often a small quantity, as a teaspoonful of milk, will produce a sensation of weight, as a heavy ball lying at the pit of the stomach. This symptom is frequently accompanied by a frontal headache, and a small and wiry pulse. Dull or shooting pains are experienced in the stomach and between the shoulders, and the patient becomes weary, melancholy, and emaciated. CAUSES. The general cause of chronic gastritis is excess in eating or drinking, and the use of alcoholic liquors. We have known it to be produced by drinking _hard_ cider. Great mental excitement predisposes the system to this affection. Occasionally it is a result of febrile diseases, as scarlatina, typhoid fever, etc. In some families there is a constitutional tendency to its development. TREATMENT. All medicines which tend to irritate the stomach, should be studiously avoided. The bowels should be kept regular, and the skin clean by frequent bathing. Stimulants of all kinds must be avoided. As a principle article of diet, we would recommend milk and farinaceous articles. If these precautions be observed, nature will sometimes effect a cure. Lime water and the subnitrate of bismuth, in twenty-grain doses three or four times a day, are useful to allay irritation. Other suggestions applicable to its domestic management, maybe found under the hygienic and medicinal treatment of dyspepsia, to which we refer the reader. NEURALGIA OF THE STOMACH. (GASTRALGIA.) Gastralgia is a neuralgic affection of the stomach, unaccompanied by inflammation. It is sometimes mistaken for chronic gastritis, although there is a marked difference in the symptoms. A PROMINENT SYMPTOM OF GASTRALGIA is a _paroxysmal_ pain radiating from the epigastric region, to all parts of the thoracic cavity. The pain is sometimes lessened by walking, lying on left side, or by gentle pressure, and usually abates after eating, but is renewed in a few hours. The patient occasionally experiences a sense of heaviness at the pit of the stomach, nausea, and frequent salty eructations. The tongue is white, the appetite variable, and there is no desire for liquids. The sleep is usually refreshing, and when not suffering from acute pain, the patient is apparently well. The _distinguishing_ symptom of this disease is a feeling of intense despondency, and, sometimes, a morbid fear of death. An effectual method of distinguishing between gastralgia and chronic gastritis is by the administration of an alcoholic stimulant. If gastritis be the affection the pain will be augmented; whereas, if it be gastralgia, it will be relieved. CAUSE. The cause of gastralgia is a local or sympathetic irritation of the nerves distributed to the stomach. TREATMENT. The pain of gastralgia is sometimes allayed by using half a teaspoonful of subcarbonate of bismuth, and repeating the dose, if the attack is not relieved. The following is a very effectual remedy: take twenty grains of quinine, combined with one drachm of prussiate of iron, and divide it into ten powders, and administer a powder every three hours until the pain is completely arrested. Temporary relief may be given by administering one-quarter of a grain of morphine, or ten to twenty drops of chloroform in a teaspoonful of glycerine, slightly diluted, taken in one dose. One of the most effective remedies for preventing a return of the attacks is that invigorating tonic and alterative, the "Golden Medical Discovery." The patient should be careful in diet, and not eat too much food, which should not only be of a nutritious kind, but easy of digestion. Cleanliness, suitable clothing, bodily warmth, exercise, and rest must not be neglected. Sometimes it is lingering and requires long persistence in hygienic and medicinal treatment. Everything tending to promote the tone of the digestive organs, and improve the functions of the system generally may be considered advantageous in this neuralgic affection. PERITONITIS. The _peritoneum_, or serous membrane which lines the abdominal cavity and invests the intestines, is liable to become inflamed. When this occurs, the affection is termed peritonitis, and may be divided into the _acute_ and _chronic_ forms. ACUTE PERITONITIS. This form may be circumscribed; that is, confined to one spot, or it may extend over the entire surface of the peritoneum, when it is known as _general_. SYMPTOMS. There is headache, quick pulse, tongue coated white, countenance pallid, features pinched, respiration difficult, nausea and vomiting, severe pain in the abdomen, which is extremely sensitive to pressure and becomes very much distended. There is also pain in the limbs, the bowels are constipated, and, in exceptional cases, diarrhea is a prominent symptom. The urine is deficient in quantity, and there is sleeplessness, chilliness, and great general prostration. Vomiting and coughing or sneezing increase the pain. An erect position occasions intense suffering. The patient is compelled to assume a recumbent posture and is inclined to lie on the back, for in that position the sufferer experiences the least pressure of the vital organs against the peritoneum. There is also an inclination to draw up the lower limbs and retain them in a flexed position. CAUSES. Prominent among these are injuries which have been inflicted upon the intestines, compression of the colon, or rectum, perforation of the stomach or bowels, either by violence or some pre-existing disease, thus allowing the discharge of blood, urine, bile, or fecal matter into the abdominal cavity; also abortion, over-exertion, and exposure to wet or cold. As acute peritonitis is always a grave disease, involving more or less danger to life, it is the wisest course to employ a physician and trust the case to his management. The same remark is equally applicable to the chronic form of the disease. CHRONIC PERITONITIS. Like the acute, it may be either _circumscribed_ or _general_. This form is sometimes, though rarely, a sequel of the acute. When it appears independently of the acute, it is generally associated with some cutaneous affection pertaining to the abdominal cavity, and the inflammation is induced by the tumor. If chronic peritonitis be connected with the _tubercular_ diathesis, tubercles may be discovered upon the surface of the stomach and alimentary canal, and may also be found in the lungs and brain. When the affection is not tubercular there will appear in the abdominal cavity an effusion of serous fluid of greater or less quantity, mingled with blood and pus. When such an effusion takes place, the abdomen gradually increases in size, or becomes smaller than is natural. There is pain, attended by soreness upon pressure, and the patient becomes emaciated. Inflammation of the peritoneum is frequently an accompaniment of _puerperal fever_, which is a disease peculiar to childbirth, and which may arise from cold, or be communicated from one parturient patient to another by midwives. TREATMENT. In the remedial management of acute peritonitis, it is obviously necessary to use some agent which will at once influence and change the congested state and inflammatory condition. One of the best agents employed to make a decided impression upon the vascular system, subdue inflammation, and modify its action, is the fluid extract of veratrum viride, administered in full doses, and repeated until the system shows its effects in a decided manner. Warm fomentations applied to the abdomen are sometimes very serviceable, and are objectionable only because of their liability to dampen the bed-clothes. When the abdomen will bear a thick, warm poultice, apply it, and then cover the entire surface with oiled silk. The tincture of opium, in doses sufficient to relieve pain and quiet the peristaltic action of the intestines, is generally necessary. EPIDEMIC CHOLERA. This is an epidemic disease, supposed to be due to an impalpable specific poison, but as to the exact nature of this poisonous matter nothing definite is known. This plague first made its appearance on our continent in 1834. Owing to its great fatality, it is a disease much to be dreaded. SYMPTOMS. These are well defined. It is characterized in its earlier stages by pain in the stomach and bowels, especially in the umbilical region, nausea, vomiting, diarrhea; later, the purging is excessive, and the matter dejected resembles rice-water, and contains white, solid, curd-like matter. The patient loses strength, and sinks rapidly. The secretory organs fail to perform their functions normally, the skin is sometimes moist, but oftener cold and dry; but little if any bile is found in the excretions, and the urine voided is very scanty. There is general nervous derangement, as indicated by the spasmodic contraction or cramping of the muscles. This first attacks the extremities, but soon affects the entire body, and gives rise to excruciating pains. The head is affected by singing, roaring, disagreeable noises in the ears, the pulse is feeble, but quick, the nails are of a bluish color, the tongue is coated white, the eyes are sunken, and the patient has a corpse-like appearance; the temperature of the body rapidly falls, the surface becomes deathly cold, and, unless the disease is promptly arrested in its course, speedy dissolution follows. The disease is rarely prolonged beyond twenty-four hours, and sometimes terminates within three or four hours after its first attack. TREATMENT. The kind of medicine required depends upon the severity of the attack and stage of the disease. In all cholera epidemics, there are premonitory symptoms, such, as an uneasy sensation at the pit of the stomach, and a rumbling of the bowels. This is apt to be followed by a painless diarrhea, which occasions no alarm, and the patient pays but little attention to it. Herein is the great and dangerous mistake. The patient is already in the stage of _invasion_, which must be promptly arrested, or he will suddenly be precipitated into the stage of _collapse_. The patient should lie down, and have placed about him bottles filled with hot water, thereby exciting warmth upon the surface of the body. At the same time, administer two teaspoonfuls of the Extract of Smart-weed. If the symptoms are urgent, repeat the dose every fifteen minutes. Brandy, thickened with sugar, may also be given. In either the stage of _invasion_ or _collapse_, the leading indication is to establish _reaction_ by promoting perspiration. Bathe the feet in water as hot as can be borne, give the Extract of Swart-weed freely, and thus endeavor to excite profuse diaphoresis. No time should be lost, for delays are dangerous. When the reaction is established, the patient should remain quiet, and not attempt to exert himself. After reaction has taken place, the sweating should be maintained for twelve hours, and the patient should drink slippery-elm tea and toast-water, and partake sparingly of soft toasted bread and chicken broth. The food should be fluid and nutritious, but taken in small quantities. Do not disturb the bowels with laxatives until the third day after the patient begins to improve, and then they may be moved by an injection of warm water. Great care should be taken that the patient does not indulge too soon or too freely in the use of food. When a skillful physician can be had, no time should be lost in securing his services, but since in epidemics of this nature, medical men are generally overworked, and not always easily and promptly to be had, we have been quite explicit in giving full directions for treatment. CHOLERA MORBUS, also known as _sporadic cholera_ and _simple cholera_, usually occurs during the summer months. The attack may be sudden, although it is usually preceded by a sensation of uneasiness and colicky pains in the stomach. SYMPTOMS. Nausea, vomiting and purging are the most prominent symptoms. The discharge from the bowels is at first of a thin, yellow appearance, but finally it becomes almost colorless. Sometimes, after the contents proper of the bowels have been evacuated, the dejections have a bilious appearance. Severe cramps and pain accompany the vomiting. The vomiting and purging usually occur in paroxysms, but finally become less frequent, a reaction takes place, the extremities grow warm, and the patient gradually recovers. It may be accompanied by intense thirst and a quick pulse, yet the surface may be cool. CAUSES. Cholera morbus is most prevalent in warm climates, and especially in malarial districts. It is generally the result of eating indigestible articles of food, such as unripe fruit or uncooked vegetables. Stimulating drinks, or those articles which furnish the elements for fermentation, also favor the production of this disease. TREATMENT. If the attack be superinduced by eating unripe or stale fruit, it may be proper to give an emetic or a cathartic, but ordinarily first give a full dose of the Extract of Smart-weed, and, if the vomited matter is very sour, give the patient a weak, alkaline drink, which may be made by dropping a few live, hard-wood coals into a tumbler of water. This will not only assist in neutralizing the acidity of the stomach, but will help to allay the thirst and accompanying fever. If the patient throw up the first dose of the Extract of Smart-weed, a second should be given. Do not allow the patient to drink cold water, and give only tablespoonful doses of the alkaline solution every thirty minutes. If the thirst is great, occasionally give a tablespoonful of a tea made from scorched Indian meal, which not only allays the desire to drink, but also the irritation of the stomach. If to be obtained, give a tea of the leaves or bark of the peach tree. The patient should be well covered in bed and kept warm. Laudanum by the stomach, or by enema, may he necessary in severe cases to relieve the pain and check the purging. Hot fomentations applied to the bowels are very valuable. A mustard plaster applied over the abdomen will assist materially in relieving the nausea and vomiting. It should not be left on sufficiently long to blister. When the affection is promptly treated as we have suggested, the patient generally quickly recovers. If, however, it does not yield to these measures, the family physician should be called in. ACCIDENTS AND EMERGENCIES. Accidents and emergencies which require immediate attention frequently occur. Professional aid cannot always be quickly obtained and hence fatal results often follow. It is, therefore, important that all persons should not only know how to proceed under such circumstances, but that they should be able to exercise that deliberation and self-control so necessary in emergencies of all kinds. Most persons are more or less affected by the sight of blood or severe wounds, and it requires an effort to maintain self-possession. One should act resolutely; otherwise he will find himself overcome and unable to render any assistance. WOUNDS. Wounds may be classified as _incised, punctured, contused, lacerated_, or _poisoned_. _Incised_ wounds are those which are made with a sharp, cutting instrument, and are characterized by their extent of surface. _Punctured_ wounds are made with a pointed instrument, and distinguished for their depth rather than breadth. _Contused_ wounds are those produced by bruises. _Lacerated_ wounds are those in which the flesh is torn and mangled. _Poisoned_ wounds are made with a poisoned instrument, or by some poisonous reptile or insect or rabid animal. [Illustration: Fig. 1. The field Tourniquet as applied. ] In all cases of wounds, the immediate danger is in the _shock_ produced upon the nervous system, and in the liability to _hemorrhage_. SHOCK. If severe, the shock is attended with symptoms of extreme prostration, such as a feeble pulse, shivering, partial unconsciousness, fainting, hiccough, vomiting, and involuntary discharges of the urine and feces. [Illustration: Fig. 2. Mode of employing flexion for the arrest of hemorrhage from a wound located below the elbow. ] TREATMENT OF SHOCK. The clothing should be loosened immediately after the accident, so that the blood may have free circulation, and the patient should be kept in a recumbent position. He should have plenty of fresh air. Camphor or ammonia may be inhaled. If he can swallow, stimulants may be given, as whiskey or brandy, but with care that they do not run into the trachea, or windpipe. If he be unable to swallow, they may be administered as injections, but should gradually be discontinued as reaction takes place. A warm pillow placed at the back and the use of electricity may be beneficial. HEMORRHAGE, or bleeding, may generally be controlled by a _compress, tourniquet, flexion of the joint_, or _styptics._ A _compress_ consists of several folds of cloth laid upon a wound, the edges of which have been brought together, and made secure by a moderately tight bandage. [Illustration: Fig. 3. Mode of employing flexion for the arrest of hemorrhage from a wound below the knee.] _A tourniquet_ may be extemporized by rolling a handkerchief into a cord and tying it around the limb, over a compress, between the wound and the heart. A stick should then be thrust between the handkerchief and skin and twisted around several times, until the pressure is sufficiently great to arrest the circulation of the blood in the wounded part. A representation of this operation may be seen in Fig. 1. [Illustration: Mode of employing flexion for the arrest of hemorrhage from a wound located between the thigh and knee.] _Flexion of the joint_, as represented in Figs. 2, 3, and 4, is adapted to many cases of hemorrhage. As water cannot flow through a rubber tube bent at a sharp angle, so the acute flexion of a limb prevents the free flow of blood through the arterial tubes. In some cases, _styptics_ may be directly applied to the wounded tissues. Cold acts as a powerful styptic, and may generally be made available for arresting hemorrhage. POISONED WOUNDS. The treatment of these should chiefly consist in the prevention of the spread of the poison. This may be done by tightly applying bandages above the wound and scarifying or sucking the parts. Nitrate of silver may then be used and the ligatures removed. Alcohol, in any form, is an antidote to snake poison. For the stings of insects, apply aqua ammonia, fresh earth, raw onion, plantain, or spirits of turpentine. FRACTURES AND DISLOCATIONS. The treatment of injuries received from the fracture of bones and the dislocation of joints should never be attempted by the inexperienced, nor should the management be left to incompetent physicians but _skillful_ surgical aid should at once be summoned. SPRAINS. A sprain consists of a sudden and forcible stretching of the ligaments and tendons connected with a joint, without there being any dislocation. It is attended with severe pain and is followed by rapid swelling. The treatment should consist of measures to prevent inflammation, promote absorption, and restore a healthy action. The affected part should be kept at rest in an elevated position, and hot or cold water applied frequently. If there is much inflammation, fomentations of hops may be used. The Compound Extract of Smart-weed is an excellent application. When the acute symptoms have disappeared, absorption should be favored by systematic rubbing and the application of stimulating liniments, or by the use of a well-adjusted bandage. Passive motion may be resorted to gradually and the subject may use the joint moderately. Should any stiffness remain, warm salt water douches should be employed and the Extract of Smart-weed applied once a day. BRUISES. Bruises or contusions are caused by falls, wrenches, or blows from blunt instruments, without breaking the skin. The soft tissues are lacerated and blood is poured out into them, constituting _ecchymosis_. The discoloration passes through various shades from a bluish-black to a violet, a green, and finally, a yellow. If the bruise is severe, the affected part should be kept at rest and frequently bathed with the Compound Extract of Smart-weed or the tincture of arnica. If inflammatory symptoms supervene, fomentations and poultices should be applied. FOREIGN BODIES IN THE NOSE. Foreign bodies, such as beads, peas, coffee-grains, and small gravel-stones are occasionally introduced into the nostrils of children, becoming fastened there, and causing great anxiety and alarm. If allowed to remain, they generally cause inflammation and suffering. Such bodies may generally be washed out by gently injecting a stream of tepid salt water with a syringe or Dr. Pierce's Nasal Douche. In no case should force be used. If these means fail, a competent surgeon should be consulted. FOREIGN BODIES IN THE THROAT AND AIR-PASSAGES. Foreign bodies are generally arrested so high up that they may be seen by simply depressing the tongue, and removed with the finger or a pair of forceps. The head should be thrown back in such a position as to cause the chin to project as little as possible beyond the prominence known as Adam's apple, in order that the finger or forceps may be readily introduced and the body released and ejected. When the foreign bodies are so small as to pass out of sight in the larynx, windpipe, or esophagus, it is generally difficult to extract them, and the services of a surgeon are required. Fortunately, however, there is not much immediate danger from suffocation in such cases. DROWNING. Recovery from drowning sometimes occurs when life is apparently extinct. The treatment, however, should be immediate and energetic, and should be given in the open air, unless the weather be too cold. TREATMENT. The patient should be gently placed upon the face with his wrists under his forehead. The tongue will then fall forward and the water run out of his mouth and throat, while the windpipe, or air-passage, will be free. To restore respiration, he should be instantly turned upon his right side, his nostrils excited with snuff or ammonia, and cold water dashed upon his face and chest. If this operation prove unsuccessful, replace the patient upon his face, care being taken to raise and support his chest, turn the body gently on the side and quickly again upon the face. Alternate these movements about every four seconds, and occasionally change sides. When the body is turned on the face, gentle but efficient pressure should be made along the back, between the shoulder blades, to assist in forcing the air out of the lungs, but this pressure ought to be removed before the patient is turned back on his side. Persistently repeat this operation, and success will often be the reward. As soon as respiration is established, warmth may be promoted by the application of warm flannels to the body and bottles of hot water to the stomach, armpits, thighs, and feet. During the entire process of restoration, the body should be thoroughly rubbed _upwards_. Turning the body upon the back or handling it roughly should be avoided. The person should not be held up by his feet, or be rubbed with salt or spirits. Rolling the body on a cask is improper, and injections of the smoke infusion of tobacco are injurious. Avoid the constant application of the warm bath, and do not allow a crowd to surround the body. FAINTING. When a person faints, _he should be allowed to remain or be placed in a recumbent posture_, and his clothing immediately loosened. The extremities should be rubbed, the patient permitted to have plenty of fresh air, and, if at hand, ammonia or camphor should be applied to the nostrils. BURNS AND SCALDS. The danger arising from burns and scalds depends not only upon the extent of surface involved, but also upon the depth of the injury. Burns are most dangerous when occurring upon the head, chest, or abdomen. TREATMENT. Soothing applications, and those which will exclude the air, should be made. Grated potato, poultices of slippery-elm, sweet oil, cotton saturated in a mixture composed of two or three grains of carbolic acid and two ounces of glycerine, and linseed oil and white lead, are all beneficial for the treatment of burns. If internal treatment be necessary, it should be given under the direction of a competent physician. SUN-STROKE. In cases of sun-stroke, the patient should be at once removed into the shade. If the face is _flushed_, apply cold water to the head and neck, and mustard to the feet. The body should be bathed in tepid water and the head slightly elevated. If the countenance is pale, the symptoms denote exhaustion, and the patient should be kept in a recumbent position, the extremities rubbed, camphor and ammonia inhaled, mustard applied to the spine, and stimulants, such as brandy or whiskey, should be administered. POISONS AND THEIR ANTIDOTES. ----------------------+-------------------------------------------------- POISONS. | ANTIDOTES. ----------------------+-------------------------------------------------- ACIDS. | | Acetic Acid. | Alkalies--carbonate of soda and potash--also Citric Acid. | lime and magnesia are antidotes to these Muriatic Acid. | poisons. As soon as the acid is neutralized, Tartaric Acid. | mucilaginous teas, such as flax-seed, gum | arabic, or slippery-elm, may be given. | Sulphuric Acid | Soap, in solution, or magnesia will counteract (Oil of Vitriol). | its influence. Water should _not_ be given | as it causes great heat when mixed with this | acid. | Nitric Acid | Lime-water, carbonates of lime and magnesia (Aqua Fortis). | in solution, are the only antidotes. Give Oxalic Acid. | mucilaginous drinks. | Carbolic Acid. | There is no special antidote. Oil, glycerine, | milk, flour and water, white of eggs, | magnesia, and flax-seed tea may be used. | Prussic Acid. | Ammonia, by inhalation or in solution, may Laurel Water. | be used. Apply a cold _douche_ to the head. Oil of Bitter Almonds.| | These agents are | speedily fatal. | | ----------------------+-------------------------------------------------- | ALKALIES. | | Liquor of Ammonia. | Vegetable acids, such as vinegar, lemon-juice, Water of Ammonia. | citric and tartaric acids, neutralize this Muriate of Ammonia. | poison. | Liquor of Potassa. | All the fixed oils, such as linseed, castor Nitrate of Potassa | and sweet oil, also almonds and melted lard (Saltpetre). | destroy the caustic effects of these poisons Carbonate of Potassa | Mucilaginous drinks may be given. (Pearlash). | Salts of Tartar. | --------------------+----------------------------------------------------- POISONS. | ANTIDOTES, --------------------+----------------------------------------------------- | IODINE. | Starch, wheat flour mixed with water, In its | whites of eggs, milk, and mucilaginous different forms. | drinks are excellent antidotes. | --------------------+----------------------------------------------------- | VOLATILE OILS AND | AGENTS. | | The same antidotes as in case of poisoning Creosote | with iodine may be used in this, or the (Oil of Smoke). | stomach may be evacuated with an emetic or a Oil of Tar. | stomach-pump. Oil of Turpentine. | | --------------------+----------------------------------------------------- | A powerful emetic of white vitriol or mustard | should be given at once, cold should be ALCOHOL. | applied to the head, and the extremities | vigorously rubbed. | --------------------+----------------------------------------------------- ANTIMONY AND ITS | COMPOUNDS. | If vomiting has not occurred, induce it by | tickling the throat and giving large draughts Tartar Emetic | of warm water, after which administer Butter of Antimony | astringents, such as infusions of galls, oak bark, Oxide of Antimony. | Peruvian bark, or strong green tea. | --------------------+----------------------------------------------------- | ARSENIC AND ITS | COMPOUNDS. | | White Arsenic. | Oils, or fats lard, melted butter, or milk Yellow Sulphuret of | should be given, then induce vomiting with Arsenic | sulphate of zinc, sulphate of copper or Red Sulphuret of | mustard; fine powdered iron rust or magnesia Arsenic | may be given every five or ten minutes. King's Yellow. | Mucilaginous drinks should be given as soon Fly Powder. | as the stomach is evacuated. Arsenical Paste. | Arsenical Soap. | Scheele's Green. | Paris Green. | | --------------------+----------------------------------------------------- COPPER AND ITS | COMPOUNDS. | Avoid the USE of vinegar. Give albuminous | substances, such as milk, whites of eggs, wheat Blue Vitriol | flour in water, or magnesia; yellow prussiate Verdigris. | of potash in solution may also be given freely. | --------------------------+------------------------------------- POISONS | ANTIDOTES. --------------------------+------------------------------------- LEAD AND ITS COMPOUNDS. | In lead, or painters' colic purgatives | and anodynes may be given, together Acetate of Lead | with large doses of iodide of (Sugar of Lead) | potassium. White Lead. | Red Lead. | Litharge. | --------------------------+-------------------------------- MERCURY AND ITS | COMPOUNDS. | Albumen in some form should be | given; if the poison is not Corrosive Sublimate. | absorbed, follow with a mustard White Precipitate. | or lobelia emetic. Red Precipitate. | Calomel. | --------------------------+----------------------------------- ACRONARCOTICS. | | The general treatment indicated for Ergot | this class of poisons, is to Black Hellebore. | evacuate the stomach with a Veratrum Viride | stomach-pump or an emetic composed (American Hellebore). | of fifteen or twenty grains of Aconite. | sulphate of zinc or copper, or large Foxglove. | doses of mustard, repeated every Gelseminum. | quarter of an hour until the full | effect is produced. | Belladonna. | Morphine, sassafras, iodine, and Stramonium. | stimulants. | Nux Vomica. | Large doses of camphor, chloroform, Strychnia. | and tobacco, may all be beneficial. | Poison Oak. | Muriate of ammonia, in solution, may Poison Vine. | be applied externally, and from ten | to fifteen grains given internally; | soda is also useful. --------------------------+----------------------------------- NARCOTICS | | White Henbane. | Sassafras may be used as an antidote Opium. | for henbane. Belladonna is an | antidote of opium; cold water should | also be applied to the head | of the patient, and the extremities | should be well rubbed. --------------------------+----------------------------------- ANIMAL POISONS. | Excite vomiting by drinking sweet | oil. Sugar and water, milk, or Spanish Fly. | linseed tea in large quantities, and Potato Fly. | emollient injections are valuable. | POSTERIOR SPINAL CURVATURE. (HUMPBACK.) Posterior curvature of the spine, sometimes known as Pott's Disease, occurs most frequently in children, and is generally developed before the seventh year. Children of a scrofulous diathesis are especially liable to this affection. It is generally due to disease of the inter-vertebral cartilages and bodies of the vertebræ. It comes on in a slow, insidious manner, hence, it often makes serious inroads upon the spine and system before its character is even suspected. [Illustration: Fig. 1. The above portion of the spinal column shows the manner of the breaking down of the vertebræ from caries, and the absorption of their bony structure.] Generally the first point of invasion is the cartilaginous substances between the bodies of the vertebræ, beginning with inflammation, and finally resulting in ulceration and a breaking-down of the cartilages. It next invades the vertebræ themselves, and producing caries, or death and decay of the bony substance, which softens and wastes away, as shown in Fig. 1. The vertebræ become softened and broken down, and weight of the body pressing them together produces the deformity known as "humpback." (See Fig. 2 and Fig. 3.) SYMPTOMS. Among the various symptoms present in the earlier stages of the disease, and during its progress, we deem it necessary to mention only a few of the more prominent ones. While the patient is yet able to go around, the disease manifests itself by occasional pain in the bowels, stomach, and chest. Often there is a hacking cough, nervousness, lassitude, and a generally enfeebled condition of the whole system. The patient is easily fatigued; there is apparent loss of vitality, impaired appetite, a feeling of tightness across the stomach and chest, gradually declining health, and loss of flesh and strength, torpidity of the liver, deficient secretions, constipation, and morbid excretions from the kidneys. The victim, in passing chairs, tables, and other objects, instinctively places his hands upon them, and, as the disease progresses, when standing, leans upon some support whenever possible. In walking, he moves very carefully and cautiously, with elbows thrown back and chest forward, to assist the body in keeping its equilibrium. The body being kept in an upright position, the patient bends the knees rather than the back in stooping, as illustrated in Fig. 5, and the body is frequently supported by the hands being placed upon the thighs or knees. Sudden movements or shocks cause more or less pain. The development of the disease then becomes rapid; suffering increases, and pain about the joints and lower extremities and muscles of the posterior part of the pelvis is experienced; numbness and coldness of the extremities are felt; locomotion becomes more difficult, and a slight projection is observed upon the back. Even in this somewhat advanced stage of the disease, when the symptoms are so apparent, many cases are shamefully neglected because an ignorant adviser says it is nothing serious and that the patient will outgrow it. The pain and tenderness not always being in the back, the inexperienced are very often misled as to the true character of the trouble. This distortion or deformity of the back now becomes painfully prominent; the diseased vertebræ quickly soften and waste away; the pressure upon the spinal cord increases, and paralysis of the limbs supervenes; the power of locomotion is lost, and, at last, the danger is realized and the struggle for life begins. [Illustration: Fig. 2.] [Illustration: Fig. 3.] Thus, through ignorance, neglect, and improper treatment, the poor, helpless victim is doomed to a life of hideous deformity and suffering. We would, therefore, urge upon parents whose children are afflicted with this terrible disease, the great importance of placing them under the care of surgeons who have for many years made the treatment of such cases a specialty, and who have every facility and all necessary surgical appliances for insuring success in every case undertaken. [Illustration: Fig. 4. Appearance of a child suffering from Pott's disease of the spine.] [Illustration: Fig. 5. Mode of stooping