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and other schemes. These lists are classified into $10 investors, $25 to $100 investors, $100 to $500 investors, and investors having $10,000 or more available. The "$10 investors" are mostly made up of a class of people who are in the habit of taking a small "flyer" occasionally of not over $10, investing this amount on the theory that it may turn out with a big profit, but that in any event the loss cannot exceed $io. This class appeals to the swindler also, in spite of the fact that the amounts invested are small, for the reason that even if the scheme is exposed as a swindle, the individual amounts invested are so small that it would not pay any single person to resort to law for the recovery. of his money. True it is that a large number of such investors, if acting in concert, would become a menace, but as a rule such investors are too widely scattered, or too unintelligent or indifferent to make any move of this kind. In number, these $10 investor lists run into the hundred thousands, and are the main avenue for floating schemes of the cheaper and more openly fraudulent variety.

The "$25 to $50" list is made up of country investors, Methodist and Baptist ministers, country doctors and all classes of teachers; also barbers, waiters, hospital nurses and the general class of people who are able in one way or other to set aside for a rainy day from $25 to $100 per year. These lists are used in slightly more pretentious schemes, of course, with sometimes a little more merit to them. The $100 to $500 investors consist of doctors of slightly higher grade than those referred to above; also college teachers and professors, small Wall Street lambs, Episcopal and Presbyterian ministers, mercantile clerks, some country merchants and other thrifty people who annually accumulate a few hundred dollars over and above their cost of living.

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While swindles are promoted to a gigantic extent thru circulars and by mail, yet much business is also done thru the medium of newspapers, magazines, and "class" publications. Many (but not all) of the large metropolitan dailies will sell advertising space in which notorious swindles are promoted; magazines, also of high-grade in other ways, constantly sell space for the exploitation of mining, real estate and other schemes; the columns of country dailies and weeklies are not only open, as a rule, to such schemes, but for a consideration they will often publish "write-ups" recommending or booming a particular enterprise. The "write-ups" generally consist of editorial or other special articles which are prepared or endorsed by the promoters themselves, and they, of course, pass in the reader's mind as genuin and truthful.

These are, of course, frauds of the most palpable kind, and the publication of such matter is entirely unfair to the readers of the paper. It is a species of cheap and insidious deception which should, wherever found, be condemned in unmeasured terms.

Another illegitimate method of the promotion of swindles is thru trade journals, particularly in the mining industry. This country is nowadays flooded with mining newspapers and journals, which, while ostensibly independent and legitimate in their character and methods, are, as a matter of fact, actually owned and controlled by the same people who are engaged in the promotion of mining and other swindles on a gigantic scale. These journals are filled with special articles and editorials which recommend and describe in glittering terms the stocks and possibilities of this and that enterprise in mining, or oil, or real estate, or manufacturing, in which they themselves are interested. This is a more modern method of exploiting swindles than some of the others, and apparently has been most effectiv.

This shows how doctors are "sized up," in relation to these schemes, by the schemers. And the fact that they continue working on the doctors indicates that they get encouragement. If, as Bobby Burns said, to see ourselves as others see us would from many a

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blunder free us, then a doctor who reads the above will never again be caught by any of these "small investor" schemes.

If doctors want to take another look at themselves "as others see them," here is another chance. Some one sent me a circular

sent out by the "Investors Name and Address Co." They make a business of furnishing to the schemers the names of "suckers." This circular offers $5 in the stock of an oil company for the names and address of five people likely to invest in such a concern. At the end of the circular is the following:

INSTRUCTIONS.

Don't send names of millionaires or wealthy people. We want only the names of small investors whom you positively know are either stockholders in mining or oil companies, or would likely become interested in investments in such companies.

What we mean by small investors is mechanics, clerks, physicians, dentists, school teachers, or small storekeepers whom you think may have surplus sums of money in savings banks of from $50 to $500 and who would be likely to invest same in mining or oil stock. As we are placing entire confidence in the public, we feel sure that no one receiving this liberal offer will abuse our trust by sending us names other than those of their friends whom they know to be interested in the above named class of investments.

There you are.

