PATENT MEDICINES
"Men who prescribe purifications and spells and other illiberal
practices of like kind."--Hippocrates.
"...Corrupted
By spell and medicines bought of mountebanks."
"Othello." Act I.
Carlyle said the world consisted of "so many million people, _mostly
fools_"; and he was right, for to public credulity alone is due the immense
growth of the patent-medicine trade.
It was formerly thought that for each disease, a specific drug could be
found, but this idea is exploded. The doctor determines the exact condition
of his patient, considers how he best may assist nature or prevent death,
and selects suitable drugs. He carefully notes their action and modifies
his treatment as required. The use of set prescriptions for set diseases is
obsolete; the doctor of to-day treats the patient, not the disease.
A few patent medicines are of limited value; many are made up from
prescriptions culled from medical works, and the rest are frauds, like
potato starch. The evil lies in charging from three to four hundred times a
just price, in ascribing to a medicine which may be good for a certain
disorder, a "cure-all" virtue it does not possess, and in inducing ignorant
people to take powerful drugs, reckless of results.
Ephemeral patent-medicine businesses, run by charlatans, whose aim is
frankly to make money before they are exposed, spring up like mushrooms;
and their cunningly worded advertisements meet the eye in the columns of
every paper one opens for a few months; then they drop out, to reappear
under another name, at another address. These rogues buy a few gross pills
from a wholesale druggist, insert a small advertisement, and so lay the
foundations of a profitable business.
The lure of the unknown is turned to account. "The discoverer went back to
the Heart of Nature--and found many rare herbs used by Native Tribes." "The
"Heart of Nature" was probably a single-room office tucked away down a
Fleet Street alley, and analysis proves these medicines contain only common
drugs, one "_Herbal Remedy_" being _metallic_ phosphates.
A common procedure is to send a question form, and, after answering the
query, "What are you suffering from?" with "Neurasthenia", the company
"carefully study" this, and then inform you with a gravity that would grace
the pages of "Punch", "You are the victim of a very intractable type of
Neurasthenia", so intractable in fact that it will need "additional
treatment"--at an "additional" fee.
The quack's advertisements are models of the skilful use of suggestion, and
turn to rare account the half-knowledge of physiology most men pick up from
periodicals. He frightens you with alarming and untrue statements, gains
your confidence by a display of semi-true facts reinforced where weak by
false assertions, and, having benefited himself far more than you, leaves
you to do what you should have done at first, go to a doctor or a hospital.
Were it made compulsory for the recipe to be printed on all patent
medicines, people would lose their childlike faith in coloured water and
purges, and cease the foolish and dangerous practice of treating diseases
of which they know little with drugs of which they know less.
The British Medical Association of 429, Strand, London, W.C., issue two
1_s_. books--"Secret Remedies: What they cost and what they contain", "More
Secret Remedies"--giving the ingredients and cost price of most patent
medicines. You are strongly urged to send for these books, which should be
in every home.
_The basis of every cure for epilepsy_ (not obviously fraudulent) _is
bromides_. The usual method is to condemn vigorously the use of potassium
bromide, and substitute ammonium or sodium bromide for it. Some advertisers
condemn all the bromides, and prescribe a mixture of them; others condemn
potassium bromide, and shamelessly forward a pure solution of this same
salt in water as a "positive cure!"
In all cases the sale price is out of reasonable proportion to the cost,
victims paying outrageous sums for very cheap drugs.
Most epileptics are poor, because their infirmity debars them from
continuous or well-paid work, leaving them dependent on relatives, often in
poor circumstances also. The picture of patients, already lacking many real
necessities, still further denying themselves for weeks or months to
purchase a worthless powder, is truly a pitiful one.
Bromides are unsatisfactory drugs in the treatment of epilepsy, but they
are the best we have at present. Get them made up to the prescription of a
doctor, and see him every month to report progress and be examined. In the
end, this plan will be very much cheaper, and incomparably better, than
buying crude bromides from quacks.
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There is no drug treatment for either hysteria or neurasthenia, and when
the doctor gives medicines for these complaints, it is to remedy organic
troubles, or, more often because necessity forces him to pander to the
irrational and pernicious habit into which the public have fallen of
expecting a bottle of medicine whenever they visit a doctor. Osier, the
famous Professor of Medicine at Oxford, truly observed that he was the best
doctor who knew the uselessness of medicines. But when public opinion
demands a bottle, and is unwilling either to accept or pay for advice
alone, the doctor may be forced to give medicines which he feels are of
little value, hoping that their suggestive power will be greater than is
their therapeutic value.
Neuropaths invariably contract the habit of physicking themselves, and
taking patent foods and drugs which are valueless.
So universal is this pernicious habit that we deem it desirable to
criticize it here at some length.
One highly popular type consists of port wine, reinforced (?) by malt and
meat extracts, and sold under a fanciful name. It has about the same value
as a bottle of port, which costs considerably less. It is well to remember
that many a confirmed drunkard has commenced with these "restoratives".
