CONTRIBUTIONS FROM THE JOURNAL: MISCELLANY
ALBERT ABRAMS, A.M., M.D., LL.D., F.R.M.S.
“Spondylotherapy,” “Electronic Reactions,” the “Oscilloclast,” the
“Electrobioscope,” Etc.
For some time _The Journal_ has received inquiries of which the
following recent examples are typical. This from an Ohio physician:
“Please give me some information concerning Dr. Abrams and his
diagnostic and therapeutic devices known as reflexaphore and
oscilloclast. If this is published please withhold my name.”
A physician in Massachusetts writes:
“Can you give me any information concerning Dr. (?) San Francisco,
California, who reports himself able to diagnose syphilis from a
drop of blood sent him on a blotting paper? He has caused a patient
of mine a great deal of needless worry.”
And from Rhode Island a physician facetiously inquires:
“I am interested to know of the ‘Reactions of Abrams.’ Have you any
information that you can give me in regard to this matter? They
apparently do wonderful things in the West.”
While a New York physician acknowledges his failure to keep up with the
times thus:
“To-day I had occasion to see a patient who mentioned having an
Abrams test for gonorrheal infection of the prostate. He also
stated he wished to have Abrams’ treatment for the same condition.
Could you enlighten me as to what these are? I thought I had kept
myself up to date as to all new tests and treatments in my line;
but evidently I have been delinquent.”
According to our records, Albert Abrams, A.M., M.D., LL.D., F.R.M.S.,
was born in San Francisco in 1864. He was graduated in medicine by the
University of Heidelberg, Germany, in 1882. Dr. Abrams is a member of
his local medical society and through that holds fellowship in the
American Medical Association. Dr. Abrams has written voluminously. In
1910, his book on “Spondylotherapy” (“Physio-Therapy of the Spine”) was
reviewed in _The Journal_. “Spondylotherapy” is a neologic creation of
Dr. Abrams. According to its disciples, it concerns itself “_only_ with
the excitation of the functional centers of the spinal cord” and has
been called “the science of evoking the reflexes of the body both to
diagnose and to cure disease.” In bringing its review of Abrams’ book
on “Spondylotherapy” to a close, _The Journal_ said:
“... one wonders whether this is an attempt to explain osteopathy
and chiropractic to the understanding of the regular practitioner,
or to exploit the very ingenious percussion devices of the
author, or whether it is really true that medical men really know
practically nothing about the cure of disease through treatment of
the spine. Let us hope that it is the latter and that a careful
study of this unique volume may open new avenues of therapy
heretofore undreamed of.”
While the review was obviously critical, yet in advertising the book,
the publisher picked out part of the closing sentence, omitted the
context, and quoted _The Journal_ as having said:
“Let us hope that a careful study of this unique volume may open
new avenues of therapy heretofore undreamed of.”
When this matter was brought to the attention of Dr. Abrams, he
replied, “I fail to see any real difference in the two quotations” and
“only one ... with an astigmatic mentality” could “see any incongruity
between the context and the concluding sentence.” Yet, in this same
letter which attempted to justify the garbling of a quotation so as
to make a critical review appear a laudatory one, Dr. Abrams declared
that the review in question was “conceived and executed in a malicious
spirit.”
Between 1912 and 1914 Dr. Abrams gave “clinical courses” on
“Spondylotherapy” in various parts of the country--price $50. These
“courses” were widely advertised by an Ohio concern that seems to make
a specialty not only of handling the advertising campaigns of those
members of the medical profession who have unusual or bizarre methods
to exploit, but also of acting as an agent for the sale of such devices
and publications as may be necessary to the proper practice of the
particular brand of therapy that is being exploited. At the time this
concern was featuring Abrams’ course it called attention to the alleged
fact that “no class were [_sic!_] so busy as those employing mechanical
treatment such as Osteopathy, Chiropractic, Mechanotherapy, etc.”
Says Dr. Abrams:
“Despite the fury of tongue or the truculence of the pen, the
osteopath and chiropractor are inspiring the confidence of the
community with their systems. Right or wrong in their theory, they
are, in vulgar parlance, ‘delivering the goods.’ Spondylotherapy
was a product of necessity--the translation of an ignored field of
medicine from a chaotic to a scientific basis.”
Possibly the following testimonial published by Dr. Abrams as typical
of many received, and credited to “Dr. Henry Stacy Dodge, Richmond,
Va.,” may explain the field that “Spondylotherapy” is to cover.
Incidentally “Dr.” Dodge is listed in the Richmond telephone directory
as a chiropractor:
“I have been in practice for fifteen years in Chiropractic and ten
years an Osteopath and I wish to say that during the last three
years I have received more genuine and sincere satisfaction from
the application of Spondylotherapy than all other methods combined.
My success in gastrology alone is worth many times the cost of the
information.”
More recently, Dr. Abrams has advertised that he gives a “course” in
Spondylotherapy in San Francisco, beginning on the first of each month.
The course last four weeks. “The honorarium for this course is $200.00.”
In 1912 an organization was created devoted to this new therapeutic
method: the “American Association for the Study of Spondylotherapy.”
Later Dr. Abrams was made Honorary President. Whether the organization
is still viable we do not know.
ELECTRONIC REACTIONS OF ABRAMS
In addition to “Spondylotherapy,” Dr. Abrams has also evolved what he
calls the “Electronic Reactions of Abrams.” These are said to make
possible long-distance diagnoses, it being necessary only to send a
few drops of blood taken from the patient and allowed to dry on a
slide. There are, it seems, certain instruments and devices used in
the performance of these diagnostic feats. By means of the “Electronic
Reactions” Dr. Abrams (while admitting the protective factor of
vaccination against smallpox) has discovered that practically all the
vaccines obtained from reliable firms yield the reaction (“electronic
tests”) of congenital syphilis, and that many of them also yield
the reaction of tuberculosis and of streptococci and staphylococci.
Further, “from the cicatrices of all vaccinated persons, one can
always elicit a reaction of congenital syphilis and in early scars a
tuberculous reaction.” Dr. Abrams also declares that exposing vaccine
virus for ten minutes to blue light will destroy the syphilitic,
streptococcic and staphylococci reactions and exposing it for the same
period to yellow light will destroy the tuberculous reaction.
One of Dr. Abrams’ disciples--Sir James Barr--frequently quoted with
evident satisfaction, declares that from a fresh sample of blood spread
over four square inches of white blotting paper, “Dr. Abrams can
diagnose the sex, race and disease of the patient.” However, there are
certain precautions that must be taken: The patient should face West,
“the blood should be taken in a subdued light and there should be no
strong red or yellow coloring material in the room.”
In various places Dr. Abrams has asseverated that “if
splancho-diagnosis is approached with a prejudiced mind, it is better
not to attempt it, for there are ‘none so blind as those that will not
see.’”
Dr. Abrams founded and edits _Physico-Clinical Medicine_. It is
published by “Physico-Clinical Co.” at 2135 Sacramento St., San
Francisco--the address, according to the telephone directory, of Dr.
Abrams’ residence. It is a quarterly “Devoted to the Study of the
Electronic Reactions of Abrams and the Visceral reflexes of Abrams, in
the Diagnosis, Treatment and Pathology of Disease.” Single copies, one
dollar; by the year, two dollars. The publication is, apparently, not
entered as second class matter, in fact, presumably, it could not be,
as it seems obviously to be an advertising affair. Each issue contains
material dealing with “Spondylotherapy,” “Splanchno-Diagnosis,”
“Electronic Reactions” and other discoveries and theories of Dr.
Abrams. In it also is published a list of “Some recent visitors at
Dr. Abrams’ laboratory,” the names and addresses of the “Lessees of
Oscilloclast” (about which more later), testimonials for Dr. Abrams,
etc.
Of course, it carries advertisements of Dr. Abrams’ “Physico-Clinical
Laboratory” (also at 2135 Sacramento St.) and his “Practical Courses
in Spondylotherapy and Electronic Diagnosis and Treatment” ($200 in
advance). Some of the devices of Dr. Abrams are also advertised. “No
apparatus sold on credit. Terms cash.” Among these are:
“Dr. Abrams’ Electrodes for Electronic Diagnosis $ 6.00
“Biodynamometer 36.00
“Dr. Abrams’ Reflex Set 36.00
“Dr. Abrams’ Electro-Concusser 120.00”
THE OSCILLOCLAST
But what seems to be the outstanding piece of apparatus, devised
or invented by Dr. Abrams, the pièce de resistance, as it were, of
physicoclinical diagnosis and treatment, is the “Oscilloclast.”
This device is not for sale. It can be had only on lease. The first
payment is $200 or $250, according to whether it is wired for
alternating or direct current. Then there is a monthly payment of
$5. Dr. Abrams publishes a list of more than 130 men who have leased
one or more “Oscilloclasts.” Sir James Barr’s name heads the list.
According to Dr. Abrams, the “Oscilloclast” owes its conception to the
therapeutic principles he advocates. These, in part, are:
“1. Physiologic phenomena are manifestations of electronic energy.
“2. Pathologic phenomena are manifestations of perturbed electronic
energy.
“3. The energy in health and disease has an invariable and definite
rate of vibration (determinable by the electronic reactions).
“4. Specific drugs possess a like vibratory rate as the diseases
for which they are effective.
“These like vibratory rates (hemovibrations) of drugs owe their
efficiency to their inherent radioactivity. Thus, an obsolete drug
like gamboge painted on the chest in incipient tuberculosis will
effect a symptomatic cure within a few weeks. Gamboge possesses
the same vibratory rate as tuberculosis. Our conception that
drug action is dependent on direct cellular contact is thus
demolished....
“5. All forms of energy whether derived from heat, electricity or
magnetism may be made to yield different rates of vibration and
these rates corresponding to the diseases are utilized for their
destruction.”
If one accepts one of Dr. Abrams’ theories, the possibilities of
such a piece of machinery as the “Oscilloclast” would seem to loom
large, not only in therapeutics, but also in economics. All one needs
to do, according to Dr. Abrams, is to ascertain “the vibration rate
of a drug” and then to substitute the same vibration as produced by
the “Oscilloclast.” Thus, if one substitutes the “vibratory rate of
atropin” for the drug itself “the mouth dries or the subject feels as
if it were puckered.” Conversely, if you switch the “Oscilloclast” to
the pilocarpin vibratory rate, there is a copious flow of saliva.
THERAPEUTIC RESULTS WITH OSCILLOCLAST
What some of the lessees of the oscilloclast are accomplishing (if we
are to believe the clinical reports published in _Physico-Clinical
Medicine_) may be gathered from the following quotations:
“Woman, Age 52.--Diagnosis of acquired syphilis made by one of our
most eminent clinicians. (?) Abrams test showed tuberculosis of the
apex of the right lung. No syphilis. Fourteen treatments with the
Oscilloclast at 5. Patient gained fourteen pounds in three weeks.
Now in perfect health.”
“Mechanic, Age 22.--Acute acquired syphilis. General eruption,
throat, mouth symptoms and chancre. Thirteen treatments with
the Oscilloclast at 3, and splenic sterilization only. Complete
abatement of all symptoms.”
“Woman, Age 42.--Strep infection of the second upper cuspid tooth
of three years’ standing. Well developed sinus. Regular discharge
of pus. Eight treatments with the Oscilloclast at 2. Clinically
cured.”
“Cancer of the pylorus and pylorectomy executed at the Mayo Clinic.
Later, vomiting, severe pains, loss in weight, etc. After the
third treatment [with “Oscilloclast”] pains ceased and, after 14
treatments, she was well and continued so when I last saw her.”
“Cancer of uterus. Inoperable. Severe uterine hemorrhages.
Electrode of Oscilloclast to cervix and hemorrhage ceased after
second treatment. After 14 treatments the patient declared she was
well. Another case of the same character was followed by equally
good results.”
ECONOMIC RESULTS WITH OSCILLOCLAST
It also seems to be a great business-getter, as the following
testimonials published by Dr. Abrams show:
“The Oscilloclast has doubled my business.”--S. King, M.D. (Pa.).
“I am doing good work with the Oscilloclast in T. B. and when I get
more room I shall want another machine.”--H. Michener (Kas.).
“We are swamped with work and our three cord Oscilloclast is
working to full capacity. We are still astonishing the incredulous
and keeping busy. We must have another Oscilloclast at once for
there are so many here who demand treatment.”--W. P. Myers, M.D.
(Cal.).
THE ELECTROBIOSCOPE
More recently, Dr. Abrams has extended his observations and
experiments, using what apparently is a modification of the old
fashioned pith ball suspended by a silk thread from a rubber rod with
which we all experimented during our high school days. This device
Dr. Abrams has called the “Electrobioscope.” It is for sale by the
Physico-Clinical Co. The “Electrobioscope,” in addition to doing
many other things, has demonstrated (to Dr. Abrams) the “sexuality
of numbers and sounds.” Thus, if the pith ball is charged negatively
and the numbers 1 to 9 are marked on a narrow board and the vowels
and consonants are marked on another board, it will be found--still
according to Dr. Abrams--that even numbers repel the pith ball while
odd numbers attract it. Vowels repel and consonants attract. “A female
hair repels and a male hair attracts.” From these data Dr. Abrams
deduces that “even numbers and vowels are female and odd numbers and
consonants are male.”
The value of music as a therapeutic agent is briefly touched on by
Dr. Abrams and we are told that the overture of “Tannhäuser” will
increase the pulse rate whereas “Meditation” diminishes blood pressure
and pulse rate. “In dogs, music augments elimination of carbonic acid
and increases the consumption of oxygen.” Love, says Dr. Abrams, “is
dependent upon matter in vibration and the passional component has a
wave metric index of 14 in both sexes.” In referring to legendary lore,
Dr. Abrams apparently assigns a scientific basis for the belief among
the bucolic that carrying around a potato has therapeutic virtue. Thus:
“A cut potato (carried on the person) prevents elicitation of the
stomach reflex when the negative pole of a bar-magnet is presented
to the stomach region whereas the positive pole will evoke dulness.”
It seems also that the “rheumatic rings” of iron “when worn yield a
neutral energy which prevents the elicitation of the stomach reflex
by either pole of a bar-magnet.” We learn, too, that the divining rod
“no longer belongs to occultism but is entitled to consideration as a
scientific fact.”