Let the medical profession

use this as a mirror, by which they can see themselves as others see them-and to look into such a mirror is a "healthy" thing to do occasionally. The trouble is that physicians can seldom find such a mirror. They are so praised, flattered and nearly worshipt by their patients that the weaker ones think that they are really great men, and almost infallible. Any man in that frame of mind is easy prey to a smooth and plausible schemer.

Dr. Frank Lydston, of Chicago, is a very level headed man. Some time ago he contributed an article upon this subject to the N. Y. Med. Jour. He gives the following summing up of the subject:

1. The man who has a profitable mining, land, or agricultural scheme to finance is not compelled to go into the office buildings of our cities, or to the modest dwellings of our country practitioners, for the purpose of inducing them to invest their hard-earned dollars. Had I a really excellent mining or other scheme to promote, I think I could spend my time much more profitably among capitalists than among doctors or other professional men. The amount of unused capital in America that is lying in wait for judicious and profitable investment is so great that even the fools should be able to understand the situation.

2. The legal rate of interest is establisht by our general financial and commercial conditions. This legal rate is supposed to be a safe rate. Yet our men of great wealth, when they desire to make investments, buy government bonds, the interest upon which is about half the legal rate of interest. They do this because they consider the bonds the only investment which is absolutely safe. This is a hint that the physician who has a few hard-earned dollars which he is tempted to invest in wild-cat schemes would do well to remember. 3. The most important point is this: With every I percent of interest promist above the legal rate, the danger compounds. The difference in safety between an investment which promises 5 or 6 percent and one

which, it is alleged, promises 10 percent, is something staggering.

4. It is well to remember that most of the men who have lost money in speculation have done it while "backing another man's game." The professional gambler considers this a very dangerous practise. As he expresses it, "Something always goes to the 'kitty, whose remorseless maw will inevitably break the outsider if he plays the game long enough." The little commission charged for turning deals on the stock exchange or grain market is the equivalent of the amount that is paid to a "kitty" in a gambling game. This amount, trivial as it is, constitutes terrific odds against the man who is playing the game from the outside. It is the fleece of which the lamb must inevitably be shorn in time.

Why the physician should be generally so incompetent in business affairs out of his own field of work is a question hard to answer offhand. His profession, perhaps, is so exacting that it leaves him little time to attend to other matters. The work of a doctor, too, brings him into contact with so much misery and suffering, that it is apt to make him unworldly and trusting. Again, it is more easy to gain an audience with a physician than with members of other professions, or business men. Be the reason, however, for the gullibility of the physician what it may, the fact remains that he is particularly open to the art of the fakir and swindler. There are signs that at last his eyes are being opened, and that in the future the doctor will lend a deaf ear to the wiles and blandishments of the mining promoter and others of that ilk.

Here is a specific case. An old subscriber writes me about a certain mining stock, in which he has been led to believe, by a brokerage firm in the Wall street district, whose nice appearing letter head he incloses, that he can realize a large profit. Here is a part of his letter:

I am an honest old country doctor who has been making pills for 30 years, and having met with reverses several years ago, I would like to "lay by an honest dollar or two for the rainy day;" and I thought of investing in mining stock.

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I don't give individual advice, nor advice concerning specific investments; but I answered his letter. It is not strange that he had met reverses, tho he did not say how, or what kind of reverses; that kind of a man will always meet reverses, sooner or later. told him that the way to avoid further reverses is to keep safely every dollar of his hard earned money, and get the good of it himself; that if he put money into such schemes he would never see it again. It is pitiful to see an honest old country doctor kept in poverty by throwing money away in that way.

Here is a doctor with his eyes open. Here is his letter:

Editor MEDICAL WORLD:-Inclosed is a sample letter which I think would be a good one for you to publish if you can spare the space, for it is from an "M.D.," and it seems as if he is the promoter of a larger concern or money maker than " optimistic Ostrander," and wants to divide his millions with the profession and put a large number of them on the retired list within "two or three years;" but I suppose that he actually means tired, not "retired" list. It seems as if he does not want the capitalist's dollars, but the long green from the real doctors. Crestone, Colo. M. C. DAVIS, M.D. Here is the circular letter which he incloses. We purposely suppress the name and address,

to avoid advertising the scheme; and we put the letter in small type to save space:

DEAR DOCTOR:-Two years ago I made arrangements with the government of Peru to buy the largest pure Para Rubber yielding property in the world. It consists of 585 square miles of dense rubber forests and can yield an immediate revenue of many million dollars per annum. I have and own for myself and others the controlling interest in the company, to prevent large capital getting hold and freezing us out.

