A detailed analysis of this is given, the sum total of which shows that each man received, in avoirdupois weight, daily: 1lbs. ozs.

2 2 34/100 of solids
1 2 84/100 of "prepared water"

3 5 18/100 total solids and fluids which cost 5 17/48 kreutzers, or twopence sterling, very nearly.

Other bills of fare of other. messes, officially reported, give about the same. This is exclusive of the cost of fuel, and so on, for cooking.

All who are concerned in soup-kitchens or other economic dietaries should carefully study the details supplied in these "Essays" of Count Rumford; they are thoroughly practical, and, although nearly a century old, are highly instructive at the present day.

With the aid of this information, large basins of good nutritious soup might be supplied at one penny per basin, leaving a profit for establishment expenses; and, if such were obtainable at Billingsgate, Smithfield, Leadenhall, Covent Garden, and other markets in London and the provinces, where poor men are working at early hours on cold mornings, the dramdrinking which prevails, with such d're consequences, in such places would be more effectually superseded than by any temperance-missions, which are limited to mere talking.

Such soup is incomparably better than tea or coffee. It should be included in the bill of fare of all the coffee-palaces and such-like establishments in our country. A. T. CUZNER.

nothing is more certain than this fact; and those gentlemen whose chests have so enlarged over the success of their course of treatment should take notice of it and become more modest.

Laton, Calif.

CHARLES W. HARDMAN.

SOME GOOD TIPS DICTATED BY EXPERIENCE

I have used an automobile in my eight years of practice, three years of which was wholly country practice while, in the other five years, a considerable amount of dirt-road driving has been done. During this time, I do not recall having hired a team more than two dozen times, although my total mileage aggregates nearly 45,000 miles. Only twice have my cars failed to bring me home.

I have owned three Fords, one Lambert, one Maxwell, and two Oakland sixes. My present cars are, an enclosed Oakland roadster and a Ford roadster, the former for regular service and the latter for muddy roads and as a relief-car. This gives me a clean car for pavement-work and eliminates the necessity of driving the more expensive one over bad roads.

As to service, the Fords, of course, depreciate less and their upkeep is less; still, one of my Oaklands ran 5,000 miles in regular use, with an average of 20 miles per gallon, and they give from 6,000 to 12,000 miles on tires. My Lambert was a used car and was too early a model to compare favorably with the modern machine. My Maxwell was a disappointment. For every use, the Oakland is almost ideal, being moderate in price, trustworthy, speedy, flexible, good-looking, easy-riding, and economical.

I consider it a wise policy to exchange for a new car after about 10,000 miles, since a busy physician can not spare the time even for minor adjustments that must come with wear.

As for pleasure-trips, my cars have afforded me no small amount of pleasure and relaxation. We have taken a few fairly long drives and in every instance were glad that we chose this mode of travel.

I often wonder what I should do were I compelled to get about as our forefathers did. It is a common occurrence for me to allot myself but two hours to drive 20 miles, make a call and return. Not so with the men of even fifteen years ago. D. J. BOWMAN.

Lincoln, Nebr.

TO THOSE THAT WANT TO KNOW WHERE TO GO ON AN AUTOMOBILE TRIP

Having read in THE CLINIC a month or two ago that someone around the office there was contemplating an automobiletrip this summer but did not know where to go, I want to extend to him an invitation to come to Colorado. For many reasons, that I have not time to give, this is the best place to go to. First, because it is not too far from home, and then, because you can find here everything, and more than elsewhere, that will add to the pleasure of your vacation.

It is easy to run down to Kansas City, then out through Kansas over the Santa Fé trail, entering the state at La Junta. then on over magnificent roads to Pueblo, Colorado Springs, Manitou, Denver, Estes Park, back through Canyon City, and so forth. This route includes the finest scenery in the world, but, I will leave the description to some enthusiastic press agent.

However, I want to tell you about the facilities available that aid to make the tourist's trip a pleasant one. All of these places have municipal camping-grounds, where you will find a built fireplace for cooking, free wood and water, and plenty of grass and shade. Here, in Pueblo, it is in the parks; at Colorado Springs, on the shore of a beautiful lake; at Canyon City, at the end of a beautifully shaded street. And you will encounter plenty of company. Hundreds of people pitch their tents in these places and make little side trips, returning home every night.

If

you want to fish and get out into the woods, you will find many places just "over the divide," a few miles from Canyon City, where there are beautiful streams. If you want a little society, go up to Estes Park.

course, you would want a tent. It would not be an auto-trip if you did not have one. If you have ladies along that do not want to camp out, they can go to the hotel for the night. But, you, yourself, I am sure, would not think of such a thing!

