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SURGEON, BELLEVUE DISPENSARY. With the coming of summer our city hospitals make preparations for the treatment of sun- stroke. In the coolest portion of the building, at ready access from the street, to save time in the removal of the patient from the ambulance, or in the yard, where a free circulation of air may be had, are set up a bathtub with connections for a plentiful supply of cold water, or the water is brought from a distance through hose-pipe, a box to hold cracked ice, and cots protected by rubber sheets, where the patient is kept until he is trans- premarin tablets ferred to a ward or goes home recovered. A rec- tal irrigator and blankets, premarin mg which are sometimes needed after reaction has taken place, with a sup- ply of antipyretics, heart stimulants, and seda- tives to be used hypodermically, complete the outfit. It is in the construction of ambulances that I think improvement could take place, and the fol- order premarin lowing is supplemental to suggestions for an im- proved form of ambulance which appeared in the New York Medical Journal for March 30, 1901 : The present-day ambulance is the result of an evolutionary development, and we have seen within a year an advance in the change from horse to automotive power. It requires no great stretch of the imagination to cheap premarin tell whence came the ambulance or to trace its development. The first patient entered buy conjugated estrogens online the hospital leaning on his friend or shambled in by the aid of his staff. Faring well, he helped to bear the fever-stricken one along the way to where the doctors buy premarin gave out health. Some returned not back, but' went the other way, and man, abhorrent with the inborn hate for bodies dead, made the beast drag away what he disliked to touch ; so there came to be buy cheap premarin a dead-cart. The generic premarin hearse, being not always in use for the re- moval of dead bodies, began to be employed for the carrying of live patients, and, while the dead- wagon grew to become the modern plumed funeral car, the ambulance changed but little, save for buy conjugated estrogens the generic conjugated estrogens warning bell, easy springs, and rub- ber tires of the present form until the instalment of automotive power. To conserve the health of the individual being the motive for the existence of hospitals and their appurtenances, the ambulance being the open door through which the severely premarin online sick most frequently pass to enter, it behooves those in au- thority to seriously consider any innovation which seems to be for the betterment of the pa- tient. As ambulances are too cold in winter, so are they too hot in summer, and, so far as an im- proved construction of the vehicle would in- crease the value of the hospital's treatment of the patient while on his way to its doors in midwin- ter, will it likewise add to the comfort of any class of patient, but becomes of buy premarin online special value, and would reduce the mortality in sunstroke cases, during the heated term of summer. Though the average "run" of an ambulance in a city like New York is seldom over twenty min- utes, in hot weather, owing to the heat-absorbing qualities of the body of the vehicle, and, too, the black color may be added as a factor, though the polished surface purchase premarin online will reflect heat to a degree, the ambulance becomes an oven and ill adapted for a patient who has dropped in the street with a heat-stroke. A lining of felt, asbestos, or any of the various fillings used in refrigerator construction, placed within the sidewalls, ceiling, and floor of the am- bulance, with due regard for side ventilators, would premarin price in a short summer's season demonstrate the value of the procedure. An electric fan might well be attached to each ambulance and a supply of ice-bags filled order premarin online for im- mediate service, to be placed beside the patient after removal of his clothing (that form of sun- stroke known as heat exhaustion, which requires opposite treatment to other varieties, must be always borne in mind in handling these cases) would enable premarin cost the accompanying physician to be of real service to his patient beyond that of mere clerical work involved in the filling out of lengthy report blanks, which takes most of his time on the way. ^ 805 Madison Avenue. PUERTO RICO : ITS CLIMATE AND purchase premarin ITS DISEASES.*

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