I am now planning to assist the company to obtain enuf funds to start tapping and developing the property, and, when once started, even on a small scale, the dividends will be enormous for

the stockholders.

Capitalists from Germany as well as this country have made propositions to buy the control. This is not for sale at any price. Doctor, I have formed a plan to share with you some of my own stock, free, if you will come in now. No bonus stock has gone anywhere, and all we want is to sell sufficient stock to work our property. I have practised over 16 years and have now retired from the profession to make rubber my life's work, and I will realize some millions out of it. If you will come in now, on my say so, I will share with you a certain amount of stock out of my pocket, free (stock has been selling at par), and I will guarantee you, on your investment, more than $700 per year on every $100 you invest; then, too, as I have decided to divide with the prefession only, a certain amount of my shares, and thus materially assist the treasury sales, there is no chance of a freeze out.

Doctor, I can show you that whatever amount you invest in our company will bring you the same amount in dividends every month for life within two or three years. This is absolutely true. It is not often the general public can get in on a deal of this sort. I have the confidence of the government of Peru, speak Spanish thoroly and have given ample credentials and bonds that I will manage this enormous property and not allow the control to leave my hands. Hence my plan to divide my stock and do you a good turn, well knowing from experience how hard it is for us to save something, for our old age, from our practise.

If this interests you, doctor, let me give you my plans in this matter and show you what I mean. As I have only a limited amount of stock to divide with my brother professionals, let me hear from you at once and I will give you confidential particulars and the best of references.

Awaiting the favor of an immediate reply, I am, sir,
Fraternally yours,

Emulation Among the States.

M.D.

Our country is made up of a number of governments-each state is a different government, making and administering laws within its own confines according to the privileges and limitations stated in the Constitution. As a result there are gradations, from good to bad or indifferent, in the laws in the different states on many questions. Massachusetts has held a long and honorable lead in the excellence of her laws, so much so that the legislators of other states have long studied the laws of Massachusetts with a view of modeling after them in many ways. But during recent years, and particularly in medical matters, New York state has perhaps taken the lead. New York was the first to establish a colony for epileptics, and I think the first to establish a state sanitarium for the treatment (open air treatment) for tuberculosis. The following extract from the daily New York Letter in the Phila. Ledger will indicate New York's determination to progress along medical and pharmaceutical lines:

NEW YORK, March 25.-Determined efforts will be made this week to effect the passage by the legislature of a bill to require manufacturers of all medicinal mixtures containing alcohol and narcotics, except those for external use, to reveal their presence, with the percentage of such ingredients, on the label.

The agitation for the measure has been conducted by leading men of this city, but there are also powerful enemies, and the fate of the bill is problematical. The charge is made by supporters of the measure that there are drug stores here which gave away cocain for the pur

pose of developing the habit and gaining customers. It is said further that manufacturers of so-called catarrh cures which contain cocain are in the habit of distributing free samples with the same end in view. Cases have been cited of persons who became addicted to the cocain habit thru this promiscuous distribution.

It is also shown that medicins advertised as "free from alcoholic stimulant" and "recommended for treatment of alcoholic habit contain large percentages of alcohol. Certain headache powders contain acetanilid in quantities which sometimes cause collapse. Other medical preparations contain opiates.

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W. Jay Schieffelin, a drug manufacturer, said today that more than 20 percent of the cocain manufactured in this country is converted to illict use, and fully 60 percent of the 200 girls in Chinatown, some not more than 14 years old, are confirmed victims of this drug. Mr. Schieffelin said that he did not want to be hysterical about this matter, but a pass had been reached when New York must be an exemplar to the other States in stamping out an evil that has made terrible inroads on the country's vitality and moral standing.