Now, do not plan to go to California. That is too far; also, you will encounter some bad roads, besides days of tiresome travel through the desert.

Oh, this is the place. I tried it last summer and had the time of my life; and I expect to go again. You will find swings for the kiddies (if you have any) at the camping-grounds and other things for amusement. Also, you will meet some of the finest people in the world and can sit around the campfire in the evening and gather so much knowledge that you will be satisfied for the whole year to come.

When you come to Pueblo look me up, and I will show you the steel-works out here, at any rate.

Here's wishing you the best time ever, and I hope the little old Ford will carry you around the circle without any mishap. But, maybe you are one of the men that had 700 cases of flu and "never lost a case," and, now, own a Packard.

Pueblo, Colo.

R. E. DAVIS.

PLEA FOR FREE TRIPS TO THE Α. Μ. Α. MEETING

I notice, in all the journals, an appeal for members to attend the annual meeting of the A. M. A. Well, I very much should like to do so, but—

At the beginning of the war, we were called upon to give our services free to the government, and many of us did this, and cheerfully. It cost many of us a great deal of labor and time and a loss of many patients (although most of them, only temporarily). It is out of the question for many of us to attend the meeting and pay our own expenses. The government runs the railroads, and, it seems to me that it would be little enough if the government were to say: "We want you doctors to attend this meeting as our guests." Remember, how much money is being spent for practically useless purposes, in comparison with which this would be but a drop in the bucket.

ernor," and both have replied "Nothin' doin'", "No use to try." Suppose the war is to continue or we must spank Mexico, how many of us are going to rush in and volunteer as we did before?

It is not the question of the money, but, of the spirit of it. Would it not be good for some of us to see something of our country? I don't know just how to put my thoughts into words, but, when I do my best for someone, voluntarily and gladly, I feel him lower, in my estimation, if he shows no appreciation.

Navy during the great war. While, naturally, of primary interest to our colleagues, the dentists, physicians also will hear much of interest by attending this meeting, and it is hoped that a large attendance will cooperate in making the annual meeting a successful one.

Information concerning the program, the place of meeting, the possibilities of hotel reservations, and so on, can be obtained from Secretary-Treasurer R. W. Waddell, 347 Fifth Avenue, New York City.

THE ASSOCIATION OF ORIFICIAL

SURGEONS

The 32nd Annual Convention of the American Association of Orificial Surgeons will be held September 15-16-17 at the Congress Hotel, Chicago. Forenoons will be given to operative demonstrations at the hospital.

The program will be replete with practical addresses, essays and papers by prominent orificialists. The clinics will be interesting as usual.

Remember, September 15-16-17, Congress Hotel, Chicago.

OBSERVATIONS IN SUMMER
DISEASES

As I have been a subscriber to CLINICAL MEDICINE for a number of years and living in far-away Arizona, where physicians are "few and far between," the editor of CLINICAL MEDICINE, in requesting me "to do my bit" in writing for the July number, no doubt thought that I might write an extensive article on summer-diseases, as, in this section of the country, there is much latitude, both geographically and professionally.

Eleven years ago, while in private practice in Denver, Colorado, I was appointed medical missionary to the Navajo Indians settled in northeastern Arizona, this work being under the Board of Home Missions of the Presbyterian Church, and, during this period, I have treated many cases in the hospital-dispensary and in the rounding country in miles.

a

sur

radius of many

Every season brings its peculiar disorders. In the winter, it is rhinitis, pharyngitis, laryngitis, tonsillitis, bronchitis, besides a few cases of bronchial and lobar pneumonia, with, possibly, later some cases of tuberculosis. In the summer, it is acute and chronic gastric catarrh, flatulence and colic, constipation and nausea and vomiting, simple diarrhea, enterocolitis, cholera infantum, chronic gastrointestinal catarrh, besides a few cases of dysentery.

The Hospital.

Consequently, one will be likely to encounter a numberless variety of summer diseases affecting the gastrointestinal tract.

Beginning with the buccal cavity, stomatitis, either catarrhal, parasitic, ulcerative or gangrenous, may be seen, with the catarrhal form predominating. I saw one case of gangrenous stomatitis that terminated in death in a few days. The cause of the catarrhal form is, lack of cleanliness regarding the mucous membrane of

mother to cleanse the child's mouth with warm water several times a day and also to give it to drink as much warm and cold water as is needed or asked for.

