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and they must pay trust prices for the articles governed by trusts. This makes the trust safe, whatever may be the price of wheat, corn, cotton, wool, etc. It is right to sustain normal (not abnormal) prices, if they are sustained all along the line, so that all producers will get the benefit of the same. When the farmers prosper, manufacturers prosper, for farmers are able to buy; then also there is plenty of work at good prices for mechanics and good business for the merchant. By a proper solution of the money question the normal prices of all staple products would be sustained. This is fully explained in the book called "Rational Money," which all voters should read before voting on the money question. The sustaining of prices of staple products would assure normal prosperity to all producers of the same, and consequently to the masses of people in general. But the sustaining of trust prices of trust products benefits only the few who are in the trust, and makes the masses of the people contributors to the prosperity of the trusts.

We have now seen how competition is crusht, and prices advanced or sustained. Production is cheapened by the concentration of production in the most favored localities, use of the latest and best machinery, etc. This is economically correct, but it entails much hardship by the closing of many factories, thus throwing many operatives out of employment. Thus at the expense of labor, the monster's profits are enhanced.

As to remedies, the most sweeping one is for all the people to be in the trust. Then economy of production would be a virtue, because all would be benefited impartially by it. However rational and complete this remedy may be, we are not ready for it, as it would put into the hands of the Government many and various enterprises. At the present time the Government could not successfully conduct these enterprises. It should begin with the distinctly public enterprises, as the telegraph, railroads, etc.

But there is another remedy that would be quite effectual, and it is entirely feasible. A protective tariff is said to be for the purpose of protection of American labor, but I have never known the most extreme protectionist claim that it should protect American trusts. Yet, when Senator Pettigrew offered an anti-trust amendment to the Dingley bill when it was pending in the Senate, it was not sustained by the party that has always advocated a tariff for the protection of American labor. However, at this late day, the Philadelphia Press, which has always been one of the leading organs for a protective tariff, says:

"The organization of vast corporations, heavily over-capitalized, which monopolize entire industries and whose avowed object is to exclude competition, must vitally alter public opinion and the demands of public policy on the protective duties imposed for the benefit of these industries." "Protection assumes, as a fundamental principle, that a high duty will be accompanied by a free internal competition.. This competition will operate both to reduce the price at which the article produced is sold by the manufacturer and increase that at which the manufacturer buys labor, because, both in selling his product and in hiring his hands, the manufacturer is competing with other protected manufacturers.

"But if this competition is removed by the sale of all the plants in an industry to a giant corporation, neither object of the duty will be achieved. Prices will not be reduced and wages will not be maintained. Under these conditions the inevitable step must be to apply competition from abroad by reducing the duty, removing it or establishing special re

lations with some country able to supply free raw material or the finished product, or both.

"If the Tinplate Trust advances the price of tinplate, as it has begun to do, the duty on tinplate will be put in the most serious peril. This duty was imposed to create a competitive domestic industry, not to enable a trust to earn money on a capital of $50,000,000. So with the Paper Trust. In the last fiscal year, 1898, the exports of printing paper were 107,405,403 pounds, worth $2,702,351. An export of this magnitude shows that paper can be made at least as cheap here as anywhere else. Yet even with these exports, as long as domestic competition exists, the duty is valuable to maintain this competition.

"The International Paper Company has destroyed this domestic competition. It is imposing on all consumers of paper the burden of paying dividends on a capital of $55,000,000 when its plant could be replaced for $15,000,000. The first step under these conditions ought to be to admit Canadian paper and paper pulp free in the treaty now under negotiation with Canada. If this does not give the needed competition, paper and paper pulp should go on the free list and foreign competition should replace the domestic competition destroyed by the Paper Trust."

The extent to which trusts are growing is becoming alarming. They seem to multiply in both hard times and good times.

A recent New York dispatch says:

The year 1898 was most prolific of trusts. Returning prosperity brought with it an unparalleled outburst of combinations and consolidations. The year closed with more trusts brewing than ever before. A trust craze seems to have developt. In dozens of important industries men are traveling and telegraphing and telephoning to bring about consolidations of competing concerns.

The new concerns incorporated during the twelve months have an aggregate capitalization of more than a quarter of a billion dollars. This, of course, is a different thing from a capital of that amount, and represents merely the quantity of paper certificates in the form of shares which these trusts have caused to be printed and hope to dispose of to the public

Since the opening of the new year the number of new trusts incorporated or projected has multiplied, and the reactionary effect is seen in the dispatches from State capitals announcing the introduction of legislation intended to check their growing power.