adopted by a child suffering from spinal disease.] TREATMENT. The great essentials for the successful treatment of disease and deformities of the spine are first, a thorough knowledge of the structure and parts involved by the disease; secondly, the adjustment of mechanical appliances perfectly adapted to the requirements and necessities of each individual case, and the proper use of our system of "vitalization," applied to the spinal muscles to strengthen the weaker and relieve the undue contraction of the stronger. For many years our specialists have experimented, and have given the various appliances in common use in these cases most thorough and practical tests, and have found them very defective, being generally constructed upon wrong principles. The physician who sends to a mechanic for an appliance, such as are now made in the shops of most instrument makers, and uses the same, is doing himself an injustice, and barbarously torturing his patient by forcing him to wear an apparatus which is heavy, clumsy, and inevitably injurious, instead of being beneficial in its results. In the treatment of diseases and deformities of the spine, there should be no compromising; the appliance that fails to give complete support should not be worn. In our treatment of these maladies we employ only appliances which are constructed under the personal supervision of our specialists, upon principles dictated by common sense and the actual necessities of the case. We do not confine the body in an iron jacket. Our apparatus is light, yet durable, and is worn by the most delicate children without pain or inconvenience. It gives proper support to all parts, and is so nicely adjusted as to produce pressure only upon those points which should receive support, leaving the muscles of the spine freedom of action, thereby assisting in their development. In many hundreds of cases treated by our specialists, the disease has been entirely cured and the deformity removed. After seeing the patients and adjusting the appliances, they can generally be treated at their homes. LATERAL CURVATURE OF THE SPINE. (CROOKED BACK.) [Illustration: Fig. 6. Lateral curvature of the spine. E to F, the primary curve.] [Illustration: Fig. 7. A mild case of lateral curvature of the spine.] This deformity appears more frequently in anæmic persons, in whom the flexibility and elasticity of the muscles are weakened, than in those of a plethoric habit. It is generally contracted during youth, between the ages of twelve and eighteen. Persons of sedentary and indolent habits are especially liable to this deformity, hence, girls are most frequently its victims. It is never seen among the natives of tropical countries who habitually live in the open air, and seldom among the barbarous races of northern latitudes. A distinguishing feature of the American Indian is his erect carriage. The _primary_ curvature is generally toward the right side, as represented in Figs. 6 and 7. Figs. 8 and 9 show the disease in a more advanced stage. The ribs are thus forced into an unnatural position, and the vital organs contained in the cavity of the chest are compressed or displaced, thus distorting the form of the whole upper portion of the body. [Illustration: Fig. 8. Lateral curvature in an advanced stage. ] [Illustration: Fig. 9. Lateral curvature in an advanced stage. ] SYMPTOMS. The first indication of lateral curvature of the spine is a marked projection of the right scapula, or shoulder-blade. It is sometimes first observed by the dressmaker, or, accidentally, while bathing. The right shoulder is slightly elevated, while the left hip is depressed and projects upward. If not corrected while in its earlier stages, it progresses very rapidly, and a second curvature is developed. The symptoms vary in different cases, and in the early stages are somewhat obscure and undefined, but generally the patient feels a sense of uneasiness, languor, stupor, and nervousness, loss of energy and ambition, general debility, poor appetite, gradually declining health, loss of strength and flesh, and, as the disease progresses, a slight elevation of one of the shoulder-blades is noticed, as well as the deviation of the spine to one side. The curve, or distortion, of the spine increases more rapidly as the body becomes heavier, the spine often assuming the shape of the letter S, and, from compression by torsion of the vertebræ and distortion of the ribs, the vital organs are encroached upon, causing serious functional derangement of the heart, lungs, liver, and stomach, producing, as its inevitable consequence a list of maladies fearful to contemplate. CAUSES. In rare instances, the lateral curvature of the spine is due to defects of certain bones of the pelvis or limbs. Cases are recorded in which this deformity was caused by diseases of the abdominal organs, but, as we have intimated, it is generally due to a lack of tonicity of the muscles, or, as a late writer has expressed it, "Want of correspondence in the antagonism of those muscles which control the motions of the spinal column." Habitual sitting or standing in a leaning posture, or standing upon one foot, thus constantly using one set of the muscles of the back, while the other becomes enfeebled by the lack of exercise, is a common cause of this deformity. The habit which so many school-girls contract of drawing up one foot under the body while sitting, often produces a lateral curvature of the spine. TREATMENT. No disease or deformity of the spine is so easily cured and perfectly corrected, if the proper plan of treatment is pursued. To correct this deformity, many ingenious forms of apparatus have been devised and invented by our specialists, which should be carefully adjusted to each individual case. In addition to this, our method of treatment by "vitalization," and by mechanical movements and manipulations, is almost indispensable in these cases. It never fails to give relief, and, if properly pursued, invariably results in a permanent cure. DEFORMED FEET, HANDS AND LIMBS. There are thousands whose feet, hands, and limbs are almost entirely useless, besides having an unsightly appearance. Their condition has been helpless so long, their treatment so varied, and their hopes of relief or cure have been so often disappointed, that few can believe the truth of our statement, when we positively assert that we can correct and cure nearly all cases of talipes, club, or crooked feet and deformed hands, and make them as perfect in appearance, and as useful in action, as feet and hands which have never been deformed. While this may seem miraculous, or even impossible, to those who are unacquainted with the wonderful improvements and rapid progress made in this department of surgical science, it is attested and verified by living witnesses whose feet and hands were once deformed and useless, but which have been made perfect by our new and improved method of treatment. We do not make these statements in a spirit of vain boastfulness, but having devoted many years to improving and perfecting surgical appliances and apparatus, and having had practical experience in the successful treatment of thousands of cases, we do say that our manner of treatment is original and employed only by us. We entirely ignore the ineffectual methods usually employed in such cases. Our treatment causes no pain, and little inconvenience, yet the curative results are speedy and certain, and a hundredfold more satisfactory than those obtained by any other course. [Illustration: Fig. 10. Talipes Equinus.] [Illustration: Fig. 11. Talipes Calcaneus.] We have most thoroughly tested all the best forms of treatment heretofore devised and employed in this class of diseases, and have adopted the best features of all the various methods heretofore pursued. We have combined these with our own improvements and, as the result, we have perfected a thorough and efficient system of treatment, based upon scientific principles. [Illustration: Fig. 12. Talipes Valgus.] [Illustration: Fig. 13. Double Club-foot.] [Illustration: Fig. 14. Bow-legs.] [Illustration: Fig. 15. Knock-knees.] [Illustration: Fig. 16.] [Illustration: Fig. 17.] [Illustration: Fig. 18.] [Illustration: Fig. 19.] [Illustration: Fig. 20.] [Illustration: Fig. 21.] [Illustration: Fig. 22. The above illustrations represent various Deformities cured by our Specialists at the Invalids' Hotel and Surgical Institute.] * * * * * MECHANICAL AIDS IN THE TREATMENTS OF CHRONIC DISEASES. We have, in different parts of this work, referred to a large variety of ingeniously devised machinery and apparatus employed at the Invalids' Hotel and Surgical Institute, in the treatment of chronic diseases. Although we can, on paper, give but a meagre idea of the variety and adaptability of these valuable mechanical appliances, yet we will endeavor to illustrate and explain a few of our machines for the application of transmitted motion. [Illustration: Fig. 1. The Manipulator. ] Fig. 1 represents a machine, called the Manipulator, which transmits motion through suitable attachments, which are adjustable by means of the ratchet _G_, so as to reach all parts of the body. It is equally available for applying motion to the head, feet, or any intermediate part of the body. _B, B_ are rubbing attachments, with two opposing elastic, adherent surfaces, between which an arm or a leg may be included. These have alternate reciprocating action from the rock-shaft _H_, and are made to approach each other, and press the included part at the will of the patient. This is sometimes called the double-rubber, and is made detachable if desired. _A_ is the lever, by which the two parts of the double-rubber are made to compress the arm or leg. [Illustration: Fig. 2. Manipulator Extended.] [Illustration: Fig. 3. Manipulator Folded.] _D_ is a single attachment for rubbing. It may be connected at either side of the machine, so as to present the rubbing surface in four different directions, as may be most convenient. It will act perpendicularly, horizontally, or diagonally, and from below or from above the part receiving the action, according to requirements. The shank of the rubber may have any special form to suit special cases. _C_ is the _foot holder._ It communicates to the leg the semi-rotary or oscillating motion of the rock-shaft. It may be attached to either end of the rock-shaft. _E_ is the _hand holder,_ which, grasped by the hand, communicates motion to the arm, shoulder, and chest; or the hand may be inserted passively, when the effect of motion is more confined to the hand and fore-arm. In the position shown in Fig. 2, by means of the single rubber attachment, the manipulator acts upon the upper portion of the trunk, neck, head, and arms; by means of the hand-holder, upon the arms; by means of the double-rubber, upon the arms, shoulders, and scalp. [Illustration: Fig. 4. Rubbing the Arms.] When the acting part or head is lowered to its extreme limit, the machine occupies the least space. In this position, by means of the foot-holder it communicates oscillation to the legs; by means of the single-rubber, it acts upon the feet, ankles, and lower leg; by means of the double-rubber, it acts upon the legs, including the feet, the patient either sitting or lying. In all of these applications of motion, energy travels from inanimate to animate matter; non-vital contributes to vital energy: and the various processes through which vital power is developed are promoted and carried forward in a degree till the point which constitutes health is attained. [Illustration: Fig. 5. Rubbing the Legs.] The name, _Manipulator_, is very naturally applied to the instrument, the action of which resembles so much that of the living operator. It is, however, impossible for the unaided hand to impart the degree of rapidity necessary to secure the effects easily attained by this machine; and, practically, restoration is often secured in cases in which it is quite unattainable by any other remedial agent. [Illustration: Fig. 6. Rubbing the Chest and Abdomen.] Motion, transmitted by the manipulator, exerts a curative effect in _all_ chronic affections, and is not limited, as is sometimes supposed, to paralytic affections and deformities. In these latter affections it is a great assistance in effecting a cure; while, in chronic affections, whatever the local symptoms, it supplies the additional energy which is indispensable for recovery in all diseases of long standing. [Illustration: Fig. 7. Rubbing the Back.] _Mode of Operation_.--Fig. 4 represents the manipulator in operation. The machine is propelled by steam power at the Invalids' Hotel and Surgical Institute, but may be worked by hand, as here represented. One arm is inserted between the double-rubbing pads, which are raised to about the height of the shoulders, the patient being seated at the side of the machine; the other hand is placed on the lever, and as much pressure is applied as is perfectly agreeable, care being taken to diminish the pressure at any part which is unusually sensitive. All portions of the arm from the shoulder down are successively included in the rubbers, while a suitable degree of reciprocating or rubbing action is obtained by giving motion to the wheel. To apply the same operation to the other arm, the patient may either turn in his seat or change his position to the opposite side of the machine. If any portion of the extremity is affected with inflammation or swelling, it is necessary to apply the action described to the whole of the unaffected portion first; after this the affected part may be beneficially operated on, provided that the sensations are strictly heeded, and that it is so managed that only a comfortable feeling is produced. [Illustration: Fig. 8. Oscillating the Arms and Chest.] In Fig. 5, the patient is so seated beside the machine that he can insert one thigh between the pads of the rubber, and also control the lever with the hand. It is sometimes more convenient to suspend a movable weight from the lever. While the machine is running, he can withdraw the leg gradually, as each portion receives its proper amount of action, till the whole, including the foot, becomes glowing with the effect. The boot or shoe affords no impediment to the effect, and should remain on. [Illustration: Fig. 9. Oscillating the Legs.] Sometimes, especially in the beginning, or when the feet are habitually cold, it is better to apply the action only from the knees down. The rubbing-pad (d) may be attached to either side of the machine, according to convenience or effect sought. The action derived from the right end of the rock-shaft is much less severe than that from the left, on account of the shape of the rubber appendage, and at the beginning should be used in preference. In Fig. 6, the patient sits on an ordinary stool, or, if feeble, in a chair, and presents any portion of the chest or abdomen to the action of the rubber. The instrument is raised or lowered to suit convenience, while the patient gently presses portions of the trunk successively upon the rubbing-pad. The degree of the effect is thus always under the absolute control of the one receiving the action. This operation, like the preceding, produces great heat, reddens the skin, relieves pain, and greatly stimulates the functions, not only of the skin, but of the organs contained in the cavities of the chest and the abdomen. [Illustration: Fig. 10. Vibrator operated by Manipulator.] The same operation may be applied also to the legs while the patient is standing. In Fig. 7, the back is presented to the action of the rubbing-pad. The action will, if desired, be made to reach from the neck to the hips, and even to the thighs. All sensitive portions of the back should at first be omitted, in order that they may be benefited by the counter-irritation or drawing away of the blood. This is easily produced by those familiar with the use of the machine. The rubbing of the back should be deferred till the close of each application, in order that the spinal centers may be relieved of hyperaemia, or excess of blood. The machine, as represented by Fig. 8, is brought to the desired elevation, about as high as the shoulders, and the hand-holder is attached. One arm is extended horizontally, and the hand grasps the hand-holder, while rapid motion is given by turning the wheel. An alternate twisting motion is communicated to the arm, which causes corresponding pressure and relaxation of all the soft tissues of the limb, combined with slight rubbing or attrition. The action is increased by contracting the muscles, and also by grasping at greater distance from the center. Both hands may grasp at the same time, or the two sides may receive the motion in turn. The effect is similar to that of the rubbing before described, but it is less limited; by grasping firmly, it may extend to the whole chest. [Illustration: Fig. 11. Vibrating Kneader.] The foot-holder is attached, as shown in Fig. 9, and brought by the means before described to a position to receive one foot at a comfortable elevation, the leg being extended, while the patient is seated in an ordinary chair in an easy position. The action is precisely like that above described as applied to the arm, and extends to the thigh and pelvis. If the knee is slightly flexed, the action is almost entirely confined to the lower leg. Each leg may be operated on in turn. _Mode of Applying Mechanical Movements to Very Feeble Invalids_.--Experience demonstrates that no degree of feebleness excludes the beneficial use of these operations. Invalids too weak to stand, or able to help themselves in the least degree are often treated with perfect success. A judicious use of the Manipulator _always_ increases nutrition and strength without any fatigue or exhaustion, however feeble the patient may be. It is only necessary to provide for these cases additional conveniences, so that the applications can be made in the recumbent position, and also that proper intervals of rest be allowed between successive operations. For this purpose couches are provided, each containing a certain portion of the Manipulator. These are operated by means of a short connecting-rod, joining the rock-shafts of the two pieces of mechanism, as shown in Fig. 10. The Vibrator has two small discs, or heads acting through an opening in the couch on which the invalid rests. These impinge with a rapid, direct stroke upon the portion of the body exposed to the action. The top of the couch is adjustable, and is quickly placed at the elevation which secures the proper force of the instrument, as shown in Fig 11. By simply turning and moving the body, the patient brings any part in contact with the vibrating discs. The cut represents the Vibrator, in which the force impinges at right angles with the surface of the body, sending waves of motion through its substance. [Illustration: Fig. 12. Apparatus for the Rubbing in a Recumbent Position.] The rubbing which is shown in Figs. 4 and 5 may be applied to all parts of the body in a recumbent position. A couch is required of similar construction to the vibrating couch, but with a rubbing-pad instead of vibrating heads acting through the opening and operated by appropriate connections, as shown in Fig. 12. The top is adjustable, and the degree of effect desired is capable of easy regulation. The patient turns different portions of the body to the action of the rubber as required. KNEADING. Kneading is a process applied chiefly to the abdomen. The purpose of this operation is to increase nutrition, the muscular power and action of the abdominal walls, and the function of the organs which they contain. Three modes of applying this operation by the mechanical apparatus are in use, effected by the Direct, the Rotary, and the Revolving Kneader. [Illustration: Fig. 13. Apparatus for Rotary Kneading.] THE DIRECT KNEADER. This resembles in form and action the vibrating instrument shown in Fig. 11. The impinging heads, however, are made broader, the motion greater in extent, and the rate of motion less than one-tenth of that employed for the purpose of vibrating. This slowness of motion seems to increase the action of the muscles. THE ROTARY KNEADER. The action of the kneading heads in this form of apparatus, as shown in Fig. 13, is _inward_ and _upward_ alternately, and it is eminently well calculated to stimulate the action of the abdominal organs. THE REVOLVING KNEADER. In the form of kneading apparatus, shown in Fig. 14, two thick rollers, which move freely on axes at the extremities of arms, projecting on either side of a shaft turned by a crank or belt, are made to act alternately upon each side of the abdomen. In the methods of kneading above described, the degree of force acting on the body is governed by an arrangement for elevating or depressing the upholstered top of the couch upon which the patient rests, and through which the action is transmitted to the body. If this form of apparatus is driven at a rate ten times more rapidly than is desired for kneading, the effect is vibratory, and it is, in fact, used for that purpose. [Illustration: Fig. 14. Apparatus for Kneading with Rollers.] THE CURE OF SWELLINGS AND TUMORS. The application of motion through the Manipulator promotes absorption, and thus all kinds of _swellings_ and non-malignant _tumors_ are made to diminish under its use. In these cases the vessels of the affected part are distended with stagnant blood, and a portion of the fluid passes through their walls, distending the surrounding tissues, which become more or less hardened. By the transmission of active motion to the affected parts, the contents of the vessels are urged forward; the outside fluids are thus permitted to return to the general circulation and become subject to the energetic vital action of the general system, local deficiencies of oxidation being increased to the normal degree, causing destruction of morbid matter and giving place for new and wholesome nutritive materials for vital use. In short, normal functional activity is established, both locally and generally. Scrofulous, dropsical, rheumatic, and other local accumulations disappear, and even tumors are dispersed, by the use of the Manipulator, in cases in which the knife would otherwise be required. COUNTER-IRRITATION AND REVULSION. Artificial means have always been employed to produce an energetic flow of blood in different parts of the body, thereby relieving morbid distention of the vessels, and consequent irritation and pain in neighboring parts. Cupping, hot applications, mustard, capsicum, blisters, and other irritants, are resorted to, but their effects, while generally very good in acute cases, are too transient to be of material aid in chronic affections. By the use of the Manipulator, we can produce the most thorough revulsive effects, operating upon large surfaces, and causing large masses of muscle to receive an increased amount of blood, thus drawing it away from parts oppressed by too great a supply, constituting engorgement. No injury is done to the parts acted upon; on the contrary, they are strengthened by the application, which can be repeated as often as necessary till relief is permanent. Thus, the head, heart, digestive organs, liver, chest, or whatever part is oppressed by excess of blood, may be speedily and permanently relieved. By means of this ability to relieve any part of the system from engorgement, and consequent inflammation and its results, are we enabled to permanently cure a large variety of chronic inflammatory, ulcerative, and nervous affections. Local inflammations by this method of treatment may be speedily cured. CURE OF NEURALGIA. By the transmission of motion through the Manipulator and other ingeniously devised apparatus and machinery, we increase the functional power and activity of the muscles, and thereby diminish morbid sensibility of the nerves, which is present in neuralgia. Prolonged and excessive nervous action is attended with too great a rush of blood to the nerve-centers, which can only be relieved by increasing the flow in the muscles. Congestion, or hyperaemia, in the spinal cord or brain, or both, is a condition ever present in neuralgia. The application of motion through the manipulator causes the blood to flow to the muscles, thus relieving nervous congestion and consequent neuralgia. CURE OF PARALYSIS. In no single disease has the transmission of motion through the Manipulator proved more thoroughly efficacious than in _paralysis_. The most prominent requirements in these cases seem to be the following: Excess of blood in the brain and spinal cord needs to be removed and diverted to parts in which it will be useful instead of obstructive. The contractile power of the capillaries should be improved. The quality of nutritive fluids should be improved by the promotion of oxidation through increased circulation. These and many more wants of disordered nerves, are readily supplied by transmitted motion. The Manipulator combines, in a single ingenious mechanical contrivance, the several movements best adapted for the promotion of healthy functional activity. CURE OF DEFORMITIES. "Deformities arising from _paralysis and contractions of muscles and tendons_, producing stiffened joints and distorted limbs, are of common occurrence. A rational explanation of the wonderful curative results which follow the employment of transmitted motion in these cases may not be without interest to the reader. The muscles are composed of _bundles_ of little fibers which glide upon one another in every movement. Another set of fibers called _connective tissue_, holds the fibers together in bundles or separate muscles, and interlaces and crosses them in every direction. Now, if these fibers remain long in a fixed position, or are involved in inflammation, there is danger of adhesions forming between them, producing permanent immobility; gliding movements are interfered with, and the muscle ceases to perform its function. Inflammation gives rise to effusion, or the formation of a kind of cement which binds together the muscular fibers and prevents motion. Rubbing, kneading, and actively manipulating the affected parts with that intensity of administration secured by the manipulator, rends asunder and breaks up these minute adhesions, re-establishing gliding motions, causes absorption of effused materials, and restores the affected part to a normal condition. [Illustration: Fig. 15. Muscular fibre highly magnified.] The deformed limb is straightened by the filling out of the muscle-cells, and increasing the length and also the nutrition of the affected muscles. No pulling or _forced extension_ is required. Deformity ceases when the conditions upon which it depends are removed by rational appliances, which are always agreeable. No brace, splints, or other confining appliances are necessary, except in rare cases in which the bones are very badly distorted. In withered and deformed limbs, resulting from infantile paralysis, the manipulator furnishes the most agreeable, direct, and certain remedy. It restores nutrition, sensation, and power, and dispenses almost wholly with mechanical supports. Club-feet, wry neck, spinal curvature, hip-joint disease, white swellings, and stiffened joints, are all readily amendable to the curative effects of motion administered by the manipulator and other machinery. Contracted and shortened muscles are gradually lengthened by vigorous, long-continued, and frequently repeated rubbing with the manipulator across their longitudinal fibers; bound-down and confined tendons are liberated and normal movements established. DISEASES OF WOMEN. Uterine and ovarian congestion, chronic inflammation, discharges, morbid enlargement, prolapsus, anteversion and retroversion, anteflexion and retroflexion, and other derangements of the womb and its appendages, are radically cured by the vibratory, rubbing, kneading, and other movements, administered through the manipulator and other mechanical appliances employed at the Invalids' Hotel and Surgical Institute. To those who are tired of taking medicine, this mode of treatment commends itself as being both agreeable and efficient. There is no case too weak, nervous, or helpless for the use of this curative agent. It is entirely devoid of objectionable features, being _always applied outside the clothing_. CAUSE OF FEMALE WEAKNESS. The true relations of cause and effect are very liable to be misunderstood, when considering the various diseases incident to the organs contained in the female pelvis. Treatment intended to be remedial is therefore very often misdirected and fails to afford relief, positive injury frequently resulting instead. When the nature of these diseases is properly understood, their cure can be effected with comparative ease. These diseases are always attended with weakness, which is often very great, of the muscles that hold the diseased organs in position. The muscles forming the walls of the abdomen, and the diaphragm, or midriff, all of which are concerned in the act of respiration, become feeble and only partially perform their functions. In health, they act constantly, even during sleep, producing a rhythmical movement, which is communicated to the contents of the abdominal and pelvic cavities. This motion promotes a healthy circulation in the parts. In almost all affections of the pelvic organs, this normal condition is greatly diminished. Diminution of the motions of respiration is attended with an increase of the amount of the blood in the pelvic organs, constituting an engorgement of the parts, called congestion, or inflammation. This gives rise to enlargement of the womb, ulcerations, tumors, and a multitude of kindred secondary effects, usually considered as the primary disease and treated as such. The contents of the cavity of the trunk, weighing several pounds, are allowed to gravitate down and rest upon the contents of the pelvis, forcing the congested uterus and ovaries down out of their natural positions, and often bending or tipping the womb in various directions. A long list of symptoms follows as the natural consequence of these abnormal conditions. RATIONAL TREATMENT. Ovarian congestion and inflammation, inflammation of the uterus, ulceration of this organ, deranged menstruation, leucorrhea with the attendant pain, nervousness, and other derangements depending upon loss of supporting power in the abdominal muscles, all result from loss of the _natural_ motions of respiration, and consequent deranged circulation. These several conditions can be cured by removing their cause. When the power of the parts involved in the weakness is restored, all these morbid conditions disappear. Judicious cultivation of power in the weakened supports is attended with certain curative results. This is best accomplished by mechanical motion, by which the normal circulation is restored, inflammations and congestions are subdued, displacements corrected, ulcers healed, and functional activity is re-established. RECAPITULATION. Motion properly transmitted to the human system by mechanical apparatus is transformed into other forms of force identical with vital energy, by which the ordinary processes of the system are greatly promoted. It increases animal heat and nervous and muscular power to the normal standard. It removes engorgement or local impediments to the circulation. The electrical induction produced renders it a most efficacious remedy for paralysis of all kinds. It removes interstitial fluids and causes rapid absorption and disappearance of solid and fluid accumulations. It is a powerful alterative, or blood-purifier, increasing oxidation and stimulating excretion. It diminishes chronic nervous irritability and promotes sleep. Deformities are easily cured without the cutting of tendons, or use of mechanical supports. It hardens the flesh by increasing muscular development and improves digestion and nutrition. * * * * * WORLD'S DISPENSARY MEDICAL ASSOCIATION INCORPORATED UNDER STATUTE ENACTED BY THE LEGISLATURE OF NEW YORK. [Illustration] Dr. R.V. PIERCE, having acquired a world-wide reputation in the treatment of Chronic Diseases, resulting in a professional business far exceeding his individual ability to conduct, some years ago induced several medical gentlemen of high professional standing to associate themselves with him, as the Faculty of the World's Dispensary and Surgical Institute, the Consulting Department of which has since been merged into the Invalids' Hotel. The organization is duly incorporated under a statute enacted by the Legislature of the State of New York, and under the name and style of the "WORLD'S DISPENSARY MEDICAL ASSOCIATION," of which Dr. PIERCE is President, and in the affairs of which he will, as heretofore, take an active and constant part. * * * * * EUROPEAN BRANCH, NO. 3 NEW OXFORD STREET, LONDON, ENG. * * * * * IMPORTANT ANNOUNCEMENT. Dr. R.V.PIERCE, having in the Fall of 1880 resigned his seat in Congress, has since been able to devote his whole time and attention to the interests of the Association, and those consulting our Medical and Surgical Faculty have the full benefits of his council and professional services. That he should prefer to give up a high and honorable position in the councils of the nation, to serve the sick, is conclusive evidence of his devotion to their interests and of love for his profession. * * * * * [Illustration: Invalids' Hotel and Surgical Institute, 663 Main Street, Buffalo, N.Y.] INVALIDS' HOTEL A MODEL SANITARIUM AND SURGICAL INSTITUTE. NOT A HOSPITAL, BUT A PLEASANT REMEDIAL HOME, ORGANIZED WITH A FULL STAFF OF EIGHTEEN PHYSICIANS AND SURGEONS AND EXCLUSIVELY DEVOTED TO THE TREATMENT OF ALL CHRONIC DISEASES. This imposing Establishment was designed and erected to accommodate the large number of invalids who visit Buffalo from every State and Territory, as well as from many foreign lands, that they may avail themselves of the professional services of the Staff of Skilled Specialists in Medicine and Surgery that compose the Faculty of this widely-celebrated institution. DESTROYED BY FIRE. On the sixteenth of February 1881, the original Invalids' Hotel was totally destroyed by fire. Although occupied at the time by a large number of invalids, yet, through the extraordinary exertions of the Faculty and employees, all were safely removed from the building without injury to any one. The Board of Trustees took prompt steps to rebuild, for the accommodation of the many sufferers who apply, to avail themselves of the skill, facilities and advantages of treatment which such a perfectly equipped establishment affords. Profiting by the experience afforded by several years' occupancy of the original Invalids' Hotel building, which at the date of its erection was the largest and most complete establishment of its kind in the world, we believe we have, in the building of the elegant structure illustrated herein, made great improvements over the original Invalids' Hotel, for the accommodation of our patients. Although our new building has only been occupied about two years, yet almost immediately our business required the erection of a very large addition thereto, to accommodate our growing practice. This large _Annex_, which is about the size of the original building, has ever since been kept well filled with patients, hailing from every State and Territory of the United States, Canada and occasionally from a foreign country, THE INVALIDS' HOTEL AND SURGICAL INSTITUTE IS PLEASANTLY SITUATED AT NO. 663 MAIN STREET, in the city of Buffalo, just above and outside the business and bustle of this Queen City of the Lakes. It is easily reached from the railroad depots by the Exchange and Main Street car lines (see map on last page of this book). It is a substantially built brick building, trimmed with sandstone, well lighted and provided with a patent hydraulic elevator, so that its upper stories are quite as desirable as any, being more quiet than those lower down. It is well provided with fire escapes, and, in fact, nothing has been neglected that can add to the comfort and home-like make-up of this popular national resort for the invalid and afflicted. Great pains and expense have been assumed in providing perfect ventilation for every room and part of the building. [Illustration: Grand Entrance.] [Illustration: Ante-room.