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year, a minister, who was cured by taking a long rest. I could not do that, as "loafing" kills me.
If you, or any of your readers can suggest any help I would be most grateful. Will gladly answer any questions. Have been a WORLD reader ever since I have been in practise.
Hoping to see some replies and wishing you long life and best of success, I remain
CHARLES M. COLLINS.
Utica Bldg., Des Moines, Iowa.
[Since you give us insufficient data upon which to base a diagnosis, we are forced to accept your own. The prognosis in the type of neuritis you describe is generally good, and recoveries are frequent, tho it may persist for months or even years. Your trouble may be due to a sprain or to the local effect of "catching cold." Complete rest is the first indication, and it is unlikely that you will secure_improvement unless you do give the arm rest. Immobilization by a splint would be the ideal method of enforced rest while you go about your professional duties. A fly blister over the affected area would probably do good previous to immobilization. A long course of applications of tincture of iodin, while the parts were immobilized, would be rational treatment. Immersion in hot water for several hours, once a day, would probably banish the pain, if bath were followed by fixation as suggested. Massage and electricity are harmful in the early stages, and should be reserved for the final treatment, in effort to combat any possible atrophy of muscular structure subsequent upon the long continued nerve inflammation.
Nondescript pains, such as you mention, have been cured by injection into the area of a solution of quinin and urea hydrochlorid or of cocain. Another good method is freezing by ice and salt or by spraying ether by means of an atomizer, using an emollient ointment after the freezing.-ED.]
Child Slow to Talk.
FEDITOR MEDICAL WORLD:-I would like to have some advice or your opinion on the following case: Girl, age 5 years, normally developt, bright looking, but has never talkt except saying a few words, as mamma, baby, etc. Understands everything said to her fairly well. She is very nervous at times, especially so on waking. Takes crying spells often and yells like insane. Family history good. None of relations on either side have been insane or had any disease that tends to lead to insanity.
Have tried various treatments, among them the thyroid gland preparations, but none have in any way proved beneficial.
Any advice that you or the profession at large can give me will be highly appreciated. Mill Spring, Mo.
R. J. OWENS, M.D.
[Your description is insufficient to enable us to identify the condition with any pathologic state. Some children are very slow in learning to talk, without being abnormal or pathologic in any way. We certainly do not advise "doping" her with thyroid or any other agent unless there is a clean-cut indication, and a clear idea of what is hoped to be accomplisht. We have known of a number of similar instances, in which the children learnt to talk by the time they were 8 or 10 years of age, and never, later in life, manifested any discoverable mental or physical abnormality traceable to their tardy vocal expression. We advise "hands off" unless some actual call for treatment be manifest, and simply persist in the effort to teach the child to talk.
Speech may be stimulated by compelling the child to name the things she wants, particularly at the table.-ED.]
Neuritis or Paraplegia.
EDITOR MEDICAL WORLD:-About three months ago a very interesting case came to my notice and I am most anxious to have some one suggest something to give relief or effect a cure. This patient has been unable to use his legs or stand up without support for six years. Otherwise is normal and this case has baffled a great many of the profession, I being the thirteenth called to attend him.
G. S., aged 49, married; height, 5 feet 8 inches; weight, 190 pounds; father of three children, all well and living, the youngest 12 years of age, the oldest 21 years. White. Austrian by birth. Father died at the age of 69 from pneumonia. Mother died at the age of 40 from tuberculosis. Occupation, operated a steam hammer. While at work, right side exposed to heat and left side exposed to draft. Perspired freely. Never had anything ailing him before, excepting about twelve years ago, when he fell on his back, striking a plank ("Am Kreuz," as the patient said). Was confined to his bed for about a week. Was obliged to have a helper about his work for two weeks more. Since then in perfect health up to his present illness.
About six years ago a sensation of heaviness appeared in his limbs, and he gained the impression that his body was too heavy for his feet. During the first year had a great deal of pain thru the pelvic region, small of back and thru the limbs. The pain was most severe at night in the small of his back. When attempting to sprinkle the lawn with the hose, or coming in the presence of water anywhere, the pain seemed to be aggravated. The legs felt heavy below the knees. He had tried the Kneipp treatment, but in the language of the patient, "it put him on the bum."
