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CONSULTATION BY LETTER.

The patient has thought over his symptoms hundreds of times. The location of every discomfort has been carefully noted. These matters are stated with accuracy, common sense and good judgment when writing to us.

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, 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 often conveys a much better idea of the case than if present in person, and subject to the most thorough questioning and "cross-examination." The timid lady and nervous young man write just as they feel and one reason why we have had such 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 unmistakably detect spurious money by a glance at the engraving or 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. To aid the patient in giving a clear and intelligible history of his case we send, when requested, a very complete question blank.

EXAMINATION OF THE URINE.

A careful, microscopical examination and chemical analysis of the urine is a valuable aid in determining the nature of these diseases of the nervous system. This important fact is not overlooked at the Invalids'

Hotel and Surgical Institute, where experienced chemists are employed to make such examinations and report the result to the attending physicians. Persons consulting us and desiring to avail themselves of the advantages afforded by these examinations, can send a sample of their urine by express. The bottle should be thoroughly cleansed and should contain from two to four ounces of that first passed after arising in the morning. It should be carefully packed in saw-dust or paper and inclosed in a light wooden box. All express charges must be prepaid through and a complete history of the case, including the age and sex of the patient, should accompany every package, or it will receive no attention. This saves valuable time by directing the examination into the channels indicated and thus avoiding a lengthy series of experiments. As we are daily receiving numerous bottles of urine, every sample, to prevent confusion, should be labeled with the patient's name. By the postal regulations, all liquids are excluded from the mails, unless packed in accordance with our printed directions, which will be sent free on request being received for them.

WE AIM TO CURE,

not merely to palliate as is so often done by practitioners in dealing with these distressing maladies. We do not prescribe coca mixtures, whiskey, malt extracts, so-called celery compounds or other nerve stimulants, which only spur the already weakened nervous system on as a man would urge his jaded horse to renewed efforts when the animal should be refreshed by proper food and rest. Neither have we any faith, in lasting good resulting from prescribing such nerve sedatives as put the nerves to sleep and so, by simply blunting sensibility, delude the patient into the false belief that he is being benefited.

To effect a radical cure of the weakness, the nerve centres must be restored to a normal condition by improving the nutrition of the nerve cells. To do this the causes of the difficulty must be understood and any local weakness or disease of any organ, be it the liver, kidneys, lungs, stomach, rectum, bladder, or generative organs, must be understood, properly treated and overcome. The desire for alcoholic stimulants is a most common and dangerous tendency of the disease. To gratify the morbid appetite for stimulants is to do the patient lasting injury.

IMPOVERISHED BLOOD.

In some cases the nervous affection is the result of an impure, or impoverished, condition of the blood. In such cases the use of Dr.

Pierce's Golden Medical Discovery has, in the great majority of cases, resulted in an immediate benefit and gradually in a permanent restoration of the nerve centres to a normal condition. This remedy, particularly if assisted by the use of Dr. Pierce's Pleasant Pellets, when constipation is present, unloads the liver, and their combined action tends to remove from the blood the poisons which it is the function of the liver to take from that fluid. The cells of the brain, after performing their function, throw into the blood certain poisonous materials which it is the function of the liver to remove. If this is not done, the cells become clogged, and can only be restored to a natural and healthful condition by increasing the activity of the liver.

This treatment gives rise to an immediate improvement, and a continuance of the remedies results in a gradual toning up of the nervous system and relief from the unpleasant symptoms.

"FEMALE WEAKNESS."

Many women suffer from nervous prostration, or exhaustion, owing to congestion of the uterus and ovaries, caused by over-indulgence; again by overwork, the strain of too many household cares, or too frequent childbirths. In these cases, the use of Dr. Pierce's Favorite Prescription is of the greatest benefit, tending to restore the uterus and ovaries to a normal condition. Its wonderful restorative effects, tonic and nerve invigorating properties, especially adapt it to the cure of these cases. Digestion and assimilation of food are promoted by its use. When the liver or blood is not in healthful condition, as previously referred to, the "Golden Medical Discovery" should be used in conjunction with the "Prescription." If menstruation be scanty, Dr.

Pierce's Pellets will have a beneficial influence in increasing the flow, and overcoming the headache and congestion of internal organs that is the result of scanty menstruation, especially if their use be accompanied with full doses of Dr. Pierce's Compound Extract of Smart-Weed.

LOCAL CAUSES.

In the great majority of cases, when nervous prostration has made its appearance at intervals, with periods of prolonged good health intervening, but in which, as a rule, slight excesses, over-exertion or the attacks of some acute disease, produces a nervous exhaustion, we have found that local derangement is the cause of the whole trouble.

This cause may often be readily removed and a perfect and permanent restoration of the health will follow.

IN MEN, we have often found a varicocele to be the cause of nervous prostration. In others rupture, or urethral stricture, sometimes of a character so mild as hardly to give serious inconvenience, has been the cause.

IN WOMEN,, ulceration of the uterus, stricture of the cervix, congestion or other diseases of the ovaries, such as cysts, abscesses, etc., inflammation of the Fallopian tubes, characterized with more or less periodical discomfort and attacks of leucorrhea, or "whites," are common causes.

In all cases in which the nervous disease depends upon local causes, we find that the relief of the local source of irritation, which tends to reduce the general health and interfere with perfect nervous tone, is all that is necessary to give the invalid a perfect restoration to health, vigor and activity. It is like removing the burden from a tired horse who has fallen prostrate under an excessive load. The removal of the burden puts the individual under a favorable condition for the immediate restoration to health and strength, and permanent relief is only a matter of a few days' or weeks' time, with appropriate nourishment and restorative nerve tonics.