Acute gastric catarrh as a rule is caused by improper diet, such as green fruit and vegetables (apples, melons, corn not in fit condition to be eaten), sometimes by exposure to atmospheric changes, many times to insufficient clothing, in connection with unhygienic surroundings. Often we are not called in till late, so that the malady is well under way, hence, the prognosis is more unfavorable. Usually, we find the patient suffering from headache, nausea and vomiting, coated tongue, slightly raised temperature, rapid pulse and respirations, pain and tenderness in the epigastric region, and constipated bowels. Here I advise hot applications, hot baths, drinking of warm water, perhaps fractional

On the Road.

the buccal cavity, exposure to atmospheric changes, unhygienic surroundings and teething. Ordinarily, I use applications of an aqueous solution of boric acid or potassium chlorate or sodium borate or, perhaps, listerine or glycerine, instructing the

On a Visit to a Sick Indian.

doses of calomel and soda followed by a laxative saline. If the pain is severe, ginger, peppermint, camphorated or plain tincture of opium, also lime-water, and, in extreme cases, a hypodermic injection of morphine may be given.

In the chronic form, I prescribe tincture of nux vomica, liquor of potassium arsenite or some form of iron and quinine, as bitter and upbuilding tonics, with instruction not to force food upon the patient when there is no desire for it and the patient cannot retain it. If there is nausea and vomiting, I try to ascertain the cause. If the cause be overfeeding or improper food, which is highly probable, I enjoin rest and complete rest for the stomach and intestines for several hours, while I may administer fractional doses of calomel, in conjunction either with sodium bicarbonate, bismuth subnitrate or cerium oxalate in small doses; this generally meets the condition.

Simple diarrhea may result from summer-heat, poor hygienic surroundings, dentition, and often from infected milk. There may be nausea and vomiting, the child also being restless, fretful, thirsty, with characteristic pallor. The stools generally are greenish and frequent. As much as is possible, I try to have the mother abstain from food, especially that of a starchy nature, and order the baby to be given to drink, plenty of hot water, preferably such as has been previously boiled. As soon as advisable, I order a dose of castoroil or laxol after an enema of plain warm water. Then, as soon as the bowels have moved, I give bismuth subnitrate, camphorated tincture of opium or some astringent in small doses.

A Missionary Talking to the Indians.

In enterocolitis the symptoms are: diarrhea, pain, nausea and vomiting, and swelling of the abdomen, caused by impure food, sour milk, hot weather, and unhygienic surroundings. The pulse is rapid and weak. The temperature registers 101 to 104 degrees or higher. The skin is hot and dry, stools are frequent, and greenish-yellow. The prognosis often is doubtful and unfavorable, although the patient may recover or the condition may later eventuate in dysentery, which then usually is fatal.

The treatment consists in advising to keep the patient warm by means of warm clothing and applied heat, warm baths, and to discontinue all food. In case any food is allowed, I limit it to meatbroths, alone. As to medical treatment, I rely upon cas

toroil or fractional doses of calomel and sodium bicarbonate, in addition to bismuth subnitrate, salol or the sulphocarbolates; also some form of opium and, locally, hot applications of oil of turpentine or of mustard upon the abdomen.

The symptoms of cholera infantum are: vomiting and purging, together with colicky pains. Generally it is caused by impure milk. The onset is sudden, with frequent watery stools. There is thirst and restlessness. The temperature runs up to 103 degrees or higher, skin is cold, pulse is very rapid. The prognosis is unfavorable. The treatment consists ingiving warm baths, hot application over the abdomen, an enema of warm water, and, if the temperature is very high, one of cold water later. Medical treatment, if it be permitted: A hypodermic injection of morphine and atropine at the beginning and stimulation with strychnine or aromatic spirit of ammonia.

Chronic diarrhea is not so frequent, but, some cases may be encountered, owing, largely, to poor food and insufficient clothing, cold and exposure, rickets, and to other causes in older children. The symptoms are: Emaciation, anemia, eructations, distention of the abdomen, colic, constipation, and diarrhea.

Treatment: Avoid sugar and starch. Feed eggs, fish, lean meat, and vegetables. Order cool baths. Prescribe such medicinal treatment as charcoal, soda-mint tablets, tincture of nux vomica, salol, and the sulphocarbolates.

Dysentery. The catarrhal form is the one met with. Causes: Warm weather, impure water, improper diet, principally unripe fruit and vegetables, as the Indians are fond of apples, corn and watermelon. Symptoms: Nausea and vomiting, great abdominal pain, mucoid and bloody stools, somewhat dark coated tongue, fever with thirst, distended abdomen, painful on pressure, with tenesmus.

Treatment: Irrigation of the colon with boiled water; internally, castoroil and, afterward, some form of opium or tinctures of capsicum, ginger, peppermint, or some other anodyne, sedative, astringent or carminative. If the pain and diarrhea are excessive, a hypodermic injection of morphine or codeine may be given.

Constipation is very frequent, both among children and grownups, not only from a lack of knowledge, but, also from