CHRONIC ENLARGEMENT OF THE PROSTATE GLAND.

The prostate gland lies just in front of the base of the bladder, and surrounding the urethra, or urinary canal. Enlargement, therefore, of this body, if it be of considerable extent, causes it to encroach and press upon the base of the bladder, and to more or less constrict the urinary canal near the base or outlet of the bladder. The enlargement may be only slight, or the dimensions of the gland may be increased from the size of a large chestnut, its normal dimension, to the volume of a pullet's egg, or even to the size of an orange.

Hypertrophy of the prostate generally arises from causes which operate in a slow and permanent manner. Whatever has a tendency to produce a determination of blood to, and an engorgement of, this organ, is capable of producing the affection, an augmented flow of blood to the the part having the effect to increase the nutrition. Among the most frequent causes of this affection, are excessive venery, masturbation, disease of the bladder, stricture of the urethra, horseback exercise, gonorrhea, and the employment of strong, stimulating diuretics. Some of the worst cases that we have had to deal with have occurred in old men, and, in fact, the malady is more common to those advanced in life; but it is frequently produced in those of middle age by the causes enumerated.

Among the earliest symptoms of the disease is an uneasy feeling in the region of the base of the bladder. There is a more frequent desire to urinate than usual, and, in the course of time, this frequency becomes more urgent; still no particular notice may be taken of it, it being considered as "only a slight inconvenience." After several months, or it may be years, the discomfort increases, and nightly calls to empty the bladder become habitual. By and by the patient begins to find the discomfort of getting out of his warm bed very troublesome; still no notice to taken of it. He does not consider it worth his while to consulta doctor for "such a trifle." In the course of time the patient is obliged to get out of bed twice during the night instead of once. Afterwards, the calls become still more frequent and urgent; the inconvenience more evident; finally, pain is substituted for inconvenience, and then the doctor is consulted. Unless a specialist of experience be consulted, the bladder will most probably be examined, and medicine will be prescribed only to excite the kidneys to secrete more urine, which does harm instead of good; the disease slowly, but surely progressing. Patients often write us that they have had something wrong with the bladder for a number of years, having to urinate more frequently than they ought; sometimes having to do so three and four times during the night; in extreme cases even every half hour or so, and that they are not able to pass it freely, but only in small quantities, and attended with much pain. These symptoms are not always constant, but let up for a few weeks and then appear again. Things go on in this way for a year or two, perhaps, when the passage of the urine is completely shut off for several hours, and the patient is in great agony until the bladder is relieved by the use of the catheter. After such instrumental relief, for a day or two the urine may be natural again, coming at first, perhaps, in very small quantities, but by and by more freely. Then, after a week or two intervening, there may be another complete stoppage, attended, as before, with intense suffering, which will have to be again relieved by the use of an instrument.

The foregoing is a fair account of the usual progress of the disease and its symptoms. As the prostate gland becomes more irritated and inflamed from the natural progress of the disease, or from the irritation caused by the passage of instruments, or the employment of strong, harsh, stimulating diuretics, the urine becomes cloudy, and still later is found to have deposited during the night in the chamber utensil a quantity of thick, tenacious, and usually offensive mucus. There is apt to be more or less discomfort in the rectum, or lower bowel, produced by the pressure of the enlarged prostate upon it. Rarely, the first intimation of a large prostate occurs through a sudden retention of the urine, and the patient being under the impression that there was nothing wrong with the organ previously. Closely questioned, however, the information is elicited that there has been a long train of mild symptoms, similar to those that we have described, preceding the attack of retention of the urine. This shows the importance of early attention and proper treatment when such symptoms are manifested. However slight the inconvenience experienced, it should not be neglected. The disease should be brought under control at the outset by skillful and nicely-adapted treatment. Usually before a person suffers from toothache, the decay occasioning it has been gradually progressing without pain for from five to eight years. Just as the decay of the tooth may be arrested by the early attention of the dentist, so may prostatic disease by early attention be not only promptly relieved, but permanently cured.

Disease of the prostate being slow in its inception and progress, is also slow to yield even to the most skillful treatment. Being slow to develop, patients rarely seek assistance until the organ has become so large as to be seldom restorable to a size where mechanical means can be wholly dispensed with for relieving the bladder. Most surgeons are too much in the habit of depending on the catheter for the relief of the patient, and usually instruct the sufferer how to use it, telling them that this, the catheter, is to be their only doctor for life. Great as is the relief afforded by the catheter, which has often saved life, yet it is a fact that its frequent and prolonged use often renders disease of the prostate very intractable and often wholly incurable. Frequent use of the catheter, without any treatment to prevent the further enlargement of the diseased gland, or to reduce its size, permits the part to go on enlarging, and, besides, the constant use of the catheter irritates the prostatic portion of the urethra, causing thickening of the lining membrane, and sooner or later a more or less complete organic stricture of this canal, depending upon thickening of the lining mucous membrane, as well as upon the encroachment of the gland itself upon this canal. Besides, when the use of the catheter is once commenced, even when the enlargement is not very great, it is with the utmost difficulty that we have been able to induce patients to leave off its use. The bladder, becoming accustomed to its use, refuses to obey the will without this help. The irritation set up in the parts by the friction of the catheter causes inflammation and exudation in the lining membrane. This extends to the structure of the prostate itself and increases the hypertrophy or enlargement. It will, therefore, be seen how important it is to early resort to treatment to relieve the first manifestations of this affection. A disease of so delicate a nature, and one so often confounded with other maladies by inexperienced physicians, should only be intrusted for treatment to expert specialists of large experience in the management of this and kindred maladies.

Stricture of the urethra generally results from some specific disease of the urethra, but may be caused by sexual excesses, exposure, or strain, or by the practice of masturbation or self-abuse. It runs a course varying in time from a few days to many weeks or months, during which time the patient is often unaware of the real cause of his sufferings.

Commonly, the attention is first called to a stricture by a slight discharge, or smarting sensation, or the appearance of an undue amount of mucous deposit in the urine. Occasionally, some difficulty in starting the water, or a diminution in the size and force, or a twisting of the stream as it flows, is the first symptom. This passive stage is of variable duration. When skillful treatment is instituted at this stage of the disease, a speedy cure is easily effected without pain or danger. Any exposure, improper use of instruments, or irritating cause, may speedily give rise to the alarming symptoms due to closure of the urethra, from which fatal consequences may suddenly ensue.

Illustration: Fig. 2. A Single Stricture of the Urethra.Fig. 2. A Single Stricture of the Urethra.

This condition is illustrated in Fig. 2, which shows the hard and tough stricture which surrounds the soft mucous membrane that lines the urinary canal. When irritated or inflamed, as the result of a cold or other cause, the mucous membrane becomes swollen and thickened, and, as the stricture will not yield and enlarge, the result is that the urethra is almost completely closed, and it becomes impossible to pass the urine. Great pain is experienced, and the surgeon has to be called to draw off the urine with a catheter, which, at best, is a very difficult and painful operation, when the urethra is so irritable and constricted.

