out as it is the evening-work. The nightwork comes only occasionally, the eveningwork, however, is a daily affair. Very often I have to travel over the same ground in the evening that I have already been over in the day."

People very likely will reply: "But, what, if the patient was taken sick only in the evening?" The answer should be: "In that case, any doctor will be glad to respond promptly. That would be no hardship, because those cases are few. The majority of evening-calls are for patients that have been sick all day and just as well could have sent earlier."

Going over the same ground two or three times in one day, wastes a great deal of time. Especially when patients live at a distance does this difficulty become serious. To make a call ten or more miles away and then, after returning home, to get a call from the same neighborhood to visit some patient too negligent to send in the order at a reasonable hour is highly exasperating. I have often said to such people: "I have just been in your locality. I am sorry that I did not know earlier that you wanted me. If I make a second trip over there today it will compel me to neglect a number of patients nearer home. I am afraid I can not come. before tomorrow."

Another trial of patience for medical men is, the person who sends an urgent call when the matter is not urgent at all. Doctors, as a class, are fairly unselfish and ready to sacrifice their hours for rest, meals, and social enjoyment in any case that is really urgent, such as a serious accident or a patient in great suffering. In my early practice, I soon learned that there were people who would send a "hurry call" for the doctor to come "right away", and then, when, perhaps, I had left an unfinished meal or a much needed nap, I would find some quite ordinary case of no urgency whatever; and, before long, I made it a point to ask for particulars. I would say, and I instructed my family to say in all cases of "urgent" messages: "Give me some idea as to what is the matter, so that the doctor may come prepared."

He

There was one druggist in particular who was sinner-in-chief in this respect. would send every message as a hurry call, whether it had come to him as such or not. I said to him, as I said to many patients: "If you send all calls as urgent, the result will be that the doctor, after being fooled

a few times, will become indifferent, and sometime, when there is a bad accident, he will take his own time about coming, and the result may be serious. It will be like the old fable of the shepherd-boy who cried 'wolf' so often for fun that when the wolf really did come nobody paid any attention to him."

A doctor that has a large practice can not make every call at once, and he can give better service if his patients will cooperate with him by sending a little correct information with the call.

Closely allied to this nuisance is the man who wants you to leave during your officehours, even though there is nothing especially urgent about his case. He comes into the office when, perhaps, there may be no patients waiting. He says: "Can you come to my house at once?" I answer, "As soon as the office-hour is over I shall be there." "But", he urges, "there are no patients here. Why can't you come now?" I reply, "It is true there are no patients here now; but, there may be the next minute. Some of my patients come long distances, some even from out of town, and it is not right to disappoint them." He is still unsatisfied. I say to him, "Let us turn the thing around. Suppose you came five miles or forty miles to see a doctor at his officehour and found him out making calls. Would you not feel that he was treating his office-patients unfairly?" Of course, in great emergencies even office-patients must come second.

The Man Who Wants to Help

There is one kind of patient who often is a good deal of a nuisance; however, we can afford to regard him with an amused tolerance, because he means so well and really thinks he is doing you a favor. I refer to the man who brings the doctor a new remedy, a "sure cure", and wants him to try it. These people imagine that the practice of medicine is simply a process of trying things that are "good for" this or that disease-a sort of glorified collection of old-women's nostrums. Well, we must admit that there still are some physicians whose conception of the healing art is about on that level. Modern scientific medicine, though, is quite another matter.

It would be amusing, if it were not so disgusting, to see some novelists set forth their ideas of the practice of medicine. There is one American woman story-writer

in particular whose descriptions of silvan and rural life have a certain charm, but, when she dips into medical matters, she furnishes the profession with material for hilarity or nausea, according to the reader's temperament. She pictures a boy of wonderful genius living in the forests of northern Michigan, cultivating medicinal plants, finding a "sure cure" for pneumonia, and presenting it to the American Medical Association. Her description of that august body in session in an eastern city, sitting at the feet of this youthful prodigy as the Jews of old sat at the feet of Gamaliel, leaves one in doubt as to whether to regard it as unconscious humor or as an emetic. The A. M. A. has much to answer for, but, not that, thank heaven, not that!