Dr. Abrams also has investigated methods whereby the sex of the fetus
may be diagnosed. In the human these investigations have, apparently,
been so limited as to permit only tentative conclusions. In the case of
eggs of the domestic fowl, Dr. Abrams reports that with four eggs that
yielded negative polarity, the result of incubation was four hens. Of
five eggs yielding a positive polarity only two hatched, one was a hen
and one a rooster, giving an “error in observation.” Three eggs tested
yielded neutral polarity and “as predicted the eggs were sterile.” In
case of an egg yielding a negative (female) polarity “an attempt was
made to reverse the sex by painting one end of the egg with a yellow
coloring material.” The result was a rooster.
Much more might be written about what one of our correspondents calls
the wonderful things they are doing in the West, but space forbids.
“Neither the fury of tongue,” says Dr. Abrams in the preface to his
book, New Concepts in Diagnosis and Treatment, “nor the truculence
of pen can discredit the author’s observations which are capable
of analyzation and demonstration.” If there is any scientific
foundation for the marvels that Dr. Abrams so picturesquely features,
the scientific world has not yet found it out!--(_From The Journal
A. M. A., March 25, 1922._)
Dr. Abrams’ Graduation
In this department of The Journal for March 25 appeared an article on
Dr. Albert Abrams and some of his discoveries. We have now received
a letter from a physician, who asks that his name be not published,
reading:
“_To the Editor_:--I notice in your article on Albert Abrams the
statement that he was born in 1864 and received his degree of M.D.
in Heidelberg 1882; if these data are furnished by himself and not
a typographical error--though I find the same data in the American
Medical Directory for 1916--then it is high time that some board of
censors should make a careful examination of his credentials.
“Anybody, like myself, who is acquainted with medical matters in
Germany knows that it is preposterous to assume that anybody could
obtain the degree of M.D. in any German university at the age of 18
years.
M. D., Leipzig.”
Eighteen _is_ rather young to receive an M.D. degree from Heidelberg!
By again going over the various sources of information available the
following data were collected: In Polk’s Medical Directory for 1886 Dr.
Abrams’ name appears as a graduate of the University of Heidelberg,
1882, and of Cooper Medical College in 1883. The records we have
from these two institutions confirm these dates. The year of Dr.
Abrams’ birth seems less clear. In the early part of 1902 the American
Medical Association sent Dr. Abrams a blank for him to fill out for a
permanent record. This was returned in due course and, according to
it, Dr. Abrams was born in San Francisco Dec. 8, 1863. This same date
appears in various editions of “Who’s Who in America.” A blank sent by
the A. M. A. Directory Department to Dr. Abrams in 1908 asking for a
personal biographical report was returned Aug. 20, 1908; it gave Dr.
Abrams’ date of birth as Dec. 8, 1864. A similar blank sent in the
earlier part of 1909 was returned giving the same birth date. We learn,
however, that an affidavit executed in 1917 states that Albert Abrams
was born in San Francisco Dec. 8, 1862.
Just how long Dr. Abrams attended Heidelberg University before he was
granted the M.D. degree, we do not know. Apparently, at that time the
standards for admission to that institution were not especially severe
and the length of time one would have to attend before being admitted
to an examination seems to have depended on the educational credentials
that the matriculant offered. What credentials Dr. Abrams submitted,
we do not know. Assuming that the earliest date (1862) represents Dr.
Abrams’ date of birth, he could have been but twenty years old when
he received his M.D. from Heidelberg. This indicates a precocity that
might have forecast Dr. Abrams’ later achievements.
Throughout the records of Dr. Abrams’ educational credentials there
appears the statement that he also graduated from the “University
of Portland” in 1892, receiving the degree of A.M. From references
available we have been unable to find any record of a “University of
Portland.”--(_From The Journal A. M. A., April 8, 1922._)
A Defense by Upton Sinclair
A somewhat voluminous letter has been received from Mr. Upton Sinclair,
which is a defense of Dr. Albert Abrams of San Francisco. We publish
Mr. Sinclair’s letter because we believe it is written in honesty and
sincerity--and because The Journal readers will enjoy it! It is worth
mentioning in this connection that Mr. Sinclair in his latest book
devotes a few pages to a eulogy of Dr. Abrams and his methods. This
material has not only been reproduced by Dr. Abrams in his “house
organ” _Physico-Clinical Medicine_ but is reprinted in leaflet form and
is being distributed by some of the individuals who are exploiting the
Abrams methods. Such reprints have been sent to this office by both
laymen and physicians.
MR. SINCLAIR’S LETTER
_To the Editor._--A few weeks ago you published an article dealing
with the discoveries or claims of Dr. Albert Abrams of San Francisco.
I happen to be attending Dr. Abrams’ clinic at the time and have
discussed this article with him at some length. Dr. Abrams follows the
policy of ignoring attacks on his work, taking the view that in the
long run, the man who cures disease makes his way in the world in spite
of all opposition. However, it is easy to see that he has been deeply
hurt by this attack on his reputation, and as one of his friends and
most ardent admirers I am taking the liberty of addressing a letter to
you.
I do not know if the rules of your publication permit intervention
in medical affairs by a mere layman. Permit me to introduce myself
as a layman who for some twenty years tried faithfully to be cured
of various diseases by many doctors of the best reputation in many
parts of the world, and failed; and who, therefore, was compelled, as
a matter of self-protection, to look into the question of health for
himself. I have read so many different kinds of books on health and
made so many experiments of my own that nowadays when I meet with a
group of physicians I find that before long they come to accept me as
one of themselves. You may not go that far, but at least you may be so
generous as to allow me to tell you a little of what I have seen during
the time I have spent in the clinic of Dr. Albert Abrams.
I observe that in the course of your two page article dealing with this
subject, you nowhere have anything to charge against Dr. Abrams, nor
do you show that you have investigated his work. You consider that all
you have to do is to quote Dr. Abrams’ own words as to what he can do,
and that _these words refute themselves_. [Italics our.--Ed.]. Also you
quote Dr. Abrams’ schedules of prices, and imply that his motives are
mercenary. I will take up these two questions one at a time.
WHAT DR. ABRAMS CAN DO
First, as to what Dr. Abrams can do: I have been here and have seen
him do all that he claims to do. Therefore, you will understand that
this portion of your argument does not produce much impression on me. I
merely say to you, why do you not come and see, or why do you not send
some reliable representative to see--before you take it for granted
that Abrams is a knave or a lunatic? This man is not merely a colleague
of yours; he is a fellow of the Royal Medical Society of Great Britain
[We know of no such society.--Ed.] and surely he was entitled to a
little elementary courtesy from you. Why did you not at least write
to him and permit him to put before you a little of his evidence on
the genuineness of his work? You admit that he is a graduate of the
Universities of Heidelberg and Stanford; [Dr. Abrams is not a graduate
of “Stanford.”--Ed.] you admit that he was graduated from Heidelberg at
the age of twenty. It happens that this was the youngest and remains
the youngest age at which any man has taken a Doctor’s Degree at that
University in a hundred years. If you had inquired further you might
have learned that ten years ago Abrams was one of the most respected
physicians in San Francisco. What has he done since to forfeit the
honors of a lifetime? All that he has done is to shut himself up in his
laboratory and make the most revolutionary discoveries of this or any
other age; and now when he emerges and offers this work to the world,
you can think of nothing to do but jeer at him.
I spent two weeks in his clinic; then I took six months to write to
his physicians all over the country, _and to experiment with his
cures on a great number of my friends_. [Italics again ours.--Ed.]
Now I am spending another two weeks in his clinic, and I venture to
stake whatever reputation I have, or hope to have in this world, upon
the statement that Albert Abrams has discovered the great secret of
the _diagnosis and cure of all the major disease_. [Again we must
italicize.--Ed.] He has proven by diagnosing with the taps of his
own sensitive finger tips over 15,000 people, and my investigation
convinces me that he has cured over 95 per cent. of these who have
taken his treatments. Moreover, he has taught his method to 200 or 300
other physicians, and some 80 per cent. of these have submitted to me
answers to a questionnaire in which they claim thousands of cures.
You may say, perhaps, that I am not competent to judge of cures.
For the sake of argument, I will grant that; but I assert that I am
competent to judge of physicians, for I have tested several score of
them, and if I ever knew a devoted scientist and a great humanitarian,
it is Albert Abrams. In his clinic I have met perhaps a hundred
physicians, and I venture to assert that a number of these are men
both of integrity and capacity, and when I asked them why they came, I
got invariably one answer: “Because I sent him blood specimens and I
found that invariably he sent me a correct diagnosis.” Not once, but at
least two score times, I have seen Albert Abrams take a blood specimen
brought to him, without even the name of the patient, and heard him
diagnose cancer or sarcoma, and from the blood specimen locate the
growth PRECISELY TO AN INCH. [Italics fail one here!--Ed.] Then I have
seen the patient, an entire stranger to Abrams, brought into the clinic
and examined, not merely by Abrams, but by a score of other physicians,
and the growth found precisely at the spot indicated. (This was done
twice between the time when this letter was dictated and the time when
it was transcribed.) Three times, yesterday, I saw a diagnosis made of
syphilis and the patient brought in, and all the standard reactions
demonstrated. I have seen, not once, but hundreds of times, tubercular
lesions diagnosed and located from the blood specimen and the patient
brought in and the condition demonstrated by percussion. All these
things are going on day after day. They are being done in other
clinics in several score of cities, and you may have the addresses for
the asking. Why do you not ask? [We have some such addresses in the
Propaganda files.--Ed.]
THE ECONOMIC ELEMENT
I take up the second criticism, that Albert Abrams is mercenary. He
charges $200.00 for the clinical course, which may last as long as
the physician wishes. It seems to me that that price is to be judged
somewhat in relation to what he has to teach. He maintains a large
establishment; he has need of many assistants, and expensive apparatus
for his research work. He charges for the use of his oscilloclast a
deposit of $250.00, and a rental of $5.00 per month. The former item
covers the cost of manufacturing the machine, and the second item must
be compared with the fact that a great number of physicians who are
using this instruments are today _enjoying incomes of from $1,000.00
to $2,000.00 per week_. [Once more, italics!--Ed.]
A few weeks ago I visited a physician who told me he had treated
thirty-two patients that day with his one instrument, and that his
income was over $1,300.00 for that week, and I could name several who
have given similar accounts. It may be, of course, that you will say
they should not charge so much. The average charge is about $200.00 for
a _guaranteed cure of such diseases as syphilis, tuberculosis, cancer
and sarcoma_. [Italics our again.--Ed.]. Do you know anyone who will
guarantee to cure a cancer or sarcoma at any price? [No!--Ed.]
I am sure you will agree with me that it would be possible to find
physicians who would be willing to put up many hundreds of dollars to
guarantee that neither cancer nor sarcoma can at the present time be
cured except by operation. And I can recall many cases in my lifetime
when I paid hundreds and even thousands of dollars to be cured of
diseases by the medical profession, and I am unable to recall a single
case where I was ever cured of anything. [Still this need not be an
indictment of scientific medicine.--Ed.]
Finally, as regards to the subject of mercenary motives, permit
me to state that I have in my possession a letter from Dr. Abrams
stating that what he desires is to have established an institute for
the purpose of making his work known to the world, and that if such
an institute is established he is prepared to give up all his other
work and devote all his time, without compensation, to the institute.
Furthermore, he is willing to furnish his instruments without charge to
any medical institution which requests them. Within the last few days,
on account of the enormous number of blood specimens brought into his
clinic, Dr. Abrams has signed in my presence, and is prepared to issue
a statement to the effect that his charge for examining blood specimens
is to be raised from $10.00 to $25.00 and all checks are to be made
payable to a Trust Fund which is to be immediately established, for the
purpose of founding the institution above referred to. I do not see how
the medical profession can ask for more than this; but if you do, I
should be pleased to receive your suggestions and transmit them to my
friend.
AN OLD STORY
Now, this failure to recognize a great medical discovery is an old
story. It was the experience of Harvey [We knew poor Harvey would be
dragged into this.--Ed.], of Jenner and of Lister. But the world moves
on, and men’s brains should improve, and it should be possible to
shorten the time of persecution which the great pioneers of science
have to suffer. I put to you this simple proposition: Send a reliable
man of science to the clinic of Albert Abrams, and let him stay there
as long as he pleases and see all that he wishes to see, and then send
you a report, and if it indicates that you have blundered in your
condemnation, be honest and say so, and save your profession from
another black mark against its name.
Upton Sinclair, Pasadena, Cal.
Comment
A testimonial is of value to the extent that the person giving it
is an authority on the subject on which he testifies. When Mr.
Sinclair testifies on socialism we may listen respectfully, believing
him competent to express an opinion; but when Mr. Sinclair gives a
testimonial on certain bizarre methods of interpreting difficult and
obscure problems in medicine, he leaves us cold.
Mr. Sinclair says that he has spent time in Dr. Abrams’ clinic and is
wonderfully impressed with Dr. Abrams’ achievements. So is the small
boy impressed with the marvelous facility with which the magician
extracts the white rabbit from the silk hat. Mr. Sinclair is convinced
“that Albert Abrams has discovered the great secret of the diagnosis
and cure of all the major diseases.” The small boy is equally convinced
that the prestidigitator has solved the mystery of producing snow white
bunnies from airy nothings.
Great store seems to be placed by Mr. Sinclair on the favorable
reports that he obtained from those who are relieving the public--of
from $1,000 to $2,000 a week--by the Abrams methods of diagnosis
and treatment. What kind of evidence did he expect to get from such
obviously _ex parte_ sources? Mr. Sinclair’s naïveté may be childlike,
but it is not scientific. While the significance of the statement may
not be apparent to Mr. Sinclair, it is a fact that when the names of
the one hundred or more lessees of the Abrams “Oscilloclast” were
checked up it was found that a number of these individuals were already
in the Propaganda files in some other connection. That these disciples
of Abrams, who are “enjoying incomes of from $1,000 to $2,000 a week,”
should speak favorably of the Abrams method was inevitable!
Some years ago Upton Sinclair wrote a book on his (at that time)
panacea for human ailments. It was the “Fasting Cure.” At that time
he told of individual acquaintances suffering from various ailments:
one was “dying of kidney trouble”; another was “in the hospital from
nervous breakdown”; still another had “only a year to live,” while a
fourth was “a nervous wreck, craving for death.” Of these Mr. Sinclair
said at the time: “And there is not one of these people whom I could
not cure if I had him alone for a couple of weeks.”
