CHAPTER XIX.

Old Phrases—Results of Stoppage of Fluids—Old Theory of Fits—What the Real Cause may be—Listen for the Cause—What is a Fit—Sensory System Demanding Nourishment—The Causes—The Remedy—Dislocation of Atlas and of Four Upper Ribs.

As old phrases that have long been in use as names for the various diseases have almost grown to the degree of disgust, I laid them aside and have been trying and have succeeded in unfolding natural laws to a better understanding, which do and should be our guide and action in treating all diseases that mar the peace and happiness of the human race by misery and death. By such old systems with their foolish and unreliable suggestions, of how to guide the doctor in treating diseases which have proven unworthy of respect, if merit is to be our rule of the weights and measures of intelligence. I have become so disgusted with such verbiage with the sense that follows the pens that have written treatise on disease, that I have concluded to do like Adam of old, give names that may appear novel to the reader when I wish todraw the attention of the student who is trying to obtain a knowledge of the mysteries hitherto unsolved and unexplained. We have panned and washed by their suggestions and have obtained no gold. There are two very large and powerful rivers passing their fluids in opposite directions over a territory that I will call the Klondike of life. This territory is bounded on the east by a great wall, which according to the old books has been called the diaphragm, through which comes forth a great river of life that spreads all over the plains of the anterior lumbar region. On that plain we find a great system of perfect irrigation of cities, villages, and fertile soils of life.

This region of country covers one of the greatest and most fertile fields of life producing elements, and places them on the thoroughfares, and sends them back over the great central railroad, the thoracic duct, from lymphatics of the whole abdomen, to the heart and lungs to be converted into a higher order of living matter. When finished it is called blood, to sustain its own machinery, and all other machines of the body, giving rise to the mental question: "What would be the effect produced to life and health, if we should cut off, dam up or suspend the flowing of the aorta as it descends closeby the vena cava and thoracic duct as they return with contents through the diaphragm on their journey to the heart and lungs for manufacture and finish. And after having supplied the plain, what would be the effect if the vena cava and its system of drainage, and the thoracic duct should be dammed up so that chyle and blood could not be carried to the heart and lungs for renewal, purification, and finish. How much thought would be required to see that by stopping the arterial flow or that of the vena cava an irritating and famishing condition would ensue, with congested veins, lymphatics and all organs of the abdomen, to that condition called fermentation, congestion and inflammation, which in time is thrown off by sloughing away the substances of the lymphatics of the whole abdominal system of glands that belong to a liver, a kidney, the uterus and the bowels, to the condition that has long since been a mystery, and called typhoid fever, dysentery, bilious fever, periodical spasms, and on through the whole list of general and special diseases of winter and summer. I would advise the practicing Osteopath to do some very careful panning up and down the rivers of this Klondike, for if you fail to find gold, and much of it, you had better spend the remainder of your life where reason dwelleth not. Ever remembering that ignorance of the geography and customs of this country is the wet powder of success."

We often see a woman or man afflicted with fits or falling sickness which the doctor has failed to cure. What is a fit? For want of a better knowledge we have an established theory that "hysteria" is purely her imagination and as we must respect old theories, we will call it a fit of meanness. This is what we have had for breakfast, dinner and supper and we are asked to respect such trash because of the "established theories."

We are instructed by the universal "all" of the graduates of various medical schools to call her a criminal and proceed to punish her with a wet towel, well twisted, and administered freely—more comprehensively expressed by the term "spanker" and "spank her" very much—late from Scotland with all Europe, and schools in America, except the American School of Osteopathy, which recommends to "wallop" and "wallop" very freely the empty headed schools and theories that have no more sense than to torture a sick person and do so to disguise their ignorance of the cause of her disease, which is shown by the spasmodic effect that has been named by a little book of guess work, generally called and universally known as symptomatology.

Not a single author has hinted or in any way intimated that the cause of her disease is a failure of the passing of the blood, chyle and other substances to and from the abdomen to nourish and renovate the abdominal viscera caused by a prolapsed diaphragm, which would cause resistance to the passing of the aorta, through which passes the arterial blood through the crura, and the vena cava that returns the venous blood, and through which crura the chyle is conducted from the receptaculum chyli before decomposition by fermentation sets up.