The New York law today lists thirty-five drugs by name, and includes many others by general descriptiv words, which, if sold, must be labeled poison. Opium, morphin, cocain and certain others cannot be sold unless in addition to the poison label, an entry is made of the date, name and address of the purchaser, the name and quantity of the poison, the purpose for which it is represented by the purchaser to be required and the name of the dispenser. Physicians, veterinarians, pharmacists, nurses, plumbers, auctioneers and engineers must be qualified and licensed or registered before practising on the public. But any irresponsible, unlicensed, unscrupulous person, without education or learning in medicin or pharmacy, may compound a mixture, using as ingredients any number of the drugs in the poison list, and may advertise it as a cure for any known ill without restraint, without poison label and without giving warning or information of its contents.

Government Opposition to Quackery. The present administration at Washington is doing more for the people in the way of putting the strong hand of the government on quackery than any administration we ever had. The following clipping from the Philadelphia Ledger indicates the mode of operation and the results:

FRAUD ORDERS ISSUED.

ACTION TAKEN IN NEW YORK SIMILAR TO PHILADELPHIA CASES.

WASHINGTON, March 25.-Orders have been issued by Postmaster-General Cortelyou instructing the postmasters at New York and Brooklyn to refuse to admit to the mails the advertisements of fifty-two illegal" medical offices located in those cities, and also to refuse to deliver mail matter received addrest to the fictitious and assumed names under which parties conducting these concerns hide their identity.

This action at New York and Brooklyn is in line with the efforts previously made by Postmaster-General Cortelyou in Boston and Philadelphia to enforce the law against this class of criminal concerns. In Boston last March thirty of these concerns were barred from the mails, and the government's crusade in Philadelphia last September resulted in closing thirteen establishments charged with being illegal" medical offices."

The order says:

"The condition of affairs which has developt under the department's investigations in all of these cities has been appalling. It was found that in a large number of instances those engaged in conducting these offices have criminal records and are 'dope' fiends. In Boston one of the concerns excluded from the mails was supposed to have been the office at which was performed the fatal operation upon the young woman Susan Geary-the suit-case murder. One of the doctors,' whom the department found identified with several of these 'offices' in Boston, was also connected with the Susan Geary case. The number of deaths that have been caused in these offices can never be known.

"The volume of business done by these concerns was large. It was said that as high as twenty criminal operations a day were performed in some of these offices, and that the income sometimes ranged as high as $2,000 a week."

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Obstacles to Quack Medicin Legislation. 'Physicians used no influence in favor of the bill, except to pass resolutions indorsing it; they advanced no arguments; they wrote no letters to the committee or to members of the legislature. So much for sins of omission. While the physicians of Mississippi were attending strictly to their private affairs and forgetting the interests of public health, the Proprietary Association of America was busy. It sent men up from New Orleans to Jackson to lobby; it manipulated the 'redclause' press (tho a number of independent weeklies thru the state came out squarely for the bill); it distributed literature. Antikamnía sent a special agent to the spot. (Observe how this 'ethical' proprietary shows its true colors when quackery and fraud are threatened.) The retail druggists were stirred up to write to the legislature, and protests poured in on the committee having the bill in charge."-From an editorial in the Jour. Am. Med. Ass'n for March 3d, page 659.

And yet a great many otherwise respectable medical journals still admit antikamnia to their advertising pages, and many of them publish puffs for it in their reading columns. Last month (page 129) we gave a list of some of the journals which still admit the antikamnia advertisement. We here repeat it :

The Great Weeklies:

The New York Medical Record. The New York Medical Journal (with which the Philadelphia Medical Journal and the Medical News are now consolidated). The Boston Medical and Surgical Journal.

The State Organization Journals:

Journal of the Mississippi State Medical Society. Journal of the Minnesota State Medical Society. Western Medical Review, the Journal of the Nebraska State Medical Association.

Other Journals:

American Journal of the Medical Sciences ($5 per year; publisht by Lea Bros. & Co.).

Surgery, Gynecology and Obstetrics ($5 per year; the great surgeons, Senn and J. B. Murphy on the staff).

Annals of Surgery ($5 per year; J. Wm. White and other great surgeons on the staff).

American Journal of Obstetrics ($4 per year).