There is in this city of Chicago a business-man, who in all the ordinary affairs of life is exceptionally shrewd and intelligent. But, he has one hobby about which he is incorrigible and about which his commonsense seems to desert him. Every now and then he brings me some nostrum that he has "discovered", and wants me to try it in my practice; and he is a little puzzled over the fact that I do not enthuse over the matter in the way he does. In a financial transaction, no one would be quicker than he to detect the "goldbrick", if it contained one. Yet, in regard to the health of himself and his family, he seems ready to swallow any humbug that comes along. He is simply a "sucker" so far as medicine is concerned. This phenomenon is a perpetual puzzle to me. I have seen many examples of it.

This man's latest find came along some two years ago. He said to me one day:

"I have something new that I want your opinion on. It was discoverd by a friend of mine, a druggist on the Pacific Coast. He says that there never has been known to chemists any way of dissolving sulphur. He has worked on it for fifteen years and has at last found a way. He makes no secret of the fact that it is simply dissolved sulphur, only the method of dissolving it he is keeping secret for the present. You see that it is not a patent medicine, but, I have never found anything that does me so much good as this." (There is nothing the matter with him except that he eats too much.) "When I don't feel well, I put a few drops of it into a glassful of water, drink it, and in a little while I feel fine." He insisted upon bringing me a sample. Examination proved it to be simply a weak solution of sulphurous acid in water with a little coloring matter; in other words, it was a repetition of a notorious "microbekiller" widely advertised some twenty or more years ago. Such things make one wonder whether the laity will ever develop an intelligent view of the practice of medicine.

And, yet, as I lay down my pen, the thought comes to me that, while we are making merry over the financier who does fool things in the medical line, what is the financier thinking of doctors that buy stock in gold-mines that exist only on paper, or land in Florida that they have never seen and which can be seen only by looking over the side of a boat, or finance-schemes for breeding stingless bees or making candy out of cactus?

[To be continued.]

WH

a

THEN Canada decided to send half million men to the defense of her mother country, the national mind generously shouldered the responsibility of caring for those who gave their all for the national welfare." The government endowed the Military Hospitals Commission (later changed to the Invalided Soldiers Commis

soldier's physical, spiritual and economic wellbeing. Public effort assists the government to insure the returned heroes a bright outlook upon life and a training for self-support." After proper medical attention, the advice of a vocational counselor is given. He is a man possessing broad knowledge of various industries and the training necessary to follow them. Of course, the question of supply and demand must enter, so that men will not be trained in occupations that produce too many uncalled-for articles. Then, too, the man's own desires must be taken into consideration.

The Military Hospitals Commission has arrived at a scheme providing for the reeducation of discharged soldiers. In nearly every province of Canada, there is: (1) a provincial disabled-soldiers training board, which determines who are fit subjects for vocational reeducation; (2) a body for each province that has general advisory powers for the coordination of local efforts; (3) vocational officers, who are in immediate charge of the work in each locality under the direction of the vocational secretary of the commission, with headquarters at Ottawa." The Canadian government has learned that even in countries where perfect administrative detail is a passion confusion is bound to arise if the care of the maimed is divided among various departments of state, because there then is overlapping and waste of effort and of expenditure, resulting in disadvantage of the patients.

a

At first, the members of the commission thought that what the returned soldiers most needed was, convalescent home where rest and refreshment might be secured. Scores of beautiful houses were offered to the commission, luxuries were supplied to the returned men, discipline was relaxed, and other kindly attractions were offered that might have proved beneficial to men who remain in hospitals for a short time before resuming an ordinary occupation. However, this treatment was found detrimental to best interests of men that must remain for long periods. These homes should not have been thought of as places for relaxation, but as places of rehabilitation; and they are being changed from convalescent homes to mili

now

tary hospitals, where, after physical restoration, the evil effects of idleness are warded off by profitable occupation.