--Invalids' Hotel and Surgical Institute.] The surroundings of the Hotel are very pleasant, it being located in the finest built part of the city, among the most elegant residences. STAFF OF PHYSICIANS AND SURGEONS. Only men who are, by thorough education and experience, especially fitted to fill their respective positions, have been chosen to serve as physicians and surgeons in this institution. After having spent a very large sum of money in erecting and furnishing this national resort for invalids with every requirement and facility for the successful treatment of all classes of chronic diseases, it is the determination of the Board of Directors that the Faculty of Physicians and Surgeons shall be superior in culture, experience and skill. We have not the space to speak, individually, of the eighteen professional gentlemen composing the Faculty, but will say that among them are those whose long connection with the World's Dispensary and Surgical Institute has given them great experience and rendered them _experts_ in their specialties. Several of them had previously distinguished themselves in both private and hospital practice, had held important chairs as lecturers and teachers in Medical Colleges, and had filled responsible positions in military and civil hospitals; also in some of the most noted Asylums, Dispensaries, and Sanitary Institutions in the land. With such a staff of Physicians and Surgeons, efficient and trained nurses, and with all the most approved sanitary, medical and surgical appliances which study, experience, invention and the most liberal expenditure of money, can produce and bring together in one institution, the Invalids' Hotel and Surgical Institute affords the afflicted unusual opportunities for relief. THE GRAND ENTRANCE. The entrance to the Invalids' Hotel and Surgical Institute is covered by a lofty porch of beautiful design, the roof of which is supported upon heavy iron columns. Above the massive double doors, through which the visitor enters, are large, heavy panels of beautifully wrought stained glass, on which the words "Invalids' Hotel and Surgical Institute" stand out conspicuously. [Illustration: Gentlemen's Reception-room, Invalids' Hotel and Surgical Institute.] FIRST FLOOR. The first floor of the building is reached through a beautifully finished vestibule, by a short flight of broad, easy stairs, and once inside the visitor is struck by the beauty of design as well as by the home-like appearance of the surroundings. The wood-work is mainly of hard woods, oak and cherry predominating. In a large part of the house the floors are of oak, with a cherry border, neatly finished in oil and shellac, and covered with rich rugs and elegant carpets of the very best quality. [Illustration: Ladies' Parlor.--Invalids' Hotel and Surgical Institute.] On the first floor is the gentlemen's reception-room, which is thronged with patients from early in the morning until late in the afternoon. It is entirely distinct from the large reception-room and parlors for lady patients, and the utmost privacy is secured throughout the whole arrangement of the Institution. On this floor are the suites of offices, parlors, and private consultation-rooms, some fifteen in all; also a well furnished reading-room and circulating library, for the use of the inmates of the Institution. On all sides are beautifully frescoed walls adorned with numerous choice engravings and other pictures. All the rooms throughout the house are furnished in the best of style, and in a manner to afford the utmost comfort and cheerfulness of surroundings for the sick and afflicted who seek this remedial resort. The Turkish and other baths are elegantly fitted up on the first floor, opposite the reading-room. THE UPPER FLOORS. Above the first, or main floor, the building is divided into separate rooms and suites of rooms for the accommodation of patients. All are well lighted, have high ceilings, and are cheerful and well ventilated apartments. On the second floor is the large medical library and medical council-room, for the exclusive use of the Faculty, also the museum-room, which contains a large and valuable collection of anatomical and morbid specimens, many of them being obtained from cases treated in this Institution. On this floor are also suites of rooms, occupied by the Bureau of Medical Correspondence, wherein from ten to twelve physicians, each supplied with the improved graphophone, are constantly employed in attending to the vast correspondence received from invalids residing in all parts of the United States and Canada. Every important case receives the careful consideration of a council composed of from three to five of these expert specialists, before being finally passed upon and prescribed for. [Illustration: Library and Reading-room--Invalids' Hotel and Surgical Institute.] ON THE THIRD FLOOR are the large treatment-rooms, supplied with all the apparatus and appliances for the successful management of every chronic malady incident to humanity. Electrical apparatus of the latest and most approved kinds, some of it driven and operated by steam-power, dry cupping and equalizing-treatment apparatus, "vitalization" apparatus, numerous and most ingenious rubbing and manipulating apparatus and machinery, driven by steam-power, are among the almost innumerable curative agencies that are here brought into use as aids in the cure of human ailments. Our ELECTRICAL OUTFIT [Illustration: President Pierce's Business Office--Invalids' Hotel and Surgical Institute.] is the finest to be found in any sanitarium in the United States and, we believe, in the world. There are two forty-cell galvanic batteries with switch boards for controlling the voltage, or force, from the whole power to one-fortieth of this amount, at the will of the physician. Safe-guards in the shape of milli-ampere meters continually indicate to the operator the force of the current. There is a dynamo for charging the storage batteries, which may be used in a patient's room when this method is found more convenient or more comfortable for the invalid. There are two static or Franklin machines. These are used when the milder current is desired, and for spraying, sparking, etc. One of the instruments is of high voltage and furnishes us with the X rays for examining the interior parts of the body. The largest treatment room also contains a powerful ozone generator, operated by a dynamo. This supplies the room with allotropic oxygen and is invaluable in treating diseases of the lungs and air passages. This supplies the patient with vitalized air, equal to the most salubrious atmosphere in any part of the globe. Beyond this and separated by a court, across which is an iron bridge, are the large dispensing-rooms, stocked with drugs and medical compounds of almost endless variety, and representing every branch of the _materia medica_. Here all medicines prescribed are most carefully and specially prepared for each individual case. Those to be sent away by mail or express, to patients being treated at a distance, are placed in trays, with full directions for use, and sent to another large room, where they are carefully packed, and shipped thence to their destination. FOURTH FLOOR. On the fourth floor are located the surgical operating-rooms and surgical ward. There are also a large number of nice, large, well furnished separate rooms on this floor, used principally for the accommodation of surgical cases. Strong, broad, iron staircases connect all the upper floors with the ground, so that in case of fire, patients need have no fear of being unable to get out safely. In fact, the building has been constructed so as to render the rapid spread of fire through it impossible, all the floors being laid on cement. A STEAM PASSENGER ELEVATOR is provided, so that the upper floors are quite as desirable as those lower down. The dining-rooms for gentlemen, as well as those for ladies, are located in the basement, which is reached either by stairways or by the elevator. The kitchen, store-rooms, chill-rooms, pantries, and all culinary arrangements are also in the basement. FIRE-PROOF VAULTS. Six large fire-proof vaults are provided in this building in which to preserve, secure from observation, as well as from fire, all records of cases examined and treated by the Faculty. Throughout all this vast building the visitor is struck with the wonderful order and system with which every detail is carried out. THE BATH DEPARTMENT. [Illustration: A glimpse at the Turkish Bath Department.] The Invalids' Hotel and Surgical Institute, as hereinbefore indicated, is provided with Turkish, and other approved baths, with a treatment-room, fitted up with vacuum and movement-treatment apparatus of the most modern and approved style. These and much more ingeniously devised apparatus and appliances are brought into use in a great variety of chronic affections with marvelously successful results. A perfect system of physical training, especially adapted to the wants of the invalid and weak, and most skillfully conducted and applied, is not the least important among the many advantages that the chronic sufferers here find. THE SURGICAL DEPARTMENT. In the Surgical Department, every instrument and appliance approved by the modern operator is provided, and many and ingenious are the instruments and devices that the Faculty of this institution have invented and perfected to meet the wants of their numerous cases. OUR REMEDIES. In the prescribing of remedies for disease, the Staff resort to the whole broad field of _materia medica_, allowing themselves to be hampered by no school, _ism_,_pathy_, or sect. The medicines employed are all prepared by skilled chemists and pharmacists, and the greatest care is exercised to have them manufactured from the freshest and purest ingredients. Our Faculty probably employ a greater number and variety of extracts from native roots, barks and herbs in their practice than are used in any other invalids' resort in the land. All of the vegetable extracts employed in our practice are prepared in our own Laboratory. REGULATION OF DIET. The table is supplied with an abundance of wholesome and nutritious food, especially adapted and prepared to suit the invalid, it being varied to suit each particular case. The Faculty recognize the importance of proper food as one of the greatest factors in the treatment of chronic diseases. While properly regulating and restricting the food of the invalid when necessary, they also recognize the fact that many are benefited by a liberal diet of the most substantial food, as steaks, eggs, oysters, milk, and other very nutritious articles of diet, which are always provided in abundance for those for whom they are suited. [Illustration: View of Lake and Boat-house.--Buffalo Park.] From previous experience somewhere, some people get the impression that they are to be half starved at such an institution as this. If this is the case anywhere it is not so here, as any one who has ever resided at our sanitarium will attest. TRAINED ATTENDANTS. A sufficient number of trained and experienced nurses are employed, that those requiring attendance may have the very best of care. GOOD ORDER. The institution is conducted in an orderly manner, that the utmost quiet may be secured. The Faculty insist, upon the part of the invalid, while under treatment, on the observance of habits of regularity in eating, sleeping, bathing and exercise. Only by such observance of hygienic laws can they succeed in their course of remedial training, and make the treatment curative. AMUSEMENTS. While insisting upon strict observance of rules established for the good of the patient, they do not make their requirements so rigid as to interfere with the comfort and enjoyment of their patients, but, on the contrary, endeavor, in every manner possible, to provide innocent and entertaining amusements for all, recognizing the great importance of pleasant occupation of the mind, as an essential part of the treatment. Hence the introduction of music, amusing games, light reading, and kindred agencies for pleasant entertainment, is not neglected. UNPARALLELED SUCCESS. [Illustration: One of the Private Consultation-rooms, Ladies' Department.] The founder of this institution commenced, many years ago, with little capital, to build up a business in the treatment of chronic diseases and devoted himself diligently to that end. His reputation for skill in his chosen field of practice gradually extended until, to-day, his fame and that of the World's Dispensary and Invalids' Hotel and Surgical Institute, are simply world-wide. As the business increased those eminent for skill have been induced to join the Faculty, until eighteen professional gentlemen, each devoting his attention to a special branch of practice, constitute the Medical and Surgical Staff. [Illustration: Soldiers' Monument.--Lafayette Park, Buffalo.] One reason why we excel in the treatment of _chronic diseases_ is the fact that we are supplied with all the modern improvements in the way of instruments, appliances and remedial agents used in the healing art, the expense of which deters the local physician in general practice from procuring, for the treatment of the limited number of cases that come within the circuit of his practice. The treatment of such cases requires special attention and special study to be successful. A COMMON SENSE VIEW. It is a well-known fact, that appeals to the judgment of every thinking person, that a physician who devotes his whole time to the study and investigation of a certain class of diseases, must become better qualified to treat them than he who attempts to treat every ill to which flesh is heir, without giving special attention to any particular class of diseases. Men, in all ages of the world, who have _made their marks_, or who have become famous, have devoted their lives to some special branch of science, art or literature. LIBERALITY. We wage no war against any physician, no matter what school of medicine he may represent; but, on the other hand, we invite the co-operation of all regular physicians. We are always ready and willing to impart to them any information or render any assistance that will be of mutual benefit to them and their patients. OUR PHYSICIANS AND SURGEONS do not travel to solicit practice, having all the business that they can attend to at our institution, nor do we employ any agents to travel and peddle or otherwise sell our medicines. If any one engaged in such business, represents himself as in any way connected with our institutions, he is a swindler and should be apprehended and prosecuted as such. And any one who will give us such information as will lead to the arrest and conviction of any person so misrepresenting will be liberally rewarded. [Illustration: Undergoing Examination of the Lungs at the Invalids' Hotel and Surgical Institute.] While not permitting any member of our professional staff to travel and solicit practice, yet we are always willing to accommodate and send a specialist to visit important or critical cases in consultation, or otherwise, or to perform important surgical operations as explained on page 971 of this book. Let none deceive you by representing that they have heretofore been connected with our institution and have thereby learned our original and improved methods of treatment. We have a large and competent Staff of Specialists and while we have sometimes found it necessary to make changes, yet we always manage to retain the most expert and skillful, as we cannot afford to part with the services of those who excel. [Illustration: Chemists' Department.--Invalids' Hotel and Surgical Institute.] By adopting similar names to those which have long designated our world-famed institutions, some have endeavored to deceive and mislead invalids who were seeking relief. Others have named so-called "Electric" Trusses, "Liver Pads," and other contrivances after our President, thereby expecting to reap benefits from Dr. Pierce's well-known professional standing. Neither the Doctor nor this Association have any interest in any such articles. NO BRANCHES.--Remember we have no branches except the one at No. 3 New Oxford Street, London, England. Those desiring to consult us by letter, should address all communications plainly to <b>World's Dispensary Medical Association, _No. 663 MAIN STREET,_ BUFFALO, N.Y.</b> * * * * * WORLD'S DISPENSARY. The immense building erected and occupied by the World's Dispensary Medical Association as a Laboratory, wherein are manufactured our Dr. Pierce's Standard Family Medicines, as well as all the various Tinctures, Fluid Extracts and other pharmaceutical preparations used by the Staff of Physicians and Surgeons of the Invalids' Hotel and Surgical Institute in their practice, is not inappropriately called the _World's Dispensary_, for within its walls is prepared a series of remedies of such exceeding merit that they have acquired world-wide fame, and are sold in vast quantities in nearly every civilized country. [Illustration: World's Dispensary.--New Laboratory Building.] The structure, located at 660 to 670 Washington Street, immediately in the rear of the Invalids' Hotel and Surgical Institute, is of brick, with sandstone trimmings, six stories high, and 100 feet square. Its most striking architectural features exteriorly are massiveness, combined with grace and beauty of outline, and great strength. THE BASEMENT. The basement or first story opens on a level with the Washington Street sidewalk, and is occupied by a plant of two large boilers, which supply the steam to run a huge American engine, of 100 horse-power, built by the American Engine Co., Bound Brook, N.J. It drives all the machinery of the establishment, including drug mills, pill machines, packing machinery, a large number of printing presses, folding machines, stitching, trimming, and many other machines, located on the different floors, and used in the manufacture of medicines, books, pamphlets, circulars, posters, and other printed matter. On this floor is located steam bottle-washing machinery, and also the shipping department. Here may be seen huge piles of medicine, boxed, marked, and ready for shipment to all parts of the civilized world. A large steam freight elevator leads from this to the floors above. MACHINERY. [Illustration: Postal, Advertising, Wrapping and Mailing Departments.] In addition to the power engine just mentioned is a 25 horse-power upright engine for running the dynamo for electric lighting, with a capacity of three hundred (300) lights. This engine and dynamo were also manufactured for us by the American Engine Company of Bound Brook, N.J. There is a small dynamo with a capacity of one hundred (100) lights used during the day to light safes, vaults, dark closets and hallways. All the offices and rooms of patients are supplied with electric light, as well as illuminating gas. An automatic Worthington pump is also located in the basement. This supplies the elevator and sprinkling system. The sprinklers come into play only in case of fire, when they are self-acting. This pump at its best is capable of forcing nearly two hundred gallons of water a minute. There is no place in which pure water is more desirable than in the manufacture of medicines. Our New York filter could, if such a large quantity were ever required, furnish the Dispensary with one hundred (100) barrels of pure water a day. Just beyond the south wall and buried several feet under ground is a boiler-shaped tank capable of storing ten thousand (10,000) gallons of medicine. MAIN FLOOR. The main or second floor of the Dispensary is entered from Main Street, through a hall leading from the Invalids' Hotel and Surgical Institute. On this floor are located business offices, counting-room, the advertising department and mailing rooms. Large, fire-proof vaults are provided for the safe keeping of books, papers, and valuables, whilst the counting-room and offices are elegantly finished in hard woods, and present a beautiful and grand appearance. THIRD FLOOR. On this floor are the Association's extensive printing and binding works. Fourteen large presses, driven by power, with numerous folding machines, trimming, cutting, and stitching machinery, are constantly running in this department. Here is printed and bound Dr. Pierce's popular work of over a thousand pages, denominated "The People's Common Sense Medical Adviser," over 1,200,000 copies of which have been sold. Millions of pocket memorandum books, pamphlets, circulars and cards are also issued from this department and scattered broadcast to every quarter of the globe. FOURTH FLOOR. Large mills for crushing, grinding and pulverizing roots, barks, herbs, and other drugs occupy a considerable part of this floor. Extensive drying-rooms, in which articles to be ground in the drug mills are properly dried, are also located upon this floor, as are also thousands of reams of paper ready for printing the different books, pamphlets, labels, etc. In large rooms set aside for that purpose, are stored vast quantities of labels and wrappers, for use in putting up medicines. FIFTH FLOOR. On this floor is located ingeniously devised filling and bottling machinery, also rooms for labeling, wrapping, and packing medicines; others are occupied for the storage of crude drugs, glass, corks, and supplies for use in the general business. SIXTH FLOOR. This entire floor is occupied with mixing, percolating, distilling, filtering, and other processes employed in the manufacturing of medicines. Every process is conducted under the watchful care of an experienced chemist and pharmacist, and in the most perfect and orderly manner; the apparatus employed being of the most approved character. Here are manufactured all the various medicinal preparations and compounds prescribed by the Faculty, in the treatment of special cases. GENERAL CONSIDERATIONS. [Illustration: Section of Chemical Laboratory.--World's Dispensary.] In all departments of this vast business establishment, the visitor is struck with the perfect system which everywhere prevails, and the wonderful accuracy with which every process and transaction is carried on and consummated; hence the uniformity of purity and strength for which the medicines here manufactured have so long been celebrated. To this, also, is due much of the marvelous success attained in the department established for the special treatment of chronic and obstinate cases of disease. In this department the Faculty are not at all limited or hampered in prescribing, and do not confine themselves in the least to the proprietary or standard medicines manufactured for general sale through druggists, but employ a series of curative agents unsurpassed in variety and range of application. They aim to carefully adapt their prescriptions to each individual case. * * * * * THE INVALIDS' HOTEL AND SURGICAL INSTITUTE _SOME OF THE CAUSES THAT LED TO ITS ERECTION, AND THE ADVANTAGES WHICH IT AFFORDS._ [Illustration: One of the Private Consultation-rooms, Gentlemen's Department.] The destinies of institutions, like those of men, are often determined by pre-existing causes. The destinies of some men are like those of way-side plants, springing up without other apparent cause than the caprice of nature, developing without any apparent aim, yielding no perfected fruit, and finally, dying, leaving scarcely a trace of their existence. Thus it is with institutions which have their origin only in man's caprice. To be enduring, they must be founded upon the needs and necessities of humanity. Many of the great men of the world owe their greatness more to surrounding circumstances than to the genius within them. The highest genius can be dwarfed or deformed by the force of adverse circumstances; hence the poetic truth of Gray in those exquisite lines: "Some mute inglorious Milton here may lie, Some Cromwell guiltless of his country's blood." Opportunity is the guiding star of genius. Without it, genius would drift hither and thither upon the restless, ever-changing waves of circumstance, never casting anchor in a secure haven. Upon opportunity, too, depends the success of institutions. By opportunity we mean a real and acknowledged public want. Whoever undertakes to supply this want finds himself upon the crest-wave of prosperity. It was to supply such a want that this institution was erected. A REMEDIAL HOME. Of the seventy millions of people living in the United States to-day, it is estimated that nearly twelve millions are sufferers from chronic disease. Think for a moment! Twelve millions of people slowly but surely dying by the insidious and fatal development of chronic diseases! This is an appalling fact. And yet this is the very class of diseases with which the general practitioner is least familiar. As a general practitioner of the healing art, fresh from _curriculum_, the founder of this institution early realized that the grand unpardonable sin of the medical profession was the neglect to more thoroughly study and investigate this class of diseases. The profession is diligently cauterizing and poulticing the sores which now and then appear on the surface, but the internal chronic disease, of which these are merely the external signs, is too often overlooked or neglected. Some years ago we devised and put into practical operation a method of TREATING PATIENTS AT THEIR HOMES, without requiring them to undergo personal examinations. We reasoned that the physician has abundant opportunity to accurately determine the nature of most chronic diseases without ever seeing the patient. In substantiating that proposition, we cited the perfect _accuracy_ with which scientists are enabled to deduce the most minute particulars in their several departments, which appears almost miraculous, if we view the subject in the light of the early ages. Take, for example, the electro-magnetic telegraph, the greatest invention of the age. Is it not a marvelous degree of accuracy which enables an operator to _exactly_ locate a fracture in a sub-marine cable nearly three thousand miles long? Our venerable "clerk of the weather" has become so thoroughly familiar with the most wayward elements of nature that he can accurately predict their movements. He can sit in Washington and foretell what the weather will be in Florida or New York, as well as if hundreds of miles did not intervene between him and the places named. And so in all departments of modern science, what is required is the knowledge of certain _signs_. From these, scientists deduce accurate conclusions regardless of distance. A few fossils sent to the expert geologist enables him to accurately determine the rock-formation from which they were taken. He can describe it to you as perfectly as if a cleft of it were lying on his table. So also the chemist can determine the constitution of the sun as accurately as if that luminary were not ninety-five million miles from his laboratory. The sun sends certain _signs_ over the "infinitude of space," which the chemist classifies by passing them through the spectroscope. Only the presence of certain substances could produce these solar signs. [Illustration: Medical Library and Council-room.--Invalids' Hotel and Surgical Institute.] So, also, in medical science, DISEASE HAS CERTAIN UNMISTAKABLE SIGNS, or symptoms, and, by reason of this fact, we have been enabled to originate and perfect a system of determining with the greatest accuracy the nature of chronic diseases without seeing and personally examining our patients. In recognizing diseases without a personal examination of the patient, we claim to possess no miraculous powers. We obtain our knowledge of the patient's disease by the practical application of well-established principles of modern science to the practice of medicine. And it is to the accuracy with which this system has endowed us that we owe our almost world-wide reputation for the skillful treatment of all lingering, or chronic, affections. This system of practice, with the marvelous success which has been attained through it, demonstrates the fact that diseases display certain phenomena, which, being subjected to scientific analysis, furnish abundant and unmistakable data to guide the judgment of the skillful practitioner aright in determining the nature of diseased conditions. So successful has been this method of treating patients at a distance that there is scarcely a city or a village in the United States that is not represented by one or more cases upon the "Records of Practice" at the Invalids' Hotel and Surgical Institute. In all chronic diseases that are curable by medical treatment, it is only in very rare cases that we cannot do as well for the patient while he or she remains at home, as if here in person to be examined. But we annually treat hundreds of cases requiring surgical operations and careful after-treatment, and in these cases our Invalids' Hotel, or home, is indispensable. Here the patient has the services not only of the most skillful surgeons, but also, what is quite as necessary in the after treatment, of thoroughly trained and skilled nurses. What should be the essential characteristics of an Invalids' Home? CLIMATE. Obviously, the most important of these characteristics is _climate_. Climatology, from being a mere speculative theory, has arisen to the deserved rank of a science. The influence of the climate of a country on the national character has long been observed and acknowledged. The languid but passionate temperaments of the South are like its volcanoes, now quiet and silent, anon bursting forth with terrible activity, flooding entire cities with molten fire; or, like its skies, now sunny, cloudless, an hour hence convulsed with lightnings and deluging the earth with passionate rain; or like its winds, to-day soft, balmy, with healing on their wings, to-night the wind fiend, the destroying simoom, rushing through the land, withering and scorching every flower and blade of herbage on its way. On the other hand, the calm, phlegmatic temperament of the North accords well with her silent mountains, her serener skies, and her less vehement, but chilling winds. The South, too, is the native home of the most violent acute diseases, such as yellow fever and cholera. But, aside from this general climatic influence, there is the yet more restricted one of locality. It has often been observed that certain classes of diseases are most prevalent in certain localities, the prevalence in every instance being due to peculiarities of climate. EXTREME HEALTHFULNESS OF BUFFALO. In the published records of the examination for military service in the army, during our late civil war, this fact was clearly and definitely stated, and maps were prepared and presented showing the comparative prevalence of certain diseases in the several States and districts represented. The maps are prepared by a graduation of color, the lighter shades indicating the localities where the special disease under consideration is least prevalent; and it is a very significant and important fact that in all chronic diseases not due to occupation or accident, Buffalo and its immediate vicinity is marked by the lighter shades. Thus, in epilepsy, paralysis, scrofula, rheumatism, and consumption, our city is little more than tinted with the several colors used to denote these diseases. [Illustration: A Patient's Room.