humidity and slightest wind movement in the United States.

Phoenix, the Princess of the Plains, is a modern city of 14,000, in which everything the world affords may be obtained at reasonable rates. Living is cheaper in Phoenix than in any other Western city, and with it the climatic conditions afford an ideal winter resort. We are 500 miles from the ocean or any large body of water. Fogs are almost unknown and in this mild land of sunshine the open air treatment and the rest cure can be carried out to their fullest extent easier and more economically than anywhere else.

Phoenix, Ariz.

WHERE DOCTORS CANNOT LIVE,

BY C. E. BOYNTON, M. D.

TRANGE it will seem to the readers of the SUMMARY to learn that in the United States there are towns of from one thousand to two thousand people without doctors, secluded towns where doctors can not make a living. The town of A has a population of sixteen hundred. A doctor located there two months ago but is not making a living. His nearest competitor is seven or eight miles away in another town of fifteen hundred population and he (this doctor) except to the south has no competitor for something like thirty miles. This doctor after eight years or more in this town is now able to build a house.

Near these two towns there are about six other towns with no doctor, yet with an aggregate population of four or five thousand.

The towns of B, C and D, each of about eight hundred population are of these six (I think D has about twelve hundred,) and in them a doctor could no more make a fair living than he could in the midst of the Idaho lava field.

The town of E, eight miles from a doctor, has no physician at present. It has starved out several. I could mention other towns. F supports one illegal practitioner who has other means of support. This town is seven miles from a regular physician.

All these towns are situated in well

drained, healthy districts, where they have large death rates.

The trouble with them is
First. The midwives.

Second. The short sighted economy of their people who are home owners and prosperous-almost wealthy.

In these districts the midwives preach that it is not nice for a woman to employ a doctor in confinement. Thus these towns are filled with crippled women and many mothers have died and are dying from puerperal causes. The midwife treats the family for a small remuneration and in spite of the heavy infant mortality they hold their jobs.

Doctors from a distance are sometimes called as people are about to die and the high mortality of such practice casts discredit upon the profession.

In these towns I have mentioned, the female population and young men dress very expensively and as the people of these towns do not encourage a doctor to locate they must pay liberally when they get one from the city. In these towns a ten cent barber can hardly live. One told me that he once charged fifteen cents for a shave and most of the town people who wished to be shaved rode eight miles to a ten cent barber.

The people of these towns regard a doctor as a bloated millionaire. One of them bringing a child with a dangling broken arm said, "Doctor, what will you charge to set this arm?" The doctor replied $30.00. The farmer declared he was poor. (He was really worth more than $10,000.) Said he could get it done for less eight miles away. The doctor did not parley. He set the arm. The farmer sent him $5.00 and the doctor returned the money. This doctor charged $2.00 per call. A prominent citizen of the town tried to prosecute him for extortion for making such a charge.

These people do not drink much liquor. They buy alcohol and dilute it because that is cheaper.

The wife of a man worth thousands had appendicitis. Neighbors called a doctor because husband would not. Doctor said operation would cost $200.00. "Can't stand that," said the husband, "she must die." And she died.

Few deaths in these towns are under the care of a physician. Many of these people use quack medicines handled by their stores in large quantities. One family has lost seven infants in succession, but still they, employ the same midwife.

A citizen of the two thousand population town said to me, "We starve out doctors here," yet this man was dying ten years too soon because of untreated complications.. Smithfield, Utah.

REMARKS ON CLYCO-THYMOLINE.

BY W. R. D. BLACKWOOD, M. D.

OR many years past this preparation has

FOR

been one of my main stays in diseases of the mucous membranes, and it has held its place despite the trials of many other agents warranted to supplant it by the advocates who decried Glyco-thymoline when I spoke of its virtues. Space is now getting too valuable to waste with long detailed descriptions of separate cases, and anyhow I never did write in that manner- I think general remarks about agents is the better way, and we need this more than stories of symptoms and temperatures, with daily alterations. No class of maladies is more troublesome than disorders of the mucous membranes, and none more difficult to eradicate thoroughly, and we have been put to our wit's end many times for remedial agents in such cases. The local treatment of catarrhs is frequently disappointing, and none more so than that prevalent one-post-nasal catarrh. Unless we can get an alterative condition established little good is done, and nothing has been of greater service to me than Glyco-thymoline, locally and internally, in several hundreds of long-standing and severe cases of this intractable and common affliction. I have come to regard this preparation as a standard and almost routine remedy; I seldom care for a post-nasal trouble without prescribing it at the onset, and if I don't it is not long before it comes into use. It is just alkaline enough; just so as to the dialysis-(the action locally with exactly the right amount of fluid excretion through the diseased membrane,) just enough astringent without drying the parts;