A table compiled by a local paper gives ninety-two trusts formed during 1898, and embracing every department of industry. The aggregate capitalization is shown to be $1.292,749.200, of which $957,957,300 is common stock and $334,791,900 preferred.

The bonded indebtedness will increase the total to over $1,500,000,000. A few comparisons will enable one to grasp the meaning of this great capital.

The total value of the United States wheat crop of 1896 is placed at $310,602,539-less than one-third of the capital of 1898 trusts.

The value of all the horses in the United States in 1897 was estimated at $452,649,396.

The value of mineral products in 1896 was $623,717,288; sheep in 1897, $67,020,942; milch cows in 1897, $369,239,993.

The value of sugar consumed in this country is now about $220,000,000 a year. The total of wages paid in the sugar refining industry is about $2,000,000-less than one six-hundredth of the new trust capital of 1898.

There has not yet been found a way for farmers to form a trust to sustain normal prices for their products. Farmers are at the mercy of railroads and of competitve prices in a world market. The prices of farmers' products are determined in Liverpool, minus the freight charges made by combined carrying companies. Farmers are not protected by either a tariff or bounty, yet for what he buys he must pay trust prices, and these trusts are protected by our tariff laws. Our enormous exports that we have been boasting so much of for the past few years, and which give a heavy "balance of trade" in our favor, are made up very largely-three-fourths or more— of agricultural products. Yet we grant the farmer no protection, either directly or indirectly (except on wool), and make him pay trust prices for most that he has to buy, as our tariff laws prote the trusts. We have a law against trusts, but we e never yet had an attorney-general that would enforce it. It is said that the attorneygenerals under every recent administration have

been corporation or trust attorneys. At any rate the anti-trust law is practically a dead-letter, for these illegal organizations thrive and multiply in spite of it. We want just and equitable laws, and equality under the law. When will we get such simple justice as this?

Later: The following news item shows that the trust industry is still active.

The trusts that have appeared since January 1st and the amount of capitalization of each are as follows:

Cereal trust, Chicago, $100,000,000; soap trust, Chicago, $100,000,000; cast iron and foundry trust, Chicago, $24,000,000; milk trust, Chicago, $10,000,000; bank combine, Baltimore, $2,500,000; American Radiator Company, Trenton, N. J., $10,000,000; Union Tobacco Company, New York, $24,000,000 Wire and Nail Company, Philadelphia, $1,000,000; second soap trust, Boston, $29,000,000; Artificial Rubber Company, Trenton, N. J., $1,000,000; American Copper Company, Tren. ton, N. J., $600,000; bicycle saddles, Cleveland, O., $1,500,000; Spool Cotton Company, New York (capital unknown); American zinc trust, Toledo, O., $5,000,000; American Steel and Wire Company, $90,000,000; chewing gum trust, New York, $15,000,000; whisky trust, $200,000,000; American Car and Foundry Company, $60,000,000, and the woolen mill trust, in which all the large mills in the country will combine, with a capital of $60,000,000. There are also rumors that the shoe manufacturers will combine with a capital of from $20,000,000 to $30,000,000, also that the winter-wheat flour manufacturers will combine with a capital of $40,000,000.

From the foregoing it will be seen that there is a tendency to combine all the great industrial operations and how it will affect business generally remains to be seen.

The Chicago Daily News, in commenting on the condition of affairs likely to ensue from the formation of so many trusts, says: "It is time to begin forming the consumers into trusts,"

The Daily News' suggestion sounds very nice in theory, but with competition barred and the power of men endowed with countless millions to control the supply and raise the prices of the necessities of life, which the masses will be obliged to pay or starve, with this condition of affairs staring them in the face, there is only one trust left for the consumers to join-which is simply a trust in God.-Exchange.

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Practical Points.

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doctor, and in writing the Mellier Drug Company concerning it, mention THe World.

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Douche for Nasal Catarrh, Ozena, etc. B Antikamnia and Codein Tablets. No. xxiv. Sig.-Crush and dissolve six tablets in a pint of tepid water and use one-third as a douche three times a day. Shake well before using.