ALCOHOL, OPIUM AND TOBACCO

affect different individuals according to their several susceptibilities. Some are able to withstand, with apparent impunity, an amount of these that can not be tolerated by others without great injury. No one, however, is wholly proof against these unwholesome agents which are in such common use. The sad results of their excessive use are seen in thousands of cases of shattered nerves and wasted vigor.

The excessive use of tea and coffee is also a prolific cause of nervous affections.

Happily, we have now at our command remedies which exercise a most potent controlling influence over the acquired, morbid appetite for these narcotics and stimulants. Of course we have to depend, to some extent, upon the will power of the patient, but where this is not wholly lost, we have in all our later experience, been able to realize a degree of success which has been alike gratifying to both physician and patient.

THE INVALIDS' HOTEL AND SURGICAL INSTITUTE SPECIALLY EQUIPPED FOR THE CURE OF NERVOUS AFFECTIONS.

Private institutions, well supplied with the numerous and costly aids to the work of the specialist treating nervous diseases, are now a recognized necessity. Physicians and sufferers alike appreciate this fact.

Public hospitals do not answer this purpose, owing to the fact that they are more especially intended for the alleviation of the sufferings of the poor, and the greater part of the work done is in affording relief from acute diseases and emergencies requiring surgical aid. Attention is thus detracted from delicate nervous affections and is almost wholly engrossed in caring for sufferers from other diseases and injuries.

Besides, association with the charity cases that abound in such places and the evidences of suffering present on every hand, are enough to prevent all improvement in sensitive and sympathetic invalids.

Perfect equipment is an important part of the battle in the cure of nervous affections.

ELECTRICITY IN NERVOUS AFFECTIONS.

[Illustration: Fig. 4.

Our large 40 cell Galvano-Faradic Battery with Switch-board.]

Electrical applications, to be beneficial, require, on the part of the attendant, a technical knowledge of the highest character with costly apparatus and special appliances. There can be little doubt that electricity is convertible into nerve force.

[Illustration: Fig. 5.

Our Franklin, or Static Electricity, Machine.]

In treating cases in the Invalids' Hotel, a large variety of batteries, dynamos and other electrical appliances are brought into use. These consist of cell batteries, such as is illustrated by Fig. 4, dynamos, operated by power, Franklin, or static electrical machines illustrated in Fig. 5, and other electrical apparatus, the choice of the particular machine or battery being determined by the nature of the case.

CARE AND SKILL REQUIRED.

Electricity, like other powerful agencies, in order to prove remedial must be used of proper strength and in proper quantity. The potential, or strength, as well as the volume, or amount, of current has to be carefully measured for that purpose. To accomplish this, we employ an instrument called a galvanometer, or amperemeter, illustrated in Fig. 6, which indicates the exact amount of current being applied. For the want of such instruments to measure the current, physicians often fail to get beneficial results, as they are not able to administer either the proper quantity or quality of current. Ofttimes, for like reasons, their hap-hazard way of employing this powerful agent does positive injury to the patient.

[Illustration: Fig. 6.

The Galvanometer, or Amperemeter.]

Of course, in treating cases at a distance, we cannot avail ourselves of all the great variety of apparatus brought into use at our Invalids Hotel, yet we have some forms of machines well adapted for home use, and so simple that, by sending plain printed directions with the machines, our patients are able to use them effectively without the aid of the physician. Especially is this true in the milder forms of nervous disease, and when great exactness and nicety of application is not so important. We show in Fig. 7 and Fig. 8, two forms of such batteries which are often furnished our patients for use at their homes. Many times, after cases are under treatment here for a while, we are able to educate them in the use of the battery so that by taking one of these home with them they can continue the treatment with good results after leaving the Institution.

ORGANIC, OR ANIMAL, EXTRACTS AS REMEDIES.

The experience of Pasteur, Brown-Sequard, and our own specialists, in the use of extracts of nerve substance and of certain glands and organs by hypodermic or subcutaneous injection of these fluids, has, in a vast number of cases, been most gratifying to both physicians and patients.

Many wonderful cures have thus been obtained. Injected subcutaneously these animal extracts are immediately assimilated and we are often able to stop, at once, the progress of disease and turn the tide towards recovery. Thus the cells receive the special stimulants upon which their life and activity depend.

[Illustration: Fig. 7.

A small Battery for home use.]

The animal extracts employed in our Institution are all scientifically and carefully produced in our chemical laboratory under the direct supervision of an experienced chemist, and are believed to be superior in quality. They are turned out fresh, as wanted, which is important, as all such preparations, no matter how carefully made and put up, deteriorate with age.

These extracts are made from the glands and organs of the lower animals, as from the brain, spinal cord, heart, testicles, ovaries and some other organs and parts of bullocks, rabbits, guinea pigs and other animals.

That they possess properties which exert most potent tonic, or invigorating, influences upon those organs and parts of the human system corresponding to the organs and parts of the lower animals from which they have been extracted, no longer admits of doubt. In cases of partial and even complete impotency, especially in elderly men, attended with nervous exhaustion, most astonishingly favorable results are obtained by our specialists through the administration of our extracts obtained from the nerve tissue of the spinal cord, associated with the use of the expressed juices from animal testes. We do not, however, prescribe these extracts to the exclusion of other well tested remedial agents, but do regard them, especially in the more confirmed and obstinate cases, as among our most positive curative agents.

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