and just the right thing in the direct line. of reparative work-it sets up tissue building soon after the membrane gets somewhere near its right shape. Many things are employed in catarrh, but I firmly believe that if I was confined to one agent only,that, would be Glyco-thymoline. For years I used the so-called antiseptic tablets of boric acid, salt, glycerin, etc., and with good results, but for a long time past this is thrown aside and the Glyco-thymoline takes its place. I use it in about half-strength with a "Birmingham" douche, and from twice to four times daily. With this, in bad cases, I give it internally, adding to it, or giving separately, mercuric bichloride, and if done separately the menstruum is compound syrup of stillingia. In presumed syphilitic persons I always do this.

In gastritis, chronic enteritis, vaginitis, gonorrhea, and in recurring attacks of what too many physicians deem appendicitis, I use this agent freely, and always with good results. As a local application to foul ulcers and especially to hemorrhoids I think this preparation is very good. In the nasty leg ulcers which now and then defy all remedies Glyco-thymoline does wonders-it can't do harm any time, and I am almost persuaded to give it in all instances. In bronchitis and asthma it is fine; in spasmodic croup it fills the bill nicely; it does well in venereal disorders locally, and in balanitis it stops the trouble at once. 852 N. 23d St., Philadelphia, Pa.

Worms.

Dr. Scholl in Jour. Med. and Surgery, says that the best treatment for expelling worms is santonin, which is prescribed probably more than any other drug. He recommends that it be given in powder form on bread and butter or in the form of lozenges; and sometimes he combines it with calomel. He states that it is destructive to both the thread and round worms and their ova. He always combines or follows the administration of the santonin with a purgative, as it assists in the expulsion of the worms and ova. The best plan is to give the anthelmintic at night and follow with the laxative the following morning. Overdoses should not be given.

Syr. pruni virg.......q. s. ad. Zij M. Sig. A teaspoonful every three or four hours.

PURE CARBOLIC ACID FOR CARBUNCLE. Dr. Manley, of New York, adds his favorable indorsement to those who advocate and practice, in cases of carbuncle, the deep hypodermic injection of pure carbolic acid. In the earliest stages an injection of one to three drops is sufficient, but in the active suppurative stage repeated injections of a large quantity, 15 to 20 drops at a time, are required. This method is not painful, and no toxic symptoms follow. Free stimulation, tonics, and a nutritious diet play a important part.

TREATMENT OF BARBER'S ITCH.-Dr. Rosenthal orders the seat of affection to be closely shaved daily, and the following ointment to be rubbed in twice a day: R. Acid tannic.,

Lact. sulphur

Zinc oxide,

Amyl.,

Vaseline

.gr. xlv

.3 jss

aa 3 iv .3 j

M. Sig. To be used twice daily. In a month nothing remains of the eruption but a very slow disappearing erythema. -Med. Review.

RETENTION OF BLOOD CLOTS AFTER LABOR.-Dr. E. P. Davis recommends the prompt removal of the clots with the aseptic hand, followed by copious douching with hot. water at a temperature not less than 110 degrees F., compressing uterus with one hand.

SALIVATION FROM MERCURY is most quickly produced by blue mass, next by

calomel, and less easily by gray powder or mercury with chalk. Persons taking mercurial preparations should abstain from acid drinks and foods as they have a strong tendency to produce salivation.

IRON is contraindicated in all forms of fever and wherever there is gastro-intestinal irritation. It has signally proven its worthlessness to reduce the albuminuria of chronic nephritis.

SUBSTITUTE FOR COD LIVER OIL.—To fatten lean subjects have them chew frequently and thoroughly throughout the day a good, big, pinch, at a time, of flaxseed and swallow.

Normal Salt Solution

Dr. Himmelsbach, in N. W. Lancet, recommends, as a matter of great importance, relatively small and repeated injections of the normal salt solution subcutaneously. The quantities formerly given in this manner, from one to three pints, are entirely unnecessary, and according to his statement an equally specific effect can be produced upon the renal organs when the solution is given in smaller amounts, as shown by the elimination which is many times greater than the quantity injected. This has the advantage in that the time taken to do the operation is curtailed, which is of great importance in children. Lenhartz advocates injections subcutaneously of two to six ounces every three or four hours, and states that they have a better diuretic effect and cause less strain on the kidneys than a pint given several times a day.Jour. A. M. Association.