My son, aged 12, had been growing nervous over the shock of his brother's death, and seemed to derive no benefit from any remedies used in his case. I put him on Celerina, and had markt benefit before the first bottle was used, and he has almost entirely gotten over it with the help of another bottle I got for him. I consider it a very nice and efficient nervine, just the thing for the children and nervous and delicate persons, where there is great prostration. I shall use it freely.-N. P. Frassoni, M.D., Moosic, Pa.

I have used Freligh's tablets for cough following la grippe with the most satisfactory results. They act promptly where other remedies fail. I would advise my medical brethren to give them a trial. They will not be disappointed, but will be pleased with their effects.-A. F. Todd, Mt. Solon, Va. Read the advertisement by I. O. Woodruff & Co., and give them a trial.

In the depraved condition of the blood following diphtheria, scarlet fever, and other acute infectious diseases, treatment with Armour's extract of bone-marrow will meet all the indications by acting as a stimulant to the formative processes increasing the production of hemoglobin and red corpuscles, promoting cell-proliferation, and supplying the new-born cells with (Continued over next leaf.)

The Medical World

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C. F. TAYLOR, M. D.

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sions the following:

Does calcium sulfid exert a beneficial effect on suppurative processes? How?

In cases of hepatic colic, what results can be obtained from the use of chloroform? Also, of olive oil?

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VOL. XVII.

APRIL, 1899.

TRADES

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PHILADELPHIA

8

No. 4.

Editor's Drawer-Shall We Have a New

Department?

The suggestion made on page 150 by Dr. Eede, of Leamington, Ont., strikes us as a most practical one, and if the consensus of thought of the readers of THE WORLD is in favor of the establishing of the new department, this will be done in the manner outlined. The full scope of the department is developt so well in the communication referred to that it need not be more fully gone into here.

General Obstetric Considerations.

Typhoid fever may be epidemic, smallpox may threaten, cases of grip and pneumonia present themselves daily, but, after all, the phenomenon of birth is the one thing the general practitioner is sure to be called upon to witness, sooner or later, more or less frequently. Of the cases he will attend in obstetric experience, by far the larger number are sure to be normal, and, it would seem, would require little discussion at the hands of those long in the harness. Yet it is just of the normal cases of labor that we wish to speak, elucidating certain points in management that will probably in their entirety be familiar to few and yet which from one point or the other may refresh memory or awaken new trains of thought. Sometimes, as an old physician once quaintly put it, "the things we are most familiar with we after all know the least about." It does no one harm to formulate his knowledge sometimes and discover how little able he is to give definitive outlines to much that he

With a view to inaugurating the depart- should know as he knows his own life.

How to conduct the normal case of The following brief outline of points labor? "Oh, we all know that!" possibly does not comprise all that might be noted, but all that is absolutely essential will be found.

do you really know all that is necessary to know? Do you know how to approach your patient? What arrangements do you make with your obstetric nurse? Do you douche, ante-partum or post-partum? Do you use chloroform or ether? Do you hasten labor or use no intervention save in urgent cases? Every accoucheur has slight differences from others in his methods, and some good reason for all that he does, no doubt. Here lies an opportunity for better knowledge. Why not compare ideas?

Too frequently the obstetrician gives his pregnant patients no attention, under the idea that their condition is a physiologic one, and that they must be regarded as individuals in good health until labor begins and he is summoned to deliver the child. This view must be condemned as in many cases productive of much harm. In the condition of pregnancy the border-line between disease and health is by no means a rigid one, and it is so easily modified that only the closest watch can in some instances prevent the thoro establishing of some serious complication, enabling it to gain great headway before it is detected.

The physician generally meets his obstetric cases during the second month of pregnancy, the patient calling in reference to the cessation of the menstrual flow, in order to ascertain whether this is indicative of pregnancy or of some pathologic process. This is the time for him to take the first steps to a proper conducting of the entire case. The confidence of the patient, if she is not already an old patient and therefore presumably establisht in faith in her family physician, should be gained at this time, and general directions as to the regulation of exercise, diet, etc., be given in order to conduce to an easy, uncomplicated labor.

Gentle questioning should obtain all necessary particulars from the patient, and these should be systematically entered into a case-book for reference by the physician.

Ascertain whether the patient has had other children, and if so, how many and the character of the labor in each confinement. Have there been any abortions, and if so, at what period of pregnancy, and to what, in the patient's opinion, attributable? Fix the probable date of confinement from the usual data. Gather family history, especially as to renal and cardiac sufficiency. Note the habit of the patient as to constipation, plethora or anemia, etc. Has there been a history pointing in any way to venereal disease?