MR. SINCLAIR AND THE MEDICAL PROFESSION
At that time Mr. Sinclair was greatly perturbed at the attitude of
the medical profession toward his dictum that “the fast is Nature’s
remedy for all diseases.” There was just one physician “who was really
interested.” This man lived “in an out of the way town in Arkansas” and
asked Sinclair to “let him print several thousand copies of the article
in the form of a pamphlet to be distributed among his patients.” As
Mr. Sinclair said at the time, “one single mind among all the 140,000
[physicians], open to a new truth!” And this “open mind,” that of a
man who was practicing in a small town in Arkansas and needed “several
thousand copies” of the Sinclair article to distribute to his patients!
After his “fasting cure” experience, Mr. Sinclair had the “raw food”
fad--also abandoned in due time. In one of his recent books (“The Brass
Check”) he refers to his outgrown fads in the following words: “I ...
was willing to try anything in the hope of solving the health problem,
which I have since realized is insolvable--there being no diet or
system of any sort which will permit a man to overwork with impunity.”
He states further in this same connection:
“I look back in retrospect and have not a little fun over my ‘monkey
diet’ days.”
Who shall say that ten years hence Mr. Sinclair may not be able to
look back, good humoredly, in retrospect, to another time when he was
“monkeying” with a subject that was beyond his ken?--(_From The Journal
A. M. A., April 29, 1922.)_
ACETYLSALICYLIC ACID, NOT ASPIRIN
The Council on Pharmacy and Chemistry publishes a report in this
issue giving its reasons for deleting “Aspirin-Bayer” from New and
Nonofficial Remedies. In order that a standard may be provided, the
drug acetylsalicylic is retained[259] in N. N. R. under its scientific
name, acetylsalicylic acid, aspirin appearing as a synonym. The
attempt on the part of the Bayer Company to perpetuate the monopoly it
has had for seventeen years in the United States was briefly discussed
editorially in The Journal, Aug. 12, 1916. We quoted from _Printers’
Ink_, a magazine devoted to advertising, in part as follows:
[259] See index for additional article.
“The manufacturers of aspirin are about to launch an extensive
advertising campaign to clinch the market as far as possible before
the expiration of their patent rights next year.... The purpose
of the campaign is to identify the product with the trademark of
the Bayer Company and to this extent hamper competition after the
expiration of the patent.”
It is worth while reminding physicians of the privileges the Bayer
Company has enjoyed for so many years, owing largely to our inequitable
and crude patent laws, or to their construction. First, it should be
remembered that practically no other country in the world, not even
the original home of the preparation, would grant a patent on either
acetylsalicylic acid, the product, or on the process for making that
product. The United States granted both! As a result, for seventeen
years it has been impossible in this country for anybody except the
Bayer Company to manufacture or sell acetylsalicylic acid, either under
its chemical name or under any other name. Neither was it possible for
individuals, hospitals or any other institutions to import it, legally,
for their own use.
Needless to say, the American people have been made to pay exorbitantly
for the monopoly our patent office granted this firm. Three or
four years ago The Journal, through the American consuls, obtained
information regarding the price at which acetylsalicylic acid was sold
in foreign countries. At that time, acetylsalicylic acid, as “aspirin,”
was costing American druggists--and of course the American public had
to pay still more for it--43 cents an ounce. Just across the border
in Canada it sold for one-third the price asked here. In some of the
foreign countries, acetylsalicylic acid under its scientific name could
be purchased by the druggists of those countries at from one-sixth to
less than one-tenth the price that it cost American druggists. Here are
some of the figures:
Austria-Hungary 4 cents an ounce Holland 4 cents an ounce
British Isles 6 cents an ounce Norway 4 cents an ounce
Denmark 4 cents an ounce Sweden 4 cents an ounce
France 4 cents an ounce United States 43 cents an ounce
Germany 4 cents an ounce
Not content with the iron-bound monopoly which it had been granted
through our patent laws, the company attempted further to clinch its
exclusive rights by giving the preparation a fancy name, “aspirin,” and
getting a trademark on this name. The patent on acetylsalicylic acid
expires next month (February, 1917). After its expiration the product,
and its method of manufacture, become common property. American
manufacturers will now be able to do what manufacturers in other
countries, other than the patentees, have long been doing--make and
sell acetylsalicylic acid.[260]
[260] The Bayer people may try to convey the impression that
“Aspirin” is pure and reliable whereas other brands are not. Since
acetylsalicylic acid is a definite chemical compound, there is
no more likelihood of this being sophisticated than there is of
quinin being adulterated. Furthermore, the Council in accepting
acetylsalicylic acid for New and Nonofficial Remedies has provided
standards of purity which will insure a uniform product. The brand of
one firm--Powers-Weightman-Rosengarten Co., of Philadelphia--has been
accepted by the Council on Pharmacy and Chemistry for inclusion in New
and Nonofficial Remedies, 1917.
Unfortunately, it is extremely improbable that any American
manufacturer will market acetylsalicylic acid under the name aspirin,
although we believe they would have a legal right to do so. The courts
have held in related instances that when a patented article has been
known during the life of the patent under a trademarked name, with
the expiration of the patent the name as well as the product becomes
common property. The classical “Singer Sewing Machine” decision and
the lanolin case are in point. The Bayer Company, through a widespread
newspaper advertising campaign, seems to be attempting to perpetuate
its seventeen-year monopoly by leading the public to believe that
there can be only one brand of genuine acetylsalicylic acid on the
market--that made by the Bayer Company.
The firm will, of course, continue to manufacture and advertise the
product under the name “Aspirin-Bayer,” and will probably charge high
prices for it, as was the case with phenacetin (acetphenetidin). In
any event, physicians hereafter should do what for a long time we have
been advising should be done, namely, prescribe the compound under
its scientific name, acetylsalicylic acid. They should do this if for
no other reason than that they would be using the name which carries
with it a reminder of the composition of the preparation. Of course,
for those who have been writing “aspirin” it will be rather difficult
to write “acetylsalicylic acid,” just as a quarter of a century ago
it was difficult for the physician of that day who had been using
the copyright name “antifebrin” to write “acet-anilid,” a name which
nowadays is easy, even for laymen.--(_Editorial from The Journal
A. M. A., Jan. 20, 1917._)
“What’s in a Name?”
Under the caption “What’s in a Name?” the current (April) issue
of the _Journal of Industrial and Engineering Chemistry_ has an
editorial dealing with the nomenclatures--common and proprietary--of
acetylsalicylic acid. The editorial was prompted by an article by Dr.
Leech printed in the same issue. Replying to its own question:
“The answer to this question so far as it applies to
acetylsalicylic acid (popularly known as aspirin) is the difference
between eighty-eight cents, the price the druggist must pay for
every one hundred tablets of Bayer aspirin, and forty cents,
the cost of an equally pure American product. Naturally, this
difference in cost is passed on to the individual consumer.
“That no scientific justification exists for this difference in
cost is clearly shown in the contribution by Dr. Paul Nicholas
Leech, of the Chemical Laboratory of the American Medical
Association, page 288 of this issue.
“On the other hand, the excess profit fully warrants the extensive
and shrewdly-worded advertising campaign now in progress, a
campaign which must eventually fail, because in the first place,
it is contrary to the prevailing spirit of modern advertising, the
motive of which is constructive rather than destructive, and, in
the second place, it appeals merely to the temporary ignorance of
the public at large, and has no basis in fact.
“We have been informed that the Custodian of Alien Enemy Property
has taken charge of the stock interests of alien enemies in the
company conducting this propaganda. Surely the Custodian will not
care, even in a trustee capacity, to continue as a participant in
a misleading campaign whose sole purpose is the perpetuation of a
monopoly hitherto enjoyed under full patent protection.”
The article to which the editorial refers is a somewhat technical one
giving the findings of an examination made, at the request of the
Council on Pharmacy and Chemistry, in the Chemical Laboratory of the
American Medical Association by Paul Nicholas Leech, Ph.D., of various
American brands of acetylsalicylic acid (aspirin). The result of the
investigation may be summed up briefly in the statement that there
are on the American market, made by American firms, several brands of
acetylsalicylic acid that are just as good as, if not better than, the
Bayer product.
The Journal has called attention to the misleading propaganda on the
part of the Bayer Company (Farbenfabriken vorm. Friedr. Bayer & Co.),
in its attempt to perpetuate the monopoly granted under our inequitable
patent laws. This is done by conveying the inference that the only pure
acetylsalicylic acid on the market is that known as “Aspirin-Bayer.”
Physicians should again be reminded of the facts in the case of
aspirin: Practically no other country in the world, and certainly not
Germany, the original home of aspirin, would grant a patent either
on acetylsalicylic acid, itself, or the process for making it. The
United States granted both! As a result no one in this country except
the Bayer Company could for seventeen years manufacture or sell
acetylsalicylic acid either under its chemical name or under any other
name. Nor was it permissible for hospitals or individuals to import it.
While the monopoly held, the American people were compelled to pay from
six to ten times as much for acetylsalicylic acid as were the people
of Great Britain, France, Germany, Austria-Hungary, Denmark, Holland,
Norway or Sweden. At a time when American druggists were compelled to
pay 43 cents an ounce for acetylsalicylic acid as aspirin, just across
the border in Canada it sold for about one-third the price.
About a year ago, the Council on Pharmacy and Chemistry announced that
“Aspirin-Bayer” had been deleted from New and Nonofficial Remedies
while the scientific term acetylsalicylic acid was retained along with
standards to insure its quality. The necessity for a standard becomes
evident when it is remembered that acetylsalicylic acid is not yet an
official drug, and its purity, therefore, is not subject to the control
of the federal Food and Drugs Act. It is worth while at this time to
remind physicians that several brands of acetylsalicylic acid (aspirin)
have been found to comply with the standards set by the Council on
Pharmacy and Chemistry and have been admitted to New and Nonofficial
Remedies.[261] These, of course, are thereby subject to the control of
the federal law to conform to the standard to which they profess.
[261] The following brands of acetylsalicylic acid conform to the
standards of the Council and are in New and Nonofficial Remedies:
“Aspirin--
L. and F.”: Lehn & Fink, New York.
“Acetylsalicylic Acid--
Squibb”: E. R. Squibb & Sons, New York.
“Acetylsalicylic Acid--
Merck”: Merck & Co., New York.
“Acetylsalicylic Acid--
Milliken”: John T. Milliken & Co., St. Louis.
“Acetylsalicylic Acid--
M. C. W.”: Mallinckrodt Chemical Works, St. Louis.
“Acetylsalicylic Acid--
Monsanto”: Monsanto Chemical Works, St. Louis.
“Acetylsalicylic Acid--
P. W. R.”: Powers-Weightman-Rosengarten Company, Philadelphia.
Leech’s report gives still greater weight to the suggestion that
has been made for some time, viz., that physicians should describe
acetylsalicylic acid under its scientific name rather than its
proprietary name, even though, in the opinion of The Journal, the
proprietary name, aspirin, has become common property since the
expiration of the acetylsalicylic acid patent. Every consideration
of public interest, of patriotism and of ordinary common sense
should prompt physicians to specify acetylsalicylic acid in writing
prescriptions.--(_Editorial from The Journal A. M. A., April 13, 1918._)
Advertising Principles--Lay and Medical
The Journal has received two letters, one from a physician who had
written to the New York _Tribune_ protesting against an advertisement
of “Aspirin (Bayer)” that appeared in the rotogravure supplement of a
Sunday edition and the other the New York _Tribune’s_ answer to the
protest. The two letters make an editorial in themselves. Here is the
letter of the physician--Dr. Edwin H. Shepard of Syracuse, N. Y.--which
was addressed to the editor of The Journal:
“When a great daily newspaper takes a stand for honest advertising
it seems worthy that acknowledgement should be made. On April 14 the
illustrated Sunday supplement of the New York _Tribune_, together
with many of the other papers of the country, published a duplicate
of the enclosed advertisement of ‘Aspirin.’ Your own instructive
editorial on ‘Acetylsalicylic Acid, or What’s in a Name?’ had
appeared in the copy of The Journal of the day preceding.
“Believing in the sincerity of the _Tribune_ in its effort for honest
advertising, I sent them a copy of your editorial together with the
page of advertisement, also calling attention to the statements in
the advertisement which seemed questionable. Among the questionable
matters in the advertisement were the statements, ‘The one genuine
Aspirin,’ ‘No other is genuine,’ ‘That which is genuine possesses
qualities of excellence never found in imitations,’ ‘For your
protection ... every package and tablet is marked with the Bayer
cross,’ ‘Your guarantee of purity,’ and ‘Refuse substitutes as they
may prove ineffective and harmful.’
“The Tribune was requested to investigate into the standing of the
Bayer company and its product. A few days later the enclosed letter
was received from the paper’s Bureau of Investigations.”
And here is the New York _Tribune’s_ answer, signed by R. R. Baer,
assistant director of that paper’s Bureau of Investigations:
“We have your letter of April 14th, which was acknowledged on
the 22nd, in re Aspirin. For your information: Our rotogravure
supplement is printed a number of days in advance of the Sunday
paper. When these copies which have already been printed are used,
no further Aspirin copy will appear. This means a loss of some four
pages.”
How many of the numerous medical journals that are still carrying the
“Aspirin (Bayer)” advertising would make such a financial sacrifice for
mere principle?--(_From The Journal A. M. A., May 25, 1918._)
“Aspirin”--A Common Name
“Aspirin” as a trademark will no longer exist if the recommendation
of the Examiner of Interferences of the United States Patent Office
is upheld, as it probably would be, should the matter be taken to the
courts. The opinion of the Patent Office was the result of a petition
by the United Drug Company in the case of that company against the
Bayer Company, or, as it was called at the time the suit was brought,
the Farbenfabriken of Elberfeld Company. The stand taken by the Patent
Office is directly in line with that that has been held in this and
other cases by The Journal, which has for years insisted that it was
against public policy to permit patentees to extend the seventeen-year
monopoly, which the patent laws grant, to a perpetual monopoly by
the simple device of obtaining a trademark for the name of the thing
patented. It is a fundamental principle in law that “no one can have a
monopoly in the name of anything.” This, of course, has been recognized
and admitted even by those manufacturers who have attempted to invoke
the trademark laws to obtain an unwarranted advantage.