The soldiers take great interest in their training, because they are told that their earning-power will not interfere with the amount of their pensions. Representatives of the Military Hospitals Commission and of the Canadian Patriotic Fund meet discharged men upon their arrival at a Canadian port, and, again, local committee-men meet the trained soldiers when they arrive home. These services often are performed at inconvenient hours, but, willingness on the part of people who volunteer the kindness has never been found wanting.*"

The Canadians are thankful, because the number of blinded that have returned is less than was expected. Only twenty Canadian soldiers were blinded in the first three years of the war, nearly all of whom remained at St. Dunstan's Hostel, London, for training. Of the nine that returned to Canada, one came to the Halifax School for the Blind for instruction. A second has entered the insurance business; a third, who had previously completed a course in electric engineering, is employed with the Hydroelectric Commission, Hamilton. A fourth is receiving instruction at Montreal, a fifth is learning to be a stenographer and dictaphone-operator at a convalescent hospital in Winnipeg. Four more do not care to accept any assistance from the Military Hospitals Commission. One has nearly completed his training as a masseur in St. Dunstan's and will be employed at Toron

Private Smith attended the blind-school at Montreal. Every day a visitor sent by the Canadian Patriotic Fund read to him. Mr. Smith became tired of the work he had to do at the school and returned to his homestead, but, he had learned one thing: that his fight was half won, because he had emerged from out of the spiritual darkness. Upon leaving, he was presented with a braille typewriter, which he had learned to use, a blindman's watch, and an outfit of clothing. Every week he receives a letter from a girl who has learned braille in order that she may write to the blind. Private Smith divides his work into three

parts: he peddles aluminum ware and books on farming, he shovels grain in the threshing season, and, when the country-fair time comes, he offers soft drinks for sale. Besides, he does the typewriting at the local hotel. What counts for more, he writes letters of encouragement to other blinded soldiers, telling them that the first duty of a blinded man is, to be cheerful.12

Aid for the Blinded Heroes of Belgium and

Italy

Although the cruel hand of Germany has nearly laid prostrate the little country of Belgium, the world offers it tribute, because it has the vitality to establish reeducation at schools outside of its borders. In Belgium, it was necessary to act quickly. The minister of war realized the importance of the situation and, so, appointed an efficient man, M. de Paeuw, to establish a fitting institution for the training of the disabled. In four months, the institution was ready for service. It is beautifully situated at Port-Ville, France, on the left bank of the Seine River, overlooking islands abounding in trees, carefully cultivated farm plots, and pleasantly situated villages.

Today, "a buzzing hive of soldiers" has broken the stillness of the wild wooded fields. Mayor Harcour is supervisor of the establishment, and, with the aid of a devoted competent staff, the disabled heroes are learning to become useful citizens. Workshops are organized in conjunction with the school-work, and all the articles made are sold. The doctor's advice, the individual's inclination, and the economic problem of supply and demand are the determining factors in the selection of a trade.

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The maimed arrive in groups after physical rehabilitation at a hospital is completed; but, the blinded are encouraged to attend the Phare de France, which is wholly devoted to those that have lost their sight." Miss Winifred Holt, who established the Phare de France, welcomes the Belgian and Italian soldier, as well as the French. In France, a beautiful scene of the winding Seine, a field rich in thickets of oak and birch, a place of musical notes of song of wild bird was chosen for a site for the institution of vocational reeducation of the Belgians; in Italy, a like magic transformed the palace of the Bourbon kings of Naples into a home for the dis

abled Italians. The once luxurious chambers of the palace have become sunny school-rooms for brave soldiers." The rich Villa Merafiori in Rome, an American academy, also was equipped for the reeducation of the disabled Italian.

