We wish to add further that we are responsible to _you_ for what we represent; we therefore ask you to come and visit our institutions; and, if you find on investigation that we have misstated or misrepresented _in any particular_ our institutions, our advantages, or our success in curing Chronic Diseases, _we will gladly and promptly refund to you all the expenses of your trip_. We court honest, sincere investigation, and are glad and anxious to show interested people what we can do and are daily doing for suffering humanity. Can a proposition be plainer? Can an offer be more fair and business-like? If, therefore, you are afflicted, and are seeking relief, come where genuine ability is a ruling feature, where _success_ is our watchword and the alleviation of human suffering our mission.
Whether arriving in our city by day or night, _come directly to the Invalids' Hotel and Surgical Institute, 663 Main Street_, where you will be hospitably received and well cared for.
Address all correspondence to
WORLD'S DISPENSARY MEDICAL ASSOCIATION, _663 Main Street, BUFFALO, N.Y._
SUCCESSFUL TREATMENT OF CHRONIC OR LINGERING DISEASES.
[Illustration]
For many years the founder of the Invalids' Hotel and Surgical Institute and World's Dispensary has devoted himself very closely to the investigation and treatment of chronic diseases. Some few specifics have, during this time, been developed for certain forms of chronic ailments, and given to the public, but they have not been lauded as "cure-alls," or panaceas, but only recommended as remedies for certain well-defined and easily recognized forms of disease. These medicines are sold through druggists very largely, and have earned great celebrity for their many cures. So far from claiming that these proprietary medicines will cure all diseases, their manufacturers advise the afflicted that, in many complicated and delicate chronic affections, they are not sufficient to meet the wants of the case. These must have special consideration and treatment by a competent physician and surgeon, the medicines and other remedial means required being selected and prepared with reference to each particular case.
In order to be able to offer those afflicted with chronic ailments the most skillful medical and surgical services, Dr. Pierce, many years ago, associated with himself several eminent physicians and surgeons, as the Faculty of the old and renowned World's Dispensary, the consulting Department of which is now merged with the Invalids' Hotel and Surgical Institute.
DIVISION OF LABOR.
In the organization of the medical and surgical staff of the Invalids'
Hotel and Surgical Institute, several years ago, we assigned to one physician the examination and treatment of diseases of the nervous system; to another, surgical operations and the treatment of surgical diseases; a third had charge of catarrhal and pulmonary diseases and affections of the heart; a fourth attended to diseases peculiar to women; a fifth, to diseases of the eye and ear; a sixth, to diseases of the digestive organs; a seventh, to special surgical cases; to another we entrusted diseases of the urogenital organs; and to others, various other specialties. Now that our practice has become so very extensive as to require for its conduct a greatly increased number of physicians and surgeons. Thus four physicians and surgeons devote their undivided attention to the examination and treatment of diseases of the urinary and generative organs of men. Three physicians give their sole attention to diseases peculiar to women and three to those of the nasal organs, throat and chest, embracing all chronic diseases of the respiratory organs. Thus we have a full council of three and four physicians in these several specialties. In several other divisions we have two specialists. No case is slighted either in the examination or in the treatment. All doubtful, obscure or difficult cases are submitted to a council composed of several physicians and surgeons. Skilled pharmaceutists are employed to compound the medicines prescribed. For the purpose of enabling us to conduct our extensive correspondence (for we have an extensive practice en every part of the United States and Canada, as well as in Great Britain from our London branch), graphophones are employed, to which replies are dictated, recording the words of the speaker. Afterwards the letters are written out in full, generally on a type-writing machine, which prints them in a plain, legible style. These machines are operated as rapidly as a person can think of the letters which compose a word, each operator thus accomplishing the work of several copyists. This system, by which we are enabled to correspond with our patients as rapidly as we can talk, has been rendered necessary by the growth of our business, which has attained immense proportions, giving rise to so large a correspondence that a dozen physicians cannot possibly conduct it all and give each patient's case careful attention, without the employment of graphophones and all other facilities which modern invention has given us. By the adoption of these various means, we are enabled to fully meet the demands of the afflicted, and give every case the most careful attention.
[Illustration: Faculty of Invalids' Hotel and Surgical Institute in Session.--Council-room.]
As many persons, particularly young ladies and gentlemen, having catarrh or almost any other chronic disease, especially if of the urogenital organs, are very sensitive and fearful that somebody will know that they are afflicted and employing medical treatment, precautions are taken that none who consult us may incur the least risk of exposure. Although none but the most honorable and trustworthy gentlemen are employed as assistants, yet as a _guarantee_ of perfect security to our patients, that every communication, whether made in person or by letter, will be treated as _sacredly confidential_, each professional associate, clerk, or assistant, is required to take a solemn oath of secrecy. Great care is also taken to send all letters and medicines carefully sealed in plain envelopes and packages, so that no one can even _suspect_ the contents or by whom they are sent.