Therapeutic Gazette (edited by H. A. Hare, the author of medical books and a professor in Jefferson Medical College, and Edward Martin, a professor in the Medical Department of the University of Pennsylvania).

The Lancet-Clinic.
The Medical Standard.
Iowa Medical Journal.
Colorado Medical Journal.
Carolina Medical Journal.
Texas Medical Journal.
Texas Medical News.

Texas Courier-Record of Medicine."
Alabama Medical Journal.

Interstate Medical Journal.

Canadian Journal of Medicine and Surgery.
International Journal of Surgery.

American Journal of Surgery,

Journal of the Association of Military Surgeons. American Practitioner and News.

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Our national quality of commercial shrewdness fails us when we go into the open market to purchase relief from suffering. The average American, when he sets out to buy a horse or a box of cigars, is a model of caution. Show him testimonials from any number of prominnent citizens, and he would simply scoff. will, perhaps, take the word of his life-long friend, or of the pastor of his church, but only after mature thought fortified by personal investigation. Now observe the same citizen, seeking to buy the most precious of all possessions, sound health. Anybody's word is good enough for him here. An admiral whose puerile vanity has betrayed him into a testimonial; an obliging and conscienceless senator; a grateful idiot from some remote hamlet; a renegade doctor, or a silly woman who gets a bonus of a dozen photographs for her letterany of these are sufficient to lure the hopeful patient to the purchase. He wouldn't buy a second-hand bicycle on the affidavit of any of them; but he will give up his dollar and take his chances of poison on a mere newspaper statement which he doesn't even investigate. Every intelligent newspaper publisher knows that the testimonials which he publishes are as deceptiv as the advertising claims are false. Yet he salves his conscience with the fallacy that the moral responsibility is on the advertiser and the testimonial giver. So it is; but the newspaper shares it.-Adams, in Collier's Weekly.

One grain of iodin and 2 grains of iodid of potash in an ounce of water will remove tartar from the teeth, if teeth are brusht with it once or twice a day.

ORIGINAL COMMUNICATIONS

Short articles of practical help to the profession are solicited for this department.

Articles accepted must be contributed to this journal only. The editors are not responsible for views expressed by contributors. Copy must be received on or before the twelfth of the month, for publication in the issue for the next month. We decline responsibility for the safety of unused manuscript. It can usually be returned if request and postage for return are received with manuscript; but we cannot agree to always do so. Certainly it is excellent discipline for an author to feel that he must say all he has to say in the fewest possible words, or his reader is sure to skip them; and in the plainest possible words, or his reader will certainly misunderstand them. Generally, also, a downright fact may be told in a plain way; and we want downright facts at present more than anything else.-RUSKIN,

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Editor MEDICAL WORLD: As a doctor, the writer is but two years old and has a tremendous amount to learn regarding the practise of medicin. However, he makes no apology for his youth, but simply states it as a fact which time will remedy, in order that too harsh criticism may not be heaped upon him by his more experienced colleagues.

The case cited below was seen soon after beginning practise among the mountair s, sixty miles from a railroad, with no facilities for surgical work, and no assistant to be had except a poor inebriate who has since died of his excesses.

Patient was a robust, powerfully built farmer of 52 years. Saw him first on Jan. 25th. Abdomen slightly rigid and tender on pressure, no tympanites, no localized pain or tumor in right iliac fossa; vomiting; temperature 99.5°, pulse 90 and quite strong; respiration about normal. Gave history of cramps on Jan. 22d. Had had them a number of times in the previous 2 or 3 years, and had taken a pint of strong infusion of cascara bark, which, he said, had always cured him. He had taken a similar dose on the 22d, and repeated it on the 23d, with copious stools resulting, and a good deal of tenesmus. On the afternoon of the 24th he had a passage, scant and hard, but none on the 25th, when I saw him first in the morning.

Treatment: Opium for the pain, turpentine stupes, and hygroscopic poultice. Did not give purgativ on account of the recent purging he had received.

Saw him again on the 26th. Still no motion from bowels. Temperature subnormal, face pale and anxious, pulse fast and weak, eyes sunken, and profuse cold perspiration; abdomen very rigid and tender, with intense pain all over abdomen. He said the opium I left had not stopt the pain. Vomiting of a greenish color.