Treatment. In the earlier stages of the malady, relief is given by the skillful use of instruments for dilating the canal, or, where this fails by the operation of urethrotomy, for which we employ an improvedand ingenious instrument, by which the stricture is readily and almost painlessly divided.

Improved Methods. Our surgeons have operated upon many hundreds of bad cases by a very ingenious and almost painless method, that requires no use of bougies in the after-treatment. This saves the patient an immense amount of pain and annoyance, and enables him to go home almost immediately after the operation.

The ordinary after-treatment, by dilatation with bougies, is very tedious, and often more painful than the operation itself, so that our peculiar method of treatment has been hailed with joy by those familiar with the old and unnecessarily-painful systems of treatment. Besides, our more improved method has been followed by far more perfect cures in every case operated upon.

In many of the cases coming under our observation and treatment, there have been several strictures, as illustrated in Fig. 3, which shows the urethra constricted at three different points, besides a congenital contraction at its mouth or meatus.

Illustration: Fig. 3. Condition of the Urethra with three Strictures and a congenital contraction at the meatus or outlet.Fig. 3. Condition of the Urethra with three Strictures and a congenital contraction at the meatus or outlet.

Spermatorrheanot infrequently results from stricture of the urethra, even when the affection is quite slight. Our attention was first called to this subject by the consideration of the numerous cases in which epileptic convulsions or "fits," and other serious diseases of the nervous system in children, have resulted from an unnatural contraction of the prepuce or foreskin, constituting what is termedphimosis.

Every surgeon of experience has met with many of these cases of reflex irritation. It occurred to us, that, inasmuch as these contractions of the foreskin give rise to nervous diseases of an alarming nature, may not an unnatural narrowing of the urethral canal, which must have exactly the same effect in retarding the flow of the urine, give rise to irritable nervous affections in adults. May not unnatural irritation and excitement of the sexual organs, so set up, cause loss of semen to occur during sleep, and consequent nervous and general debility?

It is a well recognized fact that the urethral canal should bear a certaindefinite and proportionate size to that of the penis, just as the length of the arm should naturally bear a certain proportion to the length of the body. In the case of some parts of the body, disproportionate development of the part may not give rise to anything further than unsightliness; but when we find the small size of the urethra retarding the free passage of the urine, then we may expect, if this condition is long continued, to find more or less irritation of the urethra and, perhaps, of the bladder, also. When there is a contraction of the urethra at its external orifice, or at any point along its course, unnatural pressure is put upon the urinary canal behind the constricted portion, and these parts must bear an undue strain during the passage of the urine.

It is a well established fact that improper diet, cold, exposure, and over-work exert a very powerful modifying influence upon the urinary secretion, frequently causing an acrid and irritating condition of this fluid. This condition, when associated with a contracted urethra, must result in irritation of the mucous membrane lining this canal back of the stricture, if long continued or frequently repeated. As an illustration, we have a hose pipe from which, by means of a small nozzle, water is expelled a considerable distance, but a great tension is put upon the hose behind the nozzle. If the pressure is increased greatly the hose will burst; but, if the small nozzle be replaced with a larger one, the projection of the stream will be quite as great, but all undue tension of the pipe is overcome and the danger of bursting is done away with. We have, in an unnaturally contracted urethra, a favorable condition for the development of disease in the urinary canal and adjacent parts of the generative organs. Irritation is set up in the urethra behind the stricture by undue strain in passing water, and the frequent reoccurrence of acrid urine, as the result of any of the causes we have already mentioned, this irritation keeps gradually increasing. It will be felt more during the periods when the urine is acrid, but may pass unnoticed even at such times. The seminal sacs and the prostate and Cowper's glands communicate with the deeper portions of the urethra by means of canals or ducts, lined with mucous membrane which is continuous with the urethral mucous membrane. Hence we can readily see that not only by reflex nervous irritation are those parts debilitated, through the contraction of the urethra, but the affection is apt to extend by continuity of the mucous membrane, and thus become more and more manifest, through symptoms of disease of the testicles, prostate gland and seminal vesicles, and these disorders become more and more seated the longer the morbid condition of the urethra is allowed to run on, until there may be an entire loss of the sexual functions, occurring at an age when there should be present the most vigorous manhood. From no other cause can we explain the common prevalence of disease of the deeper portions of the urethral canal and bladder, many times confounded with other diseases of the urinary and generative organs.

The following is the history of a case that fully illustrates the foregoing statements:

Case 112,289. Mr. O.C.E., single, 32 years of age.

Illustration: Fig. 4. Condition of the urethra in Case 112,289; permanently cured at the Invalids' Hotel and Surgical Institute.Fig. 4. Condition of the urethra in Case 112,289; permanently cured at the Invalids' Hotel and Surgical Institute.

He applied to us suffering from entire loss of the sexual function, with great nervous debility, and there was a thin slimy discharge from the urethra, and the usual symptoms of melancholia and weakness. He had lost all taste for business, and was extremely nervous, from the fact that he was engaged to be married, and felt that his condition would not permit it. On examination a contraction of the urethra was found at the point shown in Fig. 4, which had probably been present for years. He stated that he never had been just right in those parts, but had lived a virtuous life, had never had any venereal disease, and, hence, the true nature of his trouble had not been suspected. With the removal of the stricture there was an immediate improvement in his condition, which became more and more rapid, as his system gained strength and reaction became manifest. At the end of two months he wrote that he felt sound and well, and that he had experienced the most wonderful improvement in every way. His vital strength was fully restored, and he was most profoundly grateful.

Chronic inflammation of the bladder, sometimes called catarrh of the bladder, an affection that is elsewhere herein fully treated of, and chronic inflammation of the kidneys, and true Bright's disease, as well as prostatic disease, are all liable to result from strictures of the urethra. Hence, it behooves one suffering from this malady to have it promptly and skillfully treated.

False Passages. In very rare cases of impassable stricture, or in which fistulous openings, or false passages, have formed, through which the urine flows or dribbles away, we have resorted to the operation of perineal section with the most gratifying results. The cases requiring this operation are rare ones, in which death must generally result but for the relief afforded by the operation.

Dangerous Use of Instruments. The worst and most dangerous cases of stricture with which we have met, in a long and extensive experience, were rendered thus by the careless or unskillful use of bougies, catheters, or sounds. Many surgeons and physicians are most recklessly careless or unskilled in the use of these most dangerous instruments, as the many cases of false passage or stricture of the most painfuland dangerous kind, caused or aggravated by their ignorant or improper use, sorrowfully testify.

Delay Dangerous.By proper treatment of stricture in its early stages, all danger and pain are avoided, and a cure is effected in a very short time. In an extensive practice, in which we yearly treat hundreds of cases, we have never yet failed to give perfect and permanent relief from stricture, or diseased prostate or urethra, without the necessity of cutting instruments of any kind, when we have been consulted before injury of the urethra has been produced by improper use of instruments. Having specialists who devote their entire time to the study and cure of these diseases, we are thereby enabled to attain the highest degree of skill in the management of these cases.