--Invalids' Hotel and Surgical Institute.] There is a popular, but unfounded, belief that Buffalo is a hot-bed for pulmonary diseases. This idea could have originated only in an ignorant disregard of facts; for medical statistics prove that in her freedom from this class of diseases she is unrivaled by any city in America, not excepting those on the seaboard. EVIDENCE OF HEALTH STATISTICS. Compare, if you please, the statistics of Buffalo with those of the great Eastern cities in this respect. In Boston and New York the death-rate from consumption shows a ratio of about 1 to 5 of the whole number of deaths. In Baltimore and Philadelphia the ratio is 1 to 6, while in Buffalo the death rate from consumption is only 1 to 10--very remarkable difference in favor of our city. Only last summer a gentleman residing in the eastern part of our State collected and compared the health statistics for 1876 of all the prominent cities in the United States. The result showed that BUFFALO OUTRANKS ALL IN HEALTHFULNESS. A great deal of precious breath has been expended in blustering about "Buffalo zephyrs," as our delightful lake breezes are sometimes ironically termed. It seems to be a popular belief among our sister cities that old Boreas has chosen Buffalo for his headquarters. When we hear a person dilating upon "Buffalo's terrific winds," we are reminded of one of our lady acquaintances who recently returned from a European tour. She was asked how she enjoyed her sea voyage, and she replied, "Oh, it was delightful, really charming! There is something so grand about the sea!" We were not a little surprised at this enthusiastic outburst, as we had been told by a member of her party that the lady had industriously vomited her way to Hamburg and back again. But the lady's enthusiasm was easily explained. It is fashionable to characterize sea voyages as delightful, charming, etc. Now, we suspect this popular notion about our "trying winds" is traceable to the same source. It has become customary to call Buffalo a "windy place," and so, when the traveler feels a slight lake breeze, he imagines it to be a terrific gale. Whatever may have originated this notion, certain it is that it is utterly, undeniably false; and, in making this denial, we are not alone dependent upon observation, but upon the FACTS OF SCIENCE. The issue of July 18, 1874, of the Buffalo _Commercial Advertiser_, contained a series of tables, furnished by the Signal Service Bureau, showing the velocity of the wind at eleven prominent cities for the year 1873. An examination of the table shows that the total velocity for the year was the _lowest in Buffalo_ of any of the lake ports; while Philadelphia and New York showed far higher aggregates of velocity than our city. On this subject, in the issue of August 21st of the same year, the editor pleasantly remarks: "Only the interior and southern seaboard cities, and not many of them, show a lower total velocity of wind than is marked against this city; and as for those places, heaven help their unfortunate inhabitants in the sultry nights of the summer season, when they are gasping in vain for a breath of that pure, cool lake air, which brings refreshing slumbers to the people of blessed, breezy Buffalo." EQUABILITY OF CLIMATE. [Illustration: One of our Physician's Rooms--Bureau of Correspondence--Invalids' Hotel and Surgical Institute.] Then, in regard to _equability of climate_, the great desideratum for invalids in any locality, here again sentiment and science are greatly at variance. An examination of the official records of the Signal Service Bureau, and the statistics of the Smithsonian Institute, showed that out of a list of forty cities on the continent Buffalo ranked highest for equability of climate. Thus we quote from an editorial in the _Advertiser_ of the same issue: "While the aggregate of change for Buffalo stood at 67 for the year, that of Philadelphia reached 204, Washington was 224, Cincinnati 205, St. Louis 171. Winchester, in one of the healthiest parts of Virginia, reached as high as 201. Aiken, in South Carolina, a famous resort for invalids, touched 220. St. Augustine, one of the lowest in the list, showed a much less equable climate than that of Buffalo, being 94 to our 67." The transition from summer to winter, and _vice versa_, is exceedingly gradual, and, consequently, Buffalonians are seldom afflicted with those epidemic diseases which generally appear in other localities during the spring and summer months. Thus the thermometric readings of the Signal Service Bureau for 1873, show that the average temperature for July and August was 74°. For September it was about 64°, which was again reduced by about 10° for October. The monthly average for November was 73°, and for December 25°, which was also the average for January. Then the readings for February showed an average of 26°, for March 32°, and 43° for April. A more equable and gradual transition from midsummer heat to midwinter cold cannot be shown by any locality on this continent. Seldom does the mercury rise above ninety during our warmest summers, or fall below zero in our most severe winters. In J. Disturnal's work, entitled "The Influence of Climate in North and South America," published by Van Nostrand, in 1867, the climate of Buffalo is thus characterized: "From certain natural causes, no doubt produced by the waters of Lake Erie, the winters are less severe, the summers less hot, the temperature night and day more equable, and the transition from heat to cold less rapid, in Buffalo than in any other locality within the temperate zone of the United States, as will be seen by the following table." The table referred to shows that, "during the summer months, the temperature of Buffalo is from 10° to 20° cooler than that of any other point east, south, or west of the ports on Lake Erie; while the refreshing and invigorating lake breeze is felt night and day." The author further adds that "during the winter months the thermometer rarely indicates zero, and the mean temperature for January, 1858, was 20° above." A careful investigation into the comparative climatology of the several great social and commercial centers, proved _Buffalo to be superior to all others in the climatic requirements for the invalid_. Besides, it has the important advantage of being a central point of traffic and travel between the West and the East. ADVANTAGES OF LOCATION. The second important consideration in projecting this home for invalids was _location_. It has generally been customary to locate institutions of this character in rural districts, removed from the advantages of city life, on the plea of escaping the confusion and excitement so detrimental to recovery. The result is well known. Invalids have regarded them more as pleasure resorts than health resorts, spending the summer months there, but fleeing to their homes at the fall of the first snow-flake. The good that was done in the summer is undone by carelessness and exposure in the winter. A location that would combine both city advantages and rural pleasures, seemed to us, upon reflection, to be the desirable one. Fortunately, Buffalo afforded the happy mean. Our extensive parks, our unsurpassed facilities for yachting, fishing, and all aquatic sports, our many sylvan lake and river retreats, our world-famed Niagara,--certainly a more desirable selection of rural scenes and pleasures cannot be found in another locality in America. A GENUINE HOME. In erecting the Invalids' Hotel and Surgical Institute, our paramount design was to make it a genuine home--_not a hospital_--a home where the child of fortune would miss none of the comforts of her palatial home, while the poor man would find not only health but his pleasures multiplied a thousand fold. OUR TERMS MODERATE. The wholesale merchant's prices are far less than those of the retail dealer. He can afford it, his sales are so much larger. It is on precisely the same principle that we are able to make the rates at the Invalids' Hotel and Surgical Institute comparatively low. If we had only a limited number of patients, we should be obliged to make the charges commensurate with our expenses; but our practice having become very extensive, and the income being correspondingly large, we are enabled to make the rates at the Invalids' Hotel and Surgical Institute so moderate that all who desire can avail themselves of its medical, surgical, and hygienic advantages. [Illustration: Prescription Department--Invalids' Hotel and Surgical Institute.] FACILITIES FOR TREATMENT. Of the many advantages afforded by the Invalids' Hotel and Surgical Institute, in treating disease, we can make only brief mention of a few of the more prominent. DIVISION OF LABOR. In the examination and treatment of patients, our practice is divided into specialties. Each member of the Faculty, although educated to practice in _all_ departments of medicine and surgery, is here assigned to a special department only, to which he devotes his entire time, study and attention. ADVANTAGES OF SPECIALTIES. The division-of-labor system proves as effectual in the exercise of the professions as in manufactures. In the legal profession this has long been a recognized fact. One lawyer devotes his attention specially to criminal law, and distinguishes himself in that department. Another develops a special faculty for unraveling knotty questions in matters of real estate, and, if a title is to be proved, or a deed annulled, he is the preferred counselor. In a certain manner, too, this has long been practiced by the medical profession. Thus some physicians (and we may add physicians who call themselves "regular," and are specially caustic in their denunciation of "advertising doctors") are accustomed to distribute cards among their patrons, certifying that they give special attention to diseases of women and children. In this institution each physician and surgeon is assigned a special department of medicine or surgery. By constant study and attention to his department, each has become a skillful specialist, readily detecting every phase and complication of the diseases referred to him. Not only is superior skill thus attained, but also _rapidity_ and _accuracy_ in diagnosis. Thoroughness and efficiency in any branch of learning can be secured only by devoting to it special study and attention. When the faculty of a university is to be chosen, how are its members selected? For instance, how is the chair of astronomy filled? Do they choose the man who is celebrated for his general scholastic attainments, or do they not rather confer it upon one who is known to have devoted special attention and study to the science of astronomy, and is, therefore, especially qualified to explain its theories and principles? Thus all the several chairs are filled by gentlemen whose general scholarship not only is known to be of the highest standard, but who devote special attention to the departments assigned them, thus becoming proficient specialists therein. The same system of specialties is observed in the departments of a medical college. The professor who would assume to lecture in all the departments with equal ease and proficiency would be severely ridiculed by his colleagues; and yet it is just as absurd to suppose that the general practitioner can keep himself informed of the many new methods of treatment that are being constantly devised and adopted in the several departments of medicine and surgery. PROGRESS IN MEDICINE. In no other science is more rapid and real progress being made at the present time than in that of medicine. Even the specialist must be studious and earnest in his work to keep himself well and accurately informed of the progress made in his department. Thus it so often happens that the general practitioner pursues old methods of treatment which science has long since replaced with others, acknowledged to be superior. The specialist, on the contrary, by confining his studies and researches to one class of diseases only, is enabled to inform himself thoroughly and accurately on all the improvements made in the methods and means of practice in his special department. The difference between the practice of specialists and that of general practitioners is aptly illustrated by the difference between the old-fashioned district school, in which the school-master taught all the branches, from a-b-abs to the solution of unknown quantities and the charmed mysteries of philosophy, and the modern seminary, with its efficient corps of teachers, each devoting his or her whole attention to the study and teaching of one special department of learning. We attribute the success which has attended the practice at the Invalids' Hotel and Surgical Institute, in a great measure, to a wise adoption of this system of specialties. ADVANTAGES OFFERED TO INVALIDS. Obviously, the most important of these advantages is _facility of treatment_. Of the thousands whom we have cured of chronic diseases, we have probably not seen one in five hundred, having accomplished the desired result through remedies sent either by mail or express, and advice given by letter. Yet in some obstinate forms of disease, we can here bring to bear remedial means not to be found or applied elsewhere. That thousands of cases of chronic disease, pronounced incurable, have, by our rational and scientific treatment, been restored to perfect health, is conclusively proved by the records of practice at the Invalids' Hotel and Surgical Institute. Here, in obstinate cases, are brought to bear all the most scientific remedial appliances and methods of treatment. A system of mechanical movements, passive exercises, manipulations, kneadings and rubbings, administered by a large variety of ingeniously-contrived machinery, driven by stream-power, has been found especially efficacious and valuable, as an aid to medical and surgical treatment, in the cure of obstinate cases of nervous and sick headache, constipation, paralysis, or palsy, stiffened joints, crooked and withered limbs, spinal curvature, tumors, diseases of women, especially displacements of the uterus, or womb, such as prolapsus, retroversion and anteversion, chronic inflammation, enlargement and ulceration of the uterus, and kindred affections; also in nervous debility, sleeplessness, and other chronic diseases. Mechanical power, or force, is by these machines transmitted to the system, in which it is transformed into vital energy and physical power or strength. This mechanical, passive exercise, or movement-cure treatment, differs widely from, and should not be confounded with, "Swedish movements," to which it is far superior in efficacy. Coupled with our improved and wonderful system of "Vitalization" treatment, it affords the most perfect system of physical training and development ever devised. For the restoration of power to wasted, undeveloped, or weakened organs or parts, for their enlargement, this combined movement and "Vitalization" treatment is unequaled. It can be applied to strengthen or enlarge any organ or part. We also employ both Dynamic and Static electricity, "Franklinism" and Electrolysis, and chemical, Turkish and other baths, in all cases in which they are indicated. Inhalations, administered by means of the most approved apparatus, are employed with advantage in many obstinate lung, bronchial, and throat affections. We have no hobby or one-idea system of treatment, no good remedial means being overlooked or neglected. [Illustration: A glimpse of some of the rooms for the application of Electricity, Mechanical Massage, "Vitalization" treatment, and other agencies prescribed by our Staff; furnishing a perfect system of physical and remedial training, carefully adapted to the wants of the most delicate and feeble, as well as to the more robust.] A FAIR AND BUSINESS-LIKE OFFER TO THE AFFLICTED. Reader, are you accustomed to think and act for yourself? Do you consult your own reason and best interests? If so, then do not heed the counsel of skeptical and prejudiced friends, or jealous physicians, but listen to what we have to say. You perhaps know nothing of us, or our systems of treatment, or of the business methods we employ. You may _imagine_, but you _know nothing_, perhaps, of our facilities and advantages for performing cures in cases beyond the reach or aid of the general practitioner. Knowing nothing, then, of all these advantages, you still know as much as the would-be friend or physician who never loses an opportunity to traduce and misrepresent us, and prejudice the afflicted against us. Now to the point--are you listening? Then permit us to state that we have the largest, the best, and the finest buildings of any like Association, company, or firm in this country. We employ _more_ and _better_ Medical and Surgical Specialists in our Invalids' Hotel and Surgical Institute than any similar Association, company, or individual, and actually have more capital invested. We have a thoroughly qualified and eminent Specialist for every disease that we treat. We treat more cases, _and absolutely cure more patients_ than any similar institution in America. In addition to those we treat medically, we perform all the most difficult surgical operations known to the most eminent Surgeons, and so frequently do many of these operations occur with us that some of our Specialists have become the most expert and skillful Surgeons on this continent. We wish to add further that we are responsible to _you_ for what we represent; we therefore ask you to come and visit our institutions; and, if you find on investigation that we have misstated or misrepresented _in any particular_ our institutions, our advantages, or our success in curing Chronic Diseases, _we will gladly and promptly refund to you all the expenses of your trip_. We court honest, sincere investigation, and are glad and anxious to show interested people what we can do and are daily doing for suffering humanity. Can a proposition be plainer? Can an offer be more fair and business-like? If, therefore, you are afflicted, and are seeking relief, come where genuine ability is a ruling feature, where _success_ is our watchword and the alleviation of human suffering our mission. Whether arriving in our city by day or night, _come directly to the Invalids' Hotel and Surgical Institute, 663 Main Street_, where you will be hospitably received and well cared for. Address all correspondence to WORLD'S DISPENSARY MEDICAL ASSOCIATION, _663 Main Street, BUFFALO, N.Y._ * * * * * SUCCESSFUL TREATMENT OF CHRONIC OR LINGERING DISEASES. [Illustration] For many years the founder of the Invalids' Hotel and Surgical Institute and World's Dispensary has devoted himself very closely to the investigation and treatment of chronic diseases. Some few specifics have, during this time, been developed for certain forms of chronic ailments, and given to the public, but they have not been lauded as "cure-alls," or panaceas, but only recommended as remedies for certain well-defined and easily recognized forms of disease. These medicines are sold through druggists very largely, and have earned great celebrity for their many cures. So far from claiming that these proprietary medicines will cure all diseases, their manufacturers advise the afflicted that, in many complicated and delicate chronic affections, they are not sufficient to meet the wants of the case. These must have special consideration and treatment by a competent physician and surgeon, the medicines and other remedial means required being selected and prepared with reference to each particular case. In order to be able to offer those afflicted with chronic ailments the most skillful medical and surgical services, Dr. Pierce, many years ago, associated with himself several eminent physicians and surgeons, as the Faculty of the old and renowned World's Dispensary, the consulting Department of which is now merged with the Invalids' Hotel and Surgical Institute. DIVISION OF LABOR. In the organization of the medical and surgical staff of the Invalids' Hotel and Surgical Institute, several years ago, we assigned to one physician the examination and treatment of diseases of the nervous system; to another, surgical operations and the treatment of surgical diseases; a third had charge of catarrhal and pulmonary diseases and affections of the heart; a fourth attended to diseases peculiar to women; a fifth, to diseases of the eye and ear; a sixth, to diseases of the digestive organs; a seventh, to special surgical cases; to another we entrusted diseases of the urogenital organs; and to others, various other specialties. Now that our practice has become so very extensive as to require for its conduct a greatly increased number of physicians and surgeons. Thus four physicians and surgeons devote their undivided attention to the examination and treatment of diseases of the urinary and generative organs of men. Three physicians give their sole attention to diseases peculiar to women and three to those of the nasal organs, throat and chest, embracing all chronic diseases of the respiratory organs. Thus we have a full council of three and four physicians in these several specialties. In several other divisions we have two specialists. No case is slighted either in the examination or in the treatment. All doubtful, obscure or difficult cases are submitted to a council composed of several physicians and surgeons. Skilled pharmaceutists are employed to compound the medicines prescribed. For the purpose of enabling us to conduct our extensive correspondence (for we have an extensive practice en every part of the United States and Canada, as well as in Great Britain from our London branch), graphophones are employed, to which replies are dictated, recording the words of the speaker. Afterwards the letters are written out in full, generally on a type-writing machine, which prints them in a plain, legible style. These machines are operated as rapidly as a person can think of the letters which compose a word, each operator thus accomplishing the work of several copyists. This system, by which we are enabled to correspond with our patients as rapidly as we can talk, has been rendered necessary by the growth of our business, which has attained immense proportions, giving rise to so large a correspondence that a dozen physicians cannot possibly conduct it all and give each patient's case careful attention, without the employment of graphophones and all other facilities which modern invention has given us. By the adoption of these various means, we are enabled to fully meet the demands of the afflicted, and give every case the most careful attention. [Illustration: Faculty of Invalids' Hotel and Surgical Institute in Session.--Council-room.] As many persons, particularly young ladies and gentlemen, having catarrh or almost any other chronic disease, especially if of the urogenital organs, are very sensitive and fearful that somebody will know that they are afflicted and employing medical treatment, precautions are taken that none who consult us may incur the least risk of exposure. Although none but the most honorable and trustworthy gentlemen are employed as assistants, yet as a _guarantee_ of perfect security to our patients, that every communication, whether made in person or by letter, will be treated as _sacredly confidential_, each professional associate, clerk, or assistant, is required to take a solemn oath of secrecy. Great care is also taken to send all letters and medicines carefully sealed in plain envelopes and packages, so that no one can even _suspect_ the contents or by whom they are sent. ADVANTAGES OF SPECIALTIES. By thorough organization and a perfect system of subdividing the practice of medicine and surgery in this institution, every invalid consulting us is treated by a specialist--one who devotes his undivided attention to the particular class of diseases to which his or her case belongs. The advantage of this arrangement must be obvious. Medical science offers a vast field for investigation, and no physician can, within the limit of a single life-time, achieve the highest degree of success in the treatment of _every_ malady incident to humanity. A distinguished professor in the medical department of one of our universities, in an address to the graduating class, recently said: "Some professional men seem to be ashamed unless they have the character of universal knowledge. He who falls into the error of studying everything will be certain to know nothing well. Every man must have a good foundation. He must, in the first place, be a good general practitioner. But the field has become too large to be cultivated in its entirety by any individual; hence the advantage of cultivating special studies in large towns, which admit of the subdivision of professional pursuits. It is no longer possible to know everything; something must be wisely left unknown. Indeed, a physician, if he would know anything well must be content to be profoundly ignorant of many things. He must select something for special study, and pursue it with devotion and diligence. This course will lead to success, while the attempt to do everything eventuates unavoidably in failure. Let there be single hands for special duties." Our institution is the only one in this country in which these common-sense-ideas are _thoroughly_ carried out. The diversified tastes and talents of physicians cause each to excel in treating some one class of diseases, to which he devotes more attention and study than to others. One medical student manifests great interest in the anatomy, physiology, pathology, and treatment of diseases of the eye. He becomes thoroughly familiar with all the minutest details relative to that organ and its diseases, and so thoroughly qualifies himself in this branch of knowledge that he is able to cure an inflammation or other affection of the eye in a very short time. Another student is more interested in some other class of diseases, for the study of which he has a liking, and neglects to inform himself in the ophthalmic branch of medical and surgical science. If after engaging in the practice of his chosen profession, he is consulted by persons suffering from diseases of the eye, he tortures them with unnecessary and oftimes injurious applications, clumsily and carelessly made, and, as the result of such unskillful treatment, the inestimable blessing of sight may be sacrificed. [Illustration: A Corner in Printing Department.--World's Dispensary.] The great majority of physicians allow acute maladies, diseases of children, and the practice of midwifery, to engross most of their time and attention. They manifest an absorbing interest in everything that relates to these subjects, and devote little or no time to acquiring an intimate knowledge of the great variety of chronic maladies which afflict mankind. They acquire skill and reputation in their favorite line of practice, but are annoyed if consulted by one suffering from some obscure chronic affection, usually turn the invalid off with a very superficial examination, and, perhaps, only prescribe some placebo,[6] apparently indifferent as to the result, but really desiring thus to conceal their lack of familiarity with such diseases. The specialist, the treatment of chronic diseases being his vocation, is equally annoyed if consulted by those suffering from acute diseases, but does not pursue the inconsistent course of assuming to treat them. He refers them to those of his medical brethren whose daily dealings with such cases make them, in his way of thinking, more competent than himself to render valuable service to such sufferers. He recognizes the fact that no man is likely to succeed in any line of study or business for which he possesses no talent or relish, nor does he believe in being a "jack-at-all-trades and master of none." ADVERTISING. Having thoroughly qualified himself for the practice of some particular branch of the healing art, the specialist sees no impropriety in acquainting the public with his ability to relieve certain forms of suffering. He believes that medical men should possess equal rights with other business men, and that any code of medical ethics which would deprive him of any of the sacred rights guaranteed to all by the liberal laws of the country, is professional _tyranny_, and merits only his contemptuous disregard. Nor does he display any false modesty in the _manner_ of making known his skill. He maintains that he has an undoubted right to place his claim to patronage before the public by every fair and honorable means. He recognizes the display of goods in the merchant's show-windows as no less an advertisement and in no better taste than the publication of a card in the newspaper. So, likewise, he regards the various devices by which the extremely _ethical_ physician seeks to place himself conspicuously before the public, as but so many ways of advertising, and as not more modest than the publication of cures actually performed, or than his announcement through the public press of his professional resources for treating certain maladies. The physician who expresses a "holy horror" of the "_advertising doctor_," liberally bestowing upon him the epithet of "quack," announces _himself_ a graduate, talks learnedly and gives notice to the public in _some_ way that he is ready to serve them. He endeavors to impress upon the mind of the patient and family his skill, frequently exaggerates as to the extent of his practice, rides furiously about when he has no professional calls, keeps up business appearances by driving several horses, or joins influential societies. He may make a great display in style, manner, dress, pretensions, writing for the newspapers, exhibiting literary pedantry, referring to the superior facilities afforded by some particular school or society to which he belongs; or by editing and publishing a medical journal, ostensibly for the advancement of medical science, but practically to display titles or professorships, to publish reports which flatteringly allude to cases he has treated, the number of capital surgical operations he has performed, or the distinguished families he is treating. All these are but _modes of advertising_ professional wares; in short, are artful, though not refined, tricks, resorted to for private announcement. We say to all such adventurers in modern advertising diplomacy, that these indirect, clandestine methods are not half so candid and honorable as a direct public statement of the intentions and proposals of a medical practitioner, who thereby incurs an individual responsibility before the law and his fellow-men. No good reason has ever been assigned why any well educated physician, trained in the school of experience until he becomes proficient in medical skill, may not publish facts and evidence to disclose it, especially when these are abundant and conclusive. The following extracts from an able article by the Rev. THOMAS K. BEECHER embodies a sound view of the subject of medical advertising. He says: * * "I am glad that the doctor cured him; I am glad that the doctor put it in the paper that he could cure him. And if any doctor is certain that he can cure such diseases and don't put it in the paper, I am sorry. What a pity it would have been had this doctor come to town with his wealth of science and experience and gone away leaving him uncured! What a pity it would have been if he had been so prejudiced against advertising as to read the responsible certificate of the doctor and give him the go-by as a quack! What are newspapers for, if not to circulate information? What more valuable information can a newspaper give than to tell a sick man where he can be cured? If a man has devoted his life and labor to the study of a special class of diseases, the necessity of his saying so becomes all the more pressing. His _duty_ to advertise becomes imperative. "When I was in England, I found on all the dead walls of London, placards, declaring that Dean Stanley, Chaplain to the Prince of Wales, would preach at such a place; that his grace the Archbishop (I think) of Canterbury would preach at another time and place; again, that an Oxford professor would preach. In short, religious notices were sprinkled in among the theater bills, and the highest church dignitaries were advertised side by side with actors, singers, and clowns. Of course, I was shocked by it, but in a moment I bethought me--if it be all right and dignified to hire a sexton to ring a bell when the minister is going to preach, it is all the same to silence the bell and hire a bill-sticker to tell the same news, the essential thing being to tell the truth every time. The remedy for the lying advertisements is for honest men to tell the truth. 