The immense building erected and occupied by the World's Dispensary Medical Association as a Laboratory, wherein are manufactured our Dr. Pierce's Standard Family Medicines, as well as all the various Tinctures, Fluid Extracts and other pharmaceutical preparations used by the Staff of Physicians and Surgeons of the Invalids' Hotel and Surgical Institute in their practice, is not inappropriately called theWorld's Dispensary, for within its walls is prepared a series of remedies of such exceeding merit that they have acquired world-wide fame, and are sold in vast quantities in nearly every civilized country.
Illustration: World's Dispensary.World's Dispensary.—New Laboratory Building.
The structure, located at 660 to 670 Washington Street, immediately in the rear of the Invalids' Hotel and Surgical Institute, is of brick, with sandstone trimmings, six stories high, and 100 feet square. Its most striking architectural features exteriorly are massiveness, combined with grace and beauty of outline, and great strength.
The basement or first story opens on a level with the Washington Street sidewalk, and is occupied by a plant of two large boilers, which supply the steam to run a huge American engine, of 100 horse-power,built by the American Engine Co., Bound Brook, N.J. It drives all the machinery of the establishment, including drug mills, pill machines, packing machinery, a large number of printing presses, folding machines, stitching, trimming, and many other machines, located on the different floors, and used in the manufacture of medicines, books, pamphlets, circulars, posters, and other printed matter. On this floor is located steam bottle-washing machinery, and also the shipping department. Here may be seen huge piles of medicine, boxed, marked, and ready for shipment to all parts of the civilized world. A large steam freight elevator leads from this to the floors above.
Illustration: Postal, Advertising, Wrapping and Mailing Departments.Postal, Advertising, Wrapping and Mailing Departments.
In addition to the power engine just mentioned is a 25 horse-power upright engine for running the dynamo for electric lighting, with a capacity of three hundred (300) lights. This engine and dynamo were also manufactured for us by the American Engine Company of Bound Brook, N.J. There is a small dynamo with a capacity of one hundred (100) lights used during the day to light safes, vaults, dark closets and hallways. All the offices and rooms of patients are supplied with electric light, as well as illuminating gas. An automatic Worthingtonpump is also located in the basement. This supplies the elevator and sprinkling system. The sprinklers come into play only in case of fire, when they are self-acting. This pump at its best is capable of forcing nearly two hundred gallons of water a minute. There is no place in which pure water is more desirable than in the manufacture of medicines. Our New York filter could, if such a large quantity were ever required, furnish the Dispensary with one hundred (100) barrels of pure water a day. Just beyond the south wall and buried several feet under ground is a boiler-shaped tank capable of storing ten thousand (10,000) gallons of medicine.
The main or second floor of the Dispensary is entered from Main Street, through a hall leading from the Invalids' Hotel and Surgical Institute. On this floor are located business offices, counting-room, the advertising department and mailing rooms. Large, fire-proof vaults are provided for the safe keeping of books, papers, and valuables, whilst the counting-room and offices are elegantly finished in hard woods, and present a beautiful and grand appearance.
On this floor are the Association's extensive printing and binding works. Fourteen large presses, driven by power, with numerous folding machines, trimming, cutting, and stitching machinery, are constantly running in this department. Here is printed and bound Dr. Pierce's popular work of over a thousand pages, denominated "The People's Common Sense Medical Adviser," over 1,200,000 copies of which have been sold. Millions of pocket memorandum books, pamphlets, circulars and cards are also issued from this department and scattered broadcast to every quarter of the globe.
Large mills for crushing, grinding and pulverizing roots, barks, herbs, and other drugs occupy a considerable part of this floor. Extensive drying-rooms, in which articles to be ground in the drug mills are properly dried, are also located upon this floor, as are also thousands of reams of paper ready for printing the different books, pamphlets, labels, etc. In large rooms set aside for that purpose, are stored vast quantities of labels and wrappers, for use in putting up medicines.
On this floor is located ingeniously devised filling and bottling machinery, also rooms for labeling, wrapping, and packing medicines; others are occupied for the storage of crude drugs, glass, corks, and supplies for use in the general business.
This entire floor is occupied with mixing, percolating, distilling,filtering, and other processes employed in the manufacturing of medicines. Every process is conducted under the watchful care of an experienced chemist and pharmacist, and in the most perfect and orderly manner; the apparatus employed being of the most approved character. Here are manufactured all the various medicinal preparations and compounds prescribed by the Faculty, in the treatment of special cases.
Illustration: Section of Chemical Laboratory.Section of Chemical Laboratory.—World's Dispensary.
In all departments of this vast business establishment, the visitor is struck with the perfect system which everywhere prevails, and the wonderful accuracy with which every process and transaction is carried on and consummated; hence the uniformity of purity and strength for which the medicines here manufactured have so long been celebrated. To this, also, is due much of the marvelous success attained in the department established for the special treatment of chronic and obstinate cases of disease. In this department the Faculty are not at all limited or hampered in prescribing, and do not confine themselves in the least to the proprietary or standard medicines manufactured for general sale through druggists, but employ a series of curative agents unsurpassed in variety and range of application. They aim to carefully adapt their prescriptions to each individual case.
Illustration: One of the Private Consultation-rooms, Gentlemen's Department.One of the Private Consultation-rooms, Gentlemen's Department.
The destinies of institutions, like those of men, are often determined by pre-existing causes. The destinies of some men are like those of way-side plants, springing up without other apparent cause than the caprice of nature, developing without any apparent aim, yielding no perfected fruit, and finally, dying, leaving scarcely a trace of their existence. Thus it is with institutions which have their origin only in man's caprice. To be enduring, they must be founded upon the needs and necessities of humanity. Many of the great men of the world owe their greatness more to surrounding circumstances than to the geniuswithin them. The highest genius can be dwarfed or deformed by the force of adverse circumstances; hence the poetic truth of Gray in those exquisite lines:
"Some mute inglorious Milton here may lie,Some Cromwell guiltless of his country's blood."
"Some mute inglorious Milton here may lie,Some Cromwell guiltless of his country's blood."