Great Skill Required. The urethra is a sensitive and delicate canal, and is surrounded by tissues the most delicate, and lined with mucous membrane which is highly vascular and filled with sensitive nerves. The introduction of any instrument is to be undertaken only when absolutely required, and, when necessary, it should be so skillfully and carefully effected that no pain or irritation can result. The slightest awkwardness is liable to cause an unnoticeable injury, which results in false passage or an effusion of plastic lymph around the canal, and as it organizes, the formation of the most troublesome organic stricture. The attention not only of sufferers, but also of the profession, is called to the remarkable success of our operation, perineal section, by which a cure of extremely bad cases of impassable stricture and false passages, or urinary fistulas, is effected in from thirty to forty days, and with very little suffering. That we have been successful in such cases must be considered as conclusive evidence that no case of stricture, false passage, or urinary fistula, is beyond the reach of our skill.

In a practice embracing the treatment of a vast number of cases of diseases of the Urinary Organs, it has been our good fortune to effect many remarkable cures. The experience gained in this field of practice has made our specialists skilled experts, and hence hundreds consult them as a last resort. In fact we seldom get a case, in this line, that has not been the rounds of the home physicians before applying to us for relief and cure. The cures, therefore, which we shall introduce here are the more remarkable because of the failure, in nearly every case, of other medical men to benefit or cure. They are not the every-day, ordinary cases met with in the general practitioner's rounds, but complicated, obstinate ones, which had generally been given up as hopeless before coming to us.

Case 4A-3431."WASTED TO A SHADOW." BLEEDING FROM KIDNEYS. A SEVERE CASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

Illustration: T.S. Bailey, Esq.T.S. Bailey, Esq.

Gentlemen—I think it my duty to write to you concerning my case. In the year 1886 I was seized with inflammation of the bladder and passed nothing but thick blood, owing to heavy work, and I consulted a doctor and he said there was no cure for such a bad case; but he gave me medicine and it relieved me at the time I used it; and I took 16 bottles and I got worse and wasted to a shadow. I quit taking the medicine, and other complaints came, as rupture in the spermatic cord, for which I applied to you and soon got relief. And in 1891 the bladder disease made its appearance, and I wrote to the Invalids' Hotel and Surgical Institute and got no reply as our mails were stopped on account of snow drifts. I sent for the best doctor in Listowell and I still got worse, and he said I might live three or four weeks, but there was no stoppage of the disease. And I got so weak that I had to support myself by the furniture in my room; and I wasted down to 100 lbs. in two weeks; and I applied to your Institute and I received my medicine in a few days, and in two weeks I began to gather strength and now I am hearty and well and my weight is 145 lbs. I feel so thankful to the Medical Association and its Staff of skilled men. It is 15 months since I quit taking your medicines and no signs of the disease returning.

Yours gratefully,THOMAS S. BAILEY,Dorking, Wellington Co., Ont.

Case 23A-877.INFLAMMATION OF THE BLADDER, WITH OTHER COMPLICATIONS. SUFFERED EXCRUCIATING PAIN IN URINATING.

Illustration: G.W. Heffner, Esq.G.W. Heffner, Esq.

For many years I suffered with inflammation of the Prostrate Gland and Bladder. It became gradually worse and I endured extreme pain, so much so that I was laid up for weeks at a time, and almost gave up in despair. I was persuaded to go to the Invalids' Hotel and Surgical Institute. I have never regretted following this advice. While there I submitted to an operation by their specialist. This was entirely painless and the result perfectly satisfactory. I left in a short time delighted, and have since been strong and well. I cannot speak in too high praise of this famous Institution; the rooms are large and pleasant, the food the very best, the attendants kind and attentive and the staff of physicians skillful and of large experience. I highly recommend all invalids to the World's Dispensary Medical Association. I feel confident that all the benefit to be derived from medical treatment is to be received at this Institution.

Yours truly,GEO. W. HEFFNER,Chicago, Ills.

Case 2A-103.INFLAMMATION OF BLADDER, COMPLICATED WITH KIDNEY DISEASE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

Illustration: M. Manheim, Esq.M. Manheim, Esq.

Gentlemen—Having been a patient in your Invalids' Hotel for several weeks, I take great pleasure in telling other sufferers of my treatment which I received under your efficient staff of physicians, surgeons and nurses, and I will say with clear conscience that every care and comfort was given me that could be wished for. I am sure that your Institution is far in advance of the age, and would wish that every invalid could avail himself of the treatment that I received in your most excellently kept Invalids' Hotel. I cheerfully give this as my testimonial to individuals, friends and sufferers. My health is so fully restored that I look upon life with pleasure and comfort, whereas before I was a suffering, nervous invalid, unable to sleep and much of the time in torment. Wishing you success,

I am your friend and well wisher,M. MANHEIM,Georgetown, S.C.

Case 859,143.BLADDER, RECTAL, KIDNEY AND LIVER DISEASE. "ENTIRE URINARY ORGANS ONE MASS OF SORES." "DESPAIRED OF CURE."

Illustration: S.C. Tracy, Esq.S.C. Tracy, Esq.

My disease was caused by the roughness and exposure incidental to the life of a miner, working in the gold mines of California and Montana. I had much of the time to work in water, with my clothes wet, which finally brought on a severe pain In my kidney, which ere long completely prostrated me. I employed and was treated by six different physicians, the best I could obtain in my section of country, and who while seeming to understand the nature of my disease, yet gave me no remedy that afforded me any real relief. I grew worse under the treatment of them all. The pain in the kidney left me, but immediately located in the bladder. My bladder became very painful and commenced to ulcerate and fill up. It seemed from the excruciating agony I suffered, that there must have been an abscess in either the kidney or bladder, and from the large amount of pus discharged at one time, it appeared to me that my kidneys, bladder and the entire urinary organs were one mass of sores and pus mixed with blood. I had to use injections of laudanum daily in the lower bowels to ease the pain and live. Was reduced by long suffering, looking for each day to be my last. I felt that no human power on earth could help me. No language can describe, and God only knows, the agony I suffered. From what I have already written, you may form some faint conception of my physical condition at the end of six years' treatment by the best medical aid I could get in the section where I was living. I also used for some time (with no benefit), "Warner's Safe Cure," and in fact, tried every means that I could hear of, but to no permanent relief. Such was my condition when I was led finally to consult and be treated by your Association, though I had but faint hope of obtaining any relief from any one. With the very best description I could give in writing of my case, and all the information you got from me, you would not undertake the case until you were further informed, and for which caution I sincerely thank you. You wrote me—"we are at a loss to definitely determine your condition. We have an opinion based upon the facts before us, but we feel that we must have a personal examination." In the condition I was then in, I could not have been kept alive to reach the first railroad station, which was only six miles from my house, and much less to travel to Buffalo. Indeed I wrote you, that if you would cure me for nothing, I was unable to go to you. In reply, you then advised me to take your "Special Remedies" until I could improve sufficiently to go to Buffalo for examination. Now this frank answer of yours, removed every doubt from my mind, and convinced me that you werehonorable physicians. On March 10th, 1883, I began taking your "Special Remedies," as you prescribed them, and at the end of three years' constant treatment, I was improved sufficiently to go to Buffalo to your Institute,where I was examined as you required of me. When I reached your Institute, I was there carefully examined and received a month's treatment. When I reflect on my condition and my suffering when I first began to use your specifics, and see what I am now, I feel that no words can too glowingly express my gratitude to your Association for the physical benefits you have conferred upon me by your treatment of my despaired-of case.