The afflicted is intoxicated. Here is where she gets a poisonous alcohol and will never be relieved permanently until the "wet towel" of reason has slapped on both sides of the attending physician's head, so he can hear the squeezing and rattling of regurgitation, and straining and creaking of the fluids in their effort to pass through that great and strong towel called the diaphragm. Until he learns this I would apply the wet towel of reason to the doctor, for fear he becomes lukewarm in his studies and gives his patient a hypodermic injection of morphine, which is the advice as given at the lastcouncil of medical men who practice "old established" theories rather than be honest enough to say: "The woman is sick and I know it, but I do not know the cause of her trouble."

What is a fit? If God's judgment is to be respected a fit is the life-saving step and move, perfectly natural, perfectly reasonable, and should be so respected and received as divinely wise, because on that natural action which is produced on the constrictor nerves first, then the muscles, nerves, veins and arteries with all their centers. It appears at this time that the vital fluids have all been used up, or consumed, by the sensory system, and in order to be temporarily replenished, this convulsion shows its natural use by squeezing vital fluids from all parts of the body to nourish and sustain the sensory, which has been emptied by mental and vital action, until death is inevitable without this convulsing element to supply the sensory system, though it may be but a short time.

The oftener the fits come, the oftener the nutrient system of the sensory cries aloud in its own, though unmistakable language, that it must have nourishment, that it may run the machinery of life, or it must give up the ghost and die. In this direextremity and struggle for life, it has asked the motor system to suspend its action, use its power and squeeze out of any part of the whole body though it be the brain itself, a few drops of cerebro-spinal fluid, or anything higher or lower, so it may live.

Those of you acquainted with the fertile fields of the Klondike referred to, will be enabled to furnish the sensory system with such nutriment, as will not make it necessary to appeal to you through the language used by the unconscious convulsions with all their horrible contortions.

Thus you surely see with the microscope of reason that the sensory nerves must be constantly nourished, and that all nutriment for the nerves must be obtained from the abdomen, though its propelling force should come directly from the brain.

The nerve courses from the brain must be unobstructed from the cerebrum, cerebellum, the medulla oblongata, and on through the whole spinal cord; with a normal neck, a normal back, and normal ribs, which to an Osteopath means careful work, with power to know, and mind to reason that the work is done wisely to a finish. I hope that with these suggestions you will go on with the investigation to a satisfactory degree of success.

I wish to insert a short paragraph on a few effects following a down, front, and outer dislocation of the four upper ribs of either side. We have been familiar with asthma, goitre, pen-paralysis, shaking palsy, spasms, and heart diseases of various kinds. We have been as familiar with the existence of those abnormal variations as we are of the rising and the setting of the sun. Our best philosophers on diseases and causes have elaborately written and published their conclusions, and the world has carefully perused with deep interest, what they have said of all the diseases above named, also diseases of the lung, and to-day we are by them left in total darkness as to the cause of the above named diseases, also fits, insanity, loss of voice, brachial agitans, and many other diseases of the chest, neck and head. As the field is open and clear for any philosopher to establish his point of observation, note and report what he observes, I will avail myself of this opportunity, and say in a very few words, I have found no one of the diseases above indicated to have an existence without some variation of the first few of the upper ribs of the chest. With this I will leave farther exploration in the hands of other persons; and await the report of their observations pro and con.

Thoughts for Consideration—Offering a New Philosophy—Lymphatics and Fascia—A Satisfactory Experiment—Natural Washing Out.

"Let us not forget the assembling of ourselves together." Whether this quotation applies to us or not, as an Osteopath I will venture to say that the honored dead, and the honest living intelligent healers of all schools, and all systems of trying to relieve our race from disease and suffering, so far as I have been able to ascertain, have been forced to guess how to proceed when they enter the "sick room" for want of a philosophical system of procedure. We have collected together many or few symptoms, named the disease, opened the battle, and on our side have met the enemy and fought bravely all battles very much the same way. I have spent one-half of a century in the field trying the many methods of attacks; and used the best arms and ammunition to date, and designed to do the greatest good. For twenty years or more I was content to be governed by the opinions and customsof older and more experienced physicians. I gave the disease its proper name. I gave the medicine as taught and practiced, but was not satisfied that the line of procedure was philosophically correct.

