THE NECESSITY OF IRON TO THE PREGNANT WOMEN

It is universally conceded that the administration of iron in pregnancy is now made expedient by the development of an anemia which is usually foreign to non-pregnant subjects, and which, at one time, was an uncommon occurrence even in the case of the childbearing.

During pregnancy, the appetite is invariably capricious and there is a disposition to gratify the palate by partaking of those foodstuffs which have been rendered ficticiously attractive to the partial, or by the complete exclusion of the more simple and nutritious viands. While such indulgencies must inevitably contribute to the development of anemia, it was not until the modern table supply, consisting almost wholly of such victuals as hot breads, highly spiced refrigerated meats, artificially colored canned goods and pastries, was made the rule with the masses as well as the classes, that anemia of pregnancy became the rule and not the exception.

In addition to the inadequate food supply which is now current, the anemia of pregnancy is rendered more widespread by the style of dress imposed by society upon women in all the walks of life. Furthermore, the blood depletion of prospective mothers of the present day is materially increased. through their abandonment of outdoor exercise on account of a false sense of modesty.

In view of the fact that the health of a woman in the pregnant state, and the proper development of her unborn, is always directly dependent on a blood stream that is qualitatively and quantitatively sufficient for the exigencies of pregnancy, the administration of iron is made distinctly needful by the artificialties inseparably associated with modern life.

In selecting the form of iron to be administered to pregnant women, the ut

most discrimination should be exercised. That form of the drug which is most easily assimilated and proves most acceptable to the palate is the one which should be employed. This injunction is made for the reason that the nausea which is incident to the pregnant state must not be increased, and for the further reason that constipation must not be induced by the drug. Again, the nutritive processes must be held at the proper standard, and this cannot be done in the absence of a painstaking selection of the iron to be administered.

Pepto-mangan (Gude) is the ideal form of iron for these cases. This contention has the support of logic. The hemoglobin-imparting properties and the nutritive potency of the preparation are confessedly greater than those of any other form of iron. Then, too, pepto-mangan (Gude) is more readily absorbed and more completely assimilated than any other preparation of iron. Still further, pepto-mangan (Gude) produces no untoward effect upon the mucous surfaces of the alimentary tract, nor does it encourage constipation or increase nausea.

In adition to overcoming the anemia and the deficiencies of nutrition, peptomangan (Gude) adds tone to the blood vessels and reduces to a minimum the softening of the heart walls which always attends the pregnant state.

Certainly one of the most gratifying effects of pepto-mangan (Gude) is the increase of physical strength and buoyancy of spirits which the prospective mother derives from its administration. That the unborn participate in the benefits derivable from pepto-mangan (Gude), there can be no doubt, for at birth they present unmistakable evidences of physical robustness, and seem well fortified against those illnesses which are peculiar to infanthood. It is also a matter of common observation that the roborant action of pepto-mangan (Gude) enables the mother better to bear the strain of parturition.

business he has brought into the firm during this period.

It is evident that under this system no injustice is done to the popular ambitious man, and the drone or lazy man will get just what he earns and no more. Every member of the firm should be a family practitioner, as well as a specialist in some line of effort, and in order that no injustice be done it should be understood that if, for instance, the eye man finds a case of appendicitis which. he turns over to the surgeon for operation, fifty per cent of the fee shall be charged to the account of the eye man and the rest to the surgeon. In this way the eye man is compensated for his diligence in making a diagnosis and bringing the case into the firm, and the surgeon is compensated for his actual work.

Patients should be allowed to choose any member of the firm they wish to attend them, and if necessary other members of the firm should be willing and ready to consult with the attending physician, wthout compensation, it being presumed that the efforts would about offset each other in the course of a year, and it would be a great drawing card to the average patient to know he can get the services of six physicians, if necessary, for the price of one's services.

For night work, each physician should take turns to go on duty, so as to preserve the health of each member and prevent the soul destroying work of being up night after night.

The laboratories should be under the supervision of one member of the firm, and if practical, the actual laborious work done by a student as far as possible, as the average student can soon be trained to do this work with precision.