For the first year he was confined to his bed nearly the whole time. The second and third years he was up and around with the aid of a cane or crutches. The fourth and fifth years he was sitting in a chair most of the time; during all the six years unable to work. At present he is able to be about only with the assistance of crutches or canes. During all of the time, he had been suffering very severe cramps and in constant pain thru the pelvic region and small of back. The cramps were of a nature of knotted muscles. At the present time he does not complain of the cramps.
The patient disclaims ever having had any venereal trouble, and when well, had been in the habit of taking four or five glasses of beer a day and after work a glass of whiskey.
Examination of spine reveals no curvature or pressure on spinal cord. The patient's left leg is worse than the right. Is able to bend the right knee and ankle, as well as move his toes on this foot. The left leg, however, he must lift with his hands and cannot voluntarily bend it at the knee or ankle. Is, however, able to slightly move the little toes. No motion in the big toe. Ankle is swollen to twice its normal size. After sundown both legs and feet get cold. M. J. CAREY. Cleveland, Ohio.
[We are not able to make a definit diagnosis, but suggest careful examination with neuritis in mind. We suggest the trial of prolonged hot baths, with ice to the head. We are publishing the case in hope of suggestions from other members of the family.
It is possible that there is a degeneration of the upper neuron, within the cerebrum. To determin this definitly you will need to make an extensiv physical examination, testing reflexes, muscle action, reaction of degeneration, etc. You will find an outline of that kind of an examination in any good volume on neurology or diagnosis, such as Potts' "Mental and Nervous Diseases," publisht by Lea & Febiger, Philadelphia.-ED.]
How Do You Treat Arthritis Deformans?
EDITOR MEDICAL WORLD:-By the medical profession arthritis deformans is known as one of the most persistent and intractable diseases; and during the acute stage, where several joints are involved at one time, as a very worrying and painful disease. I find myself a victim of the disease mentioned, and it would be difficult to adequately describe the miserableness experienced. Thru these lines I appeal to the medical profession. Any doctor who may read these lines and has had much experience with the above-mentioned disease who knows of a treatment that will favorably influence the course of or mitigate the suffering, will do me a great favor by writing me in regard to the matter. Is the extract of thymus gland worth trying? Fruitland, Md. J. I. T. LONG, M.D.
Yes, extract of thymus gland is worth trying, beginning with a small dose and gradually increasing. We have been moderately successful with a combination of colchicin, 1/150 grain, and methyl salicylate, 3 minims, in capsule, giving 1 or 2 capsules an hour after each meal. In addition, after the acute stage is passed, massage and passiv action are valuable to restore mobility. We would be glad to hear from our readers on this subject.— ED.]
EDITOR MEDICAL WORLD:-I have been troubled more or less for four or five years with paralysis agitans in my right hand. I can't tell for the last two or three years if there is any material change. There is no pain and otherwise my health is good. I am 68 years old. Have been regular in the practise of medicin for 411⁄2 years, or since the spring of 1873. I do not use either whiskey, coffee or tobacco in any form or quantity; did use some coffee more than twenty years ago. I want relief. Can you give it? If not, do you know of anyone that can? I have been expecting every month to see an article in THE WORLD on such troubles, but have not so far. Any information will be gratefully received. Greenfield, Tenn. H. F. HUDSON, M.D.
[Hyoscyamus: Full doses of the tincture will palliate the trembling.
Hyoscin: Temporarily but effectually controls the trembling, but if used continually will lose its effect.
Duboisin: Acts like the two preparations above, 1/100 grain by the mouth three times daily.
Chloral. Depresses the motor tract of the spinal cord, and is of value in this affection.
Spartein: Grain 4 to grain 1⁄2, thrice daily, has proved of service.
Gelsemium: In full doses quiets the nerve irritation; and a combination of gelsemium, conium and hyoscyamus is often used.
Cannabis indica: In large doses lowers reflex activity.
Picrotoxin has greatly benefited some cases.
Opium with arsenic and hyoscyamin has given good results.
Sodium borate: Grains 15 to 45, daily, in three or four doses, has given striking results in certain cases.
Orchitic extract has been used with apparent benefit.
Sulfur baths are certainly of great value in this disease.
Cupping over skin of spinal region with dry cups to dilate the vessels of the cord and so improve its nutrition.
Electric baths cause recovery or lasting improvement.
The above list is extracted from various authors for your benefit, and some of the suggestions will doubtless make you more comfortable. You know, of course, that the disease is absolutely incurable.-ED.]