I believe at the present time I am fully prepared to say I can offer you a more rational philosophy of what should be the physician's first object, when called to repair a vessel that has become unseaworthy by accumulated barnacles, and is placed upon the dry dock for restoration to that condition called seaworthy, again. I believe this philosophy will sustain the strongest minds in the conclusion that our first and wisest step to successfully combat all diseases would be to inhibit first the nerves of the lymphatics, then produce muscular constricture and cause them to unload their diseased contents, and keep them unloading until renovation is absolutely complete; leaving the lymphatics in a purely healthy state, and keep them in this condition at any period of the disease. I have long since been of the opinion that if we could keep all impurities from accumulating in the lymphatics, and never allow them to become overloaded, we would have no such diseases as bilious fever, typhoid, mountain fever, malaria, pneumonia, flux, heart disease,brain disease, fits, insanity and on to the whole list of climatic troubles, and the troubles with the changes of winter and summer.

I have thought for many years that the lymphatics and cellular system of the fascia, of the brain, the lungs, and the heart throughout the whole system of blood supply, do get filled up with impure and unhealthy fluids, long before any disease makes its appearance, and that the procedure of changes known as fermentation, with its electromagnetic disturbances, were the cause of at least ninety per cent of the diseases that we labor to relieve by some chemical preparation called drugs. When I was fully satisfied that we were liable to do more harm than good with such remedies, I began to hunt for more reasonable methods to relieve the system of its poisonous gases and fluids, through the excretory system of the lymphatics and other channels, through which we had hoped to renovate and purify the system.

For twenty-five years I have tried to balance myself, divert my mind from all previous methods and see if I could not get more directly to the lymphatic system of nerves, and cause the millions of vessels known to exist in the body to begin to unload their contents and continue that action until all impurities were discharged by way of the bowels, lungs, kidneys and porous system.

At the conclusion of this philosophy I will endeavor to explain just how nature has provided to ward off diseases, by washing out before fermentation should set up in the lymphatics, from being received and retained the length of time, that destructive chemical changes would begin its work of converting elements into gas and discharging them from the system as unsuitable for nutriment. In order to avoid this calamity we are met with two important thoughts, one of the power of the nerves of the lymphatics to dilate and contract, also that of fascia and muscle, to dilate or constrict with great force when necessary to eject substances from gland, cell, muscle and fascia. Thus we see a cell loaded to fullness by secretion which it cannot do without; open-mouthed vessels through which it receives this fluid. Then again the system of cellular sphincters must dilate and contract in order to retain the fluids in those cell-like parts of the body. Now we are at the point when ready for use in other parts of the system, those sphincters must temporarily give away, that the gland may relax and dilate. Then the universal principleof constriction throughout the whole body can discharge the contents of the lymphatics of all divisions of the body, which is surely the normal condition. Let the lymphatics always receive and discharge naturally. If so we have no substance detained long enough to produce fermentation, fever, sickness and death.

I think this thought has been presented plainly enough to be fully understood and practiced by the reader, if an Osteopath.

With what it has Communication—Its Position—One of its Functions—Stimulation or Inhibition—Results Produced.

Every ganglion on the great chain of the sympathetic nerve has special and important functions, but upon the superior cervical falls the greatest burden of responsibility. This ganglion has communication with a greater number of nerves and organs than any other; is in direct communication with three cranial and four cervical nerves, indirectly with four more cranial nerves, and enters, by its branches into the formation of a large number of plexuses. Through this ganglion it is that much Osteopathic work is done, and the purpose of this brief paper is to point out some of the many effects which may be produced by its stimulation or inhibition.

Anatomically we know that the superior cervical ganglion is situated in relation to the transverse processes of the upper three cervical vertebrae. It gives off branches which communicate directly with the vagus, glosso-pharyngeal and hypoglossalnerves; another branch, the ascending, passes into the carotid canal and enters into the formation of the carotid and cavernous plexuses; other branches pass to the pharynx, and a branch enters the formation of the cardiac plexuses. From the carotid and cavernous plexuses pass many nerves, only a few of which need special mention; one unites with the great superficial petrosal to form the Vidian nerve which goes toMeckel'sganglion, branches pass to the Gasserian ganglion, while we have others passing to the third, fourth, the ophthalmic division of the fifth and the sixth nerve, also we have derived from the nerve the sympathetic root of the lenticular ganglion.