The manufacturers of aspirin have held that the chemical name
“monoaceticacidester of salicylic acid” was the true name of the
patented article, and was the _only_ name which became public property
when the patent right expired. The Patent Office points out, however,
that for years the only name that the public ever saw on the brand
of monoaceticacidester of salicylic acid made by the holders of the
patent on this product was “Aspirin.” The Examiner of Interferences
in his decision points out that, previous to 1915, the Bayer Company
sold no tablets to the retail-purchasing public, but marketed its
product as a powder; further, that it did sell vast quantities of the
powder to tablet-makers, who sold “Aspirin Tablets,” and that the
consuming public knew the product only by the name “Aspirin.” This
name, then, had a significance to the purchaser, similar to that of the
word “quinin” on a package of quinin tablets, or the word “calomel”
on a package of calomel tablets. As the Patent Office says: “In other
words, the _prima facie_ significance of this word ‘Aspirin’ to such
purchasers was that of a name”--and as a name it is “necessarily
incapable of exclusive use by any one.”
The Patent Office’s decision also brings out the fact that, until the
owners of the aspirin patent commenced making tablets themselves, the
aspirin tablets on the market were not uniform, and that this lack of
uniformity was a fraud on the public which the owners of the aspirin
patent should have prevented. The concern did prevent it when it began
to make the tablets itself, but maintained in its contention against
the United Drug Company that it was unable to control the matter
previously--a contention to which the Patent Office gives short shrift.
It is further pointed out that the Bayer Company evidently recognized
the weakness of its contention by the emphasis it placed through its
advertising on the “Bayer Cross.”
When the Bayer Company began manufacturing its own aspirin tablets,
it made a pretense of complying with the letter of the law, while
violating its spirit, by placing on the label under the word “Aspirin,”
the statement that “the monoaceticacidester of salicylic acid in these
tablets is the reliable Bayer manufacture.” Says the Patent Office:
“With regard to the expression ‘monoaceticacidester of salicylic
acid,’ a mere inspection of it is sufficient to apprise any one of its
inherent unsuitability for use as a name by the lay purchasing public.”
This attempt on the part of the company to “beat the devil around
a stump” tended, in the opinion of the Patent Office decision, “to
show that the respondent was familiar with the methods of some modern
traders to meet the trend of the law.” And, discussing such methods,
the Examiner of Interferences says: “A very popular one is for a trader
to seemingly bend to the necessity of the situation by placing on the
label a notation which in theory, but not in practice, may be used by
the public to identify the article after the monopoly has expired. To
the examiner this practice seems to be merely a manifestation of that
keen commercial instinct which endeavors to keep just ahead of the law.
This instinct is fairly common in traders, and is clearly disclosed in
trademark infringement cases.”
Summed up, the decision is to the effect that, as in any case prior
to 1915, the public had been driven to look on the word “Aspirin”
as the name of a _thing_, and as the Bayer Company had not used the
word as a “trademark” within the meaning of the law, the Patent
Office recommends that the registration of “Aspirin” as a trademark
be canceled. If no appeal is taken from this decision, or in case
an appeal is taken, should the opinion be sustained, the attempt on
the part of the patentees of aspirin to get a perpetual monopoly on
their product through the trademark laws will have been definitely
defeated.--(_Editorial from The Journal A. M. A., Jan. 11, 1919._)
“Aspirin Bayer” and the Sterling Products Company
A correspondent, who asks that his name be not published, writes:
“Your editorial on ‘Aspirin or Acetylsalicylic Acid--An Important Court
Decision’ is timely. Too often, I fear, physicians forget ‘what’s in
a name.’ I have been told that the Sterling Products Co., the present
owners of the Aspirin-Bayer rights, are manufacturers of other ‘patent
medicines.’ Are they interested in the Winthrop Chemical Company, which
firm seems to be using the much vaunted ‘Bayer Cross’ on the labels of
the products formerly imported from Germany by ‘The Bayer Company’? If
you answer this in The Journal, kindly omit my name.”
The recent history of Bayer & Co., is somewhat as follows: Shortly
after the United States entered the war, the Alien Property Custodian
took over the property of Bayer & Co. (Inc.) and its subsidiary, the
Synthetic Patents Co. In his report to congress the Custodian said:
“The stock of Bayer & Co. (Inc.) and of Synthetic Patents Co.
was sold by me at public auction, the successful bidder being
the Sterling Products Co., a West Virginia corporation dealing
in proprietary medicines. This company had previously agreed to
dispose of the dye plant and patents, in case it secured the
property, to Grasselli Chemical Co., one of the largest makers of
heavy chemicals in the country. The price paid was $5,310,000, plus
back taxes and other obligations of many hundred thousands more.”
After the Sterling Products Company had acquired the pharmaceutical
end of the business, the Winthrop Chemical Co. was incorporated in
the state of New York. This concern seemingly secured control of all
the Bayer pharmaceutical specialties except “Aspirin.” The Bayer
Co., it was announced, had been merged with the Sterling Products
Co., and “Aspirin-Bayer” added to the latter firm’s list of “patent
medicines”: Cascarets, Danderine, Pape’s Diapepsin, California Syrup of
Figs, Neuralgine and Dodson’s Livertone. The business is apparently a
paying one financially as witness the following excerpt from a recent
announcement in a drug journal:
“Stockholders of the Sterling Products Co., Inc., of Wheeling,
manufacturers of Neuralgine, Cascarets, Bayer’s Aspirin, and
other well known products, and the largest proprietary medicine
organization in the world, at their annual meeting received a
report of Manager W. E. Weiss, which showed that the company did
a $10,000,000 business in 1920. The total profits were $2,100,000,
while a total of $1,080,000 was paid out in dividends.”
Just what relationship exists between the Winthrop Chemical Co., and
the Sterling Products Co., we do not know. As our correspondent points
out, the “Bayer Cross” is used on the label of the Winthrop products.
The advertising campaign of “Aspirin, Bayer” since it entered the
“patent medicine” field has been typical of that field. By half truths
and inferential falsehoods the public has been led to believe that the
only genuine aspirin on the market is that put out under the Bayer
name. The facts are, of course, that the aspirin of any reputable firm
is just as good as the aspirin put out by the makers of Livertone,
Danderine and Cascarets.
There is one point, however, that is of vital importance to the medical
profession; The decision recently rendered in the United States
District Court of Southern New York makes it obligatory for druggists,
when filling a physician’s prescription calling for “aspirin,” to
dispense the Bayer product. When the public buys aspirin on its own
responsibility--without specifying any particular brand--the druggist
may give the purchaser any make of acetylsalicylic acid he sees fit. To
repeat what was said in The Journal’s comment on this decision: “Unless
a physician wishes to cater to the concern owning the Bayer rights and
to aid in perpetuating what was a monopoly for seventeen years, he
should be careful to prescribe the drug under the term ‘acetylsalicylic
acid,’ The court now places the responsibility directly on the medical
profession. Avoid ‘aspirin’--write ‘acetylsalicylic acid.’--(_From The
Journal A. M. A., June 11, 1921._)
THE ALLIED MEDICAL ASSOCIATIONS OF AMERICA
Another Rocket in the Pyrotechnics of Quasimedical Organizations
It was once said, in the days when diploma mills flourished, that
it seemed easier to start a “university” than it was to open a grog
shop. A study of quasimedical organizations convinces one that it is
easier to found a “medical society” than it is to establish a peanut
stand. Most reputable practitioners of medicine who care to affiliate
themselves with medical organizations are members of the American
Medical Association, its component societies, or similar scientific
bodies. It is not surprising then, that those who live and move in
the twilight zone of professionalism, from visionaries riding bizarre
medical hobbies to those who have special interests to exploit, should
create and make use of hybrid medical organizations. Such organizations
multiply as rapidly as rabbits. They flourish for a while, obtain more
or less newspaper and other publicity--usually more, because of the
sensational methods of those controlling them--then, having served the
purpose of those who brought them into being, they lapse into innocuous
desuetude.
The official accouchement of the Allied Medical Associations of America
occurred, according to that organization’s report, May 18, 1918. On
the official stationery of the Allied Medical Associations of America
in use in May, 1919, we find the names of the “Officers,” “Censors,”
etc. These constitute, presumably, the more prominent members of this
organization. We give briefly, some data regarding some of these so
that a rational perspective may be obtained:
L. M. Ottofy, M.D., St. Louis, Mo.--Dr. Ottofy seems to have been
the chief organizer, if not, indeed, the founder. He has been its
“Secretary-Treasurer” since its inception; he is also “editor” of
its journal. Ottofy, according to our records, was born in 1865 at
Budapest, Hungary, and was graduated in 1888 by the Homeopathic Medical
College of Missouri. In Polk’s Medical Directories for 1914 and 1917,
Ottofy has those extended notices which any physician can obtain who
cares to pay for them. According to these notices, Ottofy is, or has
been, affiliated with the following “societies”:
President of the International Cancer Research Society.
Ex-President of the St. Louis Society of Medical Research.
Second Vice President of the Missouri Institute of Homeopathy.
General Secretary of the American Association of Progressive
Medicine.
Chairman of the Board of Censors of the Missouri Institute of
Homeopathy.
Member of the American Institute of Homeopathy.
Member of the Southern Homeopathic Association.
Member of the American Association of Orificial Surgeons.
Member of the Southern Homeopathic Medical Society.
Member of the Kansas City Society of Medical Research.
Honorary member of the Chicago Society of Medical Research.
In December, 1911, numerous newspaper clippings show that Dr.
Ottofy was obtaining much publicity relative to his antivaccination
activities. At that time the papers reported that Ottofy was suing the
St. Louis Board of Education for $25,000 damages, because the board
would not admit to the schools of the city a child he had “internally”
vaccinated. In November, 1913, the St. Louis _Republic_ reported that
Ottofy had claimed to have discovered a serum for the cure of cancer,
and quoted Ottofy as claiming “a record of 72 per cent. of cures” in
“selected cases.” In February, 1914, the newspapers reported that
Ottofy was making a trip east “on the trail of radium for use in his
practice in the cure of cancer” and quoted him as stating, “I have
learned on good authority that there is radium in Missouri, and just
where I refuse to divulge at this time.” In January, 1915, the St.
Louis _Republic_ reported that Ottofy, at a meeting of the “St. Louis
Society of Medical Research,” had announced that he had perfected a
serum treatment for cancer, which “is curing patients who have been
pronounced incurable by so-called ‘cancer experts.’” In January, 1916,
the St. Louis _Star_ reported that Ottofy had sought an injunction
against the Board of Education of St. Louis to restrain it from using
its funds for “the maintenance of a Board of Hygiene.” In July, 1916,
St. Louis papers recorded that Ottofy, who was then running for
coroner, had been cited to appear before the prosecuting attorney to
explain a charge of passing out, at a political meeting, a card alleged
to have borne an indecent drawing of President Wilson. The prosecuting
attorney was said to have instructed Ottofy to bring the plates from
which the cards were printed to his office. Two days later the papers
stated that Ottofy had sent the cards and plates by messenger to the
prosecuting attorney’s office.
N. La Doit Johnson, M.D., Chicago.--Dr. Johnson’s name appears as the
“First Vice-President” of the Allied Medical Associations of America.
A few years ago, Dr. Johnson’s name also appeared as the “Dean of the
Faculty” of the “American Post Graduate School.” This “school” was
a mail-order concern which, according to the “Annual Announcement,”
would grant diplomas and confer degrees as follows: “Master of
Surgery,” “Bachelor of Medicine,” “Bachelor of Science,” “Master of
Electro-Therapy,” “Doctor of Osteopathy,” “Doctor of Psychology,”
“Master of Massage,” etc.
H. M. Goehring, D.O., M.D., Pittsburgh, Pa.--The “Second
Vice-President,” according to the letterheads of the “Association”
carries the letters D.O., M.D., after his name. So far as our records
show, and they are most complete and based on official data, H. M.
Goehring is an osteopath, but not a doctor of medicine.
A. E. Erling, M.D., Milwaukee, Wis.--A. E. Erling, according to the
stationery, is “Chairman” of “Censors.” Our records fail to show that
Erling ever graduated in medicine. The Health Department of Milwaukee,
however, says that Erling, when interviewed, claimed to have “a diploma
from the German Medical College of Chicago, but refused to show or
present the same.” The American Medical Directory has this item:
_German Medical College_, Chicago. Chartered Dec. 28, 1891, by
Johann Malok. Fraudulent. Extinct.
A few years ago Erling was in La Crosse, Wis.; and in 1908 a circular
letter bearing his name and picture was sent out from which the
following extracts are taken. Capitalization as in the original:
“Dear Friend:--Permit me to call your attention to the fact that
Dr. A. E. Erling, the eminent specialist, after many years of
travel, practice and medical research, has given up his extensive
road practice and severed his connection with the several medical
institutes which have heretofore occupied considerable of his
attention ... Dr. Erling’s success in the treatment of all CHRONIC
DISEASES is truly remarkable. NERVOUSNESS, all BLOOD DISEASES,
RHEUMATISM, DISEASES PECULIAR TO WOMEN, CATARRH, DEAFNESS, CHRONIC
CONSTIPATION ... APPENDICITIS ... PILES, STOMACH TROUBLES, PARTIAL
PARALYSIS, etc., give way as if by magic under his skillful method
of treatment ... Understand please, that Dr. Erling DOES NOT ACCEPT
A CASE FOR TREATMENT unless he can PROMISE A SPEEDY AND POSITIVELY
PERMANENT CURE.”
The Journal also has in its files advertisements (vintage of 1915),
from some Wisconsin country newspapers, which notify the afflicted that
“Drs. Erling and Karass, the expert German Specialists,” could be seen
in their offices in the “Schlegel Hotel,” the “Schlitz Hotel,” etc., as
the case might be. Whether one of these “German Specialists” was Dr.
Arnold E. Erling, The Journal does not know. Official medical records
fail to show, at least, that there is any other Erling in the state of
Wisconsin.
W. W. Fritz, M.D., Philadelphia.--Another of the “Censors.” This
presumably is W. Wallace Fritz, M.D., D.D.S., N.D., D.O., D.C., who
was the “Dean” of the “American College of Neuropathy,” and “Professor
of Neuropathy” at the same institution. According to newspaper reports
published when the “dean” of the American College of Neuropathy was
called into court to testify regarding the “school,” Fritz admitted
that when he became dean of this “college,” the “college” had three
students and thirty “Faculty Members”! Fritz, it should be mentioned in
passing, is a member of the Philadelphia County Medical Society and by
virtue of this membership he has qualified as a Fellow of the American
Medical Association! Recently Fritz’s name appeared in connection with
the formation of a new organization, founded, it appears, for the
laudable purpose of fighting the “Medical Trust.” Fritz, according to
the newspaper reports, is treasurer of this new organization, which has
adopted the inspiring title, “Constitutional Liberty League of America”
and seems to be a later edition of the mushroom “National League for
Medical Freedom.” Quoting from the newspaper report:
“Dr. W. Wallace Fritz, a member of the American Medical
Association, created a profound impression when he said that all
health laws were written by agents of, or members of, the American
Medical Association, and that this organization was at once the
most powerful and the most baneful of all the American Trusts. Dr.