Provision should be made giving each physician a vacation of one month each year, either to be taken at once or in periods of a week or more. If the member desires to go away for study, his tuition should be paid by the firm out. of the general receipts. While on his vacation, he shall draw from the general receipts the same amount as he was

paid the previous month instead of his percentage share. This is done to encourage vacations, and especially study, making each member so much more valuable to the concern.

The firm should have a press agent to give out timely hints upon the public health, giving warning upon the general increase of contagious diseases in each community; giving information. that will prevent the farther spread of disease by asking the people to follow the golden rule (the old version, not the new); cultures should be made of water, milk, etc., several times a week and the proper authorities warned of infection or when dangerous preservatives are used. Sanitary inspection should be made and all violation reported for correction.

Monographs in simple, plain language should be given to the public press from time to time as the season may warrant, giving minute directions on how to avoid certain certain diseases and prevent their spread. These, if possible, should be conservative, telling all that is actually known regarding the disease in question and pointing out the fallacy of popular beliefs.

There is no one thing that will raise the medical profession so quickly in popular estimation as telling the actual naked truth. There is nothing that will disarm the quack, both out of and in the profession, so quickly as accurate knowledge concerning medicine.

Let each member of the firm study some specialty outside of medicine that has a bearing upon our complex civilization and give accurate knowledge upon this subject through the public press. In the matter of publicity, union of physicians will solve this problem satisfactorily.

Yet another question of sociologic importance should be considered; the support of the home paper, the organ through which you can accomplish much good. It is no more than fair that it should receive your support. The printer must live and if he don't.

receive support from his townspeople he must reach out and take advertisements from other people who are willing to take a chance on getting their money back.

I am under the impression that it would pay the firm to take a small space, giving names of their members with their equipment and laboratories and pay a big price for this space, enough in fact to make it worth while for the printer to refuse all patent medicine advertisements. Or if this is not the best plan in your particular community, pay for space for your articles upon various public topics, with the direct understanding that objectional advertisements are to be left out. The public press is the greatest factor for good or evil that we have in our civilization today, and I am very much inclined to believe that they represent fairly the intelligence of their environment. If the editor can't live from the support of the good people he must cater to the evil to do so.

In this age and stage of the game we are all just as honest and law-abiding as our environment will let us be, and none of us are what we should be, or would like to be. But the ever present specter of "making a living" influences many of our actions, and not always for the best interests of ourselves or the community; so that the support of the home paper by the good people of each community is of prime importance and it should be the business of each community to hold the paper strictly to account for any dishonest tendencies.

THE DRUGGIST PROBLEM.

I have spent much time investigating this animal and have come to the conclusion, generally, that he is hopelessly depraved; that he and the profession must part company. There doesn't seem to be even a remote chance that this individual can be redeemed; dishonesty, unscrupulousness, ignorance and cupidity have ruined this right arm of the profession until he is not only at menace to the physician but to the com

munity as well. The art of substitution, counter prescribing, retailing of liquors, selling of cocaine and morphine to fiends, the business policy of saving a few cents on each drug, making all the difference between a good or a worthless one has blunted his sensibilities to such an extent that no regeneration seems possible. He has catered to the soda water and cigar trade, sold abortion pills, etc., until he has many of the qualities of a fiend in his make-up. He is not responsible for all the bad truck he sells, as my spies have told me that in the manufacturing house they have. filled many bottles of different fluid extracts from the same can and labeled them for the trade, but more anon, regarding this wealthy and corpulent individual. It is sufficient to say that no physician has any assurance that he will get what he orders when it comes directly from certain manufacturing houses, so that a specially trained pharmacist must be included in the firm as he will have no incentive to be dishonest with his employers. His judgment can be depended upon to secure to the firm a fine class of drugs and in this way one of the most serious drawbacks of our profession may be avoided.

I have had the privilege of investigating many of these medical firms in different cities and without exception they are the important factor in each community in which they have their being. The rest of the medical fraternity regulate their own conduct by the example set by the firm, and in each place investigated I found that the best practice was invariably owned and controlled by the organization, and that the members of these firms were highly respected by their competitors and called frequently in consultation when required.

If a physician who is enlightened and desires to form an organization of this kind cannot persuade his competitors to join him in an undertaking of this kind he is justified in advertising for more progressive physicians to come into his