Physiologically we know that one of the special functions of the sympathetic nervous system is to control the tone of non-striate muscular tissue, and that we have filaments distributed from the sympathetic system in the muscular wall of every blood vessel, duct and organ throughout the body. We also know that the sympathetic is the accelerator nerve of the heart, being opposed in its action by the vagus which, is inhibitory; further, that the vagus is constant in its brake-like action, while the sympathetic only acts when stimulated either directly or reflexly. While the vagus is inhibitory tothe heart it is motor to the lungs. Nerve force is not generated in the sympathetic system; the cerebro-spinal nerve force is conveyed to the ganglia by the rami communicantes and in the ganglia is transformed into sympathetic nerve force. We might compare the ganglia to electrical transformers. Such being the case it is not difficult to see that if the superior cervical ganglion receives the nerve-force for transformation from the upper four cervical nerves and we can prevent, or lessen, the passage of nerve-force from the spinal cord through those nerves to the ganglion, that we will, to a corresponding degree, lessen the amount of sympathetic nerve-force transformed in the ganglion and transmitted from it by its branches.

We can produce stimulation or inhibition of a nerve at will; press suddenly and with a little violence upon the ulnar nerve where it lies in relation with the internal condyle of the humerus and we will find a manifestation of its physiological action, evidenced by a sense of pain in the ulnar and radial sides of the fifth finger and the ulnar side of the fourth, together with contraction of the muscles supplied by that nerve. But if our pressure be less intense and more prolonged we will inhibit the nerve and produce a sense of numbness in the same area together with temporary loss of muscular control.

Osteopaths well understand how to produce either stimulation or inhibition of the ganglia by way of the nerves passing to them from the spinal cord, and the results of such inhibition or stimulation in any sympathetic area can be prophesied readily by anyone who has read with attention what I have written; for instance, in the case of inhibition in the region of the nerves supplying the superior cervical ganglion with nerve force, we will find, first, throughout the area of distribution of the branches of this ganglion a relaxation of the vascular walls. This will be marked by two indications, first, the skin will become flushed and moist; second salivary secretion and lachrymal secretion will be increased. Second, the vagus is now allowed full sway, and we will find slowing of the heartbeat. It is well known that pressure over the seat of the first spinal nerve for a very brief period of time will control a congestive headache; the pressure in such case is made only for so long time as to produce stimulation of the sympathetic to greater activity, when we will attain a vaso-constrictor action, lessen the volume of blood in the cranial cavity and so abolish the headache. The arteries of the body may be divided into three groups, the large, the medium-sized and the small; in the firstof these we find little muscular tissue and much elastic; in the second they exist in about equal proportions, while in the small arteries we find much muscular tissue and little elastic. As a consequence it is upon the smaller arteries that the sympathetic system has its greatest effect. As we dilate the smaller arteries and slow the heart action, it follows that we reduce the blood pressure, as we reduce blood pressure we reduce temperature, and within a very few minutes after the commencement of this inhibitory pressure on the upper four cervical nerves we will find in the large majority of cases, the capillaries over the entire surface of the body flushed, this being accompanied by a fall in the pulse rate and a marked diminution of the temperature. Indirectly at the same time we produce an effect upon the lungs; as we lessen blood pressure and the frequency of the heart action we find in accordance with the physiological rule an alteration in the respiration, it becomes slower and deeper. Arguing along these lines, and applying similar reasoning to each of the branches of this ganglion, anyone can trace out the many subsidiary results which may be expected from either stimulation of the rami communicantes nerves distributed to it, or their inhibition. Exactly similar rulings will find their prompt proof with regard to any other of the ganglia of thesympathetic system. We will find corresponding results in the cases of the thoracic ganglia which form by their branches the pulmonic plexuses; we get the same results from the splanchnic ganglia; while in the lumbar region we find that we have a ready means of control of the vascular system in the lower abdomen and pelvis. Much, very much, is still to be learned concerning the sympathetic nervous system, and all such increase in knowledge can come in one way only, clinical observation of Osteopathic treatment.

William Smith,L. R. C. P. and S., (Edin.), D. O.