ADVANTAGES OF SPECIALTIES.
By thorough organization and a perfect system of subdividing the practice of medicine and surgery in this institution, every invalid consulting us is treated by a specialist--one who devotes his undivided attention to the particular class of diseases to which his or her case belongs. The advantage of this arrangement must be obvious. Medical science offers a vast field for investigation, and no physician can, within the limit of a single life-time, achieve the highest degree of success in the treatment of _every_ malady incident to humanity. A distinguished professor in the medical department of one of our universities, in an address to the graduating class, recently said: "Some professional men seem to be ashamed unless they have the character of universal knowledge. He who falls into the error of studying everything will be certain to know nothing well. Every man must have a good foundation. He must, in the first place, be a good general practitioner. But the field has become too large to be cultivated in its entirety by any individual; hence the advantage of cultivating special studies in large towns, which admit of the subdivision of professional pursuits. It is no longer possible to know everything; something must be wisely left unknown. Indeed, a physician, if he would know anything well must be content to be profoundly ignorant of many things. He must select something for special study, and pursue it with devotion and diligence. This course will lead to success, while the attempt to do everything eventuates unavoidably in failure. Let there be single hands for special duties." Our institution is the only one in this country in which these common-sense-ideas are _thoroughly_ carried out. The diversified tastes and talents of physicians cause each to excel in treating some one class of diseases, to which he devotes more attention and study than to others. One medical student manifests great interest in the anatomy, physiology, pathology, and treatment of diseases of the eye. He becomes thoroughly familiar with all the minutest details relative to that organ and its diseases, and so thoroughly qualifies himself in this branch of knowledge that he is able to cure an inflammation or other affection of the eye in a very short time. Another student is more interested in some other class of diseases, for the study of which he has a liking, and neglects to inform himself in the ophthalmic branch of medical and surgical science. If after engaging in the practice of his chosen profession, he is consulted by persons suffering from diseases of the eye, he tortures them with unnecessary and oftimes injurious applications, clumsily and carelessly made, and, as the result of such unskillful treatment, the inestimable blessing of sight may be sacrificed.
[Illustration: A Corner in Printing Department.--World's Dispensary.]
The great majority of physicians allow acute maladies, diseases of children, and the practice of midwifery, to engross most of their time and attention. They manifest an absorbing interest in everything that relates to these subjects, and devote little or no time to acquiring an intimate knowledge of the great variety of chronic maladies which afflict mankind. They acquire skill and reputation in their favorite line of practice, but are annoyed if consulted by one suffering from some obscure chronic affection, usually turn the invalid off with a very superficial examination, and, perhaps, only prescribe some placebo,[6]
apparently indifferent as to the result, but really desiring thus to conceal their lack of familiarity with such diseases. The specialist, the treatment of chronic diseases being his vocation, is equally annoyed if consulted by those suffering from acute diseases, but does not pursue the inconsistent course of assuming to treat them. He refers them to those of his medical brethren whose daily dealings with such cases make them, in his way of thinking, more competent than himself to render valuable service to such sufferers. He recognizes the fact that no man is likely to succeed in any line of study or business for which he possesses no talent or relish, nor does he believe in being a "jack-at-all-trades and master of none."
ADVERTISING.
Having thoroughly qualified himself for the practice of some particular branch of the healing art, the specialist sees no impropriety in acquainting the public with his ability to relieve certain forms of suffering. He believes that medical men should possess equal rights with other business men, and that any code of medical ethics which would deprive him of any of the sacred rights guaranteed to all by the liberal laws of the country, is professional _tyranny_, and merits only his contemptuous disregard. Nor does he display any false modesty in the _manner_ of making known his skill. He maintains that he has an undoubted right to place his claim to patronage before the public by every fair and honorable means. He recognizes the display of goods in the merchant's show-windows as no less an advertisement and in no better taste than the publication of a card in the newspaper. So, likewise, he regards the various devices by which the extremely _ethical_ physician seeks to place himself conspicuously before the public, as but so many ways of advertising, and as not more modest than the publication of cures actually performed, or than his announcement through the public press of his professional resources for treating certain maladies.