Opportunity is the guiding star of genius. Without it, genius would drift hither and thither upon the restless, ever-changing waves of circumstance, never casting anchor in a secure haven. Upon opportunity, too, depends the success of institutions. By opportunity we mean a real and acknowledged public want. Whoever undertakes to supply this want finds himself upon the crest-wave of prosperity. It was to supply such a want that this institution was erected.
Of the seventy millions of people living in the United States to-day, it is estimated that nearly twelve millions are sufferers from chronic disease. Think for a moment! Twelve millions of people slowly but surely dying by the insidious and fatal development of chronic diseases! This is an appalling fact. And yet this is the very class of diseases with which the general practitioner is least familiar.
As a general practitioner of the healing art, fresh fromcurriculum, the founder of this institution early realized that the grand unpardonable sin of the medical profession was the neglect to more thoroughly study and investigate this class of diseases.
The profession is diligently cauterizing and poulticing the sores which now and then appear on the surface, but the internal chronic disease, of which these are merely the external signs, is too often overlooked or neglected.
Some years ago we devised and put into practical operation a method of
without requiring them to undergo personal examinations. We reasoned that the physician has abundant opportunity to accurately determine the nature of most chronic diseases without ever seeing the patient. In substantiating that proposition, we cited the perfectaccuracywith which scientists are enabled to deduce the most minute particulars in their several departments, which appears almost miraculous, if we view the subject in the light of the early ages. Take, for example, the electro-magnetic telegraph, the greatest invention of the age. Is it not a marvelous degree of accuracy which enables an operator toexactlylocate a fracture in a sub-marine cable nearly three thousand miles long? Our venerable "clerk of the weather" has become so thoroughly familiar with the most wayward elements of nature that he can accurately predict their movements. He can sit in Washington and foretell what the weather will be in Florida or New York, as well as if hundreds of miles did not intervene between himand the places named. And so in all departments of modern science, what is required is the knowledge of certainsigns. From these, scientists deduce accurate conclusions regardless of distance. A few fossils sent to the expert geologist enables him to accurately determine the rock-formation from which they were taken. He can describe it to you as perfectly as if a cleft of it were lying on his table. So also the chemist can determine the constitution of the sun as accurately as if that luminary were not ninety-five million miles from his laboratory. The sun sends certainsignsover the "infinitude of space," which the chemist classifies by passing them through the spectroscope. Only the presence of certain substances could produce these solar signs.
Illustration: Medical Library and Council-room.Medical Library and Council-room.—Invalids' Hotel and Surgical Institute.
So, also, in medical science,
or symptoms, and, by reason of this fact, we have been enabled to originate and perfect a system of determining with the greatest accuracy the nature of chronic diseases without seeing and personally examining our patients. In recognizing diseases without a personal examination of the patient, we claim to possess no miraculous powers. We obtain our knowledge of the patient's disease by the practical application of well-established principles of modern science to the practice of medicine.And it is to the accuracy with which this system has endowed us that we owe our almost world-wide reputation for the skillful treatment of all lingering, or chronic, affections. This system of practice, with the marvelous success which has been attained through it, demonstrates the fact that diseases display certain phenomena, which, being subjected to scientific analysis, furnish abundant and unmistakable data to guide the judgment of the skillful practitioner aright in determining the nature of diseased conditions.
So successful has been this method of treating patients at a distance that there is scarcely a city or a village in the United States that is not represented by one or more cases upon the "Records of Practice" at the Invalids' Hotel and Surgical Institute. In all chronic diseases that are curable by medical treatment, it is only in very rare cases that we cannot do as well for the patient while he or she remains at home, as if here in person to be examined. But we annually treat hundreds of cases requiring surgical operations and careful after-treatment, and in these cases our Invalids' Hotel, or home, is indispensable. Here the patient has the services not only of the most skillful surgeons, but also, what is quite as necessary in the after treatment, of thoroughly trained and skilled nurses.
What should be the essential characteristics of an Invalids' Home?
Obviously, the most important of these characteristics isclimate. Climatology, from being a mere speculative theory, has arisen to the deserved rank of a science. The influence of the climate of a country on the national character has long been observed and acknowledged. The languid but passionate temperaments of the South are like its volcanoes, now quiet and silent, anon bursting forth with terrible activity, flooding entire cities with molten fire; or, like its skies, now sunny, cloudless, an hour hence convulsed with lightnings and deluging the earth with passionate rain; or like its winds, to-day soft, balmy, with healing on their wings, to-night the wind fiend, the destroying simoom, rushing through the land, withering and scorching every flower and blade of herbage on its way. On the other hand, the calm, phlegmatic temperament of the North accords well with her silent mountains, her serener skies, and her less vehement, but chilling winds. The South, too, is the native home of the most violent acute diseases, such as yellow fever and cholera. But, aside from this general climatic influence, there is the yet more restricted one of locality. It has often been observed that certain classes of diseases are most prevalent in certain localities, the prevalence in every instance being due to peculiarities of climate.
In the published records of the examination for military service in the army, during our late civil war, this fact was clearly and definitelystated, and maps were prepared and presented showing the comparative prevalence of certain diseases in the several States and districts represented. The maps are prepared by a graduation of color, the lighter shades indicating the localities where the special disease under consideration is least prevalent; and it is a very significant and important fact that in all chronic diseases not due to occupation or accident, Buffalo and its immediate vicinity is marked by the lighter shades. Thus, in epilepsy, paralysis, scrofula, rheumatism, and consumption, our city is little more than tinted with the several colors used to denote these diseases.
Illustration: A Patient's Room.A Patient's Room.—Invalids' Hotel and Surgical Institute.
There is a popular, but unfounded, belief that Buffalo is a hot-bed for pulmonary diseases. This idea could have originated only in an ignorant disregard of facts; for medical statistics prove that in her freedom from this class of diseases she is unrivaled by any city in America, not excepting those on the seaboard.