FOOTNOTES[1]Explore: (1) To seek for or after: to strive to attain by search; to look wisely and carefully for; to search through or into; to penetrate or range over for discovery; to examine thoroughly; as, to explore new countries or seas; to explore the depths of science; "hidden frauds (to) explore."—Webster.[2]Chambers.[3]"The secretion of the external auditory meatus, mixed with the secretion of the neighboring glands or ceruminous glands, forms the well known ear-wax or cerumen. The secretion in this place contains a reddish pigment of a bitterish sweet taste, the composition of which has not been investigated." American Text-Book of Physiology.[4]Chambers.[5]Disease.1. "Lack of ease. 2. An alteration in the state of the body, or some of its organs, interrupting or disturbing the performance of the vital functions and causing or threatening pain and weakness; malady; affection; illness; sickness; disease; disorder."—Webster's International Dictionary.[6]What has the student gained by reading the above definition of this standard author and representative of present medical attainment but a labored effort to explain what he does not know.[7]Very true, if treated by the medicine man.[8]My first Osteopathic treatment for appendicitis was in 1877, at which time I operated on a Mr. Surratt and gave permanent relief. During the early eighties I treated and permanently cured Mrs Emily Pickler of Kirksville, mother of our representative, S. M. Pickler, and mother of ex-congressman John A. Pickler of South Dakota. The infirmary has had bad cases of appendicitis probably running up into hundreds without failing to relieve and cure a single case. The ability of the appendix to receive and discharge foreign substances is taught in the American School of Osteopathy and is successfully practiced by its diplomates. In the case of Mr. Surratt I found lateral twist of lumbar bones; I adjusted spine, lifted bowels, and he got well. When I was called to Mrs. Pickler she had been put on light diet, by the surgeon, preparatory to the knife. She soon recovered under my treatment without any surgical operation and is alive and well to this date.

[1]Explore: (1) To seek for or after: to strive to attain by search; to look wisely and carefully for; to search through or into; to penetrate or range over for discovery; to examine thoroughly; as, to explore new countries or seas; to explore the depths of science; "hidden frauds (to) explore."—Webster.

[2]Chambers.

[3]"The secretion of the external auditory meatus, mixed with the secretion of the neighboring glands or ceruminous glands, forms the well known ear-wax or cerumen. The secretion in this place contains a reddish pigment of a bitterish sweet taste, the composition of which has not been investigated." American Text-Book of Physiology.

[4]Chambers.

[5]Disease.1. "Lack of ease. 2. An alteration in the state of the body, or some of its organs, interrupting or disturbing the performance of the vital functions and causing or threatening pain and weakness; malady; affection; illness; sickness; disease; disorder."—Webster's International Dictionary.

[6]What has the student gained by reading the above definition of this standard author and representative of present medical attainment but a labored effort to explain what he does not know.

[7]Very true, if treated by the medicine man.

[8]My first Osteopathic treatment for appendicitis was in 1877, at which time I operated on a Mr. Surratt and gave permanent relief. During the early eighties I treated and permanently cured Mrs Emily Pickler of Kirksville, mother of our representative, S. M. Pickler, and mother of ex-congressman John A. Pickler of South Dakota. The infirmary has had bad cases of appendicitis probably running up into hundreds without failing to relieve and cure a single case. The ability of the appendix to receive and discharge foreign substances is taught in the American School of Osteopathy and is successfully practiced by its diplomates. In the case of Mr. Surratt I found lateral twist of lumbar bones; I adjusted spine, lifted bowels, and he got well. When I was called to Mrs. Pickler she had been put on light diet, by the surgeon, preparatory to the knife. She soon recovered under my treatment without any surgical operation and is alive and well to this date.