SAMUEL C. TRACYPlatteville, Wis.

Illustration: C. Hanson, Esq.C. Hanson, Esq.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, 663 Main St., Buffalo, N.Y.:

Gentlemen—I have taken treatment from you for several months for nervous debility, and although I am not quite fully cured as yet, I have been greatly benefited, and believe, if I had come to you before I was duped and swindled by different quacks and was more dead than alive, I would to-day be a thoroughly well man.

I have also been to your Institute twice for surgical operations, and cannot too highly praise the Hotel, or the skill and care of the attending surgeons and nurses. They are gentlemen in every way and the Invalids' Hotel is just as represented.

I shall advise all suffering from chronic diseases to go to you for relief, as I have never seen any one there who was not cured or greatly benefited.

Very truly yours,CHRISTIAN HANSON, Esq.Austin, Mower Co., Minn.

Case 23A-890.DISEASE OF THE URINARY ORGANS.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

Illustration: F.A. Empsall, Esq.F.A. Empsall, Esq.

Gentlemen—I feel it my duty to give my testimonial in behalf of your grand Institution. I had an operation performed at your place two years ago for the relief of a very painful disease of urinary passage, and, thanks to your skill, I was cured, and have enjoyed the best of health since. I earnestly recommend your Institution to all who are suffering, and still further let me thank you for the kindness I received at the hands of everybody connected with the Institution. I am,

Respectfully yours,FRANK A. EMPSALL,P.O. Box 980, Pittsfield, Berkshire Co., Mass.

Case 2A-208.RETENTION OF URINE. SUFFERED INTENSE PAIN.

Illustration: P.J. Hamill, Esq.P.J. Hamill, Esq.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

Dear Sirs—To your favor of the 20th ult., would say that I can only speak in the highest terms of your Institution. After suffering for ten or twelve years with retention of the urine, and bladder difficulties, I can say that I found immediate relief at your hands. When going to your place, about six years ago, I was suffering with intense pain, loss of appetite, and unable to eat a good meal. I now weigh 170 lbs., do a good day's work and feel well in every respect. I am only too glad that I am able to praise your Institution, and can highly recommend it to any one who is suffering as I was. With great respect, I remain.

Yours very truly,P.J. HAMILL,Utica, N.Y.

Case 80,115.ENLARGED PROSTATE AND CHRONIC CATARRHAL INFLAMMATION OF BLADDER.

Illustration: Abraham Schell, Esq.Abraham Schell, Esq.

Several years ago I had occasion to become an inmate of the Invalids' Hotel and Surgical Institute, No. 683 Main Street, Buffalo, N.Y. I was afflicted with an enlarged prostate and chronic Inflammation, or catarrhal condition of the bladder. I was largely benefited by the treatment I received there, and had I remained a little longer, as I was advised to do by the doctor who attended me, I should have fully recovered. I was so nearly cured that I did not think it necessary to remain longer, as I supposed nature would do for me what remained to be done, to effect a perfect cure. My business was urgent. I could not well remain longer. In this I made a mistake, I should have remained longer. I was seventy-two years old at the time. I bear willing testimony to the ability of the medical staff and the interest the doctors take in the welfare of their patients. The nurses and all the subordinates were very kind and seemed to vie with each other to contribute to the pleasure and happiness of the inmates of the Institute. One will find the Institute equipped with all the improvements known to modern science, for the promotion and restoration of health. It is impossible to do justice to its merits in a short article of this kind. Persons must go there and see and judge for themselves, of the wonders of this extraordinary medical establishment. If they cannot recover their health there, in my Judgment, it is of no use to go elsewhere.

ABRAHAM SCHELL,Knight's Ferry, Cal.

Case 820,804.OBSTINATE AND COMPLICATED DISEASE.

Illustration: John H. Smith, Esq.John H. Smith, Esq.

WORLD'S DISPENSARY MEDICAL ASSOCIATION:

Gentlemen—Yours of July 12th to hand. I am only too glad to comply with your request. Having suffered for many years with a complication of diseases and feeling conscious that they were rapidly making serious inroads upon my constitution, and that I was speedily becoming unable and incapacitated to attend to my ordinary business. I resolved, after reading a number of testimonials from your patients, to place myself under your treatment at the Invalids' Hotel and Surgical Institute. With heart-felt gratitude I can truthfully say I am relieved of my trouble. I most cheerfully and earnestly recommend this Institution to all who are afflicted with chronic and painful diseases, no matter of what nature. During my stay there I saw some wonderful cures and surgical operations.

Yours truly,JOHN H. SMITH,Deckertown, Sussex Co., N.J.

Case 520,425.COMPLICATION OF DISEASES.

Illustration: Andrew Holes, Esq.Andrew Holes, Esq.

Without solicitude or hope of pecuniary reward, with heart-felt gratitude and a desire to aid my fellow-man to health and happiness, allow me to state, that as an inmate for more than a month of the Invalids' Hotel and Surgical Institute at No. 663 Main Street, Buffalo, N.Y., I feel warranted in its highest recommendation. While there I saw and talked with a great number of people who came there as a last resort, to be cured of almost every chronic disease to which flesh is heir, and they were unanimous in their praise of the Institution and the skilled specialists who constitute its professional staff.

ANDREW HOLES,Moorhead, Minn.

Case 654,500.DISEASE OF KIDNEYS AND OTHER COMPLICATIONS CAUSED BY EXPOSURE AND MALARIA.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

Illustration: J.W. Dean, Esq.J.W. Dean, Esq.

Gentlemen—Having spent a short period of time at the Invalids' Hotel and Surgical Institute, No. 663 Main Street, Buffalo, N.Y., I must say I found it fully equal in every respect to the claims made for it by the proprietors. It was filled with invalids who were under the care of a corps of physicians and surgeons and the fact that all the sick people appeared to be improving, and that they were both cheerful and hopeful, and that they all spoke well of the Institution and of its doctors, was calculated to inspire confidence in one who went there himself to be treated. The greater number of these cases, as far as I was able to learn, were chronic and of a complicated character. They represented a wide range of the States and Territories of the Union, and had in each exhausted the resources of the home physicians. Having myself been treated by your Faculty for a complication of troubles induced by exposure and malaria, I feel that I owe my restoration to health to your skill and devotion, at a time when I was unable to perform labor and was much discouraged, and had failed to obtain relief elsewhere. You are at liberty to make any use you may desire of this communication.

