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546 Amendments to the Anti-Trust Act of 1890 Prior to 1911, the Supreme Court by a series of decisions (see 14.711) had denned the scope of the Anti-Trust law of 1890; but while the Act had been sus- tained, the net effect of the interpretations given to the law had been to limit its effectiveness. However, in the oil and tobacco cases decided in 1911 (221 U.S. 1-106 and 106-193) the Supreme Court adopted a "rule of reason" formulated by Chief Justice White, which gave greater flexibility to the Act and promised to make the law more effective. In a previous decision involving railway com- binations, the Supreme Court had interpreted literally the language of the statute, and had not considered whether the combination was reasonable or in harmony with sound public policy. This interpretation had made the statute almost a dead letter as far as regulating combinations. In the oil case, the Supreme Court, speaking through Chief Justice White, said: " It becomes obvious that the criterion to be resorted to in any given case, for the purpose of ascertaining whether violations of the section have been com- mitted, is the rule of reason guided by the established law and by the plain duty to enforce the prohibitions of the Act, and thus the public policy which its restrictions were obviously enacted to subserve." The Court held, in effect, that the purpose of the law was to pre- vent undue restraint of every kind and that it did not deny to in- dividuals the right to enter into contracts when the right was not improperly exercised.

This interpretation of the Anti-Trust law was unsatisfactory to the extreme opponents of industrial combinations, and it was thought by many that Congress should define combinations and monopolies. In response, the Clayton Act of 1913 was passed, pro- hibiting, under specified provisions, discriminations in prices and con- taining numerous other sections intended to make the general pro- visions of the Anti-Trust Act of 1890 more specific. It is doubtful, however, whether the Clayton Act has really strengthened the Act of 1890. Labour unions and organizations of farmers are exempted from the provisions of the Anti-Trust law. Interlocking directo- rates of banks are prohibited, and it is made unlawful for a corpora- tion engaged in interstate commerce to acquire control by stock owner- ship of another corporation engaged in interstate commerce when such acquisition will lessen competition. Carriers engaged in interstate commerce are prohibited, after two years from the passage of the law, from dealing in securities or supplies or from making construction con- tracts amounting to more than $50,000 with a corporation, firm or partnership having on its board of directors or as one of its officers a person who is at the same time a director or officer of the common carrier. This provision was suspended until after the conclusion of the World War, but was in force in 1921.

The most important decision of the Supreme Court subsequently to 1911 was its finding in the case of the United States against the Steel Corporation, March I 1920 (251 U.S. 417). By this decision, the largest of all industrial combinations was held not to be a viola- tion of the Sherman Anti-Trust Act. It was not shown that the Steel Corporation had unduly limited competition. The Court decided that it " should consider not what the corporation had power to do or did but what it has power to do and is doing." It reached the conclusion that the public interest would not be served by re- quiring the dissolution of the Steel Corporation, but that, on the contrary, its dissolution might result in a material disturbance to American foreign trade.