Compare, if you please, the statistics of Buffalo with those of the great Eastern cities in this respect. In Boston and New York the death-rate from consumption shows a ratio of about 1 to 5 of the whole number of deaths. In Baltimore and Philadelphia the ratio is 1 to 6, while in Buffalo the death rate from consumption is only 1 to 10—veryremarkable difference in favor of our city. Only last summer a gentleman residing in the eastern part of our State collected and compared the health statistics for 1876 of all the prominent cities in the United States. The result showed that
A great deal of precious breath has been expended in blustering about "Buffalo zephyrs," as our delightful lake breezes are sometimes ironically termed. It seems to be a popular belief among our sister cities that old Boreas has chosen Buffalo for his headquarters. When we hear a person dilating upon "Buffalo's terrific winds," we are reminded of one of our lady acquaintances who recently returned from a European tour. She was asked how she enjoyed her sea voyage, and she replied, "Oh, it was delightful, really charming! There is something so grand about the sea!" We were not a little surprised at this enthusiastic outburst, as we had been told by a member of her party that the lady had industriously vomited her way to Hamburg and back again. But the lady's enthusiasm was easily explained. It is fashionable to characterize sea voyages as delightful, charming, etc. Now, we suspect this popular notion about our "trying winds" is traceable to the same source. It has become customary to call Buffalo a "windy place," and so, when the traveler feels a slight lake breeze, he imagines it to be a terrific gale. Whatever may have originated this notion, certain it is that it is utterly, undeniably false; and, in making this denial, we are not alone dependent upon observation, but upon the
The issue of July 18, 1874, of the BuffaloCommercial Advertiser, contained a series of tables, furnished by the Signal Service Bureau, showing the velocity of the wind at eleven prominent cities for the year 1873. An examination of the table shows that the total velocity for the year was thelowest in Buffaloof any of the lake ports; while Philadelphia and New York showed far higher aggregates of velocity than our city. On this subject, in the issue of August 21st of the same year, the editor pleasantly remarks: "Only the interior and southern seaboard cities, and not many of them, show a lower total velocity of wind than is marked against this city; and as for those places, heaven help their unfortunate inhabitants in the sultry nights of the summer season, when they are gasping in vain for a breath of that pure, cool lake air, which brings refreshing slumbers to the people of blessed, breezy Buffalo."
Illustration: One of our Physician's RoomsOne of our Physician's Rooms—Bureau of Correspondence—Invalids' Hotel and Surgical Institute.
Then, in regard toequability of climate, the great desideratum for invalids in any locality, here again sentiment and science are greatly at variance. An examination of the official records of the Signal Service Bureau, and the statistics of the Smithsonian Institute, showed that out of a list of forty cities on the continent Buffalo ranked highestfor equability of climate. Thus we quote from an editorial in theAdvertiserof the same issue: "While the aggregate of change for Buffalo stood at 67 for the year, that of Philadelphia reached 204, Washington was 224, Cincinnati 205, St. Louis 171. Winchester, in one of the healthiest parts of Virginia, reached as high as 201. Aiken, in South Carolina, a famous resort for invalids, touched 220. St. Augustine, one of the lowest in the list, showed a much less equable climate than that of Buffalo, being 94 to our 67." The transition from summer to winter, andvice versa, is exceedingly gradual, and, consequently, Buffalonians are seldom afflicted with those epidemic diseases which generally appear in other localities during the spring and summer months. Thus the thermometric readings of the Signal Service Bureau for 1873, show that the average temperature for July and August was 74°. For September it was about 64°, which was again reduced by about 10° for October. The monthly average for November was 73°,and for December 25°, which was also the average for January. Then the readings for February showed an average of 26°, for March 32°, and 43° for April. A more equable and gradual transition from midsummer heat to midwinter cold cannot be shown by any locality on this continent. Seldom does the mercury rise above ninety during our warmest summers, or fall below zero in our most severe winters. In J. Disturnal's work, entitled "The Influence of Climate in North and South America," published by Van Nostrand, in 1867, the climate of Buffalo is thus characterized: "From certain natural causes, no doubt produced by the waters of Lake Erie, the winters are less severe, the summers less hot, the temperature night and day more equable, and the transition from heat to cold less rapid, in Buffalo than in any other locality within the temperate zone of the United States, as will be seen by the following table." The table referred to shows that, "during the summer months, the temperature of Buffalo is from 10° to 20° cooler than that of any other point east, south, or west of the ports on Lake Erie; while the refreshing and invigorating lake breeze is felt night and day." The author further adds that "during the winter months the thermometer rarely indicates zero, and the mean temperature for January, 1858, was 20° above."
A careful investigation into the comparative climatology of the several great social and commercial centers, provedBuffalo to be superior to all others in the climatic requirements for the invalid. Besides, it has the important advantage of being a central point of traffic and travel between the West and the East.
The second important consideration in projecting this home for invalids waslocation. It has generally been customary to locate institutions of this character in rural districts, removed from the advantages of city life, on the plea of escaping the confusion and excitement so detrimental to recovery. The result is well known. Invalids have regarded them more as pleasure resorts than health resorts, spending the summer months there, but fleeing to their homes at the fall of the first snow-flake. The good that was done in the summer is undone by carelessness and exposure in the winter. A location that would combine both city advantages and rural pleasures, seemed to us, upon reflection, to be the desirable one. Fortunately, Buffalo afforded the happy mean. Our extensive parks, our unsurpassed facilities for yachting, fishing, and all aquatic sports, our many sylvan lake and river retreats, our world-famed Niagara,—certainly a more desirable selection of rural scenes and pleasures cannot be found in another locality in America.
In erecting the Invalids' Hotel and Surgical Institute, our paramount design was to make it a genuine home—not a hospital—a home wherethe child of fortune would miss none of the comforts of her palatial home, while the poor man would find not only health but his pleasures multiplied a thousand fold.
The wholesale merchant's prices are far less than those of the retail dealer. He can afford it, his sales are so much larger. It is on precisely the same principle that we are able to make the rates at the Invalids' Hotel and Surgical Institute comparatively low. If we had only a limited number of patients, we should be obliged to make the charges commensurate with our expenses; but our practice having become very extensive, and the income being correspondingly large, we are enabled to make the rates at the Invalids' Hotel and Surgical Institute so moderate that all who desire can avail themselves of its medical, surgical, and hygienic advantages.
Illustration: Prescription DepartmentPrescription Department—Invalids' Hotel and Surgical Institute.
Of the many advantages afforded by the Invalids' Hotel and Surgical Institute, in treating disease, we can make only brief mention of a few of the more prominent.
In the examination and treatment of patients, our practice is divided into specialties. Each member of the Faculty, although educated to practice inalldepartments of medicine and surgery, is here assignedto a special department only, to which he devotes his entire time, study and attention.