A. T. Still's Table or Device,That He Has Constructed ForThe Use of The Operator, The Ease And Comfort of The Patient.It is a welcome success and does away with the lubberly old tables. It gives ease and support to all classes of patients. By its use the patient can sit in a chair or on a stool and feel at perfect ease during all treatments, then the operator gets results and is not tired to death when he has treated a patient; knows and feels that there has been some good done.The asthmatic knows he has gotten help because pain has left his chest and he breathes as with new lungs; he knows he is helped more by one treatment while sitting on a chair with his body easy and at rest in the cushioned swinging device than he would or has received by the best skill on any table. Then the operator says, "Thank fortune, I am not worn out, and know I have gotten every bone to the place it belongs, and I know I have given satisfactory relief because my patients say so."I think to an operator this device is his best friend. With it well understood he can do as much work as three good operators can do on the old tables. Remember this device does no part of the treatment but places the patient to your convenience while you do the work.I feel as I am the discoverer of the device, that I know its needs and feel free to advise pupils.The device will cost you $25 only.A. T. STILL,Founder.The American School of Osteopathy,KIRKSVILLE, MO.The course of study in The American School of Osteopathy is a carefully graded one, and is divided into four terms, of five months each. The terms beginning September and February of each year. The course thus requires two years for completion.COURSE OF STUDY.The course of study extends over two years, and is divided into four terms of five months each.FIRST TERM.The first term is devoted to Descriptive Anatomy including Osteology, Syndesmology and Myology; lectures on Histology illustrated by micro-stereopticon; the principles of General Chemistry and Physics.SECOND TERM.The second term includes Descriptive and Regional Anatomy; didactic and laboratory work in Histology; Physiology; Physiological Chemistry and Urinalysis; Principles of Osteopathy; Clinical Demonstrations in Osteopathy.THIRD TERM.The third term includes Demonstrations in Regional Anatomy; Physiology; lectures in Pathology illustrated by micro-stereopticon; Symptomatology; Physiological Psychology; Clinical Demonstrations in Osteopathy.FOURTH TERM.The fourth term includes Symptomatology; Minor Surgery; didactic and laboratory work in Pathology; Psycho-Pathology; Gynæocology; Obstetrics; Sanitation and Public Health; Venereal Diseases; Medical Jurisprudence; Clinical Demonstrations; Clinical Practice.The school is open to students of both sexes without distinction, and all have equal opportunities and privileges, and are held to the same requirements.The methods of instruction are such as obtain in the best academic and collegiate institutions, and include recitations from standard text-books, lectures, quizzes, practical laboratory work, and practical clinical work.The equipment of the school is complete in every respect. The recitation and lecture rooms are amply provided with all necessary means of illustration, such as specimens fresh and preserved, skeletons, models, charts, manikins and diagrams.The respective laboratories are fitted up with all the necessary apparatus for practical work in the Anatomical, Histological, Microscopical, Chemical and Physiological departments.The clinical facilities and opportunities enjoyed by students in this school are exceptional. An abundance of material is always available for clinic demonstrations, which are continued daily through two terms, with practical work in the clinic operating rooms by each student, under the direction of the regular operators, daily during the whole of the last term.In addition to the regular clinical department, the A. T. Still Infirmary has constantly under treatment from three hundred to five hundred patients, and although the students do not see these patients, the many cases of diseases of all kinds under the care of the regular operators in the Infirmary give them constantly fresh and varied illustrations for use in their lectures. Sometimes, too, patients whose cases may be of special interest offer the use of their cases for the purpose of demonstration before the students.Opportunities are thus furnished to students for such practice and drill in the actual work of treating diseases as we believe is not equaled by any similar institution anywhere. The course of study is progressively graded with a view to giving students a thorough and comprehensive knowledge of the facts and principles upon which their future work is to be based. These clinic exercises in connection and immediately following give them facility and readiness in the art of applying the facts and principles which they have acquired in recognizing and treating diseased conditions.Catalogue mailed upon application. For information as to terms, etc., apply toA. T. STILL,President.AMERICAN SCHOOL OF OSTEOPATHY. KIRKSVILLE, MO.The A. T. Still InfirmaryCures by the Science of Osteopathy all Diseases Which are Known as Curable.Dr.A. T. Still, founder of the Science of Osteopathy, has associated with him, in his infirmary organization, the oldest and most successful practitioners and exponents of the science, selected with special reference to their fitness for the work of practically demonstrating the principles of Osteopathy and occupying positions as teachers and lecturers in the American School of Osteopathy. All are regular graduates of this school.The students in the school are not permitted to even assist in treating the Infirmary patients. All the work is done by regular operators.The examination previous to treatment is conducted by Dr. Still's three sons assisted by the operators. After examination the patient is assigned to the room in which he or she will receive treatment, and placed under the care of an Osteopath best suited to the case.The fees for treatment at the Infirmary are $25 per month. Where patients are unable to come to the Infirmary for treatment, an extra charge of $1 to $2 per visit is added.The Infirmary maintains a complete bathing department in charge of competent attendants. As good baths are therefore obtainable in Kirksville as in any city. The charges are very moderate—twenty-five cents for a single bath, or $2.00 for a commutation ticket for ten baths. When bath tickets are procured no other fees to attendants are necessary.A representative of the Infirmary meets all trains, day and night, to help all patients who may need assistance and see that they are properly cared for.OPERATIVE SURGERY.To correct a misapprehension on the part of many, it should be understood that theA. T. Still Infirmaryis fully prepared to receive and handle the most difficult cases requiring the highest order of skilled surgery, and it is not necessary to send such cases to the great city hospitals in the east for even the most difficult and delicate operations.Dr. J. B. Littlejohn, of the faculty, is a graduate in surgery from the University of Glasgow, Scotland, and held for three years the position of Surgeon under the Government Board of England, besides other important and responsible positions in Europe and America.Dr. Wm. Smith holds evidences of qualifications as follows: Licentiate of the Royal College of Surgery, Edinburg; Licentiate of the Royal College of Physicians and Surgeons, Glasgow; Licentiate in Midwifery, Edinburg and Glasgow; etc.Cases requiring careful and delicate Surgery, the removal of fibroid tumors, and in fact any operation of whatever nature will receive the best and most scientific treatment and care in this institution.The management has now secured a powerful and perfect Roentgen or X-Ray apparatus which will be used in connection with this department, in the examination of difficult cases.Patients coming to the A. T. Still Infirmary may rely upon the fact that they will in no case be subjected to unnecessary surgical operations, as the knife is never used unless absolutely necessary.Address all letters of inquiry toA. T. STILL, INFIRMARY,KIRKSVILLE, MO