The physician who expresses a "holy horror" of the "_advertising doctor_," liberally bestowing upon him the epithet of "quack," announces _himself_ a graduate, talks learnedly and gives notice to the public in _some_ way that he is ready to serve them. He endeavors to impress upon the mind of the patient and family his skill, frequently exaggerates as to the extent of his practice, rides furiously about when he has no professional calls, keeps up business appearances by driving several horses, or joins influential societies. He may make a great display in style, manner, dress, pretensions, writing for the newspapers, exhibiting literary pedantry, referring to the superior facilities afforded by some particular school or society to which he belongs; or by editing and publishing a medical journal, ostensibly for the advancement of medical science, but practically to display titles or professorships, to publish reports which flatteringly allude to cases he has treated, the number of capital surgical operations he has performed, or the distinguished families he is treating. All these are but _modes of advertising_ professional wares; in short, are artful, though not refined, tricks, resorted to for private announcement. We say to all such adventurers in modern advertising diplomacy, that these indirect, clandestine methods are not half so candid and honorable as a direct public statement of the intentions and proposals of a medical practitioner, who thereby incurs an individual responsibility before the law and his fellow-men.
No good reason has ever been assigned why any well educated physician, trained in the school of experience until he becomes proficient in medical skill, may not publish facts and evidence to disclose it, especially when these are abundant and conclusive. The following extracts from an able article by the Rev. THOMAS K. BEECHER embodies a sound view of the subject of medical advertising. He says:
* * "I am glad that the doctor cured him; I am glad that the doctor put it in the paper that he could cure him. And if any doctor is certain that he can cure such diseases and don't put it in the paper, I am sorry. What a pity it would have been had this doctor come to town with his wealth of science and experience and gone away leaving him uncured!
What a pity it would have been if he had been so prejudiced against advertising as to read the responsible certificate of the doctor and give him the go-by as a quack! What are newspapers for, if not to circulate information? What more valuable information can a newspaper give than to tell a sick man where he can be cured? If a man has devoted his life and labor to the study of a special class of diseases, the necessity of his saying so becomes all the more pressing. His _duty_ to advertise becomes imperative.
"When I was in England, I found on all the dead walls of London, placards, declaring that Dean Stanley, Chaplain to the Prince of Wales, would preach at such a place; that his grace the Archbishop (I think) of Canterbury would preach at another time and place; again, that an Oxford professor would preach. In short, religious notices were sprinkled in among the theater bills, and the highest church dignitaries were advertised side by side with actors, singers, and clowns. Of course, I was shocked by it, but in a moment I bethought me--if it be all right and dignified to hire a sexton to ring a bell when the minister is going to preach, it is all the same to silence the bell and hire a bill-sticker to tell the same news, the essential thing being to tell the truth every time. The remedy for the lying advertisements is for honest men to tell the truth. 'When iniquity cometh in like a flood, then the spirit of the Lord lifts up the standard.' A really able man, whatever be his gifts, makes a great mistake if he fail to use those gifts through want of advertising."
If a physician possesses knowledge that enables him to remedy diseases heretofore regarded as incurable, what virtue or modesty is there to "hide his light under a bushel"? In this free country the people think and act for themselves, and hence all have a deep concern in the subject of health. The strong popular prejudice against the doctors who advertise is due to the fact, that by this method so many ignorant charlatans are enabled to palm off their worthless services upon the uneducated and credulous; but the practice of such imposition should not cause a presumption against the public announcement of real skill, for the baser metal bears conclusive evidence that the pure also exists.
Every step in scientific investigation, every proposition which relates to the interest and happiness of man, every statement and appeal involving a valuable consideration, must be submitted to the scrutiny and judgment of individual reason; for every person has the right to form his own conclusions, and justify them by experience. Those claims which are only supported by empty assertion are very doubtful. Misty theories vanish before the sun of truth. He who renders professional services cannot be successful, unless he be sustained by real merit.
TREATING PATIENTS WHO RESIDE AT A DISTANCE.
We can treat many chronic diseases as successfully without as with a personal consultation, as our vast experience enables us to correctly determine the malady from which the patient is suffering, from a history of the symptoms, and answers to questions furnished. We have not seen one person in five hundred of those whom we have cured.
Some may suppose that a physician cannot obtain, through correspondence, a sufficiently accurate idea of the condition of a patient to enable him to treat the case successfully; but a large experience in this practice has proved the contrary to be true, for some of the most remarkable cures have been effected through the medium of correspondence. In most long-continued cases, the patient has thought over his symptoms hundreds of times. The location of every pain, whether acute or mild, constant or occasional, and the circumstances under which it occurs, have been carefully noted. He has observed whether he had a rush of blood to the head, was feverish or chilly, whether troubled with cold hands and feet, whether full of blood, or pale and bloodless; and he states these matters with accuracy and common sense when writing to us, for he has a very good, if not a professional, knowledge of the relative importance of these symptoms. So in regard to digestion, he states what kinds of food agree with him, or whether he is troubled with excessive acidity or a flatulent condition of the stomach. He also informs us whether his tongue is coated and bilious, or clean and healthy, and gives many other particulars too various to enumerate, by which we are enabled to gain a perfect understanding of the case. If his description be not sufficiently complete to enable us to obtain a definite understanding of the case, he is requested to answer a list of important questions which are sent him. The people are far more intelligent in these matters than physicians are generally willing to admit. A patient is often confused while being personally examined by a physician, and gives imperfect or incorrect answers. After he has left the presence of the physician, he finds that he has failed to enumerate many of the most important symptoms. In consulting by letter, the patient is not embarrassed, he states the exact symptoms, and carefully reads over the letter to see if it is a complete and accurate description of his sufferings. In this way he conveys a much better idea of the case than if present in person, and subjected to the most thorough questioning and cross-examination. The timid lady and nervous young man write just as they feel; and one important reason why we have had such superior success in treating intricate and delicate diseases, is because we have obtained such true and natural statements of the cases from these letters, many of which are perfect pen-pictures of disease. As bank-tellers and cashiers, who daily handle large quantities of currency, can infallibly detect spurious money by a glance at the engraving or a touch of the paper, so the experienced physician, by his great familiarity with disease, becomes equally skilled in detecting the nature and extent of a chronic malady from a written description of its symptoms.