As in the other allied countries, the wounded and rehabilitated soldiers of Italy were suspicious when they were asked to learn a trade. They feared that the government pension would be withdrawn if they became able to earn a living. So, they sat in the royal garden and enjoyed the sunshine and flowers and the fickle lights on the Bay of Naples, and compared a life of future idleness with what it might have been if war had not been declared. Their pathetic dreams of a life of future emptiness was interrupted by the instruction that their pensions were but a supplement to their earning wages. Then they went to work with the unaffected joy of schoolboys.

During the absence of the King at the front, Queen Elena gives much of her time and strength in seeing to it that recreation is given to the men that came back. She entertains them in the Royal palace." The Italian soldiers, the same as the Belgian, when they have been so unfortunate as to lose the sense of sight, are requested to take the special training for the blind in the schools established in France. An international school for the blind of the allied armies will soon be in operation in Genoa, Italy.**

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Uncle Sam's Plans for Blind Soldiers Unlike France and England, both of which have had to depend upon voluntary contributions, the United States government has said that citizens who are blinded while fighting for their country shall be rehabilitated, reeducated, and taken care of at the expense and under the direction of the government. Representatives of the Surgeon-General's office thought it best to take the advice of representative workers for the civil blind in working out a system of training. Questionnaires were sent to workers for the blind throughout the country, asking for suggestions. The Committee on Ophthalmology of the Council of National Defense met at Washington, October 12, 1917, and remained in session for two days. They offered the following sugAn executive officer, with one or more assistants and a secretary, should be sent to France, with authority to determine the number of teachers required and their qualifications. They advised that at least one blinded teacher should be included in the staff, because his example would be an inspiration. The executive officer should have his office at a special hospital center.** The council arranged for efficient supervision and encouragement, as also for the services of a doctor from the time the soldier received the first dressing. Blinded soldiers should not be in a ward by themselves, but, should be in the company of other patients, so that they may secure the assistance of their comrades and that their interests may be broadened. Physical and mental occupation should be provided for the convalescent, to create a spirit of hopefulness and to avoid retardation. These activities should continue on shipboard on the homeward journey. Men otherwise wounded, should be coached to give the blinded the assistance and encouragement.

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After the soldiers arrive at the port of entry in the United States, provision should be made for their entertainment in the hospital at the port until they are dispatched to the station for reeducation of blinded soldiers. The station shall be near the eastern seaboard and of a size to accommodate not more than 200 men.

The director of each station shall appoint teachers that are efficient. Suitable instruction shall be given in reading and writing the approved uniform embossed system, writing with pencil and typewriter, transcribing from the dictaphone, and telephone switchboard operating. Practical trades, such as broom-making, basket-making, mattressmaking, rug- and carpet-weaving, farm work, mat-making, carpentery and joinery, net-making and coarse knitting, and winding of coils for armatures, will be taught. The men will be trained to help themselves dress, shave, handle knife, fork and spoon at the table, walk with a cane, write with a pencil, and sew on buttons.1

Professional training will be given to those that show indications of being successful. If a college training is asked for, it shall be given, especially if a course was

war. Readers will be provided by the staff in charge.**

Instruction in physical training will include medicine-ball, pushball, punching-bag, relay races, gymnastics, field sports, running, climbing, swimming, diving, skating, bowling, tramping, boating, et cetera. Such table-games as cards, dominoes, checkers, chess, parchesi, backgammon, fox and geese, solitaire, and marbles will be taught. Recreation shall be provided in the form of dancing, singing, cross-country walking, roller-skating, attendance at the theaters, musical and various other forms of entertainment.

The reading to be embossed will be classified as follows:

Best short modern fiction: stories, detective tales, et cetera, 50 percent.

History and biography, including sketches of blind men, 10 percent. Adventures and travel, 10 percent.

Popular science and European war, 10

At the director's recommendation, the soldier is discharged and employment is procured. Whenever this may be possible, it is deemed wise to return a man to his former occupation or to one closely allied to it. Another good plan is, to teach a member of the family to help to keep the blinded man occupied. There should be civil-service regulations for opening new occupations for the employment of the blind. The followup work should be systematic and dependable. Individual volunteer work should only supplement the work