The division-of-labor system proves as effectual in the exercise of the professions as in manufactures. In the legal profession this has long been a recognized fact. One lawyer devotes his attention specially to criminal law, and distinguishes himself in that department. Another develops a special faculty for unraveling knotty questions in matters of real estate, and, if a title is to be proved, or a deed annulled, he is the preferred counselor. In a certain manner, too, this has long been practiced by the medical profession. Thus some physicians (and we may add physicians who call themselves "regular," and are specially caustic in their denunciation of "advertising doctors") are accustomed to distribute cards among their patrons, certifying that they give special attention to diseases of women and children. In this institution each physician and surgeon is assigned a special department of medicine or surgery. By constant study and attention to his department, each has become a skillful specialist, readily detecting every phase and complication of the diseases referred to him. Not only is superior skill thus attained, but alsorapidityandaccuracyin diagnosis.
Thoroughness and efficiency in any branch of learning can be secured only by devoting to it special study and attention. When the faculty of a university is to be chosen, how are its members selected? For instance, how is the chair of astronomy filled? Do they choose the man who is celebrated for his general scholastic attainments, or do they not rather confer it upon one who is known to have devoted special attention and study to the science of astronomy, and is, therefore, especially qualified to explain its theories and principles? Thus all the several chairs are filled by gentlemen whose general scholarship not only is known to be of the highest standard, but who devote special attention to the departments assigned them, thus becoming proficient specialists therein. The same system of specialties is observed in the departments of a medical college. The professor who would assume to lecture in all the departments with equal ease and proficiency would be severely ridiculed by his colleagues; and yet it is just as absurd to suppose that the general practitioner can keep himself informed of the many new methods of treatment that are being constantly devised and adopted in the several departments of medicine and surgery.
In no other science is more rapid and real progress being made at the present time than in that of medicine. Even the specialist must be studious and earnest in his work to keep himself well and accurately informed of the progress made in his department.Thus it so often happens that the general practitioner pursues old methods of treatment which science has long since replaced with others, acknowledged to be superior. The specialist, on the contrary, by confining his studies and researches to one class of diseases only, is enabled to inform himself thoroughly and accurately on all the improvements made in the methods and means of practice in his special department.
The difference between the practice of specialists and that of general practitioners is aptly illustrated by the difference between the old-fashioned district school, in which the school-master taught all the branches, from a-b-abs to the solution of unknown quantities and the charmed mysteries of philosophy, and the modern seminary, with its efficient corps of teachers, each devoting his or her whole attention to the study and teaching of one special department of learning.
We attribute the success which has attended the practice at the Invalids' Hotel and Surgical Institute, in a great measure, to a wise adoption of this system of specialties.
Obviously, the most important of these advantages isfacility of treatment. Of the thousands whom we have cured of chronic diseases, we have probably not seen one in five hundred, having accomplished the desired result through remedies sent either by mail or express, and advice given by letter. Yet in some obstinate forms of disease, we can here bring to bear remedial means not to be found or applied elsewhere.
That thousands of cases of chronic disease, pronounced incurable, have, by our rational and scientific treatment, been restored to perfect health, is conclusively proved by the records of practice at the Invalids' Hotel and Surgical Institute. Here, in obstinate cases, are brought to bear all the most scientific remedial appliances and methods of treatment.
A system of mechanical movements, passive exercises, manipulations, kneadings and rubbings, administered by a large variety of ingeniously-contrived machinery, driven by stream-power, has been found especially efficacious and valuable, as an aid to medical and surgical treatment, in the cure of obstinate cases of nervous and sick headache, constipation, paralysis, or palsy, stiffened joints, crooked and withered limbs, spinal curvature, tumors, diseases of women, especially displacements of the uterus, or womb, such as prolapsus, retroversion and anteversion, chronic inflammation, enlargement and ulceration of the uterus, and kindred affections; also in nervous debility, sleeplessness, and other chronic diseases. Mechanical power, or force, is by these machines transmitted to the system, in which it is transformed into vital energy and physical power or strength. This mechanical, passive exercise, or movement-cure treatment, differs widely from, and should not be confounded with, "Swedish movements,"to which it is far superior in efficacy. Coupled with our improved and wonderful system of "Vitalization" treatment, it affords the most perfect system of physical training and development ever devised. For the restoration of power to wasted, undeveloped, or weakened organs or parts, for their enlargement, this combined movement and "Vitalization" treatment is unequaled. It can be applied to strengthen or enlarge any organ or part. We also employ both Dynamic and Static electricity, "Franklinism" and Electrolysis, and chemical, Turkish and other baths, in all cases in which they are indicated. Inhalations, administered by means of the most approved apparatus, are employed with advantage in many obstinate lung, bronchial, and throat affections. We have nohobby or one-idea system of treatment, no good remedial means being overlooked or neglected.
Illustration: A glimpse of some of the rooms for the application of Electricity,A glimpse of some of the rooms for the application of Electricity, Mechanical Massage, "Vitalization" treatment, and other agencies prescribed by our Staff; furnishing a perfect system of physical and remedial training, carefully adapted to the wants of the most delicate and feeble, as well as to the more robust.
Reader, are you accustomed to think and act for yourself? Do you consult your own reason and best interests? If so, then do not heed the counsel of skeptical and prejudiced friends, or jealous physicians, but listen to what we have to say.
You perhaps know nothing of us, or our systems of treatment, or of the business methods we employ. You mayimagine, but youknow nothing, perhaps, of our facilities and advantages for performing cures in cases beyond the reach or aid of the general practitioner. Knowing nothing, then, of all these advantages, you still know as much as the would-be friend or physician who never loses an opportunity to traduce and misrepresent us, and prejudice the afflicted against us.
Now to the point—are you listening? Then permit us to state that we have the largest, the best, and the finest buildings of any like Association, company, or firm in this country. We employmoreandbetterMedical and Surgical Specialists in our Invalids' Hotel and Surgical Institute than any similar Association, company, or individual, and actually have more capital invested. We have a thoroughly qualified and eminent Specialist for every disease that we treat. We treat more cases,and absolutely cure more patientsthan any similar institution in America. In addition to those we treat medically, we perform all the most difficult surgical operations known to the most eminent Surgeons, and so frequently do many of these operations occur with us that some of our Specialists have become the most expert and skillful Surgeons on this continent.