Constipation must be carefully corrected, the bowels being kept regular thruout the entire period. Once in two weeks thruout pregnancy the urine should be examined for the possible appearance of albumin, and in the last month such examination should be made at least once a week. Exercise should be regular, and out-of-door to the greatest extent compatible with conditions of the weather, but should be restricted in kind and degree to less than would produce fatigue. Lifting-exercises should especially be forbidden, as well as jumping or anything likely to cause strain or jar.

The amount of meat should be restricted, and it should not be eaten more than once a day. If the ravenous appetite that is characteristic of pregnancy in some women appears, it should never be fully gratified, the food being given more frequently possibly, but always in moderate quantities. A too generous diet places too great a strain upon the kidneys of the pregnant woman, and the fact that an accident in the nature of eclampsia has not before occurred is in no way a guarantee against its appearance in the pregnancy then present. Also, too great an amount of nutrition has the disadvantage of sometimes increasing the size and weight of the child and thus increasing the difficulties of paturition.

Exposure to wet and cold and to drafts

must be guarded against, in some instances one such exposure being sufficient to bring on an attack of acute nephritis, with fatal results to both mother and child. If the teeth decay, an evidence of under-nutrition, the syrup of the lactophosphate of lime should be given daily. During the last two months of the pregnancy, gentle massage of the nipples should be practised, together with anointing them with some emollient such as sweet almond oil, in order to keep them soft and lessen the dangers of fissure.

The sure diagnosis of pregnancy seems always an easier matter to the inexperienced than to the old practitioner. There is no common condition of the human frame that is so often diagnosed as something else or so frequently overlookt. Yet there are no mistakes in diagnosis so discrediting to the physician as this, nor so little excused by the laity, particularly when, as is quite possible, serious results occur from such lack of certitude. Cases are on record in which men with national reputations as obstetricians and gynecologists have operated for tumors on the pregnant womb. Other cases conceded to be pregnancy have finally been determined to be ovarian cyst, pseudocyesis, etc. It is for this reason that the trite rules for systematic examination of the patients have been given above, for one of the surest means of avoiding such errors is the habit of making a methodic and careful routine examination of every patient in whom pregnancy may be possible (even when not probable), neglecting not a single one of the important subjective or objective signs, and looking for them in the order they may be expected so as to not omit any. It must be remembered also that in regard to the subjective signs the patient's statements must not be depended upon, save as they are confirmatory of the diagnosis of probable pregnancy, and not then if there is on her part great desire for offspring.

The common question put to a physician called in labor, after he has made his preliminary examination, is as to the probable

duration of the process, and here too many make the mistake of committing themselves to some definite period. In no condition is it more advisable to give an evasive reply than in this. The average duration of labor in women who have had several children is about 7 hours; in a first confinement it is apt to be about 17 or 18 hours. It might be well, according to a well-known authority, to give such noncommittal reply as "the length of the labor will depend upon the strength of the pains." This phrase is very profound in its apparent wisdom, and is likely to satisfy the inquirer. It certainly will not expose the physician to injurious comment, no matter what the length of the parturition may be.

A physician should give an obstetric call the precedence of almost everything else. When he comes into the presence of his patient he must bear in mind the increased sensitiveness characteristic of preg-nancy, and avoid doing anything to offend: the patient thru this condition, so exaggerated in labor. His demeanor should be cheerful, but not obtrusively so, and, especially, sympathetic. Any statements the parturient should desire to make should be listened to attentively and met responsively. There should be a general neatness of dress, and no odor of tobacco or liquor. He should see that there is at hand some brandy, a little ether, several ounces of the the fluid extract of ergot, a binder for the mother, clothing for the infant, large and small safety pins, castile and green soap, alcohol, a pair of blunt and a pair of sharp scissors, old linen, soft towels, absorbent cotton, hot water (means for heating it also), vinegar, antiseptic tablets, a fountain syringe, a bed-pan, a new, soft-rubber catheter, five yards of carbolized gauze, a skein of bobbin, a piece of tape, carbolated vaselin, aseptic silk ligatures, hypodermic equipment, the obstetric forceps, hemostats, needle-holder, a small electric battery, etc.

The above are some of the obvious points, and yet there is in all something new, something provocative of debate, and

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