Back in the 60's the CB&Q ran steam excursions with the 5632 and the 4960 almost every weekend in the summer. Most of the passenger cars were the open window type and that was your air conditioning....as was riding in the open gons or rented cabooses. The dome cars were usually the only cars with A/C but they were hot upstairs anyway if the sun was out. The toilets always flushed as long as there was water and when the water ran out it all hit the ties anyway so gravity was the drop. As far as medical emergencies the local communities usually took care of ailing passengers with the train leaving them behind so....if you were ill you shut up so as not to miss the train.All the Sunday only excursions I was on were more fun if you were at least 4-6 hours late returning to Chicago Union Station. I usually caught the last train #55 for Milwaukee anyway.