We wish to add further that we are responsible toyoufor what we represent; we therefore ask you to come and visit our institutions; and, if you find on investigation that we have misstated or misrepresentedin any particularour institutions, our advantages, or our success in curing Chronic Diseases,we will gladly and promptly refund to you all the expenses of your trip. We court honest, sincere investigation, and are glad and anxious to show interested people what we can do and are daily doing for suffering humanity. Can a proposition be plainer? Can an offer be more fair and business-like? If, therefore, you are afflicted, and are seeking relief, come where genuine ability is a ruling feature, wheresuccessis our watchword and the alleviation of human suffering our mission.
Whether arriving in our city by day or night,come directly to the Invalids' Hotel and Surgical Institute, 663 Main Street, where you will be hospitably received and well cared for.
Address all correspondence to
WORLD'S DISPENSARY MEDICAL ASSOCIATION,663 Main Street, BUFFALO, N.Y.
WORLD'S DISPENSARY MEDICAL ASSOCIATION,663 Main Street, BUFFALO, N.Y.
Illustration:
For many years the founder of the Invalids' Hotel and Surgical Institute and World's Dispensary has devoted himself very closely to the investigation and treatment of chronic diseases. Some few specifics have, during this time, been developed for certain forms of chronic ailments, and given to the public, but they have not been lauded as "cure-alls," or panaceas, but only recommended as remedies for certain well-defined and easily recognized forms of disease. These medicines are sold through druggists very largely, and have earned great celebrity for their many cures. So far from claiming that these proprietary medicines will cure all diseases, their manufacturers advise the afflicted that, in many complicated and delicate chronic affections, they are not sufficient to meet the wants of the case. These must have special consideration and treatment by a competent physician and surgeon, the medicines and other remedial means required being selected and prepared with reference to each particular case.
In order to be able to offer those afflicted with chronic ailments the most skillful medical and surgical services, Dr. Pierce, many years ago, associated with himself several eminent physicians and surgeons, as the Faculty of the old and renowned World's Dispensary, the consulting Department of which is now merged with the Invalids' Hotel and Surgical Institute.
In the organization of the medical and surgical staff of the Invalids' Hotel and Surgical Institute, several years ago, we assigned to one physician the examination and treatment of diseases of the nervous system; to another, surgical operations and the treatment of surgical diseases; a third had charge of catarrhal and pulmonary diseases and affections of the heart; a fourth attended to diseases peculiar to women; a fifth, to diseases of the eye and ear; a sixth, to diseases of the digestive organs; a seventh, to special surgical cases; to another we entrusted diseases of the urogenital organs; and to others, variousother specialties. Now that our practice has become so very extensive as to require for its conduct a greatly increased number of physicians and surgeons. Thus four physicians and surgeons devote their undivided attention to the examination and treatment of diseases of the urinary and generative organs of men. Three physicians give their sole attention to diseases peculiar to women and three to those of the nasal organs, throat and chest, embracing all chronic diseases of the respiratory organs. Thus we have a full council of three and four physicians in these several specialties. In several other divisions we have two specialists. No case is slighted either in the examination or in the treatment. All doubtful, obscure or difficult cases are submitted to a council composed of several physicians and surgeons. Skilled pharmaceutists are employed to compound the medicines prescribed. For the purpose of enabling us to conduct our extensive correspondence (for we have an extensive practice en every part of the United States and Canada, as well as in Great Britain from our London branch), graphophones are employed, to which replies are dictated, recording the words of the speaker. Afterwards the letters are writtenout in full, generally on a type-writing machine, which prints them in a plain, legible style. These machines are operated as rapidly as a person can think of the letters which compose a word, each operator thus accomplishing the work of several copyists. This system, by which we are enabled to correspond with our patients as rapidly as we can talk, has been rendered necessary by the growth of our business, which has attained immense proportions, giving rise to so large a correspondence that a dozen physicians cannot possibly conduct it all and give each patient's case careful attention, without the employment of graphophones and all other facilities which modern invention has given us. By the adoption of these various means, we are enabled to fully meet the demands of the afflicted, and give every case the most careful attention.
Illustration: FacultyFaculty of Invalids' Hotel and Surgical Institute in Session.—Council-room.
As many persons, particularly young ladies and gentlemen, having catarrh or almost any other chronic disease, especially if of the urogenital organs, are very sensitive and fearful that somebody will know that they are afflicted and employing medical treatment, precautions are taken that none who consult us may incur the least risk of exposure. Although none but the most honorable and trustworthy gentlemen are employed as assistants, yet as aguaranteeof perfect security to our patients, that every communication, whether made in person or by letter, will be treated assacredly confidential, each professional associate, clerk, or assistant, is required to take a solemn oath of secrecy. Great care is also taken to send all letters and medicines carefully sealed in plain envelopes and packages, so that no one can evensuspectthe contents or by whom they are sent.
By thorough organization and a perfect system of subdividing the practice of medicine and surgery in this institution, every invalid consulting us is treated by a specialist—one who devotes his undivided attention to the particular class of diseases to which his or her case belongs. The advantage of this arrangement must be obvious. Medical science offers a vast field for investigation, and no physician can, within the limit of a single life-time, achieve the highest degree of success in the treatment ofeverymalady incident to humanity. A distinguished professor in the medical department of one of our universities, in an address to the graduating class, recently said: "Some professional men seem to be ashamed unless they have the character of universal knowledge. He who falls into the error of studying everything will be certain to know nothing well. Every man must have a good foundation. He must, in the first place, be a good general practitioner. But the field has become too large to be cultivated in its entirety by any individual; hence the advantage of cultivating special studies in large towns, which admit of the subdivision of professional pursuits. It is no longer possible to know everything;something must be wisely left unknown. Indeed, a physician, if he would know anything well must be content to be profoundly ignorant of many things. He must select something for special study, and pursue it with devotion and diligence. This course will lead to success, while the attempt to do everything eventuates unavoidably in failure. Let there be single hands for special duties." Our institution is the only one in this country in which these common-sense-ideas arethoroughlycarried out. The diversified tastes and talents of physicians cause each to excel in treating some one class of diseases, to which he devotes more attention and study than to others. One medical student manifests great interest in the anatomy, physiology, pathology, and treatment of diseases of the eye. He becomes thoroughly familiar with all the minutest details relative to that organ and its diseases, and so thoroughly qualifies himself in this branch of knowledge that he is able to cure an inflammation or other affection of the eye in a very short time. Another student is more interested in some other class of diseases, for the study of which he has a liking, and neglects to inform himself in the ophthalmic branch of medical and surgical science. If after engaging in the practice of his chosen profession, he is consulted by persons suffering from diseases of the eye, he tortures them with unnecessary and oftimes injurious applications, clumsily and carelessly made, and, as the result of such unskillful treatment, the inestimable blessing of sight may be sacrificed.