Very respectfully yours, J.W. DEAN,Chariton, Putnam Co., Mo.

Case 620,230.DIABETES AND INFLAMMATION OF BLADDER, GIVEN UP BY HIS HOME DOCTORS AS SURE TO DIE IN A FEW WEEKS. RESTORED TO ACTIVE WORK ON HIS FARM.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

Illustration: J.D. Parks, Esq.J.D. Parks, Esq.

Gentlemen—I received your kind letter the 12th, and was glad to hear from you and have no objection to your making use of my name in any way to help the sick and suffering, for I know what it is to be sick. I was sick for seven years; could not do anything; was visited by seven doctors and was treated by four, and was given up to die by one of the best doctors of Russellville. He said I could not live longer than fall. He treated me for Sugar Diabetes, while the rest said I had inflammation of the bladder. After giving up all hopes of being cured at home, a friend got me to write to Dr. Pierce's Institution and after corresponding: awhile I decided to go and be treated. I was there one month and I never was cared for or treated more kindly by any one. No parents could have been better to their sick children. I cannot speak too highly of the Institution, and I believe I would have been in my grave to-day if I had not gone and been treated.

I feel great pleasure in expressing to you my sincere thanks for the cure that has been effected in my case, by your very skillful treatment, whereby I am now entirely and I trust permanently cured from a dangerous disease, which had defied the utmost skill of all former medical attendants for the past five years, and from which I had despaired of being: relieved. I am happy to state that my health is so good since taking the month's course of treatment at your Institute, and, the home treatment since my return, that I am now able to carry on the work of my farm.

I would cheerfully recommend all persons requiring medical or surgical aid to consult you at the earliest possible opportunity, as I know by personal experience that the facilities cannot be surpassed for treatment of all classes of chronic diseases.

Most gratefully yours,J.D. PARKS,Homer, Logan Co., Ky.

P.S.—I have always recommended my neighbors to your Institution and was the cause of F.M. Brasher taking treatment, who was cured after two doctors gave him up. J.D.P.

Case 820,426.COMPLICATION OF DISEASES. A GRATEFUL PATIENT'S WORDS OF PRAISE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

Illustration: William Henkel, Esq.William Henkel, Esq.

Gentlemen—Having been in your Institution as a sufferer from two distinct chronic diseases of years' standing, and having been placed under the charge of your specialists, I was speedily relieved of my afflictions. The Invalids' Hotel is a place as much like home as it is possible for such an institution to be. The physicians and surgeons are all expert specialists and thoroughly efficient; the nurses are very competent, attentive and kind; and, in fact, the wholepersonnelof the Invalids' Hotel endeavor to do their best to make the patients feel like being at home. I always felt while there as if I was one of the family. I gladly recommend your Institution to all persons who are afflicted with any kind of chronic disease, for from my own experience Iknowthe professional staff will do all which they promise to do. Please accept my thanks for the speedy benefits and perfect cure of my diseases, and I think your Institution is worthy of the highest endorsement.

Yours truly,WILLIAM HENKEL,No. 1917 Congress Street, St. Louis, Mo.

"A question of life or death!"

Case 2A-107.STONE IN BLADDER. CASE SIMILAR TO THAT OF COL. ELLIOTT F. SHEPARD, WHO DIED IN NEW YORK WHILE UNDERGOING AN OPERATION.

Illustration: David S. Clark, Esq.David S. Clark, Esq.

Gentlemen—I am seventy-seven years of age and have resided in Erie for sixty-two years, and for thirty-six years have been an elder in the First Presbyterian Church. During four or five years I suffered from a painful affection of the bladder; the severity permitted neither freedom from pain by day nor calm repose by night. Meanwhile, I consulted leading physicians and visited numerous health resorts. Neither time, means nor effort were spared that I might be free from pain. Relief came unexpectedly. A signal act of Providence, that should be acknowledged daily, brought your Institution to my notice, though I had then no acquaintance with any one connected with it. With me it was a question of life or death. Up to last March I was in a condition of unendurable torture. I knew that at my age, after the months of pain already borne, that any operation would be serious, perhaps fatal. Accordingly, I arranged my temporal affairs and carefully "set my house in order." On the 13th of March last, I started for Buffalo to your Institution. Still uninformed as to the cause of my trouble, I submitted to a searching examination, as to my habits, constitution, parentage, the age and cause of death of my parents, and other facts, from which a tolerable biography could have been prepared. All was kindly intended. Their aim was to locate my ailment and then to determine my ability to undergo an operation. Having found a stone in the bladder, they advised that it be crushed and extracted. By a strange coincidence as this was announced, I learned of Col. Elliott F. Shepard's death under an operation for the same disease. He was many years my junior, and seemingly far better able to undergo the operation. Still, in my desperation, I determined to go on. During five days, I was under treatment for the coming operation. On the 18th of March the stone was crushed and extracted. It was a complete success. Of the consideration, tenderness and skill of the surgeon and his assistants, I cannot too strongly speak. Of the gentle and assiduous nurses, the system and completeness of the whole establishment, as it moved along as one harmonious whole, in all its departments, I cannot sufficiently express my admiration. I am now relieved of a state of torture, and restored to health and happiness equal to any period of my life. This I say with sincerity and emphasis. Since then I have gained twenty-two pounds in flesh. I wish my words could reach the ear of every one similarly affected, throughout our land, to banish all doubts and take advantage of the science, skill and pleasant surroundings so happily blended in your Institution, for the removal of pain and the mitigation of distress.

DAVID S. CLARK, Erie, Pa.

Case 520,123.STONE IN BLADDER. 1200 GRAINS OF STONE REMOVED WITHOUT CUTTING. PASSED BLOOD IN GREAT QUANTITIES FROM THE BLADDER. DOCTORS AT HOME (AS USUAL) DISCOURAGED HIM FROM COMING TO US.

WORLD'S DISPENSARY MEDICAL ASSOCIATION:

Illustration: James Vine, Esq.James Vine, Esq.

Gentlemen—I am glad to make public the wonderful cure that you accomplished in my case. For ten years I was a sick man, and during three years I suffered so much that life was a burden. My business had to be given up and the torments were something that could not be described. Every little while I had to urinate, and each time suffered a spasm of pain, like a knife thrust; the use of a catheter was painful and often it took long and painful trials before the water could be drawn off. I passed blood, in quantities at times. When I went to your place we had given up hope of a cure, and relief was all that I looked for. My doctors at home discouraged me. I spent four weeks in your Invalids' Hotel, and now at the age of sixty-seven years am sound and hearty as any one, work from five in the morning until seven at night. I manage a large and active business and enjoy life. I cannot express my high praise of your Institution. Your doctors are skillful and the nurses all kind and good. All understand their business and attend to it. I came home a new man and cannot say enough for your praise, and to express my thanks for the wonderful cure and comfort I have enjoyed.

Yours,JAMBS VINE, SR.