Fritz then went on to say: ‘Most of the drugs administered are
worthless. Most of the doctors who prescribe them are incompetent,
but both the injurious drug and the ignorant prescriber are
protected, in and out of court, by the American Medical
Association, which trust is now raising a vast fund with which to
drive all drugless healers out of the profession. Medicine is the
camouflage used to conceal the most alert, the most rapacious and
the least patriotic of all the trusts milking the American people.
The tyranny of the Medical Trust is unbelievable. It is also
un-American.’”
The Philadelphia _Sunday Transcript_ of May 4, 1919, had a five column
article under the name of W. Wallace Fritz. It is a most vituperative
affair, and reeks with fire and brimstone. It is directed chiefly
against the American Medical Association, and physicians are dubbed
“Prescription Writing Drug Peddlers Who Prosper Through Monopolistic
Laws Rather than by the Practice of an Exact Science.” In the course of
this diatribe we read:
“The members of the American Medical Association are manifesting an
unwarranted interest in the dear people, who, in their assumption,
need quinin and mercurial guardian; who under this class
legislation confines us to this monopoly of the big and little
pill, is trying by hook and crook to shut out the natural and
rational methods of cure which are driving the drug monopoly from
the face of the earth. Diagnosis and consultation consist in four
or five medical doctors, whose faces denote death, sitting around a
sick man and guessing what ails him. After that has been performed
they guess at what will cure him, and that is generally a sure sign
the undertaker will follow.”
C. O. Linder, M.D., Spokane, Wash.--This gentleman (another “Censor”),
seems to be an osteopath, who some years ago was “Assistant Secretary”
of the “Washington’s Physicians’ Association,” founded apparently
by rebels within the osteopathic ranks who denounced the Washington
Osteopathic Association as a “professional trust”! Linder apparently
claims graduation in 1905 from the “Thompsonian Medical College” of
Allentown, Pa. The following item from the American Medical Directory
regarding this school is of interest:
“_Thompsonian Medical College_, Allentown. Organized in 1904.
Fraudulent. No evidence to show classes were ever held.”
A. H. Flower, M.D., Boston.--Still another “Censor.” Flower, according
to the notice that appears in Polk’s Directory for 1917, claims
graduation in 1888 from the “American Health College” of Cincinnati,
and in 1894 from the “American Health University” of Chicago. Quoting
again from the American Medical Directory, here is what we find
regarding the former “college”:
“_American Health College_, Cincinnati. Organized in 1874 and
re-organized in 1876. Conducted by a Dr. Campbell who originated
and copyrighted the so-called ‘Vitapathic System,’ Fraudulent.
Extinct about 1888.”
We have no record of an “American Health University” of Chicago,
although there was an “Illinois Health University” of Chicago, one
of the numerous diploma-mill swindles operated by Armstrong. It was
declared fraudulent by the federal authorities and its charter was
revoked in 1897. Flower, according to the notice in Polk’s Directory,
is:
Ex-President Maine Eclectic Society.
Ex-President New England Eclectic Medical Association.
Member National Eclectic Medical Association.
Member American Progressive Medical Society.
Member Massachusetts Eclectic Medical Society.
Z. L. Baldwin, M.D., Kalamazoo, Mich.--Possibly the data just given
concerning some of those whose names appeared on the organization’s
stationery are more than sufficient for the average physician to get a
perspective of the Allied Medical Associations of America. Still, it is
worth mentioning that in a letter recently sent out by Ignatz Mayer,
extending an invitation to the annual convention of the Allied Medical
Associations of America, Mayer took the opportunity of incorporating in
his letter a letter which one of the members of the “association” had
been sending out, urging individuals to join. The member in question
was Dr. Z. L. Baldwin of Kalamazoo, Mich. Dr. Baldwin, as some of
our readers may remember, is the gentleman who, a few years ago, was
exploiting an “Intravenous Treatment” for the cure of tuberculosis.
According to the claims made at that time:
“... for the first time in the history of medicine, we have a
successful treatment for tuberculosis.
“... we are able to kill the germs of the disease in the body,
thoroughly ridding it of all tubercular infection, destroying the
germ and its poisons likewise.”
This was a few years ago. Whether Dr. Baldwin is still specializing in
consumption we do not know; apparently not, as we notice that at the
first meeting of the Allied Medical Associations, Baldwin’s name was on
the program for the “Cure of Goiter by Adjustment of Lenses.”
George Starr White, M.D., F.S.Sc., Lond., Los Angeles, Calif.--A
letter received by a physician a few days before the recent convention
of the Allied Medical Associations, held out as an inducement to be
present the fact that “Geo. S. White will show you how to diagnose
disease by means of dif. colored lights and the reaction of the body
to the magnetic meridian.” Dr. George Starr White was the “Second
Vice-President” of the Allied Medical Associations in 1918. White,
according to our records, was graduated in 1908 when he was forty-two
years old, by the New York Homeopathic Medical College and Hospital.
He was licensed in New York in 1908, in California, Connecticut and
Nevada in 1913, and in Michigan in 1916. He seems to have been one
of the proponents of “spondylotherapy,” “zonetherapy,” etc., and
in 1915 it was announced that he would give one week courses in
“Spondylotherapy” in Chicago, Kansas City and Denver, respectively. In
his advertisement he emphasized that he was a Fellow of the American
Medical Association, which, while true at the time, is no longer
true, as on Feb. 4, 1916, he was expelled from membership in the Los
Angeles County Medical Association. In May, 1915, White was arrested
in Chicago and fined $100 and costs for practicing medicine without a
license. Dr. White’s specialty seems to be what is ponderously known
as “Bio-Dynamo-Chromatic Diagnosis.” This has been described by one of
its enthusiastic adherents as “Diagnosis by Sympathetic Vagal-Reflex.”
To obtain the “Sympathetic Vagal-Reflex” it seems the patient must face
east or west and have his bare abdomen percussed until a dull area is
located. The patient is then faced north or south and again percussed.
Then, it seems, different colored lights are thrown on the patient,
the location of the areas of dullness being determined meanwhile. A
combination of ruby and blue lights “will cause a reflex in cases of
gonorrhea,” a “green light will cause a reflex in cases of liver or
gallbladder trouble,” while the color for carcinoma is orange red!
During the height of the influenza epidemic last winter, White seems
to have put on the market “Valens Essential Oil Tablets” which were
for “Gripping the Flu out of Influenza,” and were also said greatly to
benefit or cure incipient tuberculosis, hay-fever, asthma, and “catar.”
The letters “F.S.Sc., Lond.” after Dr. White’s name look well, sound
well, and have an air of erudition and mystery that is well worth what
they cost. They mean “Fellow of the Incorporated Society of Science,
Letters and Arts of London, Ltd.” The “Fellowship” costs one guinea.
Not a few “patent medicine” exploiters in the United States carry
these mystic letters after their names. The society in question was a
seriocomic concern that was exposed by London _Truth_ some years ago
and was also dealt with in The Journal of May 29, 1909, in connection
with the “Aicsol Consumption Cure” exposé.
So much for the Allied Medical Associations of America. At their
recent meeting in New York City they got much newspaper publicity
because of their action on the prohibition question. According to the
newspaper reports, the organization adopted a resolution declaring
that “properly brewed lager beer is absolutely essential in the
treatment of certain cases.” They were further reported as endorsing
the manufacture of light wines and of beer containing not to exceed
2.75 per cent. alcohol. As a piece of publicity work this resolution
was all that its sponsors could expect. <sc>The Journal</sc> office was
flooded with telegrams and letters from physicians, temperance workers,
congressmen, church organizations, and others, asking, in effect, What
_is_ the Allied Medical Associations of America? This is our apology
for giving the amount of space necessary to a proper understanding of
this organization. Today the rocket of the Allied Medical Associations
of America is blazing a more or less erratic course across the sky of
publicity. The stick will be down anon! Any resolution or expression
of opinion by this organization, or others of its type, when dealing
with the broader problems of public health, is wholly without
scientific significance, whether such resolutions are good, bad or
indifferent.--(_From The Journal A. M. A., July 5, 1919._)
“ARSENICALS”
The September issue of the _Archives of Dermatology and Syphilology_
presents a number of significant features regarding the use of
arsphenamin and related compounds that are at present being widely
employed in the treatment of syphilis. To one who studies these
statements of laboratory and clinical investigators in the special
field involved there must come the conviction that many therapeutic
perplexities still remain at the end of nearly a decade of trial for
the types of compounds which Ehrlich introduced. It is well for the
practitioner to realize this, especially when expert workers still
make an appeal for conservative interpretations. Stokes forcefully
summarized the situation when he stated at the New Orleans session of
the American Medical Association:
Too short a time has elapsed since the discovery of these drugs,
and too little is as yet known about the ultimate problems of the
pathology, immunology and parasitology of syphilis, to justify the
announcing of new infallibilities. The necropsy pathologist of the
next fifty years may well, like Warthin, upset our most plausible
generalizations of today. Seasoned tradition and conservatism are
still the wisest guides in our interpretation of clinical cure.
Arsphenamin has made it apparently possible and even probable,
but only to the inexperienced has cure been made absolute and
inevitable.
It is recognized that the exact composition of arsphenamin in its
available form is not fully determined. As has been emphasized again,
the quantitative determination of arsenic alone in arsphenamin is
insufficient to estimate its purity; in fact, the interstate sale of
arsphenamin is controlled by toxicity tests on guinea-pigs made by
the Hygienic Laboratory of the United States Public Health Service.
Consequently, practical medicine must be on its guard to employ a
product which is carefully controlled by such toxicity tests as well
as by other criteria. It will not do to charge untoward results offhand
solely to idiosyncrasy of the patient, faulty administration or other
errors in technic. The drug itself still has inherent dangers. It
should be borne in mind also that neo-arsphenamin behaves differently
in the animal organism from arsphenamin, and should not be regarded
simply as arsphenamin in a convenient form for administration.
It is gratifying to learn from a government expert that after the long
struggle to produce satisfactory products, arsphenamin preparations
made in the United States are generally less toxic than those of
foreign manufacture. Neo-arsphenamin preparations made in the United
States compare favorably, and in certain instances are decidedly less
toxic than most of the foreign products. Timely presentations of the
faults and dangers as well as the undisputed advantages of current
therapy in the management of syphilis should be welcomed.--(_Editorial
from The Journal A. M. A., Oct. 9, 1920._)
Pharmacology of Arsenicals
The Public Health Service some time ago[262] warned against the use in
syphilis of new arsenicals which are not related to arsphenamin; it was
stated that a number of such were being sold with unwarranted claims
as to their value. At least three such arsenicals have in recent years
been the subject of some exploitation for use in this disease: sodium
cacodylate, the sodium salt of methyl arsenic acid (“Arrhenal”) and
the sodium salt of ethyl arsenic acid (“Mon-Arsone”).[263] As regards
the first two, Castelli showed several years ago that neither has any
action on experimental trypanosomiasis and spirochete infections;
careful clinical observations in this country have confirmed the
inefficacy of sodium cacodylate in human syphilis.[264] Voegtlin
and Smith[265] of the Hygienic Laboratory have now shown in animal
experiments that ethyl arsenic acid (“Mon-Arsone”) is devoid of any
practical trypanocidal action. Thus the “therapeutic ratio” (the
ratio of the minimal effective dose to the lethal dose) was about 1,
that is, it was effective therapeutically only in approximately fatal
doses, the therapeutic ratio for arsphenamin in similar conditions
was 17, and that of neo-arsphenamin, 28. In fact, the conditions
with ethyl arsenic acid were no more favorable than were those with
arsenous acid (the active constituent of solution of potassium
arsenite), although it was far less poisonous. The validity of such
experiments in determining the probable value of drugs in human
syphilis cannot be questioned:[266] it was by such experiments that
Ehrlich and his co-workers found two or three of six hundred and six
arsenic preparations studied to be of value, and of the next three
hundred or more studied only one (neo-arsphenamin) worthy of trial in
human medicine. The time has passed when a high arsenic content of a
compound and a low toxicity, and a number of cases of apparent clinical
improvement, can be assumed to indicate that a drug has any real value
in the treatment of syphilis. Many organic compounds of arsenic as
well as other drugs may cause temporary or apparent improvement in
syphilis, but to date only those related to arsphenamin have proved of
real value and comparatively safe. Others which had some real value
proved to have dangerous side effects; readers will recall the history
of arsanilic acid (“Atoxyl” or “Soamin”) and its acetyl derivative
(“Arsacetin”).--(_Editorial from The Journal A. M. A., Feb. 26, 1921._)
[262] Warning Against Untried Medicaments, J. A. M. A. =74=:1654 (June
12) 1920.
[263] Wright, B. L.; Kennell, L. A., and Hussey, L. M.: Med. Rec.
=97=:607 (April 10) 1920.
[264] Nichols, H. J.: Salvarsan and Sodium Cacodylate, J. A. M. A.
=56=:492 (Feb. 18) 1911.
[265] Voegtlin, Carl, and Smith, H. W.: J. Pharmacol. & Exper. Therap.
=16=:449, 1921.
[266] Compare Schamberg, J. F.; Kolmer, J. A., and Raiziss, G. W.: Am.
J. M. Sc. =150=:25 (July) 1920.
Salvarsan: Abrogate the Patent
The Journal has already commented on the difficulty in securing
salvarsan, on the moral and ethical question as to whether or not it is
justifiable for one person to control the output of a drug necessary to
public health. This week we publish an account of the action of the St.