Illustration: A Corner in Printing Department.A Corner in Printing Department.—World's Dispensary.
The great majority of physicians allow acute maladies, diseases of children, and the practice of midwifery, to engross most of their time and attention. They manifest an absorbing interest in everything thatrelates to these subjects, and devote little or no time to acquiring an intimate knowledge of the great variety of chronic maladies which afflict mankind. They acquire skill and reputation in their favorite line of practice, but are annoyed if consulted by one suffering from some obscure chronic affection, usually turn the invalid off with a very superficial examination, and, perhaps, only prescribe some placebo,[6]apparently indifferent as to the result, but really desiring thus to conceal their lack of familiarity with such diseases. The specialist, the treatment of chronic diseases being his vocation, is equally annoyed if consulted by those suffering from acute diseases, but does not pursue the inconsistent course of assuming to treat them. He refers them to those of his medical brethren whose daily dealings with such cases make them, in his way of thinking, more competent than himself to render valuable service to such sufferers. He recognizes the fact that no man is likely to succeed in any line of study or business for which he possesses no talent or relish, nor does he believe in being a "jack-at-all-trades and master of none."
Having thoroughly qualified himself for the practice of some particular branch of the healing art, the specialist sees no impropriety in acquainting the public with his ability to relieve certain forms of suffering. He believes that medical men should possess equal rights with other business men, and that any code of medical ethics which would deprive him of any of the sacred rights guaranteed to all by the liberal laws of the country, is professionaltyranny, and merits only his contemptuous disregard. Nor does he display any false modesty in themannerof making known his skill. He maintains that he has an undoubted right to place his claim to patronage before the public by every fair and honorable means. He recognizes the display of goods in the merchant's show-windows as no less an advertisement and in no better taste than the publication of a card in the newspaper. So, likewise, he regards the various devices by which the extremelyethicalphysician seeks to place himself conspicuously before the public, as but so many ways of advertising, and as not more modest than the publication of cures actually performed, or than his announcement through the public press of his professional resources for treating certain maladies.
The physician who expresses a "holy horror" of the "advertising doctor," liberally bestowing upon him the epithet of "quack," announceshimselfa graduate, talks learnedly and gives notice to the public insomeway that he is ready to serve them. He endeavors to impress upon the mind of the patient and family his skill, frequently exaggerates as to the extent of his practice, rides furiously about when he has no professional calls, keeps up business appearances by drivingseveral horses, or joins influential societies. He may make a great display in style, manner, dress, pretensions, writing for the newspapers, exhibiting literary pedantry, referring to the superior facilities afforded by some particular school or society to which he belongs; or by editing and publishing a medical journal, ostensibly for the advancement of medical science, but practically to display titles or professorships, to publish reports which flatteringly allude to cases he has treated, the number of capital surgical operations he has performed, or the distinguished families he is treating. All these are butmodes of advertisingprofessional wares; in short, are artful, though not refined, tricks, resorted to for private announcement. We say to all such adventurers in modern advertising diplomacy, that these indirect, clandestine methods are not half so candid and honorable as a direct public statement of the intentions and proposals of a medical practitioner, who thereby incurs an individual responsibility before the law and his fellow-men.
No good reason has ever been assigned why any well educated physician, trained in the school of experience until he becomes proficient in medical skill, may not publish facts and evidence to disclose it, especially when these are abundant and conclusive. The following extracts from an able article by the Rev. THOMAS K. BEECHER embodies a sound view of the subject of medical advertising. He says:
* * "I am glad that the doctor cured him; I am glad that the doctor put it in the paper that he could cure him. And if any doctor is certain that he can cure such diseases and don't put it in the paper, I am sorry. What a pity it would have been had this doctor come to town with his wealth of science and experience and gone away leaving him uncured! What a pity it would have been if he had been so prejudiced against advertising as to read the responsible certificate of the doctor and give him the go-by as a quack! What are newspapers for, if not to circulate information? What more valuable information can a newspaper give than to tell a sick man where he can be cured? If a man has devoted his life and labor to the study of a special class of diseases, the necessity of his saying so becomes all the more pressing. Hisdutyto advertise becomes imperative.
"When I was in England, I found on all the dead walls of London, placards, declaring that Dean Stanley, Chaplain to the Prince of Wales, would preach at such a place; that his grace the Archbishop (I think) of Canterbury would preach at another time and place; again, that an Oxford professor would preach. In short, religious notices were sprinkled in among the theater bills, and the highest church dignitaries were advertised side by side with actors, singers, and clowns. Of course, I was shocked by it, but in a moment I bethought me—if it be all right and dignified to hire a sexton to ring a bell when the minister is going to preach, it is all the same to silence the bell and hire a bill-sticker to tell the same news, the essential thing being to tell the truth every time. The remedy for the lying advertisements is for honest men to tell the truth. 'When iniquity cometh in like a flood, then the spirit of the Lord lifts up the standard.' A really able man, whatever be his gifts, makes a great mistake if he fail to use those gifts through want of advertising."
If a physician possesses knowledge that enables him to remedy diseases heretofore regarded as incurable, what virtue or modesty is there to "hide his light under a bushel"? In this free country the people think and act for themselves, and hence all have a deep concern in the subject of health. The strong popular prejudice against the doctors who advertise is due to the fact, that by this method so many ignorant charlatans are enabled to palm off their worthless services upon the uneducated and credulous; but the practice of such imposition should not cause a presumption against the public announcement of real skill, for the baser metal bears conclusive evidence that the pure also exists.