It is a welcome success and does away with the lubberly old tables. It gives ease and support to all classes of patients. By its use the patient can sit in a chair or on a stool and feel at perfect ease during all treatments, then the operator gets results and is not tired to death when he has treated a patient; knows and feels that there has been some good done.

The asthmatic knows he has gotten help because pain has left his chest and he breathes as with new lungs; he knows he is helped more by one treatment while sitting on a chair with his body easy and at rest in the cushioned swinging device than he would or has received by the best skill on any table. Then the operator says, "Thank fortune, I am not worn out, and know I have gotten every bone to the place it belongs, and I know I have given satisfactory relief because my patients say so."

I think to an operator this device is his best friend. With it well understood he can do as much work as three good operators can do on the old tables. Remember this device does no part of the treatment but places the patient to your convenience while you do the work.

I feel as I am the discoverer of the device, that I know its needs and feel free to advise pupils.

The device will cost you $25 only.

A. T. STILL,Founder.

The course of study in The American School of Osteopathy is a carefully graded one, and is divided into four terms, of five months each. The terms beginning September and February of each year. The course thus requires two years for completion.

The course of study extends over two years, and is divided into four terms of five months each.

The first term is devoted to Descriptive Anatomy including Osteology, Syndesmology and Myology; lectures on Histology illustrated by micro-stereopticon; the principles of General Chemistry and Physics.

The second term includes Descriptive and Regional Anatomy; didactic and laboratory work in Histology; Physiology; Physiological Chemistry and Urinalysis; Principles of Osteopathy; Clinical Demonstrations in Osteopathy.

The third term includes Demonstrations in Regional Anatomy; Physiology; lectures in Pathology illustrated by micro-stereopticon; Symptomatology; Physiological Psychology; Clinical Demonstrations in Osteopathy.

The fourth term includes Symptomatology; Minor Surgery; didactic and laboratory work in Pathology; Psycho-Pathology; Gynæocology; Obstetrics; Sanitation and Public Health; Venereal Diseases; Medical Jurisprudence; Clinical Demonstrations; Clinical Practice.

The school is open to students of both sexes without distinction, and all have equal opportunities and privileges, and are held to the same requirements.

The methods of instruction are such as obtain in the best academic and collegiate institutions, and include recitations from standard text-books, lectures, quizzes, practical laboratory work, and practical clinical work.