'When iniquity cometh in like a flood, then the spirit of the Lord lifts up the standard.' A really able man, whatever be his gifts, makes a great mistake if he fail to use those gifts through want of advertising." If a physician possesses knowledge that enables him to remedy diseases heretofore regarded as incurable, what virtue or modesty is there to "hide his light under a bushel"? In this free country the people think and act for themselves, and hence all have a deep concern in the subject of health. The strong popular prejudice against the doctors who advertise is due to the fact, that by this method so many ignorant charlatans are enabled to palm off their worthless services upon the uneducated and credulous; but the practice of such imposition should not cause a presumption against the public announcement of real skill, for the baser metal bears conclusive evidence that the pure also exists. Every step in scientific investigation, every proposition which relates to the interest and happiness of man, every statement and appeal involving a valuable consideration, must be submitted to the scrutiny and judgment of individual reason; for every person has the right to form his own conclusions, and justify them by experience. Those claims which are only supported by empty assertion are very doubtful. Misty theories vanish before the sun of truth. He who renders professional services cannot be successful, unless he be sustained by real merit. TREATING PATIENTS WHO RESIDE AT A DISTANCE. We can treat many chronic diseases as successfully without as with a personal consultation, as our vast experience enables us to correctly determine the malady from which the patient is suffering, from a history of the symptoms, and answers to questions furnished. We have not seen one person in five hundred of those whom we have cured. Some may suppose that a physician cannot obtain, through correspondence, a sufficiently accurate idea of the condition of a patient to enable him to treat the case successfully; but a large experience in this practice has proved the contrary to be true, for some of the most remarkable cures have been effected through the medium of correspondence. In most long-continued cases, the patient has thought over his symptoms hundreds of times. The location of every pain, whether acute or mild, constant or occasional, and the circumstances under which it occurs, have been carefully noted. He has observed whether he had a rush of blood to the head, was feverish or chilly, whether troubled with cold hands and feet, whether full of blood, or pale and bloodless; and he states these matters with accuracy and common sense when writing to us, for he has a very good, if not a professional, knowledge of the relative importance of these symptoms. So in regard to digestion, he states what kinds of food agree with him, or whether he is troubled with excessive acidity or a flatulent condition of the stomach. He also informs us whether his tongue is coated and bilious, or clean and healthy, and gives many other particulars too various to enumerate, by which we are enabled to gain a perfect understanding of the case. If his description be not sufficiently complete to enable us to obtain a definite understanding of the case, he is requested to answer a list of important questions which are sent him. The people are far more intelligent in these matters than physicians are generally willing to admit. A patient is often confused while being personally examined by a physician, and gives imperfect or incorrect answers. After he has left the presence of the physician, he finds that he has failed to enumerate many of the most important symptoms. In consulting by letter, the patient is not embarrassed, he states the exact symptoms, and carefully reads over the letter to see if it is a complete and accurate description of his sufferings. In this way he conveys a much better idea of the case than if present in person, and subjected to the most thorough questioning and cross-examination. The timid lady and nervous young man write just as they feel; and one important reason why we have had such superior success in treating intricate and delicate diseases, is because we have obtained such true and natural statements of the cases from these letters, many of which are perfect pen-pictures of disease. As bank-tellers and cashiers, who daily handle large quantities of currency, can infallibly detect spurious money by a glance at the engraving or a touch of the paper, so the experienced physician, by his great familiarity with disease, becomes equally skilled in detecting the nature and extent of a chronic malady from a written description of its symptoms. URINARY SIGNS. A careful microscopical examination and chemical analysis of the urine is a valuable aid in determining the nature of many chronic diseases, particularly those of the nervous system, blood, liver, kidneys, bladder, prostate gland and generative organs. This important fact is not overlooked at the Invalids' Hotel and Surgical Institute, where an experienced chemist is employed to make such examinations and report the result to the attending physicians. Medical authors, professors, and practitioners of all schools, admit and even insist upon the importance of such examinations in diagnosticating diseases. Many practitioners neglect to take advantage of this invaluable aid, while others fear that if they attach much importance to such examinations they will be ranked with "uroscopian" or "water" doctors, a class of enthusiasts who claim to be able to correctly diagnosticate every disease by an examination of the urine. Persons consulting us and wishing to avail themselves of the advantages afforded by these examinations can send small vials of their urine by express. The vials should be carefully packed in saw-dust or paper and enclosed in a light wooden box. All charges for transportation must be prepaid, and a complete history of the case including the age and sex of the patient, must accompany each package, or it will receive no attention. This saves valuable time by directing the examination into the channels indicated, thus avoiding a lengthy series of experiments. As we are daily receiving numerous vials of urine, every sample should, to prevent confusion, be labeled with the patient's name. [Illustration: Binocular Microscope used at the Invalids' Hotel and Surgical Institute.] [Illustration: Fig. 1.] There is a natural, definite proportion of the component elements of every solid and fluid of the human body. These proportions have been reduced to definite standards, a deviation from which affords evidence of disease. Thus, there being a fixed standard in a normal proportion of the elements of the blood, any deviation from it, as in anæmia, leucocythæmia, etc., indicates disease. So also the standard proportion of the urinary elements being known, any considerable change, either in quantity or quality of its parts, bears unmistakable evidence of disease. The invention of the microscope has provided increased facilities for detecting diseases by examination of the urine. By the aid of this wonderful instrument, we are enabled to discover with absolute certainty the various urinary deposits characteristic of different maladies; thus in Fig. 1, A represents in a general way the sediment of abnormal urine as seen under the microscope. In division B is represented oxalate of urea upon precipitation by oxalic acid. Nitrate of urea is represented in division C. A deficiency of urea in the urine, with albumen and casts present, is a most important guide in the diagnosis of Bright's disease. The average quantity of urea present during health is 21.57 parts in 1,000. The microscopic examination of the urine, notwithstanding the distaste, and even contempt, which many physicians manifest for such investigations, is pursued at the Invalids' Hotel and Surgical Institute, with inestimable benefit to our patients. It has revealed the existence of many serious affections, which, with all our other modes of investigation, we might have been unable to detect. It has also thrown light upon many obscure chronic diseases. [Illustration: Fig. 2.] We have already spoken of the marked changes effected in the urine by a derangement of the digestive functions. It is a matter of surprise that physicians generally pay so little attention to the urine when dyspepsia is suspected, since all admit that an examination of that excretion furnishes unmistakable evidence of the nature and complications of the disease. In this way we are many times enabled to determine whether the indigestion is caused by congestion or functional disease of the liver or kidneys or by nervous debility. And when such cases are treated in accordance with the indications furnished, increased success attends our practice. In Fig. 2 highly magnified urinary deposits, which indicate impairment of the digestive functions, are represented. The crystals are composed of oxalate of lime and appear in the different forms shown in the five sections, of octahedral, decahedral, round and dumb bell shapes. The latter are formed in the kidneys, and are sometimes discovered adhering to casts. [Illustration: Fig. 3.] INVALUABLE AIDS IN DETERMINING DISEASES OF THE KIDNEYS AND BLADDER. [Illustration: Fig. 4.] The various forms of gravel, Bright's disease of the kidneys, hæmaturia, inflammation of the kidneys and bladder, diabetes, and other functional and organic diseases of the urinary organs effect characteristic changes in the urine, thus enabling us to distinguish them with certainty and exactness. Some of the various microscopical appearances of the urinary deposits in diseases of the kidneys and bladder, are represented in Fig. 3. In division A is represented pus and mucus, with decomposition, indicating suppuration somewhere along the urinary tract. In B pus globules are alone represented. In the division marked C are shown blood corpuscles as they are arranged in blood drawn from a vein or artery. D represents the same separated, as they always are when present in the urine. In E highly magnified oil globules are represented. If present in the urine, they indicate disease of the kidneys. In F are represented epithelial cells, the presence of which in large numbers is indicative of diseases of the mucous lining of the urinary organs. Fig. 4 represents the microscopic appearance of phosphates in the urine. These are present in great quantity in cases of nervous debility and kindred affections. By attaching the _camera lucida_ to the microscope we can throw an image of these urinary deposits upon paper. By the art of the engraver this may be faithfully traced, and thus we are enabled to produce an accurate representation of them. Some of the beautiful crystalline deposits shown in Fig. 4 represent less than a millionth part of a grain, yet their forms are delineated with geometrical precision. Earthy phosphates are often mistaken for pus and also seminal fluid. Phosphates are always found in decomposed urine, otherwise they indicate brain affections, acute cystitis, etc. Experience has taught us that the voiding of urine loaded with phosphates is a forerunner of cystitis, or enlargement of the prostate gland, or both. In fact, persons so affected are "prone to serious consequences from mild attacks of almost any and every acute disease." [Illustration: Fig. 5.] Fig. 5 represents the microscopic appearance of mixed urinary deposits. In division A is represented fermentation spores as they appear in diabetic urine. Pasteur asserts that the germs of this fungus get into the urine after it has been passed. Urates appear in division B. These indicate waste of flesh, as in fevers, consumption, prolonged physical efforts, etc. Division C pictures urates of ammonia. These appear in alkaline decomposition of the urine; it is isomeric with uric acid in acid urine. In division D is represented urate of soda, which is present in the tissues of persons suffering from gout. The crystals shown in division E consist of the same salt. [Illustration: Fig. 6.] In Fig. 6, division A, is represented purulent matter as it appears in the urine. The formation of pus in different parts of the genitourinary system is accompanied by the appearance of pus corpuscles in the urine. When fat globules, represented in division B, are found in the urine, they indicate fatty degeneration. In division C are representations of the cells found in the urine of persons suffering from cystitis or other inflammatory diseases. [Illustration: Fig. 7.] Fig. 7, divisions A and B, represent different forms of cystine. Fortunately this substance is rarely found in the urine. When present however it indicates liability to, or the actual presence of, a calculus or stone in the bladder. In division C is a representation of the deposits seen in the urine of those who are greatly debilitated. In division D are seen epithelial cells mixed with mucus. [Illustration: Fig. 8.] In Fig. 8, division A, are represented the caudated cells from the deep structure of the bladder. The cells represented in division B are amyloid concretions, found where there is an enlarged prostate gland. Fig. 9 represents the appearance of spermatozoa as seen in the urine. When present, they afford indisputable evidence of the escape of semen in the renal excretions. We might add many other illustrations of urinary deposits and state their several indications, but a sufficient number has been introduced to show the importance and practical value of microscopic examinations of the urine in revealing obscure diseases. Although the microscope is of inestimable value in examining the renal excretion, it does not entirely supersede other valuable instruments and chemical re-agents in determining constitutional changes. By the urinometer we determine the specific gravity of the urine; by the use of litmus its acid or alkaline reaction, is ascertained; while various chemicals, when added to it, produce certain specific changes, according to the morbid alterations which it has undergone by reason of disease. By the application of heat, or the addition of a few drops of nitric acid, the albumen, which is invariably present in Bright's disease of the kidneys, is coagulated. By the employment of other re-agents we may determine the presence of sugar--a characteristic of diabetic urine. And thus we might mention almost innumerable chemical tests by which the several changed conditions of the urine, _characteristic_ of different diseases, may be ascertained with _absolute certainty_. THE MOST EMINENT MEDICAL AUTHORITIES ENDORSE IT. Dr. Eberle, a distinguished allopathic author, thus writes: "Whatever may be the disease, the urine seldom fails in furnishing us with a clue to the principles upon which it is to be treated." Dr. Braithwaite also says: "We can arrive at a more accurate knowledge respecting the nature of diseases from examining the urine than from any other symptom." Golding Bird, whose writings are regarded as sound and practical by the most learned of the medical profession, says: "The examination of the urine in disease is now regarded as one of the most important aids in diagnosis, and which it would be injurious alike to the welfare of the patient and the credit of the practitioner to avoid." [Illustration: Fig. 9.] The eminent Dr. F. Simon writes as follows: "From the physical and chemical state of the urine, the attentive and observing physician may obtain a great quantity of information for ascertaining and establishing a diagnosis. More than all other signs, the correct examination of the sediment is of importance to the physician. * * * For the medical man it is the compass which guides him in the unlimited chaos of disease and its treatment; for the patient it is the thermometer of his condition, the premonitory indication of the decrease or aggravation of his malady; and for the healthy man it is the regulator of his diet and his life. Every one is aware of the variations of the barometer, and we know that the fluctuations of the column of mercury are closely associated with the variable conditions of the atmosphere; so, to the practical observer, variations of the urine, as well as the elements composing it, point out with certainty the changes in health, and the condition of the organs." While we recognize the importance of examining the urine as an aid in distinguishing diseases, and have made this old German method of diagnosis a special study, yet we do not claim that _all_ diseases can be unmistakably distinguished by such examinations _alone_. We take a conservative position and have no confidence in that class of ignorant fanatics whose pet hobby is "uroscopy." From every person who solicits our professional services, we require explicit answers to numerous important questions, that we may know the age, sex, vocation, etc., as well as the prominent symptoms manifested. CONSULTATIONS BY LETTER. Formerly, we published in this book a very extensive list of questions to be answered by those consulting us, but a large experience has convinced us that beyond requiring answers to a few leading questions, which we still retain, it is better to let the patient describe the malady in his or her own way and language. After receiving and considering such a history, if we do not fully understand the patient's malady, we will ask such further questions as may be necessary. The patient should, however, in addition to writing name, post-office, county, and state, _plainly_, state the name of the town containing the nearest express office. Next give age, sex, whether married or single, complexion, height, present and former weight, if known, and occupation. State also if you have been a hard worker, and whether it is necessary for you to labor hard now, how long you have been out of health, and from what particular symptoms you suffer most. Follow this with a history of your case in your own language. If you find in this volume an accurate description of your disease, state the page and paragraph where it occurs. FREE CONSULTATION. We now make no charge for consultation by letter, but, instead of the one dollar formerly charged by us as a consultation fee, as we are desirous of making our facilities for treatment known to invalids far and near, we request that all persons writing to us for advice send us the names of all those within the circle of their acquaintance who are in any way in need of medical or surgical treatment for chronic diseases. If convenient, send the list on a separate piece of paper. CHARGES MUST BE PREPAID. Should you send a vial of urine for analysis, about a cupful will do, and _all express charges on it must be prepaid_. All liquids are excluded from the mails, when discovered, and yet we have received hundreds of samples through the mails safely when put in homoeopathic or other _very small_ vials, well corked and carefully packed in a light tin can or _wooden_ box, or in a light pine stick bored out hollow, the vial being carefully packed in sufficient saw-dust or blotting paper to absorb all liquid should the vial get broken. Letter postage, that is, two cents for each one ounce or fraction thereof, must be paid upon these sealed packages. Send the first urine that is passed after rising in the morning. RELIABLE MEDICINES. Next in importance to a correct understanding of the patient's disease, is the possession of reliable remedies for its treatment. Many of the medicines employed by physicians engaged in general practice are prepared from old drugs that have lost all their medicinal virtues, and hence are utterly useless and ineffectual. Many vegetable extracts are inert, because the plants from which they are produced were not gathered at the proper time. To give the reader an idea of the great care which we exercise in the selection and preparation of our medicines, he is requested to read under the head of "The Preparation of Medicines," in "The People's Common Sense Medical Adviser." OUR TERMS FOR TREATMENT require the payment of monthly fees, in advance, which entitles the patient to medicines specially prepared for and adapted to his or her particular case, and to all necessary attention and advice. Our fees for treatment are moderate, varying according to the nature and requirements of each particular case, and will be made known at the time of consultation. WHY OUR FEES ARE REQUIRED IN ADVANCE. We receive applications from strangers residing in all parts of America, and even in foreign countries, and it is not reasonable to suppose that credit could be dispensed so indiscriminately. It would not be a correct business transaction for a merchant to send a barrel of sugar or a roll of cloth to a stranger living hundreds of miles away, to be paid for when used. Our knowledge and medicines constitute our capital in business, and an order upon that capital should be accompanied with an equivalent. Some applicants refer us to their neighbors for a testimonial of their integrity. We cannot spare the time or employ assistants to make such inquiries for the sake of trusting any one. Should credit be thus indiscriminately given, there would necessarily be losses, and, to compensate for these, and the extra expense incurred by the employment of assistants, our fees would have to be much larger, thereby imposing the burden upon those who _do_ pay. Instead of following this method of procedure, we place professional services within the reach of all, so that a greater number may be benefited. Many invalids say that they have paid large sums of money to medical men for treatment without obtaining relief. Unfortunately our land is cursed with quacks and unprincipled practitioners, who seek no one's good but their own, and it is a defect in our law that it permits such swindlers to go unpunished. Not so reprehensible is the family physician who fails, because his limited and varied practice does not permit him to become proficient in treating chronic diseases. The following beautiful sentiment of Hood truthfully expresses the sacredness of the physician's trust: "Above all price of wealth The body's jewel. Not for minds or hands profane To tamper with in practice vain. Like to a woman's virtue is man's health; A heavenly gift within a holy shrine! To be approached and touched with serious fear, By hands made pure and hearts of faith severe, E'en as the priesthood of the One Divine." We are in regular practice, responsible for what we say and do, and cordially invite those who desire further evidence of our success in curing chronic diseases to come to the Invalids' Hotel and Surgical Institute and satisfy themselves of the truthfulness of our statements. We are warranted in saying that our responsibility and disposition for fair dealing are known to many of the principal mercantile houses, as well as to all prominent American editors. We also refer to our present and former patients, one or more of whom may be found in almost every hamlet of America. To all who are under our treatment we devote our highest energies and skill, fully realizing that an untold blessing is conferred upon every person whom we cure, and that such cures insure the permanency of our business. On the contrary, we realize how unfortunate it is for us to fail in restoring to health any person whom we have encouraged to hope for relief. We are careful, therefore, not to assume the treatment of incurable cases, except when desired to do so for the purpose of mitigating suffering or prolonging life; for we never wish to encourage false hopes of recovery. TERMS FOR BOARD AND TREATMENT AT THE INVALIDS' HOTEL AND SURGICAL INSTITUTE are moderate, varying with the nature of the case and the apartments occupied. At times so great is the number applying to avail themselves of the skill of our Faculty, and the advantages which our institution affords, that we are unable to receive all applicants. To be sure of securing good apartments, it is well to engage them sometime ahead, and make an advance payment of fifty dollars or more upon them, which will be refunded in case acute sickness or any similar cause should prevent the patient from occupying them at the time specified. Complete terms for treatment and board can be arranged only when personal application for entrance to the institution is made, and the nature and extent of the disease and the necessary treatment fully determined by personal examination of the case. If satisfactory terms and arrangements cannot at that time be agreed upon, or if the case be deemed incurable, any advance payments that have been made to secure good apartments will be promptly refunded. SPECIAL ADVICE. Those coming here to consult us personally, should bring the money to pay for our services and for board and care while remaining here, in the form of drafts on New York City, Boston or Chicago, and _not_ in the form of checks on a local or home bank. Such drafts can be purchased in the home bank by paying a small amount for the exchange. If more convenient, post office orders payable at Buffalo post office will do. VISITING PATIENTS WHO RESIDE AT A DISTANCE. We are frequently asked to visit patients residing hundreds of miles away, that we may personally examine their cases, or perform difficult surgical operations. We can seldom comply with such requests as the time of our professional Staff is generally very fully occupied. TO PHYSICIANS wishing to consult us in intricate cases of chronic diseases under their treatment, we desire to say that we shall, as in the past, take pleasure in responding to their solicitations. We have all the necessary instruments and appliances required in executing the most difficult surgical operations, and, as we have had much experience in this department, we are always ready and able to assist physicians who do not practice operative surgery. In this age of railways and telegraphs medical and surgical aid can be summoned from a distance and promptly obtained. OUR MEDICINES as put up for sale through druggists, are not recommended as "cure-alls," or panaceas, but only as superior remedies for certain common and easily-recognized diseases. They are our favorite prescriptions, improved and perfected by long study and a vast experience in the treatment of chronic diseases, and have gained world-wide celebrity and sale. We are well aware that there are many chronic diseases that can only be successfully treated and cured by careful adaptation of remedies to each individual case. This is especially true of the ever-varying and delicate diseases of the kidneys and bladder. It is not less so with reference to nervous debility, involuntary vital losses, with which so many young and middle-aged men are afflicted; and we may also include in this list epilepsy or fits, paralysis or palsy, obstinate gleety discharges, and many other chronic and delicate ailments of which our staff of physicians and surgeons cure annually many thousands of cases, but _for which we do not recommend_ any of our put-up, ready-made, or proprietary medicines. NO RELATIONSHIP WITH HUMBUGS. Had our put-up or proprietary medicines, as sold by druggists the world over, been adapted to all classes and forms of chronic diseases, there would have been no necessity for our organizing a competent staff of physicians and surgeons to act as experts in the treatment of difficult, obscure, and complicated cases of chronic diseases. That we keep constantly employed, in our Buffalo and London institutions, eighteen medical gentlemen, with such helpers as chemists, clerks, etc., is indisputable proof that the medicines we offer for sale through druggists should not be classed with the humbug nostrums recommended to cure everything. They are the outgrowth of our vast and extended practice in the treatment of chronic diseases; are well-tried, world-famed, and _honest medicines_. They are not unduly puffed and lauded, but simply recommended for such diseases as are easily recognized and which they are _known to cure._ NOT CONFINED IN PRESCRIBING Our physicians, in the treatment of cases consulting us, prescribe just such medicines as are adapted to each particular case. _They are not confined in the least_ to our list of a few put-up or proprietary medicines (valuable as they are when applicable to the case) but resort to the whole broad range of the _materia medica_, employed by the most advanced physicians of the age. They are not hampered by any school, _ism_ or "_pathy_." OUR MEDICINES PREPARED WITH THE GREATEST CARE. The medicines employed are all prepared in our own Laboratory by skilled chemists and pharmacists, and the greatest care is exercised to have them manufactured from the freshest and purest ingredients. Our Faculty probably employ a greater number and variety of native roots, barks, and herbs, in their practice then are used in any other invalids' resort in the land. Using vast quantities of these indigenous medicines, we can afford and do not neglect to have them gathered with great care, at the proper seasons of the year, so that their medicinal properties may be most reliable. Too little attention is generally paid to this matter, and many failures result from the prescribing of worthless medicines by physicians who have to depend for their supplies upon manufacturers who are careless or indifferent in obtaining the crude plants and roots from which to manufacture their medicines for the market. While depending largely upon solid and fluid extracts of native plants, roots, barks, and herbs, in prescribing for disease, yet we do not use them to the exclusion of other valuable curative drugs and chemicals. We aim to be unprejudiced and independent in our selection of remedies, adopting at all times a rational system of therapeutics. This liberal course of action has, in a vast experience, proved most successful. WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 MAIN STREET, BUFFALO, N.Y. * * * * * PRESIDENT GARFIELD'S ENDORSEMENT OF THE INVALIDS' HOTEL AND SURGICAL INSTITUTE _AND ITS FOUNDER._ The following letter from an eminent lawyer of Tennessee, is noteworthy, inasmuch as it shows the estimation in which Dr. Pierce and the institutions which he has founded were held by the lamented Garfield, who was one of the Doctor's intimate friends and colleagues while he was serving as a member of Congress: OFFICE OF H.F. COLEMAN, ATTORNEY AT LAW, SNEEDVILLE, TENN., Aug. 11, 1884 _World's Dispensary Medical Association, 663 Main St., Buffalo, N.Y._ GENTLEMEN:--Your letter of the 31st ult. just received and contents noted. I am perfectly satisfied with the explanation, and ask pardon for the sharp letter written you some days since. The mails are very irregular, as you know, and we are too apt to be impatient and attribute our mishaps to the wrong cause. Your honesty, integrity and ability are not doubted in the least by me. I have, perhaps, a higher endorsement of you than any other patient under your care, and for your gratification I will give it to you. Some time since I was in conversation with Congressman Pettibone, of this State, when the following conversation took place: "You say," said the Major, "that you have visited Dr. Pierce's medical establishment in Buffalo, New York?" "Yes, sir, I did." "You found everything as represented?" "Yes, sir, as was represented, and which I assure you was quite encouraging to a man who had traveled as far as I had to visit an institution of that kind." "That man, Dr. Pierce," said the Major, "is one of the best men of the times. While at Washington, during my first term," he continued, "one day I was in President Garfield's room and a fine-looking, broad-foreheaded gentleman came in, and President Garfield arose and took him by the hand and said, 'Good morning, Doctor, I am so glad to see you,' and then turned and introduced him to me as Dr. Pierce, of Buffalo, New York. Knowing the Doctor by reputation, and having seen his pictures, I at once recognized him. He, in a short time, left the room, and Garfield said to me, 'Major, that is one of the best men in the world, and he is at the head of one of the best medical institutions in the world.'" With this high endorsement, I have unbounded confidence in your integrity and ability. Very truly yours, H.F. COLEMAN. * * * * * NOTICES OF THE PRESS. * * * * * OUR PROFESSIONAL STAFF. The Buffalo _Evening News_ says: "Each and every member of the medical and surgical staff of the Invalids' Hotel and Surgical Institute is a graduate in medicine and surgery from one or more legally chartered medical colleges, and several of the members have had many years of experience as army surgeons, and in hospital and general as well as in special practice. One is a licentiate of the Royal College of Physicians, Edinburgh; licentiate of the Faculty of Physicians and Surgeons, Glasgow; licentiate of midwifery, Glasgow; member of the Royal College of Surgeons, London, England; extraordinary member of the Royal Medical Society, Edinburgh, etc. Another is a graduate of the University of Pennsylvania, at Philadelphia; another of the New York Medical College; another of the Buffalo Medical College, and of the College of Physicians and Surgeons, New York; another of Cincinnati Medical College, and of the University of New York; another from Buffalo Medical College, and diplomas from all these institutions, as well as from many others equally noted, can be seen at the offices of this institution, if any one feels any interest in them." * * * * * _FROM THE "ROMAN CITIZEN," (ROME, N.Y.)