P.S.—You removed a stone that weighed over 1200 grains from my bladder, without cutting. The operation gave me complete relief. While there and since, I have seen a great many skillful cures done by you.

J.V., SR., St. Catherines, Out.

Case 620,610.STONE IN BLADDER—WEIGHT 530 GRAINS—SUCCESSFULLY REMOVED WITHOUT CUTTING. NEIGHBORS TOLD HIM HE WOULD BE "BROUGHT HOME IN A BOX."

WORLD'S DISPENSARY MEDICAL ASSOCIATION:

Illustration: C.A. CHURCH, ESQ.C.A. CHURCH, ESQ.

Gentlemen—Seeing the picture of the Invalids' Hotel and Surgical Institute in our local newspapers, called to my mind the treatment I received there in 1887. I had been suffering for ten or twelve years with bladder trouble, and our home physicians did not seem to understand the cause or the trouble, and I finally corresponded with your faculty, and their advice was to come and have an examination. I had been a great sufferer and was so weak that I could hardly walk from the hotel to the depot, and those who saw me start said that I would be brought home in a box. Soon after my arrival an examination revealed a stone in my bladder. After a few days' treatment to strengthen up the system, the stone was taken out, weighing 530 grains. Four or five others were afterwards taken out of smaller size, and I am still alive. Will soon be seventy-six years old, and I cannot speak too highly of the care and attention I received from the physicians and nurses while there. Everything that was provided was of the best; good food, glean apartments; and no better place can be found for treatment of the many diseases they advertise to cure.

Anyone suffering from bladder or kindred trouble can find relief at the Invalids' Hotel, Buffalo, N.Y.

Respectfully,C.A. CHURCH,New Berlin, N.Y.

Case 620,258.STONE IN THE BLADDER—GREAT SUFFERING FOR YEARS—HEART-FELT GRATITUDE.

Illustration: Wm. H. Miller, Esq.Wm. H. Miller, Esq.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

I would not be a true man If I did not acknowledge at this time (as I should have done long ago), with words of gratitude, the wonderful relief I received at your Institution five years ago. It affords me the greatest pleasure to say to you and to the world at large, that the treatment and operation I received at your Institution was an entire success and a miraculous cure. After twenty-five long years of suffering such as few people endure, caused from exposure while in the military service of the United States, I contracted kidney and bladder disease, which shortly afterwards resulted in the formation of a calculus or stone. I experimented with medicines. Special Prescriptions, etc., from some of the most eminent physicians in the world, in fact everything that promised relief and help for my kidneys was used, but received no relief, until the bladder discomfort became unendurable. As a last resort, knowing full well that life with me would be very short unless I could receive immediate relief, I went to your famous Institute, where I was treated and operated upon and a large stone was removed from the bladder. The old method of cutting, which is so dangerous, was not employed, but the new and painless process of crushing; this process was an agreeable surprise to me, no pain and no risk, as in the old method of cutting. From the day of the operation I began to improve, and in a few weeks thereafter I returned home to my wife, family and friends, a well and happy man, and I have spent the last five years with ease, comfort and pleasure—a living, walking testimonial for your renowned Institute. Believe me, when I say that words fail me to express to you my sincere gratitude for your marvelous and almost miraculous cure effected in my case. I feel sure no invalid could receive more skillful and kindly attention anywhere in the world. I would urge every sufferer to take treatment at the Invalids' Hotel and Surgical Institute, believing it to be the most skillful, and feel sure that it is the most advanced of the age.

Sincerely and gratefully yours,WM. H. MILLER,Stoyestown, Somerset Co., Penna.

Case 720,402.STONE IN BLADDER ONE AND A HALF INCHES IN DIAMETER SUCCESSFULLY REMOVED WITHOUT CUTTING OR PAIN.

Illustration: Thos. Daltry, Esq.Thos. Daltry, Esq.

From severe exposure when in the army, I brought upon myself an acute attack of rheumatism, from which I suffered terrible pain. Following this I began to be troubled with my bladder and kidneys. For three years I experienced considerable discomfort. There was severe burning and scalding, and urination caused much pain. I passed two pieces of gravel and became convinced that I had stone in the bladder. Was examined by my home physician, who said there was no stone. I was not satisfied, however, and went to the Invalids' Hotel and Surgical Institute. I was examined by their specialist. After an injection of cocaine and carefully cleansing out the bladder, a stone was found about one inch and a half in diameter, probably similar in its composition to the pieces already passed. I was advised to have it operated upon and removed, which I arranged to do. The process used was their new and painless one of crushing, no knife or other cutting instrument being employed. The stone was readily grasped by the crusher and reduced to small fragments. The evacuator was then introduced and the stone entirely removed. After a few weeks' careful attention my health was entirely restored and I was able to leave for home. I take great pleasure in making public my wonderful cure. I could not speak in too high praise of those who took charge of my case, nor recommend too highly this famous Institution. It is about three years since I was operated on, and pave not felt any bad effects since.

THOS. DALTRY,Huntington, Huntington, Co., Ind.

Case 820,539.GRAVEL OR STONE WITH CHRONIC KIDNEY AND BLADDER DISEASE. CURED NINE YEARS AGO AFTER BEING GIVEN UP TO DIE.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

Illustration: Mr. O. Thompson.Mr. O. Thompson.

In 1884, at the age of fifty-four years. I was prostrated with Kidney and Bladder complaint and told by the best physicians that I was but ten days out of the grave. I applied to your Institute for help and received treatment, and now after nearly nine years am in comparatively good health. All this time I have been able to do much work and to oversee my farm. Two stones or gravel were passed while under home treatment. No further formations have developed. The many cases I have recommended to you have all been more than satisfied with the results of their treatment. I wish to thank you for the great benefit and care I received at your hands.

Yours truly,ORVILLE THOMPSON,Avoca, Steuben Co., N.Y.

Case 859,612.A STRONG ENDORSEMENT.

Illustration: H.E. Bankston, Esq.H.E. Bankston, Esq.

To whom it may concern:

This is to certify that I took treatment at the Invalids' Hotel and Surgical Institute, Buffalo, N.Y., and I was cured of a chronic trouble that had been maltreated by other physicians. While there I saw a man who had been cured by the specialists, who had before been given up to die by the best doctors in Troy, N.Y. Of course, the case must have been a very stubborn one. I afterwards saw a man here, in Georgia, die, who, if he had been in Pierce's Surgical Institute under the treatment and care of his skilled doctors and nurses, I know would have most assuredly got well. Why? Because it was only a case ofstone in the bladder, and they are easily cured at Dr. Pierce's Surgical Institute. I think almost any chronic disease can be cured there, if taken in time, judging from my observations while an inmate of that Institution.

H.E. BANKSTON,Barnesville. Pike Co., Ga.

Case 820,260.COMPLICATION OF DISEASES.

WORLD'S DISPENSARY MEDICAL ASSOCIATION:

Illustration: J.F. Ritter, Esq.J.F. Ritter, Esq.