EDITOR MEDICAL WORLD:-I would like to ask you a question. According to the consensus of medical opinion, is it in any way injurious for an inveterate tobacco smoker of years' standing to quit the habit entirely? In my opinion, it is not, but I would like to know the best opinion on this subject. GEO. NELSON DOLBECK.
111 East 28th St., New York City.
[We have no knowledge of any publisht consensus of opinion representing any material proportion of the medical fraternity's ideas regarding this matter. Isolated individuals have, from time to time, ventured radical opinions on the subject. Our opinion is not worth more than that of any other intelligent practician of extended experience, but we have frequently observed cases where we were convinced grave harm had resulted from aged men suddenly abandoning a habit to which they had been accustomed from childhood. The too radical man frequently errs. Even if one be opposed to the use of tobacco, he need not be so rabid as to attempt convincing himself that it is altogether an evil. Smokers rarely suffer from constipation, and many tobacco users find it a positiv aid to digestion. We cannot think that so powerful a drug can be safely and abruptly discontinued after almost hourly indulgence thru a lifetime. We are not, however, advising any one to contract the habit.-ED.]
DEAR DOCTOR TAYLOR:-Can you give me any advice in the following case?
Miss A. W., aged 20, single, of good parentage (farmers), good home surroundings, is well-developt, well nourisht, weight 120 lbs., height 5 ft. 3 in., has convulsions every menstrual period for 4 years, usually 5 or 6 hours after the flow has started. I can find nothing that would cause same; pelvic organs seem normal; urin normal; bowels regular. These convulsions are both tonic and clonic. At times she will strike with hands and feet so violently that they must be held by strong men, these attacks lasting from 15 minutes to half an hour. If left alone she will go out of one into another from 1 to 10 or 12 seizures. I usually give her a hypo of hyos., morph. and dig., which usually puts her to sleep for 6 to 12 hours, wakes up and is over it until next time. When the attacks are tonic, then all her muscles are drawn up into a knot, mouth and eyes wide open. When such attacks are on she is certainly a sight to see.
lasts 5 to 10 minutes. clonic spasm and her her. She could not strike; she at once went into a tonic spasm, and a bad one, too.
To-day she went into a father and brothers held
Now I have given her all the various treatments I know of. H. v. c. before menstrual period; dicrotalin for her nervous system, thinking that might help, but to no avail. Now, can you suggest from what I have stated, anything that would be of benefit to her? DR. L. M. FRIEDRICH.
[If the attacks are only in evidence at the menstrual period, the way to a diagnosis is pointed out. The irritation and congestion about the pelvis incident to the flow is evidently the cause of the attacks, and if a cure be brought about, it must be by making the molimen a normal one. It is a possibility that you have an epilepsy to deal with, or the attacks may be hysteric in nature.
We suggest that you make sure that the bowel functions are properly performed at all times, and the only way we know that you can make sure is by the nightly administration of a laxativ like Drysdale's aperient pill, cascara sagrada, or phenolphthalein. For three nights before the appearance of the flow we suggest a hot sitz bath of twenty minutes' duration, with due caution about passing immediately from the bath to bed. At the same time, on retiring, we would use a glycerin and iodin vaginal depletiv suppository or vaginal tampon. Examin the os uteri and see if a uterin sound will pass freely-which is not likely. If it does not, dilate and curet. Curetment is to be followed by swabbing out the uterus with Churchill's tincture of iodin, and the curetment may have to be_repeated several times.
Iron, manganese and strychnin should be used in full dosage over a length of time. Bulkley's uterin tonic pill every quarter to one hour at about the beginning of the period, has helpt similar cases.-ED.]
DEAR DOCTOR TAYLOR:-I wish you would write an article in THE WORLD on neurasthenia and its treatment. I've had it for four years. My appetite and digestion are good. Insomnia is the only symptom that bothers me. Veronal is the only hypnotic I take; I take 5 grains twice a week, but I find that 10 grains act better. I'm uneasy, afraid I'll form a drug habit. I'm 62 years old, have head noises some; I weigh 195 lbs. What kind of physical culture do you think would help me most? I've been practising thirty-four years, so I hate to give up just now. Joshua, Texas.
J. T. SELMAN, M.D.
[Neurasthenia is too large a subject to take up in THE WORLD, for it would occupy many columns, and most readers prefer searching textbooks devoted to neurology, anyway. Without further details, it would not be possible for us to make any suggestions of value for the treatment of your case. As to the insomnia, we think you need not fear to take 10 grains of the drug as often as you need it, as that is not an excessiv dose. You are in no danger of forming a habit as long as you only require it twice a week. Drug habits are formed when the dose is regularly increast, and the drug is used regularly and daily.