Louis and Chicago medical societies, which are calling on the medical
profession to appeal to their senators and congressmen to abrogate this
patent. The Journal believes that this patent should be abrogated, not
alone because the patentees have not supplied the demand, not alone
because they have dictated to the medical profession who should have
the drug and how much a physician might have, not alone because of
the war with Germany, not alone because of the special needs of the
government at this time for the control of venereal diseases, not alone
because, as some claim, the patent at Washington does not correctly
describe the product, but also because the people who are supplying
this product are charging prices that are exorbitant compared to the
price at which others in this country can supply it. The fact is that
the salvarsan one can obtain today costs $4.50 per ampule of 0.6 gram,
whereas the same dose of arsenobenzol--a preparation identical with, if
not better than, salvarsan--costs $2.00 at retail, and as Dr. Schamberg
says: “If we are permitted to continue marketing the same drug after
the war, we can sell it at $1.00 or less per tube.” To abrogate this
patent would be doing an injury to no one. Certainly the patentees of
salvarsan have already reaped their harvest--and a pretty rich one. The
supply of salvarsan at a reasonable price in proportion to its actual
cost of production is in the interest of the health of the entire
population of the country, whereas to let matters rest as they are,
is to the benefit of one man. While we are emphasizing here the cost,
there is after all a greater question, and that is the supply necessary
to help control the ravages of one of the most serious diseases
which afflict humanity today. It is the duty of Congress to abrogate
the patent on this preparation and, incidentally, on all medicinal
preparations of importance.--(_Editorial from The Journal A. M. A.,
April 21, 1917._)
End the Monopoly
The Adamson Bill, known as the “trading with the enemy act,” has
recently been passed by the House of Representatives, is now before
the Senate, and will doubtless be enacted into a law. One of its
clauses confers authority on the Federal Trade Commission to grant
licenses to citizens of this country to operate patents owned by enemy
aliens. Physicians are interested in the bill primarily because it
includes the salvarsan situation. The manner in which salvarsan has
been supplied in this country has been so arbitrary and the prices
charged so tremendously above the actual cost, that we should not be
satisfied unless the monopoly is ended so that the drug can be supplied
at least at a fairly moderate figure, and the old methods eliminated.
It is to be hoped, therefore, that the Federal Trade Commission will
not grant exclusive control--that is, exclusive license--to any one
person or firm. To do so would simply perpetuate the old monopoly and
the old conditions. England has adopted a law, which, in principle,
is similar to the Adamson Bill, and there several concerns have been
licensed to manufacture the product. The same should be done here. The
Dermatologic Research Laboratories of Philadelphia announce that they
can supply arsenobenzol at $1.50 a tube, and that there is immediately
available a supply sufficient for any demand that may be made. The same
laboratories have announced also that in a few months they will be able
to supply hospitals for $1.00 a tube. Considerable responsibility rests
on the Federal Trade Commission in this matter, for it is not only a
question of monopoly, but also a question of scientific qualifications
and ability to make the product on the part of some who may make
application. Undoubtedly the commission will secure the cooperation of
the United States Public Health Service, under whose supervision these
drugs should be manufactured no matter who shall be licensed to make
the product.--(_Editorial from The Journal A. M. A., July 21, 1917._)
Arsphenamin
No, this is not a new chemical; it is simply the name adopted
by the Federal Trade Commission for the hydrochlorid of
3-diamino-4-dihydroxy-1-arsenobenzene--in other words, salvarsan. As
our readers already have been informed three firms have been licensed
to manufacture and sell arsphenamin; but, while each manufacturer may
have his own trade name on the label, the official name must be the
prominent one on all packages. Hence, physicians should at once make it
a point to learn and use the name “arsphenamin” in place of salvarsan.
At first sight, arsphenamin looks formidable. In reality, it is just as
easy to familiarize oneself with the word “arsphenamin” as it was to
learn to use the terms “salvarsan,” “arsenobenzol” or any other of the
trade names.--(_Editorial from The Journal A. M. A., Jan. 19, 1918._)
BEER AND CANCER CURES
Did the Brewing Interests Advertise Autolysin?
Our readers may remember that an article appeared in this department of
The Journal for July 6, 1918, under the title “Henry Smith Williams and
‘Proteal Therapy.’” “Proteal Therapy” is a treatment exploited by Henry
Smith Williams, M.D., of New York, for use in tuberculosis, cancer,
rheumatism, etc. It is apparently a modification of the “Autolysin”
cancer “cure” which Williams had previously puffed in _Heart’s
Magazine_.
The Journal’s article pointed out that Henry Smith Williams, although
entitled to write “M.D.” after his name, is essentially a journalist.
He has written voluminously for some years in lay publications on
various subjects, both under his own name and under his _nom de plume_,
“Stoddard Goodhue, M.D.” In addition, Williams runs a publishing
concern called the Goodhue Company, which issues a number of books,
many of them being reprints of Williams’ own articles.
Closely associated with Henry Smith Williams is his brother, Edward
Huntington Williams, who also is a prolific writer. The Journal’s
previous article called attention to the fact that there had been sent
broadcast to physicians a neat little cloth-bound book, entitled,
“Alcohol, Hygiene and Legislation.” This book, which evidently cost
somebody a good deal of money to distribute gratis, was published by
the Goodhue Company, and was written by Edward Huntington Williams.
Enclosed with the book was an advertising leaflet on the “Autolysin”
cancer cure and also a letter from the Goodhue Company, asking
physicians to accept it “with our compliments and the compliments of
the author.” The letter was chiefly devoted to calling attention to
Henry Smith Williams’ “new book, the Autolysin Treatment of Cancer.”
The last thirteen pages of the book “Alcohol, Hygiene and Legislation”
contained advertisements of the Goodhue Company’s publications,
particular emphasis being placed on the “Autolysin Treatment of
Cancer,” by Henry Smith Williams.
So much by way of retrospect. Now comes information that may throw
an interesting side-light on the matter just presented. There is at
present being conducted by a committee of the United States Senate,
an investigation relative to the purchase of a Washington (D. C.)
newspaper with money alleged to have been furnished by those interested
in the brewing industry.
At the opening hearing before the Senate Committee, Tuesday, November
19, the secretary of the United States Brewers’ Association, after
admitting that brewers’ propaganda had been published in the
_International Monthly_, edited by Viereck (of the _Fatherland_), also
declared that the Publication Committee of the brewers’ association
employed writers to “write up certain subjects” relating to the
brewers’ trade. One of the writers mentioned in this connection was,
according to the newspaper reports, “Dr. Edward H. Williams, author of
articles published in medical and other journals.”
With this fact before us, it seemed worth while to go through the
book that had been distributed so lavishly to physicians with the
compliments of the Goodhue Company and Dr. Edward Huntington Williams,
in the exploitation of “Autolysin,” and Henry Smith Williams’ book on
the subject.
The first chapter of “Alcohol, Hygiene and Legislation” consists of
a reprint of an article from the _New York Medical Journal_ of May
8, 1915. The article is a skilful presentation of the case for the
defenders of the lighter alcoholic beverages, especially beer. This
chapter and all succeeding chapters of the book attempt to discredit
prohibitory legislation, and argue that prohibition drives the public
to the use of the more ardent alcoholic beverages, while preventing the
use of the milder beverages, such as beer, which one is led to infer
is not particularly harmful. Throughout the book, also, the state of
Kansas is held up as an example of the harm done by prohibition, and
the theme is developed that insanity and the use of cocain and other
habit-forming drugs follows in the wake of prohibition. The following
extracts are from Chapter I:
The evil effects of _beer_ and wine, for example, are greatly less
than those produced by spirituous liquors.... [Italics ours.--Ed.]
If our theory of immunity is correct we should expect to find that
the older beverages, such as _beer_ and wine, which have been
used for thousands of years, are less productive of alcoholic
insanity, for example, than the spirituous liquors which are recent
innovations. In point of fact we find this to be the case: the
spirituous liquors are almost wholly responsible for all forms of
alcoholic insanity. [Italics ours.--Ed.]
Chapter II is a reprint of an article that appeared in _Everybody’s
Magazine_, August 1914, and deals with “Legislation from a Medical
Viewpoint.” It is to the effect that drug addiction and insanity,
together with special forms of mental disease directly attributable to
alcoholism, seem to flourish best in prohibition territory.
Chapter III deals with “The Peace and War Footing of Alcohol,” and
is a reprint from the _Medical Record_, Aug. 7, 1915. It, too, sings
the praises of the “lighter beverages,” while deprecating the use of
“ardent spirits.” For instance:
An overwhelmingly large proportion of persons who develop alcoholic
psychoses in America are drinkers of whisky, or some corresponding
ardent spirit, whereas this condition is seldom seen in _beer_ and
wine drinkers. [Italics ours.--Ed.]
Thus we find the highest percentage of alcohol psychoses among
the whisky drinkers who come from western Europe, while the wine
and _beer_ drinking races of central and southern Europe show
a distinctly lower percentage, in some instances only about
one-fourth as many per thousand. [Italics ours.--Ed.]
Chapter IV deals with “Some Aspects of Liquor Legislation.” Like
Chapter II it is an indictment of prohibition, and the United States
Census Bureau’s reports are called on to sustain this thesis.
Quotations, too, are made from the writings of Henry Smith Williams
further to prove the point. “Dry” Kansas and “wet” Nebraska are
frequently compared, to the detriment of the former. One who accepts
the statements in this chapter will get the impression that Kansas has
more lawlessness, illiteracy, pauperism, and insanity than Nebraska.
Chapter V deals with “The Problem of Legislation.” It is based on the
premise that “prohibition does not prevent the consumption of liquor,”
but on the contrary, “prohibitive legislation induces the consumption
of the most harmful form of liquors.” Stated in another way, it is
equivalent to charging that prohibition is hard on the brewers, but
beneficial to the distillers. In fact, E. H. Williams, in another book
(“The Question of Alcohol”--Goodhue Co.) which also champions the case
for the milder alcoholics, quotes Henry Smith Williams as saying,
relative to prohibitory legislation: “In general, it would appear
that, if our legislators of recent years had been in league with the
distiller, they could not have served his purpose better.”
Whether or not Edward H. Williams’ or Henry Smith Williams’ conception
of the alcohol problem is good, bad or indifferent, need not at this
time concern us. The medical profession, however, has a right to ask
two questions: First, Is the Dr. Edward Huntington Williams who wrote
“Alcohol, Hygiene and Legislation” the “Dr. Edward H. Williams” who was
employed by the brewers to write propaganda favorable to the brewing
interests? Second, Was the cloth-bound book, “Alcohol, Hygiene and
Legislation,” which was distributed by the Williams brothers, paid for,
wholly or in part, by the United States Brewers’ Association?
For those who wish to read Dr. Edward Huntington Williams’ opinion on
the alcohol question, the following bibliography may be of service:
“Liquor Legislation and Insanity”: _Medical Record_ =84=:791, 1913.
“The Liquor Question in Medicine”: _Medical Record_ =85=:612, 1914.
“Inebriety as a Medical Problem”: _Post-Graduate_ =29=:603, 1914.
“The Problem of Inebriety”: _N. Y. Medical Journal_ =101=:940, 1915.
“Aspects of Inebriety in Alcohol”: _British Journal of Inebriety_
=13=:9, 1915-1916.
“The Peace and War Footing of Alcohol”: _Medical Record_ =88=:226,
1915.
“Alcohol and Therapeutics”: _Medical Record_ =92=:666, 1917.--(_From
The Journal A. M. A., Nov. 30, 1918._)
BIOLOGIC THERAPEUTICS AND ITS COMMERCIAL DOMINATION
The danger of commercialized therapeutics has been enormously increased
by the introduction of biologic products. These substances offer a rich
field for the commercially minded, first, because of the remarkable
results which seem to have followed the use of certain products of
this type; second, because the field is new and the mode of action
of these substances not readily understood and, third--and most
important--because, by the very nature of the problems involved, few
physicians are well informed concerning them. The influenza epidemic of
last year was widespread and fatal in character. It stimulated earnest
research in methods of prevention and cure. We were all in a frame
of mind to grasp at any straw. Here and there some worker would cry
“Eureka”--only to be disappointed when his product was actually put to
the test. However, there were more than enough manufacturers ready to
place any product on the market with specious claims that could not
be positively denied. Vaccines, serums, proteins--all were advanced
with such glowing statements as to their properties that only those
physicians who kept their feet firmly on solid ground could resist
the appeal. Now we have had another epidemic--mild, it is true--but
the memories of last year make the average physician ready to accept
anything which promises hope, and the manufacturers “make hay while the
sun shines.” Physicians have been and are being deluged with literature
on the prophylaxis and treatment of influenza. So far as we know, few
publications have contained any word of warning on these matters. One
exception has just come to notice: the _Medico-Military Review_, a
semimonthly mimeographed publication sent to medical officers of the
Army by the Surgeon General’s Office. This says:
YOU ARE REMINDED that so far a comprehensive analysis of results
obtained by the use of monovalent and polyvalent vaccines in the
prevention of influenza has not demonstrated their value. Much
carefully controlled experimental work is now being carried out
on this subject both in civil institutions and in the Army, and
any worthwhile advances will be reported in the _Review_ from
time to time. If a prospective vaccine is developed, it will be
prepared at the Army Medical School for general distribution and
all medical officers will be duly notified. The general use of the
present commercial polyvalent protective against influenza is not
considered desirable. Numerous telegrams and other requisitions are
being received for influenza vaccine. In view of the fact that no
prophylactic influenza vaccine is available, such requisitions should
be discontinued.--(_Editorial from The Journal A. M. A., Feb. 14,
1920._)
CAPELL’S UROLUETIC TEST
U. S. Marine Hospital, Chicago.
_To the Editor_:--A member of the consultant staff of this hospital
recently referred to us a “Doctor” H. F. Matthews, who was supposed
to give demonstrations of a new test for syphilis--“Capell’s
‘Uroluetic’ Test.” The test was to be made of the urine of the
patient. The above mentioned consultant was under the impression
that the said “Doctor” Matthews was a graduate physician.
“Doctor” Matthews came to the hospital according to the appointment
made by the consultant, and proceeded to give his demonstration.
Several of the junior officers and interns were present to
witness it. He was asked questions in an attempt to determine
the scientific status of the test which he was demonstrating.
His answers were always vague and indefinite and not clothed in
scientific words.
We became suspicious of him, and he was asked if he was a graduate
physician. He admitted that he was not. He was further asked if he
had studied chemistry and bacteriology; he stated that he had in
1888. Inquiry was made as to where; he replied that it was at the
University of Illinois. He was further asked if he was familiar
with the Wassermann reaction. He stated that he was not.