Adjustment of Labour Disputes. The Erdman Act of 1898' was amended by the Newlands Act of July 15 1913, and more adequate machinery provided for mediation and arbitration of labour dis- putes. The Erdman Act had provided for voluntary conciliation upon the initiative of the chairman of the Interstate Commerce Commission and the Commissioner of Labor. If conciliation failed, the parties might submit their controversy to arbitration. In that case a board of three men was provided, one arbitrator selected by each side, these to choose the third arbitrator, or, if they failed, the third arbitrator to be chosen by the chairman of the Commission and the Commissioner of Labor. Both the railway companies and their employees objected to submitting their disputes to such a small board, and the Newlands Act therefore provided for a board of five to nine men and also created a board of mediation and con- ciliation composed of a commissioner and two other designated offi- cials of the Government. A series of important arbitration proceed- ings was held under the Newlands Act, but by 1916 the railway employees had become dissatisfied with the results of arbitration and made a demand on the carriers for the establishment of an eight- hour day and for a general increase in wages. The carriers resisted and the deadlock was broken by the passage of the Adamson Act in Sept. 1916, establishing the standard eight-hour day in the railway service, and providing for a commission to decide upon wages. There was much popular dissatisfaction with the Adamson Law, which was hurriedly enacted by Congress under the pressure of a threatened labour crisis. The Supreme Court the following spring held the law to be constitutional, and the Adamson Law has definitely established the standard eight-hour day in the railway service (243 U.S. 232). The Newlands Act and the machinery it created have been sup- plemented and in fact supplanted by the labour provisions of the Transportation Act of 1920. Whether the machinery created by this Act would work satisfactorily had not been fully determined in 1921, but the success of the Board in averting a threatened strike on Nov. I of that year gave the Board increased popular support. For details as to statutes, consult Barnes' Federal Code (1919) and the supplement (1921). The most important decisions of the Supreme Court interpreting the power of the Federal Government over intra-state railway rates are Simpson et al. vs. Shepard, 230 U.S. 352 ; Houston East and West Texas Railway Co., and Houston and Shreveport Railway Co. et al. vs. United States, 234 U.S. 342. The most recent significant decisions of the Supreme Court inter- preting the Anti-Trust Law are Standard Oil Co. vs. United States, 221 U.S. I ; United States vs. American Tobacco Co., 221 U.S. 106; United States vs. U.S. Steel Corporation, 251 U.S. 417, und the Adamson Law Case, Wilson vs. New, 243 U.S. 232. (E. R. J.) INTESTINAL STASIS (see 8.263; 19.924; 19.430; 1.33). In abdominal surgery during recent years some of the principal advances have been due to the increased attention given to the study of chronic intestinal stasis, a term which comprises a sequence of changes which affect the entire gastro-intestinal canal. They are in the first instance mechanical in character and are due to the delay in the evacuation of the contents of the intestine. Later the accumulation of material in the large bowel leads to stagnation of the chyme in the small intestines and to its infection by organisms. These germs extend upwards through the ileum, jejunum and duodenum, and foul their contents from which the body obtains its nutrition. The material absorbed from the infected contents of the small intestine contains toxins and perhaps organisms. These may be in a quantity sufficient to escape excretion and alteration by the liver and kidneys. They are carried in the blood-stream and supply the cells of all the tissues of the body with a medium which rapidly produces degen- erative changes in them. This infection of the contents of the small intestine by organisms is a matter of the most serious importance in its bearing on the health of the individual.

The Mechanical Changes in the Large Bowel in chronic intestinal stasis usually originate early in the lifetime of the individual. When the napkin of the infant is discarded, the child is educated to expel the faeces only once a day, so that the product of a whole 24 hours' digestion is collected in the distal portion of the large bowel and especially in its pelvic segment. The bulk of faecal matter in these circumstances appears to be greater than this section of the bowel can accommodate without undergoing alterations in form. Changes in the intestine and in its connexion to adjacent structure develop. These vary in character with the vitality of the subject. In one extreme of low vitality the colon elongates and dilates, and consequently loses in expulsive power. The elongation of the pelvi" colon affords a serious obstacle to the evacuation of its content: Infective processes in the mucous membrane also produce a condi- tion of spasmodic obstruction. In the other extreme, in the more vigorous subject, lines of resistance are crystallized as bands or membranes which tend to retain the bowel in position and to oppose its distension and elongation. These bands are generally distributed along the concavity of the large bowel and reach a high state of development at certain definite points. At first they perform a useful function but later, as they contract, they obstruct the lumen of the bowel and tend to shorten life. These deviations from the normal are characteristic of two extreme types of intestinal stasis, within which all varieties and combinations exist.

A matter of great importance is that the cases included in the first group do not get cancer of the large bowel any more than they get carcinoma of the stomach and oesophagus, while those in the second group are very liable to the formation of cancer at any of the points of obstruction produced by the acquired bands or in the situation of the muscle at the junction of the pelvic colon and rectum, or about the sphincter ani. Another point is that the consistence of the contents of the large intestine varies greatly throughout its length; while in the caecum and ascending colon it is of a fluid or pasty consistence, in the descending, iliac, and pelvic portions of the colon it is usually firm and may be very hard. Therefore the physical character of the faecal matter is a matter of importance in the consideration of its effects upon and its capacity to pass through any portion of the bowel whose lumen is materially constricted. The explanation of the varying frequency of cancer in the two extreme types is obvious. To exert traumatism at the seat of constriction it is necessary that there should be sufficient thrust produced by the muscular wall of the bowel, and again the mechanical effect of that thrust varies directly with the bulk and consistence of the portion of the intestinal contents which is forced against the partly obstructed segment of bowel, and with the degree of the obstruction. In the first group the very elongated bowel with its feeble muscular wall, with its inflamed mucous membrane and its very scanty contents, exerts but a slight effect upon the mucous membrane at the junction of elongated loops of colon, the kinking or obstruction by membranes being non-existent in these cases. Instead of developing excessive power by the hypertrophy of the muscle coat of the