Every step in scientific investigation, every proposition which relates to the interest and happiness of man, every statement and appeal involving a valuable consideration, must be submitted to the scrutiny and judgment of individual reason; for every person has the right to form his own conclusions, and justify them by experience. Those claims which are only supported by empty assertion are very doubtful. Misty theories vanish before the sun of truth. He who renders professional services cannot be successful, unless he be sustained by real merit.
We can treat many chronic diseases as successfully without as with a personal consultation, as our vast experience enables us to correctly determine the malady from which the patient is suffering, from a history of the symptoms, and answers to questions furnished. We have not seen one person in five hundred of those whom we have cured.
Some may suppose that a physician cannot obtain, through correspondence, a sufficiently accurate idea of the condition of a patient to enable him to treat the case successfully; but a large experience in this practice has proved the contrary to be true, for some of the most remarkable cures have been effected through the medium of correspondence. In most long-continued cases, the patient has thought over his symptoms hundreds of times. The location of every pain, whether acute or mild, constant or occasional, and the circumstances under which it occurs, have been carefully noted. He has observed whether he had a rush of blood to the head, was feverish or chilly, whether troubled with cold hands and feet, whether full of blood, or pale and bloodless; and he states these matters with accuracy and common sense when writing to us, for he has a very good, if not a professional, knowledge of the relative importance of these symptoms. So in regard to digestion, he states what kinds of food agree with him, or whether he is troubled with excessive acidity or a flatulent condition of the stomach. He also informs us whether his tongue is coated and bilious, or clean and healthy, and gives many other particulars too various to enumerate,by which we are enabled to gain a perfect understanding of the case. If his description be not sufficiently complete to enable us to obtain a definite understanding of the case, he is requested to answer a list of important questions which are sent him. The people are far more intelligent in these matters than physicians are generally willing to admit. A patient is often confused while being personally examined by a physician, and gives imperfect or incorrect answers. After he has left the presence of the physician, he finds that he has failed to enumerate many of the most important symptoms. In consulting by letter, the patient is not embarrassed, he states the exact symptoms, and carefully reads over the letter to see if it is a complete and accurate description of his sufferings. In this way he conveys a much better idea of the case than if present in person, and subjected to the most thorough questioning and cross-examination. The timid lady and nervous young man write just as they feel; and one important reason why we have had such superior success in treating intricate and delicate diseases, is because we have obtained such true and natural statements of the cases from these letters, many of which are perfect pen-pictures of disease. As bank-tellers and cashiers, who daily handle large quantities of currency, can infallibly detect spurious money by a glance at the engraving or a touch of the paper, so the experienced physician, by his great familiarity with disease, becomes equally skilled in detecting the nature and extent of a chronic malady from a written description of its symptoms.
A careful microscopical examination and chemical analysis of the urine is a valuable aid in determining the nature of many chronic diseases, particularly those of the nervous system, blood, liver, kidneys, bladder, prostate gland and generative organs. This important fact is not overlooked at the Invalids' Hotel and Surgical Institute, where an experienced chemist is employed to make such examinations and report the result to the attending physicians. Medical authors, professors, and practitioners of all schools, admit and even insist upon the importance of such examinations in diagnosticating diseases. Many practitioners neglect to take advantage of this invaluable aid, while others fear that if they attach much importance to such examinations they will be ranked with "uroscopian" or "water" doctors, a class of enthusiasts who claim to be able to correctly diagnosticate every disease by an examination of the urine. Persons consulting us and wishing to avail themselves of the advantages afforded by these examinations can send small vials of their urine by express. The vials should be carefully packed in saw-dust or paper and enclosed in a light wooden box. All charges for transportation must be prepaid, and a complete history of the case including the age and sex of the patient, must accompany each package, or it will receive no attention. This saves valuable time by directing the examination into the channels indicated, thus avoiding a lengthy seriesof experiments. As we are daily receiving numerous vials of urine, every sample should, to prevent confusion, be labeled with the patient's name.
Illustration: Binocular MicroscopeBinocular Microscope used at the Invalids' Hotel and Surgical Institute.
Illustration: Fig. 1.Fig. 1.
There is a natural, definite proportion of the component elements of every solid and fluid of the human body. These proportions have been reduced to definite standards, a deviation from which affords evidence of disease. Thus, there being a fixed standard in a normal proportion of the elements of the blood, any deviation from it, as in anæmia, leucocythæmia, etc., indicates disease. So also thestandard proportion of the urinary elements being known, any considerable change, either in quantity or quality of its parts, bears unmistakable evidence of disease. The invention of the microscope has provided increased facilities for detecting diseases by examination of the urine. By the aid of this wonderful instrument, we are enabled to discover with absolute certainty the various urinary deposits characteristic of different maladies; thus in Fig. 1, A represents in a general way the sediment of abnormal urine as seen under the microscope. In division B is represented oxalate of urea upon precipitation by oxalic acid. Nitrate of urea is represented in division C. A deficiency of urea in the urine, with albumen and casts present, is a most important guide in the diagnosis of Bright's disease. The average quantity of urea present during health is 21.57 parts in 1,000. The microscopic examination of the urine, notwithstanding the distaste, and even contempt, which many physicians manifest for such investigations, is pursued at the Invalids' Hotel and Surgical Institute, with inestimable benefit to our patients. It has revealed the existence of many serious affections, which, with all our other modes of investigation, we might have been unable to detect. It has also thrown light upon many obscure chronic diseases.
Illustration: Fig. 2.Fig. 2.
We have already spoken of the marked changes effected in the urine by a derangement of the digestive functions. It is a matter of surprise that physicians generally pay so little attention to the urine when dyspepsia is suspected, since all admit that an examination of that excretion furnishes unmistakable evidence of the nature and complications of the disease. In this way we are many times enabled to determine whether the indigestion is caused bycongestion or functional disease of the liver or kidneys or by nervous debility. And when such cases are treated in accordance with the indications furnished, increased success attends our practice. In Fig. 2 highly magnified urinary deposits, which indicate impairment of the digestive functions, are represented. The crystals are composed of oxalate of lime and appear in the different forms shown in the five sections, of octahedral, decahedral, round and dumb bell shapes. The latter are formed in the kidneys, and are sometimes discovered adhering to casts.