This man is going around representing himself as a physician who
has a new test which he claims is superior to, and more delicate
than, the Wassermann test; yet he knows nothing whatever of the
technic of the Wassermann reaction.
In one case, we gave him the same specimen of urine in four
different containers. He read a different degree of reaction for
each of them. In other words, in a specimen from the same patient,
his four different tests showed, respectively, a +, a ++, a +++ and
a ++++ reaction.
It occurred to me that it might be well to inform you of this
man’s methods, as he told us that he had been to a good many
institutions, and I am sure he will soon start a plan to
systematically force his pseudoscientific test on credulous
physicians everywhere.
J. O. Cobb, M.D., Senior Surgeon in Charge.
The Propaganda Department has in its files a business card reading:
“Capell’s Laboratories, Room 1510 Masonic Temple, Chicago. Dr. H. F.
Matthews, Special Representative.” Capell’s Laboratory has its
headquarters in Omaha, and is apparently conducted by Dr. W. L. Capell,
who, for many years, seems to have been more or less interested in
proprietary medicines. Some years ago he was connected with a concern
known as “Acneine Pharmacal Company,” which, apparently, was dissolved
some time in 1910; and soon thereafter a new company was organized
known as the LeRoy Drug Company. In 1917 W. L. Capell was connected
with the Capell, Cameron Co., Inc., of Lincoln, Neb., which was
selling “Capell’s Uroluetic Test”, “Capell’s Treatment for Syphilis”
and other remedies. The “Treatment for Syphilis” was said to be
“Painless, Pleasant, Harmless, Efficacious, and requires usually
from 30 to 90 days only to eradicate the disease.”
The name of the treatment is “Mercarodin”--earlier it was called
“Camit”--and it is now being sold from “Capell’s Laboratory,” Omaha.
In addition, Capell’s Laboratory sells Acneine, which apparently is
the same product that was sold in 1906 and 1907 under the name of
“Sambu-Co” by the Holtman-Stringer Co. of Omaha and later was put out
by the Acneine Pharmacal Company of Omaha.
While Capell’s Laboratory sells proprietary remedies, it is the
“Uroluetic Test” which the concern now seems to be featuring. The
claims made for this are:
“This test requires no expert knowledge, is inexpensive, and can be
made in a few minutes, and is so plain that it cannot be mistaken.”
The idea of being able to determine the absence or presence of syphilis
by a simple color test of the urine is a fascinating one. The present
reliable diagnostic tests are, as Capell’s Laboratory so plausibly
emphasizes, somewhat involved, and call for rather delicate technic.
But there are no short-cuts to knowledge.
A physician who ordered Capell’s Uroluetic Test some weeks ago received
with the bill the letter that follows: It is given not so much for what
it says, as for how it says it. It is copied _verbatim et literatim_:
“Your letter received, and we have mailed you as per your letter
1 Doz. of Capell’s ‘Uroluetic’ Tests. In close find statement and
instructions, for same.
“The ‘Uroluetic’ Test is meeting a far greater approval from the
Medical profession than we had expected, while we do not claime
that it is perfect, yet we have only received one unfavorable
report, and we daily feel incuraged in its efficacy.
“You know Doctor that there are two dangerous elements in this
world, one is the extreme pessimist and the other is the extreme
optimist. The immoral Lincoln said, ‘That there was nothing that
was wholly good or wholly evil,’ and we presume that this is
equally true of the ‘Uroluetic’ test. But we want the truth no
matter what it is.”
“Capell’s Uroluetic Test” would be “important if true.” Unfortunately,
its scientific value to the sufferer is negligible compared with its
economic value to the exploiter. It is not so much a test for lues
in the patient as of credulity in the doctor.--(_From The Journal
A. M. A., Aug. 23, 1919._)
Another Urinary Test for Syphilis
_To the Editor_:--Will you kindly inform me whether the test in the
enclosed “literature” is what it is represented to be?
Charles M. Thomas, M.D., Sunbury, Pa.
ANSWER.--The “literature” referred to by Dr. Thomas dealt with the
“Uri-Na Test” sold by the Standard Appliance Company of Philadelphia.
There seems to be a strong family resemblance between this alleged test
and that known as “Capell’s Uroluetic Test,” which was discussed in
the Propaganda Department of The Journal, Aug. 23, 1919. Of that The
Journal said: “Unfortunately, its scientific value to the sufferer is
negligible compared with its economic value to the exploiter. It is not
so much a test for lues in the patient as of credulity in the doctor.”
The same may be said of the “Uri-Na Test.” The facts are, there is no
method at present known by which the absence or presence of syphilis
may be determined by a simple color test of the urine.--(_Query in The
Journal A. M. A., Nov. 22, 1919._)
CHEMOTHERAPY AND TUMORS[N]
Richard Weil, M.D., New York
[N] From the Cancer Research Service of the General Memorial Hospital,
New York.
[N] This critical discussion of the status of chemotherapy in tumors
was prepared at the request of the Council on Pharmacy and Chemistry of
the American Medical Association.
Within the last three years a number of reports have appeared in the
medical press which bear on the treatment of malignant growths in
human beings by chemical preparations. The most persuasive and the
most insistent claims have been made in connection with the colloidal
solutions of certain metalloids and metals, notably selenium, vanadium
and copper. At the same time a number of drug houses, both in this
country and abroad, have placed on the market proprietary preparations
of these substances in various forms, for which the claim is made that
they produce striking therapeutic effects and sometimes even cures in
malignant neoplasms.
The impulse toward the use and production of this type of preparation
is directly traceable to a series of scientific experiments on the
tumors of animals, which date back no farther than the year 1911. In
that year Wassermann and his co-workers[267] published a report on
the treatment of rat tumors by means of the intravenous injection of
selenium compounds. This paper received wide notoriety through its
enthusiastic diffusion by the lay press. Shortly afterward Neuberg and
his co-workers[268] published their observations upon the therapeutic
effects of certain metallic compounds. The clinical application of the
encouraging results obtained by these authors in animal tumors followed
rapidly, and up to the present time a number of papers have appeared
in which the claim is made that human tumors also may be favorably
influenced through the constitutional use of substances similar to
those used by Wassermann or Neuberg. In some cases, use has been made
of colloidal solutions of the heavy metals, such as copper; in others,
selenium compounds have been used, while in a third set of observations
the therapeutic agent represents an attempt to combine the virtues of
these two types of therapy by employing selenium in colloidal form. As
an example of the first class, may be cited the cuprase of Gaube du
Gers;[269] of the second, the seleniovanadic ointment of Roemer and the
sulpho-selene of Walker; of the third, seleniol and electro-selenium.
[267] Wassermann, Keysser and Wassermann: Deutsch. med. Wchnschr.
=37=:2389, 1911. Wassermann and Hansemann: Berl. klin. Wchnschr. =49=:4,
1912.
[268] Neuberg and Caspari: Deutsch. med. Wchnschr. =38=:375, 1912.
Neuberg, Caspari and Löhe: Berl. klin. Wchnschr. =49=:1405, 1912.
[269] Gers, Gaube du: La cuprase et le cancer, Paris, 1913.
Inasmuch as this new type of cancer therapy derives its origin,
its justification and its support, in very large measure, from the
laboratory results obtained in animals, it is a matter of considerable
importance to examine those results with care, in order to determine
whether they furnish a satisfactory basis for human therapy, and
whether they justify the hopes to which they have given rise.
It is safe to assert that the application of chemotherapy to the
treatment of tumors practically dates from the publications of
Wassermann. He stated the principle that a rational therapy of tumors
must be based on constitutional treatment. It appears evident that
local treatment can have only local effects. The lymphatic extensions
of tumorous growths, and the often unsuspected metastases in distant
organs must of necessity escape the effects of purely local treatment.
Hence, Wassermann reached the conclusion that all treatment of cancer
which was to be effective, and not merely palliative, must be carried
to all parts of the body by means of the blood stream. He therefore
introduced the use of intravenous injections in the experimental
therapy of rat and mouse tumors. An accidental observation led him
to believe that selenium was a substance possessing a high degree of
affinity for tumor cells.
In order to insure the penetration of the tumor in the live animal by
this substance, however, he considered it essential to combine it with
some other highly diffusible substance. This type of substance, which
was to act as a carrier of the selenium, he described under the name
“cytotrochin,” from the Greek word τροχιά {trochia}, meaning road. For
this purpose he selected eosin. The eosin and the selenium were then
combined by a method and in a form the details of which have never
been published. All that we know of this preparation is contained in
the statement that it is very difficult to produce, and that it is
extremely unstable and difficult to keep. Mice can be given amounts of
from 2 to 3 mg. of this substance in solution. Wassermann experimented
with mice inoculated with transplanted tumors of the types of carcinoma
and sarcoma. After from three to five intravenous injections of the
drug, he noted that the tumors become softer and fluctuate. After still
further injections the fluid mass undergoes absorption, and the tumor
gives the impression of an empty sac. If it is possible to carry the
injections up to the number of ten or twelve, recovery ensues. In such
cured animals there remain only the unabsorbed portions of the fibrous
capsule. Recurrences were not observed in the cured animals. Wassermann
further stated that two spontaneous tumors in mice which had been
treated by this method presented favorable results.
Wassermann’s original presentation gave few experimental details, and
has not been followed by the promised scientific report. From his
article it is impossible to determine what proportion of his animals
were cured and what proportion failed to survive the treatment. From a
later paper by Keysser[270] we learn that by far the larger portion of
the animals perished during the treatment in the stage of softening,
so that a cure was accomplished in from only 3 to 5 per cent. of the
animals. This is a point of great importance, inasmuch as it furnishes
an indication of the highly dangerous character of this mode of
treatment. Fatal results are attributed by Keysser to the absorption of
toxic products from the tumor. This contention, however, is supported
by no observations, and it is certainly equally fair to assume that
death results from the toxic effects of the compound. A microscopic
study of tumors taken from animals undergoing treatment was made by
Hansemann. He found that the death of the cells was the result of
nuclear destruction.
[270] Keysser: Wien. klin. Wchnschr. =26=:1664, 1913.
Within a very few months after Wassermann’s publication, Neuberg
and Caspari[268] published a paper which was the first of a series
of studies on the therapeutic effects of the heavy metals on the
animal tumors. They used zinc, platinum, tin, selenium, copper,
silver and cobalt in the form of certain complex organic compounds,
the composition of which is not revealed. Owing to the fact that
intravenous injections of these compounds produced a specific effect on
the tumors, they are described as “tumoraffin” substances. Immediately
after the intravenous injection of these preparations, there followed
a marked hyperemia of the tumor, whereas the remainder of the mouse’s
body appeared markedly anemic. The hyperemia was often attended
by hemorrhage into the tumor. This first stage was succeeded by
liquefaction and absorption followed by recovery in favorable cases.
The authors failed to state in what proportion of their experiments the
animals died, and in what proportion recovery ensued.
The second paper on this subject is by Neuberg, Caspari and Löhe,[268]
in which further details are vouchsafed. They state that with the
compounds used by them the toxic and the therapeutic doses approximate
very closely, from which it follows that the treatment, as with the
Wassermann method, results in a very high mortality. Smaller doses
produce no therapeutic effect; on the contrary, they seem to act as
a stimulus to the tumor, accelerating the normal rate of growth.
Spontaneous tumors show similar effects, but no cures are recorded.
Only in tumors in which autolysis is active _intra vitam_ does the
method exert any effect. Consequently the benign primary tumors of
animals, such as fibromas, are not influenced by it.
Neuberg and Caspari are to a great extent responsible for the colloidal
theory of treatment in tumors. Accepting the observations of Petri and
others that the autolytic ferments in tumors are quantitatively greater
and qualitatively different from those present in the normal tissues
of the body, they venture the assumption that the process of recovery
in the experimental tumors of animals is due to the self-digestion of
the tumor by these ferments. Ascoli and Izar[271] had shown that such
ferments are materially stimulated by the presence of metals, and more
especially of metals in colloidal form. This contention is apparently
in harmony with the well-established fact that certain colloidal metals
of themselves are capable of acting under certain circumstances as
ferments. Neuberg and Caspari were at first of the belief that the
compounds produced by them circulate in colloidal form. Subsequently
they stated that these compounds were crystalline substances, but they
assumed, under the influence of the theoretical consideration mentioned
above, that these substances are broken up in the tumor and there
undergo transformation into the colloid state.
[271] Izar: Ztschr. f. Immunitätsforsch., 1913. Izar and Basile: Berl.
klin. Wchnschr., 1913, p. 1312.
In connection with the preceding observations there are certain other
experimental results which require mention. Izar[271] succeeded in
curing rat tumors by means of injection of colloidal sulphur. C.
Lewin[272] cured subcutaneous mouse tumors with various preparations
of gold. Werner and Szécsi[273] produced similar results through
a combination of selenium-vanadium with cholin-borate; in these
experiments the selenium-vanadium was supposed to be present in
colloidal form.
[272] Lewin, Carl: Berl. klin. Wchnschr., 1913, p. 147; Berl. klin.
Wchnschr., 1913, p. 541.
[273] Werner and Szécsi: Ztschr. f. Chemotherap., 1913, Orig., i, 358.
Szécsi: Ibid., ref., 1913, ii, 1060.
Within a comparatively brief period of time, therefore, it fell to the
lot of a number of observers, using strikingly different substances,
to produce therapeutic effects amounting in a certain percentage of
cases even to cure in the experimental tumors of the lower animals.
The various procedures have little in common. Both metals and
nonmetallic substances have been employed either in colloidal form or
in combination with organic radicals. In some instances a diffusible
carrier is combined with the basic substances; in others not. All of
the preparations appear to possess a high degree of toxicity, although
adequate data on this very essential feature are almost invariably
withheld.
Wassermann’s results with eosin-selenium were soon critically examined
by other observers. Uhlenhuth[274] and Contamin[275] were unable to
confirm his observations, but their negative results are attributed
by Keysser to the fact that they were not in possession of the proper
formula for the preparation of the eosin-selenium compounds as used
by Wassermann. Apolant,[276] however, in Ehrlich’s name confirmed
Wassermann’s findings.
[274] Uhlenhuth, Dold and Bindseil: Ref., München. med. Wchnschr.,
1912, p. 1782.
[275] Contamin, Detoeuf and Thomos: Bull. de l’assn. franç. pour
l’étude du cancer, vi, 62.
[276] Apolant, H.: VI Tag. der freien Vereinigung für Mikrobiologie.,
Berlin, 1912. Ref. München. med. Wchnschr., 1912, p. 659.
