Two T.L.s. (signature apparently in inkstamp) from Richard Palmer, President of Tyrrell's Hygienic Institute (152 West 65th Street, New York, N.Y.) to Mrs. R.W. Costilo, Foxboro, Mass. in 1923, offer information about the company's products and highlight its "J.B.L. Cascade" Treatment, "one of the most common-sense and practical methods, in our professional opinion, for preventing and relieving most of the diseases known to the world." The letterhead indicates that Tyrrell's Hygienic Institute owns "The 'J.B.L. Cascade' internal bath" enema treatment which it promotes as a cure-all. Included are advertisements for the Cascade Treatment and for the 210th edition of Tyrrell's "The Royal Road to Health," which Palmer advises should be read before using the enema. A handwritten note from Costilo requests directions for using the Cascade, "so I can commense treatment, hoping it will help me mentally as well as physically as I seem to be losing my energy fast." A T.L.s. from consulting physician L.H. Pinco to Costilo requests her to "kindly fill in the enclosed diagnosis form and return it to me." In a final letter, the doctor explains, "I beg to say that there is not the slightest doubt in my mind from your description that your condition is primarily due to one and only one cause, and that is imperfect elimination of waste product and other deleterious substances from the intestinal canal and colon," and recommends the Cascade enema treatment and Tyrrell's book.

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