Gentlemen—It is now about six months since I discontinued your treatment, and as I have had no return of the old symptoms, I consider it unnecessary to take more medicine. When I visited your Institution some two years ago, I had but faint hopes of ever being restored to health, as I was suffering from a complication of diseases. My case was an unusually obstinate one, yet I am satisfied that a cure could have been accomplished in half the time, had I been able to follow your directions in regard to diet more closely. I hereby tender you my sincerest thanks for the kind treatment received while at your Institution. Those days will always be the happiest in my memory. I will close by giving your faculty my sincere thanks, and hope success will crown your business.

Yours very gratefully,J.F. RITTER,Medford, Jackson Co., Oreg.

Stricture, the result of injury from falls and accidents, is particularly difficult of permanent cure. The following gratuitous recommendations are from cases belonging to this class who entirely approve of the publication, with full name, photo-gravure and address.

Case 820,507.STRICTURE CURED AFTER MANY OPERATIONS BY OTHER SURGEONS HAD PROVEN TO BE FAILURES.

WORLD'S DISPENSARY MEDICAL ASSOCIATION:

Illustration: Archie Ritchie, Esq.Archie Ritchie, Esq.

I would state that I am an architect, fifty-two years of age, that about seventeen years ago I fell from a scaffold, a distance of eighteen feet, across a beam, striking upon the perineum. A physician was immediately called and I was treated by him for about eight or ten weeks. A catheter was introduced into the bladder, but caused such intense pain and anguish that it had to be withdrawn. It was tried again but could not be introduced on account of the lacerations in the urethra, caused by the violence used. A consultation was held and an operation recommended. An anæsthetic was used and a cut made through the perineum from the outside into the bladder. A catheter was inserted into the bladder, tied in place and left in position for about eight weeks. After eight or nine weeks the catheter was removed, but it was four or five weeks before the wound in the perineum healed. After a few months I began to have a urinary difficulty, and symptoms of urethral stricture. This condition continued until the urethra was entirely closed, and it was impossible to make water. A physician attempted to pass a catheter, but could not do so. He continued to treat me by the process of dilation for five or six months. I began to feel more comfortable, but the symptoms of stricture would manifest themselves again. I then went to a hospital at Toronto. There I was treated also by the dilating method. The treatment was continued for about four weeks, but became so very painful, and there was so much irritation in the urethra, that it was impossible to endure it longer. They then called an electrical specialist and he began treatment by electrolysis. In about three weeks I went home, but in a short time the stricture again manifested itself; the contraction was very marked, and micturition very difficult. It grew gradually worse and I could not receive any comfort or benefit. I returned to Toronto to take further treatment from the electrical specialist. During the operations of dilation of the urethra, I passed some gravel. After four weeks treatment I returned home, but in about two months was as bad as ever, and last October went back to Toronto and was again treated by the electrical method. The doctor had much difficulty in inserting the smallest catheter, and it caused intense pain and suffering. The last time he attempted to insert a catheter, there seemed to be something give way, and a large amount of pus and fluid passed from the rectum. The physician told me an abscess had formed. I returned home and tried to keep as comfortable as possible, but could not micturate with any degree of satisfaction or comfort. I gradually began to grow worse and there was a return of the stricture with inflammation of the bladder. In March, 1892, there began to be formed gravel in the bladder. They would at times obstruct the flow of urine entirely. I kept going from bad to worse, until the urethra appeared to be entirely closed. The physician I called found it impossible to pass a catheter Into the bladder, and advised me to go to some hospital where I could receive proper treatment, and where proper appliances for this class of cases were used, as he felt satisfied nothing could be accomplished for me at home. I then came to the Invalids' Hotel and Surgical Institute in Buffalo to receive treatment, and the treatment has been so successful that the urethral stricture as well as the gravel have been removed. After I returned home I felt as if a great load had been lifted from my shoulders. I have no irritation at all as I used to have, and I can keep my water for six or seven hours without any trouble, and the water seems to be clear and free from sediment of any sort, and in general I feel as I never expected to again. The doctors here were dumb-founded at the short time I was in getting fixed at your Institution, and feel ashamed to ask any questions as to treatment. Many months have passed and I continue well and active in my profession. Any one I can send the way of your Institution you may be sure I shall do so, and thanking you personally for your kind and successful treatment of my case,

I remain ever your well-wisher,ARCHIE RITCHIE, Architect,Mount Forest, Ont.

GRATEFUL LETTER FROM A PROMINENT ARCHITECT.

TO THE WORLD'S DISPENSARY MEDICAL ASSOCIATION:

Gentlemen—It is again with the greatest of pleasure that I write you after twelve months since I was treated in your Institution, to add to my former testimonial. With the blessing of good health I have been able to attend to my business as well as ever, and have the greatest of comfort in every respect, and feel about ten years younger than I was when I came to your Institution for treatment, and I have still again to thank you, gentlemen, for the kind and courteous attention I received from every one I came in contact with in your Institution, while under treatment, and shall ever remember my visit to your Hotel with pleasure, and shall advise any one suffering under the same trouble, with whom I may come in contact, to come to your valuable Institute for treatment, where they can have the best of attention and skill. Again thanking you, gentlemen, for what you have done for me, I hope that your Institute may long be kept up to minister to suffering humanity. God bless your staff of physicians, and may success attend you, is the wish and prayer of ever your well-wisher and grateful patient,

ARCHIBALD RITCHIE,Mt. Forest, P.O., Ont.

[See Mr. Ritchie's former communication, onpage 857.]

Case 2A-126.PAINFUL IMPEDIMENT TO THE ACTION OF URINARY ORGANS.

Illustration: Edward Compton, Esq.Edward Compton, Esq.

WORLD'S DISPENSARY MEDICAL ASSOCIATION:

This is to certify that I have been to the Invalids' Hotel and Surgical Institute, at Buffalo, N.Y., for treatment, and cannot speak in too high terms of the staff of physicians and surgeons, or of the treatment which I received. I consider the Hotel one of the best in the country, the table being excellent, and the treatment the very best to be found in the land. It is a most pleasant place to stay. The attention which is given by the nurses could not be better. As surgeons I think your specialists possess the finest skill that can be found. Any person suffering should not delay, but go at once and be treated and get well. You are at liberty to use this endorsement in any way that will do the most good.

With gratitude, I remain,EDWARD COMPTON,Chillicothe, Ill.

Case 620,380.STRICTURE, THE RESULT OF INJURY—CURE PERMANENT.

Illustration: Mr. Fay Sawdy.Mr. Fay Sawdy.

The stricture, which resulted from an injury, had been greatly aggravated by uric acid crystals which were continually forming in the urine. Patient had rheumatism, causing this acid state of the system. He had been a great sufferer for many years, continually experiencing the nervousness, smarting, pain and burning, with occasional attacks of urethritis, common to the malady in this form. This made the stricture almost unbearable, and he was practically incapacitated for his labor at the time that treatment was undertaken in our Institution. He had been to the Hot Springs and in the care of other physicians with no satisfactory results. The relief of the stricture by our new and painless method was followed by very great improvement in his condition, after which appropriate remedies for the rheumatism were administered, and the result was a very gratifying and satisfactory relief from his difficulty. Patient afterwards embarked in business as a proprietor of a hotel of his own, and has been ever since very active in carrying on the business, and extremely successful. The stricture showed no tendency to recur, as is commonly the case where it is cured by other methods than employed by us. Many years elapsed from the time that it was treated before the testimonial appended was written.