Malt extracts are also popular. They contain diastase, and therefore aid
the digestion of starch, but the diastatic power of most commercial
extracts is negligible.
Meat extracts of various makes contain no nourishment, but are valuable
appetisers. Meat gravy is as effective and far cheaper.
Foods containing digestive ferments, which are widely advertised under
various proprietary names are practically valueless, as are the ferments
themselves sold commercially. Digestive disorders are very rarely due to
deficiency of ferments, while pepsin is the only one among all the ferments
that could act (and that only for a little while) in the digestive system.
Some of the disadvantages of predigested foods have been noted, and their
prices are usually so exorbitant that eggs at 2_s._ 6_d._ each would be
cheaper. The remarks of Sollmann the great pharmacologist are pertinent:
_Limitations_. The administration of food in the guise of medicine is
sometimes advantageous; but medicinal foods are subject to the ordinary
law of dietetics, and therefore cannot accomplish the wonders which are
often claimed for them. The proprietary foods have been enormously
overestimated, and have probably done more harm than good. The ultimate
value of any food depends mainly on the amount of calories which it can
yield, and on its supplying at least a minimum of proteins. In these
respects, the medical foods are all inferior, for they cannot be
administered practically in sufficient quantity to supply the needs of
the body. They have a place as adjuvants to other foods, permitting the
introduction of more food than the patient could otherwise be induced
to take. Aside from the special diabetes foods and cod-liver oil, their
value is largely psychic.
_Predigested Foods_. The value of these is doubtful, for digestive
disturbances involve the motor functions and absorption more commonly
than the chemical functions. Their continued use often produces
irritation.
_Liquid Predigested Foods_. As sold, these are flavoured solutions
containing small amounts (½-6 per cent) of predigested proteins, ½-15
per cent of sugars and other carbohydrates, with 12-19 per cent of
alcohol, and often with large quantities (up to 30 per cent) of
glycerin. Their protein content averages less than that of milk, and in
energy value they are vastly inferior. Their daily dose yields but
55-300 calories including their alcohol; this is only one-thirtieth to
one-fifth the minimum requirements of resting patients. To increase
their dose to that required to maintain nutrition would mean the
ingestion of an amount of alcohol equivalent to a pint of whisky per
day.
Of recent years very expensive preparations of real or alleged organic iron
compounds have had a large sale. Iron is a component of hæmoglobin, a solid
constituent (13 per cent by weight) of the blood, which combines with the
oxygen in the lungs, and is carried (as oxyhæmoglobin) all over the body,
giving the oxygen up to the tissues. Hæmoglobin is an exceedingly complex
substance, but it contains only one-third per cent by weight of iron in
organic form.
The liver is the storehouse of iron, its reserve being depleted when there
is an extraordinary demand for iron. The minute amounts of iron in ordinary
food are amply sufficient for all our needs; any excess is simply stored,
and, later excreted, and has no effect whatever on the circulating
hæmoglobin.
Iron is only of value in certain forms of anæmia, and the many patent
medicines purporting to contain hæmoglobin or organic iron are therefore
useless to neuropaths. The Roman plan of drinking water in which swords had
been rusted, is quite as valuable as drinking expensive proprietary
compounds. When iron is indicated Blaud's Pills are perhaps the best
preparation.
Huge quantities of patent medicines containing phosphates in the form of
hypo-or glycerophosphates, and (or) lecithin are sold annually.
All phosphorus compounds are reduced to inorganic phosphates in the
digestive tract, absorbed and eliminated, so that, as with iron, if
phosphates are needed, the form in which they are taken is of no moment.
Why, then, pay huge sums for organic-phosphorus compounds (synthesized from
inorganic phosphates) when they are immediately reduced to the same
constituents from which they were constructed, the only value in the
reduction process being seen in the immense fortunes which patent-medicine
proprietors accumulate?
Lecithin is isolated from animal brain, or egg-yolk, and commercial
lecithin is impure. Not only does the ordinary daily diet contain ample
lecithin (5 grammes), but two eggs will double this, while liver or
sweetbread, both rich in phosphorous, may be eaten.
The much-vaunted glycerophosphates are decomposed to and excreted as
phosphates. Sollmann's remarks apply to all similar proprietary articles:
"A proprietary compound of glycerophosphates and casein has been widely
and extravagantly advertised as 'Sanatogen'. It is a very costly food,
and in no sense superior to ordinary casein, such as cottage cheese."
Hypophosphites have been boomed by various people, chiefly for financial
reasons. Five or six of them are usually prescribed, with the addition of
cod liver oil, and perhaps quinine, and (or) iron and strychnine, the
complexity of the prescription being expected, apparently, to compensate
for the uselessness of its various ingredients.
To deduce rational remedies, it is first necessary to elucidate the causes
of inefficiency; and to expect a brain which is out of order to function in
an orderly manner simply because it is supplied with one of the substances
necessary to its normal functioning (regardless of whether a deficiency of
that substance is the cause of the disorder), is as rational as it would be
to expect to restart an automobile engine, the magneto of which was broken,
by filling up the half-empty petrol tank.
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