The equipment of the school is complete in every respect. The recitation and lecture rooms are amply provided with all necessary means of illustration, such as specimens fresh and preserved, skeletons, models, charts, manikins and diagrams.

The respective laboratories are fitted up with all the necessary apparatus for practical work in the Anatomical, Histological, Microscopical, Chemical and Physiological departments.

The clinical facilities and opportunities enjoyed by students in this school are exceptional. An abundance of material is always available for clinic demonstrations, which are continued daily through two terms, with practical work in the clinic operating rooms by each student, under the direction of the regular operators, daily during the whole of the last term.

In addition to the regular clinical department, the A. T. Still Infirmary has constantly under treatment from three hundred to five hundred patients, and although the students do not see these patients, the many cases of diseases of all kinds under the care of the regular operators in the Infirmary give them constantly fresh and varied illustrations for use in their lectures. Sometimes, too, patients whose cases may be of special interest offer the use of their cases for the purpose of demonstration before the students.

Opportunities are thus furnished to students for such practice and drill in the actual work of treating diseases as we believe is not equaled by any similar institution anywhere. The course of study is progressively graded with a view to giving students a thorough and comprehensive knowledge of the facts and principles upon which their future work is to be based. These clinic exercises in connection and immediately following give them facility and readiness in the art of applying the facts and principles which they have acquired in recognizing and treating diseased conditions.

Catalogue mailed upon application. For information as to terms, etc., apply to

A. T. STILL,President.AMERICAN SCHOOL OF OSTEOPATHY. KIRKSVILLE, MO.

Dr.A. T. Still, founder of the Science of Osteopathy, has associated with him, in his infirmary organization, the oldest and most successful practitioners and exponents of the science, selected with special reference to their fitness for the work of practically demonstrating the principles of Osteopathy and occupying positions as teachers and lecturers in the American School of Osteopathy. All are regular graduates of this school.

The students in the school are not permitted to even assist in treating the Infirmary patients. All the work is done by regular operators.

The examination previous to treatment is conducted by Dr. Still's three sons assisted by the operators. After examination the patient is assigned to the room in which he or she will receive treatment, and placed under the care of an Osteopath best suited to the case.

The fees for treatment at the Infirmary are $25 per month. Where patients are unable to come to the Infirmary for treatment, an extra charge of $1 to $2 per visit is added.

The Infirmary maintains a complete bathing department in charge of competent attendants. As good baths are therefore obtainable in Kirksville as in any city. The charges are very moderate—twenty-five cents for a single bath, or $2.00 for a commutation ticket for ten baths. When bath tickets are procured no other fees to attendants are necessary.

A representative of the Infirmary meets all trains, day and night, to help all patients who may need assistance and see that they are properly cared for.

To correct a misapprehension on the part of many, it should be understood that theA. T. Still Infirmaryis fully prepared to receive and handle the most difficult cases requiring the highest order of skilled surgery, and it is not necessary to send such cases to the great city hospitals in the east for even the most difficult and delicate operations.

Dr. J. B. Littlejohn, of the faculty, is a graduate in surgery from the University of Glasgow, Scotland, and held for three years the position of Surgeon under the Government Board of England, besides other important and responsible positions in Europe and America.

Dr. Wm. Smith holds evidences of qualifications as follows: Licentiate of the Royal College of Surgery, Edinburg; Licentiate of the Royal College of Physicians and Surgeons, Glasgow; Licentiate in Midwifery, Edinburg and Glasgow; etc.

Cases requiring careful and delicate Surgery, the removal of fibroid tumors, and in fact any operation of whatever nature will receive the best and most scientific treatment and care in this institution.

The management has now secured a powerful and perfect Roentgen or X-Ray apparatus which will be used in connection with this department, in the examination of difficult cases.

Patients coming to the A. T. Still Infirmary may rely upon the fact that they will in no case be subjected to unnecessary surgical operations, as the knife is never used unless absolutely necessary.

Address all letters of inquiry to

A. T. STILL, INFIRMARY,KIRKSVILLE, MO

Transcriber's note:Corrections have been made to everyday words printed incorrectly, but all technical terms are as in the original.

Transcriber's note:

Corrections have been made to everyday words printed incorrectly, but all technical terms are as in the original.

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