At your age you should not attempt any violent exercise. All you require is regular, mild, muscular activity. Walking, riding, etc., cover the ground.
Oleoresin black pepper.
40 grain . grain grain
Solution iron chlorid, q. s. to make 1 pill.
Antimalarial "minnie balls" frequently miss the mark, so we believe 'tis better to use "doublebarrel shotgun" doses hereabouts. In one year there have been five cases of typical yellow chills within one mile of my office. These in addition to numerous cases of other manifestations of pernicious malaria.
Thanking you in advance for your attention.
[There is nothing incompatible in either of the prescriptions, but about 2 grains of quinin is as much as is generally used in a dram mixture. There would be no harm in adding not only a little more alcohol, but also a little more acidthe latter to improve the solution of the quinin. Immense doses of quinin are used in pernicious malarial fever, as much as 90 grains at a dose being nothing unusual for some practicians.-Ed.}
Spastic Paraplegia or Friedreich's Ataxia.
EDITOR MEDICAL WORLD:-Will you kindly give me assistance in diagnosis and treatment of the case, history of which is written on inclosed sheet? I have diagnosed it spastic paraplegia, and treated it by massage, electricity and general tonics. I have described the condition as nearly as possible to do so.
The condition has been diagnosed many different things, and some by good physicians, too. White, male, aged 14 months. Weight at birth, 7 pounds. Present weight, 20 pounds. Mother and father perfectly healthy. Birth of this child took fourteen hours, terminated after injection of pituitrin and traction by hand.
Mother nurst child for first three months, then until nine months fed on Mellin's food, at which time it weighed but 15 pounds. We then changed it to cows' milk, and in the five months it has gained 5 pounds.
Present condition: Color slightly anemic, well nourisht, never sick, no fever, etc.
At nine months of age it was noticed child could not hold its head up and had no control over action of hands and arms. All movements were of spastic nature; try to grab articles, but could not control action of hands and arms.
condition continued and at present time, child 14 months old, weight 20 pounds, eats and sleeps well. Eyes normal. Hearing good. Action of kidneys and bowels good. Sweats very much at night, especially about the head. Can't hold head up. Can't walk. Has no use of legs and spine. Movements of arms spastic, hands in crampt position most of the time. Notices music, flowers or anything, same as any child of 14 months. Can't speak any words, but seems to understand when talkt to.
Tries to grasp articles in hand and will move arms and hands, and if it strike article will hold it and shake it about. But all movements are irregular and of spastic nature.
Treatment has been massage and general tonics.
Would like any suggestion or helpful hints in the treatment of the foregoing case; will appreciate any help greatly. DR. A. R. RICHEY.
Herreid, S. Dak.
Add the chlorid of lime to the water, shake well and then set aside for a week, then decant the clear liquid and to it add the borax solution.
For use, saturate the spot with solution a, apply a blotter to take up the excess of the liquid, then apply solution b. When the stain has disappeared, apply the blotter and wet the spot with clean water; finally dry between two sheets of blotting paper.
A good single solution which will answer for erasure of many inks is prepared by mixing citric acid and alum in equal parts. The powder is spread well over the spot and rubbed in with the fingers. A drop or so of water is then added, and also rubbed in. A final rinsing off with water, and then drying of the paper completes the process.-En.]
DEAR DR. TAYLOR:-Knowing your vast experience with so many cases, am coming to you for information:
Tubercular patient, white, aged 36, has fistula at junction of ascending colon and cecum, of eleven months' standing. Patient was operated
on for appendicitis a year ago, in which fistula developt in February last. Was reoperated on in April of this year, when gut was closed and drainage left in cavity, as there was considerable pus at time of last operation. In six weeks' time the fistula was open, and draining fecal matter as much as ever.
Has been treated with Beck's paste, alcohol and iodin half and half. Patient went to Asheville, N. C., first of last July, where he was treated by packing with iodoform gauze twice a day for three months with some benefit, gaining fifteen pounds during his stay there, but the opening is still there, discharging as much as ever. Any assistance you or any of the brethren can give me will be greatly appreciated. There is no specific trouble. W. M. TURNAGE.