._ THE INVALIDS' HOTEL AND SURGICAL INSTITUTE. One of the most extensive institutions in this country for the treatment of chronic ailments is the Invalids' Hotel and Surgical Institute at Buffalo, under the control of the World's Dispensary Medical Association, of which Dr. R.V. PIERCE is President. The hotel itself is a wonderful affair, combining all the comforts and conveniences of a luxurious home with the most complete facilities for the successful treatment of all chronic diseases incident to humanity. Dr. PIERCE has a world-wide fame as a skillful practitioner, and his corps of assistants comprises many physicians and surgeons of great ability and large experience in the treatment of chronic and surgical diseases. Those who have been treated by the Association are loud in their praises, and we understand that the number of its patients increases with each succeeding year. The country is full of people who have been "doctoring" year after year without successful results, and the probabilities are that in a majority of such cases a few months spent at the Invalids' Hotel and Surgical Institute in the care of its medical experts, would result in material and permanent benefit. * * * * * _FROM THE WASHINGTON (D.C.) CHRONICLE._ ONE OF THE ATTRACTIONS AT BUFFALO. In the enterprising city of Buffalo some eminent and capable professional people have established an "Invalids' Hotel and Surgical Institute," under the comprehensive direction and control of the "World's Dispensary Medical Association" at 663 Main Street, in that beautiful city. This Institute is organized with a full staff of eighteen physicians and surgeons, and the hotel is exclusively devoted to treatment of chronic diseases. This corps of doctors make a specialty of chronic maladies, and the Institute is reputed to have abundant skill, facilities and apparatus for the successful treatment of every form of chronic ailment, whether requiring for its cure medical or surgical means. The building occupied is a massive one of five stories. * * * * * _FROM THE MISSOURI REPUBLICAN_ (_ST. LOUIS_). A REMARKABLE PROFESSIONAL SUCCESS. Among the notable professional men of this country who have achieved extraordinary success is Dr. R.V. PIERCE, of Buffalo, N.Y. The prominence which he has attained has been reached through strictly legitimate means, and so far, therefore, he deserves the enviable reputation which he enjoys. This large measure of success is the result of a thorough and careful preparation for his calling, and extensive reading during a long and unusually large practice, which has enabled him to gain high commendation, even from his professional brethren. Devoting his attention to certain specialties of the science he has so carefully investigated, he has been rewarded in a remarkable degree. In these specialties he has become a recognized leader. Not a few of the remedies prescribed by him have, it is said, been adopted and prescribed by physicians in their private practice. His pamphlets and larger works have been received as useful contributions to medical knowledge. He has recently added another, and perhaps more important work, because of more general application, to the list of his published writings. This book, entitled "The People's Common Sense Medical Adviser," is designed to enter into general circulation. For his labors in this direction, Dr. PIERCE has received acknowledgments and honors from many sources, and especially scientific degrees from two of the first medical institutions in the land. His works have been translated into the German, Spanish, French, and other foreign languages. * * * * * _FROM THE TOLEDO BLADE_. Dr. PIERCE has now been before the general public long enough to enable the formation of a careful estimate of the efficiency of his treatment and his medicines, and the verdict, we are glad to know, has been universally favorable to both. * * * * * _FROM THE ST. LOUIS GLOBE_. THE SUCCESSFUL PHYSICIAN. Dr. PIERCE is a type of a class of men who obtain success by careful and well-directed effort, not attempting too much, nor creating false ideas as to ability. The only reliable physician, in these days of complicated disorders and high-pressure living, is the "Specialist," the man who understands his own branch of the business. Such, in his line, is Dr. Pierce. He has written a "Common Sense Medical Adviser," which is well worth reading. With strict business honor, high professional skill, reasonable fees, and a large corps of competent assistants Dr. Pierce has made his name as familiar as "household words." * * * * * From _the Rocky Mountain Herald_. Dr. R.V. PIERCE, the greatest American specialist, and proprietor of the World's Dispensary, Buffalo, N.Y., has sent us his new book entitled "The People's Common Sense Medical Adviser," which is a handsome, large volume, elegantly got up, with hundreds of wood-cuts and colored plates, and a complete cyclopedia of medical teachings for old and young of both sexes. _It has every thing in it,_ according to the latest scientific discoveries, and withal is wonderfully _commomensical_ in its style and teachings. * * * * * _From the Lafayette Daily Courier._ Dr. R.V. PIERCE, of Buffalo, distinguished in surgery, and the general practice of the profession he honors, has made a valuable contribution to the medical literature of the day, in a comprehensive work entitled "The People's Common Sense Medical Adviser." While scientific throughout, it is singularly free from technical and stilted terms. It comes right down to the common-sense of every-day life, and, to quote from the author himself, seeks to "inculcate the facts of science rather than the theories of philosophy." This entertaining and really instructive work seems to be in harmony with the enlarged sphere of thought, as touching the open polar sea of evolution. He considers man in every phase of his existence, from the rayless atom to the grand upbuilding of the noblest work of God. Dr. PIERCE is a noble specimen of American manhood. He has sprung from the people, and with many sympathies in common with the masses, has sought to render them a substantial service in this the great work of his life. * * * * * _From the New York Independent._ LAURELS FOR TRUE WORTH. "A wise physician, skill'd our wounds to heal, Is more than armies to the public weal." To be honored in his own land is the crowning blessing of the man who has been "the architect of his own fortune"--the man who has made for himself, with his own hands and brain, a princely fortune and an enduring fame. From COMLEY'S History of New York State, containing biographical sketches of the men who "have given wealth, stamina, and character" to the Empire State, we clip the following brief sketch of the distinguished physician, Dr. R.V. PIERCE, of Buffalo: "Every nation owes its peculiar character, its prosperity--in brief, every thing that distinguishes it as an individual nation,--to the few men belonging to it who have the courage to step beyond the boundaries prescribed by partisanship, professional tradition, or social customs. In professional no less than in political life there occasionally arise men who burst the fetters of conventionalism, indignantly rejecting the arbitrary limits imposed upon their activity, and step boldly forward into new fields of enterprise. We call these men _self-made._ The nation claims them as her proudest ornaments--the men upon whom she can rely, in peace for her glory, in war for her succor. Of this class of men the medical profession has furnished a distinguished example in the successful and justly-celebrated physician, Dr. R.V. PIERCE, of Buffalo, N.Y., and any history treating of the industries of the Empire State would be incomplete without a sketch of his useful and earnest work. * * * Specially educated for the profession which he so eminently adorns, he early supplemented his studies by extensive and original research in its several departments. He brought to his chosen work acute perceptive and reflective powers, and that indomitable energy that neither shrinks at obstacles nor yields to circumstances. In physique, Dr. PIERCE is an ideal type of American manhood. Of medium stature, robust, his appearance is characterized by a healthful, vigorous vitality, while the full, lofty brow and handsomely cut features are indicative of that comprehensive mental power and remarkable business sagacity which have combined to place him among the distinguished men of the age. * * * As an earnest worker for the welfare of his fellow-men, Dr. PIERCE has won their warmest sympathy and esteem. While seeking to be their servant only, he has become a prince among them. Yet the immense fortune lavished upon him by a generous people he hoards not, but invests in the erection and establishment of institutions directly contributive to the public good, the people thus realizing, in their liberal patronage, a new meaning of the beautiful Oriental custom of casting bread upon the waters. Noted in both public and private life for his unswerving integrity and all those sterling virtues that ennoble manhood, Dr. PIERCE ranks high among those few men whose names the Empire State is justly proud to inscribe upon her roll of honor." Dr. PIERCE has lately erected a palatial Invalids' Hotel for the reception of his patients, at a cost of over half a million dollars. * * * * * A MAN OF THE TIME. Speaking of Dr. R.V. PIERCE, the _Buffalo_ (N.Y.) _Commercial_ says: "He came here an unknown man, almost friendless, with no capital except his own manhood, which, however, included plenty of brains and pluck, indomitable perseverance, and inborn uprightness, capital enough for any man in this progressive country, if only he has good health and habits as well. He had all these great natural advantages, and one thing more, an excellent education. He had studied medicine and been regularly licensed to practice as a physician. But he was still a student, fond of investigation and experiment. He discovered, or invented, important remedial agencies or compounds. Not choosing to wait wearily for the sick and suffering to find out (without any body to tell them) that he could do them good, he advertised his medicines and invited the whole profession of every school, to examine and pronounce judgment on his formulas. He advertised liberally, profusely, but with extraordinary shrewdness, and with a method which is in itself a lesson to all who seek business by that perfectly legitimate means. His success has been something marvelous--so great, indeed, that it must be due to intrinsic merit in the articles he sells, more even than to his unparalleled skill in the use of printer's ink. The present writer once asked a distinguished dispensing druggist to explain the secret of the almost universal demand for Dr. PIERCE'S medicines. He said they were in fact genuine medicines--such compounds as every good physician would prescribe for the diseases which they were advertised to cure. Of course, they cost less than any druggist would charge for the same article, supplied on a physician's prescription, and, besides, there was the doctor's fee saved. Moreover, buying the drugs in such enormous quantities, having perfect apparatus for purifying and compounding the mixture, he could not only get better articles in the first place, but present the medicine in better form and cheaper than the same mixture could possibly be obtained from any other source. * * * * * _Extracts from Biographical Sketches of New York Senators._ At the age of eighteen, he (Dr. PIERCE) entered a medical school, and proved a devoted student, graduating at twenty-three with the highest honors. A simple knowledge of the routine of practice as then in vogue, was not enough. He sought new means of healing, and explored "schools" of practice that were prohibited by his sect. He denounced errors in the prevailing "schools" and accepted truths belonging to those prohibited. Every one knows how such daring and destructive innovations are regarded by the medical profession generally. Dr. PIERCE was no exception to the rule. But he paid no attention to detraction, pursuing his own way with that energy which proves now to be a most excellent ally of his medical instincts. The World's Dispensary is to-day the greatest institution of its kind in the world. More than two hundred persons are employed, eighteen being skillful physicians and surgeons, each devoting himself to a special branch of the profession, all acting together when required, as a council. The printing department of the Dispensary is larger than the similar department of any paper outside of the _New York Herald._ * * * * * _From The New York Times._ WELL-MERITED SUCCESS. The author of "The People's Medical Adviser" is well-known to the American public as a physician of fine attainments, and his Family Medicines are favorite remedies in thousands of our households. As a counselor and friend, Dr. PIERCE is a cultured, courteous gentleman. He has devoted all his energies to the alleviation of human suffering. With this end in view and his whole heart in his labors, he has achieved marked and merited success. There can be no real success without true merit. That his success is _real_, is evidenced by the fact that his reputation, as a man and physician, does not deteriorate; and the fact that there is a steadily increasing demand for his medicines, proves that they are not nostrums, but reliable remedies for disease. The various departments of the World's Dispensary in which his Family Medicines are compounded and his special prescriptions prepared, are provided with all modern facilities. * * * * * _The New York Tribune says:_ "The American mind is active. It has given us books of fiction for the sentimentalist, learned books for the scholar and professional student, but _few books for the people_. A book _for the people_ must relate to a subject of universal interest. Such a subject is the physical man, and such a book 'The People's Common Sense Medical Adviser,' a copy of which has been recently laid on our table. The high professional attainments of its author,--Dr. R.V. PIERCE, of Buffalo, N.Y.,--and the advantages derived by him from an extensive practice, should alone insure for his work a cordial reception." Price $1.50, post-paid. Address, WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y. * * * * * _From The Boston Daily Globe._ A CURE FOR MANY EVILS. What can be accomplished by judicious enterprise, when backed up by ability and professional skill, is shown by the magnificent buildings of the World's Dispensary and the Invalids' Hotel and Surgical Institute, at Buffalo. While models of architectural beauty and completeness, their real worth and usefulness consist rather in the humanitarian objects they are made to serve. They stand superior to all institutions of their kind, not only in material proportions but as well in the medical knowledge and practical experience of those connected with them. In each department are those and those only who by natural bent and training are specially adapted to combating their particular class of "the ills which flesh is heir to." VOCABULARY OF THE COMMON SENSE MEDICAL ADVISER, _GIVING EACH TECHNICAL WORD EMPLOYED, REFERRING TO ITS IMAGES/ADVISE WHEN POSSIBLE, AND IN CASE THE WORD WILL NOT PERMIT OF A SHORT DEFINITION, REFERRING TO THE PAGE WHERE A FULL DESCRIPTION OF ITS MEANING MAY BE FOUND._ A ABDOMEN. The part of the body between the diaphragm and pelvis, containing the stomach, intestines, etc. The belly. ABDOMINAL. Belonging to the Abdomen. ABORTION. Expulsion of the foetus before the seventh month of pregnancy. ABSORPTION. The function of taking up substances from within or without the body. ACETABULUM. The bone socket which receives the head of the thigh bone. ACNE. Pimples upon the face, more common at the age of puberty. ADIPOSE TISSUE. A thin membrane composed of cells which contain fat. ADVENTITIOUS. Acquired. ALBUMEN IN URINE in chemical composition resembles the white of an egg, and is detected by the application of heat, nitric acid, etc. ALBUMINOID. Of the nature of albumen. ALBUMINURIA. A condition or disease in which the urine contains albumen. (See above.) ALIMENTARY CANAL. The canal extending from the mouth to the anus, through which the food passes. ALLOPATHY. Allopathic school. Defined on page 293. ALTERATIVE. A medicine which gradually changes the constitution, restoring healthy functions. ALVEOLAR PROCESS. The bony structure which contains the sockets of the teeth. AMAUROSIS. Loss or decay of sight from disease of the optic nerve. AMENORRHEA. Suppression of the menses. AMNION. A membrane enveloping the foetus and the liquid. AMPUTATION. The operation of cutting off a limb. AMYLOID DEGENERATION. Alteration in the texture of organs, which resembles wax or lard. AMYLOIDS. Foods composed of carbon and hydrogen; as sugar, starch, etc. ANÆMIA. Privation of blood. Lack of red corpuscles in the blood. ANASARCA. Dropsy attended with bloating all over the body. ANATOMY. The science of the structure of the body. ANESTHETIC. An agent that prevents feeling in surgical operations, and in some diseases of a painful nature. ANGINA (PECTORIS). Violent pain about the heart, attended with anxiety and difficult breathing. ANIMALCULA, ANIMALCULE. An animal so small as to be invisible, or nearly so, to the naked eye. ANODYNES. Medicines which relieve pain. ANTEVERSION. The womb falling forward upon the bladder. Illus. p. 716. ANTHELMINTICS. Medicines which destroy or expel worms from the stomach and intestines. ANTIDOTE. A remedy to counteract the effect of poison. ANTIFEBRILE. A remedy which abates fever. ANTIPERIODIC. A remedy which prevents the regular appearance of similar symptoms in the course of a disease. ANTISEPTIC. Medicines which prevent putrefaction. ANTISPASMODICS. Medicines which relieve spasm. ANUS. The circular opening at the end of the bowel, through which the excrement leaves the body. AORTA. The great artery of the body arising from the heart. Illus. page 58. APERIENT. A medicine which moves the bowels gently. APHTHÆ. Sore mouth, beginning in pimples and ending in white ulcers. APHTHOUS. Complicated with aphthæ. APNOEA. Short, hurried breathing. APOPLEXY. The effects of a sudden rush of blood to an organ; as the brain, lungs, etc. Brain pressure, from rupture of a blood-vessel. AQUEOUS HUMOR. The clear fluid contained in the front chambers of the eye. ARACHNOID. A thin, spider-web like membrane covering the brain. AREOLAR TISSUE. The network of delicate fibres spread over the body, binding the various organs and parts together. ARTERY. A vessel carrying blood from the heart to the various parts of the body; usually red in color. ARTICULAR. Relating to the joints. ARTICULATED. Jointed. ARTICULATIONS. The union of one bone with another. A Joint. ASCITES. Accumulation of fluid in the abdominal cavity. ASPHYXIA. A condition of apparent death owing to the supply of air being cut off; as in drowning, inhalation of gases, sun-stroke, etc. ASPIRATOR. An instrument for the evacuation of fluids from the cavities of the body, as water in abdominal dropsy, the contents of tumors, etc. ASSIMILATION. Appropriating and transforming into its own substance, matters foreign to the body. ASTRINGENTS. Medicines which contract the flesh. ATONIC, ATONY. Wanting tone. ATROPHIED. Wasted; lessened in bulk. ATROPHY. Wasting away; diminution in size. AUDITORY NERVES. The nerves connecting the brain with the ears and employed in exercising the sense of hearing. AUSCULTATION. Diagnosing diseases by listening, either with or without instruments. B BALANITIS. Gonorrhea of the mucous surface of the head of the penis. BENIGN. Harmless; a term applied to tumors. BEVERAGE. A liquor for drinking. BILE. A yellow bitter fluid secreted by the liver. Defined on page 80. BILIOUS. Disordered in respect to bile. Relating to bile. BILIOUS TEMPERAMENT, VOLITIVE TEMPERAMENT. See page 173. BIOLOGY. The science of life. BISTOURY. A small cutting knife. BLADDER (URINARY). The organ, situated behind the pubic bone, which holds the urine until its expulsion. Illus. pages 206 and 207. BLEBS. Eminences of the skin containing a watery fluid. BLOODY-FLUX. A disease characterized by frequent, scanty, and _bloody_ stools. BOIL. An inflamed tumor which comes to a head and discharges matter and a core. See page 443. BOLUS. A large pill. BOUGIE. A long, flexible instrument used for dilating contracted canals and passages. BREACH. Some form of hernia of the abdomen. See page 862. BROAD LIGAMENTS OF THE UTERUS. Folds of the peritoneum which support the womb and contain the Fallopian tubes and ovaries. Illus. p. 206. BRONCHEA. Tubes formed by the division of the windpipe. Illus. page 64. BRONCHOCELE. Thick neck, goitre. BUBO. An inflammatory tumor in the groin. BULLA. A bleb or large pimple containing transparent fluid. C CACHEXIA. A depraved condition of the system; as from poor food, syphilis, etc. CALCAREOUS. Containing lime. CALCIFICATION. The process of forming of, or converting into, chalk. CALCULUS, CALCULI. Stones or similar concretions formed by the deposit of solid matter; of lime, soda, uric acid, urates, oxalates, etc. CALISTHENICS. Healthful exercise of the body and limbs, for purposes of strength and agility. CANCELLATED STRUCTURE. Cells communicating with each other forming a structure resembling "lattice-work." CANKER. Ulcers in the mouth. CAPILLARIES. Very small blood-vessels. Defined on page 60. CARBONIC ACID. A heavy, poisonous gas. Choke damp. CARDIAC. Pertaining to the heart. Near or towards the heart. CARMINATIVES. Medicines which allay pain in the stomach and intestines by expelling the gas. CAROTIDS. The great arteries at the sides of the neck. CARTILAGE. A solid part of the body found in the joints, ends of the ribs, etc. It is softer than bone but harder than ligament. CARTILAGINOUS TISSUE. Parts of the body of the nature of cartilage. CARUNCULÆ. Fleshy growths. CASEIN. The part of milk which contains nitrogen. Cheese curd. CATALYTICS. Medicines which destroy morbid agencies in the blood. Alteratives. CATAMENIA. Monthly flow of the female. CATARACT. Opacity of the lens of the eye, or its covering, or both. CATHARTICS. Medicines which cause evacuation of the bowels. CATHETER. A hollow tube introduced into the bladder through the urethra for the purpose of drawing off the urine. CAUSTICS. Substances which destroy animal tissue. CAUTERIZATION. Burning or searing by a hot iron, or caustic medicines. CAUTERIZE. To burn or sear by a hot iron, or by medicines which destroy. CELL. A little vessel having a membranous wall and containing fluid. The whole body may be considered as formed of different kinds of cells. CELLULAR STRUCTURE. See CANCELLATED STRUCTURE. CEREBELLUM. Little brain. Base brain. Illus. page 100. CEREBRUM. The upper or large brain. Illus. page 100. CERVIX. Neck; neck of the womb. Illus. page 206. CHALYBEATE. Mineral waters which contain iron. CHANCRE. A virulent, syphilitic ulcer. Figs. 27 and 28, Plate V., Pamphlet X. CHANCROID. Resembling infectious chancre. Soft chancre. CHLOROSIS. Green sickness. A disease of young women attended with a greenish hue of the skin, debility, etc. CHOLAGOGUES. Cathartics which stimulate the liver. CHORDÆ TENDINEÆ. Cord-like substances about the valves of the heart. See page 57. CORDEE. CHOROID. The dark colored lining membrane of the eye. CHYLE. Food digested and ready for absorption. See pages 45 and 49. CHYLOUS PRODUCTS. See CHYLE. CHYME. Food after being subjected to the action of the gastric fluids. CICATRIX. The scar or place where parts which have been cut or divided, are united. CILIA. Small hairs. CIRCUMCISION. An operation for removing superfluous foreskin. CIRCUMVALLATE. Arranged in oblique lines, as the prominences on the back of the tongue. CLAP. Gonorrhea. A venereal disease of the urethra. CLAVICLE. See COLLAR-BONE. CLINICAL MEDICINE. Investigation of disease at the bedside. COAGULATE. To thicken or harden, as heat hardens the white of an egg. COITION. Sexual intercourse. The act of generation. COLLAR-BONE (CLAVICLE). A bone at the front and top of chest, attached by one end to the breast-bone and by the other to the shoulder-blade. COLON. Part of the large intestines. Illus. page 40. COMA. A condition of profound sleep from which it is difficult to arouse the patient. COMEDONES. Pimples on the face. See page 412, and Fig. 8. Plate II. COMPRESS. A soft cloth folded to several thicknesses, so that with a bandage pressure can be applied, or by wetting in hot water, a part can be subjected to the influences of heat and moisture. CONCEPTION. Impregnation of the ovum; the beginning of a new being. CONGENITAL. Applied to a disease born with one; from birth. CONGESTION. An abnormal amount of blood in a part or organ. CONJUNCTIVA. The membrane which covers the external surface of the eyeball. CONJUNCTIVITIS. Inflammation of the eye. CONTAGION. The transmission of disease from one to another by contact, as hydrophobia, syphilis; or otherwise, as measles, scarlet fever, etc. CONTAGIOUS. Capable of being transmitted from one person to another. CONTINENCE. Abstinence from sexual intercourse or excitement. CONVALESCENCE. The recovery of health after sickness. CONVOLUTED. Curved or rolled together. COPULATION. Sexual intercourse. CORIUM. A layer of the akin. CORNEA. A transparent covering of the front of the eye. CORPUSCLES OF THE BLOOD. Defined and illustrated on page 53. COUNTER-IRRITANTS. Defined on page 331. COWPER'S GLANDS OF THE MALE. Glands situated in front of the prostate gland. Illus. page 207. COXALGIA. Hip-joint disease. See page 451. CRANIUM. The skull. The bones of the head. CRAYONS. Sticks or cylinders made of Cocoa butter and medicated. CROSS-EYE. One or both eyes drawn towards the nose. Squint. CRUSTACEOUS. Belonging to the class of animals covered by a crust-like shell. CUTANEOUS. Belonging to, or affecting, the skin. CUTICLE. The outer layer of the skin, consisting of small bony scales. CYSTITIS. Inflammation of the bladder. In chronic form, Catarrh of the bladder. D DEBRIS. Broken-down tissue. Waste material. DECOCTION. Defined on page 303. DEFECATION. Voiding excrement from the body. DEGENERATION, FATTY. The deposit of particles of fat instead of the proper muscular tissue. DEGLUTITION. Swallowing. Conveying food to the stomach. DEJECTION OF MIND. Despondency. Low spirits. DEJECTIONS. The matter voided from the bowels. DELETERIOUS. Destructive. Poisonous. DENTITION. Cutting of the teeth in infancy. DEODORIZER. A substance that destroys a bad smell. DEPLETION. To empty the blood-vessels by lancing a vein or by medicines. DEPRAVATION. Corruption. DEPURATING. Cleansing. DERMATOLOGIST. One who makes diseases of the skin a specialty. DESICCATE. To dry up. DESQUAMATION. Scaling off of the skin, after fevers. DESQUAMATIVE NEPHRITIS, Bright's Disease, in which epithelial cells escape with the urine. DIABETES. Defined on page 835. DIAGNOSIS. The determination of a disease by its symptoms or characteristics. DIAGNOSTIC. The symptoms by which a disease is distinguished from others. DIAPHORETIC. Medicines which increase perspiration. DIAPHRAGM. Defined on page 32. DIATHESIS. Peculiarity of constitution. Predisposition to certain diseases. DIGESTION. The function by which food passing along the alimentary canal is prepared for nutrition. DILATATION. Increasing in size by Instruments or other agencies. DILUENTS. Fluids which thin the blood or hold medicines in solution. DIRECTOR. An instrument having a groove which directs the knife and protects underlying parts from injury. DISINFECTANTS. Substances which arrest putrefaction. DISLOCATION. The act of or state of, being forced from its proper situation. DISTILLED. Separated by heat from other substances and collected by condensation. DIURETICS. Medicines which increase the flow of urine. DOUCHE. Dashes of water. An instrument for washing the nasal membrane. DRASTICS. Medicines which move the bowels harshly or frequently. DROPSY. The accumulation of fluid In the cavities or cellular tissue of the body. DUODENUM. The first portion of the intestines. Illus. page 44. DURA MATER. A thick, fibrous membrane lining the skull. DYSCRASIA. A bad condition of body. DYSENTERY. A disease characterized by frequent, scanty and _bloody_ stools. DYSMENORRHEA. Difficult or painful menstruation. DYSPNOEA. Difficult breathing. E EAR, INTERNAL. Defined on page 110. Illus. page 109. EARTHY PHOSPHATES. The white deposit in urine, composed of phosphoric acid and a base. ECCHYMOSIS. Black or yellow spots produced by effused blood. Black eye Is an example. ECLECTIC SCHOOL. See page 294. ECRASEUR. An instrument which amputates by a loop of wire. ECZEMATOUS. Of the nature of Eczema. See page 430. EDEMA (OEDEMA). Puffiness of the skin from the accumulation of fluid. General dropsy. EFFLUVIA. Unpleasant odors or exhalations. EFFUSION. The pouring out of blood or other fluid. ELECTROLYSIS. Decomposing or modifying by the application of electricity. ELIMINATED. Discharged, expelled. EMACIATION. Leanness in flesh. EMBRYO. The young of an animal at the beginning of its development in the womb. EMETICS. Medicines which empty the stomach upwards. EMMENAGOGUES. Medicines which favor or cause menstruation. EMPIRICISM. Practicing medicine upon results of experience, generally by a person without a medical education. ENCEPHALIC TEMPERAMENT. Defined on page 177. ENDOCARDITIS. Inflammation of the lining membrane of the heart. ENDOCARDIUM. The lining membrane of the heart ENDOMETRLTLS. Disease of the lining membrane of the womb. ENTERIC. Intestinal. ENTERITIS. Inflammation of the mucous lining of the small intestines. EPIDEMICS. Diseases which attack a number of persons at the name time: as yellow fever, small-pox, etc. EPIGLOTTIS. A cap over the windpipe, allowing the admission of air, but preventing the introduction of foreign bodies. EPITHELIAL CELLS. Cells belonging to the epithelium. EPITHELIUM. The thin covering upon the lips, nipple, mucous and serous membranes and lining the ducts, blood-vessels and other canals. ESOPHAGUS (OESOPHAGUS). The food-pipe. Illus. page 44. EUSTACHLAN TUBE. The tube leading from the throat to the inner ear. Illus, page 109. EVACUAUT. Cathartic. EVOLUTION. Defined on page 14. EXCORIATES. Removes the skin in part. EXCORIATION. A wound which removes some of the skin. EXCREMENTITIOUS. Pertaining to the matter evacuated from the body. EXCRESCENCES. Surface tumors; as warts, piles, polypi, etc. EXCRETION. The process by which waste materials are removed from the blood, performed particularly by the lungs, skin and kidneys. EXCRETORY DUCTS. Minute vessels which transmit fluid from glands. EXHALATIONS. That which is thrown off by the body, as vapor, gases, etc. EXPECTORANTS. Medicines which promote discharges from the lungs. EXPIRATION. Expelling the breath. EXTRANEOUS MATTER. Any substance which finds a place in the body and does not belong there. Foreign substances. EXTRA-UTERINE. Outside of the womb, but in its vicinity. EXTRAVASATED. Escaped into surrounding tissues. EXTREMITIES. Legs or arms. EXUDATION. Substances discharged through the pores. EXUDE. To sweat; to pass through a membrane. F FALLOPIAN TUBE. The canal through which the ovum passes from the ovary to the womb. FARADIZATION. The application of electricity by inductive currents. FASCIA. The white fibrous expansion of a muscle which binds parts together. FATTY DEGENERATION. The deposit of particles of fat instead of proper muscular tissue. FEBRIFUGE. A medicine which abates or cures fevers. FEBRILE. Relating to fever. FECUNDATION. The ovum uniting with the male germ. Impregnation. FEMORAL HERNIA. Thigh hernia. Illus. page 863. FERMENTED. Changed by a process of decomposition. FERRUGINOUS. Containing iron. FETID. Having an offensive smell. Stinking. FETOR. Offensive smell. Stench. FIBROUS. Composed of fibres. FIBROUS TISSUE. The texture which unites every part of the body. FILAMENTS. Fibre; the basis of texture. FIMBRIATED. Finger-like. FIRST INTENTION, HEALING BY. Healing without suppuration or the formation of pus. FISSURE. A crack. FISTULA: FISTULÆ. Small canals or tubes which carry pus or other liquids through the flesh. FISTULA, URINARY. The abnormal communication between the urinary passages and the external surface. FISTULOUS OPENINGS. The outer end of canals or tubes which carry pus to the surface. FLATULENCY. Wind gathered in the stomach or bowels. FLEXION OF THE WOMB. A partial misplacement in which the womb is bent upon itself. FLEXURES. Bending. Motion of a joint. FLOCCULENT. Combining or adhering in flocks or flakes. FLUID EXTRACTS. The active principles of medicines in fluid form. FOETUS. The unborn child. FOLLICLES (OF HAIR). Small depressions in the skin. FOLLICULAR. Relating to or affecting follicles. FOMENTATIONS. Local application of cloths wrung out of hot water. FORCEPS. An instrument having a motion and use like the thumb and fore-finger. Pincers. Obstetrical forceps embrace the head of the foetus. FORESKIN. That part of the skin of the penis which is prolonged over the head of the organ. FORMICATION. A sensation like a number of ants creeping on a part. FRACTURE. Broken bone. _In compound fracture_ the end of the bone projects through the skin. FUNCTION. The peculiar action of an organ, or part of the body. FUNCTIONAL. Pertaining to the specific action of an organ or part. FUNDUS. The bottom or base of an organ. The fundus of the womb is its upper part, when in its natural position. FUNGIFORM. Mushroom-shaped. G GALVANISM. Electricity. GALVANO-CAUTERY. Burning or scarring by galvanic electricity. GANGLION. A nerve center which forms and distributes nerve-power. GANGRENE. Death of a part. GASTRIC. Pertaining to the stomach. GASTRIC JUICE. The digestive fluid supplied by the mucous membrane of the stomach. GELATINOUS. Jelly-like. GENERATION. The functions which are active in reproduction. GENITALS. The sexual organs. GESTATION. Carrying the embryo in the uterus. GLANS. Head of the penis. GONORRHEA. A discharge of mucous from inflammation of the urethra or vagina, caused by impure connection. Clap. GRANULAR CASTS. Moulds of epithelium found by the microscope in chronic Bright's Disease. GRANULAR LIDS. Roughness on the inner surface of the eyelids. GRANULATIONS HEAL BY. See GRANULATIONS. GRANULATIONS. Flesh-like shoots, which appear in a wound and form its scar. GRANULES. Small grains. GRAVEL. Substances precipitated in the urine resembling sand. GROIN. The oblique depression between the belly and thigh. GRUBS. Pimples on the face. See page 442. GYNECOLOGIST. One who makes the Diseases of Women a specialty. H HAIR BULBS. The expansion or root of the hair. HALLUCINATIONS. Perception or sensation of objects which do not exist; as in Tremens. HECTIC. Constitutional; as hectic fever, in which all parts of the body become emaciated. HEMIPLEGIA. Paralysis affecting only one side of the body. HEMORRHOIDAL VEINS. The veins about the rectum which enlarge and form piles. HEPATIC. Relating or belonging to the liver. HEREDITARY. A disease transmitted from parent to child. HERNIA. Defined on page 862. HOLLOW OF THE SACRUM. The concave portion of the lower part of the spinal column within the pelvis. HOMEOPATHY. Defined on page 294. HYALINE CASTS. Glassy appearing substances found by the microscope in urine in chronic Bright's Disease. HYDRAGOGUES. Cathartics which produce copious watery discharges. HYDROCELE. Accumulation of fluid in the scrotum. HYDROCEPHALUS. Accumulation of fluid in the membranes about the brain. HYDROTHORAX. Accumulation of fluid in the chest cavities. HYGIENE. The principles or rules for the promotion or preservation of health. HYMEN. Described on page 687. HYPERSEMIA. Full of blood. Congestion. HYPERTROPHY. Enlargement, thickening. HYPOCHONDRIAC. A person, usually dyspeptic, who is unreasonably gloomy, particularly about his health. HYPODERMIC SYRINGE. An instrument having a very fine tube and needle-like point, by which medicines are lodged immediately under the skin. HYSTEROTOME. An instrument described and illustrated on page 696. I IDIOPATHIC. Primary: not depending on another disease. ILLICIT. Not permitted; unlawful. ILLUSIONS. See HALLUCINATIONS. IMPACTED. Wedged. Applied to feces which have remained in the rectum a long time. IMPERFORATE. Without a natural opening. IMPOTENCY. Loss of sexual power. IMPREGNATION. Imparting the vital principle of the sperm-cell to the germ-cell, by which a new being is created. INCIPIENT. Commencement; first stage. INDEPENDENT PHYSICIAN. Defined on page 295. INDIGENOUS. Native. Grows in a country. INDOLENT. Painless; a term applied to tumors. INDURATION. Hardening of a part or organ. INFECTION. A prevailing disease. A disease spread only by contact, as itch, syphilis, etc. INFILTRATION. The passage of fluid into the cellular tissue; as in General Dropsy. INFLAMMATION. Defined on page 398. INFUSION. Defined on page 303. INGUINAL CANAL. A canal situated in the groin, through which the spermatic cord passes. The common seat of Hernia. Illus. page 862. INOCULATE. To communicate a disease by inserting matter in the flesh; as by vaccination. INORGANIC. Mineral. Bodies without organs. INSALIVATION. Mixed with the saliva of the mouth, as food. INSEMINATION. The emission of sperm in coition. INSPIRATION. Drawing in the breath. INTEGUMENT. The skin. INTENTION, HEALING BY FIRST. Healing without the formation of pus. INTERCOSTAL. Between the ribs. INTERMITTENT. Having paroxysms or intervals. INTERNAL EAR. Described on page 110; Illus. page 109. INTUSSUSCEPTION. One part of the intestines forced into another part. INVAGINATION. See INTUSSUSCEPTION IRIDECTOMY. A surgical operation for the removal of the Iris. IRIS. A curtain which gives the eye its color. ISOLATION. Separation from others. K. KADESH-BARNEA. The holy place in the desert of wandering; the headquarters of the Israelites for 37 years. L LABORATORY. The work-room of a chemist or pharmacist. LACERATION. A wound made by tearing. LACHRYMAL. Belonging to the tears. LACHRYMAL GLANDS. Minute organs about the eyes which secrete tears. LACTATION. The act of giving suck. LACTEALS. The vessels of the breast which convey milk. LAMELLA. Layer. LAMINAE. Thin bones, or the thin parts of a bone. LANCINATING. Acute, shooting pains fancifully compared to the pierce of a lance. LARYNX. That portion of the air-passage indicated in the male by "Adam's Apple." LASCIVIOUS. Lustful; producing unchaste emotions. LATERAL OPERATION. Cutting through the perinæum into the bladder. LAXATIVES. Medicines which move the bowels gently. LESION. Derangement. Tearing or other division of parts, previously continuous. LEUCORRHEA. Described on page 702. LIBERAL PHYSICIAN. Defined on page 295. LIGAMENT. A white inelastic tendon binding bones together. LIGATION. See LIGATURE. LIGATURE. A cord or catgut tied around a blood-vessel to arrest hemorrhage. LINE. One-twelfth part of an inch. LITHIC DEPOSITS. Sediment or stone formed in the