URINARY SIGNS.
A careful microscopical examination and chemical analysis of the urine is a valuable aid in determining the nature of many chronic diseases, particularly those of the nervous system, blood, liver, kidneys, bladder, prostate gland and generative organs. This important fact is not overlooked at the Invalids' Hotel and Surgical Institute, where an experienced chemist is employed to make such examinations and report the result to the attending physicians. Medical authors, professors, and practitioners of all schools, admit and even insist upon the importance of such examinations in diagnosticating diseases. Many practitioners neglect to take advantage of this invaluable aid, while others fear that if they attach much importance to such examinations they will be ranked with "uroscopian" or "water" doctors, a class of enthusiasts who claim to be able to correctly diagnosticate every disease by an examination of the urine. Persons consulting us and wishing to avail themselves of the advantages afforded by these examinations can send small vials of their urine by express. The vials should be carefully packed in saw-dust or paper and enclosed in a light wooden box. All charges for transportation must be prepaid, and a complete history of the case including the age and sex of the patient, must accompany each package, or it will receive no attention. This saves valuable time by directing the examination into the channels indicated, thus avoiding a lengthy series of experiments.
As we are daily receiving numerous vials of urine, every sample should, to prevent confusion, be labeled with the patient's name.
[Illustration: Binocular Microscope used at the Invalids' Hotel and Surgical Institute.]
[Illustration: Fig. 1.]
There is a natural, definite proportion of the component elements of every solid and fluid of the human body. These proportions have been reduced to definite standards, a deviation from which affords evidence of disease. Thus, there being a fixed standard in a normal proportion of the elements of the blood, any deviation from it, as in anaemia, leucocythaemia, etc., indicates disease. So also the standard proportion of the urinary elements being known, any considerable change, either in quantity or quality of its parts, bears unmistakable evidence of disease. The invention of the microscope has provided increased facilities for detecting diseases by examination of the urine. By the aid of this wonderful instrument, we are enabled to discover with absolute certainty the various urinary deposits characteristic of different maladies; thus in Fig. 1, A represents in a general way the sediment of abnormal urine as seen under the microscope. In division B is represented oxalate of urea upon precipitation by oxalic acid.
Nitrate of urea is represented in division C. A deficiency of urea in the urine, with albumen and casts present, is a most important guide in the diagnosis of Bright's disease. The average quantity of urea present during health is 21.57 parts in 1,000. The microscopic examination of the urine, notwithstanding the distaste, and even contempt, which many physicians manifest for such investigations, is pursued at the Invalids'
Hotel and Surgical Institute, with inestimable benefit to our patients.
It has revealed the existence of many serious affections, which, with all our other modes of investigation, we might have been unable to detect. It has also thrown light upon many obscure chronic diseases.
[Illustration: Fig. 2.]
We have already spoken of the marked changes effected in the urine by a derangement of the digestive functions. It is a matter of surprise that physicians generally pay so little attention to the urine when dyspepsia is suspected, since all admit that an examination of that excretion furnishes unmistakable evidence of the nature and complications of the disease. In this way we are many times enabled to determine whether the indigestion is caused by congestion or functional disease of the liver or kidneys or by nervous debility. And when such cases are treated in accordance with the indications furnished, increased success attends our practice. In Fig. 2 highly magnified urinary deposits, which indicate impairment of the digestive functions, are represented. The crystals are composed of oxalate of lime and appear in the different forms shown in the five sections, of octahedral, decahedral, round and dumb bell shapes. The latter are formed in the kidneys, and are sometimes discovered adhering to casts.
[Illustration: Fig. 3.]
INVALUABLE AIDS IN DETERMINING DISEASES OF THE KIDNEYS AND BLADDER.
[Illustration: Fig. 4.]