[Such cases are always discouraging. course, only an operation will result in a cure, but the chances are nearly all against a successful operation. It is useless to try paste, packing, iodin, or anything else. If he could maintain the improvement indicated by the gain in weight at Asheville, there might be hopes of success by another operation. Unless his physical condition can be improved and toned up there would not likely be any use in suggesting another operation. We are sorry that we cannot offer greater encouragement. Why not first try to cure the tuberculosis by hygienic, dietetic and tuberculin or calcium creosote treatment? Send him to a climatic resort for tubercular patients.-ED.]
Remedies for Indigestion Must Be Properly Prepared and Sold While Fresh.
The Service and Regulatory Announcements of the Bureau of Chemistry, U. S. Department of Agriculture, Washington, D. C., state that examination of a number of products which purport to contain certain enzymes or ferments supposed to be useful in promoting digestion shows that these contain little, if any, of these activ agents. Further investigation shows that the manufacturers frequently have employed a sufficient quantity of pepsin, diastase, pancreatin, trypsin, or similar material, but in many cases no attempt has been made to determin whether the material used is really activ. In certain cases, manufacturers have combined pepsin and trypsin, which tend to negativ each other, and in other cases they have used pepsin in alkalin media, which destroy its activity, and have combined trypsin with acid substances which are not suited to it. Under certain methods of preparing the remedies, heat is applied to a degree that may destroy the activity of the pepsin or other enzymes. Similarly, many of these substances which owe their properties to the action of enzymes are put up in too strong alcoholic solutions or in other ways which lessen their effectivness.
The great trouble with many of these preparations, however, is that they do not keep well, and while activ at first, after a time lose their digestiv activity. The Department of Agriculture therefore warns manufacturers that preparations claiming to contain digestiv enzymes should be put up in such a way that they will have suffered little, if any, loss of activity when sold to the consumer.
In the case of preparations which are liable to
For some years the Dr. Jiroch Company, 533 South Wabash Avenue, Chicago, has been conducting a mailorder medical concern. On June 24, 1914, the federal authorities declared the concern fraudulent and denied it the use of the mails. The attorney for the Dr. Jiroch Company was Fletcher Dobyns, of Chicago, the same man who appeared in behalf of a similar fraud operated from Detroit, the "Interstate Remedy Company." The Jiroch fakery also introduced, thru its attorney, a physician, who attempted to justify the methods of this concern. This physician was Dr. Nathaniel H. Adams, of Chicago, member of the Chicago Medical Society and, thru this membership, Fellow of the American Medical Association.
The methods of the Dr. Jiroch Company were investigated some time ago by the Journal, and much of the matter that follows was written nearly two years ago. Other matters prevented the completion of the "story" and it was filed away.
As in all such cases, the physician whose name gives the title to this fraud has been but a mere stool-pigeon. At the time of the Journal's investigation the real men behind the scheme seem to have been Melville W. Johnson, Garrett, Ind., president; A. G. Hagerty, secretary; Thos. R. Bradford, treasurer; F. W. Jiroch, medical director.
Jiroch was a student at the Harvey Medical College at Chicago at the time this low-grade institution went out of existence. He then seems to have gone over to Jenner Medical College, Chicago, by which school he was graduated in 1906, receiving a license to practise, from the State of Illinois, the same year. The practical man of affairs in the Dr. Jiroch Company seems to have been Thomas R. Bradford, who, It is said, was formerly with a somewhat similar fake concern, the "Blair Remedy Company," of Chicago. Bradford, apparently, is an old hand at mailorder medical frauds. In 1904 Thomas R. Bradford was operating a business in Cincinnati under the name of "Bradford & Company." The scheme was an attempt to sell an alleged cure for "lost vitality, sexual debility," etc., and was put out of business by the federal authorities in December, 1904.
The Dr. Jiroch Company obtained its victims thru advertisements placed in the cheaper weeklies and daily papers. In addition, the concern bought or rented "sucker lists" either from letter brokers or from concerns in a similar disreputable business. enormous amount of circularizing was done, much of it in a haphazard way; the member of the Journal staff, who has corresponded under assumed names with various medical frauds, was richly favored with Jiroch "bait," altho he had never written to the concern, showing that these names had been purchased or rented.
While, in what follows, Jiroch's name is used as tho he was the one individual responsible, it should be borne in mind that he was but the "hired man" of the concern. Nevertheless all letters were signed (in facsimile) with Jiroch's name and the victim was led to believe that Jiroch gave personal and individual attention to each case.