Made my diagnosis as intestinal obstruction

and acted accordingly. As emesis was free, I gave no emetic; and failing to get relief by a high enema, askt that a surgeon be surgeon be sent for. Relativs objected, so I made the patient comfortable as possible and came away. Before daylight next morning the son called and told me not to come again, as they were going for another doctor-the inebriate before mentioned. He went, told them he could do nothing, gave an enema and left. This information I received from the doctor later on.

Early on the morning of the 30th, 8 days from the first appearance of the cramps, I was called to help operate. Two surgeons had been sent for, and were on the ground. I went. Vomiting was stercoraceous, abdomen immensely distended and hard as a plank, with great pain. Still no passage from bowels.

Upon request I gave my picture of the case and diagnosis. They said "appendicitis," and decided to make the incision over McBurney's point. I "kicked," and requested a median incision. But it was two against one, and I had to swallow it. The peritoneum was as black as my shoe, and gut likewise. Intestin so d s'ended with gas that it was almost impossible to return it to the abdominal cavity, for patient died on the table even before the appendix was found. Then I requested the operator to go ahead and ascertain what the trouble was, but he refused on the ground that he did not wish to infect his hands!!! He was wearing rubber gloves, too.

Now, I have confest that I am only a young doctor and I do not "know it all," but I am pigheaded enuf to believe that my diagnosis was correct, even if my treatment was not the best possible. On the first day I made no diagnosis. There seemed to be a peritonitis, the source of which was obscure, so I simply tried to relieve the pain and reduce the inflammation. When the diagnosis was clear (were it obstruction or appendicitis) surgical interference was the treatment indicated.

From the data given, was my diagnosis correct? or was that of the big guns who operated? Don't score me too hard, doctor, even if I deserve it, for " thy servant is but a little child." J. T. LEFEVRE.

Sumpter, Oregon.

[You did right in advising operation, of course, and we have no criticism of your treatment except that we would have given morphin hypodermically until we had obtunded the pain before leaving the patient, and then left opium with him to prolong the effect until you could return. In so severe a case, and remembering that the dose of opium

varies so greatly in different patients, you could hardly have allowed him an unlimited quantity for fear of poisonous results, and yet it was your duty to make sure that he got the effect.

Either appendicitis or obstruction could have produced the symptoms found on operation, of course. What you ought to have done at the time of operation was to insist upon verification of their or your diagnosis. It would only have taken a moment, and if the surgeon was so fearful of his hands, where were yours?

You are getting a good training, doctor. The man who is thrown on his individual resources. frequently, learns to become self reliant, and, almost always, competent. Try to carry with you armament suitable to permit your coping, fairly equipt, with any emergency; and when caught in a bad case and far from help, work it out as best you can.-ED.]

Obstetrical Experience.-Rupture of the Uterus.

Editor MEDICAL WORLD:-I have often thought that it would be profitable to us all if we would give our failures, and report our difficulties, as well as our successes. It is pleasant to report a brilliant success, or relate a fierce encounter with some deadly malady in which we have come out victor; but it takes some courage to always "fess up" and tell of our disappointments and failures. With this thought in mind I offer the following clinical notes along the line of obstetrics:

In an experience extending over a quarter of a century I have encountered the following abnormalities: Four cases of puerperal eclampsia; two cases of shoulder presentation; one prolapsus funis; one hand and arm presentation; one case of puerperal insanity; six cases of violent postpartum hemorrhage; one case of inversion of the uterus; and one case of rupture of the uterus.

The four cases of eclampsia were all due to albuminuria. There were three recoveries and one death. The fatal case was a primipara, aged 25, who showed most pronounced symptoms of albuminuria very early in her pregnancy. There was albumin in large quantities at the sixth month. She was put on approved diuretics, and a milk diet urged. Under this treatment she improved some, but grew rapidly worse after the seventh month. The entire body was swollen, and the labia majora were so enormously enlarged that the patient could not walk, and tapping was done with markt relief. Saline diuretics, comp. jalap powder, and iron were the drugs relied upon, and the patient came to her confinement in fair condition. I feared trouble in this case, and called

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