Illustration: Fig. 3.Fig. 3.
Illustration: Fig. 4.Fig. 4.
The various forms of gravel, Bright's disease of the kidneys, hæmaturia, inflammation of the kidneys and bladder, diabetes, and other functional and organic diseases of the urinary organs effect characteristic changes in the urine, thus enabling us to distinguish them with certainty and exactness. Some of the various microscopical appearances of the urinary deposits in diseases of the kidneys and bladder, are represented in Fig. 3. In division A is represented pus and mucus, with decomposition, indicating suppuration somewhere along the urinary tract. In B pus globules are alone represented. In the division marked C are shown blood corpuscles as they are arranged in blood drawn from a vein or artery. D represents the same separated, as they always are when present in the urine. In E highly magnified oil globules are represented. If present in the urine, they indicate disease of the kidneys. In F are represented epithelial cells, the presence of which in large numbers is indicative of diseases of the mucous lining of the urinary organs.
Fig. 4 represents the microscopic appearance of phosphates in the urine. These are present in great quantity in cases of nervous debility and kindred affections. By attaching thecamera lucidato the microscope we can throw an image of these urinary deposits upon paper. By the art of the engraver this may be faithfully traced, and thus we are enabled to produce an accurate representation of them. Some of the beautiful crystalline deposits shown in Fig. 4 represent less than a millionth part of a grain, yet their forms are delineated with geometrical precision. Earthy phosphates are often mistaken for pus and also seminal fluid. Phosphates are always found in decomposed urine, otherwise they indicate brain affections, acute cystitis, etc. Experience has taught us that the voiding of urine loaded with phosphates is a forerunner of cystitis, or enlargement of the prostate gland, or both. In fact, persons so affected are "prone to serious consequences from mild attacks of almost any and every acute disease."
Illustration: Fig. 5.Fig. 5.
Fig. 5 represents the microscopic appearance of mixed urinary deposits. In division A is represented fermentation spores as they appear in diabetic urine. Pasteur asserts that the germs of this fungus get into the urine after it has been passed. Urates appear in division B. These indicate waste of flesh, as in fevers, consumption, prolonged physical efforts, etc. Division C pictures urates of ammonia. These appear in alkaline decomposition of the urine; it is isomeric with uric acid in acid urine. In division D is represented urate of soda, which is present in the tissues of persons suffering from gout. The crystals shown in division E consist of the same salt.
Illustration: Fig. 6.Fig. 6.
In Fig. 6, division A, is represented purulent matter as it appears in the urine. The formation of pus in different parts of the genitourinarysystem is accompanied by the appearance of pus corpuscles in the urine. When fat globules, represented in division B, are found in the urine, they indicate fatty degeneration. In division C are representations of the cells found in the urine of persons suffering from cystitis or other inflammatory diseases.
Illustration: Fig. 7.Fig. 7.
Fig. 7, divisions A and B, represent different forms of cystine. Fortunately this substance is rarely found in the urine. When present however it indicates liability to, or the actual presence of, a calculus or stone in the bladder. In division C is a representation of the deposits seen in the urine of those who are greatly debilitated. In division D are seen epithelial cells mixed with mucus.
Illustration: Fig. 8.Fig. 8.
In Fig. 8, division A, are represented the caudated cells from the deep structure of the bladder. The cells represented in division B are amyloid concretions, found where there is an enlarged prostate gland.
Fig. 9 represents the appearance of spermatozoa as seen in the urine. When present, they afford indisputable evidence of the escape of semen in the renal excretions.
We might add many other illustrations of urinary deposits and state their several indications, but a sufficient number has been introduced to show the importance and practical value of microscopic examinations of the urine in revealing obscure diseases.
Although the microscope is of inestimable value in examining the renal excretion, it does not entirely supersede other valuable instruments and chemical re-agents in determining constitutional changes. By the urinometer we determine the specific gravity of the urine; by the use of litmus its acid or alkaline reaction, is ascertained; while various chemicals, when added to it, produce certain specific changes, according to the morbid alterations which it hasundergone by reason of disease. By the application of heat, or the addition of a few drops of nitric acid, the albumen, which is invariably present in Bright's disease of the kidneys, is coagulated. By the employment of other re-agents we may determine the presence of sugar—a characteristic of diabetic urine. And thus we might mention almost innumerable chemical tests by which the several changed conditions of the urine,characteristicof different diseases, may be ascertained withabsolute certainty.
Dr. Eberle, a distinguished allopathic author, thus writes: "Whatever may be the disease, the urine seldom fails in furnishing us with a clue to the principles upon which it is to be treated."
Dr. Braithwaite also says: "We can arrive at a more accurate knowledge respecting the nature of diseases from examining the urine than from any other symptom."
Golding Bird, whose writings are regarded as sound and practical by the most learned of the medical profession, says: "The examination of the urine in disease is now regarded as one of the most important aids in diagnosis, and which it would be injurious alike to the welfare of the patient and the credit of the practitioner to avoid."
Illustration: Fig. 9.Fig. 9.
The eminent Dr. F. Simon writes as follows: "From the physical and chemical state of the urine, the attentive and observing physician may obtain a great quantity of information for ascertaining and establishing a diagnosis. More than all other signs, the correct examination of the sediment is of importance to the physician. * * * For the medical man it is the compass which guides him in the unlimited chaos of disease and its treatment; for the patient it is the thermometer of his condition, the premonitory indication of the decrease or aggravation of his malady; and for the healthy man it is the regulator of his diet and his life. Every one is aware of the variations of the barometer, and we know that the fluctuations of the column of mercury are closely associated with the variable conditions of the atmosphere; so, to the practical observer, variations of the urine, as well as the elements composing it, point out with certainty the changes in health, and the condition of the organs."
While we recognize the importance of examining the urine as an aid in distinguishing diseases, and have made this old German method ofdiagnosis a special study, yet we do not claim thatalldiseases can be unmistakably distinguished by such examinationsalone. We take a conservative position and have no confidence in that class of ignorant fanatics whose pet hobby is "uroscopy."
From every person who solicits our professional services, we require explicit answers to numerous important questions, that we may know the age, sex, vocation, etc., as well as the prominent symptoms manifested.