The most important critique of eosin-selenium has been contributed
by the subsequent investigations of one of Wassermann’s original
collaborators, F. Keysser.[277] Keysser’s publication contains a large
number of very careful observations on the various forms of eosin
supplied by the German manufacturers, as well as on other matters which
cannot here be considered in detail. He finally reached the conclusion
that the eosin furnished by the manufacturing house of Sandoz was
the most effective for his purposes, inasmuch as it combined the
lowest grade of toxicity with the highest capacity for discoloring
the tissues. The selenium he used in the form of selenio-vanadium
furnished by Clin of Paris, which was the identical preparation used
by Werner and Szécsi in combination with borcholin. The maximum dose
of this selenio-vanadium is 0.06 c.c. for each gram of mouse. Eosin,
0.01 gm., dissolved in 0.5 c.c. of physiologic salt solution, is mixed
with 0.5 c.c. of the selenio-vanadium. This mixture is then used for
intravenous injections. The results produced by the injection of this
mixture are to all intents and purposes similar to those obtained by
Wassermann, except that Keysser induced cure in a larger proportion of
animals, namely, from 6 to 8 per cent. It is evident from his careful
description of his experiments that the treatment is extremely toxic to
the animals. The therapeutic dose is considerably greater than one-half
the toxic dose. This accounts for the fact that an extremely large
proportion of the animals perish during the course of the treatment.
The tumors failed to be influenced unless the dose given fell very
little short of the fatal amount. Moreover, in order to accomplish a
complete cure, at least eight to ten injections must be given, and in
some instances not less than fourteen.
[277] Keysser, F.: Ztschr. f. Chemotherap., 1914, Orig., ii, 188.
Keysser’s most important conclusions, however, were obtained by
following an altogether different line of procedure. It has been
pointed out by Carl Lewin[272] that the therapeutic results obtained
from subcutaneous mouse tumors, however encouraging, could not be
logically applied to the treatment of human cancers. The subcutaneous
transplanted tumors, as is well known, are as a rule limited by a
distinct capsule and show no tendency to infiltrative growth. In this
particular they present a most striking difference when compared
with human tumors. On the other hand, the metastases of mouse tumors
in the internal organs present an infiltrative mode of growth and
thus approximate very much more closely to the human type of tumors.
Keysser, therefore, determined to test the therapeutic effectiveness
of his compounds on tumors implanted in various organs. He developed a
technic which enabled him to implant tumors in the liver, the spleen,
the kidneys and other parts of the mouse by means of injection through
special needles, often without the assistance of a cutting operation.
The tumors so implanted grew rapidly, and within from two to
three weeks reached the size of cherry pits. The growth was
characteristically infiltrative. Animals with these tumors were then
submitted to intravenous injection of the therapeutic agents in exactly
the same fashion as the animals carrying subcutaneous tumors. The
results, however, were absolutely different. Whereas the subcutaneous
tumors invariably showed a much more intense discoloration than the
other tissues of the mouse, this feature was entirely lacking in the
case of the internal tumors. Softening and liquefaction, which almost
invariably follows on the third or fourth injection in the case of
subcutaneous tumors, and which is the first symptom of cure, never
presented itself in the case of the internal tumors. Their consistency
throughout the treatment was indistinguishable from that of the tumors
of control animals. The treatment, in fact, appeared to exercise not
the slightest influence on internal tumors. There was neither cessation
nor retardation in growth, but the tumors continued their normal rate
of destructive increase with the production of metastases, leading
eventually to the death of the animal either during the course of the
treatment or shortly thereafter. Microscopic changes, such as had been
observed by Hansemann in the case of subcutaneous tumors, were entirely
lacking. No matter in what organ the tumors were implanted, these
results remained the same. No matter what type of tumor was employed,
whether carcinoma, adenocarcinoma or sarcoma, the therapeutic outcome
was regularly and consistently nil.
These results induced Keysser to determine whether or not
eosin-selenium could actually be shown to exercise a deleterious
effect on cancer cells outside the body. In order to do this he made a
suspension of mouse tumor cells in salt solution and mixed this with
the eosin-selenium-vanadium, using the latter in amounts equivalent to
three times the fatal dose for a mouse. After the mixture had stood
from one to three hours, it was injected either subcutaneously or
intravenously into mice in order to test the vitality of the cells.
In every instance the injections resulted in the production of tumors
which could be in no way distinguished from the tumors produced by
untreated cancer cells. In other words, the therapeutic preparation had
absolutely no effect on the tumor cells.
In the same way Keysser carried out experiments along the lines
inaugurated by Neuberg, using a combination of glycocoll and copper.
He also tested the combination of borcholin with selenium-vanadium
used by Werner and Szécsi. He was able to confirm the fact that both
of these substances produced an unmistakable therapeutic effect on
subcutaneous tumors. On the other hand, they were absolutely without
influence on the internal tumors. In this respect, therefore, they were
entirely comparable with the eosin-selenium compound. The theoretical
basis constructed by Neuberg, which rests on the assumption that the
metallic compounds stimulate autolytic processes in the tumors, was
also subjected by Keysser to destructive criticism.
Finally, Keysser showed that none of these therapeutic agents were
effective even in the case of subcutaneous tumors, unless the latter
had reached at least the size of cherry pits. If a therapeutic
injection were made immediately after inoculation of the tumors, no
effect was observed. The tumors grew exactly as in the control animals,
and the injected animals died in about the same period of time as they.
All of these facts, which taken together constitute a very remarkable
and convincing piece of scientific investigation, permit of but
one conclusion. It is quite clearly established that none of the
preparations of which the therapeutic effectiveness has hitherto been
proclaimed exercise any direct influence on the life or development
of the tumor. Under certain very definite and restricted conditions,
however, they do appear to produce certain changes in the tumors,
and in a small proportion even cures. These results, however, are
obtained only in the case of tumors which are subcutaneous in location
and not smaller than a cherry pit in size. Keysser’s interpretation
of the striking differences between tumors is of interest in this
connection. He believes that the constant palpation and examination
of the subcutaneous tumors, which is prompted by interest in the
experiment, produces circulatory changes with hyperemia and hemorrhage.
These circulatory changes are responsible for the increased tendency
of the injected substances to lodge in the tumors, thereby possibly
increasing the tendency to autolysis which the circulatory changes have
inaugurated. It is, of course, questionable whether this explanation
can be regarded as final. In a series of experiments which I performed
many years ago, I was able to show that sodium iodid when injected
intravenously accumulates in tumors in larger amounts than in any other
tissue of the body in rats. A similar observation has been recorded
by Wells, De Witt and Corper.[278] In the same way I found that
various dyes, such as Congo red, when injected intravenously, could be
demonstrated in tumors long after the rest of the body had recovered
its normal color; the liver alone vied with the tumors in this respect.
The dyestuff was invariably sharply localized in the necrotic portions
of the tumor. The conclusion seemed obvious that, owing to circulatory
conditions or possibly even to chemical conditions, the dye was
retained longest in the necrotic parts of the tumor. This effect was
unquestionably not due to handling, inasmuch as the animals in my
experiments were not palpated from the time of injection until death.
[278] Wells, H. G., De Witt, and Corper: Ztschr. f. Chemotherap., 1914,
Orig., ii, 110.
I have, however, had an even more striking demonstration of the same
fact. I have given intravenous injections of dyes to patients suffering
with various forms of internal tumors, as, for example, cancer of the
breast, in the hope of favorably influencing the growths. At operation,
the picture presented by the tumor is striking in the extreme. It
presents areas of various size which are intensely discolored by the
dye. These areas, both to the naked eye and under the microscope,
are the necrotic parts of the tumor. The actively growing areas of
tumor tissue and all the normal tissues of the organ present their
normal color. All of these observations lead to the conclusion that
the necrotic areas in tumors either possess a higher affinity for
sodium iodid and for the dyes than do the normal tissues, or that
these substances are more slowly absorbed from the necrotic areas
owing to the circulatory deficiency. Whichever of these explanations
is accepted, it is quite reasonable to believe that necrotic areas
might well undergo liquefaction under the influence of the various
substances which have been used for therapeutic injection. Such a
result is, of course, without direct effect on the growth or vitality
of the living part of the tumor. This fact is quite clearly evidenced
by the experimental data, which show that the internal portions of the
tumor might undergo liquefaction and yet the tumors were not cured.
Indeed, Löhe, who made microscopic examinations of the tumors treated
by Caspari and Neuberg, states particularly, with reference to a tumor
which had been subjected to treatment, that “the central portion of
the tumor showed softening, while the external margin was composed of
actively growing cells.” The central portions of implanted tumors are,
of course, those which first undergo spontaneous necrosis.
It still remains to explain the small percentage of cures achieved by
Wassermann and by Keysser. It does not appear to me that this problem
presents any insuperable difficulties. The fact must be emphasized
that practically 95 per cent. of the animals die under the treatment,
which sufficiently indicates the toxic effects of the agent used. We
must remember that transplanted tumors are under all circumstances
at a certain disadvantage as compared with the normal tissues of the
body. After all, they are implanted on a foreign soil. Their blood
supply is impoverished and imperfect. They have a natural tendency to
undergo necrosis, and in many cases spontaneous retrogression. It is
not strange, therefore, that they should prove in slight degree more
susceptible to toxic effects than are the normal tissues of the body.
If we remember that the various therapeutic agents introduced in all
probability reach a somewhat higher degree of concentration in the
necrotic areas of the tumor than in the normal tissues of the body, an
assumption which is entirely in accord with the facts as observed in
the case of sodium iodid and of various dyes, we may be quite prepared
to believe that this factor is sufficient to induce the destruction of
the marginal healthy and living cells of the tumor. The fact that small
subcutaneous tumors were found by Keysser to be entirely refractory
to the treatment is entirely in accord with this assumption, in view
of the fact that tumors of this size present practically no central
necrosis. The same explanation holds of the observation previously
cited from Caspari that the primary spontaneous tumors of animals
do not yield to the treatment. Indeed, he himself states that the
treatment is effective only in tumors in which autolysis takes place
during life. The word autolysis, however, in this connection is a
misnomer and represents a gratuitous assumption; as an actual fact,
one is entitled to say only that such tumors undergo central necrosis,
in all probably owing to defective circulatory supply. The process is
exactly similar to the coagulation necrosis described in the case of
tubercles by Weigert. If autolysis occurs, it is only secondary to the
preceding necrosis.
This explanation, however, is confronted by the fact that the internal
tumors produced by Keysser showed no tendency to effect a localization
of the dyes, and correspondingly no tendency to be affected by the
therapeutic agents. One might be permitted to inquire whether these
internal tumors had undergone any necrosis. Keysser unfortunately makes
no mention of this matter. It is certainly true that the infiltrative
mode of growth of the internal tumors, which is entirely different
from that of the subcutaneous implantations, is associated with a
much better blood supply and a lessened tendency to undergo necrosis.
That such tumors can undergo necrosis, however, is evidenced by
certain illustrations given by Carl Lewin in his paper on internal
tumors. But such changes usually occur only in advanced stages. To
judge from his plates, Keysser worked with relatively small tumors,
an assumption which is rendered even more likely by the fact that his
injections were undertaken in a fairly early stage of their growth. In
this connection I may quote certain experiments of my own on internal
tumors.[279] The implantations made in my experiments were produced by
intravenous injections of a tumor suspension into the jugular vein of
rats. Such injections resulted almost invariably in the production of
a large number of tumors in the lungs, which, as is well shown in the
figures accompanying the original article, differed very markedly in
size. The smaller of these tumors are composed throughout of actively
growing cells, while the large tumors present an area of central
necrosis exactly as do the subcutaneous tumors. If such an animal be
given an intravenous injection of a dye such as Congo red, it will be
found that the larger tumors present an area of central discoloration
corresponding to the area of previous necrosis, while the smaller
tumors, like normal tissues, are not colored. Thus, it is clear that
the internal tumors implanted in animals are subject to the same laws
concerning the distribution of dyes and, of course, other substances as
are the subcutaneous tumors. As I have stated previously, an exactly
analogous observation has been made in a human breast tumor. In the
absence of any contradictory evidence, therefore, I think that it is
perfectly justifiable to assume that Keysser failed to achieve a result
in the internal growths simply owing to the fact that those growths
presented practically no areas of necrosis at the time of his injection.
[279] J. M. Research, 1913, p. 497.
Another theoretical question which bears closely on the recent
therapeutic investigations in human beings concerns the rôle of
colloids, as such, in the procedure. It is quite clear from what has
already been said that all experiments with animal tumors have been
largely influenced by the belief that metals in the colloidal form
exercise a peculiar and characteristic influence on the destruction
of tumors. Even when the therapeutic agents have been introduced
in crystalline form, as by Neuberg and Caspari, the authors find
themselves compelled to assume that the metals are reduced to colloidal
form within the tumors. For the latter assumption there is absolutely
no evidence; it is due simply to the influence of the colloidal theory.
If one critically examines the data on which this theory is based, one
is forced to the conclusion that it has practically no established
claim to validity. If we grant that colloidal metals have been shown to
stimulate autolysis in the test tube, the same fact must be admitted of
metals in noncolloidal solution. The experiments, however, are very far
from establishing either of these facts satisfactorily. But even were
this the case, it is an unjustifiable inference that living tumor cells
would be influenced in anything like the same manner as are the dead
cells observed in test tube experiments. As an actual fact, we know
from the work of Evans and Schulemann that only the “scavenger cells”
of the body take up foreign colloids, and to this class the tumor cells
do not belong. Moreover, the form in which metals are introduced
into the circulation is not necessarily or even probably the form in
which they act on the tissues. Colloidal solutions of the metals are
certainly subject to precipitation and other changes on entering the
blood. This fact I have shown experimentally in a previous study on
colloidal copper.[280] In the same way it is probable, as has been
pointed out by Wells, that metals when introduced in crystalloid form
may rapidly be altered so that they are carried throughout the body in
colloidal form. All of these considerations indicate how unjustifiable
is the assumption that colloidal metals exercise a peculiar action on
growing tumors. It is hardly surprising that their empiric use has
failed to measure up to expectations based on so slim a foundation of
fact.
[280] Weil, Richard: The Effects of Colloidal Copper with an Analysis
of the Therapeutic Criteria in Human Cancer, J. A. M. A. =61=:1034
(Sept. 27) 1913.