urine by uric acid. LOBES. Bound projecting parts of an organ; as lobes of the lungs, of the liver, etc. LOIN. The side of the body between the hip-bone and ribs. LOTION. A wash. LUMBAGO. Rheumatism in the small of the back and loins. LUMBAR VERTEBRÆ. That part of the backbone in the vicinity of the loins. LYMPH. A transparent fluid, resembling blood, found in lymphatic vessels. It contains corpuscles and coagulates. LYMPHATICS. Defined on page 49. LYMPHATIC TEMPERAMENT. Described on page 157. M MALARIA. See MIASM. MALFORMATION. Irregularity in structure. MALIGNANT. Applied to diseases which threaten life. MAMMÆ. See MAMMARY GLANDS. MAMMALIA. Animals that suckle their young. MAMMARY GLANDS. The breasts or organs which secrete milk. MANIPULATIONS. Examination and treatment by the hand. MASSAGE. Kneading, rubbing and stroking the surface to improve circulation and nutrition and to remove effete material. MASTICATION. Chewing. MASTURBATION. Excitement of the sexual organs by the hand. MEATUS. Canal or passage. External opening of a canal. MEDIAN SECTION. An operation for stone in the bladder in which the perineum and part of the urethra are cut; the prostatic portion of the urethra is dilated to introduce forceps and withdraw the stone. MEDULLA OBLONGATA. Described on page 90; illus. page 96. MELANCHOLIA. A mild form of insanity attended with great gloom and mental depression. MEMBRANOUS. Of the nature or construction of membrane. MENINGES. Membranes covering the brain. MENORRHAGIA. Immoderate monthly flow. MENSES. Monthly flow of the female. See page 686. MENSTRUATION. The bloody evacuation from the womb. MENSTRUUM. A solvent; as water, alcohol, etc. MESENTERIC GLANDS. Glands about the peritoneum which secrete lymph. MESENTERY. Described on page 49. MIASM, MIASMA. A poisonous, gaseous exhalation from decaying vegetation, or from the earth. MIDWIVES. Females who attend women at childbirth. MISCARRIAGE. Defined on page 682. MOLECULE. A minute portion of any body. MONADS. The smallest of all visible animalcules. MONOMANIA. Insanity on one subject. MUCO-PURULENT. Composed of mucus and pus. MUCOUS MEMBRANE. The thin, web-like lining to the canals and cavities which secretes a fluid by which it is constantly lubricated. MUCUS. A mucilaginous fluid found on the surface of certain membranes which keeps them soft and pliable. See MUCOUS MEMBRANE. MUSCLE. The structures of the body which execute movements. MUSCULAR TISSUE. The flesh forming the muscles of the body. MYALGIA. Muscular rheumatism. N NARCOTICS. Medicines which stupefy. NECROSIS. Mortification or death of bone. NERVINES. Defined on page 345. NERVOUS TISSUE. That part of the body composed of nerve-fibres. NEURALGIA. Described on page 635. NICOTIN. A poisonous principle of tobacco. NITROGEN. One of the gases in the atmosphere. NODES. Hard lumps, principally found upon the bones in syphilis. NOXIOUS. Injurious. NYMPHOMANIA. Extreme desire for sexual intercourse in the female. O OBSTETRICAL. Relating or appertaining to childbirth. OCCLUSION. Approximation or closure. OEDEMA. See EDEMA. OLFACTORY NERVE. The nerve employed in the sense of smell. Illus. page 111. ONANISM. See MASTURBATION OPACITY. Opaque condition of parts of the eye, causing blindness. OPALESCENT. Reflecting a milky light. OPAQUE. See OPACITY. OPHTHALMIA. Inflammation of the eye. OPHTHALMIC. Belonging to the eye. OPHTHALMOSCOPE. An instrument for examining the inside of the eye, for diagnostic purposes. OPTIC NERVE. The nerve connecting the brain and eye, and employed in the sense of sight. ORGANIC. Pertaining to the structure of an organ. ORIFICE. Opening or mouth. OSSEOUS TISSUE. Bony structure. OSSIFICATION, OSSIFYING. Made into bone by the deposit of phosphate of lime. OS UTERI. Mouth of womb. Illus. page 206. OVA. Plural of ovum. OVARIES. Two ovoid bodies situated either side of the womb. Illus. page 206. OVARY. The female organ in which the ovum, or germ-cell, is formed. Illus, page 206. OVULATION. The formation of the germ-cell in the ovary and its release from that organ. OVUM. Defined and illustrated on pages 12 and 13. OXYGEN. The vital gas of the atmospheric air. OZÆNA. Described on page 474. P PALLIATIVE. A remedy or treatment which relieves, but does not cure. PAPILLA, PAPILLAE. Small, nipple-shaped prominences found on the tongue, the skin, etc. PARAPLEGIA. Paralysis affecting the upper or lower extremities of the body PARASITES. Animals which live in the bodies of other animals; as the tape-worm itch insect, etc. PARENCHYMA. The texture of an organ; as the liver, kidneys, etc. PAROTID GLANDS. These are situated under the ear, just at the angle of the lower jaw, and secrete saliva. PAROXYSMS. The periodical attack, fit or aggravation in the course of a disease. PARTURIENT. Bringing forth or having recently brought forth. PARTURITION. Labor; the delivery of the foetus. PASTILES. Small medicated lozenges. PATHOGNOMONIC. A _characteristic_ symptom of a disease. PATHOLOGY. That part of the Science of Medicine the object of which is the knowledge of disease. PEDICLE. The stalk or narrow part of a tumor by which it is attached and supported. PELVIC. Belonging to and relating to the pelvis. PELVIS. The lower part of the abdomen or trunk, composed of bone, containing the genital and urinary organs; supports the backbone and is supported by the legs. PENIS. The male organ of generation. Illus. page 207. PEPSIN. The digestive solvent secreted by the stomach. PEPTIC. Pertaining to the stomach. PERCUSSION. Striking the surface and by the sound produced judging of the condition of the internal organs. PERICARDITIS. Described on page 548. PERICARDIUM. The membranous sac enclosing the heart. PERINEAL SECTION. An operation by division of the perineum. PERINEUM. The space bounded by the end of the spine, sexual organs and the bony prominences on which one sits. PERIOSTIUM. The membranous covering to all bones. PERISTALTIC MOTION. A worm-like movement of the bowels by which the food is moved forward. PERITONEUM. The membrane (serous) which lines the abdominal cavities and surrounds the intestines. PERITONITIS. Inflammation of serous membrane lining abdominal and pelvic cavities. PESSARIES, PESSARY. An instrument for holding the womb in its place. PESTILENCE. A malignant, spreading disease. A plague. PHAGADENIC. That which corrodes or eats away rapidly. PHARMACEUTICAL. Anything belonging to pharmacy. PHARYNX. The cavity back of the mouth and palate through which the air passes when breathing and the food when swallowing. PHIMOSIS. Elongated prepuce PHLEGMONOUS. Affecting the cellular membrane. The common boil is an example. PHOSPHATE. A substance containing phosphorus. PHOSPHATES, EARTHY. The white deposit in urine composed of phosphoric acid and a base. PHTHISIC. Consumption. By some the word is used for Asthma, or difficulty in breathing. PHTHISIS. Consumption. See p. 497. PHYSIOLOGICAL ANATOMY. The branch of medicine that defines the organs of the body and their particular actions. PHYSIOLOGY. The science which treats of the phenomena and functions of animal life. PIA MATER. The internal vascular membrane covering the brain. PIMPLES ON THE FACE. Defined on page 443. PLACENTA. Afterbirth. PLAGUE. A malignant epidemic; begins in Asia Minor. PLETHORA, PLETHORIC. Full of blood; maybe general or confined to a part. PLEURA. Defined on page 64. PLEURODYNIA. Spasmodic or rheumatic pain in the chest muscles. PLEURO-PNEUMONIA. Inflammation of both the pleura and lungs. POLLUTION (SELF). Excitement of the sexual organs by the hand or other unnatural method. POLYP. An aquatic animal, as the coral builders. POLYPI. More than one polypus. POLYPOID. Like a polypus in shape or construction. POLYPUS. Tumors which grow from mucous membranes, commonly found in the nasal and vaginal cavities. PORTAL VESSELS. The cluster of veins which join and enter the liver. POTT'S DISEASE. Described on page 898; illus. pages 898 and 899. POULTICE. A mixture of bread or meal, etc., and hot water, spread on a cloth and applied to the surface. POX. Syphilis. PRECOCITY. Prematurely developed. PREHENSION. Carrying food to the mouth. PREPUCE. Foreskin. PROBANG. Soft swab. PROBE. An instrument for examining wounds and cavities. A piece of wire with a blunt point is a probe. PROCREATION. Production or generation of offspring. PROGNOSIS. Opinion of the future course of a disease. PROLAPSUS. A falling down of an organ through an orifice, as the womb, bowel, etc. PROPHYLACTIC. Preventive. PROPRIETARY MEDICINES. Described on page 298. PROSTATE GLAND. Described on page 778 and illus. on page 207. PROTEIDS. goods composed Of carbon, hydrogen, oxygen and nitrogen: as the white of an egg. PROTOZOÖN. First life; life in the lowest scale; as sponges. PROUD-FLESH. Abnormal growths which arise in wounds or ulcers. PRURITIC. Itching. PRURITUS VULVAE. A nervous disease attended with excessive itching of the external genital parts of the female. PSOAS OR LUMBAR ABSCESS. An abscess discharging at the groin. PSYCHICAL. The relation of the soul to animal experiences and being. PSYCHOLOGICAL. The spiritual potencies of the soul. PTYALIN. The ferment of the saliva which converts starch into sugar. PUBERTY. The age at which the subject is capable of procreation. PUBIC. Relating to the pubes, a part above the genital organs, covered with hair at puberty. PUERPERAL FEVER. Child-bed fever. PULMONARY. Relating to the lungs. PUPIL. The circular opening in the colored curtain within the eye. PURGATIVES. Medicines which cause evacuation of the bowels. PURULENT. Discharging pus; as an ulcer. PUS. A yellowish, inodorous, creamy secretion from inflamed parts; contained in abscesses or discharging from ulcers. PUSTULAR. Belonging to or affected by pustules. PUSTULE. An elevation on the skin, containing pus or "matter," and having an inflamed base. PUTRESCENCE. Decomposition, rottenness. PUTRESCENT. Decomposing offensively. PUTRIDITY. Corruption. PYRÆMIA. Blood-poisoning from the absorption of decomposing pus or "matter." PYLORIC ORIFICE. The lower opening of the stomach; illus. page 39. PYRIFORM. Shaped like a pear. Q QUICKENING. The time when the motion of the foetus within the womb is first perceptible; between the fourth and fifth months of pregnancy. R RADICAL CURE. A cure in which the disease is entirely removed, root and branch. RALES. Noises produced by air passing through mucus in the lungs. RECTAL. Pertaining to the rectum. RECTUM. The lower portion of the intestines terminating in the anus. RECUMBENT. Reclining. REFLEX ACTION. See pages 93 and 99. REGURGITATION. The act by which blood is forced backwards in an unnatural manner. REMISSION. A temporary diminution of the symptoms of fever. REPRODUCTION. Producing living bodies similar to the parents. RESOLUTION. The disappearance of inflammation without suppuration. RESPIRATION. The function by which the blue blood is converted into red blood in the lungs. RESPIRATOR. Described on page 230. RETINA. Defined on page 107. RETROCEDENT. Moving from one part of the body to another; as gout. RETROCESSION. Change of an eruption from the surface to the inner parts. RETROVERSION. A change in the position of the womb in which the top falls back against the rectum. REVULSION, REVULSIVE. Calling the blood away from the diseased part. RICKETS. A disease in children characterized by crookedness of the spine and long bones resulting from scrofula or poor and insufficient food. RICKETY. Affected with rickets. RINGS (HERNIAL). Circular openings with muscular edges through which a vessel or part passes. RUBEFACIENTS. Medicines which produce redness of the skin. RUPTURE. Bursting. Hernia. S SACCHARINE. Like or containing sugar. SALIVA. The secretion of the glands of the mouth. SALPAE. Little sack-like shaped, soft, fleshy bodies, found in the open ocean, and sometimes phosphorescent. SANATIVE. Curative. Tending to restore lost health. SANGUINE TEMPERAMENT. Described on page 163. SANITARIUM. An institution for the treatment of the sick. A healthy retreat. SCALES. The epidermis or outer part of the skin consists of minute scales. See Fig. 50, page 71. SCALP. The skin covering the head. SCAPULA. Shoulder blade. SCIATIC NERVE. The great nerve of the thigh. SCIRRHUS. Stony hardness, characteristic of cancer. SCLEROTIC COAT. The hard, pearly white covering of the eye. SCORBUTIC. Producing scurvy, a disease caused by improper or insufficient food. SCORBUTUS. Scurvy. SCROFULOUS. Suffering from a condition of the system characterized by enlargement of the glands, eruptions, etc., with great susceptibility to contagion. SCROTUM. The bag of skin which covers the testicles. SCURVY. A disease due to impaired nutrition. SEA TANGLE. A water-plant, which in its dried state is introduced into a canal and dilates the canal as it expands by the absorption of moisture. SEBACEOUS GLANDS. The oil-tubes of the skin. Illus. page 71. SECRETION. The process by which substances are separated from the blood. SEDATIVES. Medicines which allay irritation or irritability of the nervous system. SEDENTARY. Requiring much sitting. SELF-POLLUTION. See SELF-ABUSE. SEMEN. The secretion of the testicles which is thrown out during sexual intercourse and contains the principle of generation. SEMI-FLUID. Half fluid. SEMILUNAR VALVES. Valves in the heart. See 9 and 17, Fig. 41, page 58. SEMINAL VESICLES. Reservoirs for the sperm. See Seminal Sac, on page 207. SEPTIC. That which corrodes or produces putrefaction. SEPTICÆMIA. Blood-poisoning; usually by absorption. SEQUEL. That which follows; the condition or malady which follows a disease. SEROUS. Watery. Pertaining to the serous membrane. SEROUS TISSUE. The membranes lining the closed cavities of the body, which secrete a watery, lubricating fluid. SHOCK. Sudden depression of vitality occasioned by injury. SITZ BATH. See page 367. SLOUGHING. The process of separating a mortified part from a healthy part, through the agency of pus. SMELL, NERVES OF. Illus. page 111. SOLAR PLEXUS. Described on page 104. SOLVENTS. Those chemicals which break up or dissolve substances. SORDES. Foul accumulation on the teeth, noticed in fevers. SOUND. An instrument for exploring cavities or canals for diagnosis or treatment. SPECIALTY. That to which special attention is given. SPECIFIC GRAVITY. Comparative weight; as between urine and water. SPECULUM. An instrument for examining cavities. Illus. pages 717 and 718. SPERM. See SEMEN. SPERMATIC CORD. The mass of arteries, veins, nerves, absorbents and their coverings, which passes along the groin and over the pubic bone, to the testicle. SPERMATORRHEA. Described on page 772. SPERMATOZOA. More than one Spermatozoön. SPERMATOZOON. Defined on page 12; Illus. page 13. SPHINCTERS. Bound muscles which close natural openings. SPHYGMOGRAPH. An instrument for examining the heart. Illus. page 548. SPICULA. A small pointed piece of bone. SPINAL COLUMN. The twenty-four bones, which, situated one above the other, form the backbone. SPINAL CORD. Described on page 90. SPIROMETER. A gauge of chest capacity. Illus. page 392. SPONGE TENT. Compressed, dried sponge previously treated with Gum Arabic, used for dilating the uterine canal. SPORADIC, SPORADICALLY. A term for diseases which appear frequently, independent of epidemic or contagious influences. SPRAIN. A straining or rupture of the fibrous parts of a joint. STAPHYLOMA. Protrusion of the eye, sometimes with loss of sight. STERILITY. Barrenness. Inability to bear children. STERNUM. The breast-bone. STETHOSCOPE. An instrument for examining the heart and lungs. STIMULANTS. Medicines which increase the vital activity of the body. STOOL. Evacuations of the bowels. Dung. STRABISMUS. Cross-eyes. STRANGULATED. Caught or fastened in the hernial canal. STRIATED. Grooved or striped. STRICTURE. A contracted condition of a canal or passage; of the food-pipe, rectum, urethra, etc. STRUCTURAL. Belonging to the arrangements of tissues or organs. STRUMOUS. Scrofulous. STUPOR. Great diminution of sensibility. STYE. A little boil on the eyelid. STYPTIC. An external astringent wash. SUB-ACUTE. A moderate form of acute. SUDORIFEROUS GLANDS. Minute organs in the skin, which secrete the perspiration. Illus. page 70. SUPPORTERS (UTERINE). Instruments intended to hold the womb in its natural position. SUPPRESSION. Stoppage or obstruction of discharges; as urine, menses, etc. SUPPURATION. A gathering. Formation of pus, as in an abscess or ulcer. SUTURE PINS. Pins or needles, which are passed through the edges of wounds to bring them together. Thread is then wound around the pin to hold the edges in place. SUTURES. The ragged edges of bones by which they are joined to each other. Stitches of thread to bring the edges of a wound together for their union. SYMPATHETIC NERVE. Defined on page 101. SYMPTOM. A change in the body or in its functions which indicates disease. SYMPTOMATIC. Pertaining to symptoms. SYNOVIAL MEMBRANE. The lining of a joint, which from its oily secretion allows the bones to move freely upon each other. SYNOVITIS. Described on page 452. T TAPPING. Removing collected fluid by introducing a hollow tube through the flesh. TEMPERAMENT. Peculiarities of the constitution manifested by traits which we denominate character. TENESMUS. Straining at stool. TENT. A compressed, dried cylinder of sponge, previously treated with Gum Arabic, which enlarges the canal in which it is placed by expansion from the absorption of moisture. TESTICLES. Described on page 773; Illus. page 207. THERMOMETER. An instrument for determining temperature. THORACIC DUCT. A canal which carries the chyle from its repository in the abdomen to the large vein in the chest, near the heart. THORAX. Chest. TINCTURES. Medicines held in solution by alcohol. TONIC. Defined on page 350. TOPICAL. Local. TOPOGRAPHY. Description in detail of a place; in hygiene, to determine its adaptability to residence. TORMINA. Griping of the bowels. TORTICOLLIS. Stiffness or contraction of the muscles of the neck. Wryneck. TOURNIQUET. An instrument to stop bleeding. Illus. Fig. 252, page 890. TRACHEA. Windpipe. See page 63. TRANSLUCENT. Transmitting light, but not permitting objects to be seen distinctly. TRANSUDATION. Passage of liquid through the tissues of the body. TRAUMATIC. Relating to a wound or injury. TREPHINING. Removing a piece of bone by a cylindrical saw. TRITURATE. To pulverize. TROCAR. An instrument for removing fluids from cavities. It consists of a perforator within a cylinder. TRUNCATED. Shaped like a pyramid with its top cut off. TRUSS. A mechanical appliance for preventing protrusion or strangulation. Hernial support. TUBERCLE. See pages 431 and 498. TURN OF LIFE. The change of life when menstruation ceases. TYMPANUM. Ear-drum. Illus. p. 109. U UMBILICAL. Of the navel; as umbilical hernia. Illus. page 883. UMBILICAL CORD. A cord-like substance which conveys the blood to the foetus from the placenta or afterbirth. UMBILICUS. The Navel. UNSTRIATED. Not grooved or striped. URÆMIC. Pertaining to blood-poisoning from the presence of urea in the circulation. URATES. The pinkish deposit found in urine. UREA. A constituent of the urine. URETERS. The canals leading from the kidneys to the bladder. Illus. pages 85 and 207. URETHRA. The canal leading from the bladder outwards, by which the urine is voided. Illus. page 207. URETHROTOMY. The operation for opening the urethra for the removal of stricture. URIC ACID. A constituent of the urine. URINARY FISTULA. Abnormal communication between the urinary passages and the surface. URINO-GENITAL ORGANS. Pertaining to the urinary and sexual organs. UTERINE. Belonging or relating to the womb. UTERINE CAVITY OR CANAL. From the month of the womb to a constriction called the internal orifice, is a cylindrical space called the canal. Above this to the fundus or base is a triangular and flat space called the cavity. V VAGINA. A canal, five or six inches long, situated between the vulva and womb. VAGINAL. Pertaining to the vagina. VAGINISMUS. Irritable vagina. VALVES OF THE HEART. See page 58. VARICOCELE. Described on page 803. VARICOSE. Veins that are twisted or dilated. VASCULAR. Belonging or relating to vessels. VASCULAR SYSTEM. The heart and blood-vessels. VEINS. The vessels which return the blue blood to the heart. VENEREAL. Syphilitic. VENTRICLES. Chambers in the heart. See 5 and 14, Fig. 41, page 58. VERMIFUGE. A medicine which destroys or expels worms. VERSION. Displacement of the womb forwards or backwards. VERTEBRÆ. The twenty-four bones which joined together form the backbone. VERTEBRATES. Animals having the jointed skeleton within; distinguishes between these and insects, worms, oysters, jelly fish, etc. VERTIGO. Dizziness Or swimming of the head. VESICLES. Small bladders or sacs. Pimples. VESICULAR. Belonging to or containing cells. VILLI. Minute thread-like projections. VIRILE POWER. Masculine vigor. Sexual vigor. VIRUS. Poison. The agent which transmits infectious disease. VISCERA. (Plural of Viscus.) More than one internal organ. VISCOUS. Sticky. Tenacious. VISCUS. Any internal organ. VITREOUS HUMOR. The fluid in the eye behind the lens. Illus. page 107. VOLITIVE TEMPERAMENT. See page 171. VULVA. The external organs of generation in the female, or the opening between these projecting parts. W WALLS. The sides of an enclosure, as the walls of the vagina, which to soma extent support the womb. WHITES. Described on page 702. * * * * * HOW TO AVOID SWINDLERS WHO SOMETIMES INFEST THE CARS AND DEPOTS IN AND NEAR THIS CITY. * * * * * WE WARN ALL THOSE WHO CONTEMPLATE VISITING US, that we have the most _positive proofs_ that a gang of confidence men have at different times made it their business to watch for sick and infirm people on the way to our institutions, and divert them into the hands of "sharpers," confidence men and swindlers. These men have watched for the coming of invalids on the cars, in and around the depots, in the offices of the hotels located near the depots, and if inquiry was made for our institutions, or if the object of the visit to the city was made known or suspected from the invalid appearance of the traveler, they at once commenced weaving their skillfully-wrought web to catch a victim. WE, THEREFORE, ADVISE ALL THOSE DESIRING TO VISIT US, FIRST.--TO ASK FOR NO INFORMATION FROM POLICEMEN, OR THOSE APPEARING TO BE POLICEMEN, IN OR ABOUT OUR DEPOTS. CONFIDENCE MEN OFTEN ASSUME A STYLE OF DRESS SIMILAR TO THAT WORN BY POLICEMEN. SECOND.--LET THE OBJECT OF YOUR VISIT TO THE CITY BE KNOWN TO NO ONE WHOM YOU MEET ON THE CARS, OR IN THE DEPOTS OR NEAR THEM. THIRD.--IF YOU HAVE A CHECK FOR BAGGAGE, WHEN THE BAGGAGE-MAN COMES THROUGH THE CARS, AS ONE DOES ON EVERY TRAIN BEFORE IT REACHES THE CITY, ASKING IF YOU WILL HAVE YOUR BAGGAGE DELIVERED ANYWHERE IN THE CITY, OR, IF YOU WILL HAVE A CARRIAGE; IF YOU HAVE A TRUNK, GIVE HIM THE CHECK FOR IT, PAY HIM 25 CENTS ONLY AND HE WILL HAVE IT DELIVERED AT THE INVALIDS' HOTEL AND SURGICAL INSTITUTE. 663 MAIN STREET. (Do not forget the number). You had better, also, procure a ticket from this baggage-man, or agent, for a _coupe_ or carriage to our place, for which you will have to pay only fifty cents. (Outside prices are higher.) This saves all trouble and anxiety, as the agent will look carefully after both yourself and baggage, and you are sure of reaching our place promptly and safely. If you have only hand-baggage, such as bundles, traveling-bags, or similar luggage, you can take it with you in the carriage without extra cost. Mr. C.W. Miller, whose agents solicit on all the in-coming trains for the delivery of passengers and baggage, has an office in every passenger depot in this city, to which you can apply if, by any chance, you miss his agent on the train. THE INVALIDS' HOTEL AND SURGICAL INSTITUTE IS OPEN DAY AND NIGHT, AND YOU WILL BE CORDIALLY RECEIVED AND WELL TAKEN CARE OF. THE TABLE IS PROVIDED WITH THE BEST OF FOOD. NO HOTEL IN THE CITY HAS BETTER ROOMS OR BEDS THAN THE INVALIDS' HOTEL. THIS INSTITUTION IS NOT A HOSPITAL, BUT A COMMODIOUS AND COMFORTABLE INVALIDS' HOME. If all we say of our institutions, and our advantages and facilities for the successful treatment of disease is not found, on your arrival and investigation, to be just as we have represented them, WE WILL PAY ALL THE EXPENSES OF YOUR TRIP AND YOU CAN RETURN HOME AT ONCE. "A WORD TO THE WISE," in the nature of advice, to those about to visit us, in conclusion, may not be out of place. KEEP YOUR BUSINESS TO YOURSELF WHILE ON THE ROAD HERE, ALSO WHEN ABOUT THE DEPOTS, AND ASK NO QUESTIONS OF ANYBODY. MAKE NO TRAVELING ACQUAINTANCES. THEY ARE DANGEROUS. Observe the foregoing directions, and any child of twelve years, possessed of ordinary intelligence, can reach our conspicuous place, 663 MAIN STREET, Buffalo, N.Y., without fail. WORLD'S DISPENSARY MEDICAL ASSOCIATION. * * * * * [Illustration] * * * * * INDEX. A Abortion, 682 Abscess, Lumbar, 446 Abscess, Psoas, 448 Absence of the Ovaries, 688 Absence of the Womb, 689 Absolutely Painless Operation, 491 Absorption, 48 Acacia Catechu, 325 Accidents, 889 Acetabulum, 25 Acetate of Potato, 338 Acid, Aromatic Sulphuric, 310 Acid Bath, 367 Acid, Carbolic, 318 Acid, Gallic, 325 Acid, Hydrochloric, 310 Acid, Muriatic, 310 Acid, Tannic, 325 Acid, Uric, 86 Acids, 309, 895 Acidum Gallicum, 325 Acidum Tannicum, 325 Acne, 442 Aconite, 346 Acute Articular Rheumatism, 425 Acute Bright's Disease, 830 Acute Bronchitis, 509 Acute Catarrh, 473 Acute Gastritis, 883 Acute Inflammation of the Bladder, 824 Acute Inflammation of the Bowels, 655 Acute Inflammation of the Kidneys, 823 Acute Inflammation of the Liver, 569 Acute Inflammation of the Stomach, 565 Acute Laryngitis, 496 Acute Nephritis, 829 Acute Peritonitis, 886 Adhesion, 400 Adipose Tissue, 20 Affections, Alphous, 441 Affections, Boil-like, 443 Affections, Bullous, 438 Affections, Eczematous, 430 Affections, Erythematous, 436 Affections, Furuncular, 443 Affections, Nervous, of the Skin, 440 Affections of the Hair-follicles, 441 Affections of the Male Generative Organs, 773 Affections of the Urinary Organs, 825 Affections of the Urinary Organs, Sympathetic, 826 Afferent Nerves, 87,93 Afterbirth, 216 Age of Nervousness, the, 619 Ague, 405 Air-cells, 63 Air-passages, Foreign Bodies in the, 893 Air, Pure, 822, 223, 378 Albumen, 53, 238 Albuminuria, 422 Alcohol, 849, 627, 896 Alcohol Habit, 627 Alcoholic Liquors, 255 Alder, 304 Alkalies, 809, 895 Alkaline Bath, 367 Allopathic School of Medicine, 293 Alnuin, 305 Alnus Eubra, 304 Aloes, 328 Alphos, 441 Alphous Affections, 441 Alteratives, 303 Alteratives, Compounding of, 303 Alternate Generation, 16 Althea Officinalis, 336 Amenorrhea, 687 American Colombo, 353 American Hellebore, 347 American Poplar, 350 Ammonia, 349 Amnion, 216 Amperemeter, 630 Amygdalus Persica, 346 Amyloid Degeneration of the Kidneys, 830 Amyloids, 238 Anæmia, 419 Anaesthesia, Local, 806 Anaesthetics, 806 Anal Fistula, 583 Anasarca, 422 Anatomy, 11 Anatomy, Physiological, 11, 19, 30, 37, 48, 56, 63, 68, 75, 84, 87 Anatomy, Physiological, of the Testes, 774 Anatomy, Physiological, of the Urinary Organs, 823 Angina Pectoris, 552 Ammalcular Lite, Universality of, 16 Animal Extracts as Remedies, 631 Animal Faculties, 130 Animal Food, Value of, 241 Animals, Cold-blooded, 55 Anise-seed, 325 Anodynes, 310 Anteflexions of the Uterus, 714 Anterior view of Deformed Nasal Cavity, 492 Anterior view of Nasal Cavity, 490 Anthelmintics, 319 Anthrax, 475 Antidotes for Poisons, 895 Antiperiodics, 316 Antiseptics, 317 Antispasmodics, 318 Anus, Fistula of the, 583 Aorta, 58 Aperients, 326 Aphasia, 639 Apnoea, 421 Appendix Vermiformis, 41 Apthæ, 553 Aqueous Humor, 107 Arachnoid Fluid, 90 Arachnoid Membrane, 90 Arbutus, Trailing, 336 Arctium Lappa, 307 Areolar Tissue, 19 Aristolochia Serpentaria, 333 Aromatic Sulphuric Acid, 310 Arteries, 58 Artery, Pulmonary, 58 Art of Swimming, 274 Ascaris Lumbricoides, 561 Ascaris Vermioularis, 561 Ascites, 423 Asclepias Tuberosa, 332 Asclepin, 333 Aseptic Precautions in Operations, 492 Ashes, 335 Ash, Prickly, 349 Aspen Poplar, 315 Asphyxia, 421 Aspidium Filix Mas., 315 Assafetida Ferula, 318 Assimilation, 233 Asthma, 511 Asthma, Hay, 514 Astringents, 320 Ataxia, Locomotor, 640 Atomizer, 481 Atomizer, Steam, 482 Atropa Belladonna, 312 Atrophy of the Heart, 551 Atrophy of the Testicles, 773 Atropia, 312 Atropin, 312 Auricle, 57 Auscultation, 391 Axis, Cerebro-spinal, 89 Axis-cylinder, 87 B Back, Crooked, 901 Baked Mutton, 248 Balmony, 315 Baptisia Tinctoria, 318 Baptisin, 318 Barber's Itch, 442 Bark, Cramp, 320 Bark, Slippery-elm, 335 Barosma Crenata, 338 Barosmin, 338 Barrenness, 707 Base Ball, 273 Basilar Faculties, 132 Battery for home use, 631, 632 Bath, Acid, 367 Bath, Alkaline, 367 Bath, Cold, 356 Bath, Cool, 357 Bath, Douche, 365 Bath, Foot, 366 Bath, Head, 367 Bath, Hot, 358 Bath, Iodine, 368 Bath, Russian, 358 Bath, Scott's Acid, 367 Bath, Shower, 365 Bath Sitz, 367 Bath, Spirit Vapor, 382 Bath, Sponge, 365 Bath, Sulphur, 368 Bath, Temperate, 357 Bath, Tepid, 357 Bath, Turkish, 358 Bath, Warm, 357 Bathing, 353 Bathing, Sea, 364 Baths, Medicated, 367 Bed, 279, 377 Bedding, 380 Beef Soup, 247 Beef Tea, 381 Belladonna, 312 Beverages, 248 Bicarbonate of Potash, 309 Bile, 80 Biliary Calculi, 560 Biliary Salts, 81 Bilious Colic, 557 Bilious Disorder, 569 Bilious Fever, 408 Biliverdin, 81 Biology, 11 Blackberry-root, 321 Black Cohosh, 305, 341 Black Pepper, 348 Black-root, 327 Black Snake-root, 305, 341 Black Vomit, 883 Bladder, 823 Bladder, Chronic Inflammation of the, 836 Bladder, Stone in the, 838 Blood, 53 Blood Corpuscles, 53 Blood, Physical Properties of the, 53 Blood-root, 306 Blood, Vital Properties of the, 53 Bloody-flux, 888 Blue Flag, 307 Blushing, 62 Boiled Fish, 247 Boiled Meat, 247 Boil-like Affections, 443 Boils, 443 Bones, 19 Bones of the Head, 22 Bones of the Lower Extremities, 27 Bones of the Upper Extremities, 25 Boneset, 316, 341 Boxing, 273 Boxwood, 351 Brain, 95 Brain Fatigue, 621 Branny Tetter, 431 Breach, 864 Bread, 248 Bright's Disease, Acute, 830 Broiled Steak, 247 Bronchia, 63 Bronchial Cells, 63 Bronchitis, 476 Bronchitis, Chronic, 509 Bruises, 892 Buchu, 338 Bugle-weed, 383 Bullous Affections, 438 Burdock, 307 Burns, 894 Bursæ Mucosæ, 29 Butterfly-weed, 333 Butternut, 328 Butter-weed, 324 C Chachexia, 431 Caecum, 41 Caliculi, 837 Camp Fever, 408 Camphor, 312 Canada Fleabane, 324 Canals, Haversian, 21 Canals, Semi-circular, 110 Canker, 553 Cannabis Indica, 334 Capacity, Cranial, 139 Capillaries, 60 Capsicum Annuum, 348 Capsule, Synovial, 29 Carbolic Acid, 318 Carbonate of Iron, 354 Carbuncle, 444 Carminatives, 325 Carpus, 26 Cartilage, 29 Cartilaginous Tissue, 20 Cascara Sagrada, 328 Casein, 82, 338 Castor Oil, 328 Catarrh, Acute, 473 Catarrh, Chronic Nasal, 474 Catarrh, Hay, 514 Catechu, 325 Cathartics, 326 Catnip, 334 Caustics, 331 Cayenne Pepper, 348 Cellars, Damp, 228 Cells, Bronchial, 66 Centres of Ossification, 20, 27 Centre, Specific, 14 Cephælis Ipecacuanha, 339 Cerebellum, 95, 97 Cerebral Nerves, 89 Cerebral Physiology, 114 Cerebro-spinal Axis, 89 Cerebro-spinal System, 89 Cerebrum, 95, 98 Cerevisiæ Fermentum, 317 Ceruminous Glands, 77 Cervical Rheumatism, 427 Cessation of the Menses, 700 Chalybeate Waters, 250 Chamomile, 350 Chamomile, Wild, 834 Chelone Glabra, 315 Chelonin, 315 Chicken-pox, 412 Chimaphila Umbellate, 338 Chimaphilin, 338 Chloride of Iron, Tincture of, 355 Chloride of Sodium, 815 Cholagogues, 326 Cholera, Epidemic, 887 Cholera Infantum, 555 Cholera Morbus, 888 Cholesterin, 81 Chordæ Tendineæ, 57 Chorea, 650 Chorion, 216 Choroid, 107 Chronic Articular Rheumatism, 426 Chronic Bright's Disease, 830 Chronic Bronchitis, 509 Chronic Cystitis, 836 Chronic Diarrhea, 568 Chronic Gastritis, 884 Chronic Gout, 430 Chronic Hepatitis, 569 Chronic Inflammation of the Bladder, 836 Chronic Inflammation of the Bowels, 549 Chronic Inflammation of the Liver, 569 Chronic Inflammation of the Stomach, 884 Chronic Laryngitis, 496 Chronic Nasal Catarrh, 474 Chronic Peritonitis, 886 Chronic Ulcers, 454 Chyle, 45, 49 Chyme, 45 Cimicifuga Racemosa, 305, 341 Circulatory Organs, 56 Citrate of Iron, 354 Classes of Food, 238 Clavicle, 26 Cleanliness of Body, 281, 380 Clergymen's Sore Throat, 496 Climate, 243 Closure of the Tear-duct, 477 Clot, 54 Clothing, 264, 380 Coagulation, 55 Coccyx, 23, 25 Cochlea, 110 Cochlearia Armoracia, 331 Coffee, 258 Cohosh, Black, 305, 341 Cold-blooded Animals, 55 Colic, 557 Colic, Bilious, 557 Colic, Flatulent, 558 Colic, Lead, 558 Colic, Painters', 558 Coliea Pietonum, 558 Collinsonia Canadensis, 337 Colombo, American, 358 Colon, 41 Colts-tail, 324 Columnæ Carneæ, 57 Column, Spinal, 24 Comedones, 442 Compound Extract of Smart-weed, 312, 326, 335, 342, 349 Compounding of Alteratives, 308 Conception, Double, 215 Conception, Prevention of, 212 Congestive Fever, 406 Conium Maculatum, 311 Conjugal Love, 186 Connective Tissue, 19 Constipation, 573 Consumption, 476, 497 Consumption, Curability of, 503 Consumption, Tubercular, 497 Continued Fevers, 407 Contractility, 34 Contused Wounds, 889 Convolutions, 98 Cookery, 246 Copper, Sulphate of, 339 Coptis Trifolia, 354 Cord, Spinal, 90 Cord, Umbilical, 217 Core, 399 Cornea, 106 Cornus Florida, 351 Corpora Olivaria, 95, 96 Corpora Pyramidalia, 95 Corpora Quadrigemina, 95, 97 Corpora Restiformia, 95, 96 Corpus Callosum, 98 Corpuscles, Blood, 53 Corpuscles, Ganglionic, 87, 88 Costiveness, 573 Cotton-wool Respirator, 230 Cough, 502, 506 Countenance, 394 Counter-irritants, 331 Cow-pox, 411 Coxalgia, 450 Cramp Bark, 450 Cranberry, High, 320 Cranesbill, 322 Cranial Capacity, 139 Cranial Nerves, 100 Cranium, 22 Creasote, 317 Creation, Special, 14 Creeping Palsy, 640 Cricket, 273 Criminal Abortion, 682 Crocus Sativus, 333 Crooked Back, 901 Croup, Membranous, 878 Croup, Spasmodic, 878 Crow-foot, 332 Crura Cerebelli, 97 Crusted Tetter, 433 Crystalline Lens, 107 Cueurbita Chrullus, 338 Cucurbita Pepo, 338 Culture, Mental, 276 Culver's-root, 327 Cupri Sulphas, 339 Curability of Consumption, 503 Cure, Radical, for Hernia, 892 Curvature of the Spine, Lateral, 901 Curvature, Posterior Spinal, 898 Cuticle, 68, 70 Cutis Vera, 68 Cypripedin, 320, 345 Cypripedium Pubescens, 320, 345 Cystitis, Chronic, 836 D Damp Cellars, 228 Dancing, 276 Dandruff, 431 Danger in the use of Instruments, 846 Datura Stramonium, 344 Deadly Nightshade, 312 Deafness, 476 Debility, Sexual, Symptoms of, 777 Decidua, 216 Decoctions, 303 Deformed Feet, 903 Deformed Hands, 903 Deformed Limbs, 903 Deformity of the Nasal Septum, 490 Degeneration of the Heart, Fatty, 551 Degeneration of the Kidneys, 832 Deglutition, 233 Desquamative Nephritis, 833 Development of the Individual, 192 Diabetes, 835 Diagnosis, 