Management of Retained Placenta.

Dr. Lusk directs to bring down border of placenta if over os; separate attachments by a sawing movement with the fingers, dividing any bands between the thumb nail and the index finger. If the placenta is on the anterior wall, place the patient on her side. Carefully remove every portion of membrane, following with a warm antiseptic douche.

In concluding an article in Journal Obstetrics on "The Treatment of Puerperal Sepsis" Dr. Hiram H. Vineberg, of New York, says:

I desire to lay especial emphasis on the importance of watching very carefully every puerperal woman who shows the slightest elevation of temperature. If it be assumed that such elevation denotes sepsis unless some other cause unmistakably accounts for it, and the proper treatment institued at once, then in my opinion, it will rarely occur in private practice that a case of puerperal sepsis will be encountered in which any serious surgical intervention will be needed.

I am in the habit of using Unguentum Crede in cases of sepsis where I can find no lesion which demands surgical intervention, or in those cases in which the gross source of infection has been removed by surgical means and the manifestations of sepsis still persist. I have gained the impression from its use that it is of some service either in aiding the system to eliminate the toxins produced or in some way counteracting their deleterious effects. Certain it is that several desperate cases in which the silver was employed by inunc

Dr. Anders advises a supporting treatment, including concentrated liquid foods at regular brief intervals and artificial stimulants in liberal quantities. Quinine, sodium salicylate and antiseptics may be tried. Ammonium carbonate is given to relieve embolic symptoms. Antistreptococcic and antistaphylococcic sera are efficacious in special cases.

Intermittent Malarial Fever.

Quinine is, of course, the specific remedy, and is best given, according to Dr. Cushny, in the decline of the fever-15 grains in a single dose or in divided doses during fall of temperature. If this does not prevent the next attack, a smaller dose should be administered. Afterwards 15 grains should be given every six days to complete the destruction of the protozoa.

"German Measles.”

For rubella, or roetheln, Shoemaker advises rest, light diet, and confinement to the house for a few days. If there is much fever, restlessness and sore throat, he gives a mild diaphoretic mixture and opens the bowels freely with saline laxatives.

Al

The methods for the treatment of septicemia employed by Dr. J. C. Da Costa may be summarized as follows: Drain at once an asepticize putrid area; enormous doses of alcohol; strychnine and digitalis are useful. Establish action of skin and kidneys. lay vomiting with champagne, cracked ice, calomel, cocain or carbolic acid with bismuth. Feed every three hours with milk, or milk and lime water, and other concentrated foods. Give quinine in stimulating doses ;antipyretics are useless. Watch out for any visceral congestion and treat it at once. Intravenous or hypodermic infusions of normal salt solution are used extensively by some physicians.

Treatment of Erysipelas.

Dr. Stelwagon gives a purge, followed by tincture of chloride of iron and quinine, with stimulants if needed. Benedict recommends a five per cent. solution of menthol in petroleum. Stevens prescribes one part of ichthyol to four parts of vaseline, spread thickly on lint and applied to the affected parts. Seneca Powell uses the local application of strong carbolic acid, leaving it on for a few moments till the skin whitens, then neutralizing with alcohol.

Paralysis Agitans.

Dr. A.T.Stewart, of Pilcher,O.,in a recent number of Merck's Archives says:

I submit a treatment for paralysis agitans which has rendered very good service in a case complicated with mitral regurgitation, renal insufficiency, edema of the extremities and insomnia. The disease involved nearly all the muscles of the body. In my opinion, caffeine is contraindicated in cases complicated with cardiac disease, as it increases the irritability of the reflex center in the spinal cord and would, hence, be calculated to aggravate the paralysis agitans.

I have prescribed the following with excellent results:

Dr. Finley Ellingwood, of Chicago, Ill., wrote of cimicifuga a year or more ago as follows: "In the premonitory stage of acute fevers, or of inflammatory troubles of whatever character, this is a common symptom, a general tired feeling with aching of the muscles. In these cases there is usually a chill, or chilliness with more or less fever with the aching. One drop of the tincture of cimicifuga every hour will absolutely relieve this aching in from six to twelve hours. If given with aconite for the fever, and belladonna for the rigors, the time may be reduced to three or four hours. Don't fail to give this remedy when indicated, as its influence upon the nervous system will probably abridge all the other symptoms."