The prospectiv victims were sent circular letters, printed in imitation of typewriting. With each letter was a brilliantly colored "certificate" that was alleged to entitle the holder to a "Special Free Proof Treatment and Diagnosis." Not all the "certificates" were the same; they varied in color and in the series of questions askt. Some were sent to those supposed to be suffering from "female trouble," others to those presumably deaf, still others to those whose ailments were of a general or indefinit nature. But whatever kind of "certificate" was sent they all offered the "Special Free Proof Treatment and Diagnosis."
Those who answered the advertisements or who sent in the "certificates" received a "free proof treatment" consisting of two small boxes of tablets, one kind pink, sugar coated and ovoid in shape, varying in number from four to six; the other white or very
faintly pinkish, sugar coated and cylinder shaped, varying in number from seven to fourteen. By the same mail a circular letter came giving directions as to the use of the "free treatment." This "letter" also was prepared in imitation of typewriting and the name of the individual to whom it was sent was filled in by means of a typewriter. All of the "proof treatments" seem to have been identical irrespectiv of the age or sex of the persons to whom they were sent or whether the recipients were suffering from consumption, rheumatism or malaria.
Within twenty-four hours of receiving the "free treatment" the patient had inflicted on him, unaskt, a "full-size treatment." This came in a cardboard box holding four small boxes numbered respectivly, "1." "2," "3" and "4." The boxes were labeled as follows:
Box 1: "Prescription No. 16759. Directions: Take one tablet before or after the morning meal. Swallow with a little water."
Box 2: "Prescription No. 29408. Directions: Take one tablet before or after the noon meal. Swallow with a little water."
Box 3: "Prescription No. 30651. Directions: Take one tablet before or after the evening meal. Swallow with a little water."
Box 4: "No. 4039. Directions: Take one tablet at bedtime, or as often as necessary to insure about two movements of your bowels each day."
The tablets labeled Prescription No. "16759" that came in Box 1 are white or faintly pinkish, sugar coated, cylindrical-shaped tablets, apparently identical with part of the "free proof treatment."
The tablets in the box labeled Prescription No. "29408" were large, bright yellow, sugar-coated tablets.
The tablets in Box 3-Prescription No. "30651"were brown, uncoated tablets oval in shape.
The tablets in Box 4, labeled "No 4039," were apparently identical with the pink tablets that came with the "free proof treatment.'
Analysis of the "Treatment."
A complete set of the "Dr. Jiroch Treatment" was subjected to examination in the Association's laboratory, and the chemists' findings may be briefly summarized as follows:
Box 1 (R 16759): These pinkish pills were found to contain licorice root, starch, some vegetable extractiv and a trace of alkaloid, apparently strychnin. Box 2 (R 29408): These yellow pills were found to have for their chief constituents powdered licorice root and cornstarch with small quantities of vegetable extractiv.
Box 3 (R 30651): These tablets, according to the chemists, were found to consist essentially of cornstarch and extract of nux vomica. Quantitativ analysis indicated that the total alkaloidal content was equivalent to about 1/3 grain of nux vomica in each tablet.
Box 4 (R 4039): These pink pills were found to consist essentially of starch and aloes, with a trace of strychnin. No other medicinal ingredient was found.
What Were the Diagnoses Worth?
We have said that the second letter from Jiroch to his prospectiv victim gave what purported to be a "diagnosis" of the patient's case. As a matter of fact, this diagnosis, so called, was one that could have been made by the girl typists who filled it in on the imitation typewritten letters-and perhaps was. Did the person put crosses against "rheumatism," "indigestion" and "piles," Jiroch made a "diagnosis" that the person was suffering from rheumatism, indigestion and piles. This was the method by which these quacks cajoled their victims into believing that a physician had carefully studied their cases and diagnosed their ailments.
To show the worthlessness of Jiroch's "diagnoses," the Journal had "symptom blanks" sent to the company from various parts of the country and describing widely varying forms of ailments. In every instance Jiroch sent the free trial treatment and followed it up immediately with his "full-size treatment," together with a "diagnosis" letter detailing the very symptoms that had been sent in. The "fullsize treatments" that were sent were all the same, whether the supposed patient was suffering from consumption, rheumatism or Bright's disease. One letter was sent from Virginia and a cross was put against the following list of symptoms: "Spit up mucous and slime." "Pain in the back."
"Heartburn and indigestion."