WORLD'S DISPENSARY MEDICAL ASSOCIATION, Buffalo, N.Y.:

Dear Doctors—I want to thank you, but words cannot express my gratitude, foryour treatment white at your Institution, but I will say for the benefit of persons afflicted with stricture, that I was entirely cured by you, and after several years have not seen any signs of its returning.

Yours truly,FAY SAWDY, Proprietor Hotel Sawdy,Earlville, Madison Co., N.Y.

Case 551,864,URETHRAL STRICTURE—NASAL CATARRH—CURED IN TWENTY DAYS—A PREVIOUS OPERATION BY A NASHVILLE (TENN.) SURGEON UTTERLY FAILED.

Illustration: S.A.D. Smith, Esq.S.A.D. Smith, Esq.

WORLD'S DISPENSARY MEDICAL, ASSOCIATION. Buffalo, N.Y.:

In September, 1886, I was examined by one of your able staff of physicians and was found to be suffering with a bad form of nasal catarrh and with two strictures in the urethra (water passage). After a few days' general treatment, I was operated upon and turned over to be cared for by the nurse, from whom I received all the attention that was necessary. To my utter astonishment I was dismissed in twenty days from the Surgical Institute, cured of the stricture. I had been operated on by one able surgeon of Nashville, Tenn., and was worse after the operation than before. I have never had a symptom of the stricture since I was dismissed from the Invalids' Hotel and Surgical Institute, and have been in better health than ever before in my life.

Very truly,S.A.D. SMITH,Laurel Hill, Tenn.

Case 820,201.STRICTURE OF THE URETHRA OF THREE YEARS' STANDING—COULD PASS URINE ONLY IN DROPS AND WITH GREAT PAIN.

WORLD'S DISPENSARY MEDICAL ASSOCIATION:

Illustration: Frank Brendell, Esq.Frank Brendell, Esq.

Gentlemen—Wishing to add my testimony as to your great skill in surgery, I will say that I suffered with stricture of the urethra, due to an injury, for about three years. It became so bad that at times I could pass water only in drops and with great pain. I went to a doctor here, who used sounds which helped me for a time, but in less than six weeks I was worse than ever. Hearing of your place, I came to you and had a painless operation performed, and have ever since been thoroughly cured. I experience no trouble or pain. It is three years since I had the operation, and the cure has proved permanent. You have my deepest gratitude.

Yours truly,FRANK BRENDELL,Olean, Catt. Co., N.Y.

Case 820,472.COMPLICATED AFFECTION OF NERVOUS SYSTEM AND URINARY ORGANS.

Illustration: E.J. Archer, Esq.E.J. Archer, Esq.

To the afflicted with chronic Diseases:

It is with great pleasure that I refer to the successful treatment, together with the kind care and attention received at the hands of the professional staff, both physicians and nurses, of the world-renowned Invalids' Hotel and Surgical Institute. In every way It verifies their statement—"Not a hospital but a pleasant remedial home," and as such I add my name to the thousands who know and recommend it to the afflicted. Not only was this true in my own case, but in many which came under my observation while there, so I say to the afflicted—visit them if you can and if your case (no matter of what character) is Within human skill, you will never have to regret it.

Very sincerely yours,EDWARD J. ARCHER,Plainwell, Mich.

Case 520,408.STONE IN THE BLADDER.

WORLD'S DISPENSARY MEDICAL ASSOCIATION:

Illustration: Rob't Worthington, Esq.Rob't Worthington, Esq.

Gentlemen—For six years I had been a great sufferer from stone in the bladder. The discomfort increased, until it almost became unbearable. Hearing of the universal success of the specialist at the Invalids' Hotel and Surgical Institute, in similar cases, I went there and submitted to an operation. The method employed was their new and painless one of crushing, no knife or cutting instrument being used. I felt no pain afterward, there was no fever, and I could have gone home the day after. The operation was witnessed by one of my friends, who says it was very artistic and done with skill. It was a complete success, for I have not been troubled in the least, although nearly seven years have passed.

I feel that I cannot speak in too high praise of this renowned Institution and its staff of skilled physicians. No invalid need fear to place himself under the skillful treatment and kindly care to be received there, for I am confident that all the benefit known to medical science, can be obtained at the Invalids' Hotel and Surgical Institute.

ROBERT WORTHINGTON,Staunton, Fayette Co., Ohio.

Case 114,747.NERVOUS DEBILITY, DYSPEPSIA, KIDNEY AND LIVER DISEASE—CURED.

WORLD'S DISPENSARY MEDICAL ASSOCIATION:

Illustration: B.V. Wright, Esq.B.V. Wright, Esq.

Gentlemen—I take pleasure in informing you that the treatment you gave me for the relief of an affection of the spine and nervous system, disease of the digestive organs, kidneys and liver, has been entirely successful. I had feared that my health was gradually being undermined, prior to entering your institution, and I can testify to the perfect appointment that you have, the excellent apparatus for the administration of electrical and other massage treatment and baths. My relief was most satisfactory, and the cure has remained permanent.

I take pleasure in recommending your institution to the afflicted, believing that you have the very best treatment for chronic diseases known, and I have had an opportunity to satisfy myself, from conversation with other invalids in your Institution, of the care and skillful treatment that you administer, and its excellent effects. I believe that it is fully abreast of the times, and equal to any institution in the world.

With many good wishes and thanks for my cure,

I remain, Yours truly,B.V. WRIGHT,Graniteville, Middlesex Co., Mass.

Case 790,698.DIABETES CURED BY HOME TREATMENT.

Illustration: Mrs. Woodruff.Mrs. Woodruff.

To whom it may concern:

This is to certify that for a number of years I was a constant sufferer, and what was many times termed a hopeless victim of that terrible disease, diabetes. The symptoms were indeed alarming; my strength being so completely exhausted that my walking from room to room was attended with difficulty. My nerves were in a constant tremor, and in fact no other words than that, "I was completely out of fix all over," will express my condition. Having purchased a bottle of Dr. Pierce's Favorite Prescription for my daughter, and in looking over the directions of the accompanying circular and finding my own case so thoroughly described, I decided at once to give his special home treatment a trial, which I did during the three months that followed. This proved to be all that was required for the restoration of my usual health, and during the four years which have since elapsed I have had not the slightest reason for believing otherwise than that a perfect cure has been effected, and can most heartilyrecommend Dr. Pierce's medicines and treatment to any or all who may be suffering with kidney complaint in any form.

Very sincerely yours,MRS. MARY A. WOODRUFF,Columbus Junct., Louisa Co., Ia.

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