390 Diagnostic Symptoms, 390 Diaphoretics, 332 Diaphragm, 32 Diarrhea, 502, 555 Diarrhea, Chronic, 568 Diathesis, 391 Diathesis, Scrofulous, 445 Diathesis, Strumous, 445 Diet, 380 Digestibility of Food, 248 Digestion, 37 Digestive Organs, 37 Digitalis Purpurea, 387 Dilatation of the Heart, 551 Diluents, 335 Dioecious Reproduction, 202 Dioscorea Villosa, 320 Dioscorein, 320 Diptheria, 414 Discovery, Golden Medical, 308, 316, 355 Disease, Bright's, 830 Disease, Dust and, 229 Disease, Hip-joint, 450 Disease, Remedies for, 298 Disease of the Throat, 476 Diseases and their Remedial Treatment, 386 Diseases of the Heart, 547 Diseases of the Kidneys, 829 Disease of the Larynx, 476 Diseases of the Liver, 559, 569 Diseases of the Skin, 430 Diseases of the Stomach, 430 Diseases of the Urinary Organs, 823 Diseases of Women, 684 Disinfectants, 317 Dislocations, 892 Displacements of the Womb, 713 Distilled Liquors, 264 Diuretics, 336 Dock, Yellow, 304 Dog-button, 350 Dogwood, 351 Domestic Management of Fevers, 403 Door of Life, the, 681 Dose, 300 Double Conception, 215 Douche Bath, 365 Douche, Dr. Pierce's Nasal, 486 Dover's Powder, 311 Drastics, 326 Dropsies, 422 Dropsy of the Scrotum, 821 Drowning, 893 Ducts, Lactiferous, 82 Duodenum, 40 Dura Mater, 90 Duration of Pregnancy, 219 Dust and Disease, 229 Dwellings, Ventilation of, 226 Dynamometer, 391 Dysentery, 588 Dysmenorrhea, 692 Dyspepsia, 565 Dyspnoea, 502 E Ear, Catarrh of the, 477 Eating, 233 Eclectic School of Medicine, 294 Eczema, 430 Eczema, Infantile, 430 Eczematous Affections, 430 Efferent Nerves, 87, 98 Effusion, 400 Electricity in Nervous Affections, 629 Elixir of Vitriol, 310 Elongation of the Uvula, 419, 495 Emergencies, 889 Emetics, 339 Emetic-weed, 340 Emissions, Involuntary Seminal, 773 Emissions, Nocturnal 773 Emmenagogues 341 Emotive Faculties 126 Encephalic Temperament 177 Endocarditis 549 Endocardium 57 Endolymph 110 Enlarged Spermatic Veins 803 Enlarged Tonsils 417, 494 Enlargement of the Prostate Gland 840 Enteric Fever 407 Envelope 9 Epidemic Cholera 887 Epidermis 68, 70 Epigea Repens 336 Epiglottis 67 Epilepsy 647 Epsom Salts 328 Erect Carriage 272 Ergot 341 Erigeron Canadense 324 Eruption, Heat 430 Eruptive Fevers 408 Erysipelas 413 Erythema 436 Erythemaious Affections 436 Esophagus 39 Ethmoid Bone 22 Eupatorin 316, 341 Eupatorin (Purpu) 338 Eupatorium Perfoliatum 316, 341 Eupatorium Purpureum 338 Eustachian Tube 110 Evolution 14 Examination, Microscopical 398, 825 Examination of the Urine 397, 625, 825 Excretion 84 Exercise 382 Exercise, Horseback 276 Exercise, Physical 270 Exercises of the Gymnasium 275 Expanding Uterine Speculum 718 Expectorants 342 Expectoration 502 External Auditory Meatus 77, 109 Extract of Smart-weed 312, 326, 335, 342, 349 Exudation 422 Eye 397 F Face, Bones of the 23 Factories, Ventilation of 226 Faculties, Animal 130 Faculties, Basilar 132 Faculties, Emotive 126 Faculties, Volitive 129 Fainting 894 Falling of the Uterus 713 Fallopian Tubes 209 False Measles 413 False Membrane 878 False Passages 846 Fascia 30 Fasciculus 30 Fats 238 Fatty Degeneration of the Heart 551 Fatty Degeneration of the Kidneys 832 Favorite Prescription, Pierce's 342, 346, 355 Favus 441 Fecundation 211 Feebleness, Region of 134 Feeding Infants 235 Feet, Deformed 903 Female Generative Organs 206 Female Regulator 341 Female Urinary Organs 206 Femoral Hernia 863 Femur 27 Fencing 273 Fennel-seed 325 Fergusson Speculum 717 Fermented Liquors 263 Fern, Male 315 Ferri Carbonas 354 Ferri Citras 354 Ferri Ferrocyanidum 316 Ferri Pyrophosphas 354 Ferri Redactum 354 Ferrocyanide of Iron 316 Ferrum 354 Fever 401 Fever and Ague 405 Fever, Bilious 406 Fever, Camp 408 Fever, Congestive 406 Fever, Enteric 407 Fever, Gastric 405 Fever, Hay 514 Fever, Hectic 502 Fever, Hospital 408 Fever, Intermittent 405 Fever, Jail 408 Fever, Pernicious 406 Fever, Remittent 406 Fever, Scarlet 408 Fever, Ship 408 Fever, Typhoid 407 Fever, Typhus 408 Fever-sore 446, 454, 456 Fevers, Continued 407 Fevers, Domestic Management of 403 Fevers, Eruptive 408 Fevers, Malignant 407 Fevers, Putrid 407 Fibrillæ 30, 32 Fibrin 53, 238 Fibroid Polypus 487 Fibroid Tumors 722 Fibula 27 Fish 247 Fissure of Sylvius 98 Fistula in Ano 583 Fits 647 Flag, Blue 307 Flatulent Colic 558 Flax-seed 335 Fleabane, Canada 324 Flesh 30 Flexions of the Uterus or Womb 709, 714 Fluid Arachnoid 90 Focus 108 Foetus 216 Follicles of Lieberkuhn 79 Follicular Laryngitis 496 Follicular Ulcer 718 Fomentations 386 Food 233 Food, Classes of 238 Food, Digestibility of 243 Food, Preparation of 236 Food, Value of Animal 241 Food, Variety of, Necessary 236, 239 Foot-bath 366 Foreign Bodies in the Nose 893 Foreign Bodies In the Throat and Air-passages 893 Fountain Syringe 705 Foxglove 867 Fractures 892 Franklin Electric Machine 629 Frasera Carolinensis 353 Fraserin 353 Fretfulness 623 Frontal Bone 22 Function 11 Furuncular Affections 443 Furunculus 443 G Gall-bladder 80 Gallic Acid 325 Gall-stones 560 Galvano-Faradic Battery 628 Galvanometer 630 Gamboge 327 Ganglia 89, 103, 115 Ganglionic Corpuscles 87, 89 Gangrene 400 Garget 304 Gastralgia 885 Gastric Fever 405 Gastric Juice 45, 79 Gastritis, Acute 883 Gastritis, Chronic 884 Gaultheria Procumbens 325 Gelatinoid Polypus 487 Gelsemin 320, 348 Gelseminum Sempervirens 319, 348 General Paralysis 639 General Treatment of Paralysis 641 Generation 11, 12 Generation, Alternate 16 Generation, The Process of 15 Generative Organs, Hygiene of the 282 Generative Organs, Male, Affections of the 772 Gentian 350 Geranin 323 Geranium Maculatum 322 Geranium, Spotted 322 Germ-cell 12, 15 Ginger 325, 335 Gland, Prostate 827 Gland, Prostate, Enlargement of the 840 Gland, Sublingual 38 Gland, Submaxillary 39 Glands, Ceruminous 77 Glands, Meibomian 78 Glands of Brunner 79 Glands, Parotid 38 Glands, Salivary 38 Glands, Sebaceous 70, 77 Glands, Sudoriferous 69 Glycocholate of Soda 81 Goitre 470 Golden Medical Discovery 308, 316, 355 Golden Saffron 333 Golden-seal 352 Gold-thread 354 Gouty Headache 635 Granular Ulcer 717 Gravel 837 Gravel-plant 336 Gravel-root 336, 338 Gravel-weed 338 Gray Matter 91 Great Sympathetic System 101 Grip, The 471 Gum Arabia 335 Gutta Rosacea 433 Gymnasium, Exercises of the 275 H Habit, Alcohol 627 Habit, Opium 627 Habit, Tobacco 627 Hæmatoxylon Campeachianum 321 Hæmoptysis 502, 507 Hair-follicles, Affections of the 441 Hairs 72 Hamamelin 322 Hamamelis Virginica 321 Hands, Deformed 903 Hardhack 323 Haversian Canals 21 Hay Asthma 514 Hay Catarrh 514 Hay Fever 514 Headache 634 Headache, Malarial 635 Headache, Nervous 635 Headache, Neuralgic 635 Headache, Periodical 635 Headache, Rheumatic 635 Head Bath 358 Head, Scald 441 Head, The Bones of the 22 Health, Light and 231 Hearing 109 Heart 56 Heart, Atrophy of the 551 Heart, Dilatation of the 551 Heart, Diseases of the 547 Heart, Fatty Degeneration of the 651 Heart, Hypertrophy of the 550 Heart, Neuralgia of the 552 Heart, Organic Disease of the 547 Heat Eruption 430 Heat, Prickly 432 Hectic Fever 502 Hedeoma Pulegioides 341 Hellebore, American 347 Hellebore, Swamp 347 Hellebore, White 347 Hemiplegia 639 Hemlock, Poison 311 Hemorrhage 578, 890 Hemorrhoids 578 Hemp, Indian 344 Henbane 311, 343 Hepatitis, Chronic 569 Hermaphrodite 199 Hermaphroditic Reproduction 199 Hernia 862 Hernia, Radical Cure for 866 Herpes 438 High Cranberry 320 Hitus 84 Hip joint Disease 450 History of Marriage 188 Hives 437 Homes, Site for 227 Homoeopathy 294 Hops 312, 345 Horseback Exercise 276 Horse-balm 337 Horse-radish 331 Hospital Fever 408 Hot Bath 358 How to use Vaginal Injections 705 How to use Water 252 Human Temperaments 148 Humerus, 26 Humid Tetter, 430 Humor, Aqueous, 107 Humor, Vitreous, 107 Humpback, 898 Humulin, 312, 345 Humulus Lupulus, 312, 345 Hydragogues, 326 Hydrargyri Sulphas Flava, 339 Hydrarthrus, 452 Hydrastia, Muriate of, 352 Hydrastin, 352 Hydrastis Canadensis, 352 Hydrocele, 423, 821 Hydrocephalus, 433 Hydrochloric Acid, 310 Hydrothorax, 423 Hygiene ,222 Hygiene of the Reproductive Organs, 282 Hygiene, Practical Summary of, 288 Hygienic Treatment of the Sick, 375 Hymen, Imperforate, 687 Hyoscyamin, 311, 344 Hyoscyamus Niger, 311, 343 Hypertrophy of the Heart, 550 Hysterical Headache, 635 I Icterus, 559 Ileum, 40, 41 Imperforate Hymen, 687 Impetigo, 433 Impotency, 776 Impoverished Blood, 626 Impurities, Mineral, 249 Incised Wounds, 889 Incus, 110 Independent Physician, 295 Indian Hemp, 344 Indian Physic, 327 Indian Poke, 347 Indian Tobacco, 340 Indigestion, 565 Indigo, Wild, 318 Individual, Development of the, 192 Indolent Ulcer, 455 Indulgence, Solitary, 772 Induration, 400 Infantile Eczema, 430 Infants, Feeding of, 235 Inferior Maxillary Bone, 22 Inferior Turbinated Bones, 22 Inflammation, 398 Inflammation of the Bladder, Chronic, 836 Inflammation of the Bones, 458 Inflammation of the Liver, 569, 570 Inflammation of the Stomach, Acute, 882 Inflammation of the Stomach, Chronic, 884 Inflammation of the Vagina, 702 Inflammation, Phlegmonous, 399 Inflammation, Termination of, 400 Inflammation, Treatment of, 401 Influenza, 471 Infusions, 303 Inguinal Hernia, 863 Insalivation, 233 Insertion, 31 Insomnia, 623 Instruments, Danger in the use of, 846 Intermediate Muscles, 32 Intermittent Fever, 405 Interpretation of Symptoms, 893 Intestinal Juice, 79 Intestinal Worms, 561 Intestines, 49 Introductory Words, 9 Involuntary Muscles, 32 Involuntary Seminal Emissions, 773 Iodine, 307, 896 Iodine Bath, 368 Ipecac, 339 Ipomoea Jalapa, 326 Iris, 107 Iris Versicolor, 307 Iron, 354 Iron by Hydrogen, 354 Iron, Carbonate of, 354 Iron, Citrate of, 354 Iron, Ferrocyanide of, 316 Iron, Pyrophosphate of, 354 Iron, Tincture of Muriate of, 355 Irritable Ulcer, 455 Itch, 434 Itch, Barber's, 442 Itching of the Vulva, 702 J Jaborandi, 334 Jail Fever, 408 Jalap, 326 Jalapin, 327 Jaundice, 559 Jejunum, 40, 41 Jessamine, Yellow, 319, 348 Juglandin, 328 Juglans Cinerea, 328 Juice, Gastric, 45, 79 Juice, Intestinal, 79 Juice, Lemon, 335 Juice, Orange, 335 Juice, Pancreatic, 89 Juice, Tamarind, 335 K Kidneys, 823 Kidneys, Diseases of the, 829 Knee-joint, Tuberculosis of the, 453 Knot-root, 337 L Labyrinth, 110 Lacerated Wounds, 890 Lachrymal Bones, 22 Lacteals, 48 Lactiferous Ducts, 82 Lady's-slipper, Yellow, 320, 345 Laryngitis, Chronic, 496 Laryngitis, Follicular, 496 Larynx, 63 Larynx, Disease of the, 476 Latent Life, 11 Lateral Curvature of the Spine, 901 Late Suppers, 235 Laudanum, 310 Laxatives, 326 Lead Colic, 558 Lemons, 335 Lens Crystalline, 107 Leptandra Virginica, 327 Leptandrin, 327 Lesions, Valvular, 549 Leucocythæmia, 491 Leucorrhea 702 Liberal Physician 295 Lichen 431 Lids, Granular 649 Life, Latent 11 Life Line 169 Life, Origin of 17 Life-root 341 Life, Transmission of 181 Life, Turn of 700 Ligaments 29 Light and Health 231, 378 Limbs, Deformed 903 Liniments 342 Liquor Amnii 216 Liquor Sanguinis 53 Liquors, Alcoholic 255 Liquors, Distilled 264 Liquors, Fermented 263 Liquors, Malted 262 Liriodendron Tulipfera 350 Literature, Obscene 285 Liver 42 Liver, Chronic Inflammation of the 569 Liver Complaint 569 Liver, Diseases of the 569 Lobelia Inflata 340 Lobes 64, 80 Lobules 64, 80 Locomotor Ataxia 640 Logwood 321 Loss of Sexual Power 776 Love 184 Love, Conjugal 186 Lower Extremities, the Bones of the 27 Lumbago 427 Lungs 63 Lycopin 324 Lycopus Virginicus 323 Lymph 51 Lymphatics 49 Lymphatic System 49 Lymphatic Temperament 157 M Machines, Electrical 629 Macrotin 306 Macrotys 305 Mad-dog Weed 345 Magnesia Sulphas 328 Malar Bones 22 Malaria 227 Malarial Headache 635 Male Fern 315 Male Generative Organs 207 Male Generative Organs, Affections of the 772 Male Generative Organs, Physiology of the 772 Malformation of the Vagina 687 Malformation of the Womb 687 Malignant Fevers 407 Malleus 110 Malted Liquors 262 Management, Domestic, of Fevers 403 Mandrake 304 Manipulator 373 Marriage 184 Marriage, History of 188 Marsh-mallow 336 Maruta Cotula 334 Massage 362 Mastication 233 Masturbation 286, 772 Matter, Gray 91 Matter, Sebaceous 77 Maxillary Bones 22 May-apple 304 May-weed 334 Meadow Sweet 323 Meals, Regularity of 234 Measles 412 Measles, False 413 Meatus External Auditory 77, 109 Mechanical Movements in the Treatment of Paralysis 641 Mechanical Movements, Value of 371 Mediastinum 65 Medical Diagnosis 390 Medicated Bath 367 Medicine, Allopathic School of 293 Medicine, Eclectic School of 294 Medicine, Homoeopathic School of 294 Medicine, Preparation of 301 Medicine, Progress of 292 Medicine, Properties of 300 Medicine, Rational 292 Medicines, Proprietary 298 Medulla Oblongata 95 Medulla Spinalis 25 Meibomian Glands 78 Melancholy 621 Membrane, Arachnoid 90 Membrane, False 878 Membrane, Mucous 37 Membrane, Pituitary 111 Membrane, Synovial 29 Membranous Croup 878 Menorrhagia 697 Menses 210 Menses, Cessation of the 700 Menses, Retention of the 687, 688, 689, 690 Menses, Suppression of the 687, 688, 689, 690 Menstruation 210, 686 Menstruation, Painful 692 Menstruation, Profuse 697 Mental Culture 276 Mentha Piperita 326 Mentha Viridis 326 Mercury 307 Mercury, Yellow Subsulphate of 339 Metacarpus 26 Metatarsus 27 Miasm 405 Microscopical Examination 398 Miliaria 439 Milk 381 Mind, Nature of 146 Mineral Foods 238 Mineral Impurities 249 Mitral Valve 57 Miscarriage 682 Modified Small-pox 411 Monogamy 188 Morphine 311 Motherwort 342 Motion as a Remedial Agent 369 Motion, Peristalic 49 Motor Nerves 87, 93 Mouth 37 Mouth, Nursing Sore 554 Mouth, Sore 553 Movements, Mechanical, in the Treatment of Paralysis 661 Mucosin 78 Mucous Membrane 37 Mucus 78 Mumps, 471 Muriate of Hydrastia, 352 Muriate of Iron, Tincture of, 355 Muriatic Acid, 310 Muscles, 30 Muscles, Intermediate, 32 Muscles, Involuntary, 32 Muscles, Voluntary, 31 Muscular Tissue, 20 Mustard, 331, 339 Mutton Soup, 247 Myalgia, 427 N Nails, 73 Narcotics, 343, 897 Nasal Bones, 22 Nasal Catarrh, Chronic , 474 Nasal Cavity, anterior view of, 490 Nasal Cavity, view of deformed, 492 Nasal Douche, Dr. Pierce's, 485 Nasal Polypus, 487 Nasal Tumors, 489 Nasal Septum, deformed, 490 Nature of Asthma, 512 Nature of Disease, 390, 512 Nature of Mind, 146 Nature's Mode of Sustaining Health 371 Neck, Thick, 470 Necrosis, 456 Nepeta Cataria, 334 Nerve-fibers, 87 Nerve, Pneumogastric, 101 Nerves, Afferent, 87, 93 Nerves, Cerebral, 89 Nerves, Cranial, 100 Nerves, Efferent, 87, 93 Nerves, Motor, 87, 93 Nerves, Olfactory, 100, 111 Nerves, Sensory, 87, 93 Nerves, Spinal, 89 Nerves, Sympathetic, 101 Nervines, 345 Nervous Affections of the Skin, 440 Nervous Debility , 619 Nervous Exhaustion, 619 Nervous Headache, 635 Nervous System, 87, 617 Nervous System, overworked, 622 Nervous Tissue, 20 Nettle-rash, 437 Neuralgia, 635 Neuralgia of the Heart, 552 Neuralgia of the Stomach, 885 Neuralgic Headache, 635 Neurasthenia, 620, 622 Neurilemma, 89 Nightshade, Deadly, 312 Nitre, Sweet Spirits of, 338 Nocturnal Emissions, 773 Nosebleed, 881 Nose, Foreign Bodies in the , 893 Nucleolus, 19 Nucleus, 19,64 Nurse, 375, 376 Nursing Sore Mouth, 554 Nux Vomica, 350 O Obscene Literature, 285 Occipital Bone, 22 OEdema, 422 Old School of Medicine, 293 Old Sores, 454 Oleum Ricini, 328 Olfactory Nerves, 100, 111 Onanism, 286, 772 Opium, 310 Opium Habit, 627 Opium, Use of, 384 Oranges, 335 Organic Disease of the Heart, 547 Organic Extracts as remedies, 631 Organic Impurities in Water, 251 Organs, Circulatory, 56 Organs, Digestive, 37 Organs, Generative, 206, 207 Organs of Respiration, 63 Organs, Urinary, 206, 207 Orifice, Pyloric, 82 Origin, 31 Origin of Life, 17 Os Hyoides, 23 Osmosis, 46 Os Orbiculare, 110 Ossa Innominata, 23, 25 Osscous Tissue, 20 Ossification, 20 Ossification, Centers of, 20, 27 Ovarian Tumors, 722 Ovaries, 209 Ovaries, Absence of the, 688 Ovaries, Disease of the, 710 Ovulation, 209 Ovum, 12, 209 Ozæna, 474, 475 P Pack, Wet Sheet, 368 Pain, 395 Painful Menstruation, 692 Painters' Colic, 558 Palate Bones, 22 Pallor, 62 Palsy, 638 Palsy, Creeping, 640 Palsy, Shaking, 641 Pancreas, 44 Pancreatic Juice, 80 Pancreatin, 80 Papaver Somniferum, 310 Papillae, 69, 112 Paralysis, 638 Paralysis Agitans, 641 Paralysis, General, 639 Paralysis, General Treatment of, 641 Paralysis, Progressive, 640 Paraplegia, 639 Paregoric, 310 Parietal Bones, 22 Parotid Glands, 38 Parotitis, 471 Parsley, Poison, 311 Passages, False, 846 Passions, Influence of Physical Labor on, 283 Patella, 27 Patient, Clothing and Bedding of, 380 Peach Tree, 346 Peduncles of the Cerebellum, 97 Pelvis, 25 Pelvis, Bones of the, 85 Pemphigus, 139 Pennyroyal, 341 Pepper, Black 348 Peppermint 326 Pepsin 79 Percussion 391 Pericarditis 548 Pericardium 56 Perichondrium 29 Perilymph 110 Periodical Headache 635 Periosteum 27 Peristaltic Motion 45 Peritoneum 84 Peritonitis 886 Permanganate of Potash 318 Pernicious Fever 406 Perpetual Reproduction 11 Perpetuation of the Species 194 Perspiration 75 Pertussis 880 Pettenkoffer's Test 81 Phalanges 27 Pharyngitis and Post-nasal Catarrh 493 Pharynx 39 Phthisic 511 Phthisis Pulmonalis 497 Physical Exercise 270 Physical Properties of the Blood 53 Physician, Independent 295 Physiological Anatomy 11, 19, 30, 37, 48, 56, 63, 68, 75, 84, 87 Physiological Anatomy of the Urinary Organs 823 Physiology 11 Physiology, Cerebral 114 Physiology of the Male Generative Organs 772 Phytolacca Decandra 304 Phytolaccin 304 Pia Mater 90 Pierce's Comp Extract of Smart-weed 312, 326, 335, 342, 349 Pierce's Favorite Prescription 342, 346, 355 Pierce's Golden Medical Discovery 308, 316, 355 Pierce's Nasal Douche 485 Pierce's Purgative Pellets 308, 328 Pigeon-berry 304 Piles 578 Pile Tumors, Radical Cure of 581 Pine-apples 335 Pink-root 314 Pin-worm 561 Pipsissewa 338 Pituitary Membrane 111 Pityriasis 431 Placenta 216 Pleura 64 Pleurisy-root 332 Pleurodynia 427 Pleximeter 391 Pneumogastric Nerve 101 Podophyllin 304 Podophyllum Peltatum 304 Poison Hemlock 311 Poison Parsley 311 Poisoned Wounds 890 Poisons and their Antidotes 895 Poke 304 Poke, Indian 347 Pollution, Voluntary 772 Polygamy 188 Polypi 723 Polypoid Tumors 723 Polypus, Nasal 487 Polyuria 835 Pond's Sphygmograph 548 Pons Varolii 97 Poplar 315, 350 Populin 315 Pork Steaks 247 Portal System, Veins of the 60 Position in Sleep 280 Position of Patient 393 Posterior Pyramids 95, 96 Posterior Spinal Curvature 898 Post-nasal Catarrh 493 Post-nasal Syringe 493 Potash, Acetate of 338 Potash, Bicarbonate of 309 Potash, Nitrate of 338 Potash, Permanganate of 318 Pott's Disease 898 Powder, Dover's 311 Practical Summary of Hygiene 288 Preface 5, 7 Pregnancy 212 Pregnancy, Derangements Incident to 721 Pregnancy, Duration of 219 Pregnancy, Signs of 219 Prehension 233 Premature Labor 682 Preparation of Food 236 Preparation of Medicines 301 Prescription, Pierce's Favorite 342,346,355 Prevention of Conception 212 Prickly-ash 349 Prickly Heat 437 Pride-weed 324 Prince's Pine 338 Principle, Vital 15 Processes, Articular 24 Processes, Spinous 24 Processes, Transverse 24 Process of Generation 15 Profuse Menstruation 697 Prognosis 390 Progress of Medicine 292 Progressive Paralysis 640 Prolapsus of the Uterus 713 Properties of Medicine 300 Proprietary Medicines 298 Prostate Gland 827 Prostate Gland, Enlargement of the 840 Proteids 238 Prurigo 440 Pruritus Vulvae 702 Prussian Blue 316 Psoriasis 431 Ptyalin 78 Puberty 210 Puccoon, Red 306 Pulmonary Artery 58 Pulmonary Tuberculosis 497 Pulmonary Veins 60 Pulsatilla Nigricans 346 Pulse 61, 395 Pumpkin Seeds 338 Puncta Lachrymalia 77 Punctured Wounds 889 Pupil 107 Pure Air 222, 223, 378 Purgatives 326 Purification of Water 252 Putrid Fevers 407 Pyloric Orifice 83 Pyrophosphate of Iron 354 Q Quackery Exposed, 780 Queen of the Meadow, 338 Quickening, 217 Quinine, 315 Quinsy, 416 R Rachitis, 453 Radical Cure for Hernia, 866 Radical Cure for Pile Tumors, 581 Radius, 26 Rash, 436 Rash, Papular, 431 Rash, Rose, 413 Rational Medicine, 292 Receptaculum Chyli, 46 Rectum, 42 Red Puccoon, 306 Reflex Action of the Spinal Cord, 93 Region of Feebleness, 134 Regularity of Meals, 234 Regular School of Medicine, 293 Remedial Agent, Motion as a, 369 Remedial Treatment of Diseases, 386 Remedies for Disease, 298 Remittent Fever, 406 Renal Calculi, 837 Reproduction, 11, 196 Reproduction, Dioecious, 202 Reproduction, Hermaphroditic, 199 Reproductive Organs, Hygiene of the, 282 Resolution, 400 Respiration, Organs of, 63 Respiration, Pure Air for, 223 Respirator, Cotton-wool, 230 Rete Mucosum, 70 Retention of the Menses, 687, 688, 689, 691 Retina, 106, 107 Retroflexion of the Uterus, 709, 714 Rheumatic Headache, 635 Rheumatism, Acute Articular, 425 Rheumatism, Cervical, 427 Rheumatism, Chronic Articular, 426 Rheumatism, Muscular, 127 Rhubarb, 327 Ribs, 24 Rickets, 453 Right to Terminate Pregnancy, 218 Rooms, Sleeping, 278 Rose Rash, 413 Rosy Drop, 433 Rubbing, 372 Rubeola, 412 Running Scall, 430 Running-sores, 454 Rupia, 439 Rupture, 862 Russian Bath, 358 S Sacrum, 23, 25 Sage, 313, 333 Saleratus, 309 Salicin, 315, 351 Saliva, 38, 78 Salivary Glands, 38 Salt, 315 Saltpetre, 333 Salt-rheum, 430 Salts, 53 Salts, Biliary, 81 Salvia Officinalis, 313, 333 Sanguinaria Canadensis, 308 Sanguine Temperament, 163 Santonin, 313 Sarcolemma, 32 Saturnine Colic, 558 Scabies, 434 Scalds, 894 Scall, 433 Scall, Running, 430 Scaly Skin Diseases, 441 Scapula, 26 Scarlatina, 408 Scarlet Fever, 408 School-rooms, Ventilation of, 225 Sclerotic, 106 Scott's Acid Bath, 367 Scrofula, 445 Scrotum, Dropsy of the, 821 Scull-cap, 345 Sea Bathing, 364 Seat, 390 Seat-worm, 561 Sebaceous Glands, 70, 77 Sebaceous Matter, 77 Secretion, 75 Sedatives, 346 Self-abuse, 286, 622 Self-pollution, 772 Semen, 772 Semi-circular Canals, 110 Semilunar Valves, 58 Seminal Emissions, Involuntary, 773 Sense of Hearing, 109 Sense of Sight, 106 Sense of Smell, 111 Sense of Taste, 112 Sense of Touch, 113 Senses, Special, 106 Sensory Nerves, 87, 93 Septum, Deformed Nasal, 490 Serum, 54, 55, 238 Sexual Abuse, Story of, 394 Sexual Debility, Symptoms of, 776 Sexual Influences, 383 Sexual Power, Loss of, 776 Shaking Palsy, 641 Shingles, 438 Shock, 890 Shower Bath, 365 Sick, Hygienic Treatment of the, 375 Sick-room, 377 Sick, Visiting the, 383 Sight, 106 Signs of Pregnancy, 219 Site for Homes, 227 Sitz Bath, 367 Skeleton, 22 Skin, 68 Skin, Diseases of the, 430 Skin Diseases, Scaly, 441 Skin, Nervous Affections of the, 440 Skoke, 304 Sleep, 278, 382 Small-pox, 410 Smart-weed, Compound Extract of, 312, 326, 335, 342, 349 Smell, 111 Snake-head, 315 Snake-root, Black, 306 Society, Welfare of, 193 Soda, Glycocholate of, 81 Soda, Sulphite of 309 Soda, Taurocholate of 81 Sodium, Chloride of 315 Soft Rubber Bulb Syringe 705 Solitary Indulgence 772 Sore Mouth 553 Sore Mouth, Nursing 554 Sore Throat, Clergymen's 496 Soups 246 Spasmodic Croup 878, 879 Spearmint 326 Special Creation 14 Special Senses 106 Species 14 Species, Perpetuation of the 194 Specific Center 14 Speculum 717 Spermatic Veins, Enlarged 803 Spermatocele 803 Spermatorrhea 620, 772, 844 Spermatozoön 12 Sperm-cell 15 Sphenoid Bone 22 Sphygmograph, Pond's 548 Spigelia Marilandica 314 Spinal Column 24 Spinal Cord 25, 90 Spinal Cord, Reflex Action of the 93 Spinal Curvature, Posterior 898 Spinal Nerves 89 Spirit Vapor-bath 362 Spirometer 391, 392 Spleen 44 Sponge Bath 365 Sprains 892 Squaw-root 305 Stapes 110 Static Electrical Machine 629 Sterility 707 Sternum 23 Stethoscope 391 Stimulants 348 Stomach 39, 52 Stomach, Inflammation of the 882, 884 Stomach, Neuralgia of the 885 Stomatitis 553 Stomatitis Materna 554 Stone in the Bladder 838 Stone-pock 442 Stone-root 337 Story of Sexual Abuse 394 Stramonium 344 Striae 31 Stricture of the Urethra 775, 843 Strumous Diathesis 445 Strumous Synovius 453 St. Vitus's Dance 650 Styptics 320, 890 Sublingual Gland 39 Submaxillary Gland 38 Sudatorium 359 Sudoriferous Glands 69 Sudorifics 332 Sulphate of Copper 339 Sulphate of Quinia 315, 339 Sulphate of Zinc 318 Sulphite of Soda 309 Sulphur Bath 368 Sulphuric Acid, Aromatic 310 Sulphur Vapor-bath 368 Summer Complaint 555 Sun-stroke 894 Superior Maxillary Bones 22 Suppers, Late 235 Suppression of the Menses 687, 688, 689, 691 Suppuration 400 Surgical Treatment of Epilepsy 649 Sutures 23 Swamp Alder 304 Swamp Dogwood 351 Sweet Elder 307 Sweet Spirits of Nitre 338 Swelling 400 Swelling, White 452 Swimming 274 Sycosis 442 Sylvius, Fissure of 98 Sympathetic Nerve 101 Symptoms 390, 392, 393 Symptoms, Interpretation of 393 Symptoms 01 Sexual Debility 776 Synovia 29 Synovial Capsule 29 Synovial Membrane 29 Synovitis 453 Synovitis, Rheumatic 453 Synovitis, Strumous 453 Synovitis, Syphilitic 453 Syphilitic Synovitis 453 Syringe, Post-nasal 493 Syringe, Soft Rubber Bulb 705 System, Cerebro-Spinal 89 Systemic Veins 60 System, Lymphatic 49 System, Nervous 87, 617 System, the Great Sympathetic 101 System, Vascular 56 T Tænia 562 Tag Alder 304 Tall Speedwell 327 Tamarind 335 Tanacetum Vulgare 341 Tannin 325 Tansy 341 Tape-worms 562 Tarsus 27 Taste, Sense of 112 Taurocholate of Soda 81 Tea 253 Tear-duct, Closure of the 477 Tear-duct, Obstruction of the 477 Tears 77 Teeth 37 Temperaments, Classified 156 Temperaments, Human 149 Temperate Bath 357 Temporal Bones 22 Tentorium 97 Tepid Bath 357 Termination of Inflammation 400 Test, Pettenkoffer's 81 Tetter, Branny 431 Tetter, Crusted 433 Tetter, Humid 430 Thick Neck 470 Thoracic Duct 42 Thorn-apple 344 Thoroughwort 316 Thread-worm 561 Throat, Disease of the 476 Throat, Foreign Bodies in the 893 Throat, Ulceration of the 496 Thrush 553 Tibia, 27 Time for Sleep, 279 Tinctura Ferri Chloridi, 355 Tincture of the Chloride of Iron, 355 Tincture of the Muriate of Iron, 355 Tinctures, 302 Tissue, Adipose, 20 Tissue, Areolar, 19 Tissue, Cartilaginous, 20 Tissue, Connective, 19 Tissue, Muscular, 20 Tissue, Nervous, 20 Tissue, Osseous, 20 Tobacco Habit, 627 Tobacco, Indian, 340 Tobacco, Use of, 384 Tongue, 3, 394 Tonics, 350 Tonsilitis, 416 Tonsils, Enlarged, 417, 494 Torpid Liver, 569 Torticollis, 427 Touch, Sense of, 113 Tourniquet, 890 Trachea, 63 Trailing Arbutus, 336 Transmission of Life, 181 Transudation, 422 Treatment, 390 Treatment of Diseases, Remedial, 386 Treatment of Epilepsy, Surgical, 649 Treatment of Inflammation, 401 Treatment of Paralysis, 641 Treatment of the Sick, Hygienic, 375 Trichina Spiralis, 564 Tricocephalus Dispar, 562 Tricuspid Valve, 57 True Skin, 68 Trumpet-weed, 338 Trunk, 23 Tube, Eustachian, 110 Tube, Eustachian, Obstruction of the, 477 Tubercle, 445 Tubercular Consumption, 497 Tuberculosis of the Knee-joint, 453 Tuberculosis, Pulmonary, 497 Tumors, Fibroid, 722 Tumors, Ovarian, 722 Tumors, Polypoid, 723 Tumors, Uterine, 122 Turkish Bath, 358 Turn of Life, 700 Turpeth Mineral, 339 Tympanum, 110 Typhoid Fever, 407 Typhus Fever, 407 U Ulceration of the Throat, 496 Ulceration of the Uterus, 717 Ulcer; Follicular, 718 Ulcer, Granular, 717 Ulcer, Indolent, 455 Ulcer, Irritable, 455 Ulcer, Varicose, 455 Ulcers, Chronic, 454 Ulna, 26 Umbilical Cord, 217 Umbilical Hernia, 863 Umbilicus, 217 Universality of Animalcular Life, 16 Upper Extremities, the Bones of the, 25 Uræmic Headache, 635 Urea, 86 Ureters, 84 Urethra, 86, 827 Urethra, Stricture of the, 843 Uric Acid, 86 Urinary Fistula, 721 Urinary Organs, Diseases of the, 823 Urinary Organs, Physiological Anatomy of the, 823 Urine, 86 Urine, Examination of the, 397, 825 Urinometer, 392 Urticaria, 437 Use of Tobacco and Opium, 384 Uterine Pregnancy, 215 Uterine Speculum 717, 718 Uterine Tumors, 722 Uterus, Falling of the, 713 Uterus, Prolapsus of the, 713 Uvula, Elongation of the, 495 V Vaccinia, 411 Vagina, Inflammation of the, 702 Vagina, Irritable, 702 Vagina, Malformation of the, 687 Vaginal Injections, How to Use, 705 Vaginitis, 702 Valerian, 320 Valeriana Officinalis, 320 Value of Animal Food, 241 Value of Mechanical Movements, 371 Valve, Mitral, 57 Valve, Tricuspid, 57 Valves, Semilunar, 58 Valvulæ Conniventes, 40 Valvular Lesions, 549 Vapor-Bath, 358 Vapor-Bath, Spirit 362 Vapor-Bath, Sulphur 368 Varicella, 412 Varicocele, 803 Varicose Ulcer, 455 Variety of Food necessary, 239 Variola, 410 Varioloid, 411 Vascular System, 56 Veins, 59 Veins, Enlarged Spermatic, 803 Veins of the Portal System, 60 Veins, Pulmonary, 60 Veins, Systemic, 60 Vena Cava, 56,60 Ventilation of Dwellings, 226 Ventilation of Factories, 226 Ventilation of School Rooms, 225 Ventilation of Workshops, 226 Ventricle, 57 Veratrum Viride, 347 Vermifuge, 313 Versions of the Uterus or Womb, 709, 714 Vertebræ, 23 Vesical Calculi, 838 Vestibule, 110 Viburnin, 320 Viburnum Opulus, 320 Villus, 41,48 Virginia Snake-root, 333 Visiting the Sick, 383 Vital Principle, 15 Vital Properties of the Blood, 53 Vitreous Humor, 107 Vitriol, Elixir of, 310 Vitriol, White 818 Volitive Faculties 129 Volitive Temperament 171 Voluntary Muscles 31 Voluntary Pollution 772 Vomer 22 Vomit, Black 883 Vulvitis 702 W Wafer-ash 351 Wakefulness 623 Warm Bath 357 Warmth 379 Water 248 Water-bugle 323 Water-hoarhound 323 Water, How to use 252 Water-melon Seeds 338 Water, Organic Impurities in 251 Water-pink 336 Water, Purification of 252 Waters, Chalybeate 250 Waters, Saline 250 Waters, Sulphurous 250 Welfare of Society 193 Wet Sheet Pack 368 White Hellebore 347 White Poplar 350 White Swelling 452 White Vitriol 318 White-root 332 Whitewood 350 Whites 702 Whooping-cough 880 Wild Chamomile 334 Wild Indigo 318 Wild Yam 320 Willow 351 Windpipe 63 Wintergreen 325 Witch-hazel 321 Woman and her Diseases 684 Womb, Absence of the 687 Womb, Displacements of the 713 Womb, Elongation of the Neck of the 709 Womb, Flexions of the 709, 714 Womb, Malformation of the 687 Womb, Versions of the 709, 714 Workshops, Ventilation of 226 Worms, Intestinal 561 Wounds 889 X Xanthoxylin 349 Xanthoxylum Fraxineum 349 Y Yam, Wild 320 Yeast 317, 335 Yellow Dock 304 Yellow Jessamine 319, 348 Yellow Lady's-slipper 320, 345 Yellow Subsulphate of Mercury 339 Z Zinci Sulphas 318, 339 Zinc, Sulphate of 318, 339 Zingiber Officinalis 325, 335 * * * * * INDEX TO APPENDIX A Advantages Offered to Invalids 951 Advantages of Location 948 Advantages of Specialties 950, 956 Advertising 958 Affidavit 905 Aids, In valuable, in Urinary Diseases 964 Amusements 932 Analysis of Urine 962, 967 Appendix 905 B Bath Department 931 Beecher on Advertising 959 Board and Treatment, Terms for 970 Buffalo Outranks all in Healthfulness 946 C Cause of Female Weakness 919 Caution 936 Charges Must be Prepaid 968 Chemical Laboratory 940 Chronic Diseases, Mechanical Aids in the Cure of 906 Chronic Diseases, Treatment of 954 Climate 944 Common Sense View, A 934 Consultation, Free 968 Consultations by Letter 968 Consultations with Physicians 971 Counter-Irritation 916 Cure of Deformities 917 Cure of Neuralgia 916 Cure of Paralysis 917 Cure of Swellings 915 Cure of Tumors 917 D Deformities, Cure of 917 Disease Has Certain Unmistakable Signs 943 Diseases of Women 918 Division of Labor 949, 954 E Eminent Medical Authorities 967 Endorsement, President Garfield's 973 Equability of Climate 945, 947 Evidence of Health Statistics 945 Extreme Healthfulness of Buffalo 944 F Facilities of Treatment 949 Facts of Science 946 Fair and Business-like Offer 953 Fees, Why Required in Advance 969 Female Weakness, Cause of 919 Fire-Proof Vaults 930 Free Consultation 968 G General Considerations 940 Genuine Home, A 948 Good Order 932 H Home, A Genuine 948 Home, Remedial 942 How to Avoid Swindlers 990 I Important Announcement 921 Invalids, Advantages Offered to 951 Invalids' Hotel and Surgical Institute 922, 924, 941 Invaluable Aids in Urinary Diseases 964 J Joints, Stiffened 951 K Kneader 914 L Liberality 934 Location, Advantages of 948 M Manipulator 908 Map of Buffalo 992 Mechanical Aids in the Cure of Chronic Diseases 906 Medical Authorities, Eminent 967 Medicine, Progress of 950 Medicines, Our 971 Moderate, Terms 949 N Neuralgia, Cure of 916 Not Confined in Prescribing 972 Notices of the Press 974 O Offer, Fair and Business-like 953 Our Medicines Prepared with the Greatest Care 972 Our Physicians and Surgeons 935 Our Remedies 931 P Paralysis, Cure of 917 Patient's Room 945 Patients, Treating at a Distance 960, 971 Physicians and Surgeons, Staff of 925 Physicians, Consultation with 971 President Garfield's Endorsement 973 Press Notices 974 Printing Department 939 Progress in Medicine 950 R Rational Treatment 919 Recapitulation 920 Regulation of Diet 931 Reliable Medicines 969 Remedial Home, 942 Revulsion 916 S Signs, Urinary 962 Specialties, Advantages of 950, 956 Staff of Physicians and Surgeons 925 Statistics, Evidence of Health 945 Steam Passenger Elevator 930 Surgical Department 931 Swellings, Cure of 915 Swindlers, How to Avoid 935, 990 T Terms for Board and Treatment 970 Terms for Treatment 969 Trained Attendants 932 Treating Patients at their Homes 942 Treatment, Facilities of 949 Treatment of Chronic Diseases 954 Tumors, Cure of 915 Turkish Bath 931 U Unparalleled Success 933 Urinary Signs 962 V Vibrator 911 Visiting Patients who Reside at a Distance 971 Vocabulary 979 W World's Dispensary 937 World's Dispensary Medical Association 921 * * * * * FOOTNOTES Footnote 1: Darwin. Footnote 2: The males of Cryptophialus and Alcippe, species of marine animals, are apparent exceptions to this rule. They are parasitic, possess neither mouth, stomach, thorax, nor abdomen, and are, necessarily, short-lived. Footnote 3: Dalton--Human Physiology. Footnote 4: In the use of the terms psychical and psychological, we have observed the distinction which metaphysicians have recently made. They employ the term psychical to indicate the relation of the human soul to sense, appetite, propensity, etc., and psychological, as indicating the ultimates of spiritual being. In this manner we use the word psychical as describing the relationship of the soul to animal experiences and being, and psychological as referring to the spiritual potencies of the soul. The distinction being introduced, we continue its use rather then coin new words. Footnote 5: Certain disturbances of the bodily organs excite fear. The apprehension of danger, or simply mental excitement, does not explain what is called "water fright," "stage fright," terror excited by the raging of a storm, or the rocking of a boat. In such instances the heart may beat heavily, the respiration be irregular and attended by precordial oppression, giddiness, weakness, and physical inability to articulate a word or recall a thought. These bodily conditions are not subject to the control of the will, but arise when individuals are perfectly assured that no danger threatens. At other times, as in a fearful tempest upon the sea, although the danger be imminent, if the bodily functions are not disturbed, there is not the least manifestation of fear. Footnote 6: A _placebo_ is a harmless and valueless prescription, which physicians sometimes make merely to gratify the patient, as a dose of "bread pills," etc.